After the death of Galen, Medicine ceased to make progress. Amidst the Gothic invasions the medical sects “dwindled down to individuals, who achieved for medicine what the monastics effected for ancient classic literature: they maintained it in the condition of a small but continuous stream, in the midst of so much charlatanism that no man could talk nonsense so gross, or profess supernatural powers so incredible, but that the ignorance of the community would give credit to his assertions.” All through the dark and the Middle Ages astrology, alchemy, magic, and cabalistic arts predominated; all physical phenomena were ascribed to occult causes; in short, as Sir John Herschel remarks, “If the logic of that gloomy period could be justly described as ‘the art of talking unintelligibly on matters of which we are ignorant,’ its physics might, with equal truth, be summed up in a deliberate preference of ignorance to knowledge in matters of every day’s experience and use.” Sometimes, however, the false arts served indirectly to advance the true. Alchemy led the way to chemistry, and enriched medicine with new remedies, and at least one crotchet of scholastic divinity may be supposed to have done something for the progress of anatomy; for “the skeleton received, perhaps, an adventitious attention in consequence of the popular belief that, in man, some one particular bone existed of an imponderable, incombustible, and indestructible nature, around which, as a nucleus, all other tissues and organs would collect and re-assume their vital actions at the resurrection. Accordingly, every bone was tested by fire, for the purpose of discovering the hypothetical one.”—Dr. Meryon’s History of Medicine.
Brief History of Medicine.
Great honour is, unquestionably, due to those medical men who by their learning, counsel, and experience, have contributed so many and great things to the improvement of their profession. The art of healing may be considered as a legacy left to us by former ages and enriched by ancient writers, and no doubt ordained by a benevolent Creator for the benefit of His creatures, who, being endowed with reason, are enabled to prosecute Medicine and the collateral sciences with wonderful sagacity. The impossibility of learning medicine properly by experience alone, implies the necessity of studying both ancient and modern writers; but, in the words of Harvey, “men were not to swear such fealty to their mistress Antiquity, as openly and in sight of all to deny and desert their friend Truth.” Medical history unfortunately affords many examples of despisers of the mighty dead and of eminent living authorities. Paracelsus burnt the writings of Galen and Avicenna before his pupils, and proclaimed himself the king of medicine. Hahnemann much resembled Paracelsus, for he despised the inspection of dead bodies, and preferred the homœopathic doctrine to pathology; but both had dared to do “aliquid Gyaris vel carcere dignum.” Hahnemann’s doctrine, that numerous chronic diseases originated in the itch, was neither new, safe, nor true. Dr. C. G. Zieger had many years before promulgated the same idea in a dissertation published at Leipsic in 1758, without boasting, as the other did, that he was engaged twelve years in the discovery. False theories, however, with scientific pretensions, have flourished through many ages. Hence arose homœopathy, kinesipathy, table-turning, and various despicable “isms” of the present day. But, happily for the poor, at least, such lies could not exist in the schools of Harvey, Baillie, and Hunter. The low condition of medicine at the time of Linacre, and the improvement with the aid of Henry VIII. and Cardinal Wolsey, may next be mentioned. Linacre, the founder of the College, and Dean Colet, the founder of St. Paul’s School, of grateful memory to the orator, were among the first to restore ancient learning to this island. The College of Physicians having been established, its members were separated from vulgar empirics; but by a new law homœo-empirics may be registered, which was nothing less than legal homicide, and strongly to be protested against.—Harveian Oration, 1863.
What has Science done for Medicine?
The practice of Medicine is full of difficulty. Modern Science has done something to aid in the diagnosis, often the most difficult part of the physician’s task. Auscultation and the use of the microscope have substituted certainty for conjecture in many cases. But, for this essential preliminary of ascertaining what is the matter with the patient, a combination of faculties is often needed which cannot be communicated in the schools. The power may be developed and improved by use, and corrected by careful observation; but it is born with certain men, and it is not to be gained by teaching or study. Then, supposing the disease to be ascertained, it constantly happens that there is little or nothing to be done that can with any confidence be expected to shorten or reduce the intensity of the attack. The option lies between a system of slight palliatives, almost or quite inoperative, and the application of stronger remedies whose action is uncertain. Fortunately, the effects of medicine in general are far less considerable than is commonly supposed. The statistics of hospitals in which the most different systems of treatment have been adopted do not, indeed, prove that all the systems have been equally good or bad; but they do show that in many diseases there is no known system of treatment that has any marked advantage over others. It is not too much to say that, for one case in which the medicine administered has been of real use, there are ten where the patients would have thriven as well or better without it.
A further difficulty in medical practice has been less noticed than it deserves to be. All that is known of the effect of remedies is the general or average result of a large number of cases in which they have been applied. But no two men are exactly alike in the manner of action of their various organs. When the chemist who has once tried an experiment brings the same substances together under similar conditions, he is absolutely certain that they will act on each other as they did before. Not so is it with the living organism. The idiosyncracy of each patient is more or less unknown to the physician; and till the experiment has been tried, he can have no certainty as to the result of his treatment. It is quite true that the exceptional cases that sometimes arise present apparent rather than real anomalies. There is no reason to suppose that the laws of physics have been suspended by an independent disturbing power when a drug produces on a particular patient an unusual effect. The conditions of the experiment have doubtless been changed by some peculiarity in his organization, which the present means of science are powerless to detect.
The main cause why medicine is still so little advanced is to be found in the backward condition of the science on which it mainly rests. 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.[20] Of course it is all otherwise in pseudo-medicine. Here “specifics” are as rank as weeds. Here little account is taken of natural provisions for the cure of disease. Here physic is everything, and nature and the physician are unimportant. Given the symptoms of a disease and a book of “testings,” every old lady thinks herself as competent a physician as Hahnemann. Every disease and symptom of disease has its corresponding remedy, or rather we should say two remedies, for it will nearly always be found that homœopathic patients take two medicines, in equal doses and with equal frequency. Homœopathy abounds in principles. Its great principle is that of “specifics”—that certain medicines have the most definite and designed relation to certain ailments—are the thing and the only thing. Then there is what we may call the alternating principle, in virtue of which two medicines—each, we suppose, a specific!—are so much better than one. Upon these two principles the enlightened patron of homœopathy is made the receptacle of a most unprincipled amount of physic. We conclude by impressing upon our brethren who are studying medicine in the light of reason and science, the urgency of the duty that devolves upon them of so using the element of physic in medical practice as to make more and more apparent the great gulf that is fixed between their practice and the rival quackeries of the day. Let them use medicine so that the most undiscerning patient will perceive that it is only one of many means to an end, auxiliary only to great provisions in the body itself, and for the most part acting, not mysteriously, like quinine, but sensibly or chemically. Let the form of their drugs be unpretentious and inexpensive, so that whatever the cost to the patient may be, he may understand that he pays, not for physic, but for the attention, the skill, and the judgment, of the physician.—Lancet.