Physician and patient

by Worthington Hooker

CONTENTS.

CHAPTER I.

UNCERTAINTY OF MEDICINE,

[25]

Importance of the subject. Definiteness of results in chemistry. Only a distant and humble approach to this possible in medicine. Illustration from chemistry. Causes of the Uncertainty of Medicine. 1. Sympathy between different organs; 2. Symptoms produced at a distance from the seat of disease. Disease extended by sympathy. Transposition of disease from one organ to another. 2. Influence of unseen or secret causes. Nature of many causes of disease unknown. Combination of many agencies in producing disease, some of them having acted a long time. Cases rendered complex by treatment before physician is applied to. 3. Natural changes in the system arising from the curative power of nature, and from the principle of self-limitation in diseases. Illustrations of the operation of the vis medicatrix naturæ—vomiting to remove offending matters from the stomach—suppuration and discharge of a swelling. Tendency of diseases to come to a conclusion—more definite and regular in some complaints than in others. Mistakes from confounding the effects of remedies with the changes produced by these two tendencies. 4. Mental influences. Connection of mind with body modifying disease. Effects produced through the mind often attributed to physical causes and remedies. Case of the dyspeptic. 5. Individual peculiarities.

CHAPTER II.

SKILL IN MEDICINE,

[50]

Show in what medical skill consists, in view of the uncertainty of medicine—appreciating the condition of the patient in all respects, and applying remedies in the best manner to relieve this condition. Errors impairing skill. Taking limited views of disease. Directing attention too much to particular organs. Undue attachment to certain modes of investigation. Difficulties in the way of deciding what it is best to do. Course of different physicians in view of these difficulties. Accurate proportioning of means and ends. Value of experience. Illustration of some of these points in the case of a sick traveller assisted by his friend in going through a mountain pass.