That the Massachusetts Medical Society was incorporated mainly for the purpose of establishing a proper standard of medical education, and of insuring a competent degree of knowledge among those who should be authorized to practise the profession of medicine in this Commonwealth, and they are not aware that the Society possess any power to coerce men, after they have been thus educated and qualified, to embrace, or renounce, any theoretical opinions, or modes of practice, which they may innocently believe, or which, not believing, they may think it proper to profess.
In medical science there are certain fundamental laws relating to the structure and functions of the body, and the morbid changes to which it is subject, also regarding the signs by which those changes are discovered, upon which all well-educated physicians are agreed. But in certain provinces of medical science such fundamental laws, owing to the imperfection of our means of knowledge, cannot at the present time be established. This is the case with Therapeutics, or the art of treating or curing diseases, in which the evidence required by science is difficult to obtain, and in regard to which writers and teachers, sects and individuals, and even the same individual in the course of an ordinary lifetime, may without dishonesty entertain great diversities of opinion.
The tendency of modern observation is such as to lead us to the belief that disease is less frequently under the control of remedial treatment than it was formerly supposed to be. Where observations are impartially made by competent persons, it is found that people recover, and also that they die, under all the ordinary modes of treatment. And the evidence collected from sources which are worthy of reliance, is not so abundant or satisfactory as to convince a reasonable man that any general system of practice can be relied on for the cure of all cases. Hence it is not surprising that diversities, contrasts, and even extravagances in practice, are embraced by the sanguine, the credulous, the uninformed and the interested, frequently based upon no better authority than accident, imperfect observation, or defective power of judgment in the party who adopts them.
The broadest division which has been recognized for centuries in the treatment of disease, is that which resolves the whole subject into the active and the expectant modes of practice. The first employs various interfering agencies in the management of the sick, the last waits more on the unassisted course of nature, and both have long had their exclusive advocates.
To the last of these divisions Homoeopathy really, though not avowedly belongs. Its character is, that while in reality it waits on the natural course of events, it commends itself to the ignorant and credulous by a professed introduction into the body of inappreciable quantities of medicinal substances. Now the nugatory effect of such quantities is demonstrated by the fact, that in civilized life every person is exposed to the daily reception, in the form of solution, dust or vapor, of homoeopathic quantities of almost every common substance known in nature and art, without any appreciable consequences being found to follow. And the pre tended exactness with which such nominal doses are administered by homoeopathic practitioners, is doubtless a fallacy, capable of producing in the living body no other effects than those which charlatanry has in all ages produced in the minds and bodies of imaginative patients.
It is a fact much older than the institution of this Society, that visionary systems of practice have replaced each other in the faith of multitudes, at least several times in a century. And this will probably be the case, so long as practical medicine continues to be, what it now is to a great extent, a theoretical and conjectural science. At the present period, among the sects usually called irregular, the homoeopathic sect prevails to a considerable extent in this country and in Europe. In the United States it is exceeded only by the sect called Botanic, or Thompsonian practitioners, which at the present time appears, of the two, to number most disciples. It is not probable that the faith of either of these sects will be displaced by a return of their followers to any more enlightened or rational creed. Nevertheless, it is safe to predict that they will both be superseded in the course of time by other systems, not more rational or probable in themselves, but possessing the attraction of greater novelty, or urged upon the credulous with greater adroitness. When the world, and especially the unenlightened part of it, shall be settled in their opinions on other sectarian subjects, we may anticipate unanimity of opinion among them in the science of practical medicine.
But it is not only to expectant medicine, in the form of its counterfeit, homoeopathy, that the censure of prejudice and credulity is to be attached. The opposite system of active practice, carried to the extreme usually called heroic, is alike chargeable with evil to the patients, whenever it becomes the absorbing and exclusive course of the practitioner. Physicians are too often led to exaggerate the usefulness of the doctrines in which they have been educated, and especially of those by the exercise of which they obtain their daily bread. In such cases habit gets the ascendancy over enlightened judgment, and the man of routine, or of narrow views, asks himself, from day to day, what drug or what appliance he shall next resort to, instead of asking the more important question, whether any drug or any appliance is called for, or is properly admissible in the case.
In Medicine, as in the other inexact sciences which deeply concern the welfare of mankind, enough has been learned to show that extreme measures, either of omission or of commission, are not, when systematized as a whole, productive of benefit or safety to mankind.
It is quite probable that the prevalence, at times, of eccentric and ultra-sectarian doctrines in medicine, is attributable to the exaggerated value attached by physicians themselves to incessant activity in practice, and an assumption of credit for particular modes of medication, to which, as such, they are not entitled. There is often a want of openness in the intercourse of physicians, both enlightened and ignorant, with their patients, who are requested to believe that their cure depends not in any degree on the salutary influences of nature and time, but in the rigid enforcement of a prescribed routine of practice, either active or formal, as the case may be. And when opposite modes of treatment are urged upon the public by different practitioners with reasonings equally specious, it is not surprising that patients should some times adopt that which is least troublesome in its operation. Neither is it surprising that they should sometimes embrace even a deception, which absolves them from their allegiance to an unnecessarily severe or troublesome course of treatment.
An honest and independent practitioner, and especially a member of the Massachusetts Medical Society, should never be induced to give his counsel, or his aid in any shape, to empiricism and dishonesty, whether it occur among those who are within or without the pale of its membership. And no consideration of gain or notoriety should induce those, whose age or standing cause them to be resorted to for ‘consultation, to lend their influence or countenance to encourage either the delusions of those who are honest, or the practices of those who are not.
If quackery, individual or gregarious, is ever to be eradicated, or even abated, in civilized society, it must be done by enlightening the public mind in regard to the true powers of medicine. The community must be made to understand that there are certain things which medicine can do, and certain other things which it cannot do; that some diseases are curable by active interference, and others by time and nature alone; that true medical skill lies in discrimination and prognosis, and judicious adaptation of management, more than in assumed therapeutic power, in regard to special agents; and that he who professes to cure by medicine a self-limited fever, is as much an impostor, or deluded man, as he who pretends to do the same thing with a fractured bone or incised wound. Nothing so much shakes the confidence of man kind in the medical profession as unfulfilled promises; nothing so much strengthens this confidence, as fair dealing exhibited in an earnest requirement and fearless expression of the truth. Such a course, by commending itself to the sensible and enlightened, may be expected, sooner or later, in some measure to influence the unreasonable and ignorant, much sooner, indeed, than a warfare carried on in the arena of empiricism with its own weapons.
This page was posted on April 8, 2007.