History of a successful case of amputation at the hip joint / by J. Sampson Gamgee.

  • Gamgee, Sampson, 1828-1886.
Date:
1865
Catalogue details

Licence: Public Domain Mark

Credit: History of a successful case of amputation at the hip joint / by J. Sampson Gamgee. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    In medicine, as in other departments of knowledge, the greatest errors have been promulgated on the alleged foundation of facts. To test the value of such teaching, two inquiries have to be instituted ; lstly, into the reliability of the individual facts, 2ndly, into the soundness of the method of arranging them, and reasoning upon them. The mere enunciation of a proposition, on the basis of a number of facts, is repeatedly taken as evidence of proof, but on the slightest reflection it must be evident that it is not so. Great as was the value in his day of JVTorgagni's aphorism, Observations perpendendae non numerandae, it is not applicable to our time; the copulative must now be substituted for the disjunctive, and the sentence then accurately expresses the order to be followed in the process of inquiry,—observations of fact have to be well weighed and then counted. It is the peculiarity of the facts which come under our observation in medicine and surgery, that they are very rarely simple, often exceedingly complex ; each fact is not a thing to be merely seen or felt, but only to be arrived at in the majority of instances by a process of reasoning, and by careful exclusion of every one of the many sources of fallacy. This difficulty of observation is greater, the facts being more complicated, in some departments than in others. It is in pathological anatomy and semeiology that observation is least beset with difficulty,—in etiology and therapeutics that it is most so. Numerous and varied as are the structural appearances in disease, their physical characters admit of such faithful word painting, and such minute record with the aid of physical instruments, as to invite precision and facilitate the detection of error. The same observations apply in substance to the symptoms of disease, with this difference; that the variety being more extended, a larger number of classified observations is required for the foundation of inferences. Accordingly it is in determining the anatomical characters and the signs of particular maladies, that some of the principal victories have been achieved with the numerical method-—to wit, Louis on Phthisis, Walshe on Cancer, Tenner on Fevers. It is much to be desired that the natural history of disease, to the study of which the numerical method has proved particularly applicable, may be more widely investigated by its aid; for although the knowledge thereby gained may not directly conduce to the great requirement of our day—advancement in therapeutics—it is an essential foundation for their profitable study. A knowledge of the value of remedies in particular diseases pre-supposes ability to distinguish the latter in their various stages and complications,