DOCTORS AS DETECTIVES

Star (Christchurch), Issue 7329, 15 February 1902, Page 1

DOCTORS AS DETECTIVES

Sow Olovor Medical Men Tracls Out Complaints. (Pearson's Weekly,) To the average mind, a doctor diagnoses a complaint by certain set methods, such as feeling the pulse, looking at the tongue, or sounding the heart. As a matter of fact, these things often count far less in divining what a patient is suffering from -than certain little peculiarities in dress, look or j manners. To be an ideal doctor, it is necessary to be able to read people after the manner peculiar to Dr Conan Doyle's wonderful detective. Neglect of the quality >of observation has often led to complete misapprehension of a patients complaint, where a little element ary' reasoning would have at once got at the cause of trouble, and terrible suffer.ng has often resulted through wrongly treating such, cases. , J A woman went to a hospital recently, , complaining of a skin disease, which had showed itself in her head. She was taken to the skin specialist, andi in his company were one or two younger doctors. The specialist examined her head and divined what looked like a disease called' purpura. There were several spots of the same size, and all were confined to a, small area on the left side of the head. The specialist was baffled, but prescribed a tonic for the com* plaint mentioned. »■■•'■ One of the young doctors present, how-^ ever, was a keen .observer of small things^ about the patients, andi be had noticed a* peculiarity about the woman, which was the real causa of her complaint. Had he not carefully observed her movements, it would have been quite overlooked. She was left-handed, and brought a child with her by the left hand — a most unusual thing to do. When she took her hat off it was with the left hand, and this had' not escaped the doctor in Question. When she was about to go, he watched her put on her hat, and pin it in. Then he told her to remove it again. She did so, and on examining her head, he saw that she had made, ever so slight a prick on the left-hand side. THE HAT TIN BESPONSIBLE. " I thought so," said the doctor. "She is not suffering from skin disease at all. Those spots are entirely the result of a constant pricking of the head 1 caused by pinning on her hat left-handed." In a very, short time,, she was treated for this, and the rash disappeared. Had it not been that the young ' doctor was a minute observer of every detail in a patient's appearance, manner and walk, she might have been -treated for an entirely different complaint^ with who knows what results?. ■ This incident shows how important the quality of detective-like observation is m a doctor. He should, in fact, have a good many of those methods associated with Sherlock Holmes, and notice everything about a patient, before making a diagnosis. The same doctor diagnosed another case in a similar way, that is, by observing outside things about a patient, which, when a doubt* arose as to her complaint, gave him- a sort of clue to the mystery. This time it was a young girl, who was brought to a hospital on, account of ;her limping. As a alight limp is the earliest,sijm crf.Mp__disease,,ifce young x sraS&feoner first consulted concluded that ifliis' was; what she was suffering from: , As hap disease does not reveal itself on'the outside of the limb, 'but comes from infernal causes, there was nothing to wove the doctor wrong. But his more observant colleague _ had noticed that the patient -wore very, pointed: shoes. EYES BEVEAI. MANY THINGS. . Curiosity prompted him to examine her f OO !t a thing the other doctor wouldi not have d-rea/mt of doing—^and' the result revealed rthaftthe girl suffered from dngrowing toe-nail. This was the sole cause of her limping, and' sh« was not suffering Xrom hip disease at all. Yet, had tfhe doctor not shotted those tight shoes, and made a deduction accordingly, she would have been treated quite wrongly. Children iv slums are ( often taken to hospitals for general debility. This arises from various causes, and there is, of course, certain regular treatment for it. One child was taken to the doctor, above mentioned. From, its symptoms it might have been a consumptive, andi treated 'according- j ly, but the doctor noticed that the child had a squint. He at once saiw, to this peculiarity, the cause of the whole trouble. The constant straining of the eyes involved upon a child with a squint meaas a strain to -the brain, and the strain to the brain affects the nerves, muscles, and the whoie system. Thus the general debility which ensued. By treating the child) for am eye complaint, dnstead of an organic disease, he soon put it on the way to recovery. j Women have often been knowm to take children to doctors saying tihey have convulsions. An unobservant doctor would treat them straight away, and, perhaps, commit a- complete mistake. If the child has completed! its teething, and its teeth, j aTe in good condition, tihere will probaibly be no reason for convulsions. Examination: of its clothing will, in all probability, reveal the cause as a safety .pinflpimned through the skin, or some other careless act, which, would account for the agony suffered. There are a score of ways iaai" which' you reveal yourself to a doctor, quite apart from those mentioned. Your eyes are not only the windows of your soul. They are no less the windows of your state of health. One glance at your optics may tell a doctor more about your complaint than all the testing of the body, and 1 , though they do not always reveal the nature of your complaint, there are many ailments which assert themselves in the eves in a manner peculiar to themselves. Diabetes is one of these, and reveals itself in a cataract m the eye. This is not always noticeable at a casual glance, but an observant doctor will spot it, and 1 know at once what is the "matter with you. Clironic poisoning, kidney diseases and other complaint® equally reveal themselves ait the back of. the eyes/ but this would not be noticed save by a doctor who understood the eye thoroughly. Doctors ignorant of this, would, perhaps, pass over one of the most valuable guides in diagnosing you. The manner in which, you walk is, in 1 the case of several diseases, a direct guide to your oomplaint, but a doctor unobservant of such, a peculiarity, might- go wrong entirely. Locomotor ataxy is one of these complaints, and reveals itself in your walk. A sufferer from it has a veiy high-stepping walk, and always carefully looks where he is treading. Observation of this peculiarity, therefore, gives a doctor the necessary clue. HOW THE SJIOKEB IS FOUXD OTTT. An epileptic drags his limbs one after the other, and' ai doctor given to observation will spot this on his entering, »nd know at or.cc what ails his caller. V * .non-observant dwtor will overlook this a highly important sign. ... A knowledge of your daily habits "h™ greatly affect a doctor in diagnosing your complaint. Ate you a smoker, a drinker, do you keep late hours, or hurry over your meals, is your occupation a sedentary o active one? All these are- vital pom'ts xne average doctor will ask you pom* b ™ th«ere things. The " Sherlock Holmes doctor " will know f rom a glance without asking you. As, generally speaking, doctors consider all patients are liars-, the latter is the more trust worthy method 1 of raiding out. A smoker of cigarettes has certain P ecU ] liarities which au observant man wi" flO " v

tice. First, bis fingers show the extent to ■ which be smokes, and often the depth of the nicotine will reveal the kind of tobacco used. Further, the constant cigarette ; smoker keeps has case in a right-hand breast pocket, and uses his left, inand to- ] get the case out. The pipe-smoker shows nothing on his haii'ds, and generally keeps : his pouch in am outside pocket. Late hours reveal themselves in the look about ithe eyes, and a " cute " observer will very soon divine what your probable occupation is. The methods of divining this are too well known to need repeating, but as to how valuable they are ■ in enabling a medical man to correctly find out your complaint will be obvious to everyone.