medical essays-第65部分

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　obliged　to　please　my　patients　sometimes　with　reasons；　and　I　have　found　that　any　will　pass；　even　with　able　divines　and　acute　lawyers；　the　same　will　pass　with　the　husbands　as　with　the　wives。〃　　If　the　community　could　only　be　made　aware　of　its　own　utter　ignorance；　and　incompetence　to　form　opinions　on　medical　subjects；　difficult　enough　to　those　who　give　their　lives　to　the　study　of　them；　the　practitioner　would　have　an　easier　task。　　But　it　will　form　opinions　of　its　own；　it　cannot　help　it；　and　we　cannot　blame　it；　even　though　we　know　how　slight　and　deceptive　are　their　foundations。

This　is　the　way　it　happens：　Every　grown…up　person　has　either　been　ill　himself　or　had　a　friend　suffer　from　illness；　from　which　he　has　recovered。　　Every　sick　person　has　done　something　or　other　by　somebody's　advice；　or　of　his　own　accord；　a　little　before　getting　better。　　There　is　an　irresistible　tendency　to　associate　the　thing　done；　and　the　improvement　which　followed　it；　as　cause　and　effect。　This　is　the　great　source　of　fallacy　in　medical　practice。　　But　the　physician　has　some　chance　of　correcting　his　hasty　inference。　　He　thinks　his　prescription　cured　a　single　case　of　a　particular　complaint；　he　tries　it　in　twenty　similar　cases　without　effect；　and　sets　down　the　first　as　probably　nothing　more　than　a　coincidence。　　The　unprofessional　experimenter　or　observer　has　no　large　experience　to　correct　his　hasty　generalization。　　He　wants　to　believe　that　the　means　he　employed　effected　his　cure。　　He　feels　grateful　to　the　person　who　advised　it；　he　loves　to　praise　the　pill　or　potion　which　helped　him；　and　he　has　a　kind　of　monumental　pride　in　himself　as　a　living　testimony　to　its　efficacy。　　So　it　is　that　you　will　find　the　community　in　which　you　live；　be　it　in　town　or　country；　full　of　brands　plucked　from　the　burning；　as　they　believe；　by　some　agency　which；　with　your　better　training；　you　feel　reasonably　confident　had　nothing　to　do　with　it。　　Their　disease　went　out　of　itself；　and　the　stream　from　the　medical　fire…annihilator　had　never　even　touched　it。

You　cannot　and　need　not　expect　to　disturb　the　public　in　the　possession　of　its　medical　superstitions。　　A　man's　ignorance　is　as　much　his　private　property；　and　as　precious　in　his　own　eyes；　as　his　family　Bible。　　You　have　only　to　open　your　own　Bible　at　the　ninth　chapter　of　St。　John's　Gospel；　and　you　will　find　that　the　logic　of　a　restored　patient　was　very　simple　then；　as　it　is　now；　and　very　hard　to　deal　with。　　My　clerical　friends　will　forgive　me　for　poaching　on　their　sacred　territory；　in　return　for　an　occasional　raid　upon　the　medical　domain　of　which　they　have　now　and　then　been　accused。

A　blind　man　was　said　to　have　been　restored　to　sight　by　a　young　person　whom　the　learned　doctors　of　the　Jewish　law　considered　a　sinner；　and；　as　such；　very　unlikely　to　have　been　endowed　with　a　divine　gift　of　healing。　　They　visited　the　patient　repeatedly；　and　evidently　teased　him　with　their　questions　about　the　treatment；　and　their　insinuations　about　the　young　man；　until　he　lost　his　temper。　　At　last　he　turned　sharply　upon　them：　　〃Whether　he　be　a　sinner　or　no；　I　know　not：　one　thing　I　know；　that；　whereas　I　was　blind；　now　I　see。〃

