Medical theory

“ There is no science, in which there has been so much theorizing, as there has been in that of medicine. Its history seems to be almost altogether a history of untenable theories. These theories are at least the prominent objects that present themselves to view. Every period has had its favorite theory, which has exerted its influence upon the general medical mind. Almost every great name in medical history is associated with some celebrated hypothesis. ”

“ They looked upon it as the art of the diagnosis and treatment of disease, in which the unerring tact of a practiced and happy judgment is of primary importance, and where the rapid and searching glance of genius into the secret laboratories of life or into the hidden sources of disease is, and ever will be, the principal and most essential point. The mere historical acquaintance with the different forms of diseases and their remedies, with botany, and the anatomy of the human body, with the number and structure of its organs, forms merely the materials, the external sphere of medical practice ”

“ 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. ”

“ 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. ”

“ So, likewise, are there numerous, acute diseases of a milder character which are easily and unmistakably recognized without the possession of great medical knowledge, and which readily yield to plain, simple, medical treatment which is within the ready reach of all who strive to acquaint themselves with the rudiments of medical science. ”

“ Physiology prepared the way for Pathology, and the Principles and Practice of Medicine placed the experience of the whole world under contribution. Therapeutics claimed for her use the vegetable, mineral and animal kingdoms, the collateral sciences became cultivated as auxiliaries, and Botany, Mineralogy, Chemistry and Zoölogy became branches of medical study ”

“ During the last half century a great change has taken place in the treatment of disease. Medicine has advanced with rapid strides, from the narrow limits of mere empiricism, to the broader realm of rationalism, until to day it comprehends all the elements of an art and a science. ”

“ Yet we regard clinical medicine as illustrating art, and didactic medicine as representing science. What figure, think you, would the hospital professor make who should come before you with a patient, and be unable to determine with what disease the person was suffering, the organs affected by it, the nature of their functional disturbance, why some functions rather than others were disordered, how these various elements affect the issue of the attack, what that issue will probably be, and finally, what means should be taken to render it favorable? ”

“ Medicine was the foster-mother of chemistry, because it has to do with the preparation of drugs and the detection of poisons; of botany, because it enabled the physician to recognize medicinal herbs; of comparative anatomy and physiology, because the man who studied human anatomy and physiology for purely medical purposes was led to extend his studies to the rest of the animal world. ”

“ It is by the recognition of this true method of biological research and by the generous support of physiologists who honestly seek for truth, even when opposed by temporary fashions of medical opinion, that medicine will become a science. ”

“ 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. ”

“ Although a disease which has been recognized for centuries, it is only in recent years that medical science has been brought to bear upon it and the causation fully investigated. The result is that much new knowledge has been brought to light. ”

“ Nowadays, all this is past, in medical science. As to the causes of disease, we know that they are facts of nature,—various, but distinguishable by diagnosis and research, and more or less capable of prevention or control or counter-action. ”

“ Every malady is accompanied by its characteristic indications, some of which are diagnostic, i.e., they particularize the affection and distinguish it from all others.
Medical diagnosis is both a science and an art; a science when the causes and symptoms of a disease are understood, and an art when this knowledge can be applied to determine its location and exact nature. Science presents the general principles of practice; art detects among the characteristic symptoms the differential signs, and applies the remedy. ”

“ Although pathology, therefore, as a branch of medical science, is necessarily founded on physiology, questions may nevertheless arise regarding the true character of a structure or organ, to which occasionally the pathologist may be able to return a more satisfactory and decisive reply than the physiologist—these two branches of medical knowledge being thus found mutually to advance and illustrate each other. ”

“ Physiology gives us the clearest light in the cure of diseases, which is the grand object of all our inquiries in medicine. The study of it is most entertaining, and engages our closest attention from the many curious subjects with which it abounds. ”

“ DISEASE HAS CERTAIN UNMISTAKABLE SIGNS,
or symptoms, and, by reason of this fact, we have been enabled to originate and perfect a system of determining with the greatest accuracy the nature of chronic diseases without seeing and personally examining our patients. In recognizing diseases without a personal examination of the patient, we claim to possess no miraculous powers. We obtain our knowledge of the patient's disease by the practical application of well-established principles of modern science to the practice of medicine. ”

