THOMAS KING CHAMBERS, HONORARY PHYSICIAN TO H. R. H. THE PRINCE OF WALES, CONSULTING PHYSICIAN AND LECTURER ON THE LOCK HOSPITAL, AUTHOR OF "LECTURES CHIEFLY CLINICAL, ETC. PROSUNT OMNIBUS. LANE LIBRARY PHILADELPHIA: HENRY C. LE A. 1867. пр 2801 044 1867 PREFACE. IN 1856 I published a small volume on the same subject that I am now again taking up. It has been a good while out of print, for I was not content with it enough to sanction a reproduction in the same shape. But I have always intended to handle it again some time or another. During the last year or so I have been looking over my old notes of cases, and it struck me that it would be interesting to pick out such as bore upon indigestion, to classify them according to the points they illustrated, and see how far they upheld or overthrew my previous views. Then linking them together, after the fashion of a clinical teacher, with a running commentary, I made them tell their own tale, and added such observations as either occurred to me at the time I had the patients under my eye or have flowed from after experience. So grew up, not the new edition I had thought of, but what consistency bids me call a new work. It has therefore a new title, pointing to the different aspect in which the subject is viewed. In the former work it was anatomically, here it is functionally treated. So pleasant has been the holiday task thus ".........to the sessions of sweet silent thought that I am fain to dwell upon it, and to try to lead others towards 112339 not lean on my memory alone, or the number of trustworthy histories would have been few indeed. The cases of those who are named as inmates of St. Mary's Hospital in the following pages are copied mainly from the diary kept by the clinical clerks. I have been always used to make this a chief source of teaching. The clerk was instructed to take notes with the sick person before him, and in his own words; and when he read them out at my visit, I added my observations, sometimes in the hospital case-books, sometimes in my own. These formed a groundwork on which to build my clinical lectures for the current week. They are irregular in wording, but preserve a fair record of the disease. The details of private practice have been kept in a shorter and more mechanical way. I make it a rule, to which exceptions need be very few, to write all prescriptions and papers of advice in a copying-book, which makes a duplicate of them by means of transfer paper; and at the back of this transcript I write, usually with the patient before me, his symptoms and history, at least so far as to explain my reasons for the advice, before I go on to the next page. The periodical indexing of these sheets is an easy job for an hour of weariness; and the whole time consumed is so crumbled up that it is never missed, and neither business nor amusement feel themselves robbed. Some people tell me they can make their notes of the day's work more fully and scientifically when it is over, and they quiet in their study. I do not like the plan so well. For one thing it interferes with the relaxation needed to keep the mind healthy and broad. That time belongs to rest-datur hora quieti -and should not be wasted on labor. An instinctive feeling of the truth of this causes a duty which is put off to such an opportunity to be put off often still further, often altogether. Again, unless an immediate note be made, the new and the strange in the day's experiences are stamped in the mind deeper than the common place, and so they are apt to take up more |