ON
ECCLECTICISM II  MEDICINE:
OR,
A CRITICAL REVIEW
OF THE
LEADING MEDICAL DOCTRIlNES
   AN INAUGURAL THESIS,






      PRESENTED AT THE






NEW-YORK UNIVERSITY





    ON THE FIRST OF MARCH, 1845,










          BY
V*
CHARLES JULIUS HEMPEL, M. D.
           NE W.YORK :




PUBLISHED BY WM. RADDE, 322 BROADWAY.




              1 845. 

,*<*
H. LCmVIG, PRINTER,
 70 & VZ, Vesey-st. 
TO
PROFESSOR   MARTYN  PAINE,  M.D.
       Dear Sir,

An inquiry into the leading medical doctrines  has  Seemed  to
me the fittest subject for the dissertation which the rules of the
University require  a candidate for the profession of medicine
to present as his inaugural thesis.  I take the liberty to  address
these pages to you as an acknowledgment of the pleasure and the
advantage which I  have  derived from the study of your works
and from your lectures.   The earnestness with which you stand
by your principles in medicine, has inspired me with the deep-
est confidence in your  impartiality, and has convinced  me that
the great object which you have constantly in view in teaching
the Institutes  of medicine, is, not only to educate the profes-
sional conscience of your hearers, but also to excite in their
hearts that desire of self-judgment and self-determination  with-
out which no practitioner of the healing art can realize the beau
ideal which I have formed to myself of a good physician, that of
being a lover of truth  and of suffering humanity.
   It cannot appear strange to you, sir, that, in the study  of
medicine, I should have pursued the same mode which I have
pursued  in  the study  of philosophy and theology.   It  is the
nature of my mind to inquire into all things that constitute—to
use  an  expression  of  the illustrious  Vico—the scibile  of  all
knowledge.   The principle which old Terentius has expressed
in the verse,  " Nihil humani a me  alienum puto," and the still
more weighty precept addressed by the Scriptures to all think-
ing  minds, " Prove all  things and hold fast to that which is
good," have constantly actuated and shall ever actuate my mind
in all literary and scientific pursuits.
   The candidate for the medical profession, unless  he be en-
dowed with the happiest powers of discrimination, and  with a
common sense which has constantly stood triumphant above the
assaults of prejudice and which the experience of practical life
has sharpened, cannot be expected to leave his " alma mater "
with firmly-established  views on the various important ques- 
4
 tions which the  treatment of disease involves.   The science
 of medicine cannot be studied in  a couple of years, and the
 great Boerhaave,  after having  spent an eventful  life as the
 most distinguished physician of his age,  is said to have left be-
 hind him the advice, that it would be best for any  one to have
 nothing to do with doctors, provided he keeps his head and his
 feet dry, eats and drinks moderately, and regulates his bowels.
   All that  a man who studies the healing art as  a  philosopher
 and a lover of truth, can be expected to  accomplish during the
 period  of initiation, is, to acquire  a knowledge of the medical
 doctrines which now claim the attention of the profession.  And
 every well-organized university should give him abundant oppor-
 tunities  for their investigation.  If medicine were  constituted
 as .a mathematical science, he could not  fail to  acquire  an
 immoveable basis for his   treatment of  disease ;  but when
 he sees the  medical profession  divided  into  sects that com-
 bat  each other with  unrelenting opposition,  and often with
 bitter enmity, what else can he do, except to take cognizance of
 the contending principles, to examine their  respective claims,
 and, after calm and impartial  reflection,  to decide for himself
 like a man and a Christian ?
   The  books which treat of the healing  art,  are  so filled with
 idle  and mischievous speculations and contradictory doctrines,
 that the  study of medicine is a study of  contending assertions
 rather than a study of harmoniously-united truths and  practical
 precepts.  " Fever is nothing but debility," teaches one school;
 " fever is nothing but inflammation," inculcates another; " fever
 is  a morbid  state of the intestines," says another : one  is giving
 wine while another is drawing blood ; and some, disgusted with
 such  empiricism, or deterred by such opposition, leave nature
 to herself, believing with Rutty, that " those  who  are left to
 God's providence and cold water, have  the best chance of re-
 covery.
   What rational  treatment can  the  beginning practitioner of
medicine adopt, if guided by the contradictory, speculative and
fanciful definitions  of  the many diseases to  which  the human
organism is  liable ?  You remark  very justly  in your Com-
mentaries, that you "consider it utterly chimerical to  attempt an
explanation either of the modus operandi of the morbific cause,
or of the nature of  the morbid changes;  and that we can only
say that a morbific  cause exists, and that there are certain phe-
nomena which denote a primary lesion of the vital forces of  the
solids."   And yet the great body  of the medical writers  are
tenacious of  speculating upon  the  causes of disease and con-
structing their therapeutic principles upon fanciful hypotheses.
   Look at the various definitions which  have been offered of 
5
   delirium tremens.   Armstrong  regards it  as  a venous conges-
   tion in the brain  and liver, consequent upon the activity  of the
   heart and  arteries increased by irritation; Playfair  derives it
   from a morbid state of the liver and the intestinal secretions ;
   Goeden finds the seat in the solar and cceliac plexuses, and re-
   gards the affection of the brain as simply sympathetic; according
   to Clutterbuck, it is the  consequence of inflammatory action in
   the arachnoid and pia mater ; Hufeland believes that it is only a
   passive nervous delirium ; Stokes says there  are  two kinds of
   delirium tremens, one consisting in diminished irritability, the
   other in  increased excitement.   Upon this doctrine of Stokes,
   you comment critically in your article on venous congestion.
      Is it astonishing, in the presence of this mass of contradictory
   and futile  speculations that the great  and philosophical  Bichat
   should utter these rebuking accents on the  profession of  his
   choice?   "To what errors have not mankind been  led in the
   employment and denomination  of medicines ?  They  created
   deobstruents when the theory of obstruction was in fashion, and
   incisives, when that  of the thickening of the humours prevailed.
   The expression  of diluents  and attenuants were common be-
   fore this period.  When  it  was necessary to blunt the acrid
   particles, they created inviscants, incrassants, etc   Those who
   saw in diseases  only a relaxation or tension  of the fibres, the
   laocum and strictum as they called it, employed astringents and
   relaxants.    Refrigerants and heating remedies  were brought
•  into use by  those who had a special regard  in diseases to an
   excess or a deficiency of caloric.  The same identical remedies
   have been employed under different names, according  to the
   manner in which they were supposed to act.  Deobstruent in
   one case, relaxant in another, the same medicine has been em-
   ployed with  all these opposite views ;  so true is it that the mind
   of man gropes in the dark, when it is guided only by the wild-
   ness of opinion."
      And  then he thus  contemptuously and  deridingly speaks of
   the profession which he has ennobled with his great talents and
   brilliant exertions in the cause of science : " Hence the vague-
   ness and uncertainty our science presents at this day.   An in-
   coherent assemblage of incoherent opinions, it is, perhaps, of all
   the physiological sciences, that which best shows the caprice of
   the human mind.  What  do I say ?   It is not a science for a
   methodical mind.  It is a shapeless assemblage  of inaccurate
   ideas, of observations often puerile, of deceptive remedies, and
   of  formulae  as  fantastically conceived, as they are tediously
   arranged."
      Surely,  when  a man of great genius  such as Bichat, enter-
   tains such a common opinion of the present state of medical 
6
science, the young practitioner fulfils a duty towards himself,
by making himself acquainted with the various doctrines which
now constitute the science of medicine.  Wo unto him, who,
in medicine, admits the principle, "in verba magistri jurare ; "
he is inevitably doomed to mediocrity and comparative useless-
ness.   As for my own part, I never could nor would resign the
independence of my mind.  I have now breathed for ten years
the spirit of American institutions, and this period has sufficed
to make me both capable and desirous of warming my soul with
the Promethean spark, and enjoying the exalted freedom of an
earnest seeker of truth.

