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Oliver Wendell Holmes MD 1809–94 and the logic of medicine
  1. D Neuhauser
  1. Correspondence to:
 Professor D Neuhauser
 Department of Epidemiology and Biostatistics, Medical School, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-4945, USA; dvn{at}case.edu

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Oliver Wendell Holmes MD was one of America’s best known literary figures of the 19th century. His collected works of poetry, novels, letters, essays, and medical writings fill 15 volumes.1 His poems include the popular “Old Ironsides” (1830)2 and “The Deacon’s Masterpiece”:3


 “Have you heard of the wonderful one-hoss shay
 That was built in such a logical way
 It ran a hundred years to a day.”

His essays included “The Autocrat at the Breakfast Table” (1857).4 He gave us the word “anesthesia” to describe the use of ether during surgery by Morton in 1846.5,6

Graduating from Harvard College in 1829, he learned medicine in Boston and went to Paris from 1833 to 18357 to study with Pierce C A Louis8,9 who, in turn, was a student of Rene Laënnec, inventor of the stethoscope.10 Holmes’ MD degree was granted in 1836 and he opened his practice in Boston. “Holmes was not kept busy with patients, since a reputation for wit and poetry has never been known to increase a doctor’s practice.”11 He taught medical students and was Dean of the Harvard Medical School from 1847 to 1853, continuing as a professor there until 1870.12

THE LOGIC OF MEDICINE

Holmes wrote of his education in Paris under Louis: “I have learned at least three principles … not to take authority when I can have facts, not to guess when I can know, not to think a man must take physic because he is sick13 Holmes’ logic can be seen as three diagnostic choices: do nothing, test, or treat. This choice depends on the probability that the patient has the disease and the value of treatment. It depends on the accuracy of the …

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