Goldman-Cecil Medicine

Citation

Goldman, L., & Cooney, K. A. (Eds.). (2023). Goldman-Cecil Medicine (27th ed.). Elsevier.

Chapter Summary

The 27th edition is a two-volume work of about 3,040 pages, arranged in 30 numbered parts and 409 chapters. Parts follow organ systems and specialties, and many begin with an "Approach to the patient" chapter before moving to individual diseases.

Parts I–II: Social and Ethical Issues in Medicine; Principles of Evaluation and Management (Chapters 1–11)

The opening parts frame the practice of medicine: the approach to medicine and the patient, bioethics, palliative care, health disparities and global health, followed by the history and physical examination, abnormal vital signs, statistical interpretation of data for clinical decision making, measuring health care, quality, safety and value, and population health.

Parts III–IV: Preventive and Environmental Issues; Age-Specific and Geriatric Medicine (Chapters 12–24)

Prevention (the preventive health visit, diet and nutrition, physical activity, immunization) sits beside environmental topics such as occupational medicine, climate change, radiation injury, bioterrorism and chronic poisoning. Adolescent medicine, the epidemiology of aging, geriatric assessment and common sequelae of aging follow.

Parts V–VII: Clinical Pharmacology; Genetics; Principles of Immunology and Inflammation (Chapters 25–38)

Cross-cutting science comes before the organ-system parts: principles of drug therapy, pain, addiction, immunomodulatory and biologic agents; principles of genetics, clinical genomics and regenerative and gene therapy; and the innate and adaptive immune systems, tissue injury and repair, complement and transplantation immunology.

Parts VIII–IX: Heart Diseases; Vascular Medicine (Chapters 39–70)

The cardiovascular block runs from the approach to the patient with possible cardiovascular disease through electrocardiography, echocardiography and imaging, heart failure, arrhythmias, congenital heart disease in adults, coronary disease, valvular disease, endocarditis and pericardial disease. The vascular part covers diseases of the aorta, arterial hypertension, peripheral arterial disease, thrombosis, pulmonary hypertension and antithrombotic therapy.

Parts X–XI: Respiratory Diseases; Critical Care Medicine (Chapters 71–99)

Respiratory chapters cover imaging, respiratory testing, asthma, COPD, cystic fibrosis, interstitial and occupational lung disease, pneumonia and interventional approaches. Critical care adds acute respiratory failure, mechanical ventilation, shock syndromes, heat and cold disorders, poisoning, trauma, envenomation and rhabdomyolysis.

Parts XII–XIV: Renal and Genitourinary Diseases; Gastrointestinal Diseases; Diseases of the Liver and Biliary System (Chapters 100–141)

The renal part includes sodium, water, potassium and acid-base disorders, acute and chronic kidney disease and glomerular disease. The gastrointestinal and hepatobiliary parts move from endoscopy, bleeding and motility through inflammatory bowel disease and pancreatitis to hepatitis, cirrhosis, liver failure and gallbladder disease.

Parts XV–XVI: Hematologic Diseases; Oncology (Chapters 142–188)

Hematology begins with hematopoiesis and the peripheral blood smear, then anemias, white-cell and bleeding disorders, transfusion medicine and hematopoietic cell transplantation. Oncology starts with the approach to the patient with cancer, cancer epidemiology and cancer biology and genetics before site-specific chapters from leukemias to skin cancers.

Parts XVII–XIX: Metabolic Diseases; Nutritional Diseases; Endocrine Diseases (Chapters 189–218)

Inborn errors of metabolism, lipid disorders, storage diseases and iron overload are followed by malnutrition, micronutrients, eating disorders and obesity. The endocrine part covers the pituitary, thyroid, adrenal glands, diabetes mellitus, hypoglycemia, sexual development, transgender medicine and reproductive endocrinology.

Parts XX–XXIII: Women's Health; Bone and Mineral Metabolism; Allergy and Clinical Immunology; Rheumatic Diseases (Chapters 219–255)

Women's health covers contraception, medical issues in pregnancy, menopause and intimate partner violence. Bone chapters include osteoporosis and the parathyroid glands, allergy chapters include anaphylaxis and drug allergy, and the rheumatic part runs from laboratory testing and imaging to rheumatoid arthritis, lupus, vasculitis and crystal deposition diseases.

Part XXIV: Infectious Diseases (Chapters 256–352)

The largest part, with 97 chapters. It opens with microbial disease, the human microbiome and anti-infective therapy, then approaches to fever, enteric, urinary and sexually transmitted infection and travel, before organism-by-organism chapters on bacteria, mycobacteria, fungi, parasites and viruses, including three chapters on COVID-19.