                      CHARLES JULIUS  HEMPEL
  New-York, March, 1845. 
ECCLECTICISM  IN  MEDICINE.
    The medical profession may be said  to be divided into four
    different schools, all of which are more or less opposed to each
    other. These schools are, 1, the Vitalists ; 2, the Humouralists ;
    3, the Homoeopathists ;  4, the Chemical Physiologists.  These
    different schools I shall review in  the  order  in which I have
    enumerated them here.
      Among the Vitalists, the learned Professor of the Institutes
    is, in this.country, one of the chief leaders.   The vitalists hold
    the  distinguishing  doctrine that the  functions of the animal
    economy are the result  of a peculiar vital force inherent in the
    different organs and tissues of the organism,  and that the mor-
    bid  influences which produce that abnormal  condition of the
    vital principle which we designate by the term " disease," act
    directly upon the solids.  In this respect they differ completely
    from both the humouralists and the chemical  physiologists, the
    former of whom cause all diseases to originate  in a vitiated
•   state of the blood,  and  the latter of whom  consider the  differ-
    ent functions of the animal economy as results of chemical and
    physical action.
      The vitalists, in their treatment of disease, proceed upon the
    principle, that in any  peculiar form of disease an impression
    must be made upon the  vital principle for the purpose of causing
    it to react with  the necessary force  in order to conquer the  in-
    vading disease.  It is upon this  principle that the operation of
    bloodletting, of cathartics, of emetics, &c, is justified and ad-
    vocated by  the vitalists.  They let  blood not for the purpose of
    evacuating  a vitiated fluid, but for the purpose of making such
    an impression upon the capillaries, and, through them, upon the
    central organ of the circulation and the cerebral mass, as will
    restore the  equilibrium of  the  circulating fluid.   They give
    an emetic not for the purpose of evacuating bile, but in order to
    make such  an impression upon the acini of the liver as will re-
    store the harmonious  functions  of this organ;  and, if they
    administer a cathartic, their object is not to free the bowels from
    accumulated  excrementitious matter, but to excite their vital
    force into that state of activity which  will enable the languid
    intestinal canal to perform its inherent functions. 
8
  There can be no doubt but  that the  law of reaction is  a
fundamental law in the animal economy, and that  it is at the
very basis of all rational and  successful treatment  of disease.
We know this from daily experience.   Great relaxation is often
followed by  obstinate  constipation.  If  we  plunge  a  burnt
limb into cold water, the pain may be alleviated for  a moment;
but in  a few minutes already it  will  considerably  increase.
The application of opium to a diseased tooth, after  a moment's
alleviation  of the  suffering, has  often  been succeeded by the
most excruciating  pain.   The law of reaction is so well  estab-
lished in the minds of the practitioners, both by experience and
philosophical reasoning, that no  medical man would  dare vio-
lently to interfere  with a  spontaneous diarrhoea, or a sponta-
neous hemorrhage, lest he  should  concentrate the force  of the
disease, and cause it to break forth with  redoubled vigour, as
soon as the restraining influence of the remedy shall have  lost
its power.  And even in cases where the continuance  of those
morbid  conditions  would become dangerous, he acts with great
caution, and checks their career not directly, but indirectly, by
making, by appropriate remedies, such an impression upon the
vital force of the capillaries or the walls of the intestinal canal,
as will induce them,  naturally and without force, to resume
their normal functions.
  Surely this practice is eminently philosophical, because it is
agreeable to nature.  When the  humouralist sees in the human
organism nothing but a stable  of Augias that requires constant
washing and sweeping in order  to be kept clean, the vitalist views
it as a living mechanism whose harmony rests  upon  physical
nature as its  ultimate basis ; and when this harmony has been
disturbed in such a way as to  allow the chemical forces of na-
ture an overpowering influence, he restores  it not  by clearing
away imaginary obstacles which the humouralist supposes  to
exist in the circulatory fluid or the various secretive processes.
No, he  knows that the disease  is an  impaired activity  of the
vital force itself, and it  is this vital force  itself which he tries
to rescue from its  embarrassed condition.
  Hence, in the hands of the  vitalist, the  operation of bleeding
and the various processes of artificial evacuation are not objects
but means.  He resorts to them as means of causing the de-
pressed vital force  to react against the invading disease.
  The  principle  which is involved in  this  mode of  aoifon
is eminently rational.  It  leaves the  medical practitioner free
to act agreeably to what he conceives to  be  Nature's dictates,
and  never entangles his mind in the cobwebs of the  specula-
tive necessities of  theories.
  Armed with the principles of the vitalist, I bleed,  not because 
9
I see putrid  or otherwise vitiated blood coursing through the
veins, but, because the  inflamed  state of the circulation indi-
cates to  my  mind a peculiarly-depressed condition of the vital
force of the circulatory organs, which I rouse again to its genu-
ine and harmonious action by depressing it a little more, just as
a sinking  body, overcome by the law of gravitation,  will bound
up from the ground by being forced against it with an additional
quantity  of depressing power.
   The principle  upon which the vitalist acts, leaves the medi-
cal practitioner free to inquire  into the propriety of his usual
modes of treatment.   Because  he has  bled to-day,  this is for
him  no reason why he  should  bleed to-morrow, even though
the disease were  similar.  Bloodletting, in his hands, is a mere
means of causing  the vital force  to react; it is this peculiar
impression upon the vital force which is the  great object he
desires to  attain ;  hence, by virtue of his principles, he is left
free  to inquire, whether  bloodletting is the most appropriate
means of producing the  desired impression.
   The illustrious Rush, who is  so justly  surnamed  the Ameri-
can  Sydenham, was  independent  enough  of established doc-
trines to dare to entertain the  idea that there is no absolute
impossibility of  bloodletting being some time  superseded by
an adequate remedy.  " In reviewing the prejudices against
bloodletting  in consumption," says Rush,—which he calls an
excellent remedy in  that disease, " I have frequently wished
to discover such a substitute for it as would with equal safe-
ty and certainty take down the morbid excitement and action of
the arterial system.   At present we know of no  such remedy ;
and, until it be discovered, it becomes us to combat the pre-
judices against bleeding, and to derive all the advantages from
it which have been mentioned."
   Habit and education  may make the medical practitioner fa-
miliar with the operation of  bleeding;  but, standing  as I do
upon the threshold of the temple of iEsculapius, I  must be at
liberty to feel that it is  no  trifle to inflict upon  the organism,
voluntarily and  designedly, the  great loss of blood which is
demanded in some inflammatory diseases.   And I  feel confi-
dent that the young philosophical practitioner is  entitled to the
cheering hope, that all violent operations upon  the  human or-
ganism will  be abandoned,  when medicine shall have truly and
fully become a Christian science and shall rest upon a princi-
ple, the  application of which to  the treatment of  existing forms
of disease will suffer no exceptions in its  comprehensiveness
and  delicate  regard for the  system.
   What I have  said  of bloodletting, applies»with  equal force
to the operation of cathartics, emetics, &c.   If I give  an emet- 
10
ic, it is not with a view of evacuating bile, but in order to pro-
duce such an impression upon the  secreting organ of the bile
as will restore the harmony of its vital  functions.   Or, in giv-
ing a cathartic, my object is not  to produce simply an evacua-
tion of excrementitious matter, but to make such an impression
upon the vital force of the intestines as will restore the harmo-
ny of their peristaltic motions and  the  absorbing  functions of
their lacteals.
  The inquiry whether such  an  impression  can be produced
without violently affecting the organic  viscera, is a  perfectly
legitimate inquiry.   Celsus was right in defining the character
of a philosophical cure of disease by cito, certe, and jucunde—
quick, certain, and  sweet.   If we consider disease and the  or-
ganism as two enemies struggling with  each  other, upon which
of the two should fall the blow of the physician ?   Surely not
upon the organism.   From the  moment the physician gives
his remedy, if it be the true remedy, the organism should feel
relieved and should give itself up  with pleasure to the influence
of the remedial agents.
  The formula which so many physicians have constantly upon
their lips, "Let  the  system feel the action  of the remedy,"
evinces a most dangerous and reckless carelessness.
  The poor system!   Is it not  sufficient that it  should have
been invaded  by unrelenting disease ?   Is not the system, so
invaded,  entitled  to the most delicate care of the physician ?
Is it  not the  most sacred  duty  of the doctor to employ,  as
much as possible, such a mode of cure  as will free the system
from the enemy without  doing violence to its already weaken-
ed and exhausted powers ?
  Why do not physicians act like Christian philosophers and
lovers  of truth and progress ?   In no department of knowledge
is conservatism worse than in  medicine.  What do most phy-
sicians care  for enlightening  their minds after they  have re-
ceived their diplomas at  the university ?  Most of them study
their profession for the sake of a livelihood, not for the nobler
and truly Christian purpose of benefitting their suffering breth-
ren, and  availing themselves of the light which the wisdom of
gifted minds and the increasing progress of science are continu-
ally shedding  around  us  in  brilliant rays, for  the  purpose of
simplifying the methods of cure,  and protecting the organisms
of the existing generation more and more against the deleteri-
ous  effects  which  remedial agents, if improperly and incau-
tiously administered,  may incidentally  exercise upon the sys-
tem.
  Far  different from  the spirit with which most men, and un-
fortunately too most physicians study their profession, did  the 
11
immortal  Schiller conceive the beau ideal which every student
of wisdom should constantly keep in view.   In his opening dis-
course as the  newly-appointed Professor of History  in  the
University of Jena, he  draws this parallel between the true
lover of wisdom and him who studies a profession for a mere
livelihood.  " As carefully as the money-seeking savant isolates
his  science  from  other sciences, does the philosophical mind
endeavour to enlarge its sphere, and to  restore  its union with
other sciences — to restore, I  say, for  it is the abstract under-
standing that has separated them.   Where the money-seeking
savant disunites, the  philosophical  mind unites.   He has soon
become convinced that in the spiritual as well as in the physi-
cal world, all things join into  each other ; and his intense de-
sire for union cannot be  satisfied  with  mere fragments.  All
his efforts tend  towards completing the formation of his con-
science ;  his noble impatience does not rest until all his ideas
are arranged into an harmonious whole, until he has reached the
centre of  his art, of his sciences, from whence he reviews them
to their ultimate boundaries.  New discoveries in the circle of
his activity, which are discouraging to the  money-seeking ped-
ant, delight  the true student of wisdom.   They form perhaps a
last link in the series of his ideas, which is completed by these
discoveries.  And even if it were torn by ihem ; if a new phe
nomenon, a newly-discovered law of Nature dashed the whole
structure  of his knowledge to pieces :  he has loved truth more
than his system, and he is at once willing to relinquish it for
the sake of a newer and more beautiful form.  Yea, if no blow
from without, shakes the  arrangement of his ideas, then, stimu-
lated by  an ever-stirring desire of improvement, he is himself
the first to recombine anew the series of his ideas in order to
make it more perfect.  Through ever new and  more beautiful
forms of thought the philosophical mind arrives at more exalted
excellence,  whereas the money-seeking  pedant guards the bar-
ren sameness of his  dogmatism in the desolate and silent rest
of his understanding."
   I cherish the doctrine of the vitalists because it leaves the
inquiring practitioner  the fullest  latitude of investigating for
himself the true relation existing between disease and the heal-
ing power  of remedies.   Remedies  should constantly be pre-
scribed in the spirit of a true  vitalist.  If we administer cathar-
tics or emetics  we  should  administer  them with  a view  of
making an appropriate impression upon the vital force ;  and
we  should  constantly try to  obtain this impression in  such a
manner as to leave the system unharmed by the inherent sub-
versive action of the remedy.
   The law of adaptation which is a fundamental  principle in the 
12
philosophy of vitalism, makes it especially incumbent upon the
medical practitioner to act upon the principle which I have ex-
pressed in the foregoing paragraph.
  The law  of adaptation is  beautifully exhibited in every part
of the animal economy.   Every organ in the animal economy
has a  special destiny to accomplish, and, by its structure and
its relation with other parts,  it is admirably fitted for the  per-
formance  of  its peculiar functions.  The bladder secretes the
urine and stores  it up, uninjured by the fluid, whilst a single
drop of it, which  may have escaped  perhaps into the thigh  in
the operation of lithotomy, will invariably produce gangrenous
inflammation.  Air may pass in and out through the larynx and
may spread itself in abundance through the parenchyma of the
lungs ; but in an inflammation of a joint let a little air pass into
its cavities through a punctured bursa mucosa, and a most hor-
rible emphysema will result from this intrusion, and the life  of
the distressed patient, distended like a sort of balloon, is in im-
minent jeopardy ; or let air enter into  some opened vein  and the
death of the patient is almost certain.  Why is bile inoffensive
when enclosed within the thin walls of the gall-bladder, whilst
it becomes a deadly poison when injected into the circulatory
apparatus ?   Why does venous blood with its volume  of car-
bonic acid course through the veins in perfect harmony, whilst
in the  arteries it would result in a stagnation of the vital func-
tions ?  The ear-passage  may hold a considerable quantity  of
wax without irritation, whilst a foreign  body would excite an
inflammation in the delicate coating of its walls.   Here there
is adaptation  between the containing and the contained, the pre-
paring and the prepared substance.
  But the law of adaptation does not only extend to the nature
of those substances, it is equally applicable to the  quantitative
relation existing between the vessel and its contents.  There is
as much bile in the gall-bladder, as much urine in the bladder,
as much blood in the circulatory vessels, as much excremen-
titious matter in the intestinal canal, as much wax  in the ears,
as those organs are capable of holding in that peculiar  state  of
their vital activity.  Each organ  is to determine what its con-
tents shall be and how much of them there shall be.    If this
quantity could be increased or diminished by the arbitrary regu-
lations of  man, he would necessarily possess the power not of
regulating but of  arbitrarily controlling the organic life.   Such
a power cannot exist;  Omnipotence himself cannot interfere
with the operations of those causes that result from the eternal
and unchangeable principles of his wisdom.
  The law of adaptation is as true in the morbid as in the nor-
mal vital conditions of the animal economy.  Its operations  in 
13
the morbid state of the system have been lucidly and beautifully
shown by the learned Professor of the Institutes in his treatise
on humoural pathology. After having shown why morbid blood,
as in malignant fever, should excite disease when injected into
the cellular tissue of an animal—because there is no adaptation
of one to the other and it therefore acts as a local irritant—he
continues :  " What we have stated in regard to the progressive
adaptation of the blood in diseases to the existing alterations of
the vital properties of the solids, and that, however varied the
condition of the former, it does not become an aggravating cause
of disease, is founded in an  all-pervading law of the animal
economy.   We have shown its operation in the normal state of
its organization, and  we see it every where  illustrated in dis-
eases.   Various morbid secretions, which are offensive to the
parts producing them in their healthy state, are innoxious to the
same parts during their generation of the morbid products.   And
again,  although these morbid secretions act with violence upon
sound  parts, as soon as the latter are brought into a morbid
state, corresponding with that by which the virus was generat-
ed, the irritant is no longer hurtful.  The surface which produces
the syphilitic virus,  or that of the small  pox, etc.,  is not of-
fended by its presence ;  and yet, when  applied to the abraded
skin in its healthy state, it soon excites inflammation.  But this,
in its  turn, assumes the  suppurative condition, when  it is no
longer irritated  by the offending cause; but,  on the contrary,
the vital forces may obtain an ascendency, throw off the enemy,
and return spontaneously to their  natural state.  Had it been
otherwise, nature would not have been true to herself, since the
process would have been unceasingly destructive."
   These beautiful and eminently philosophical  remarks suggest
to me serious and important reflections on many existing modes
of treatment.   They lead me to inquire :  If this great  law of
equilibrium pervade all the functions of the animal economy in
their normal as well as their abnormal condition, is it just, is it
philosophical  that we should deprive an organ of the  results
which it has worked out as the support of its  peculiar state of
vitality ?   If there must be this equilibrium between an organ
and the results of its vital force, is it not true, that, by depriving
the gall-bladder of the bile which is the necessary support of
the peculiar vital condition of the organ, we excite the liver into
an unnatural  secreting process in order that  the gall-bladder
may receive the supply  adequate to its peculiar vital state ?
And not only do we  commit this devastation upon an unoffend-
ing organ,  but we increase the virulence of the morbid condition
of the gall-bladder itself, since it  will now claim with an in-
creased vigour, and guard with a more intense anxiety, the fluid 
14
 which it  considers the legitimate support of  its peculiar vital
 condition.   And is  it not  the  same with the intestinal canal,
 with  the  bladder, with the circulatory apparatus, and with the
 dropsical fluid ?
   There  are three principles which  make up the unit—man :
 passion, the intellectual principle,  and the physical powers.
 Our ethical philosophers try to teach us that  man may realize
 any relation he pleases between those principles.  Be this so
 or otherwise, in the functions of the organic viscera his  power
 of changing the harmonious relation of cause and effect,  does
 not exist.   If the  organic viscera are affected with a peculiar
 morbid condition, it will manifest itself by corresponding phe-
 nomena ;  if man  destroy those phenomena  they will immedi-
 ately  be reproduced with a renewed intensity,  with this differ-
 ence, that, whereas in the natural development  of the disease
 those phenomena constituted visible symptoms affecting the
 skin or the muscular clothing, they now spread over the  inner
 surfaces with a view, as it were, of shielding themselves from
 the invading action of man, thus concentrating their forces upon
 the hidden and more delicate organs, and making the destruc-
 tion of the animal functions an almost inevitable necessity.
  What suggestions of vital importance does the law of adapta-
 tion furnish us  in regard to exanthematous diseases ?  Does it
 not teach us that we ought to respect  the  external phenomena
 of the disease, which have received, as it were, the disease into
 themselves  and have thus become the guardians of organic
 life ?   Does it not teach the physician that  in exanthematous
 diseases, be they  ever so insignificant, he ought  to dread  the
 application of all salves and lotions  which have a repelling
 power, and that he should beware how he considers the disease
 cured when it has been merely  removed from the skin ?   How
 many thousands  of patients have been killed by having had
 eruptions  upon the skin, in scarlet-fever, in typhus, and in the
 various forms of ulcers, repelled into  the  system ?  A sponta-
 neous hemorrhage, a  diarrhoea, may have been curative symp-
 toms, which should have been suffered to run to  a spontaneous
 termination, when behold, the ruthless hand of an ignorant prac-
 titioner arrests  their benign course and converts them into a
fatal disease.
  And even in many surgical  diseases, what  does the law of
 adaptation  suggest in  reference to the established  modes  of
 treating them ?   True, we  tear a polypus from  the nose  and,
by doing so, we often cure the  disease, because a polypus has
little  or no vitality.  But  is  a surgical  operation a rational
 method of curing hemorrhoids?   Suppose we  tie them low
 down, will they therefore remain away, or will  they reappear 
15
higher up ?   They will rise higher up, and become more dan-
gerous and troublesome in consequence.  An encysted tumour,
or a lypomatous excrescence of the adipose tissue may be ex-
tirpated by the knife, because they contain little or no vitality;
but  does  the law of adaptation sanction this violent mode in
treating cauliflower excrescence of the womb or tumours which
are not evidently adventitious growths and therefore deprived of
vitality ?  The illustrious Professor of Surgery has related the
case of a lady who had a little tumour upon her chest and whose
children were desirous of haVing the tumour exsected from her
person.   The tumour was an  external vicarious embodiment of
some internal disease ; for, as soon as the tumour had been re-
moved, the internal disease became fatal almost instantaneously.
   When  I thus review in admiration the important philosophi-
cal suggestions to which the law of adaptation gives rise, I can-
not  help  being  amazed that its application to  the treatment of
all existing  forms of disease  should not have been rigorously
and scrupulously  inquired into.
   Armed with the glorious truth of this law the question with
a medical practitioner ceases to be, to remove the bile, to evacu-
ate  the bowels, to lessen the amount of the circulating fluid;
but simply to make such an  impression upon  the morbidly af-
fected viscera of organic life, as will restore the harmony of their
individual functions  and their universal relations.
   The philosophy of vitalism, though it seems to be based upon
a noble and rational  view of the functions of the animal econo-
my, is far from being universally recognized as true.   It is op-
posed by many different doctrines among which  we may espe-
cially notice the doctrines of the mechanical, microscopical, an-
atomical, humoural  and chemical physiologists.
   The learned Professor of the Institutes combats these differ-
ent doctrines with  great force, and, I beg to  be permitted  to
add, with great success.  In this opposition he is powerfully
seconded by all leading vitalists, especially Hunter and Bichat.
   The mechanical, microscopical and anatomical schools err
especially in this  that they mistake results for causes, and that
upon this fundamental confusion they construct their systems of
cure.   Their therapeutic views may be said to be identical.  It
is especially in their theories  of inflammation  and  congestion
that those schools  differ  from the  vitalists.   Those  morbid
 symptoms in the  circulatory apparatus, which the vitalists refer
to  a morbid  condition of the vital  force  of the vessels,  the me-
chanical  school  considers results  of physical  obstructions  in
the circulation of the blood-   Serum  and lymph, arising from
inflammation, are merely a  mechanical exsudation from  the
blood.   Pus is supposed to be a component part of the  blood 
16
 and to make its escape in a purely mechanical manner.   Mr.
 Earle, who is one of the most consistent advocates of the me-
 chanical school, has illustrated the mechanics of inflammation
 in the following manner : " Would it be  a  matter of astonish-
 ment" he says, " if the several parts of a fluid  like the blood,
 upon being pressed through an excessively fine sieve, were to
 come through in the order of their  fluidity; that is, the finest
 and most fluid first, and the largest and  coarsest  last ?"
  Professor Paine  has put this hypothetical illustration to the
 test of experiment.   But he found that " every  species of the
 finest texture  was permeable by the  serum,  and  admitted,  also,
 the passage of the red globules."
  Berzelius says that they pass readily through filtering paper.
  But suppose that the exsudation of serum  and the formation
 of pus  are  a mechanical process, can  you, upon mechanical
 principles, restore those parts to the blood, and, in this way, pre-
 vent the  farther decomposition of this fluid ? What causes the
 blood to  be decomposed ?  Is there not a  morbid action going
 on  in the vascular system ?   Can you prevent this morbid ac-
 tion by mechanical  means ?   Remedial  agents must act upon
 the forces which produce disease ; an analysis of the results of
 morbid action does  neither show us the  nature of those  forces,
 nor the mode in which they can be and ought to be acted upon.
  Boerhaave, one of the great lights of  the mechanical school,
 accounts for inflammation  by his  theory of " error loci."   He
 supposes that  a part is inflamed in  consequence of stray globules
 of blood which have been arrested  in the capillaries ; it  is to
 this excess of blood  in the  capillaries that he  ascribes the great
 heat which may be felt in inflamed parts.
  Celsus has  indicated redness, swelling, heat and pain, as the
 four leading characters of inflammation ;  but if the explanation
 that Boerhaave gives of the nature of inflammation, were correct,
it seems  to me that the temperature of an inflamed part  should
be less than the common temperature of the body.  It  cannot
be supposed that blood which is severed, as  it were, from the
circulation, and is therefore more  or less deprived of the influ-
 ences of those forces which maintain the animal life  of the
economy, should be as warm as the fluid circulating in the ar-
teries.   Indeed, in mortification, which, according to Hunter, is
one of  the  terminations  of inflammation, and which, being the
ultimate  and highest development of inflammation, should ex-
hibit the greatest amount of heat, the limb is  often icy cold.  If
phlegmonous inflammation depended upon the capillaries of an in-
flamed part being clogged up  with an excessive amount of blood,
we might justly conclude that the temperature of the body should
not only rise in proportion as we approach the central organ of 
17
circulation, but that this rise  should  be distinctly perceptible.
We know that there is sometimes an increase of temperature of
from 20 to 30 degrees, but the system is unconscious of this dif-
ference, though it is infinitely greater than the difference exist-
ing between the temperature of an inflamed part and the same
part in its natural conditions of vitality.
  And we now also know to a certainty that the characters which
Celsus  ascribes to inflammation, do by no  means embrace all
the varieties of that morbid condition.   Cloquet, Beclard, Louis
and Bichat, assert that red vessels have never been detected in
the  tunica arachnoides, even when the membrane has offered
every other proof of an inflammatory affection.  Hunter affirms
the same thing of the brain.  Dupuytren  considers  the white
gangrene and the gangrena  senilis an inflammatory affection of
the arterial capillaries; and the learned Professor  of the Insti-
tutes tells us that, upon this  principle,  Dupuytren restored a pa-
tient " comme  par enchantement," by drawing blood from the
arm.   The hands and feet were the seat of the affection.  The
fingers and feet were blanched, of an icy coldness, wholly in-
sensible, immoveable and dry as parchment.   This " white gan-
grene " is also particularly noticed by Dr. Graves, as resulting
from inflammatory action.   Louis affords abundant proof that a
part may be  inflamed without being red.   In his " Researches
on Phthisis," he says, that " paleness of inflamed structure takes
place sooner or later, as  is exemplified in  the various shades of
colour of the hepatized lung."  " It ought to be  noticed," he
says, " that continuous with a red and  softened portion of mu-
cous membrane, we often  find another equally softened, but
without  redness.  If the first, therefore, be inflammatory, it is
probable that the other is  also."   Professor Gross considers
scirrhus, tubercle,  ulceration, softening, to be,  invariably, the
results of inflammation.

