NOTESTOTHEADDRESSONCURRENTSANDCOUNTER
CURRENTSINMEDICALSCIENCE。
SomepassagescontainedintheoriginalmanuscriptoftheAddress,andomittedinthedeliveryonaccountofitslength,arerestoredinthetextorincorporatedwiththeseNotes。
NOTEA——
Thereisgoodreasontodoubtwhetherthenitrateofsilverhasanyrealefficacyinepilepsy。Ithasseemedtocuremanycases,butepilepsyisaveryuncertaindisease,andthereishardlyanythingwhichhasnotbeensupposedtocureit。Dr。Coplandcitesmanyauthoritiesinitsfavor,mostespeciallyLombard’scases。ButDelaBergeandMonneretComp。deMed。Paris,1839,analyzethesesamecases,eleveninnumber,andcanonlydrawtheinferenceofaveryquestionablevalueinthesupposedremedy。Dr。JamesJacksonsaysthatreliefofepilepsyisnottobeattainedbyanymedicinewithwhichheisacquainted,butbydiet。LetterstoaYoungPhysician,p。67。GuyPatin,DeanoftheFacultyofParis,ProfessorattheRoyalCollege,AuthoroftheAntimonialMartyrology,awitandamanofsenseandlearning,whodiedalmosttwohundredyearsago,hadcometothesameconclusion,thoughthechemistsofhistimeboastedoftheirremedies。“Did,youeverseeacaseofepilepsycuredbynitrateofsilver?“Isaidtooneoftheoldestandmostexperiencedsurgeonsinthiscountry。“Never,“washisinstantreply。Dr。
Twitchell’sexperiencewasverysimilar。How,then,didnitrateofsilvercometobegivenforepilepsy?Because,asDr。Martinhassowellremindedus,lunaticswereconsideredformerlytobeunderthespecialinfluenceofLuna,themoonwhichEsquirol,beitobserved,utterlydenies,andlunarcaustic,ornitrateofsilver,isasaltofthatmetalwhichwascalledlunafromitswhiteness,andofcoursemustbeintheclosestrelationswiththemoon。Itfollowsbeyondallreasonablequestionthatthemoon’smetal,silver,anditspreparations,mustbethespecificremedyformoonblastedmaniacsandepileptics!
Yetthepractitionerwhoprescribesthenitrateofsilversupposesheisguidedbythesolemnexperienceofthepast,insteadofbyitsidlefancies。Helaughsatthoseoldphysicianswhoplacedsuchconfidenceintherighthindhoofofanelkasaremedyforthesamedisease,andleavestherecordofhisownbeliefinatreatmentquiteasfancifulandfarmoreobjectionable,writteninindelibleinkuponalivingtabletwherehewhorunsmayreaditforawholegeneration,ifnaturespareshiswalkingadvertisementsolong。
NOTEB——
Thepresumptionthatamanisinnocentuntilheisprovedguilty,doesnotmeanthattherearenorogues,butlaystheonusprobandionthepartytowhichitproperlybelongs。Sowiththisproposition。
Anoxiousagentshouldneverbeemployedinsicknessunlessthereisampleevidenceintheparticularcasetoovercomethegeneralpresumptionagainstallsuchagents,andtheevidenceisveryapttobedefective。
ThemiserabledelusionofHomoeopathybuildsitselfuponanaxiomdirectlytheoppositeofthis;namely,thatthesickaretobecuredbypoisons。Similiasimilibuscuranturmeansexactlythis。Itissimplyatheoryofuniversalpoisoning,nullifiedinpracticebytheinfinitesimalcontrivance。Theonlywaytokillitandallsimilarfancies,andtothroweveryquacknostrumintodiscredit,istorootoutcompletelythesuckersoftheoldrottensuperstitionthatwhateverisodiousornoxiousislikelytobegoodfordisease。Thecurrentofsoundpracticewithourselvesis,Ibelieve,settingfastinthedirectionIhaveindicatedintheaboveproposition。Toupholdtheexhibitionofnoxiousagentsindisease,astherule,insteadofadmittingthemcautiouslyandreluctantlyastheexception,is,asIthink,aneddyofopinioninthedirectionofthebarbarismoutofwhichwebelieveourartisescaping。ItisonlythroughtheenlightenedsentimentandactionoftheMedicalProfessionthatthecommunitycanbebroughttoacknowledgethatdrugsshouldalwaysberegardedasevils。
Itistruethatsomesuppose,andourscientificandthoughtfulassociate,Dr。Gould,hashalfcountenancedtheopinion,thattheremayyetbediscoveredaspecificforeverydisease。Letusnotdespairofthefuture,butletusbemoderateinourexpectations。
Whenanoilisdiscoveredthatwillmakeabadwatchkeepgoodtime;
whenarecipeisgivenwhichwillturnanacephalousfoetusintoapromisingchild;whenamancanenterthesecondtimeintohismother’swombandgiveherbacktheinfirmitieswhichtwentygenerationshavestirredintoherblood,andinfusedintohisownthroughhers,wemaybepreparedtoenlargetheNationalPharmacopoeiawithalistofspecifiesforeverythingbutoldage,——andpossiblyforthatalso。
