Physician and patient : $b or, a practical view of the mutual duties, relations and interests of the medical profession and the communityHooker, Worthington
Science
Physician and patient : $b or, a practical view of the mutual duties, relations and interests of the medical profession and the community
Hooker, Worthington
Medical ethics; Physician and patient; Physicians; Quacks and quackery
physicians to mistake these local complications of delirium tremens
for the disease itself.
Another error, of a more directly practical character, which existed
for a long time in relation to this same disease, will serve as
another illustration of the influence of a partial view of facts, in
leading to wrong conclusions. Dr. Sutton, one of the early authors
on delirium tremens, asserted as the result of his observation, that
the patient must sleep or die, and that opium in _large_ doses was
the proper remedy to produce the sleep. This opinion was for a long
time almost universally adopted, and practised upon. But the compared
experience of _many_ observers has demonstrated this practice to be
erroneous, and it is now very commonly given up by the profession.
In examining disease, whether in a single case, or in groups of
cases, it is essential to the formation of correct conclusions, that
_all_ the symptoms be observed, and that their relative importance be
duly estimated. Much error has arisen from a disregard of this plain
truth. Take for example the observations of different individuals in
regard to fever. Boerhaave, looking mainly at one class of symptoms,
taught that fever was caused by a bad state of the blood; Cullen
looking at another class of symptoms, considered fever to be an
affection of the nervous system; Clutterbuck, fixing his eye upon
another class of facts, was very sure that the cause of fever is
always to be found in the brain; Broussais, directing his attention
to the symptoms developed in another quarter of the system, asserted,
that all fever arises from an inflammation of the mucous membrane of
the stomach and of the upper portion of the intestines; Dr. Cooke of
this country, narrowing his vision down to a certain set of symptoms,
proclaimed that the primary cause of fever is a weakened action of
the heart, producing an accumulation of blood in the venous system;
and Samuel Thompson, following in his rude way the example of all
previous theorizers on this subject, in taking into view but a part
of the facts in the case, declared that fever is a battle between the
cold and the heat, and that, if the cold conquer, the patient dies,
and if the heat gain the victory, the patient lives.[29]
It is thus that a disposition to form conclusions from a limited
experience, and to take partial views of facts, leads to errors of
opinion, and consequently errors of practice. I might multiply
illustrations on this point, but it is not necessary.
Public-domain text, read in full here on John Shaqi.
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