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Preface
It is now nearly eleven years since the author published the first edition of his " Six Lectures on the Causes and Cure of Consumption? etc. ; and in that time he has had very ample opportunity of practically testing the correctness of the views he there announced. The position taken in that work that pulmonary consumption is curable by medical treatment, with the proof presented that the author had succeeded in curing it, attracted very general attention, and brought to his office in New York, for consultation and treatment, invalids from all portions of this country, and even from Europe and other parts of the world. His practice, having had this wide range, and embracing, as it has, in its scope over seventy thousand patients, of all classes and ages, and of both sexes, has enabled him to determine with great accuracy, how much is due to climate, to habits of life, to hereditary peculiarities, and to the various influences acting upon us, both in producing and preventing or arresting this disease. He has also been enabled to ascertain, by personal observation, how much and what efficacy there is in the various remedies and modes of practice— -whether regular or irregular — which have at one time and another challenged public attention in the treatment of consumption. The result has been not only completely to demonstrate, as he believes, the truth of the doctrines heretofore announced by him, but to impress still more forcibly on his mind their great practical importance.
And now it is from a sense of duty, as well to those who are fall-
IV PREFACE.
ing victims to this terrible scourge, as to the medical profession and the community at large, that he has prepared this volume, in which are more fully unfolded his views of the causes and nature of phthisis, and the system of remedial measures which may be made effectual in curing it ; also the general results of his experience and observations as gathered from his practice.
In a practice thus widely extended, the author has necessarily been called upon to treat a great variety cf chronic disorders besides such as are peculiar to the lungs and throat — those complicated with and tending to consumption, as well as those that are independent of pulmonary affections ; and in observing the very uniformly successful result of the treatment employed, he has seen it demonstrated that nearly all the prevalent chronic diseases — such as heart disease, liver complaint, chronic diarrhoea, constipation, skin diseases, kidney complaints, gravel, piles, rheumatism, female complaints, etc. — are entirely amenable to medical remedies, correctly employed. A consideration of these maladies occupies considerable space in this Treatise.
From the favor with which his former book has been received, the author gives this volume to the public in the hope that he will at least have the credit of desiring to be useful in doing so. He has only aimed to convey what he regarded as important truths, in plain, untechnical, intelligible language ; and if he shall be instrumental in contributing to alleviate human suffering, to promote health, and prolong life, he will have secured his reward. 714 Broadway, New YorTc, May, 1857.
Contents
PARK
Introduction xvii
Chapter I. Examination Of The Chest
Methods of ascertaining the condition of the lungs 9
Methods of ascertaining the condition of the lungs by the sounds 11
Manner of examining the chest 14
Sounds emitted in respiration by healthy lungs 15
Sounds emitted on inspiration of the air by healthy lungs 16
Sounds emitted on expiration of the air by healthy lungs 17
Sounds indicating disease 18
Sounds in bronchitis 20
Sounds indicating asthma 22
Sounds indicating emphysema of the lungs 23
Sounds produced by tubercles in a state of softening 24
Sounds indicating the presence of pus in cavities 24
Sounds indicating excavations not filled with pus 24
Sounds revealed by auscultation in inflammation of the lungs 25
Resum6 of the subject of sound and the manner of exploring the lungs
in a state of disease 25
Position of the patient with diseased lungs on lying down 26
Importance of an erect figure and a full expanded chest 27
Mechanical remedies to prevent stooping 28
CHAPTER n.
PULMONARY CONSUMPTION— ITS VARIETIES.
Hereditary Consumption 34
Tubercular Consumption 36
Symptoms of tubercular consumption 39
Persons liable to tubercular deposits in the lungs 44
Treatment of tubercular consumption 45
The influence of posture in lung disease 46
VI CONTENTS.