  The microscope has been a powerful ally of the mechanical
school.   Armed with the microscope, the eye of the physiolo-
gist  has  boldly and perseveringly  searched the intimate struc-
ture of organs ; and upon  the facts which the microscope  had
revealed, have often been erected  theories explanatory  of  im-
portant vital functions and the nature and  origin of diseases.
  Some of the most distinguished physiologists have been con-
stantly opposed to the use of the  microscope in physiological
investigations.   Bichat and Hunter condemn it as  being un-
trustworthy.   It  seems  to  me that the desire of investigating
the inmost structure of parts is  legitimately inherent in  the
minds  of physiological anatomists, and I, for my  part, do not
feel  authorized to condemn it.  But what is  highly condemna-
         2 
18
ble is, to erect a system of therapeutics upon such microscopi-
cal discoveries.   The inmost operations of the animal economy
no mortal eye is permitted to behold.  And, fortunately  for us,
it is not necessary that we should know the nature or the mo-
dus operandi of the vital force in order to cure disease.   I con-
fess, and I suppose every body else will be willing to confess,
that I am perfectly ignorant of the  use which a  knowledge  of
the intimate structure of organs may afford in the treatment of
disease.  What avails Kiernan's description of the liver in the
treatment of bilious fever ?   Does  it teach us how the  bile  is
formed, or how we can retard or hasten the secretion of that
fluid ?   Again, what matters  it in  a  practical sense to  know
that the human ovum is a perfectly spherical body about the one
hundred-and-twentieth part of an inch in diameter ;  that it con-
sists of a thick but very transparent coat which  surrounds the
substance of the  yolk; that  within the  yolk is situated the
germinal vesicle  of Purkinje about  the seven-hundred-and-
twentieth of an inch in diameter,  and within that the germinal
spot of Wagner  about the two-thousand-five-hundredth or the
three-thousand-five-hundredth of  an inch ?  These apparently
wonderful discoveries which have  been realized by means  of
untiring labour and research, do not shed a single  solitary ray
upon the great problem of conception and the development  of
the incipient embryo : still far less do they reveal to us new
modes of treatment in the diseases of the uterus, the ovaries,
and the other organs connected with gestation and parturition.
Will the knowledge which we possess of the intimate structure
of the kidneys aid us in the treatment of diabetes, or of reten-
tion of urine ?   Whether we adopt the opinion of Malpighi that
the granules in the pyramids of the kidneys  are  simple bodies,
or whether we  believe with Ruysch that each granule  consti-
tutes a glandular group, when we come to the bedside  of the
patient we shall then feel, that our microscopical anatomy is a
lifeless science, and we shall feel tempted to admit with Bi-
chat " that we ought to neglect all these idle questions in which
neither  inspection  nor experiment can guide  us ;  that  we
ought to begin to study anatomy where  the organs can be sub-
jected  to  the  senses ;  and that the exact progress  of the sci-
ences in this age is not accommodated to these hypotheses which
made general anatomy and physiology a frivolous romance  in
the last."
   Among the ridiculous doctrines to which the  pretended dis-
coveries of the microscope  have  given origin, the  doctrine  of
the animalculae deserves a  special mention.   Thanks to the
microscope, we now not only know that this globe probably is
nothing but a huge pile of carcasses of insects, but it has been
even discovered that the process of fecundation is probably ef- 
19
fected by a spermatozoon.   According to Messrs. Dumas and
Prevost a spermatozoon fecundates the corpuscle of de Graaf,
as this is  met by the former on passing through the fallopian
tubes into the upper cavity of the uterus.  But does this theo-
ry, which, disgusting as it is, is seriously proposed as explana-
tory of the process of conception, show the mode in which the
human ovum is fecundated by the spermatozoon ? It is serious-
ly proposed that advantage should be taken of the existence of
spermatozoa in legal medicine for the purpose  of discovering
whether rape has been actually committed.   Absurd and even
dangerous speculation can hardly be carried farther.
   Another of these wonderful productions of the vermine king-
dom is said  to be the cause of the itch ; it is called the itch-
insect.   Linnaeus  describes  it on  the  authority  of  others*
Adams tells a story about the itch-insect which the professor of
the  Institutes has  thus transcribed into  his " Physiological
Commentaries."   " An old woman " says  Adams, " who had
consulted me for her niece, found no difficulty in detecting sev-
eral of these  insects ; but in vain  I endeavoured to trace  the
appearances  by which  she was directed.   My  friend Bangor^
whose patience in every investigation of natural history infinite-
ly exceeds whatever I have  met with, even in professed natu-
ralists, was, for the most part, as unsuccessful."   Adams final-
ly caught the itch himself, as he well deserved ; " when," he
says,  " I applied  to my old woman who readily drew two
oucoes from  my arm, but not from the vesicles.  She constant-
ly answered to our inquiries, that where the bladder was form-
ed, the oucoes had left the spot."   Adams at length found that
the  oucoes  only burrowed  in the hardened pimples.  It is
manifest that ihey are nothing more than an indurated secretion
which  precedes the  serous stage  of the  eruption ;  which ac-
counts for the old woman's philosophy that  the oucoes  always
leave  the bladders.  Adams states " that the late Mr. Hunter,
in his lectures and conversations, always acknowledged that he
could never discover the itch-insect, and went so far as to sus-
pect that  the opinion concerning its existence was derived from
a preconceived theory, and supported by credulity."                   /
   Has that insect ever been seen anywhere else except in the
itch vesicle or the hardened secretion ?  Why should not measles,
scarlet fever,  small  pox, and all other exanthematous diseases
owe  their origin to  a  similar animalcule?  Why should the
itch become a fatal  disease when  it is repelled upon the inner
surfaces ?  It is an eternal law, that diseases which can be re-
pelledupon the inner surfaces have their origin,  not in some lo-
cal action upon the skin, but in the inmost depths  of the vital
forces.  The itch has never formed an  exception to this law. 
20
  The distinguished Schoenlein doubts very much the existence
of the itch-insect; but even if it exist, he regards it merely as
a morbid  product resulting from the peculiar morbid action
which the itch-virus exercises upon the skin.  How can it be
imagined that an invisible entozoon,  should, by its sting or bite,
produce that horrible itching upon the skin, the improper treat-
ment of which often gives rise to a fatal disease 1  And how
do we explain that one individual among many should have been
chosen by those entozoa as an object of their  assaulting fury ?
Whence do they  obtain  this power  of discrimination ;  and
whence, above all do they come ?  For there must  have been
many who committed the attack, and those many must have
been united like a band of depredating enemies.

