94 Course of Disease. 



bearing on questions of heredity; subsequently the general pre- 

 vious medical history of the subject, the anamnesis, is taken up, 

 and a study of the known features of the present attack in its 

 development. Thereafter is made a close and complete objective 

 study of the subject, this including as thoroughly as possible the 

 whole body, the condition of every organ by the methods of ordinary 

 physical diagnosis and the more elaborate methods of clinical 

 technology. Given such data one should be able by his patho- 

 logical training to recognize the seat of the affection and the 

 extent of its distribution in the body, the topographical diagnosis, 

 and the nature of the affection, the nosological diagnosis.] 



The establishment of a diagnosis leads directly to prognosis 

 and therapeutic application. By the term prognosis is meant the 

 foretelling of the mode of development [the order of the events 

 in the course, and the duration of the disease] and termina- 

 tion (whether favorable, prognosis faiista ; unfavorable, prognosis 

 infansta ; or uncertain, prognosis anccps). The course and ter- 

 mination of many diseases may be predicted with more or less 

 certainty, inasmuch as examples of the aft'ections are constantly 

 occurring and an experienced physician is quite familiar with their 

 development and modes of progress. The prognosis must, 

 however, in a measure depend upon each individual case, its 

 special constitutional peculiarities, the degree of general involve- 

 ment of the bod}' and the distribution of the disease-changes, the 

 vital importance of the affected organ, the variations of the disease 

 from its usual trend, the complications and the possibility of em- 

 ploying proper remedial measures. 



Therapeutics (i) Oepawela, from eepairevco, to serve or cure) or 

 remedial treatment has to deal with eft"orts directed toward com- 

 pensation for and removal of disease. Where it is possible by 

 definitely conceived measures to remove the basic fault, the 

 anatomical alterations and the causative influence underlying the 

 morbid condition, therapy manifestly becomes rational or radical; 

 where it is possible only to combat symptoms (pain, fever) it is 

 said to be symptomatic treatment, which at best is but a tempo- 

 rary means or measure of relief (paUiative, from pallium, a cloak 

 or protection). 



The duration and course of diseases depend closely upon their 

 causes and upon the extent and nature of their basic structural 

 alterations. Some diseases are sudden in their onset, last but a 

 few minutes or hours, and terminate in the death of the individual 



