Case teaching in medicine : a series of graduated exercises in the differential diagnosis, prognosis and treatment of actual cases of disease / by Richard C. Cabot.

  • Richard Clarke Cabot
Date:
1906
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Licence: Public Domain Mark

Credit: Case teaching in medicine : a series of graduated exercises in the differential diagnosis, prognosis and treatment of actual cases of disease / by Richard C. Cabot. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    INTRODUCTION The most important lesson to be learned by every student of medicine is the art of recognizing the physical signs of disease, — a displaced cardiac apex, a succussion-sound, an Argyle-Robertson pupil. a malarial parasite. With these basic facts we can become familiar only by direct contact with patients and by long practice. But these data of physical diagnosis have to be interpreted. They do not crystallize spontaneously into conclusions. They do not arrange themselves in those significant groups which we call diseases. They have to be worked up into diagnoses by a reasoning process, and Un- reasoning needs practice. A man may collect with accuracy and thoroughness the data of the history and the physical examination, and then find that he does not know what they mean, — what judgment can safely be based upon them, which of them are of primary and which of secondary importance. For this secondary and relatively easy step in the development of medical knowledge, one does not need the actual presence of a patient. With a book and a teacher it can be learned anywhere and at any time as well as in the clinic. Indeed it is easier to concentrate atten- tion upon the processes of memory, comparison, and exclusion, which form the essence of diagnostic reasoning, if the senses are not distracted by the presence of the patient. After the student has learned to open his eyes and see, he must learn to shut them and think, and when he is thinking the less he has to distract him the better. To aid the teacher in training his pupils to think clearly, cogently, and sensibly about the data gathered by physical examination is the object of this book. I present these cases because I have found them useful in this type of instruction. They are selected from a much larger number which I have used and tested in case-teaching exer- cises during the past eight years. Advantages for the Student 1. By means of these cases and others like them we can present a boundless wealth of material, unhampered by the narrowness of our clinical resources.
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