IV. Permit me to recommend to you a regard to all the interests of your country. The education of a physician gives him a peculiar insight in the principles of many useful arts, and the practice of physic favours his opportunities of doing good, by diffusing knowledge of all kinds. It was in Rome, when medicine was practised only by slaves, that physicians were condemned by their profession “mutam exercere artem.” But in modern times, and in free governments, they should disdain an ignoble silence upon public subjects. The American revolution has rescued physic from its former slavish rank in society. For the honour of our profession it should be recorded, that some of the most intelligent and useful characters, both in the cabinet and the field, during the late war, have been physicians. The illustrious Dr. Fothergill opposed faction and tyranny, and took the lead in all public improvements in his native country, without suffering thereby the least diminution of that reputation, or business, in which, for forty years, he flourished almost without a rival in the city of London.
V. Let me advise you, in your visits to the sick, never to appear in a hurry, nor to talk of indifferent matters before you have made the necessary inquiries into the symptoms of your patient's disease.
VI. Avoid making light of any case. “Respice finem” should be the motto of every indisposition. There is scarcely a disease so trifling, that has not, directly or indirectly, proved an outlet to human life. This consideration should make you anxious and punctual in your attendance upon every acute disease, and keep you from risking your reputation by an improper or hasty prognosis.
VII. Do not condemn, or oppose, unnecessarily, the simple prescriptions of your patients. Yield to them in matters of little consequence, but maintain an inflexible authority over them in matters that are essential to life.
VIII. Preserve, upon all occasions, a composed or cheerful countenance in the room of your patients, and inspire as much hope of a recovery as you can, consistent with truth, especially in acute diseases. The extent of the influence of the will over the human body, has not yet been fully ascertained. I reject the futile pretensions of Mr. Mesmer to the cure of diseases, by what he has absurdly called animal magnetism. But I am willing to derive the same advantages from his deceptions, which the chemists have derived from the delusions of the alchemists. The facts which he has established, clearly prove the influence of the imagination, and will, upon diseases. Let us avail ourselves of the handle which those faculties of the mind present to us, in the strife between life and death. I have frequently prescribed remedies of doubtful efficacy in the critical stage of acute diseases, but never till I had worked up my patients into a confidence, bordering upon certainty, of their probable good effects. The success of this measure has much oftener answered, than disappointed my expectations; and while my patients have commended the vomit, the purge, or the blister which was prescribed, I have been disposed to attribute their recovery to the vigorous concurrence of the will in the action of the medicine. Does the will beget insensibility to cold, heat, hunger, and danger? Does it suspend pain, and raise the body above feeling the pangs of Indian tortures? Let us not then be surprised that it should enable the system to resolve a spasm, to open an obstruction, or to discharge an offending humour. I have only time to hint at this subject. Perhaps it would lead us, if we could trace it fully, to some very important discoveries in the cure of diseases.
IX. Permit me to advise you in your intercourse with your patients, to attend to that principle in the human mind, which constitutes the association of ideas. A chamber, a chair, a curtain, or even a cup, all belong to the means of life or death, accordingly as they are associated with cheerful or distressing ideas, in the mind of a patient. But this principle is of more immediate application in those chronic diseases which affect the mind. Nothing can be accomplished here, till we produce a new association of ideas. For this purpose a change of place and company are absolutely necessary. But we must sometimes proceed much further. I have heard of a gentleman in South-Carolina who cured his fits of low spirits by changing his clothes. The remedy was a rational one. It produced at once a new train of ideas, and thus removed the paroxysm of his disease.
X. Make it a rule never to be angry at any thing a sick man says or does to you. Sickness often adds to the natural irritability of the temper. We are, therefore, to bear the reproaches of our patients with meekness and silence. It is folly to resent injuries at any time, but it is cowardice to resent an injury from a sick man, since, from his weakness and dependence upon us, he is unable to contend with us upon equal terms. You will find it difficult to attach your patients to you by the obligations of friendship or gratitude. You will sometimes have the mortification of being deserted by those patients who owe most to your skill and humanity. This led Dr. Turner to advise physicians never to chuse their friends from among their patients. But this advice can never be followed by a heart that has been taught to love true excellency, wherever it finds it. I would rather advise you to give the benevolent feelings of your hearts full scope, and to forget the unkind returns they will often meet with, by giving to human nature—— a tear.
XI. Avoid giving a patient over in an acute disease. It is impossible to tell in such cases where life ends, and where death begins. Hundreds of patients have recovered, who have been pronounced incurable, to the great disgrace of our profession. I know that the practice of predicting danger and death upon every occasion, is sometimes made use of by physicians, in order to enhance the credit of their prescriptions if their patients recover, and to secure a retreat from blame, if they should die. But this mode of acting is mean and illiberal. It is not necessary that we should decide with confidence at any time, upon the issue of a disease.
XII. A physician in sickness is always a welcome visitor in a family; hence he is often solicited to partake of the usual sign of hospitality in this country, by taking a draught of some strong liquor, every time he enters into the house of a patient. Let me charge you to lay an early restraint upon yourselves, by refusing to yield to this practice, especially in the forenoon. Many physicians have been innocently led by it into habits of drunkenness. You will be in the more danger of falling into this vice, from the great fatigue and inclemency of the weather to which you will be exposed in country practice. But you have been taught that strong drink affords only a temporary relief from those evils, and that it afterwards renders the body more sensible of them.