An address, DELIVERED AT THE ANNUAL MEETING OF THE BROOME COUNTY MEDICAL SOCIETY, Jmnutry 11, 1842—at the Court House in Binghamtan, by S. D. HAND, M. D.t PRESIDENT OF THE SOCIETY. PUBLISHED BY DIRECTION 01* THE SOCfETT. BINfiHAMTON, N.T., Orton heaili,h a large proportion of persons afacked with almost any disease however malignant: but it is among ignorant barbarians very much ash isammng igno- rant civilized men; where real medical knowledge is wanting, its place is usurped by Quackery. The unfortunate victim of disease is not left to the simp.e efforts of Nature, but is subjected to every kiryj of process, to every variety of torture that Human ingenuity and Human absurdity can possibly suggest; all with the humane intention of removing disease. Medical science has probably ben* •fit'.ed mankind as much by exposing the absurdities and supersti- tions of former times, as by the discovery of the (acts and principles Ol) which the science is now based. The science of medicine in its progress of improvement, has bad to contend with difficulties peculiarly its own. The very great importance attached to the healing art, and the estimation in whk-h •urcessful members of the profession have eTt-r been held, have induced great numbers of ignorant unprincipled men in every age of the world, to palm themselves off upon community as men capa- ble of healing disease; and always by tome new and unheard ol but secret process: and the extreme anxiety of the diseased, and (heir readiness to grasp at any promised relief, have always sup- plied this class of men with a sufficient number of victim*. The hlttery of Quackery from the eaily ages of the world dowa to the the present very enlightened era, and an exhibition of some of ita workings even at the present time, would form an amusing but sad ehapter in the history of Human affairs: It would be a melancho- ly story of Human depravity on the one hand, and of Human folly and credulity on the other. The sinceie enquirer after truth, has had to meet this difficulty in everv stage of his progress. Onq system of imposition and absurdity has been overthrown, only to give place to another perhaps still more absurd : and sos'rong has been the impression made, frequently, by some popular error, that the experience of ages has not been sufficient to disabuse the public mind. Even to the present day public opinion is strongly influen- ced by -erroneous notioDS which have come down to us from the dark ages, and which science has demonstrated to be false long ago. Take for examplo the old notion that every thing is composed of the four elements, fire, air. earth, and water: this opinion is made the foundation principle of an extensive system of modern Quack- ery, and is regarded as fundamental truth, by that most absurd of all classes of Empirics called Thompsonians. Quackery is not confined to any age or any people. Men of this generation may smile at the explode absurdities of the dark ages, or they may pity the ignorance and credulity of the poor savage: but at the same time impositions are palmed off upon mankind at the present day, different in kind truly, but not less absurd, not less ridiculous, than those that deceived our ancestors, or that now mislead the Indians of our forests. It is not confined to the classes of society that we call ignorant or illiterate. Men who seem to be tolerably well informed on other subjects, and who generally act fiom rational principles; on the subject ot disease and medicine, cut loose from reason and give the froe rein to then credulity I The American people claim to be the most enlightened well informed people in the world—the most liberal minded, the most thinking people. The state of New-York is not considered in these respects a whit behind other portions of the republic; and Broome county—why that is one of the choice spots of the earth, its inhabitants are so independent minded—such investigators—so free from fanaticism and what is called humbuggery of every kind. We sit down and read the history of the dark ages, and are aston- ished thatihe human mind conld wander so far from the paths of reason. The history of the Salem witchcraft excites in us feelings of the most startling hoi ror: we wonder that so much intelligent- 6 so much virtue, so much sturdy independence, as characterized our fathers, could possibly be mixed with such ridiculous such absurd credulity. The erroneous notions of the benighted Indian, the foolish mummery of his medicine man, in which he vainlyconfidea in case of disease, produce in us contempt mingled with commiser- ation for iheir ignorance and delusion. Could a full history of human credulity in all ages of the world, be spread out before the people of Broome, they would probably look upon themselves with a feeling of complacency—thh all quackery in the regular profession. The quack has certain distin- guishing charae'terislics, the same as any other genus of animals ; and when the man who claims 'o be a man of science assumes any of these characteristics, or adopts any of the practices