But must the physician say nothing about results to the public? Certainly he should.
In the first place, he should endeavor to guard those, with whom he has daily intercourse, against erroneous views of results in medicine, by showing them the difficulties that lie in the way of estimating them with correctness. If he succeeds at all in producing a proper impression upon their minds, and thus induces them to be modest and careful, instead of being bold and heedless, as too many are, in expressing their opinions on such subjects, he will exert an effectual influence, in preventing them from being deluded by the partial views of facts, and the mis-statements, upon which empiricism relies for its success.
In the second place, whenever he can make a comparison between the results of good practice and those of quackery, which can be fairly understood, let him do it. To warrant such a comparison the facts should be clear, well authenticated, and in sufficient number to justify the general conclusions drawn from them.
In the third place, whenever he can show, by facts which can be appreciated by the common observer, that the practice pursued by any pretender has been entirely inappropriate to any case, especially if this can be done by evidence discovered in an examination after death, let him do it, and explain with all clearness the nature of that evidence to the friends of the patient, and, if necessary, to the community. At the same time, he should avoid joining in with the popular disposition to ascribe death to the treatment pursued as a matter of course, whether the proof be or be not satisfactory.[28] There is no doubt that death is frequently the consequence of bad practice, when it cannot be proved to be so; but not even the quack, murderous as his course certainly is, should be condemned upon faulty and defective evidence.
FOOTNOTES:
[25] The above remarks may be applied to an exclusive system quite popular just now—I refer to Hydropathy. Cold water is a valuable remedial agent, used both internally and externally, as the recorded experience of medical men abundantly proved long before Priesnitz appeared on the stage. But the indiscriminate and exclusive use of it, which is prescribed by his system, is as bad practice as the indiscriminate and exclusive use of anything else—and a full and impartial record of Hydropathic practice would show it to be so.
[26] When an epidemic is prevalent, such a physician instead of allaying the undue public excitement, as it is his duty to do, increases it by his very grave and wise air of conversation, and by his reports of his cases, of which he is apt to have more than his neighbors, and to be of course very successful in their treatment. Even when there are only distant rumors of the epidemic, he has occasion to report to gossiping circles some cases which at least come very near to being true cases of it.
[27] Dr. Holmes says of this pre-eminently talented and learned man—“Berkeley died at the age of about seventy; he might have lived longer, but his fatal illness was so sudden that there was not time enough to stir up a quart of his panacea. He was an illustrious man, but he held two very odd opinions; that tar water was everything, and that the whole material universe was nothing.”
[28] The bare fact that death results is obviously no proof of the want of skill, any more than the bare fact that a case has ended in recovery is proof of the possession of skill. But the disposition to which I have alluded is quite common, and gives rise to many unjust conclusions in regard to the merits of physicians. Hence physicians often manifest, in various ways, a dread of having the charge of cases, which are sure to end fatally. Some, to avoid the imputation of “bad luck,” as it is expressed, often manage adroitly to throw such cases off from their own hands into those of some neighboring practitioner, or some empiric, before death actually occurs.