Physical examination

“ The external symptoms visible to the clinical eye of a physician worthy of the name, vastly outweigh in important significance, all the objectionable detailed examination of parts and organs which from long use has become the habit of the old-school practitioner. ”

“ Physical examination shows a well developed and nourished man. The general physical examination is negative. 304The lungs show nothing abnormal. The heart is not enlarged, there are no murmurs or irregularities; blood pressure, 145 systolic. The alimentary system is negative. No palpable lymph glands. Neurological examination: pupils equal and react to light and accommodation. ”

“ In conclusion, I would urge that physical examinations be conducted along standard lines, as far as possible, in order that the data may be assembled in homogeneous form whenever possible. A complete survey of the body should be made, in order that any abnormality of any region may be recorded for future study, as well as for immediate use in benefiting the individual. ”

“ Sargent, realizing the usefulness of these tests in measuring physical efficiency, included them in the physical examinations of the Harvard students. The strength tests consist in the strength of each forearm, of the back of the legs, the dip, the pull up, and the lung capacity. ”

“ How weak appears the reasoning of many great physicians, when we examine it, not in their works, but on the dead body. Medicine was for a long time excluded from the circle of the exact sciences; it will have a right to be associated with them, at least in the diagnostics of diseases, when we shall every where unite to accurate observation, an examination of the changes our organs undergo. ”

“ Physiology, including pathology—the first taking cognizance of all the vital functions of organized beings, the second of the disturbance of those functions by disease—is far from maintaining its place in the general march of physical science.—Saturday Review.
The Element of Physic in Medical Practice.
The Element of Physic in Medical Practice becomes constantly more simple. Our drugs are fewer and less complicated. ”

“ At the end of the first year the student is examined in osteology, myology and the elements of physiology; at the end of the second year, in anatomy and physiology in all their branches; at the end of the third year, in medicine and surgery; at the end of the fourth year, an examination is held over the whole field of study.
No one is allowed to enter on the study of medicine without passing the Artium examen of a secondary school. This is the equivalent of the German Abiturienten Examen of a classical gymnasium. ”

“ On the other hand, if any person has directed in writing, or verbally as above, that an anatomical examination shall be held, his direction is to be carried out, unless the surviving spouse or a relative require the body to be interred without such examination. ”

“ In respect to movements, it is possible to measure speed, lung capacity and action, strength of grip, legs, back, and chest. Physiological defects are discovered and measured, as corrugation of face, inco-ordination of eyes, twitching, pallor, mouth-breathing. All of these throw light on the physical basis of mental life, the power to work, the requirements of training, diet, and exercise. A detailed study pf the senses may be made, as of sight, hearing, touch, muscle sense, smell, taste, pain. ”

“ And in the infinitely minute, as in the infinitely great, the seekers after natural knowledge, of the kinds called physical and chemical, have everywhere found a definite order and succession of events which seem never to be infringed.
And how has it fared with "Physick" and Anatomy? Have the anatomist, the physiologist, or the physician, whose business it has been to devote themselves assiduously to that eminently practical and direct end, the alleviation of the sufferings of mankind,—have they been able to confine their vision more absolutely to the strictly useful? ”

“ Since comparative anatomists and physiologists have revealed the structure of animals and the functions of their organs, from the lowest protozoan to the highest vertebrate, the physician may avail himself of this knowledge, and thus gain a deeper insight into the structure and physiology of man. An intimate acquaintance with the physical, is a necessary preparation for the study of the psychical life, for it leads to the understanding of their mutual relations and reactions, both in health and disease. ”

“ A trained physician is supposed to know something of all the organs in the body. Even a dentist or an oculist has had some training on all the bodily organs and not merely on the special ones he treats. Among the organs of the body, the medical profession is supposed to include the brain and all the functions of the brain. This implies that he is supposed to have at his finger-ends the ability to make an examination so complete that a whole day would be needed to finish it. ”

“ Anatomy must ever remain one of the great central subjects of your medical studies. Like the keystone of the arch, touching both halves of your work—medicine on the one hand, surgery on the other—and fitly crowning the span of your knowledge, for without it neither side could stand secure. ”

“ It seems to me that we live at a period, when morbid anatomy should take a higher stand. This science is not only that of organic derangements, that take place slowly, as the principles or consequences of chronic diseases,60 it consists in the examination of all the alterations our organs can undergo, at any period in which we may observe their diseases. With the exception of certain kinds of fevers and nervous affections, every thing in pathology is within the province of this science. ”

“ Whatever skill we may boast in investigating the nature of a disease, or in understanding the structure of the body, yet without a knowledge of the instruments which are to be used, and of their properties and action upon the body, whereby they produce a change from sickness to health, other knowledge avails little in the cure of diseases.
The Theory of Physic, more commonly termed Medical Institutions, comprehends under it, the important doctrines of Physiology and Pathology. ”

“ Besides the instruments of precision referred to above, more careful percussion, more careful auscultation, more careful measurements, roentgenoscopy and fluoroscopic examination of the heart, and a study of the circulation with the patient standing, sitting, lying and after exercise make the determination of circulatory ability a specialty, and the physician who becomes an expert a specialist. It is a specialization needed today almost more than in any other line of medical science. ”

“ Hence in the study of physiology in schools many things must be taken for granted. The observation and experience of medical men, and the experiments of the physiologist in his laboratory must be depended upon for data which cannot be well obtained at first hand by young students. ”

