凯利风湿病学(英文原版)(1.2)

Morethan20yearsago,intheprefacetothefirsteditionoftheTextbookofRheumatology,wesuggestedthat"Thefieldofrheumatologyhascomeofage."Whatwemeantwasthatrheumatologyhadsheditsstrictlyempiricalbaseanditshostofunprovenremediesandbecomeahealingdisciplinethoroughlygroundedinscience.Wethoughtitwastimeforanewtextbook,onethatreflectedthispassagethroughepistemologicalpuberty.Thesixtheditionreflectsthematurationofrheumatologyasasubspecialty.Itisinstructivetocomparethecontentsofthefirstandsixtheditions.Manychaptershavedisappearedentirely,andtheirmaterialhasbeencondensedandincorporatedintoexistingchapters.Consider,forexample,thatinthebasicsciencesectionofthefirsteditionwedevotedentirechapterstoimmunoglobulinstructure,thecontactactivationsystem,andlysosomes(nottomentionpurinemetabolism,asubjectdeartotheheartofthethensenioreditor).Cyclicnucleotidesandeosinophilicchemotacticfactorofanaphylaxisfiguredprominentlyinthetitlesofotherbasicsciencechapters.NoneofthesehasaplaceintheTableofContentsofthecurrentedition.Instead,therearechaptersdealingwithdendriticcells,leukotrienes,mastcells,nitricoxide,fibroblasts,cytokines,andapoptosis.Theimportanceofthesetopicstounderstandingtherheumaticdiseaseswasunknown20yearsago,andsomeofthemhadn'tevenbeendiscovered!Whocanimaginewhatthescientificbasisofrheumatologywillbeinthe10thedition,20yearsfromnow?Surely,knowledgeobtainedfromtheworkingthroughofthehumangenomewillfigureprominently.