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observed;' and it was wisely said-for there he will have a history of the effects of ignorance and weakness, as well as of the art and ambition of human nature; and if a review of them does not make him a more charitable and wiser man, he must have a weak and highly prejudiced mind, or has it contracted and blinded by interested motives. An equally important lesson may be learned from the history of medicine; for there the physician will see the folly, credulity, and impositions which have been connected with the healing art; how the opinions and practice of its professors have fluctuated; and the conflicting testimonies of men all equally honest and zealous to promote the advance of medicine, and all equally positive as regards the effects of opposite modes of treatment in diseases. One would naturally conclude that the review of such a history would excite in the mind of a reflecting man a spirit of caution and modest doubt, in all cases where he had not the guide of uncontroverted facts and sound experience to justify confidence, decision, and assurance. There is nothing in the history of medicine, either in ancient or modern times, calculated to excite more surprise than the absurd statements connected with homoeopathy and the astonishing credulity of the advocates of it. But if, as you conclude, and I believe justly, there are really honest men who sincerely believe in the whole of homeopathy, what a lesson should it teach us of humility and charity, that honest minds in the search of truth should embrace such follies!

"The practical importance of the statements made by the homoeopathists is, that they furnish some aid in solving the interesting questions-how far the use of drugs and other active agents have tended to promote the cure of diseases? and how far, and in what respects, the present practice of medicine is preferable to that of Hippocrates, who chiefly relied on regimen and what is called the expectant treatment? Every medical practitioner, who is a friend to truth, and who wishes that medicine should be based upon rational principles, will court for its practice the strictest investigation and scrutiny, and rejoice to see it cleared of everything which is injurious or useless, that ignorance, prejudice, or credulity have introduced into it. It will be only persons to whom the words of Bacon are applicable who will fear the light of truth: Doth any man doubt that if there were taken out of men's minds vain opinions, flattering hopes, false valuations, imaginations as one would, and the like, but it would leave the minds of a number of men poor shrunken things, and unpleasing to themselves.'

"Nothing can be more injurious to the true interest of medicine than holding out false hopes in attributing too much to its powers. The power we possess in what are termed surgical cases is very different from that which we have over internal diseases; the changes which take place in our internal organs in disease are often of a mysterious nature, and out of our power to discover or control; and it is happily ordered that, in most cases, much more depends on the powers of Nature than the knowledge and skill of man, or else, woe unto the poor and helpless, and those who depend upon the judgment of the unskilful practitioner. But when the Healing Art has been stripped of all its unjust pretensions, much will be left to prove its importance. No one will deny the great improvements which, in modern times, have taken place in the treatment of cases which belong to surgery, and the immense benefit which surgery has conferred on mankind. It is equally certain that there have been great additions to our knowledge in regard to the remote and exciting causes, as well as the nature and treatment of internal diseases. If medical treatment only saved one life in a hundred, medicine would be a science of vital importance; and the man who does this surely should be as much valued as the pilot who, in conducting ships through a dangerous passage, preserved one in a

hundred from destruction.

"There is no doubt that many practitioners of medicine have presumed too much on its efficacy, and, by an officious interference with Nature, instead of

affording relief and benefit, have often been the cause of torment and injury, and thereby lowered the just estimation of the profession of medicine. There is as much truth as wit in Molière's description of the orthodox physician in his time: C'est un homme tout médecin depuis la tête jusqu'aux pieds; un homme qui croit à ses règles plus qu'à les démonstrations des mathématiques, et qui croirait du crime à les vouloir examiner; qui ne voit rien d'obscur dans la médecine, rien de douteux, rien de difficile; et qui, avec une impètuosité de prévention, une roideur de confiance, une brutalité de sens commun et de raison, donne au travers des purgations et des saignées, et ne balance aucune chose.' It will be allowed that the character of physicians has improved since the days of Molière, but if a little more modest doubt,' which has been called the beacon of the wise, had influenced their opinions and practice, the stability and dignity of medicine had not been left so much at the mercy of homœopathists and other theorists.

"One great cause of the present imperfect state of medicine is the ignorance of the public as regards the important principles which ought to guide the medical practitioner: they are pleased with what appeals to their senses rather than to their reason. The opus operosum of medicine has, in every age, been more captivating to all classes, than the recommendation of simple means which reason and experience may dictate as best adapted to their case. When Elisha told Naaman the leper to wash in the Jordan for the cure of his disease, he was wroth at the simplicity of the remedy, and went away and said, 'Behold! I thought he would surely come out to me and stand and call upon the name of the Lord his God, and strike his hand over the place and recover the leper,' and such unfortunately is the state at present of the public mind, that, in the majority of cases, a medical man cannot do justice to himself or give satisfaction to his patients, if he does not practise a little of the 'Art and Mystery' of Medicine.....

