2001/05/15 by Philip Carling · 1 citation
Medicine · Neuroscience · Health Professions · #Historical Medical Research and Treatments #Neurology and Historical Studies #Child and Adolescent Health #Medicine
paper · pdf · doi:10.1086/320174
openalex publication_date 2001/05/15 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/29
Sir—The thoughtful and carefully annotated essay “Skepticism: A Lost Clinical Art,” written by Dr. Mark J. DiNubile [1], provided a lucid perspective on the importance of prudent skepticism in clinical practice. The essay called to mind advice given by Thomas Sydenham (1624–1689) in his monograph “Medical Observations Concerning the History and Cure of Acute Diseases,” which was published in 1666 (translated by R. G. Latham [2]). Sydenham, a diligent and insightful observer of clinical issues, was the first true epidemiologist, although he realized only limited success in categorizing many diseases on the basis of the nature and the patterns of the fevers with which they were associated. Despite the frustrations that he experienced in his attempts to understand infectious diseases prior to the advent of the germ theory, his skepticism regarding the use of unproven treatment modalities are as applicable today as they were more than 330 years ago: “It is difficult to lay down any general rules for treating these fevers. Hence, in darkness so dense, I prefer nothing, upon the breaking out of a new fever, to a little delay; and I proceed especially towards greater remedies, with a slow foot and with circumspection.”