CHAPTER III. PULMONARY CONSUMPTION— ITS VARIETIES— (Continued)
PAGE
Bronchitis and Bronchial Consumption 48
How bronchitis progresses and ends 50
Varieties of bronchitis 51
Is bronchial consumption curable ? 52
Case of bronchial consumption cured 52
Sad consequences of confounding the two diseases 56
Mechanical remedies i 63
Accompanying disorders 64
Purifying the blood 65
Management of the cough 69
Special symptoms 71
Pure air — healthy climate and occupation 72
Medicinal inhalations 73
Diet for the consumptive 74
Remedies which should be rarely or never used 74
General blood-letting 75
Blistering 75
Croton oil 77
Mercury 77
CHAPTER IV. PULMONARY CONSUMPTION— ITS VARIETIES— (Continued)
Asthma 7g
What asthma is 80
Causes of asthma 81
Treatment of asthma 84
Treatment of the patient during fits of asthma 86
Asthmatic Consumption 87
Curability of asthmatic consumption 88
CHAPTER V. PULMONARY CONSUMPTION— ITS VARIETIES— (Continued)
Congestive Consumption 90
Causes and varieties of congestive consumption 90
Treatment of congestive consumption when characterized by difficult
breathing g^
CONTENTS. Vll
PAGE
Congestive consumption, characterized by bleeding at the lungs 95
Treatment of consumption, with bleeding at the lungs 97
Diet in congestive consumption 100
Hygienic treatment 101
PULMONARY CONSUMPTION— ITS VARIETIES— (Continued).
PAOE
Dyspeptic Pulmonary Consumption 137
Diet for the dyspeptic 1"°
Dyspepsia dangerous in those predisposed to consumption 140
Causes of dyspeptic consumption 141
Curability of dyspeptic consumption 1*2
CHAPTER XII. PULMONARY CONSUMPTION— ITS VARIETIES— {Continued)
Hepatic (Livee) Pulmonary Consumption 143
Fatty degeneration of the liver 145
Cod-liver oil promotes fatty degeneration of the liver 149
CHAPTER Xni.
PULMONARY CONSUMPTION— ITS VARIETIES— {Continued) .
Bowel Consumption 152
Curability of chronic diarrhoea 154
Treatment of bowel consumption 154
PULMONARY CONSUMPTION— ITS VARIETIES— (Continued).
Spermatic and Utero-Pulmonary Consumption 176
Spermatic Consumption 177
Curability of spermatic consumption 178
Utero-Pulmonary Consumption 179
Inflammation, ulceration, and prolapsus of the uterus lead to consumption 182
Curability of female disorders 184
CHAPTER XIX. PULMONARY CONSUMPTION— ITS VARIETIES— (Continued)
Consumption produced by Fever Sores, White Swelling, Diseases of the
Bones, Fistula, Hip Disease, Lumbar Abscess, etc 186
Complications of Consumption 190
Every Case of Consumption an Individuality 190
There is no " Specific" for Consumpiion 191
Consumption the Citadel of Quackery 192
Chapter XX
PULMONARY HEMORRHAGE, SHORTNESS OF BREATH, VARIETIES OF COUGH AND EXPECTORATION.
Hemorrhage 193
From mechanical inj uries 1 94
From plethora and congestion 194
From taking cold 195
From softening of tubercles 195
From suppressed catamenia, drying up of old sores, &c 196
From debility, and contraction of the chest 196
Remedies for hemorrhage from the lungs 196
Shortness of Breath 198
Of the Different Varieties of Cough 199
Consumptive cough 200
Congestive cough 201
Stridulous cougli 202
Humid cough 202
Asthmatic cough 203
Cough in bronchitis and pulmonary catarrh 203
Worm and stomach cough 203
X CONTENTS.
PAGE
General remarks on cough -°*
Expectoration in true Pulmonary Consumption -05
Expectoration that often precedes true pulmonary consumption 206
Peculiar substances sometimes expectorated ~"°
Does matter that sinks in water always indicate ulceration ? 208
Chapter XXI. Consumption In Children
Examples of consumption in children 210
Coughs in children -1°
Proper treatment of children for colds, and during winter coughs 219
Chapter XXII. Croup— Quinsy Sore Throat— Acute Pleurisy
Croup 221
Seat of the disease 222
Nature of the disease 222
Croup a curable disease 223
Treatment to prevent and cure croup 224
Quinsy Sore Throat 226
Pleurisy 227
Treatment of acute pleurisy 228
Chapter XXIII. On The Treatment Of Invalids— Hygienic, Mechanical And
MEDICINAL.
