K^JA^tfA
0-&<?  AX (-■'>

Of>j-
THE
PSYCHICAL TENDENCIES OF MEDICAL SCIENCE,
By A. 0. Kellogg, M. D. 
 
THE  PSYCHICAL  TENDENCIES  OF  MEDICAL
                         SCIENCE.
                   By A. 0. Kellogg, M. D.
  [The following  paper is the concluding one of a series contribu-^
ted to the American  Journal of  Insanity, under the title, " Con-
siderations on the Reciprocal Influence of the Physical Or-
ganization and Mental Manifestations." These papers have been
received with much favor  by the readers of the Journal, have ob-
tained at  various  times flattering notices from the press,  and have
been in part translated for the columns of European journals.  The
concluding essay, being of a character to make it proper for publica-
tion apart from the remainder of the series, we are happy to reprint,
in compliment to the writer, and for the gratification of his numer-
ous friends.—Pubs. Journal of Insanity.]


  " The future elevation of medical science, in  all its branches, will be most
intimately connected with the advancement of Psychology."—Damerow.
   Those who  have watched carefully the progress of medical science
during the last quarter  of a century, can not have failed to perceive
to what extent the psychological element has entered into, and con-
tributed to this advancement.
   This fact finds  illustration not  only in the science, legitimately
so-called, but  in thdse  modern systems of practice, which, whether
reasonable or unreasonable, philosophical or  unphilosophical, true or 
2
 false, have each found able and conscientious supporters, and equally
 able and honest opponents—faithful believers, " even  unto death,"
 and unfaithful disbelievers ; men having nothing whatever in com-
 mon with each other except the one sole principle, that in all things
 they are bound to disagree, and that the same class of facts, observed
 by opposing sects, shall serve to confirm diametrically opposite theo-
 ries, and lead to sadly conflicting  resuks.   One  sect goes forth to
 combat  disease armed with the most potent weapons,—the lancet
 and barber's basin, the blistering plaster and bolus-box—and inscrib-
 ing upon their banners, as a watchword,  " Contraria  contrariis
 curentur."   Another, trusting in minute saccharine globules, equally
 remarkable  for their impotence, unfurl their  banners inscribed,
 " Similia similibus curentur"  and rush to the  contest, shouting,
 " Great  is Hahnemann of the  homeopaths !"   While some faithful
 disciple of a third class, like Diogenes in his tub, looks out from his
 comfortable  sitz-bad, or  from under  the droppings of his  shower-
 bath, and shouting, " Great is  Priessnitz of the hydropaths !" seeks
 to throw cold water upon all sects, systems and patients, applying it
 to his own indiscriminately.  A fourth class, respectable in  philo-
 sophical attainments  at least, if not  in numbers, in  their  dealings
 with human infirmities are beginning to recognize in all  cases, and
 among all sects, the operation of a psychological element as influ-
 encing  the  result, as well as  one purely physical or physiological,
 and contend most logically that neither of these  elements can be
 entirely ignored while man is recognized as a composite being.
   It must be admitted that there is  in all systems much good,  as
 well as some evil; in  this system perhaps  more evil of a positive,
 in the other of a negative character.   Were this not the case, medi-
 cal science would not be like most other things belonging  to the
earth; and, judging from the signs of the times, the medical, like the
 Christian millennium, though approaching  is yet some centuries in
 the future.
   In former papers we  have endeavored to  throw some light upon
the reciprocal influence of these two elements, the physical  and the 
3
psychological in  human nature, in  their intimate relation to the
treatment of disease, both  physical  and  mental,  (though by these
terms we would not be understood as speaking of  two distinct and
always separable entities;  we regard the connection as too intimate,
ever to admit of  complete  separation,) and to show that this influ-
ence  is  in  operation  in conditions  and under circumstances which
have not hitherto been sufficiently recognized and acknowledged;
and in further proof of this we shall here attempt to examine how far
the psychological element has contributed, and still continues almost
imperceptibly  to contribute to the success of so many conflicting
theories  and systems of medicine ; and not to those which we have
dignified with the names of theory or  system only, but to the many
forms and  phases of charlatanism, which, like parasites, have at-
tached themselves to what is now a great, noble, and must become
ultimately,  a perfect science.
   In the first place let us  consider that most specious, popular, fash-
ionable, and, for quite obvious reasons to the attentive observer, suc-
 cessful medical innovation known as homeopathy,  from a psychologi-
 cal point of view.
