[PW] Adage: It is more important to know what sort of a patient has a disease than what disease a patient has

ADSGarson O'Toole adsgarsonotoole at gmail.com
Sun Jul 21 00:30:54 PDT 2019


Garson O'Toole wrote:
> >>> Multiple requests to examine the saying in the subject line have been
> >>> sent to me over the years. It is often ascribed to William Osler, one
> >>> of the creators of Johns Hopkins School of Medicine.

Donna Halper wrote
> And what's interesting is another widely-quoted version of that saying,
> "The good physician treats the disease; the great physician treats the
> patient who has the disease," is also frequently attributed to Osler;
> but unless I am looking in the wrong places, I cannot find any
> verifiable sources that show where he originally said it-- in fact, it
> may not have come from him at all, at least not in that form.

Excellent point, Donna. I also came across that saying during my
exploration. William Osler died in 1919, and the earliest (apparent)
match I found during a preliminary search was the following unverified
Google Books snippet:

Year: 1943
Periodical: Journal of the Association of American Medical Colleges
Volume 18
Quote Page 169
Google Books Snippet Match: data may be inaccurate and must be
verified with hardcopy or scans; probe with "1943" indicates that the
volume does contain issues from 1943

[Begin excerpt]
How novel it must have sounded in that prelaboratory era when the
brilliant analysis of symptoms was all absorbing, to have Sir Wm.
Osler say, “The good physician treats the disease, but the great
physician treats the patient who has the disease." Today students are
taking this for granted.
[End excerpt]

There was another adage I encountered that fits within this broad
thematic family:  "Treat the patient and not the disease". This
exhortation seems to be older than the other sayings. During a
preliminary search I found a match in the 1840s.

[ref] 1846 October 10, The Lancet, Medical Society of London, Monday,
October 5th, Mr. Denby, President, Quote Page 407, Published at the
Offices of the Lancet, London. (Google Books Full View) link [/ref]
https://books.google.com/books?id=GJdMAQAAMAAJ&q=%22treat+the+patient%22#v=snippet&

[Begin excerpt]
DR. Golding BIRD agreed in an observation that had fallen from a
speaker at the last meeting, that, in the practice of medicine, the
great point was to treat the patient, and not the disease. He
proceeded to show the necessity of treating various cases of the same
disease in various ways, according to the constitution and habits of
the patient, &c. He proceeded to show that the objects of treatment
generally of the sagacious practitioner tended to the same result,
however different the modes might appear to be.
[End excerpt]

Garson


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