MH^»
"863 ionAL   MEDICINE:


ITS  PAST AND PRESENT;
ITS TRUE RELATIONS TO SPECIALISTS, TO THE PARTI-
      SANS OF EXCLUSIVE SYSTEMS, AND
              TO EMPIRICS.
TIMOTHY GUILDS,  M.  D.,
         OF PITTSFIELD.
Road at the Annual Meeting of the Mass. Med. Society, May 29, 1859.
        NEW YORK:
BAKER & GODWIN,  PRINTERS
  PRINTING-HOUSE SQUARE, OPPOSITE <TTY HALL.
            1863.
 
ARMY MEDICAL LIBRARY
FOUNDED 1836
& -■>.... plat
WASHINGTON, D.C. 
DUE -             • LAST DATE
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RATIONAL   MEDICINE:
ITS PAST AND  PRESENT;
ITS TRUE RELATIONS TO SPECIALISTS, TO THE PARTI-
      SANS OF EXCLUSIVE SYSTEMS, AND
              TO EMPIRICS.
            \/
TIMOTHY CHILDS, M. D.,

         OF PITT6FIBLD.
Read at the Annual Meeting of the Mass. Med, Sooiety, May 29, 1869,
        NEW YORK:    shh^.^<"'
BAKER 4 GODWIN, PRINTERS,
  PRINTING-HOUSE SQUARE, OPPOSITE CITY HALL.
           1863. 
WB
C53£r
 186 3 
RATIONAL MEDICINE:
ITS PAST AND PRESENT ; ITS TRUE RELATIONS TO SPECIALISTS, TO
   THE PARTISANS OF  EXCLUSIVE SYSTEMS, AND TO EMPIRICS.


           BY TIMOTHY CHILDS, M. D.;
Read at the Annual Meeting of the Mass. Med. Society, Mat 29, 1859.
Mr. President, and
          Gentlemen Fellows of the Society:
  The 20th  By-Law of this venerable Society pro-
vides, u That the Councillors at their Annual Meet-
ing shall appoint some Fellow to deliver a Discourse
on some subject connected with Medical Science, at
the Anniversary Meeting of the Society on the next
vear."
  I would that  this unexpected, undeserved, and I
may add, unsought honor, had  devolved on some
Fellow  more  competent to interest and to instruct
you than myself; but cherishing, as  I do, a sincere
attachment  to  this  noble fraternity, and  a pro-
found sense of the compliment paid me by its Board
of Councillors, I shall do  as I have ever  done, in
the humbler  sphere of my own  District Society, ac-
cept whatever duty is put upon me and fulfil it to
the best of my humble ability. 
4
RATIONAL MEDICINE.
  It is a kindly usage to begin this hour with brief
remembrance  and  memorial of the  brethren  who
have  fallen in  our ranks,  wearied with the  march
and battle of  life, during the year.   Twenty-two
have  rested from  their labors, and their works do
follow them.
  Conspicuous among these, was Dr.  James Deane,
of Greenfield, whose  loss  to the  profession and to
science  we all  deplore, but whose eulogy has been
already elaborately and eloquently uttered by a dis-
tinguished Fellow.
  The subject which  I propose briefly to discuss, is
two-fold,  and  comprises—1st, A hasty glance  at
some of the milestones of medical progress thus far,
with  a rapid sketch of the present state of our sci-
ence  and  our  art; and,  2d,  The consideration of
the true position of the Profession and of the Society
with'reference to Specialists, to the Partisans of Ex-
clusive Systems of Medicine, and to Empirics.
  The Temple of  our Art (and, if  I  mistake not,
the Temple of our Science  too) is, as you well know,
at least as old as the  old master-builder of Cos, who
laid its corner stone 2300 years ago.
      " There every quarry  lends its marble spoil,
       And clustering ages blend their common toil;
       The Greek, the Roman, reared its mighty  walls,
       The silent Arab arched its  mystic Halls.
       In that fair niche by countless billows laved,
       Trace the deep lines that Sydenham engraved.
       On yon broad front  that breasts the changing swell,
       Mark where the ponderous sledge of Hunter fell.
       By that square buttress, look where Louis stands,
       The stone yet warm from his uplifted hands.
       And say, 0 Science, shall thy life-blood freeze,
       When fluttering folly flaps on walls like these ? " 
             ITS  PAST AND PRESENT.             5