   This  most fanciful system maintains, as is well known, that all
 diseases are cured by the administration  of medicines which are ca-
 pable of inducing in the healthy system disordered actions analogous
 to those brought about by the disease.  With the theory, per se, we
 shall  not  quarrel.   It may, or may not be  quite as true  as other
 theories of  obscure and  imperfectly understood actions, for aught we
 know :  we therefore leave this an open question.  The means, how-
 ever, by which  the  theorists suppose they bring about the  action in
 question, we can not, even with the utmost stretch of credulity, rec-
 ognize.   Indeed, when they tell us  of the potency of the decillionth
 part of a  grain, of a substance like  charcoal, nearly if not quite
 inert, we are inclined to smile at the wonderful credulity of the hu-
 man mind, and  are only prevented from laughing outright  by the
 thought that this credulity is  in  itself a powerful curative agent of
 a character strictly psychological. 
4
   Looking merely at the physical agencies which this sect profess to
 employ, we are forced to exclaim, Ex nihilo nihil fit!  But when
 they point us to their results, and defy us to ignore them—to hun-
 dreds of most intelligent men and women, exclaiming,  " I was sick,
 and am well; great is homeopathy !" " I was dying, and am again
 made alive and whole; great is Hahnemann of the homeopaths !"
 we are forced, in the absence of all other  means, to recognize the
 psychological element, which has unconsciously, so far as the prac-
 titioner  and  patient are concerned, contributed to, if not been the
 sole means of the results made manifest—results which it is not the
 mission of true  science to ignore or despise, but to recognize, as far
 as they go, and to show <by what physical means these good results
 could have been made better, had not the sect unconsciously perhaps
 ignored them;  in the same way as the psychological  element has
 been too much disregarded by those who  have placed too much reli-
 ance on pure physical means, and these frequently of too much  po-
 tency, becoming not unfrequently, it is to be feared,  " like a sword
 in the hands of  a fool."

   As a psychological experiment  testing the power of mind, unaided
 by any other rational means (aside from the recuperative energies of
 nature) in removing physical infirmities, homeopathy can not but
 be regarded  as  most  eminently  successful.  Success, however,  is
 never an exact test of the entire truthfulness of any thing.  By fol-
 lowing an ingeniously devised and cunningly wrought illusion, such
 as frequently springs up in the dark and devious paths of an abstruse
 science, this sect has unconsciously stumbled upon the fragment of a
 great truth, which the credulity of human nature has enabled them
 to illustrate most amply.  Having  accomplished this they seem to
 have fulfilled their mission ; for, amply satisfied with the thought of
 having developed  the whole  truth, and originated a perfect system,
 they become henceforth useless in  the domain of scfence,  and must
 give place to those who are prepared to take other steps in advance.
  Homeopathy with its infinitesimals, hydropathy with its sitz-baths,
its douches, its wet sheets and frictions, having failed to confer com- 
5
plete earthly immortality upon  mankind, the vapor of water, medi-
cated or non-medicated, also having failed in this, we may reason-
ably anticipate shortly the introduction of a new system ; and we
would suggest to those who are  ambitious of an  immortality like
that of Hahnemann or Priessnitz, that pneumopathy be the designa-
tion of the coming innovation, before which undoubtedly for a time,
all other systems and theories, together with  all accumulated facts
and deductions—all in short which has been based upon the experi-
ence of past centuries, will vanish into  air,  into  " thin air,"  and
" like the baseless fabric of a dream, leave not a wreck behind."
   The statistical results of a new system of therapeutics based en-
tirely upon air, and its numerous modifications and compounds, may
not, after  all, be so contemptible.  Let us therefore look forward
with  confident hope  and happy expectation to  the coming innova-
tion, whatever it may be, and  with a lively faith that it will be in
the exact order of Providence,  and that  it will fulfill its destiny, in
strict accordance with, and conformity to, the spirit of the times in
which it will  appear, like those gone before.
