Henderson Daily Dispatch

Sherlock Holmes' Test Helps Out in Medicine

By LOGAN CLENDENING, M. D.

MY FRIEND, the diagnostician in the large clinic, told me another story which illustrates how valuable it is to use common sense instead of too many scientific instruments in trying to find out what is the matter with people. I told one of the stories yesterday. Here is another one.

People come to the clinic from all over the country. They have usually been examined by half a dozen good doctors beforehand.

This patient was a retail merchant of about 50 years of age who, according to the stories of his friends and family, had gradually begun to lose interest in his business. He became abstracted and things. His friends found him unresponsive; sometimes he did not recognize them on the street.

He lost weight and walked with a peculiar gait. He had to turn over the conduct of his business to other members of his family and finally the diagnosis of melancholia was made.

He went through a great many tests in the clinic and nobody seemed able to arrive at any different diagnosis physicians.

Finally he was brought to the diagnostician's office, who decided he would dispense with the scientific tests and see if he could not figure out what was the matter with the man by observation.

Patient Wore Galoshes

The physical examination revealed nothing but an apathetic man, unnaturally thin and weak for his age. Finally, in looking him over, the diagnostician noticed that he was wearing galoshes. He said to him, "What in the world are you doing with galoshes on in May?".

The man replied, "I am cold all the time. I can't seem to get enough clothes on me."

The diagnosis was myxoedema in other words, an atrophy of the thyroid gland with a lowered thyroid secretion. (In this particular case the test for thyroid function by the measurement of oxygen use had not been conclusive. In this case also, the characteristic changes that occur in the face were absent, which also misled the other doctors.)

This diagnosis is as often missed as any other in medicine because the symptoms are so indefinite.

Often they point simply to a general nervous or mental state and the thyroid is forgotten by the diagnostician. The right diagnosis brings brilliant results, because in many cases the patients can be restored to practically normal health by the use of thyroid extract.