"Much has been said and written about medical reform, but in my opinion none is so desirable or would contribute so much to the welfare of the medical profession, as an elevation of the mental character of its members: this, I think, would be the best, if not the only remedy for the present defects and follies connected with the practice of medicine. There should be required from all those who enter the medical profession, a knowledge of authors whose works tend to develop the reasoning powers-such as those of Bacon, Locke, Paley, &c., as well as a knowledge of the history of medicine, and of subjects immediately connected with the preservation of health-public and private hygiene, in addition to those on which candidates are now accustomed to be examined. The first examination, (that qualifying for practice), might be of such a kind as any one of average talents, with common industry, may undergo with facility. Every one might follow that branch of practice which his talents, his taste, or circumstances may dispose him to cultivate; but surely no one will deny that a knowledge of surgical subjects is highly desirable, if not necessary, to the 'pure physician.' Professor Alison, of Edinburgh, says, that many physicians of high eminence, both those employed in consulting practice as well as those attached to hospitals, have few opportunities of witnessing the effects of bleeding in the early stages of violent inflammatory diseases (Pract. of Med. p. 221), and this observation is equally applicable to other important diseases. When a medical practitioner has had opportunities to acquire experience, and seen what may be called the active service of medicine, he would in the course of years, say ten, have some claim to the title of doctor, which he should acquire by undergoing a more extensive examination on all those subjects he had been previously required to have some knowledge of as a licentiate; and he might take his degree either as doctor of medicine, or of surgery, or both. If a competent knowledge of philosophical subjects, including mental and moral philosophy, was required of every one who took rank higher than a

licentiate in medicine and surgery, it would give a motive for and a stimulus to the study of subjects the knowledge of which necessarily tends to elevate the character and accomplish what Hippocrates says ought to be done, to bring medicine to wisdom and wisdom to medicine, so that the physician should be a divine philosopher.' (De Decent. Habit.) Such a reform in my opinion would remove what are now thought to be unjust privileges and invidious distinctions, and tend to place the practice of medicine on the basis of sound experience and philosophy."

(H)

Hospital, 3d March, 1846.

"The general error into which English practitioners are falling is the empirical use of powerful remedies, with a strong disinclination to be quiet, even when the diagnosis is obscure. The general scope of your paper I take to be to combat this mistake, and I hope that it will be the means of bringing about an improvement in our practice. The table (Fleischmann's) you have given is curious, and could it be implicitly relied on, would prove to me at least that we had better, in some diseases, give up prescribing altogether. Thus we have 188 cases of rheumatism, all of which are cured; and even of articular inflammations, 203 are cured out of 211. Now we have no success at all approaching to this at our hospital. I treat about 100 cases of these diseases annually; but I should be ashamed to place the results in a tabular form by the side of the homoeopathist's table.

"In regard to pneumonia, used as a general term, the results of our hospital practice would differ little from the table, or even appear more favorable. I studied under a physician of the old school, who was fully impressed with the virtues of Seneka in cases of inflammation of the respiratory organs, and seldom prescribed venesection; yet he was as successful as his neighbours. But I have so often witnessed the sudden extinction, as it were, of incipient pleuritis, or pneumonitis, by a timely bleeding, that I should consider myself culpable in neglecting such a remedy. The fatal cases of pneumonitis are those in which the disease has been silently going on for a week or more, without pain or much uneasiness, and the patient has been living in his accustomed manner, and perhaps taking more strong drink than usual to relieve the languor which he feels. We receive five or six such cases annually, mostly men who are living with their families, and are not seen daily by a medical officer. They are sent to us either as cases of typhus, or of pneumonia, with typhoid fever; but, in fact, they are cases of hepatized lung, proceeding to the gray or suppurating stage, and the great debility, which generally comes on suddenly, is caused by the want of oxygenization of the blood. They do not bear bleeding at the arm at all; and the blood drawn has a dark venous colour. This form of the disease is, I believe, more frequent with spirit drinkers.

"Again, of dysentery, all are cured in the homeopathic table, except two that died. Now, I have very many cases of dysentery from the coasts of Syria and China, and experience leads me to believe that permanent recovery is an exception to the general rule in cases sufficiently severe to require hospital treatment, after two or three months' duration. The cases discharged from the hospital are merely relieved, for the complaint recurs again and again, or alternates with irregular remittent; yet, judging from the result of dissections, there is no ulceration in the intestinal canal in the majority of fatal cases.

"Pericarditis, too, is set down as cured, in the only two cases mentioned in the table. It is a frequent disease with us, as might be expected, since

rheumatism is our most common acute disease. Now, unless it can be speedily cut short, we find that the functions of the heart are permanently injured, and life shortened. A considerable number of men are invalided annually for this cause, and many of them return to the hospital in a year or two with the usual dropsical symptoms that attend dilatation of the ventricles of the heart in its advanced stage. In regard to continued fever, perhaps the homoeopathic treatment is equal to any. When the skin is kept cool, thirst allayed, the bowels cleared out, and air freely admitted, the vis medicatrix must do the

rest.......

