INTRODUCTORY LECTURE, delivered in the fourth street concert hall, On Wednesday evening, November 5th, 1851. BY JOSEPH R. BUCHANAN, M.D., professor of physiology and institutes of medicine in the eclectic medical institute. (published bv the medical class of the institute.) CINCINNATI: PRINTED BY W. M. NAUDAIN, corner vine and centre sts. 1851. At u m-stins cf the S-.'.idewts of the Eclectic Medical Instim'e of Cincinnati, held a he College i^iiiiao Nov-ml.er ' th, Wal Chasers called to the Chair, and Charles 0. Myers appoii.tel Seen lury. On motion.^it wa> Reio'ved, Thut a cimmii.ee of f v.- he aproicted to salic-h of I'm. ftfsor J. R. Ei«han/n a opy o" his Introductoryaddr » Lr iiH:-!L:.>tbn. Whereupon, Messrs. George IV. i^ in. J- Q. * . VcWi'fi m:s, D. M. Keith, H. H: Smally, and D. J. Sherer, were appointed E iu cc mrcittee. ^ ( ^ ^£ chaim,„n C 0. Myers, Secretary. Cincinnati, November 12th, 18:1. Professor J. R. Buchanan: Bear Sir,—Being highly pleased with the intelligible manner, in which you elucidated the principles of the different systems of Medical Practice, in your Introductory Address, delivered in Fourth Street Hall, on the evening of Nov. 5th,—we as a Committee, in behalf of the Class, respectfully solicit a copy for publication. Very sesoectfully, yours, GEO- M. DA-KIN, J. Q. A. Mc'WILLlAMS, H. H. SMALLY, D. M. KEITH, D.J. SHERER. Committee. Cincinnati, Nov. I3lh, 1851. Gentlemen: . The introductory Lectura which has baen favored by your approbation, was designed simply as a plain popular description of the relative characteristic of Eclecticism and Ex- clusive As such it is verv respect ully placed at your dispasal-hoping that it may assis' in diffusing a knowledge of that benevolent reform in which we feel so deep an in- terest, and which is entitled to demand tha ardent sympathies of every lover of liberality •and justice. Respectfully, and cordially, \ ours, JOS. R. BUCHANAN. Messrs. Dakin, McWilliams, Smally, Keith and Sherer, Committee. INTRODUCTORY LECTURE. Gentlemen :— You have entered a College which professes a liberal Eclecti- cism—but eclecticism is not our sole characteristic. It is not merely the restrictions and despotic discipline of the old school system from which we escape—we escape far greater evils. We are proud to say, that we have abolished, so far as we are con- cerned, that despotic edict of the National Old School Medical Association, passed at their Philadelphia session, which prescribes that every physician shall be strictly regular in his practice, and follow the course laid down by his masters, or else that he and his students shall be proscribed from the ranks of the profession, and excluded ever from the privilege at the present day ? They are ceitainly the bold use of mercury, antimony and opium, and the general addiction to Chemical remedies in preference to those of the vegetable kingdom. When did this originate ? Not with Hippocrates— : not with Galen—*not with any of the ancients, nor did it originate in any honorable quarter. This heroic chemical medicine origi- nated with the greatest quack that ever dishonored the medical profession, who assumed the pompous name of Phillipus Aureo- ius Theophrastus Paracelsus Bombastus De Hohenheim. Paracelsus had the most unbounded arrogance—claimed to be the supreme sovereign of the medical profession—exacted the most exorbitant fees—made the most disgraceful failures—pre- tended to have the elixir of immortal life, and after all, died a [^] drunken vagabond* a* about 48 years of age,; leaving writings which were full of absurdities. Galenical practice, derived from Galen and Hippocrates, in op- position to the Paracelsian practice, was distinguished by pre- ferring medicines compounded from botanical sources. But the practice adopted by. the quack was of a bold and dashing charac- ter, and modern Allopathy can claim.no higher origin for its pe- culiar distinctive features than the quack Paraeelsus. It is these features which were introduced by the quack ..which we would still condemn as quackery. But in doing this-*-in maintaining; that Galen and Hippocrates were nearer right' than Paracelsus,. we are not following their system. It is true that so far as com*- mon sense and moral sentiment might go, Hippocrates and Ga- len, the leaders of medical, practice for two thousand years, as welL as Erasistratus and Herophilus, of the Alexandrian school, who were the originators of anatomical science, were nearer right than some of their successors ; but we never quote them, as authority. We would' merely show thatthere was good common sense among the ancients, and that our modern Allopathies would be rebuked for their errors, if the spirits of Hippocrates and Ga- len—of Erasistratus and Herophilus, could rise before us. Could they come back to life, Erasistratus w«uld rebuke their use of the lancet and calomel—Hippocrates, Herophilus and Galen would rebuke their disregard of the botanic for chemical ; remedies. They would all disavow the present old school frater- nity, as having departed widely from the true path of