POPULAR ESTIMATES OF PHYSICIANS.
There is no class of men whose talents and attainments are so
erroneously estimated by the public as are those of physicians. Some
of the causes of this erroneous estimate have been brought to view
in the chapters on the Uncertainty of Medicine, and on Good and Bad
Practice. I propose in this chapter to treat of this subject more
distinctly, to point out some other causes operating with those which
I have already mentioned, to show the results of this false estimate
of medical character and attainments, and to develope some plain
principles, on which a correct estimate may for the most part be
secured.
I presume it is sufficiently clear to the reader, from the views
which I have before presented, that the community cannot judge
with any degree of correctness _directly_, of the practice of
physicians,—either of the truth of the principles on which it is
based, or of its actual results.
How then shall the community judge of physicians? This question I
will endeavor to answer.
The view which I gave, in the first chapter, of the uncertainty of
medicine, I trust, made it obvious to the reader, that a thorough
education is pre-eminently necessary to the proper practice of the
medical art. In endeavoring therefore to form an estimate of the
qualifications of any physician, let the evidence of his having
obtained such an education be well considered.
But what is this evidence? Is it to be found in the bare fact
that he has a diploma, obtained from some respectable medical
institution? While a diploma is worth something as evidence, as
there must be some improvement of the means of education, in
order to pass the examination requisite to obtain it; yet it must
necessarily be defective evidence. That the truth may be more fully
ascertained, let the inquiry be made, how far the physician has
improved the advantages he has had; for it must be remembered, that
it is especially true of medicine, that a diligent and wise use of
limited opportunities will impart more knowledge and skill, than
can be acquired by a careless and unwise use of the most extensive
advantages afforded by the profession.
I will allow that there are difficulties in the way of arriving at
the truth in this inquiry, and the public are often most grossly
deceived by the parade which is made by some physicians, in regard to
the opportunities which they have enjoyed. Still, I apprehend, that
the erroneous judgment of the public in regard to such cases, arises
from a too ready confidence in mere pretensions, and that it can be
avoided for the most part by a little more pains-taking in making the
inquiry, and by applying tests of another character, to which I shall
soon allude.
But education in the science of medicine is practically despised by
quite a large portion of the community. Though this sentiment is not
often distinctly avowed, yet it exists to a greater extent than is
generally supposed. It shows itself in an indifference to the true
evidences of a physician’s qualifications, and in a readiness to put
the quack on a level with the thoroughly-educated physician, or even
above him. These indications of the prevalence of this sentiment, are
not confined to the ignorant; but they often appear among the well
informed, and even the learned.
Sometimes this sentiment is boldly avowed in language like the
following: ‘I care little about the evidence of a physician’s having
had an education. The fact that he is successful in treating disease
is worth vastly more than a piece of parchment. Many a man has risen
to eminence in other professions by his own exertions, without any
great amount of education; and why should not this be the case in
the practice of medicine? There was Franklin, who rose by his own
efforts to a post of honor and usefulness far above multitudes of
his cotemporaries, who had a most finished education; and why should
there not be Franklins in medicine, as well as in other departments
of knowledge?’
The assertion, that success in curing disease is worth more than a
piece of parchment, is strictly true. But the evidences, on which a
correct estimate of success can be formed, are not ordinarily, as the
reader has seen in the chapter on Good and Bad Practice, within the
reach of the community; and the attempts which it makes to form an
estimate from the defective evidence at its command, often result in
the bestowment of the praise due to success upon those who are really
unsuccessful.
As to the use which is made of so great a name as that of Franklin
to justify a disregard of education in medicine, I remark, that
those who hold such language forget three very plain truths. 1st.
That self-education is, after all that can be said, education. It
is education acquired in spite of difficulties, and without the
aids which men usually have. 2d. That education thus obtained
indicates the possession of _uncommon_ power of mind. There are but
few Franklins in any profession. It is not common for men to rise to
eminence with the small means which he enjoyed, and in face of the
difficulties which he encountered. 3d. That Franklin, and all those
men who have thus risen to eminence, so far from despising education,
made most diligent use of all the means of education which they could
command, aspiring all the time to higher and higher advantages; and
while they lamented the deficiencies of their own early training,
they labored most assiduously to give to others the most extensive
means of acquiring knowledge. Very different from this, I cannot
avoid remarking in this connexion, is the spirit of those pretenders
in medicine, who affect to despise education, and who claim that they
have an innate skill, which education can neither impart nor improve.