  But I shall  not ask you to go back with me to
Hippocrates, of whom one of his translators wittily
remarks, we say much and know little, nor, indeed,
to the era of the revival of letters;  but  beginning
with the 17th century, we hail Fabricius, the Italian,
who finds  that there are valves in  the veins—and
soon  after, his  pupil, the immortal Harvey, makes
his noble discovery of the true circulation of the
blood—well termed the " rock-based foundation of
modern medicine."
   A  few yeai* later, comes Assellius, also  of Italy,
who discovers the lacteals; Pecquet, of France, the
thoracic duct;  and Kudbeck, a Swede, the lympha-
tics.  Then Malpighi, an Italian, introduces " magni-
fying glasses " (microscopes) to facilitate the study of
minute parts;  and Steno, and De Graaf, and Van
Horn, and Swammerdam, and Ruysch,  compete with
the Italian school in the cultivation  of anatomy and
medicine.   Malpighi discovers the capillaries  in
1661.  Towards  the close of the century, anatomical
injections of the blood-vessels are invented and car-
ried to great perfection by Ruysch.   These Harvey
did not have, as  his laborious dissections of the ves-
sels of the body (still preserved in the museums of
the Royal College of Physicians and Surgeons) yet
show.   Nor must we forget that  Sydenham (the
British Hippocrates), " the restorer  of true physic,"
 as Hume calls  him, belongs to this age.    This
 brings our  hurried sketch  to the  18th century
__the Italian and Dutch schools in the van.  In the
 dawn of this  century, appears the famous Haller,
 the Father of  Physiology, with his  " vis insita," the 
6              RATIONAL MEDICINE.
inherent irritability of animal  (muscular)  fibre—a
brilliant discovery, which the researches of modern
physiology have only confirmed.  Priestley and La-
voisier share the glory of the discovery of oxygen,
and of the true  function of the lungs;  and Monro
and William Hunter each claim the priority,  and
refuse to share the honor of settling  the true func-
tion of the lacteals,  lymphatics, and thoracic duct,
and demonstrating that  they constitute one great
and general system for  the  purpose of absorption.
TJiis was  a  stride equalled  only by She great  dis-
covery of Harvey.  Reaumer and  Spallanzani  and
the great Hunter begin to unfold the philosophy of
Digestion and  the solvent  power of  the  Gastric
Juice.  But this, you know, is but a tithe of what
this great genius and hard-working observer did for
medicine.   We have not time  for an enumeration
even of his manifold discoveries in every department
of our science,  and  his  practical improvements in
every branch of our art.  I will only  refer, as an
example of each, to his doctrine and practice of Ad-
hesion, and  the  improved operation for Aneurism
which still bears his name.
  The preservative art of Inoculation, formerly prac-
tised  in many countries (as appears from their  tra-
ditions), had been lost in Europe, and is  re-introduc-
ed from the barbarous East, by the heroism of Lady
Montague, who causes her own daughter to be first
inoculated, and  is hooted and  pelted through  the
streets of London—the  unnatural mother who per-
illed the  life of  her own offspring.   This was in
1721.  It is introduced the same year, in the same 
             ITS PAST AND PRESENT.            7

month, into Boston, by Dr. Boylston, who also inoc-
ulates his own children first, aided by the Rev. Cot-
ton Mather, for which we forgive the latter a multi-
tude of  sins of bigotry.   Benjamin Franklin de-
dounces  the new practice in the columns of  the
Courant.  He was a  very young man, the philoso-
pher, then.  Dr. Boylston's  house is mobbed and
sacked,  and he flees  for  his life—"of  whom  the
world was not worthy."
  And  time would fail to tell of Cheselden, and of
Pott, of the Bells, and the Monros, and the Meck-
els—of  Morgagni, the father  of pathology—and of
Cuvier,  who declares the glories of a past and pres-
ent creation.   In France, too, Desault  does for
French surgery, what Hunter had done for the whole
science in Britain, and the genius of his illustrious
pupil, the gifted Bichat, irradiates the close of this
century.   Petit introduces the ligature; but in 1798
Jenner makes his grand discovery of vaccination,
and this is the true climax of the medical progress
of the 18th century.   Let us  make honorable men-
tion, too, of Lind, who, " while scurvy raged among
the crews"  of the English Frigates,  "and corpses
were daily flung out of the port-holes," investigates
this other scourge, and lays down the method of pre-
vention and cure.  I have said nothing of the  dis-
tinguished theorists and sect-founders, from Galen
and Paracelsus to Broussais  and Hahnemann;  nor
shall I, save that many of them have done good ser-
vice to medicine, in spite of their theories.
  The 19th century opens, and what  shall I say of
the crowd of laborers,  with sharpened and burnished 
8
RATIONAL MEDICINE.
sickles, wending their way to the whitened fields.
I shall not attempt  even a catalogue of them.   In
no period of the history of medicine has there been
witnessed a progress at all comparable to that which
has characterized the first half, and especially the
second quarter, of this century.   This was to be ex-
pected.   Medicine can only improve as the collateral
and tributary sciences  improve.  As these are  per-
fected and applied to the study of our science, and
as nature is more severely interrogated by better and
more  thorough methods of investigation, medicine
does improve.  I can only glance at some of the
gains that have been made during the period we are
considering.
  1st. The creation of the Science of General Ana-
tomy, the true point of departure for the cultivation
of Physiology and Pathology.
  2d. The application of Chemistry and the Micro-
scope to the elucidation of these branches.
  3d. The increased  accuracy of Diagnosis, and this
aided by a careful study of  the Physical  Signs  of
Disease.
  4th. The better understanding of the nature and
relations of that most extensive morbid process, In-
flammation.
   5th. The study of the Pathology of the Blood—
the life—the " Moses"  that  urges on and sustains
the tissues that fight; and the Chyle and the Lymph
—the "Aaron" and the "Hur" that stay up his
 hands—" Chemical Food," by which I do  not mean
 the contents of bottles so labelled, nor any particu-
 lar combination of  "superphosphates" or "hypo- 
                ITS PAST AXD PRESENT.            9