  The numerical method is another mode of  determining  the
respective value of remedial agents.  This method has lately
been introduced in France under the auspices of the celebrated
Louis.
  The numerical method is strongly objected to by the learned
Professor of the Institutes upon the ground that numbers may
lead astray as easily at least as generalizations deduced from  the
carefully collated facts of conscientious and judicious observers.
  This method is equally objectionable upon the ground that
numbers may be  erroneously stated by careless observers, and
that many numerical statements are results of wholesale trials
in hospital practice, which cannot possibly be  regarded as fair
indications  of the relative merits of one method of cure over
another.   An illustration of such trials is furnished in the report
from the French Academy of Medicine, made  by Messrs. An-
dral, Louis, Bouilland, and others, upon the  purgative treat-
ment of typhoid fever, which had  been so exclusively recom-
mended by Larroque.  The commission physicked one hundred
patients without the slightest  regard to symptoms, age, sex, or
stage of the disease.  They  bled  another  hundred upon  the
same plan ; and with another hundred they adopted " une me-
thode a-peu-pres expectante."
  Another instance of this kind of wholesale practice is fur-
nished by the   illustrious  Zimmermann : "I know,"  he says,
" a  certain ^Esculapius who  has fifty or  sixty patients every
morning in his antechamber.  He just listens a moment to  the
complaints of each,  and  then arranges them in four divisions.
To  the first he prescribes bloodletting ; to the second, a purge ;
to the third, a clyster ; and to the fourth, a change of air."
  Such wholesale practising is an  opprobrium to the  medical
profession, and is too much practised even at this distant day.
rurging, vomiting, bleeding, and sweating, are even now  the
leading operations of medicine in the hands of the great num.- 
21
ber of both licensed and unlicensed physicians.   And  " bark
and wine " is yet looked upon as the great harbinger of strength.
It is the Brunonian  philosophy measuring the quantity of the
remedy by  the higher or lesser  degree of excitability of the
system.   Nothing but the crassest empiricism, the most reck-
less and brutal abuse of the human organism.  With its high
and varied susceptibilities, the  inmost nature of which is com-
pletely hidden from our minds, each organism being created to
embody  a peculiar and perfectly distinct form of beauty  and
harmonious life : this  masterpiece of the Infinite God,  the re-
flex of his infinite wisdom and power, falls  a victim to  the ig-
norance of a licensed murderer.

   The anatomical school numbers among  its members some of
the most brilliant minds of the medical profession.  The object
of pathological anatomy is, to investigate  the structural  lesions
consequent upon disease.  Considered  in itself, this investiga-
tion is an interesting business ; but I do not think that a know-
ledge of  the  lesions which  disease will produce in  certain or-
gans,  can shed  much light upon the  treatment  of such  dis-
eases.  Pathological anatomy has shown us that certain  inflam-
matory diseases of the lungs will terminate in the hepatization
of that organ, or in the formation of  tubercle.  Are we better
informed of the  treatment of tubercular phthisis since we know
its devastating effects and have even analyzed with  great care
the tubercular mass ?
   Pathological anatomy reveals to us  the effect, not the  causes
of disease.   What is generally called the pathological cause of
a disease, is in fact  nothing  else  but the aggregate of its inter-
nal phenomena.   " It has been the folly of a great many upon
dissecting a corpse, to take the part that  was most  affected to
have been the cause of a person's death, when it  was only the
consequence of a disease which  might  have been cured if the
original cause had been at the  first considered.   Thus,  dropsy
is invariably ascribed to a disease of the liver by some,  and by
others to the brain, stomach,  mesentery, spleen, kidneys, be-
cause they saw some one of these parts mostly affected.  And
so again, a fever  is generally ascribed to  a dry, thick blood,
because they find none but such in the veins, whereas these ac-
cidents are produced by the  greater or  less  violence  of the
disease."
   Mortification of the extremities is said to result from an ossi-
fication of the coats of the arteries ;  but  what is the ossifica-
tion itself except one of the  phenomena by which the  disease
manifests itself?
   Retention of urine  is, by some, supposed to result from an
excessive  distention  of the  bladder.   Surely, when that vis « 
22
cus is excessively distended, the contracting energies of its en-
circling muscular fibres are considerably diminished.  But why
was it that the urine should have accumulated in the bladder in
such an unnatural quantity ?  Why did the bladder cease to be
stimulated to the expulsion of its fluid after it had passed into
the bladder in the necessary quantity from  the pelvis of the
kidneys ?  Must  not the walls of the bladder have been morbidly
affected  before  the  urine was  permitted to  accumulate  in
excess in its  interior ?   I  understand  very well that the phe-
nomena of  disease should  be related to each  other in a certain
order, and that one may result from the other through a princi-
ple of sympathy and a law of growth.   A morbid enlargement
of the uterus may induce  a sympathetic swelling of the mam-
mas and a secretion of milk ; a morbid condition of the stomach
may give rise to a headache ; prolapsus of the womb or of the
bladder  may cause  mucous discharges from the vagina.   If
morbid anatomy can, by its analytical investigations,  shed light
on the course which a disease pursues and on the order in which
the symptoms of a disease are related to each other,  it may be-
come a powerful auxiliary  to the science of cure.   But anato-
my is too much inclined  to construct medical theories  upon
structural lesions;  in conjunction with its  new  ally, pathologi-
cal chemistry, it exposes  us to the dangers of imagining that
the difference existing between  an organ in its healthy and its
morbid state, is the disease from beginning to  end, that  the dis-
ease originates in a mere  physical  abnormal metamorphosis of
the different tissues, and may be cured by physical action.  This
belief has indeed carried away the humoural philosophers so far
as to make  them assert that in pestilential fevers and the malig-
nant cholera saline medicines are the best  remedies,  " because
the blood in those diseases is black, and muriate of soda,  mag-
nesia, or chloride of sodium restore the bright arterial colour of
the blood in the  crucible of the chemist."
  Pathological anatomy is, nevertheless, an interesting  form of
science and a most legitimate object of human research.  I am
confident that it  has to fulfil ends which we are not yet aware
of.  If we  consider  that we are yet perfectly ignorant of  the
functions of some of the most important organs of the animal
economy, the sympathetic  nerve, the spleen, the thyroid body,
and most parts  of the  brain, we have no right to impose re-
strictions upon the desire which may animate our minds of in-
vestigating  the  var nud  op.ndes in which the  operations of the
organism are carried on, or the results which they may realize
either in the normal or abnormal states of the economy.  Gen-
eral anatomy itself is as yet in many respects  a lifeless science.
We devote hours and pages to the description of a single bone, 
23
like  the  sphenoid; our  works  on anatomy teach us all the
ramifications and terminal  branches of the arterial and venous
trunks, and show us the course of the nerves, even  of their
smallest filaments ; and  this display of science requires great
expenditure of time and labour ;  but would any impartial anato-
mist pretend to say that a complete knowledge of general anato-
my is necessary to be a distinguished surgeon, or eminently use-
ful and enlightened practitioner of the healing art ?
   But shall we therefore pronounce the study of the human or-
ganism unnecessary? or shall we not rather  consider the hu-
man organism a  riddle, the  solution of which will  teach us the
true principles of all those institutions that concern man's liberty
and  happiness ;  government, commerce,  education and  social
life ?  Indeed it is upon physiological facts that all psychologi-
cal theories should be based.   Do we not know  that all the
functions  of organic life are intimately related to  the play of
the passions ? that digestion, respiration, circulation and secre-
tion are  either favoured or injured  by the  workings of the
passions?   Do we  not eat more heartily and plentifully in the
society  of cheerful and  sympathizing companions than in the
narrow circle of  the family and under the  excitement of our
daily business ?   Do not grief or anxiety deprive us of our ap-
petite, or  interfere with  the process  of digestion 1  And may
we not ask  ourselves in view of this complete independence of
the organic life of the body from the will of man,  whether the
organic life of the  soul, its sensitive and impelling principles
do not enjoy a similar independence from the direct influence
of the will, and whether we are not bound to regulate this life
in the same way  as we regulate the  organic life of the body;
not by imposing  upon it an order which it rejects, but  by in-
quiring into its  own genuine laws and permitting it to expand
agreeably to the regulations which constitute its true and har-
monious  order ?   And  lastly, if we apply  the Cousinian doc-
trine of the  will,—that man, while he is stimulated by some mo-
tive to the performance of a certain act, can perform  an action
diametrically opposed to the one intended,—to the fact of mus-
cular antagonism, do we not find that physiological truths give
the lie to such metaphysical speculations, and that man can no
more be simultaneously  governed by two antagonizing motives,
than two antagonizing muscles can act at the  same time—the
quadriceps extensor femoris extend the leg upon the thigh and
the biceps flexor  cruris relax it ?  A philosophical  practitic aer
cannot study  medicine simply  for immediate purposes.   The
study of medicine is for  him a  means of becoming a minister
of nature, and, in whatever direction he may turn his attention,
he sees doctrines, principles and institutions which  he  appropri- 
24
ates to himself as elements of the science of man and stepping-
stones  to goodness and wisdom.