which distin- guish this class of men, he not only brings a stain upon himself, richly meriting our contempt, but he degrades the whole profession of which he is a member. The first thing to which I shall allude under this head is the course of conduct which we ought to pursue towards the class of men of which I have been speaking. Perhaps it is unnecessary for me to say, that we never should consult with e them or consent to practice in connection with them under any possble circumstances. The temptation to do this is sometimes very strong ; but should always be promptly resisted: we should consult with no man who is not in regular standing with the pro- fession. The medical man who will do it is unworthy the name of a phjsician. and possesses but a slight sense of honor as a man. Physicians sometimes admit in conversation, that quacks are good i« some cases. This is an admission which should never be made, for the very good reason that it is not true. We should undoubt- edly extend to these men the usual courtesies of society in our social intercourse with them ; but as medical men we should exhibit to- wards them unceasing, uncompromising hostility ; duty to ourselves to our profession, to society, requires of us such a course of action. It is unnecessary to quarrel with them, no man should so far demean himself; but on all proper occasions in o;ir intercourse with socie- ty, we should hold them up in their true light. The man who is afraid to do this, is afraid to do right, and he who will sacrifice truth and justice for the sake of peace, would do well to retire from society, for mankind will certainly never be wiser or better for his sojourn among them. One of the most perplexing difficulties with which the profession have to contend, is the prejudice excited in the public mind through the influence of quackery, against some of our most important remedies. The strong wide spread and most ridiculous prejudice against mineral substances as medicines, has its origin entirely from this source; and I regret to say that men are not wanting in the regular professipn who instead of standing up manfully, to stem the torrent of popular delusion, and fearlessly expose the fallacy, in- directly give countenance to it; such men will admit in conversa- tion, that physicians do use rathertoo large an amount of minerals in their practice, especially of mercury] they take special pains to state that their prescriptions are generally vegetable, and when spea- king of a neighboring practitioner, they often remark by way of reproach—he uses a great deal of calomel, &c. Now language is inadequate to describe the contemptible mejmnessof such a course of conduct. This is real quackery ; it is dishonestly lending sup- port to ignorance, for the sake of a little personal advantage. It is jnost manifestly the duty of members of the profession to enlighten the public mind in reference to such matters. Under our present system of popular education, about all the information people have fifi medical subjects, must come to them through the profession ; 10 and no absurdity can be more easily demonstrated to be false than the very common opinion, that minerals are more dangerous when taken into the system than other substances. Physicians have the information and it is very easy to communicate it, that the most ac- tive and dangerous poisons in existence, are from the animal and vegetable kingdoms, principally from the latter. It is a remarka- ble fact that those poisons that have produced far the greatest amount of misery in the world by their destructive influence upon the brain and nervous sys'em, are entirely of vegetable origin. The mineral kingdom never produced alcohol, opium and tobacco : it is incapable of producing substances which like these will lay the mind in ruins, by making a wreck of that most noble, most mys- terious structure—the brain. It is difficult to understand the ori- gin of this prejudice against mineral substances as remedies for disease. Nature has kindly provided minerals in variety and abundance, as food and drink for man : and he finds not only his eomfort, but his health, his very existence, depend upon their free use. And, that man in his most simple condition may make no mistake in this matter, nature has provided and thrown in his way these substances in abundant profusion. Soda, Iron, Lime, Potash, &c, substances which constitute a part of ihe human body itself, and which must be constantly and regularly supplied, are found in every part of the globe. The untutored savage finds the little streamlet from which he quenches his ihirst, saturated with them. The civilized man as he draws the same cooling beverage from the depths of the earth, finds in solution abundant supplies from the mineral kingdom. People inhabiting some of the mountainous districts of Europe, who are confined to the water melted from the ir mountains of snow, fall into a distressing condition of mental and bodily imbecility. Whatever speculations may have been afloat on this subject, the want of a proper supply