Medical practice

“ Medical Science is one whole, of which all the branches I have enumerated are the several parts. They may be considered as the links of a chain that have a mutual connection with one another. Anatomy, Materia Medica, Botany, Chymistry, and the Institutions, are only the ladder by which we are to mount up to practice. A general knowledge, at least, in each one of them, is useful to both Physician and Surgeon; particularly to the former, who in proportion as he is more intimately acquainted with them all, will become more skillful in the healing science. ”

“ The practice of medicine is every year becoming [pg 293] more successful. New and improved methods of treating disease are being discovered and developed, and the conscientious physician will avail himself of all the means, by a knowledge of which he may benefit his fellow-men. ”

“ ADVANTAGES OF SPECIALTIES.
By thorough organization and a perfect system of subdividing the practice of medicine and surgery in this institution, every invalid consulting us is treated by a specialist—one who devotes his undivided attention to the particular class of diseases to which his or her case belongs. The advantage of this arrangement must be obvious. Medical science offers a vast field for investigation, and no physician can, within the limit of a single life-time, achieve the highest degree of success in the treatment of every malady incident to humanity. ”

“ And it is to the accuracy with which this system has endowed us that we owe our almost world-wide reputation for the skillful treatment of all lingering, or chronic, affections. This system of practice, with the marvelous success which has been attained through it, demonstrates the fact that diseases display certain phenomena, which, being subjected to scientific analysis, furnish abundant and unmistakable data to guide the judgment of the skillful practitioner aright in determining the nature of diseased conditions. ”

“ In securing such a result there will be needed medical practitioners who are imbued with the ideals of preventive medicine in its widest sense. Let me, in this connection quote the following extract from a recent official report of my own:
There is needed a reconstruction of the training of each medical student, which will make preventive medicine in its widest sense an integral part of his training, and will insure that before he begins practice he has definite instruction in the application of the whole of his knowledge to preventive purposes. ”

“ Its practitioners brought with them much of the knowledge and many of the errors of the Old World; they have always been in communication with its wisdom and its folly; it is not without interest to see how far the new conditions in which they found themselves have been favorable or unfavorable to the growth of sound medical knowledge and practice.
The state of medicine is an index of the civilization of an age and country,—one of the best, perhaps, by which it can be judged. Surgery invokes the aid of all the mechanical arts. ”

“ In ordinary practice, the physician's time is divided in his consideration of acute, chronic, surgical, and obstetrical cases; in fact, much of it is occupied in riding to reach his patients. His attention is continually diverted from one class of cases to another, effectually preventing investigation in any particular direction. ”

“ The great majority of physicians allow acute maladies, diseases of children, and the practice of midwifery, to engross most of their time and attention. They manifest an absorbing interest in everything that [pg 958] relates to these subjects, and devote little or no time to acquiring an intimate knowledge of the great variety of chronic maladies which afflict mankind. ”

“ Definition, Exceptions.—Any person is deemed practising medicine, surgery, or obstetrics, or to be a physician, who publicly professes to be a physician, surgeon, or obstetrician, and assumes the duties, or who makes a practice of prescribing, or prescribing and furnishing medicine for the sick, or who publicly professes to cure or heal by any means whatsoever ”

“ In private and even dispensary [Pg 46] practice, where the subjects were of a better physical and moral nature, we often saw the disease subside, and health return, after less attention to administer medical aid, or to supply other wants, than was exhibited at the hospital. We are, notwithstanding, sanguine enough to anticipate useful results from our attentive study of the symptoms of the disease, in connexion with that of the post mortem examinations, and to consider ourselves as in possession of lights to guide us with more certainty than before. ”

“ The advances in general medical science and practice have also necessitated great elaboration of the resources for the study and treatment of the physical condition of the patients. Instruments of precision, laboratories, x-ray departments, dental and surgical operating rooms, massage and hydrotherapy departments, facilities for eye, throat, nose, and ear examinations and treatment, and all the other means of determining disease processes and applying proper treatment have been supplied and the methods and standards of modern clinical medicine and surgery are utilized. ”

“ We are in regular practice, responsible for what we say and do, and cordially invite those who desire further evidence of our success in curing chronic diseases to come to the Invalids' Hotel and Surgical Institute and satisfy themselves of the truthfulness of our statements. ”

“ Object of this chapter to show how the community can judge of them correctly. Education of physicians—evidences of it. Medical education practically despised by a large portion of the public. Standing of medical man among his brethren criterion of merit. Difficulty in getting their unbiased opinions. Certain mental qualities essential to skill in the practice of medicine. How the common observer can detect and measure these qualities. Observe them as exhibited in regard to subjects which he understands in common with the physician. Illustration from surgery. ”

“ Among the various avocations of men, that of the physician deserves to be placed in the foremost rank. The profession is founded in the multiplicity of diseases to which humanity is liable, and in the medical qualities of certain substances, which have been found to supply a remedy. ”

“ Believing that the diffusion of knowledge for the prevention of disease is quite as noble a work as the alleviation of physical suffering by medical skill, we have devoted a large portion of this volume to the subjects of physiology and hygiene. ”

“ Yet we regard clinical medicine as illustrating art, and didactic medicine as representing science. What figure, think you, would the hospital professor make who should come before you with a patient, and be unable to determine with what disease the person was suffering, the organs affected by it, the nature of their functional disturbance, why some functions rather than others were disordered, how these various elements affect the issue of the attack, what that issue will probably be, and finally, what means should be taken to render it favorable? ”