  The humoural school rests upon principles which are totally
opposed to the philosophy of vitalism, and which, in its results,
must cause just as much destruction of human life as truly phi-
losophical vitalism discloses means to save it.
  Humouralism abounds  with  absurd definitions, foolish infer-
ences and pernicious modes of treatment.
  According to the humoural pathologists, all diseases originate
in a vitiated state of the blood.   Andral, who may be regarded
as one of their most celebrated leaders, lays down the univer-
sal principle, " that the blood is first vitiated by the commix-
ture of deleterious substances ;  that its usual appearance leaves
no room to doubt its being altered in its nature, and that it is
the vitiated blood which usually affects the solids."   Hence the
great  object of the  physicians  of this school is,  to  give  such
medicines as will, according to their supposition, act upon the'
blood."  " I am satisfied," says Dr. Hosack in his correspond-
ence with Dr. Stevens, " that in malignant fevers, the disease
can only be cured by the proper use of those medicines that
possess the power of acting upon the blood, and that  prevent or
remedy its diseased condition."
  The contamination of the whole mass of  blood is accounted
for upon the principle of fermentation.  " A little leaven  leav-
eneth the whole lump."  This  fermentation in the living body
is called " the silent fermentation, as having some laws peculiar
to itself;  as opposed to that which takes place in the open  air
or under other circumstances."   But " analogies," says the ele-
gant Professor of the Theory and Practice, " are mighty slip-
pery things."  The analogy which humouralists suppose to exist
between the fermentation going on  in the open air and the  so-
called  silent fermentation  of the blood,  as well as between the
putrefaction of dead matter and their so-called vital putrefaction,
is founded upon fancy much more than upon reality.  There is no
such thing as  putrefaction  in the living body ; and the whole
doctrine of  putrid fevers, which is a doctrine  of  the humoural
school, is the  result of a most  pernicious delusion.   Putrefac-
tion  invariably results in the evolution of nitrogen and carbon-
ate of ammonia.  But carbonate of ammonia never exists in a
free  state in the system, and only begins to be evolved from the
urine two or three hours after it has been exposed to the action
of atmospheric oxygen.
   It has been shown by physical experiment that the doctrine
of fermentation, or the contamination of  the whole mass of blood
by the absorption of the morbific poison, is fallacious.  Accord-
ing to Muller, it takes at least from one minute to a minute and 
25
 a half for any substance to be absorbed and distributed through
 the system.  How shall we  reconcile this fact with the instan-
 taneously  fatal  action of certain  poisons  upon the organism ?
 Acetate of morphia has produced its effects in one minute, prus-
 sic  acid in  a second;  the  vegetable poison " tshettik" with
 which the savages of  Java poison their arrows, has caused in-
 stantaneous death with the most horrible symptoms of tetanus.
   On the other hand there are instances where  the  morbific
 poison has been dormant in  the system for months and  years.
 The poison of hydrophobia has often  manifested its fatal symp-
 toms several years only after the wound had been inflicted.
 And in many chronic diseases the morbid diathesis has skipped
 a generation, reappearing again in the grand-children.   Surely
 physical Nature nowhere exhibits a similar mode of fermen-
 tation.
   Humouralism is on a par with the anatomical school"in this re-
 spect that it confounds effects with causes.  " Pus," for exam-
*ple, says Dr. Hosack, "produces a peculiar form of fever, called
 hectic fever ; and this, I believe, is the only way in which hec-
 tic fever is  ever formed."  Mr.  Gulliver  considers  pus  the
 proximate cause  of " sympathetic, inflammatory,  sympathetic
 typhoid and hectic fever."   Now, it is  not true  that what is
 called healthy or laudable pus gives rise to hectic  fever ; every
 body may have seen pus intermixed with the  healthy granula-
 tions of a wound without a trace of hectic fever being percepti-
 ble in the system.  But suppose there is  hectic  fever in con-
 junction with the formation of an unhealthy pus, why would we
 not consider both these morbid phenomena results of one and
 the same morbid  action in the system?  Why would we  con-
 sider the fever as  a mere development of the action of pus, when
 we know that the pus itself is the result of a morbid virus with
 which the system has been tainted ?
   A host of objections can be raised against humouralism, objec-
 tions which must  appear unanswerable except to those whose
 personal vanity and interest are involved in the maintenance of
 the humoural doctrines.
   The mode of treatment which humouralism proposes, is,  on
 the  face of it, absurd.   Dr. Stevens maintains that "the red
 colour of the blood depends on the presence of its saline con-
 stituents,  and that, when deprived of them, this fluid is black."
 Hence the  practice which is proposed to restore them to the
 blood  is, to give  saline medicines.   This practice is absurd.
 There  is no reason why the externally introduced saline  sub-
 stances should  not be expelled again  much more easily than the
 original saline particles were, which  were essential constituents
 of the blood, and united to it in their very inmost essence.  And 
26
then, the muriate of soda does not act upon the blood coursing
through the system, in the same manner as it does upon the
blood out of the system.   Out of the system, blood  saturated
with chloride of sodium forms a saline mixture ; but when has
the blood in the system ever obtained a saltish taste, even after
a sufficient quantity of salt had been swallowed to impart its
taste to the whole mass of blood ?
  Dr. Mitchill, in order to free the blood from the acids which
have  blackened it by depriving it of its saline constituents, re-
commends the use  of " all such compounds of other bodies,
with alkaline bases, as are capable of being decompounded by
the septic poison or acid they meet with in the human body, and
of furnishing an alkali to unite in such cases with those sour and
acrimonious fluids, and thereby to  saturate them."   Dr. Mitchill
considers the human body a mere chemical laboratory, where
chemical  action and reaction can  be carried on the same as in
the crucible.   But there is  one small circumstance which Dr.
Mitchill has left out of consideration in his recommendation of
the use of alkalis, it is this : that the  acids with which  the
blood is saturated, are not the result of chemical agency, but of
a morbid action of whose origin  and present condition in  the
system we know nothing ; and that no chemist can determine
the influence which that  morbid  action will exercise  upon the
chemical  relations  existing between the alkalis and the acids.
It is just as probable that the vital force will prevent the reac-
tion from taking place as not; and even if it did take place, new
quantities of acid would be constantly formed with this differ-
ence that the morbid cause, by having been violently deprived
of the results of its action, and being itself left unrestrained and
continuing to act in perfect freedom, will have become exaspe-
rated, and will not only restore the loss it has suffered, but will
produce an  additional quantity of the deleterious acids, since
acids there are.
  If the  phenomena of disease depend upon a contamination
of the blood, how does humouralism  account for the periodical
quiescence in intermittent fevers ?  Senac, after describing the
terrific symptoms which  attend " malignant intermittents," re-
marks, that a person inexperienced in the disease would scarcely
believe it possible for the  patients to rise  again.  But, strange
to tell, at the termination  of  the paroxysm these terrible symp-
toms abate, and oftentimes entirely disappear."  Does not  this
show that the blood cannot be the  exciting cause of the disease ?
  How do  humouralists  account for the cotemporaneous ex-
istence of diseases in the system: for instance, smallpox and
measles, of which Dr. Russell has reported two cases ; or scar-
latina and small pox, as reported by Hufeland ?  Here, accord- 
27
ing to the doctrine of humouralists, the  blood must have been
contaminated in two different ways at one and the same time.
   How does humouralism account for tetanus  arising in con-
sequence of punctured wounds in the sole of the foot, or of sur-
gical operations?  Or how does  it account  for  the  sudden
changes of colour in the hair and skin from violent emotions of
     CD
the mind ?
   How  does it account for local swelling and pain, and  for me-
tastasis 1  Has the infection of the blood any thing to do with
an exanthematous eruption  being  repelled and  spreading over
the inner surfaces ?
   And lastly, how shall we, upon humoural principles, account
for the effects from mechanical injuries, such as compression of
the brain ?  How shall we, upon those principles,  account for a
sick headache arising from disturbed digestion, or for a  point in
the  side from over-running, for  mortification arising from cold,
or for the  sudden  death  consequent upon drinking cold water
while  the system is in a state of great heat?  Some people often
get a violent inflammation of the throat from substituting a thin
cravat for one of more weight.  An alteration of the circulating
fluid has nothing to do with the phenomenon.   Nor has it any
thing to do with difficulty of breathing, lumbago, sciatica, wry-
neck,  dysentery, nor any of those diseases in which particular
organs seem to be principally affected.   The normal state of the
 blood  depends indeed upon the  harmonious action of all the or-
 gans of the  body.  If their vital  functions  are deranged,  the
 blood, even if it retained its genuine unaltered condition, would
 nevertheless  minister to disease by furnishing to  each special
 organ the fibrinous material out of which the organ is  to con-
 struct itself.   But it is not in the blood that the disease is first
 excited.  To admit  such a fact is  shocking to common sense.
 The blood is a mere result of the united vital action of all the
 organs ; it is absolutely dependent upon that action.  How then
 is it possible to suppose that while this action is  unimpaired, it
 should  not have the power to resist any morbid changes taking
 place in the blood, a fluid which is completely and absolutely a
 mere  result of the organic life of  the system, which is absolute-
 ly dependent upon the instruments of organic life, and which has
 itself just so much power and life as the organic viscera im-
 part to  it ?  When we see these viscera differ essentially in their
 constitution ; when we see them endowed with the power and en-
 trusted with t're office of performing distinct functions ;  is it not
 rational to suppose,  that the morbid alterations to which those
 functions  are liable, depend, all of them,  upon special causes
 just as  much as the  vital activity of the organ does  in its  nor-
 mal state ?   We speculate about the nature  and the  origin  of 
28
disease with as much assurance as though we knew all about
the nature and the origin of life. And yet we know nothing, ab-
solutely nothing, of the  operation of final causes.   And I will
even go farther, and say that we know absolutely  nothing of
the operation of final causes in the results of our most  simple
physical experiments.   I throw potassium  upon water ; it ig-
nites.  I know  that potassium has so strong an affinity for  oxy-
gen that it will take this substance even from water and set the
hydrogen on fire.  This  explanation satisfies my mind ; but it
only  explains the evolution  of certain results.   What  is  hy-
drogen 1  What is it in its inmost essence ?  No one  can tell
anything about  its inmost  constitution except that it is an in-
flammable elastic something, and that we drink it in the shape of
an oxide.  Truly does the distinguished Liebig  remark, "that
the formation of a  crystal, of an octohedron, is not less  incom-
prehensible than the production of a leaf or of a muscular fibre ;
and the production of vermilion from mercury and sulphur, is as
much an enigma as the formation of an eye from the substance
of the blood."
   I quote these expressions from Liebig in order to show that
even in the opinion  of great chemists, the operation  of  first
causes is completely hidden  from our sight.  What Liebig  says
about the formation of an eye from the substance of the blood,
I can only understand in this way, that the creative force which
originally formed the eye, maintains the integrity of this organ by
assimilating to its substance those constituents which the blood
is able and destined to furnish to all the organs of the  animal
economy.
   The human organism is indeed a unit; but it is a most com-
plete  unit, distinguished into parts that  exist  amongst  each
other in harmonious alliance, but each of which fulfils a special
destiny and exhibits a most various form and structure.  Not
only is it not absurd, but it is even eminently philosophical to sup-
pose that the forces which create the living organism, constitute
just as harmonious and  complete a unity as the  organism itself
does ; and that they establish such relations among the viscera of
organic life as to secure an individual existence to  each, and to
make the integral  existence of each dependent upon  the har-
monious relations of all.
   May it not be the office of the sympathetic nerve to preserve
this harmony among all  the viscera and  organs  of  the  animal
economy ?  The organs of  the animal economy  cannot be ex-
empt from the  moral law of respecting each other's rights, of
knowing the precise limit to which they may use their inherent
vitality without interfering with the rights of their associate or-
gans ?  May it not be that it is the function of the sympathetic 
29
nerve of whose mysterious agency almost nothing is  known,
to be the great  watchman of the respective rights of the differ-
ent organs ?   May it not be the office  of the sympathetic nerve
to establish and to preserve a system of mutual responsibility
among the different organs ?   And while  the motor and sensi-
tive nerves preserve the individuality of the  different  organs,
may not the sympathetic nerve be destined to watch over their
harmonious alliance ?   May we  not infer the moral office  of
this nerve from the fact that it is neither a nerve of motion nor
sensation, and  that even wounds may be inflicted upon it with-
out  the animal suffering any pain ?  It is certainly not absurd
to suppose that the solar plexus whose branches are irradiating
from their central body like rays from the sun, should have been
placed behind the  stomach and should send its various plexuses
to the abdominal viscera for the purpose of regulating their assim-
ilating power in reference to each other.
   The language to which humouralism  has given origin in pro-
fessional treatises  and which it has engrafted upon the public
mind,  is replete  with  gross  and unmeaning  technicalities.
" Among physical people," says Mr. Hunter," we find such ex-
pressions in  common use, as, the  humours are  affected in the
blood ;  sharp humours  in the blood ; the whole humours being
in a bad state ; the whole blood must be altered,  or corrected ;
and a variety  of such  expressions without  meaning;  they
even go so far as to have hereditary humours, as gout, scrofula,
etc., and make us  the parents of our own  humours, saying that
we  breed  bad humours.   Accidents or even the application of
poultices, have been supposed to  bring bad humours to a  part,
because the part in which the accident  happened, or to which
the poultice was applied, would not readily heal.   Humours are
even supposed to gravitate to  the legs slowly ;  and, in short,
the  whole theory  of disease has been  built upon the supposi-
tion of humours in the blood, or of the blood itself being changed.
I cannot conceive what is meant,  unless it be, that strong sus-
ceptibility to a specific  disease exists ; as, smallpox may bring
on  scrofula, or a strain, the gout."
   What are  sensible people to think of  a profession  that has"
given birth to such an unmeaning "jargon," which betrays the
crassest ignorance of the  nature  of disease, and a disgusting
mania to establish therapeutic principles upon absurd and dan-
gerous speculations ?   Some of the most shining lights of the
profession have made  themselves guilty of these violations of
common sense.  Boerhaave, for instance, admits some forty dif-
ferent kinds of scurvy,  all of them speculatively arising  from
forty diseased states of the blood.  " One tells us," says Beddoes,
"that the blood is polluted;  another, that it is  contaminated; 
30
a third, that it is acrid /  a fourth, that it is putrescent, without
ever recollecting that to employ terms expressive of phenomena,
such as the  senses may recognise,  and to  reason  upon  such
phenomena alone, are indispensable  conditions in philosophiz*
ing."
  It is not to be  wondered that the  medical profession  should
have furnished the great satyrist Moliere a theme for one of his
most admirable comedies.
  Even at this  moment  when  common sense seems to  have
more  sway over the  multitude than  has been the case at any
time previous, the humoural doctors find means to practise  upon
the ignorance of the  public, and to  gather fortunes by  their
gross deceptions, and their pernicious assaults upon the delicate
robe which enshrouds man s immortal spirit.
  What  do these  Brandreths and  these  Thomsons  with
their   beastly  conception  of  the  operations of  the  vital
force,  know  about disease and the laws  of cure ?  All they
care for is to minister to the brutish taste of the multitude that
is yet  crawling in the polluting mire of materialism, and, des-
pite of the refining influences of Christianity and art, views the
body as a mere  material machine, performing  material func-
tions,  and liable to the  visitations of material disease.
  And agreeably to the notion of disease being  some material
miasm which has introduced itself into  the  recesses  of the
system, one advises that it should  be drawn out again by the
blood,  another by the skin, a third  by the  bladder, a fourth by
the intestines, a  fifth by the  salivary glands,  all of them for-
getting that the substances which they introduce into the stom-
ach as remedial agents, make an inroad  upon the vital energies
by being acted upon  by the assimilating power of the organism
as nutritive substances are.  But what do the great exertions of
the organism result in ?  The tissues refuse to receive the de-
leterious poisons of the doctor as component parts ; hence these
tissues are forced into a resistance  that wears them out, lays
them waste, weakens their vital  activity, and instead of  dimin-
ishing  the  force of the  disease,  secures its supremacy over the
system.
  Material disease, we may consider wounds,  ruptures, chemi-
cal poisoning.  But an inflammatory fever, a schirrus, a fungus
hematodes are not  the results  of physical influences.   They are
the  results of influences of an order analagous to the order of
the  vital principle itself.  They are dynamic conditions, morbid
modifications of the  vital forces of  the economy, and cannot be
drawn  out of the system as you  draw one material body out of
another.   In  surgical  operations we are  required  to proceed
with the utmost gentleness and caution; and if it be necessary 
31
to use more than common force, we never act until we are sure
of the very point where the  blow is to be struck.  Only in the
affections of organic life we deem ourselves authorized to  offer'
violence to the system, and to shake it to the very centre in the
foolish expectation that the ultimate result of this horrible sub-
version will be the restoration of harmony.

