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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    2. Take care, in making both the oral and deal examinations, not to do anything whieh is likely to offend the dclicaey of the ixitient.—The only reason for directing attention to this rule, which insensibly guides the conduct of all right-thinking men, is to point out that no examina- tion which the practitioner is called upon to make, is in itself indeli- cate, provided that it is necessary and made in the right spirit. Young ])ractitioners are sometimes apt to forget this. I have met with cases in which a mistaken idea of delicacy has led to errors in diagnosis, by interfering with the thoroufdi investmation whicli the circumstances of o o o the case required. 3. Endeavour at the outset to gain the confidence, esteem, and respect of the p>atient.—The importance of gaining the full confidence and trust of tlie patient is so ol)vious—-both with the object of getting full infor- mation regarding his illness and complaints ; for the puiposes of treat- ment (for in many cases the mere impression jiroduced on the mind of the jiatient by the presence of tlie practitioner, and liy a hopefully ex- ]iressed and confident opinion, is far more powerful as a curative agency tlian all the drugs of the pharmacopeia) ; and indeed for one’s whole success—that it need not lie furtlier insisted u])on. The man of average ability who acts with courtesy and kindne.ss tem})ered with firmness and decision, who takes a .sympatlietic interest in the complaints and sufferings of his patients, who regards them not merely as so many cases of this or that disease, but as fellow-creatures, doing to them as he would wish to be done by, need have no fear as to his success. 4. Do not he in too great a hurry to conunence the p>hysical examina- tion.—Many patients, more e.specially women and children, are con- siderably disturbed by the entrance of the doctor; care should be taken to allow their agitation to subside before the pulse is felt or the examination commenced. A little time, a few general remarks, and above all, a self-possessed and confidence-inspiring manner and address, are usually all that is required. 5. Xever ask the same question ticice.—Mr Syme, from wliom 1 learned this rule, used to point out that if the same question is asked twice, the patient is very apt to think that the practitioner’s thoughts have been wandering, and that he has been giving no attention to his statements and complaints. AVithout doubt such a conclusion would, in many cases, lie correct. Fortunately it is not, as a rule, hard to get out of the difliculty. - Whenever I have made such a mistake I have at once perceived my error, and have, as a rule, been able to cover my retreat. AVhen, for instance, I have, through forgetfulness, asked the patient to .show his tongue a second time, 1 have, perceiving
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