Medicine. A Guide for Study and Practice. 2nd Edition

65 phasized during medical school and residency training. Unfortunately, these skills are often taught during a brief course in the second year of medical school, and not developed further during medical training in any formal way. This book aims to provide students with a rational approach to history taking and physical examination and to further provide a sense of how information gained from these activities is used to construct a differential diagnosis and guide further investigations. It largely succeeds. The book begins with an introductory chapter on history taking skills and an overview of what a complete physical examination includes, then progresses to chapters dealing with the major body regions and systems, including separate chapters on the neurologic and musculoskeletal systems and sections pertaining to the special situations of geriatric and pediatric patients. Each chapter begins with a section on detailed history taking for that region, including discussions of specific symptoms, what causes them, and which clinical entities they may portend. Physical examination techniques are then presented, organized along the familiar inspection, palpation, percussion, auscultation sequence. Each chapter concludes with a section describing the history and physical findings in selected disease processes of the particular system under discussion. Throughout the book are helpful and information-filled tables with titles such as "Physical Exam Clues to Pulmonary Disease" and "Differential Diagnosis of Chest Pain". The section on the skin is well written and illustrated, including thirty-nine excellent color plates. The chapter on the neurologic examination is commendable for its approach emphasizing pathophysiologic correlates of physical findings and advocating tailoring the neurologic examination to the patient's symptoms rather than merely describing a mind-numbing list of ways to test various pathways. No text can be all things to all people, and the major drawback of this book as an introductory text on history taking and physical examination is that it does not have a large enough number of photographs and drawings illustrating just how to perform various physical examination maneuvers. The written text is excellent, but as the saying goes, a picture is worth a thousand words. In summary, this is a unique book that attempts to bridge the gap between basic history taking and physical examination skills and an understanding of how information obtained from the patient leads to construction of a rational differential diagnosis and to the appropriate use of further studies. A second year medical student may need to supplement the …