   phosphites,11 but the doctrine, the  grand idea that
   the pathological chemistry of the blood is to be care-
   fully studied, with the view to antidote or eliminate
   what  is poisonous, to reduce what is in excess,  to
   supply what is lacking, as we  do- through the soil to
   the sap, the  blood  of the plant.  In this direction
   much is to be hoped for medicine.  There is philos-
   ophy as well as poetry in the fancy of Rush—" Who
   knows but that, at the  foot of the Allegany moun-
   tain,  there blooms a flower that is an infallible cure
   for the epilepsy ?  Perhaps on the  Monongahela  or
   the Potowmac there may grow a root that shall sup-
   ply, by its tonic powers, the invigorating effects of
   the savage or military life in  the cure of consump-
   tions;"  and  in the  prophecy of  the  enthusiastic
•  Churchill, that in the mineral kingdom there shall
   be found  substances which shall  so restore to the
   blood its normal richness, that consumption, now the
   scourge of our latitude, shall become (as smallpox
   has  become  through the preservative influence  of
   vaccination) a rare and exceptional disease.
     Here, as elsewhere, Art oftenest precedes  Science.
   Iron  cured chlorosis  long  before Andral and Ga-
   varet weighed the corpuscles in scales, and measured
   the liquor sanguinis in a balance.
     6th. The enlargement and the intensification  of
   the Materia Meclica—the introduction  of new and
   valuable agents, and (not less important) the reform
   in excessive medication.
     7th. The increased knowle.dge of  the  Principles
   and  Methods of Hygiene, and  of Climatic  Influ-
   ences.
             2 
10
RATIONAL  MEDICINE.
  8th. The greater boldness, and not less, the greater
conservatism of our Surgery.
  9th. The discovery, and introduction into general
use, of Anaesthetics.
  10th. The better appreciation of Nature in Dis-
ease, and this from a better  acquaintance with the
Natural History  of Disease.   Need I remind you
that "Natnra Duce" is our chosen motto?
  The members of this Society have added their
massive blocks  and glittering panes to  the ever-
ascending temple of the science of Rational Medicine.
To illustrate by details, I need not go beyond mat-
ters in which they have borne an honorable part:—
The improved treatment of peritonitis, ovariotomy,
paracentesis thoracis by the new method; the in-
troduction  of that beautiful arterial sedative, the
Veratrum Viride; the establishing of the contagion
of puerperal fever—" puerperal fever a private pesti-
lence"—and  the prophylaxis that results; the in-
troduction, if not the discovery, of one of the valua-
ble anaesthetics; " Nature in Disease."
  In  Anatomy, we have seen the structure of the
liver and kidney unfolded; in Physiology, the true
function of the pancreas and the  kidney, and mea-
surably, that  of the  liver; in  Surgery,  practical
lithotrity, silver  sutures, anaesthetics, "the  ready
method" in asphyxia, &c.; in Obstetrics, the phil-
osophy of menstruation, the improved (local) treat-
ment of uterine  disease, the modern treatment of
puerperal peritonitis, and the more  scientific treat-
ment of puerperal convulsions;  in  Pathology and
Practice, order educed from chaos  in the pathology, 
SPECIALTIES*.
11
diagnosis  and treatment of syphilis—syphilis, says
Andral, a disease so systematic and  orderly, that it
ought, so to speak, to serve as the hey to all patho-
logy—the  alkaline  and  eliminative treatment  of
rheumatism and gout—the pathology  of  tubercle,
and  the analeptic treatment of phthisis—the suc-
cessful  cultivation of specialties, those of the eye
and ear, for example.
  The catalogue might be largely increased; but,
after all, let us frankly admit the imperfections  of
our science; let us admit that " there remaineth yet
much land to be possessed;"  let us adopt the  beau-
tiful motto of Seneca, prefixed by  one of the Fel-
lows of this Society to his excellent book :—" Mul-
tum egerunt qui ante nos fuerunt, sed  non perege-
runt; multum adhuc restat operis, multumque rest-
abit; nee ulli nato, post mille saecula, prsecluditur
occasio aliquid adhuc adjiciendi."
   And this brings me to my second, and, I would
fain hope, not untimely topic—the true position of
the Profession and the Society towards Specialists,
towards the partisans of Exclusive Systems, and  to-
wards Empirics.

   And, 1st, Should the  cultivation  of  specialties in
our Profession be  encouraged ?  I am aware that
there are differences of opinion on this point in the
Profession and in the Society.  One eminent member
of this Society  commences his excellent address to
the Fellows of his District Society, thus :—" I stand
 before  you an humble advocate for the  study of 
12
RATIONAL MEDICINE.
Specialties in Medicine.," *  Another  and a distin-
guished Fellow, in a speech brilliant with the corus-
cations of his  own fine genius, warns us  against
their  cultivation,  and  points  out their narrowing
tendencies as follows :—" And, in the mean time, we
must  not  disguise it from ourselves, that causes are
at work within as well as  from without, that  may
well occasion grave thought on the part of  all who
are anxious that  the Profession should maintain its
high standing.  Medical practice is breaking up into
specialties, that  make men  skillful  and   narrow-
minded,"  &cf   Is  there no underlaying principle
which the Profession and the Society  will recognize
and accept as  harmonizing extreme  views  of this
matter ?
  The advantages  attendant on  division  of labor
are recognized in every other department of science
and of art.  Every man cannot be in and of himself
a good (not to say the best, the most accomplished)
astronomer, geologist,  naturalist,  chemist,  <fcc., &c
Neither can he be in and of himself the best anata-
mist,  physiologist, pathologist, microscopist,  surgeon,
obstetrician, oculist,  aurist,  and, highest   of all,
scientific  physician.  The  circle of the sciences  and
the circle of our science have too long  radii for this.
And  in  an  advanced  state of the arts, we do not
look  to one and the same man as the best architect
mason, carpenter,  painter, plumber, cabinet-maker