I shall in another chapter maintain, that it is both the duty and
the interest of the community, to demand that there shall be a
respectable standard of education in the medical profession, and will
therefore dismiss this topic for the present.
The second source of evidence, in regard to the qualifications of a
physician, is to be found in the unbiassed opinion of his medical
brethren. I allow that there are difficulties in the way of obtaining
such an opinion. There is, on the one hand, the prejudice of rivalry,
and, on the other, the partiality arising from mutual interest.
Sometimes these influences extend beyond the individual, and arrange
medical men in small parties, or cliques; and these often render it
exceedingly difficult to discover the standing which any physician
has among his brethren. Yet it is true, that every physician has a
general estimate put upon him by the profession, _and it is commonly
a correct one_. And this estimate can ordinarily be ascertained by
any one, who makes due allowance for the influences to which I have
alluded.
While this strictly professional reputation, which is awarded
to every physician by his brethren, is commonly very nearly
correspondent with his true merits, that which the public awards
to him may be far otherwise. It is often the case, that, while a
physician, of whom his brethren have an exalted opinion, meets with
but little favor from the community; another, who is a very ordinary
practitioner, and who is so considered by the profession at large,
has an extensive practice, and a high popular reputation. Such a
physician may be treated with much outward deference by his medical
brethren, on account of the position in which the public favor
has placed him; and this is often very erroneously considered as
evidence, that he is held in great estimation by the members of the
profession generally.
I pass now to the consideration of a means of estimating the
qualifications of physicians, which is of a more practical character,
and more certain in its results, than those which I have already
mentioned. And yet it is one which has been very generally neglected,
for reasons which I shall give in a future stage of my remarks.
There are certain mental qualities, which are essential to the
possession of skill in the practice of medicine. Whoever is found to
possess these qualities, you may be sure, will with proper education
make a good physician. And if they are wanting in any one, no
education, nor experience can supply the deficiency. He never can be
truly skilful as a physician; and if such an one acquire a reputation
for skill, which is no uncommon thing, all that we can say is, that
the public are deceived in their estimate of his qualifications.
How then can an intelligent man discover, whether a physician has
these requisite mental qualities, and to what extent he has them?
What tests can he apply to bring them out, so that he can see them
distinctly, and measure them with any good degree of accuracy?
The science of medicine is so much a mystery to the common observer,
that he cannot, as you have already seen, apply his tests to a direct
examination of the physician’s knowledge. He is not competent to make
the estimate in this way; and if he is not aware of this, he will
certainly be deceived. If he wishes effectually to avoid error, he
must apply a touchstone which he himself understands, and not one of
which he is profoundly ignorant. What is this touchstone? Plainly
this. _Let him observe the mental qualities of the physician, as they
are exhibited in regard to any subject, with which he is himself
familiar in common with the physician_; and he has here a test upon
which he may rely with absolute certainty. He discovers in this way
the character of the physician’s mind; and it is just to infer that
the mental qualities thus laid open to view, stamp their impress upon
the practice of his profession, and give to it its character. No
change comes over his mind when he passes from other subjects to that
of medicine. The same mental powers are there, and he will observe,
think reason, and act, just as you have seen him do in regard to
common subjects.
Take an illustration from surgery. You see a surgeon set a fractured
limb. You cannot judge whether he does it skilfully, because you
do not understand how it should be done, so as to bring the broken
ends accurately together, and keep them so. But if that surgeon,
in passing your house, by some accident breaks the thill of his
carriage, you can watch him as he splices the thill, and you can
judge, for you are competent to do so, whether he exhibits mechanical
talent in the operation. If he does, you can safely infer that the
same mechanical talent will be brought into exercise in setting a
bone, and that he will set it as skilfully as he spliced the thill.
Other talents in a medical man can be tested in a similar manner.
The truth, of which I have given this single illustration, is so
obvious when plainly stated that it hardly needs to be dwelt upon at
all; and yet, it is so often disregarded by the community, in the
estimates which are made of physicians, that it may be profitable to
illustrate it somewhat at large. In doing this we shall accomplish
another important purpose—we shall obtain a clear view of those
qualities which are most necessary in the particular calling of a
physician.
Let us then cursorily notice some prominent characteristics, as they
are seen in physicians in your daily intercourse with them on common
subjects, and apply the criterion which we have under consideration.
Look at the mode in which physicians form their opinions.
You discover in your conversations with a physician upon politics,
religion, or the occurrences of the day, that he is very credulous.
