Hygienic Influences AN ADDRESS DELIVERED BEFORE THE MEDICAL SOCIETY OE THE COUNTY OF KINGS ON ITS FORTY-SEVENTH ANNIVERSARY, A.. IX, 1868, BY J. H. HOBART BURGE, M. D. NEW-YORK: Francis Hart k Company, Printers and Stationers, No. 63 Cortt.andt Street. J871. J. H. Hobart Burge, M. D., President of the Medical Society of the County of Kings. My Dear Doctor: I hope you will not he offended at the liberty I have taken in having the manuscript I borrenved so long ago published. I send you the entire edition, and await your approval before appropriating a single copy to my own use, or dis- tributing any copies among my friends. I particularly desired to sec this address in print, because I believed it calculated to do good. It 7uill present to the popular mind a clearer view of the relations of the medical profession to the people, than can be found perhaps anywhere else so concisely written. If you accept this tribute of my affectionate appreciation in the spirit wh ich prompts it, I shall feel proud to have associated 7uith your honored name, that of your sincere friend and quondam patient, Charles C. Yeaton. Ne7o-York, May 25th, 1871. ADDRESS. In speaking to you on this forty-seventh, almost semi-cen- tennial, anniversary of the Medical Society of the County of Kings, fo be altogether professional would hardly be courteous to those of other tastes who have come up hither at our invita- tion ; and yet, to lay aside entirely the themes upon which we are wont to reflect, would, perhaps, disappoint all. Attempt- ing, then, no learned disquisition, I bespeak your indulgence while I talk of Hygienic Influences. Of these, some are familiar to you as household words, yet even these we shall not pass over in silence ; others are so subtle that no chemist has analyzed them,—no re-agent de- tected them,—no microscope discerned them ; and yet, “ by their fruits,” we “ know them.” To treat elaborately and dis- cuss scientifically even the main topics, which present them- selves under the head of “ Hygienic Influences,” would not only require much talent and research to make it of any practi- cal value or interest, but the hour would be all too short for such a purpose. The very expression suggests to your mind everything physi- cal, moral, intellectual, spiritual, which can, directly or indi- rectly, have any effect upon vital phenomena. The subject being illimitable, it is obvious that I must prescribe to myself some special train of thought. Very briefly, then, let me suggest some of the influences which are exerted upon our health by Generation, Nutrition, Ventilation, Occupation, Recu- peration, Religion and Medication. There is no legacy which we can inherit or which we can ensure to our children, at all comparable to a good constitu- tion. Of what avail is it to inherit gold, honor, titles, king- doms, together with a gouty diathesis, a syphilitic taint, a 4 scrofulous habit, an epileptic predisposition, a rickety frame? The practical lesson in this connection lies in the fact that children are, with, of course, certain limitations and excep- tions, just what their parents are. It is by this transmission of appetites, dispositions, faculties and frailties, that “ the sins of the fathers are visited upon the children to the third and fourth generation of them that hate God,” while through the same channel “mercy ” is shown “ to thousands of them that love Him and keep His commandments.” There are whole families who never make a misstep without breaking a bone ; who never cut a finger, or have a tooth extracted without danger of fatal hemorrhage ; who never expose them- selves to any depressing influence without dread of im- pending decline ; who never live to middle age without sure prospect of cancer, insanity, or some other kindred ill. To none of these unfortunates have we any infallible elixir to offer. We can only say to them, avoid persistently the exciting causes of those ills to which you have a natural proclivity or pre-disposition, and submit yourselves to the best hygienic influences within your reach. I venture a word more than I would upon this branch of my theme, because there is no woe so keen in this world as that experienced by a fond parent, in the chastening which some- times comes through the cradle of his precious child. Every physical organism possessed of circulating fluids and endowed with the vital principle, is constantly subject to molecular waste; and as effete particles are, by various won- derfully reciprocating processes removed, their places must be steadily supplied, or destruction to the whole system, or to some individual organ, must ensue. Wemust eat. So impor- tant is this that our beneficent Creator has established laws which act as universal life-preservers to the race. Not only is the supply of food regulated by the demand—through the arts of husbandry—but we are enticed by the delights of the palate on the one hand, or lashed by the pains of abstinence on the other, so that of all the methods of self-destruction, that by starvation is most unfrequent and most difficult to accomplish. No aliment can be regarded as suitable for the exclusive diet of man, unless in it are represented all the ele- ments which enter into the composition of all the anatomical 5 tissues. Inanition is, therefore, possible even where large quantities of food are taken—that food being of unsuitable quality. This fact obtains at every period of life ; so that infants are starved at the breast and die of marasmus, and men of full age die scorbutic in consequence of being fed upon a diet wanting some of the elements essential to supply the waste which, as already intimated, every muscular mo- tion, every arterial 'pulsation, and every intellectual operation is sure to cause. Man is omnivorous, as is shown not only by his almost universal habit, but by his anatomical peculiarities. Yet so rich is the vegetable kingdom in nutrient materials— both nitrogenized and non-nitrogenized—that the experiment of proscribing animal food altogether has often been declared a success. It is said that neither Lamartine nor his mother ever tasted animal food. There are hundreds of vegetarians in our own country, who claim for their system great advan- tages. Though admitting that we cannot see any evils di- rectly accruing therefrom to the masses, yet individual lives seem to be occasionally sacrificed by too rigid an adherence to the Gfrahamite theory. Beside, we cannot be sure that the strength of our race would not gradually be impaired, and new forms of disease developed, by following a system so de- cidedly at variance with some of the simplest indications of nature. The cupidity of those who deal in the necessaries of life has led to extensive adulterations, so that to get in their purity the commonest articles of daily consumption, is some- times said to be the exception instead of the rule. The effect of this iniquity is two-fold—sometimes simply robbing us of the materials which we suppose we are taking, and sometimes introducing to our systems the most deleterious agents. To overcome this evil, legislation has proved impo- tent. Let every man, therefore, be his own inspector, his own chemist, and test, as far as practicable, the articles which are brought into his kitchen. There are, perhaps, no more universally adulterated articles than milk and coffee; and I refer to these particularly as af- fording good illustrations of the two-fold effect already men- tioned. If milk be simply diluted with