Preface
‘There must be a good reason to write a new textbook of medicine when there are already a good number on the market
.’ So began the preface to the First Edition of Clinical Medicine, published 33 years ago this year
. Edited by Professor Dame Parveen Kumar and Dr Michael Clark, ‘Kumar and Clark’ has become synonymous not just with a medical textbook, but with the combination of excellence and accessibility they sought to provide. Their desire to empower clinical students and doctors has been the driving ambition behind the book ever since – ‘to strike a balance between exciting new developments in medical research and the vast quantity of established fact that needs to be absorbed… so that the management of disease can be based on sound physiological concepts’
. The book they produced has become an international medical best-seller, and has played a crucial part in the education of a generation of doctors – among them a new team of editors, humbled to be standing on the shoulders of these medical giants
. Taking over is an honour and a great responsibility, and we are grateful for the legacy they have left, as well as for their continued support and input as we have brought this current edition to production
. Clinical Medicine has always attempted to bridge the gap between basic introductory texts and larger reference works: to be as comprehensible as it is comprehensive
. The pace at which medical science continues to develop is astounding. The present generation of junior doctors and undergraduates must provide high-quality, patient-centred care in the context of a burgeoning body of medical research, patients presenting with multimorbidity and resulting polypharmacy, continuing inequalities in society and across the world, and a medical culture that expects doctors to work within teams, bridging traditional specialty and professional divides
. For this reason, we have introduced into this edition a number of new chapters to equip readers to address these new challenges: Evidence-based practice (Ch. 4), Surgery (Ch. 11), Public health (Ch. 14), Geriatric medicine, frailty and multimorbidity (Ch. 15), Haematological oncology (Ch. 17) and Men’s health (Ch. 40). In some cases, we have divided up larger chapters to highlight conditions that straddle traditional subspecialty boundaries but require a joined-up approach: Sepsis and the treatment of bacterial infection, (Ch. 8), Venous thromboembolic disease (Ch. 29), Hypertension (Ch. 31) and Obstetric medicine (Ch. 38). We have included new clinical skills content at the beginning of most of the chapters to try to fulfil the historic aims of this book: bringing the clinical sciences to bear on the problems experienced by patients in day-to-day medical practice. We hope readers will learn not just to take generic histories and perform routine physical examinations, but to tailor their approach according to the presentation of the individual patient in front of them. We offer our own take on the clinical method and the importance of building a therapeutic relationship with patients in a new first chapter, describing what we believe remains key to the art of medicine: diagnosis (Ch. 1). Online, readers will find a range of additional resources, including self-assessment questions, bite-sized overview topic pages covering major conditions, clinical skills videos and expanded coverage of subjects with particular international or regional relevance. We hope you will find this edition helpful in your efforts to learn and practise medicine. Any suggestions you may wish to make are warmly welcomed and will help us to ensure that this book continues to meet the needs of its readers.
Acknowledgements
As always, this book is made what it is by the diligence and expertise of the individual chapter authors, who have worked hard to ensure that the content they provided is up to date, well presented and reflective of modern practice. We are grateful to them for their efforts
. The process of editing has been made much easier by the high standards and clear priorities set out by Parveen Kumar and Mike Clark through their careful editorial work on an astonishing previous nine editions of this book
. We are now in a better position than many to appreciate the sheer amount of hard work this involved, and on behalf of the medical profession – our thanks
. We would like to acknowledge and offer grateful thanks for the input of all previous editions’ contributors, without whom this new edition would not have been possible. As well as welcoming a number of new contributors to this edition, we would like to thank various others who have stepped down this time around – especially those who have had a long association with the book
. Much of their work is reflected in the text of this edition, and so we thank them for their input:
• John V Anderson (Diabetes mellitus and metabolic disorders)
• Rachel Buxton-Thomas (Respiratory medicine)
• Sarah R Doffman (Respiratory medicine)
• Gail E Eva (Palliative medicine)
• Anthony J Frew (Respiratory medicine)
• Edwin AM Gale (Diabetes mellitus and metabolic disorders) • Christopher J Gallagher (Malignant disease)
• Charles J Hinds (Critical care medicine)
• Katharine Hurt (Respiratory medicine)
• Miriam J Johnson (Palliative medicine)
• Louise Langmead (Gastroenterology)
• James Lindsay (Gastroenterology)
• Kenneth J Linton (Molecular cell biology)
• Adam Mead (Haematology)
• Michael J O’Dwyer (Critical care medicine)
• Donncha O’Gradaigh (Bone disease)
• David G Paige (Skin disease)
• Rupert M Pearse (Critical care medicine)
• Sean L Preston (Gastroenterology)
• Michael Rawlins (Clinical pharmacology)
• Matthew Smith (Malignant disease)
• J Allister Vale (Poisoning)
• David Westaby (Biliary tract and pancreatic disease)
• Peter D White (Psychological medicine) We were saddened to hear of the untimely death of Anthony J Frew (Respiratory medicine), who made a major contribution to this book but also to the wider practice of medicine
. We are grateful to the International Advisory Board, who have supplied a significant amount of online material that helps to ensure this book maintains the global relevance it has always striven to enjoy
. We would like to thank Dr Robert Stephenson and Dr Joseph Davies for their radiological input and figures
. The team at Elsevier have worked extremely hard in bringing this project to fruition
. We are particularly grateful to Pauline Graham and Helen Leng, the commissioning and development editors, who did so much to drive this project forward before they left Elsevier
. We owe them much gratitude and wish them every success in their future ventures. Pauline in particular has worked on a number of previous editions of this book and the recent success of Clinical Medicine owes much to her oversight. Thanks to Alex Mortimer, who took over as commissioning editor relatively late in the project, and from a standing start provided helpful guidance and direction in the final stages of production
. Thanks to Louise Cook, who completed various aspects of development with a close eye for detail. Thanks to our copy-editors, Wendy Lee and Lynn Watt, who checked thoroughly, detected error and redundancy, and acted pre-emptively to offer helpful suggestions. Julie Taylor and Anne Collett acted as production managers and we are grateful to them for their experience and efficiency in bringing a large and spreading project together into a finished piece of work. Thanks to Kim Benson for her work in putting together the online content in a way that will maximize its usefulness to readers around the world. Finally, thanks to our long-suffering families, who have endured much absence and distraction as we have worked at antisocial hours on manuscripts at various stages of development. This would not have been possible without your patience and support, and we are most grateful.
