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目前日益增多的实验室检查不仅增加了卫生保健的花费,而且似乎越来越多地取代了对病史和物理检查的信任。学校对在校生不强调临床技术。学生和老师也只对新的诊断技术感兴趣。现代医学教课书随着新的复杂的诊断技术和治疗方法的发展而不断增厚,但对疾病的临床描述却越来越浓缩和简化。过去的临床家们依靠他们的临床技术,把对疾病的准确描述和他们毕业的经验留在书中,如西塞尔内科学中对痛风的描述:“急性痛风性关节炎,常呈暴发性发作,达残废程度。急性痛风主要是下肢病。最初发病.75—90%的人为单关节。至少半数,累及(?)趾的跖趾关节,其次依序为足背、踝、足跟、膝、腕、指和肘。以后发病常为多关节性的,
The current increasing number of laboratory tests not only increases the cost of health care, but also seems to increasingly replace the trust in medical history and physical examination. Schools do not emphasize clinical skills on students. Students and teachers are only interested in new diagnostic techniques. Modern medical textbooks continue to grow with the development of new sophisticated diagnostic techniques and treatments, but the clinical description of the disease has become increasingly concentrated and simplified. Past clinicalists have relied on their clinical techniques to keep an accurate description of the disease and their graduation experience in the book, such as the description of gout in the science of Xisailel: "Acute gouty arthritis, often fulminant Onset, to the degree of disability.Acute gout is mainly lower extremity disease.Initial onset.75-90% of the people are single joints.At least half of them involve the metatarsophalangeal joint of the(?)toe, followed by the dorsal, ankle, heel, Knees, wrists, fingers, and elbows. Later onset is often polyarticular.