pure water, the vil- lain who does it has only to answer for withholding from the innocents who depend on him for their daily supply, one-half 6 of that nourishment which is essential to life. He does not 'poison, he starves a few hundreds ; and because he cannot hear their piteous wail he imagines himself guiltless. The case is quite different when milk is otherwise adulterated, or when furnished from an impure source. Then the wretched dealer must answer for the direct but slow poisoning of his uncon- scious victims. Of the adulterations of coffee, so familiar to all, I have only to say, that in the case of an article almost essential to the health and comfort of those long accustomed to its use, if any inert substance be palmed off* in its stead, a serious loss is sustained ; while if it be adulterated with blast- ed rye, or any other material having toxic qualities, the evil lies in a direct attack upon the powers of life. Some will perhaps be surprised at this incidental praise of a beverage which often meets with unqualified condemnation. It will be instructive to note that coffee, tea, cocoa and mate, so differ- ent in external appearance, in taste, and in the sources from whence they are derived, contain active principles, called re- spectively caffene, theine and theo-bromine, which are chemical- ly almost identical, and which are found nowhere else. These active principles afford nourishment, gentle stimulation and direct support to the nervous system : and it is interesting to consider that different nations, at different times, long before these chemical relations were known, instinctively chose these articles as affording safe and refreshing daily beverages, and notwithstanding the occasional violent tirades of learned ig- noramuses, they are as popular now as ever.- But, are they never injurious? Yes. What is not ? Like all good things, they should be used judiciously. So long as there are persons in the world of such delicate and impressible nervous organi- zation, that some will even “die of a rose in aromatic pain,” it is not strange that there are many who cannot take these powerful nervines, even in a very dilute state, without dis- comfort, neuralgia, headache or dyspepsia. It is no doubt as natural for man, endowed as he is with reason to guide him to many inventions and discoveries, to cook his food, as it is for the panther to take his raw, and yet through the oven comes to us the greatest amount of injury to health and danger to life. The extent to which the culinary art has devoted itself to the pleasures of the palate, has ren- 7 dered easy, indeed, the first steps in the process of digestion, prehension, mastication, insalivation and deglutition,—while the more important processes of chyinification, chylification, absorption, distribution and assimilation, are left to be wrought out with groanings unutterable. Feasting is a delight which has been highly appreciated in all ages and by all classes of men. It is called generally a sensual pleasure, but it is so only in part, and especially when carried to excess. An active brain would soon collapse if fed only with intellectual pabulum. Never have I seen any class of young men do ampler justice to the noonday viands than students after four hours’ close application to college themes, with almost no bodily exercise. The brain—the impressible organ upon which the spirit of man first operates in its every effort to communicate with the external world, is just as lia- ble to waste and loss of substance, as are the other tissues of this wonderfully complex machine, and the materials for its repair are drawn from the same alimentary source. Call not, then, sensual with any emphasis which shall seem to cast a slur upon the pleasures of the table, that attention to the wants and cravings of “ the inner man,” without which not only the heart would cease to beat, but the very “ heart of hearts ” would find no means of communication with its loved ones of earth, and without which, not only the “ inner man ” of this literal phrase would soon come to grief, but the high- est achievements of the veritable inner man—the spirit itself— would be lost to earth for want of a suitable medium through which to convey impressions. It is natural and healthful to eat to satiety, and can hardly serve any good purpose, either physical or spiritual, to follow the advice of some ascetics and go hungering and thirsting all through life—unless it be “ after righteousness.” But just here, let me remind you, that to eat to satiety of the Scotchman’s oatmeal-stirabout, or of Yankee corn-bread, or of any other simple fare, such as honest toil would crave, is a very different thing from the satis- fying of that last possible tingle of pleasure, of which the gustatory organs can take cognizance when tempted by a thousand dishes, in a thousand fascinating forms, with a thou- sand delicious sources and the conventional number of courses. Let me also remind you that there is generally nutriment 8 enough in a tithe of our food for all the requirements of the system, and that nine-tenths are taken solely for the pleasure of it. Again, in this connection, it should be said that al- though there is a healthy stimulus to body and mind, in a certain amount of even generous living, yet too frequent or too continued indulgence tends to sluggishness of thought and obscurity of the mental vision; while dieting and fasting are often of the greatest hygienic importance, freeing as they do the body from peccant humors and the soul from physical thraldom. There is, perhaps, no subject, the importance of which is more universally acknowledged, and none more generally neg- lected than ventilation. As air is essential to life, so is pure air, and enough of it, to health. Every one knows that at- mospheric air is composed of that great supporter of combus- tion and respiration—oxygen gas—diluted with about three and a-half times its volume of nitrogen, and that it is liable to be vitiated and rendered unfit for use in a great variety of ways. These sources of impurity are known and read of all men who make the slightest pretension to intelligence. One hundred years ago, facts which lie very near the founda- tion of physical science, arid which are now familiar to all, were not known, even to the philosophers—and yet our grand- fathers knew as well as we know the fact—that a man cannot live without air one-fiftieth part as long as a fish can out of water. Take away a man’s native element and he dies quick- ly ; take half away, and he dies less quickly ; take away any portion of that which is necessary to the full and free expan- sion of his lungs, and to the thorough oxydizing and decar- bonizing of his blood, and in that proportion he languishes. I can, of course, in the few words permitted me, only hur- riedly hint at facts as familiar, perhaps, to every one of my auditors as to myself; yet, notwithstanding the “ line upon line, and precept upon precept,” to which we are constantly subjected, we live in ill-ventilated dwellings—and our court- houses, prisons, churches, school-houses and hospitals, though they be elegant structures, are often stifling in the extreme. No room can have proper and uniform ventilation unless there be means provided, at intervals proportioned to the room’s capacity, for the free egress of both light and heavy gases. The requisite ingress of fresh air to all parts of a building can seldom be had, unless provided for by the architect of that