IN REPLY TO A YOUNG PHYSICIAN
Portland, Sept. 16, 1860
Yours of the 5th is received, and in answer I would say that it is easier to ask a question than to answer it. But I will answer your question partly by asking another, and partly by coming at it by a parable. For to answer any question with regard to my mode of treatment would be like asking a physician how he knows a patient has the typhoid fever by feeling the pulse, and requesting the answer direct so that the person asking the question could sit down and be sure to define the disease from the answer.
My mode of treatment is not decided in that way, and to give a definite answer to your inquiry would be as much out of place as to ask you to tell me all you know about medical practice so that I could put it into practice for the curing of disease, with no further knowledge [apart from what] I might get from you. You see the absurdity of that request.
If it were in my power to give to the world the benefit of twenty years' hard study in one short or long letter, it would have been before the people long before this. The people ask they know not what. You might as well ask a man to tell you how to talk Greek without studying it, as to ask me to tell you how I test the true pathology of disease, or how I test the true diagnosis of disease, etc. All of these questions would be very easily answered if I assumed a standard, and then tested all disease by that standard.
The old mode of determining the diagnosis of disease is made up of opinions of diseased persons, in their right mind and out of it, all mixed up together, and set down accompanied by a certain state of pulse. In this dark chaos of error [the doctors] come to certain results like this: If you see a man going towards the water, he is going in swimming; for people go in swimming. But if he is running with his hat and coat off, he is either going to drown himself, or someone is drowning, and soon. This is the old way. Mine is this.
If I see a man, I know it, and if I feel the cold I know it. But to see a person going towards the water is no sign that I know what he is going to do. He may be going to bathe, or may be going to drown himself. Now. here is the difference between the physician and myself, and this may give you some idea of how I define disease.
The regular [physician] and I sit down by a patient. He takes her by the hand, and so do I. He feels the pulse to ascertain the peculiar vibration and number of beats in a given time. This to him is knowledge. To me it is all quackery or ignorance. He looks at the tongue as though it contained information.
To me this is all folly and ignorance. He then begins to ask questions, which contain nothing to me, because [this questioning] is of no force. All this is shaken up in his head, and comes forth in the form of a disease, which is all error to me, and I will give you the diagnosis of this error.
The feeling of the pulse is to affect the patient so he will listen to the doctor. Examining the tongue is all for effect. The peculiar cast of the doctor's head is the same. The questions, accompanied by certain looks and gestures, are all to get control of the patient's mind so as to produce an impression. Then he looks very wise, and so on. All the symptoms put together show no knowledge, but a lack of wisdom, and the general credulity of mankind rendering [people] liable to be humbugged by any person however ignorant he may be, if he has the reputation of possessing all medical knowledge.
Now, sir, this is the field you are about to enter, and you will find the hardest stumbling block from diplomas. Greek and Latin, and the like are all of no consequence to the sick. It is impossible to give you even a mere shadow of twenty years' experience. But I may be of some use to you. I will say a word or two on the old practice, (not taking much time,) that will answer all your questions on the old school; for the less you know the better.
Watch the popular physician. See his shrewdness. Watch the sick patient: nervous and trembling like a person in the hands of a magistrate who has him in his power, and whose real object is to deceive him. See the two together, one perfectly honest, and the other, if honest, perfectly ignorant, [the physician] undertaking blindfolded to lead the patients through the dark valley of the shadow of death, the patient being born [mentally] blind. Then you see them going along, and at last they both fall into the ditch.
Now, like the latter, do not deceive your patients. Try to instruct them, and correct their errors. Use all the wisdom you have, and expose the hypocrisy of the profession in any one. Never deceive your patients behind their backs. Always remember that as you feel about your patients, just so they feel towards you. If you deceive them, they lose confidence in you. Just as you prove yourself superior to them, they give you credit mentally. If you pursue this course you cannot help succeeding. Be charitable to the poor. Keep the health of your patient in view, and if money comes, all well; but do not let that get the lead.
With all this advice, I leave you to your fate, trusting that the True Wisdom will guide you — not in the path of your predecessors. Shun evil and learn to do good.
PORTLAND, Sept. 16, 1860.