The Quarterly review

UR medical readers will probably think that the following statement, on a most important subject, consists of little more than truisms, and that we are taking great pains to enforce what nobody doubts. Our answer is, that we are not writing to them, but to our legislators and to the public; and if they imagine that these are sufficiently impressed with the importance and true bearings of the question which we are about to explain, they know little of the state of feeling and opinion on the subject. They will think, too, that we have treated the subject in a way far too homely; that we depend for success on propositions as to which the public, if they will but reflect, know as much as ourselves; that we ought to have entered into professional details, and made our readers stare by learning and hard words: but here again we differ from them. We are convinced that, in the present case, the most homely arguments are the most home, and that the public will be most likely to be moved by considerations which they have but to open their eyes in order to appreciate,—which require only to be stated to be acknowledged,-which, like many other things, have ceased to impress men strongly only by reason of their familiarity.

It is of little consequence to medical men, but of vital consequence to the public, that the former should be well instructed in their profession,-as well, at least, as is consistent with the difficulty of the art, the brevity of life, and the ordinary mediocrity of the human mind. To medical men it is important only in as much as it is more gratifying to practise an art with the consciousness of knowledge than with that of ignorance, and pleasanter to assuage pain, restore health, and rescue life, than to witness suffering without the power of relief, and disease which they cannot arrest. But further than this it is of no importance to them at all, not even with a view to lucre; for whether they be well or ill educated, knowing and skilful, or ignorant and incompetent, they are equally sure, as a class, of employment and maintenance. The public cannot tell the difference, and even

if that were otherwise, they could not help themselves. A sick man must employ either nobody, or old women and quacks—or educated medical men with all their imperfections; and, objectionable as the latter often are, such is the timidity of sickness, the anxiety for relief, and the disposition to lean on other minds when our own are too weak to stand alone, that few sufferers will consider this alternative, and not conclude in their favour.

But, of what importance is it to the public, that those to whom they apply for relief should be so instructed as to be able to afford it. It may be painful to witness suffering which cannot be relieved, and disease which cannot be arrested, but how much worse is it to endure them? The public have no notion of the power of medical men in families where sickness is going on: the monks had less in the plenitude of their influence. An ignorant man to whom a family have given possession of their confidence (a mistake which people, with all their sagacity, are continually committing) may not only fail to do good, and inflict irreparable mischief, but may occasion a quantity of unnecessary alarm, trouble, expense, and sacrifice, which amount to as great an evil as sickness itself. nounces some hidden part to be diseased, which requires a long, If he protroublesome, and expersive mode of treatment, who is to gainsay him? The patient scarcely knows that he has such a part, or where it is placed, much less its healthy or diseased condition. The doctor only possesses the means of reconnoitring its state: whatever he reports, however false, is believed; and whatever he directs, must be done. He may tell his patient that his liver is too large, that his brain is soft (ramollissement de cerveau: in pathology this does not mean foolishness); or that disease has fixed on some organ, of which he never heard before, as his mucous membranes,'-and it is wonderful how the news will affect him. Give a disease a local habitation and a name,' and though it may be neither visible nor tangible, nor perceptible by any of his senses, it will fasten on his imagination, influence his feelings, and make him as docile as a lamb: the doctor may do any thing with him. Of what importance is it that persons possessed of so much power should have the knowledge necessary to use it properly! To relate all the blunders we have seen committed by ill-informed practitioners of medicine and surgery, lives lost, health ruined, limbs sacrificed, trifles mistaken for dangerous cases, and dangerous cases mistaken for trifles, measures employed which required the greatest sacrifices, and which turned out to be unnecessary and injurious-to relate all these would require a thousand and one nights, and days beside.

Those who are behind the scenes, who have sense enough to perceive the truth, and candour enough to confess it, will acknowledge.

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The Quarterly review, Volume 42