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But for these very reasons, for the reason of the helplessness of the world in judging of us, and the security of our own isolated position, we ought to guard the more jealously the unity of our science, and endeavour to become, not many men treading diverse paths, and aping before universal ignorance superiorities which we cannot substantiate before ourselves, but as one man treading the same path, and striving for such union of power as shall make all who will the best in all places, and in all time. Above everything, we ought not to permit a future Le Clerc, Sprengel, or Freind, to say of us, that in an age, crowded with every advantage, we forgot Hippocrates, and, bitten by the practices of inferior minds, turned our Temple into a market-place, each man with his own stall, and no stall with anything upon it the historian cares to discover.
By what steps shall we then progress towards that unity to which it is essential to aspire, towards that high standard of producing and fruitful research which shall put our work among the philosophies, and give us command and power. Proceeding to answer this question from its negative side, let me at once express an entire disbelief of the utility of spending time in putting down what is called quackery. Of course I do not mean that men who cultivate scientific medicine should associate with men of quackish mind and instinct, or that it is bad for us to do as we usually do, scent out with uncommon sharpness, all such representatives of the rat and weasel type, and send them to perpetual Coventry, with such marks on them as shall fix their positions and characters too firmly to admit of mistake. But I mean that it is in vain to enter into waste of controversy with systematised quackery, because, if we can make our science pure, there could be no quackery in existence, while there will be quackery so long as the science is impure. We see that in astronomy there are no quacks, that amongst skilled artisans there are no quacks;
and, turning to our own world, we know that even with us some parts of our field are entirely free of quacks. Who can find me a quack anatomist? Mark! as surgery has become more precise, how in surgery the quack has slunk aside. Where now is the quack woman who would venture, as in the time of good old Daniel Turner, to plunge a needle into the eye-ball to extract opaque bodies from its chambers. These errors have passed away, and so shall all quackeries pass as the certain takes the place of the doubtful or obscure. Respecting blatant quackery out of our sphere, I think we have every reason to be satisfied with its rapid decline; it has virtually ceased as a distinct and recognised trade, and in that character needs no more punishment. In our ranks, though it hides still, and, I veritably believe, exists often of necessity in the natural constitution of those who exhibit it, in men of small brain and cold blood, it is growing more harmless, day by day, under the influence of exposure, and its own idiotic feebleness.
Leaving then the negative side of the question, let us consider in what way our lines of research shall so be carried out that our united forces shall be brought into full and combined action. And first, it appears
to me, that such weakness as we show lies amongst those of us who represent the actual living fact of physic—lies in this, that we are walking separated from each other, on lines divergent so that we cannot meet, and so broadly apart that we do not even hail each other. as rays of light entering transparency, and yet not combining to form a focus, making no picture of such definition that the world can see a design in our combined action. If this be so, then the first step in our research must come from the active members of the profession, and must show itself by a resolution to arrest the present centrifugal aberration, to concentrate the forces, to consolidate the bases of our science.
In this sense, it is of first importance to forbid at once and for good the centrifugal mania of instituting a separate society for every artificially divided branch of medicine, and to prevent the molecular disintegration of the grand old Republic which our fathers left us to foster, to strengthen, to hold, to beautify, but never to dissever. It is not too late to amend this error.
Let there be as many societies as there are tens to form them, if they all meet in the unity of physic; but the crash into sects, can no one stop that? Is there in medicine, and in this country, no central body that will attract the fragments and save anarchy ? What should we say if the astronomers divided themselves into the telescopical society, the air-pump society, the solar society, the lunar society, the planetary society, the Saturn's ring society, the asteroid society, the fixed star society, the comet and meteor society, the star spectrum analysis society, the worlds-on-fire society ; to say nothing of the Keplerian, the Newtonian, the Halleyan, or the zodiacal, ecliptic, or orbital societies ? What should we say? Why that the astronomers were on their last wings
-a mad crew, splitting up, as best they could, the blessed universe and the universal harmonies, for gross imaginings, with as little compunction as a printer who distributes the type of a great book, and making themselves as loose as sand.
The object of all societies, in short, should be simple union of men together for a common purpose, with independence of individual action and entire freedom from all that shall tend to specialise either men or things. When a man enters an arena, knowing that he will be allowed only to stand on one leg, he may, by the rehearsing he has been guilty of, and by the advantage of the trained and prepared tastes of the audience, make a very creditable display. But what belongs to the display or what comes of it? When a man, bound to a special society, is teamed with another man for a sub
special purpose, he may pull very hard and do all the work, or he may not pull at all; but in neither case will he be quite satisfied, and in neither case will the work have the breadth and touch, and colour of one skilful hand. Indeed, so formed are we by nature to differ, that the evolution of a single harmonious thought by two minds is a physical accident. The early Mythology, which gave to many gods the construction of the universe, was not intrinsically weaker, nor falser, nor more mischievous to the conception of order than are we at this moment. Let us, then, learn to respect in the fullest degree the absolute independency of mind. Let every man be a law unto himself. Let us seize, as truths, that all great progress is the result of individual labour, that genius has no double, and bears no double yoking; but that, fastened in their independency by the social ties of friendship, and sharpened by the criticism of other minds, the units of the profession of medicine may each become so strong that their very individuality shall be their safest bond, and their independent strength the best surety of their united endurance.
Unity of Practice. To secure a sound method of research in medicine, unity of practice, and of observation over the whole field of disease, is another essential. I am quite free to admit that men have certain differences of capacity and feeling which education cannot at all equalise; and I also see that, in our great work, there are practically a few grand parts which, though, not altogether, nor, indeed, at all disconnected, do, nevertheless, allow scope for certain differences of capacity and power. The governance of the hand and the eye for precise co-operation is natural in some men, and when this gift is combined with a firm heart, the man, owning all, stands forward, pre-eminently qualified for the handicraft of Physic.
He is, by nature, a Surgeon, and although he may likewise be a good
Physician, he will soon be detected as having the mechanical art at his fingers' ends. There are other men who are naturally endowed with perceptive knowledge of habits, tastes, and feelings, mental or physical. These men are, by nature, Physicians, and though they may likewise become good Surgeons, they are soon read off and placed by their compeers in their true positions.
Corresponding with these natural qualities of professors of our art, there are tracks in the art itself for peculiar skill, and the general division of medicine into the medical and the surgical, is probably a sound practice, resting on necessity and on natural law. A plea also may be put in with fairness, founded exclusively, however, on artificial necessity, peculiar to the age and civilisation, for the separation of the Physicians into those who treat physical, and those who treat mental disease. But beyond these general divisions, there can be no rending for anything but evil. Separate an organ from an organism, and the organ no longer belongs to the organism. Make diseases isolations, and you make them entities, to be treated as such. What child's play! If the theory, hapless, were true, what hope were there for advance in knowledge of disease or its management ? Entities, how many are you? Physicians, on what is your particular knowledge of your particular entity based ? rate one of your entities, or find an exclusive seat for it in the vile body? Well, if you can, then has your labour not commenced, for entities never die, and although you may live long to study yours, and to make the description of it sensational, and to talk to it and get many fees for the talking, which fees shall be, after all, the best of the intercourse, yet shall the entity remain unexorcised, and lively as ever, when you are very quiet indeed.
The entity doctrine in physic, having its origin in the dreams of Van Helmont and Stahl, dreams grossly perverted
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