The principal goal of the pathology course in medical schools is to
foster understanding of the mechanisms of disease (pathogenesis) as a
foundation for dealing with a vast amount of clinical information the
student will encounter in later clinical years. Important lesser goals are
to teach students how to use the laboratory and to help them pass the
examinations necessary to earn a medical degree, including the various
This book addresses these goals. In
developing it, we have endeavored to present information at the level of the
second-year medical student, guiding the reader logically and as concisely
as possible through the mechanisms by which the normal in our bodies is
converted to the abnormal. Because our objective is to use pathology to
facilitate medical education, we stress mechanisms leading to diseases
rather than the morphologic alterations used by pathologists to make
pathologic diagnoses. Understanding these mechanisms is more a function of
logic than of memory. We hope this book will leave students with a lasting
knowledge of pathology and a desire to use pathology for the rest of their
career as the scientific basis of the "art" of medicine.
ORGANIZATION & APPROACH
The study of pathology is traditionally divided into
general and systemic pathology, and we preserve this distinction.
In the general pathology
chapters (Part A), the
pathologic changes occurring in a hypothetic tissue are considered. This
idealized tissue is composed of parenchymal cells and interstitial
connective tissue and is the prototype of every tissue in the body. General
pathology explores and explains the development of basic pathologic
mechanisms without detailing the additional specific changes occurring in
In the systemic pathology
chapters (Part B), the pathologic mechanisms discussed in the general
pathology section are related to the various organ systems. In each system,
normal structure, function, and the symptoms and signs that arise from
pathologic changes are discussed first. The diseases in each organ system
are then considered, with emphasis given to those that are more common, so
that the student can become familiar with most of the important diseases
encountered in clinical practice.
We have divided
this book into sections that cover a broad topic, eg, the endocrine system.
Each section is divided into chapters, eg, pituitary gland, thyroid gland.
We have aimed to make this book as easy to study from
as we believe is possible for a textbook of pathology. We have paid special
attention to the following features that facilitate achievement of these
•The chapters are—with few exceptions—short
enough to be assimilated in a reasonable length of time, enabling the
student to set easily achievable goals.
•The text is concise. We
have tried our best to use the minimum number of words to impart the
•The text is comprehensive. The student's
needs are completely satisfied, both from the point of view of understanding
the subject and of passing examinations.
•The text is logical. We
have presented the material in a logical sequence wherever possible. When
doubt or controversy exists, we have indicated this clearly.
illustrations and tables are extensive and designed to visually reinforce
the text in the more important areas.
•The identification and
localization of human genes occurs almost daily due to continuing advances
in molecular technology and the progress of the Human Genome Project. We
have incorporated this molecular pathology information into the text when it
is pertinent and when the mechanisms of pathogenic action are sufficently
clear as to contribute to the overall understanding of the disease process.
•The text stresses clinical correlations and aims to give the student
an understanding of disease mechanisms via pathology. The pathologic details
used by pathologists in making diagnoses are included only to the extent
that they enhance the understanding of disease processes; otherwise, such
minutiae are deferred to the pathology residency program, which is their
Original illustrations in this book are the work of
Biomed Arts Associates, Inc., San Francisco, and in particular the following
individuals: Laurel V. Schaubert, Susan Taft, Walter Denn, Gay Giannini,
Ward Ruth, Hisako Moriyama, Michael Yeung, Terrence Schoop, Kenneth Rice,
and Wendy Hiller. Electronic versions were provided by HRS Electronic Text
Parakrama Chandrasoma, MD, MRCP(UK)
Clive R. Taylor, MD, DPhil, FRCPath, MRCP(Ir)