_Professor of the Institutes of Medicine, and Senior Professor of
Clinical Medicine in the University of Edinburgh._
I have long formed the opinion that the prevailing method of determining
the value of any particular medicine or mode of treatment is essentially
faulty. Practitioners, after watching a few cases, form a favourable
opinion of this or that mode of procedure; they then publish their
views, supporting them with their successful cases, and strongly
recommend them to the consideration of their medical brethren. Then
follow trials more or less numerous by others, some of whom think the
method recommended good, whilst others find it useless or injurious.
Such a system is characteristic of an imperfect acquaintance with
medicine, and during the progress of many centuries, while it has led to
some valuable knowledge, has for the most part only tended to
superficiality and the utmost contrariety in medical practice. What
seems to be necessary at present for determining the real value of any
kind of treatment is—
1st. Rigid accuracy in the diagnosis of the case.
2d. A clear comprehension of the nature of the pathological condition
treated.
3d. An acquaintance with the natural progress of the disease.