building in its original construction. I am not alone in the opinion that hospitals should have fresh air admitted at the head of each bed,—the beds, of course, being at least eighteen inches from the wall, and the patients properly protected from draught. Some of our common school-houses should have been indicted for manslaughter, or rather for infanticide long ago : the atmosphere in some of the rooms, particularly those assigned to the infant department being absolutely poisonous, and the temperature, on some of the colder days during the last winter, not rising to fifty degrees F. at any time during the daily session. Stringent laws should be enacted, prohibiting property own- ers from leasing basement-room to be occupied as family resi- dences. It is time enough to be put under ground after we have stopped breathing altogether. Not long ago, I called to see a sick girl who lived in one of these underground tene- ments. I said, as I entered, hardly seeing whether there were any to reply, “ How can you expect to be well in such a place as this ?” “ Why,” said the mother, “ is not this healthy ? I’ve lived here eleven years and always thought it a healthy place.” I asked her if she had any other children. “ Oh! yes,” she said, “ I’ve had seven, but there’s only one left.” Upon inquiry, I found they had all died in that room, and that they were cut off by just such diseases as were most likely to be developed by damp, foul air. There is no period when a pure atmosphere is more essential to health than during sleep, and yet this is the time when “ tired Nature ” is especially robbed of her rights—that which Gfod designed as her “ sweet restorer,” being stifled with noxious and stagnant exhalations from lungs and skin, to say nothing of the products of com- bustion from coal and gas. (I would recommend, as particu- larly adapted to dormitories, the occasional swinging of the doors back and forth upon their hinges ; try it and you will not think it so insignificant a point as it might otherwise seem.) What would our grandsires have thought of the at- tempt by weatherstrips or otherwise, to exclude the last breath of vital air as it struggles to reach some unconscious mortal in his heavy, unrefreshing slumber '? As there is a time 10 and a place for everything under the sun, no doubt there is for weatherstrips; but as a rule, I would rather break out every fifth pane in your sleeping apartment, and by just so much would I lessen the pains in your physical organism. When our grandmothers lay upon their nurse’s laps (nurses, did I say ? Our grai£-grandmothers were their nurses), they could look out ol the noble chimney-top and see the heavens, or feel at times the rain-drop or snow-flake; there was venti- lation worthy the name ! We would not go back to these primitive times of curfue-bells, cranes, pot-hooks, bake- kettles, foot-stoves, warming-pans, andirons, backlogs, fore- sticks, bellows, steel and flint—but let us not, in this age of comfort and luxury, forget the essentials of a hardy manhood, viz.: pure air, plain food, honest labor and full rest. “ As the sea contains a little of everything that is soluble in water, so the atmosphere may contain a little of everything which is capable of assuming the gaseous form. There are also floating in it innumerable particles of dust, some simple and inocuous ; others irritant and poisonous.” In this circum- stance is found the key to the remarkable healthful ness which prevailed during the early part of last summer. So frequent were the showers that the atmosphere was washed and con- stantly presented to us in its greatest possible purity. This branch of our theme naturally includes the effects of vegeta- tion, together with all miasmatic, barometric, thermal, and electric changes in the atmosphere, and involves a considera- tion of the styles and materials of dress suited to different ages, seasons and climates. The methods of heating our dwellings also constitute a subject inseparable from that of ventilation. So diverse are these various branches of study that we can only allude to them, and slightly indicate their importance by a few desultory reflections. The lower the temperature of the air, the less of it can we comfortably ad- mit to our dwellings, and the more fuel do we consume. Now, oxygen is alike the essential supporter of combustion and of respiration, and carbonic acid is alike the main product of both. Imagine, then, these two processes, combustion and respiration, carried on simultaneously in an apartment where the ingress of air is insufficient to supply this great demand, and you will behold a contest between the burners and the breathers as to which can hold out the longest. Each is consuming the oxygen so essential to the other, and each is producing the carbonic acid gas, so stifling to the one and so extinguishing to the other. It would appear from these con- siderations that a fire should always receive the atmosphere necessary to its support, from some other source than the apartment intended to be warmed by it. Catcris paribus, 1 have no doubt of the truth of this proposition ; yet an open fire in a grate or on a hearth, where there is a free draught, may secure a more healthful condition of the air in the room than is generally the result of our cellar furnaces ; for, in the one case the draught carries off freely the injurious products of combustion, and occasions an inward current of pure air from every crevice in every part of the room ; while in the other case, the dried and rarified atmosphere is constantly pressed up from the chamber about the furnace, and may even have largely yielded of its vitalizing qualities to the incandes- cent mass below. The necessity of furnishing moisture to the air of every heated room is too familiar a fact to mention, and yet it is generally forgotten. I suppose the method of heating by steam comes nearer perfection than any other. It is automatic. It furnishes no blast of heated air from un- known and questionable sources. It gives its caloric directly to the atmosphere of the room designed to be warmed, with- out abstracting the oxygen so much needed for other purposes ; and you have only to admit a sufficient amount of fresh air from without, and give suitable egress to that which is vitia- ted by respiration and insensible perspiration, to secure the greatest purity possible to a heated room, occupied by living beings, each one of whom demands about forty cubic inches of air for every minute of time. Sitting-rooms, lecture-rooms, school-rooms, churches, prisons, sleeping apartments, or any other places occupied for considerable periods uninterrupted- ly, should allow eight hundred to one thousand cubic feet of air to each occupant. Among the many abuses which that noble animal, the horse, suffers at the hands of the ingrate whom he so faithfully serves, is that of being locked up every night in a tight box—not one stable in ten having'sufficient ventilation. Owing to this and other depressing influences, horses are considered old at six- 12 teen, winch ought to be vigorous at thirty years. A gentle- man invited me the other day to look at a stable which he had just built for six high-priced and highly-prized horses ; and though he considered it a paragon, I assure you there was not sufficient ingress of fresh air to inflate the capacious lungs of one such animal healthfully. This whole subject needs ventilating, but other topics beckon me away for the present. Among the hygienic