Medical diagnosis, with special reference to practical medicine : a guide to the knowledge and discrimination of diseases / by J.M. Da Costa.

  • Da Costa, J. M. (Jacob Mendes), 1833-1900.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: Medical diagnosis, with special reference to practical medicine : a guide to the knowledge and discrimination of diseases / by J.M. Da Costa. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    informs us of these different causes; but to find out the precise meaning of the abnormal manifestation in an individual ease, we have to draw our inference from all the signs encountered ; to compare them with one another; to seek out those that are in the background. We are thus arriving, step by step, at the explana- tion of the morbid appearances, the starting-point in deduction always being what is known of the affection the presence of which is suspected, and the symptoms of which we are contrasting with those before us. For the conclusion to be valid and exact, it is of course requisite that each part of the testimony have the proper position assigned to it. In reasoning correctly on symptoms, the same laws apply as in reasoning correctly on any other class of phenomena : the facts have to be sifted and weighed, not merely indiscriminately collected. And while the intellectual act is being performed, much collateral evidence is to be sought before a final judgment is given ; especially is it necessary to view the symp- toms with constant reference to the age, sex, and habits of the patient, and to the circumstances amid which the disorder develops itself. To accomplish all this effectually, the physician ha- need of much and varied knowledge. He must be master of something more than of the information supplied to him by semeiology. He must be an anatomist to pronounce with certainty on the seat of the malady; a physiologist to appreciate the aberration of func- tions. Above all, he must be a pathologist in the full sense of the term: he must understand the antagonism between diseases; the frequency with which they coexist; the influence of remedial agents on them; and be cognizant of their natural history and of the general laws governing them,—for how else can he form an esti- mate of morbid action while in progress? Then it is desirable that he should be aware of what are their current divisions and classifications. From what has already been represented, it is evident that he must also be a correct reasoner; for even a good observer will, by bad reasoning, arrive at a faulty diagnosis; just as sometimes a bad observer may, by the same process, blunder into the truth. There is, indeed, no end to the extent of knowl- edge which may be brought to bear in working out a conclusion regarding the character and seat of a malady. The habit of obser- vation once acquired, information of the most varied kind will, by