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Holmes, Oliver Wendell, 1809-1894

"Medical Essays, 1842-1882"

Of course, he has to be wheedled out of this, a recipe
is written for beefsteaks and porter, the twins are ignominiously
expelled from the anaemic bosom, and forced to take prematurely to the
bottle, and this prolific mother is saved for future usefulness in the
line of maternity.
The practice of making a profit on the medicine ordered has been held up
to reprobation by one at least of the orators who have preceded me. That
the effect of this has been ruinous in English practice I cannot doubt,
and that in this country the standard of practice was in former
generations lowered through the same agency is not unlikely. I have seen
an old account-book in which the physician charged an extra price for
gilding his rich patients' pills. If all medicine were very costly, and
the expense of it always came out of the physician's fee, it would really
be a less objectionable arrangement than this other most pernicious one.
He would naturally think twice before he gave an emetic or cathartic
which evacuated his own pocket, and be sparing of the cholagogues that
emptied the biliary ducts of his own wallet, unless he were sure they
were needed. If there is any temptation, it should not be in favor of
giving noxious agents, as it clearly must be in the case of English
druggists and "General Practitioners." The complaint against the other
course is a very old one.


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