Various

“ The educated physician is the only person who is equipped to solve the problems of disease; and it is, in the long run, cheapest, even from the financial point of view, for one who is ill to obtain competent medical advice. Therefore, considering merely the welfare of the patient, the physician deplores the custom of counter-prescribing.
The universal practice among apothecaries of refilling prescriptions indefinitely, without the sanction of those who wrote them is frequently the subject of adverse criticism by physicians. “But,” says the pharmacist, “is not the prescription mine?” ”

“ Above all, do not let every physician within reach be sent for, unless the situation is one of great urgency, as I believe many patients have been frightened to death by the demoralization of solicitous friends.
If you can show yourself capable and maintain your own composure of mind, you will be able in nearly every instance to avert a panic, and in many cases prevent disastrous results to your patient. But if you fail at times for want of proper courage, do not give up with a feeling that you are unequal to emergencies, only be the more determined not to show the white feather again. ”

“ It is very pertinent to ask, in what pursuit in life inheres that tendency to make the laborers therein independent of labor? It is equally pertinent to ask, where is there an instance, in the history of labor, where a man, following the duty common to his fellow workers and relying on his own unaided hands and brain, ever acquired the competency to live, in his accustomed sphere, independent of labor? ”

“ With him the first step in every case of disease is diagnosis, without which prescribing is simply drawing a bow at a venture, with small probability of penetrating a joint of the harness; and he insists that neither the apothecary nor the patient is qualified to make a diagnosis. The determination of the character of a disease is not a simple matter, often baffling the profoundest learning and the broadest experience, and, in most cases, requiring special knowledge and discriminating judgment. The most obtrusive symptoms are by no means necessarily the most characteristic ”

“ Nobody knows as well as the pharmacist what quantities of drugs are sold in this form; nobody knows as fully as the physician the enormously baneful effects which they produce. If apothecaries would refuse to handle this class of goods, they would confer a wonderful blessing on humanity, by demonstrating their belief in the injuriousness of these articles, and thus bringing them into disrepute; and they would vastly dignify their profession by displaying its sense of moral obligation, even at the sacrifice of a lucrative part of its business. ”

“ You are the physician’s eyes, ears, and hands while he is absent; you cannot therefore be too watchful.
Each one of us has certain vulnerable points of character, but it is not always easy for us to see them. If we would be self-possessed we must seek to discover these weak points in our armor by seeing ourselves as others see us; then by learning how to cover them, and not be disconcerted when our weak point is attacked. No one virtue is of more value in your arduous calling than this one of self-possession. ”

“ When we reflect on the mode of nutrition of the tooth, it seems almost self-evident that any depressing agency which could lead to disease of the pulp must, by an augmented action, cause greater disease in the structures which depend on the pulp for their nutrition to start with. At most, disease and pain in the pulp alone must be nothing less than a pathological curiosity. Such, however, is not the case in the vast multitude of cases dependent on caries, in which the pulp has lost in part or in whole its protection from external morbid influences. ”

“ The opium habitué realizing that he is looked upon as one who has given himself up to a vicious habit, a habit in which he persists from mere desire to enjoy the pleasures of opium—pleasures which, be it ever remembered, soon give place to its pains—and so liable to the censure which a vicious indulging involves, is impelled—by a feeling common to us all of guarding our good repute—to yield to the protective temptation to untruth. ”

“ When we come to the question of why pain is located or referred to a particular nerve, I believe the answer in the overwhelming majority of cases will be because there is some peripheral abnormality in that nerve or in some other nerve with which it is intimately associated; for we have to recognize in the philosophy of pain the same fact that we do in the philosophy of the human mind, namely, that our ideas are so closely associated that one thought will almost necessarily suggest another. ”

“ I presume the symptom of pain is the one for which the overwhelming number of your patients, as the majority of ours, apply to us for relief. And yet common as this sensation is both in ourselves and in others, it is very remarkable how little settled opinion is, as to its nature. If you have never had occasion to try and put into the form of a definition the idea of pain, and proceed to consult the authorities, you will be surprised that so many different views could be held of what at first seems so common and obvious as to be beyond dispute. ”

“ The moment the competition for existence and for wealth becomes keener, the greater will be the temptation of the unsuccessful or depraved to seek oblivion for their failure in some narcotic, which will for the time being quiet their disappointed consciousness. When in addition you have an inherited weakness on the part of your patient in his susceptibility to pain, or in a condition of pain actually existing, can you wonder that so many fall by the way? ”

“ The earliest record I can find of women devoting themselves to the care of the sick, and attending to all the duties of a trained nurse, is that of Empress Helena, mother of Constantine the Great. This noble woman, who lived nearly fifteen hundred years ago, not only founded a hospital and endowed it, but herself, with the ladies of her court, there gave the most devoted and tender care to the sick poor. ”

“ On the other hand, the conditions of a cultured life are of an ever widening horizon, and it is characteristic of medical men that their intellectual sense is inquisitive, keen, appreciative and alert in their own sphere of action, less satisfied with what is and more anxious for better results, beyond the genius of any other professional life, and this for the distinctive reason that every new discovery in medical science promotes accuracy in the application of medical art. Working becomes a passion with medical men; the more they know the more eager they are to work. ”

