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The Neurological Examination as Taught in 1897 Compared with 2002 – from Hutchison’s Clinical Methods
  1. Alisdair McNeill, Pre-registration House Officer
  1. College of Medicine, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG; E-mail: AmcNeill{at}doctors.org.uk

    Abstract

    INTRODUCTION

    In contemporary medical practice most diagnoses are based on key features of the patient’s history, backed up by laboratory and radiological investigations, while comparatively few diagnoses are made mainly on the basis of the physical examination. This decline in the importance of physical examination has been attributed to the development of modern diagnostic techniques, which now answer the diagnostic questions previously addressed by the physical examination. Arguably, neurology should be the specialty to have benefited most from such technological advances, particularly in imaging, with the development of CT, MR and PET scanning. Despite this, it is still an article of faith by some that the ability to perform a comprehensive neurological examination is vital in the assessment of diseases of the brain and peripheral nervous system – and so it must be done, and taught, properly.

    To investigate whether advances in modern diagnostic techniques have or have not rendered some

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