Have you a doubt that the same credulity follows him into a sick
room, and mars the accuracy of his observations of disease and of the
influence of remedies? And so, on the other hand, the physician who
shows a sceptical cast of mind on other subjects, will assuredly be a
doubter on a subject clothed with so much uncertainty as medicine is,
and his treatment of disease will be marked by hesitation and lack of
energy and firmness.
You see a physician apt to form his opinions on ordinary subjects
hastily. Slight evidence satisfies him, and he makes up his mind at
once. It may be that he does it with so much shrewdness that he is
very apt to be right in his conclusions; but sometimes he is entirely
wrong, because he has in his haste overlooked some apparently slight
circumstances which are really of vital importance. There is quite a
large class of such minds in the medical profession. They are better
fitted to practice in acute forms of disease than in chronic cases.
These latter require patient investigation to thread out all their
intricate complications.
I once knew two physicians of considerable eminence, who had directly
opposite casts of mind, in regard to the qualities to which I have
just alluded. They lived and practised in the same neighborhood
through a long life. The one would spend perhaps an hour in ferreting
out all the hidden labyrinths of a chronic case, and I have often
been delighted, as he would clearly and in choicest language unfold
his views, after he had concluded his examination. The other never
wanted more than a few minutes to learn all he wished to know
of a case, and he was prepared to act. Possessed of much native
shrewdness, it was astonishing to see how he would avoid error in
forming his hasty opinions. He seemed to be aware in what his forte
lay. He had an abhorrence of all long and intricate cases, and turned
them over, so far as he could, to his brethren; and he took peculiar
pleasure in managing acute cases, in which the changes were rapid,
and the end either for good or ill came soon.
You discover in your conversations with one physician on common
subjects, that he is very slow and cautious in adopting opinions, and
when he has once adopted them he adheres to them with great tenacity;
while another, on the contrary, is exceedingly changeable in his
opinions. These opposite qualities, exhibited as they are abroad in
society, go with them to the sick chamber, and they exert their full
influence. The one will fix upon a course of practice in a given case
with all due consideration, and when he has once fixed upon it, he
will pursue it most faithfully, even though the progress of the case
may furnish conclusive evidence that he is wrong. He will be blind to
that evidence, because he believes most assuredly that he is right in
his views of the case. The other will not pursue a course long enough
to determine whether it be right, but will see continual reasons
for change; and his course from the beginning to the end of a case
will often present a medley of variations, from which no intelligent
conclusions can be drawn. The one will have a few favorite remedies,
which he reckons as old and tried friends, and he adds but few to the
little group from year to year. The other will make frequent changes
in the remedies which he employs, and will try in rapid succession
the new medicines, which every fresh periodical bring to his notice.
Some men take strong views of everything which they see. They must
always have an opinion, whether the evidence upon which it is based
be sufficient or not; and that opinion fills the mind, and actuates
all the conduct. They are apt to have very partial and exclusive
views, overlooking in their ardor points, which, though they may
have little apparent prominence, may, if properly examined, lead to
discoveries of great importance. Such men in the medical profession
always make a decided impression upon the public mind, and have many
strong and ardent friends; and if they possess considerable talent,
they generally acquire a dazzling reputation. It is true that they
commit frequent and often great errors. But when their bold opinions
turn out to be correct, it adds wonderfully to their reputation for
acuteness and wisdom, while their errors are mostly concealed,
and the whisper that tells of those errors that chance to be
discovered, is effectually drowned in the noisy commendation of their
enthusiastic adherents.
If I at all succeeded in my object in the chapter on the Uncertainty
of Medicine, the reader was convinced that there is no pursuit in
which a habit of accurate observation is more needed than in the
practice of the medical art.
How then can a common observer test a physician in regard to this
talent? If the observer were himself a physician, he could do this
by watching him in his examinations of cases of disease. But as he
is not, and is therefore ignorant of the subjects to be examined,
he will fail in any attempt of this kind. He will be apt to commit,
for example, this error. He sees that a physician makes a great
many inquiries of his patients in regard to their complaints, and
he may for this reason alone conclude that he is a nice observer.
