RENE LAENNEC'S SYNDROME-BASED CLINICAL REASONING

RENE LAENNEC'S SYNDROME-BASED CLINICAL REASONING

The development of clinical reasoning, which is the basis of medical education, is of great importance inmedical universities. One of the founders of modern structural clinical reasoning, based on the knowledgeof pathological physiology, is the inventor of the stethoscope Rene Laennec (1781-1826). He described thepioneering experience of clinical reasoning in the pages of his treatise A Treatise on the Diseases of theChest and on Mediate Auscultation, which is of lasting value, since every rookie physicians in hisprofessional development goes through the path of Laennec. Laennec's practice is of great importance fornovice physicians since Laennec’s treatise contains a diagnostic analysis of the most common clinical cases. Each such analysis demonstrates the algorithm of clinical reasoning. The purpose of this study was toanalyze the approaches of clinical reasoning by René Laennec, which made it possible to identify two basicprinciples. Laennec's diagnostic reasoning involved two principles: pathogenetic analysis of clinicalmanifestations and a syndrome-based approach to differential diagnosis. These principles help distinguishbetween diseases with similar symptoms and physical findings are used to demonstrate the practicalapplication of syndrome-based differential diagnosis. These principles can be easily mastered byunderstanding the pathogenesis of clinical manifestations. Thanks to the pathogenetic basis, the principlesof clinical reasoning of Rene Laennec are universal and applicable to the analysis of any signs of the disease:not only physical but also laboratory and instrumental.