THE CONCEPT OF TRUTH AND LAW IN MEDICINE

  “There is something harder and stronger than bronze or marble; it is prejudice” - HORACE.

  The search for truth is the supreme goal towards which science struggles; we pursue truth and yet, when almost perceived, it frightens us.  Deceiving us time and again, this phantom  appears  for an instant, and is gone; we must pursue it further and even further without hope of overtaking it...  and he who would join in this pursuit of truth must be absolutely independent, he must completely free his soul of prejudice and passions; he must resolve himself to an absolute sincerity. [5]

  “It would seem almost impossible to find at the present time an unprejudiced observer.  All men are prejudiced.  Man is fixed in  his politics, fixed in his religion, fixed in his ideas of medicine; because of his prejudice he cannot reason.  You need only talk to him a moment these subjects and he will begin to tell you what he thinks, he will give his opinion, as if that had anything to do with it” [6]. An unprejudiced student is the only truly scientific observer.  And it is only to the extent to which we can really free ourselves from preconceived ideas, that scientific truth  united  with moral truth, can procure joy [7] for us.  These verities entice us and elude us; even in the moment when the pursuing mortal believes himself to have attained to her feet, truth is gone, and he is gone, and he is condemned ever to follow after, nor may he know repose.

SCIENCE

  According to BOUTROUX, science is: “The hypothesis of a constant relation between phenomena and an indefinitely perfectible induction”.  Science no longer dreams of giving the intellect an image of externalities which perhaps do not exist, it exposes relationships that may be obviously verified by experience.  And this is sufficient to justify our applying to science the adjective true.Scientific investigation consists in questioning nature in accordance with the hypothesis of this constant interphenomenal relationship.  The object of the scientific intellect is always the same; to create for the human intelligence as faithful and serviceable a representation of the conditions under which phenomena appear, as may be possible.

  Formerly science pretended to be the absolute knowledge of the nature of things, knowledge which is certain and definitive, as opposed to belief which is variable and individual, but this concept of science as absolute and illimitable has not been maintained.  At the moment, science holds that it is based on experience and on experience only.  Thus, by giving to man the means whereby he may induce nature to repeat herself, it lays hold on reality.  It escapes from the everlasting and infinite variety of opinion, in this sense, it is not only compelling on all intelligences, but all its acquisitions are definitive.  But, on the other hand, these very assets form a limitation of its extent and its philosophic value.

  BOUTROUX defined the scientific spirit as essentially “The fact considered as the source, the rule, the measure and the control of all knowledge”.

THE FACT

  But a fact from the standpoint of science, is not merely a reality which may be ascertained or verified.  The investigator who proposes to establish a fact, sets himself before this fact and observes it, as could any other individual, equally motivated solely by a desire for knowledge.  In this sense, he applies himself to discern, to watch, to reckon, to express by means of symbols, and if possible to measure this phenomenon.  But the reflecting mind wonders whether experience can furnish nothing more than mere fact, and whether it would not be possible, solely under the guidance of this same experience, to pass beyond the fact, as here defined, and attain to that which we call law.

  The real object of science is essentially to explain the fact through the discovery of the laws which govern it.

  In beginning this study, in order to avoid the sophisms, the false ideas and ambiguities which cling to words, it is necessary to rigorously define the terms employed.

LAW

  Law (Latin: lex) is defined as the necessary linkage by which phenomena succeed one another, or more simply:

  “A constant relationship, invariable and necessary, uniting two phenomena.” [8]

  REGNAULT [9] defines it: “The regular sequel (or the idea therein) indefinitely identical, of effects of the same cause”.  According to BOUTROUX [10] it is the coupling of phenomena, related among themselves, but isolated from other phenomena.  To MONTESQIEU, it is the necessary relationship existing in the nature of things.

  In order to be of a scientific character, law must be based on observation and on experience, moreover, it must analyze the circumstances producing phenomena and resynthesize them with respect to their normal relationships of similarity and succession.[11]

  This idea of law is the directing concept of modern science.  Unquestionably it is very old; even in the days of Greek science, investigators such as ARCHIMEDES, found laws analogous to those which our physicists formulate.  But it is only in our day that it has become the fundamental idea of science.

  Thus, the law of falling bodies is a constant relationship, invariable and necessary; during a given time, a falling body always traverses the same distance.

  Of course, such accuracy in the determination of law cannot be the object of all sciences.  When biology for instance, investigates the behaviour of an organism under variations of its environment, it does not pretend to measure these variations.  It is however no less true that all sciences work toward the establishment of a definite law.

