Hickam's dictum

Dr Daniel J Bell et al.

Hickam's dictum is usually stated as "patients can have as many diseases as they damn (or darn) well please". This aphorism has been attributed to John Hickam (1914-1970) an American physician, who was Chair of the Department of Medicine at the University of Indiana 1

The importance of this dictum lies in it acting as a counterweight to Occam's razor, declaring that a patient's clinical presentation may be secondary to two or more pathologies, rather than the parsimony of a single condition explaining all the symptoms and signs as put forward in the eponymous razor. Indeed in many cases it is more probable that an individual has multiple morbidities underlying the presentation, instead of one unifying diagnosis.

Hickam's dictum has also been expressed in a slightly different way as Saint's triad.

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Article information

rID: 66957
Section: Approach
Synonyms or Alternate Spellings:
  • A patient can have as many diseases as they damn well please
  • Patients can have as many diseases as they darn well please
  • Patients can have as many diseases as they damn well please
  • Hickam dictum

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