influences, of which I promised to say a word, is occupation. I have chosen this term purposely,— not exercise, but occupation. We may assume that to be the highest state of health in which there is the greatest normal development of all the powers and faculties of soul and body. Hence no amount of mere physical exercise can make a strong man—it may make a strong animal, with enough of the hu- man to sustain him in respectable society. On the other hand, no amount of mere intellectual effort can make a strong man—it may make an enthusiast, a fanatic or a sickly philoso- pher, with enough of the animal to require food and drink. When it is said that to be healthy we must have exercise, let it be understood, then, that no mere muscular motion is meant by this, but the fullest and freest normal activity of all the powers and faculties which God has given us. That blessed curse, “ By the sweat of thy brow slialt thou eat bread,'" and that generally overlooked commandment, “Six days shalt thou labor” sufficiently indicate both the necessity and the duty of occupation. As “ bread ” is generic, stand- ing for all food, so is “ labor ” for all active duty. It seems essential to the best health, that every one should have some definite object in life—some special avocation—and not be left to the caprice of the moment to determine what the mind shall contemplate or the hand fashion. Doubtless here is room for the greatest possible variety of choice and adapta- tion. Do not suppose because you occupy a high station in society that your son must be a professional man. He may be happier, more highly respected, and, what has more to do with our present purpose, he may be healthier in body and mind, in any other capacity. Never try to make a whistle or a silk purse till you have examined the materials with which you have to deal. It is a happy circumstance that the legiti- mate, honest and honorable occupations of man in every civil- 13 ized community, are so varied that every taste can be gratified, every one’s ambition stimulated, every reasonable hope satis- fied. Beside these, however, are many avocations which turn night into day,—many which necessitate the constant inhala- tion of noxious vapors, of metallic or other irritating parti- cles, or the introduction to the system of dangerous elements ; some which subject their followers to a temperature far above or far below the healthy standard ; some which require a de- gree of toil too nearly incessant to be compatible with health, and some which demand a life so sedentary that vigor were an impossibility. Examples will readily suggest themselves to every mind. We have used the word occupation to stand for exercise of every kind and degree, and we regard it as one of the most important of hygienic influences, that every one should have something pleasant to do, and you will not appreciate the full meaning of this remark unless you apply it to persons of every age, from the cradle to the grave, and to every condition of life. To supply material for healthful action of head, and heart, and hand, is a problem of no mean importance to the convalescent after severe illness, and in our public hospitals would save from many a relapse, and hasten the hour of per- fect recovery. If this be true, what shall we say of the in- curables ?—those patient prisoners for life, who, with no hope of recovery, drag out the weary months, or even years, with no occupation. It may be they cannot read nor write—give them oakum to pick, a pine stick to whittle—give them domi- nos, jackstraws ; anything but stagnation. There is, perhaps, no class who suffer so severely the depressing influence of nothing to do as little children. Their active brains will, un- der favorable circumstances, seize upon something congenial, and their little fingers are generally active in attempting to unravel the surrounding mysteries; but how important when disease or bereavement has awakened a morbid train of thought, and circumstances have conspired to shut from them that joy which is their proper occupation, that we should as quickly as possible supply the loss. Medicine will not do it; nutrients and stimulants will not do it; trinkets, and dolls, and pictures, and peep-a-boo, and a good hearty laugh, together with the very business of the baby-house, are alone adequate 14 to the tusk. Now, when cradledom is passed, let all the branches of education go hand-in-hand,—intellectual, moral, physical,—that each may aid the others, as it will, if none be unduly stimulated nor depressed. And let me beg you to re- member that both girls and boys, even to early manhood and womanhood, should not only be catechized, and trained, and disciplined in all that is needful to develop an earnest Chris- tian and literary character, but should have ample opportunity to run, and romp, and scream with fun. It is not conven- tional, but it is natural and sensible ; and tan and freckles are vastly prettier than scrofula and effeminacy. Next in hygienic importance to labor, occupation, activity, exercise—call it by whatever name you will—comes Rest, or, as we prefer to say, Recuperation. Not that these are synony- mous terms; but rest being the means and recuperation the end, we prefer to keep the end in view. Not only the body, as a whole, requires frequent and regular periods of quiet and sleep, but each separate organ or system of organs needs op- portunity to recover the power which is sure to be impaired by long continued effort. The eye may be used out of propor- tion to the other organs, and become amaurotic. In such a case, ordinary rest will not suffice. Let the eye itself stop all work, and roam pleasantly over the fields of nature. The brain may be unduly taxed while the amount of sleep is quite sufficient for the animal frame ; stop all study—all close ap- plication to intellectual labor ; let your thoughts be free and easy,—your conversation jovial,—your reading light, and the jaded organ will soon regain its wonted vigor. When the poor, abused stomach is made a receptaculum omni rerun, and called upon to digest food taken every hour in the day, is it any wonder that it rebels against such misrule, and refuses all overtures of peace? Even the heart itself, accustomed as it is to ceaseless though involuntary action, may be over-worked, and since it can never rest in the full sense of the word, till its destiny is fulfilled, it must be brought under sedative influ- ences, and the other organs which suffer with it must minister to its comfort, and enable it to recuperate in the only way possible to such an organ. The muscular system, too often and too continuously taxed, grows sore, and stiff, and weak. The world is all alive to the importance of exercise ; but lit- 15 tie is said or thought of the hundreds who die for want oi rest—rest for the body—rest for the mind—rest for the soul. The Sabbatical law is founded in the necessities of our three- fold nature, and its spirit extends to other days than the seventh and the first. Even those men whose Sundays are so actively spent in religious work, that the holy hours are more fully occupied than those of any other day, often find in the differ- ent set of faculties brought into exercise, just the relief then- systems require. This necessity for bringing different powers successively into action in order that each, in turn, may rest and recuperate, is illustrated by the familiar fact that one, tired by walking on level ground, finds partial rest by ascending