In 1823 the great German physician C. W. Hufeland wrote a brief treatise, strikingly entitled, "On the Physician's Power over Life and Death." 1 In it he attempted to define the unique relationship that binds the patient to his physician and, conversely, the physician to his patients. Indeed, Hufeland felt that this relationship, based on confidence, dependence, and need, was such an integral part of the successful practice of medicine that he inserted his maxims on the doctor's ethical obligations into his medical textbook, "Enchiridion medicum."
In the late 19th century, when Japanese medicine began to follow the German pattern, a group of leading physicians adopted Hufeland's work and extracted from it the ethical precepts as a basis for a Japanese code of medical ethics. While the Japanese gave grateful credit to the German author, they were obviously quite unaware of Hufeland's own source of inspiration and of the fact