About: The clinical differentiation between functional and organic disease is at times difficult to establish, because, presumptively, in the beginning, at least, all organic disease is preceded by a physiologic perversion, that is, functional alteration, which may or may not be apparent with our present diagnostic limitations. […] Though benign rhythmic disturbances, such as premature contractions or paroxysmal tachycardia, do occur, it is notoriously difficult and still the subject of argument whether these may be called functionally benign or whether they may prove to have organic significance. […] The lack of opportunity for the medical student to observe the functional states in the medical school clinics and hospital practice, because of lack of space, or interest in their care in intramural teaching, is, I believe, a most forceful argument for a period of extramural practice under intelligent tutelage.     Permalink

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