   But before the advent of what we have anticipated, let us cast a
passing glance at another system which we already have, from a
psychological point of view, lest we be charged with unthankfuhiess
for allowing the old to pass away,  or in the rapid transmutation of
all earthly tilings, be crowded  from the scene, without our having
recognized the good and  useful, however small  the amount, which
will be left behind.   In hydropathy, the system  of Priessnitz, the
great " water witch" and medical necromancer of Silesia, the phys-
izzl means employed, though not as in the former a complete nulli-
ty, are yet, (when not abused, as they frequently are most undoubt-
edly, by this sect,)  not  sufficiently far removed  from it to interfere
with or greatly confuse the obvious operation of the psychological
element which has contributed largely towards bringing about its
success, and to whatever amount of good it has wrought.  The opera-
tion of causes of a purely psychological character, is  equally if not
mo^e obvious  in this system than in homeopathy, to which we have
already referred. 
6
  What the well-conducted, modern lunatic asylum is to trie insane
psychologically, the modern watering-place, or the yet more modern
" water cure" might and should be to the hypochondriac, the dys-
peptic, and the hysterical,—all those afflicted with some one of the
many phases of nervous or chronic disease, and  if the medical offi-
cers were always men  of science,  and never the financiers  as well
as the physicians of their establishments, but paid officials, men pla-
ced by official position and emolument above  the  necessity of be-
coming money-changers in the temple  of science ; if, in short, these
establishments were less tinctured with  professional charlatanism, and
like the former,  ready  to adopt everything which the experience of
past times, and the results of modern science have shown to be use-
ful, we see no reason why they should not be productive  of an equal
amount of good  to  the class  of patients with  which they  mostly
have to deal.
  But to hydropothy, as now understood and practiced, we may ap-
ply the language  of an admirable and unanswerable critique on
Homeopathy in the " Atlantic Monthly" for December, 1857, words
which, from their careless ease, truthfulness and elegance, it seems
to us  could only have  fallen  from the  inimitable " Autocrat" and
" Professor" in one of his happiest breakfast-table moods.
  " It pleases," says the critic, " the imagination, it  is image-wor-
ship, relic-wearing,  holy-water sprinkling, transferred from the  spir-
itual world to that of the body.  Poets accept it, sensitive and spir-
itual women become Sisters of Charity in its service ; yet we must
own that it may have been indirectly useful, as the older farce of the
weapon ointment was, in teaching medical practitioners to place more
reliance on nature.  Most scientific men see through its deceptions
at a glance.  It may be practiced by shrewd men  and by  honest
ones; rarely, it must  be feared,  by those who are both shrewd and
honest."
  But it  is unnecessary, and would occupy too much time and space,
to trace the operation  and influence  of the psychological element
through all grades  of charlatanism, from the refinements of home-
opathy, "that most epigrammatic* of paradoxes, that crowning ex- 
                               7

ploit of pseudo-scientific audacity," to use the words of the critic
already quoted, down to the mountebanks of the St. John Long and
Cagliostro school,  the Pain  Killers,  the  Ready Relievers, the pill,
sarsaparilla,  and plaster  makers ;  for the success of all these wor-
thies  depends, as we have ample proof and illustration, upon  the
most powerful psychological element in human nature, credulity.
   We all know that agues have  been cured  by the most opposite
and heterogeneous means.   Even the most ridiculous and disgusting
have often proved the most  successful, probably from giving greater
play to the operations of the psychological element.  Let us there-
fore take this as a type of the whole class of  operations.
   We should not  be discharging our obligations to medical psychol-
ogy, and to  science,  but taking a  one-sided  view of the question, if
we neglected to consider carefully in this connection  the manifold
relations of the former to the ordinary practice of medicine ;  to allo-
pathy,  as it  has been somewhat unhappily termed, in mere contra-
distinction to homeopathy.   In allopathy the psychological element
has had to contend not with a mere nullity, but with physical agents,
powerful for good or evil; agents, we must confess with sorrow, often
grossly misapplied, through ignorance and error of judgment on the
part of miserable pretenders to medical skill, with which this noble
science, now painfully emerging from the bogs and quagmires of su-
perstition and ignorance, false doctrine and authority, is infested.
   It is painful to make this humiliating acknowledgment, bnt truth
calls aloud  for it, and the interests of humanity seem to demand it
at our hand.  Let us therefore deal with all these morbid excrescences
which have  engrafted themselves-upon the body of our  noble  art,
like a faithful and conscientious surgeon, determined to know the
worst, and, if necessary, to apply the knife.
