Causative Factor

In the classic Chinese humor book "笑林廣記", there is an amusing story:

一人睡在床上，仰面背痛，覆臥肚痛，側困腰痛，坐起臀痛，百醫無效，或勸其翻床。及翻動，見褥底鐵秤錘一個墊在下面。

This story reminds me of another similar one I had once encountered as a physician. One day, a psychiatrist referred one of her psychiatric inpatients to me for consultation. The patient had been treated by her for a chronic nasal symptom of three months' duration. As the patient was unable to provide me any relevant history due to his insanity, she attached a note explaining the reason of the need for consultation. She indicated that the patient had suffered from persistent nasa lsymptoms with nasal congestion and discharge. She had tried various decongestants, antihistamines, or their combinations, but all the remedies had failed. The patient's nasal symptoms got worse and the nasal discharge was becoming yellow and green .Obviously, the psychiatrist had tried to treat this patient's symptoms without performing a simple "physical examination". By using an ordinary equipment (actually the handy otoscope, which is available in every doctor's office), I easily made the diagnosis and cured his problem. A "foreign object" was easily removed from his nasal cavity. It was a small roll of paper. I opened that piece of paper roll and was surprisingly to see that it was a package insert of a psychiatric drug called "Haldol". The patient's nasal symptoms resolved instantly.

Finding the underlying causative factor of an illness is essential, not just treating the symptoms.


Yeh Tze