Principles of diagnosis and treatment in heart affections / by Sir James Mackenzie.

  • Mackenzie, James, 1853-1925.
Date:
1916
Catalogue details

Licence: In copyright

Credit: Principles of diagnosis and treatment in heart affections / by Sir James Mackenzie. Source: Wellcome Collection.

    22/280 (page 10)
    had little difficulty in recognising that he had that form of paroxysmal tachycardia which is due to auricular flutter. I was fortunate in catching him during an attack and obtained polygraphic and electro-cardio- graphic records which confirmed the diagnosis. The observer himself must be trained before he can interpret the sensations of abnormal heart action. My object in giving this illustration is to draw atten¬ tion to the manner in which this abnormal action was recognised. In the first place, the observer had to be trained. To obtain the knowledge necessary for elicit¬ ing the information from the patient I had devoted over twenty-five years to the study of abnormal actions of the heart. I had to learn how to differentiate one abnormal action from another. I have had opportuni¬ ties of observing a number of people during these at¬ tacks, and I have made a study of attendant circum¬ stances, such as the behaviour of the heart when an attack is in progress and when it has passed off. I have inquired carefully into the sensations that were provoked in the patient during the different phases of the attack, so that now, after many years’ study, I am capable of eliciting from the patient the essential facts which make it possible for me to recognise and interpret his sensations. You will gather from this that, before we are capable of appreciating the patient’s sensations, it is necessary for us to have experience of a large number of indivi¬ duals who have suffered, and to have made a careful correlation of their sensations with the morbid con¬ ditions which may be present. You will thus realise what it is I am driving at when I say that the systematic investigation of the patient’s sensations would reveal the early stages of disease; but it is absolutely neces¬ sary that the investigator shall have a long and careful training if he is to be capable of eliciting and under¬ standing the facts.