429 



conipjiratively few. States of ill health where no accurate diagnosis can 

 he made are many. Some physicians hesitate to make a diagnosis when 

 tliey know the patient has already had a variety of diagnoses and likely 

 will receive more after leaving him. Some "cases" are as easy to "treat" 

 as they are difficult to diagnose. Physicians liave an old saying. Any one 

 can prescribe, the difliculty consists in making a proper diagnosis. 



It sliould be kept in mind that Medicine like everything else is an 

 evolution and that it has not yet reached a stage where it can properly 

 classify the things with which it deals — ^with reactions and states of the 

 body variously termed disease, maladies, affections, symptoms. Much is 

 still to be learned about the common ills of the common people. 



Primitive Medicine included all the sciences, as knowledge developed 

 sciences crystalized out and each pursued an independent course; some 

 have now little connection with Medicine proper. We need only think of 

 chemistry, as an outgrowth of alchemy, and the search for the elixir of 

 life and the transmutation of metals, or of the herbalist changing into a 

 botanist and more recently into a bacteriologist concerned with microscopic 

 plants. In short, sciences formerly studied by medical men have now 

 developed to such an extent that the practitioner of medicine can not ac- 

 quire more than a smattering knowledge of them ; and that means in pro- 

 portion as men specialize they must limit their field of work. A specialist 

 in one department of Medicine may scarcely know what is going on in 

 other departments. 



There are topics that are of interest to all, such as the life conditions 

 imder which we live and the search for the favorable ones and avoidance 

 of the unfavorable. Favorable conditions tend to what we call health, 

 unfavorable ones to ill health, disease and death. Extinction may come 

 suddenly or slowly ; it may not appear for several generations — in what 

 is called race suicide. 



Differential Diagnosis. — Just where reactions, or symptoms shade off 

 into disease is often difficult to determine, in fact is impossible because 

 there is no exact definition of the very term disease.^ In order to diag- 

 nose Coniosis properly one must rule out other more or less related condi- 

 tions, especially diseases, socalled. For the puiiioses of this paper it may 



^ Di.spases thomsplves arp vai'iously classifiable. A common division is into 

 rarasitic klue to invasion of parasites of ali kinds) and constitutional (due to de- 

 fects in tlip body, congenital or acquired). Anotjier general classification Is struC' 

 }.ur^l and functional. 



