T/iee (XW/ M AN ESSAY UPON THK PRACTICE OF MEDICINE. AMES AV. PRICE, M.J). WASHINGTON-, ua. NEW YOKK : WM. I. S. HaIIRISOX. PUINTER, M iHANK STKKKT, XK.vit HRoaHWAY. 1 x 5 8. \WX.\ v>\\c\ AN ESSAY. "A cripple in the right way may beat a racer in the wrong. "—BACON. In every age of the world, from the earliest dawn of medical science to the present period, physicians have ever been regarded as the guardians of the public health, and perhaps no class of men, of whom history gives an account, are the subjects of greater sacri- fices mentally and phyitylv. But, as it is not my purpose in the following essay to appear Ufore my readers in defence of my profes- sional brethren, or to "meddle in other men's matters," I shall pro- ceed to the elucidation and exposition of such principles and facts, as shall subserve toy own purposes, and ultimately, I trust, be pro- ductive of my future prosperity. Twenty-five years of my life have been passed in endeavoring, by the closest application, to obtain a thorough knowledge of the nature and cure of diseases, during which time I have met with and treated almost every variety and class of diseases incident to this climate. During which time my great ob- ject has been to arrive at fads based upon scientific research, and reconcile discrepancies. " Truth, order, and harmony prevail every where in the physical world ; where we do not find them, we may be certain that the fault lies in a deficiency of knowledge or percep- tion on our part. Our duty, therefore, is still to pursue our inves- tigations until we find the sacred prize, and thus have obtained a revelation of new glories." Great indeed are the responsibilities which rest upon the man who assumes the position of a physician. To him is intrusted the lives of his fellow men ; and if he is the possessor of those feelings which should characterize the man and the Christian, he must not regard his calling as one of small im- port. Hence, looking with the deepest interest upon this subject, 4 as it presented itself to my mind, with all its momentous consequen- ces, I have endeavored to investigate every system of practice which has been presented to the consideration of the people from that of the immortal Hippocrates, whose "principal object was closely to observe nature, collect facts, make experiments, and to record his own experience, or that of others, wherever he could," down to the present time. This fad, in my medical education, has been the fruitful source of much of the opposition to my success in practice with which I have had to contend. But, as I intend to be my own guardian in the future management of my profession, re- gardless of the opinions of all others, except those who may favor me with their patronage. I shall concede to others the same gener- ous privilege, submitting the whole matter to the discrimination of those who are competent judges. JK, " The student of medicine," says Ja^,^* should scorn to swear by the words of his master. If this blind allegiance should be re- quired of him by his master, this gentleman makes himself liable to the suspicion of charlatanism and unenlightened intolerance ; and, on the other hand, the student who submits to this species of despotism, is entirely unlit to practice the sacred art of healing. A skilful artist may indeed construct a harmony with the various vi- brations of the same chord ; but what a much more beautiful and perfect harmony he might construct by a proper combination of all the sounds that can be elicited from all the chords of his instru- ment." This is likewise true in regard to the various systems of practice now in the world. There is no subject which has ever been brought before the peo- ple, with which they are so little, acquainted as that of medicine. The world is filled with schools, flooded with medical literature, with innumerable young men crowding the arena of life with "sheep-skin" authority and pills, ready to contend with disease, and disarm the " King of Terrors" of his power and put him to flight, and as mat- ter of course, each contending streriuously for the correctness of his practice and the system which he may assume to be scientifically right. The Allopath, Homeopath, Hydropath, Thomsonian, and Ep 7 b m^ |ectant, equipped according to law, are attacking us with their various systems, all clamoring for the ascendancy in the medical world. How shall their differences be reconciled and contending parties be brought down to a proper level, and the people see their true in- terests ? It can only be accomplished through the agency of con- servative medical men, who shall consecrate their time and talents to an honest investigation of the whole subject, culling out from the great mass of theories now extant, those facts which are reliable and based upon scientific principles. But here " most of them unfortu- nately remain, careless or careworn, according to their several na- turds; expecting yet to find a firm foothold among their chaotic confusion of doctrines, they plod along on the old beaten track without joy or energy. " The more learned portion of them, however, threatens to leave them : a second division of the great chaotic mass has to take place. Seeing the errors of the old, or heroic practice, they start the idea that the nihilistic, or do-nothing method, is the only one which a learned medical gentleman ought to adopt. Accordingly they advo- cate it to be the physician's highest duty never to give any medi- cine whatever, but to watch the efforts of nature, in order tg guard against any interference. They style themselves the physiological or pathological school. " A third portion of the old chaotic mass, more inclined to ener- getic action and empirical routine, has been attracted in another direction by the wonderful power which the cold-water system has exhibited in curing diseases. Thus the medical world, which, sixty years ago, still formed one chaotic mass, void of form, but full of useful elements