nature versus art

The resultant debate of “nature versus art” (“art” denoting the doctor’s
pharmaceutical armamentarium) was a hotly contested issue among America’s
regular physicians from the 1830s into the 1860s. But the fact that Oliver
Wendell Holmes, the profession’s most articulate spokesman for therapeutic
humility, described “nature-trusting” as a “heresy” indicates that the majority
of doctors denied nature’s power to heal unassisted, and stayed on the side of
active intervention. Some of the orthodox actually denied there was any such
thing as the vis medicatrix naturae. (“Obscure and incomprehensible,” one
doctor called it; “only an inference—a theory,” stated another.) Most acknowledged
that when the body was attacked by disease it did make efforts
to reverse the injury and reclaim health but believed that generally the aid of
the physician was required nonetheless. To have concluded otherwise would
have been a form of professional suicide, an admission that the doctor was
redundant. Even Holmes and other nature-trusters hardly abandoned drugs
altogether. They simply called for a more moderate and discriminating use of
those that seemed to have some clinical evidence in their favor, rationalizing
their use as agents that removed obstacles to nature’s reparative activity.
Judged that way, even calomel could be identified as a friend of nature; used
judiciously, the purgative eliminated constipation, which might otherwise cause
discomfort, weakness, and sleeplessness.