a gentle acclivity; and in the mental and moral world an illus- tration may be'found in the alleged fact that the custom of appointing permanent curates to the great cemeteries of Eng- land was abandoned, because such continued sameness of intellectual effort was found to produce demency. There is no rule which can be laid down as to the amount of sleep which it is best for man to take. That ascribed to Franklin : “ Five hours for a man, six for a woman, and eight for a fool,” might have applied to himself, his wife, and to some simple- ton whom he knew. It could hardly have had a wider range, since most men require the fool’s allowance. Neither is the amount of sleep required any criterion of talent. Examples are familiar to all of those who require and take a liberal al- lowance of the “ sweet restorer,” and who, nevertheless, when awake are wide-awake, and ready to make their presence and power felt in their day and generation. On the other hand, I knew a mechanic of very ordinary ability, who seldom slept an hour at any time. He was full of vigor, and worked nearly as much by night as by day. Such instances as those of Na- poleon and Charles the quite as rare in regard to their vigilance, as to their other distinguishing characteristics. Tossed and torn, wearied and worn, as is the whole degener- ate race of man—sickness, and sorrow, and death—being so oft the legitimate sequence of sin, a rest and a recuperation are needed, such as no earthly pillow and no exemption from toil can afford. “ Come unto me all ye that labor and are heavy laden,” saitli the Great Physician, “ and I will give you rest.” The hygienic influences of Religion are many and great. It has been said that “ any religion is better than nonebut it may reasonably be questioned whether some systems of reli- gion are not equivalent to none. The word, you know, is from re and ligo—to bind anew, and implies either a binding by oath or obligation to God, or a binding or holding oneself back from the indulgence of any inclination which is not ap- proved by the individual’s conscience. Thus, you perceive, it involves on the one hand all the wild notions of the barba- rian who sacrifices his offspring and tattoos his own body to appease the wrath of his imaginary God ; and on the other, all the temperance, soberness and chastity—all the meekness, humility, faith, hope and charity of the true Christian. It must, therefore, in these its extremes, and in'its thousand in- termediate phases, exert a powerful hygienic influence upon every community. The rites, restrictions, ablutions, fasts, feasts and Sabbaths of the Jewish Theocracy were doubtless, in great measure, designed for sanitary effect; and if we con- sider the systems of the present day, we shall find some fur- nishing patients to our insane asylums, while others exert so salutary an effect upon the mind and heart, that they promote the health and increase the longevity of the race. While of true Wisdom it may be said: “ All her ways are pleasantness and all her paths are peace “ The way of the transgressor is hard,” and “ The ungodly do not live out half their days.” Mormonism thrives on lust, degrading both soul and body ; and many less flagrant systems, having in them the seeds of infidelity and self-indulgence, tend to lessen, materially, the standard of public health and morals. It is a trite remark that “ he who is prepared to die, is best prepared to live ;” but I tell you, my friends, when danger is imminent, such a one is more likely to live than he who has not the consolations of divine grace. I am much mistaken if I have not known anx- iety as to one’s spiritual condition to militate against convales- cence. But the greatest value of religion in its hygienic re- lations is as a prophylactic. It prevents disease by restrain- ing from those excesses and those indulgences which are sure to produce it; it casts its burden of cares upon one divinely strengthened to bear them ; it moderates the intensity of a grief which might otherwise terminate in despair, insanity or 17 death ; it imparts of that “ perfect love which casteth out fear;” it restrains wrath, and enjoins upon him who would go through life “with his hand against every man and every man’s hand against him,” inasmuch as lietli in him to live peaceably with all men ; it forbids avarice; it commands for- giveness ; it inculcates cheerfulness; it inspires confidence in God, which is a good definition of faith; it fills the soul with hope in the hour of greatest adversity; and as already suffi- ciently implied, it confers “ that most excellent gift of charity, without which, whosoever livetli iscounted dead before God.” Who that at all appreciates the intimate relations of soul and body, of mind and matter, can for one moment doubt that the possession of this all-pervading, all-embracing principle of divine love, is fraught with incalculable sanitary blessings; while its absence leaves one a prey to temptations involving innumerable morbific agencies. Of all the hygienic influences, none demand of us more ex- tended notice than those of Medication. A facetious Yankee doctor, well-known to the readers of light literature, once said : “ If all the medicine in the world were thrown into the sea, it would be all the better for mankind and all the worse for the fishes.” Many regarded this as a slur upon the medi- cal profession, and as an attempt on the part of the author to gain favor by yielding to popular prejudice, and by sacrificing fact to fun. A more careful consideration of the subject will, however, not only justify the remark, but will make men aware of the terrible danger which constantly overhangs them, and which, with shocking certainty, abbreviates the life of at least one in every hundred of our race. When we remember that medicine is administered not by educated and conscientious physicians only, but by charlatans innumerable, who know little of the effects of the agents they use, and still less of the maladies they profess to cure, nor yet by these alone, but by the rank and file of every community, so that the grand mission of every intelligent physician is to exhort people in the name of God and the Sixth Commandment not to dose, continually, themselves and their children. when we reflect that every apothecary shop is packed, almost from Zenith to Nadir, with compounds equally villainous for inertness on the one hand, or for power of random good or 18 ill on the other, can you wonder that any careful observer should say : “ These follies, these excesses, these ignorances, these cupidities, more than counterbalance all the good that highminded and conscientious practitioners are able to effect in relieving the ills of the flesh.” “ Throw, then, physic to the dogs,” I say, and I say it deliberately, heartily., conscientious- ly, “ Throw physic to the dogs,” if you want the dogs to die and men to live, unless you can find in the circle of your search some good man and true, who devotes his life to the careful study of remedial agents in reference to their thera- peutical value, and to the study of disease in its amenability to treatment. Then, and then only, may you, with any safety, medicate yourselves and your little ones. Fond mothers can never know, till they meet them on the other side the river, how many of their children they have sent home before the time, by the administration of what seemed to them some simple, domestic remedy,—mark the word, there was nothing simple about it, except