INFLUENCE OF MEDICAL MEN. good advantage, the primal cause and real nature of every distinct disease—and to learn that the whole mystery concerning disease arises mainly from our ignorance. Never was there a time in medical his- tory when we might understand so well the exact place and adaptation of medi- cine in the treatment of disease—to avoid the extremes, on the one hand of over- medication and on the other, the rejection of all medicine. The profession has been inclined, we think, in the past, to use altogether too much medicine, both in quantity and va- riety, which has produced serious evils. This practice has misled the members of the profession in placing too much confi- dence in the virtue of medicine, and not enough in the recuperative powers of na- ture. It has also inspired the community with such unbounded confidence in medi- cine alone, that it is difficult to change their views and instill into their minds the value of sanitary influences. On the other hand, the physician who carefully studies into the causes of disease and the laws that govern it, is apt to lose faith in medicine and is liable to take radical ground against the use of all medicine. A well balanced progressive mind will avoid either extreme. Here is a grand opportunity for a physi- cian to do good service, to make his influ- ence felt and known both in the profession and in the community. It is in the direc- tion of improvement where advanced views in respect to medical practice and the good of society can be entertained. In this way the medical student may estab- lish land-marks which will cause him to be long remembered. If all diseases are the result of violating the laws of health and life, the symptoms are the indications or outward signs of this violation, and medi- cines are employed to aid in removing or allaying the disturbances. Drugs can never mend broken limbs, neither can they restore the system to a perfectly sound and healthy state, when ]5Y NATHAN ALLEN, M. D., OF LOWELL, MASS. Head before the American Academy of Medicine at its annual meeting in Philadelphia, Oct. 26th, 1882. NEAR a century ago, a distinguished French man in speaking of the per- sonal influence of educated men, made this remark : “We must not live here in this world without leaving traces which shall make us to be remembered by posterity.” This statement on the first impression might seem rather presuming, if not arro- gant, but upon more reflection, we believe, it indicates a purpose and determination that are commendable. If there was a propriety or any good reason why such a statement should be called for one hundred years ago, there is certainly greater propriety and stronger reasons for its utterance at the present day. And if this remark may properly or justly bo applied to any class of educated men, it is surely to the members of the medical profession. Let us inquire* then, what are the rea- sons, and what the circumstances which justify such a statement! What are the relations particularly which medical men sustain .to the public and posterity ! No in this profession should rest satisfied with present attainments, or allow himself to settle down in a mere routine £<}urse of study and practice. Not only in justice to himself, but for the public welfare as well as for the good of posterity, he should do something more. Otherwise, he leaves no permanent traces or marks bv which he may hereafter be remembered. In the present state of medicine there are certain subjects that require of its cultiva- tors special attention. At no former period in the history of medicine have the causes ot disease been so carefully scrutinized, or in which greater advances have been made in this direction. Never was there a time when the nat- ural laws of disease could be studied to so 2 its inherent laws have been repeatedly violated. Nor can disease be rationally and successfully treated, until its causes and nature are better understood ! Medi- cal practice can never be reduced to a true system of art or science, until the causes and laws of diseased action are better un- derstood. A most important field of study is open- ed in this direction in which an inquiring mind may do immense good. It is true, researches have here been made by many students, but there is still room for further explorations. Men in the profession both in England and in this country, are wak- ing up more and more to inquiries of this kind. Marks will here be made which will be remembered. Closely connected with this improved rational treatment of disease, is a most in- viting field opening for study and in- fluence—that is the prevention of disease. Formerly cure was the supreme if not the leading object of the physician, but the time is fast approaching when preven- tion will be the watch-word. What can you do to prevent disease ? This requires study, thought, and a sincere love of humanity. There is here a great work for the medical profession, and it is the duty* qf its members—a duty which they owe toAhemselves and to the public, to engage earnestly in such work. This can be done in a variety of ways,—in daily private practice, and, by seizing every opportunity to enlighten the com- munity on the subject by speech or by the pen. Here the thoughtful and progressive physician can exert great influence and establish land-marks which will long be remembered. In fact, no one question is coming before the public of such vital im- portance and magnitude as this prevention of disease under the head of Sanitary Sci- ence. The principles of this Science are based on the laws of Physiology. While there has been no change in the functions of Physiology, there have been discovered new or far more important relations, as it respects health, between this science and objects external to the body. There is a natural