On the separation of consumptives — Ventilation and cleanliness — Consumption may be propagated — Whooping-cough dangerous 230
Exercise 232
Change of air and place — The best climate — Sea voyages— Going to Europe, &c 234
Diet 237
The wet-sheet 242
Sweating — Dress, clothing, &c 243
Beds, sleeping-rooms, &c. — Cheerfulness 245
Self-denial necessary to invalids 246
Invalids never should be told they look sick 247
Chapter XXIV
SPECIAL REMEDIES IN PULMONARY DISEASE, MEDICINAL AND ME- CHANICAL—INJURIOUS REMEDIES, TREATMENT, ETC.
Counter-irritation — Spanish-fly blister 250
Mustard poultices — Emetic tartar— Croton oil 251
CONTENTS. XI
PAGE
Plasters for children 253
Fomentations — Blood-letting 254
The inhaling-tube , 255
Shoulder-braces 257
Abdominal supporters 258
The benefits of these mechanical remedies stated by those who have used
them 260
Letter from D. S. McAdie, of Scotland 260
Letter from Mrs. E H , of Massachusetts 263
Letter from L. T. Fales, of Illinois 264
Letter from Miss H E. W , of Vermont 265
Letter from Mr. Merritt Martin, of New York City 266
Letter from Mrs. Sylvanus Johnson, of Iowa 266
Injurious remedies and hurtful treatment in consumption 266
Blood-letting — Iodine 271
Cod-liver oil 273
Emetics 274
Sulphate of copper 275
Chapter XXV. Various Forms Of Consumption, Described By The Patients
THEMSELVES.
Statement of a patient in true tubercular consumption 277
Case I.— Mr. Geo. D. Y , of Ogdensburg, N. Y 277
Statements illustrating how consumption is developed by simple cold. . . 280
Case II.— Mr. W. P , of Livingston, 111 280
Case III.— Mr. J. W. P , of Jacksonville, 111 281
Case IV.— Mr. D. P. V , of Lafayette, Ind 281
Statement of cases in which consumption commenced with bronchitis. . . 282
Case VI.— Mrs. S. T , of Manchester, N. H 284
Statement of cases of consumption from salt-rheum and other humors, or
Case VII.— Mrs. E. A , of Peterboro, N. Y 285
Case VIII.— Mr. M. T , of Corinna, Me 286
Statement of complications of disorders from humor 288
Case EX.— Mrs. E. A. P , of Canton, N. Y 288
Case X.— Mr. J. D , of Bayham, C. W 290
Case XL— Mr. A. McH , of Cannonsburg, Mich 291
Case XII.— Mrs. M. D . of Hayfield, Peun 293
Statement of cases of congestive consumption, attended with bleeding,
occurring in those predisposed to phthisis 294
Case XIII.— Mr. A. N. P , of Macon, Ga 294
Case XIV.— Mr. J. Van N , of Charleston, S. C 296.
Xll CONTENTS.
PACK
Case XV.— Mr. H. G , of Hamilton, C. W 297
Case XVI.— Mr. A. P , of Sandy Creek, N. Y 298
Statement of a case of hepatic (liver) consumption 299
Case XVII.— Mr. H. G. C , of Amherst, N. H 299
Statement of a case of consumption from mechanical injury 301
Case XVIII.— Mr. R. H. P , of Chaplin, Conn 301
Statement of cases of imposthumous consumption, or abscesses in the lungs 303
Case XIX.— Mr. H. H , of Oberlin, Ohio 303
Case XX.— Mrs. M. Van H , of Floyd, N. Y 304
Statement of a case of congestive consumption, not attended with bleeding 305
Case XXL— Mr. J. H. S ■, of Peacham, Vt 305
Chapter XXVI. Consumption Can Be Cured
Testimony or those who have been the Subjects or Dr. Fitch's Treatment 307 Case XXII.— Letter from W. H. Bangs, Esq., of Washington, D. C. . . . 308
Case XXIII. — Letter from John Gordon, Esq., of Ottawa, C. E 311
Case XXIV.— Letter from Dustin E. Kimbel, Esq., of Newark, Vt 312
Case XXV.— Letter from Mrs. Martha L. Bradeen, of Wilton, Vt 312
Case XXVL— Letter from Mrs. Ann A. Cole, of West Derby, Vt 314
Case XXVII.— Letter from E. F. Nelles, of Gait, C. W 314
