These few example instance how invaluable special training of the natural senses may be to the scientific clinician in his capacity of diagnostician. That he must be expert as a diagnostician should go without saying. It may be true that the Homoeopathic clinician is safe in selecting the same drug to meet the same symptoms, from however widely different diseased conditions the symptoms may have rise. But it is certainly true that the hygienic and, above all, the dietetic treatment prescribed must, to be efficient, vary widely with the pathological condition for which it is prescribed, and exact apprehension of which is therefore a prime requisite of the scientific clinician.
Again, he must be a logical reasoner. Without the power of reasoning logically, closely, clearly, the physician may be an exceedingly popular and successful practitioner, but he can never be a scientific clinician. One infallible sign of the clinician who is a logical reasoner is the infrequency with which the word “cure” is heard upon his lips. He may and will speak often and gratefully of recoveries, but only in rare instances refer to them as “cure.” The reverent saying of the great surgeon-“I dressed his wound, and God healed the man”-represents the habitual attitude of the logical thinker toward the recoveries that take place under his treatment.
“I gave the drug, and the man was healed'” that is the utmost be will often venture to say. Data alike concerning the origin and natural course of disease and the power of drugs over diseased conditions are far too scant, for too unreliable for us to pronounce for them, in most cases, what power was instrumental in a patient’s recovery. We know in how many cases of acute and infectious diseases the tendency is toward spontaneous recovery entirely without medical assistance-measles, for instance, croup, pneumonia, typhoid fever.
We know how many diseases, distinctly malignant, will most certainly cause death in the patients who are their prey, in spite of every known medical resource-phthisis, diabetes, locomotor ataxia, sarcoma, tubercular meningitis. Knowing these things, surely the scientific clinician will content himself with adding, so far as he can, from the fruits of his conscientious and impartial observation, to the data from which, in the far future, reliable deductions may be made as to the power of drugs over diseases, but will modestly realize, meantime, that the only class of cases to-day from which such deductions can be safely made are cases-like those of skin disease or of neurasthenia- which are known to be benign, and yet, without medical interference, to persist indefinitely, apparently insusceptible of spontaneous cure.
He will study unweariedly, not only in man but in the lower animals-where frequent spontaneous recovery from illness furnishes such suggestive instances of the power of the vis medicatrix naturae-the phenomena of disease, recovery and cure. He will learn to look upon the patient under his care as a unit made up of many complexities-a creature made up of body, mind and will-and who can only be successfully treated by the physician who has at command not only the drugs that act upon the body, but the resources of those mental and psychological therapeutics whose potency for the “mind diseased” is every day more intelligently recognized.
Finally, the scientific clinician will, with every year of experience of its value and its usefulness, learn more an more thankfully, as time goes on, upon the guiding law of Homoeopathy. To know the exact pathogenetic scope of drugs; to choose, with sensitive discrimination, the closest similimum to the diseased condition presenting; to administer this drug with full realization how portent and beneficent is the milde macht; this to do is to follow the only channel through which, among the hundred shifting currents of medical empiricism, among the dangerous shoals and quicksands of medical commercialism, one may reasonably hope to steer to the harbor of safety and success.
Action from first-hand experience and not from hearsay; logical reasoning; acute and trained observation; the modesty which hesitates as long to say “I cured,” in event of a patient’s recovery, as in event of a patient’s death it would hesitate to say “I killed;” wide sympathy; mastership f many resources; such consistent adherence to the strict principles of Homoeopathy as forbids experiment upon the human body in disease with any substance whose effects upon the human body in health are not thoroughly demonstrated and forever demonstrable; these are the signs by which men may know the scientific clinician. They may or may not mark the successful practitioner, since what pleases the patient is not infrequently preferred over what helps the patient. But they will mark, the honorable practitioner, and perhaps, in the long last, that is best.
DISCUSSION.
GEORGE B. PECK, M.D.: The paper to which we have just listened in its entirely, and with the signification the author in its closing paragraphs clearly indicates his intention to convey, is entitled to our unqualified approval. It accurately delineates that ideal whose realization should be our constant endeavor. And yet his discussion of empiricism is so confusing and indeed so contradictory I fear much of the good that otherwise might have been secured to the junior members of the profession has been lost.
Webster tells us that an empiric is one whose knowledge is founded exclusively on personal experience, and that any procedure is empirical that is unwarranted by science.
But the essayist declares that the “empiricist is not such by virtue of prescribing under this or that therapeutic rule, or lack of therapeutic rule; but by virtue of accepting and acting on a thing because somebody else has told him it is true, and not becomes he has seen for himself that it is true and why it is true; that the girl who buys cuticura soap because the advertising testimonials in the newspapers tells her it is good for her complexion, is no more an empiricist than the Homoeopathist who cheerfully administers inert substances whose potency he has never once tested on himself or for himself because he has read in one of his journals that symptoms have been created and are controlled by them; and, finally, that we are empiricists and nothing else when we take our materia medica as it stands on hearsay.”
He further states that “the scientific clinician never employs a drug whose pathogenetic power he does not know all about that can be known.” Then the scientific clinician must content himself with a contemptibly small number of remedies or be the fortunate possessor of an unrivalled intellect.
Who knows all that can be known on any subject or anything? What science, what knowledge does not depend on statements by others that it is impossible for us to verify in any particular? Do we, therefore, discard the one and dispute the other? Establish the integrity and the opportunity for knowing of a witness and you must accept his testimony. This sort of evidence which might seen you or me to the electric chair upon occasion is good enough to risk our own lives and the lives of our patients upon. At all events it is the only kind of evidence you ever will or ever can obtain.
Nothing has impressed me more in scanning the pages of Allen’s Cyclopaedia than the number of symptoms of unquestioned value that have been noted only by single provers, though a dozen or more tested the drug. He is no empiric but a strict scientist who administers Lycopodium or any other so- called inert substance properly attenuated for the removal of a group of symptoms alleged to have been produced by that substance, even though only upon a single creditable experimenter, whether the statement is to be found only in the Cyclopaedia of Drug Pathogenesy, Allen’s Cyclopaedia, or the last issue of some magazine, for it is based upon an unchanging and unalterable law of nature and not upon a fickle whim of the prescriber.
The essayist states that “data alike concerning the origin and natural course of disease, and the power of drugs over diseased conditions, are far too scant, far too unreliable for s to pronounce from them in most cases what power was instrumental in a patient’s recovery.” I dissent emphatically from that proposition. While no honorable practitioner will boast of this cures through the restraints alike of modesty and dignity, if a man does not know inmost cases, I had almost said in all, whether he cures or fails to cure, he lacks the first essential of the physician-sound judgment-and is therefore unfit for that vocation.
In conclusion I wish to quote, with my hearty endorsement, the statements that the scientific clinician “must be a trained observer, a logical reasoner, an unbiased thinker, a truth-seeker of such high calibre that no theory, however cherished, will be respected by him when he finds it opposed by demonstrable fact, and that he will with every year of experience of its value and usefulness lean more and more thankfully as tie goes on upon the guiding law of Homoeopathy?.
