Vinay Kumar, Abul K Abbas and Nelson Fausto:

Robbins and Cotran Pathologic Basis of Disease (7th edn), 1525 pp, Philadelphia, Elsevier, 2005 ($95).

The 5 years since the publication of the last edition of this leading textbook of pathology has seen rapid progress in medical science and technology. The human genome project has been completed, innovative techniques such as ‘knockout’ technology have appeared to provide further insights into gene function in vivo and a whole field of stem cell research has evolved (despite current political obstacles), paving the way for a new branch of regenerative medicine. Developments such as these, all given attention to in this 7th edn of Robbins, are now an integral part of basic science curricula in most medical schools, This rapid pace poses a challenge to pathology texts to keep current. As the emphasis in the discipline of pathology shifts from traditional studies of structure and morphology to the basic mechanisms of normal and pathologic processes such as cellular adaptation to injury and the regulation of the cell cycle, to remain successful and relevant textbooks of pathology must ensure that their panel of contributors have the requisite expertise and that their material is regularly updated.

It is inevitable that the text field will narrow as only a few of the standard texts have the resources to meet this rapidly changing environment. Two pathology texts now account for over 90% of the US market: Rubin's Pathology (Lippincott, Williams & Wilkins), which coincidentally came out with its new edition also this past summer, and Robbins and Cotran Pathologic Basis of Disease (Elsevier/Saunders), the most widely distributed. Both texts cover virtually the same topics, and both do it very well. The new Robbins edition has made laudable strides in keeping its material up to date and relevant to the modern curriculum by adding numerous references to papers published in the last 1½ years, offering purchasers on-line access to a digital text and access to the text website, which continuously updates the material in the printed text. In addition, a CD-ROM is provided containing case studies from the University of Texas School of Medicine, illustrating clinical correlates of pathologic principles.

The 1440 pages are organized as before into two sections; one covering general pathology and the other covering diseases of organ systems. Particularly, notable chapters include one on hemodynamic and clotting disorders by Harvard pathologist Richard Mitchell (who edited the new edition of the Pocket Companion to the Robbins and Cotran text.) A skilled teacher, Mitchell has made understandable even to the unsophisticated reader, the increasingly complex processes of the coagulation cascade and the recently recognized ubiquitous activities of the vascular endothelium. Equally noteworthy is the chapter on genetic disorders, a comprehensive survey covering Mendelian disorders as well as those of multifactorial and nonclassic inheritance. (A minor flaw; the authors’ estimate of the incidence of Marfan Syndrome of 1 in 5000 is twice the incidence cited by most other experts.) Finally, a new chapter has been introduced devoted to ocular pathology by Robert Folberg from the University of Illinois.

In sum, this new edition is praiseworthy for the breadth and depth of its content and its ability to remain up to date. It serves the needs not only of the beginning student, the pathologist in training, but all practitioners of medicine with intellectual curiosity.