Weekly National Intelligencer

PHYSICIANS AND PATIENTS.

The wisdom and importance of the following
suggestions, adopted by the National Medical Con-
ventions of 1846-'7, have struck us so forcibly
that we transfer them to our columns:

Of the Duties of Physicians to their Patients and
of the Obligations of Patients to their Physi-
cians.

Art. I.--Duties of Physicians to their Patients.

1. A physician should not only be ever ready to obey the
calls of the sick, but his mind ought also to be imbued with
the greatness of his mission, and the responsibility he habi-
tually incurs in its discharge. Those obligations are the more
deep and enduring, because there is no tribunal other than
his own conscience to adjudge penalties for carelessness or
neglect. Physicians should, therefore, minister to the sick
with due impression of the importance of their office; reflect-
ing that the ease, the health, and the lives of those committed
to their charge, depend on their skill, attention, and fidelity.
They should study also, in their deportment, so to unite ten-
derness with firmness, and condescension with authority, as
to inspire the minds of the patients with gratitude, respect,
and confidence.

2. Every case committed to the charge of a physician should
be treated with attention, steadiness, and humanity. Rea-
sonable indulgence should be granted to the mental imbecility
and caprices of the sick. Secrecy and delicacy, when re-
quired by peculiar circumstances, should be strictly observed;
and the familiar and confidential intercourse to which physi-
cians are admitted in their professional visits should be used
with discretion, and with the most scrupulous regard to fide-
lity and honor. The obligation of secrecy extends beyond
the period of professional services; none of the privacies of
personal and domestic life, no infirmity of disposition or flaw
of character observed during professional attendance, should
ever be divulged by him except when he is imperatively re-
quired to do so. The force and necessity of this obligation
are indeed so great, that professional men have, under cer-
tain circumstances, been protected in their observance of se-
crecy by courts of justice.

3. Frequent visits to the sick are in general requisite, since
they enable the physician to arrive at a more perfect know-
ledge of the disease, to meet promptly every change which
may occur, and also tend to preserve the confidence of the pa-
tient. But unnecessary visits are to be avoided, as they give
useless anxiety to the patient, tend to diminish the authority
of the physician, and render him liable to be suspected of in-
terested motives:

4. A physician should not be forward to make gloomy
prognostications, because they savor of empiricism by magni-
fying the importance of his services in the treatment or cure
of the disease; but he should not fail, on proper occasions, to
give to the friends of the patient timely notice of danger when
it really occurs, and even to the patient himself, if absolutely
necessary. This office, however, is so peculiarly alarming
when executed by him that it ought to be declined whenever
it can be assigned to any other person of sufficient judgment
and delicacy; for the physician should be the minister of hope
and comfort to the sick, that by such cordials to the drooping
spirit he may soothe the bed of death, revive expiring life, and
counteract the depressing influence of those maladies which
often disturb the tranquillity of the most resigned in their last
moments. The life of a sick person can be shortened not
only by the acts, but also by the words or the manner of a
physician. It is, therefore, a sacred duty to guard himself
carefully in this respect, and to avoid all things which have a
tendency to discourage the patient and to depress his spirit.

5. A physician ought not to abandon a patient because the
case is deemed incurable; for his attendance may continue to
be highly useful to the patient and comforting to the relatives
around him, even in the last period of a fatal malady, by al-
leviating pain and other symptoms, and by soothing mental an-
guish. To decline attendance, under such circumstances,
would be sacrificing to fanciful delicacy and mistaken liberali-
ty that moral duty which is independent of and far superior
to all pecuniary consideration.

6. Consultations should be promoted in difficult or pro-
tracted cases, as they give rise to confidence, energy, and more
enlarged views in practice.

7. The opportunity which a physician not unfrequently
enjoys of promoting and strengthening the good resolutions
of his patients, suffering under the consequences of vicious
conduct, ought never to be neglected. His counsels, or even
remonstrances, will give satisfaction, not offence, if they be
proffered with politeness, and evince a genuine love of virtue,
accompanied by a sincere interest in the welfare of the person
to whom they are addressed.

Art. II. Obligations of Patients to Physicians.

1. The members of the medical profession, upon whom are
enjoined the performance of so many important and arduous
duties towards the community, and who are required to make
so many sacrifices of comfort, ease, and health, for the welfare
of those who avail themselves of their services, certainly have
a right to expect and require that their patients should enter-
tain a just sense of the duties which they owe to their medical
attendants.

