Dr. Proudie

“ Proudie by no means despised a countess, and as this countess lived in the county and within a sort of extensive visiting distance of Barchester, she was glad to have this opportunity of ingratiating herself.
"My dear Lady De Courcy, I am so delighted," said she, looking as little grim as it was in her nature to do. "I hardly expected to see you here. It is such a distance, and then you know, such a crowd."
"And such roads, Mrs. Proudie! I really wonder how the people ever get about. But I don't suppose they ever do." ”

“ The palace with Mrs. Proudie was always a palace, and never a house. "No; no; ten thousand times, no. Are you not aware that he insulted you, and grossly, most grossly insulted me? I was never treated with such insolence by any clergyman before, since I first came to this palace;—never, never. And we know the man to be a thief;—we absolutely know it. Think, my lord, of the souls of his people!"
"Oh, dear; oh, dear; oh, dear," said the bishop. ”

“ Proudie.
"Mr. Slope," began the bishop, in a solemn, serious voice, "it grieves me to have to find fault. It grieves me much to have to find fault with a clergyman; but especially so with a clergyman in your position."
"Why, what have I done amiss, my lord?" demanded Mr. Slope, boldly.
"What have you done amiss, Mr. Slope?" said Mrs. Proudie, standing erect before the culprit, and raising that terrible forefinger. "Do you dare to ask the bishop what you have done amiss? does not your conscience——"
"Mrs. Proudie, pray let it be understood, once for all, that I will have no words with you." ”

“ And the woman who thus so spoke was very different from that Miss Dunstable whom Mrs. Proudie courted, and the Duke of Omnium fêted, and Mrs. Harold Smith claimed as her bosom friend. If only she could find among such one special companion on whom her heart might rest, who would help her to bear the heavy burdens of her world! But where was she to find such a friend?—she with her keen wit, her untold money, and loud laughing voice. Everything about her was calculated to attract those whom she could not value, and to scare from her the sort of friend to whom she would fain have linked her lot. ”

“ Oriel. "I can understand that the bishop may have found a difficulty."
"The bishop, indeed! The bishop doesn't care two straws about it. It's Mrs. Proudie! She has put her finger on the poor man's neck because he has not put his neck beneath her feet; and now she thinks she can crush him,—as she would crush you or me, if it were in her power. That's about the long and the short of the bishop's solicitude."
"You are very hard on him," said Mr. Oriel.
"I know him;—and am not at all hard on him. She is hard upon him if you like. Tempest is fair. ”

“ Why should he encounter such evil for a man whom he loved so slightly as Mr. Slope? Why should he give up his enjoyments and his ease, and such dignity as might be allowed to him, to fight a losing battle for a chaplain? The chaplain after all, if successful, would be as great a tyrant as his wife. Why fight at all? why contend? why be uneasy? From that moment he determined to fling Mr. Slope to the winds, and take the goods the gods provided.
"I am told," said Mrs. Proudie, speaking very slowly, "that Mr. Slope is looking to be the new dean." ”

“ Look through the world and see if this is not so always, except in those rare cases in which the human being lives and dies without joys and without sorrows, like a vegetable. A man shall be possessed of florid, youthful blooming health till, it matters not what age—thirty; forty; fifty—then comes some nipping frost, some period of agony, that robs the fibres of the body of their succulence, and the hale and hearty man is counted among the old.
He came down and breakfasted alone; Mrs. Proudie, being indisposed, took her coffee in her bedroom, and her daughters waited upon her there. ”

“ The patient, however, must take it on himself to accomplish this, while the physician, with the aid of suggestion, makes it possible for him to do so. The suggestion works in the nature of an education. We are therefore justified in saying that analytic treatment is a sort of after-education. ”

“ When a physician attempts to convince a person, who has fallen into the Homoeopathic delusion, of the emptiness of its pretensions, he is often answered by a statement of cases in which its practitioners are thought to have effected wonderful cures. The main object of the first of these Lectures is to show, by abundant facts, that such statements, made by persons unacquainted with the fluctuations of disease and the fallacies of observation, are to be considered in general as of little or no value in establishing the truth of a medical doctrine or the utility of a method of practice. ”

“ The utmost 'right of private judgment' which anybody claims in such cases, is the choice of the physician to whom he will trust his body, or of the counsel to whom he will commit the conduct of his cause. The expression, as it is commonly used, implies a belief that, in matters of religion, the criteria of truth are different in kind from what prevail elsewhere, and the efforts which have been made to bring such a notion into harmony with common sense and common subjects have not been the least successful. ”

“ His practice as a physician, although respectable, was never large. He wanted that confidence or assurance which is so necessary to the successful exercise of the profession. He was perhaps too deeply informed, and therefore too sensible of the difficulty of arriving at true knowledge in the science of medicine ever to form a hasty judgment; while his great love of, and adherence to truth, made him often hesitate where others would have felt no difficulty in expressing an opinion. ”

“ The young physician, just beginning to practise, is astonished at the remarkable things which his patients tell him with the utmost confidence and in all good faith. Nearly all relate the story of their illness, beginning with that circumstance which, in their opinion, originated it. It is an innate tendency which spurs the human mind to find an explanation for everything; and the reason of phenomena, which is the foundation of science, is yet the cause of prejudices and the most abundant source of error. ”

“ How much more then should they be cautious in the inferences which they draw, who have never studied the human frame, and who have had but little experience of the treatment of disease. And yet many make no scruple in forming the most decided opinions of the practice of physicians, in every case of which they have any knowledge, however limited, and in proclaiming those opinions with all the authority of an oracle. ”

