Practical medicine and medical diagnosis / by Byrom Bramwell.

  • Byrom Bramwell
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Practical medicine and medical diagnosis / by Byrom Bramwell. Source: Wellcome Collection.

    147/164 (page 139)
    comes to consult a doctor; try to realise, if yon have not actually done so in your own persons, the immense effect which his opinion will, in many instances, produce on that patient's mind; and you will have no difficulty in understanding the tremendous influence—I can use no minor term—which that opinion will, in many instances, produce upon the organism, and hence upon the pathological condition (in some cases directly as in many functional derangements, and in others more or less indirectly, as in some organic conditions). I repeat that a favourahle opinion, confidently expressed by a physician in whom the patient places implicit trust is, in many cases, the most potent tonic and restorative which it is possible to administer. In some instances, as for example, in many cases of functional derange- ment (the functional fibrillary twitchings which I have previously mentioned, many forms of functional derangement of the heart, some cases of hysterical disease, even hysterical paralysis), it is the only medicine which is required, and is of itself sufficient to effect a cure. Tt must, however, be remembered that in many cases the effect is only temporary, and that it is generally advisable to keep up the tonic in- fluence by the administration of remedies—coloured water being, in many instances, all that is required. But even where the patient is actually suffering from severe organic disease, the beneficial effect is often most striking,—and in some cases, where life is hanging in the balance, as for instance in some acute diseases, the opinion of the doctor may turn the scale, and death or recovery may depend upon the effect which it produces upon the mind of the patient. But in order that a favourable opinion may produce this tonic and restorative effect, it is essential that it should be expressed with con- fidence, and that the patient should thoroughly believe in it. And here let me say in passing, that there is no quality which is more conducive to success in practice than the power of impressing patients favourably, and of creating confidence. I cannot too strongly urge you to do your utmost to cultivate and elaborate this faculty, for it can, to a large extent, be improved and cultivated. It is perfectly true that tliere are great natural differences in individuals in this respect. To some extent the power of inspiring confidence is a matter of 'manner' and 'address,' but to a still greater extent it depends upon the confidence which the practitioner feels in himself. Now self- confidence is of two kinds. There is, on the one hand, that self- confidence which is due to mere self-assurance—and that the arrant quack who is totally ignorant of the mere elements of medicine can by dogmatic opinions, tlie result of mere self-assurance, and by the