ABSTRACT
This chapter provides discussion of interesting or troublesome cases, physicians invoke the familiar maxims. Only recently has there begun to be a serious consideration of clinical intuition. Leaps of diagnostic insight involve the skillful reading of signs, many of which like clubbing of the finger ends are well established in clinical lore. Like the patient's history, the physical examination poses the question of whether the physician's proper clinical focus is the particular or the general, the immediately apparent malady or the full spectrum of bodily signs and symptoms. Aphorisms and maxims are the summary formulations of the not-quite-invariant truths of clinical practice. They are the intermediate rules of medicine's clinical casuistry. Clinical rationality has this casuistical character and if it is what Aristotle in the Nicomachean Ethics described as phronesis a case-based, experiential, hermeneutical reasoning then it is not surprising that, as a part of the care of patients, clinical ethics must be described in much the same way.
