The examination of patients

Front matter

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Preface

This book has been written in the belief that it will help practitioners of medicine. Its aim is to present as clearly and concisely as possible, methods of determining the facts on which accurate diagnosis rests. For the most brilliant discoveries in therapeutics or the most skillful surgery avail nothing if the patient's disease is not correctly diagnosed. Experience in hospital and private practice has impressed upon me the need for such a book to furnish an intermediary between the classical description of the textbook of medicine and the treatise on the latest methods of treatment. Refinement of diagnosis compels the use of the trained senses of touch, sight, and hearing. The development of laboratory methods has diverted attention from these fundamentals. Those of us who have lived in laboratories as well as hospital wards may realize this fact, but the realization is not general. Rarely can a laboratory test alone reveal the nature of disease. Usually it is a support to other evidence — a bit of data like other signs to be weighed in forming opinion. Not even a throat culture which is positive for Klebs-Loffler bacilli is alone sufficient to demonstrate that an individual has diphtheria; he might be a carrier, or the organism might be non-pathogenic.

It has been a matter of doubt in my mind whether I can describe methods which I have taught for years by demonstration. But I have faith that the earnest worker will make up for any deficiency by practice. A refined technique is always a product of the individual.

Nellis B. Foster.

New York.

Contents

„ _ Paqb

The Theory of Diagnosis 17

Anamnesis — The Clinical History 20