The 24TH Edition of Goldman’s Cecil Medicine symbolizes a time of extraordinary
advances in medicine and in technological innovations for the
dissemination of information. This textbook and its associated electronic
products incorporate the latest medical knowledge in formats that are
designed to appeal to learners who prefer to access information in a variety
of ways.
The contents of Cecil have remained true to the tradition of a comprehensive
textbook of medicine that carefully explains the why (the underlying
normal physiology and pathophysiology of disease, now at the cellular and
molecular as well as the organ level) and the how (now frequently based on
Grade A evidence from randomized controlled trials). Descriptions of physiology
and pathophysiology include the latest genetic advances in a practical
format that strives to be useful to the nonexpert. Medicine has entered an era
when the acuity of illness and the limited time available to evaluate a patient
have diminished the ability of physicians to satisfy their intellectual curiosity.
As a result, the acquisition of information, quite easily achieved in this era, is
often confused with knowledge. We have attempted to counteract this tendency
with a textbook that not only informs but also stimulates new questions
and gives a glimpse of the future path to new knowledge. Grade A
evidence is specifically highlighted in the text and referenced at the end of
each chapter. In addition to the information provided in the textbook, the
Cecil website supplies expanded content and functionality. In many cases, the
full articles referenced in each chapter can be accessed from the Cecil website.
The website is also continuously updated to incorporate subsequent Grade
A information, other evidence, and new discoveries.
The sections for each organ system begin with a chapter that summarizes
an approach to patients with key symptoms, signs, or laboratory abnormalities
associated with dysfunction of that organ system. As summarized in
Table 1-1, the text specifically provides clear, concise information regarding
how a physician should approach more than 100 common symptoms, signs,
and laboratory abnormalities, usually with a flow diagram, a table, or both for
easy reference. In this way, Cecil remains a comprehensive text to guide diagnosis
and therapy, not only for patients with suspected or known diseases but
also for patients who may have undiagnosed abnormalities that require an
initial evaluation.
Just as each edition brings new authors, it also reminds us of our gratitude
to past editors and authors. Previous editors of Cecil Medicine include a short
but remarkably distinguished group of leaders of American medicine: Russell
Cecil, Paul Beeson, Walsh McDermott, James Wyngaarden, Lloyd H. Smith,
Jr., Fred Plum, J. Claude Bennett, and Dennis Ausiello. As we w
associate editors—Wendy Levinson, Donald W. Landry, Anil Rustgi, and
W. Michael Scheld—we also express our appreciation to Nicholas LaRusso
and other associate editors from the previous editions on whose foundation
we have built. Our returning associate editors—William P. Arend, James O.
Armitage, David Clemmons, Jeffrey M. Drazen, and Robert C. Griggs—
continue to make critical contributions to the selection of authors and the
review and approval of all manuscripts. The editors, however, are fully responsible
for the book as well as the integration among chapters.
The tradition of Cecil Medicine is that all chapters are written by distinguished
experts in each field. We are also most grateful for the editorial
assistance in New York of Theresa Considine and Silva Sergenian. These
individuals and others in our offices have shown extraordinary dedication
and equanimity in working with authors and editors to manage the unending
flow of manuscripts, figures, and permissions. We also thank Faten Aberra,
Reza Akari, Robert C. Brunham, Ivan Ciric, Seema Daulat, Gregory F.
Erikson, Kevin Ghassemi, Jason H. Huang, Caron Jacobson, Lisa Kachnic,
Bryan T. Kelly, Karen Krok, Heather Lehman, Keiron Leslie, Luis Marcos,
Michael Overman, Eric Padron, Bianca Maria Piraccini, Don W. Powell,
Katy Ralston, James M. Swain, Tania Thomas, Kirsten Tillisch, Ali Turabi,
Mark Whiteford, and Y. Joseph Woo, who contributed to various chapters.
At Elsevier, we are most indebted to Dolores Meloni and Linda McKinley,
and also thank Cathy Carroll, Taylor Ball, Virginia Wilson, Linda Van Pelt,
Suzanne Fannin, and Steve Stave, who have been critical to the planning and
production process under the direction of Mary Gatsch. Many of the clinical
photographs were supplied by Charles D. Forbes and William F. Jackson,
authors of Color Atlas and Text of Clinical Medicine, Third Edition, published
in 2003 by Elsevier Science Ltd. We thank them for graciously permitting us
to include their pictures in our book. We have been exposed to remarkable
physicians in our lifetimes and would like to acknowledge the mentorship
and support of several of those who exemplify this paradigm—Robert H.
Gifford, Lloyd H. Smith, Jr., Frank Gardner, and William Castle. Finally, we
would like to thank the Goldman family—Jill, Jeff, Abigail, Mira, Daniel, and
Robyn Goldman—and the Schafer family—Pauline, Eric, Pam, John, Evan,
and Kate—for their understanding of the time and focus required to edit a
book that attempts to sustain the tradition of our predecessors and to meet
the needs of today’s physician.
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