Medical America in the Nineteenth Century: Readings from the Literature

Nature and Art. Their Relative Influence in the Management of Diseases. Are They Antagonistic or Co-operative?

NATHAN S. DAVIS NATURE AND ART. THEIR RELATIVE INFLUENCE IN THE MANAGEMENT OF DISEASES. ARE THEY ANTAGONISTIC OR CO-OPERATIVE? Editor's Note Nathan Smith Davis (1817-1904) is best known for his efforts to reform medical education. He was one of the principal founders of the A.M.A. and in 1859 helped to establish the three year curriculum at the medical department of Lind University (later Northwestern). Davis was also an energetic medical editor. He founded the Chicago Medical Examiner in 1860. With the establishment of the Journal of the American Medical Association, in 1883, he became its first editor, resigning in 1889. In the early 1860's two conflicts in regard to therapeutics exemplified the stresses within the profession. Both were part of a larger discussion about the role of nature in the cure of disease. This latter, a subject going back at least to the Hippocratic writers, was also prominent in contemporary European thought, where therapeutic nihilism was becoming widespread among the academic centers . While Americans usually did not adopt a posture of actual nihilism, the discussions regarding "rational medicine," or reliance on less active bleeding and purging did fill many pages of American medical journals. The first of the two conflicts alluded to above was over statements made by Oliver Wendell Holmes in his oration to the Massachusetts Medical Society in 1860. Since the paper by Davis was, in part, an answer to Holmes, the latter's remarks deserve our attention.1 Holmes's speech "Currents and Counter-Currents in MedicalScience," greatly disturbed a large number of America's doctors. Indeed, the society that had invited him to deliver the annual oration publicly disavowed itself from what he said, an unusual step, to say the least. "The object of Dr. Holmes," the reviewer in the American Journal of the Medical Sciences pointed out, "in his address is to favor a general current which has manifestly been setting in during the past twenty-five or thirty years in favor of assisting nature in the treatment of disease, and in opposition to a predominant dependence on art."2 Holmes in his oration took to task many aspects of his profession's practices, its journalism and therapeutics coming in for the most scorn. The passage most Chicago Med. Examiner 2 (1861): 129-39. An essay read to the Chicago Medical Society , October 19, 1860. 1 1 have elsewhere dealt with the other therapeuticdiscussion, the banning of calomel and tartar emetic by Surgeon-General Hammond. "Therapeutic conflicts and the American medical profession in the 1860's," Bull. Hist. Med. 41 (1967): 215-22. 2 Am. J. Med. Sci. 40 (1860): 462-74; 463. This was one of the most thoughtful reviews ; it was also friendly to Holmes. The reviewer was Worthington Hooker, a kindred spirit in the quest for a "rationalmedicine." 127 128 MEDICAL PRACTICE often quoted and that which doubtless gave most offense to his colleagues and the greatest satisfaction to the medical sectarians had to do with the materia medica: Throw out opium [meaning retain for use], which the Creator himself seems to prescribe . . . ; throw out a few specifics which our art did not discover, and is hardly needed to apply; throw out wine, which is a food, and the vapors which produce the miracle of anesthesia, and I firmly believe that if the whole materia medica, as now used, could be sunk to the bottom of the sea, it would be all the better for mankind -and all the worse for the fishes."3 Although a medical man believes he treats his patients on principles founded in his experience, this is not always the case. Much is really belief or fashion of the time. There are in every calling, Holmes pointed out, those who go about their daily tasks according to the rules of their craft, without questioning past or future. These he called the practical men; "They pull the oars of society." Holmes wanted to awaken his audience to the intellectual currents of the time, such as positivism. And awaken them he did—to the point where many became enraged. Nathan Smith Davis was one who felt compelled to answer some of Holmes's charges. Bibliographical Note Thomas N. Bonner, "Dr. Nathan Smith Davis and the growth of Chicago medicine, 1850-1900," Bull. Hist. Med. 26 (1952): 360-74. An extensive discussion of works by Jacob Bigelow, Worthington Hooker, and John Forbes appeared as an essay review, "Nature and art in the cure of disease...