Ursus-Nikolaus Riede, Martin Werner: Color Atlas of Pathology. Pathologic Principles-Associated Diseases-Sequelae, 457 pp, Stuttgart, New York, Thieme, 2004 (Euro 49.95, $65).

The Department of Pathology of the University of Freiburg in Breisgau, Germany has been known for its textbooks of pathology. Some of these, especially the well-known atlases of macroscopic and microscopic pathology have been translated into English and have enjoyed for many years considerable popularity on this side of the Atlantic. The present book continues that illustrious tradition. It is an atlas of macroscopic and microscopic pathology combined with an outline of all major topics of general pathology.

Most pathologists would agree that the study of the principles and concepts of general pathology is an essential first step toward understanding of diseases. Unfortunately, in most medical school curricula in the US, general pathology has been reduced to a rudimentary course. The fact that the USMLE 1 devotes more questions to special than general pathology does not help either in promoting general pathology. Hence, the question for most educators is on how to take advantage of the short time allotted and generate as much interest as possible for the subject that the students intuitively do not perceive as essential for their future practice.

This atlas illustrates one approach, which we could call ‘how they do it in Germany’. The hooker are the illustrations chosen to catch students’ attention, and to explicate details and intricacies—along the lines of the old adage that one pictures is worth a hundred words. As a teacher I would invite my students to describe the color figures and try to see how far they can go. Once they become involved and realize ‘how much they can see just by observing’, I would ask them to read the text on the opposite side and ‘try to make sense of what they have seen’, connecting words with the visual data. Finally, they would be asked to formulate a pathophysiologic explanation and reconstruct the entire clinical picture. All this could be done relatively easily by moving from the macroscopic to microscopic or ultrastructural illustrations or sketches and outlines of the diseases included in this Atlas. I feel confident that I could keep my class interested in deciphering the significance of the pictures in this atlas, their clinical implications and hidden pathophysiological meanings. Whether students could do it on their own, I am not sure. However, once they have been through the course I am sure that they would easily do it and use the Atlas to review of all that they have learned before.

The authors deserve congratulations for the well-chosen pictures, some of which cannot be described otherwise than stunning and memorable. As a critic I feel that some pictures could have been better, but, I must hastily add that such pictures are in a minority. To give a few examples, wouldn’t the splenic amyloidosis have been better illustrated with a color photo of the gross specimen than with a black and white picture of the microscopic changes? Furthermore, will the anglophone students appreciate the cartoon of the mythical bug Petrophaga lorioti supposedly used in the treatment of gallstones? Some concepts remain contentious—for example, are oral contraceptives really ‘phlebotoxic’ to hepatic veins? However, these are minor quibbles, that should not detract from this excellent atlas cum textbook.

Will this Atlas become popular with US medical students? I believe it could sell since the students like picture books and at the present time, there are no similar atlases covering the macroscopic, microscopic and ultrastructural aspects of general pathology all in one. With adequate marketing and exposure to critical student groups, to get enough word of mouth publicity, it could get even on the list of recommended texts in the almighty First Aid for the Boards! Otherwise, it will remain on the shelves of the professors, which would be a pity, since a quality textbook of this kind deserves wider usage.