“ In a discussion of professional service, however brief, no thoughtful medical man could forbear some comment on the present general status of clinical medicine and its developments within the last few years. ”

“ The more nearly the treatment of diseases can be brought throughout to this degree of accuracy, the more scientific will the art of physic become, and the tendency of all medical observation and of all medical writing, should be to advance in this direction. ”

“ General practitioners shall mainly provide such services as diagnosis, treatment, referral, prevention, healthcare and rehabilitation of common diseases and frequently-occurring diseases, chronic diseases management, and health management. ”

“ How can you be physicians if you do not examine the functions of the living body, and note how they are affected by emotions of the mind, and by other moral and physical influences; if you do not learn to mark the early inroads of disease, and watch its onward progress; to ascertain the effects of different remedies under varying conditions of human suffering, and to estimate correctly, by personal observation, the extent of the power which the body possesses of repairing functional or structural lesions? ”

“ So, likewise, are there numerous, acute diseases of a milder character which are easily and unmistakably recognized without the possession of great medical knowledge, and which readily yield to plain, simple, medical treatment which is within the ready reach of all who strive to acquaint themselves with the rudiments of medical science. ”

“ Whatever skill we may boast in investigating the nature of a disease, or in understanding the structure of the body, yet without a knowledge of the instruments which are to be used, and of their properties and action upon the body, whereby they produce a change from sickness to health, other knowledge avails little in the cure of diseases.
The Theory of Physic, more commonly termed Medical Institutions, comprehends under it, the important doctrines of Physiology and Pathology. ”

“ A patient suffering from a disease belonging to the last class remains well as long as he continues the use of medicine, but relapses as soon as the treatment is stopped, just as a tottering house collapses on the removal of the props. The physician is advised to refrain from treating a disease which is quite incurable.* [2] The other two classes of diseases should be treated with all possible care and skill. In order to acquire success in his profession, the physician is expected to know both the theoretical and the practical sides of the science of medicine. ”

“ We have all observed the truth of this inspired utterance in the fact that the physicians, as a body, are almost constantly in bed of one disease or another. The wonder is that any of them ever survive the courses of preparatory study. ”

“ It can hardly be but that the modes of investigating disease ordinarily followed, labour under some radical errors or defects, else the researches of ages, pursued, as they have been, with exemplary diligence, and, in many splendid instances, by minds of the first order of intellect, must, ere this, have rendered our knowledge of the nature and treatment of disease more certain and more complete. ”

“ Combe: “The little regard,” he says, “which has hitherto been paid to the laws of the human constitution, as the true basis on which our attempts to improve the condition of man ought to rest, will be obvious from the fact, that, notwithstanding the direct uses, to which a knowledge of the conditions, which regulate the healthy action of the bodily organs, may be applied in the prevention, detection, and treatment of disease, there is scarcely a medical school in this country (Great Britain) [4] in which any special provision is made for teaching it.... ”

“ Only through extensive experience can the medical practitioner become expert at detecting and successfully meeting, by rational scientific and carefully adapted treatment, the many phases and complications incident to the different forms and stages of this very prevalent malady. ”

“ There is another profession, to the members of which, I think, a certain preliminary knowledge of physical science might be quite as valuable as to the medical man. The practitioner of medicine sets before himself the noble object of taking care of man's bodily welfare ”

“ In the more dangerous, obscure, or complicated forms of chronic diseases, the correct diagnosis and successful treatment of which tax all the skill possessed by the experienced specialist, the invalid will not be misled into the dangerous policy of relying upon his own judgment and treatment, but will be counseled not to postpone until too late, the employment of a skillful physician. ”

“ The facts of hygiene and therapeutic measures are widely scattered through medical literature, and extend over hundreds of years of time. Many volumes have been written on diseases of the eye, the heart, liver, and stomach, brain and other organs, to understand which requires special technical education. ”

“ Thus clinical experience is opposed to what is learnt from laboratory research or theoretical considerations. The substantive “clinic” is technically employed for a medical school or class where instruction is given in practical work as illustrated by the examination and treatment of actual cases of disease. ”

“ The last Caution I shall give to Parents relative to Health, is, the Danger of Nostrums and Quack-Medicines. I believe there is not a Physician nor an Apothecary in the Kingdom but what has seen the Lives of People, particularly of Children, sacrificed to this Practice. What is it that constitutes the Physician, that proves the Man of Judgment, but the varying his Prescriptions, not only according to different Diseases, but according to the different Circumstances of the same Disease? ”

“ None of the learned professions have advanced during the last thirty years so much as the medical. Medicine has become a new science since it has taken hold of the sanitary improvement of our towns and dwellings. ”

“ It is a subject not unbecoming the highest attainments, to increase the stock of medical knowledge in that branch of our art. So important, indeed, to society, is the successful treatment of infantile diseases, that happy shall I be, if any effort of mine shall awaken attention to this hitherto neglected department of medicine. ”

“ In no class of diseases is greater care, scientific knowledge and skill more necessary than in the treatment of nervous affections. Almost every case is a law unto itself, and must receive careful consideration, pains-taking advice and specially prescribed treatment suited to the peculiarities of the individual. Hereditary influences, causes of the disease and constitutional peculiarities of the patient must all be taken into account. ”