therapeu- tics. They would recognize in the Eclectic practice the same kind, liberal and courteous spirit in which they practised medi- cine themselves—and they would eagerly enter the Hall, to begin anew as learners, and discover how far modern medicine liad transcended their ancient ideas.. Herophihas was partial to a he- roic practice with hellebore—but I think he would acknowledge- that ws have much .more satisfactory remedies. Erasistratus would ask why these modern physicians persisted in using the lancet, when he had demonstrated at Smyrna the value of other measures.. What course Hippocrates would have pursued, I do not know,. for his general policy was like the Eclectic except in the use of the lancet, which Erasistratus reformed, but there is a pas- sage in his writings which shows that his rules of progress were similar to our own. He says: "No difficulty should be made at receiving information from the most illiterate, (provided it appears that they have some knowledge of the subject under consideration.) It was thus,X> think, that our art had its origin; collfeeting together from ail' quarters a body of facts. We ought not to neglect what chance may present, especially if it be reiterated, listening with attention in order, to pnofit, and not repulsing our informant, by boasting of our own cases, and deemi/hg his experience void of utility J* [25] In behalf of our ethical principles I might 'quote from many writers of different ages. And in behalf of our practical mea- sures I could adduce sufficient testimony to show that while the Paracelsian errors have prevailed in the practice of the maJon" ty there has been a steady protest against these among the best men of the profession, and that in making the reform which we have accomplished^ we have but done boldly and manfully what thousands have desired to see accomplished. What are the reforms by which American Eclectics are distin* guished from old schoolmen? They are eight. 1. We deny the papal infallibility of the profession. 2. We deny that it is impossible to produce satisfactory rer suits without the lancet. 3. We deny that mercurials are ever necessary. 4» We deny the propriety of using any injurious remedies. 5. We deny that a physician should be allowed to lose mose than 2 per cent. . 5. We deny that we know enough of the Materia Medica. 6. We deny that the functions of the brain should be omitted in our systems of physiology. 8. We deny that physicians should be the last to'learn new truths. . , 1. As to Papal Infallibility. I wish it to be distinctly under- stood by the American people that there are two parties in med- icine. One contending that medical societies and medical col- leges constitute a supreme tribunal which is competent to settle all questions in science, and .which after it has settled them is au- thorized to demand acquiescence and obedience from all who do not submit—authorized to denounce all who do not agree to their decisions as empirics, quacks and enemies to the profession, against whom we should conspire to put them down, lhe other party like the protestants of the Reformation, denying that there is any divine right of the few to rule the many, and asserting the sacred right of private judgment and the binding duty which compels us when we know how to heal the sick, to save their live* whether we are permitted or not, by our National conven- tions Upon this issue we are willing to go before an intelligent public, and I trust, gentlemen, you will not fail to explain it pro- P62y We affirm that bleeding is a barbarous and unscientific remedy, and deny that it is ever necessary. In this matter we take our stand upon the facts recognized by the highest authori- ties in medical literature. We refer to the most recent and ac- curate researches in Chemistry and pathology—to the experi- mental investigations of Andral, Majendie, Louis, Simon and many others which have settled beyond all doubt, and placed among the permanent facts of medical science, to be received by ail medical schools of whatever therapeutic faith, the phenome- [26] na of the blood, when its composition has been affected by hem- orrhage, by bleeding and by various other agencies. It is indisputably established that bleeding produces a special change in the composition of the blood. The change which it produces is not a removal of any effete or morbid materials—not a removal of any element which tends to create or aggravate di- sease, but a removal of the most necessary and healthy portion, upon the presence of which we depend for the maintenance of health and vigor. Bleeding inevitably reduces the red or globu- lous portion of the blood, because it removes or destroys a cer- tain .amount of the red globules, and the loss which it produces is readily supplied by absorption of water and of comparatively crude materials, while the highly organized globules are regener- ated with great slowness and difficulty. It is a well established fact that the red globules of the blood are essential to life, and that their abundance or scarcity is a cri- terion of the