often very important that these patients be amused with the appearance of something being done,- though here again the more bulky vehicles of nothing may do as well, for aught I can see, as the infinitesimals. 3rdly. For those who have, indeed, something the matter with them, but whose symptoms are so obscure that a wise doctor is afraid to do anything lest he do mischief; while yet (the general case) the patient insists that something shall be done. Now here the globulets (if I may venture on the double diminutive) are admirable, I admit ; though, again, the more corpulent pill of bread may be just as efficacious.

I am afraid you will consider these large concessions of the utility of your doses rather an insult than a compliment; but if so, you will please to recollect that it is extended with much im.. partiality to the opposite practice. In good earnest, as long as men are so credulous in their reliance on medicine, as to insist that when the doctor knows that nothing need be done or can be done, or knows not what is to be done, he yet shall do something, I see no help for it. If it be gravely argued that it is unworthy of a physician to administer a system of delusion, and that he had better leave his patient uncured than cheat him into health, it is a pleasant question of casuistry which the doctor may, if he will, discuss in a clinical lecture, and see what his patient says to it. If the system be one of deception, I fear, nevertheless, that the physician must, to some extent, practise it or -starve.

But,-pardon me for saying so,- excepting the above cases, that is, when disease and its indications do not summon to prompt and decisive treatment, I, for one, had rather not trust to the globules.

Yours truly,

R. E. H. G.

τα

My dear Friend,

LETTER LXXI.

It is in vain that

To the Same.

you reiterate that you have " seen the good effects" of your darling globules-that you have seen your children recover under their use. I have already told you I have no difficulty in believing any "facts," merely on account of their "mystery;" and that if, on a fair induction, more patients were discovered to be cured by your system than by any other, I should believe in it, were it (if that be possible) ten times as mysterious. But a single case or two, or indeed any man's private experience, is not worth a rush in the controversy either way: and for this simple reason that every system of medicine might be proved equally efficacious on the same ground, inasmuch as it is the general rule that the sick get well, whether you do anything or not. Now, if I found, as I often should, that of three cases of (say) measles, all recovered, though one was treated allopathically, and one homœopathically, and one not treated at all—(mind, I say not that it is of little consequence which system, or whether any, be adopted, for Nature may be wisely aided even when she is quite competent to the case)-what right should I have to assign the cure, in the one case, to the infallible globule? You will say,-" "As much as the allopathist to assign his cure to the more bulky drugs." I answer, just as much,- that is, none at all; for the third cure, it seems, is to be attributed to—nothing!: In fact, such individual instances are of no value; nor anything less than the wide and patient inductions I mentioned in the

outset.

A very common fallacy is that of "Non causa pro causâ,” and especially in medicine, where a plurality of causes or apparent causes may perpetually mislead. To the generality of men, it is enough if a certain antecedent has preceded a certain consequent, to satisfy them that there is the relation of cause and effect.

Hence numberless fantastical remedies which different ages and nations have prescribed as useful in disease, merely because their employment has happened to be nearly coincident with the cure, though they have no more caused it than the cock's crowing causes the sun to rise. This credulous association of a mere antecedent of the cure with the cause of it (which is all but universal with patients), is, it must be allowed, too much encouraged by doctors of all kinds. Nothing is more common, in reports of cases, than to find an improvement attributed undoubtingly to the administration of such a medicine, when the difficulty really is to establish the connection. If a patient gets worse after the medicine, I never find this sequence insisted on; though, for anything that we know, it might be just as reasonably. "Ah!" says a patient, "it was a good thing I called in the doctor; he cured me." If he is cured without any doctor at all, he thinks nothing of it! If a patient recovers, it is always the doctor that cures ; if he dies, ought it not often to be the doctor that kills? But it is then always-Nature. When the patient recovers, the doctor gets rid of the disease in spite of Nature; when the patient dies, Nature gets rid of the patient in spite of the doctor! How do we know how often the statement ought to be reversed; how often Nature saved the patient in spite of the doctor, and how often the doctor killed the patient in spite of Nature?

