Browse’s Introduction to the Symptoms and Signs of Surgical Disease 4th Edition PDF
The first edition of this book was written, 25 years ago, to help medical students develop their bedside clinical skills, namely, their ability to take a full clinical history and to conduct a complete clinical examination – the prime purpose of medical education.
Although the symptoms and signs of the common ‘surgical’ diseases have not changed for centuries, the style in which they are presented in textbooks and our understanding of the underlying pathological processes and, in some instances, their classification have. These changes have prompted the production of this fourth edition.
The past 25 years have also seen changes in the style and methods of medical education, especially in the UK, with the term ‘problem-orientated medicine’ purporting to describe the current popular approach. This is not a new approach. Students beginning their medical training have always been taught to begin the taking of a history by asking the patient ‘What are you complaining of?’. To me, this is and always has been a problem-orientated approach.
Having asked all the questions about the patient’s main complaint, together with those concerning all the other bodily systems, the student’s growing knowledge of the symptoms and signs of individual diseases inevitably begins to guide them to those further questions which are likely to illuminate the cause of the main complaint. This is why it is helpful to learn the symptoms and signs of the common diseases from a book at the same time as acquiring that knowledge through growing clinical experience. This book seeks to expedite that learning.
I firmly believe that what some criticize as dogmatic teaching – following a strict ritual when taking a history and performing an examination – must remain a vital part of clinical education because it accelerates diagnosis and helps avoid errors and omissions.
Medical students know and appreciate this. The continuing success of this book indicates that it helps to fill the deficit that exists in those new courses of medical education that have mistakenly reduced the apprenticeship aspects of learning medicine.
Having retired from clinical practice, I felt it was important to ask three surgical colleagues with an approach to clinical teaching similar to my own, but who are still clinically active, to join me as editors. They have combined Chapters 2 and 3 and Chapters 13 and 15 of the third edition into single chapters (now Chapters 3 and 14) and added a new chapter on the symptoms and signs of trauma (Chapter 2).
In this edition, John Black has revised Chapters 8, 12, 13, 14, 16 and 17; Kevin Burnand has revised Chapters 1, 3, 7 and 15 and written the new Chapter 2; and William Thomas has revised Chapters 4, 5, 6, 9, 10 and 11. I have collated and edited their revisions to ensure that the book’s original systematic approach and style of presentation were maintained. I am most grateful for their hard work and willing co-operation. When the fifth edition is needed, in 5–8 years’ time, I know it will be in excellent hands.
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