Evening star., 1963-12-30
StOpKiIIing
Yourself
By Dr.. Peter J. Steinerohn

Sometimes two physicians
presented the same facts will
make different diagnoses.
guess that's why the phrase
when doctors disagree" is
used so often.
FOR EXAMPLE, here is
Mr.. Smith complaining of
what appears to be simple
indigestion. The ordinary di-
agnOStician' will prescribe
something for what he consi-
ders to be an intestinal upset.
But another doctor, unwill-
ing to accept what seems to
easy to diagnose, will take
more time with the patients
history. He viii discover that
the soc allie d indigestion
seems to come on mostly
when the patient exerts. He
wonders if it is an off-beat
kind of angina symptom. He
takes electrocardiograms and
does other studies and the
cause is found to be heart dis
ease rather than simple indi-
gestion.
Or, consider Mrs. Jones
who has also been having
indigestion. Gall bladder x
rays and ordinary CT series
are negative. There is no evi-
dence of hiatal hernia. A
careful history elicits the fact
that the trouble comes on only
after the patient eats chicken.
An allergiSt finds she is aller-
gic to chicken. No chicken, no
more attacks of indigestion.
Diagnosis is not easy. 1t re-
mains a challenge in every
patient the doctor sees.
Whenever we take a diagnosis
for granted is just about the
time we will not make the
true one. The good doctor
keeps all his senses alert, dis
trusts his first impressions,
and isn't sure until he has
made careful and thorough
examination and study of his
patient.
Write for my ledtIet,
"Allergy: Disguised Attdcker,"
in care of The Star, inclosino
IS cents and a stamped, self
addressed envelope.
Dear DR.. Steincrohn: Will
you name some collagen dis
eases? Just what are they?-
Mr.. ].
IN THESE DISEASES, so
stubborn to treatment, there
is some disturbance in the
connective tissues around
blood vessels, joints, and in
the skin. Cause is unknown.
Symptoms depend upon where
the involvement is. Doctors
have means of making the di-
agnOsis by special laboratory
and microscope tests.
Here are the more common
ones: ,rheumatoid arthritis,
sclerodetma, systemic lupus,
periarteritis nodosa, and der
matomyoSitis.
-
Dear DR.. Steincrohn: NV
doctor tells me am de-
pressed and nervous. He says
my rapid heart beats and fear
of impending death are not
unusual symptoms in depres-
sion. Do you agree?-Mrs. D.
| CAN'T SAY whether or
not you are in a depression
but | agree that such patients
quite often have complaints
which make them believe that
they have some real, organic
illness which is their trouble.
For example, the condition
is often missed because the
patient complains of pain in
the abdomen; or, shortness of
breath and difficulty in filling
the lungs with sufficient air:
or, nausea, constipation or
dlarrhea; or, headache and
ear noises; or, numbness, ex-
cesSive perspiration, and fire.
quent urination.
TirednesS to actual exhaus-
tion may be the only Symp-
tom. Other patients lose an
interest in their family and
friends and in life. Only when
they speak of suicide is the
suspicion of depression really
centered on these unhappy
people.
Whenever there is a definite
change in personality, the
doctor should always check
for depression if there is no
other evidence of organic
disease. A few electroShock
treatments may help very
much.
(Bell-McClure syndicate)