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ON DECENCY IN MANNERS AND IN DRESS. - Hippocrates, The Writings of Hippocrates and Galen [1846]Edition used:The Writings of Hippocrates and Galen. Epitomised from the Original Latin translations, by John Redman Coxe (Philadelphia: Lindsay and Blakiston, 1846).
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ON DECENCY IN MANNERS AND IN DRESS.SECTION I.—TREATISE VI.
Haller says this treatise has been always considered spurious, and is unnoticed by the ancients. The writer, whoever he may have been, is nevertheless a philosophic physician, and the work is replete with sound morality. It instructs the practitioner as to what is essential in his attendance on the sick, so that he may be esteemed a learned, prudent, careful, and attentive man. It is with justice that philosophers commend wisdom in the common concerns of life. There are, however, many kinds of wisdom or philosophy which tend in my opinion to no useful purpose. I mean such as consist of mere verbiage on points of no importance. Yet of these something may be learned, provided it is unmixed with depravity—I say depravity, for ignorance and inutility are nearly allied to mischief, and often lead to it. Every thing that awakens attention and accustoms the mind to think, leads to good habits; even discussions on subjects not in themselves of much utility. Such things as are connected with the improvement of science, and subservient to the welfare and honour of mankind, are with reason to be preferred; whatever is not base in itself, or merely connected with worldly advantage, is deserving of attention, but it must at the same time be perfectly innocent. Youth often fall into the hands of persons who are continually arguing; but when arrived at maturity, they regard them with contempt, and at a later period, from indignation perhaps, obtain the passage of some law, to banish them. Such persons are well adapted to hold forth in public assemblies, where they industriously propagate their deceptions, and thus extend them through a community. They may be known by their dress and their manners. The more extravagant their attire, the more carefully should they be shunned. How different are those who are neat and simple in their dress; you see at a glance that they are deserving of esteem, and their prudence and moderation are readily appreciated; always uniform, there is neither pride nor ostentation in their demeanour. Serious in conversation and mild in reply, they are nevertheless acute in argument, and not readily discomposed in pursuing it. They are amiable amongst friends and moderate towards all; silent to the clamours of others, and deliberating before they speak, they await patiently for the proper occasion. Temperate in their mode of living, a little contents them, and when necessary, can submit to abstinence. Lucid in their discourses, they conceal nothing that they are acquainted with; and from their graceful delivery, are respected by all who hear them, for they assert nothing which they cannot demonstrate. To nature they are principally indebted for all these qualifications, which, when attained, enable them rapidly to advance in science, for in the acquirement of knowledge, some preparatory attainments are absolutely requisite. Nature and art then happily combine in their improvement. We see many who, from the deficiency both from nature and from teaching, attract no notice; hence if required by any one to demonstrate what they have asserted, neither nature nor art can aid them. Yet they have pursued the method of the Sophists we have animadverted on, but being deficient in essentials, they are exposed, and finally become contemptible. Instruction, to be beneficial, should be founded on facts. Arts are deduced from reflection; but any reflections or reasoning, not accompanied by facts, evince that fault somewhere exists. To think merely, and produce nothing, is a proof of error, or of ignorance especially in medicine. Here, opinion alone is criminal, and becomes injurious to the sick. Confidence in self-opinion is delusive, since fact too often proves its falsehood, as impure gold is tried in the furnace. The common remark, that “finis coronat opus,” is lost on such persons as I have pointed out, although the true method of attaining the science is daily manifested to all who desire its acquirement. It may be concluded then, admitting the truth of the preceding remarks, that knowledge and medicine must go hand in hand. The physician who is truly a philosopher is a demigod. Medicine and philosophy are closely allied. That which is taught by the latter, is practised by the former,—contempt of riches, moderation, decency, modesty, honour, justice, affability, cleanliness, gravity, a just appreciation of all the wants of life, courage in adversity—opposition to fraud and superstition, and due consideration of the Divine power. The physician is perpetually exposed to the hazards of incontinence, turpitude, avarice, intemperance, detraction, and insolence. How far these may influence his character, may be estimated by his conduct towards his patients, his friends, and families. In all these particulars, the appropriate connexion of wisdom and of medicine is conspicuous; but particularly so in respect to the Deity, towards whom the thoughts of the physician must be perpetually directed; for the various accidents of life which come under his notice must compel him to acknowledge His omnipotence. He dare not ascribe to his art unqualified power, when he reflects on its frequent failure; even when success attends, it is to Heaven alone he owes it. We perceive now, how medicine leads to wisdom. They, even, who