Robbins and Cotran Pathologic Basis of Disease

Abstract

A good clinician is first a good pathologist. —William Osler (1849-1919) In practical terms, pathology is the study of disease; however, in literal terms, it is the study of suffering (from Greek, pathos: suffering, logos: study). Of course, studying disease need not itself be an experience in suffering. It ought to be inspiring. Furthermore, per the current editors of Robbins and Cotran Pathologic Basis of Disease (Robbins), it should whet the “appetite for learning beyond what can be offered in any textbook.” In this respect, Robbins—arguably the most influential undergraduate pathology textbook in history—fits the bill. The latest edition of Robbins presents an exhaustive and updated review of not only the cellular and molecular basis of disease but also its clinical and morphologic aspects. The book opens with an extraordinary chapter entitled “The Cell as a Unit of Health and Disease.” This sets the stage for all that comes later. What follows spans an overview of essential pathologic principles and common diseases, cutting-edge concepts of aging and of apoptosis, avant-garde accounts of coronavirus and of clonal hematopoiesis, detailed descriptions of microbiome and metabolome, and outstanding outlines of precision diagnostics and personalized medicine. Physicians of today, and those of tomorrow, need to fully comprehend fundamental pathobiologic concepts if they are to effectively counteract diseases. In this regard, the text is supplemented by explanatory figures, tables, and diagrams. The illustration depicting gene editing with clustered regularly interspaced short palindromic repeats and the table outlining targeted treatments for breast carcinoma exemplify elegant explanations of complex hybrid clinicopathologic concepts. The previous editions of Robbins have been thumbed for decades, primarily by medical students, to learn pathology. Residents as well as physicians, of all specialties, have turned to Robbins to relearn pathology. More than ever, the clarity of writing in its latest edition facilitates swift learning, Likewise, the vivid colors in the illustrated material, the boldface emphasis of key information, the instructive boxes with key concepts, and the cautiously curated lists of suggested readings expediate study. In a testament to the skills of the editors, the overall length of the book remains essentially unchanged despite the addition of significant volume of fresh material. The electronic version, available with acquisition of the print edition, complements the content for readers (and teachers). In the first edition of Textbook of Pathology published in 1957, Stanley L. Robbins (1915-2003), the visionary sire of the book, stated, “The study of morphology is only one facet of pathology. Pathology contributes much to clinical medicine. The pathologist is interested not only in the recognition of structural alterations, but also in their significance, i.e., the effects of these changes on cellular and tissue function and ultimately the effect of these changes on the patient. It is not a discipline isolated from the living patient, but rather a basic approach to a better understanding of disease and therefore a foundation of sound clinical medicine.” It is our collective good fortune that more than six decades later, the current editors of Robbins are driven by the same belief—one that Osler had ostensibly also held more than a century earlier.