Dr. Valerj's Introductory Lecture

1866 Boston Medical and Surgical Journal  
The discussion of such difficulties, or the just solution of them, comprehending, as a necessary consequence, both the necessity of medicine and the usefulness of the physician and his remedies, if it requires on my part a clear exposition of the subject, requires on yours the most serious attention. In order to perceive that nature does not effect the cure of diseases with discernment or intelligence, it is requisite first to bear in mind, that we defined this term as being " an aggregate of
more » ... " an aggregate of forces, which, though special, efficient, and acting according to provident laws for the conservation of our economy, act, nevertheless, of necessitythat is, void of discernment or reflection with regard to the end in view ; in other words, they operate fatally, physically, without knowing, or being enabled to avoid or modify the scope for which they were destined by the infinite wisdom of the Creator, namely, the health of the individual. Now the same happens in the state of illness. Nature, the moment our organism enters into the abnormal condition of suffering, displays her salutary activity, but without volition or choice. Indifferent with regard to the consequences of her operations, she is forced to act of necessity, not as a being endowed with will, compos sui, but according to those immutable laws which her Author has imposed upon her. Just as a stone thrown into the air invariably falls towards the centre of the earth ; just as an acid, when it comes in contact with certain alkalies, is invariably converted into salt, so the vis medicatrix natura, invariably and unfailingly, unconscious why or how, effects the process of curing, of restoring health. It hence follows that when we physicians, observing a crisis, which, far from saving a patient, occasions his death, exclaim, that nature deceives herself our declaration in this case should be received in a metaphorical, not positive sense ; because error belongs only to him who possesses the faculty of choosing, and the consciousness of what he is transacting, and not to that which acts through physical necessity, ignorant both of cause and effect, and operating according to determined laws and with appointed instruments. Let me give you here some actual proofs of the truth of my assertion. Let us suppose that several persons, in order to pursue their journey, are constrained, in a state of perspiration, to cross a current of cold water, and that the arrested perspiration has been the cause of illness to them all. Nature, ever watchful and operating for their benefit, begets a fever, which on the morrow terminates in the case of one with a profuse diaphoresis; in that of another, far from ceasing, it progresses to a pneumonia; in the case of a third, it results in a violent and acute rheumatism. Now can we interpret these three different maladies, all derived from one identical cause, as an operation of a rational intermediating nature, acting with discernment, with pre-
doi:10.1056/nejm186612060751902 fatcat:fagihc25tbftxkppqmfgmsmcuy