The art and science of surgical diagnosis

Abstract

The History obtained by interrogation of the patient, and sometimes of other persons as well, is as important as any of the other legs of the diagnostic tripod if the whole thing is to stand up. Sometimes, when no physical signs can be elicited, it can be the single broad base of the structure. Its value is inestimable, its elicitation is a fine art and an exact science. It can make or mar any diagnosis. It can tax all one's skills and all one's patience. When totally deprived of its help, as with an unconscious patient or a small child or an unintelligible language, one can feel hopelessly disarmed. The science of surgical diagnosis can be taught and learned as can the method of scientific enquiry. It is indeed but one further example and application of the mental processes that constitute what one comes to a University to be trained in from one's very first days as a freshman. The subject for diagnosis is always a living patient in bed, and not a portfolio of radiographs or a sheaf of laboratory reports. This we must always remember, for reasons of science no less than of humanity.