4 of 4 people found the following review helpful
on 24 March 2014
My late father was taught many years ago by Sir Stanley Davidson who produced the first edition of this book in 1952. This is an Edinburgh book, with a world view, and among other improvements, it is good to see stroke medicine given a separate chapter. The size is right, as is the level of coverage. If you are starting life as a medical student this would be a good purchase to see you through. AS for me, with increasing age, this edition will see me out.
on 13 February 2015
Previous reviewers have used a set of adjectives repeatedly to describe this book, and appropriately so: Davidson's is comprehensive, clear and enjoyable to read. The short 'Principles' section kicks things off by highlighting key factors in disease, important considerations before dipping our toes into the Practice of Medicine section - which makes up the bulk of the book.
Rather than giving a general overview, which other reviewers have done well, I'd like to dissect a specific chapter to properly illustrate some of the wider compliments/ criticisms I have for the 'Practice' part of the book. Importantly, each chapter follows a largely predictable format, and by virtue of good editing the style of writing is consistent, so most comments apply equally to other chapters.
I have a special interest in neurology and neuroanatomy, so I'll discuss the chapter 'Neurological disease'. My intercalated year focussed on the biology of brain disorders, the neuroscience of sleep and its disorders, and neuronal degeneration and regeneration. We had to read lots of primary and secondary material, of very variable quality, stretching far beyond the contents of this chapter. Pleasantly, as a tertiary text, this chapter recapitulates the best in the field.
Firstly, the selection of authors is commendable - RJ Davenport and JP Leach are both extensively published and experienced neurologists; not only do they know their stuff, they are excellent at explaining it.
Secondly, the chapter format is perfect (and identical across most chapters). The fundamentals (including clinical examination, basic gross and histological anatomy/ physiology) are supplemented by economical diagrams, well worth copying into personal notes. If you've ever picked up "Blumenfeld's neuroanatomy through clinical cases", you'll know how daunting clinical neuroanatomy can be. Within 8 pages, all the necessary functional anatomy for clinical students is dealt with effectively. If I were to be really picky, certain parts are too short, and are on the verge of becoming redundant packets of information. For example, 'Sleep' is described using the EEG. While clinically appropriate, the description is incomplete: 'the cycle [REM/ Non-REM cycle] repeat[s] several times throughout the night'... how many times? how long are the cycles? how many cycles are deemed to be necessary/ normal? A small diagram would have answered all of these questions, and would tie the description of the phases of the EEG together succinctly, making them easier to understand and remember. The 'neuroimaging', 'presenting problems', and 'functional symptoms' sub-topics are outstanding summaries (very quick to digest, and again the summary boxes are great for adding to notes), and lay the necessary groundwork for tackling specific diseases.
Thirdly, the extent of diseases covered is brilliant, and typically each is well characterised. The pages on Epilepsy are my favourite, and they exemplify the structure of the best parts of Davidson's: what is currently known about the pathophysiology is explained in basic terms, from the cellular to cortical level; the important features of different types of seizures and common syndromes are detailed, with specific emphasis on what is often missed; little heads up to on-going work (e.g. 'It is anticipated that genetic testing will ultimately demonstrate similarities in molecular pathophysiology') allow those interested to go off and explore; the pros and cons of investigations (e.g. CT and EEG) are not just documented but explained, and well-supported by study data; and the 'management' section is compendious and up-to-date. Worthy of a 5/5.
This contrasts sharply with the 1 page section on sleep disorders, an example of the worst parts of Davidson's. Where the hell is the description of insomnias, beyond a cursory definition in the introductory paragraph? The management of insomnias is very controversial, and well worth mentioning. Look at the Great British Sleep Survey results, and you'll see how important, variable and wide-spread these disorders are. The part on hypersomnolence is OK, but unlike the epilepsy section (where the guidelines for anticonvulsant therapies are laid out nicely, and key study data is mentioned), the management of narcolepsy just isn't explained: "Treatment is with sodium oxybate, modafinil, dexamfetamine or methylphenidate". I have a friend with narcolepsy, so am familiar with the large pitfalls of drug therapy in this condition... here they give no indication of the inefficacy of these drugs, nor the important side effects/ concerns. If you just want to pass MCQs, I guess the approach is sufficient; it's just disappointing for a textbook. Another minor point: incidence and prevalence are not consistently mentioned throughout chapters. This may be a result of caution by the authors (for example, the prevalence of insomnias varies from 10-40% depending on insomnia case definitions - Mai and Buysse, 2008), but if that's the case, then say so. It's better to have some idea than none. I got the feeling this topic was obligatory but the authors didn't find it overly interesting or judge it to be important, hurried through it, and left it a complete shambles.
Overall, the other sections within the chapter, and across chapters share more in common with the Epilepsy section than the Sleep section, which represent two ends of the quality spectrum of Davidson's. It is on that basis that I've chosen to give this book 4/5.
In summary, this chapter - which I feel adequately illustrates the pros and cons of all of the chapters - is eruditely constructed and written, contains excellent supplements (diagrams, tables, summary boxes) for high-yield learning, and covers an impressive breadth. Unfortunately, there are patches of inconsistency (e.g. management explanations, incidence/ prevalence) and incompletion (e.g. insomnias) that left me too disappointed to give this book a 5/5.