  The  homozopathic  school  has been founded by the German
physician Hahnemann.   Hahnemann was an intimate friend of
the distinguished Hufeland, and was considered by his fellow-
practitioners an ornament of his profession.  The uncertainties
and  the inconsistencies  with which  the  practice  of medicine
seemed  to him replete,  sickened  his mind so much,  that he
resolved to abandon the  exercise of his profession, and to se-
cure a livelihood by translating medical works.  In translating
Cullen's Materia Medica, he was struck by the fact that Cullen
recommended  cinchona  bark as a tonic, and a specific against
intermittent fever.  Hahnemann immediately  resolved to try
the action of this drug upon  himself, and to  his astonishment,
he found himself in a little while affected with all the symp-
toms of fever and  ague.  This discovery led him to establish
in his own mind the following propositions :
   1, That the so-called tonics are in their essence debilitating ;
and  that they strengthen the system simply by causing the de-
pressed vital energies, by means of  an increase of depression
within conservative limits, to react against the depressing cause;
and
  2, That the pathogenetic  effects  of  remedial  agents  in a
healthy system, are indicative of the disease which these agents
are capable of curing.
   Hahnemann and his friends  have inflicted  upon themselves
endless  sufferings by trying upon their own persons the effects
of the  various mineral  and vegetable poisons,  and by dint of
great perseverence and  privations, have succeeded in indicating
with great minuteness the virtues of some three hundred reme-
dial  agents.
  Agreeably to my habits of independent study, I have investi-
gated the doctrines of Hahnemann alike  with those of all the
other leading  men of our profession.  I may briefly  arrange
them here in the following series of propositions.

                      SERIES  I.

  Man is in relation with outward nature.
  This relation is either essential, or accidental.
  By essential relation, I mean a relation with those things of
substances of nature, which  are necessary to the preservation 
32
and progressive development of man's essence, both the mate-
rial and spiritual organism.
   By accidental relation, I understand  a relation with those
substances  of nature which are pernicious to man's essence,
and the continual influence of which would finally destroy his
organism.
   To the former series  belong all  the  nutrilive, or otherwise
useful animals, plants, minerals, etc.
   To the latter belong the non-nutritive, poisonous or otherwise
hurtful animals,  plants, minerals.
   For  the  sake  of convenience, I shall  designate  the former
substances by the term " harmonic" and the latter by  the term
" subversive"

                     SERIES  II.
   Every created being exists for some use or good purpose.
   The truth of  this proposition  has been universally demon-
strated by science.
   It is  moreover established in the Scriptures: " And God
saw every thing that  he  had made,  and behold, it was very
good."
   Hence, there must exist an essential or good relation between
man and all the things of nature, even those substances which
I have designated by the  term " subversive."
   The criterium of the goodness of a relation existing  between
man and a natural substance, is the increase of health, strength,
and beauty, which man derives from the  use of that substance.
   Hence, there  cannot exist any essential relation between a
subversive  substance and the human organism in equilibrium
or health, on account  of  this equilibrium  or  health being infal-
libly destroyed by the contact with  subversive substances in
sufficient quantity.
   Therefore, if  there exist at all an essential relation  between
subversive  substances and  the human  organism, it  must  be
when the equilibrium of  the latter is disturbed.
   Indeed, experience proves that there is an essential relation
existing between the human organism in a state of disturbance
and the subversive substances.
   That relation fulfils all the condition's of an essential rela-
tion : it preserves the human organism, it develops and perfects
it.
   In other  words, that relation restores the organism in disturb-
ance to the original conditions of health.
   That restoration having been accomplished, the essential re-
lation between the human  organism and the subversive sub-
stance ceases to exist. 
33
  Henceforth, if the relation between the human organism, re-
stored to its original  conditions of health, and the  subversive
substance  were  to continue, this relation from  an essential
would become an accidental, or subversive, and the original con-
ditions of health would again be destroyed.
  It  seems natural to conclude  that this  second destruction of
the original conditions of health will be indicated by the symp-
toms of the previous or a similar disturbance reappearing in
the organism.

                     SERIES III.

   I have said that all living organisms hold certain relations to
external nature.
   Certain  stomachs require certain kinds of food;  certain tenv
peraments  require certain degrees  of temperature ;  certain
muscles are adapted to certain kinds  of motion.
   If  such  fixed relations exist between the things  of nature and
the organism in health, they must exist so much more necessa-
rily between the things  of nature and the organism in  disturb-
ance.
  Hence there must exist an essential relation between each pe-
culiar disturbance of the system and the subversive substances.
   How is  the essential relation existing between a peculiar dis-
turbance of the organism and a subversive substance to  be
determined ?
   As a state  of health is perceived by  certain indications, so
does  a disturbance manifest itself by an aggregate of peculiar
symptoms.
   All subversive substances produce in a healthy organism
disturbances,  each of which is characterized by peculiar symp-
toms.
   Each subversive substance must therefore necessarily be in
essential relation with the disturbance  which it  is capable of
producing  in  the system;  in other  words,  it must be more
closely, or more essentially related to that than to any other dis-
turbance which is different from its own.
  Hence any given disturbance in the organism is in essential
relation with the subversive substance which is capable of pro-
ducing an  analogous  disturbance in the healthy organism.
  And as the ultimate result of any essential relation between
a subversive substance and the organism in disturbance is the
restoration of that organism in disturbance to its original condi-
tions  of health,  it follows again from  the preceding proposition,
that any given disturbance in the organism is cured by admin-
istering remedies, the pathogenetic effects of which in a healthy
         3 
34
organism are similar to the symptoms  by the integrality and
the relation of which among themselves the disturbance is indi-
cated.

                     SERIE S  IV.

   I have distinguished the natural  substances  with which man
is  in relation, into harmonic substances, or such as  develop
the organism out  of itself; and into subversive, or such sub-
stances as lead to  the destruction of the organism.
   1 have farther shown that the subversive substances can only
be in essential relation with the organism, when the latter  exists
in a state of disturbance,  and when the symptoms by which
this  disturbance is indicated,  are analogous to the symptoms
which the  subversive substances are capable of producing in a
healthy organism.
   I  have also  remarked  that  any essential 'relation which is
practically  established between a  natural substance  and the
organism, will result in harmoniously developing, or beautifying
and perfecting the organism.
   It  is  evident that by  an essential relation being practically
established  between a natural substance and the organism,
nothing else can be  understood except the introduction of  the
substance into the organism.
   Let us  now  proceed to inquire  how, according to  the ho-
moeopathic  doctrine, this developing and perfecting of the or-
ganism is effected  by subversive substances.

                      SERIES  V.

   Every spiritual or material substance or  state is  created
according to its order.
   This order constitutes the form  of that substance  or state.
   This  form is essential to and inherent in the substance or
state  and cannot be imposed  upon  another substance  or state,
without violating their essential existence.
   The natural or essential order of the organism is health.
   Hence disturbance, or a deviation from the natural conditions
of health is not the natural or essential order of the organism.
   Disease, therefore, in the organism, is not in its order ;  in other
words, the organism is not the natural or essential form  of the
disease.
   Hence again it follows  that the disease must have a desire—
a tendency, to leave the organism, which is not its true, its essen-
tial mode of existence or  form.
   What then is the natural or essential form or  order of  exist-
ence  of  a disease ? 
35
                     SERIES  VI.

  I have shown above that disturbances in the organism are
essentially related to the subversive substances,  or  in  other
words, that natural or dynamic disturbances in  the  organism
are closely similar to those which subversive substances are ca-
pable of producing in a healthy organism.
   Such disturbances being developed out of the subversive sub-
stance, it necessarily  follows that the subversive substance con-
tains them.
   The subversive substance may therefore be said to be the
material measure, type, or form of the dynamic or vital disturb-
ance.
   It is  therefore the  natural mode of existence of the disturb-
ance, its essential form or order.
   Hence the disturbance will  desire and endeavour to return
to its natural or essential  order of existence, when that order is
brought within the reach of the disturbance.
   The  subversive substance being that order, it  is brought
within the reach of the disturbance by being introduced into the
organism.
   After being introduced  into the organism, the subversive sub-
stance receives  the disturbance into itself.
   The dynamic disturbance thus materializes itself in its type
or esssential form.
   This materialization of the disturbance takes place altogether
voluntarily on the part of the disturbance.
   It  farther takes place without affecting the  organism, pro-
vided the subversive substance has not been introduced into the
organism in too large a quantity to exert its inherent  influence
upon the organism subversively, in other words, to poison it.
   In proportion as the process  of materialization goes on, the
vital force of the organism is enabled to return to its normal
state, and to regain its control over the organism.
   The organism then begins effectually to react against the ma-
terialized disease.
   When the process of materialization is completed, that reac-
tion becomes entire,  and it results in the disease—as concen-
trated or materialized in its form or type—being ejected from the
organism.

