Page:Essentials of the Art of Medicine Stille.djvu/7

medical science and medical art. The science is limited strictly by a knowledge of structure and function. The limits of the art cannot be defined. In medical science (not mere theory) the facts are definite and do not readily admit of diverse interpretations. Once clearly determined, they are more or less fixed for all time. The history of medicine excites the wonder of every thoughtful student as he finds the descriptions of disease by Hippocrates or Aretœus, so far as they go, no less precise and accurate than those furnished by modern pathologists, because these physicians were content with picturing nature as they saw it. They remind one of the portraits recently discovered in the sepulchres of the Greek colonies in Egypt. Not heroic types such as poets described and sculptors represented, but real and familiar human countenances, with the same features and expressions that we constantly meet with in our daily walks. So, too, the features of diseases are essentially the same, whether pictured by Hippocrates or by the physicians of to-day. But in medical art the case is different. The facts and laws of practical therapeutics are unstable, and their interpretation is uncertain. In this as in every other department of knowledge, ignorance and vanity are active and aggressive in the direct proportion of the intricacy and obscurity of the subject discussed. In the domains of anatomy (normal or morbid) and in physiology the passions have little opportunity to exhibit themselves, because in these sciences rigorous laws rebuke and repel pretenders whose ignorance soon brings them into contempt. But in therapeutics there is no one, from the learned and ingenious spinner of theories to the ignorant and credulous dispenser of nostrums—often absurd or disgusting—who does not assume for himself a mental penetration which accomplished therapeutists modestly but emphatically disclaim. If there is any branch of knowledge in which modesty and humility are becoming it is that which concerns the action of medicines and their curative powers, for in them the elements are infinite in number and constant in their inconstancy. How cautious should we be in formulating laws in this branch of medicine when we remember that the strictest rules of interpretation have been applied only in the most exact of all natural sciences—astronomy. Yet it is related that Newton was asked one day what enabled him to walk as he willed, and he boldly answered, "I do not know." But, said the inquirer, surely you who are so familiar with the laws of gravitation can explain to me why the earth and all the planets revolve only in one direction; but again he answered, "I do not know." As in Newton's