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Diagnostic Touch Its Principles and Application PDF
Diagnostic Touch Its Principles and Application PDF
Diagnosis as an Art
Diagnosis as an art is an important component in the field of diagnosis. It has always
been. It always will be. Diagnosis as a science
brings to the physician those data that can be
learned objectively with the minimum of human
error. The blood count that can be done by a
machine is more accurate than that run by a
technician counting the cells. So it is with all
the biological detail that can be done by scientific instruments. The art of diagnosis is that
ability applied by the physician himself. It
involves the following factors: his interpretative skill in analyzing the data supplied to him
by his scientific tools and the use of his own
personal skills in evaluating the patient before
him. These are subjective in nature. These
may not bring the finite detail of the instrument
but neither are they limited by the finite detail
that the instrument is only capable of perceiving.
There is room for variables, there is the ability
to perceive past events, present events, and
predictability for forecasting future changes,
There is a wider latitude of functioning in the
subjective field in the art of diagnosis and this
coupled with the scientific data gives the
physician an over all picture that can bring a
more complete and knowledgeable diagnosis.
A scientific diagnosis is not enough. It is too
limited. It is the composite use of both scientific (objective) and personal (subjective) tools
that gives the physician a true diagnosis.
Interpretative skills within the physician
are a subtle mixture of many years of training,
of knowledge of the available scientific tools
and their use, of experience, of a mind that
keeps itself open to any and all approaches
that will enhance his abilities, of the development of his own personal subjective tools, his
eyes in accurate inspection, his ears in accurate
auscultation and percussion, his nose and taste
where indicated, and his thinking, feeling,
Three Problems
There are always three problems every
time a patient enters your office. There are
the patients ideas and beliefs of what he
considers his problem to be: there is the
physicians concept of what he considers the
patients problem to be; and, finally, there is
the problem of what the anatomical-physiological
wholeness of the patients body knows the
problem to be.
The patient of today is a better informed
patient than the one of a few years ago. He
reads medical articles in the periodicals. He
translates this information into his terminology,
not always correctly, and he has been to other
physicians before coming to you. He has heard
their diagnosis of his problem and adds that to
his opinion. He tells you his story and tries to
explain his physical feelings. He is sensitive
to your opinions and if you can come up with a
picture that will explain his problem to him in a
satisfactory way, he is able to cooperate with
you. But in the final analysis he still has his
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Fulcrum
To develop this sense of touch it is
necessary to learn the principle of the fulcrum
and then to develop a method of using the fulcrum
in the diagnostic approach to these problems.
Webster defines a fulcrum as the support or
point of support on which a lever turns in raising or moving something; hence, a means of
exerting influence, pressure, etc. (4) Dr. W. G.
G. Sutherland in describing the fulcrum in
relationship to the two halves of the tentorium
cerebelli and falx cerebri stated, The Fulcrum
(the junction of the falx cerebri and tentqrium
cerebelli at the straight sinus) is the stillleverage junction over and through which the
three sickles function physiologically in the
maintenance of balance in the cranial membraneous articular mechanism. Like all fulcrums,
it may be shifted from point to point, yet
remaining still in its leverage functioning.
The key to understanding the principle of a
fulcrum is to realize that it is a still-leverage
junction, yet it may be shifted from point to
point while remaining still in its leverage
functioning.
On a gross level of functioning the
scientists on the B-29s were relatively still
points, riding in a plane that was responding
to the storm into which they were flying. The
scientists whole bodies reflected the movements of the storm and the potency or stillness
of the eye of the hurricane. This was something
they could feel during the flight, could report,
and interpret. The physician must bring this
principle down to a much finer degree of use
than that of the whole body. He must set up a
still-leverage mechanism with which he can
feel the stress and tension in the tissues under
his hands and fingers and find the potency or
area of stillness within that area of stress. He
does this by placing his hand or hands near the
area in which the patient is experiencing
difficulties and then establishes a fulcrum with
his elbow, his forearm, his crossed fingers, or
any other part of him that is convenient to his
comfort. From this fulcrum, his fingers become
the end of a lever that can note the changes
taking place within the body. His fulcrum
point can be shifted from time to time to adapt
to changes within the body, yet remaining
still in its leverage functioning.
Touch
In placing the hands and fingers on the
tissues under examination, do so with the idea
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REFERENCES:
(1) Sutherland, W. G., Preface to Reprint Edition of THE CRANIAL BOWL issued by the
Osteopathic Cranial Association.
(2) Websters New World Dictionary, College Edition; 1960; pg. 1143
(3) Websters New World Dictionary, College Edition: 1960; pg. 1143
(4) Websters New World Dictionary, College Edition; 1960; pg. 585
(5) Sutherland, W. G., Lets Be Up and Touching, The Osteopathic Physician; 1914
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