and seeds of promise, is divided now into three con- crete parts, each of which tries to enlarge itself from without by elaborating within the powers of attraction. " The physiological, or do-nothing school, does not really pretend to cure a disease, but merely to watch its natural progress without interfering ; they affect to be the high priests of nature, clothed with the robes of her pontifical dignity, in which capacity they pronounce nature's will. It seems not to be a part of their duty to 6 % alleviate the poor patient's sufferings,—that would be an invasion $f -t nature's rights. Nature will do that- herself, if she can, and if not, no power on earth can relieve the sufferer or divert the fatal shaft; no medicine exists to assist nature or to cure disease. Such reasoning is at once the death of the science, and if it does not immediately cause the death of the patient, it certainly is not calculated to avert it." Under all these circumstances, it is the imperative duty of the scientific physician, regarding the interest of the community in which he may reside, to investigate the claims of each of these, and adopt, in part or as a whole, the one which, after mature delibera- tion, he may conceive to be based upon correct pathological prin- ciples. Influenced by motives of this nature, I have endeavored to gather from these various systems of medicine, a practice which I conceive to be in accordance with sound judgment and practical experience, whether it emanated from the mineral, animal, vegetabl", or any other kingdom. The want of a similar course in others ha> led to a want of confi >ncp. in the public mind in reference to the practice of medicine, vjftle the adaptation of remedies to disease has been only palliative in its effects and injurious in its results. Quinine cures everything wi.th some. Not an ache or pain exists in the human frame which may not be reached by this immortal drug. % It is a tonic, sedative, nervine, &c. To the latter property I attribute for it all that is claimed by its strongest advocates ; for, doubtless, more nerves have been shattered and constitutions debilitated by its use, than any other article within the range of the materia medica. Acting directly upon the brain, the nervous centre, and from thence conveyed off through all the ramifications of the nervous system, producing its dire effects to the remotest tissue of the body. The effects of one dose having passed away, it is necessary soon to repeat it, until the subject finds him or herself the unfortunate victim of a sort of quinine ddirium tremens, from which there is no relief until there is a repetition of the medicine, thereby establishing the cor- rectness of the old adage, that "the hair of the dog is good for J;he bite." In all reason, how is it possible that one article of the ma- / teria medica can meet the demands and combat all the diseases which flesh is heir to ? It is contrary to common sense and sound philosophy, and cannot stand the test of scientific research or inves- tigation. Again: Morphine and Elixir of Opium are the "Alpha and Omega" with thousands of unfortunate victims, who are daily slum- bering on in unconscious insecurity, who have been made the sub- jects of this mania through' the injudicious and unguarded application of these articles in their prescriptions. And hence the practice of medicine in the present day is narrowed down to a few experimental palliatives, resulting in an almost entire loss of confidence in the science, and an abandonment of all curative agents. And when we turn and look around us at the violence of diseases, and the fatality attending a large proportion of the cases, the heart sickens at the thought and anxiously inquires, is there no "balm in- Gilead, and is there no physician there ?" I allude to no particular location or class of physicians, but upon general principles, as I have witnessed the march of death through the earth, spreading ruin and dismay, and clothing once happy faces in the habiliments of mourning. After mature deliberation andj-ears of research upon this subject, I have determined to gather from the great mass of authors upon the different systems of practice now extant in the world, that mode of treating diseases suited to my own views and conceptions in reference to a matter of such vast importance to my fellow beings and my own responsibilities, morally or otherwise. In some sec- tions I have been charged with being aThomsonian, in others a real bona fide Calomel and Blister doctor—again a Homoeopathist—next a Ilydropathist, and any and every thing which might subserve the purposes of those who have desired to crush my future success in practice. I trust that I may be permitted to set this matter at rest, by stating that I am an Eclectic in my views of medicine, and shall use such remedies as I humbly conceive may be best adapted in their nature to alleviate the sufferings of my patients, whether gathered from Allopathy, Hydropathy, Homoeopathy, or any other pathy. And "in this light I have presented the relation of these new 8 forces, which seem to be destined to bless the suffering world in a degree hitherto unknown, when linked together and understandingly practiced. Each oife separate will of course be able to produce upon its own legitimate field a great deal of good, but it will still be partial and limited, when compared with the good which, united, they are able to produce. Party feeling, as we have seen, has cre- ated strict party lines to keep them asunder, but their common in- terest in the service of humanity demands their union. "If thus a union of these three most effective methods is realized, a complete revolution in medical matters must be the result; medi- cal success will be increased until disease willlbe almost annihilated and death retarded to its natural limits." And he who comes out from a medical school with his diploma, content to plod on in the same old beaten track, as taught him in the