There is one part of their business which certain medical practitioners are too apt to forget; namely, that what they should most of all try to do is to ward off disease, to alleviate suffering, to preserve life, or at least to prolong it if possible. It is not of the slightest interest to the patient to know whether three or three and a quarter cubic inches of his lung are hepatized. His mind is not occupied with thinking of the curious problems which are to be solved by his own autopsy,—whether this or that strand of the spinal marrow is the seat of this or that form of degeneration. He wants something to relieve his pain, to mitigate the anguish of dyspnea, to bring back motion and sensibility to the dead limb, to still the tortures of neuralgia. What is it to him that you can localize and name by some uncouth term the disease which you could not prevent and which you cannot cure? An old woman who knows how to make a poultice and how to put it on, and does it tuto, eito, jucunde, just when and where it is wanted, is better,—a thousand times better in many cases,—than a staring pathologist, who explores and thumps and doubts and guesses, and tells his patient be will be better tomorrow, and so goes home to tumble his books over and make out a diagnosis.
But in those days, I, like most of my fellow students, was thinking much more of “science” than of practical medicine, and I believe if we had not clung so closely to the skirts of Louis and had followed some of the courses of men like Trousseau,—therapeutists, who gave special attention to curative methods, and not chiefly to diagnosis,—it would have been better for me and others. One thing, at any rate, we did learn in the wards of Louis. We learned that a very large proportion of diseases get well of themselves, without any special medication,—the great fact formulated, enforced, and popularized by Dr. Jacob Bigelow in the Discourse referred to. We unlearned the habit of drugging for its own sake. This detestable practice, which I was almost proscribed for condemning somewhat too epigrammatically a little more than twenty years ago, came to us, I suspect, in a considerable measure from the English “general practitioners,” a sort of prescribing apothecaries. You remember how, when the city was besieged, each artisan who was called upon in council to suggest the best means of defence recommended the articles he dealt in: the carpenter, wood; the blacksmith, iron; the mason, brick; until it came to be a puzzle to know which to adopt. Then the shoemaker said, “Hang your walls with new boots,” and gave good reasons why these should be the best of all possible defences. Now the “general practitioner” charged, as I understand, for his medicine, and in that way got paid for his visit. Wherever this is the practice, medicine is sure to become a trade, and the people learn to expect drugging, and to consider it necessary, because drugs are so universally given to the patients of the man who gets his living by them.