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Harrison's Principles of Internal Medicine (HPIM) provides a comprehensive body of information important to an understanding of the biological and clinical aspects of quality patient care. It remains the premier medical textbook for students and clinicians. With the rapidly expanding base of medical knowledge and the time constraints associated with heavy patient-care responsibilities in modern health care settings, it is not always possible to read a comprehensive account of diseases and their presentations, clinical manifestations, and treatments before or even immediately after encountering the patient. It was for these reasons, among others, that in 1988 the Editors first condensed the clinical portions of HPIM into a pocket-sized volume, Harrison's Manual of Medicine. Similar to the prior seven editions, this new edition of the Manual, drawn from the 18th edition of HPIM, presents the key features of the diagnosis, clinical manifestations, and treatment of the major diseases that are likely to be encountered on a medical service.

The Editors stress that the Manual should not substitute for in-depth analysis of the clinical problem, but should serve as a ready source of well-crafted and informative summaries that will be useful "on-the-spot" and that will prepare the reader for a more in-depth analysis drawn from more extensive reading at a later time. The Manual has met with increasing popularity over the years; its popularity and value relate in part to its abbreviated format, which has proven to be extremely useful for initial diagnosis, brief description of pathogenesis, and outline of management in time-restricted clinical settings. The book's full-color format will increase the speed with which readers can locate and use information within its chapters. The Manual has been written for easy and seamless reference to the full text of the 18th edition of HPIM, and the Editors recommend that the full textbook—or Harrison's Online—be consulted as soon as time allows. As with previous editions, this latest edition of the Manual attempts to keep up with the continual and sometimes rapid evolution of internal medicine practices. In this regard, every chapter has received a close review and has been updated from the prior edition, with substantial revisions and new chapters provided where appropriate. The format of the book has been further streamlined to reflect more use of abbreviated text, with use of numerous tables and graphics to help guide understanding and decisions at the point of care. In full recognition of the important role of digital information delivery in alleviating the increasing time demands put on clinicians, the 18th edition of the Manual has also been made available in portable format for the smartphone and tablet.

We would like to thank our friend and colleague Eugene Braunwald, MD for his many contributions and years of wise advice in shaping the Manual and indeed all the publications in the Harrison's family.

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