While I was an undergraduate student, I felt dearth of a single comprehensive book in clinical medicine which could provide most of the information that an undergraduate student should know to get a firm grip over clinical practices in medicine, so as to become a full-fledged doctor. My friends also shared the same idea. Most textbooks of clinical medicine originate from the West and many a times are difficult to be appreciated in the Indian setup. These authors sometimes, unnecessarily, deal in great depth, with certain topics that does not suit to our setup, while leaving other topics (though of similar importance) to the students. So, being constantly insisted and hard pressed by my beloved friends and colleagues, I ultimately ventured to write a textbook on clinical medicine, which should be comprehensive as well as oriented to improving the hands of our budding doctors in the field of clinical practices. This book also finds itself to be examination oriented. My sole intention has been to write in a clear, concise and easily understandable way, in my own style, keeping always a vigilant watch to the student’s interest.

An earnest attempt has been made to merge the clinical methods and principles of internal medicine and to present it in a condensed form. To keep the size and volume compact, and small, only certain important clinical topics are included in this manual, even references are not included since high-tech reference system is available in all good libraries.

This book is primarily intended for the undergraduate medical students and practicing physicians with special emphasis on clinical methods and clinical features. The book does not provide much information about the investigations and management part of various clinical disorders, because, the author is of the opinion that these can be read by the students from any standard textbook of medicine.

The core skills of communications, clinical examination, objective assessment and planning are as important clinical practices as ever. These skills can only be gained by learning and practice. Medicine is a noble profession, there is a relationship of trust between patients and doctors, and the doctor is recognized to have acquired knowledge and skills relevant to the practice of medicine. In addition, a code of ethics binds the doctors to certain modes of conduct in the clinical relationship with a patient and in relation with colleagues. All these matters are a part of clinical method in the modern world. Essentials of Clinical Medicine seems to teach an integrated approach to clinical practice, so that new methods and techniques of examining a patient are merged into established patterns.

All of us find new things to learn everyday, and the more alert we are, more we find there is to learn. Knowledge and understanding are the keys to good practice. With the advent of Internet, and easy availability of information, people are generally better informed than in the past. The modern doctors need to be aware of this and to develop particular skills in dealing with the informed patient and their family. A firm foundation in clinical methods is essential to this process.

This book is divided into six sections: The General History Taking, The Common Symptoms Presented by the Patients and Questions to be Asked for Them, Symptomatology and its Causes; The General Examination; The Systemic Examination and Common Cases Encountered in Clinical Medicine. It also includes X-rays, CT-scans, MRI, photographs, ECGs and procedures routinely followed in medical wards. The whole text is organized into both body system-related and problem-oriented chapters. The basic method of cardiology, neurology and other specialities are described in chapters devoted to these topics. The special skills required in dealing with unconscious patients are also discussed. There are many illustrations and diagrams to help the students to understand the topic well.

In preparing a textbook like this, I have freely utilized the knowledge and experience of the stalwarts in this profession and I have consulted many books on clinical medicine and various established global journals.

I would sincerely like to acknowledge the supporting hands of MY TEACHERS; Dr(Mrs) SHWETA PAWAR; my colleaguesDrKUMAR SAURABH GAUR,Dr(Ms) MEGHNA MAHESHWARI, andDrSAURABH ARGAL6and my friendsABHISHEKSAXENAandASHISH SAXENA (SOFTWARE ENGINEERS) for their full co-operation and support. They all stayed besides me when I needed their help.

I sincerely thank my patients who allowed me to picture themselves in this textbook. I am deeply indebted to GOD AND MY PARENTS for supporting and encouraging me during the complete period from writing to the printing of the text.

Last but not the least, I wish to acknowledge the help and encouraging attitude of EditorialBoard and the entire staff of Jaypee Brothers Medical Publishers(P) Ltd. for their generous cooperation and coordination in bringing out this first edition. I am definitely confident that this manual will help the students to look into the subject of clinical medicine in much simpler, better and broader way.

Once again, my heartful thanks to DrKUMAR SAURABHGAUR, DrSAURABH ARGAL, Dr(Ms) MEGHNA MAHESHWARI, ABHISHEK SAXENA and ASHISH SAXENA (Software Engineers) for encouraging me and providing their invaluable help.

To arrive at a correct diagnosis, a physician has to follow a certain path (or rules). This includes:

The clinicians (and of course the students also) should always attempt to take a good history, as this practice will help them to arrive at a correct diagnosis.