  * Dr. Collins, in the Boston Medical  and Surgical Journal, Vol.
XLVIL, No. 23.
  t Dr. Holmes.  Anniversary Meeting at Springfield.—{Springfield
Republican,  June 28th 1855.) 
SPECIALTIES.
13
upholsterer, &c, &c.   And, practically,  neither in
our science nor in our art, do we find it so.  Sichel,
and Guthrie, and Agnew, and Williams, and Noyes,
lean to the eye.   Kramer, and Wild, and Toynbee,
to the ear;  Ricord, and  Acton, and Bumstead, to
syphilis; Trousseau, and Green, and Bowditch, to the
chest, the respiratory organs; Langenbeck, and Dief-
fenbach, and Carnochan, and Sanborn, to  plastic sur-
gery ; Howship, and Quain, and Bushe, to the rec-
tum ;  Longet, and Flourens, and Bernard, and Dal-
ton, and Stiles, and Flint, Jr., to experimental phy-
siology ; Rokitansky,  and  Paget,  to  pathological
anatomy.   There is, then, a place for specialties in
medicine; and it is to the labors of the much-decried
specialists that medicine owes much of its advance
for the last fifty years.
   I admit, on  the other hand, that there exists the
danger so graphically depicted by the Fellow I have
quoted, of the narrowing tendency of their cultiva-
tion.  This, indeed, must be  guarded against, as he
suggests,  by  a wide  and liberal  culture,  and es-
cially by  a thorough grounding in the principles of
the general science  of medicine, before  cultivating
any specialty in medicine.   There are two kinds of
specialists—those who, having thoroughly mastered
the general science  of medicine, cultivate, in a sci-
entific spirit, some particular department; and those
who,  all ignorant of the general science,  hold them-
selves up as oculists, aurists,  and the like.  To the
first class, all praise and all encouragement are due ;
the second are pure empirics—arrant quacks.
   2d As to the proper method of dealing with the 
14
RATIONAL MEDICINE.
  partisans of exclusive systems and schemes of medi-
  cine.
    Medicine does improve,  but it improves  slowly.
  Eager minds are not content to labor and to wait, and
  to tread slowly and painfully  the toilsome path of
  induction,  and the narrow and more  difficult  and
  more  dangerous path of scientific deduction in medi-
* cine.  A just and almost perfect combination of the
  inductive and the deductive mind is a gift rarely
  vouchsafed to any.  A Hunter is almost a miracle;
  a second  Hunter, in our fast  age, would be quite
  miraculous.  Schemes and  systems of  medicine are
  invented; some inchoate, modest, and promising in
  the distant future—more complete, perfect, boastful
  of present  results—all challenging our admiration
  and acceptance,  all  exclusive.    On  the extreme
  right, the inductive side, we have the  exclusives of
  the " school of observation," with their Procrustean
  bed of the "numerical method"—on  the extreme
  left, the  deductive  side, we have the exclusives of
  Homoeopathy.  The sage of quiet Misnia, in deduc-
  tive Saxony, of mystic Germany, possessing himself
  of the universal law, " similia similihus curantur,"
  announces, when he hears of the approach of God's
  dread messenger and scourge—cholera—that drop
  doses of the tincture  of camphor are  the  specific.
  Clever Dr. Henderson heads one of  his chapters__
  his racy chapters—" vulgar errors about the induc-
  tive method," and scouts Bacon's notion  of  reason-
  ing from particulars up to generals.  Aristotle was
  right after all—the genius of Hahnemann has given
  the universal law, and from it we must  reason down. 
THE  NUMERICAL  METHOD.
15
Between the two, with their imperfect and limited
inductions, and their still  more careless and hasty
deductions, Priessnitz avers that  the whole  science
consists in the right application of cold water;  bo-
tanic Thompson declares that heat is life and cold is
death—and hence, as  a corollary,  that steam and
pepper, lobelia inflata and no calomel, are  the es-
sence and the consummation of all medical science;
" Eclectics," falsely so called—who, instead of select-
ing their remedies from the three  kingdoms—nay,
like the true eclectic, taking the lightning from  the
heavens above, and mercury from the earth beneath,
and iodine from the waters under the earth, make
their eclecticism to consist in the rejection of " poi-
sonous minerals."
   But of all these full-blown  schemes of medicine,
there are but two that I know of that possess any
fascination for the cultivated and well-instructed
physician.  These  are, the exclusive  system of the
partisans of the " Numerical Method," and  the ex-
clusive system  of the partisans of  Llomceopathy.
Each of  these has its attractions for a different class
of minds, and of  each of  these two  I would say  a
few words.
   1st.  Of the  exclusive system of the "Numerical
Method."  What  is it ?  It consists, as defined by
one of its ablest American  advocates, in a " Numeri-
cal method  of statement, analysis, and appreciation
of medical facts."   Every man (adds the late accom-
plished author of  the Philosophy of Medicine),  " in