of mineral substances to the system, is probably among the most efficient causes of the disease called Cretinism. I have taken this brief view of this subject, not that it is necessary to argue the question before men of science; but to show how nu- merous and common place the facts, and how simple and conclusive thearguments, by which the absurdity of this prejudice may be demonstrated to any man of common sense. Nothing can exceed the folly of the man calling himself a man of science, who will give any countenance to this foolish opinion ; who will suffer himself to float along upon the current of popular ignorance, and who to gain 11 a slight personal advantage, will help keep alive in community a delusion which is one of the principal supports to quackery of every kind. Anoiherof our most important remedies against which con- siderable prejudice has been excited, is blood letting. Now to at- tempt to discuss the propriety of blood letting with the quacks, would bethe height of folly—the reason is, they are totally unqualified to conduct such a discussion: so indeed is every man in community, unless he be thoroughly versed in the science of Anatomy and Physiology: certainly no man is capable of conducting an argu- on this or any other subject, who is entirely ignorant ofthe facts rela- ting tothe subject. The whole tace ot quacks are thus ignorant.— Tbey generally deny the necessity of understanding anatomy and physiology at all: they are therefore not only unable ta discuss ihe subject but even to appreciatean argument. The man deeply versed in science and of large experience, isthe only man qualified to judge in this matter; such men have had this subject under investigation for centuries, and no practice in the who'eciide of medical science is more firmly established,or more uniformly sanctioned than blood letting; and yet some Physicians speak of it as a necessary evil, to be resorted to only in cases of urgent necessity ; andnever if other remedies jvill possibly meet the emergency. Now this is nothing more nor lessthan quackery. It is basely giving countenance to opinions conceived in ignorance, and set afloat by the most unprinci- pled Empiricism Theduty ofthe Physician in thiscaseas in every other ofthe kind, istome very obvious; he should be honest, he should make no compromise with error. He may not be able to explain to a community unacquainted with the Philosophy of the human system the modus operandi of blood letting; he may nntbeable to demon- strate to the unlearned thereason why blood should be abstracted from the system in certain diseases; but it is easy to point to its effects; these are decided, obvious, and immediate, more so than almost any reme- dy we possess; ana we have few active remedies which are so seldom injurious; by accident or otherwise; and if wecannot demonstrate the modus operandi of the remedy, we can generally demonstrate the ignorance ofthe men who disseminate the error: wecan easi- ly show community that they are not only ignorant of Physiology, but that they have never had a particle of experience of the remedy they condemn. They never have observed probably in a single in- stance its effect upon the human system. The very great number aud variety of prejudices against our methods of practice would pre- sent an endless theme of remark, were I to pursue the subject; for 12 there is scarcely a remedy adopted by the regular profession, but what has been a subject of unceasing attack. Aliho' we can atthis time but barely glanceat the subject, in pursuing this part of it, there is one error more to which I will briefly direct your attention; it has. obtained a very general circulation and is unfortunately countenan- ced by some members ofthe profession—That is, the opinion that th© remedies used by the regular profession are more dangerous than the simple roots and herbs ofthe Empiric; that if ihe regular physician does not succeed in relieving his patient, he will certainly make him worse; whilethe remediesof the quack are so very simple, that if they do nol havetheir intended effect they will certainly da no harm. This opinion as far as it relates to men of science, may be true in some few cases. In a profession as numerous as our own, we have some weak men, men who have not talent sufficient to meen its important responsibilities. Such men may fail to benefit, they may even injure their patients; medical men shqnld not pretend to the contrary; but their mistakes prove nothing against the regular practice. The man who has a scientific knowledge of the human system and its diseases and who brings to his aid a strong discriminating mind, will seldom render the condition of his patient worse, if he cannot relieve him. Physicians should give no support to this veiy common error. They can point triumphantly lo the general success of their practice, to their conquest over numerous diseases which were once very generally fatal, to their superior knowledge of others, by which their fatality has been diminished more than 50 per cent. They can allude with