With all the A&P textbooks that were already available, I had to think more than twice about my publisher's original invitation, in the late 1980s, to write another one. When I accepted in 1992, it was with the conviction that I could contribute something to the curriculum that other authors were not. The features described here, taken collectively, offer a perspective and pedagogy unlike that of any other A&P textbook.

I found long ago that students especially enjoyed lectures in which I introduced brief stories of the personal dramas that enliven the history of biomedical science. Thus, I incorporated that approach into my writing as well. Reviews of the first edition have shown that students elsewhere, like my own, especially like these stories. Some said that these were their favorite parts of a chapter and that they read the sidebars first. The stories in this book, selected for their poignant and inspiring quality, give students a more humanistic perspective on the field they've chosen to study and, I hope, cultivate an appropriately thoughtful attitude toward the discipline.

Profiles of Marie Curie, Rosalind Franklin, and Charles Drew, while telling of the struggles and ironies of their scientific careers, may also inspire students in their own career aspirations and ideals. Some of my favorite stories are of William Beaumont's digestive experiments on Alexis St. Martin; Crawford Long's first surgical use of ether, known in his time mainly as a party drug; the radical alteration of Phineas Gage's personality by a construction accident; and newly added to this edition, the feud between Nobel Prize corecipients Frederick Banting and J. J. R. MacLeod over the discovery of insulin. I am happy to find that instructors elsewhere regard this as a welcome addition to A&P teaching.

I feel that human form and function can never be fully appreciated without a sense of how and why it came to be as it is. Several books of "darwinian (evolutionary) medicine" appeared in the mid-1990s, and the medical journals since then have continued to show considerable interest in the evolutionary perspective on human structure, function, and disease. Yet other A&P textbooks are so far largely disregarding this development and point of view. I give a brief introduction to natural selection as applied to humans in chapter 1, nine Evolutionary Insight sidebars in other chapters, and occasional evolutionary remarks elsewhere. Students will thus find in these pages a novel and intriguing way of looking at such topics as mitochondria, body odors, bipedalism, hair, erythrocytes, the nephron loop, our taste for sweets, lactose intolerance, menopause, and senescence. Users of the book have often written that this perspective has been long overdue in A&P.

It is our primary task in A&P textbooks to teach the basic biology of the human body, not pathology. Yet students want to know the relevance of this biology-how it relates to their career aims. Furthermore, disease often gives us our most revealing windows on the importance of normal structure and function. What could serve better than cystic fibrosis, for example, to drive home the importance of membrane ion pumps? The clinical remarks and insight boxes in this book therefore substantially outnumber the historical and evolutionary ones.

This book differs from others in its sequence of certain topics. The principles of heredity are presented early, for example. Students are ill-prepared to understand color blindness, blood types, hemophilia, sickle-cell disease, sex determination, and many other topics if they do not already understand dominant and recessive alleles, codominance, sex chromosomes, and sex linkage. Most textbooks postpone these concepts until the last chapter. I present them in chapter 5.

Other textbooks treat muscle physiology before anatomy. I reverse this order so that the anatomy of the muscles (chapter 11) is closely tied to the joints on which they act (chapter 10), whereas muscle physiology (chapter 12)-which is where membrane potentials, synapses, and neurotransmitters are first introduced-is closely tied to the physiology of neurons (chapter 13).

Many instructors told us that nervous system coverage has gotten out of hand in A&P textbooks. This is often cited as the most difficult system for students to understand, yet most textbooks overwhelm the students with six chapters of it. This system typically concludes the first semester of A&P, and it is simply unmanageable to cover so much material at the end of the term. I have condensed the nervous system to four chapters-50 pages less than other leading books-yet retained its human interest through biographical and historical notes and discussions of such topics as speech defects, emotion, sensory deprivation, human pheromones, and other subjects missing from most textbooks.

My last major departure from the sequence found in other A&P textbooks is placement of the urinary system. Other textbooks place this near the end because of its anatomical association with the reproductive system. I feel that its intimate physiological ties with the circulatory and respiratory systems are far more important than this anatomical issue. I place the respiratory and urinary systems and the chapter on water, electrolyte, and acid-base balance as close as possible to the circulatory system (only a chapter on the lymphatic and immune systems intervenes). There are several compelling reasons for doing this: the respiratory and urinary systems collaborate to regulate the pH of the body fluids; the urinary system has more influence than any other on blood volume and blood pressure; and understanding glomerular filtration requires a knowledge of the forces of capillary fluid exchange explained in the chapter on the blood vessels. This sequence gives students a much better-integrated view of these system interactions than textbooks that relegate the urinary system to nearly the end.

M. Van Cura, Brunswick Community College

Most instructors probably agree on the need to emphasize the interrelationships among organ systems and to discourage the idea that a system can be put out of one's mind after an exam is over. This book helps to underscore the connections in three ways. (1) Beginning with chapter 3, each has a Brushing Up box that lists concepts from earlier chapters that a student should understand before beginning to study the new one. This can also be useful for students returning to college after a break in their education and to instructors teaching the systems in a different order than the book does, and it helps reinforce the continuity between A&P I and II. (2) For each organ system, there is a Connective Issues page that summarizes many ways in which that system affects others and is affected by them. (3) In chapter 29, the section on Senescence of the Organ Systems compellingly shows how the age-related degenerative changes of each organ system contribute to the senescence of other systems. Senescence is an increasingly important topic for health-care providers as our population increases in average age. This section should help sensitize students not only to issues of gerontology but also to measures they can take at a young age to promote a better quality of life in their old age. These descriptions can be used throughout the course by those who prefer to teach aging as they teach each organ system, or used as a fine capstone topic at the end of A&P II to review and relate ideas that have been studied throughout the two semesters.

Some textbooks present all of the learning objectives at the beginning of a chapter and all of the review questions at the end. I divide each chapter into four to eight short, digestible segments, typically about five pages long, with a list of objectives at the beginning and a list of review questions at the end of each segment. This enables students to set concrete, attainable goals for a study session and to test their comprehension before going on to the next section.

Each chapter of Anatomy & Physiology has 50 to 65 self-testing questions at three levels of difficulty: recall, description, and application. The ability to recall terms and facts is tested by 10 multiple choice questions and 10 sentence completion questions in the chapter review. The ability to describe concepts is tested by 20 to 30 "Before You Go On" questions at the ends of the chapter subdivisions. The ability to apply ideas to new clinical situations and relate concepts in different chapters to each other is tested by 5 "Testing Your Comprehension" questions at the end of each chapter and an average of 5 "Think About It" questions dispersed through the chapter.

A&P students must assimilate a large working vocabulary. This is made far easier and more meaningful if they can pronounce words correctly and if they understand the roots that compose biomedical words. Appendix C is a two-page synopsis of my biological etymology course, enough to give students an appreciation of the value of dissecting words into their roots. The inside back cover has a lexicon of the 400 roots and affixes used most frequently in the book. The roots and affixes of new terms are given throughout the book in footnotes. Pronunciation guides are given parenthetically when new words are first introduced, using a "pro-NUN-see-AY-shun" format that is easy for students to interpret.