Black’s Medical Dictionary first appeared in 1906. That new century was to see health care in the United Kingdom evolve from a largely personal, paternalistic consultation between doctor and patient, based more on medical tradition than medical science, to a complex, science-based, team-oriented and managed service. Even so, the core of medical practice has survived: the face-to-face consultation between doctor and patient. But the nature of this core activity has been irreversibly altered by a shift in the ‘balance of power’ between the participants as patients became better informed about their health, illnesses and possible treatments. A significant catalyst in the emergence of the informed patient has been the media, including publications like this dictionary, the contents of which have during its 41 editions reflected these changes in medicine. One modest constant in this sea of change, however, has been the objective of Black’s Medical Dictionary. When launching the first edition, the editor, Edinburgh physician John D. Comrie, declared his aim as being to produce ‘a work which would occupy a position somewhere between that of a Technical Dictionary of Medicine and one intended merely for the domestic treatment of common ailments. . . [giving] information in simple language upon medical subjects of importance and general interest’. That initial mission-statement underpins this first edition of the 21st century. Entries in the 41st edition have undergone major revision where medical knowledge or research has resulted in greater understanding or changed practice. These include anaesthesia, breast screening and mammography, chronic fatigue syndrome, clinical guidelines, clinical trials, evidence-based medicine, Gulf War syndrome, hormone replacement therapy and post-traumatic stress disorder. Ironically the greatest changes in British medicine seem to be taking place in how doctors are required to work, rather than what they actually do. Many of the bodies which constitute the National Health Service have been replaced or merged, new ones have come into existence and functions changed. I predict that such reorganisation will continue throughout the life of this edition, so readers wishing to check on how the NHS works may need to refer to other sources to beabsolutely sure of remaining up-to-date.
Black’s Medical Dictionary is neither a textbook of medicine nor a formulary of therapeutic drugs. The many drugs that are included are given their generic title as used in the British Pharmacopoeia. Patients are individuals who react in varying ways to injuries, diseases and their treatments. Appendix 1 explains some basic first-aid procedures, but patients’ own doctors are normally the appropriate source for personal medical advice. The dictionary should, however, help readers to decide when it would be wise to seek medical advice and subsequently help them to set such advice in context.
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