medical essays-第36节
按键盘上方向键 ← 或 → 可快速上下翻页，按键盘上的 Enter 键可回到本书目录页，按键盘上方向键 ↑ 可回到本页顶部！
————未阅读完？加入书签已便下次继续阅读！
tion； the first…fruit of the Restoration of Science； was given to the world。
And is it to be looked at as a mere accidental coincidence； that while Napoleon was modernizing the political world； Bichat was revolutionizing the science of life and the art that is based upon it； that while the young general was scaling the Alps； the young surgeon was climbing the steeper summits of unexplored nature； that the same year read the announcement of those admirable 〃Researches on Life and Death；〃 and the bulletins of the battle of Marengo？
If we come to our own country； who can fail to recognize that Benjamin Rush； the most conspicuous of American physicians； was the intellectual offspring of the movement which produced the Revolution？ 〃The same hand；〃 says one of his biographers；〃 which subscribed the declaration of the political independence of these States； accomplished their emancipation from medical systems formed in foreign countries； and wholly unsuitable to the state of diseases in America。〃
Following this general course of remark； I propose to indicate in a few words the direction of the main intellectual current of the time； and to point out more particularly some of the eddies which tend to keep the science and art of medicine from moving with it； or even to carry them backwards。
The two dominant words of our time are law and average； both pointing to the uniformity of the order of being in which we live。 Statistics have tabulated everything；population； growth； wealth； crime； disease。 We have shaded maps showing the geographical distribution of larceny and suicide。 Analysis and classification have been at work upon all tangible and visible objects。 The Positive Philosophy of Comte has only given expression to the observing and computing mind of the nineteenth century。
In the mean time； the great stronghold of intellectual conservatism； traditional belief； has been assailed by facts which would have been indicted as blasphemy but a few generations ago。 Those new tables of the law； placed in the hands of the geologist by the same living God who spoke from Sinai to the Israelites of old； have remodelled the beliefs of half the civilized world。 The solemn scepticism of science has replaced the sneering doubts of witty philosophers。 The more positive knowledge we gain； the more we incline to question all that has been received without absolute proof。
As a matter of course； this movement has its partial reactions。 The province of faith is claimed as a port free of entry to unsupported individual convictions。 The tendency to question is met by the unanalyzing instinct of reverence。 The old church calls back its frightened truants。 Some who have lost their hereditary religious belief find a resource in the revelations of Spiritualism。 By a parallel movement； some of those who have become medical infidels pass over to the mystic band of believers in the fancied miracles of Homoeopathy。
Under these influences transmitted to； or at least shared by； the medical profession； the old question between 〃Nature；〃 so called； and 〃Art；〃 or professional tradition； has reappeared with new interest。 I say the old question； for Hippocrates stated the case on the side of 〃Nature〃 more than two thousand years ago。 Miss Florence Nightingale；and if I name her next to the august Father of the Healing Art； its noblest daughter well deserves that place of honor； Miss Florence Nightingale begins her late volume with a paraphrase of his statement。 But from a very early time to this there has always been a strong party against 〃Nature。〃 Themison called the practice of Hippocrates 〃a meditation upon death。〃 Dr。 Rush says： 〃It is impossible to calculate the mischief which Hippocrates； has done； by first marking Nature with his name and afterwards letting her loose upon sick people。 Millions have perished by her hands in all ages and countries。〃 Sir John Forbes； whose defence of 〃Nature〃 in disease you all know； and to the testimonial in whose honor four of your Presidents have contributed； has been recently greeted； on retiring from the profession； with a wish that his retirement had been twenty years sooner； and the opinion that no man had done so much to destroy the confidence of the public in the medical profession。
In this Society we have had the Hippocratic and the Themisonic side fairly represented。 The treatise of one of your early Presidents on the Mercurial Treatment is familiar to my older listeners。 Others who have held the same office have been noted for the boldness of their practice； and even for partiality to the use of complex medication。
