THE MODERN DOCTOR

OUR first medical traditions date back to the East Indies and Egypt; our first real knowledge is derived from Hellas, the mother of the world's culture. Even Hellas had no regular physicians until the period of Lycurgus. It is true that Homer eulogizes the man of healing, but medicine was mostly theocratic. Gods, demigods, and their priests healed the sick. It was Apollo who smote men and armies with infectious diseases, and again relieved and saved them. But as there were always those who were sick and injured, attempts to aid them were the results of sympathy. Herodotus tells us that in Babylon the sick person was carried to the market place and took his choice from among the various cures advised by the multitude. In Greece the temples of the gods in which the priest practised celestial fraud and secured terrestrial experience, the tablets on which individual ailments and remedies were collected accumulated a store of available advice. But the translucent sky of Hellas did not permit of a predominance of obscurantism; her shrewd politicians and profound philosophers would not be satisfied with the mental slavery engendered by credulity; in the absence of manifold knowledge of natural things they began to philosophize.

Empedocles taught a theory of affinities-he called them love and hatred-that regulated the globe, which was composed of four elements, viz.: air, earth, water, and fire. In the animal body these were represented in blood, mucus, and yellow and black bile, and laid the groundwork for a humoral theory, while Democritus and Epicurus established the first atomistic theory and the solidist pathology. In the last century before Christ this was elaborated by that learned and popular Greek physician of Rome, Asclepiades. Hippocrates was brought up in the theories of Empedocles, but never was there a more observ

ing, empirical, reasoning, and practical mind than his; never a warmer heart, a more ethical conscience, or an intellect freer from hypothetical or unfounded assumption.

Neither Aristotle nor Plato appreciated Hippocrates at his full value. Though the former had all and more than the learning of his period, he was too much of a theorist like Plato himself to understand or to follow the great physician in his empiricism and the observation of facts. But it was Aristotle, and after him Herophilus, and two centuries later Galen, who added immensely to the knowledge of anatomy. Thereby they created a foundation for surgery, which during the reign of the school of Alexandria nobody had the unscientific tendency, rather prevalent with us, to separate from medicine. Galen could have continued to be the idolized creator of medicine to our own times if he had been able to keep apart from the speculations of Greek philosphy and had clung to the Hippocratic method of observing without theorizing.

Still, his means for obtaining knowledge were limited. His anatomy is that of animals; the teachings of the Koran, centuries afterwards, were opposed to the study of human anatomy, and both Galen and the medicine of the Arabs, while adding profusely to what we should call clinical and pharmaceutical knowledge, fell short of being the elaborators of Hippocratic medicine. Still, Galen and Aristotle controlled the thinking of the world until the era of Bacon, for fifteen hundred years.

Such an unbounded influence is never exerted by a single man anywhere except in religion or in science. In politics the gradual evolution of a nation, or of mankind, is not governed by an individual. No Alexander, or Cæsar, or Charlemagne, or Napoleon, or much smaller men with only a single thought in their heads like Bismarck, could have shaped the world anew, if the social and political situation had not favored them. History made them, but in science single men may make history. So did Paracelsus when he discarded the yoke of Galen, who had reigned undisturbed 1,600 years. So, towards the end of the eighteenth century, did Morgagni, when he introduced anatomical thinking into medicine; Haller, when

he taught the functions of different organs, mainly the muscles, and discovered the existence of sensitive nerves, and of the different directions of nerve currents. So did John Hunter, when he established pathological anatomy and experimentation-for that is what he founded when he preached the paradoxical text: "Do not think, try"; Jenner, when he laid the foundation of sero- and organotherapy; Bichat, when he created histology. That is what Virchow did-guided by his predecessors and by Schwann and Schleiden-when he fixed the throne of life in the invisible cell; or Pasteur, when forever he demonstrated the omnipresence and omnipotence of the unscen microbe. "The universe itself is narrow," says the poet, 68 when compared with the vastness of man's brain."

Still, the few centuries following the time of Bacon and of Paracelsus were barren in their effect or clinical medicine. Sydenham, Boerhaave, Van Swieten, and Peter Frank were great and influential, but the foundation of medicine was not sound, and wanton systems followed one another both in philosophy and medicine.