“ Its size indicates that it contains an enormous quantity of material on the gross and fine anatomy, but excursions are also made into the domain of medicine to illustrate the application of the anatomical knowledge to the explanation of symptoms in disease; and quite frequently physiology and pathology are dealt with. ”

“ Anatomy—the the knowledge based on principle—is the foundation of the curative art, cultivated as a science in all its branchings; and comparison is the nurse of reason, which we are fain to make our guide in bringing the practical to bear productively. The human body, in a state of health, is the standard whereunto we compare the same body in a state of disease. ”

“ No doubt both clinical study and pathological observation have not only helped practical medicine onward, but they have also greatly contributed to the progress of physiology itself. In fact, I find it impossible to separate exact clinical and pathological work from scientific research of a purely physiological nature. Is not all treatment more or less experiment? ”

“ Such demonstration is a thrilling spectacle to inexperienced students. It appeals to that love of excitement which makes them rush to a surgical operation, or to an extraordinary medical case which may have no bearing whatever on their future practice, whilst the commonplace but all-important bedside observation seems dull in comparison. Yet patient work in the anatomical and microscopic rooms, and in the chemical laboratory for general and animal chemistry, and close clinical study, all of which involve no form of suffering, are of primary importance. ”

“ To understand the nature of disease we must understand health, and the understanding of the healthy body means the having a knowledge of its structure and of the way in which its manifold actions are performed, which is what is technically termed human anatomy and human physiology. The physiologist again must needs possess an acquaintance with physics and chemistry, inasmuch as physiology is, to a great extent, applied physics and chemistry. ”

“ The preliminary examination in general subjects is taken before admission to the medical school. After this, the first year at the medical school is spent in scientific study, such as Biology, Inorganic Chemistry, etc. Having passed her first scientific examination, the student proceeds to the study of the human individual, and deals for the next two years with Anatomy, which includes dissection, Physiology, the study of drugs in Materia Medica and Pharmacology, and Organic Chemistry. ”

“ Although pathology, therefore, as a branch of medical science, is necessarily founded on physiology, questions may nevertheless arise regarding the true character of a structure or organ, to which occasionally the pathologist may be able to return a more satisfactory and decisive reply than the physiologist—these two branches of medical knowledge being thus found mutually to advance and illustrate each other. ”

“ Careful anatomical study is the sure and indispensable preparation for that next advanced range of clinical observation, where pathology and therapeutics bring us into the direct study of the sick.
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The more thoroughly the human organization is investigated, the more wonderful will the unapproachable mechanism for the use of human life be seen to be. We shall never regret any amount of time and care spent in acquiring the most intimate knowledge of human anatomy. ”

“ Everyone knows the doctor, and everyone knows that physiology deals with the ‘functions of different organs of the body’; but the public rarely meet the physiologist, except in the fanciful caricatures of his enemies, which though frequently personal are rarely accurate. ”

“ Much of what is taught to-day in pathology belongs to clinical medicine and surgery, for it is largely special and diagnostic in character. The pathologist is now the servant of the physician and surgeon in completing and rectifying their diagnoses. The pathologist of the future will deal with more general phenomena derived from experimental and comparative data, just as the physiologist has moved onward, or backward if you please, into general and comparative physiology. ”

“ Anatomy, Physiology, and Hygiene have their places in the curriculum of our leading schools, but the knowledge too often is simply technical and without practical results. What greater travesty than to listen to a glib discourse on nutrition, digestion, circulation, respiration, the muscles, nerves, bones or brain by a pupil with thin chest, lack-lustre eye, sallow complexion, and weak frame? ”

“ Whatever method is chosen, it must be borne in mind, particularly in practical diagnostic work, that the portions chosen for microscopic examination must represent the characteristic anatomic structures of the tissue or organ, that living tissue be included, that the pathologic condition be represented both in its fully-developed state and at the transition-border between it and the healthy tissue, and that when sections are cut the block or tissue must be so oriented as to give the most comprehensive view of the tissue and the pathologic process. ”

“ Those medical men, however, who are called anatomists have investigated with careful scrutiny, by dissecting processes, even living men, so far as men have been able to retain any life in the hands of the examiners; their researches have penetrated limbs, veins, nerves, bones, marrow, the internal vitals; and all to discover the nature of the body. ”

“ Anatomy, in a more limited view, considers the structure of the dead body only; but Physiology teaches the functions of the living body. The distinction will he more easily apprehended from observing, that a person may be a good practical Anatomist, and yet be ignorant of Physiology; but it is impossible to be a good Physiologist, without being an able Anatomist.
The great stock of literature, as well as genius, which is requisite to become an adept in this science, and the important nature of the subject it treats of, point out its dignity and excellency. ”

“ Primary examinations of chest, heart, and other viscera are long and troublesome, and the first study of a case which is at all difficult, demands such time as it is increasingly hard for the busy to find. ”

“ The value of an examination depends, of course, entirely on its thoroughness and on the experience of the physician who makes it. It is only too easy to overlook one of the faint grayish patches in the mouth or a trifling pimple on the genitals. The time and special apparatus for a microscopic examination are not always available. ”

“ He richly endowed it with all the materials for teaching, and into every department of this varied subject introduced appropriate illustrations in the form of drawings of the pathological lesions of the organs, together with physical apparatus, and casts and models of the various forms of disease. ”

“ A man who would minister to a diseased body must have an accurate knowledge of the organs, and of the whole structure of the body, in a sanitary condition. We oblige our physicians to know anatomy and physiology. ”