Volume 1

A system of medicine / by many writers ; edited by Thomas Clifford Allbutt.

Date:
1896-1899
Catalogue details

Licence: Public Domain Mark

Credit: A system of medicine / by many writers ; edited by Thomas Clifford Allbutt. Source: Wellcome Collection.

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    causation. Excessive concentration, if it fit a man for analytical study, may unfit him for the world. Moreover, the purely scientific physician tends to undervalue opinion, as the man of the world to overvalue it. Now, prevalent opinions, though not formal truth, generally contain truth, and this the practical physician does not fail to perceive; nor does he forget that the observations of any one person, however pro- found, being the observations of an individual of brief life and limited faculties, need some tempering by traditional lore—by the embodied opinions of a vast numljer of observers OA'er a long period of time; opinions which, individually inaccurate as they may be, yet make collect- ively an approximation to truth of no small value to the man, be he statesman or physician, who has usually to act on a choice of second best courses \yide paragraphs on Prognosis]. Methods.—We are met at the outset of our study by the questions —What is health; and what is disease? The man who lives to the age of a hundred years, and who during that time suff'ers no pain, and is continually able to make use of the powers proper to his age, would by iiniversal testimony be regarded as an example of health : yet even the life of such an one would not always be at its best; and health, like every other such name, is to be used in a relative sense. Into the life of the healthiest man disorder must frequently enter. Absolute health is an ideal conception, as the line of the mathematician, the ether of the physicist, and the atom of the chemist; it is a positive conception of a perfect balance of the moving equilibrium which we call systemic life: disease is a negative conception, and signifies something less than this perfect balance. In other times, nay, even in our own, there has been a disposition to regard disease as something imported into the system, as a possession of it by a malign agent which may be exjjelled by some sorcery or virtuous herb ; in this sense health and disease are not different attitudes of one thing, but a binary combination. Insensibly this personification of disease falls by a sort of refinement into the principle of the vitalists, as in the phrase of a distinguished physician who describes a patient as saturated with insanity; or it becomes the peccant humour of a less unscientific pathology; or, again, it may be identified with a microl^e or a virus. Yet to speak thus is to confound disease with the causes of disease, and to use figurative language to our confusion—the perilous stuff from which the bosom must be cleansed is no more a disease than a blackthorn staff is a broken head. The blackthorn may be the cause of a green wound; by this gate other bacilli, less gross in kind, may enter the body, and cause the oscillations in its system which we call fever; the consequent dislocations and disturbances in the body are properly called diseases. A cancer is no more a disease than the hyssop on the wall: a cause of disease it may be, but the disease is in the damaged tissues, which are irritated, invaded, or choked by the growth. Again, whether the causes be prevented inside the body or outside it,