Practical medicine and medical diagnosis / by Byrom Bramwell.

  • Byrom Bramwell
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Practical medicine and medical diagnosis / by Byrom Bramwell. 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.

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    exteiuliiig Llic periud ul'study—an c.xtra year devoted to the tiiial sub- jects M'ould 1)0 highly advantageous—or, if that cannot be done, it would be better, I think, to limit the subjects rc([uired for the purposes of examination—more especially some of the preliminary subjects—and to demand a thorough knovdedge of the great principles of medicine, and of all the common and important medical affections, rather than an imperfect smattering and ‘cram’ knowledge of the M'hole. While, therefore, I am of oj)inion that too much detailed knowledge of rare and obscure aflections should not be required for the purposes of a pass exaiidnation, I think, and think most strongly, that no student should be allowed to enter practice who is not thoroughly versed in the details of clinical investigation and of clinical Mmrk, and who is not practically familiar with all the more important instruments, such as the laryngoscope, the ophthalmoscope, the electric battery, etc., which are used in medical research. Unless you acquire this sort of know- ledge during your student days, you wdll probably never acquire it; and unless you possess this knowledge, you vdll not be so well fitted, as you otherwise would be, to add to the science and progress of medicine. 8ome of you may perhaps say, ‘but we intend to be general practitioners, and what opportunity shall we have of making original observations.’ llelieve me—and I speak from some years’ active experience as a general practitioner—your opportunities will be great. To mention one point only, the general practitioner sees disease from its commencement, he lias, consequently, better o])portunities of ascertaining its causation than the hospital physician, to whom cases are brought in their later and more developed stages. Hence the general practitioner is much more likely to discover the means by which diseases can be prevented, and I need not tell you that ‘ prevention is better than cure.’ If you enter into practice with the desire and determination to observe and record clinical facts you will find your work a pleasure, you will treat your patients much more satisfactorily, and you will get reputation and prac- tice more quickly than if you looked upon your profession as a mere business and matter of routine. Importance of a full and accurate Diag-nosis.—Xow, the great object of the physician is to cure disease, or if, as unfortunately too often happens, that be impossible, to relieve suffering and to prolong life. Treatment is therefore the point which we must always keep in view. In order that our treatment may be rational and scientific, it is neces- sary in the first place to ascertain exactly, or as exactly as the present state of medical science wdll allow, the morbid condition or conditions which are present; in other words, to make a full and exact diagnosis.