Preface

Physiology is a dynamic discipline, and as new information and concepts emerge and our understanding evolves, the material we teach must also change. Each chapter of the third edition of Essential Medical Physiology has been updated and revised to encompass this new information. The authors and I have tried to eliminate errors that appeared in the previous edition without introducing new ones. We are grateful to our colleagues and students for help in identifying mistakes and inconsistencies, and we ask for their continued aid in improving future editions. In addition, four new chapters have been added integrating material in the important areas of exercise, heart failure and circulatory shock, maternal adaptations to pregnancy, and diabetes.

Each of the authors is an acknowledged expert in the field he or she is writing about. This is the major strength of this text. In contrast to many texts, which are single-authored or written by members of a single department, the authors represent seven different medical schools. Each has more than 20 years of experience teaching medical students in his or her area of expertise. All are nationally and internationally known for their research and contributions in the field about which they are writing. This expertise is manifested in many different ways. Six authors have written monographs for medical or graduate students. Seven are, or have been, the chairs of their departments and responsible for the content of the course in medical physiology. Six have served as consultants for developing the Part I examination for the National Board of Medical Examiners, and three have chaired the Physiology Test Committee for that organization. This experience has made it possible for each author to select the material that is essential to the discipline of medical physiology. Each is an excellent writer and has provided a thorough, up-to-date treatment of this material. As editor, I am grateful to them for their willingness to contribute their time and abilities to this project.

Most modern textbooks contain features to make them easier for students to use and to identify important concepts. Each chapter begins with a page-indexed chapter outline and a bulleted summary of the major points covered. Basic items and concepts in the text appear in bold type the first time they are used and defined. Chapters contain clinical notes emphasizing the relationships between physiology and clinical medicine. This clinically-related material has been highlighted and serves to reinforce the physiology as well as identify clinical relevance.

With this edition, however, we have gone one step further and created a set of outlines integrated with the figures in the text. As our research has become more cellular and molecular the classical boundaries between basic science departments have disappeared. Most departments responsible for teaching physiology have faculty members who were not trained as medical physiologists. It is our hope that these outlines, presented as a compact disc, will aid in the organization of lecture notes or serve as the basis for student handouts.

Simply stated, physiology is the study of function. Function occurs at three levels: molecular, subcellular, and cellular. Events at these levels in turn determine the activities of tissues, organs, and systems. Understanding at each level is necessary to appreciate the overall function or dysfunction of an individual. The overriding principle of physiology is the integration of a variety of mechanisms. For example, how does the kidney produce urine? And how is this process regulated so that the volume and salt content of urine are matched to the salt and water intake of the individual and the loss of salt and water via other processes such as respiration and sweating? Each of the authors has presented and integrated in his or her section the material that is necessary to medical physiology as it is taught in most medical schools. Cell biology is integrated as part of the physiologic discipline as it arises, not in a separate section. Chapters often found in physiology textbooks that are better suited to disciplines such as histology, immunology, or biochemistry have been omitted. This textbook contains the information the authors and editor believe essential to providing a strong background in physiology for the practice of medicine. This is the basis of the title chosen for the text.

Physiology is the primary basic medical science. It is essential to pharmacology, the study of the effects of drugs on physiologic processes. Most of medicine itself is pathophysiology. We hope that each student will realize that the study of physiology should continue throughout his or her career. With that in mind, a few references are included at the end of each chapter. They cite well-written, recent articles that provide a wealth of information as well as extensive bibliographies for further, more detailed reading.

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