Theory versus Practice.

Selected writings of John M. Scudder.

In speaking of the theory of medicine, it was intended to convey the idea of its principles, as distinguished from its practice. But in reality it was a "speculation or scheme of things," not founded on well-proven facts. Thus theories were being constantly advanced and changed by writers on medicine, and the study of medicine resolved itself into the analysis of various theories and the adoption of one suited to the mentality of the individual. In this reasoning from imagination, the practice of medicine has been rendered theoretical and its progress constantly impeded.

We would naturally suppose that theories would have been based upon actual observation at the bedside of the sick, and made to conform to facts observed in the treatment of disease. But this was not the case. On the contrary, a theory having been formed, the facts of observation were contorted to fit the theory, and the administration of remedies was controlled by it.

There are three truths, that should be constantly borne in mind by every one engaged in the practice of medicine, as upon them only can a rational practice be founded. They are: 1st, That in all cases of disease there is an impairment of vital power in the parts involved. 2d, That there is a, natural tendency to recovery or renewal of life; and 3d, That the human body acts on medicine, and not medicine on the body. These propositions may not be new to our readers, yet they are frequently, if not generally, ignored in practice, and to draw attention to them as principles of action and not articles of faith is the object of this article.

It is the common opinion that medicine acts on the system and thus aids in removing disease. Now, I am well satisfied that this is an error, and that the contrary is the fact—instead of medicines acting on the body, the body acts on them. For instance, a sinapism or blister, if applied to the healthy skin, produces redness and then vesication; but in enfeebled conditions of the system, it acts slowly and imperfectly, and on the dead body it produces no effect. Here, it is the natural efforts of the system to remove an irritant that causes an increased flow of blood to the parts, and, at last, separation of the epidermis. Administer a diuretic, and it passes into the blood and out through the kidneys. Why? Because the kidneys are stationed as guards to remove certain material from the blood, and when such remedies are absorbed the kidneys act upon them. The class of restoratives are very marked examples. Give a patient iron and the system acts upon it and appropriates a portion as the basis of red globules, just as it acts upon a beefsteak and appropriates it to form a pabulum for the nitrogenized tissues.—JOHN M. SCUDDER, M. D., Eclectic Medical Journal, 1865.

The Biographies of King, Howe, and Scudder, 1912, was written by Harvey Wickes Felter, M. D.