TALKS ON HEALTH.

Star (Christchurch), Issue 18188, 22 June 1927, Page 6

TALKS ON HEALTH.

(BY A FAMILY POCTOR.) From time Jo time the members of the medical profession are reminded, by one or other of their leaders, of a tendency which has been noticeable for a long time, and has been getting more and more marked lately: namely, the tendency of the doctor —especially the young doctor —to concentrate his interest on those series of impersonal symptoms that make up the text book pictures of most of the diseases to which names have been attached. Less and less, it is alleged, does the modern doctor cultivate an. interest in the patient, the individual. The great _ advance which has been made in certain scientific procedures which contribute largely to accurate diagnosis—such as radiography', bacteriology, blood-tests, and so on —has inclined the newer race of medical practitioners to rely' more on what may be called laboratory findings than on first-hand observation. Indeed, many modern physicians play a part almost entirely judicial. Having taken their various specimens, or directed the patient to the several specialists who will take the necessary specimens for themselves, the physician’s verdict is based very largely indeed oil the several reports that he receives from the radiographer, the pathologist, and the rest. Of course, this is never literally true, in its extreme form; but a very close approximation to it is frequent enough. Passing of the “Family” Doctor. If the tendency continues, and becomes even more pronounced, as it looks like doing, a totally new rela- ’ tion between doctors and patients is inevitable. The relation will become less and less intimate, less and less personal. The family doctor, who, in his ideal incarnation, understands the idiosyncrasies, family history, and do- ! mestic circumstances of his patient, has small place in the society towards which we seem to be moving. The matter, however, is not one entirely for regret. After all, so far as what are called purely' organic disorders (that is to say, disorders due to new growths, tumours, germs, and physical injuries) are concerned, impersonal science is far more likely to lead to a full and correct diagnosis, and, therefore, to successful treatment, than any amount of intuition, personal sympathy, and general psychologic nous. Of course, these things will help, even in treating the organic lesion, but they will not take the place of radiograms, electrocardiograms, or bacteriological tests. Unlabelled Disorders. But few human ailments come under the heading of the purely organic or structural. There is what is called a functional or neurotic element in nearly every sickness. Probably', in the majority of cases the functional predominates. This is where the doctor, trained and accustomed to regard the patient rather than the disease, scores over his more mechanical-minded confrere. When the thermometer and the stethoscope and the radiogram and all the rest of it reveal nothing abnormal the ultra “scientific” doctor is inclined to lose interest, and dismiss the patient with a contemptuous “Nothing the matter.” The patient obviously is suffering from no ailment for the recognition of which we have, at present, any instrument or laboratory test. Therefore, says our modern Calvinist, he can be suffering from no ailment at all. This is but an up-to-date form of the ancient fallacy that what one cannot see or hear or smell or touch does not exist. Science has, in the last two decades, added enormously to the diagnostic power of the doctor. It would be the merest stupidity to under-value these discoveries and the methods based on them. At the same time, it would be a great pity if these impersonal techniques were employed, not to supplement human insight and human understanding, but to replace them.