The Practitioner. May, 1869. / A Monthly Journal of Therapeutics

Transcriber’s Note:
The cover image was created by the transcriber and is placed in the public domain.
BY JOHN HUGHES BENNETT, M.D., F.R.S.E.
Professor of the Institutes of Medicine, and Senior Professor of Clinical Medicine in the University of Edinburgh.
I have long formed the opinion that the prevailing method of determining the value of any particular medicine or mode of treatment is essentially faulty. Practitioners, after watching a few cases, form a favourable opinion of this or that mode of procedure; they then publish their views, supporting them with their successful cases, and strongly recommend them to the consideration of their medical brethren. Then follow trials more or less numerous by others, some of whom think the method recommended good, whilst others find it useless or injurious. Such a system is characteristic of an imperfect acquaintance with medicine, and during the progress of many centuries, while it has led to some valuable knowledge, has for the most part only tended to superficiality and the utmost contrariety in medical practice. What seems to be necessary at present for determining the real value of any kind of treatment is—
1st. Rigid accuracy in the diagnosis of the case.
2d. A clear comprehension of the nature of the pathological condition treated.
3d. An acquaintance with the natural progress of the disease.
And
4th. A tabulated account of the cases treated, showing the care with which they were observed, and their chief symptoms, including the time they were under treatment, and the termination in success or failure.
Doubtless this method of determining the value of any treatment requires a high degree of medical knowledge, and some trouble; but I would suggest that it is the only one capable of inspiring confidence and permanently advancing the interests of the medical art. If it cannot be carried out during the exigencies of every-day practice, there is nothing to prevent its prosecution in our public hospitals, where the patients are under constant observation, and where there are in many of them a staff of assistants whose business it is to make the necessary records.