Clinical manual for the study of medical cases / edited by James Finlayson.

Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: Clinical manual for the study of medical cases / edited by James Finlayson. Source: Wellcome Collection.

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    it is the study of these, properly speaking, which affords to the well-informed physician almost the whole basis of objec- tive fact out of which a morbid tendency, or diathesis, can be inferred with a fair amount of probability. In other words, diathesis, as a study of facts, in an individual case, is an inference either from previous facts in the history indicating deranged physiological function, or from manifest structural changes, the result of these; whereby we are enabled to estab- lish, but only as a presumption founded with more or less pro- bability on the evidence, the existence of a tendency to similar changes, or changes of some allied order, in the future. In other words, the proof of diathesis is essentially the proof of disease; but, it may well be, disease in its earliest manifesta- tions and least notable forms. There is a whole group of diseases, for example, which affect the human body chiefly or exclusively during its period of growth, whether of early infancy or of adolescence ; and another group, the first approaches of which are usually observed only along with, or succeeding, the physiological signs of senile decay. As regards the latter group, it may be said with truth that physiology and pathology are inextricably intermingled. A too early arcus senilis, the premature development of crow's feet at the outer margins of the eyelids, wrinkles in the skin of the face, diminished sensibility of the retina, or early presby- opia ; still more, the well-known changes in the arteries, twist- ing or rigidity of the radials, etc.; falling or greyness of the hair, diminution or loss of sexual activity, and cessation of the catamenia in women ; all of these (and yet perhaps none of them to disease. ... If there be a distinct proclivity, we must then use a stronger terra, and speak of diathesis (p. 3). Temperament-the original vital endowment of the individual—is unquestionably a real force, and one which we would most gladly recognise and estimate if we could. The scepticism which I have been expressing applies not to the reality of the thing, but to our ability to discriminate it (p. 22). The whole work, in fact, although perhaps not suitable for beginners, may be commended to advanced students as a commentary on the rules and methods of diagnosis recommended in this chapter.
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