THE LAHORE MEDICAL SCHOOL.
October 1, 1S7-JL]
THE DIAGNOSIS OF FEVERS.
Surgeon-Major Tulloch, in the interesting paper which we print on another page, draws attention to an important source of fallacy in army statistics, caused by the present system of weekly returns. A patient may bo admitted during the week or towards its close, and before a medical officer ha3 had time to determine. the actual nature of his fever, a diagnosis must be made. It is quite true that a diagnosis need not necessarily be made, the case being entered as not yet diagnosed j" but no man will impugn his own skill and acumen by making much use of this column, a practice which, moreover, entails more or less trouble. It is also true that the disease may be changed, a case, for instance, of remittent fever being discharged from that heading and readmit"
ted under enteric fever when the existence of the latter form
recognised.
is
This practice, however, involves two errors: 1st, fictitious admission into hospital; and 2nd, there
there is a is a case entered under remittent fever which is not remittent fever at all. Many repetitions of this expedient would render returns very far from strictly accurate. Unless a medical officer i3 quite certain of his diagnosis he should, wc think,
undoubtedly
return the case
as
"not
yet diagnosed."
When
the diagnosis has been made with certainty, say on the man's recovery or death, the case could be entered in its proper place. Returns covering a longer period would not of course show the admission under " Eot yet diagnosed," which would be merely a convenient shelf for doubtful and erroneous
short periods
diagnosis.
cases
As
and
long
as
a
safeguard against hasty
returns are
required
for
such practice appears absolutely necessary. A general (provisional) heading of "fevers" in weekly returns ou^ serve the same some
purpose.
207
October 1, 1S7-JL]
THE DIAGNOSIS OF FEVERS.
Surgeon-Major Tulloch, in the interesting paper which we print on another page, draws attention to an important source of fallacy in army statistics, caused by the present system of weekly returns. A patient may bo admitted during the week or towards its close, and before a medical officer ha3 had time to determine. the actual nature of his fever, a diagnosis must be made. It is quite true that a diagnosis need not necessarily be made, the case being entered as not yet diagnosed j" but no man will impugn his own skill and acumen by making much use of this column, a practice which, moreover, entails more or less trouble. It is also true that the disease may be changed, a case, for instance, of remittent fever being discharged from that heading and readmit"
ted under enteric fever when the existence of the latter form
recognised.
is
This practice, however, involves two errors: 1st, fictitious admission into hospital; and 2nd, there
there is a is a case entered under remittent fever which is not remittent fever at all. Many repetitions of this expedient would render returns very far from strictly accurate. Unless a medical officer i3 quite certain of his diagnosis he should, wc think,
undoubtedly
return the case
as
"not
yet diagnosed."
When
the diagnosis has been made with certainty, say on the man's recovery or death, the case could be entered in its proper place. Returns covering a longer period would not of course show the admission under " Eot yet diagnosed," which would be merely a convenient shelf for doubtful and erroneous
short periods
diagnosis.
cases
As
and
long
as
a
safeguard against hasty
returns are
required
for
such practice appears absolutely necessary. A general (provisional) heading of "fevers" in weekly returns ou^ serve the same some
purpose.
207