a proud satisfaction to the gradual increase in the average length of human life during the last century, just about in proportion as medical science has received an increased share of public attention; and this too in the midst.of causes of disease, such as our simple and hardy forefathers never knew.' These facts should be spread out before the public by the physician in his daily intercourse with them ; the common sayir.g that 'doctors kill about as many as they cure,' should be promptly rebuked; no man of sconce should so far demean himself as to silently listen to the base assertion: much less should he countenance the equally erroneous- and more dangerous opinion, that the medicine's prescribed by quacks are harmless, that if their prescriptions do no good ihey do no hurt &c. Of all the errors abroad in the world on the subject of medicine, this is probably the most dangerous. A premature grave has closed ovar thdusandUjWho from imbibing this foolish opinion have been induc- ed for some trifling disease to try what they deemed a harmless ex- periment. Experience has taught them when too late, that the. strongest constitution may be undermined and destroyed, by the in- discriminate use of even Roots and Herbs. The medical man in- stead of admitting even carelessly that the quack will do no hurl, should point to the unfortunate victims which every where surround us, and press home the question, who was ever benefitted by their absurd mummery? The active and dangerous character of their most common remedies should be explained lo community, a laige share of whom have nevei given the subject any investigation; but 1 have continued lo receive as truth, what they have beard often as- serted and perhaps never contradicted! I have extended my remarks to a considerable length upon that kind of quackery in the profession which consists in giving coun- tenance to, or silently acquiescing in, the absurd opinions propaga- ted through the influence of Empirics. I will now call your at- tention to that kind of quackery in the profession which consists in imitating the quack by certain practices which form the most degrading trait of his character. The first thing I shall men ion under this head is the practice of various kinds of deception. Sonie physicians contend that this is absolutely necessary ; that mankind are' so ignorant, there is no other way of successfully managing ihem. This to my mind is a very curious argument! because mankind are ignorant, that ignorance must be pampered ■<&)& confirmed, by the very men whose duty it is, and who alone have the power to enlighten them. The scientific physician has noihicg to gain, but every thing to lose, by the ignorance of community upon medical subjects; while quackery is nourished and sustained by popular ignorance alone. Some practitioners are in the habit of misrepresenting the con- dition if the patient they may be called to treaty by speaking of some trifling or perfectly manageable tnalady,.as a disease of very greai danger; in this way an alarm is frequently spread through a whole neighborhood in a case which should never have been heard of beyond the immediate family circle. How often do we bear of individuals who are not expected to live from day to day, and at a time when the pubhe are anxiously awaiting the solemn event, which is to call them to perform the last sad dujy to the unfortunate man, you piss by bis habitation, and behold! he is diligently pursuing his usual business. The, temptation to this ki»d •/<*««•«"*• fion may be very airong ; but it is dishonest, and meet outempti'ble-, it has the worst influence upon the public mind ; an influence most adverse to the interests of the profession. This is the very kind of deception by which the quack uniformly lays the foundation t« his reputation ; for if a man can treat suceesfully a most wonderful disease, he must be a wonderful man. Another kjnd of deception very nearly allied to this, is the practire of relating the history of most marvelous cases which have occurred under the observation of the practitioner; cases of such a character, (at least soma of them) as to place them entirely beyond the scope of probability.-^ These cases of course havs all been treated successfully !! Sonvi physicians will sit for hours and deal out to their ignorant an>l credulous auditors, such entertainment as this. Of the moral character of such conduct, I will not speak in this place: but «sv—' influence upon community, is, to induce the belief and expectation of these strange occurrences, and to throw s»n air of mystery around medical subjects : a condition of the public mind upon which quackery pan operate most successfully. Another prajetiae characteristic of the quack, and which w unfortunately adopted by some members of the profession, is to- administer a great many medicines for the mer? purpose of display, or to amuse the patient; and :o each medicine they will give ft most tremendously learned name, and pretend to expect wonderful effects fiom Its operation, while in reality they are doing nothing, but silently awaiting the salutary operations of Nature. Now this kind of deception tends to foster ignorance, and will sooner or laiei be detected ; it degrades the profession in the eyes of com- munity, and destioys that confidence in them which is so necessary to the interests of medical science and the welfare of community.