  Science, thus, by general recognition, is characterised by its endeavour to discover the constant, invariable and necessary relationships existing between the facts of observation.

MEDICINE

  Despite the present tendency to consider applied medicine as a science, it possesses neither principle nor law in anything resembling therapeutic medication.

  In general definition, medicine is at one time both an art and a science; a science in its scientific perception, and art in its application.  But there are times when all recognition of the scientific character is denied.  In the last edition of the dictionary of medicine, LITTRÉ defines it as follows:

  “An art and not a science, for it seeks a  practical result and not a scientific truth.  It rests on individual procedures and not on principles of constant formulations.”

  This definition, however, cannot be considered as adequate today.  In reality, while surgery, anatomy and physiology are rapidly becoming medical sciences, therapy remains, as ever an art, pure and simple, in as much as no law has been formulated in accordance with which the physician decrees his prescription.

  Any one is capable of understanding the science of medicine, and most succeed in brilliantly passing their examinations.  In spite of this, however, many are incapable of applying and practising that which one may still call the medical art, the art of healing.  To apprehend the mere science, application and perseverance coupled with intelligence are necessary, the art requires more.

  If the physician has not the love of his art and his profession, united with a sincere desire to heal, he cannot succeed.  But though he may combine all these qualities lacking a law and principle of therapy, he lacks a compass, he wanders aimlessly, dependent on authority, obliged to follow hidden paths, to pay homage to the goddess called “Fashion” who exists unfortunately even in medicine.

  Therapeutic treatises of past centuries hold for us today nothing more than historic interest and amusement, for the interpretations and hypotheses built on the experiences of that period have been modified by a succeeding age.  And to the extent to which theories change, therapeutic agents change also.

  At first it seemed as though theories lasted only a few moments, and that ruins were piled upon ruins.  On one day they are born, on the following they are the mode, the third day they are classic, and the fourth day they are obsolete.  But, if one searches more profoundly, one sees that those which die in thi s fashion are theories, properly so-called, theories which pretend to teach us the nature of things.  However, they frequently hold within themselves a something which survives; if one of them has shown us a true relationship, the knowledge of that relationship is definitely acquired and one finds it again, disguised anew in the other theories which successively reigned in its place.  This certainly should give us a little courage!

  Today, the traveller is struck by the realization of the extent to which the great medical center of different countries lack unity of opinion concerning the administration of remedies, as well as the choice and the dosage of the latter.  Here is it opotherapy, there vaccinotherapy, somewhere else serotherapy which is being developed and tested.  Still elsewhere a scepticism born of past experiences and an examination of statistics brings a return to the hypocratien method of expectation, or reinstates physiotherapy as the only method of treatment, “Primum non nocere” becoming the order of the day.  Thus, according to Johns Hopkins University at Baltimore, one of the best American Universities, statistics show a lower mortality wherever medication has been supplanted by rigid hygienic and dietetic measures.  Meanwhile the laboratories multiply; researches, of which numerous publications are the fruit, grow, but all aim rather at producing new remedies, than demonstrating the danger of such medication habitually employed.  No one seeks through research to synthesize a guiding law  in the art of healing.  Has such a definite law, such a compass on our uncharted sea, never existed in our therapy?

  Apriori, one may wonder or conjecture - but that is not the attitude of the man of science.  To seek it, that is his duty!

  But this unhoped for law, the homœopathic physicians think they possess - the homœopathic doctrine pretends to disclose.  Should the fact that this doctrine is considered by the best European scientists as empirical, prevent our testing it by the criterion of experience and reason?  A paucity of  partisans of any given doctrine does not apriori, weaken its conclusions; among its supporters there may be such as give proof of their ignorance, their lack, not merely of scientific spirit, but of professional probity itself.  Even this is not a valid argument against the theory which is an entity in itself, independent of individuals.  Any doctrine, be it what it may, is always worthy of attention and criticism, though this may be given merely from the view-point of the history of the sciences.  Finally, if there be reality here, it is urgently necessary to study this system with the most profound care, for it would indicate the dawn of a new era in medicine.

  The art of therapy would  be transformed into a science!

  It is the resolution of precisely this problem, which has forced us to undertake a voyage of discovery and study to this new world.  Seven years of investigation of the facts yielding these conclusions have led to the work presented in this thesis, written to fulfill the requirement for the doctorate of medicine, and refused by the faculty of medicine of Geneva.

(From Proceedings of the Forty-Seventh Annual Session of the International Hahnemannian Association, Philadelphia, July 1-3, 1926)

  Homoeotherapy, June, Aug. & Oct. 1976.