The Best Physician
What chiefly characterizes the most eminent physicians, and gives them their real superiority, is not so much the extent of their theoretical knowledge—though that, too, is often considerable—but it is that fine and delicate perception which they owe, partly to experience, and partly to a natural quickness in detecting analogies and differences which escape ordinary observers. The process which they follow, is one of rapid, and, in some degree, unconscious, induction. And this is the reason why the greatest physiologists and chemists, which the medical profession possesses, are not, as a matter of course, the best curers of disease. If medicine were a science, they would always be the best. But medicine being still essentially an art, depends mainly upon qualities which each practitioner has to acquire for himself, and which no scientific theory can teach. The time for a general theory has not yet come, and probably many generations will have to elapse before it does come. To suppose, therefore, that a theory of disease should, as a matter of education, precede the treatment of disease, is not only practically dangerous but logically false.—Buckle’s History of Civilization, vol. ii.
In 1857, Sir John Forbes, M.D., after fifty years of professional experience, left, as a legacy to his successors, the emphatic avowal, that Nature is, after all, the real physician—since, however human ingenuity may devise means of alleviation and acceleration, it is Nature and not Art which cures all curable diseases. Sir John is, however, far from implying that the art of medicine is without its use and importance, especially in preventing disease; but he wishes attention to be more sedulously fixed upon the degree to which nature can be left entirely to herself, in order that we might know how, and to what extent, art may with advantage interfere. There are many cases in which nature, left to herself, will infallibly kill her patient—say, for instance, in a case of poisoning—whereas the application of a stomach-pump, or a chemical reagent, arrests the evil at once.
Sir John Forbes invites his brethren to collect and classify the evidence which shows how nature cures disease; and the prejudices which hamper the physician, he indicates in the following enumeration of current delusions:
1. Ignorance of the natural course and progress of diseases which are essentially slow and not to be altered by any artificial means, often leads the friends of the patient to be urgent with the medical attendant to employ more powerful measures, or at least to change the means used, to give more frequent or more powerful doses, &c.
2. Ignorance of the power of Nature to cure diseases, and an undue estimate of the power of medicines to do so, sometimes almost compel practitioners to prescribe remedies when they are either useless or injurious.
3. The same ignorance not seldom occasions dissatisfaction with, and loss of confidence in, those practitioners who, from conscientious motives, and on the justest grounds of Art, refrain from having recourse to measures of undue activity, or from prescribing medicines unnecessarily; and leads to the countenance and employment of men who have obtained the reputation of greater activity and boldness, through their very ignorance of the true character and requirements of their art.
4. It is the same state of mind that leads the public generally to give ear to the most ridiculous promises of charlatans: also to run after the professors and practisers of doctrines utterly absurd and useless, as in the instance of Homœopathy and Mesmerism, or dangerous, except in the proper cases, as in the instance of Hydropathy.
5. Finally, it is the same ignorance of Nature and her proceedings that often forces medical men to multiply their visits and their prescriptions to an extent not simply unnecessary, but really injurious to the patient, as could be easily shown.
The sick man is impatient to be well. Ignorant of nature’s slow processes, “the strongest and most effective powers of art,” says Sir John, “are usually employed for the very purpose of setting aside or counteracting, or modifying in some way or other, the powers of nature. Generally speaking, we may even say that all the heroic arms of physic are invoked purposely to disturb, and obstruct, and overwhelm the normal order of the natural processes.”