Diseases of the nervous system : a text-book of neurology and psychiatry / by Smith Ely Jellife and William A. White.

  • Smith Ely Jelliffe
Date:
1935
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Licence: Public Domain Mark

Credit: Diseases of the nervous system : a text-book of neurology and psychiatry / by Smith Ely Jellife and William A. White. Source: Wellcome Collection.

    31/1210 (page 27)
    CHAPTER I. METHODS OF EXAMINATION OF THE NERVOUS SYSTEM.1 The student of human disease, whether manifesting itself through faulty integration of the vegetative mechanisms, through disturbance in somatic sensorimotor pathways, or in faulty social conduct, should first learn a precise systematic series of methods for examining his patients. Such a scheme of case-examination should be orderly, and sufficiently extensive to enable him first to make a rapid sizing-up of the chief features of the disturbance under investigation. The first approach should be general and not detailed. A broad perspective is the primary requisite. • A minimum requirement case-history should include a study of the I. Family History. II. History of Patient’s Previous Life. III. History of the Present Illness. IV. General Observations. V. General Examination of Bodies—Major Organs. VI. Examination of Vegetative Nervous System. VII. Examination of Somatic Sensorimotor Pathways. VIII. Examination of Mental Functionings. For the sake of convenience the main factors to be covered are here given in the form of printed questionnaires. Such printed schemes have advantages as well as disadvantages. If carefully and thinkingly used the former outweigh the latter. For the beginner to whom this book is addressed chiefly, such routine examinations well systematized are the first steps in the development of a technic of case-examination which will prove invaluable. It is not thought that other forms may not prove as satisfactory, but some definite scheme is indispensable. Questionnaires.—The heading, size, form of binding, of ruling, etc., will be determined by local conditions and by special needs. The definite data which are noted in the questionnaires are not by any means' all of the observations which may be collected, and such printed question blanks are given here simply as guides, rather than as finished products. As practical blanks for out-patient dispensary work they are valuable and also for note-taking in private work. In hospital work where it is hoped that autopsy material may afford opportunities for research, the main data are essential, but they are insufficient for detailed studies. A general-status blank is advisable. Such a blank is here given in short form. Its details are discussed later. 1 This chapter cannot claim to be a semiologie. Advanced students should consult special works. The most complete is that of Dejerine: Semiologie des Affections Nerveuses. The work of Levy-Valensi, Diagnostic Neurologique, is very practical. In English, Purves Stewart: Diagnosis of Nervous Diseases; Barker: Monographic Medicine vol. 4. Tilney and Riley: Forms and Function of the Nervous System, and Oppenheim Textbook, tr. by Bruce, are recommended. Frequent footnotes refer to special studies of significance and further tests of function are found in later chapters.