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JACOB BIGELOW ON SELF-LIMITED DISEASES Editor's Note Jacob Bigelow (1787-1879) after receiving his medical degree in Philadelphia spent his professional career in Boston. Known as one of America's foremost early botanists, Bigelow was Harvard's first professor of materia medica and played an important role in bringing her medical school and the Massachusetts General Hospital to the forefront of medical education. Henry Nash Smith has described the American love for oratory as one of the most conspicuous features of American culture in the decades before the Civil War.1 In medicine this judgment is readily borne out if one looks at the tremendous numbers of printed orations, discourses, and dissertations stemming from medical schools and societies throughout the land. Although their prose is usually florid and their sentiment lofty, these speeches provide a useful source of information for the historian. The selection by Bigelow fits the category of orations. Delivered before the august Massachusetts Medical Society in 1835, when its author was forty-eight years old, it soon became a classic, widely referred to. It was Bigelow's central theme, that nature not art should more often be relied upon, and not his words themselves that received the most attention. Bibliographical Note George E. Ellis, Memoir of Jacob Bigelow, M.D., LL.D., Cambridge: Wilson, 1880. The death of medical men is an occurrence which eminently demands our attention, for it speaks to us of our science and of ourselves. It reminds us that we, in turn, are to become victims of the incompetency of our own art. It admonishes us that the sphere of our professional exertions is limited, at last, by Med Communications Mass. Med. Soc. 5 (1836): 319-58. Reprinted from Nature in Disease (Boston: Ticknor & Fields, 1854), pp. 1-58. This is a paper delivered before the Massachusetts Medical Society, May 27, 1835. 1 Popular Culture and Industrialism, 1865-1890 (New York: Anchor, 1967), p. 428. 98 JACOB BIGELOW 99 insurmountable barriers. It brings with it the humiliating conclusion that while other sciences have been carried forward within our own time and almost under our own eyes to a degree of unprecedented advancement, medicine, in regard to some of its professed and most important objects, is still an ineffectual speculation . Observations are multiplied, but the observers disappear and leave their task unfinished. We have seen the maturity of age and the ardent purpose of youth called off from the half-cultivated field of their labors, expectations, and promise. It becomes us to look upon this deeply interesting subject with unprejudiced eyes and to endeavor to elicit useful truth from the great lesson that surrounds us. In comparing the advances which have been made during the present age in different departments of medical science, we are brought to the conclusion that they have not all been cultivated with equally satisfactory success. Some of them have received new and important illustrations from scientific inquiry, but others are still surrounded with their original difficulties. The structure and functions of the human body, the laws which govern the progress of its diseases, and more especially the diagnosis of its morbid conditions are better understood now than they were at the beginning of the present century. But the science of therapeutics , or the branch of knowledge by the application of which physicians are expected to remove diseases, has not, seemingly, attained to a much more elevated standing than it formerly possessed. The records of mortality attest its frequent failures, and the inability to control the event of diseases, which at times is felt by the most gifted and experienced practitioners, give evidence that in many cases disease is more easily understood than cured. This deficiency of the healing art is not justly attributable to any want of sagacity or diligence on the part of the medical profession. It belongs rather to the inherent difficulties of the case and is, after abating the effect of errors and accidents, to be ascribed to the apparent fact that certain morbid processes in the human body have a definite and necessary career from which they are not to be diverted by any known agents with which it is in our power to oppose them. To these morbid affections, the duration of which, and frequently the event also, are beyond the control of our present remedial means, I have on the present occasion applied the name of self-limited diseases, and it will be the object of this discourse to endeavor to...

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