Monday, November 20, 2006

Item of the Day: Benjamin Rush "On the Vices and Virtues of Physicians" (1801)

Full Title: Sixteen introductory lectures, to courses of lectures upon the Institutes of Practical Medicine, with a syllabus of the latter. To which are added, two Lectures upon the pleasures of the senses and of the mind; with an inquiry into their proximate cause Delivered in the University of Pennsylvania by Benjamin Rush, M.D. Professor of the Institutes and Practice of Medicine, the said University, Philadelphia: Published by Bradford and Innskeep, 1811.


Lecture V.

Delivered November 2d, 1801.

Gentlemen,

Man is a compound of good and evil. These dispositions appear in different proportions, according to the circumstances in which he is placed. They are much influenced by different states of society, and by different pursuits and occupations in life. Every profession has its peculiar vices and virtues. The business of our present lecture shall be to point out such of them that are attached to the profession of medicine. This investigation I hope will be useful, by teaching you in your outset in life, to avoid the former, and to cherish the latter. By these means, you will at once render the practice of physic, and your own characters, more respectable. You will likewise be enabled thereby, to bear with more composure and fortitude the vexations and distresses which are connected with a medical life.

The vices of physicians may be divided into three heads.
I. As they relate to the Supreme Being.
II. To their patients, and
III. To their professional bretheren.

1st. Under the first head I shall begin by lamenting, that men whose educations necessarily open to them the wisdom and goodness of the Creator, and whose duties lead them constantly to behold his power over human life, and all its comforts, should be so very prone to forget him. This they evidence by their neglect of that worship, which is paid to him in different forms, under true, or false names, in every country. If it be a fact, that physicians are more inclined to infidelity, than any other body of men, it must be ascribed chiefly to this cause. To correct this disposition, it is necessary we should be frequently reminded of the arguments on which Christianity is founded, and of the numerous and powerful motives which enforce a belief of it. It is in places of public worship that these arguments and motives are delivered to the most advantage, and it is by neglecting to hear them, that the natural propensity of the human heart to infidelity, is cherished and promoted. This vice of the understanding has no natural alliance with the practice of physic, for to no secular profession does the Christian religion afford more aid, than to medicine. Our business leads us daily into the abodes of pain and misery. It obliges us likewise, frequently to witness the fears with which our friends leave the world, and the anguish which follows in their surviving relatives. Here the common resources of our art fail us, but the comfortable views of the divine government, and of a future state, which are laid open by Christianity, more than supply their place. A pious word, dropped from the lips of a physician in such circumstances of his patients, often does more good than a long, and perhaps an ingenious discourse from another person, inasmuch as it falls upon the heart, in the moment of its deepest depression from grief. There is no substitute for this cordial in the materia medica.

2d. An undue confidence in medicine, to the exclusion of a Divine and Superintending Power over the health and lives of men, is another vice among physicians. A Dr. -----, in New York prescribed on an evening for a sick man. The next day he called and asked him how he was: "Much better (said he), thank God." "Thank God! (said the doctor) thank me, it was I who cured you."

3d. Drunkenness is a medical vice, which offends not only God, but man. It is generally induced by fatigue, and exposure to great heat and cold. But a habit of drinking intemperately is often incurred by a social spirit, leading physicians to accept of offers of wine, or spirits and water, in every house they enter, in the former part of the day. Good men have often been seduced and ruined by this complaisant practice. I shall hereafter mention to you the safety, and advantages of eating a little fruit, or portable aliment, in preference to drinks of any kind before dinner, or when the body is in a languid state from fatigue. Drunkenness is a hideous vice in any person, but peculiarly so in a physician. If it rendered him offensive to his patients only by the smell it imparted to his breath, it should be sufficient motive to deter him from it, but its evils are much more serious and extensive. It corrupts his manners, impairs his judgment, and renders him unfit to prescribe for the sick. Two instances of death have occurred, within my knowledge, from patients having excessive doses of liquid laudanum, from the hands of a drunken physician.

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