C. M. T. Hulett[29] says: “Only when we can know all the conditions,
causative and sequential, with their possible complications and
terminations, together with a full history of therapeutic results in
a large number of similar cases, and carefully analyzing and weighing
these various elements, are we prepared to really make a prognosis.”
Nettie H. Bolles[30] writes as follows: “The prognosis depends upon
the cause of the disease, the possibility of removing the cause, or
the likelihood of recurrence of causes, and the chances of avoiding
such recurrence. The circumstances to modify the outlook are various
and deserve careful consideration.” It is not the purpose here to
go into the many essential details, for that would mean an outline
and forecast of all disease processes, and the effect of numerous
extenuating circumstances. The medical profession have been gathering
data for these three thousand years and prognosis with them is still
inaccurate and incomplete. Osteopathic science will add just so much to
the accuracy of prognosis as the sum total of the knowledge displayed
in the fields of osteopathic etiology, diagnosis, pathology and
therapeutics. Suffice it to give here a few salient practical hints as
noted in the osteopathic treating room and at the bedside.
Osteopathically it may be said that prognosis depends, first, upon the
true conception of osteopathy; second, upon the relative value of all
factors pertaining to health and disease; and, third, upon the skill
(technique and native ability) of the osteopath. The first and second
being granted, the third includes a remarkably practical and pregnant
field, for in no school does the physician get into as close touch
and understanding of the actual condition of the patient’s disorder
as in the osteopathic. Although the fundamentals and principles of
the osteopathic conception of diseases are really broad, liberal,
and all-inclusive, still owing to the fact that each individual (and
thus each disease) is more or less a law unto himself should there
not be absolute tables and prescriptions to be governed by; remember,
however, this does not imply our fundamentals are not basic or our
principles are not truths, but rather the application and execution of
the same are as varied as the individual’s constitution, temperament,
and disease. Herein rests the really difficult practical consideration
of etiology, pathology, diagnosis, treatment, and prognosis. In other
words, if the diagnosis and treatment are accurate the result rests
entirely with the patient.
First, too much emphasis cannot be placed upon the fact that prognosis
is dependent upon the osteopath—his education, training, ability,
experience, and technique. One’s fitness is most important. And fitness
and personality complement each other. An osteopath may know theory and
still not be practical; still one cannot be practical unless he knows
theory.
Public-domain text, read in full here on John Shaqi.
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