Licence: Public Domain Mark
Credit: A manual of medical diagnosis / by A.W. Barclay. Source: Wellcome Collection.
Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.
64/642 (page 40)
![the special phenomena of disease, and it is a good plan I to ascertain, first, in what direction the sensations of I the patient point. Then it is important to remember ,1 that every ]ierson has a tendency to express a theoiy ■ of his malady, rather than to relate the simple facts of 1 which his sensations have made him conscious; not I satisfied with the knowledge that such and such effects 1 have followed, he always fixes his mind on what he I assumes to be their cause, and when asked what he I has to complain of, his answer is commonly framed in I the language of this theory. The French phy.sicians I have a form of question which seems to me veiy well I suited to avoid this evil; they ask, “oil avez vous mall” I and it would be well to adopt something of the same I kind among ourselves, rather to ask where is the com- 1 plaint, than what it is. I In making tlie observations which have just been detailed, it I not unfixMpienlly hajipens tliat some j'articular or unusual condition I is present, whicii oi’ itself lias a direct bearing upon the diagnosis I of the disease ; not, let it be understood, as a distinctive mark, or special diagnostic sign, Init as a phenomenon which, in the majority of instances, has hcen found associated with only one form of disease, or at least with a comparatively small variety of cases. Some of these are very distinct and unmistakeable, while others scarcely admit of description, and are only learned hy repeated observation. Even to the most jn-actised eye, such signs arc more or less uncertain, and the student should never place reliance on them : they arc hut solitary indications, and his object should be to acquire accurate knowledge, which is only to bn obtained by testing conclusions drawn from one series of observations, by others which arc as distinct I'rom them as possible. The sources of ] fallacy which especially alfect all these .s])ecial indications have \ been already noticed, and it is most essential to remember that ., they have no necessary or absolutely inseparable conne.xion with any one single morbid state, to the exclusion of all others. The deeper seated the le.sion in all these cases, the more liable are we to fall into, error. It surely needs no argument to prove that instead of tnisting to such sjx'cial signs, a systematic examination ot the whole synqjtoms of the case may not only lead to the dis- covery of some other disease in addition to that which the parti- cular sign, however truthfid, may have indicated, but it may also point out ])eculiarities in the case under observation which a more cursory view must overlook ; and with reference to treatment, both of these circumstances arc of much importance. A few of these •](https://iiif.wellcomecollection.org/image/b24989812_0064.jp2/full/800%2C/0/default.jpg)