"I trust that your paper will have a beneficial effect, by causing medical men to weigh the facts well before they come to a decision as to the effects of the medicines prescribed. I firmly believe that the cure is much oftener retarded by the medicines administered than it would be safe to say in these times of advanced medical knowledge, and the mischief would be still greater were it not that much of the stuff sent to the patient is not swallowed by him. Could the public mind be so far influenced that a post-mortem inspection of the body took place in every case of death, by experienced anatomists, the foundation of rational medicine would be laid. The opportunities we have of testing our diagnosis in hospitals, though not so good as they might be made under better arrangements, are of much service to the individual practitioners in charge, and might be made of more general use by a system of reporting."

(1)

February 18th, 1846.

"During above thirty years of extensive practice, consequent upon eight or nine years of studentship, I have really attended as unremittingly as most men to my profession; and am arrived at the period when I feel no hesitation in stating, that the best part of medical science consists in observing symptoms, so as to form a correct diagnosis, and in ascertaining the restorative powers of the system, so as to aid without interrupting them. I have long taken leave of the worrying excessive method of treatment, by which the juvenile practitioner expects to knock down every disease, as systematically and surely as the soldier the enemy's stronghold in a bombardment. I suppose most men, as they go on in years and experience, leave off the over-active dosings and depletions in all ordinary medical cases, and find themselves proportionately rewarded with success. I feel convinced that, in my own circle, I have witnessed patients evading successfully from a protracted and dangerous disease, owing to forbearance in the treatment of its early stages, who would, under an opposite plan, have shown no powers of recovery, or have sunk under diseases induced by the treatment.

"In proportion as a physician respects the natural vis medicatrix, does he attend to diet, exercise, fresh air, cheerful impressions, &c. which are admitted to be beneficial under all the theories and vagaries of practice. I have been so impressed with the effect of the mind upon a great proportion of the ordinary ailments claiming our attention, as to be led to remark, that the practitioner of great renown often gives a fillip to recovery by the confidence he inspires, and which the familiar and daily medical attendant has no chance of inspiring. You will readily conceive, my dear sir, that, embued with these sentiments, I can readily appreciate your explanation of the only merit and efficacy of homoeopathy-the most nonsensical and wild doctrine that ever took possession of the human mind, not excepting the darkest period of our history-and when the practice is successful, this can only be attributed to the natural vis medicatrix having fair play in the absence of treatment by medicines, or to the favorable influence of the mind under the confidence

inspired in the patient, or to both these, aided however by rules of diet, exercise, &c., which the homoeopathists, I believe, pay sufficient attention to. "I trust that your prediction, as to the homeopathic practice causing the restorative powers of the living system to be better understood and more respected, will be realized, and shall be glad to find that your pen continues to be exercised towards the fulfilment of so desirable an object. I am sure we want something to help us, and to right us, in this respect for excessive bleedings, continual raking of the bowels by purges, and indiscriminate mercurialization of the system, cause more diseases than they cure. Injurious as these measures prove, unless temperately and very carefully applied, they are nevertheless regarded by those fresh from the schools as the great and chief resources against the most frequent diseases. I involve my own past errors and early notions in making this statement; and am free to confess that what I now know, in regard to the proper and successful treatment of many chronic diseases, and particularly such as require a tonic plan of diet or medicine, I have found out by experience, and was ignorant of them at first starting in practice."

(K)

(Scotland) 18th Jan., 1846.

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"I have not ventured to bore you with my opinion of your Young Physic' article, because abundance of more valuable opinions would be poured in upon you for some weeks. Now, when probably the inundation of letters is diminished, or diminishing, allow me to say that I think it a right bold, and right good essay. On this side of the Tweed we all belong much more to the school of Young Physic' than our Southern neighbours, with all their gigantic drug-loving, drug-giving, and drug-swallowing propensities. Still, however, the article will be of great use even in old Scotland. Some here are in great wrath at it. Never mind. Fiat justitia, &c.

"Pardon me if I say I think you would have made the article as useful as it will be, and less offensive to the 'some,' if you had done two things—first, not contrasted Homoeopathy and Allopathy, but merely adduced homœopathic results to show (as they do) medicines of no use in many recoveries; and, second, I think you should have brought out more forcibly the fact that we have Some POSITIVE agents in allopathy-that opium does and can act as an anodyne, antimony can sweat, ipecacuanha vomit, jalap purge, &c. &c. What we want is more precision as to when and where we should purge, vomit, sweat, &c., or where we should not."

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Feb. 7, 1846.

(L) I do not imagine that my opinion will be of any consequence to a veteran writer like you, but I hope I may be excused for indulging myself in the pleasure I feel in expressing to you the great satisfaction with which I have read the article in question. It is long since I read anything embracing so many opinions on different subjects, to which I could give so hearty and unreserved an assent. It is a bold, a well-timed, and a classical exposition of most momentous truths; and, if it be appreciated, it may lead to most important results. I wish the spirit which dictated that article could be deeply impressed on the mind of every medical man in existence. Many of the opinions you have expressed I have often inculcated in my daily public duties; and I have so earnestly longed to see them more widely disseminated that, if my pen had been as ready as yours appears to be, or my engagements less pressing, I might have robbed you of the honour you have nobly achieved in thus giving them to the world.

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