SCIENCE. 



89 



cians are scarcely acquainted with it. When I was a 

 young hospital assistant I was frequently forced to per- 

 form cupping four or five times in one morning. Singu- 

 larly enough the change came at a time when we were 

 the least prepared for it. In cases ot inflammation of the 

 lungs, where the most audacious blood letting was con- 

 sidered an almost irrefragable means of restoring the 

 patient, they began in the Universal Hospital at Prague 

 to observe the natural course of the disease without the 

 application of any remedies. They contented themselves 

 with giving the patients plenty of fresh air, good attend- 

 ance, greater cleanliness than they were in the habit of 

 getting and strict dietetic surve'llance. In the way of 

 medicine, they got nothing, and yet very favorable stat- 

 istics were obtained. In this way physiology gained a 

 victory over technology, and at the first step reached the 

 highest form —nihilism. 6 



Since then a certain reconciliation has taken place. A 

 firm conviction arose that hospital practice could not 

 merely be influential to private practice — that the hospi- 

 tal, with its manifold contrivances, its order and regimen, 

 possessed provisos and remedies which in a private fam- 

 ily, even a wealthy one, could only be imperfectly estab- 

 lished, or else not at all— and finally that the nihilism of 

 the hospital physician could not be transmitted to fam- 

 ilies. 



Of course, both physiology and technology will con- 

 tinually enlarge in the future, the more so as experience 

 gains new perceptions and increased povver. This, we 

 all know, is inevitable, and the public, which might justly 

 reprove medicine for its scientific changeability, should 

 bear in mind constantly that it is the fate of humanity to 

 be fickle, not only in regard to science, but also every 

 other matter, from the State to the Church. We can only 

 hope that changes everywhere will be made with as much 

 honest intention as they generally are in regard to 

 science. 



It would, perhaps, be possible to check trivial fluctua- 

 tions if people could only agree better as to proper heal- 

 ing objects. This is precisely the point over which scien- 

 tific men find it so difficult to attain to a uniformly of 

 opinion. When a physician is called upon to cure he has 

 the case before him, represented by tha patient — a unity 

 so to speak. And yet the malady itself gives the im- 

 pression of another unity.- It has the appearance of some 

 strange being which has implanted itself in the individ- 

 ual. It has been not improperly termed a parasitic or- 

 ganism, which lives in or upon the system of the patient. 

 Numbers of times it has been asserted that a strange ex- 

 istence has penetrated into the sick man and "possessed " 

 him. All these ideas unite in the practical task of ex- 

 pelling the disease by driving it forcibly from the body. 

 Is it not perfectly evident that a double existence takes the 

 place of the former unity? Can any conclusion be drawn 

 from such premises, except that the " case " must be re- 

 garded as dualistic ? If the physician has the patien-t and 

 the disease before him ; if he is to separate the one from 

 the other ; if the practical endeavor is to act against the 

 disease and for the individual, can it be a question of a 

 unitarian conception ? 



Truthfully speaking, such an idea has never properly 

 existed. Even in cases of sickness which were termed 

 rather figuratively universal, it was always understood that 

 a more or less large portion of health should remain un- 

 disturbed. It was this remainder that caused " reaction " 

 according to some schools, and led the battle against 

 strange intruders. Paracelsus, in the Middle Ages, ex- 

 pressed these thoughts in the most worthy manner. Let 

 us take up the point and imagine a defensive battle whose 

 seat of action is the human frame. Who are the combat- 

 ants > On one side we have the disease, in the other the 

 healthy portion. The latter, of course, can go forth with 

 no other weapons of defense and attack than those pre- 



' Archives of pathological anatomy, 1849, Vol. II., p. 14. 



viously possessed. Where can new ones be found ? The 

 means of resistance must necessarily spring from the 

 physical system itself. Thus far the ideas are simple 

 enough. But if we see that the struggle is carried on 

 according to a military principal, that it has a tendency 

 to cure, and that the means of reaching this end are ap- 

 parently, purposely and systematically chosen and put 

 into action, what power shall we consider the decisive 

 one? What is the leading principle, and where are we 

 to look for it? The generality of physicians say with 

 Hippocrates, it is Nature. But do we not, so to speak, 

 run around in a circle when we first of all call the legiti- 

 mate formation of the body nature, and then again have 

 recourse to the same term when we wish to explain how 

 this arrangement resolves itself into a systematic unitar- 

 ian course of action ? Have we not a substance to deal 

 with in the first case, and a force in the second — and an 

 organized force too, a force with designs and purposes — 

 a species of spirit in fact ? Paracelsus was firmly con- 

 vinced on this latter point. He designated the decisive 

 power the Archaus maximus, which corresponded to 

 spiritus rector, or leading spirit. 



Georg Ernst Stahl, the celebrated clinical lecturer, in 

 the beginning of the past century, went a step further. 

 He set up the soul itself, the aninia, as the decisive prin- 

 ciple. But at that time the philosophy of the unknown 

 was not yet invented, and it was difficult to demonstrate 

 that the hitherto thinking and conscious soul could here 

 work in an entirely unconscious manner, and yet be sys- 

 tematic withal. It was also extremely hard to trace the 

 diseases of cattle, the morbi brutorum, or the maladies 

 of plants to a soul, if we did not wish to run the risk of 

 losing the conception of the term by this extensive gener- 

 alization. 



Toward the close of the past century we became 

 more and more inclined to admit the existence of an or- 

 ganic force secondary to the soul — some called it vitality, 

 others natural healing power. Those inclined to the for- 

 mer opinion endeavored to unite a given relation of the 

 healthy organism with an effort directed upon itself. 

 Those who adhered to the latter idea were firmly con- 

 vinced that a peculiar regulating force existed. 



At all events, the much sought for unity was driven 

 further and further into the background by the sudden 

 appearance of these new forces. There was no longer 

 merely a dy as, but a trias. The disease, the remaining 

 healthy portion of the body, and the particular force 

 which ruled it. And no matter what special term was 

 employed to designate the latter, it always partook of a 

 distinctly spiritual character. Many attempts were made 

 to reduce it to a scientific quality ; to construct it accord- 

 ing to a physical dynamic system ; to interpret it as a 

 particular form of electricity or magnetism. 



However, as soon as the matter was entered upon se- 

 riously, and all the systematic plans and workings investi- 

 gated, natural science became instantly transformed into 

 a spirit. 



Nevertheless, assistance was frequently deemed neces- 

 sary. The course of the struggle was observed more 

 minutely, and if it was found to be too weakly conducted 

 either by vitality or natural healing force, endeavors were 

 made to strengthen both, or at least to incite them 

 to greater activity. But if the battle was found to be 

 sustained with more force than necessity required, pains 

 were taken to moderate and reduce the action. Thus 

 arose a classification of conditions pertaining to disease — 

 asthen c, sthenic and hypersthenic, names derived from 

 st/ienos, signifying strength. 



It would lead us entirely too fai from our course, should 

 we attempt to expound the history of the various healing 

 systems. It may suffice to say that every one of them, 

 to use a common expression, has left its traces behind, 

 and that an acute eye can easily detect them. Accord- 

 ng to our present ideas all these systems rest upon an 

 rroneous conception of life and disease, inasmuch as 