adaptation between certain organs in the human system, and outward objects which, if brought into their true relation, are healthful and nor- mal. Pure air, pure water, and pure soil, representing the externals on the one hand, and on the other, physical exercise, proper diet, and suitable clothing, repre- senting the body—these constitute the ground work—the pillars of sanitary sci- ence. These apply to human life in all its connections and aspects. They include nearly every agency and influence opera- ting upon the growth and development of the body, or upon the occupation and pur- suit of every individual, or upon the food, drink, and home life,—his place of resi- dence and dwelling. They cover the whole ground of his education—physical, intellectual and moral,—and his religious being, whether they harmonize with the laws of physical organization. But the principles of sanitary science have a far wider scope the individual —they extend to the family, to the school, to the State, and to the church. They take cognizance of all the agen- cies connected with those great centers of power and influence, in order to determine their sanitary effect on the human system —whether healthful and normal, or hurt- ful and injurious. In each one of those centers, the princi- ples of sanitary science as based on phy- siology must be brought to bear with far greater force and effect than at any former period. There are questions involving the highest interests of all those institutions which are comparatively new in their ap- plication, and which no man can discuss so well as a thoroughly educated physi- cian. Among those questions the following may be mentioned : Notwithstanding the family is an old institution, and its 3 lines or objects might seem to be well de- fined, still we think there are some things here to learn in the application of physio- logical laws. This institution is based upon Physiology as well as Revelation. It can be demonstrated, we believe from the principles of this science that the hu- man body cannot reach its highest devel- opment, neither can the race be perpetua- ted in its best estate, without just such an institution as the family. It can, more- over, be demonstrated from the same source that the primal objects of the fami- ly are three-fold : 1. Production of chil- dren. 2. Chastity; and 3. Mutual help and company; and, if there is a failure in either one of these, by design or defective organization, it goes so far to break down the family relation. Closely connected with this institution is, another subject of vital importance— that is, the laws of inheritance. No one but a medical man or thorough physiolo- gist can understand so well these laws. From proper investigation, these will be found to compose a part and parcel of a great law of propagation, which is a gen- eral and fundamental truth. Physiology is yet in its infancy as respects some of its most important applications. The time will come when the duty and agency of man in respect to observing hereditary laws will be far better under- stood than at the present time. Closely connected with the family is still another question which has within a few years at- tracted much attention—that is, woman’s position and rights. The settlement of some points in this controversy involves certain physiological laws which persons thoroughly versed in the principles of this science can alone discuss understandingly. Radical changes in woman’s position, employment, and relations in society, must change more or less her organization, and consequently certain mental qualities, which may affect sensibly the marriage rate and the stability of the family. It may be premature to forecast what those changes will be or inquire what will be their effects, but there are physio- logical problems involved here we believe which are fundamental and should come under the review, particularly of the medi- cal profession. Some of these questions in dispute can never be settled by the opinions of individuals nor by the resolu- tions of conventions, but by great princi- ples based upon physical organization. Here is an opportunity for the members of our profession to settle questions which will long be remembered. New and important questions also are raised in respect to schools which par- take of a physiological and sanitary char- acter. It is maintained that the mind is being educated at the expense of the body, or in other words that the physical development is too much neglected. Such is the whole course of education in our schools and higher institutions of learning, that it causes an undue development of the brain and nervous system, while the exer- cise of the muscles and other portions of the body is neglected. Hence there is not that physical strength and energy, that vital force and power of endurance to meet the demands which circumstapces and so- ciety make upon educated penjarfis. What is most needed in all our edr.c.i- tional institutions is a well balanced sym- metrical development of the whole body, which affords not only the greatest amount of physical capital but the best ground- work for mental labor and success. To this end the principles of physiology must be better understood and more generally applied. . Here is most important work for the physician, where he can make his influ- ence felt and remembered. In our com- mon schools and educational institutions, there is great need of a more thorough ap- plication of the principles of Sanitary Sci- ence. The matter of ventilation, of tem- perature, and drainage connected with school houses, and hours for study, physi- cal exercises and means of recreation on 4 the part of pupils,—these involve sani- tary laws, and demand the special atten- tion of medieal men. Multitudes in our High Schools, Col- leges, Seminaries