the act of giving it, for it awoke a train of morbid sympathies in intricate and delicate organs which ceased not till the spirit was driven out in search of a more peaceful tenement, where it would be no more liable to disease nor death, nor to attacks of uneducated self-constituted doctors. A noble and honorable calling is that of the apothe- cary ; but a mere medicine-maker and vender is culpably ig- norant or basely unprincipled. The rumseller is saintly by comparison, for he never denies that what he sells will kill, while the other professes to make alive, but kills as surely. ’Tis a sad fact that thousands who would never go there for anything else, are willing to climb up to Heaven at the risk of their necks to find some new aethereal compound or subli- mate,—or go as far in the other direction for pyrogenous or sulphurous mixtures, if they only knew that they would sell. I know not how to illustrate adequately the folly of submit- ting oneself to ignorant and non-professional medication. If you had a watch of curious and costly workmanship—valua- ble to you not alone for its intrinsic worth, nor yet for its simple relation to every day use and convenience ; but one associated with all that was dear to you on earth, and with those who had gone before you to Heaven, and to your dismay you should discover that something was disturbing the beau- 19 tiful harmony of its movements,—what would you do ? Would you, with delicate tweezers, and fine points, and soft brushes, try to remedy the evil yourself? Or, would you go to a doctor of medicine, or a lawyer, or to some one else equally ignorant of the work to be performed, and equally destitute of the requisite means to be employed ? Would you not rather seek an artisan who had well learned the trade of a watchsmith, and had judgment and honesty to practice it faithfully ? Not inferior, in danger and criminality, to this self-dosing is the practice, unhappily too common among otherwise intelligent people, of entrusting the health and life of their families to some one who, through the various styles of advertising and the thousand meretricious arts which the regu- lar profession scorns and condemns, has risen to notoriety and false fame. There is not one of this class who does not merit the halter. Each one knows himself to be a quack, yet owing to your encouragement and support, my non-professional Christian brother, he goes scot free. There is a class of quacks who are too ignorant to know it, and yet they are often learned and conscientious men. What a bull! The only explanation I shall offer of this apparent paradox is, that men may be very learned in some things which very few know anything about, and yet very ignorant of what everybody ought to know all about. Again, some are so visionary and credulous by nature, that no academic, collegiate or practical advantages or opportunities can possibly save them from all manner of clairvoyant, mesmeric, Swedenborgian and spirit- ualistic complications : against such, there is no protection for the non-professional masses, except such as is afforded by sterling sense and intuition. There is, however, a still more dangerous quack—a perfect rara avis. He is educated, and may be refined,—he has experience, knows how to treat dis- ease, and he cures his patients. In what, then, you may ask, does his quackery consist ? Simply in that he is dishonest, and uses his professional opportunities for base and selfish ends. Some will say : “ If there are such men in the profes- sion, how shall we protect ourselves against imposition?” I answer—just as you would protect yourself against a hypo- critical clergyman, a tricky lawyer, a knavish tradesman, or a thievish clerk. If you will admit to the privacies and sanc- tities of your family circle the profane, the vulgar, the intem- perate and the licentious, you must not hold the profession, but the individual and your own folly responsible for the con- sequences, whatever they may be. There are, no doubt, as bad men in any profession as there out of it; this fact must be charged to the race and not to the professions. No doubt, my friends, there be some who, for many years, have suffered many things of many physicians, and were nothing bettered, but rather grew worse; but ?twere well to reflect how many facts contribute to this result,—the certainly incurable nature of some maladies, the still greater intractability of some pa- tients—and, lastly, the consummate ignorance of some doc- tors. So many forms of unscrupulous criticism have been used against the medical profession by so many interested and prejudiced persons, that many are led to suppose, and are really honest in the conviction, that nothing is more vague, and uncertain, and contradictory, than medical practice. So far, however, is this from being true, that there is more of certainty and positiveness in the teachings of medical schools, and the application of medical principles, than is to be found in the theory and practice ol either law or divinity. I have too deep a sense of the truth of divine revelation and the sa- credness of the sacerdotal office, to push the comparison far in that direction ; yet, who does not know that two teachers in Israel, equally learned and apparently equally honest,— reading the same word and studying the same history,—differ so widely, not only in externals, but in the vital points of faith and theology, that large congregations of earnest wor- shipers look upon each other as committing idolatry on the one hand, or “ denying the Lord that bought them,” on the other. (The true explanation, however, of these differences is to be found in the short-sightedness of men, and more or less of uncertainty is inherent in all human affairs.) High and holy as is the office of a judge ; honorable as are the duties of a counsellor; sacred as is the law of the land— are there no doubts and uncertainties in the higher or lower courts? no decisions reversed ? no innocents condemned? no traitors unpunished? no common criminals left unwhipped of justice? no princely fortunes frittered in endless quibbles on 21 technical points ? ’Tis only a rare experience to leave the halls of justice thoroughly impressed with the positiveness and even-handedness of legal decisions, as were the two men who found the oyster. A dispute arising as to which saw it first, and consequently as to who should have it, they repair- ed to the office of a distinguished jurist, who assured them that in his judgment it was the simplest case imaginable,— unquestionably the oyster ought to be equally divided, to which the finders readily assented as eminently just and proper. The lawyer immediately proceeded to make the equal division by eating the oyster himself and giving to each client a shell. As in Theology, there are sacred lights which occasional stupidity and hypocrisy can never befog ; and, as in Law, there are precedents, and axioms, and golden rules, which no pettifogger’s pitiable plea can obliterate. So in medicine, there are facts innumerable and inestimable which can never be obscured by the dust of passing theories, nor overthrown by the false logic of the charlatan ; but, like the fixed stars, they shine brightly above all the clouds of error, and above every ignis fatuus, and all the flickering torches of quackery, which but serve to make the darkness visible in the stratum wherein they move. Can any one doubt the fact that a perfect flood of light was poured into the brain and first