disbelieve in Providence, are compelled to recognise it in their examination of what takes place in the system, in the change of forms produced, and of the cures, both surgical and medical, from operations, or from internal remedies, and good regimen. These are considerations of extreme importance. Besides what is said above, something more is wanting to the physician. This is urbanity. Austerity, repulsive to those in health, is much more so to the sick. He must carefully avoid exposing his body too much, or discoursing with the bystanders beyond what is absolutely necessary. A good physician avoids all measures that are not conducive to the welfare of the patient; he adopts nothing that is singular or inefficient. A physician should always be prepared for whatever may occur, by having every thing essential to his practice duly at hand, or it may chance that some article may be wanting when he is most in need of it. He ought to accustom himself at all times to prepare his remedies, &c., such as lotions, liniments, pledgets, compresses, and bandages of different kinds,—collyria, &c.; and he should have in readiness all sorts of instruments, machines, and apparatus. Deficiency in these, implies a want of foresight that may prove injurious. A smaller collection should be kept ready in case of a distant call. All should be properly arranged, so that what is necessary may be immediately found, for it is impossible to carry every thing with him. His mind should fully retain the recollection of his medicines and their virtues,—that also of diseases, their various forms and accompanying symptoms. This may be esteemed the A, B, C, of medicine. He is also to acquaint himself with the compounding of his drugs for the various intentions he has in contemplation; such as different drinks, purgative potions, &c., having due regard to the articles he employs, not only as respects their source and species, but likewise the bulk, and age, &c., all in reference to what is required in visiting his patients, so as to be certain of having them at the time they are essential. Previous to seeing the sick, he should consider what he may find it necessary to do,—for it is assistance that is needed, and not speculation. Experience will enable him to foresee what may take place; this gives him credit, and is not always very difficult. On entering a sick chamber, he should pay attention to his mode of seating himself, and arranging his dress (mantle); he should talk but little, and neither be disturbed himself, nor trouble others. Address the patient cautiously, and let his own remarks be calm, even if agitation and apprehension exist around him. By this he will show that he knows what is to be done on the existing occasion. He then may give his directions, and mention his opinion as to what further may ensue. Frequent visits are required to regulate the changes that may take place from error or inattention. The disease will thus be better understood, and mistakes less liable. The humours are perpetually varying, either from their peculiar nature or from accident. If the proper moment is neglected for timely assistance, the disease soon increases, and the patient may be carried off from the concurrence of numerous unsurmountable symptoms, that would have readily subsided had they been foreseen and promptly attended to, by the experience acquired from similar cases. Notice should be taken of the faults committed by the sick, who often deceive with respect to their remedies. Many fall victims to this duplicity, arising from their aversion to them. So far from avowing this neglect, they blame the physician.—Care is requisite respecting the sleeping apartments, which should be accommodated to the season, and to the nature of the disease. Some require beds in an elevated situation; others, low, and in dark rooms. All noise and odours should be guarded against, especially that of wine, which is very hurtful. If changes of situation are requisite, let all be done with perfect silence, and as quickly as convenient, so as not to disturb the patient, for tranquillity is highly essential to his welfare.—The physician should possess the tact of directing his patient’s longings, by a proper intermixture of mildness and determination,—and afford them every consolation, without letting them know the nature of their disease, or its probable event.—Inattention in these particulars has tended to augment the present danger, and hasten on the future. It is requisite to have the co-operation of a pupil or assistant, to receive and execute the orders of the physician. He should be selected from amongst the more advanced in their studies, capable of acting, in any sudden emergency, without injury and of detailing with accuracy all that has taken place during his absence. By no means should the patient be committed to the ignorant and unskilful; their ill conduct will be ascribed to the physician. Nothing should be equivocal; by which all blame will be avoided, and his merit acknowledged.—Let the physician therefore announce to the attendants all that may be anticipated. Since what we have said respecting decorum and wisdom is equally applicable to philosophy and to medicine, and to all other arts, the physician will attend to them in their particular connexion with himself, without neglecting what is common to him with society at large; for what is favourable to a good name should be generally pursued by all mankind. Such is the method by which celebrity may be attained, both present and future.—If intelligence is, however, unhappily wanting, at any rate, let prudence, as far as possible, supply its place. |

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