NOTEC——
Thetermspecificisusedhereinitsordinarysense,withoutraisingthequestionoftheproprietyofitsapplicationtotheseorotherremedies。
ThecreditofintroducingCinchonarestsbetweentheJesuits,theCountessofChinchon,theCardinaldeLugo,andSirRobertTalbor,whoemployeditasasecretremedy。Pereira。Mercuryasaninternalspecificremedywasbroughtintousebythatimpudentandpresumptuousquack,ashewasconsidered,Paracelsus。Encyc。Brit。
art。“Paracelsus。“ArsenicwasintroducedintoEnglandasaremedyforintermittentsbyDr。Fowler,inconsequenceofthesuccessofapatentmedicine,theTastelessAgueDrops,whichweresupposed,“probablywithreason,“tobeapreparationofthatmineral。Rees’sCyc。art。“Arsenic。“Colchicumcameintonoticeinasimilarway,fromthesuccessoftheEauMedicinaleofM。Husson,aFrenchmilitaryofficer。Pereira。Iodinewasdiscoveredbyasaltpetremanufacturer,butappliedbyaphysicianinplaceoftheoldremedy,burntsponge,whichseemstooweitsefficacytoit。Dunglison,NewRemedies。AsforSulphur,“thecommonpeoplehavelonguseditasanointment“forscabies。Rees’sCyc。art。“Scabies。“ThemoderncantiscorbuticregimeniscreditedtoCaptainCook。“Tohissagacityweareindebtedforthefirstimpulsetothoseregulationsbywhichscorbutusissosuccessfullypreventedinournavy。“Lond。Cyc。
Prac。Med。art。“Scorbutus。“Ironandvarioussaltswhichenterintothenormalcompositionofthehumanbodydonotbelongtothemateriamedicabyourdefinition,buttothemateriaalimentaria。
Forthefirstintroductionofironasaremedy,seePereira,whogivesaverycuriousoldstory。
Thestatementinthetextconcerningaportionofthemateriamedicastandsexactlyasdelivered,andismeantexactlyasitstands。Nodenunciationofdrugs,assparinglyemployedbyawisephysician,wasorisintended。If,however,asDr。Gouldstatedinhis“valuableandpracticaldiscourse“towhichtheMassachusettsMedicalSociety“listenedwithprofitaswellasinterest,““Drugs,inthemselvesconsidered,mayalwaysberegardedasevils,“——anyonewhochoosesmayquestionwhethertheevilsfromtheirabuseare,onthewhole,greaterorlessthantheundoubtedbenefitsobtainedfromtheirproperuse。Thelargeexceptionofopium,wine,specifics,andanaesthetics,madeinthetext,takesoffenoughfromtheusefulside,asIfullybelieve,toturnthebalance;sothatavesselcontainingnoneofthese,butloadedwithantimony,strychnine,acetateoflead,aloes,aconite,lobelia,lapisinfernalis,stercusdiaboli,tormentilla,andotherapproved,and,inskilfulhands,reallyusefulremedies,brings,onthewhole,moreharmthangoodtotheportitenters。
Itisaverynarrowandunjustviewofthepracticeofmedicine,tosupposeittoconsistaltogetherintheuseofpowerfuldrugs,orofdrugsofanykind。Farfromit。“Thephysicianmaydoverymuchforthewelfareofthesick,morethanotherscando,althoughhedoesnot,eveninthemajorpartofcases,undertaketocontrolandovercomethediseasebyart。ItwaswiththeseviewsthatIneverreportedanypatientcuredatourhospital。Thosewhorecoveredtheirhealthwerereportedaswell;notimplyingthattheyweremadesobytheactivetreatmenttheyhadreceivedthere。Butitwastobeunderstoodthatallpatientsreceivedinthathouseweretobecured,thatis,takencareof。“LetterstoaYoungPhysician,byJamesJackson,M。D。,Boston,1855。
“Hygienicrules,properlyenforced,freshair,changeofair,travel,attentiontodiet,goodandappropriatefoodjudiciouslyregulated,togetherwiththeadministrationofourtonics,porter,ale,wine,iron,etc。,supplythediseasedorimpoverishedsystemwithwhatMr。
Gull,ofSt。Bartholomew’sHospital,aptlycallsthe’rawmaterialoftheblood;’andwebelievethatifanyrealimprovementhastakenplaceinmedicalpractice,independentlyofthosetrulyvaluablecontributionswehavebeforedescribed,itisinthesubstitutionoftonics,stimulants,andgeneralmanagement,fordrasticcathartics,forbleeding,depressingagents,includingmercury,tartaremetics,etc。,somuchinvogueduringtheearlypartevenofthiscentury。“
F。P。Porcher,inCharlestonMed。JournalandReviewforJanuary,1860。
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第53章