- Some men seem to be quarks instinctively, every thing they say or do seems shrouded in mystery, every look and action to conceal a .tfratageim ! Such men make successful quackajthey never should study medicine and pietend to be men of science: what litt knowledge they acquire, seems a disadvantage to them. When such men entei the regular profession, they generally bring a disgrace upon it, for which no benefits they can confer upon man- kind will ever atone. To trace out the various deceptions practiced by them would be an endless task : they are the men who make ft great many new discoveries in medicine, they deal in specifics— have secret remedies for almost every disease, remedies unknown *o the rest of the profession: no subject is so simple but they make 15 of it a theme of wonder in the community. Some practitioners are in the habit of greatly exaggerating the amount andcharacter of their business; and not a child in the street but is a daily listener to their improbable stories. I once knew a physician who hid ninety rases of Typhus Fever m onp season, and treated them all successfullv-at least sosaid every man woman and child in his neighborhood. Now this must have been a wonderful man. and it was very fortunate that these cases all fell into the hands of a man who could treat them so successfully ; for I believe every case came under his care: I did not hear of another caseoccurring in the county. Some men always have »ti immense amount of business according to their own stoiy, and yet every body knows that they enjoy an abundance of leisure 1 These tricks strongly mark the quack, and when the man of pretended science resorts to them, he exhibits a small mind, little honorable reeling, and no real dignity of character: and as to his integrity, I will only say, the public would do well to investigate him thoroughly, before they commit to him very important responsibilities. I will now proceed to the consideration of another very important cause of ihe disposition in the public mind to patronise quackery, and be deceived by its foolish pretensions—That is the universal ignorance ofthe Human system and its functions, which is well known lo exist. The age in which we live claims to be an enlightened age: men push their investigations every where, no department of science or literature is unexplored. Years of intense sfudy are spent :o ascertain what the ancients thought, and to un lerstand the medium of their communications. Men traverse the whole Earth—cross barren deserts—climb the burning mountain top—plunge into the regions of perpetual snow—spend years of privation in the trackless forest—and boldly encounter every hardship and danger, that nothing in the whole range of Human knowledge may escape their observation. And much pains is taken to diffuse "the knowledge thus obtained throughout community by popular lectures, and bv books of every variety of size, shape, and complexion. That kind of knowledge especially, in which man's personal interest is supposed to be concerned, is most arduously cultivated : and yet the man ueeply versed in all these kinds of knowledge whose acuteness and sagacity secure him from fraud and deception of almost every kind; in matters relating to his own system, is as ignoraat as the uvtutored savage. The 16 most accomplished knave shall strive in vain to overreach or defraud him to the amount of one farthing, and yet the stupid, ignorant, swinish, quack (in consequence of this kind of ignorance) will bring him completely undor his influence. ' The study of tha human system as a science is the most interesting of any thing that can possibly attract the attention of man. He may search the universe throughout, to gratify his curiosity and enlarge the sphere of his knowledge: and yet he carries about with him in his own person, a system of machinery, more curious in its mechanism than the proudest achievrnents of ancient or modern art, more interesting and wonderful, as a display of Almighty wisdom and power than nature exhibits in any other of her works. But as a matter in which all men have a deep personal interest, it exceeds in importance almost every other kind of knowledge. A knowledge of anatomy and physiology should be thoroughly diffused throughout community ; it should be considered an important branch of popular knowledge; and as such, it should be taught in our seminaries of learning. It always appeared strange to me that so much importance has been attached to the study of mathematics and the Languages, to the entire neglect of other branches of knowledge of ihe greatest practical importance. Let a general knowledge of the laws whisb govern the Human system be popularly diffused, together with a thorough knowledge ofthe science of Chemistry, and the benefits conferred on society would beincalculable. The days of quackery would be numbered I The absurd theories which Empiricism has introduced, and popular credulity fostered, would, vanish in the light of science, like our river fogs before the beams of a rising sun. Take the ridiculous theory of Thompson for instance. One of its fundamental principles is that every thing is composed of four Elements, Fire. Aji, Earth, ahd Water. The school boy in his first lesson in Chemistry would learn to demonstrate ihe falsehood and absurdity of thisopiniorj. Three of these pretended Elements can very easily be.