Medical experiment

“ No doubt both clinical study and pathological observation have not only helped practical medicine onward, but they have also greatly contributed to the progress of physiology itself. In fact, I find it impossible to separate exact clinical and pathological work from scientific research of a purely physiological nature. Is not all treatment more or less experiment? ”

“ Whatever skill we may boast in investigating the nature of a disease, or in understanding the structure of the body, yet without a knowledge of the instruments which are to be used, and of their properties and action upon the body, whereby they produce a change from sickness to health, other knowledge avails little in the cure of diseases.
The Theory of Physic, more commonly termed Medical Institutions, comprehends under it, the important doctrines of Physiology and Pathology. ”

“ Placed, moreover, as we shall be here, in more or less close connection with a splendidly-equipped hospital, so that we shall be able constantly to combine skilled pathological observation with physiological experiment in an excellent laboratory, we have duties to perform toward the advancement of scientific medicine, from whose performance I believe it would be criminal in us, as it would be shameful, to flinch in any way. ”

“ Such demonstration is a thrilling spectacle to inexperienced students. It appeals to that love of excitement which makes them rush to a surgical operation, or to an extraordinary medical case which may have no bearing whatever on their future practice, whilst the commonplace but all-important bedside observation seems dull in comparison. Yet patient work in the anatomical and microscopic rooms, and in the chemical laboratory for general and animal chemistry, and close clinical study, all of which involve no form of suffering, are of primary importance. ”

“ The more nearly the treatment of diseases can be brought throughout to this degree of accuracy, the more scientific will the art of physic become, and the tendency of all medical observation and of all medical writing, should be to advance in this direction. ”

“ The immediate object of physiological experiment is, then, not to make out new practical methods of treating disease, but rather to attain to a more complete and sound understanding of those general laws which govern the actions of the living body in health—laws which must ever form the only firm basis of the knowledge of disease, and the only sure guide to judicious modes of treatment. ”

“ If in this brief article, which does not purport to be more than a sketch of the tremendous strides made by medicine in the Nineteenth Century, so much space has been given to the germ theory of disease, it is because the demonstration of the truth of that theory has been absolute, and has constituted the very marrow of almost all the medical progress of the century that has been the outcome of continuous thought and study as opposed to chance discovery. ”

“ Seeks to utilise at the bedside the most recent researches of the Physiologist, the Chemist, and the Bacteriologist. . . . Belongs to the same series of Manuals which has given us the issue of Landois’ ‘Physiology,’ wherein Prof. Stirling sought to bring the most advanced Physiology into relationship with clinical work; and the very valuable treatise of V. Jaksch on ‘Clinical Diagnosis.”—British Medical Journal. ”

“ It has been asserted that all the improvements brought about by experimental research would have been introduced with equal certainty had experiment on living animals never been attempted. Observation, experience, and thought would have attained all the results we now enjoy. Possibly so; but when? Clinical observation can be traced back some three or four thousand years, and even then it started with a rich legacy of traditional knowledge. Experimental physiology as a science was only born about a hundred years ago. ”

“ Dr FRANK, an eminent author and practitioner.
"Our actual information or knowledge of disease does not increase in proportion to our experimental practice. Every dose of medicine given is a blind experiment upon the vitality of the patient." ”

“ These accessory sciences have considerably developed in the evolution of medicine, and the art of medicine has become the chief motive power which urges men to research and discovery in the biological sciences, such as histology, embryology, comparative anatomy and physiology, anatomy and physiology of the brain, bacteriology, etc. Pure science now occupies such a position in medical studies that the "healing art" often remains in the background ”

“ The chemist or entomologist expects to spoil many materials in the course of his tests. Human material is, however, so precious that the experimenter is not justified in assuming the risk of spoiling it. The child is more precious than the problem. The only field in which experiment on the human being is recognized, or rather practiced without recognition, is medicine, where the material is already threatened with destruction through sickness, and the physician introduces an experimental change, say the use of a serum, which gives a chance of preserving life and restoring health. ”

“ Medical research is under-endowed and stupidly endowed, not for systematic scientific inquiry so much as for the unscientific seeking of remedies for specific evils—for cancer, consumption, and the like. Yet masked, misrepresented limited and hampered, the work of establishing a sound science of vital processes in health and disease is probably going on now, similar to the clarification of physics and chemistry that went on in the later part of the eighteenth and the early years of the nineteenth centuries. ”

“ It is our pride that medicine, from an art, and a pretty black one at that, originally, is becoming a science. And the most powerful factor in this development, its indispensable basis, in fact, has been the invention of instruments of precision—the microscope, the fever thermometer, the stethoscope, the ophthalmoscope, the test-tube, the culture medium, the triumphs of the bacteriologist and of the chemist. Any man who makes a final diagnosis in a serious case without resorting to some or all of these means is regarded—and justly—as careless and derelict in his duty to his patient. ”

“ It can hardly be but that the modes of investigating disease ordinarily followed, labour under some radical errors or defects, else the researches of ages, pursued, as they have been, with exemplary diligence, and, in many splendid instances, by minds of the first order of intellect, must, ere this, have rendered our knowledge of the nature and treatment of disease more certain and more complete. ”

“ Physiology, including pathology—the first taking cognizance of all the vital functions of organized beings, the second of the disturbance of those functions by disease—is far from maintaining its place in the general march of physical science.—Saturday Review.
The Element of Physic in Medical Practice.
The Element of Physic in Medical Practice becomes constantly more simple. Our drugs are fewer and less complicated. ”