every a^e, who has stated  numerable facts in anato-
my, physiology,  patholgy, or therapeutics,  in spe- 
16
RATIONAL MEDICINE.
 dfic numbers, has made use of the mumerical method.
 Every observer who counted accurately his cases of
 disease, or any of the phenomena connected with
 these cases, and gave the result in numbers, instead
 of resorting  to the more common  and indefinite
 terms of ' a small number,' or ' a large number,' i fre-
 quently,'  or  ' rarely,' has so far made  use of this
 method."
   This  accurate and  beautiful method  of observa-
 tion I do not stand up here to decry.  It is its abuse
 by insisting on it as the one and exclusive method in
 the cultivation of medicine, against which I protest.
 These " ultraists of the rigorous school" date  the
 dawn of medical science at about 1827, when  Louis
 —whose name I mention with the  profoundest re-
 spect—published his  great work on the Typhoid
 Affection (Fever) ; and the very liberal of them see
 a dim morning twilight as early as 1808, when Brous-
 sais—before he apostatized and set up  a theory of
 his own—published his  " History of the Chronic
 Inflammations."  These gentlemen have  no faith  in
 Sydenham or Hunter, or any body else who has not
 fulfilled all the requirements of their  "method."
 Tell one  of  them (usually  a young  man,  fresh
 from Paris) that Dr. Nathan Smith found that, with
 the best treatment he could  give to typhoid fever
 one in ten die, he shakes  his head;  Nathan Smithj
 though an excellent observer, did not make use of
the "numerical method."   Tell him  that M. Louis
finds the mortality to be one in  9  and  7-llths, he
takes off his  hat.  They complacently reduce the
objections  to their exclusive method to three or four 
THE NUMERICAL METHOD.
17
  heads.   1st, " Ignorance of the object for which the
  mathematical processes are employed;"  2d, "Self-
  esteem, which resists all contrivances for  demolish-
  ing cherished errors;"  3d, " Indolence;"  and, 4th,
  the very liberal add, " Reverence for the opinions of
  the past."  Now we might say—and it would be a
  sufficient answer  to  such arrogance to say—that
  modesty is  the badge  of  true wisdom ; that such
  pretension is not without its parallels in the history
  of medicine.  "There  is more wisdom in a single
  hail- of my  head, than in Hippocrates and all  the
  Fathers," said Paracelsus.  " Quapropter non dubito
  me solvissc no bile problema dato morbo in venire
  remedium,"  said Pitcairn, a famous champion of  the
  mechanic theory  of the 17th century.  "After so
  many vacillations  in its march, medicine at length
  has found the only path that can conduct it to truth,"
  said Broussais.  " Since this art (referring  to medi-
  cine) consists in  a gross imitation of a dangerous
  and insufficient process, it must be admitted that the
  true medicine was not discovered until by me" said
  Hahnemann.
      But to the point.  They tell us—these exclusives
  of the school  of observation—that "all  true  and
  direct  relationships are invariable ;11 e. g., that " a
  quart  of blood, drawn in a given time, from the aim,
x  will always, under the same circumstances, produce
  the same effect;  that  two grains  of calomel, or a
  quarter  of a grain of the tartrate of antimony  and
  potassa, or one half a grain of opium, or these three
  substances in combination, introduced into the  sys-
  tem every three or six hours, will always, under the
              3 
18             RATIONAL MEDICINE.
 same circumstances, be followed by precisely the
 same results."  They repeat that " all true and direct
 relationships are invariable."  Now we venture to
 say—Not so fast, gentlemen.  You must allow us to
 put some faith in  the records of such observers as
 our science  boasts—at least till  the Numerical
 Method shall have shown their fallacy; and, in the
 mean time, do  not  render worthless your numerical
 method of statement, analysis, and appreciation, by
 vitiating its most important element.  Do not exact
 of every poor pleuritic the pound of blood, or the
 swallowing of just  two grains of calomel, or a quar-
 ter of a grain of the " tartrate of antimony and po-
 tassa," or the " half grain of opium," or " these three
 substances in combination every three or six hours."
 We have such  tables, and I cannot but see in them
 an abuse of figures.  You are grasping at the shadow
 of accuracy, and losing the substance, as much as
 did the mathematicians of the  17th century, with
their tables of medicines accurately graduated  to
the  squares  of the constitution,  and just sixty-
eight pounds of bile  passing through the  hepatic
 duct in every 24 hours—a conclusion, quaintly ob-
 serves  Dr. Percival, " repugnant  to fact and experi-
 ence."  The therapeutical results arrived  at by the
numerical method are mere averages, and, therefore
 of no practical value in particular cases.  A patient
it has been well said, is never an average, but a case
 by and of itself.*
  You will observe that it is  not  the Numerical