and Universities, are constantly suffering from the violation of these laws. There is a large expenditure of means, time and labor from ignorance on this subject which is worse than wasted. The great objects of education are thus (je- feated ; in many cases weakness, disease and premature death are produced. Here is a wide range for the application of the principles of physiology and sanitary sci- ence. It opens a large, a most promising field for medical men to enter and culti- vate. Influences and improvements may here be started which will transmit their benefits to future generations. There is another great center of power and influence—the State—which stands in pressing need of medical knowledge. In consequence of discoveries in science and the advances in civilization, new ques- tions are coming up for legislation. It is found that the health and lives of the people must be subjects of legislation as well as property and material interests. To this end pure air, pure water and a clean soil must be provided. The ques- tion of preventing disease on a large scale is becoming an important subject for legis- lation. Perhaps nowhere can a medical man do so much good as in the halls of legislation, in devising and enacting laws for promoting the health and the highest welfare of the people. The more thoroughly the causes of dis- ease are understood, together with, the laws of health, the more fully do we find that the preservation of health and life depend upon human agency. Hence the need of increased intelligence on this subject, and also that new and important legislation should take place. In France, Germany and Great Britain, the medical profession have had far more to do, than it has in this country, in gov- eminent matters, and in the establishment and management of public institutions. Members of this profession have held in those nations some of the highest official positions, have been leaders in public af- fairs, and exercised a commanding influ- ence in every department of society. It may safely be said, we think, that the medical profession has held its way there in position and general influence with either of the other professions, and the chances at the present time would indicate that it was destined to rise still higher and higher. While the government and the state of society are very different in this country, and there may be other extenuating cir- cumstances, the medical profession if we are not mistaken, ranks much below the other professions in public estimation and general influence ; it may in a few locali- ties have a leading influence and com- mand much respect, but we must admit that on the whole, the profession in the United States have not possessed that wide extent of knowledge,—those high scientific attainments and general weight of character which are found abroad. The question very naturally arises Why this difference in the standing and influ- ence of the medical profession ! Some reasons may readily be given. In the na- tions mentioned, the profession is much older; its members are better compensated for services rendered ; many medical men inherit wealth which gives them leisure; then in communities abroad, there exists generally a higher appreciation of medical skill and knowledge as well of scientific and literary attainments. But after all, the fault in this country rests much with the profession itself. Its members have not been trained with reference to secur- ing great distinction in knowledge, in science, and education j neither while en-1 gaged in professional duties have they been encouraged to put themselves in the way of prominent positions connected with 5 public institutions, or with the State and national government. It would seem as though there had been an admission on the part of the profession, if not an under- standing in the community, that medical men could not leave their duties for pub- lic life, either to become scholars, authors or statesmen. If the promotion of public health or sanitary interests were made as prominent in our country as they are in Great Brit- ain, medical men in far greater numbers would be called into public life. The time is, however, coming when this will be demanded. But the responsibility rests much upon the profession. Its members must make themselves more thoroughly acquainted with physiology and sanitary science in their relations to public health and the welfare of mankind generally. Its members must not be so much absorb- ed in seeking a mere support or in the ac- cumulation of wealth, but must listen more to the calls of humanity, to the demands of the age and to the good of coming genera- tions. \y It is by such means that the profession will command greater respect in the com- munity-will exert a more beneficial in- fluence on the public and leave marks which will long be remembered. The leading object of this Academy of Medi- cine, we find expressed in these words : “ To extend the bounds of medical sci- ence, to elevate the profession, to relieve human suffering and prevent disease.” The suggestions made in this paper are calculated, we think, to promote every one of the objects here mentioned. If the medical profession is elevated to a higher plane and wider influence, the bounds of medical science must be extend- ed in every direction, which at the same time cannot fail to relieve suffering and prevent disease on a large scale. If the fields suggested in this paper for medical researches and labors, could be thorough- ly cultivated, it would redound greatly, not only to the credit of the profession, but work out most beneficent results. Never were the calls more urgent for such work, never were the times so propi- tious, never were the prospects of a rich harvest 30 favorable. 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