356 



NA TURE 



[August 9, 1900 



be very liable to yellow rust ; (3) this rust is always more 

 prevalent in sunny parts of the field. 



A hypothesis so revolurionary is not likely to be adopted by 

 a cautious fungologist without further evidence. At present, 

 as far as we know, no figures illustrating the development of 

 the mycelium have been published, nor can we obtain details 

 of the staining methods adopted. Klebahn {he. cit.) has entered 

 his protest to the theory, chiefly, however, in general terms. In 

 regard to the prevalence of rust in sunny parts of a field, he 

 points cut that Eriksson's own results confirm the fact that 

 dormant spores are induced to germinate by alternate cooling 

 and heating, drought and moisture ; just the conditions to be 

 expected in early summer in sunny parts rather than in shaded 

 parts of a field. Klebahn also supports the view that spores of 

 rusts are capable of wider distribution than Eriksson's results 

 show ; for instance, they have been found in analyses of air. 

 We may recall, in support of this, Robert Hartig's observation 

 in the Tyrol, when, after showers of rain, a yellow dust, coating 

 objects in the neighbourhood, was found to consist almost 

 entirely of the yellow spores of a rust-fungus, Chrysomyxa 

 (" Diseases of Plants," Tubeuf and Smith, London, 1897, p. 54). 

 If it be the case, as Eriksson says, that certain rusts of cereals 

 appear regularly in four or five weeks, it seems quite as likely 

 to indicate external infection of young plants at a certain stage 

 in their existence, as to support the theory of an internal germ. 

 The Swedish experiments in isolating test-plants from con- 

 tagion have been repeated in America by Bolley.' Young 

 plants of cereals growing amongst others in a field were enclosed 

 in rust-proof cases ; they grew to maturity without showing any 

 rust, although plants left unenclosed were much attacked. The 

 results are quite negative. 



Recent investigations have been directed towards advancing 

 our knowledge regarding the varieties of cereals suited to resist 

 the various forms of rust. Carleton,- whose work was aimed in 

 this direction, summarises our general knowledge thus: "as 

 yet there is but little certainty concerning rust resistance, which 

 varies continually under different conditions. Heretofore, in 

 testing varieties for rust resistance, little attention has been 

 paid to the species of rust concerned." For our own part, we 

 feel that our ability in combating the diseases of plants would 

 be greatly strengthened by searching investigations towards 

 attaining disease-proof varieties. A certain amount has been 

 done, much more must yet be done. The results hold good for 

 only small areas of the earth, and there must be thorough and 

 systematic research in many countiies before any definite con- 

 clusion be arrived at. From a practical point of view the 

 combating of rusts of cereals, and diseases of plants generally, 

 seems likely to be solved sooner in this way than by investiga- 

 tions on the complex conditions of life amongst the rust-fungi. 

 One cannot but feel that the long recent researches have added 

 to what we knew only minor details of practical importance, 

 although they have opened new vistas of the deepest interest to 

 the fungologist ; the outstanding lesson is the close dependence 

 of the fungi on their environment, and the complexity thereby 

 introduced into the study of diseases of plants. 



William G. Smith. 



MEDICINE AS A SCIENCE AND MEDICINE 

 AS AN ART? 



T T has sometimes been disputed whether medicine should be 

 regarded as a science or an art, but there is no doubt that 

 the original meaning of the term medicine, in English and in 

 other languages, is the Art of Healing. Medicine is so defined 

 by Aristotle, and it has all the characters of an art. It depends 

 Upon experience and skill ; it deals with individual cases ; and 

 the perfection it aims at is practical, not speculative : the know- 

 ledge how to do, not the knowledge how things happen. 



Nevertheless, as practical navigation is founded on astronomy, 

 meteorology and physics ; as the art of agriculture rests on 

 botany, geology and vegetable physiology, so the art of medicine 

 depends on the science of pathology, the practice of physic on 

 the principles of physic. 



1 Centralhlatt f. Bakt. u. Parasitenkunde, Abt. II., vol. iv., 1898, pp. 

 855-9, 889-96, 913-9 (6 figs.). Also Proc. Amer. Ass. Adv. Science, 1898, 

 p. 408 (the limits of this paper prevent a longer reference to this research). 



^ Loc. cil., p. 69. 



S Abstract of the Address in Medicine delivered before the British Medical 

 Association at Ipswich, on August i, by Dr. P. H. Pye-Smith, F.R.S. 