 * Dr. E. R. Peaslee's Anniversary Discourse, New York Academy of
Medicine, 1858. 
HOMCEOPATHY.                19
Method, but  the  abuse of it—that is, the exclusive
use of it—to which  I object.  Let it be applied
wherever and whenever it be found applicable—let us
learn all we can from it; but do not confine us to it.

  I pass to the second exclusive system I propose to
notice—the doctrine and practice  of Homoeopathy.
" Vita brevis, ars  longa, occasio prseceps, experientia
fallax, judicium difficile."  So reads the first axiom
of the Father of Medicine; and it  is as true now as
it was 2300 years ago.  Not so, say  the Honioeo-
pathists of our day.  The  life of Samuel Christian
Frederic Hahnemann  (born in 1755, and died 1843)
was long enough to   establish a perfect theory of
medicine.   Occasions  for testing  the truth  of the
system have been  ample;  their experience  is not
deceptive; judgment in the application of the " Uni-
versal Law "  is comparatively easy—uSimilia simili-
bus  curantur."  Find the  remedy homoeopathic to
the symptoms  of the  sick man, and administer it.
The cure is almost certain.   If there be any failure,
it is not to be laid to  the charge of the system; the
error is in the imperfect application of it.
  Let  me  state fairly the doctrine and practice—
" Similia  similibus curantur."  Like  cures like.
Find in the materia medica a drug which, when given
to a healthy person, will produce  symptoms  similar
to those under which  the patient  is laboring—that
is  the remedy.  The  theory is, that such remedy
acts on the diseased part by creating an analogous
medicinal  disease,  which extinguishes the original
one and soon subsides of itself.  Inseparably linked 
20
RATIONAL MEDICINE.
with this doctrine  is the complementary one, that
these  remedies, so acting, are to be  given in  very
minute  and generally infinitesimal doses—else the
"medicinal disease  persists," and the last state  of
that man is worse than the first.  Now we object to
this exclusive system—
  1st, That it  ignores  the very existence  of the
" vis medicatrix naturae," the tendency and the ca-
pacity,- under  favorable  conditions, with  which  a
kind Providence has endowed every organ, and the
totality of the organs composing the system, to re-
turn to a healthy structure and function, when these
have  been  impaired  or deranged.   Hahnemann
frankly avows his total scepticism as to the curative
powers of nature.*   Has this been the error of the
regular profession ?  Or rather, has not their  error
been that, while acknowledging themselves, in words,
the minisfri Naturae, they have, in fact, with Hahne-
mann, fancied themselves the magistri Naturae %  May
I not go farther, and ask, is disease ever  cured save
by  aiding her whom the great poet so justly styles
" excelling Nature."
  2d, Exclusive Homoeopathy ignores all entities in
disease, and deals only with the subtle vital  power.
It ignores, for example, the condition of the blood in
blood diseases.   Take, for  instance, the case  of a
worker in lead.   He inhales  the lead  fumes, the
poison is absorbed by his  lungs, it  circulates  with
his blood to his stomach, and he has lead colic.  It
circulates to the extensors of his wrists, and he has
* Organon, pages 30-34, 
HOMOEOPATHY.                21
lead paralysis.   He  dies, and  Devergie and Tan-
querel find " a considerable quantity of lead" at the
sites of the disease.  Is not lead an entity t  Taught
by experience, we say this poison of lead is the cause
of the  disease.   We say—" tolle causam cessit affec-
tus."   We antidote or eliminate the poison, and, jp#W
passu with the elimination of the poisonous mineral,
the patient regains  his  health.  But the Homceo-
pathist overlooks all this.  He asks not what is  at
fault with the machine, to apply the proper correc-
tive ;  but what are the symptoms, and what drug is
homoeopathic to the symptoms ?  But this, you say,
is a case of poisoning / and are not gout, and rheuma-
tism, and typhus, and ague, equally  cases of poison-
ed blood'(  Admit frankly that we do not yet know
the history of some of these, as well as that of lead-
poison ; 25  years ago we knew less of lead-poison
than we now know of the poison of rheumatism  or
the poison  of  gout.  The illustrations might be in-
definitely multiplied—chlorosis, uramia, scurvy, <fcc,
&c.   In scurvy, Dr. Kane's "last scraped  potato"
and raw  walrus were certainly entities, and did not
act on the universal law of  cure of Homoeopathy,
" similia  similibus curantur"
   3d,  And closely connected with the homoeopathic
dogma just adverted to, that  " the causes of disease
cannot possibly be material," as Hahnemann phrases
it, is  another dogma, that the totality of the symp-
toms represent, constitute, are, the  disease.*  This,
indeed is an  essential feature of the homoeopathic
A Organon, page 80 
 22             RATIONAL MEDICINE.

