Full-size Left-side Hidden
Section 2 – Symptoms and Signs

Chapter 9 – General Approach to the Patient

Gary Maartens,
Peter Mwaba,
Alimuddin I. Zumla


The knowledge base of medicine in the tropics has grown rapidly[1,2] yet the fundamental practice of clinical medicine in the tropics remains more of an ‘art’ than a ‘science'. The ability to establish a sympathetic rapport with the patient, understand the social, cultural and economic reasons underlying the patient's ill health, elicit the important parts of the history, identify the important physical signs and make sound judgements in the absence of sophisticated technological help, and maintain the highest ethical standards when dealing with patients from different ethnic and cultural backgrounds constitutes the ‘art’ of the practice of medicine in the tropics.

Despite the technological advances of the past two decades,[3] history taking and physical examination remain the mainstay of the practice of medicine.[4–6]Clinical acumen is of paramount importance in arriving at a …