2. The first duty of a patient is to select as his medical ad-
viser one who has received a regular professional education.
In no trade or occupation do mankind rely on the skill of an
untaught artist, and in medicine, confessedly the most difficult
and intricate of the sciences, the world ought not to suppose
that knowledge is intuitive.

3. Patients should prefer a physician whose habits of life
are regular, and who is not devoted to company, pleasure, or
to any pursuit incompatible with his professional obligations.
A patient should also confide himself and family, as much as
possible, to the care of one physician; for a medical man
who has become acquainted with the peculiarities of constitu-
tion, habits, and predispositions of those he attends, is more
likely to be successful in his treatment than one who does not
possess the knowledge.

A patient who has thus selected his physician should al-
ways apply for advice in what may appear to him trivial cases,
for the most fatal results often supervene on the slightest acci-
dents. It is of still more importance that he should apply for
assistance in the forming stage of violent diseases: it is to ne-
glect of this precept that medicine owes much of the uncer-
tainty and imperfection with which it has been reproached.

4. Patients should faithfully and unreservedly communi-
cate to their physician the supposed cause of their disease.
This is the more important as many diseases of a mental ori-
gin simulate those depending on external causes, and yet are
only to be cured by ministering to the mind diseased. "A pa-
tient should never be afraid of thus making his physician his
friend and adviser. He should always bear in mind that a
medical man is under the strongest obligations of secrecy.
Even the female sex should never allow feelings of shame or
delicacy to prevent their disclosing the seat, symptoms, and
causes of complaints peculiar to them. However commend-
able a modest reserve may be in the common occurrences of
life, its strict observance in medicine is often attended with the
most serious consequences, and a patient may sink under a
baneful and loathsome disease, which might have been readily
prevented had timely intimation been given to the physician.

5. A patient should never weary his physician with a tedi-
ous detail of events or matters not appertaining to his disease.
Even as relates to his actual symptoms, he will convey much
more real information by giving clear answers to interroga-
tories, than by the most minute account of his own framing.
Neither should he obtrude the details of his business, nor the
history of his family concerns.

6. The obedience of a patient to the prescriptions of his
physician should be prompt and implicit. He should never
permit his own crude opinions as to their fitness to influence
his attention to them. A failure in one particular may ren-
der an otherwise judicious treatment dangerous and even fatal.
This remark is equally applicable to diet, drink, and exercise.
As patients become convalescent, they are very apt to sup-
pose that the rules prescribed for them may be disregarded,
and the consequence but too often is a relapse. Patients
should never allow themselves to be persuaded to take any
medicine whatever that may be recommended to them by the
self-constituted doctors and doctresses who are so frequently
met with, and who pretend to possess infallible remedies for
the cure of every disease. However simple some of their pre-
scriptions may appear to be, it often happens that they are
productive of much mischief, and in all cases they are injuri-
ous, by contravening the plan of treatment adopted by the
physician.

7. A patient should, if possible, avoid even the friendly
visits of a physician who is not attending him; and when
he does receive them, he should never converse on the sub-
ject of his disease, as an observation may be made, without
intention of interference, which may destroy his confidence
in the course he is pursuing, and induce him to neglect the
directions prescribed to him. A patient should never send
for a consulting physician without the express consent of his
own medical attendant. It is of great importance that phy-
sicians should act in concert; for, although their modes of
treatment may be attended with equal success when employed
singly, yet conjointly they are very likely to be productive
of disastrous results.

8. When a patient wishes to dismiss his physician justice
and common courtesy require that he should declare his rea-
son for so doing.

9. Patients should always, when practicable, send for their
physician in the morning, before his usual hour of going out;
for, by being early aware of the visits he has to pay during
the day, the physician is able to apportion his time in such a
manner as to prevent an interference of engagements. Pa-
tients should also avoid calling on their medical adviser un-
necessarily during the hours devoted to meals or sleep. They
should always be in readiness to receive the visits of their
physician, as the detention of a few minutes is often of serious
inconvenience to him.

10. A patient should, after his recovery, entertain a just
enduring sense of the value of the services rendered him by
the physician: for these are of such a character that no mere
pecuniary acknowledgment can repay or cancel them.