   When we look back over  the records of medical experience, and
consider what the human organization has been subjected to through
the prevailing theories and  ideas  of men respecting  the nature of
disease and the operation of remedies, we cannot fail to see that the
struggle has been in too many instances, between nature and her
most  salutary operations on  the one hand, and the allied powers of 
                                8

 disease, the physician, and the operation of his remedial means on
 the other.  And it is somewhat surprising, how, in the unequal con-
 test and against such fearful odds, the victory has been so frequently
 gained by the former, while the latter have uniformly, and most un-
 justly usurped  the laurels.  Whole  volumes might be  filled with
 illustrations of this melancholy truth, but such will readily suggest
 themselves to every candid and enlightened mind in the profession.
   But the dawn of a brighter and happier day is already perceived.
 The principles  of a sound  philosophy are being applied  to medical
 science in all its branches, and the  operations  of nature in disease,
 and the  systematic  phenomena observable, are, on the whole  rec-
 ognized, and calculated to lead to a favorable result, if closely watch-
 ed and duly modified by the  operation  of remedial means, both
 physical and psychological, now much better  understood  than in
 former times.
   We venture  to assert,  without the least desire to  disparage phys-
 ical means,  which,  notwithstanding their manifold abuses, we still
 hold in veneration, and  shall continue to while man has  a  physical
 organization  to which they are applicable, that the bringing about of
 this happy result, is, in no small degree, dependent upon a better un-
 derstanding,  not only of  the operations  of  nature in disease, but of
 that psychological  element the influence of which  we have been
 striving to illustrate, in so far as it  has contributed to the success of
 systems where the physical means have been either a complete nul-
 lity or bordering upon  it, and we shall  now attempt to illustrate its
 influence  in a system where the physical means have ever been the
 very antipodes of this.           ,
   No  physician of discernment and  experience can  have failed  to
 observe, with how much more ease and satisfaction to himself, he is
 enabled to conduct a case of disease to a satisfactory termination,
 when he possesses the free and complete confidence  of his  patient.
 In fact, so important is this to secure it should be the first object of
the intelligent  physician, an object, we had almost said, paramount
in importance to all others.
   With it almost all his remedies, unless applied most injudiciously, 
                                9

and with  great want  of skill  are sure to agree.  Without it what-
ever they may be, even the most inert substances, are sure to disa-
gree.   Every physician must have observed this, particularly, if from
untoward circumstances on his part, and ill  luck on the part of his
patient, he is under the necessity of treating one who has no confi-
dence  in  his system of practice.  Who would  not  sooner be  com-
pelled to treat a case, having this implicit confidence of the patient,
though deprived of every thing  else (except perhaps homeopathic
remedies, and cold water) than be without confidence, and backed by
the  most potent articles of the  materia medica ?   In attaching  so
much importance to this matter, let us not by any means be under-
stood  as  undervaluing  any physical means, which experience has
demonstrated to  be useful when properly applied.   We would  con-
tend strongly for the combined operation of both physical and psy-
chological means, for in the proper and judicious combination of the
two consists the strength of the truly great and eminent practitioner,
as the biography of all such men amply illustrated  The  very name
and personal  presence alone of such men as Pare, Baron  Larrey,
Abernethy, Astley Cooper, and Sir  Benj. Brodie, have been sufficient
to impart a curative impulse to  many a poor sufferer from the more
severe bodily diseases and  wounds.
   Mrs. Sigourney,  in her  lines on the death of Dr. Brigham, says
with great truth as well as beauty:         ,
            "The sufferer marked his hope-inspiring brow,
            Tlis warm solicitude, his truthful soul,
            And took new courage.  Well he knew to blend
            The friend with the physician;  and to win
             The confidence of those he toiled to save;
            Poising the weapons that his science gave
            With wariest skill, as one who feared their power
            And fain would aid weak nature to avoid
            Nor tempt their discipline."
   The above  lines point  out briefly all that belongs to legitimate
success in the  noble  art of medicine, and  it is evident  to  aU who
knew this eminent man, that the amiable and truthful poetess drew
the sketch from a  close observation of his manner of dealing with
his patients. 
10
  In the first place the confidence of the patient is to be secured  by
kindness, truthfulness,  and  a genuine  humanity, prompting that
"warm solicitude" for his welfare  here  pointed out, and not  by
knowing looks, and pompous words of doubtful meaning, which may
catch the ears of fools, but to sensible men and women are evidence
of the emptiness of his head and heart.
