History

In the diagnosis of each disease role of history is especially great.
I. P. Pavlov was attached special significance in detail to collect the medical history, the light of all the previous life of the patient when determining the pathogenesis of the disease.
I. P. Pavlov wrote: "And in fact, is commonly causes disease does not provide and does not begin to act in the body before the patient is made the object of medical attention. And the knowledge of the reasons, of course, is a significant cause of medicine. First, only knowing the cause, you'll be able to strive against it, and secondly, and more importantly, can not allow her to action, before the invasion of the body" 1.
Pathological condition (illness) I. P. Pavlov was described as follows: "This is the meeting, the contact of the body with any emergency condition or, rather, with the unusual size of the daily conditions. You are exposed to mechanical shock, heat or cold, attack by pathogens, and so on, begins Naturally and especially serious struggle of the organism to these terms, i.e. ...set in motion defensive devices body... On the fight ends or odbiciem enemy and termination of operation defensive devices, or the victory of the enemy - then comes the floor or destruction of one or another part of the body... If irritation limited to one known by the body, it begins a gradual compensation of its activity, comes the new trim body..." 2.
Of these instructions I. P. Pavlova follows that at every moment the body reacts as a system, including pre-impact and response of the body. That is why in every case of human disease should be considered as characteristics of the body of the sick, and all specific features of his life.
Getting to the study of gynecological patient, one must first be able to collect the medical history. This is especially important because in some cases correctly assembled history immediately discovers the cause of the disease. For example, the patient appeared to accept complaining of fever, sharp pain in the lower abdomen, purulent discharge, said at the same time a sharp pain in the study in the field of appendages that are detected increased. When interviewing the patient submits that the disease she began soon after she started sexual life; when, first appeared pain during urination, and soon - Beli.
If collecting history are well aware of how valuable for recognition of gonorrhea specifying the patient in pain when urinating and Beli, then, certainly, there is a suspicion in this case it gonorrhea. This is very important, because immediately gives the right direction for further examination of the patient, destination mode pre-therapy, etc.
In some cases, history cannot be built for one reason or another, the patient (fainting, unconsciousness, etc.,); then we have to use interviewing relatives or others sick violence. it is also sometimes possible to get a very important historical information. For example, during examination of the patient are in an unconscious state, determined barely perceptible, rapid pulse, General paleness skin and mucous membranes, cooling of the extremities, shallow breathing; on questions of the patient is not responding. From the questioning relatives turns out that the patient suddenly felt ill, fell unconscious and since then is above condition.
The causes of such a state can be a lot of (acute poisoning, brain hemorrhage, a dead faint, and so on). Distraught relatives may themselves and not to report some important historical data that would give the opportunity to bring an idea about the true cause of the disease; it should then ask in detail about their patient.
On some issues, perhaps the answers and will not be received, but even some indications may be sufficient for a correct diagnosis of the disease.
For example, in this case from relatives became known that the patient was delayed menstruation or that she considered herself pregnant 2 months. Knowing the symptoms of violations of ectopic pregnancy, in this patient, of course, first of all, you should suspect this disease (upon further observation that the suspicion must be confirmed or excluded).
Such examples could be quoted a lot, but two is enough to understand critical to diagnose accurately and in detail of the collected history.
But to fully take history and not to miss anything, it is best to use a particular scheme, the plan of collection of anamnesis.
When entering the patient is in the hospital in the history of the disease marked the time of receipt, the number of the receiving magazine, surname, name, patronymic, place of birth, nationality, age, profession and occupation. Then you first need to see the patient complaints, which caused her to seek medical help. This must be done for timely instruction of the medical staff on the care of the patient. So, do not just have to see how the patient, suffering from severe pain, still patiently waiting for collecting history will exhaust all their questions. Sometimes she even does not tell immediately that she profuse bleeding. Maybe you will immediately begin to perform certain activities for elimination of pathological symptoms, but anyway timely clarification of complaints of the patient creates an opportunity to give the patient the appropriate quiet position and only then to question her further.
After clarification of the main complaints of the patient to the further history is collected in the following order.

1. Pavlov I. Ii. Full. SOBR. Trudy inst., T. II, S. 358, 1946.
2. Ibid., C. 348.

  • The age of the patient
  • Influence of conditions of work and life
  • Complaints of the patient
  • Childhood
  • Sex life
  • Pregnancy and its outcome
  • Pre-existing illnesses