opening of the nineteenth century, unbiassed and without comment, drawn from the text-books then in use. The exposition might be greatly extended, but to do so would only multiply facts and occupy space without adding to knowledge, or changing inferences or deductions. It is clear from what has been shown that Practice had not advanced beyond the state of Empiricism, not far removed from that in vogue in the time of Galen and Asclepiades, at Rome, especially in the treatment of neuroses, the nature and causation of which were obscure or unknown. But it was still largely so in the diseases of everyday life, the most common and prevalent diseases which demanded the services of the physician. In such ailments, where the medicine which from long use and experience had been found to be beneficial proved ineffectual, the next most eligible remedy was exhibited, and this failing, the next was tried, and so on until the physician descended from the rank of being a devotee of experimental medicine to that of an empiric, subject to the taunt of empiric, than which nothing was more insulting to his dignity.

It goes without saying, that until the profession of medicine had acquired experience in the treatment of malady, multiplied their resources, and increased their armamentarium so as to cover all the ills and emergencies to which humanity are subject, their attitude toward the sick must necessarily be that of an empiric. The most

that could be in reason required or expected from the doctor is that he should know what the best informed knows; in other words, not only that he be well-read, but that he keep well-read as to the progress of his art.

It is not our purpose to indulge in criticism of the state of the profession of medicine at the time of which we are writing. The world never knew a greater or a nobler class of men than that which filled the chairs of the universities, and occupied the lecture-rooms of the hospitals of Europe at this time. They challenge our admiration. There was little of the spirit of jealousy, rivalry, evil-speaking, or a disposition to discredit the importance of the labors and discoveries of colleagues and collaborators, which were so prevalent in the previous centuries. It was an age of work; and if rivalry existed at all it was to see which university could graduate the best students, or which professor could write the best thesis on the medical art, or make the most important additions to the knowledge of chemistry, or add most to the resources of the materia medica.

What impresses the judicial mind of the historian the most at that time in reading works on Practice, is the poverty of materia medica. There was at this time no real science of chemistry and no real pharmacy; but a few of the primary elements had been discovered. A hundred or more herbs and a few metals composed

the materia medica. Of the true medicinal virtues of plants but little was certainly known. The art of chemical synthesis had not been discovered, and the active principle of an infusion or a tincture was a matter of conjecture. There was no real pharmacy in existence. The Dispensatories were the product of a few years later. Physicians had to collect their own herbs, make their own infusions and tinctures, and grind by mortar and pestle their own powders, or have their students do it for them. To a large extent, therefore, every physician was his own apothecary. It is to some extent the same to-day in the back countries of Europe and America. To this fact was largely due the industry of proprietary medicines and quack nostrums.

Another fact, of interest to note, strikes the impartial mind in this connection, namely, the vitality of the philosophy and practice of Hippocrates, especially in respect of the custom and practice of venesection for the more serious forms of fever and inflammations, and the use of mercury in small doses and large in the treatment of so large a class of maladies. Nothing was more common in certain well-known conditions than to give mercury to complete salivation and the falling out of the teeth. This was doubtless due, in part at least, to the poverty of medicaments of wide range of action, and in part to the unrivalled powers of the drug, which invited abuse of them. Its use justified Prof.

I

Paine's epigram, "that we do but cure one disease by producing another; Nature does the rest." That was his idea, or explanation, of the modus operandi of medicaments. Indeed, the value of most drugs of powerful reactions appears to be upon that principle. It is in accordance also with the maxim of Galen, contraria contrariis curantur, that diseases are cured by their contraries.

Nothing could be more rational, however, than that the treatment of maladies, the nature and causation of which were unknown, like epilepsy, etc., should be the object of endless experimentation. Try this, then that, and that, has been the order in the selection of remedies in serious diseases from the beginning; and that method of treating epilepsy, which is on the increase, or at least is believed to be on the increase, is still in vogue. But that disease has long since lost its sacred character, which is an advance in the direction of discovering its nature.

In the foregoing observations, we would not be understood as criticising the order of medical progress. When a sage like Hippocrates, or Moses, acquires the position of an oracle in the mind of humanity; when utterances are in some mysterious way the voice of God, they possess an authority which it is difficult to uproot or to displace. They may be outgrown by time and circumstance; conditions may change the nature Vide Paine's Institutes of Medicine.

and indications of the treatment of malady, and supersede, or render inoperative, or worse, the oracles of the old régime; nevertheless, they continue in force, and must be obeyed, until belief in something better possess the multitude. The oracles said take blood in pneumonia and pleurisy, again and again, so long as the "buffy" coat of the blood remain; give mercurials to the verge of salivation in hepatic complications and venereal; use cupping glasses and leeches in local congestions; blisters for local pains; give tartarized antimony freely in lung hepatization, and opiates for the cough; and if the patient die, be consoled by the reflection that the treatment was at least according to the oracles, secundum artem, and that the providences of God were fulfilled, so that at the last rites over the remains of the deceased it could be said, with some show of consistency, "The Lord gave and the Lord hath taken away."

END OF VOLUME I