The Philosophy of Medical Science. Considered with special reference to Dr. Elisha Bartlett's "Essay on the Philosophy of Medical Science" (pp.69-74; 89-95; 115-121).

Boston Med. Surg. J., 48/ 4-6. - Boston, David Clapp, Wednesday, February 23, March 2 and 9, 1853, 8°, pp.69-128, fine wrappers. First Edition! "In 1853, Edwin Leigh wrote a Boylston Prize winning essay entitled "The Philosophy of Medical Science" and subtitled it with "special reference" to Bartlett's Essay. Leigh's essay is probably the most philosophically sophisticated of the critiques of Bartlett's own day. Leigh insightfully remarks that even the most earnest empiricists who will not admit to any "philosophy in science" will insist upon "their peculiar philosophy of science". No one can study science or medicine without some philosophy. Articulating this philosophy is, of course, just what Bartlett was doing. Leigh admires what Bartlett is trying to do, but doubts whether his philosophy is the correct one. Science cannot be only "observed facts." Leigh argues that Bartlett's philosophy is not based upon observation; hence, it amounts only to the sort of speculation that he is trying to be rid of. There must be some fundamental principles that allow the observation of phenomena in the first place. Leigh further criticizes Bartlett for arguing that because some facts cannot be proved from other facts, therefore no facts can be proved from other facts. This is clearly fallacious reasoning. Leigh admits that all particular facts ought to be confirmed by observation. But this does not mean that there are never sufficient reasons for arguing from one class of facts to another. For example, by our knowledge of anatomy of the urinary system, we know that the kidney must secrete urine. Yet the kidney actually secreting urine had not at that time been observed. Hence, the fact must have been established through reasoning. Therapeutics depends largely upon reasoning from cause to effect. Reasoning by exclusion results in facts, but these are not observed facts. Laws of uniformity and laws of causation, to which Bartlett refers on pages 79 and 87 of his Essay, are not arrived at by observation. The great vice of Bartlett's theory, according to Leigh, is that it excludes from science all its "ideas, thought, truths and principles, leaving nothing but an array of lifeless material facts". Leigh plausibly argues that "a law is a general truth proved by the facts, and not a general phenomenon observed in the facts." It is not, as Bartlett (148, 175, 220) says, the phenomena and the relationships themselves. General truths, for Leigh, are deduced from particular facts. For example, "vertebrae" is a general concept arising from the observation of many like bones. This seems to be just what Bartlett has in mind when he talks about arranging and classifying. Yet Leigh argues that laws comprise another ontological level and are not simply the phenomena themselves, arranged and classified. Leigh admits that we must rid ourselves of as many previously-formed opinions as possible so that we can be impartial observers free of scientific prejudice. But it is impossible to observe the phenomena of nature with no ideas about what we might expect to find. The human mind just cannot do this. Leigh thus nods to Kant's categories. Bartlett alludes to the imperfection of science. But are such imperfections removed by eliminating hypothesis and reasoning from medical science? According to Leigh, most error comes not from faulty reasoning, but from imperfect observation. The only remedy for this is "sound judgment and clear discrimination in the observer". Science should drive away "ridiculous theories, absurd hypotheses, and false doctrines" but Bartlett has also driven away "rational hypotheses" which are like partial truths from which we discover the complete truth. " William E. Stempsey (Ed.): Elisha Bartlett's Philosophy of Medicine (2005), pp.23-24.…