Excerpt from The Canadian Journal of Medicine and Surgery, 1914
In discussing cases of psychoses which come up daily in the wards, our housemen nearly always furnish the same reply to certain enquiries. If, for example, I tell them that Mrs. Smith has certain delusions or hallucinations and ask them why they did not find that out, the reply comes, "But she did not say anything about them to me." I am nearly always safe in suggesting that they did not ask the questions necessary to discover these important facts; indeed, this type of houseman exemplifies what we find commonly in a certain class of physician, who can see only one thing in a patient and deliberately overlooks what should be apparent to a careful investigator. Ordinarily an insane person does not furnish many difficulties in the way of examination, as he will generally co-operate pretty well, but occasionally there is a hard nut to crack and time, patience and adroitness will be required to get at the facts necessary to enable one to make a diagnosis.
In dealing with supposed cases of dementia precox, for example, it is absolutely essential that one shall get, if possible, a life history of the patient he is examining; indeed, after some years of experience, one can almost write the life history before many of the questions are asked. Very little work has been done on the first stages of dementia precox, a disease which undoubtedly can, in many of the cases, be traced back to the early periods of childhood. In other words, the victims of this disease have the earmarks of fate stamped upon them from the first dawn of consciousness. It is this fact that makes the prognosis so unfavorable. Since developing a clinic for the so-called defective and feeble-minded in the General Hospital it has become possible to make investigations which, if I may dare to pose as a prophet in my own country, will eventually throw some interesting light on the early history of dementia precox.
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