(showri lb be compounds : composed of substances entirely dissimilar to each other, and to the original compound — Another opinion put forth by the notorious Thompson—that Heat is life, and Cold is death, is equally conceived in ignorance. Let I man study the laws ofthe Human system as a science, and the manner in which animal heat is produced, and he woul dsoon ascer- tain that heat instead of being a cause, is a mere result of life ; it is on- ly one of a thousand little circumstances resulting from a healthy it action of the living powers. The very common notion that diseases originate in a bad condition of the blood, would be at once and forever exploded, if the specific character of the blood were well understood^ the manner in which it is produced and its peculiar office in the animal economy. The senseless tinkering with the system under pretence of cleansing the blood, and the foolish prejudice against Bloodletting as a remedy, would be at once and forever put to rest. A knowledge of these sciences would not only put an end to quackery by enabling men to detect and consequently avoid it, but it would do more than any thing else to advance the progress of medical science in the profession. Let the public be so enlightened as to be able to detect ignorance and Empiricism, (in the profe-ssion even) nnd science, talent, and moral worth, world be properly appreciated: it would holdout strong inducements to the medical man to cultivate science assiduously, and make tne greatest attainment in his profession. But in the present state of public opinion a man's science, his industry, his intellect, and even his integrity, have very little to do in securing the public approbation. This is notoriously true! The subject of medicine unlike every thing else is considered a most incomprehensible mystery. It seems to be considered that some men have a knowledge of it intuitively: that though a man be unfit for any thing else, he may be a good physician: he may be a man of notoriously weak intellect, and yet be a very able physician; he may be flagrantly dishonest, confessedly so, and yet be entirely fit to be"entrusted' with the most importat responsibilities; and that too under strong temptations to betray the trust. He may be stupidly intemperate, so as to unfit him for any ordinary business, and yet be a most excellent Doctor. Such is public opinion, very generally, such are some of the evils to be corrected by enlighieing ihe public mind on these subjects. It ought to be well understood that medical science is like any other extensive and complicated system of knowledge; to be.acquired and successfully practised in precisely the same way: that there is nothing mysterious or intuitive" connected with medicine, more than in the cultivation of ihe soil, or in the practice ofthe mechanic arts : that the man of small intellect, will consequently be a small physician, that the man of dishonest principles, will find in the practice of medicine an ample field for the exercise of his peculiar characteristics; and he will not fail to avail himself of the opportunities thus afforded him.— IB And the intemperate man is belter fitted fcr any ether business whatever, than tor the treatment of disease. You may make o! him a foreign ambassador, or set hirh to calculating the distance and magnitude of the fixed stars, but never admit him into the apartment of a man laboring under disease. Correct information on medical subjects might be very generally diffused, by the uniform, faithful, and well directed, efforts of medical men in their constant and extended in'ercourse with society; but the evils of which i have spoken will never be. entindy corrected until the mass of community shall receive a large amount of knowledge ofthe subject as a part of iheir education. I cannot dismiss this subject without expressing my sincere desire that the me mbers of this fociety may give it their serious consideration.and if any vest.ige of quackery should chance to exist in the regular medical profession of Broome County, either individually or as a society, we begin the reformation at home; that before we give loud utterance to our complaints of the prevalence of quackery we bring ourselves to that high standard of honorable action which alone can secure the eonfidence and respect of community, and place the profession upon that high and dignified elevation where it properly belongs.