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JAMA 100 Years Ago
August 10, 2011


JAMA. 2011;306(6):660. doi:10.1001/jama.2011.1054

Long ago Roger Bacon declared that the principal reason why men did not advance in knowledge was that they were afraid to say “I do not know.” Most persons prefer a dubious explanation to none. Words often conceal the speaker's ignorance even from himself. This tendency has now and again been observed in medicine.

Thus, Sir William Gowers1 called particular attention to the ease with which a word may come to conceal our ignorance or laziness, or lack of time to study a case. Speaking of the word “neurasthenia,” he said: “Its practical utility is low, but has influenced its use. Its employment is extended far beyond the needs of the patient and, indeed, did so from the first. It often tends to be too satisfying. If physicians actually think that they have found the malady from which the patient is suffering, an influence is often exerted on them of which they are unconscious, which lessens the tendency to go further in search for the whole morbid state. Words are our servants, but they often exert a very masterly influence on us, none the less effective because we are not conscious of it. They have also their own vitality, feeble or vigorous, and we have little power to influence their career.”