诊 断
1.God gave you ears, eyes, and hands; use them on the patient in that order.
—— William Kelsey Fry, 1889——1963
【译文】上帝赐予你耳朵、眼睛和手，你就按此顺序去检查患者吧。
2.All the causes of things cannot be seen, because they appear to depend on circumstances which are unknown, or appear to be accidental.
—— John hunter, 1728——1793
【译文】事情的原委都藏而不露，它的出现似乎取决于某些未知情形，或纯属偶然。
3.Symptoms are the body’s mother tongue; signs are in a foreign language.
—— John Brown, 1810——1882
【译文】症状是身体的母语，体征说的是外语。
4.We are too much accustomed to attribute to a single cause that which is the product of several, and the majority of our controversies come from that.
—— Justus von Lieebig, 1803——1873
【译文】我们太习惯于把几个结果归结为一个原因，大多数争论都由此而来。
【点评】临床经验告诉我们，一因多果（一元论）还是多过数因一果或多因多果。
5.Having lice doesn't mean not having fleas.
—— Jorge Bezama
【译文】有虱子并不意味着没有跳蚤。
6.Diagnosis by intuition is a rapid method of reaching a wrong diagnosis.
—— J.Chalmers Da Costa, 1863——1933
【译文】凭直觉诊断是通往误诊的捷径。
7.A spot diagnosis is the surest way to a wrong conclusion.
—— Charles F.M.Saint, 1886——1973
【译文】当场做诊断最容易导致诊断错误。
8.The misleading symptoms are misleading only to one able to be mislead.
—— William Heneage Ogilvie, 1887——1971
【译文】误导性症状只会将容易被误导的人引入歧途。
9.Place your bets on uncommon manifestations of common conditions rather than on common manifestations of uncommon conditions.
—— Mark M.Ravitch, 1910——1989
【译文】你应该把赌注压在常见情况的不常见表现上，而不是少见情况的常见表现上。
10.When you hear hoof beats, think of horses, not zebras: common is common!
—— Gail Waldby
【译文】听到马蹄声首先应想到马，而不是斑马：常见的还是常见!
11.The most important thing to remember about rare diseases is that they are rare.
【译文】说到罕见病最重要的是需谨记：罕见病毕竟罕见。
12.Fascinoma=something you don't see everyday.
【译文】Fascinoma就是那些不是每天都能见到的怪病。
【点评】此句话直译将失去太多的精彩内涵，据在国外行医的同学说，Fascinoma是一个较常用的医学俚语，是指那些疑难得一塌糊涂，但一旦确诊会令人拍案叫绝的罕见病例。
13.Beware of the diagnosis of hysteria, neurosis or neuralgia, unless organic disease can be excluded with certainty.
—— Rutherford Morrison, 1853——1939(https://www.daowen.com)
【译文】谨慎做出歇斯底里、神经衰弱或神经痛的诊断，除非已经明确排除器质性疾病。
14.We diagnose that which we are thinking about, we think about that we know, and we know only that we have studied.
【译文】我们基于所思考的做诊断，所思源于我们的所知，所知也只能基于我们所学。
【点评】可见我们的诊断思路总是跳不出我们已知和所学过的，反过来我们只有加强学习才能拥有更多知识、知识越多方能思考更多、思考更多才能做出更接近真相的诊断。
15.The more non-indicated test you order, the more false positive results are obtained, which in turn compel you to order more tests which lead to additional,potentially harmful, diagnostic and therapeutic interventions.
【译文】没有指征的检验做得越多，假阳性结果就越多，这反过来又迫使你做更多的检验，从而导致一些有潜在危害的额外诊断和治疗干预。
16.The more the noise——the less the fact.
【译文】杂音越多，真相越少。
17.When all else fails, order a physical exam.
—— Leo A.Gordon
【译文】所有其他方法都不管用时，就再去做体格检查吧。
【点评】这一点对临床医生太重要了！回到床边做仔细的体格检查、补充追问病史所获取的信息是任何先进的辅助检查都替代不了的。
18.Diagnosis may be based on the X-ray or the tissue section, but not on the report.
—— Mark M.Ravitch, 1910——1989
【译文】可根据X光片或组织切片下诊断，但不是依据这些“报告”下诊断。
19.Treat the patient, not the X-ray.
【译文】治疗的是患者，而不是X光片。
【点评】这也是当下许多临床医生的一大误区，即喜欢单凭X光片的改变评价治疗效果，而忽视患者自身的整体感觉。
20.Time is the greatest diagnostician.
【译文】时间是最了不起的诊断高手。
21.You cannot operate on a differential diagnosis.
—— Claude Organ, Jr.1926——2005
【译文】不能为诊断不明确的患者做手术。
22.Remember that exploratory incisions should be made a cloak for diagnostic incompetence.
—— Rutherford Morrison, 1853——1939
【译文】记住，探查切口是诊断能力不足的一块遮羞布。
23.Mistakes in surgical diagnosis occur not from want of knowledge but from carelessness, over–confidence, being in a hurry, or jumping to conclusions.
—— James Berry, 1860——1946
【译文】外科诊断中的错误通常不是源于知识缺乏，而是因为粗心大意、过度自信、匆忙或贸然下结论。
24.How does a surgeon measure the patient's pulse? Takes it for a second and multiplies by sixty.
—— Franz Bauer
【译文】知道外科医生如何数脉搏吗——数一秒钟，然后乘以60。
25.No amount of genius can overcome a preoccupation with detail.
【译文】再多的天才也难以胜过对细节的专注。
【点评】所以细节才显得如此重要。
26.Surgeons … ought to become the best diagnosis; because the frequent use of exploratory incisions is a check upon diagnostic error.
—— J.Chalmers Da Costa, 1863——1933
【译文】外科医生……理应成为诊断高手，因为他们常用“剖腹探查”来核验其诊断的偏差。