The Structure of Medicine

The Harveian Oration was delivered before the Royal College of Physicians of London on Oct. 18 by Dr. F. M. R. Walshe, F.R.S., physician in charge of the neurological department, University College Hospital, and physician to the National Hospital, Queen Square. In a discourse on "The Structure of Medicine and its Place among the Sciences" Dr. Walshe began by quoting Harvey's famous injunction to the Fellows of the College, "To search and study out the secrets of nature by way of experiment," and he drew attention to a further passage in De Motui Cordis, -"It has been shown by reason and experiment that the blood . ."-noting the sequence of the operations " reason " and " experiment." Harvey seemed to differ from John Hunter (" Why think ? Why not try the experiment ? "), but of course both were saying that reason and experiment could not be disjoined. In discussions on the intellectual structure of medicine there was too great a tendency to expound the theme in terms of hard antitheses-observation and experiment, art and scienceas though there was here a necessary dualism. Some physiologists showed a tendency to deny medicine its place among the sciences; they spoke of it as nothing more than applied physiology. Historically that was easily disposed of, for the hospital was the cultural ancestor of the laboratory, and experimental physiology was born of therapy. But. the physiologists' argument implicitly was that medicine did not carry its analysis of phenomena back to fundamental notions; it stopped at a half-way house, where it might borrow from other sciences. Even so, among the biological sciences medicine was not peculiar in this respect, and physiology itself had been eagerly borrowing from other sciences for the past hundred years. The truth surely was that every successive layer of thought in the annals of nature, living and dead, from biology to physics, stopped at a half-way house when tracing its ideas back to their basic elements; yet each remained a field of discourse in its own right, one of the layers in the palimpsest of natural knowledge, each with its own distinguishable intellectual content.