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April 1966

Primum non nocere

Arch Ophthalmol. 1966;75(4):456-457. doi:10.1001/archopht.1966.00970050458002

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A physician's first responsibility is to do no harm. Hippocrates may have said it first, but modern courtrooms now reverberate with its implications, and the popular press is wont to dwell on its newsworthiness. Episodes such as the thalidomide affair have become as familiar to the housewife as to the physician.

Yet those in the practice of medicine know the responsibility is not as clear-cut or the error as unavoidable as the nonparticipants, viewing from a safe distance and with retrospective clairvoyance, seem to believe. There was, for instance, no way of knowing that dinitrophenol, an effective antiobesity drug, would cause cataracts until it had had extensive trial in human beings. Experimental tests had not produced cataracts in other mammals. Nor have animals developed cataracts from triparanol when it is used in doses comparable to those employed in the treatment of hypercholesterolemia. But man has, and some score or

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