Instruments

“At the same time that diagnostic instruments promised to place diagnosis on a sounder foundation, they threatened the professional ethos that valued artistry accrued over a lifetime. The physiologists who designed these instruments promoted objective over subjective data, quantitative over qualitative information, and precision over vagueness. In so doing, they stripped diagnosis of much of its mystique and suggested a new set of priorities for medical thinking. Ideally, the instruments would serve as an objective arbiter of the physician’s diagnostic skills and a predictable, standardized reference for the student learning diagnosis” (J. J. H. Evans, 787). . . . Calling hypertension a ‘sphygmomanometric disease’ alerted physicians to a perceived danger that the instrument could falsify reality and mislead doctors by arbitrarily making disease out of a healthy process. In other words, doctors questioned the validity of obtaining a numerical value for blood pressure and using that number to determine normality and abnormality. Instruments could distort diagnosis. The finger, they argued, was as accurate a gauge of blood pressure as was medically necessary” (797).