Case XXVIIL— Letter from Mrs. D. L. Montanye, of Shandakin, N. Y. 315 Case XXIX. — Letter from Rev. H. C. Longyear, Esq., of Phoenicia, N.Y. 316
Case XXX.— Letter from Mr. G. C. Ball, of Michigan City, Mich 317
Case XXXL— Letter from C. De Revere, Esq., of Tarrytown, N. Y 319
Case XXXIL— Letter from Miss Jane Gray, of Brooklyn, N. Y 320
Case XXXIIL— Letter from W. A. Hillyer, Esq., of New Yoik City. . . 321
Case XXXIV.— Letter from Mrs. Annie P. Davis, of Berlin, Ohio 322
Case XXXV. — Letter from Mrs. Lucretia Louis, of Jeffersonville, Ind . . 323
Case XXXVI.— Letter from Mr. Jno. Patten, of Medina, Ohio 324
Case XXXVII. —Letter from Mr. Thomas Briggs, of Erin, C. W 326
Case XXXVIII. —Letter from Rev. H. W. Baker, of York, Mich 327
Case XXXIX.— Letter from Mrs. T. E. Cadwell, of Saratoga Co. , N. Y. 328 Case XL. — Letter from A. H. Rock, of Winton, Iowa 329
Chapter XXVII. Diseases Of The Heart
Organic Diseases of the Heart , 332
Enlargement of the heart 332
Symptoms indicating enlargement of the heart 333
Ossification of the heart 335
Fat about the heart 337
Thickening of the valves of the heart 338
Rheumatism upon the heart 338
CONTENTS. Xlll
PASE
Causes of enlargement, ossification, and thickening 338
Curability of organic diseases of the heart 339
Remedies for organic diseases of the heart 340
Functional Diseases of the Heart 340
Influence of diseased lungs upon the heart 340
Influence of deranged stomach upon the heart 341
Effects of indigestion other than mechanical upon the heart 342
Curability of functional disorder of the heart 344
Functional and Sympathetic Diseases of the Heakt 345
Palpitation of the heart 345
Palpitation from falling of the bowels 346
Effects of derangement of the liver upon the heart 346
Effects of costiveness upon the heart 347
Influence of the spermatic organs upon the heart 348
Causes of Angina Pectoris 350
Treatment of angina pectoris 352
Diseases of the heart may be cured — with the testimony of those who
have been cured 355
Case XII.— Letter from A. H. W. Vansiclen, Esq., of New York. . 356
Case XLII.— Letter from Mrs. S. Lock, of Michigan 357
Case XLIIL— Letter from Mrs. M. H. Valentine, of Brooklyn, N. Y. 358 Case XLIV. — Letter from Mrs. E. K. Clements, of Pennsylvania. . . 359 Case XLV. — Letter from Geo. S. Parker, Esq., of Illinois 359
Chapter XXVIII. Dyspepsia
Distinction between indigestion and dyspepsia 3C0
Process of digestion explained 361
The remarkable history of Alexis St. Martin, as given by Dr. Wm.
Beaumont 363
Experiments with St. Martin by Dr. Beaumont 369
Preliminary remarks of Dr. Beaumont 370
Appearance of humor in the stomach 377
Peristaltic motion of the stomach 378
Varieties of Indigestion and Dyspepsia 381
Indigestion from disorder of the stomach 381
Indigestion from derangement of the liver 384
Indigestion from derangement of the pancreas 387
Indigestion from disease elsewhere than in the digestive organs 389
Induced by disease of the lungs 389
Induced by disease of the heart 390
Induced by uterine disease 390
Induced by spinal disease 391
Induced by over-stimulation of the brain 392
XIV CONTENTS.
PAGE
Induced by acute disease, fevers, &c 392
Induced by humor determining on the digestive organs 393
Medical treatment in indigestion 394
Hygienic treatment in indigestion 394
Diet in dyspepsia "96
Beaumont's table showing the comparative digestibility of different articles of food 399
Obstruction of the gall-ducts by gall-stones 402
Chapter XXIX. Skin Diseases— Felon— Cancer— Scrofula— Goitre— Rheumatism
—GOUT— UTERINE DISEASES— DISEASE OF THE OVARIES—
WHAT IS INFLAMMATION?
