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On Hypothesis in Medicine

H. J. Bigelow
1846 Boston Medical and Surgical Journal  
But such mental efforts precede the discovery of every law in science. Every discoverer forms his hypothesis, and tests it by the truth ; if the facts are numerous, the inductive method, with its tabulating machinery, offers the surest and the shortest test ; if, on the other hand, the facts are few in number, especially if a law of cause is being tested by laws of phenomena, which then bear to it the relation of simple facts, I doubt if philosophers commonly have recourse to Bacon's tables ;
more » ... Bacon's tables ; but the process still embodies the soul of the inductive method. It is induction with its tablets in the memory, an analysis far more subtle than the gross elaborations of material tables, but subject to the imperfections of the memory. In proportion as the facts are numerous, or extended through a long period of time, impressions are distorted and effaced, and results become inaccurate. It is this induction of the mind which accumulates what is called medical " experience " ; and it is the multiplicity of facts which makes it so inaccurate. Apart from the results derived from the experience of others, medical experience is preceded by hypothesis. Unless the observer has no aim or object in his experiments, he wishes to ascertain something ; the frequency of a symptom, or the effects of a remedy. His first few experiments give him a leaning to one side or the other, inappreciable though it be, or even disowned by himself. This is his hypothesis, and he goes on to correct or verify it. All individual experience in life is summed up in hypothesis of future probabilities. By original experience I mean that which is not communicated to us by others : the philosopher has his hypothesis of the laws of the mind ; the burnt child has his equally stringent hypothesis of the action of caloric. In a word, hypothesis in its wide sense is based upon experience ; it is the sum of past knowledge aggregated, with a view to its bearing upon future knowledge. From the wildest theories of Kepler, to which he was pointed by some hand invisible to other eyes, down to the most inevitable results of accumulated facts, all is hypothesis in its bearings upon the future and the unknown. I am aware that such a view leads to the acknowledgment of an hypothesis of cause based upon experience ; but if we are sure of anything, if we know that a material mass will feel the influence of gravitation, are we not infinitely more certain of the truth founded upon all we know of constant and seemingly necessary prece-
doi:10.1056/nejm184601140332404 fatcat:efg3xewtq5gmdfccdm3mp6457e