vital force and activity of the constitution. As the proportion of the red globules increases, the general vital power rises, and the activity or energy of all the organs increases; while a diminution of their ratio enfeebles or disorders the vari- ous organs, and predisposes to nervous and tuberculous disor- ders, and to the whole range of .adynamic and cachectic diseases. If the ratio is diminished as much as one seventh, general debil- ity is the consequence, predisposing to disease, and diminishing the power of recovery; if as much as one fourth or more, this reduction of vital power is incompatible with health, and inevi- tably results in some form of disorder. Is it not then exquisitely absurd to adopt, as a remedy in dis- ease, a measure which, even in the most vigorous health tends directly, with rigorous precision, to destroy the vital powers and bring on disease! Yet this measure has been, and still is sustain- ed by many medical men, although clinical experience, as well as chemical science, has shown its injurious effects, and thou- sands in America and Europe have been, and are now demon- strating, that all forms of disease may be better treated without blood-letting than with it. We affirm that in disease, the pathogenetic elements of the blood should be removed, instead of its healthful and necessary constituents. Nature has provided for the removal of all noxious materials, by numerous appropriate outlets, which discharge ev- erything that is injurious to human health. It is the duty of the physician to aid nature by such medicines and means as will rouse the secretions and excretions, and thus ensure the restora- tion of the blood to a perfectly healthy condition. When, for want of knowledge how to accomplish this, he destroys, with un- natural violence a large portion of the vital blood itself, which is as necessary to the body as its solid tissues, he acts with as much scientific precision as the savage, who would treat a case of. con- [27 J vulsions, not by removing its causes, but by cutting out a portion of the convulsed muscles. 3. We deny that mercurials are ever necessaiy—we affirm that we are acquainted with better medicines, and that they should, like all other inferior remedies, become obsolete. 4. We deny the necessity of using any remedies really inju- rious to the patient. When you inform physicians said to be well educated in the old Colleges, that there are better and more powerful remedies than the mercurials—articles better adapted to act on the liver, and which will act on the liver when calomel totally fails, they will stare at you in astonishment, or flatly deny it. Our colleges, societies and authors are in general profoundly ignorant upon this subject—stubbornly and wilfully ignorant—ignorant as was the in- quisition which condemned Gallileo for maintaining the rotation of the earth—ignorant of the medicines that we employ, and of their properties—ignorant because they were educated in the mercu- rial system of practice, and are too sluggish or too stubborn to learn anything else. All candid physicians will acknowledge that Paracelsus intro- duced a poison which has been destructive to millions ; which, as Watson says, is a two edged sword. Many will acknowledge that mercurials, taking their whole history together, have done more harm than good—have poisoned or killed more than they have saved; and taking into consideration all the evils of mercu- ry, antimony, opium, arsenic and the lancet, a large number of even the medical profession will acknowledge that medical prac- tice, upon the whole, has been of no benefit to mankind; for the harm that it has done has been fully equal to the benefit. This was distinctly acknowledged by the leading medical authority in Great Britain—the editor of the ablest Medical Review in En- gland—the Royal Physician, Dr. Forbes. He had the manliness and candor to acknowledge the entire failure of old school medi- cine, when he examined the statistics. He reasoned thus—Ho- moeopathy is absolutely nothing, but Allopathy exhibits results which are either worse, or no better than those of Homoeopathy. Consequently, Allopathy does no good in diminishing the fatality of disease; and as old medicine is a grand failure, he could on- ly hope that something else should come on—that Young Physic should arise and restore us a benevolent science. To this we say Amen—but Young Physic cannot be born of de- crepid old parents. Young Physic is already born in Young America, and already he has thousands under his banner. It may be startling to some to affirm that old school Allopathy is as positively useless as its leading review has admitted ; but have not a gjeat number of the most eminent physicians admit- ted the same ? Majendie, the distinguished French physiologist, in lecturing upon the blood, took occasion to remark that he was [28] struck, and he supposed the members of his class were also struck with the small amount of benefit which the study of medi- cine conferred upon society. Did not our own Dr. Rush acknowl- edge that medicine was an unsound