A clinical text-book of medical diagnosis for physicians and students : based on the most recent methods of examination / by Oswald Vierordt ; authorized translation, with additions, by Francis H. Stuart.

  • Vierordt, Oswald, 1856-1906. Diagnostik der inneren Krankheiten. English
Date:
1898
Catalogue details

Licence: Public Domain Mark

Credit: A clinical text-book of medical diagnosis for physicians and students : based on the most recent methods of examination / by Oswald Vierordt ; authorized translation, with additions, by Francis H. Stuart. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    ratus of the man or woman, but especially the question of syphilis. The puerperal period, even when it does not pursue an unfavorable course, may in various ways be a source of disease. 3. Diseases which one has had—not only acute diseases, but the temporary outbreak of a chronic disease ending in apparent or real recovery. Certain acute diseases may have as sequelae certain other diseases which either are directly connected with them, as paralysis following diphtheria, nephritis after scarlet fever, or which appear after a shorter or longer period, as valvular disease of the heart from endocarditis in acute articular rheumatism, arising during scarlet fever. The outbreaks of a chronic disease are often spoken of by patients as diseases which they have gone through ; as, especially, the primary and secondary affections of syphilis, temporary manifestations of tuber- culosis of the lungs, etc. Some acute diseases are not prone to attack a person a second time. This is true of scarlet fever, measles, and typhoid fever. [But it is not uncommon for a person to have measles two, three, or even four times, and a second attack of typhoid fever is occasionally met with.] Cer- tain other diseases, however, are liable to befall a person again, either because they leave behind a general disposition, the nature of which we do not understand, or because they produce some chronic local changes which give occasion for a new attack of the disease (erysip- elas, malaria, pneumonia, articular rheumatism, appendicitis, and peri- typhlitis). Certain diseases of childhood are especially to be considered —for example, scrofulosis as early indication of tuberculosis ; mani- festations of hereditary syphilis ; frequent convulsions as an early sign of anomalous condition of the nervous system. The diseases ordinarily designated as children's diseases generally have no significance as to the future, but yet sometimes, unfortunately, they leave lasting suffering behind them, as emphysema after whooping-cough, etc. The Present Disease. 1. The possible exciting causes must be first considered. It is espe- cially important for the early diagnosis of an infectious disease to in- quire whether the patient has been exposed to infection. Many diseases are conveyed by a very short exposure; others require a longer exposure or even a personal contact. Also the period of incubation must be con- sidered. This is the period from the moment of infection until the outbreak of the disease. With most transferable diseases this period is of a known, somewhat exactly defined, duration. Moreover, taking cold, over-exertion, improper eating and drinking, taking of poison, etc. come under consideration. It is to be remarked that the laity often assume something as an exciting cause, thus especially taking cold. 2. The first appearances and the course of the disease up to the time of examination. With chronic diseases the first appearances are sometimes, at the beginning, scarcely noticeable: they often consist only in a change from the previous behavior, unless the new condition in itself directly