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demand. That the diversity observed in the use of remedies is unfortunate is obvious. It is the cause of many extremes in medicine, and the origin of divers 'isms and 'pathies. Every such diversion has its pet dogma, which it carefully fosters and diligently promulgates. Allopathy, on the one hand, is wedded to its ancient rule of contraries, and Homœopathy, on the other hand, advocates the law of similars, while Eclecticism is opposed to both as extremes. Because either doctrine is true, it does not make the other untrue. There is virtue in each that needs only to be extracted.
Physicians of opposite schools naturally disagree on fundamental principles; but members of the same practice differ widely in the execution of details. No two physicians prescribe just alike. Often they are directly opposed in their methods of treatment, and yet appear to be equally successful. Because of such differences, a skepticism has been developed in the profession which doubts any certainty of drug-action, or benefit accruing from the use of drugs, but regards the practice of medicine only as affording an opportunity for the unscrupulous charlatan to ply successfully his trade of deception and fraud. It would not seem strange, under the circumstances, to meet an occasional skeptic; but when it becomes the rule rather than the exception, for physicians to doubt the virtue of drugs as remedial agents, the question of medication presents a serious aspect. Either extreme of believing too. much or too little is wrong; and when such a position in one direction is abandoned, the natural tendency of the reaction is to fly to the opposite extreme. An extremist on any subject, should be careful how he forsakes his position for a new one, lest, by the change, he should fail to better his condition.
The tyro in medicine is apt to be credulous, and overrate the value of what he is taught. All that is told him he believes implicitly; and by the time that he is ready to put into practice what he has learned, he imagines that all that is necessary for him to acquire distinction is an opportunity to display his prowess. Only repeated failures and disappointments can convince him of the folly of his delusion; and he is fortunate indeed, if, after the recoil from the first shock, he
does not conclude that medicine is a humbug, and its practice a fraud. If, in the rebound, he succeeds in keeping his balance, he has learned a valuable lesson, and by counselling caution and prudence in the future, he is reasonably sure of success. The physician, be he never so learned in his profession, if he lacks judgment and misapplies his knowledge, can never become a successful practitioner. Indeed, many a man succeeds with comparatively little book-learning, who uses his little store with tact and judgment. There are men who, though profoundly learned and entertaining as writers and teachers, are yet failures in practice. The trinity of elements in a physician that are essential to success, are knowledge, judgment and experience. Any lack in either of these elements must curtail success.
Medicine, unfortunately, is not an exact science like mathematics, and is, therefore, not capable of like lucid demonstration. The solution of the problem depends upon so many contingencies, that it cannot be calculated with any degree of certainty. The body is subject to so many changes that no two cases ever occur exactly alike. For this reason no routine treatment can be successful, but the means used must be varied to suit the peculiarities of each individual case. A patient cannot be treated under contract by exact rules, as a mechanic will construct and guarantee a piece of work. In the very nature of things, it is impossible for a physician to work by any such method. The best that he can do is to look the case over, and, from the existing condition of the patient, form an estimate of the character of his disorder, and deduce. an opinion of the probable issue, under a judicious course of treatment. To promise anything more is presumption, and can only be charged either to pure ignorance or a deliberate purpose to deceive. Some few things a physician can know, which at best is but a small fraction of all that the question involves. Under the existing circumstances, he is sometimes compelled, by policy, to say differently from what he knows, in order to cheer and sustain the patient, or to pacify the friends. This statement, however unpleasant it may seem, is not intended as an apology for deception, but is simply the
recognition and expression of a fact which is of daily occurrence. The physician, under the stress of circumstances, is sometimes compelled either to do this or worse-losing his patient in a double sense, and forfeiting the confidence of his friends. It is right to tell the truth, but not always necessary nor expedient to tell the whole truth.
The success of every physician hinges principally upon his knowledge of therapeutics, and the skilful use of remedies. Notwithstanding the different methods employed, and the variety of results obtained, it cannot be gainsaid that success depends upon such experimental and practical knowledge. The typical Allopathist believes that no good can be accom plished, except by the exhibition of heroic doses, while the high-potency Homœopathist declares that only by the use of infinitesimals is success in the healing art achieved. Although so radically different in their methods, they each, nevertheless, appear to succeed. To reconcile such differences, it is necessary to go back of the methods employed for the real cause of their seeming success. Nature is possessed of wonderful recuperative power, which medicine can either assist or obstruct. When it is admitted that on an average about ninety per cent. of all the sick will recover without the aid of medicine, it ought to be enough to take the conceit out of the boastful mediciner; and any practice which cannot show a higher per cent. of recoveries than the above, is no improvement on nature's unaided effort.
