In 1977 I wrote up a small booklet called CLINICAL STUDENTS COMPANION and had it published by AzamSons, a book seller across from Dow Medical College. It was basically notes on General Medicine I made for the Final Professional MBBS Exam. It was common for oral examiners to ask for causes of symptoms, signs or abnormal lab values. This helped junior students to brush up on lists of causes which one could not find easily from text books of Medicine like Davidson or Harrison or Cecil Loeb. I then published two more editions wht last one being what is being uploaded here, a 260 page book with illustrations. The third edition was typed by me on the old manual Smith Corona portable type-writer.
One technique we learnt from teachers like Prof. S.M Rab (with whom I did my first intership in Medicine at Jinnah PostGraduate Medical Center, Karachi) was to think about the causes of a presentation or symptom or sign one at a time. If patient has 2-4 signs think of all the causes separately and try to figure what runs common to all the lists. This may lead one to correct diagnosis. For example when presented with Fever of Unknown Origin, think of the causes and if the patient also has anemia and splinter hemorrhages, one would find that bacterial endocarditis is present in all the 3 lists. Same for other problems.
Hope you enjoy reading. Mind you this is 45 years ago and applies to diseases found commonly in Pakistan and India. It’s value at this stage may be more historical than actual since everything now is a mouse click away on ChatGPT! 🙂 Amin H. Karim MD September 25 2025
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