“ Thanks to this school, and others, everyone can now have skilled female care when sickness and disease are upon them.
You who are about to go out from us to-day, are entering upon a calling which will require all the skill, faithfulness, courage, patience, forbearance, endurance, watchfulness, self-possession, tenderness, cheerfulness and tact, that a human being can possess, and above all, “a conscience void of offence toward God and man.” “To thine own self be true, and it doth follow as the night the day, thou canst not then be false to any other.” ”

“ We are apt to claim the trained female nurse as the outcome of the more rational treatment of disease, in modern times, but this is wide of the truth. So far as I can ascertain, in my researches among the ancient Vidas of Hindostan, and the literature of Egypt, Greece and Rome, I find no allusion to female nurses as a class, until the third century of the Christian era. Surgery and medicine had attained a high degree of perfection, many operations which to-day we claim as new to the nineteenth century were successfully performed 4,000 years ago ”

“ Looked upon as the victims of their own wrong-doing, or as unworthy the sympathy that should ever exist between physician and patient, or treated on the erroneous belief that such is the only proper method, they are consigned to the brutal ordeal of abrupt and entire opiate disusing, which, while it may end in the desired result, entails such suffering of mind and body as to be utterly inexcusable—because a more humane method will avail—except under conditions peculiar and beyond control. ”

“ The first point which strikes every observing man is the difference of individuals in their susceptibility to pain. It is not merely or even mainly a question of the amount of courage of the patient in bearing pain, but it is far more a question of inherited or acquired sensitiveness. The same amount of injury, as nearly as we can judge, in two differently organized individuals will produce extremely differing degrees of pain. ”

“ If this be true—and it is true—what justice is there in the charge that these unfortunates continue the use of opium from an innate propensity to evil, or a merely vicious desire? What right have we to set ourselves up in judgment to note the beam in our brother’s eye, when the only reason it is not in our own—when the only reason you and I are not opium habitués—is because a kind Creator has so conditioned us that this physical necessity, and consequent opiate need, does not, with us, obtain? ”

“ Granting, however, for the sake of the argument, that the apothecary is the rightful owner of the prescription, he triumphantly asks, “May not one do as he chooses with his own?” Not always, by any means, unless he elects to use his property in a way which will not imperil the welfare of others. The law puts many restrictions on the natural rights of ownership, for the purpose of shielding society from the ignorance, the malice, and the cupidity of proprietors. ”

“ When any unexpected emergency arises, which to your educated eye teaches you that your patient is in extreme danger, do not alarm the friends unnecessarily; try not to show in your voice or conduct that you are demoralized and have lost courage. While doing the best you can (until the arrival of the physician, whom it was your first duty to have summoned) , encourage those around you, and keep them busy if you can, as, unless they are occupied, the coming of the physician will seem to them unreasonably delayed, even though he be at hand when called. ”

“ So able a writer as Wm. Henry Potter (of Harvard) says: “In the first place, it may be said that caries of the teeth does not resemble caries of the bone. The term caries, as applied to the teeth, is a misnomer, given at a time when the true nature of the process was not understood.... The pathological change which occurs in caries is a decalcification and disintegration of the several tissues of the teeth.”
I confess that strikes me as a very excellent description of what surgeons usually term caries, namely, a molecular death of bone tissue. ”

“ The writer has been studying opium and opium habitués for more than sixteen years, with an annual experience, of late, as regards number of cases, that is probably unequalled in this country, and yet he stands more and more in awe of this peculiar power with every case that comes under his care.
Granting a painful physical necessity, and the daily or semi-daily use of opium—especially morphia, subcutaneously—for a few weeks or months, and there are few, if any, who can withstand the ensnaring, enslaving power of this drug. Men stronger of brain and brawn than we have gone down before it. ”

“ I need not tell you that I am proud of my victory. The struggle against ungentle and unfair judgment of those around you make a combination of overwhelming power against the reformed opium taker. It is there that the real conflict begins. ”

“ You remember the physicists talk of bodies being in stable equilibrium when after a disturbance they tend to return to their bottom, or centre of gravity; while unstable equilibrium is that state where a little shove off the centre, results in a big tumble. Now, the people who are markedly susceptible to pain, who have recurrences of it, may be said to have a nervous system in a state of unstable equilibrium. In other respects these same individuals may be splendid types of muscular or mental development. ”

“ But it is possible that much of your practice may have been truly antiseptic, just as the wise surgeon’s has been, long before we knew the why and wherefore of what experience has now taught us to be true. We are all more or less like the hero of Moliére’s comedy, who was astonished to find when he arrived at middle age that he had been talking prose all his life without knowing it. ”

“ It is so much easier to relieve the symptom pain, when called to a sufferer, by a dose of morphine, and then when the next attack comes on to repeat it, than to analyze the complex group of phenomena on which that pain depends. You will perceive that the question with which we started as to the nature of pain is of vital importance in this regard.
The last group of constitutional agents which act as pain disposers is one with which you are all familiar, namely, the action of certain metallic poisons; of these the most important are mercury and phosphorus. ”

“ They are foreign to the genius of labor where combination is impossible, and where the labor is of such a character that there is no monopoly of skill and many can accomplish it equally well. A medical man’s labor is limited by what he can himself do, personally and unaided. ”

“ It would be absurd to claim the diploma as representing a liberal education or even high special attainments, as it would be ridiculous to assert that a dispensary patient regularly received the attention given to the German Kaiser or General Sheridan. There are instances of failure and poverty among medical men, but when the doctors in the country stand to the population in the proportion of 1 to 580, the assumption is that they have become needful, each to his 580. Doctors have many book charges that are not collected. ”