I am sure, as students and interns many of us were taught what’s known as ‘bed-side diagnoses’ – a process of navigating and analyzing patient’s symptoms and physical signs to arrive at the most probable ‘clinical diagnosis’. These presentations have not changed much over the centuries. But our insights into what these represent have changed greatly. Often a symptom that has not concerned the patient has little clinical significance; but in certain situations a seemingly insignificant complaint may have considerable importance. Therefore the doctor should be constantly alert to the possibility that any event related to the patient and his family, however trivial or insignificant, may be the clue to the solution of his illness. The physician with the greatest insight into the aetio-pathogenesis of illness is best equipped to deal with such intricate diagnostic problems. And without ant doubt, to hone this art and science of clinical diagnosis is a life-long process.

In this modern era of hi-tech science, clinical medicine may seem primitive to younger generation of clinicians. But in reality, it provides an accurate diagnosis in over 80% of the cases, where as all the sophisticated investigations combined together yield only about 10% more. A small percentage of patients will definitely need hi-powered hi-tech medicine, but the large majority of patients would do well with good bedside clinical medicine. May be we should ponder over Sir William Osler’s wise words:

“Observe, record, tabulate, and communicate. Use your five senses… learn to see, learn to hear, learn to feel, learn to smell, and know that by practice alone you can become expert. Medicine is learnt by the bedside and not in the classroom. Let not your conceptions of disease come from words heard in the lecture room and read from the book. See and then reason and compare and control. But see first.”