Physician, an appellation given, in general, to those persons only, who exercise the medical profession, under the sanction of a diploma granted by an university, after a regular course of study. ln a strict sense, every surgeon, or apothecary, who has received a liberal education, and practises the healing art on scientific principles, is fully entitled to the same distinction ; though he have not obtained the degree which constitutes a doctor of medicine.—Consistently with this explanation, we shall venture to illustrate the official capacity of a physician, with a few occasional remarks.
When we consider the almost boundless acquisitions to be made in the different branches of natural knowledge, as well as in the practical acquaintance with that complicated machine, in which the human mind acts the most conspicuous part; when we reflect on the various requisites to form the character of a true physician, and the great trust reposed in him by all ranks of society- it will not appear surprizing to the cool observer,
B that, in this honourable profession, the number of its adepts should be equally diversified by their talents, their claims to public favour, and their modes of action.
It would be an invidious task, to attempt a classification of those numerous members of the medical profession, who are variously engaged in its different branches. We have already, under the articles Apothecary, and Midwifery, briefly stated their respective qualifications; and, that we may not exceed the limits of our plan, we shall in this place confine our attention to the duties of a physician.—A man, who maintains this important station in society, ought, beside a competent share of knowledge, to possess a humane and sympathizing, though intrepid, disposition of mind : he must be candid on all occasions, without any studied reserve, but circumspect in his declaration to the patient ; and, where danger is to be apprehended, nothing should deter him from concealing the probable termination of the case from parents, or the nearest relations. Nor will a physician of a liberal and enlightened mind, hesitate to explain the reasons, or causes, which induced him to prescribe certain medicines, in preference to others, perhaps differing from those of his predecessor. And, if he cannot, on the spur of the moment, determine himself respecting the most proper treatment, instead of prescribing conformably to the common routine of business, or copying a recipe from his memorandum-book, he will frankly inform the patient of the difficulty attending his complicated disease, and give the most appropriate directions for arranging every part of his diet and regimen.
Thus, he cannot fail of acquiring confidence and credit; while he enjoys the pleasing satisfaction,that he has acted consistently with his conscience, and the dignity of his profession.
On the contrary, the man of bu-siness, when entering the sickroom, will previously direct his attention to the curtains, pictures, chairs, etc. instead of examining with the most scrutinizing attention the expressive countenance of the person, whose life perhaps depends on the first criterion, thus neglected. The truth of this remark must be obvious to every rational practi-tioner; though the result of it be not always of equal consequence.. Having asked a few superficial questions (which are scrupulously repeated to every patient, and couched in the most concise phraseology, in order to save time and trouble) the man of business hastily feels the pulse ; and, as it were by inspiration, writes a most elaborate and mysterious prescription, which is always obedient to his will:- a work of ten, or at the farthest fifteen, minutes! Its effects,however, are not so uniformly favourable to the expectations, and sanguine hopes of the patient:—nevertheless, after observing the operation of the medicines swallowed, in consequence of the second, third, or fourth visit, the disease acquires a name and character, not only corresponding to the symptoms now evident, but likewise to the definition given by the best nosologists. Thus, error is reconciled to error; and the daily reward is collected, while Nature exerts herself under this struggle of symptoms, till she at length makes a critical effort, either for t!:e recovery or dissolution of the patient. Such is said to be the practice of those physicians, who degrade their profession into a trade; which is comparatively less respectable than that of the lowest mechanic!
Having hazarded these observations on the usual routine of a modern, or fashionable, physician (including both graduated and un-graduated, as well as associated and permitted, members of the different Colleges), we deem it our duty to point out those circumstances, and conditions, which deserve minute attention in the first examination of a patient. In order to obtain a clear and complete view of chronical diseases, for which a physician is generally consulted, after the apothecary, together with the old matrons, have exhausted their stock of medicinal Remedies, it will be requisite to proceed more systematically, and to inquire into the following particulars : 1. Duration of the disease. 2. Age and sex of the patient. 3. His external form and constitution of body. 4. His usual occupations, trade, or rank in life, 5. Whether married or single. 6, Climate; native country; and local situation with respect to dwelling. 7. Domestic circumstances and employment, if connected with the disorder. 8. Disposition of mind; character ; mode of thinking; if influenced by political or religious views. 9. Extent of his mental capacity, or cultivation of mind. 10. Favourite pursuits. 11. Usual intercourse, or society. 12. Particular habits or customs. 13. Mode of living, with respect to food and drink. 14. Local or external affections. 15. The peculiar temperament.
When these preliminary inquiries have been cautiously instituted, without intruding on the patient ; or appearing too officious to his affable relations; the systematic practitioner will next endeavour to ascertain the following data, leading to a more intimate knowledge of the disease : 1. The countenance of the patient. 2. His situation and posture in bed, or gait in the room. 3. His previous state of health. 4. The remedies and physicians he has employed on former occasions. 5. Idiosyncrasy, or peculiarity of constitution. 6. Instinctive propensities. 7. The prevailing character of diseases at the time, whether of an infectious, epidemic, or endemic nature.
Lastly, in order to discover the exact deviation from a natural or healthy state, none of the following points ought to be disregarded ; though it should be impracticable to pay the most scrupulous attention to each, at the first interview : namely, 1. The internal and external sensations of the patient. 2. The commencement and progress of the disease. 3. Pulse. 4. Breathing. 5. Muscular energy. 6. The appearance of the head and hair. 7. The throat and neck. 8. Deglutition, or swallowing. 9. The chest, 1O. The abdomen. 11. Appetite for eating or drinking. 12. The back or vertebrae. 13. The anus. 14. Vision, and the eyes, eye-lids, region about the eyes, and lachrymal glands. 15. The skin, with respect to its colour, and elasticity. 16. The nails. 17. The organ of smelling. 18. The prevalent taste in the mouth; appearance of the tongue and palate, together with the lips. 19. The organs of hearing. 20. State of the bowels, whether lax or costive. 21. Urine. 22. Insensible perspiration. 23. Ex-pectoration. 24. Nausea, retching, or vomiting. 25. The circulation of the blood. 26. The organs peculiar to the sex, and their functions. 27. Periodical evacuations designed by Nature. 28. Sleep.
Beside these general points, which relate to every individual, an experienced inquirer will adapt his questions to the particular age, sex, and condition of the patient:— thus, children and young mothers; the nervous and hysteric ; the hypochondriac and melancholic; each will suggest to his mind a different course for ascertaining the nature, seat, and origin of the disease. The result of this examination constitutes the difference between the empiric, and the rational physician : the former cures symptoms, not unlike the sagacious old woman who has studied Hill's and Culpepper's Herbals, or Buchan's Domestic Medicine, and similar Family Physicians; but the chief object of a medical philosopher, is the removal of disease, without neglecting the mitigation of painful symptoms; provided they originate from natural, not incidental causes ; or, in other words, if they are conceded with the state and progress of disordered functions. — Who, then, will pretend, or believe, that a task so important and complicated, can be accomplished during the usual short visit paid by a fashionable physician ?