Blotches, spots, pimples, &c. , on the face 406
Erysipelas on the face 407
Skin disease affecting the lips 408
Skin disease in the scalp 409
Skin disease affecting the hands 410
Skin disease affecting the legs 410
Skin disease affecting the feet 411
Felons 411
Cancers 412
Causes of cancer 413
Curability of cancer 413
Scrofula, or King's Evil 414
Treatment of scrofula 415
Goitre, or Swelled Neck 416
Curability of goitre 417
Rheumatism 417
Causes of rheumatism 418
Curability of rheumatism 419
Gout 420
Not now a common disease 420
Causes and curability of gout 420
Leucorrhcea 422
Inflammation of the uterus, acute and chronic 423
'Ulceration of the cervix uteri 423
Danger of mistaking other disorders for disease of the uteri 425
Causes of uterine disease 427
Curability of uterine disease 427
Disease of the Ovaries 428
CONTENTS. XV
PAGK
What is inflammation ? 429
Inflammation not a disease 431
All inflammation has a specific cause . . : 431
Internal inflammation 432
Humor the great cause of both internal and external inflammation 433
Art, not Nature, the great Physician 437
What causes and what cures disease ? 437
Chapter XXX. Cathartics
Nature and use of cathartic medicines 451
How the different emunctories are relieved 453
Opening of the skin 453
Opening of the kidneys 454
On abstinence in place of cathartics 454
The bowels the great emunctory 456
What the character and effect of cathartic medicines should be 458
Cathartics for affections of the head, catarrh, consumption, heart disease, dyspepsia and stomach complaints, liver complaints, bilious fever, fever and ague, derangement of the bowels, kidney complaints, female disorders, congestion, inflammation, scrofula, salt-rheum, all humors, sallow complexion, pimples and spots on the face ; for cholera, common
colds, influenza, after a surfeit, &c 458 to 477
Diet while using cathartics 477
Diet for children 479
General remarks 480
Examples showing the benefits of cathartics 481
Chapter XXXI. The Laws Op Life, And Means Of Promoting Longevity
The great processes of animal life 486
The process of nutrition 487
Conditions necessary to perfect nutrition 489
The process of calorification 492
The process of excrementition 492
What is the natural limit of human life ? 494
Examples of longevity 495
May longevity be promoted, and the vigor of youth extended into age,
and how ? 502
Suggestions on the mode of preserving health and attaining old age 505
A purpose in life necessary to longevity 507
Vice tends to shorten life 508
Virtue tends to lengthen life 509
XVI CONTENTS.
CHAPTER XXXH.
MEDICINE.
Its mission 511
Prejudice against medicine unfounded 512
Vegetable, not mineral, medicines should be used 512
Examples showing the value of true remedies 514
Change of air and climate 516
Two great classes of remedies 517
Poisons of the blood demand antidotes 518
Preventives of disease 519
Surgery and Medicine 519
Medical skeptics 521
Conclusion 522
Introduction
The late celebrated Dr. Rush, of Philadelphia, was once asked whether he believed the Profession of Medicine had been, on the whole, a benefit to the world. "Do you," he inquired in reply, "intend to include in 'the Profession,' old women and nurses ? If so, then I answer, yes ; if not, doubtful." Says the French physician and author, Bichat, speaking of the " Science of Medicine :" " An incoherent assemblage of incoherent opinions, it is, perhaps, of all the physiological sciences, that which best shows the caprice of the human mind. What do I say ? It is not a science for a methodical mind. It is a shapeless assemblage of inaccurate ideas, of observations often puerile, of deceptive remedies, and of formula? as fantastically conceived as they are tediously arranged." Said another French physician and professor, Magendie, in a recent lecture to his class of students in the city of Paris : " Gentlemen, Medicine is a great humbug ! I know it is called a science : science, indeed — it is nothing like science ! Doctors are mere empirics, when they are not charlatans. We are as ignorant as men can be. Who knows any thing in the world about Medicine? * * * Who can tell me how to cure the headache ? or the gout ? or disease of the heart ? Nobody. ' Oh,' you tell me, ' doctors cure people !' I grant you, people are cured ; but how are they cured ? Gentlemen, nature does
a great deal ; imagination does a good deal ; doctors do devilish
little .... when they don't do harm !"
