It Is Quite As Important To Know What Kind of a Patient the Disease Has Got As To Know What Kind of a Disease the Patient Has Got

William Osler? Caleb Hillier Parry? Henry George Plimmer? Woods Hutchinson? Walter Moxon? Albert Abrams? Hippocrates? Anonymous?

Dear Quote Investigator: In medicine it is crucial to identify the disease that afflicts the patient, but that is only one part of the full assessment. Determining the best treatment requires a careful examination of the history and the behavior of the patient. Here is a germane adage:

It is more important to know what kind of a patient has the disease than what kind of a disease the patient has.

This saying has been attributed to several famous medical educators including William Osler and Caleb Hillier Parry. Would you please explore this topic?

Quote Investigator: A precursor adage emphasizing the need to focus on the patient was circulating in 1846 when it appeared in “The Lancet” with an anonymous attribution. Emphasis added to excerpts by QI: 1

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.

In 1894 a different precursor appeared in the book “A System of Genito-Urinary Diseases, Syphilology and Dermatology”. Professor Andrew R. Robinson was the author of a section containing the following passage which highlighted the need to understand the patient: 2

Why is it that one case of scarlatina or pneumonia or smallpox is severe and even fatal, and another mild? The organism is always a definite and similar one, even if it varies in virulent powers at different periods of an epidemic; consequently it is not a question of the kind of disease (or organism) the patient has, but rather the kind of patient the disease has attacked, and an appreciation of this fact gives the best results in treatment.

In 1899 Henry George Plimmer who was a Lecturer on Pathology and Bacteriology at St Mary’s Hospital Medical School delivered a short address that was recorded in “St. Mary’s Hospital Gazette”. The following excerpt contains the earliest strong match for the adage known to QI: 3

You will have to acquire, too, for any success to be given you, an accurate knowledge of human nature, and you will find that it is quite as important for the doctor to know what kind of patient the disease has for host, as to know what sort of disease the patient has for guest.

Below are additional selected citations in chronological order.

Continue reading It Is Quite As Important To Know What Kind of a Patient the Disease Has Got As To Know What Kind of a Disease the Patient Has Got

Notes:

  1. 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
  2. 1894, A System of Genito-Urinary Diseases, Syphilology and Dermatology by Various Authors, Edited by Prince A. Morrow, Three Volumes, Volume 3: Dermatology, Sycosis by Andrew R. Robinson (Professor of Dermatology in the New York Polyclinic), Start Page 881, Quote Page 891, D. Appleton and Company, New York. (HathiTrust Full View) link
  3. 1899 October, St. Mary’s Hospital Gazette, On Some Motives and Methods in Medicine by H. G. Plimmer (Lecturer on Pathology and Bacteriology at St Mary’s Hospital Medical School), Address delivered October 2, 1899, Start Page 116, Quote Page 117, London. (HathiTrust Full View) link

Most People Would Die Sooner Than Think—In Fact, They Do So

Bertrand Russell? Sheldon? John Ruskin? Woods Hutchinson? Anonymous?

Dear Quote Investigator: Cantankerous individuals who believe they are surrounded by an ignorant and unthinking public sometimes proclaim:

  • People would rather die than think.

This statement has been enhanced with a funny addition that reinvigorates the cliché. Here are two versions:

  • Many people would sooner die than think; in fact, they do.
  • Most people would rather die than think, and many of them do.

The influential British intellectual Bertrand Russell has received credit for this saying. Would you please trace this saying?

Quote Investigator: Bertrand Russell did include an instance in his 1925 book about physics titled “The ABC of Relativity”. Emphasis added to excerpts by QI: 1

We all have a tendency to think that the world must conform to our prejudices. The opposite view involves some effort of thought, and most people would die sooner than think—in fact, they do so. But the fact that a spherical universe seems odd to people who have been brought up on Euclidean prejudices is no evidence that it is impossible.

Confusion has occurred because Russell’s book has been reprinted and revised several times over the years. The humorous statement above was omitted from the revised 1958 edition and subsequent editions.

Interestingly, Bertrand Russell did not create this joke. An elaborate version was in circulation by 1913. Below are additional selected citations and further details in chronological order.

Continue reading Most People Would Die Sooner Than Think—In Fact, They Do So

Notes:

  1. 1925, The ABC of Relativity by Bertrand Russell, Chapter XI: Is the Universe Finite?, Quote Page 166, Harper & Brothers, New York. (Verified with scans)