Commentary on iatrogenic disease.

T he defin itio n o f ia tro gen ic d isease su p p lie d b y O. H . P e rry P e p p e r m akes u se o f th e G reek ia tros (physician) an d genesis, s ig n ify ing o rig in .31 In itia lly re ­ ferring to a d isease in d u c e d by a p h y si­ cian, th e te rm is freq u en tly u se d in re la­ tio n to im ag in ed a ilm en ts .45 E v e n th e m ost co n sc ien tio u s p h ysic ian adm in is­ te r in g th e m ost p ro p e r o f trea tm en ts m ay p ro d u ce d ev asta tin g effects. A com ­ p reh en s iv e rev iew o f th e lite ra tu re o f ia t­ rogen ic d iseases rev ea ls th a t th ey are , in ­ d eed , ch iefly g en e ra te d b y igno rance, e r­ ror, ca re lessness , g reed , o r in ex trem e in ­ stances, ev en m alice on th e p a rt o f p eo p le in th e m ed ica l fie ld . K ent, in D ea d ly M edic in e ,18 m akes us aw are th a t g reed a n d m alice have b e e n ch a rg ed to o u r col­ leag ues a n d th a t in p rev io u s cen tu rie s po iso ners h ad a free re in . P ed d le rs “b lith e ly an d w ith o u t fear” d isp e n se d th e ir w ares o f “ S p o u se -rem o v er an d In h e ritan ce -p o w d er b y th e w h o lesa le to n ”—w h ile in ea rly anatom ic d issec tio n , the grow ing dem an d for fresh cadavers by th e p u p ils o f D r. R o b ert Knox w ere m e t b y B urke an d H are an d le d to th e hum erous observation : “ U p th e close an d dow n th e stair A round th e h o u se w ith B urke an d H are, B urke’s th e b u tch e r, H a re ’s th e th ief, Knox th e bo y w ho b u ys th e b e e f .18 ” An u p d a te d —an d alw ays grow ing—list o f ia trogen ic d iseases takes us in to n early ev e ry sp e c ia lty a n d is re p le te w ith tum ors, p o iso n in gs, in tracran ia l h em o r­ rhages, d ru g in te rac tio n s an d surgical in ­ ju rie s , to n am e on ly a few.