 system.  But is it so?   In a very common disease
 of the hip joint,  the pain is often referred  to  the
 knee, and very frequently the knee is swollen, even;
 in short, all the sensations of the patient are refer-
 red to the knee.  In tetanus, the symptoms pertain
 to the voluntary muscles, or  certain  of them, as
 those which  close the jaws; the disease  may be  a
 thorn in the foot, or strychnine in the blood, &c.  In
 gout, the  symptoms  are in the  toe; the  disease,
 lithic acid in the blood.  In rheumatism, the symp-
 toms are in the shoulder;  the disease, lactic acid in
 the blood.   Is  not a quart of serum  compressing  a
 lung  an entity;  and is it to be ignored ?  And is
the indirect pleuritic cough, one of the consequen-
 ces of this pressure, the disease itself?  I say, then,
that the symptoms,  even the totality of them,  are
not the  disease, and often do not even represent  the
 disease.   Symptoms are but the glass that suffering
nature holds out to  the true physician, with which
to inspect the disease.
  4th, We object to Homoeopathy, that  it ignores
the ascertained practical facts of that most common
pathological  process, Inflammation.   Twenty-five
years ago, this would have been no great deficiency ;
but within that period, the labors of Paget and  his
collaborateurs have evolved from this chaos a beau-
tiful order, which is destined to work vast practical
improvements in  our art.  We do  now hnow that
inflammation may begin by a vitiation of any one of
the four essential conditions of the healthy action of
any  part—that is, it may make its  debut in  the
bloodvp=t els of the part, in the blood of the part, in 
HOMOEOPATHY.
23
the nerves of the part, or in the essential  structure
of the part.   We do know that, when the  disease is
grave, when the  scales  hang fearfully balanced be-
tween struggling nature on the one hand and deadly
inflammation on the other, our art may come to the
rescue—not to  take the case out of her beneficent
hands, but to aid her by removing one or more of
these abnormal conditions—she taking up the work
and completing the cure by the removal of the rest.
Let me instance that once fearful disease, peritonitis.
We now  administer the large doses of opium; we
cure the nervous element of the disease  (which is
the leading element) ; we allay the horrible  pain.
Excelling Nature takes up the cure, and removes the
other faulty conditions.
   And here I should be recreant to  that  command
of the Decalogue which enjoins me to "honor my
father and  my mother,"  if I did not  claim for a
Fellow of this Society the honor of the discovery,
the introduction and the public teaching of this, the
opium-treatment of peritonitis, twenty-five years ago.
   In a case of specific inflammation,  where the  in-
flammatory process begins in the blood, we antidote
or eliminate the poison from the blood ; Xature again
takes up the cure, and removes the other  abnormal
conditions.  Again, if the  engorgement of the blood-
vessels  of the part be the leading  faulty  condition,
we unload  these by local depletion.  We  apply a
few leeches  or cups; and, as before, Nature  thus
aided, takes up, and completes  the cure   All this,
the now  well-settled history and pathology of m-
flammation, Homoeopathy utterly  ignores.  It only
c 
24
RATIONAL MEDICINE.
asks what are  the  symptons,  and what is homoeo-
pathic to the symptoms.
  5th, We say that the homoeopathic diet, enjoined
as a means of cure, is, like the rest  of the system,
fanciful and empirical—no scientific principle under-
laying it.
  Rational Medicine aims, at least, to adapt the diet
to the condition of the patient.   In consumption,
for  instance,  where  the  blood is  impoverished, in
part,  certainly, by lack of its  oily element, we pre-
scribe an " apoplectic " diet, and we  administer the
cod liver oil; and,  under favorable  circumstances,
the  chyle, and thence the blood being enriched by a
due proportion of oil, the general nutrition  is im-
proved, and the patient is cured.   The statistics of
the  Brompton Hospital, the accuracy and  veracity
of which are beyond question,  prove  that, of all the
cases  there treated, in all stages of the disease, near-
ly one third  are cured; the disease is  arrested in
nearly another third—leaving the mortality less than
40 per cent.  Where can Homoeopathy point to re-
sults  like these ?   In the  much  vaunted  and not
over honest tables of Fleischmann, of Vienna  (con-
fessedly one of the  best homoeopathic practitioners
in Europe), all  the  poor consumptives,  98 in num-
ber, go into the black column—whole number, 98 ;
died 71; " discharged uncured," 27.  Ah, we know
what that means—sent home to die, 27 ; 71 and 27 =
98.    Why did not Homcepathy cure one of the 98 \
Read Bennett on Tuberculosis, and you will see.  Tu-
bercle from  an impoverished  blood, the main  defi-
ciency,  or certainly  a leading deficiency, is in the 
HOMCEOPATHY.
25
amount of the oleaginous element furnished. Hence
the treatment  (and the diet is an essential part of
the treatment) should have steadily in view a richer
blood—a better nutrition.  Cod liver oil,  perhaps
from containing the biliary principles, is more readi-
ly assimilated than other fats, and hence, in the ma-
jority of cases, a  leading  article in the treatment.
Why is the disease unknown among the Esquimaux
—while here, in Boston, it heads the weekly list  of
your City Registrar—and throughout New England
causes one fourth of the total mortality ?   No  other
explanation of the fact can be given, than that they
live on a highly oily diet.  Arctic explorers tell us
that no bonbons  are so  acceptable to Esquimaux
belles, as tallow candles.  The  mysterious  darkness
of Paris, on the night of  April 31st, 1814,  was ex-
plained next  morning  by  the discovery  that the
Cossacks  had drank up all the oil in the street
lamps.
   Do you ask why we see no such results from the
" analeptic " treatment of phthisis, as those claimed
by Bennett and  the  physicians  of  the  Brompton
Hospital ?   I  answer, 1st, and chiefly, because we
are not sufficiently impressed  with the importance
of the constitution of the  blood in this disease.  We
are too much wedded to the old idea of treating the
symptoms  of consumption,. and its complications—
have too little faith in the grand fact that it is by a
better nutrition and a richer blood, and by this alone,
that it is to be cured.
   But we see people every day taking cod  liver oil
and dying of consumption.  True we do—but what
            4 
26
RATIONAL MEDICINE.
else are they doing, or leaving undone ?  They are
shut up  in  close rooms, instead of inhaling God's
oxygen, on foot, on horseback, and in open carriages.
They are taking nauseous " cough mixtures," which
destroy the appetite and  prevent that  better nutri-
tion from which alone a cure is to be hoped.  They
are taking too much of the oil, and  often a purely
factitious article of the oil.   Take the converse class
of cases,  where the oleaginous element is in excess
—the surplus must be eliminated  in great part by
the liver  ; this organ is overworked, and bilious at-
tacks  result—perhaps biliary calculi form.   We in-
terdict the oily and saccharine articles of diet—and,
with or without appropriate medicinal treatment, the
diathesis  is overcome.  Dr. Smith, late of Stockholm,
Sweden, tells us that in that capital this disease is
endemic,  and is  always cured  by a prescribed  diet.
One more example.  Macaulay, layman as he is, has
not failed to mark the  change in the character of
the diseases of England, wrought by the introduc-
tion of the potato and other roots and esculents into
the diet of the people. When the diet of the English
people consisted almost exclusively of wheat bread
and meats, the albuminous  group of aliments was in
excess, and the result was a great prevalence of gouty
and calculous disease. ^When the diet of the people
was changed by the introduction of  new vegetables
and  fruits,  these  affections decidedly diminished.
Among the poorer classes of society, those compelled
to live on a poor, vegetable diet, we find rheumatism;
and in the penitentiaries and the work-houses of Eng-
land-—where, as Dickens well satirizes it, " a Board 
HOMCEOPATHY.
27
of fat Governors spend their official time in diluting
gruel and writing reports "—we find that out of 860
inmates,  437,  or 52 per  cent., were affected  with
scurvy, when the wise Board of Governors aforesaid
cut down the allowance of nutriment from 31 to 21
ounces per diem.   In  other  public institutions,
where similar wise  Boards undertook to keep the
paupers  on bone soup, we find  a malignant  fever
breaking out, and  decimating the inmates two or
three  times  over.   In  short, Rational  Medicine,
guided by experience  and  experiment, recognizes
the fact  that a well-arranged dietetic scheme ought
to  consist of  such a combination of the several
groups of aliment as is  most appropriate to the re-
quirements of the given patient.
   This is of itself a great subject, and  deserves
more attention than it has yet received from the pro-
fession.   What makes dyspepsia (the forerunner of
phthisis) so common, so universal, on the highest
hills of Berkshire and in the most elegant avenues of
 Boston ?   What more than a  badly-regulated diet,
 and a horribly unscientific cookery ? You dine freely
 in Paris, and you feel no sense of oppression.   You
 dine freely here, and you are stupid all the evening.
 There cookery is a science; here it is hardly an art
 The point I make, is this—that there is a science of
 diet; the well-instructed physician avails himself of
 it; the dietetic prohibitions of Homoeopathy, though
 they may and do effect  a great deal of good in some
 cases, are at best exclusive and  arbitrary, based on
 conceits that  "veal" and "tooth-powder," "pork" 
 28            RATIONAL MEDICINE.

