Benjamin Rush - Signer of the Declaration of Independance
When a man’s knowledge is not in order, the more of it he has, the greater will be his confusion.— (Herbert Spencer.)
Confusion worse confounded is the only explanation that can be given of the theory and practice of medicine. Of course, it is hoary with age, and is one of the learned professions. With much just pride can the rank and file point to its aristocracy—its long list of famous dead as well as living physicians? What has made most of them famous?
The same that has made others famous in and out of the professions—namely, personal worth and education. Franklin was not a doctor; yet he was as great as any doctor, and could use his gray matter in advising the sick as well as those not sick. He appeared to have a senseperception for truth; and I would say that his discrimination is the leading, if not the distinguishing, trait that has divided, and always will divide, the really great from the mediocre majority. They are the leaven that leaveneth the whole herd of humanity—the quality of character that could not be found in all Sodom and Gomorrah.
There was another discriminating mind in the eighteenth century—another Benjamin, who also was a signer of the Declaration of Independence—Benjamin Rush, a physician, a luminary that brought distinction to medical science. He was larger than his profession. He left seeds of thought which, if acted upon by the profession, would have organized medical thought and prevented the present-day confusion. He left on record such golden nuggets as:
"Much mischief has been done by the nosological arranemgent of diseases ... disease is as much a unit as fever ... its different seats and degrees should no more be multiplied into different effects of heat and light upon our globes should be mulitplied into a plurality of suns.
The whole materia-medica is infected with the baneful consequence of the omenclature of disease; for every article in it is pointed only aganist their names ... by the rejection of the artificial arrangement of diseases, a revolution must follow in medicine ... the road to knowledge in medicine by this means will likewise be shortend; so that a young man will be able to qualify himself to practice physics at a much less expense of time and labor than formerly, a s a child would learn to read and write by the help of the Roman alphabet, instead of the Chinese characters.
Science has much to deplore from the multiplication of diseases. it is a repugnant to truth in medicine as plytheism is to truth in religion. Th ephysician who considers every different affect of the different parts of the same system as distinct diseases, when they arise from one cause, resembles the Indian or African savage who considers water, dew, ice, frost, and snow as distinct essences; while the physician who considers the morbid affections of every part of the body, however diversified they may be in their form or degrees, as derived from one cause resembles the philosopher who considers dew, ice, frost, and snow as different modifications of water, and as derived simply from the absence of heat.
Humanity has likewise much to deplore from this paganism medicine. the sword will probably by sheathed forever, as an instrument of death, before physicians will cease to add to the mortality of mankind by prescribing for the names of diseases. There is but one remote cause of disease ... these remarks are of extensive application, and, if duly attended to , would deliver us from a mass of arror which has been accumulating for ages in medicine; I mean the nomenclature of disease from their remote cuases. It is the most offensive and injurious part of the rubbish of our science.
The physician who can cure one disease by a knowledge of its principles may by the same means cure all the diseases of the human body; for their causes are the same.
There is the same difference bewteen the knowledge of a physician who prescribes for diseases limited by genera and species, and of one who prescirbes under the direction of just principles, that there is between the knowledge we ontain of the nature and extent of the sky, by viewing a few feet from the bottom of a well, and viewing from the top of a mountain the whole canopy of heaven. I would soon believe that ratafia was intended by the Author of Nature to be the only drink of man, instead of water, as believe that the knowledge of what relates to the health and lives of a whole city, ornation, should be confined to one, and that a small or privilaged, order of men.
From short review of these facts, reason and humanity awake from their long repose in medicine, and unite in proclaiming that it is time ot take the cure of pestilential epidemics out of the hands of physicians, and to place it in the hands of the people.
Dissections daily convinse us of our ignorance of the seas of disease, and cause us to blush at our prescriptions ... what mischief have we done under the belief of false facts, if I may be allowed the expression, and false theories! We have assisted in multiplying diseases. We have done more - we have increased their mortality. I shall not pause to beg pardon of the faculty for acknowledging, in this public manner, the weaknesses of our profession. I am pursuing Truth, and while I can keep my eye fixed upon my guide, I am in different whither I am led, provided she is my leader.
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Oliver W. Holmes, M. D., was a man who gave dignity and respectability to the profession. He was a literary man, and from his beginning to his end, was always larger than his profession. He once said: “I firmly believe that, if the whole materia medica could be sunk to the bottom of the sea, it would be all the better for mankind and all the worse for the fishes.” “Breakfast-Table Series” will be read by the intelligent people of the future, who will know nothing of
Holmes’ fight for women against the dirty hands of herddoctors and their consequences—puerperal fever.
“AEquanimitas” will keep Osler in the minds of intelligent people “Osler’s Practice of Medicine” will be found only in the shops of bibliomaniacs. Such men as
Osler keep the dead weight of mediocre medicine from sinking to oblivion by embellishing medical fallacies with their superb personalities and their literary polish. Throughout all the ages the finest minds have sensed the truth concerning the cause of disease, and this has bulked large against medical insanities and inanities. A very striking picture of the medical herd was made by “Anonymous” in his essay on “Medicine” in “Civilization in the United States.”
It has been remarked above that one of the chief causes of the unscientific nature of medicine and the anti-scientific character of doctors lies in their inflate credulity and inability to think independently.
This contention supported by the report on the intelligence of physicians recently published by the National Research Council. They are found by more or less trustworthy psychologic tests to be lower in intelligence of all the professional man, except only dentists and horse-doctors. Dentists and horse doctors are ten per cent less intelligent. But since the quanititative methods employed certainly carry an experimental errot of ten per cent or even higher, it is not certain that the members of the two more humble professions have not equal or even greater intellectual ability.
It is significant that engineers head the list of intelligence. In fact, they are rated sixty percent higher than doctors. this wide diseparity leads to a temptation to interesting psychological probings. is it not the lamentable lack of intellectual discipline?
many conditions conspire to make him an intellectual cheat. Fortunately for us, most diseases are self-limiting. But it is natural for the physician to turn this dispendation of nature to his advantage and to intimate that he has cured John Smith, when actually nature has done the trick. On the contrary, should John Smith die, the good doctor can assume a pious expression and suggest that, despite his own incredible skill and tremendous effort, it was God's (or natures) will that John should pass beyond.
Now, the engineer is open to no such temptation. He builds a bridge or erects a building, and disaster is sure to follow any mistep in calculations or fault in construction. Should such a calamity occur, he is presently discredited and disappears from view. Thus he is held up to a higher mark of intellectual rigorous discipline that is utterly unknown in the world the doctor inhabits.
The critic appears to think that “one of the chief causes of the anti-scientific character of doctors lies in their innate credulity and inability to think independently.” I presume he means that the doctors cannot think independently; for if medicine, scientific or unscientific, could think at all, it might have thought itself out of its present-day muddle. The only thing that saves all physicians from the above indictment is that they are not examined on the cause and treatment of disease.
If average physicians pass low on “trustworthy psychological tests,” it does not speak very well for the higher education which put so many medical schools out of business a few years ago. But these psychological tests may be fitted to educational standards which are assembled with intelligence left out. Intelligence, like the cause of disease, is a force in nature that can be used under the proper environments; but it cannot be monopolized to the exclusion of all mankind. Gladstone in youth was passed upon by the psychological test of his teacher, and pronounced incorrigible; yet at eighty-six he was wielding an ax and translating Virgil. |