both science and profession—has had only detractors and apologists, believers or skeptics. It has been attacked and defended by special pleadings only; there have been arguments on both sides, but no decision. But where is the Kant who can and will tell us the fact? Shall we seek him in a professor's chair, or in an Academy? Wherever he is, he should show himself, for his time is come." It is with some faint hope of calling out the individual so much needed, that I have selected my present subject. The limited time allowed me on this occasion will of course compel me to treat some of its subdivisions in a very cursory manner; and entirely to omit others. But in what I may say, I will hope to avoid the errors both of the panegyrist of his own times, and of the "laudator temporis acti." I shall necessarily adduce many facts familiar to all medical men; though not, I will hope, for a trite purpose.

The medical profession, like the others, is somewhat inclined to cherish the idea of modern perfection. Like the other professions also, its members generally adopt the principles and acknowledge the influence of their predecessors without questioning their correctness. A candid inquiry into the real progress, and present condition of our science will, therefore, perhaps somewhat abate our complacency; but it should stimulate our highest efforts to advance it towards that perfection which all invoke, and would witness for themselves. We are, however, during most of our lives, too much immersed in strictly professional labors, to give much attention to these higher subjects; and are too prone to feel that

INTRODUCTION. 0

they do not particularly concern ourselves. But there should be times, when our personal responsibilities in these respects are presented to us; and I have assumed that this is appropriately an occasion of that kind.

There are those who assume that the human mind itself has undergone a progressive increase of power and perfection in modern times; so that we now seize, intuitively as it were, on what cost the ancients much study and application; and hence, know all they did almost as a matter of course. This assumption is, however, opposed to all observation, and to fact. The infant of 1858 requires as long a time to learn to talk and to walk, or to acquire any other accomplishment, for aught we can conceive to the contrary, as did the first-born of Cain. And there are no intellects now-a-days superior to the most brilliant of ancient times. The advantage of the moderns consists in the improved facilities for acquiring knowledge; and especially from the art of printing. A few weeks may now suffice to acquire an amount of knowledge it cost the ancients, perhaps, a thousand years to establish. But the power of acquisition is no greater now, and its necessity no less, than it was then. Nor is it by any means certain, or even probable, that the ancients knew so much less in the aggregate than the moderns, as is so generally assumed. They knew not precisely what the moderns know; but the world has not improbably forgotten quite as much as it knows. We have derived from the ancients, but a small part even of their recorded knowledge. But that little is calculated to give a most exalted idea of the intellect and the learning of antiquity, since it has impressed its character upon all ages up to the present, and will impress all succeeding ages to the end of time. And some of the recently invented instruments of our art, and which were supposed to indicate a degree of progress and perfection never dreamed of by the ancients, are now known to have been used at least 1,800 years ago.* We, therefore, as truly as the ancients, can by labor alone improve, or even acquire, our science.

PART I.

THE CONSTITUENTS AND THE METHODS OF SCIENCE.

The following inquiries present themselves as preliminary to my main subject.

I. What is the distinction between science and art?

II. What are the elements constituting an actual science?

III. What is the true character of medical science as compared with the other sciences?

I. It is often asserted that science is the basis of all art. But it will be found in the majority of actual instances, that art is the forerunner, and not the fol

SCIENCE DISTINGUISHED FROM ART. 7

lower—the parent, and not the offspring—of science. It is the province of science to know; of art, to do. Science inquires and ascertains what is; art changes what is to something different. Science foresees and predicts the phenomena around us; art forestalls, controls, or prevents them; science discovers; art invents. The immediate object of science is truth; of art, either pleasure or utility. But we must try, before we can ascertain and know; the tentative must precede the positive: art in its primitive forms, must precede science. It is true that every effort of art is made in accordance with certain facts and principles; but such efforts may be repeated for centuries, before the facts or principles are discovered. Meantime the art is improving, though the science still remains unformed. Some of the inventions of the present day even, have not yet found a scientific basis. Hence in the early ages of society there are many arts, but no sciences.

The art of medicine, therefore, dates back to the earliest times; while our science is of comparatively modern date. The old adage—" Nusquam medicina non est"—refers to the art or practice of medicine alone; and implies that there never has been a time, in any nation, where the treatment of diseases and injuries, has not in some form obtained. Much importance has been attached to the assertion of Pliny the elder, that Rome had no physicians for the period of 600 years; as if this city were an exception to the general proposition just quoted. It is, however, the fact that in no age are physicians the sole practitioners; and I have also elsewhere shown that Pliny's assertion is not correct.* The early physicians of Rome were merely slaves, both male and female; and therefore found no historian. This was the case indeed with the majority of them, until Csesar decreed to all who practised medicine, the rights of citizenship. f In Athens, on the other hand, it was forbidden by law, that a slave or a woman should practise physic ; and thus a dignity was imparted to our art which secured its transmission to succeeding times.

THE CONSTITUENTS OF A SCIENCE.

II. A science has been said to consist of the facts, ideas, and principles of any department of knowledge—classified and arranged in a systematic manner.J

1. Facts are something external to ourselves, and therefore existing independently of our own minds; e. g. the rising and the setting of the sun. Pacts then, depend upon the nature of things; and if actual or real, are, of course, true. But we acquire facts by the exercise of our senses. Whether we perceive facts, therefore, as they are, depends upon our powers of observation and their use. If these prove deceptive, our supposed facts are not true, i. e. they

* See Amer. Med. Monthly for April, 1859.

t Subsequently, however, slaves were again allowed to practise medicine. And the Code of Justinian, promulgated about A.d. 500, fixed the price of physicians, male and female, at 60 solidi—or $257 12.

I Sir William Hamilton's definition is too transcendental for our purpose. "A science is a complement of cognitions, having in point of form, the character of logical perfection, and in point of matter, the character of real truth."