 and " perfumery," may militate against the action of
 hepar 3 or nux 30.
   And this brings  me to the  ludicrous side of the
 argument—that medicines are efficient in infinitesi-
 mal doses, though, as plain  and palpable grains of
 powdered oyster shells or chamomile flowers, they
are inert.  On this I shall not dwell—not because
it does not afford a beautiful example of the " reduc-
 tio ad absurdum," but because its exposition, though
 legitimate, is somewhat stale.  I only allude to it to
 show where the adoption of this exclusive doctrine
 led its illustrious founder:—" Latterly I have been
 forced by experience to reduce the number of shakes
 to two, of which I  formerly prescribed ten to  each
 dilution ;"*  " Of late I  have  become convinced of
 the fact (which I would not have previously believ-
 ed), that smelling imparts a medicinal influence as
 energetic and as long-continued, as when the medi-
 cine is taken  in substance by the mouth."f  Such
 vagaries,  such absurdities, are  the natural  fruit
 of the adoption of an exclusive  theory in  medicine
 —" obsta principiis."
   And this brings  me to speak very briefly of the
 true  position  of the Profession  and the  Society
 towards  the partisans of these exclusive  systems.
 " Nullius addictus jurare in verba magistri," should
 certainly  be  the  motto  of  the  scientific   phy-
 sician ;  but the profession excommunicates no  man
 because he  believes in the  "numerical method  of
 statement, analysis and  appreciation"—because he
* Organon, page 205.          f Organon, page 209. 
HOMOEOPATHY.
29
is  a numeralist, or an  exclusive  numeralist;  nor
should it excommunicate any man because he believes
that quinine cures ague, or aconite cures congestion,
on the principle of  "similia similibus curantur" or
because he prefers small doses or infinitesimal doses
of either.  You do  not expel a Brunonian, a Brous-
saisan, a Tullenian, for his therapeutical views, ex-
clusive though they are.  Why, then,  should  you
expel  a Hahnemannian for his therapeutic views,
however exclusive  or however absurd? In short,
the inquisition is not to be carried into the thera-
peutic views and opinions, any more  than  into the
physiological or pathological views and opinions, of
any member of a liberal profession.
   Do  I then  defend or countenance Homoeopathy,
or the partizans of  Homoeopathy ?  God forbid.   I
have refused, in writing, to consult with them, even
in  surgical and obstetrical  cases.  Would  I retain
them in the Society ?  No—but I would expel them
on the right ground, and such ground we have.
   Against the empiric or the quack all will agree
that the Profession and the Society should set their
faces like a flint.  But what constitutes an empiric I
What  makes a quack?   Chiefly, as I humbly con-
ceive, two things—1st,  Ignoring the wisdom  and
guidance of the past; 2d, Assuming and advertising
to be possessed of a skill beyond our contemporaries.
" Quack," says Walker, " is a boastful pretender to
arts  which he  does not  understand"—" One  who
proclaims his  own  medical abilities in  public
places."  "Advertising " is a relative term.  In Paris,
it is advertising to put the modest prefix of Doctor 
30             RATIONAL MEDICINE.
on your door plate.   I care not whether the adver-
tising be by the newspapers, by advertising vans,
or by private trumpeting.  The moment you adver-
tise yourself, or allow yourself to be advertised, or
written down, or called a  Homoeopathist,  an Al-
lopathist, or an Antipathist, a Hydropathic, Botanic,
Eclectic, Electric, Analeptic, or any other sort of Doc-
tor, you cut yourself off, and justly, from the com-
munion of the Medical Church Catholic; and the
essence of the quackery is, that you ignore the  wis-
dom and guidance of  the past, and assume  and ad-
vertise yourself to be possessed of a wisdom  beyond
your contemporaries.   Here is solid ground.  On
this ground, I would expel a Homoeopathist, and on
the same ground I would expel all other empirics.
That this is the true  principle on which the Profes-
sion and the  Society  should act,  I  entertain no
doubt;  that there may be difficulties in the applica-
tion of this  principle  (as there are in the practical
application of all principles), is freely conceded.  I
was glad to see that the action of the Censors of the
Suffolk District Medical Society measurably recog-
nized this principle, and that it was endorsed by the
Councillors of this Society.   How has  the other
policy—the  carrying the inquisition into the  theo-
retical views and opinions  of the applicant or the
Fellow—worked ?  " The thing that hath been shall
be, and that which is  done is that which shall be
done, and  there  is  nothing new under  the  sun."
The Homoeopathists have raised the cry of persecu-
tion for theoretical views and opinions; the heresy
has spread, as heresy always has  spread when met 
HOMOEOPATHY.
31
by persecution, real or imaginary.   A homoeopathic
statistician informs me that there  are  over  200 ho-
moeopathic physicians in Massachusetts.  Now that
there will always be " homoeopathic" doctors,  as
there will always  be " protestant" gardeners, and
" evangelical"  chambermaids, and " sober " coach-
men, and "virtuous"  chimney-sweeps, as  long  as
they are wanted, I do not doubt; but I would take
from the first  mentioned  article—the  "homoeo-
pathic " doctor—this weapon, that he is a martyr to
his  therapeutic  views and opinions,  by expelling
and rejecting him not because he is a Homoeopathist,
but because he is a Quack.

   Gentlemen  Fellows,—I have  detained  you too
long;  I will relieve your  patience with the prayer
that this ancient and honorable Society,  more  valu-
able to the State than to herself,  may still continue
her beneficent mission—that she will still continue
to  bend  gracefully  to the progressive and liberal
 spirit  of the  age; that she will hold ever to the
 glorious  maxim of  St. Augustine—" In essentials
 unity, in non-essentials liberty, in all things charity."
   So shall her glory endure in its freshness, and the
 bow be strengthened in her hand. 
 

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