When a person is sick, there is always something to be done for him, and done at once.If it is only to open or shut a window, if it is only to tell him to keep on doing just what he is doing already, it wants a man to bring his mind right down to the fact of the present case and its immediate needs.Now the present case, as the doctor sees it, is just exactly such a collection of paltry individual facts as never was before,--a snarl and tangle of special conditions which it is his business to wind as much thread out of as he can.It is a good deal as when a painter goes to take the portrait of any sitter who happens to send for him.He has seen just such noses and just such eyes and just such mouths, but he never saw exactly such a face before, and his business is with that and no other person's,--with the features of the worthy father of a family before him, and not with the portraits he has seen in galleries or books, or Mr.
Copley's grand pictures of the fine old Tories, or the Apollos and Jupiters of Greek sculpture.It is the same thing with the patient.
His disease has features of its own; there never was and never will be another case in all respects exactly like it.If a doctor has science without common sense, he treats a fever, but not this man's fever.If he has common sense without science, he treats this man's fever without knowing the general laws that govern all fevers and all vital movements.I 'll tell you what saves these last fellows.They go for weakness whenever they see it, with stimulants and strengtheners, and they go for overaction, heat, and high pulse, and the rest, with cooling and reducing remedies.That is three quarters of medical practice.The other quarter wants science and common sense too.But the men that have science only, begin too far back, and, before they get as far as the case in hand, the patient has very likely gone to visit his deceased relatives.You remember Thomas Prince's "Chronological History of New England," I suppose? He begins, you recollect, with Adam, and has to work down five thousand six hundred and twenty-four years before he gets to the Pilgrim fathers and the Mayflower.It was all very well, only it did n't belong there, but got in the way of something else.So it is with "science" out of place.By far the larger part of the facts of structure and function you find in the books of anatomy and physiology have no immediate application to the daily duties of the practitioner.You must learn systematically, for all that; it is the easiest way and the only way that takes hold of the memory, except mere empirical repetition, like that of the handicraftsman.Did you ever see one of those Japanese figures with the points for acupuncture marked upon it?
--I had to own that my schooling had left out that piece of information.
Well, I 'll tell you about it.You see they have a way of pushing long, slender needles into you for the cure of rheumatism and other complaints, and it seems there is a choice of spots for the operation, though it is very strange how little mischief it does in a good many places one would think unsafe to meddle with.So they had a doll made, and marked the spots where they had put in needles without doing any harm.They must have had accidents from sticking the needles into the wrong places now and then, but I suppose they did n't say a great deal about those.After a time, say a few centuries of experience, they had their doll all spotted over with safe places for sticking in the needles.That is their way of registering practical knowledge: We, on the other hand, study the structure of the body as a whole, systematically, and have no difficulty at all in remembering the track of the great vessels and nerves, and knowing just what tracks will be safe and what unsafe.
It is just the same thing with the geologists.Here is a man close by us boring for water through one of our ledges, because somebody else got water somewhere else in that way; and a person who knows geology or ought to know it, because he has given his life to it, tells me he might as well bore there for lager-beer as for water.
--I thought we had had enough of this particular matter, and that Ishould like to hear what the Master had to say about the three professions he knew something about, each compared with the others.
What is your general estimate of doctors, lawyers, and ministers?--said I.
--Wait a minute, till I have got through with your first question,--said the Master.---One thing at a time.You asked me about the young doctors, and about our young doctor.They come home tres biens chausses, as a Frenchman would say, mighty well shod with professional knowledge.But when they begin walking round among their poor patients, they don't commonly start with millionnaires,--they find that their new shoes of scientific acquirements have got to be broken in just like a pair of boots or brogans.I don't know that I have put it quite strong enough.Let me try again.You've seen those fellows at the circus that get up on horseback so big that you wonder how they could climb into the saddle.But pretty soon they throw off their outside coat, and the next minute another one, and then the one under that, and so they keep peeling off one garment after another till people begin to look queer and think they are going too far for strict propriety.Well, that is the way a fellow with a real practical turn serves a good many of his scientific wrappers, flings 'em off for other people to pick up, and goes right at the work of curing stomach-aches and all the other little mean unscientific complaints that make up the larger part of every doctor's business.I think our Dr.Benjamin is a worthy young man, and if you are in need of a doctor at any time I hope you will go to him; and if you come off without harm, I will recommend some other friend to try him.
--I thought he was going to say he would try him in his own person, but the Master is not fond of committing himself.