science, and that physicians had multiplied diseases, and increased their mortality ? This is no jest upon the profession : it is a sad and honest confession. It is no speculative theory—it is a solemn and blood-stained fact. It is a fact re-affirmed every year by the reports of our own Cin- cinnati Commercial Hospital, under the care of the Ohio Medical College: every year it appears by their reports that of all who cross their threshhold, more than one sixth pass to "the bourne whence no traveller returns." Can any believe that one sixth of of all the cases would die if there was no physician—if they had nothing but good nurses.? Did any one ever hear of such a fatality in the ordinary course of nature, in all varieties of diseases where there were no physi- cians at hand to make them worse ? Does not every one know that seven-eighths of our ordinary cases of disease tend to a spon- taneous cure if they are only let alone ? Does not every one know that where the mercurial and bleeding system is rigorously carried out, there is a great amount of disease which was pro- duced by the medicines and the lancet? And do not all medical statistics go to prove the same thing, that the mercurial depletory- practice is worse than no practice at all ? Has not every system of treatment which lays aside bleeding and poisoning succeeded vastly better than the old system. Does not even Hydropathy vastly surpass it in its results? Ask enlightened patients from water-cure establishments, and they will tell you that it does. Ask such men as Bulwer, Dr. Forbes, Sir Charles Scudamore, Drs. Wilson, Gully, and others. Does not infinitesimal Homoeop- athy surpass it? Look at the statistics of all the Allopathic and all the Homoeopathic Hospitals of Europe, collected by a learned and impartial German, Kurtz of Dessau. In these statistics we perceive that all the recorded results of old school Hospitals, for a series of years, published in an authentic and official manner, un- der the sanction of government, exhibit a mortality of nine or ten in every hundred cases—while the grand aggregate of nearly 30 Homoeopathic Hospitals presents a mortality of but 4 or 5 in the hundred. The mortality under Allopaty being twice as great as under Homoeopathy. And how does Allopathy compare with unassisted nature? Dr. Dietl, learned German has enabled us to answer the question, by treating a larger number of cases of pneumonia with medi- cine and without medicine. 380 cases of pneumonia were treated ; 85 by bljood letting, 106 by tartar emetic in large doses, and 189 by diet and rest alone. Of those treated by blood letting— 20.4 per cent, died ; of those treated by large doses of tartar emetic—20.7 per cent. [29] died ; while of those by diet and rest only—14 or 7.4 per cent. died. Thus while the disease alone killed 7. 4 per cent., the disease assisted by tartar emetic killed nearly three times as many or 20.7 per cent; and assisted by blood letting, it killed 20.4 per cent. Thus the intermeddling of the physician rendered the disease nearly three times as fatal as it was when let alone, and left to nature. Why were these measures so fatal ? Because they were skilfully adapted to aggravate the disease. Blood letting is calculated to render all diseases more dangerous to life; and tartar emetic is specifically calculated to produce inflammation of the lungs if given to a man in perfect health. We have long since rejected these two remedies, and this learned German has proved in the most conclusive manner that we were right. The fever lasted longest in those who were bled, and their convales- cence was the slowest. Those who had neither medicine nor the lancet had a shorter fever and a speedier convalescence. And how does Allopathic medicine compare with a rational or Eclectic treatment ? I would only refer to the history "of cholera in this city. The mortality in cholera which was acknowledged by old school physicians, varied from 20 to 50 per cent. In many cases it was more than 50 per cent, in England, and in France, under the most eminent physicians. Under the Eclectic treatment in Cincinnati fifteen hundred cases yielded but sixty-five deaths, the mortality being less than 5 per cent. The result then was five times as favorable as the best old school practice, and ten times as favorable as the worst. What is such an antiquated and boastful system worth ?—a system boasting the accumulated learning of ages, but surpassed by an ignorant German peasant with a tub of cold water—a system surpassed by infinitesimal Homoeopathy in Europe in the ratio of two to one—some of its leading measures surpassed by unassisted nature in the ratio of nearly three to one, and sur- passed by a rational practice in cholera in the ratio of five to one and ten to one. This imposition upon human credulity has lasted too long. It has been sustained by a wide spread conspiracy, and by the con- tinual deception of the young. The facts of-medical statistics are universally concealed. Not one student in five hundred ever hears of them. It is this imposition upon the young alone which sustains these antiquated errors. But enough ol this—let us look at the brighter side of the pic- ture—at the bright future that is dawning upon our long abused 5. We deny that a physician should be allowed to lose more than 2 percent, of all classes of patients, and affirm that tho&e who have such a mortality are behind the. present development of scienee, and unfit to fee entrusted with the public health. [30] 6. We deny that we know enough of, or have attended sufficient- ly to the materia medica, and affirm that improvement in that department is worth all other improvements in the profession. 