1. The Patient

As it is the physician's business to cure the sick (at least, that is what nearly all laymen, and perhaps ninetynine and nine-tenths per cent of the profession, believe), those who are uncomfortable or in pain place themselves under the care of a physician to be made well, and when the pain is gone a cure is supposed to have been wrought.

The patient presents symptoms, some of which are subjective and a part of which are objective. The subjective symptoms are those about which the patient knows, while the objective symptoms are the changes of the exterior and interior about which the physician knows.

The subjective symptoms are those that have developed in the consciousness of the patient. They may have come on rapidly, or they may have come on very slowly.

The history of disease is that of a coming-on and a going off of discomfort; and on the revolutions--the cycles--made by diseases rests the reputation of all systems of palliation. The patients feel bad, and the doctors of high and low degree, representing schools whose scientific data--theories of cause and cure--are poles apart, and whose therapeutics range from conceit to the fanciful and on to the grotesque, gather around their victims and administer their "dope;" when, behold! as if by the touch of the lamp of Aladdin, the victims are blessed by the remedies, in spite of the fact that these are as opposite in their specific actions as it is possible for them to be. Yet the sufferers are "cured"! Of course, it matters not if the patients are sick again in a week, or a month, or a year, with the selfsame disease--another fanciful "cure" is made, which again our doctors and patients celebrate in the usual way, by telling in scientific terms just how it came about, even the wisest among them being ignorant of the fact that the natural progress of all disease is rhythmical or cyclical--better and worse--until the organism is broken down, and then the patient is better and worse, but never well, until death gives full relief.

It is the history which the patient recites to the physician; and it is the physician's business to weigh, analyze, and criticize what the patient tells him, and, by a physical examination, to determine just what the derangement of body is.

It should be borne in mind that the diagnosis of the exact derangement--discovering just what organ is affected, and determining whether the disease is functional or organic innocent (benign) or malignant--is very far from discovering the primary and insidious cause, without which discovery the treatment must be palliative. There is no cure short of removing the primary or initiative cause. If the initiative cause has passed away, then the secondary cause, which is doing primary work, must be discovered and removed.

The patient may be making his first call upon the doctor. He may be having his first pain or discomfort, or he may have had many attacks of sickness and pain.

The discomfort that caused the patient to seek relief may be a link in a chain of morbid derangements leading back to childhood, or even infancy--not on the order of heredity, for nothing is inherited except a predisposition to be sick in a given way; but if the tendency ever becomes a realization, habits that pervert nutrition must be practiced long enough to break down resistance and start the morbid tendencies to work.

It is necessary to get all the history of the life of the patient, and, when possible, the family history, age, sex, habits, occupation, temperament, beliefs, environments, mode and manner of the care of the body.

It is necessary to know all about the life which the patient is living, and all about the life which he has lived, if he has changed his style recently. It is not only necessary to know the physical habits of the patient, but his mental habits as well; and, in addition, the physician must have the confidence of the patient and know his secret life. The physician must enter into the relationship of "father confessor" with every important case that calls upon him. If he has not the personality to secure this confidence, and draw out the secrets that are hidden in the occult chamber of the individual's soul, he is not possessed of those qualities of character which make for healing. The doctor must have sympathy--not, however, without firmness and sternness, when necessary. The quality of selfishness in a doctor must be covered by a very large coating of politic politeness, or he will not draw patients, and certainly will not be a physician at any time. If his selfishness is pronounced, it is liable to be subconsciously interpreted by the patient, and this knowledge kills influence.

Lost self-confidence, self-respect, and self-control are the psychical elements with which the patient contends in chronic diseases, and which make management of a cure impossible for the selfish, vain, and unsympathetic doctor; for only the sympathetic can draw confessions--and confession is necessary to cure.

It is well, this early, to disabuse the mind of any reader of the idea which he may have that a successful curing system is, or can be, based on a set of cut-and-dried formulas. Indeed not; every case is different and a law unto itself. The only thing that is fixed and unchangeable is the natural laws within and without the patient. It is our attitude before the law that determines health or disease. If our actions agree with the law of our being, or the environment, all is well.

Health results from an agreeable adjustment of the body and mind to natural law and order; and impaired health--a lowered health standard, called disease--comes from disagreeable adjustment of the body and mind to natural law and order.

Diagnosis is determining the symptoms and learning just what is the cause of the morbid process, and its effect on the body.

I practiced medicine in the orthodox manner for twenty-five years. A number of those years were spent in determining just how much my treatment had to do with the recovery of my patients, and how much it did not. Little by little my drug superstition sloughed off. Not rapidly, but little by little, I learned that the physician is a woefully deluded man.