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:
1890
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 Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    of comparatively modern times has taught us to enlist the sense of hearing, and demonstrated how a disciplined ear may detect the workings of disease in cavities into which the eye cannot penetrate. The effect of all these improved methods of study has been to give an immense impetus to clinical research, and thus to lead to the construction of a solid groundwork of experience in striking contrast with the looseness of former times. The advance in diagnosis thus attained forms, indeed, one of the most pleasing portions of medical history. When, by means of the aided or unaided senses, the symptoms of the malady have been discovered, the next step toward a diag- nosis is a proper appreciation of their significance and of their relation toward one another. Knowledge and, above all, the exercise of the reasoning faculties are now indispensable. The daily habit of investigating disease; a scrutinizing study of the anatomical lesions; chemistry, with its most searching analyses ; the microscope, with the wonders it reveals,—are all of little use, unless we have been taught the necessity of placing in connec- tion with one another the morbid signs they lay bare, and of considering in individual cases their respective value. Were it otherwise, the science of diagnosis would be simply a matter of memory. It is, however, this very analysis of symptoms and the lengthy process of induction attending it which make med- ical diagnosis so difficult and so unattractive to the beginner. He sees that by reflecting and reasoning on what are frequently but indirect manifestations he must find the seat and nature of disorders hidden from his view. Nor is it reasoning on the ascertained facts alone that is required ; the premises may be but probabilities; for, in truth, diagnosis deals at times with the logic of probabilities as much as with the logic of patent facts. Now, we are greatly aided in appreciating morbid signs, and in interpreting them correctly, by already existing knowledge. We look to landmarks which our predecessors have erected, and the gradually accumulated science of semeiology, rightly employed, furnishes the clue to the discovery of the disease. Thus the stores which medicine has laboriously collected during centuries can be used with advantage by all, and exist for the good of all. But an acquaintance with semeiology is far from being the sole guide to diagnosis, nor does it at once help to a recognition of the