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.