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medical essays-第44章

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 October; 1851。  (From New Monthly Journal of Med。  Science。)

Simpson。 Observations at a Meeting of the Edinburgh Obstetrical Society。  (An 〃eminent gentleman;〃 according to Dr。  Meigs; whose 〃name is as well known in America as in (his) native land。〃 Obstetrics。  Phil。  1852; pp。  368; 375。) The student is referred to this paper for a valuable resume of many of the facts; and the necessary inferences; relating to this subject。  Also for another series of cases; Mr。 Sidey's; five or six in rapid succession。 Dr。 Simpson attended the dissection of two of Dr。 Sidey's cases; and freely handled the diseased parts。  His next four child…bed patients were affected with puerperal fever; and it was the first time he had seen it in practice。  As Dr。 Simpson is a gentleman (Dr。 Meigs; as above); and as 〃a gentleman's hands are clean 〃 (Dr。 Meigs' Sixth Letter); it follows that a gentleman with clean hands may carry the disease。  Am。  Jour。  Med。  Sc。; October; 1851。

Peddle。 The five or six cases of Dr。 Sidey; followed by the four of Dr。 Simpson; did not end the series。  A practitioner in Leith having examined in Dr。 Simpson's house; a portion of the uterus obtained from one of the patients; had immediately afterwards three fatal cases of puerperal fever。  Dr。  Veddie referred to two distinct series of consecutive cases in his own practice。  He had since taken precautions; and not met with any such cases。  Am。  Jour。  Med。  Sc。; October; 1851。

Copland。  Considers it proved that puerperal fever maybe propagated by the hands and the clothes; or either; of a third person; the bed… clothes or body…clothes of a patient。  Mentions a new series of cases; one of which he saw; with the practitioner who had attended them。  She was the sixth he had had within a few days。  All died。 Dr。 Copland insisted that contagion had caused these cases; advised precautionary measures; and the practitioner had no other cases for a considerable time。  Considers it criminal; after the evidence adduced;which he could have quadrupled;and the weight of authority brought forward; for a practitioner to be the medium of transmitting contagion and death to his patients。  Dr。 Copland lays down rules similar to those suggested by myself; and is therefore entitled to the same epithet for so doing。  Medical Dictionary; New York; 1852。  Article; Puerperal States and Diseases。

If there is any appetite for facts so craving as to be yet unappeased;Lesotho; necdum satiata;more can be obtained。 Dr。  Hodge remarks that 〃the frequency and importance of this singular circumstance (that the disease is occasionally more prevalent with one practitioner than another) has been exceedingly overrated。〃  More than thirty strings of cases; more than two hundred and fifty sufferers from puerperal fever; more than one hundred and thirty deaths appear as the results of a sparing estimate of such among the facts I have gleaned as could be numerically valued。  These facts constitute; we may take it for granted; but a small fraction of those that have actually occurred。  The number of them might be greater; but 〃't is enough; 't will serve;〃 in Mercutio's modest phrase; so far as frequency is concerned。  For a just estimate of the importance of the singular circumstance; it might be proper to consult the languid survivors; the widowed husbands; and the motherless children; as well as 〃the unfortunate accoucheur。〃






III

CURRENTS AND COUNTER…CURRENTS IN MEDICAL SCIENCE

An Address delivered before the Massachusetts Medical Society; at the Annual Meeting; May 30; 1860。

               〃Facultate magis quam violentia。                                    HIPPOCRATES。

Our Annual Meeting never fails to teach us at least one lesson。  The art whose province it is to heal and to save cannot protect its own ranks from the inroads of disease and the waste of the Destroyer。

Seventeen of our associates have been taken from us since our last Anniversary。  Most of them followed their calling in the villages or towns that lie among the hills or along the inland streams。  Only those who have lived the kindly; mutually dependent life of the country; can tell how near the physician who is the main reliance in sickness of all the families throughout a thinly settled region comes to the hearts of the people among whom he labors; how they value him while living; how they cherish his memory when dead。  For these friends of ours who have gone before; there is now no more toil; they start from their slumbers no more at the cry of pain; they sally forth no more into the storms; they ride no longer over the lonely roads that knew them so well; their wheels are rusting on their axles or rolling with other burdens; their watchful eyes are closed to all the sorrows they lived to soothe。  Not one of these was famous in the great world; some were almost unknown beyond their own immediate circle。  But they have left behind them that loving remembrance which is better than fame; and if their epitaphs are chiselled briefly in stone; they are written at full length on living tablets in a thousand homes to which they carried their ever…welcome aid and sympathy。

One whom we have lost; very widely known and honored; was a leading practitioner of this city。  His image can hardly be dimmed in your recollection; as he stood before you only three years ago; filling the same place with which I am now honored。  To speak of him at all worthily; would be to write the history of professional success; won without special aid at starting; by toil; patience; good sense; pure character; and pleasing manners; won in a straight uphill ascent; without one breathing…space until he sat down; not to rest; but to die。  If prayers could have shielded him from the stroke; if love could have drawn forth the weapon; and skill could have healed the wound; this passing tribute might have been left to other lips and to another generation。

Let us hope that our dead have at last found that rest which neither summer nor winter; nor day nor night; had granted to their unending earthly labors!  And let us remember that our duties to our brethren do not cease when they become unable to share our toils; or leave behind them in want and woe those whom their labor had supported。  It is honorable to the Profession that it has organized an Association a for the relief of its suffering members and their families; it owes this tribute to the ill…rewarded industry and sacrifices of its less fortunate brothers who wear out health and life in the service of humanity。  I have great pleasure in referring to this excellent movement; which gives our liberal profession a chance to show its liberality; and serves to unite us all; the successful and those whom fortune has cast down; in the bonds of a true brotherhood。

A medical man; as he goes about his daily business after twenty years of practice; is apt to suppose that he treats his patients according to the teachings of his experience。  No doubt this is true to some extent; to what extent depending much on the qualities of the individual。  But it is easy to prove that the prescriptions of even wise physicians are very commonly founded on something quite different from experience。  Experience mus
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