beautiful theories and systems promulgated by medical lecturers in schools bf science, and never looks beyond these for other lights, nor ventures an opinion of his own, will find after a few years practice that all was not "gold that glistens," and that his misfortunes in the practice of medicine was but the result of not thinking for himself. With the most profound respect for the experience and scientific research of our fathers in medicine, as laid down in the text books, I would say, that he who follows to the letter the dictation of such, without ex- ercising discretion and judgment, and watching the operations of nature, as exhibited by a totality of symptoms in diagnosis, and then fails to select his remedies to meet the emergencies of his case, outside of what he has been taught by his medical dictators, will find himself and his patient in a labyrinth from which there is no extrication. I am not opposing a thorough medical education, but I do most strenuously oppose that system of education which pro- hibits the exercise of free thought and carrying it out into practice. If there is a decided improvement in, medical science as taught in regular schools, I would ask the most strenuous advocates of such views to point them out. The lancet, ouce the sheet-anchor in acute diseases, is now abandoned almost entirely by the profession. Cal- omel, the " Sampson" of the materia medica, is gone out of repute. 9 when we take into consideration its application to the treatment of diseases in former years. If there is an improvement in the science, it has grown out of the fact that first principles have been aban- doned and new theories erected on the ruins thereof. These are facts which cannot be evaded. Agents are now recommended to the students of medicine in institutions of the present day, which would have been considered sacrilege twenty years ago. This, however, is but the force of public opinion, growing out of the increased in- telligence of the people, who are no longer to be duped and drugged to death ; and I believe that there are very few diseases which may not be reached by rational medical treatment, if timely and pro- perly administered. I am candid in saying, that education alone cannot constitute a successful practitioner. There are innumerable instances where individuals have received the most enlightened edu- cation who have "been perfect dupes in medicine, and were compelled to retire from the profession. While others, with less advantages, have arrived at eminence and accomplished wonders in the profes- sion of medicine. There is a peculiar tact and talent required, which all do not possess—it is almost of a divine origin—a sort of intuition, which gives its possessor advantages not to be compre- hended or explained by the powers of reasoning or philosophy. And while I would not have my readers believe me contending for Spiritualism, yet, the position assumed is at least tenable and not easily confounded. " A physician's practice," remarks Hempel, " is scarcely ever pro- portionate to the real merits of the treatment he pursues ; on the contrary, it depends chiefly upon accessary causes, so much so, that many a deserving physician, distinguished by his skill and success, is scarcely able to get along in the world, whereas an ignorant pre- tender, who happens to be a bold, an intriguing tactitian, is looked upon as the leading man of the profession. If a physician succeed by dint of manoeuvring, in spreading among the people the belief that he is the cleverest physician in the place, they will run to him in preference to any other, though a much more inferior man. Of course these remarks do not apply to this vicinity. They are simply 10 intended to show that a large practice is no proof of a physician's superior skill and success, and that, therefore, the large practice which a physician may have cannot be adduced as an argument in favor of the exclusive preference which may be given to him." Doubtless many, very many, of the errors in practice, have grown out of the fact, that physicians eagerly seek for names, and prescribe for diseases, whereas, if symptoms were more closely analyzed as the means of arriving at a correct xliagnosis, many errors would be avoided. The closest and most scrutinizing observation ought to be called in to aid the physician in making a proper prescription, at the same time watching the operations of nature, in removing from the system diseased morbific matter, and restoring to healthy action those organs which are endeavoring to throw off that which may be derogatory to the animal economy. Nature "has a meaning in every thing that she does, and there is no occurrence, however com- mon, which is not the exemplification of some law of nature. As the operation of one law is usually found to accomplish an infinity of ends, so the discovery of any one exemplification of it usually leads to the explanation of many other things of which we were previously ignorant." Dr. Dixon, editor of the N. Y. Scalpel, the enlightened surgeon, who has been contending with error and striving to establish a more rational system of medicine for years, says, " Nature is ever busy, by the silent operation of her own forces, endeavoring to cure disease. Her medicines are air, warmth, light, food, water, exercise, and sleep. Their use is directed by instind, and that man is most worthy the name of physician who most reveres its unerring laws." Medical science," says Macilwain, "is in part the study of the laws and relations of animal bodies, in order to ascertain the modes in which nature relieves diseases or repairs accidents ; and to deter- mine the conditions of the whole body, which favor or impede these processes in its various parts ; with an especial view, in the one case, to tb^e maintaixance of such conditions, in the other, to their re- moval." This great principle must be admitted to the fullest extent, and any remedial agent thrown into the constitution of