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In thinking about a contribution we could make to the modern practice of medicine that
had not yet been achieved by others, we remembered what constituted the complete
physician at the time of Sir William Osler: A working knowledge of multiple disciplines
and of disease processes that affect many organ systems. This was perhaps even more
important in that era of medicine when laboratory and imaging modalities were
essentially nonexistent, forcing physicians to use their powers of history-taking, physical
examination, keen observation, and even sense of smell to enable them to come to a
correct diagnosis. Further, Osler's famous and oft-quoted comment, "To know syphilis is
to know medicine," was especially meaningful at the time because of that particular
disease's possible presentation in so many different organ systems. Osler clearly understood
that a physician must know the manifestation of a systemic disease in every region
of the body.
We have spent our respective careers caring for challenging patients and investigating
diseases in the laboratory, as well as serving as teachers of young physicians and
medical students. As a result, we can confirm that one must strive to enlarge the base of
knowledge of one's own specialty to a broader knowledge of systemic diseases. Because
of the enormous expansion of medical knowledge over the past several decades, it is
natural to find comfort in a subspecialty area. However, it is still apparent that the very
accomplished physician must know more than his or her own specialty area and be wellversed
in multiple disciplines.
It is in this spirit we have assembled this textbook, Head and Neck Manifestations
of Systemic Disease. We recognize that while we have made every effort to include
common as well as somewhat esoteric entities that affect the head and neck, this list is
not complete or exhaustive and is somewhat limited by what is practical and timely for
the life of this textbook. We have selected disorders that a specialist or primary-care
practitioner working in this area of the body should keep in mind when seeing an
ailment or a complaint. We have divided this book into two sections. The first section,
Systemic Disorders with Head and Neck Manifestations, includes chapters that deal with
specific disease classifications: rheumatic diseases, infectious diseases, malignant diseases,
and other systemic diseases. The second section, Differential Diagnosis and
Treatment of Clinical Presentations in the Head and Neck, covers common signs and
symptoms in the head and neck region and is intended to give a perspective of the
differential diagnosis that would be compiled by an expert practicing in the field. In this
way we have presented our topics both from a traditional didactic approach and a
practical hands-on point of view. |