“ At a period when pathological research is lending its aid in investigating the appearances of disease in every part of the body, and many nice distinctions in diagnosis are aimed at, which are better calculated for nosological than practical purposes, it seems to me not a little extraordinary, that so few have cultivated that most important branch of medicine, the study of the diseases of children. ”

“ Yet there are signs that we are entering on a new phase, and that a realisation of the importance of early diagnosis is slowly permeating through the medical profession. In America we see an increasing insistence on the use of detailed and specialised laboratory methods for exact diagnosis ”

“ It is by an immense number of experiments or trials on a large variety of cases, at different times, by different observers, and under varying conditions, that medical science has been able, after centuries of doubt and struggle, to arrive at some few real scientific facts in regard to the action of medicines. If these six elements of error had, from the first, been everywhere recognized and comprehended and systematically guarded against, the process of finding the truth in this department might have been abridged by hundreds of years. ”

“ In the investigation of diseases he pursued the same method of observation and experiment which had characterized his researches in physiology. He learned their history by studying them at the bedside of his patients, and by accurate dissection of their bodies after death. He engaged in a series of examinations, with a view to ascertain the changes induced in the various organs by disease, and in less than six months he had opened above six hundred bodies. ”

“ Boyle's medical studies fall into at least two categories. These were the purely physiological experiments, such as those on respiration or on blood, and the more clinical experiments, concerned with [Pg 35] pharmaceuticals, clinical pharmacology, and clinical medicine. The purely physiological experiments have great merit and were profoundly influential in shaping modern physiology. The clinical experiments throw great light on the development of critical judgment in medical history, and the relations of judgment and faith. ”

“ ONE of the greatest contributions of the nineteenth century to scientific medicine was the discovery of the internal secretions of organs. The basic work on the subject was done by Claude Bernard, a pupil of the great Magendie, whose saying it is well to remember—"When entering a laboratory one should leave theories in the cloakroom." More than any other man of his generation, Claude Bernard appreciated the importance of experiment in practical medicine. ”

“ The examination of the medical value of treatment by light has scarcely begun, nor has much been done toward the study of weight or pressure, in their relations to medical science. At all events, there is now forming and gaining increased development, alongside of the medicinal use of bodies, a medicinal use of forces—besides the physic of drugs, a physic of powers. ”

“ To a certain degree we can understand—and this contributes to an explanation of matters—how medical science of our time has come to regard so lightly the loss of appetite as a special object for treatment. Now, however, the experimental method has penetrated more and more into medical science, with the result that many pathological factors and therapeutic agents are judged of according to whether they hold good in the laboratory or not—that is to say, they are valued only in so far as they can be verified by laboratory experiments. ”

“ The progress made by today's medical researchers is part of a long tradition in American biomedical research. In the past century, researchers have triumphed over such formerly deadly diseases as diphtheria, polio, and tetanus. ”

“ PROFESSOR OF PHYSIOLOGY IN KING'S COLLEGE.
OVER and over again we have been challenged by the opponents of science to give "one conclusive example where experiment has been of direct use to practical medicine." To any one familiar with the history of scientific medicine there can be no difficulty in finding numerous such instances, and, as a matter of fact, many examples have from time to time been given by various writers ”

“ And if a forecast may be made without offence, it is certain that the work of physiology, as in the past and the present, so in the near future, will exercise a profound influence for good on medical and surgical treatment. Among the subjects that especially occupy physiologists now are, the more exact localisation and interpretation of the special 69 sense-centres, and the better knowledge of the internal secretions and chemical influences of the glands and tissues of the body. ”

“ The use of our instruments of precision, our knowledge, of pathology, all tend to narrow that bridge which must extend as a connecting link between empirical treatment, and treatment depending for its success upon a comprehensive knowledge of the natural history of disease. ”

“ After 1861, physiology took the lead, and kept it. But, through all the work, science and practice have been held together; the facts of experimental physiology have been and are tested, every inch of the way, by the facts of medicine, surgery, and pathology. The infinite minuteness and complexity of the investigation, and its innumerable side-issues, are past all telling. They who are doing the work, in science and in practice, have always had in their thoughts the fear of fallacies in the interpretation of these highest forms of life. ”

“ Remember, this is not the tale of a perfervid spiritist. On the contrary, it is the scientific account of a laboratory experiment by a physiologist of high rank. The incident is not a part of a séance in the home of a medium in a dark parlor full of side-doors and trick windows. It is a registered phenomenon in the physiological department of a great university, occurring under scientific test conditions. I confess it gives verity to many a doubtful thing I have myself seen. ”

“ Thanks, however, to an extensive knowledge and skilful use of anæsthetics, the obstacles to this method of investigation have been overcome, and its results have proved very profitable. The absence of pain is a very important factor in an experiment, and even if the physiologist took the wanton delight in inflicting suffering which the imagination of his enemies attributes to him, he would have to restrain its indulgence in his laboratory, or forego the hope of even moderate success. ”

“ In the first place, the medical profession is largely indebted to physiology on account of special discoveries and particular experimental researches. If we regard the profession simply as a body of men who possess or should possess a remedy for every disease, this may seem an exaggerated statement. Many of the remedies in use or in vogue at the present day have been discovered by chance, borrowed from ignorant savages, or lighted on by blind trials. Physiology can lay no claim to the introduction of opium or quinine. ”