-
Conservative Medicine
- Johns Hopkins University Press
- Chapter
- Additional Information
AUSTIN FLINT CONSERVATIVE MEDICINE Editor's Note Austin Flint (1812-86), who taught in six schools in his forty-year teaching career, was a prolific writer of books, articles, and editorials. His text of 1866, A Treatise on the Principles and Practice of Medicine (Philadelphia: Henry C. Lea), was one of the most popular American medical books of its time. His case records alone are said to fill nearly 17,000 folio pages. His writings reflect careful observation and recording of clinical cases, a procedure he urged his many students to follow. The work of Louis and Laennec in Paris impressed him greatly, although he did not go abroad to study. Samuel D. Gross called Flint the Sydenham of his time.1 This paper on "Conservative Medicine" followed in the tradition of rational therapeutics, although Flint was not as staunch a believer in nature as were Worthington Hooker or Jacob Bigelow, for instance. Flint's paper, as he explained , was inspired by the surgeons and their interest in conservative operations . Bibliographical Note Flint wrote two other essays dealing with a similar theme: "Conservative medicine as applied to therapeutics," Am. J. Med. Sci. 45 (1863): 22-43; and "Conservative medicine as applied to hygiene," ibid. 46 (1863): 361-77. These essays are collected and published as Essays on Conservative Medicine and Kindred Topics, Philadelphia: Lea, 1874. For biographical information on Flint see A. S. Evans, "Austin Flint and his contributions to medicine," Bull Hist. Med. 32 (1958): 224-41; and Norman Shaftel, "Austin Flint, Sr. (1812-1886): educator of physicians,"/. Med. Educ. 35(1960): 1122-35. "What does the writer mean by conservative medicine!" This will be the mental inquiry of the reader when the caption of this article meets his eye. It is Am. Med Monthly 18 (1862): 1-24. 1 S. D. Gross, Autobiography, 2 vols. (Philadelphia: Barrie, 1887)2: 161. 134 AUSTIN FLINT 135 desirable, first of all, for the writer to explain the subject which he ventures to hope will appear to possess interest enough to lead to a perusal of the pages which are to follow. The meaning of conservative surgery is well understood. This phrase has been sufficiently common of late years. The conservative surgeon aims to preserve the integrity of the body. He spares diseased or wounded members whenever there are good grounds for believing that by skillful management they may be saved. He resorts to mutilations only when they are clearly necessary. He weighs carefully the dangers of operations, so as not to incur too much risk of shortening life by resorting to the scalpel. By conservative medicine, I mean an analogous line of conduct in the management of maladies which are not surgical. The conservative physician shrinks from employing potential remedies whenever there are good grounds for believing that diseases will pursue a favorable course without active interference. He resorts to therapeutical measures which must be hurtful if not useful only when they are clearly indicated. He appreciates injurious medication, and hence does not run a risk of shortening life by adding dangers of treatment to those of disease. Such, in brief, is an explanation of the subject of this article. For the phrase conservative medicine I am indebted to a distinguished friend and colleague, well known as eminently a conservative surgeon . During the last quarter of a century a change has taken place in medical sentiment as regards surgical operations. New and grand achievements in surgery seemed formerly to be the leading objects of personal ambition. To borrow a fashionable expression, they were decidedly the rage. Boldness in the use of the knife was the trait in the character of the surgeon which was most highly admired. The history of surgery during the first third of the present century is characterized by the introduction and frequent performance of numerous formidable operations. It was customary to speak of them as brilliant, and the daring surgeon enjoyed somewhat of the eclat which belongs to the hero of the battlefield. This analogy was implied when one of the greatest of our American surgeons wishing to distinguish his most brilliant exploit styled it his Waterloo operation. The change that has taken place is marked. We hear now comparatively little of terrible operations and of that sort of heroism which is associated with bloody deeds. What would once have been considered as a degree of courage to be admired is now stigmatized as rashness. It is an equivocal compliment to say of a practitioner that he...