Medicine Bend

“ Many centuries had still to elapse before medicine could gain that freedom of action, that rich equipment of tools, and that stock of accumulated knowledge which enable her in these days to make such giant strides forward as we have witnessed during the past twenty or thirty years.
The question will naturally arise, How did the Methodists decide, in the presence of an actual case of illness, which one of these abnormal states (the laxum, the strictum, or the mixtum) was the condition that called for medical treatment? ”

“ Thirty years of active practice had made him familiar with disease in its varied forms, and had led him to reject as useless that which was merely speculative in medicine, while it enabled him to speak with authority of all that was valuable in our science. Thoroughly familiar with medical literature, he had also studied disease in the great book of nature, at the bedside in private practice, and in the wards of hospitals. ”

“ One of the phenomena which baffle the science of medicine had appeared on the doctor's threshold—the sporadic case. Long after an epidemic is over, by an untraceable path infection arrives. It is quite as if a bird that cannot migrate should be found unearned on the opposite coast of a sea.
There was little need of the consultation; the disease was well known, the treatment was that agreed upon by the profession; Dr. Birney himself was the most successful practitioner. A well-known disease, an agreed-upon treatment—but a rate of mortality. ”

“ And the importance of understanding the true conditions of health and disease—of knowing how to acquire and preserve that healthy habit of body which the most tedious and costly medical treatment so often fails to restore when once lost, should secure a place in general education for the principal maxims of hygiene, and some of those even of practical medicine. For those who aim at high intellectual cultivation, the study of physiology has still greater recommendations, and is, in the present state of advancement of the higher studies, a real necessity. ”

“ I have no doubt, that some diseases not yet understood may in time be transferred to the table of those known. But, were I a physician, I would rather leave the transfer to the slow hand of accident, than hasten it by guilty experiments on those who put their lives into my hands. The only sure foundations of medicine are, an intimate knowledge of the human body, and observation on the effects of medicinal substances on that. ”

“ Notwithstanding all that Medicine can achieve, to succour the body as it struggles against actual disease—notwithstanding those resources of drugs and handicraft, by which the physician or surgeon opposes death or mitigates pain in the detailed exercise of his art, all past experience, and every transaction of our daily practice, confirm the popular adage that prevention is better than cure. ”

“ A medical school is not a scientific school, except just so far as medicine itself is a science. On the natural history side, medicine is a science; on the curative side, chiefly an art. This is implied in Hufeland's aphorism: “The physician must generalize the disease and individualize the patient.”
The coordinated and classified results of empirical observation, in distinction from scientific experiment, have furnished almost all we know about food, the medicine of health, and medicine, the food of sickness. ”

“ The physician is, alas! too often powerless to contend against the ills that are raging around us. But, really, we can not expect physiology to cure incurable diseases and make men immortal; its mission is to discover the truth, and it is for the physician to apply the lessons of the new truth to the treatment of diseases. Who can say seriously that modern medicine, enlightened by the great physiological discoveries of this and former centuries, is not superior to the medicine of the middle ages? The circulation of the blood was discovered by vivisection. ”

“ How weak appears the reasoning of many great physicians, when we examine it, not in their works, but on the dead body. Medicine was for a long time excluded from the circle of the exact sciences; it will have a right to be associated with them, at least in the diagnostics of diseases, when we shall every where unite to accurate observation, an examination of the changes our organs undergo. ”

“ Many practitioners, indeed, hold every thing that is in the least theoretical, in great contempt. They 3alledge, that a physician possesses all the knowledge requisite in medicine, who is acquainted with particular remedies which will infallibly cure particular diseases. Could such remedies be discovered, their reasoning would indeed hold good; and medicine, which, of all arts, is in reality the most difficult, would be the easiest. ”

“ We have to dissect nature; which, for practice, is better than to abstract it.” “To clinical medicine the body becomes a pathological museum. In every part we recognise certain proclivities to morbid action; and the purpose of our study is to trace these tendencies to their source on the one hand, and to their effects on the other.” “The effects of disease may be for a third or fourth generation, but the laws of health are for a thousand.” “Happily, at this day, hygiene has gained strength enough to maintain an independent position in science. ”

“ In the first place, if he has never seen any plan of treatment put into practice, how is he to decide between the merits of different, and it may be, opposite plans recommended by different authors? These differences, in many cases, may be satisfactorily explained and reconciled; but to the student, brought into contact with disease for the first time, they must prove hopelessly embarrassing. In the second place, medicine is a progressive science. ”

“ To physicians who are students not alone of the manifestations of disease but also of the workings of human nature, there are few chapters in the history of medicine more interesting than those which record the welcome by each generation of the supposed advances in the treatment of disease. Each generation announced its cures for diseases, provided its remedies to relieve symptoms, and invented methods of treatment that seemed to put off the inevitable tendency toward dissolution. ”

“ While the practice of medicine is so vast and extensive a field, that it has been found necessary to subdivide it amongst physicians, surgeons, accoucheurs, apothecaries, oculists, aurists, dentists, men for the gout and men for the gravel, one for the belly and another for the brain, these reformers seem to regard medical knowledge and medical practice as in a nutshell,—as already perfect and complete. ”

“ So the doctor learns to combat disease with science, and at the same time to apply scientific laws of health that he may fortify the human body against the invasion of harmful germs. Thus, eventually, he makes medicine itself less necessary. ”