   The doctrines of Hahnemann have been persecuted in Ger-
many with an  unmitigated rage, and, for  aught I know, they
have met every where with the most vehement and bitter oppo-
sition.   I am rather  astonished at seeing members of our pro-
fession condemning and  vilipending each  other without often
any one  knowing any thing about the  other's creed.    This 
36
injustice has been liberally practised  towards  Hahnemann.
Though he was confessedly a man of  unbounded erudition and
sterling character—the great Jean Paul Richter designates him
" this rare double-head of genius and erudition,"—yet the vilest
names have been  profusely lavished  upon his  devoted  head.
This is wrong.  It is indiscreet to speak about things that we
know nothing of, but it is immoral and unchristian to pronounce
condemnation upon them from mere prejudice.  I have vowed that
this shall never  be my course in the exercise of the medical
profession.
  Whatever may  be  said of the mode in which Hahnemann
applies his doctrines to the treatment of disease, it cannot be
denied that he has furnished most valuable  contributions  to
physiology and hygiene.  He has shown conclusively,
  1, What are truly nutritive and non-nutritive substances;
  2, That the speculative doctrines of humouralism about final
causes are  just as foolish and  pernicious in  the treatment  of
disease as  a careful  observation of the  external phenomena of
disease is useful and philosophical.
  3, That  a single remedy, if  carefully selected with a view
of making the proper impression upon the depressed vital forces,
can do and will do more good than all the compound fabrics of
the humoural philosophers.
  4. That medicines should be so administered not only as not
to excite any disgust, but to make them positively palatable to
the patient.   This is of the greatest importance, as the effect of
the most valuable remedies is  often greatly injured by the dis-
gust which those remedies excite, and by the opposing idiosyn-
cracies which they call into play ',  and
  5, That remedies which have been carefully selected and are
perfectly adequate to make that impression upon the vital forces
which is required for the cure  of a given disease, need not  be
given  in such large doses as will taint the system with the in-
herent poisonous effects of the  remedial agent.
  Who would have thought, a few hundred years ago, when a
single prescription often contained a hundred, and even a hun-
dred and fifty, or a hundred and seventy different remedies, that
we should simplify our prescriptions as much as we have done,
and cure dysentery with one twentieth of a grain of calomel,
and scurvy with lemon-juice ?
   I doubt whether the magnitude of a dose of medicine  in  a
given  case of disease will ever be rigorously  determined by a
scientific formula.  The learned Professor of the Institutes in-
deed teaches in his treatise upon bloodletting,  that, under cer-
tain circumstances, we must not  draw a single  drop of blood
either too much or too little j but it seems to me that the tact 
37
and the judgment of the practitioner must be the rule by which
the magnitude of a dose in a given case of disease is to be
measured.   I am confident, however, that the high susceptibili-
ties of the system are overlooked by a great number of prac-
titioners, who are much more intent upon making a physical
impression upon the system than to select a  remedy with that
scrupulous care which will secure it a safe and triumphant im-
pression upon the disease.
   Dr. Paine has interspersed his " Commentaries " with a great
many facts illustrative of the high susceptibility of the  system.
It may not be amiss to mention a few of them here.
   Fear has suddenly changed the black colour of hair to gray.
   Hodgkin  relates, that Rostan states  an  instance where  the
skin  of a female, who had been condemned  to the  guillotine,
became black in consequence of the shock.   The colour was
formed by "the deposit of pigment in that  part of the tissue in
 which its presence is natural in the dark races of  mankind."
   Caldwell  inquires whether any thing passes from the orator,
 the musician, the  poet, the warrior, etc. into  the  blood of the
 multitude, when they rouse the heart into tumultuous action.
   Armstrong,  in his  lectures on acute and chronic diseases,
 vol. ii. p. Ill, says, that "when typhoid patients  are apparent-
ing dying, they will often recover from that slate by the stimulus
 of pleasant  impressions upon the mind."
   Boyle, in the first volume of his philosophical works, relates
 an instance where a quartan  was cured by a fright from a rat;
 and again, where  the  gout, and an obstinate case  of scarlatina,
 were suddenly removed by a paroxysm of fear.   In two  other
 cases, whitlows were  removed by putting the finger into a cat's
 ear.
   Baglivi says, in his practice of  medicine, " as many diseases
 depend upon a little cause, which may be even invisible, and
 may not  have been  introduced into the  organism, nor  even
 seem to exist, so are many considerable diseases cured in a
 moment, without any apparent evacuation."    ....
    The fearful convulsions to which infants are liable during the
 period of dentition, are at once relieved by lancing the  gums.
    Dr. Frank,  senior, describes  a quartan, which  resisted all
 possible drugs for several months.  The patient  was  cutting a
 dens sapiential   The gum being lanced, the ague was  seen no
 more.                                              r  ,   .
    Mr. Boyle relates  that the bare scent of a dose ot physic
 operated better  upon a young gentlewoman, than it did upon
 her  sister,  who took the medicine.
    Dr. Pfeil, when he wanted a purge, would go into an apothe-
 cary's shop, where  purging electuaries  were preparing,  the 
38
 scent whereof would work as well with him as a dose of medi-
 cine.
   A woman used to purge herself with beef broth, but having
 broke her leg, used no other cathartic than the scent of it.
   Mr. Lemery states, that he knew two people that purged and
 vomited in a most violent manner, after being confined some four
 or five hours where there was a large quantity of damask rose.
   The chewing, and picking at the nose of some of my fellow-
 students, has often produced ptyalism in me for more than an hour.
   A small phial of the " otto of rose," although nearly hermet-
 ically sealed, will send its perfume over a  large space for many
 years, without any apparent diminution of its contents.
   A single drop of kreosote has not only increased the flow of
 urine, but changed its colour to black and other hues.
   Dr. Paine says, that he knows a lady in this city, who is al-
 ways purged by shaking in her ears a box of pills, which is
 sometimes employed for this special purpose.
   He also knows an apothecary, who is invariably salivated by
 rolling with his fingers some half dozen blue pills.
   Dr. Madden was purged by rubbing over his hands a solution
 of tartarized antimony.
   "We know," says  Dr. Paine, " that a grain of calomel  will
 cause the saliva to flow in torrents long after the administration
 of the poison."
   " We know," says again Dr. Paine, " that bad forms  of fever
 have been cured by  mercury, when the  constitutional effects of
 the poison were scarcely perceptible in the gums."

  The principle upon which Hahnemann's system rests, is ex-
 pressed  by  the  formula:  "similia similibus  curantur,"  like
 cures like.   It is upon this principle, that the school of Hahne-
 mann explains the cure of certain forms of diarrhoea by rhubarb;
 of nausea and vomiting, by an emetic; of confluent smallpox,
 dysentery and  the cholera infantum by mercury; of scurvy by
 citric acid; of burns by the  application of heat; of chilblains
 03^ the application of cold ; of itch by sulphur; of marsh inter-
 mittents by cinchona ; of hemorrhoidal flux, hemoptysis, hema-
 turia and epistaxis by millefoil (Hoffmann, Stahl); of gripes of
 the stomach connected with uneasiness and great agitation by
jalap; of dropsy-like, oedematous swelling by sambucus niger
 (Boerhaave, Sydenham);  of pleurisy by  squills (De Haen,
 Wagner);  of  spasmodic asthma by ipecacuanha; of certain
 ophthalmic diseases by euphrasia (Murray, Lobelius); of slow
 nervous fevers  with  decreased  temperature of the body, de-
 pressed  sensibility and a great diminution of the vital powers by
 camphor,  (Huxham, Cullen); of painful ischuria by cantha- 
39
ides (Forest, Young, Huxham);  of syphilis by mercury; of
certain forms of  intermittent fevers, with violent drawing and
tearing in the bones, and tearing headache, by arsenic ;  of can-
cerous ulcers by arsenic;  of chorea and epilepsy by copper
(Boerhaave, Cullen) ; of obstinate constipation by  lead in the
shape of the so-called saturnine pills, etc.
   The idea of " like curing like," has been broached by physi-
cians of old and modern times.   The great Haller has adverted
to  it.  In the book " on the relations  of  medicines to man,"
which is  attributed to  Hippocrates, we read these remarks:
'' oiu Tat ope to, vevcrei ylvercci,  xett Sie\ ru  o(4.otei 7rpo<r<pepof4,evct  tx
voo-iuvtuv uytctivovTxt;—sick  people  are  cured by remedies pro-
ducing  analogous diseases.  And again:  hu t«  l^tUiv  'cperos
Trccuercti ; vomiting is cured by vomiting."
   The  Professor of Midwifery looks upon this latter principle
as an eminently true and practical principle, and recommends his
class to cure the nausea in chlorosis agreeably to this principle,
by administering sulphate of zinc.
   The illustrious Professor of Surgery, in his interesting lectures
on tetanus, has several times lauded the principle now under
consideration.
   The celebrated Danish physician Stahl expresses himself as
follows on the  use of remedies:  " The received method in
medicine of treating diseases by opposite remedies—that is to
say, by medicines which  are opposed to the effects they pro-
duce, is completely false and absurd.   I am convinced, on the
contrary,  that diseases  are  subdued by agents which produce a
similar affection; burns, by the heat of a fire to which the parts
are exposed ; the frost-bite  by snow or icy cold water;  and in-
flammations and  contusions by spirituous applications.  It is by
these means, I have succeeded in curing a disposition to acidity
of the stomach, by using very small  doses of sulphuric acid in
cases where a multitude of absorbing powders had been admin-
istered to no purpose."  (See I. Hummel, Comment, de Arthri-
tide tam  tartarea, quam scorbutica.   Budingae,  1738—in 8,
pp. 40, 42.)
   As for  myself, I accept fully and unequivocally  the principle
" contraria contrariis curantur," which, if understood philosophi-
cally, is identical with the principle " like cures  like."
   Where  do we find the greatest opposition, between two indi-
viduals who pursue totally different, or  between those who pur-
sue the same avocations?   Interests which are   not similar,
never oppose each other.   Doctors may look upon each other
with a squinting eye ; but doctors and lawyers will never quar-
rel on account of professional interests.   There is no antagonism
unless  there is analogy.  Women of equal beauty will look 
40
upon each other as rivals ;  talents of the same order and rank
will do the same;  tastes that  are closely allied, or judgments
boasting of the  same degree of acuteness and the same amount
of practical wisdom, will never  yield to each other; but there
is no opposition where there is  no analogy;  in proportion as
similitude increases, opposition  does, so that analogy  may be
and must be considered the  highest expression and development
of the law of antagonism.
   There is no sense in the  formula " contraria contrariis curan*
tur," except so far as it  is admitted to be identical with the  for-
mula " similia similibus."   The formula " contraria contrariis "
is true only when it is understood of the antagonizing analogy
between  the  remedies and  the disease;  but  it becomes false
and absurd when it is understood of a pretended antagonizing
difference existing between  the disease and the remedial agent.
There is no such  antagonism in Nature.  What is the contra-
rium  of  an inflammation of the  liver, of a sick-headache, or a
bowel-complaint ?
   It seems to me that the homoeopathic  school is  an essential
ally of the doctrines of vitalism.  Like these it considers disease
an  abnormal condition  of  the dynamic or vital forces  of  the
economy ;  like these it acts upon the principle that the true  and
philosophical mode of effecting  a cure, is to produce such  an
impression upon the vital powers  as will cause them to react
against the morbific influences.
   Vitalism and the homoeopathic school simply differ in their
mode of producing this  impression.  The homoeopathic school
teaches that this impression can be most adequately produced
by remedies that  act analogically to  the forces productive of
disease.
   I cannot abandon this  theme without making a few remarks
in reference to  the various experiments which have been made
upon living beings,  for the purpose of discovering  the genuine
forces of remedial agents, and the physiological principles which
govern the life  of the animal economy.
   Enthusiastic physicians have,  at all times, brought their own
bodies, while in a state of perfect health, under the influence of
remedial agents, in  order to obtain a precise knowledge of their
remedial  virtues, and  of the use which they are capable of
affording in disease. The learned Professor of the  Institutes, in
his essay on vitality, states his belief that the value of  a reme-
dial  agent is to be determined " ab usu in morbo;" or from the
curative influence which it  manifests in a given case of disease.
It is undoubtedly true that, as long as the value of a remedial
agent has not been verified  a posteriori, it remains more  or  less
hypothetical.   But can we, with propriety, and without violating 
41
the principles of inductive philosophy, resort to the application
of a remedial agent in a given form of disease, without having
first determined its remedial virtues in a healthy system ?  My
opinion is, that we cannot.   Indeed, primitive man, unless he
enjoyed a  special revelation on the  subject, cannot have been
aware of the existence of vegetable or mineral poisons until, by
some accident or  other,  he brought them in contact with his liv-
ing organism.  Nor can he  have had an idea of using them as
remedial agents, when he observed the first case of disease, un-
til a correct knowledge of their  medicinal virtues enabled  him
to establish, by a  process of a priori reasoning based  upon ex-
perience, a proper relation between the disease and the remedy.
It is a matter of course, that all such experiments upon the hu-
man body,  should be carried on without endangering life.
   Both the humoural and homoeopathic school have been distin-
guished by the great zeal with which those experiments have
been  carried  on.  But there  is this difference between the two
schools, that the humoural school pretends to reproduce by med-
icines the identical  disease, whereas, the  homoeopathic school
simply teaches that  the medicinal disease, far from being identi-   „
cal with the morbid condition of the vital  forces,  merely simu-
lates  it as its lifeless and momentary form.
   Hear Magendie : " You saw me,  says he, " give rise, at my
pleasure, to pneumonia, scurvy, yellow fever, typhoid fever, not
to mention a  number of other affections, which,  so to speak, I
called into  being before  you."
   And Andral: " Those derangements of  functions and organs
produced  by  the experimenter, when he introduces different
deleterious substances directly into the blood, are likewise those
that are produced by the sting or bite of certain animals ;  they
are also those that take  place in smallpox, measles, and scarla-
tina, of a malignant nature as it is called.  They  are  the same
derangements that appear in  persons exposed to putrid emana-
tions, vegetable and animal,  and to miasmata from the bodies of
other persons that are themselves diseased and crowded in con-
fined places.   Lastly, they show themselves also  in individuals
whose blood is only imperfectly or badly repaired by insufficient
or unwholesome diet."
   Deluded mortals !  Is not this world a  world of effects, and
can the world of  effects act as the world of causes ?  As life
originates  in  the world of causes, so does disease, which is a
vital poisoning.  Disease may be simulated, but not identically
reproduced by the substances which owe their existence to the
morbid influences acting down upon this world  of effects from
the world of causes ; in  this world of causes, disease acts upon
the vital forces analogically, as  chemical poisons do  upon our 
42
bodies here.   Chemical  poisonings  are the only diseases that
the world of effects can legitimately claim as its own.
  Experiments have  also constantly been made upon animals
for the purpose of determining the physiological laws of the ani-
mal  economy.   Unspeakable tortures  have been inflicted  for
that purpose upon dogs, mice, horses, cows, rabbits and pigeons,
that  seem to enjoy the special  privilege of ministering to the
slaughtering energies of physiological experimenters.   The vi-
tal philosophers are the only  ones that  have raised their voices
against these horrible mutilations of the brute creation.   Some
of these  experiments have shed a little light, but only a feeble
gleam, upon the functions of certain parts of the nervous sys-
tem ; but I am confident that their importance has been greatly
overrated, and that they are  of next to no use in their bearing
upon therapeutic science.   A man starts a physiological specu-
lation, he takes hold of a beast, mutilates it  fatally, and, from the
phenomena which the vital principle manifests in this mutilated
and dying being, he draws  conclusions relative to the opera-
tions of the living and healthy organism of man.   Most of Ma-
gendie's  experiments are of this nature.   To prove, for exam-
ple, that  the nerves do  not absorb, he severs a limb completely
from a trunk, leaving it connected with the trunk only through
the nerves.  He then applies the morbific virus, and finds that
it  does  not  act.  Or to prove that the veins absorb, he severs
the limb, leaving only the  veins; and, on applying the poison,
he finds that absorption takes place.   I really do not  see that
such experiments prove any thing else except that when a poi-
son is mechanically introduced into the  blood, it is mechanically
carried along with the current.   This mode of extorting from
Nature her inmost secrets, leads only to deceptive theories ; and
whatever great and  untiring energies  Magendie, Miiller, and
their friends may have evinced in carrying on their physiological
experiments; nevertheless, the true mode  of investigating Na-
ture's operations, is, to humbly watch their free and regular
evolution as Newton did in the fall of  an apple,  and Kepler in
the phenomena of motion of the heavenly bodies.