Nevertheless, compared to other clinical medicine textbooks e.g. Kumar and Clark's, I prefer the style of this book. Reading it feels less of a chore. Conclusion: definitely worth buying as a core text during clinical training, but don't solely rely on it.
Declaration: Elsevier Student Rep provided with gratis copy, and in 3rd year of medicine at Oxford Uni
on 29 January 2015
I believe Davidson's is the best undergraduate medical textbook in the market! I have spent a lot of time in medical school just looking for a reliable, comprehensive, easy to read and up-to-date textbook to rely on as my main core source of information. Amongst a few I have tried - Kumar and Clark, Cecil Essentials of Medicine, Harrison's Principles of Internal Medicine, and Merck Manual - Davidson's is the best choice a medical student in a UK University can choose. If you have a sound understanding of physiology, pharmacology and general pathology from your pre-clinical years, Davidson's will elegantly add to those foundations with simple and fast explanations of pathophysiology. It manages to connect the investigations and treatment of a condition with the pathophysiological rationale, something I personally find excellent.
Without exaggerating, I have found many conditions where the investigation and treatment section in Davdison's is more up-to-date and clear than Harrison's (e.g. stroke! Harrison has an extensive essay on the recent trials without actually mentioning the recent superiority of clopidogrel for secondary prevention, while Davidon's clearly and succinctly not only provides instructions on what to do when someone presents with a potential cerebrovascular accident, but the Evidence Based Medicine section provides all the landmark trials underpinning the modern management of stroke)
While I still consult Harrison's for its superb analysis on pathophysiology, Davidson's is a core foundation around which I base my reading.
In conclusion, advice to medical students. Get Davidson's and read it FIRST before anything else. Then you will be in a better position to add to your knowledge with textbooks like Harrison's, handbooks like the Oxford Acute Medicine, Up-To-Date database, reviews, and papers. With Davidson's you will never focus on the tree and miss the forest!
P.S. Also think how cool you'll look when you mention landmark trials during ward rounds ... ;)
on 22 June 2014
Davidson’s Principles and Practice of Medicine is a concise, comprehensive and well laid out text encompassing all important aspects of clinical practice. It is an essential guide for medical, nursing and dental students and a brilliant reference material for any qualified Healthcare Professional.
The text is divided into two sections: Around 160 pages on Principles and about 1000 pages on Practice. The shorter Principles section introduces the fundamentals of medicine, including: therapeutics, genetics, immunology, infection and environmental & nutritional causes of disease. Following this concise introduction, the succeeding (and substantially larger) half of the book deals with the practice of clinical medicine.
Each chapter of the main Practice section covers a particular body system or medical field, ranging from respiratory disease, to dermatology, to strokes. Most of these chapters follow a similar layout:
• Clinical examination of the relevant system
• Concise overview of relevant anatomy and physiology
• Followed by the pathophysiology and clinical management of the most common diseases and disorders of that system.
The text is easy to follow and understand for anyone with mild to moderate amount of medical training. Long paragraphs are broken up with relevant charts and diagrams which makes exam revision a whole lot easier. The book can also be accessed as an ebook with a unique code in each copy – making this fairly hefty book a lot more portable.
I’d thoroughly recommend Davidson’s Principles and Practice for anyone studying a medical degree or as a reference text for all Health Care Professionals.
Declarations: Elsevier Student Rep provided with a gratis copy.
4 of 5 people found the following review helpful
on 21 February 2014
I have been using Davidsons since entering medical school in 1999 and have acquired each new addition. Aside from a strange version they produced in about 2005 where they chopped out most of the basic science chapters, each revision has successively strengthened the book whilst keeping the page limit down. I had no trouble reading Davidson's cover to cover a couple of times at medical school. As has been said many times before Davidson's has an uncanny ability to foster understanding rather than just presenting a list of facts in need of memorisation.
The changes to the new edition are fairly subtle; as they should be since most of it was already optimally written and presented. There are now a couple of new features such as boxes on adolescent interface issues which are marginally useful. Since it is not a directly referenced text by way of mitigation there are evidence based medicine boxes that cite key studies which is a very useful feature the last couple of editions have carried.
As ever the tables and figures are completely apt and there is a major overhaul of the stroke section which now has its own chapter and is significantly expanded.
There are a few niggles though. Whilst its understandable one would wish to keep the page numbers down it seems there is a desire to add new FEATUREs like the adolescent boxes and less desire to see what is deficient in the actual text itself which ought to form the bulk of the book.
So for example, the vitamin C section has no mention of cork screw hairs....and there is no mention of basic facts like the incidence of many disease. E.g. look at the endocrinology section - acromegally chapter - there is no mention of the incidence and prevalence. Perhaps it is an incredibly common disease, perhaps it is incredibly rare....impossible to know from the book.
Overall, I would say Davidson's is pleasurable to read, is definitely high yield, has lots of principle and practical type information but for uber marks one would still be best off looking things up in a more specific text. I also have Harrison's which has more detail overall but it less practical to read and in its instructions. E.g. the anaphylaxis section is far better in Davidson's than Harrison's. And Harrison's doesn't mention cork screw hairs either! Perhaps one is copied from the other.
Anyway, in future issues I would suggest that the temptation to add 'features' or convert it to a more dumbed down book be strongly resisted and instead the actual text be given an overhaul to key in more actual facts whilst not expanding the number of pages.