NO. 1606, VOL. 62 



On the one hand, then, we must never forget that we practice 

 an art ; we must never allow theories, or even what appears to 

 be logical deduction, or explanations, however ingenious, or 

 statistics, however apparently conclusive, or authority, however 

 venerable, to take the place of the one touchstone of practical 

 medicine, observation and experience. We must never treat the 

 disease without considering the patient, for the art of healing is 

 the art of healing individually ; nor need we wonder if profound 

 learning and the best scientific training sometimes fail to make a 

 successful practitioner. For beside adequate knowledge to save 

 us from gross blunders, and a strenuous endeavour to do your 

 best for each individual patient, however uninteresting the case 

 or however irksome and unrewarded our toil — beside these first 

 requisites for our art, there is ample room for those personal 

 qualities which ensure success in every department of life ; for 

 power of observation and insight, for the personal influence by 

 which a strong character will secure obedience and inspire hope, 

 for the judgment which divines what kind of remedies are suited 

 to each patient, what kind and of what strength, and for the 

 sympathy which puts one in the patient's place, and not only 

 meets, but anticipates his wants. 



On the other hand, however, if medical science without art is 

 inefficient, medical art without science is not only unprogressive, 

 but almost inevitably becomes quackery. As soon as we treat 

 our patients by rule of thumb, by tradition, by dogmas, or by 

 metaphysical axioms, we do injury to ourselves as well as to 

 them. The bone-setter who is ignorant of anatomy ; the wise 

 woman, who cures by charm, are not more irrational or less 

 succes>ful than was the physician of the seventeenth century 

 who, in obedience to the doctrine of signatures, advised an 

 infusion of roses for hcemorrhage, and saffron for jaundice, and 

 lung- wort for consumption ; or the astrologer who prescribed 

 salts of silver, of iron, copper, lead, or mercury in accordance 

 with the horoscope of the patient and the planet under which he 

 was born. ^ Not less mischievous, and in the true sense of the 

 word unscientific, were the systems of medicine known as the 

 latromechanical and the latrochemical, which in their turn had 

 their vogue. The Biunonian .system, explaining all diseases as 

 due to laxity of fibre, was no better ; for indiscriminate use of 

 "corroborants," or as they would now be called "tonics," is 

 irrational. There is no such thing as a tonic or strengthening 

 medicine, the only source of strength is oxidisable food, and 

 bitter medicines only give strength indirectly by improving 

 appetite. The last of the systems of medicine founded on a 

 dogma is homoeopathy, of which the theoretical absurdity is 

 somewhat concealed by the more obvious nonsense of infini- 

 tesimal doses. It, like the other systems which preceded it, 

 is not a rival to rational medicine ; they are not mistaken 

 answers to a legitimate question, but attempted solutions of a 

 problem which does not exist, attempted answers to a riddle 

 which has none. 



Apart from these exploded systems of treatment, our pro- 

 fession has often suffered from lack of the scientific, inquiring, 

 sceptical spirit, and has often been led too easily by authority, 

 by tfadition, and by fashion. The reckless abuse of venesection 

 in the last century and the former half of this led to alniost 

 complete disuse of a valuable means of treatment ; the misuse 

 of mercury in the treatment of syphilis led to the denial of its 

 unquestionable efficacy ; have we not seen the value of stimu- 

 lants with fever lead to their indiscriminate use in almost 

 every ailment? Has not the immense value of careful and 

 thorough nursing led to its absurd exaltation to an independent 

 place, as if good nursing was anything more than an intelligent 

 carrying out of the physician's directions ? Has not the re- 

 markable powers of electrical stimuli led to a blind, unscientific 

 and mischievous employment of this remedy, as if it had some 

 mystic power apart Irom its demonstrable physiological effects ? 

 May we not say the same of hydropathy, of massage and of 

 hypnotism ? It is significant that the irrational exaltation of 

 any of these particular modes of treatment into a panacea, 

 while it begins in want of scientific intelligence invariably ends 

 in imposture and deceit. Our only safeguard against the spirit 

 of quackery and the deserved loss of public confidence in the 



© i) <J ^ 7/ 9 h 



1 Sol Luna Mars Mecurius Jupiter Venus Saturnus 



Au Ag Fe Hg Sn Cu Pb 



Sunday Mon-day Mardi Mercredi Thors-day Vendredi Saturday 

 These relations of metals to the planets, and also to the days of the 

 week, are commemorated in the phrases : — lunar caiistic, martial disposi- 

 tion, mercurial temperament, B before a prescription, Cuprum a Cypro 

 {divapotevs Cypri) and saturnim gout. 



