Evening star. [volume] (Washington, D.C.) 1854-1972, 1889-03-28
PERIODICAL EXAMINATIONS.


From Earpers Magazine
The family physician should have constant
opportunity to know just what is the physical
condition of each member of the family in the
absence of any manifest evidence of disease
To this end periodical examinations should be
made of such character as to reveal any Turk
ing morbid tendency, without waiting for its
development into actual disease. There should
be no such thing as a discoverable affection
remaining undiscovered. Death from unsus-
pected heart or kidney disease, for example,
should cease to be possible. There should be
no more histories like the following, now 30
frequently repeated:
A person supposed to be in good health is
fastening along the street, perhaps hurrying to
catch a train. ALI at once he is seen to stagger
and fall. Passers-by rush to his assistance. but
he gasps q few times, and before any aid can be
rendered he is dead An autopsy reveals that
he had fatty degeneration of the heart and the
extra demand made upon the heart by the I'M
usual exertion was more than its enfeebled
walls could respond to. He was not aware of
the existence of this condition but if ms doctor
had merely laid his finger on the pulse his sus-
pIcion would have been aroused. and listening
to the heart would immediately have confirmed
1t. BY proper treatment and the avoidance of
severe exertion, the catastrophe might have
been averted for many years and the usual
limit of life might perhaps have been attained.
Or again. gentleman who has thought him.
self quite well goes as usual in the morning to
his place OF business. A few hours later he is
brought home IN carriage in a state of uncon-
seriousness. In spite of the most prompt and
Judicious treatment he does not recover from
his coma. On the contrary, commissions set in,
and in the course of a few hours he dies. IN
known to him or to his family. he has been
suffering from Brights disease, the symptoms
Tot
simple examination would have revealed to his
doctor the actual condition of affairs and by
proper care and proper treatment the fatal ter.
mination might have been almost indefinitely
deferred.
The records of examinations by the physi-
clans OF lfe-insurance companies show numer-
Gus instances in which very serious disease ex-
lists without being suspected either by the
patient or his friends This fact. in addition
to the frequency of cases such as those de-
scribed above. is enough to show the extreme
Importance of system by which the actual
condition of persons not consciously i'll should
be periodically Investigated.
In view of this it should be part of the duty
OF the family physician to make a thorough
physical examination of every member of the
family at least twice a year. and in the case of
a feeble or delicate person at much shorter in
tervals. The results of these examinations
should be fully recorded and the record kept
IN the possession of the doctor. to be trans
would possess immense value, not only for the
persons immediately Interested, but also for
their posterity. 1t is by knowing the vital his
tory of the parents that we know what to ex-
peet IN the children. Heredity is an influence
which II Is difficult to estimate for the reason
that the absence of records prevents our trac-
ing 1t backward in the family history. Yet we
know that this influence may shape the physical
destiny or generations to come. DIR. Holmes
mas SAID That the proper time to begin the
rln ~ mi n IL IL
before the birth of the patient. He might have
added that the treatment sometimes needs to
be continued for a hundred years after his
death.
But the opportunity afforded to the family
physician to ward off injurious influences from
those under his care might be extended
much further. 1t should be within his prov
lnce to indicate what occupations were suita-
Die to given youth. and what. in the interests
OF his health, should be avoided He should
be able to prevent feeble, ill-nourished. mar
row-chested lad being put behind desk in a
countlnS-room, where the tendency to pull
monary disease already existing would GER
tainly be developed. He should have such a
voice IN the selection of boarding schools as
would prevent the children being sent to insti-
buttons i'll unheaithful localities, or in which
there was danger from defective sanitary pre-
cautions. In the selection of new dwelling
and even in choosing a summer resort his
Judgment as to the topography and the sani-
Idry CONDITIONS should nave a controlling in
fuence. His supervision should extend to a
proper adaptation of educational methods to
the capabilities of the several children of the
family, and to the order in which their facul-
ties develop. On this latter point it is high
time that the influence of medicine should be
felt in pedagogics. Mental physiology should
lie at the foundation of every school curricu-
lum. 1t is incongruous that at this age of the
world the development of the mind should be
intrusted unreservedly to those who have not
even the most elementary knowledge of the
minds organ, the brain.