These are certainly neither complimentary nor hopeful views of Medicine. It may, however, be presumed, I think, that the men who spoke thus bitterly, did not intend that we should understand their caustic language in a strictly literal sense. They have evidently
Xviii INTRODUCTION.
taken a little license with facts, in their ambition to give epigrammatic point and sharpness to their periods— to say striking things. And yet they do plainly intend to declare a great want of faith in Medicine, both as a science and as an art. And when it is remembered that these men are the " lights" and " guides" of the medical profession, confessedly standing at its head, the unsophisticated, nonprofessional reader at least may, we confess, very well be excused if he is somewhat astonished at the glimpse " behind the scenes" which they afford him. And it should be added that Rush, Bichat, and Magendie are not the only physicians who have fulminated such terrible criticisms upon Medicine; they are but the representatives of a large class who, either openly or to themselves, denounce while they practice it. Indeed, the medical infidelity to which these men honestly give expression, pervades to a most lamentable extent the whole profession. There are wide-spread skepticism, doubt, uncertainty, and embarrassment, with regard to the value of medical remedies and treatment in the cure of disease, prevailing extensively among physicians ; and this skepticism is rapidly spreading among the people. It cannot remain confined to the profession. The absence in the physician of heart-felt faith in medicine cannot long escape the notice of the patient, whatever attempts may be made to disguise it. The resolutions of medical conventions, the addresses of medical professors, the protestations issued through medical periodicals and books, or whatever other expedient may be resorted to, will do but little to sustain the waning confidence of the people in the benefits of Medicine, so long as those who administer it hesitate and doubt.
It becomes, therefore, a most important subject of inquiry, whether Bichat is right in declaring that " Medicine is not a science for a methodical mind ;" whether Magendie states the truth when he exclaims, " Medicine is a humbug ;" and whether Rush had good ground for doubting whether the Profession of Medicine had, on the whole, been of benefit to the world. If they have herein really told us the truth, then it is still more important to inquire, whether this great failure of Medicine, for a failure it is, has resulted from an inevitable necessity, or from the fault of its professors?
I do not propose to enter at length upon a discussion of these questions — this would require more space than can be properly occupied here. But I will throw out a few suggestions, which may, per-
INTRODUCTION. xix
haps, indicate to the desponding practitioner of Medicine the road of investigation wherein he will discover an escape from his skepticism, and to the invalid a ground of confidence in the "Healing Art."
In doing so, it is proper to bring distinctly before our minds the great object of Medicine ; and let me remark, that whether regarded as an art or as a science, it will not be denied by any one that to the physician, as such, this object is simply the prevention and cure of disease. Its aim is one of immediate practical utility and usefulness. In the circle of sciences there are those — that of music, for example — which, like the ornaments of our dress and the adornments of our dwellings, have for their purpose the gratification of our taste, or the polishing of our minds — they are among the embellishments of life. There are others which embrace in their design both ornament and use, contributing at once to our pleasures and our necessities. Astronomy, for instance, reveals to us the sublime wonders of the heavens, and we may study it, either, on the one hand, to unfold our minds, give breadth and compass to our intellects, and kindle our admiration and reverence for its Great Author ; or, on the other, to enable us successfully to traverse the ocean with our ships, and map out the geography of our globe. Medicine, however, has only a practical value. There are, it is true, embraced in the range of study necessary to equip the physician for his duties, many subjects which are worthy of pursuit for themselves, or merely as mental accomplishments. La this view anatomy, physiology, botany, chemistry, and many other sciences, are of high interest. But it is not with this view that the physician masters them ; this is not the place they occupy in the comprehensive system of Medicine. Here their exclusive office is to subserve the practical end of preventing and curing the diseases to which our race is subject; aside from this, they have here no value.
