Robbins & Cotran Pathologic Basis of Disease, 8th edition
As we launch the 8th edition of Pathologic Basis of Disease we pause to look back 50 years ago, when the first edition of this book, entitled “Pathology with Clinical Correlations” was published. (For those who may not know, the first three editions were published under this name and so the current “8th edition” is really the 11th edition of this book.)In the preface of the first edition, Stanley Robbins wrote:
• “But the study of morphology is only one facet of pathology. Pathology contributes much to clinical medicine. The pathologist is interested not only in the recognition of structural alterations, but also in their significance, i.e., the effects of these changes on cellular and tissue function and ultimately the effect of these changes on the patient. It is not a discipline isolated from the living patient, but rather a basic approach to a better understanding of disease and therefore a foundation of sound clinical medicine.”
• “The why’s and how’s are as important as the what’s.”
In today’s vocabulary, what Robbins said in 1957 was that pathology is the study of the mechanism of diseases and morphology is a tool (the only one available at that time) to gain insight into pathogenesis and clinical correlations. Over the past 50 years, this focus has not changed and it remains the guiding principle for the current edition. The main difference is that now we have many more tools to supplement morphology, including molecular biology, genetics, and informatics, to name a few. Indeed, it might be said that this book presents the molecular basis of human disease with clinical correlations. This edition, like all previous ones, has been extensively revised, and some areas have been completely rewritten. A few examples of significant changes are as follows:
• Chapter 1 has been completely reorganized to include the entire spectrum of cellular responses to injury, from adaptations and sublethal injury to cell death.
• Chapter 3 , covering tissue repair and wound healing, has been extensively revised to include new and exciting information on stem cell biology, growth factor signaling, and the mechanisms that underlie fibrosis.
• Chapter 5 includes a completely rewritten section on molecular diagnosis that reflects rapid advances in DNA sequencing technology. The principles of genome-wide analysis, now becoming a powerful tool in the study of complex human diseases like cancer and diabetes, have also been added.
• Chapter 9 has been completely revised and reorganized in view of the increasing importance of environmental factors in human diseases.
• Chapter 17 has been completely rewritten and highlights new insights into the pathogenesis of inflammatory bowel disease and gastrointestinal cancers.
• Chapter 22 , covering diseases of the female genital tract, includes discussion of the molecular basis of cancer, endometriosis, and preeclampsia.
• In addition to the revision and reorganization of the text, many new photographs and schematics have been added and a large number of the older “gems” have been enhanced by digital technology. Thus, we hope that even the veterans of Robbins Pathology will find the illustrations and figures sparkling and fresh.
Wherever appropriate, we have blended new discoveries into the discussion of pathogenesis and pathophysiology, while never losing sight that the “state of the art” has little value if it does not enhance the understanding of disease mechanisms. As in the past, we have not avoided discussions of “unsolved” problems because of our belief that many who read the text might be encouraged to embark on a path of discovery.
Despite the changes highlighted above, our goals remain the same as those articulated by Robbins and Cotran over the past many years.
• To integrate into the discussion of pathologic processes and disorders the newest established information available—morphologic as well as molecular.
• To organize information into logical and uniform presentations, facilitating readability, comprehension, and learning.
• To maintain the book at a reasonable size and yet provide adequate discussion of the significant lesions, processes, and disorders. Indeed, we have reduced the girth and the weight of this book by trimming out about 80 pages (making it less useful for weight lifting).
• To place great emphasis on clarity of writing and proper use of language in the recognition that struggling to comprehend is time-consuming and wearisome and gets in the way of the learning process.
• To make this first and foremost a student text—used by students throughout all years of medical school and into their residencies—but, at the same time, to provide sufficient detail and depth to meet the needs of more advanced readers.
We have been repeatedly told by readers that up-todatedness is a special feature that makes this book very valuable. We have strived to remain current by providing new information and references from recent literature, many p
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