AN TELL FROM APPEARANCES

It is our pride that medicine, from an art, and a pretty black one at
that, originally, is becoming a science. And the most powerful factor in
this development, its indispensable basis, in fact, has been the
invention of instruments of precision--the microscope, the fever
thermometer, the stethoscope, the ophthalmoscope, the test-tube, the
culture medium, the triumphs of the bacteriologist and of the chemist.
Any man who makes a final diagnosis in a serious case without resorting
to some or all of these means is regarded--and justly--as careless and
derelict in his duty to his patient.

At the same time, priceless and indispensable as are these laboratory
methods of investigation, they should not be allowed to make us too
scornful and neglectful of the evidence gained by the direct use of our
five senses. We should still avail ourselves of every particle of
information that can be gained by the trained eye, the educated ear, the
expert touch,--the _tactus eruditus_ of the medical classics,--and even
the sense of smell. There is, in fact, a general complaint among the
older members of the profession that the rising generation is being
trained to neglect and even despise the direct evidence of the senses,
and to accept no fact as a fact unless it has been seen through the
microscope or demonstrated by a reaction in the test-tube. As one of our
keenest observers and most philosophic thinkers expressed it a few
months ago:--

"I fear that certain physicians on their rounds are most careful to take
with them their stethoscope, their thermometer, their hemoglobin papers,
their sphygmomanometer, but leave their eyes and their brains at home."

And it is certain that the art of sight diagnosis, which seems like half
magic, possessed in such a wonderful degree by the older physicians of
the passing and past generations, has been almost lost by the new.

A healthful reaction has, however, set in; and while we certainly do not
love the Caesar of laboratory methods and accuracy the less, we are
beginning to have a juster affection for the Rome of the rich harvest
that may be gained from the careful, painstaking, detective-like
exercise of our eye, ear, and hand.

As a matter of fact, the conflict between the two methods is only
apparent. Not only is each in its proper sphere indispensable, but they
are enormously helpful one to the other. Instead of our being able to
tell less by the careful, direc