Science Versus Empiricism

Abstract

During the first 12 months of anaesthesia, two key advocates emerged and remained as figureheads of British practice throughout the nineteenth century. London practitioner John Snow and Edinburgh physician James Simpson were unanimous that pain-relief was justified in all cases of surgery and childbirth; they agreed that the patient should have a voice in the matter, and were equally condemning of those doctors who refused patients painless surgery for fear of the risks (Figure 3.1). But they diverged hugely when it came to the method of administration: Snow designed and employed inhalers, Simpson promoted the use of a sponge or handkerchief. Given their shared commitment to anaesthesia, this difference might seem insignificant. Certainly at the time, William Fergusson, Snow’s lead surgeon at King’s College hospital, dismissed the difference of methods as irrelevant.¹ Yet, when the reasoning behind each man’s method is teased out, the divergence reveals far more than a simple practice distinction. Rather, it reveals how the new view of the body, as a universal system of tissues and organs, had reconfigured not just the knowledge and practice of medicine but the very identity of doctors. The sticking point between Snow and Simpson was science, not just in its broad meaning, which both affirmed as an irreplaceable source of new knowledge and understanding, but in the very specific way in which its bodies of knowledge — chemistry and physiology for instance — should feed into and shape medical practice.²