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The History of the Patient History since 1850

For the ordinary doctor the taking of a medical patient history is and has been one of the fundamental procedures. This article looks at instructions on the taking of a history in medical texts, to delineate what happened to the position of the patient history in clinical assessment with the increased emphasis on physical examination that began around the middle of the nineteenth century. The analysis reveals that the taking of a history remained important, with a consistent approach from 1850 to the end of the twentieth century. The patient history became incorporated into the physician's examination as another set of observations and signs, thus producing two histories: a superficial, chaotic story presented by the patient, and a deep, "true" history revealed by the skill of the physician. Within pediatrics, the primacy of the physical examination appears to have been asserted well before the introduction of history-taking.