7. We deny that the functions of the brain should be omitted in a system of Human Physiology as is now done in medical schools, and affirm that the constitution of man cannot be under- stood without understanding thoroughly the seat of all his con- scious vitality—his brain and nerves. 8. We hold it to be a burning disgrace that medical science and the members of the medical profession should linger in the rear of human progress, and be the last to adopt improvements and discoveries. You know that it has been thus heretofore that the medical profession has been improved in spite of the opposition of its members. You know that as the Roman Inquisition condemn- ed Galileo for teaching the rotation of the earth—so did the mass of the profession and its great authorities condemn the discovery of the circulation of the blood by Harvey, the discovery of vacci- nation by Jenner, and the discovery of the anatomy and physi- ology of the brain by Gall. So at the present time have they met Baron Yon Reichenbach, who has made discoveries in physi- cal and physiological science, as important as were those of Frank- lin in electricity; and although he is one of the most eminent and most accurate and cautious experimental chemists of Europe he has already been compelled to exclaim against the illiberality aud unkindness of the medical profession, for they will not listen fairly to the philosopher who has given a scientific demonstration to animal magnetism. The discovery of the use of ether and chloroform in surgery is now established all over the world, but it is only a few years since the original discoverer attempted in vain to introduce his discovery in Boston, and was compelled to aban- don it in despair. At an early period the discoverer of the power of steam was imprisoned a sa maniac, and fifty years ago in this region,the dis- coverer of steamboats was called a madman, and up to the present time some of the greatest benefactors of medicine have been de- nounced as quacks and impostors ; and persecution might slill be the reward of every benefactor of his race. But we proclaim anew era—we have proclaimed medical independence. And in this new era—mark my words fellow-eiLzens of Cincinnati!—mark my words young men of the medical pro- fession! In this new era, the mortality from our principal prevalent diseases, will be reduced to one-fourth of what it has been. In this new era, medicines now unknown will be brought for- ward, and will supercede the inferior medicines now in use. In this new era, physicians shall differ in sentiments, and yet unite as friends in the work of benevolence.. [31] In this new era; the entire constitution of man shall be un- derstood; the secret springs of life laid bare. In this new era, Europe shall look westward to America for medical knowledge. In this new era, a great American system of science, born of radicalism and freedom, shall strike down hoary falsehoods, and shall lead on this continent's high destiny. In this new era, those great and holy, and radical truths which have been despised and trampled under foot by aristocratic com- binations in government and science ; those principles for which American medical reformers have been battling 20 years, will- assert their power; for this is the Age of Reform. Our movement is a part of the great movement of revolution, liberty, and progress throughout the world; it is a movement upon principles, like those of John Huss, of Martin Luther, af George Washington, of the Hungarian Kossuth; a movement for the welfare of mankind—and the fate of such principles and move- ments, embodying the spirit of radical progress, has been de- scribed.by our own poet, Gallagher, under the title Radicalos -:. " Through the ages long, and dreary, Since first morning dawned on Earth, Man has had but feeble glimpses Of the glory of his birth. Faint revealings, thwarted hopings, Wearying struggles day by day,— So the long and dreary ages Of his life have worn away. But, through slow and stately marches Of the centuries sublime, Radi alos hath been strengthening F< the noblest work of time. And ■■■■ comes upon the Present Like a God in look and mien, Wit! composure—high—surveying Ah the tumult of the scene. Wo! - Pi-idc, that now shall scorn him: I] will bring it fitly low,— Wo the arm that shall oppose him; H will leave it at a blow,— Wo: he hosts that shall beset him; H will scatter them abroad,— He will strike them down forever— Radicalos is of God.!