An Address ON THE TREATMENT OF DISEASE: Being the Address in Medicine before the Ontario Medical Association, Toronto, June 3rd, 1909
Authors: W. Osler
Journal: BMJ (1909)

As true to-day as when Celsus made the remark, "The dominant view of the nature of disease controls its treatment."As is our pathology so is our practice; what the pathologist thinks to-day the physician does to-morrow.Roughly grouped there have been three great conceptions of the nature of disease.For long centuries it was believed to be the direct outcome of sin, flagellum Dei pro peccati8 mundi, to use Cotton Mather's phrase, and the treatment was simple-a readjustment in some way of man's relation with the invisible powers, malign or benign, which had inflicted the scourge.From the thrall of this " sin and sickness " view man has escaped so far as longer, at least in Anglo-Saxon communities, to have proper saint for each infirmity.Against this strong bias towards the supernatural even the wisdom of Solomon could not prevail; was not the great book of his writings which contained medicine for aJl manner of diseases and lay open for the people to read as they came into the temple removed by Hezekiah lest out of confidence in remedies they should neglect their duty in calling and relying upon God And the modern book of reason, which lies open to all, is read only a few in the more civilized countries.The vast majority are happy in the childlike faith of childhood of the world.I am told that annually more people seek help at the shrine of Ste.Anne de Beaupre, in the Province of Quebec, than at all the hospitals of the Dominion of Canada.How touching Rome to see the simple trust of the poor in some popular Madonna, such as the Madonna del Parto!It lends a glow to the cold and repellent formalism of the churches.all matters relating to disease credulity remains a permanent fact, uninfluenced by civilization or education.From Hippocrates to Hunter the treatment of disease was one long traffic in hypotheses; variants at different periods of the doctrine of the four humours, as dominated by some strongmind in active revolt it would undergo temporary alteration.The peccant humours were removed by purging, bleeding, or sweating, and until the early years of the nineteenth century there was very little change the details.To a very definite but entirely erroneous pathology was added a treatment most rational in every respect, had the pathology been correct !The practice the early part of the last century differed very little from that which prevailed in the days of Sydenham, except, perhaps, that our grandfathers were, if possible, more ardent believers in the lancet.In the past fifty years-in the memory, indeed, of some present-our conception of the nature of disease has been revolutionized, and with a recognition that its ultimate processes, whether produced by external agents or resultof-modifications in the normal metabolism, are chemico-phyaical, we hhave: reached a standpoint from which to approach the problems of prevention and cure in a rational way.Let me indicate briefly the directions in which the new science has transformed the old art. the first place, the discovery of the cause of many of the great scourges has changed not only its whole aspect, but, indeed, we may say, the very outlook of humanity.lon'ger is our highest aim to cure, but to prevent disease;