“ The physician's capacity to stimulate and maintain the power of suggestion, which he possesses in virtue of this attitude on the part of those who consult him, is undoubtedly the secret of much real success in medical practice, inasmuch as the mental factors in disease—the importance of which is now becoming fully recognised, although their nature is not yet always clear—are to a large extent directly affected by the patient's belief in his doctor's ability to understand and cure the complaint from which he suffers. ”

“ Such a verdict is tantamount to saying that the physician ought to have known better what course to pursue, and was therefore guilty of ignorance, on which ground it would, perhaps, have been better to base the verdict than on an error of judgment.
Fortunately for the profession, there are some limitations upon its liability. Ordinarily the physician is supposed to possess a familiarity with the characteristics of the dominant disease. ”

“ Do not let your good judgment be governed by your prejudices, but give the above named remedy a fair and patient trial, and I believe you will not only be rewarded by a perfect restoration to health, but you will also be convinced that the medical profession does not possess all the knowledge there is embraced in medical science. ”

“ If intelligent men would adopt the course which I have indicated, in their attempt to estimate the professional merits of physicians, they would for the most part avoid the errors which they now so frequently commit. But, as it now is, they very generally form their judgment from a direct observation of medical practice, and from the reports which their friends and acquaintances give of their observations; and they make but slight use of those means of judging, which I have shown to be the least liable to error. ”

“ On the other hand, I call him a dogmatical physician who is very ready to assume opinions, to be prejudiced in favour of them, and to retain and assert very tenaciously, and with too much confidence, the opinions or prejudices which he has already taken up in common life, or in the study of the sciences.” He sought to [Pg 94] build up rational views of medicine, indeed, on the basis of fact and experiment. In giving his clinical lectures he was at great pains to choose diseases of the most common types, as most useful to the students. ”

“ The young physician will find equal profit and delight in studying those profound connoisseurs of the human mind, La Chambre, Stahl, Pinel, Hoffmann, Bichat, Tissot, Richerand, Alibert, Georget. From them the student will not only learn how to judge wisely of the passions of others and of the best means of treating them, but will also get sage counsels for the government of his own. ”

“ But we must never trust our own impressions merely. “When the theologian, who deals with the supersensible, has said all that, from his point of view, he can say, when the jurist, who represents those fundamental laws which are the result of social experience, has considered all reasons from his own point of view, the final authority in certain cases must be the physician who is engaged in studying the life of the body.” ”

“ Men of intellect, science, and humanity, are engaged in this good cause, and, so sure as “truth is mighty,” it must prevail. In order, however, to the accomplishment of this desired event, physicians must be men of principle, and adhere firmly to that which they know to be right. In the practice of some, there is too148 much disposition to accommodate the taste and prejudice of the patient, even at his expense. I was talking with a physician not long since, who advocated the practice of making medicine to suit the taste of the patient. ”

“ Study in the spirit of an investigator, who has no other than a scientific interest in what he sets himself to examine. The wise physician is wholly intent upon making a correct diagnosis, though the patient be his mother. What gain would self-delusion bring him or her he loves? Things are what they are, and it is our business to know them. Observe and hold thy judgment in suspense until patient looking shall have made truth so plain that to pass judgment is superfluous. ”

“ The patient understands every suggestion, he concentrates on the problems that the treatment requires him to solve, reminiscences and ideas flood his mind. The physician is surprised by the certainty and depth of these interpretations and notices with satisfaction how willingly the sick man receives the new psychological facts which are so hotly contested by the healthy persons in the world outside. An objective improvement in the condition of the patient, universally admitted, goes hand in hand with this harmonious relation of the physician to the patient under analysis. ”

“ While a course of medical study is at times severely condemned by some Scientists, she feels, as she always has felt, that all are privileged to work out their own salvation according to their light, and that our motto should be the Master's counsel, “Judge not, that ye be not judged.” ”

“ Besides, locating among those who had known me from boyhood, the probation I would have to undergo before I secured their full confidence would be more severe, and of much longer duration, than if I had landed in their midst a perfect stranger. The transition from the boy to the man, and from the mischievous student to the grave, serious physician, is so gradual and imperceptible, that our old and intimate acquaintances do not realize it; and when they should know us as doctor they still give us our youthful appellatives, and regard us as boys. ”

“ A reform is now in progress in the medical profession. The struggle to break loose from theory is fairly begun. A deep consciousness, that the science of medicine is cumbered [Pg 219] by a mass of rubbish, has awakened a disposition to a more careful and rigid observation. The Materia Medica of the profession is especially burdened in this way. The virtues which are attributed to a large portion of the remedies in use require to be tested in order to strip the statements which are made in regard to them of all that is inaccurate and false. ”

“ In such cases external solutions are worse than none at all. Naturally the particular situation dictates which road the doctor must ultimately follow, and what is then his duty. I regard the conscience-searching question of the doctor's remaining true to his scientific convictions as rather unimportant in comparison with the incomparably weightier question as to how he can best help his patient. The doctor must, on occasion, be able to play the augur. Mundus vult decipi—but the cure is no deception. It is true that there is a conflict between ideal conviction and concrete possibility. ”

“ Ready though people be to avail themselves at need of the skill of the physician, when they are in, shall we say, rude health, they regard him as very fair game for banter. "He that wants health wants all," but while they are enjoying this happy condition of rampant well-being they cry cheerfully enough, "Throw physic to the dogs, I'll none of it." [140:A] Another proverb, however, declares that "Physic always does good—if not to the patient then to the doctor." ”