Clif Hotvedt's picture

Eight-and-a-Half Pounds of Pharmacology?

[[wysiwyg_imageupload:34:]]I just bought the 12th edition of Goodman & Gilman’s Pharmacological Basis of Therapeutics.  It weighs eight-and-a-half pounds.  This is the standard textbook of pharmacology and I own all twelve editions as part of my personal library.  When I was taking medical microbiology in college, I asked my professor whether there was any reference book I should be using to supplement the course text.  He immediately said Goodman & Gilman, but noted that the school library didn’t have the current edition, just the two older ones.  So, on my next trip home to New York, I visited the McGraw Hill Technical Book Store (two blocks from where I now work) and purchased the then current, third edition.  After I graduated, I went to work for a medical foundation, and had them buy the fourth edition, then a drug company, that I coaxed to buy the fifth and later the sixth edition. When I started in healthcare public relations, I splurged on the newly-released seventh edition and have bought the others as they were released and ultimately found the others I didn’t already own on the Internet.  (I’m pleased that my second edition was first owned by Louis K Dahl, a research pioneer on the relationship between salt and blood pressure and my first edition was a doctor TF Smith’s 1943 Christmas present.)

In an electronic era, what possible reason is there to own a shelf full of seriously heavy texts?  Can’t you find just about anything you need on the web?

Certainly, one can find learned bits of information scattered across the electronic terrain.  What’s often missing is the consolidation of that information into a cohesive framework.   If one were to be researching antibiotics, the first edition (1941) of G&G didn’t mention penicillin, but the second edition (1955) had a chapter on penicillin – as well as a section on penicillinase.  Developments in newer agents and emerging bacterial strategies to counter them have been dutifully described over the ensuing decades.  The anticoagulant warfarin is noted in the second edition, but not discussed, as it was not yet available for general clinical use.  Likewise, the earliest use of levodopa in Parkinson’s disease was summarized in the fourth edition (1970) but only expanded into a chapter in the fifth edition (1975) that also included carbidopa.  After writing the first several editions themselves, Louis Goodman and Alfred Gilman shifted to a multi-author format with experts in the emerging therapeutic categories assuming responsibility for those chapters.             

Must the current volume weigh almost five pounds more than the first edition?  I imagine so.  The reality of medicine is that while there is some turnover in what doctors prescribe, the mechanisms behind the old drugs often inform newer generations of drugs and the older drugs remain available for prescribing.  At the same time, new previously-unimagined chapters on concepts like pharmacogenetics are added, looking forward to newer agents and helping educate readers about how they fit into the therapeutic continuum.   The Internet is wonderful for referencing many things, but if you want it to all fit together, I find books like Goodman & Gilman or others in my collection like John Eberle’s 1838 Practice of Medicine or William Martindale’s 1883 Extra Pharmacopœdia of Unofficial Drugs invaluable for making the pieces of the drug development and prescribing story fit together into a comprehendible narrative.