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.

    33/1016 (page 27)
    CHAPTER I. THE EXAMINATION OF PATIENTS, SYMPTOMS OF GENEPvAL IMPORT, AND SOME OF THE INSTRUMENTS EMPLOYED IN THE DIAGNOSIS. To elicit the facts of a case by a careful examination is, as has been stated, the first requisite for diagnosis. To conduct, however, a clinical inquiry with precision and facility, requires continual practice, and is rendered easier by following some well-digested plan. The advantage of adopting a method is clearly seen, if the attempts of a beginner be watched. He wanders in his search from one part of the body to another, attracted by different symp- toms in turn; pointless question succeeds to pointless question; and a conclusion, almost certainly erroneous, is finally jumped at, or an acknowledgment made of inability to arrive at any. Now, there are several ways which have been proposed to over- come this embarrassment. One of the principal consists in first questioning the patient with regard to his history. His age ; his occupation; the diseases from his childhood up; his habits; his constitution; the affections hereditary in his family,—are all minutely inquired into. After this the origin and progress of the existing disorder are traced, and the remedies ascertained that have been used against it. The present condition is then ex- plored ; each organ or each system being in turn interrogated. The investigation is now regarded as complete; the facts are con- sidered, and the diagnosis, prognosis, and treatment determined. This method of examining is termed the synthetical or historical. The analytical reverses the order. The present condition is first ascertained, and subsequently the patient's history or anamnesis. Both of these courses have something to recommend them, and to both there are objections. The synthetical method is the more purely scientific; but it is too full, and calls for too much labor, to meet the requirements of ordinary professional life. It is