MODERN METHODS OF MEDICAL SCIENCE 33 



advantage which comes from the use of instruments of precision in 

 investigating phenomena, in that the continued use of the methods, 

 the constant seeking for exact knowledge of conditions removes the 

 tendency toward speciilation. 



The brilliant results which have been reached in surgery, changing 

 this from the most despised to the leading branch of medicine, show 

 the advantage of methods which are founded on knowledge. Surgery 

 was despised in the period in medicine in which speculation was in 

 the ascendency, when the answers to its problems were sought in 

 the study rather than at the bedside and in the laboratory. The art 

 of surgery has been dependent upon direct observation of disease, 

 and its remedial measures were applied to the disease as revealed 

 by sense-impressions. Theories and systems in medicine have come 

 rather from internal medicine, in which field the diseased conditions 

 were not so susceptible to study as things. The broken leg, however, 

 is revealed by sight and touch, the tumor is an object. Moreover, 

 the training in the anatomic and other laboratories so essential for 

 a surgeon, gave the knowledge and the methods, and the manual 

 skill to make them effective. At an early period surgery had re- 

 course to animal experimentation, for the animal body offered the 

 readiest means for testing new devices. In surgery new knowledge 

 has been readily accepted and utilized. The demonstration of 

 anesthesia came first from the surgeon, and the surgeon was the 

 first to accept and apply the knowledge that infection is due to the 

 action of living organisms. By the use of anesthesia and of measures 

 of preventing infection, surgery has been extended into fields for- 

 merly supposed not to be open to the exercise of its art. Medicine 

 owes a debt to surgery for not only what it has accomplished, but 

 for holding to proper methods and demonstrating their importance. 

 The less advance in modes -of treating disease which internal medi- 

 cine has made, compared with that made in surgery, is to be attri- 

 buted to the difficulty of obtaining definite knowledge of the con- 

 ditions of disease in internal organs. 



That the lack of power is due primarily to lack of knowledge 

 is shown by the fact that for diphtheria, formerly one of the most 

 dreaded, now probably the best-known of diseases, there is a remedy 

 which leaves little to be desired. The production of antitoxin is the 

 greatest triumph of scientific medicine and is due to knowledge 

 obtained by the application of scientific methods to the study of 

 a disease which gave unusual opportunities for investigation. It 

 points out what may be accomplished in the future by not seeking 

 for analogies between other diseases and diphtheria, but by pursuing 

 the same methods. Modern therapeutics is guided by two principles 

 in each of which efficiency is dependent upon knowledge of disease. 

 In the most important, the remedial agent has a specific action on 