Now, if we turn to the history of Medicine as it is recorded for us, and notice the position in which we find it at the present time, I apprehend we shall be struck with the fact that, instead of its true design, as above stated, having been always kept steadily in view by our profession, it has been too much regarded as a science — a department of study and labor — having a value in and of itself— a dignity and importance of its own ; not as a mere instrumentality to a practical end, and to be made at all times subordinate to that end, but rather as itself an end. From the earliest periods, when the
XX INTRODUCTION.
demons of disease were exorcised by jugglery and incantation in the temples of the Egyptian priesthood, down through all the schools and sects, the discoveries and improvements, the developments of science and the progress of learning, to our own day, we find the traces of an ambitious pretension in behalf of Medicine simply as a learned profession, laying claim to dignity and the homage of the world, rather because of the intellect, the learning, and the science by which it has been illustrated, than because of the actual good accomplished by it. To be sure, such an ambition is not in terms avowed. On the contrary, it is in terms frequently denied ; and Medicine is even defined in our text-books as a science which has for its object the prevention and cure of disease. Still this ambition exists, lurking in our colleges and schools, and pervading to a great extent our ranks. To be convinced of it, we have but to call to mind any of the great masters in our profession, whose names the world recognizes as illustrious. Upon what does their fame rest? Is it based upon the triumphs which they themselves are known to have achieved over disease ? Have these men towered above their contemporaries because they have themselves been more successful in curing disease than all others ? What, in fact, do we know of the private practice of very many of them ? How often is even inquiry made as to what the result of that practice was, or whether they were themselves successful practitioners or not ? Is it not rather the fact that they have acquired their celebrity by some unusual exhibition of intellectual or scholastic accomplishment — by propounding a novel theory, by writing an erudite book, by delivering brilliant lectures, by founding a new sect, or by some other remarkable achievement in the world of science or letters? It is true that there have been and are those who have become celebrated by their researches in anatomy and investigations in physiology — by their intimate knowledge of the human frame, its condition in health and its altered condition in disease ; others, again, by making new and valuable discoveries, such as the circulation of the blood, and the prophylactic virtues of vaccination— who have thus really been of great benefit to the world by directly promoting the prevention and cure of disease. Still, few of even this class of men are known to us as themselves excelling in the art of healing ; and how very small is the proportion of all our medical celebrities whose fame is founded upon their own personal success in the use of medical remedies ! Is it not true, therefore,
INTRODUCTION. XXI
that even in the awarding of honors among us, science, as such, has a higher place in the scale of merit than skill and practical success? — that we place the mere means and instrumentalities of Medicine before its great purpose and design ?
Again, why is it that there is among us so jealous a watchfulness to guard what are called the honor and dignity of our profession? Why is it felt to be a greater stain upon professional character to employ remedies which have been condemned, ex cathedra, as "empirical" or " quackish," even though life is saved by them, than to kill a patient by the blundering use of an " orthodox" medicine ? Why is it that we "cry havoc, and let slip the dogs of war" against every man who undertakes to cure the sick upon any other system than that denominated the " regular practice," however skilful and successful he may be — while at the same time we throw the shield of our professional influence over all who stand within the pale of " regularity," however unskilful and unsuccessful ? Why is the " irregular" practitioner, when accused of harming his patient, condemned without a hearing, and the "regular" physician, under like accusation, acquitted without a defence ? Why are the errors of the so-called " empiric" blazoned and magnified, while the errors, equally hurtful and disreputable, of the " rationalist" are apologized for and covered up ?
No one can successfully deny that these inquiries point to incontrovertible facts : and, now, can these facts be explained upon the hypothesis of a controlling regard for human health and life? Is it true that the scale of " dignity" hi medicine is really graduated with a single reference to skill in preventing and curing disease — skill which has been demonstrated by actual success ? Is the most honor awarded to that physician who cures the greatest number of his patients aud saves most lives, without regard to the school or sect to wdiich he belongs or the system of treatment he employs ? In a word, is the exhibition by the physician of practiced skill and capability to cure the sick the only criterion of merit and honorable position in our profession — competent intellectual and moral qualities, of course, being assumed ? We all know that it is not. On the contrary, the man who presumes to present himself before the community as a practitioner of Medicine, whatever may be his qualifications or his skill, unless he confesses allegiance to the predominant, reigning school of Medicine, and shapes his course by the rules issued
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