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Excerpt from The British and Foreign Medical Review, or Quarterly Journal of Practical Medicine and Surgery, Vol. 2: April-October, 1836
We believe that few practical surgeons will be inclined to dis sent from the truth Of these observations. That organic disease to a great extent may exist, and yet furnish no indication of its existence by symptoms during life, will be readily acknowledged by all who have directed their attention to necroscopic examina tions. In the works of various pathologists instances of the same kind may be found; and Mr. Travers refers to a case of stone in the bladder, which was never suspected to exist during life. Andra], in the fifth volume of his Clinique Médicale, mentions cases of softening of the brain, only detected at the post-mortem examina tion. These, and similar instances of every-day occurrence, should only lead us to prosecute with more industry our pathological and semeiological investigations. The fatality of relying on the appear ance of symptoms alone must now be generally acknowledged, and the importance of combining them with physical signs, whenever these latter can be detected, must also be granted by every one who has attempted to arrive at a just diagnosis of disease. We have only to look back a few years, before the works of Laennec and other pathologists appeared, and contrast the state Of knowledge at that period with respect to diseases Of the internal cavities with what it is at present, and we shall be at once sensible of the advance of modern medicine in this particular. The investigation of the physical signs of disease may be considered to be yet in its infancy, and we may hope, from what has hitherto been done in this way, that the art of diagnosis may be able to reach a much higher state of perfection than could have been anticipated even by its most sanguine cultivators. The importance to the surgeon of being able to detect visceral disease previous to an operation, we shall presently have occasion to refer to.
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