Medical diagnosis : with special reference to practical medicine : a guide to the knowledge and discrimination of diseases / by J.M. Da Costa.
- Date:
- 1890
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 Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
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![malady. There are few symptoms in themselves distinctive ; and often a symptom may be due to one of several causes. Semeiology informs us of these different causes; but to find out the precise meaning of the abnormal manifestation in an individual case, we have to draw our inference from all tlie signs encountered ; to compare them with one another; to seek out those that are in the background. We are thus arriving, step by step, at the explana- tion of the morbid appearances, the starting-point in deduction always being what is known of the affection the presence of which is suspected, and the symptoms of which we are contrasting with those before us. For the conclusion to be valid and exact, it is of course requisite that each part of the testimony have the proper position assigned to it. In reasoning correctly on symptoms, the same laws apply as in reasoning correctly on any other class of phenomena: the facts haye to be sifted and weighed, not merely indiscriminately collected. And while the intellectual act is being performed, much collateral evidence is to be sought before a final judgment is given; especially is it necessary to view the symp- toms with constant reference to the age, sex, and habits of the patient, and to the circumstances amid which the disorder develops. To accomplish all this effectually, the physician has need of much and varied knowledge. He must be master of something more than of the information supplied to him by semeiology. He must be an anatomist to pronounce with certainty on the seat of the malady; a physiologist to appreciate the state of the great centres and the aberration of function. Above all, he must be a pathologist in the full sense of the term : he must undei-stand the antagonism between diseases; the frequency with which they coexist; the influence of remedial agents on them ; and be cogni- zant of their natural history and of the general laws governing them,—for how else can he form an estimate of morbid action while in progress? Then it is desirable that he should be aware of what are their current divisions and classifications. From what has already been represented, it is evident that he must also be a correct reasoner; for even a good observer by bad reasoning, arrive at a faulty diagnosis; just as sometimes a bad observer may, by the same ])rocess, blunder into the truth. There is, indeed, no end to the extent of knowledge which may be brought to bear in working out a conclusion regarding the char-](https://iiif.wellcomecollection.org/image/b21934812_0024.jp2/full/800%2C/0/default.jpg)
