Volume 1

A system of medicine by eminent authorities in Great Britain, the United States and the Continent / edited by William Osler, assisted by Thomas McCrae.

Date:
1907-10
Catalogue details

Licence: In copyright

Credit: A system of medicine by eminent authorities in Great Britain, the United States and the Continent / edited by William Osler, assisted by Thomas McCrae. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    usurped, I fear, some of their duties, and have advantages that they do not possess) we eould give them at least a good introduction to tlieir life- work; and a man could enter upon practice with a rational outlook on disease, and be prepared to continue his education with the help, not at the expense, of the ])ublic. But all this is changing rapidly, and year by year the men who leave our schools are better educated and in every way better fitted to practise medicine intelligently. Lack of critical judgment is another serious obstacle in the way of the young man. It is hard to get life’s spectacles adjusted, so hard to get clear vision, where so much is obscure. The faculty of “right judgment in all things” is granted to few men, but the physician to be of any value must at least asjiire to that round-about common sense which was so distinguishing a feature in Sydenham. It may be cultivated, but with caution, as it is one of the virtues more readily acquired when not too consciously sought. Slow of growth, and the fruit of a seasoned experience, good clinical judgment only comes with careful study, and is best seen in men who appreciate the value of thoroughness in their work. The mental attitude controls the course of a man’s evolution as a clinical physician. While nothing can be more fatal than a cold Pyrrhonism in which everything is doubted, in the midst of so much credulity, lay and professional, it is well for the young man to take as a motto the saying of that wise old pre-Hippocratic poet-physician, Epicharmus, of Syracuse: *“Be sober and distrustful; these are the sinews of the understanding.” Credulity is of the very essence of human nature and we physicians are not exempt from the common lot. Our work is an incessant collection of evidence, weighing of evidence, and judging upon the evidence, and we have to learn early to make large allowances for our own frailty, and still larger for the weaknesses, often involuntary, of our patients. The history of medicine is full of instances of self-deception on the part of the best of men, and it is well that the young man should at the outset be humble, as he is not likely to escape altogether. Science has done much in revolutionizing mankind, but man remains the same credulous creature as he has been in all ages. Tar-water, Perkin’s tractors, laying on of hands, Christian' Science, Lourdes, and the other miracle-working shrines illustrate the deep, intense credulity from which science has not yet freed mankind and is not likely to do so. It is an aspect of human nature which we must accept and .sometimes utilize, remembering the remark of Galen: “He cures the greatest number in whom most men have most faith.” It is for the practitioner to make the new facts of science efficient and useful, to translate science into practice Often a very prolonged affair from inherent difficulties connected with the complicated mechanism of man’s body, this is sometimes a source of discouragement, and we hear complaints of the slowness of progress in medicine, and of the inability of physicians at once to turn to practical account some striking discovery. The history of science teaches us that it takes many years from the announcement of the fact to its full a]i])licalion. From Faraday’s work on electromagnetic induction to the making of dynamos for com- mercial purpo.ses was a longer period than from Claude Bernard’s discovery of internal secretion to the suece.ssful treatment of a ca.se of myxoedema with thyroid extract. In making a new application of science the stages are well defined. First there is the discovery of the phenom-