The relation of the visiting and house staff to the care of hospital patients / by W. Gilman Thompson.

  • Thompson, W. Gilman (William Gilman), 1856-1927.
Date:
1906
Catalogue details

Licence: In copyright

Credit: The relation of the visiting and house staff to the care of hospital patients / by W. Gilman Thompson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    charge. One of these is the clinical laboratory, the other the overtrained nurse. The growth of so called “ clinical laboratory methods is phenomenal. They afford interesting and for the most part valuable aids to diagnosis, and be- ing visible and tangible methods they naturally im- press the mind of the beginner in medicine as open- ing a royal road to diagnosis—diagnosis “ while you wait ”—in the laboratory! Why give quinine if a single examination fails to reveal the plasmodium malarise, and why give it at all until the patient has had several chills, thus allowing time to discover the plasmodium? Why open the window and let in fresh air to the obviously tuberculous patient be- cause the first examination has failed to demonstrate the presence of the tubercle bacillus? Why begpn the treatment of chlorosis or lead poisoning until the exact proportion of polymorphonuclear nutrophiles or granular basophiles has been definitely estab- lished ? Far be it from the intent of this criticism to disparage the value of laboratory methods—i. e., the use of physical and chemical tests for diag- nosis. On the positive side they are often of great interest and practical importance, and may be of unique service (as when the accidental discovery of an eosinophilia in a routine blood count leads to the demonstration of an intestinal para!site). On the negative side, however, they may be actually harm- ful, if too much weight is given to such evidence, as when repeated failure to obtain a positive Widal re- action is made to outweigh bedside evidence of typhoid fever. In just so far as they lead the house staff away from bedside methods of close observa- tion they work injustice to the patient. T have known of a house physician who was so eager to search for leucocytosis in a case of pneu- monia that he was unable to tell upon which side of the patient’s chest the lesion was present. Surely