THE PKESENT ASPECT OF MEDICINE. 339 



How much of the mass of medical literature that has 

 accumulated during the latter half of the last and the first 

 half of the present century must the future historian of our 

 art record as the result of the unconscious influence of the 

 mythical conception of disease and of cure, working under 

 the guise of scientific research and inductive philosophy ? 

 "When shall we, in medicine, consciously and utterly reject 

 the dregs of the Manichean doctrine, and see clearly, and for 

 a practical end, that the essence of disease is only the disturb- 

 ance of the laws of health ? 



But it may be said, " If disease be merely a transgression 

 of or disharmony in the conditions of health, then medicine 

 as an art (the art of healing, or skill in the application of the 

 remedies of disease) can have no real existence ; it has been 

 a dream all along, an unconscious and unintentional im- 

 posture. Pathology, the science of disease, alone constitutes 

 physic ; and the learned and candid physician, who is doing 

 so much to increase our knowledge of that science, can only 

 shrug his shoulders when called on to prescribe." In this 

 objection lies a fallacy, by which our profession is not a little 

 influenced in these times. It also exhibits a form of pro- 

 fessional scepticism that naturally results from a change 

 begun in our conceptions of disease, without a corresponding 

 change in our conceptions of treatment. We are casting 

 aside the idea of the specific entity of disease ; but we have 

 not to the same extent freed ourselves from the influence 

 of the idea of specific cure. The fallacy may be expressed 

 thus : — There is no such entity as disease ; therefore there 

 in ('d be no attempt at treatment. Our professional duty is a 

 necessary form, due to the prejudices of the public and to 

 the natural desire of suffering humanity for sympathy and 

 assistance. 



This reactionary tendency at particular epochs, of which 

 the reasoning jusl noticed is an example, is not peculiar to 