man which 11 does not act in strict conformity with the principle inculcated in this doctrine, is contradicted by the laws of nature, and will be produc- tive of immense injury, if not loss of life. Then how closely should we study the various and diversified symptbms which may be pre- sented to the eye of the practitioner, in any given case which may come within his jurisdiction ; for he who would carelessly or inad- vertently make a thrust at disease, irrespective of the laws which govern and control our animal machine, being " wonderfully and fearfully made," is but tampering with the lives of his fellow beings, and deserves, to say the least of it, the epithet of a scientific murderer. Mistakes have been made in the hands of physicians that time nor memory can ever efface from the minds of the living. How impor- tant, then, that we should watch attentively all the minutiae of dis- ease, with every attending symptom in the case, before we bring to bear upon the case those remedies which may be necessary to control the malady on the one hand, and in strict conformity to scientific principles upon the other. "After all," says an elegant writer, "pathological symptoms do not amount to much, provided we prescribe in accordance with the totality of the symptoms ; for, by pursuing this course, we cannot fail to prescribe for the thing, even if the name be left out of con- sideration." Names are but empty sounds at best. If I say the patient has pneumonia, I simply state a fact, which may or may not exist. How do I ascertain that the individual has the disease alluded to ? I arrive at the correctness of my opinion by certain develop- ments, which are characterized as symptoms or signs. Then I pre- scribe for .the thing according to those symptoms, and if the same group were existing in any other given case, and I could not desig- nate the disease sufficiently to tell whether it was pneumonia or anything else, I should direct my remedies so as to cover the great- est amount of symptoms in the case, whether I ever succeeded in applying a name or not. I could illustrate cases where physicians have been for days puzzled to ascertain a name before the disease was determined upon, or a prescription made, while the unfortunate victim has been suffered to struggle on, awaiting the decision of his 12 physician, until'the malady had fastened upon his constitution, and rendered his case utterly hopeless. And it is to be regretted that an opinion is rife in many sections of the country, that some diseases are within the reach of remedial agents, only so far as to palliate the symptoms, leaving nature to work out its own cure. Truly if this be correct we are not much in advance of the old Mosaic doc- tors, who were both hydropathists and vegetable—for the prophet commanded them to wash in the river of Jordan, and they were healed—and a fig was applied to the old prophet's boil with the de- sired effect. And if I could imbibe the principle, and reconcile it with the immutable laws of God, that he had provided a ransom for the soul and not the bodies of his intelligent creatures, then 1 should necessarily conceive the work of redemption was only par- tial, and comes far short of accomplishing that which was the inten- tion and design of the God who made us of " one flesh and to dwell upon the face of the earth." But, I entertain no such thoughts ; with unshaken confidepce in that Providence who has " numbered the very hairs of our head," and notices even the "sparrow's fall," I believe he has placed upon this wide earth remedial agents, if " everywhere known," sufficient to* remove every pain or affliction which the violation of the Divine law has entailed upon the human family. And with all due respect for the opinions of others who may differ with me upon this subject, I must be permitted to state as my honest conviction, that the prevalent opinion now existing in many neigh- borhoods and families in reference to Typhoid Fever, has done im- mense mischief. The generally received opinion is, that if you give medicine you kill your patient. Let us analyze a little. This scourge of the human family has swept over our country, mowing down its thousands, almost unmolested in its work of death. I have seen it where medicine was given, and many died ; and I have witnessed its inroads upon many families, where nothing was done except a few palliatives to soothe and quiet the sufferer, and they have all almost universally died. And from an experience of some ten years in my own practice and that of others. I am decidedly under the impression, 13 that typhoid fever may be as successfully treated, and brought as much under the control of remedial agents, as any other fever of as malig- nant a type. If I am wrong, it is but the honest conviction of my mind, backed and sustained by my past experience in the manage- ment of the disease—not presuming, however, to avow that I am better posted than others of my professional brethren. And with bright anticipations of the future, the bow of promise now looms up before us with all its variegated beauties, giving en- couragement to the afflicted and wayworn, that the time will yet come when on the mountain-top and in the valley, remedies will be found commensurate with the afflictions of man, and he shall live out his " three score and ten," and return to the earth full of years and covered with honor, to rest in peace. .yt,v v\. C^/ & Ovi/t/viA-. ^ToAr-f. 'ri--V72~- y 14 TO THE AFFLICTED. I will treat the following Diseases at the respective residence* of the Patients, or at my house in Washington, Ga., where they shall receive every attention necessary, together with moderate charges. DROPSIES, of different kinds. RHEUMATISM. FILES. KIDNEY AFFECTIONS. LIVER COMPLAINTS. APOPLEXY. PALSY. DYSMENORRAIKEA. SYPHILIS. GONORRH(EA, in all its stages. MENSES. DYSPEPSIA. ' GLEET. PROLAPSUS UTERI And every other variety of Chron.c Diseases which may be inci- dent to a Southern climate.