  The chemical physiologists constitute a school that numbers
among its members some of the finest,  most persevering  and
most gifted men who devote  their energies to the cause of sci-
ence.  We  need but  mention  Mulder of Leyden,  Liebig of
Giessen, Dumas of Paris, and Dr. Draper of New-York.
  The doctrines of this school are less calculated to exercise an
important bearing upon the treatment of disease than upon gen-
eral hygiene.
   I  shall briefly indicate the leading views  of this school, and 
43
then inquire whether they may be made available to therapeutic
science.  Some of these views  are peculiar to the brilliant and
expert Professor of Chemistry of New-York University.
   An animal is an oxydizing machine evolving heat.
   The  functions of  the animal  economy rest upon three cardi-
nal results, the combustion of carbon, of hydrogen and of nitro-
gen ; carbon being given  out by the lungs in the shape of car-
bonic acid, hydrogen by the skin, lungs, and bladder, in the shape
of water, nitrogen by the kidneys in the shape of ammonia.
   The  animal  creates nothing, it simply gathers.
   This gathering is accomplished by means of a progressive
oxydation of the food introduced into the stomach.
   Digestion is  simply a process  of fermentation carried on by
means of the substance called pepsine.
   This pepsine is mucus secreted by the stomach, and acted
upon by the oxygen which is carried down to the stomach by
the saliva.
   The result of this fermentation is a splitting of the nutritive
particles or molecules, of the starch molecules for instance into
lactic acid.
   By means of this fermentation, the  food in the  stomach be-
comes a pulpy  matter; the different articles  of  food all termi-
nating in the starch group, which is composed of
         Grape sugar,            C12  On   Hn
          Gum,                  C12  O11   H11
          Starch,                 C12
          Lignine,                C12
          Dry cane sugar,         C12
   Human food may be divided into two classes,—one, which
contains nitrogen, the neutral  nitrogenized bodies;  and one
which does  not contain nitrogen, the non-nitrogenized bodies.
   The  non-nitrogenized bodies, fat, starch, gum,  sugar, alcohol,
are designated  as the elements of respiration ; the neutral nitro-
ganized bodies, fibrine, albumen, caseine are designated as the
elements of nutrition.
   Fibrine, albumen and caseine are the primordial constituents
of all animal and vegetable nutritive substances  ;  hence these
substances are  all  isomeric bodies.
  The comminuted food  is absorbed by the lacteals originating
in the villi of the coats of the intestines.
  This absorption takes place by a  process of capillary attrac-
tion through the microscopic orifices of the lacteals.
  The  lacteals absorb  the  elements of  respiration, the veins
those of nutrition.
  The deposition of fat in the tissues is a purely chemical  and
physical process ; fat is already formed in the food, from which
the animal gathers it.
O10	H10
Oa	Ha
On	H10
 
44
   The circulation of the blood is likewise explained on chemi-
cal and physical principles.
   The  systemic  circulation originates in the  oxygen existing
in the arterial blood having a stronger affinity for the coats of
the arteries than the blood itself has ; this is therefore pushed
bodily forwards by the oxygen ; the circulation  stops as soon
as venous blood enters the arterial tissues.
   The pulmonary circulation is owing to  the affinity of venous
blood for oxygen ;  the arterial blood not having any such affinity,
it is pushed along by the venous blood.
   The arterialization of the venous  blood gives  rise  to animal
heat.
   These several propositions Dr. Draper has illustrated by the
most  beautiful experiments which it is not my object to  relate
here.
   It is evident that physical principles are involved in some of
the functions of the animal economy,  especially in the mechan-
ism of vision and of hearing; but it seems to me that the  exist-
ence of a vital force inherent in the tissues of the organs cannot
be  denied.  At any rate the chemico-physical doctrine of life
must necessarily be prepared to meet the following objections :
   1. The secretion of the gastric juice cannot be explained on
physical principles, for it is only the living  stomach that  can
secrete it.
   2. It is asserted by the  chemical  physiologist that the true
gastric juice may be manufactured by mucous membranes, no
matter whether of the stomach or  the bladder, being  dissolved
either  in muriatic or acetic acid.   According to Schwann and
Miiller this artificial  digestive principle may  be neutralized by
an alkali, and  afterwards precipitated from the neutral solution
by acetate of  lead, and obtained again in an active state from
that precipitate by hydrochloric acid.   Such  assertions are  un-
founded, inasmuch as it can never be ascertained whether such
an  artificial digestive  mixture is  a  real substitute for the true
gastric juice,  whereas, on the  other hand, the experience  of all
medical observers establishes the fact that hydrochloric acid, if
given at all in the necessary quantity to  act as a dissolvent in
the stomach, ruins the digestive power of this organ.
   3. If the animal merely gathers, and does not assimilate, it
is  for the chemist to prove that the human  head is contained
in a cabbage head.
   4. Dr. Draper's views of the circulation of the  blood are con-
tradicted by the fact that venous blood courses through the pul-
monary artery, and arterial blood through the pulmonary veins  ;
and moreover by the fact, that the portal vein fulfils  both the
office of artery and vein. 
45
  5. In regard to animal heat, it may be observed, that if animal
heat be a mere result of a process of combustion going on in the
lungs,  there must have been a moment when the system  ex-
isted before the evolution  of  heat  took place;  the various se-
cretions, preparatory to the arterialization of the venous blood,
must  have been carried on without  any animal heat being
present.  Is this possible ?   It is for the chemical physiologist
to solve this objection.
   Again :  is it certain that remedial agents are assimilated by
the animal economy in the  same way as nutritive substances
are ?   This is very  doubtful.  Dr. Wright introduced into the
stomach of a dog an ounce and a half of the sulphate of  iron,
along  with a  pound  of bread  and milk, after the animal had
fasted fifty-six hours.   The  presence of the  iron could not be
detected in the thoracic duct by the tincture of galls.  Mitscher-
lich, of Berlin, could detect no lead in  the blood of the various
secretions  of those who laboured under colica plumbae.  Liebig
positively  asserts that  he never detected the  least trace of a
vegetable medicinal substance in the system.
   No disease can be cured on chemical principles.   " In  cer-
tain diseased  conditions," says this remarkable chemist, " in
which the blood  acquires a viscid consistence, this state cannot
be permanently removed by a chemical action on the fluid cir-
culating in the blood-vessels.   The deposit of a sediment from
the urine,  may, perhaps, be prevented by alkalis, while  their
action  has not  the  remotest tendency to remove the cause of
disease.   Again, when we observe, in  typhus, insoluble salts of
ammonia  in  the faeces, and a change in the globules of the
blood similar to  that which may be artificially produced by am-
monia, we are not, on that occount, entitled to consider the pre-
 sence  of  ammonia  in  the body as the cause, but only as the
 effect of a cause."

   I cannot lay down my pen  without expressing my warmest
 sympathy for that  kind of family teaching which is carried on
 in our school, and which is so different from the pompous teach-
 ing of most other Universities.  Our  school now rests upon a
 foundation as firm  as  a rock in the ocean.  The talent of its
 Professors, who are equal to  the best, and  superior to many;
 their  unwearied kindness, their  justice, and their  unbounded
 liberality, are certainly not its least guarantee of success. 
 
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  of  the  Maladies of Infants, Children,  and  Adults,  &c.  8vo.  1943.
  Bound.  $0 75.
 HAHNEMANN. DR. S.   Organon of Homoeopathic Medicine.   Large 8vo.
  1843.   Bound.'  $100.
 HARTMANN, DR. F.  Practical  Observations on some of the chief Ho-
  moeopathic  Remedies.  Translated from the German, with additions, by A.
  H. Okie, M.D.   1st series.  Large 8vo. 1845.   (The  2d series  will be  out
  soon) 91 00.
 JAHR,  G. H. G.  New Homoeopathic Pharmacopoeia and Posology, or  the
  Preparation of Homoepathic Medicines. Translated, with additions, by James
  Kitchen, M.D.  Large 8vo.  1842.  Bound.   $2 00.
 LAURIE, DR. F.  Homoeopathic Domestic Medicine.  Second American edi-
  tion.  Enlarged and improved by A. G. Hull, M.D.  1845.  Bound. $0  75.
 RUOFF'S Repertory of  Homoeopathic Medicine,  Nosologically arranged.
  Translated  from  the German, by A. Howard Okie, M.D.  2d improved
  edition, 8 vo.   1845.   Bound. $1 50.
 ROKITANSKY, DR. C. Pathological Anatomy, or the Abnormal Conditions
  of the Organs of Respiration.  Translated from the German, with  additions
  on Diagnosis from Shoenlein, Skoda, and others, by  John C. Peters, M.D.
  Large 8vo.   1815.  Stitched. $0 75.
      ITThis important work is the result of his  experience, gained in  the
    careful examination of over 12,000 bodies.
WEBER, DR. M. I.  Anatomical  Atlas of the  Human Body in Natural Size.
  The plates  are on a large scale, the size of life, coloured, and their number
  is 84.   To  these are added a supplement of six new plates, (sold before at
  $40, without the six  supplement plates,) at present limited for uncertain
  time at $25 00.

 CRUVEILHIER, F.  Anatomie Pathologique du Corps Humain, ou descrip-
  tions avec  figures lithographiees et coloriees, des diverses alterations mor-
  bides dont le corps humain est susceptible.  L'ouvrage complet forme 2 forts
  volumes grand in folio avec 233 planches coloriees.   $120 00.

ID" Always on hand a large assortment of Anatomical Atlasses in the English,
  French, and German languages ; also Medical and other works.