, 1922-04-22
STILL A
EMINENT AUTHORITY SAYS ONLY FIFTY
PER ENT CORRECT

AUTHORITY SAYS ONLY IFTY
PER CENT
The Medical Brief tst. Louis) had the following
editorial in its issue OF December. 1910:
MISTAKEN IN DIAGNOSIS
Or. Richard Cabot, of Boston LIS n man who Is
desCrvedly held in high repute by the entire medi-
cal profession throughout the country as an ex-
coedingiy able exponent Of Medical Science and
Pacfioe. He holds a chair of medicine in Harvard
University; is the author OF a standard textbook on
practice; is a man Of exceptionally high personal
character and integrity, and is, in addition. one OF
influence and work have extended beyond the con-
fines OF his own calling. and have told effectively
In the direction Of wise philanthrophy and pract-
At the last convention of the American Medical
Association, held in st. Louis. this gentleman, with
a courage and intellectual Honesty which marks
him df any further indication should be necessary
as a great man. presented, a unique and thought
sonal experience, entitled "a Study OF Mistaken
tory OF one thousand cases, diagnosed by himself in
the Massachusetts General Hospital, which after
ward came to autopsy, comparing the showings
of the postmortem examination with the clinical
finding. The paper has recently been published in
the Journal of the American Medical Association,
and makes exceedingly interesting and instructive
reading.
Tho analysis, as may be supposed. is q very
comprehensive one. embracing almost every type
Of disease in various stages and manifestations
and represents a careful and systematic in~vestiga-
tion Of every case. both before and after death. Its
net result shows that the diagnosis was correct in
casss; in the other fifty per cent, the postImorten
demonstrated that he was mistaken in his dag
nosis, either by commission or omission. 1. E., he
had either diagnosed conditions which were not
present, or had overlooked those that were there.
and it must be borne in mind that in this fifty per
cent Of correct diagnosis there were n large num-
Der OF cases OF diseases whose manifestations are 50
plain that the merest tyro in medicine would rec
ognize them almost at a glance; such. for instance,
as typhoid fever. diabetes, pneumonia, meningfts.
valvular disease Of tho heart, and others which
present a well-marked and easily recognized group
of symptoms. It is therefore plain that, IL all Of
these simple cases had been eliminated the proper
ton of mistakes would have been greater; for &C
cording to DR.. Cabot's statements. the percentage
of correct diagnoses reached the low figure of six
teen per cent in acute nephritis. Twentytwo per
cent In chronic myocarditis, Thfrtythree per cent
In broncho-pneumonia, and 80 on.
Now, If a man OF DR.. Cabot's recognized So
premacy I'm the field Of diagnosis with the courage
and candor to face the real facts, ~confesses that he
is only able to make correct diagnosis in something
like fifty per cent of all the cases he undertakes-.
and considerably less than that in those diseases
which make anything like a tax upon expert skill
what is the irresistible conclusion concerning the
THOUSANDS OF practicfng physicians whose skin in
this direction Is admittedly far below that of DR..
Oabot, who have not the facilities that lie at his
command, and whose opportunities for vertfication
or disproof ar@ practically nll