You will say, perhaps, that I speak like one who is "sceptical" as to the use of medicine altogether; you will infer falsely then. I do indeed believe that attacks of ordinary disease would, in the immense majority of cases, be cured, though every physician in the world were poisoned; and that the great agent of cure is the "vis medicatrix” with which God himself has fenced the human organism, and by which it stoutly resists every incursion of disease. But I believe there is a noble sphere for the physician too; though I frankly confess my fear, that from the extreme difficulty of a really comprehensive induction,-of establishing the true connection of "antecedents" and " consequents," and from the infinitely variable, evanescent phenomena the science has to deal with,-it will yet be many ages before it attains

much certainty, and will always be, to a great extent, a science of guessing. Nevertheless, even now the wise physician has plenty to do, especially if he will not promise or attempt too much; if he will but be content to be the cautious "naturæ minister,” and stand by with the hope of aiding those processes within us, so many of which transcend all his art, and which, if he be rash, he may much more easily hinder than help; if, in a word, he takes that view of his position to which "old experience does attain,” and which, in the language of Dr. Forbes, will lead him to acquiesce "in a mild tentative or expectant mode of practice;"certain to appear wise "in old age, whatever may have been the vigorous or heroic doings of youth."

Surely we must allow that even if the physician only alleviates pain, and abridges processes which might otherwise be tedious, he is well worth all his fees. Nor less if he takes charge of us in health, and, studying its general physiological conditions, endeavours to keep us well. In truth, paradox as it may seem, it is when we are in health that we ought chiefly to look to the physician, and to avail ourselves of his skill. We should hear what he says (usually wise enough) about how we are to keep out of his hands; about regimen, diet, hours, occupation, and so forth: and the next best thing is to consult him, not when we are, but when we are going to be ill; when we are "getting out of health,” as the phrase is. Then he has a chance of doing much more for us than in actual disease, and can often ward sickness off or break its force. We are told that the Chinese Emperor's plan is to pay his physician while he is in health, and stop his pay when sick: the plan is ingenious, but can hardly be safe; for if, as the Celestials allege, it will stimulate the doctor's diligence, it is equally probable that should his Emperorship be labouring under a chronic or incurable disease, which might keep the doctor starving for a twelvemonth, it might stimulate his industry a little too much, and usher in the reign of a younger and a more healthy monarch! Nevertheless, it is quite true that while the physician keeps us in health he best deserves his fees, and if we knew our own interest, we should then most willingly pay them.

In sickness, as I surmise, his art becomes darker and its success more dubious; his study of physiology is calculated to do more for us than all his study of pathology.

I have, you see, kept to my word, and said little or nothing of your system, except in relation to that point in which you have, to speak honestly, rather bored me,- the infinitesimal globules.

As to the "universal principle" of homœopathy, I leave it to professional people to fight it out, though I must say, for one, that the assertion of some one "universal principle,” on which all diseases are to be cured (like "Similia similibus curantur "), has a mighty occult quackish sound, and looks much more worthy of Paracelsus than Bacon. Neither does it seem quite fair of Hahnemann to charge all other practitioners with uniformly proceeding on some one opposite principle, as "allopathy or antipathy;" for neither "homœopathy" nor "allopathy" was ever heard of till he chose to invent the terms, and taking one himself, gave the other to all the rest of the medical world; whereas, I suppose, there is hardly any practitioner that would deny there are some cases in which his "similia similibus" would apply well enough, though they would be loth to make it a "universal principle."

By the way, I perceive with much satisfaction that these infinitesimal doses, which you are so anxious to vindicate, are no longer insisted on as necessary to the system, by your homœopathic friends, many of whom are abandoning them in practice. Most, I observe, are in open revolt against Hahnemann's principle of "Dynamisation," which affirms that drugs are potent in proportion to the attenuation of the dose; according to which a pinch of arsenic equably diffused in the Atlantic might prove fatal to all the fish in it!—The curative property of a medicine is, according to Hahnemann, developed in a far higher degree by an inconceivably small than by a palpable dose!

Will you be angry if I tell you of a curious instance of the power of fancy in relation to your globules? One of the "faithful" on a certain night had taken two globules instead of one;perhaps three! Alas! what was to be done in a case so imminent! The unhappy man lived in a small town near Edinburgh, in whose