CLINICAL FACTS, &c. CHAPTER I. GENERAL REMARKS- CASES OF PERITONITIS POST-MORTEM APPEARANCES. THE march of science in medical philosophy must follow the laws of the inductive process, and ascend from individual instances to general propositions. In the application of the proposition to general practice, the direction of thought is reversed. But we should err if we limited the science of medicine by this description of it for pari passu with the proceeding there noticed, and subsidiary to the application of the principles so acquired, another highly scientific operation is required. Indeed, the march of science towards the formation and application of general principles will be practically fruitless, if the above mentioned procedure be deemed all sufficient; if an inquiry be not at the same time vigorously conducted as to the shades of difference which separate from each other cases of the B same kind. In the first point of view in which I have placed this subject, we deal with facts in relation to their common points; but in this second point of view we have to deal with them in relation to their discrepancies. The first operation is statistical in its nature, and would lead to an undiscriminating practice. The latter operation unties the facts thus accumulated, and subjects them to an ordeal which is requisite to their exact use. I make the above remarks, in order to obtain its just place and importance for an enumeration of cases, either single or in groups. Thus individualised, they possess perhaps a less philosophical air than in their cumulative state. But their utility is obvious. Indeed, the practical character of the English mind has largely enriched our medical literature with cases contemplated in this point of view. We abound in valuable monographs. I am desirous of adding to their quantity, whatever may be the quality of my contributions. But in reference to the publication of cases, there is another consideration, to which I would gladly call attention; and I shall not have altogether failed, if I shall stimulate other members of the profession to take it up themselves. If a discovery be made by a physician in pathology or therapeutics, he records it by publication. If he has lectured ably on these subjects, he publishes his course of lectures. In the first case, the practice laid down will be particular, but it will relate only to the immediate department of medicine in which the discovery is made; in the latter case the practice will be studiously |