Medical diagnosis, with special reference to practical medicine : a guide to knowledge and discrimination of diseases / by J.M. DaCosta.

  • Jacob Mendes Da Costa
Date:
1870
Catalogue details

Licence: Public Domain Mark

Credit: Medical diagnosis, with special reference to practical medicine : a guide to knowledge and discrimination of diseases / by J.M. DaCosta. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    30/850 (page 28)
    CHAPTER I. THE EXAMINATION OF PATIENTS, AND SOME SYMPTOMS OF GENERAL IMPORT. To elicit the facts of a case by a careful examination is, as has been stated, the first requisite for diagnosis. To con- duct, however, a clinical inquiry with precision and facility requires continual practice, and is rendered easier by followin.^ some well-digested plan. The advantage of adopting a method IS clearly seen, if the attempts of a beginner be watched He wanders in his search from one part of the body to another, attracted by different symptoms in turn; pointless question succeeds to pointless question; and a conchision, almost cer- tainly erroneous, is finally jumped at, or an acknowledgment made of inability to arrive at any. Now there are several ways which have been proposed to overcome this embarrassment. One of the principal consists in first questioning the patient with regard to his history. PIis age; his occupation; the diseases from his childhood up; his habits; his constitution; the affections hereditary in his family,-are all minutely inquired into. After this are traced the origin and progress of the existing disorder, and the remedies ascertained that have been used against it. The present condition is then explored; each organ or each sys- tem being in turn interrogated. The investigation is now regarded as complete; the facts are considered, and the diag- nosis, prognosis, and treatment determined. This method of examining is termed iha synthetical or historical; another, the analytical, reverses the order. The present condition is first ascertained, and subsequently the patient's history or anam- nesis. Both of these courses have something to recommend them, and some strong objections. The synthetical method is the more purely scientific; but it is too full, and calls for too