Epidemics. 247 



up to the mark, or very much superior, should altogether 

 fail to detect it in its early stage ? 



Abe.rnethy sighted off his patient and diagnosed his 

 disease without scarcely a word, and many have tried to 

 imitate this real or supposed acuteness in a very superior 

 and accomplished surgeon. But it is good enough for men 

 of slower thought, and less prescience, to compass an end by 

 much more common tactics than sight alone ; and, to very 

 dull men, the aid of two or three senses is called into 

 requisition to make them ordinarily safe in careful diagnosis. 

 From a habit early contracted (by reading in the Lancet 

 one of Arnott's lectures), no patient, for more than twenty- 

 five years, has ever been prescribed a dose of medicine 

 without inquiries about the head and downwards throgh 

 the entire trunk, and invariably examining, in some way 

 or other, the heart and lungs, and the lungs from apex to 

 base. 



In this manner many a latent heart and lung disease has 

 been detected where there has not been a single symptom 

 which the eye could recognise, or the patient has mentioned, 

 which could lead to the supposition of the slightest flaw in 

 either of these important organs, but which auscultation or 

 percussion has detected in a moment. 



The only way to prove many of our morbid changes to 

 have this or that origin is not in the autopsy, for that is the 

 end of the beginning, but it is to observe the disease from 

 its first deviation from health, and from that point to slowly 

 mark the successive inroads from health to functional and 

 then to structural changes ; by which means a moderately 

 correct history of the pathological changes in their order 

 of succession and intensity may be obtained, much better than 

 by the most exact descriptions of diseases given subsequently 

 to their having arrived at a fixed stage of development, or 

 from the most accurately conducted autopsy, aided by every 



