To read the papers you would think that medical science was on the brink of knowing it all. But 95% of people who do not feel very well and decide to consult their family doctor can still only be assessed by clinical judgement. Any blood tests, X-rays or other scientific investigations performed to clarify the diagnosis, are invariably negative. The big unknown in modern medicine is not cancer or heart disease but the cause of all those niggling nerves, coughs and collywobbles.

In modern medicine, ‘collywobbles’ in all their manifestations are accepted as an inescapable fact of clinical life. Before Lister and aseptic surgery, wound infections were also accepted as an inescapable fact of life. But just as Lister strove to understand their cause and how to prevent them, so also in the future it is possible that by understanding the cause of ‘collywobbles’ we will learn how to prevent them.

It was striving to understand ‘collywobbles’ that was the central preoccupation of my career as a general practitioner which is documented in my book, ‘More than a Puff of Smoke’, and which will form the subject of later posts.

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