Table Of ContentGUYTON
HALL
and
and JVlechanisms
»
lsease
ixth
edition
^Wk lA^nM^
Human
I hysiology
and JVlechanisms
Disease
of
Digitized by the Internet Archive
2011
in
http://www.archive.org/details/humanphysiologymOOguyt
Human
Physiology
and JVlechanisms
ofDi
lsease
sixth
edition
MD
Arthur C. Guyton,
Professor of Physiology and Biophysics
Department of Physiology and Biophysics
University of Mississippi Medical Center
Jackson, Mississippi
and
John E. Hall, PhD
Professor and Chairman
Department of Physiology and Biophysics
University of Mississippi Medical Center
Jackson, Mississippi
SAUNDERS COMPANY
W.B.
A Division ofHarcourt Brace & Company
Philadelphia London Toronto Montreal Sydney Tokyo
W.B. SAUNDERS COMPANY
A Division ofHarcourt Brace &Company
TheCurtis Center
Independence Square West
Philadelphia, Pennsylvania 19106
Library of Congress Cataloging-in-Publication Data
Guyton, ArthurC.
Human physiology and mechanisms of disease/Arthur C Guyton
andJohn E. Hall.—6th ed.
p. cm.
Includesbibliographical references and index.
ISBN 0-7216-3299-8
1. Humanphysiology. 2. Physiology, Pathological. I. Hall,John
E. (John Edward). II.Title.
[DNLM: 1. Physiology. 2. Disease. QT 104G992b 1997]
QP34.5.G87 1997
612—dc20
DNLM/DLC J5-47117
<
Portions of this book, including both text and illustrations, have appeared previously in the Text-
bookofMedical PhysiologybyArthurC. Guyton andJohn E. Hall, published by W.B. Saunders, 1996.
Cover illustration is THE EXPLORER 1970, enamel on steel, by Virgil Cantini, PhD, with permis-
sion from the artist, owned by Mr. and Mrs. Richard Natheson, Pittsburgh, PA.
HUMAN PHYSIOLOGYAND MECHANISMS OFDISEASE: Sixth Edition 0-7216-3299-8
Copyright © 1997, 1992, 1987, 1982, 1977, 1971 byW.B. Saunders Company.
All rights reserved. No part of this publication may be reproduced or transmitted in any form or
by any means, electronic or mechanical, including photocopy, recording, or any information storage
and retrieval system, without permission in writing from the publisher.
Printed in the United States ofAmerica.
98765432
Last digit is the print number:
Prehace
This textbook, entitled Human Physiology and Mechanisms ofDisease, is written
for those students who do not have the time to study one of the more formida-
ble books and yet require more than the usual college introduction to the phys-
iology of the human body These include medical students, dental students,
pharmacy students, other paramedical students in all fields, and many biology
students.
In general, the types of material presented are threefold: first, the basic fun-
damental principles of life itself, beginning with the physical, chemical, and
molecular laws of cellular function; second, the special concepts and principles
necessary for understanding the overall integrated function of the human body;
and, third, multiple illustrative examples of how physiological function can be-
come abnormal in human disease conditions.
This is the sixth edition of this text. The changes from the fifth edition have
been many, including update of the physiological understanding of virtually
every functional area of the body However, the most extensive changes have
come in two special areas: First is the fundamental molecular mechanisms of
physiology, a field that is advancing exceedingly rapidly. Fortunately, newer
knowledge in this area simplifies many of the explanations for which only
speculation could be given previously. The second major area of change has
been in the higher functions of the nervous system. Research on nervous mech-
anisms has always been difficult, so that new fundamental principles of ner-
vous function have been very slow to develop. Yet, within the past decade, es-
pecially with the advancing knowledge of neuronal molecular physiology,
many of the deeper levels of nervous function are at last beginning to fall in
place.
We hope especially that this text can convey to the student that our bodies
are among the most complex and yet most logical and beautiful of all func-
tional mechanisms. We hope, too, that he or she will understand that each indi-
vidual living cell carries within its nucleus all the genetic information required
to create an entirely new human being; yet, this same genetic pool serves as al-
most 100,000 separate intracellular control systems that regulate the chemical
reactions within the cells. And, finally, we hope that all students will recognize,
as a special example, the majesty of the human brain as a powerful computer
having capabilities that all the electronic computers in the world cannot at
present achieve.
We could go on detailing the miracles of the human body. That, indeed, is
the purpose of this entire text. The success of the book will be measured by the
degree of excitement that it leaves with the student for further study in the
field of physiology or for a lifetime of physiological thinking.
A small but important portion of this text presents not only knowledge that
has come from basic experiments in animals but also knowledge that has come
from human experiments, especially unplanned experiments caused by disease.
For instance, a major share of our knowledge of the regulation of blood glucose
and of the mechanisms of carbohydrate metabolism has come from study of di-
VI Preface
abetes mellitus, a disease that alters these physiological functions profoundly
and that is widespread among the human population. Likewise, literally thou-
sands of human disease "experiments" proceed each day in the fields of high
blood pressure, congestive heart failure, gastrointestinal disturbances, respira-
tory diseases, and so forth. The physiology of each of these abnormalities is
discussed briefly, partly because study of the diseases themselves can be en-
lightening but even more, because they give important insights into basic phys-
iological concepts.
Finally, we would like to thank many others who have contributed to the
development of this text. For the illustrations we are especially indebted to
Tomiko Mita, Michael Schenk, Cathy Garrity, Angela Gardner, and Myriam
Kirkman, and for excellent secretarial services we owe our gratitude to Ivadelle
Osberg Heidke, Gwendolyn Robbins, and Susie Zuller. We also extend our ap-
preciation to the staff of the W.B. Saunders Company for its continued excel-
lence in all publication matters, with appreciation especially to William Schmitt,
Editorial Manager; Nicholas Rook, Designer; Linda R. Garber, Senior Produc-
tion Manager; Wynette Kommer, Manuscript Editor; and Walter Verbitski, Illus-
tration Specialist, whose editorial and technical help have been invaluable.
MD
Arthur C. Guyton,
John E. Hall, PhD
