The neighbors do
not need to be told when a person has advanced tuberculosis; neither is
an expert required to see that something ails a man with a broken leg.
Furthermore less pronounced symptoms may often be clearly seen by any
observant person, even by those not specially trained. Accordingly it is
important for every woman who has charge of others, sick or well, to
form the habit of noticing unusual appearances of any kind. This habit
is one that most people must take pains to acquire, because people
generally see only the things that their own experience in life has
taught them to see. An added difficulty is the fact that when illness
begins it is not a trained observer, but the untrained sufferer or
untrained member of his family who decides whether to send for the
doctor and thus to set in motion the machinery for treatment and cure.

All the training and experience of a physician are required in order to
decide what symptoms indicate, and to prescribe proper remedies.
Diagnosis, or the process of determining the nature of illness from the
symptoms observed, is often exceedingly difficult; it must take into
consideration not one symptom only but the presence or absence of a
number of symptoms. Untrained persons who attempt to make diagnoses are
frequently led astray by the fact that actual causes of trouble may be
situated far from the places where symptoms are felt or observed. For
instance, the real cause of headache may lie in a region far removed
from the head; and so-called heart-burn, which is caused by disordered
digestion, has nothing to do with the heart. Again, an early symptom of
tuberculosis of the hip joint is pain under the knee; a mother is
clearly not doing the best thing when she assumes that any pain in a
joint means rheumatism, and therefore doses her suffering child with the
medicine that "helped" his rheumatic grandfather. No untrained person is
equipped to make a diagnosis, and still less to prescribe medicine or
treatment.

Symptoms, like all other forms of discomfort, tend to trouble a patient
in proportion to the amount of attention that he gives them. Hence, in
order to avoid calling his attention to them unnecessarily they should
be observed so far as possible without his knowledge; when it is
unavoidable for him to realize what is going on, observation should be
made a matter of routine, so that his interest may not be especially
excited. For instance, everyone who has seen the routin