Practical diagnosis : the use of symptoms in the diagnosis of disease / by Hobart Amory Hare.

  • Hare, H. A. (Hobart Amory), 1862-1931.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Practical diagnosis : the use of symptoms in the diagnosis of disease / by Hobart Amory Hare. Source: Wellcome Collection.

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    disorder on her tongue, it is well to remember what Battey, of Georgia, said in regard to this condition : ''Always believe a young unmarried woman with abdominal tumor, of high social position and unimpeachable virtue, if she has been watched over by a platonic and abstemious young cousin of the male persuasion while the mother went out, to be pregnant. Again, if a married woman of some years tells her physician that she has no children, the physician naturally asks some questions which elicit the fact that she has had frequent miscarriages. He in this way finds quite as much about probable syphilitic infection as if the question had been put: Have you ever had a sore on your privates, which would embarrass the patient, produce domestic troubles, and probably be lied about if she was forced to answer the question. Again, when asking a woman about the health of the living parents, or the cause of death of the dead, care should be taken not to ask a direct question, as, for example, whether the mother has died of cancer, for the patient may be already greatly worried lest she has that disease. It is better to ask the cause of death, or of the illness she is suffering from. If the story is that the parents died of''bronchitis, in all human probability the real cause of death was tuberculosis of the lungs. If the patient complains of pain, past or present, the best way in which to discover its true seat is to ask him to place his hand on the affected part, as in this way errors in his description of his anatomy will not be committed, and false impressions will not be conveyed to the physician's mind. Even this direct method of showing the area of pain is not to be absolutely relied upon, for often pains are referred to parts in which there is no disease. Thus, the pain of coxalgia is apt to be felt in the knee and ankle, and in children the pain of acute pulmonary disease is often described by the patient as felt in the abdomen. If the pain has been really abdominal, there will, in most cases, have been diarrhoea or free passage of flatus. It is not to be forgotten, on the other hand, that a question which discovers the fact of several movements of the bowels does not prove the pres- ence of true diarrhoea, because a purgative may have been taken by the patient. In asking questions as to constipation the physician must not for- get that the opinion of the patient as to what constitutes regularity of bowel-movement is of very little value in many instances. A