# Harrison's Principles of Internal Medicine

FOE Harrison's Principles of Internal Medicine is an American textbook of internal medicine.

## 20th ed.
### Chap. 1 : The Practice of Medicine

* This combination of medical knowledge, intuition, experience, and judgment defines the art of medicine, which is as necessary to the practice of medicine as is a sound scientific base.
* An informative history is more than an orderly listing of symptoms. By listening to patients and noting the way in which they describe their symptoms, physicians can gain valuable insight.
* All physicians have had experiences in which imaging studies revealed findings that led to an unexpected diagnosis. Nonetheless, patients must endure each of these tests, and the added cost of unnecessary testing is substantial. Furthermore, investigation of an unexpected abnormal finding may be associated with risk and/ or expense and may lead to the diagnosis of an irrelevant or incidental problem. A skilled physician must learn to use these powerful diagnostic tools judiciously, always considering whether the results will alter management and benefit the patient.

## Quotes from book reviews

* It seems to us that the world is divided into those who read Harrison's and those who don't; it is only fair in beginning this review to acknowledge our allegiance to the former. Just as Arrowsmith and Of Human Bondage have shaped our imaginations, our view of internal medicine, perhaps inevitably, has been shaped by our allegiance to this textbook.
** Anand Karnad and Abraham Verghese, (August 24, 1994)"Harrison's Principles of Internal Medicine". JAMA: The Journal of the American Medical Association 272 (8): 642. DOI:10.1001/jama.1994.03520080084052.
* This text, whose first edition appeared in 1950, has been devoted to what the editors have called the "clinical method." The book centered around the thinking processes of a physician; for the patient, when he consults a physician, comes with symptoms, not with a diagnosis. The Harrison textbook tries to analyze the symptoms, recognize the groupings (or syndromes) into which they fall, and discuss the various mechanisms at work.
** Lester S. King, (February 15, 1971)"Harrison's Principles of Internal Medicine". JAMA: The Journal of the American Medical Association 215 (7): 1161. DOI:10.1001/jama.1971.03180200083038.
* Building on 6 decades of tradition, the 18th edition of Harrison's Principles of Internal Medicine features an updated, multimedia format that presents the core knowledge of internal medicine in a comprehensive yet easy-to-navigate fashion. This hefty, 2-volume text is a worthy update to what is arguably the most recognized book in all of medicine. Medicine has evolved considerably during the 63 years since the first edition, and several entirely new specialties have emerged. As the editors recollect in the preface, “peptic ulcer disease was thought to be caused by stress, nearly every tumor that was not resected led to death, rheumatic heart disease was widely prevalent, and hepatitis B and [human immunodeficiency virus] infection were unknown.” Today, the sheer volume of information required by the internist is mind-boggling, and the body of evidence informing clinical care continues to burgeon. The transformation in how physicians learn the art and science of medicine has been equally dramatic.
** Preeti N. Malani, (November 7, 2012)"Harrison’s Principles of Internal Medicine". JAMA: The Journal of the American Medical Association 308 (17): 1813–1814. DOI:10.1001/jama.308.17.1813-b.
* Every three years there is a new edition of Harrison's Principles of Internal Medicine. This year's version, the 11th, lives up to expectations. Students unfamiliar with this book should be told that it is a 2118-page compendium of medicine written by 280 contributors, each an expert in his or her field. Part 1, the famous "Cardinal Manifestations of Disease," discusses alterations in various body systems and clinically pertinent symptoms and findings. The 80-page section on the nervous system deserves separate mention; it represents a masterful introduction to neurology. Part 2 deals with biologic considerations in the approach to clinical medicine, and part 3 treats infectious diseases and those due to environmental agents. Then follow ten more parts, each of which constitutes a different system. The orientation is pathophysiological and clinical throughout.
** John J. Massarelli, (September 11, 1987)"Harrison's Principles of Internal Medicine". JAMA: The Journal of the American Medical Association 258 (10): 1396. DOI:10.1001/jama.1987.03400100134038.