This　is　the　answer　that　always　has　been　and　always　will　be　given　by　most　persons　when　they　find　themselves　getting　well　after　doing　anything；　no　matter　what；recommended　by　anybody；　no　matter　whom。　Lord　Bacon；　Robert　Boyle；　Bishop　Berkeley；　all　put　their　faith　in　panaceas　which　we　should　laugh　to　scorn。　　They　had　seen　people　get　well　after　using　them。　　Are　we　any　wiser　than　those　great　men？　　Two　years　ago；　in　a　lecture　before　the　Massachusetts　Historical　Society；　I　mentioned　this　recipe　of　Sir　Kenelm　Digby　for　fever　and　ague：　Pare　the　patient's　nails；　put　the　parings　in　a　little　bag；　and　hang　the　bag　round　the　neck　of　a　live　eel；　and　place　him　in　a　tub　of　water。　The　eel　will　die；　and　the　patient　will　recover。

Referring　to　this　prescription　in　the　course　of　the　same　lecture；　I　said：　〃You　smiled　when　I　related　Sir　Kenehn　Digby's　prescription；　with　the　live　eel　in　it；　but　if　each　of　you　were　to　empty　his　or　her　pockets；　would　there　not　roll　out；　from　more　than　one　of　them；　a　horse…chestnut；　carried　about　as　a　cure　for　rheumatism？　　Nobody　saw　fit　to　empty　his　or　her　pockets；　and　my　question　brought　no　response。　But　two　months　ago　I　was　in　a　company　of　educated　persons；　college　graduates　every　one　of　them；　when　a　gentleman；　well　known　in　our　community；　a　man　of　superior　ability　and　strong　common…sense；　on　the　occasion　of　some　talk　arising　about　rheumatism；　took　a　couple　of　very　shiny　horse…chestnuts　from　his　breeches…pocket；　and　laid　them　on　the　table；　telling　us　how；　having　suffered　from　the　complaint　in　question；　he　had；　by　the　advice　of　a　friend；　procured　these　two　horse…chestnuts　on　a　certain　time　a　year　or　more　ago；　and　carried　them　about　him　ever　since；　from　which　very　day　he　had　been　entirely　free　from　rheumatism。

This　argument；　from　what　looks　like　cause　and　effect；　whether　it　be　so　or　not；　is　what　you　will　have　to　meet　wherever　you　go；　and　you　need　not　think　you　can　answer　it。　　In　the　natural　course　of　things　some　thousands　of　persons　must　be　getting　well　or　better　of　slight　attacks　of　colds；　of　rheumatic　pains；　every　week；　in　this　city　alone。　Hundreds　of　them　do　something　or　other　in　the　way　of　remedy；　by　medical　or　other　advice；　or　of　their　own　motion；　and　the　last　thing　they　do　gets　the　credit　of　the　recovery。　　Think　what　a　crop　of　remedies　this　must　furnish；　if　it　were　all　harvested！

Experience　has　taught；　or　will　teach　you；　that　most　of　the　wonderful　stories　patients　and　others　tell　of　sudden　and　signal　cures　are　like　Owen　Glendower's　story　of　the　portents　that　announced　his　birth。　　The　earth　shook　at　your　nativity；　did　it？　　Very　likely；　and

　　　　　　　　　　　　　　　〃So　it　would　have　done；　　　　　　At　the　same　season；　if　your　mother's　cat　　　　　　Had　kittened；　though　yourself　had　ne'er　been　born。〃

You　must　listen　more　meekly　than　Hotspur　did　to　the　babbling　Welshman；　for　ignorance　is　a　solemn　and　sacred　fact；　and；　like　infancy；　which　it　resembles；　should　be　respected。　　Once　in　a　while　you　will　have　a　patient　of　sense；　born　with　the　gift　of　observation；　from　whom　you　may　learn　something。　　When　you　find　yourself　in　the　presence　of　one　who　is　fertile　of　medical　opinions；　and　affluent　in　stories　of　marvellous　cures；of　a　member　of　Congress　whose　name　figures　in　certificates　to　the　value　of　patent　medicines；　of　a　voluble　dame　who　discourses　on　the　miracles　she　has　wrought　or　seen　wrought　with　the　little　jokers　of　the　sugar…of…milk　globule…box；　take　out　your　watch　and　count　the　pulse；　also　note　the　time　of　day；　and　charge　the　price　of　a　visit　for　every　extra　fifteen；　or；　if　you　are　not　very　busy；　every　twenty　minutes。　　In　this　way　you　will　turn　what　seems　a　serious　dispensation　into　a　double　blessing；　for　this　class　of　patients　loves　dearly　to　talk；　and　it　does　them　a　deal　of　good；　and　you　feel　as　if　you　had　earned　your　money　by　the　dose　you　have　taken；　quite　as　honestly　as　by　any　dose　you　may　have　ordered。

