A Handbook of Medical Diagnosis for Students (Classic Reprint)

Excerpt from A Handbook of Medical Diagnosis for Students

The most important question the physician is called upon to answer when he is at the bedside of his patient is not what is the cause of the disease or its proper treatment, but what is the disease. What is the matter? The mastery of the diag nosis is half the battle. Treatment follows naturally when the ailment is known, and especially if an operating causal factor can be removed. Now, just as treatment is either rational or empirical, so diagnosis may in a sense be rational or empirical - rational where the physician in diagnosing typhoid fever or pneumonia has a clear conception of the causative agents of the disease, the pathological processes thereby excited and the morbid changes wrought in various organs of the body with consequent alteration of function; empirical where, without any deep insight into the changes produced, he recognizes by certain clinical features the like ness of the case in hand to the case of his text-book, and so names his disease, and prescribes according to name and not the actual condition of the patient before him.

The ability to make an accurate and, at the same time, rapid diagnosis is, in a measure, a gift, but in much larger de gree the result of careful training and experience. Students are prone to look upon the diagnoses of their preceptors or clinical instructors as made by intuition. But the accurate diagnosis is made as the result of observation and reasoning.

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