Page:Introductory Lecture 109 Medical Department University of Pennsylvania Stille.djvu/16

 repelled by the often wearisome details of observation; in a lower stratum still are they who concern themselves about details alone, and work out from these more or less empirical rules which serve them instead of principles; while the humblest grade of all consists of men but little apt to generalize or reason, and whose chief aim is to learn from scanty compends what is “good” in this or the other disease.

The history of medicine is marked by successive periods in which empirical and scientific methods have by turns prevailed, and a study of them both must satisfy impartial inquirers that neither can be relied upon exclusively to establish principles or to found a method of practice. Of the two the empirical is unquestionably the most fruitful in lasting results; and the successive rise and fall of systems opposed to one another proves that a trust in them as an end, and not as a means, is delusive. Such a delusion in regard to an analogous subject is attributed to the famous Metternich, who for so long a time controlled the political condition and relations of European States. He is reported to have said: “I believe that the science of government might be reduced to principles as certain as those of chemistry, if men instead of theorizing would only take the trouble to observe the uniform results of similar combinations of circumstances.” (Lond. Quar. Rev., July, 1872.) But precisely similar combinations of circumstances in the political, as well as in the medical world, are never reproduced, and hence the successive results of observation are never identical, and the laws which they are used to construct can never be applied without modification to individual cases. To what extent they must be modified depends upon the individual who applies them. His natural genius and his acquired skill may make all the difference between their success and their failure in his hands; and hence the same method may produce brilliant results, or altogether fail, according to the skill which directs its application. This skill belongs to the individual, he cannot communicate it to others, and when he dies it perishes. In this view of the subject the influence of the individual, whether teaching orally or by example merely, can hardly be over-estimated,