The clouded mental atmosphere produced two peculiar systems, the modifications of which claim our attention this very day. They were Mesmerism and Hahnemannism. Mesmer was not always a fraud. Contrary to most frauds he was learned, but his mind was always tinged with mysticism. His very inaugural thesis, on the influence of the planets on the human body (1766), betrays him. He sank so far as to treat diseases by animal magnetism at a disOur present fakirs are only shallow imitations. Hahnemann began his career with a paper published in 1796. Within a few years he completed his teachings, the principal of which were as follows:

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The only vocation of the physician is to heal; theroretical knowledge is of no use. case of sickness he should only know what is curable, and the remedies. Of the diseases he cannot know anything except the symptoms. There are internal changes, but it is impossible to learn what they are; symptoms alone are accessible; with their removal by remedies the disease is removed. Their effects can be studied in the healthy only. They act on

the sick by causing a disease similar to that which is to be combated, and which resolves itself into this similar affection. The full doses required to cause symptoms in the well are too large to be employed as remedies for the sick. The healing power of the drug grows in an inverse proportion to its substance. He says literally: "Only potencies are homeopathic medicines." "I recognize nobody as my follower but him who gives medicine in so small doses as to preclude the perception of anything medicinal in them by means either of the senses or of chemistry." "The pellets may be held near the young infant when asleep.' Gliding the hand over the patient will cure him, provided the manipulation be done with firm intention to render as much good with it as possible, for its power is in the benevolent will of the manipulator." Such is the homeopathy of Hahnemann, which is no longer recognized in what is called homeopathy to-day.

A modern critic (Tagel) says of Hahnemann's teaching that "his new system, which was announced with ferocity, and appeared unintelligible and crude to a sound mind, could not but impress the multitude, which did not differentiate between one bad logic and the other. His contempt for actual observations and experience pleased the igonrant, his violent criticisms of everything preceding him appealed to the unschooled protestant mind; indeed, he compared his cause with the fight of Protestantism against Catholicism; his very violence tallied with the revolutionary spirit of the time; the mysticism of the medicinal power of a substance when reduced to an unthinkable minimum was an astounding exemplification of the superiority of the spirit over the body; the ridicule and persecution to which his teaching and his vehemence exposed him were claimed as martyrdom."

Moreover, the homeopathists had a real martyrdom. Some sixty years ago the regular profession of the United States turned against them with the same vehemence that was exhibited by Hahnemann himself and his first apostles. That was taken by the American public as unfair; it always takes the side of those who are or appear to be persecuted. From that time dates the success of homeop

athy in America, and its conquest of the hearts and minds of a large portion of the public. That is why homeopathy had a longer life than any other system which was the outcome of any man's mere thinking or mere imagining. Indeed, all systems are of that origin-Stahl's, Brown's, Rademacher's, Thomson's, no matter whose. To-day, however, medicine has reached that period of evolution which no longer permits it to be called a system. Since it came to be studied like one of the natural sciences, like biology, there are no schools any more, but simply medicine. Homeopathy also has undergone changes like everything mortal in its own ranks. We in New York know that better than most States. Twenty-five years ago there were in our city a hundred medical shingles with the title homeopath painted on them. I believe there has not been one these ten years. The examination papers of the State Board of Examiners are the same for all the three boards, with the exception of those questions which refer to materia medica. A goodly number of practitioners who are called by the public by their former name never use it themselves; there is no doubt that many who graduated from a homeopathic college and are called homeopaths by the ever faithful ladies of the hotel piazzas are satisfied to be practitioners of medicine. And I have reason to believe that the time is not distant when there will be no school, no sect, but medicine only. If a practitioner, after having, by passing his examinations, satisfied the people of the State that he is competent, chooses with the consent of his patient to regulate his therapeutical measures to suit himself or his patient, that is his own taste or business. For remember what we have sworn to in our Hippocratic oath: "I will follow that system of regimen which according to my ability and judgment I consider for the benefit of my patient." But I believe firmly that in a short time we shall have one board of examiners in place of three, and one solid body of medical men willing and competent to fight for the welfare of the public against quackeries of all sorts.

In New York State we had year after year to convince the legislature that the claims of so-called osteopathy and