A text-book of medical diagnosis / by James M. Anders and L. Napoleon Boston ; with 418 illustrations in the text and 25 plates, 17 of them in colors.

  • Anders, James M. (James Meschter), 1854-1936.
Date:
1911
Catalogue details

Licence: In copyright

Credit: A text-book of medical diagnosis / by James M. Anders and L. Napoleon Boston ; with 418 illustrations in the text and 25 plates, 17 of them in colors. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    29/1276 (page 23)
    INVESTIGATION OF INDIVIDUAL CASES. Coming now to the question of the investigation of individual cases ■with a view to the recognition of human diseases in their multitudinous forms, two things are essential: (a) Close observation and scrutiny of the symptoms and signs and the utilization of the laboratory resources, according to the most approved method of conducting an examination; and (b) the harmonizing inductively of the essential features and data with a mental picture of definite morbid states or entities. (a) Nothing is more important for the student or practitioner than the adoption and rigorous enforcement of a method or system in taking up the study and examination of special cases. This mode of procedure insures the accumulation of the largest possible mass of clinical data and minimizes the necessity for making a diagnosis by mere inference—always an uncer- tain product. The clinician who, during the earlier years of his professional career, unswervingly adheres to a proper system of investigating cases will meet with a progressively smaller number in which questions regarding diagnosis must remain sub judice. The well-poised, calm, logical practi- tioner, skilled by a long process of self-imposed training, and armed with sharpened perceptivity and an extensive experience, may often infer a correct diagnosis from a limited number of essential facts, but this is a license which few have a right to enjoy. For every induction is apt to be faulty that does not proceed from full information gained by a thorough and systematic objective investigation, coupled with the result of accurate clinical observation. While it is impossible for any busy practitioner to keep abreast with the kaleidoscopic details of chemical and biologic technic, he should, with a view to becoming a trained clinical investigator, supplement bedside observation by familiarizing himself with the use of the microscope and other instruments of precision, as well as utilizing the advantages offered by even a small private laboratory. The clinician who is a trained micro- scopist and avails himself of the practical advantages of the bacteriologic laboratory can often make an etiologic diagnosis which no amount of clinical testimony can shake. At all events, every progressive physician must acquaint himself with the fundamental basis on which laboratory methods rest, since a ready interpretation of the results reported from public labora- tories is a dominating necessity. The method of noting down all data gained in study of a given case is conducive to precision of results and amplitude of view. The important matter of comparing one case with another is also thus facilitated. As regards the best method of conducting an examination, it may be stated that the details of the procedure should be arranged under various heads. It is one of the objects of this work to teach the method of conducting an examination of patients, and to that end we submit the subjoined scheme, believing that if its structural details are rigidly and systematically pursued, the results will be in a form that shall be of the greatest practical value to the examiner. The object of the plan is not merely to enable the student and physician to render a diagnosis with precision, or to quicken his intellectual acumen, but to afford them an essentially practical knowledge whereby the indica- tions—more especially those that spring from causative conditions and agencies—for the amelioration and cure of the complaints which are recog-