Pathophysiology of Disease: An Introduction to Clinical Medicine (2nd edition)

I like it so far.

If you’ve never opened a textbook about medicine, genetics, microbiology or similar stuff before in your life, it’ll probably be too technical for you to benefit much from it; I’d certainly have had an easier time reading chapter two on genetic diseases if I’d had a stronger background in biochemistry, and it’s not like this is a topic I’ve never dealt with before. Chapter 3, on disorders of the immune system, was even worse than chapter two. Microbiology, which is somewhat related to the field of immunology, is also a subject I’ve read about in the past, however that reading has been much more ‘fragmented’ and less systematic than has my reading of e.g. the genetics literature (which is itself rather scattered and unsystematic, compared to my reading of the diabetes literature…). So even though while reading the immunology part I seemed to remember both having seen some of this stuff before in the textbooks as well as having touched upon some of the themes on Khan Academy and Wikipedia, I found some of this stuff quite hard to read and understand. In the genetics section, it helped a lot to be familiar with a lot of the key concepts (‘fitness’, ‘linkage disequilibria’, ‘stages of meiosis’, ‘genotype/phenotype’, ‘Mendelian inheritance’, ‘mutation and drift’, ‘fixation’, …) – I had no such systematic knowledge to rely on when reading about the immunology stuff.

All that said, there’s a lot of good stuff in this book and when you’re not reading a book like this in order to pass an exam you’re not as worried about missing some details – I don’t plan on understanding everything in this book and I feel fine about ‘mentally skipping sections’ which are very technical (meaning reading the words but not fully understanding what the words mean). It doesn’t seem likely to me that the added understanding I’d get from ‘looking up everything’ would add enough to my understanding of the material to justify the costs. I want to enjoy reading this, so I’ll read all the stuff but I won’t look up all the unknown stuff.

As can probably be inferred from the above comments, the book is much more technical than the sexual diseases book I covered a few days ago. I decided to include below a few examples of what this means by quoting a couple of passages from chapter three, on disorders of the immune system:

“Activated macrophages secrete proteolytic enzymes, active metabolites of oxygen (including superoxide anion and other oxygen radicals), arachidonic acid metabolites, cyclic adenosine monophosphate (cAMP), and cytokines such as interleukin-I (IL-I), IL-6, tumor necrosis factor (TNF), and IL-8, among others. Many tissue-specific cells are of macrophage lineage and function to process and present antigen (Langerhans’ cells, oligodendrocytes, etc.).” […]

“Polymorphonuclear leukocytes (neutrophils) (PMNs) are granulocytic cells that originate in the bone marrow and circulate in blood and tissue. Their primary function is antigen-nonspecific phagocytosis and destruction of foreign particles and organisms. The precency of Feγ receptors on the surface of neutrophils also facilitates the clearance of opsonized microbes through the reticuloendothelial system.” […]

“in the airway inflammatory response in asthma, eosinophil-derived mediators of inflammation, including major basic protein (MBP), eosinophil-derived neurotoxin (EDN), eosinophil cationic protein (ECP) and lysophospholipase (LPL) are toxic to respiratory epithelium.”

Of course it’s not all like this but if you’re not okay with not always knowing more or less completely what’s going on, you should probably stay away from this book.