Physician and patient : $b or, a practical view of the mutual duties, relations and interests of the medical profession and the community — John Shaqi
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
An undue attachment to certain modes of investigation, to the
exclusion of others, is also frequently a source of error. I mention
as an example a too implicit and exclusive reliance upon what are
called the physical signs of disease. Percussion and auscultation are
valuable sources of evidence, but when they are relied upon to the
exclusion of other sources, as is often the case, they lead to error.
Some who have attained to a high degree of skill in the use of the
stethoscope, have on this account sometimes adopted very erroneous
conclusions, which might have been avoided by a careful examination
of _all_ the sources of evidence in the case.
Having pointed out some of the errors produced by narrow and
exclusive views in the investigation of the symptoms of disease, let
us now attend to some of the errors which result from this cause, in
the _application of remedies_.
A remedy may be applicable to a disease which the physician finds
developed in a given case, but there may be some condition of some
organ, which may render it wholly inapplicable to that case. For
example, in a case of inflammation of the lungs, the state of the
stomach may be such as utterly to forbid the use of some remedies,
which would otherwise be proper. If they be administered in spite
of this circumstance, they may perhaps produce a beneficial effect
upon the inflammation, and yet may do a great injury to the patient,
perhaps even a fatal one, by their direct effect upon the diseased
stomach. Errors of this kind do often occur in the practice of those
who observe inaccurately, or who have fallen into a sort of routine
of practice from disinclination to mental effort.
The general condition of the patient sometimes fails to be
appreciated by the practitioner. He may be pursuing a course which
would be admirably adapted to cure the same disease in a more
vigorous patient, and yet in the case in hand it may be ruinous.
Though it may relieve and even cure the disease, it yet may destroy
the patient. The judicious physician in some cases feels obliged
to let morbid processes go on, because the violence which must
necessarily be done to the debilitated system by the attempt to
arrest them, would put the patient’s life in greater jeopardy, than
it would to let them have their course. Questions frequently arise
on this point, which tax the physician’s skill and judgment to the
utmost. Even when it is proper to moderate the activity of a diseased
process, it is often a very delicate point to determine just how far
this can be done without doing harm to the patient. Fever is often
moderated by means that irritate the system, or prostrate its powers
to such an extent, that bad results, sometimes fatal ones, occur;
when, if these means had been used less largely, or perhaps even if
they had not been used at all, a recovery might have taken place.
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