Indiana University School of Medicine - Caduceus Yearbook (Indianapolis, IN)

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4 THE NEW ENNUI JURINAL OF SCUT May 15, 1977 The Pathologic Guide to the History and Physical A paucity of literature exists describing a pathologist's approach to the history and physical. The NEJS now presents such an article as a service to its readers. This section issent free of charge to medical students, interns, and other housekeeping staff only. When did you first experience the pain Does your stool glow in the dark? Do your teeth itch? What is the air-speed velocity of an un- ladened swallow? 1 — INTRODUCTION: A firm, warm handshake will allow the interviewer to gain the patient's confidence and transfer germs. This is a good opportunity to examine the nailbeds to note if the nails are asleep. 3 - INSPECTION: Careful visual exami- nation should be executed in the best tradition of General Anesthetic, Major Criteria, Extra-Corporal Pump, and Private Parts. One should always note if the bucket looks like it's a little pail. 2 — HISTORY TAKING: Keen interrogation skills and a finely-tuned hearing aid are definite assets for the pathology interview.

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VOI.. I NO. I gri.yi momi n is in mi iiistoky or sen The name Sanjaya Bhagavad-Gita Arjuna is often touted among medical circles as the inventor of the IV. It is commonplace knowledge that in the early 1800's, this Indian anesthesiologist utilized bamboo shoots to replace fluids in a severely dehydrated aged sage who succumbed to evil vapors and cholera. Unfortunately, no credit is given to Sri Pranananananada, the medical student on call that fateful night, who was given most humble task of starting IVlee. It was the same Sri P. who, over a decade later, invented the finger, which revolutionized the removal of impacted fecal masses. The artist refused to be named. (Hint — she is a medical illustrator somewhere in a Gulf city that rhymes with Gnu Morleans.)

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VOL. 1 NO. 1 THE PATHOLOGIC GUIDE TO THE HISTORY AND PHYSICAL 5 4 — PALPATION: Laying on of hands is a diagnostic therapeutic concept dating to Hippocrates and recently perfected by Xavier Hollander. Put your finger in every orifice. Put your head in, if it fits. 5 — AUSCULTATION: Although an important ex- amination technique, this will probably never surpass the popularity of osculation. Listen carefully for murmurs, gallops, rales, and things that go bump in the night. 6 — PERCUSSION: Great pathologists including Drs. Ginger Baker and Gene Krupa beat this into the ground. 7 — REMUNERATION: A meticulously performed H and P, incor- porating basic scientific skills, is certainly its own reward. Be prepared to resusciate patients unfamiliar with physicians' fees.