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Book Review |
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Physiology, 5th Edition |
| Robert M. Berne, Matthew N. Levy, Bruce M. Koeppen, and Bruce A. Stanton. St. Louis, MO: Mosby, 2004, 1024 pp, illus., index, $74.95. ISBN: 0-323-02225-1. Those given the responsibility of teaching first year medical students about human physiology have a number of excellent texts from which to choose. Berne and Levy’s classic text has been a standard for many years. Readers familiar with the previous editions will find this one very similar. Physiology covers, in six sections, the nervous, the cardiovascular, pulmonary, gastrointestinal, renal, and endocrine/reproduction systems. It begins in the standard way with the basics of cellular physiology, including transport, osmotic equilibrium, bioelectricity and signal transduction, with a section by Howard Kutchai, who also has written the gastrointestinal chapters. These introductory chapters are followed by compact, but thorough, chapters on the somatosensory, the somatic motor, and the autonomic motor systems. Also covered are the special senses, sight, hearing, balance and, briefly, smell and taste, provided by William Willis. James Watras has provided a concise and authoritative section on skeletal and smooth muscle, which serves as an introduction to Mathew Levy’s portion on cardiac muscle and the heart. The cardiovascular portion has remained a standard since the first edition of this textbook. In addition to those previously mentioned, we were impressed by the other authors, including Stanton and Koeppen on renal physiology, Cloutier and Thrall on respiratory physiology, and Saul Genuth’s outstanding coverage of endocrinology and reproduction. One feature particularly appealing was the highlighted clinical issues that are interspersed throughout and used to illustrate basic physiological concepts. These blend seamlessly with the text. Clinical issues always seem to help motivate first year medical students eager to learn about “medicine” and thirsty for relevance at this early stage of their careers, which traditionally has been devoted to basic science. Although it seems unlikely that anyone would make a decision of textbook selection based on these reviewers’ comments, we have used two criteria on which comparisons might be made. a) Can the text be easily used as an authoritative reference for medical students (and residents) later in their careers? b) Is it an effective teaching device for beginning students, i.e., would first year medical students, who have little time for browsing or digging for information, find the organization of topics, clarity of exposition, and use of illustrations an efficient aid in learning physiology? Obviously these criteria are somewhat overlapping, as students who find a textbook clear and easy to use will be more likely to refer back to it in their later clinical years. However, textbook (and chapter) authors are pulled in two directions with respect to these two demands. Making a section authoritative requires inclusion of a vast amount of the biomedical information that is developing at an increasingly rapid pace. Yet students require a guided, less detailed view of this landscape to find their way through the many facts. a) Use as a reference. There is a 35-page index, which, though not as extensive as in some texts, was quite good in directing us to any topic that we sought. To guide a review of physiology, each chapter ends with a concise summary emphasizing ten or more main points. Much of the text is adapted from the earlier editions, and occasionally the vocabulary seems older. For example, the terms symporter, antiporter, and multiporter are not developed in the cell physiology sections, although they are used in later portions of the book. Also, there appeared to us to be occasional ambiguities. For example, the development of osmotic concepts blurs the distinction between osmolarity and osmolality (which is not defined). In spite of minor areas where individual preferences may differ, the text overall seemed to us authoritative and thorough. b) Organization of topics and teaching effectiveness. Physiology is traditionally taught one organ system at a time. Although the sequence of the organs is somewhat arbitrary, it has become standard over the years to arrange the topics similarly to that of this text. In a few cases authors could have, for brevity, referred to earlier chapters. For example, the descriptions of the resting potential of cardiac cells and of phase 0 of the cardiac action potential could have simply referred to chapters 2 and 3. A minor point, but one possible area of confusion, is in the relationship between the ventricular action potential and the contractile force shown in Figure 15-2. This suggests that the contractile force lasts twice as long as the cardiac electrical activity, which to the student may appear to conflict with the temporal relationship shown in the basic Wiggers diagram of Figure 16-10. In the description of the electrocardiogram, some students might benefit from a statement that the “mean electrical axis” of the heart actually represents the orientation of the cardiac electrical vector at a single instant in time. A more detailed description of the unipolar and precordial leads would be useful. In modern science textbooks, much of the clarity is provided with illustrations. This book averages roughly an illustration per page. The editors have chosen to use two color tones, and two colors quite adequately illustrate the concepts. Most of the illustrations are schematic rather than representational; they focus attention to the points discussed within the text and are clean and uncluttered in appearance. The authors have made a reasonable compromise between the competing goals of clarity and completeness. The writing in the forty-six chapters is quite good overall: although we noticed an occasional misprint (or figure error), students should find this text relatively easy to read. Assuming that a course is given in one semester of fifteen-sixteen weeks, three chapters per week would need to be covered. The average chapter is twenty-one pages, though some are half this and the longest, nearly sixty pages. This book could be the basis for an intense semester-long course, although if all the material is covered, a year would be more realistic. In summary, this physiology textbook will continue to be one of the standards for medical education for the foreseeable future and is a lasting tribute to, and one of the legacies of, the late Professor Robert Byrne, to whom it has been dedicated. Ron Abercrombie and John Pooler Emory University Medical School |
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Animal Physiology. Richard W. Hill, Gordon A. Wyse, and Margaret Anderson. Sunderland, MA: Sinauer Associates, Inc., 2004, 770 pp., illus., index, $104.95. ISBN: 0-87893-315-8. Biopac Laboratory Exercises. Richard G. Pflanzer. Dubuque, IA: Kendall/Hunt Publishing Co., 2004, 181 pp., illus., table of contents, $39.95. ISBN: 0-7575-0386-1. Human Physiology: The Basis of Medicine, Second Edition. Gillian Pocock and Christopher D. Richards. New York: Oxford University Press, 2004, 714 pp., illus., index, $59.50. ISBN: 0-19-858527-6. ORI Introduction to the Responsible Conduct of Research. Nicholas H. Steneck. Rockville, MD: Office of Research Integrity, 164 pp., illus., table of contents, $12.00. ISBN: 0-16-072285-3. Primer on the Autonomic Nervous System, Second Edition. David Robertson, Italo Biaggioni, Geoffrey Burnstock, and Phillip A. Low (Editors). New York: Elsevier Academic Press, 2004, 459 pp., illus., index, $79.95. ISBN: 0-12-589762-6. Principles of Gender-Specific Medicine, Vol. 1. & Vol. 2. Marianne J. Legato (Editor). New York: Elsevier Academic Press, 2004, 625 pp., illus., index, $279.95. ISBN: 0-12-440906-7. Space and Life: An Introduction to Space Biology and Medicine. Hubert Planel. Boca Raton, FL: CRC Press, 2004, 186 pp., illus., index, $74.95. ISBN: 0-415-31759-2. |
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