Advances In Medicine

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Advances In Medicine

As the history of medicine has evolved, a number of trends and prevailing opinions have swept the profession. One of the most subtle, and yet most revealing results of these sweeping trends manifests itself by altering the tone in medical conversations and dialogues, often available to the non-medical person in the form of texts and literature. A relatively current example appears in the form of Perri Klass’ A Not Entirely Benign Procedure, a text dedicated to the experiences of the author at Harvard Medical School. Published in 1987, Klass’ work offers an interesting, if not shocking comparison to Philippe Pinel’s “The Clinical Training of Doctors,” an article published in 1783. It seems that, despite the obvious advancements and progress in medical technology and general care, the modern Klass presents less certainty about the profession and its abilities than does the eighteenth century article. In Pinel’s article, however, a distinct tone of holistic healing pervades the proposed training of physicians—the lack of which Klass bemoans in her work. The contrast between the two works affords the reader a view into two parallel transitions in medicine: the decline of certainty and the decline of holistic care.
One of the most shocking aspects of Pinel’s article involves the specificity in patient setting and observation he demands. From precise measurements of the weather to room orientations, Pinel seems to imply that precision in observation and care-giving will lead to precise diagnoses and eventual cures: “It is obvious that medical observations can be precise and conclusive only if the evidence is reduced to the smallest possible number of facts and to the plainest data.” The outline for the training of physicians Pinel proposes attempts to create an environment that allows the kind of precision that will lead to conclusive outcomes in patient care. Pinel’s demands range from the sensible to the seemingly outrageous. His proposal to closely scrutinize the diets of patients, as well as to experiment with these diets, seems to coincide with modern beliefs and practices. Indeed, just as Pinel recommends, one of the first and fundamental questions asked by any physician or health care provider involves an investigation into previous food intake. Most of his section entitled Questions to ask upon admitting a patient conforms with modern practice. The more extreme requests and propositions, however, offer a more penetrating insight int...

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