You　must　take　the　community　just　as　it　is；　and　make　the　best　of　it。　You　wish　to　obtain　its　confidence；　there　is　a　short　rule　for　doing　this　which　you　will　find　useful；deserve　it。　　But；　to　deserve　it　in　full　measure；　you　must　unite　many　excellences；　natural　and　acquired。

As　the　basis　of　all　the　rest；　you　must　have　all　those　traits　of　character　which　fit　you　to　enter　into　the　most　intimate　and　confidential　relations　with　the　families　of　which　you　are　the　privileged　friend　and　counsellor。　　Medical　Christianity；　if　I　may　use　such　a　term；　is　of　very　early　date。　　By　the　oath　of　Hippocrates；　the　practitioner　of　ancient　times　bound　himself　to　enter　his　patient's　house　with　the　sole　purpose　of　doing　him　good；　and　so　to　conduct　himself　as　to　avoid　the　very　appearance　of　evil。　　Let　the　physician　of　to…day　begin　by　coming　up　to　this　standard；　and　add　to　it　all　the　more　recently　discovered　virtues　and　graces。

A　certain　amount　of　natural　ability　is　requisite　to　make　you　a　good　physician；　but　by　no　means　that　disproportionate　development　of　some　special　faculty　which　goes　by　the　name　of　genius。　　A　just　balance　of　the　mental　powers　is　a　great　deal　more　likely　to　be　useful　than　any　single　talent；　even　were　it　the　power　of　observation；　in　excess。　　For　a　mere　observer　is　liable　to　be　too　fond　of　facts　for　their　own　sake；　so　that；　if　he　told　the　real　truth；　he　would　confess　that　he　takes　more　pleasure　in　a　post…mortem　examination　which　shows　him　what　was　the　matter　with　a　patient；　than　in　a　case　which　insists　on　getting　well　and　leaving　him　in　the　dark　as　to　its　nature。　　Far　more　likely　to　interfere　with　the　sound　practical　balance　of　the　mind　is　that　speculative；　theoretical　tendency　which　has　made　so　many　men　noted　in　their　day；　whose　fame　has　passed　away　with　their　dissolving　theories。　Read　Dr。　Bartlett's　comparison　of　the　famous　Benjamin　Rush　with　his　modest　fellow…townsman　Dr。　William　Currie；　and　see　the　dangers　into　which　a　passion　for　grandiose　generalizations　betrayed　a　man　of　many　admirable　qualities。

I　warn　you　against　all　ambitious　aspirations　outside　of　your　profession。　　Medicine　is　the　most　difficult　of　sciences　and　the　most　laborious　of　arts。　　It　will　task　all　your　powers　of　body　and　mind　if　you　are　faithful　to　it。　　Do　not　dabble　in　the　muddy　sewer　of　politics；　nor　linger　by　the　enchanted　streams　of　literature；　nor　dig　in　far…off　fields　for　the　hidden　waters　of　alien　sciences。　　The　great　practitioners　are　generally　those　who　concentrate　all　their　powers　on　their　business。　　If　there　are　here　and　there　brilliant　exceptions；　it　is　only　in　virtue　of　extraordinary　gifts；　and　industry　to　which　very　few　are　equal。

To　get　business　a　man　mast　really　want　it；　and　do　you　suppose　that　when　you　are　in　the　middle　of　a　heated　caucus；　or　half…way　through　a　delicate　analysis；　or　in　the　spasm　of　an　unfinished　ode；　your　eyes　rolling　in　the　fine　frenzy　of　poetical　composition；　you　want　to　be　called　to　a　teething　infant；　or　an　ancient　person　groaning　under　the　griefs　of　a　lumbago？　　I　think　I　have　known　more　than　one　young　man　whose　doctor's　sign　proclaimed　his　readiness　to　serve　mankind　in　that　capacity；　but　who　hated　the　sound　of　a　patient's　knock；　and　as　he　sat　with　his　book　or　his　microscope；　felt　exactly　as　the　old　party　expressed　himself　in　my　friend　Mr。　Brow