DIAGNOSIS

is the recognition of the cause of any ill-health, Correct diagnosis must precede rational treatment, and until it has been made treatment should be of a simple and cautious nature. It is for this reason more than any other that medical aid is so valuable and in the future will be of more and more value according to the progre made in the perfection of diagnostic methods (c/ the value of the stet has cope, thermometer, or X rays). Disease should be dealt with by the detection of the cause and then by methods direoted to the removal of that cause. A diacnosis is mado in the following way. The symptoms for which the patient seeks advice are first cnquired for; next the account of the illne given by tho relatives is often taken, this is often useful, as in the description of a fit for instance, and then the patient is carefully examined, beginning with the organ which from the history of the case is ap tly at fault; for instance the patient has a cough, Bn pac and lo of weight, the chest is then neancel in the expectation of finding signs of consumption; or paralysis, when the nervous system would be taken first, but al the organs receive attention, for it is important to know whether these are sound or not in addition to knowing the state of the organ principally affected. Questions relating to family history, and to personal habits in regard to food, work, tobacco, alcohol, regularity of the bowels, monthly lo and the like sh then ripe to be asked ee ae at the beginning, it is of great importance that such questions should be answered fully and aay Diagnosis at homo is nece arily limited, because the layman cannot sound a chest or test the urine, etc., and the parent should be prompt to distinguish ill-health from lazine or pe amongst his children rather than —- to decide what illne his child has. No one should spend time in attempting to diagnose his own condition, to do so by concentrating attention on a symptom is to exaggerate it and do harm. Moreover, the po ible causes of any one symptom are so great that diagnosis cannot be made except by 3 broad view of the patient, his habits, his past history and his inherited tendencies. There are at least twenty distinct groups of causes of hcadache, each of which are subdivided further. There are quite half as many po ible causes of pain in the back, ranging from a strain to an ancurism and soon. Hence the habit of buying eo and so's tincture, pills, pastilles or what not because you are breath-: le on exertion. have a bad taste in the mouth on waking,. or suffer from pain in the back, eto,, is a custom only worthy ‘ of the middle ages, if that, and is as different from the usual l way of doing busine as it is po ible to rr <i In detecting illne from health amongst children the following oints deserve attention. A good tempered child that Sanam irritable or a mischievous child that is suddenly quiet is probably ill; a child, which not only does not want to go to school but also does not want to play is almost always ill. Lo of appetite, headache, vomiting, diarrhoea and sore throat should receive prope attention, and a rash in such cases should be looked for as any of these symptoms sf be the onset of one of the fevers, and if the temperature ia found raised, isolation for a day or two is wise. The attitude of a healthy child more is with the cheek in contact with the pillow ps often with the back up and the abdomen in contact with the bed, If the child be on its side with its head drawn back and the neck rigid, meningitis has to be feared; if it lies on its back with its legs drawn up and its abdomen distended and hard it probably has colic due to wind or something wrong in the abdomen; if it pre es its forehead into the pillow persistently, it may be because the light 7 agesie owing to conjunctivitis or the onset of measles. © movements during ri are normally absent, hence twitching or rolling of the head from side to side are signs of illne , the ite srapon may be due isomer; Tho expre ion is a valuable sign, especially to who knows the usual expre ion so well The cry is Beare in illne . It is lost when tho child is very short of breath, as in bronchopneumonia, and in extreme weakne , when the features look as though the child were crying, but no sound is produced; it is often paroxysmal in celic and ince ant with earache; a shrill scream at intervals with. drowsine between whiles occurs at the onset of meningitis, Shortne of breath occurs at the onset of bronchopneumonia and other chest affections, to detect this the margin of the nostril should be watched, as this does not dilate with each breath, except during shortne of breath; the breathing will be at the same time noticed to be hurried. The pulse in an infant is too fast to count, and the slightest excitement: sends up the pulse rate to 180 even in an older child; irregularity in the pulse is common in @ healthy child.; The gap between the bones of the top of the skull which docs not close till the end of the second year, should be felt instead; of the pulse at the wrist. If tho scalp here is found sunk in; or bulged out the infant is ill. The temperature is raised trifling causes and need not cause the alarm that. ing rises of temperature would cause in the adult. to Infants and the separate heading of the di suspected.) [s. 351]