This minuteness of examination often gives a physician very unjustly
this reputation; and in fact it is one of the most common tricks of
the trade. There is often a great parade of questioning with very
little true observation. A physician who is a skilful observer will
learn more of a patient’s condition, by watching him as he lies in
bed, and making a few inquiries, than another will by a multitude
of questions; just as one man, who scarcely appears to look at
anything as he passes through a street, may really observe and
know more about the various objects in that street, than another
man, who appears with eyes wide open to look at everything. A mere
glance will sometimes reveal to the skilful observer the true nature
of the case, when the unskilful have not been able to discover it
with the most diligent examination of the symptoms. I will mention
a single example. A man who was severely sick was attended by two
physicians, who were somewhat at a loss in regard to the nature of
his disease. Another physician, who was called in, before asking a
single question, suspected from the posture of the patient that he
had a hernia, in common language a rupture; and on examination this
was found to be the case.
I might mention some other errors, to which the inquirer would be
liable, if he attempted to judge directly of the physician’s mode of
examining disease, but it is not necessary.
How then, the question recurs, shall he test the physician on the
point under consideration?
Let him see how the physician observes in regard to some subject,
with which he himself is acquainted. He will discover in this way
what his habits of observation are; and he may be sure, that these
same habits mark his investigations of disease in the chamber of
the sick. No man has different habits of observation for different
subjects.
Suppose that you have a curious article in your possession, and you
have become acquainted with all the facts in regard to it. If you
show it to several physicians, and observe the inquiries which they
make in relation to it, you can discover the different characters
of their minds, and may thus know how they observe and investigate
disease.
One of them asks perhaps but few questions, and some of those are
irrelevant. He discovers but little in regard to the article, and
you may be sure that he will never discover but little in regard to
disease.
Another, after making a few inquiries, starts some supposition or
theory, and this directs all his future inquiries. He of course
obtains a very partial knowledge of the facts, and this is mingled
with errors. And so it is with him in his investigation of medical
subjects. He is a theorizing practitioner.
Another makes many inquiries, but they are of a rambling character.
He finds out many of the facts in regard to the article, but
by no means all of them. His observation is active, but it is
without method and incomplete. Though he will be diligent in the
investigation of disease, and will appear to most persons to be an
acute and skilful observer, he never will obtain a thorough and
complete knowledge of any case.
Another, by a natural succession of inquiries, discovers one fact
after another, till he knows the whole. He does not ask a single
irrelevant question. The answer to every question either developes a
new fact, or confirms one already discovered. He separates accurately
the probable from the true, wholly rejecting the merely plausible.
He frames no theory. His search is only for facts. You may be sure
that he will be a skilful observer in the sick room, and that in the
investigation of disease he will be constantly adding to his store of
valuable and well-arranged facts.
Do you wish to ascertain what characterizes a physician’s _measures_
in the treatment of disease? Instead of watching his practice, of
which, as you have seen, you cannot judge with any good degree of
correctness, observe what measures he proposes when acting, not in
the capacity of a physician, but in that of a citizen, a neighbor,
a member of an association, and what reasons he gives for these
measures. If you find that he advocates measures which show common
sense, shrewdness, and good judgment, and which accomplish the
purpose aimed at; you may safely conclude that the same common sense,
shrewdness and good judgment mark his treatment of his patients, and
that he is a skilful and successful practitioner of medicine.
A very little thing will sometimes develope some characteristic of
a physician’s measures. A physician, as he starts his horse to
leave you after a pleasant chat, finds the rein caught under some
part of the harness. He pulls it up to disengage it; but, as he does
not succeed, he gives it a twitch in which he succeeds no better.
His face reddens, and he twitches again and again, each time more
violently, and finally, by tearing out a loop in his harness, he
disengages the rein. You may safely infer that that physician will
be apt to have just such twitching measures in his treatment of the
sick, and will in this way mar some things which are of some more
importance than the loops in his harness.
It is quite a prevalent idea in the community, that a man may be an
ignoramus in regard to other subjects, and yet may have great skill
in medicine. It is supposed that there is in the healing art a sort
of mysterious tact or skill, innate in the man, and not acquired
like other knowledge. It is this idea which gives such a reputation,
for infallibility almost, to the natural bone-setter. We find here,
also, the reason that intemperance in a physician so little impairs
the confidence of his employers. It must be obvious that in no
employment is a steady and clear state of mind more needed; and the
obscurity of mind and recklessness, which intoxication, even when
existing only in a slight degree, invariably produces, must unfit the
physician for the proper performance of his duties. And yet how many
sensible people, who would fear to trust an intemperate stage-driver
or engineer, will unhesitatingly commit their health and life to the
care of an intemperate physician, because they suppose that he has
a peculiar skill, of which even intoxication cannot deprive him.