“ Everybody was having gleamings then of vast possibilities in medical science, especially in the direction of nervous pathology and the study of morbid diseases resulting from highly complex methods of living. ”

“ This state of things has been occasioned by the circumstance that medical practitioners have often been more given to the formation of theories upon the nature of |43| disease and the mode of its treatment, than to that careful observation and patient accumulation of facts by which, in other sciences, the phenomena of nature have been unravelled. * * * It is not to be overlooked that as an art it has been characterised in a greater degree by fluctuations of opinion as to its principles and the mode of its practice than perhaps any other pursuit. ”

“ The first and indispensable basis of medicine is anatomy, with which physiology is inseparably blended; for human physiology can only be properly studied in connection with the human structure, whose condition in health and disease forms the direct object of our profession. No student should be satisfied until she has most carefully followed out the structure of every region of that human body with whose life we shall have to deal. ”

“ Perhaps it is because physicians have hitherto been restrained from investigating, and deciding upon these subjects, by an erroneous belief that they belong exclusively to another profession, that physiology has so long been an obscure and conjectural science.
In beholding the human body, the first thing that strikes us, is its life. ”

“ He showed how medicine was gradually raised from mere empiricism and based upon true pathological principles, through the independent growth of physiological knowledge, and its correlation to chemistry and physics.] "It is a peculiarity," [he remarks,] "of the physical sciences that they are independent in proportion as they are imperfect." [Yet] "there could be no real science of pathology until the science of physiology had reached a degree of perfection unattained, and indeed unattainable, until quite recent times." ”

“ A vast variety of the approaches known to medical science has been explored to find better methods of treatment and prevention of major diseases, particularly heart diseases, cancer, and mental illness. ”

“ This universal and acknowledged rule is Pathology, the science which unfolds and exhibits the nature and character of disease, and "dictates the maxims of rational practice." It is the foundation and only base of rational medicine, which proceeds on the assumption that the nature and character of disease is fully known and appreciated. This knowledge is not only rational, but indispensable, in order to understand and apply the principles which ought to govern in the medication and cure of disease. ”

“ 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? ”

“ For physiology is the study of natural conditions, and must first be studied by physicians, inasmuch as what is normal is healthy, and the rule for its own rightness, as well as for every abnormal deviation therefrom. But when deviations from health, or any abnormal conditions are defined by the light of healthy structures, then pathology, the science of disease, becomes intelligible. Then also from a knowledge of pathology the practice and art of healing, and numberless new methods of treatment, will naturally spring. ”

“ Henceforward, as it appears to me, the connection of medicine with the biological sciences is clearly defined. Pure pathology is that branch of biology which defines the particular perturbation of cell-life, or of the coördinating machinery, or of both, on which the phenomena of disease depend. ”

“ 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. ”

“ 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. ”

“ To understand the nature of disease we must understand health, and the understanding of the healthy body means the having a knowledge of its structure and of the way in which its manifold actions are performed, which is what is technically termed human anatomy and human physiology. The physiologist again must needs possess an acquaintance with physics and chemistry, inasmuch as physiology is, to a great extent, applied physics and chemistry. ”

“ So in natural science and in art the mind must, first of all, distinctly apprehend the thing that is to be studied, and after that its relation to associated things. So in medicine the only safe clue to an accurate conception of disease is through a minute study of all its forms and relations and the modifications they undergo through internal and external influences, and, next to those the variations imposed upon them by hygienic and therapeutic measures, i. e., by treatment. ”

“ The essential fault of every medical doctrine is that of considering diseases too abstractedly; they are so modified in each system, that their aspect is wholly different. If I may be allowed the expression, it is always the same individual, but in entering each system, it has a different appearance there, so that often you cannot recognize it. ”

“ 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. ”

“ The facts of hygiene and therapeutic measures are widely scattered through medical literature, and extend over hundreds of years of time. Many volumes have been written on diseases of the eye, the heart, liver, and stomach, brain and other organs, to understand which requires special technical education. ”

“ 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. ”