  This confidence  once  legitimately secured, and the battle is half
won, for the force of the psychological element we have insisted up-
on, is brought into active cooperation with other means.  The battle
as we  have said is half won, but only half won,  for this confidence
once secured, is not to. be  abused by infinitesimal  jugglery, ww-holy-
water-sprinkling, or any description of pseudo-scientific humbug and
quackery, in the use of physical means, but by carefully estimating
and applying such as an enlightened  experience,  and true scientific
research have given, by those who know well their power for good
or  evil,  and are  capable of applying them in a  manner becoming
reasonable beingsf
   The genuine physician should be a man endowed by nature with
peculiar gifts of disposition and mind; one who has some understand-
ing, not only of himself but of that world of mind and matter, with
which he is in contact, and of which he forms  a part;  a man who
should combine  large scientific attainments, with broad and liberal
views; one unswayed by  prejudice, and untrammeled by authority;
fit  to  estimate all systems, by whatever name they may be called,
by  their true value,  and by the amount of good  they contain, and
capable of applying  the principles of a sound philosophy and vigor-
ous logic to all;  separating  the good  and true from that which is
modern, and combining it with the good  and true of that winch is
ancient and time-honored,  retaining nothing which is bad, and reject-
ing nothing which is good, from whatever  source it may emanate.
   The sacred maxim, " Prove  all things — hold  fast to that which
is  good " is equally applicable to the  physician and the theologian,
and,  though a hard doctrine, it is one which  lays at  the founda-
tion—is a  " chief corner-stone " — of the temple of truth: yet, as
we have said, so hard to  follow, it is greatly to be feared that from 
                               11
                                                             •
indolence, carelessness, or mental obtuseness, men in all callings are
more apt to prove nothing, but hold fast to that which is bad, hav-
ing it on the " authority of the fathers."   But those who have ob-
served carefully the signs of the times cannot fail  to have been im-
pressed with the strong tendency of the  human mind in this age to
question.closely all authority which has the least semblance of be-
ing doubtful.
   Truths,  to  be accepted  as such, must be absolute and unmixed,
without even the shadow of doubt.
   The  times when, without questioning, one  man was ready to be-
lieve implicitly another man's imagination, in order to save either
body or soul from destruction, are rapidly passing  away, and what
is imaginary and what is real, what is genuine and what  is false,
are questions which every man who thinks at  all is beginning to ask
of himself and not of his neighbors, and to seek a solution within the
deepest recesses of his own spiritual and material nature.  Men are
now beginning to see that it is far worse to believe a lie than to be
denounced as  heretics or infidels in theology,  or quacks and charla-
tans in medicine, for refusing to give their assent to a dogma.
   Fearful men, and men of narrow views look on from a distance,
trembling and quaking when some intellectual giant lays his strong
grasp upon the pillars which support some towering  structure of er-
ror, and causes  it to tremble to  its foundations, lest the beautiful
temple of truth should also fall, and be crushed and. buried among
the ruins: but such fears are groundless, for
               "Truth crushed to earth will rise again;
               The eternal years of God are hers."
    The light  of truth cannot be permanently concealed.  It may
 perhaps be eclipsed for a time,  but it will shine forth anew with in-
 creased brightness.  That which is true cannot be overturned, for ifs
 foundations are laid deep upon the " Rock of Ages." Let  therefore
 system succeed  system, and innovation follow innovation  in  rapid
 succession, that and that only which is true will remain behind to
 confer upon mankind  its benefits and  its blessings; and that in all
 systems which have been, or may yet spring up, which is untrue and 
                               12

• hurtful, will be swept away in the onward march  of things,  and
 come to be remembered only by the evil it has wrought.
   One thing, however, is evident to all who have looked carefully
 into the  present tendency of every thing relating to our art.  It is
 this : whenever  in coming time medicine shall assume, or even ap-
 proximate  anything like a perfect scientific system, that system, by
 whatever name it may be called,  will be one based upon a more
 thorough comprehension of the  entire corporo-spiritual nature of
 man, than  any that has preceded it, for we are  fully persuaded of
 the  profound meaning, and far  seeing and  truthful insight of the
 words of Damerow placed at the head of this  paper, that — " The
future elevation of medical science  in all its branches, will  be most
intimately connected with  the advancement of  psychological knowl-
 edge.