His drunkenness seems to act as a dark background, making his skill
appear the brighter by contrast.[34]
In confirmation of this idea of the possession of innate skill, it
is said that a man may be a fool on one subject, and yet may be a
genius on another. A man may be, for instance, a great arithmetician,
or a very ingenious mechanic, and may yet exhibit folly on most
other subjects. This may be true in some few instances, but it is
not at all common; and rare cases never can establish a general
rule or principle. And besides, a genius in medicine, if he be a
mere genius, in the popular sense of the term, makes but a poor
practitioner. For true skill in the practice of medicine requires
the possession of a wide range of talents, and among these sound
judgment, or, (as it is familiarly called when used in reference
to ordinary subjects,) common sense, is pre-eminent. This is a
_sine qua non_ in the physician. The most brilliant talents cannot
make one a good practitioner without this qualification. They may
make him an interesting lecturer, or writer, and may give him a
high reputation in the community. But his lack of this practical
talent must render him unsuccessful in the treatment of disease,
and the lectures which he may give will be deficient in practical
instruction, and the books which he may write will add nothing to
that storehouse of facts, which come only from observation, guided by
a discriminating judgment, and plain common sense. He may construct
beautiful theories, and explain and defend them with ingenuity, but
he never can be a reliable source of instruction and information to
his medical brethren.
The reader has seen that there are then _five_ ways of judging of
the skill and the attainments of a physician. 1st. By examining his
opinions on medical subjects, and the reasons upon which they are
based. 2d. By observing his practice, and comparing its results
with those of the practice of others. 3d. By inquiring into the
evidences of his education. 4th. By observing the unbiassed opinions
entertained of him by his medical brethren. 5th. By observing his
mental qualities as they are exhibited in relation to those subjects
which the observer himself understands.
If the inquirer be a physician, he can very properly make use of the
two first-named means of arriving at the estimate. But if he be a
non-professional observer, he must for the most part give up these
means, as being liable to lead him into error, and resort to the
remaining ones. That he should _entirely_ give up the two first means
I do not claim. All that I claim is, that he should place very little
reliance upon them, while his chief reliance should be upon the three
last.
If intelligent men would adopt the course which I have indicated, in
their attempt to estimate the professional merits of physicians, they
would for the most part avoid the errors which they now so frequently
commit. But, as it now is, they very generally form their judgment
from a direct observation of medical practice, and from the reports
which their friends and acquaintances give of their observations;
and they make but slight use of those means of judging, which I have
shown to be the least liable to error. And I fear that they will be
slow to change in this respect, for the simple reason, that they will
be slow to admit their incompetence to sit in judgment on modes of
treating disease. Dr. Beddoes, an eminent English physician, once
remarked, that “there are three things which almost every person
gives himself credit for understanding, whether he has taken any
pains to make himself master of them or not, These are: 1. The art
of mending a dull fire: 2. Politics: and 3. PHYSIC.” And this is
especially true of the last of these. Both the well informed and the
ignorant seem to think, that they are perfectly competent to decide
whether a physician is treating a case properly; and watch the effect
of remedies in order to do this, and hesitate not to express their
opinions on this point in the most positive manner. So common and
inveterate is this habit in the community, that it will be difficult
to eradicate it. And yet I think it can in some good degree be done.
Intelligent men can be made to see, by a candid exposition of the
peculiar liability there is in medical experience to mistake in
regard to the relation between cause and effect, that it requires an
extensive knowledge of medicine to make accurate observations of the
influence of remedies; and that therefore one who has never studied
this science, and who has had but limited means of observation, must
be but a poor critic on the practice of physicians. They can see
that, though such an one may cope with others in the art of mending
a dull fire, or on the subject of politics, yet on so abstruse
a subject as medicine is, he ought to be somewhat modest in his
opinions, and not put them forth, as is now so often done, with all
the authority of an oracle.
Why then, let me ask, have not intelligent men been made to look upon
this subject in this light? This question I will endeavor to answer.
There is, in the first place, a large class in the medical
profession, who desire no change in the views of the community, but
prefer to maintain their present false position. Their success, like
that of the quack, actually depends on practising upon the credulity
of the public. They would dread being scrutinized in the way which I
have pointed out, by tests which the observer himself understands.
They would prefer that people should continue to judge of them as
they have done, by tests of which they are ignorant, because they can
in this way continue to deceive them. The number of such men in our
profession, I am sorry to say, is very large; and many of them have
an extensive practice, and stand high in the public favor, and for
this reason are quite indifferent both to their own standing with
their brethren, and to the general standing of the profession itself.