Parts XXV–XXVII: Retroviruses; Behavioral Medicine; Neurology (Chapters 353–390)

Eight chapters on HIV and other retroviruses (from pathobiology to prevention and antiretroviral treatment) are followed by delirium, psychiatric disorders in medical practice, tobacco, alcohol and drug use. Neurology spans headache, brain and spinal injury, dementia, epilepsy, coma, sleep, stroke, movement disorders, multiple sclerosis, infections of the nervous system, neuropathies, muscle disease and neuromuscular transmission.

Parts XXVIII–XXX: Eye, Ear, Nose, and Throat Diseases; Medical Consultation; Skin Diseases (Chapters 391–409)

The last parts cover the visual system, hearing and equilibrium, smell and taste, throat disorders, the principles of medical consultation, preoperative evaluation, anesthesia, postoperative care, and seven chapters on skin disease from the approach to the patient to hair and nails.

Key Concepts

Parts I–VII: Frameworks and Cross-Cutting Science

• Statistical interpretation of data for clinical decision making (Chapter 8): the chapter on turning test and study results into decisions.
• Quality, safety, and value and population health (Chapters 10–11): the system-level view of care that sits alongside the individual patient.
• Principles of drug therapy (Chapter 25) and clinical genomics (Chapter 32): general principles that later disease chapters rely on.

Parts VIII–XXX: Organ Systems and Specialties

• Approach to the patient: the chapter that opens many system parts and sets out how a presentation is evaluated before disease-by-disease detail.
• Pathobiology to treatment: the publisher describes a templated chapter organization with evidence-based references.
• Diagnostic modalities as chapters: electrocardiography, echocardiography, respiratory testing, endoscopy and laboratory testing in rheumatic disease each get their own chapters.

Critical Analysis

Strengths

• Breadth in one reference. With 409 chapters across 30 parts, the book covers everything from bioethics and preventive care to rare infections and skin disease. The Doody's reviewer called the topic coverage exhaustive for internal medicine and noted that the major organ systems and critical care receive appropriate attention.
• Common structure. The publisher describes a practical, templated organization, which helps a reader who dips in for a single condition find the same kinds of information in the same places.
• Designed for lookup. The reviewer notes that the whole text is also available on a website and mobile app, with supplementary videos; the publisher lists over 100 supplementary videos, heart sounds and key references, and continuous updates between editions.
• Currency. The 27th edition adds chapters on population health, climate change and health, bradycardias, transgender medicine, Whipple disease, polyomaviruses and three on COVID-19.

Limitations

• A reference more than a first course. The reviewer describes the aim as a quick and thorough reference for clinicians at any stage; the same breadth that suits lookup makes cover-to-cover reading impractical.
• Uneven weight. Infectious disease consumes more than 450 pages according to the reviewer, while ethics, geriatrics, women's health and behavioral medicine receive short sections, so those areas usually need a dedicated source.
• Size and cost of carrying it. At about 3,040 pages in two volumes, the print edition is not a portable study text; the electronic version is the practical way to use it day to day.

Where It Fits in the Course

Goldman-Cecil is one of two large reference works in the clinical medicine list; the other is Harrison's Principles of Internal Medicine. Both cover the whole of adult internal medicine. The tables of contents differ in layout: Goldman-Cecil is organized by specialty from Part VIII onward, with its pharmacology, genetics and immunology parts placed before the organ systems, whereas Harrison's puts a large part on cardinal manifestations of disease (symptoms and presentations) early in the book.

Smaller books come first. Clinical Medicine: Lecture Notes is a concise guide for students starting on the wards, organized around history, examination and diagnosis; Macleod's Clinical Examination teaches the history and examination skills themselves; Davidson's Principles and Practice of Medicine is a one-volume textbook of internal medicine and a more manageable first pass through the subject; the Oxford Handbook of Medical Sciences is a compact guide to the scientific foundations. Goldman-Cecil belongs after these, when a student or resident needs more depth on a specific disease than a one-volume text gives.

How to Use This Book

The book is aimed at readers who have completed preclinical sciences and basic clinical training: senior students, residents and practising physicians. It is best used problem-first rather than front to back.

• Start with Parts I–II. Chapters 6–8 (history and physical examination, abnormal vital signs, statistical interpretation of data) are the most transferable to everyday clinical reasoning.
• Read the "Approach to the patient" chapter for a system first (for example Chapters 39, 71, 100, 118, 164, 202, 236 and 366), then go to the specific disease chapters.
• Use the pharmacology, genetics and immunology parts (Chapters 25–38) as background when a disease chapter assumes mechanisms.
• Treat Part XXIV selectively. Read Chapters 256–265 on approaches to infection, then the organism chapters as cases demand.
• Use the electronic version for searching, the videos and heart sounds, and the periodic updates the publisher provides.