stimulated the heart of our profession by Harvey’s brilliant discovery ? Can there a man be found so unintelligent as to believe that the world gained nothing by a knowledge of the vital current’s ebb and flow ? Did Laennec, for all practical ends, listen in vain to Nature’s “ still small voice,” as she speaketh the truth from the heart ? And as Avenbrugger knocked at the door of Science, was there not a response elicited which, for all time, shall guide to surer diagnoses, and therefore to sounder therapeutics ? Is there anything in life more fixed and absolute than the teachings of chemistry,—which science has been developed and almost perfected by our profession ? By it, poisonous sub- stances, accidentally or criminally introduced to the system, are neutralized and rendered harmless,—by it the slightest aberrations from the healthy standard are detected in the ani- 22 mat fluids,—by it suicides are rescued from tbe effect of their madness; murderers brought to justice; dangerous adultera- tions exposed ; valuable analyses effected ; new combinations originated ; new elementary substances discovered ; and, what is more to our present purpose, a host of new remedies brought to light—definite in composition, certain in physiological ac- tion, and invaluable in their therapeutic relations. Is anything in heaven or earth more certain than that the discovery of the immortal Jcnncr has saved millions from an untimely and loathsome death ; tens of millions from disfig- urement, and hundreds of millions from fear? Did ever Bell ring out a clearer sound than that which Sir Charles caused to vibrate and undulate from brain to brain, from nerve to nerve, from ganglion to ganglion, through mo- tor, and sensitive, and sympathetic ? Who has not heard of Marshall Hall’s Reflex Motor action, —simplifying many obscure affections ; and does not his very name bring to your mind’s eye a drenched multitude rescued from a watery grave; even after the last sense of suffering had been experienced, and thousands of otherwise asphyxiated mortals brought back to the embrace of earthly friends? Would bleeding humanity readily relinquish the gift of the renowned Ambrose rare, and go back to the days of stypstics and escharotics—exchanging the simple ligature for hot tar? Do you need to be reminded that myriads of lives have al- ready been saved by the haemostatic properties of the subsul- phate of iron, so lately discovered by Monsel ? Can any one doubt the excellence and accuracy of Schleiden and Schwann’s microscopical observations in JH37, in their bearing upon physiology and pathology; and the subsequent demonstration by Virchow and others, of the cellular origin and growth of all living tissues, normal and morbid ? Who does not know that the practical suggestion of our own T. Gail lard Thomas has enabled us to slip the cord that would otherwise have bound many an innocent juvenile to in- evitable death ? Are you not all familiar with the opium treatment of peri- tonitis, introduced by the elegant and erudite Alonzo Clark, of New-York—a discovery by which he has saved the lives of a thousand wives, though he never had a wife of his own ? Who thinks now of questioning the feasibility of ovariotomy, an American operation, introduced by Ephraim McDowell, and clearly proved to be less fatal than amputation of the thigh after severe injuries? Again, what American is not proud of the triumphs of Marion Simms, in a field not pre- viously unexplored, but one which required just his indomita- ble energy and perseverance to overcome its sterility ? If you should chance to meet with that horrible accident, dislocation of the hip joint, would you be patient under the direction of one who should carry you back to the days of the lancet, the hot bath, tartar emetic, tobacco and the pul- lies, instead of the gentle, painless, American method revived and established by Reid, of Rochester ? Can any one, relieved in the twinkling of an eye by hypo- dermic medication, of an excruciating neuralgia, ever doubt his obligation to the profession in general, and to Charles Hunter, of London, in particular ? Is it of no consequence that aneurism succumbs to digital pressure and to forced flexion, and that ligation—distal or proximal—is now the exception rather than the rule ? Need I enumerate the thousand arti- cles of the Materia Medica to remind you that the accumula- ted observations and records of ages concerning them, are now the property of the profession ? Need I exhibit to you innu- merable models of ingenious mechanism for the relief of de- formities, fractures, dislocations, etc., in order to convince you that brains, and hearts, and hands have been actively engaged in this labor of love ? When to save life a limb must be severed, a strangulated hernia liberated, or any other serious operation performed, and you shudder to think of the sensitive fibres beneath the scal- pel’s edge, do you doubt the excellence of that mysterious agent by which you are rocked to pleasant dreams, and from the effects of which you awake to thank Grod that such power has been given unto men ? If you happen to be a little too light-headed to judge of the relative merits of Wells, Morton and Simpson, do not be surprised, for the rest of the scientific world is, to a great extent, in the same predicament. The value of the thermometer as a means of diagnosis and prog- nosis, although taught by Von Hagen a hundred years ago, reserved its greatest triumphs for the latter half of the nine- 24 teenth century. Who does not now rejeice in the accnracy of its revelations, and the increased power it gives us over all febrile diseases ? The haemadynamometer and the sphyg- mograph, though instruments of less practical value, show the eternal vigilance of those who stand on the watch-towers of the medical Zion. Every day new and useful applications of the cerosmic slce- dater or atomizer are discovered, giving efficiency to our efforts iu many cases where formerly the impotence of our art was proverbial. Among the latest advances in our science, may be mention- ed the antiseptic or non-suppurative plan for the treatment of compound fractures and other terrible lacerations—so marvel- ous are the results as compared with all former experience, that it seems but slight exaggeration to say that if one gets blown up you have only to pick up the pieces, wrap them in carbolic acid, linseed oil and carbonate of lime, and in two or three weeks he will be about his business. Can any one doubt that new scope has of late been given to our science, when he reads but the names of the instruments now employed ? The microscope is, indeed, an old instrument, though new in its wonderful revelations, with its monocular and binocular arrangements, and in its association with the spectroscope of Sorby, it will detect the one hundred thou- sandth part of a grain of mercury or of arsenic, or demonstrate the presence of a single blood-disc. The stethoscope—a title as unscientific and ridiculous as that by which I often designate Cammann’s double instru- ment, viz. : “ My ear spectacles,”—nevertheless it does reveal to our mental vision not only what is transpiring in the breast of a fellow mortal, but by means of vesicular murmurs, rales, bruits, funic souffles, aneurismal thrills, &c., faithfully con- ducted to the tympanum, it tells its tale of joy or sorrow, dispelling ill-grounded fear; or, fortifying against the evil day which it enables us to prognosticate. The ophthalmoscope— comparatively