Though they do nothing perhaps which is sufficient to endanger their
loss of caste among physicians, their influence is detrimental to the
interests of the profession, and favors in the worst possible way the
hold of quackery upon the community.
There is another large class of medical men, who really desire to
be honorable in their course, but who have felt themselves obliged
to use to some extent the same arts with which the dishonorable
impose upon their patients. They feel that they cannot reform
public sentiment, but must take it as it is, and do the best they
can with it. They find whims and caprices and false ideas among the
intelligent, as well as the ignorant; and instead of taking any
pains to correct the evil, they succumb to it, and set themselves to
work to make capital out of it. They thus place themselves on common
ground with the quack and the pretender, and subject themselves to
be estimated by the same false rules which are applied to them. They
thus have almost insensibly contracted habits of low cunning and
shallow pretension; and these are habits which are not easily given
up. Of course this class of medical men will be inclined to look with
distrust upon any efforts to reform the profession, and the public,
in the particulars to which I have alluded; and, though they may not
actually oppose such efforts, or may from selfish motives even make a
show of favoring them in certain quarters, they cannot be expected to
give them any active support.
There is, however, one result of the course which this class of
medical men have pursued, which seems to be opening the eyes of the
most honorable among them, and which promises to bring them out from
their false and degrading position. They find that their cunning
subservience to the false opinions of the people, has increased the
hold of those opinions upon the public mind; and, as a wide door has
thus been opened for quackery, they find that the same arts, in using
which they have been so successful, are now used quite as dexterously
by the whole herd of ignorant quacks and showy pretenders. They find
that the Homœpathist is stealing away some of their best, and, as
they thought, their most reliable patients. The Thompsonian, the
Chrono-thermalist, &c., are committing similar depredations. And of
all this they have no right to complain, because these pretenders
obtain these patients by the same artful and deceptive means, by
which these physicians at first acquired them, and by which they have
so long retained them among their patrons.
The result which I have pointed out is an accumulated result. The
community are running wild now after various systems and modes of
practice, and the public mind is all afloat, carried about by every
wind of doctrine in medicine. It is now the hey-dey of quackery of
all kinds and degrees. The causes of the great prevalence of this
evil are not temporary and recent, but they have been acting for a
long time, and we now see the accumulated result. Among the chief of
these causes is the course which has been pursued by a large portion
of the medical profession. The profession itself has given birth to
much of the quackery of the present day.
The evil of this comes upon the profession generally, but more
particularly and grievously upon the class of physicians of which I
have just been speaking. The first class which I mentioned are not
as much affected, because, being less scrupulous, they have a wider
range of arts to be used; and the mortifications to which they are
subjected in their competition with quacks are more easily borne,
because they have less of honor and conscience to trouble them in
relation to their course. While this class will be utterly opposed
to any attempts at reform, the second class of which I have spoken,
seeing their false position, and beginning to suffer some of its
vexatious results, will probably experience a sifting process,
whenever efforts at reform shall be thoroughly entered upon. The
least honorable, and those whose habits of imposition (for such they
must be termed), have become fixed, will join the first class, giving
up all scruple, and adopting in full the measures of the quack and
charlatan. But I am persuaded, that the largest portion of this class
of practitioners have so much of honor and conscience, that, whenever
a general effort shall be made to redeem the profession from its
false position before the community, they will be ready to unite in
that effort.
But this effort is not to begin in this class. There is still another
class of physicians who are to originate it. They are the men in our
profession who have always pursued an honorable course, and have
never yielded to the temptations to use the arts of empiricism,
however strong they may have been—who, though they have often seen
their brethren use such arts successfully in their competition with
them without injuring their standing in the community, have never
allowed such mortifications to induce them to swerve from the path
of honor and duty. Efforts, it is true, have been made by such
physicians to enlighten the public mind in relation to its false
estimates of professional merit; but they have been for the most part
isolated and individual efforts, and they have soon been given up for
reasons to which I have before alluded. A general and united effort
is needed, and I have no doubt that it would be successful.
FOOTNOTES:
[34] We had some years ago, says Dr. Rush in one of his lectures,
a physician in this city of sprightly talents, who was an habitual
drunkard. Soon after his death, I was called to attend a gentleman
who had been one of his constant patients. He submitted with
reluctance to my prescriptions, because they were contrary to the
modes of practice of his former physician, to whom he was so much
attached, that he declared he would rather be prescribed for by him
when drunk, than by any sober physician in the city.