Etiology at the Bedside

概要

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Alert clinicians have made important contributions to the etiology of disease. From observations at the bedside new understanding can be developed about host susceptibility or effects of the environment. No special equipment is required. The clinician needs only to be curious about peculiarities in the occurrence of disease in the patient, family, , community or work-place. In this way, Ieukemia was linked to Down's syndrome, and, through a series of other astute clinical observations, to other syndromes and environmental exposures characterized by chromosomal abnormality. In consequence, leukemogenesis is now known to be closely related to inborn or acquired chromosomal abnormalities. Also, Iung cancer has been shown to be due to exposure during the manufacture of mustard gas, and all known causes of birth defects in man have come from clinical observations, especially from Australia: embryopathy from German measles during pregnancy, limb abnormalities (phocomelia) from exposure to thalidomide, adenosis (frequently) and adenocarcinoma of the cervix or vagina (rarely) after maternal therapy with diethylstilbestrol; and a greenish-yellow staining of the teeth from intrauterine exposure to tetracycline. Any clinician can help make medical history by thinking effectively and in a novel way about etiology.(Received 16 September 1979)
産業医科大学学会の論文
1980-03-01