new—tells with accuracy not only the physio- logical and pathological processes which are going on in the very recesses of the eye, but by its use disease of distant or- gans has been detected before it had been suspected to exist; and even this slight reference will recall to every medical mind another accurate means of diagnosis discovered by a Bright light of the present century. The Laryngoscope holds such intimate converse with the very organ of voice as to make it declare facts which otherwise would never have been known or spoken. The Rhinoscope often puts us on the right scent; and the Gastroscope, the Stomatoscope, the Otoroscope, and all the other scopes, give but a slight indication of the constant periscope which every medical man must observe, if he would not be considered as belonging to a bye-gone age. Yet, notwithstanding the endless series of classified, de- monstrable and practicable verities existing in every depart- ment of medicine and surgery; to say that there were no doubts, no difficulties, no uncertainties, would be to rob the profession of half its glory; out of these springs the impossi- bility of any fellowship with the uneducated ; out of these grows the immense responsibility which attends his every movement; he must decide between life and limb when the question is so evenly balanced that a hair would turn the scale. ’Tis his solemn duty, “ in as much as in him lieth,” to resolve these doubts, to clear up these uncertainties, by the indefatigable and self-sacrificing use of all the organs of spe- cial sense, aided by all the knowledge that faithful study can afford, and assisted by all the means which Nature (whose re- sources are deloped by science and art) has so liberally placed at his disposal. If, after all these, doubt and danger and death succeed each other, as sometimes they will, ’twere arrant folly to suppose that ignorance and empiricism could have done better. But, there comes up from respectable sources the serious charge that the members of the medical profession are narrow-minded, sectarian, illiberal ; so wedded to old theo- ries and old habits as to refuse assent to important truths when fairly discovered and fully proved. If this charge can be sub- stantiated, then surely our stewardship as guardians of the public health ought to be taken from us. Oh! let the evil day never come when the profession shall be frightened out of its conservatism. It is well, that occupying so high a trust, it should ever obey the apostolic injunction to 11 prove all things, and hold fast” only “ that which is good.” In the ex- ercise of this blessed conservatism, the acceptance of some half-demonstrated fact may have been slightly delayed, but it can easily be shown that in all its history the regular profes- sion has been an earnest defender of, and eager seeker after, truth. Having no exclusive system of practice to maintain (for remember, that word allopathy is a misnomer, which, when- ever used in reference to scientific medicine, implies on the part of the speaker carelessness, ignorance or impertinence), having, I repeat, no exclusive dogma to defend, it has ever been ready to accept truth from any and every source. Thus from a negro it received the knowledge of the tonic virtues of quassia, and generously acknowledged the debt by transfer- ring the negro’s name to the article. It learned the use and the dangers of antimony from the combined experience of the monks and the swine, and again the name is significant of the fact. It learned the feasibility of the Ccesariau section of a distracted and despairing cobbler, who used a shoe-knife for the operation, and pack-thread for sutures. It learned the anterior operation for cataract from the accidental wounding of an opaque lens by an awl thrust through the cornea and the pupil. From a Jesuit it received its knowledge of cin- chona. A dairy-maid taught it how to prevent small-pox. It learned the anthelmintic properties of koussou of the Chi- nese, and the use of lobelia of the American savage. In all ages, in all climates—from black and white, rich and poor, old and young, male and female—from ignorant and learned— from dead and living—from accident and design, it gathered one by one its facts both great and small, despising none, prizing all ; arranging, comparing, classifying and preserving for the cure and prevention of the “ ills that flesh is heir to”— and this is our stock in trade. Now, can any man believe that if a simple law were discovered running through all na- ture,—a law, by the observance of which we could make medicine a pastime and cure our patients with ease,—can any one belive that we are so stupidly blind to our own interests as to refuse all the benefits of so brilliant discovery, when we might have them for the asking? You know better. You know that one has only to announce to you, with apparent sincerity, that a drop of vinegar would produce general anaes- thesia if allowed to fall from a height upon the second toe of the right foot, and ridiculous as the proposition seems, and really is, yet so important are the interests involved, that be- fore to-morrow night numerous experiments would be tried to demonstrate the truth or falsity of the proposition. Every physician in the land would be prepared to say, and positive- ly, too, it's false ; but the rest of mankind would be divided. D. D.s and LL. D.s (I say it respectfully) would give cer- tificates that they had seen the thing done ; and so the cause of true science must ever suffer till those who, of all the citi- zens, are best qualified to judge correctly, shall be more de- liberate and careful in their observations, and more logical in their conclusions. It will be observed that a large proportion of the more brilliant discoveries in medicine have been made within the memory of men now living. Is not this true in every depart- ment of science and art ? Was it not reserved to this age, so to utilize the most explosive of detonating compounds, that a child can take* them in his tiny hand and safely strike a light ? Have we not pontooned the Atlantic with steamships, and tunnelled it for lightening steeds which bring the news of each day fresh from the Old World, like hot rolls for the break- fast table ? Is it not a worn-out and feeble metaphor to say that we send messages everywhere “ on the wings of the wind ?” And are not these and a thousand other wonders the product of our ingenuity—the result of our wisdom ? Is not tliis the greatest of all the ages, and are not we the cleverest of all the people of this clever age ? My friends, this is the boastful spirit of the times—this the temper by which the wisdom of all the past is ignored. But, my medical breth- ren, let it not be so with us; let us at least remember the debt of gratitude due to. all who have labored diligently in the earlier days, when lights were few and dim. Let us re- member that what they bequeathed to us was just as essential to our progress as is the alphabet to all literature. The labors, the mistakes, the failures, as well as the successes of our forefathers have Tadually and certainly led us to every scien- tific achievement of which we are so justly proud. I say this, not only as an act of simple justice to our predecessors, but to remind you how certainly we should grope without the light of their experience, and how ridiculously false any theory must be which madly denies the value of all they did— of all they suffered, and of all they observed.