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Holmes, Oliver Wendell, 1809-1894

"Medical Essays, 1842-1882"

I have
great pleasure in referring to this excellent movement, which gives our
liberal profession a chance to show its liberality, and serves to unite
us all, the successful and those whom fortune has cast down, in the bonds
of a true brotherhood.
A medical man, as he goes about his daily business after twenty years of
practice, is apt to suppose that he treats his patients according to the
teachings of his experience. No doubt this is true to some extent; to
what extent depending much on the qualities of the individual. But it is
easy to prove that the prescriptions of even wise physicians are very
commonly founded on something quite different from experience.
Experience must be based on the permanent facts of nature. But a glance
at the prevalent modes of treatment of any two successive generations
will show that there is a changeable as well as a permanent element in
the art of healing; not merely changeable as diseases vary, or as new
remedies are introduced, but changeable by the going out of fashion of
special remedies, by the decadence of a popular theory from which their
fitness was deduced, or other cause not more significant. There is no
reason to suppose that the present time is essentially different in this
respect from any other. Much, therefore, which is now very commonly
considered to be the result of experience, will be recognized in the
next, or in some succeeding generation, as no such result at all, but as
a foregone conclusion, based on some prevalent belief or fashion of the
time.


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