History of medicine
History Of Medicine / / April 24, 2016
Method of examination of the patient is always dependent on the views of the major pathology doctors.How we examined the patient and the disease was determined Russian doctors XVIII century?In one of the works of that period, we read: "Before than he, the doctor, will be accepted to the patient and before he came to write his first prescription, he want to talk a lot.
It must, first of all, learn kind of illness, consider your body type of the patient, his temperament, his character, his tendency, his habits, his thoughts and his imagination.Then they all signified figure with external circumstances, ie. E. Place the property, the air times of the year, the situation at that hour of heavenly bodies and their influence in the composition of our body.Knowing he must present takozhde internal direct causes of disease, their symptoms, their stress, these diseases are critical;in their properties medicines potions ... the country where they are ... how they are fresh and hand: all this to balance, lead to
Here the author briefly given the whole patient survey system, and if we exclude the astrological indications of the order, it is impossible not to recognize the wisdom of asking questions.
Russian doctors the second half of the XVIII century, the importance attached to thorough questioning and examination of the patient.Among the representatives of: the national medical school, which ushered in the method of questioning the patient for diagnostic purposes, it is necessary, first of all, called FG Politkovskaya.In his thesis "On the festering," the author pointed out that understanding in the patient's condition, we must first pay attention to what the body affected initially.Then it is necessary to find out whether congenital or acquired disease.After this you should go to the questioning of the patient, which he suffered before, and that worried him now.In the future, it is necessary to inquire about particulars: sore if the head, what a dream, there are no troubles in the chest, abdomen, extremities, etc.
This technique examination of the patient in the second half and especially in the last decades of the XVIII century was sufficiently developed..according to the concept of disease.The study of "mournful sheets", or histories, preserved from the time shows that doctors usually inquired about the age, the patient's life, asked about food and drink, sleep, state of mind and so on. At the same time take into account the place where he lives patient and timeof the year.
After questioning doctors transition to objective study.It consisted in the inspection, palpation and pulse study.We determined the body of the patient, his general appearance.Inspects the mouth, tongue, observed his color, moisture.By probing studied painful places, dryness or moisture of the skin and so on.
special place was given to the pulse.By pulse judged on the state of the whole organism, as determined by the pulse of the disease, the degree of its manifestation.Distinguish pulse at the height of rush at the end of the fever, the crisis pulse and so on. D. Taken into account that the pulse may vary from different causes and that its character is dependent on age, temperament, sex, sleep, climate, seasons, diet, heat and cold.Pulse varied over time, strength, rhythm and tension of the arteries.In addition, they inspected various isolation of the patient, determined by their color, texture, quantity.
discussing these issues, it is impossible not to stop and on the methods of physical investigation.As is known, in 1761 in Vienna Auenbruggera treatise on the diagnostic value of chest percussion has been published.It took a long time before this method is implemented in medical practice in the West.German doctors for a long time did not recognize him.In France, began to use the method of percussion only from 1808, when Corvisart translated the work Auenbruggera.
Some Russian doctors began to use percussion much earlier.At the end of the 90 codes of the XVIII century St. Petersburg Professor J. O. Sapolovich was aware of the discovery.According to JF Bush Ya O. Sapolovich first in Russia, guided by this method of research, I made the operation "perforation of the chest" with success.From the same source it became known that O. Ya Sapolovich not only tapped, but also listened to patients.
For proper diagnosis of the doctors of the XVIII century it was necessary to remember a lot of symptoms that make up the picture of this or that disease.Gradually, however, the doctors realized that the same disease can occur in different ways, and so they began to look for the main symptoms and distinguish them from other, not major.
individual approach to the patient, complicating the diagnosis, however, moved forward, and medical thought contributed to the transition from diagnosis of anatomical and physiological statistics to the diagnosis and dynamic.This process was time-consuming and not completely ended even in the XIX century.
Nosological disease systems known in the XVIII century (Sauvage, Linnaeus, Vogel, Sagara, Cullen), not only did not contribute to the correct diagnosis, but often makes it difficult.These systems mostly;They were based on arbitrary fictions writers, and "not to the knowledge of the human body," as AM Shymlanskaya.It does not always help diagnose and familiarity with the ruling General pathological views.FG Politkovskaya rightly pointed out that, where practical, doctors came in the wake of mainstream theorists of medicine, they fell into a pattern.
The hospital records of the second half of the XVIII century following diagnoses met:
- fever, is divided into continuous, intermittent, inflammatory, mokrotnye, rotten, etc .;
- inflammation - external and internal (domestic attributed to inflammation inflammation of the brain, frog, lung inflammation, inflammation of the liver, stomach, intestines);
- consumption, bleeding from various organs;
- scurvy, scabies, Vered;
- colds breast disease;
- lomotnaya disease or rheumatism;
- nerve disease (which treat hysteria, hypochondria, melancholia, paralysis);
- pox, measles;
- scrofula, British disease;
-glisty et al.