Cornhill Magazine,  8 (1863), 154–63.

Medical Etiquette

[Francis E Anstie]

Genre:

Essay

Subjects:

Medical Practitioners, Professionalization, Medical Treatment, Humanism, Induction, Methodology, Nomenclature, Quackery, Education, Hospitals, Progress, Class, Conservatism, Religion, Supernaturalism, Charlatanry, Commerce, Analytical Chemistry, Narcotics


    Referring back to an article in the previous number of the Cornhill [see CM1/8/1/4], claims that the unique 'esprit de corps which unites medical men' derives from the 'grand distinctive feature of medicine', which is that 'it is at once an inexact science and one which is absolutely necessary to the wants of humanity'. Because medical men can offer only 'systems of treatment which often rest upon inductions which they well know are neither as numerous nor as carefully made as they should be', the observance of strict 'rules of medical etiquette' provides the 'best preservatives against the evils which such uncertainties might give rise to'. (154) Medicine is indeed 'an empirical science' according to 'a most eloquent living physician—M. Trousseau', although he uses the word to signify 'Experiment independent of all theory' and holds that medicine is 'an art, rather than a deductive science' (154–55). As such, it 'demands, in those who practise it, an unusual amount of some uncommon virtues' such as 'a courageous and clear-sighted honesty' (155). A medical man must give evidence of having undertaken the 'enormously expensive and troublesome' studies which 'can only be carried out by means of the association of students in a hospital school, such as exist in our metropolitan and some of our provincial cities' (158). But beyond this he must also 'be able to prove that he is acting in good faith', often by means of good etiquette, and the 'essence of all quackery, properly so called, is the absence of a bona fides' (157). Condemns those practitioners who remain 'blind to the progress of science and [...] continue obstinately to stick fast super antiquas vias, in the bad sense', even though 'this sort of negative conservatism is rather encouraged than otherwise by one class of patients, and the men who practise it sometimes obtain a large business and a high social consideration'. Amongst this class of doctors and patients, medical etiquette comes to 'resemble the vexatious frivolity of a Spanish code of ceremony'. (158) In asserting that, even when dealing with the dying, 'the doctor is no theologian, that is, no decider of theological questions', insists on 'putting aside altogether the question of supernatural influence, as a topic unfit for discussion here' (159–60). Concludes by denouncing the increasingly common practice by which a 'merchant dares to offer a bribe to the scientific man', who, after 'quieting his first qualms of conscience with the fallacious truism that the goods really are excellent, reports accordingly, with all due flourish of scientific trumpets' (162). There is, for instance, the case of 'a well-known analyst [who] declares (with such emphasis that one could fancy tears of gratitude standing in his eyes) that B— and Co.'s London stout is a pure, a wholesome, a nourishing, a life-giving drink' (161).



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