Undergraduate and postgraduate teaching increasingly favours a symptom-based approach to diagnosis. Unlike many other textbooks in acute medicine, this book reflects this shift in emphasis, presenting a logical and structured approach to the diagnosis and initial management of acutely unwell adults. It discusses the relevant pathophysiology of each clinical presentation, and provides a comprehensive table of differential diagnoses, highlighting common causes. The book's description of generic emergency management emphasises important diagnoses, and explains relevant history, examination findings and investigations involved in assessment or diagnosis. Senior medical students and junior doctors in their first four years after qualifying will find this an invaluable aid to honing their clinical practice. The logical systems of diagnostic thought will serve them throughout their careers. No book can replace hard work on the ward and in clinics but books can speed up the acquisition of skills by fostering sound basic principles and developing the right instincts. Diagnosis in Acute Medicine is particularly helpful in this regard. I strongly recommend it.A - From the Foreword by Ian Pavord