The diagnosis, pathology and treatment of diseases of women : including the diagnosis of pregnancy / by Graily Hewitt.

  • Hewitt, Graily, 1828-1893.
Date:
1868
Catalogue details

Licence: Public Domain Mark

Credit: The diagnosis, pathology and treatment of diseases of women : including the diagnosis of pregnancy / by Graily Hewitt. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    positive ones. The experienced observer may know at once how far special facts can be safely neglected, but the student having yet to learn which are important, which trivial, must pass over none. The beginner Avill find that the labor bestowed by him on the investigation of the minutest details of the case before him will not have been thrown away. A habit of exactitude has been acquired, a habit of system has been induced, invaluable in so far as they tend to exactitude in the results obtained. While thus occupied in the acquirement of the art of observing, the student learns much which it is impossible to possess himself of in any other way. The constant practice of putting questions familiarizes him with the art of cross-examination, and makes him acquainted with the best method of securing correct answers. It is always best to leave as little as possible for the patient to do. The questions put as to matters of fact should be put so as to re- quire a simple negative or affirmative on the part of the patient, and it is hardly necessary to say that leading questions can elicit no information to be depended upon. When, however, the patient's sensations or feelings are matter of inquiry, it is the better course to allow them to be described by the patient, merely insisting on the arrangement of these in a proper chronological order. In the next place it is well to be aAvare that facts stated, often do not warrant the interpretations put upon them by the patient. Thus, a patient may say that his or her father died of consumption, but it is not to be immediately concluded that such was the case. It must be ascertained what are the grounds for this opinion, and, if possible, corroborative evidence, jjro or con, must be obtained. In short, the statements of a patient with reference to any disease are valueless unless accompanied by a description of the symptoms and course of that disease. In the case just supposed, if it be found that the father died at the age of twenty-eight after an ill- ness of one year or upwards, which began with hsemoptysis and cough, and was followed by purulent expectoration, wasting, night sweats, and so on, the assertion that the individual in question really did succumb from the disease called consumption may be considered as nearly conclusive. These matters may seem of little importance; but, seeing how great are the difficulties which now and then present themselves in the attempt to form a diagnosis, no information is to be despised. The scale is often turned in favor of a particular view of the case by a fact in itself trifling, but which, in conjunction with others, forms an element in the consid- eration of very great value.