A recent movement of the medical profession in this country, if I mistake not, is destined to exert a great and a permanent agency in the overthrow of empiricism. I refer to the formation of the “American Medical Association” in 1847. Although the meeting in Boston in May last was only the second annual meeting of the Association, so fully did the profession throughout the country respond to the call, that the number of the delegates amounted to about four hundred and fifty. The measures which have already been entered upon, and the spirit which has been manifested, clearly indicate, that the great object for which the Association was formed, “the elevation and advancement of our common calling” will be rigorously and steadily prosecuted. The recurrence of this festival of the profession from year to year, I fully believe, will be marked by real advances in all the interests of medical science.
And now, I ask, is it too much to expect of the stable and well-informed in the community, that they will give their countenance to the objects at which we aim? While we are thus struggling together to elevate the standard of medical education, and to rid our noble profession of the abuses which impair its honor and its usefulness, we have a right to demand of the community, which is to be especially benefitted by these efforts, a cheerful and active support. Whether this shall be given us, will depend upon the men of influence in every profession and occupation in our land. It is to them that we make our appeal, and we believe that it will not be made in vain.
FOOTNOTES:
[35] There is nothing by which the quackish practitioner is more plainly distinguished from the honorable one, than by the mode of competition in which he engages, and the kind of reputation at which he aims. He resorts to tricks, and raises false issues. He boasts of success; and, if he do it skilfully, he does not much endanger his reputation for a proper degree of modesty. He is always finding out something wonderful in his cases—something which it is supposed other physicians have not acuteness enough to discern. He loves to see the credulous, whether learned or unlearned, gaze at his wonders, and to hear the loose tongues of gossipers busy in his praise. He aims at a reputation for performing great cures in cases in which others have been said to fail—a reputation which no honorable physician ever has, however eminent he may be, because he does not seek after it. Every quack seeks for it, and acquires it to a greater or less extent. The physician can have it if he will make it his aim, but in doing this he puts himself on a level with the quack in the common field of empiricism.
CHAPTER XII.
INTERCOURSE OF PHYSICIANS.[36]
The object of this chapter is to notice some points in relation to the intercourse of physicians, which the community ought to understand, and to correct some prevalent errors, which tend to destroy the harmony of the profession, and to impair its usefulness.
Mistaken notions are very prevalent, even among thinking and judicious men, both in regard to the object of consultations, and the principles by which they should be regulated. These notions sometimes exert a very injurious influence, and the patient is deprived of the benefit to which he has a right, from the combined wisdom of those who consult upon his case.
What then is the main object of a consultation, is an important inquiry.
It seems to be considered by many as the chief object of a consultation to decide the question, whether the patient will die or recover. We hear ignorant people talk about a ‘jury of doctors,’ and they ask ‘what they gave in,’ as if a sort of verdict was to be pronounced of a decisive, almost a binding, character, in regard to the result of the case. The same erroneous ideas are, to some extent, to be found among sensible and well informed people, though they are expressed in a different way. Let me not be understood to say, that the question, whether the patient will probably recover, should not come up for consideration at all. But it is certainly a gross error to suppose, that the decision of this question is a principal object of the consultation. It is in fact a merely incidental object, and it is profitable only as it may have some bearing upon the treatment, as it sometimes does, though much less often, and to a less extent, than is commonly supposed. Sometimes, I may say often, nothing like a decision of this question can be arrived at. Farther developments in the progress of the case must be waited for before this can be done.
Neither is it the object of a consultation to have the physician who is called in prescribe to the attending physician what he shall do; though this is often considered to be the object, especially when the consulting physician is much older than the one who is in attendance upon the case. Dictation is certainly very far from being consultation.