On the side of 〃Nature〃 we have had； first of all； that remarkable discourse on Self…Limited Diseases； ＇On Self…Limited Diseases。 A Discourse delivered before the Massachusetts Medical Society； at their Annual Meeting； May 27； 1835。 By Jacob Bigelow； M。 D。＇ which has given the key…note to the prevailing medical tendency of this neighborhood； at least； for the quarter of a century since it was delivered。 Nor have we forgotten the address delivered at Springfield twenty years later； ＇Search out the Secrets； of Nature。 By Augustus A。 Gould； M。 D。 Read at the Annual Meeting； June 27； 1855。＇ full of good sense and useful suggestions； to one of which suggestions we owe the learned； impartial； judicious； well…written Prize Essay of Dr。 Worthington Hooker。 ＇Rational Therapeutics。 A Prize Essay。 By Worthington Hooker； M。 D。； of New Haven。 Boston。 1857。＇ We should not omit from the list the important address of another of our colleagues； ＇On the Treatment of Compound and Complicated Fractures。 By William J。 Walker； M。 D。 Read at the Annual Meeting； May 29； 1845。＇ showing by numerous cases the power of Nature in healing compound fractures to be much greater than is frequently supposed；affording； indeed； more striking illustrations than can be obtained from the history of visceral disease； of the supreme wisdom； forethought； and adaptive dexterity of that divine Architect； as shown in repairing the shattered columns which support the living temple of the body。
We who are on the side of 〃Nature〃 please ourselves with the idea that we are in the great current in which the true intelligence of the time is moving。 We believe that some who oppose； or fear； or denounce our movement are themselves caught in various eddies that set back against the truth。 And we do most earnestly desire and most actively strive； that Medicine； which； it is painful to remember； has been spoken of as 〃the withered branch of science〃 at a meeting of the British Association； shall be at length brought fully to share； if not to lead； the great wave of knowledge which rolls with the tides that circle the globe。
If there is any State or city which might claim to be the American headquarters of the nature…trusting heresy； provided it be one； that State is Massachusetts； and that city is its capital。 The effect which these doctrines have upon the confidence reposed in the profession is a matter of opinion。 For myself； I do not believe this confidence can be impaired by any investigations which tend to limit the application of troublesome； painful； uncertain； or dangerous remedies。 Nay； I will venture to say this； that if every specific were to fail utterly； if the cinchona trees all died out； and the arsenic mines were exhausted； and the sulphur regions were burned up； if every drug from the vegetable； animal； and mineral kingdom were to disappear from the market； a body of enlightened men； organized as a distinct profession； would be required just as much as now； and respected and trusted as now； whose province should be to guard against the causes of disease； to eliminate them if possible when still present； to order all the conditions of the patient so as to favor the efforts of the system to right itself； and to give those predictions of the course of disease which only experience can warrant； and which in so many cases relieve the exaggerated fears of sufferers and their friends； or warn them in season of impending danger。 Great as the loss would be if certain active remedies could no longer be obtained； it would leave the medical profession the most essential part of it's duties； and all； and more than all； its present share of honors； for it would be the death…blow to charlatanism； which depends for its success almost entirely on drugs； or at least on a nomenclature that suggests them。
There is no offence； then； or danger in expressing the opinion； that； after all which has been said； the community is still overdosed： The best proof of it is； that no families take so little medicine as those of doctors； except those of apothecaries； and that old practitioners are more sparing of active medicines than younger ones。〃 ＇Dr。 James Jackson has kindly permitted me to make the following extract from a letter just received by him from Sir James Clark； and dated May 26； 1860： 〃As a physician advances in age； he generally； I think； places less confidence in the ordinary medical treatment than he did； not only during his early； but even his middle period of life。〃＇ The conclusion from these facts is one which the least promising of Dr。 Howe's pupils in the mental department could hardly help drawi