“ In every age in which we may study the history of medicine, we cannot fail to be impressed by the one dominant idea which appears to have possessed the minds of those who have made medicine their peculiar study; I allude to the search for specific remedies against disease. There are undoubtedly those who profess to believe that we have but to search with sufficient acuteness, to find a remedy specific in its action against any disease which we may be called upon to treat ”

“ As I devoted myself with all possible zeal to the work in hand it was not long before I realized thoroughly that the best way of increasing one’s knowledge of medicine is to begin applying, in actual practice, such principles as one may already have acquired; and thus I became convinced that the physician [421] who earnestly studies, with his own eyes,—and not through the medium of books,—the natural phenomena of the different diseases, must necessarily excel in the art of discovering what, in any given case, are the true indications as to the remedial measures that should be employed. ”

“ Undoubtedly one of the most important steps which medicine has made in its development, is the recognition of the difference between disease itself and those symptoms which may be caused as the result of such disease. We shall find that in most, if not in all, of the older writers on medicine, the treatment of the physician was directed towards the alleviation of those prominent symptoms, which, then not so much looked upon as symptoms, were only recognized as the main cause of the attack. ”

“ The biological healing system, based on the laws of nature and the acknowledgment of the fact that no two cases of disease are exactly alike, requires much broader knowledge and much deeper insight on the part of the physician than did the old-school of medicine with its search for symptoms of special diseases and its occult prescriptions. ”

“ As a matter of course, he soon was elected a Fellow of his college, where he continued to reside until his marriage in 1794. During this period of learned leisure he devoted his time to the study of medicine, and the MS. notes in the possession of his biographer, Mr. Hare, “prove the diligence with which he studied his profession, and there we see the origin of his enlarged views of the causes of disease, so much insisted on by these fathers of medicine, and so much neglected by modern physicians in their search for chemical remedies.” ”

“ In 1660 the students at Jena, on one occasion, carried on a regular battle with the police, and as a result of this encounter several persons were killed. In the light of this evidence, therefore, it is not surprising that the science of medicine made comparatively little advance in Germany until after the eighteenth century was reached. ”

“ The great bulk of his fraternity went through their studious, conscientious, hard-working, and not infrequently heroic lives under the contented conviction of having to deal with two principal facts—disease and medicine—both accessible through study. To them the imponderable factor of the patient represented such or such an aggregation of material—muscle, nerve, blood, brawn, bone, and tissue—which might be counted upon to respond to such and such a treatment in such and such a manner, with very slight variation. The Doctor envied them their simplicity of faith. ”

“ And the highest aim of the physician is to gain such knowledge as will assist him in stamping out those evils of the human race which are the necessary concomitants of disease. And it needs no mere believer in an Utopian existence to follow me in this statement. The practical daily work of the physician, and, indeed, still more the study of medical history, cannot but convince the would-be sceptic that a very large proportion of those diseases which we are called upon to treat, are by their very nature to be prevented ”

“ For these notes show that here too he had reached the same conclusion which we noted in the foregoing, namely, that the results produced by physicians in treating the sick depend upon securing the attention of the patient in favor of a certain diagnosis and the proper medicine to be taken for the supposed disease. In fact he says, convincingly, that “all medical remedies affect the body only through the mind.” The one who takes medicine must believe in medicine and anticipate the desired result. The result is then created by the believer. ”

“ Preventive medicine, then, has for its object the prevention rather than the cure of disease. By showing the causes of disease and telling us where and how they are contracted, it is telling us how they may to a large extent be avoided. Unlike practical medicine, this subject is one which has a direct relation to the general public. While it may be best that the knowledge of curative methods be confined largely to the medical profession, it is eminently desirable that a knowledge of all the facts bearing upon preventive medicine should be distributed as widely as possible. ”

“ On the other hand, I call him a dogmatical physician who is very ready to assume opinions, to be prejudiced in favour of them, and to retain and assert very tenaciously, and with too much confidence, the opinions or prejudices which he has already taken up in common life, or in the study of the sciences.” He sought to [Pg 94] build up rational views of medicine, indeed, on the basis of fact and experiment. In giving his clinical lectures he was at great pains to choose diseases of the most common types, as most useful to the students. ”

“ Professor Clark, of the Harvard Medical School, in Boston, in an address of his, recently published, insists, again and again, that medicine never cures, and that it rarely, if ever, so much as aids nature ”

“ A hearty emetic effected a cure; and the first child of Jerry and Mary Wilson was distinctly marked on the left shoulder with a bunch of grapes.
HOW TO CURE FITS. Not none of the least difficult problems, in the practice of medicine, is the distinguishing between cases of real disease, and those that are feigned. It is a great stumbling block in the path of young practitioners, and even the old members of the fraternity find a few chips of it in their way occasionally. ”

“ Anyhow, lecturing a quarter of a century ago on diabetes, his special subject, Claude Bernard spoke out his longing to compel men into the ways of science, to give them some immediate sign which they could not refuse to see:—
"At this present time, medicine is passing from one period to another. The old traditions are losing ground, and scientific medicine (la médecine expérimentale) has got hold of all our younger men: every day it gains ground, and will establish itself against all its critics, and in spite of the excesses of those who are over-zealous for its honour.... ”

“ Guy was not, as some writers have asserted, a professor of surgery in the University of Montpellier; he was simply a physician who had won at that institution the title of “Master in Medicine”—the highest grade conferred by the university authorities, and one which necessarily implied that the recipient had given a certain number of public readings on medical topics. And yet in actual practice Guy manifested a strong preference for the management of diseases which demanded surgical treatment. ”