It is not so much the mission of the physician to save life in the abstract-prevent people from dying—as it is to mitigate suffering, and shorten the duration of disease. People generally so understand it; and when a patient calls the physician, it is usually not from a fear of death, but to ease his pain and to cure him in the shortest possible time. Since it has been ascertained that life and health are more dependent on vitality than upon drugs, and that health is often damaged and life endangered by excessive and foolish drugging, many physicians have discarded drugs, and treat their patients on the "expectant plan," giving but little medicine, but rather depending upon the recuperative powers of nature, and the use
of hygienic means and careful nursing for success. The study of physiology, and a better understanding of physiological action, naturally inclines to a passive policy in therapeutics, for by it is seen how wonderful are Nature's processes, and how adroitly she manages to re-adjust derangements of the organism; and, therefore, men like Chambers and Flint advise but few remedies in the treatment of disease. The "expectant plan" of treatment is good as far as it goes, but it is not enough. Experience teaches that there is virtue in drugs, and that if properly used they are invaluable. The danger in the search for remedies, and the adoption of a plan of treatment, is that experiments are made with a view to establishing some particular hypothesis to which the alleged facts are forced to conform, instead of building up a theory from bare facts.
The system of practice known as "Specific Medication," has some excellent features, and commends itself to the profession for its directness and simplicity. It does not view disease as an entity—a hideous monster-that has taken up its abode in the body to torment it, but rather that it is the result of abnormal action by a deviation from the physiological or health standard, and aims at a restoration of the disturbed equilibrium. It seeks to occupy middle ground, and thus avoids the grossness of Allopathy, on the one hand, which does positive injury by over-dosing, and the dilettanteism of Homœopathy on the other, which sacrifices valuable lives by under-dosing and the loss of precious time. The value of this system can not be adequately estimated at the present time. While it contains some absurd things, as others see them, and is not free from error, yet its value cannot be questioned, It embodies true conservatism, which is the core of Eclecticism, and yet advocates substantial progress. Its direction is towards demonstrated facts and positive teaching, which are the pressing needs in medicine. It will no longer do to use remedies on the equivocal endorsement of "found valuable" or "said to be useful" of the past; but a remedy, to be worthy of recognition, should give the same results, upon being tested in a large number of cases, in similar conditions, and under like circumstances. In the selection and use of remedies,
three considerations should have prominence, namely: palatability, small but appreciable doses, and direct action.
While these objects, perhaps, cannot be attained in every instance, an effort should at least be made to approach them as nearly as possible. Close study of the Materia Medica will be necessary to properly estimate the action and value of each drug; but since some definite information has already been obtained in that direction, more is possible. In pursuing such a course of procedure, it is both unsatisfactory and unwise to fall into the common error of prescribing a single remedy for every disease, which is the tendency of a routine-practice, or the equally fallacious custom of attempting to antagonise a disease with a multitude of remedies promiscuously mingled. Each agent should be studied with a view to its value in one or possibly two abnormal states, and be satisfied when that much is done. By attempting too much, nothing is accomplished. When the science of therapeutics is raised to such a plane of excellence can physicians boast of "specifics," and an eminently successful practice.
EARLY BRAIN AND PHYSICAL CULTURE.
By ALEXANDer Wilder.
The province of education is not to create scholars, but rather to develop the faculties and capacity for the greatest usefulness. It is impossible, therefore, to regard too highly the importance of correct and enlightened views upon this subject. Virtue, beauty or excellence in an individual, as in a weapon or implement, consists in fitness for the ends of existence. Agesilaos, the Spartan King, being asked what things were most proper for boys to learn, replied: "Those which they ought to carry into practice when they become men."
Lykurgos bred two dogs from the same litter; one of which became a dainty and ravenous cur, the other, a quick-scented and active hound. Differences as broad as these may be established between children of one family by means of early