This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
Frequently we lose sight of the fact that illness is not a matter of just an infection, an injury, a neoplasm, or a metabolic disorder, but of a combination of factors, not the least important of which may be life-style or behavior. Unless the multiple factors underlying an illness are recognized, the diagnosis may be missed or the treatment fail. Such a situation is described in the CLINICAL NOTE in this issue of The Journal (p 2718). Fiumara's account of diagnosing gonococcal proctitis in a married woman illustrates once more that the practice of medicine is as much an art as it is a science, and that the securing of a complete and detailed history is an important part of that art.
The time constraints of medical practice frequently pressure us into making a hurried diagnosis or instituting a routine form of treatment. Although this approach may suffice for most,
Barclay WR. Even Common Diseases Can Be Complex. JAMA. 1977;238(25):2722. doi:10.1001/jama.1977.03280260052021