A treatise on the principles and practice of medicine : designed for the use of practitioners and students of medicine / by Austin Flint.
- Austin Flint I
- Date:
- 1884
Licence: Public Domain Mark
Credit: A treatise on the principles and practice of medicine : designed for the use of practitioners and students of medicine / by Austin Flint. Source: Wellcome Collection.
Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.
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![scope may show significant intra-ocular morbid appearances when there is neitlier defect of vision nor any subjective symptoms referable to the eye. The careful study of the morbid appearances which are observed in different diseases, in connection with other symptomatic phenomena and post-mortem examinations, for a longer period, is necessary to determine the full amount of reliable information to be obtained from this source. It is certain, how- ever, that the ophthalmoscope is a highly important acquisition of modern clinical medicine as a means of investigating, especially, diseases of the ner- vous system with reference to diagnosis and prognosis, sustaining, in relation to these diseases, in some measure, at least, the same relation as the stetho- scope to the affections within the chest. In treating of the diseases of the nervous system, in the second part of this work, the symptoms furnished by the ophthalmoscope, according to the observations of those who have devoted attention to this field of clinical study, will be noticed. To distinguish with accuracy the varied morbid appearances which are to be observed by means of this instrument, requires an amount of skill which can only be obtained by giving to its use special attention, and by considerable experience. The student or i)ractitioner who desires to become a skilful ophthalmoscopist should, if practicable, obtain practical instruction from an expert, and he will, of course, consult works which treat in extenso of ophthalmoscopy.^ The symptoms and signs which occur during the course of a disease, are the events which make up its Clinical history. This phrase is applied to a description of the manifest phenomena taking place from the beginning to the end of a disease, together with the order of their succession and the laws which govern tliem. Or, instead of clinical liistory, it is proper to say the natural history of a disease, when the disease is allowed to pursue its course unaffected by disturbing influences of any kind, and when no attempt is made to arrest, abridge, or modify its course by therapeutical measures. How is the clinical or natural history of a disease to be obtained? There are three methods which may be employed. One method consists in selecting, as types of the disease, a few well-marked cases, and basing the description of the disease on the events observed in these cases. This method is defective, because some symptoms belonging to the disease might be wanting, and some symptoms not belonging to the disease might be present in these few repre- sentative or typical cases. Moreover, this method is inadequate to show the relative importance of particular symptoms. Another method is to make out a history from recollection, after liaving observed a greater or less number of cases. A history thus obtained must be imperfect from the obvious inability to retain in the memory all the events which occurred while the cases were under observation, together with the oixler and relative frequency of their occurrence. The third method is the only one by means of which an accurate clinical history of a disease is to be obtained. It consists, ^rs^, in the accu- mulation of a certain number of cases fully and carefully recorded; and, second, in an analysis of the recorded cases with reference to the symptomatic phenomena which occurred, the relative frequency of their occurrence, the order of their succession, the number of deaths and recoveries, the duration of the disease, etc. By this method are ascertained events which are con- stantly present, and, therefore, have an essential relation to the disease; events which are incidental to the disease, being present more or less fre- quently, and events the presence of which is purely accidental. There are many diseases which have not, as yet, been sufficiently studied after this ' The work by Dr. AUbutt On the Use of the Ophthahnoscope, etc., is the fiibest on this subject in the English laiignase. Dr. A. treats of the subject with comraendabh^ caution and candor. Vide Traite icouographique d'Ophthalmoscope ]jar N. Galezowski, Paris, 187U.](https://iiif.wellcomecollection.org/image/b21198135_0114.jp2/full/800%2C/0/default.jpg)
