DIAGNOSIS



Patient- Age, sex, nationally, occupation personal health, habits of living, family history.

Disease Symptoms and their peculiarities.

Lesions Character, evolution, size, shape, color, distribution, effects.

Causation.

Diagnosis.

Treatment.

Prognosis.

To explain the above, a few words concerning the patient, his disease and its lesions are necessary. Before proceeding to this brief explanation, it should be remarked that patience and tact are often required to elicit the facts, because inaccuracies of description and misuse of technical terms must be expected of the layman. The patient’s family and personal history, age, sex, nationality, civil condition, occupation, habits of living, general appearance and systemic or local disturbances should be noted. Inasmuch as these items have been discussed in the chapter on etiology, to which the student is referred for particulars, it is only necessary to emphasize a few items. Hereditary influence may be noted in the family history and particular attention should be paid to rheumatic, alcoholic, nephritic, diabetic, cancerous and syphilitic tendencies as well as the matter of drug habits. The question of previous attacks of the same disease, as may be noted in psoriasis, eczema and urticaria, is suggestive. Antecedent personal history should particularly disclose if the patient has had any of the exanthemata, syphilis, erysipelas, gonorrhoea, tuberculosis, typhoid fever, diabetes or pronounced gastrointestinal or mentonervous disorders. Habits of living should be carefully investigated because they frequently cause anemic or plethoric conditions practically diathetic in nature.

The disease manifests itself by general or local symptoms which may precede or attend the eruption. There may be constitutional disturbances during syphilis, leprosy, etc.; pronounced fever in most of the inflammatory, contagious skin diseases; itching in eczema and the parasitic dermatoses; burning or neuralgic pains in zoster. Some of these sensations are quite diagnostic, added to the clinical history. The same may be said of the odor attending some eruptions, mouse-like in favus, typically offensive in syphilitic, variolous and gangrenous ulcerations.

The duration of the eruption may aid in diagnosis. It is not always easy to arrive at the real facts as regards the normal duration of disease because some conditions disappear spontaneously while others can be relieved as quickly by the proper treatment. However, there are some morbid conditions that are typically acute, subacute or chronic. Among the eruptions of short duration, rarely exceeding a few weeks, may be mentioned dermatitis medicamentosa, dermatitis venenata, ecthyma, erysipelas, many of the erythemata, furunculus, herpes zoster, impetigo contagiosa, miliaria, and ringworm of the non-hairy surface. Among the eruptions of moderate duration, rarely exceeding two months, may be mentioned erythema multiforme, pityriasis rosea, pompholyx, purpura and the secondary syphilids. Many of the so-called chronic diseases are, strictly speaking, recurrent. Among these may be mentioned eczema, psoriasis, acne, seborrhea, tuberculosis cutis, lupus erythematous, tinea versicolor, erythrasma and many of the new-growths and neoplasms.

The course of the eruption is frequently characteristic. Thus it may appear all at once as in herpes; in crops as in varicella and pemphigus; continuously as in acne; by progressive spreading as in many cases of eczema and in parasitic diseases. It is well to notice the change caused in an eruption by scratching or by purely external methods of treatment and to note if the present lesions are primary or changed by past and present stages of evolution. While the collection of facts relating to a patient may be for the purpose of making a diagnosis, frequently the cause of the disease will be learned at the same time. It is in this particular that modern medicine is superior, inasmuch as the microscope and other instruments of precision enable the clinician to examine in detail parasites, sections of living tissue or morbid growths, and specimens of urine, sputum, feces, milk and blood. Bio-logic reactions should also be mentioned in this connection.

Frederick Dearborn
Dr Frederick Myers DEARBORN (1876-1960)
American homeopath, he directed several hospitals in New York.
Professor of dermatology.
Served as Lieut. Colonel during the 1st World War.
See his book online: American homeopathy in the world war