A DISCOURSE 
INTRODUCTORY TO A COURSE OF IECTURES 
ON THE 
INSTITUTES OF MEDICINE AND MATERIA MEDICA, 
DELIVERED BEFORE THE 
J*fotr(cal (Elass of tf\t ©tatfcersttfi of Neto ¥orfc, 
AT THE SESSION OF 1841-42, 
BY 
MARTYN PAINE, A.M. M.D. 
PROFESSOR, &c. 
Republished from the “ Boston Medical and Surgical Journal.” 
BOSTON: 
D. CLAPP, JR. PRINTER 184 WASHINGTON STREET, 
1842. A DISCOURSE 
INTRODUCTORY TO A COURSE OF LECTURES 
ON THE 
INSTITUTES OF MEDICINE AND MATERIA MEDICA, 
DELIVERED BEFORE THE 
(Elass of tfjc ©tattositg of Neto ¥or!tt 
AT THE SESSION OF 1841-42, 
BY 
MARTYN PA INE, A.M. M.D. 
PROFESSOR, &c. 
BOSTON: 
D. CLAPP, JR. PRINTER 184 WASHINGTON STREET. 
Office of the Medical and Surgical Journal. 
1842. This Discourse is respectfully dedicated to the MEDI- 
CAL CLASS attending the Session in the New York 
University, for 1841-42. DISCOURSE 
Gentlemen,—It being a part of the duties of my chair to teach you 
the Philosophy of Medicine, I shall endeavor, at all times, to follow the 
simple path of Nature; and in so doing, we shall find nothing but an ad- 
mirable system of design, intimately associated in all its parts, always con- 
sistent, reaching from the rudimentary development of the organic being 
to the ultimate extinction of its laws, whose multifarious phenomena per- 
petually spring from principles which are established in the gem. What- 
ever, therefore, may be the complexities of disease, you have the conso- 
lation of knowing that it is simple in its essential elements, that these 
elements are forever present, and that you will he mainly employed in 
investigating the modifications which they undergo. Here, then, you 
will always stand upon a great and immutable foundation of Nature. 
This will always be your guide, always your point of departure, and to 
this you will always return from your excursions into the paths, which 
radiate from it in conformity with the constitution of the great plan of 
organic life. 
Nature, indeed, is always simple in her fundamental laws. She ab- 
hors a complexity of causes, as much as she is said to do a vacuum. 
The Institutes of Medicine, therefore, and the Philosophy of the opera- 
tion of Remedial Agents, being directly the offspring of the properties and 
laws of organic beings, they, also, must, of necessity, be simple in their 
essential attributes. Hence, it is manifest, that my course of instruction 
will have mutual and intimate dependencies—forming a connected chain 
which cannot be interrupted without impairing the whole. 
But, there are, also, artificial institutes of medicine—such as are not 
recognized by Nature; and which, therefore, consist of a broken series 
of hypotheses, either having no relation to each other, or standing in di- 
rect opposition. From this, it necessarily results that the treatment of 
disease, which is founded upon these hypotheses, is not less unphilosophi- 
cal, not less contradictory of itself, and abundantly demonstrative of the 
primary error. This has been the misfortune of medicine at all ages of 
the art, but, at none more so than in our own times. With these I must 
also make you acquainted, though I shall limit my exposure of error to 
the doctrines of the present day. You will thus enjoy the opportunity 
of exercising your own judgments, and of making your election between 
good and evil—myself allowing that the evil may be mine. 
In adopting this only method of arriving at the truth, my earnest de- 6 
or. paine’s introductory lecture. 
sire to remove some formidable obstacles from your path will necessarily 
give an appearance of asperity where none is intended. It will unavoida- 
bly result from the nature of the contrasts which will be presented ; 
and the importance of our pursuits to the interests of mankind, and to the 
dignity of mind, will permit no complimentary sacrifice to the ingenuity 
of speculations. Truth must be stern and inexorable, to overcome the 
obstinacy of error; for error, like the heads of the hydra, can never be 
propitiated. We may cut off its heads—but still the principle of re- 
generation may remain. We must then come to the actual cautery, as 
employed by Hercules in the case of the hydra, as our only infallible re- 
source. But, in all that I may say, now, or hereafter, I wish it to be 
distinctly understood, that my remarks have no intended application to 
men, but are simply designed for the promotion of truth—of that truth 
which was so beautifully recommended to your admiration, the last even- 
ing, by its “ Professor in Theory and Practice.” 
I shall begin my course of instruction by examining the composition of 
organic beings in both animated kingdoms—though not so much for the 
purpose of acquainting you with the abstract fact, as of presenting a 
series of coincidences at the very foundation of organic beings, which 
irresistibly demonstrate their dependence upon peculiar properties and 
laws, about which all physiology, all pathology, all therapeutics, are im- 
mediately concerned. A knowledge of these vital properties and the 
laws they obey, and which, as of all other existences, we acquire through 
their peculiar and endless phenomena, is fundamental in medicine. They 
preside over all healthy and morbid conditions. The functions, and all 
the products of the living being, are primarily referable to these proper- 
ties. Unlike all other properties or powers of nature, they are suscepti- 
ble of influences from external and internal causes, and are liable to great 
instability. This instability is at the foundation of disease, and of thera- 
peutics—though the latter involves the important constitutional principle, 
that when these properties are diverted from their natural condition, they 
have an inherent tendency to return to their natural standard. 
We have thus before us, in a few words, the simple elements of phy- 
siology, pathology, and therapeutics. They are all immediately concerned 
about one elementary principle, which is manifested under different phases. 
The physiological or natural condition is constituted when the vital pro- 
perties possess their normal state; the pathological, when they are altered 
from their natural condition; whilst therapeutics modifies their morbid 
changes, and places them in a condition to obey their constitutional ten- 
dency to return to a state of health. This they are often able to accom- 
plish without the intervention of art, which never cures, but only places 
nature in the ivay of cure. This is all that can be understood of the 
celebrated vis medicatrix naturee, a most important law appertaining to 
the constitution of the vital properties, but about which much illusion, 
and many extravagancies have prevailed. 
Such, then, is fundamental in medicine. But, however elegant this 
simplicity in the most essential attributes of organic beings, such are the 
natural modifications of the properties of life in the different organs and 
tissues, and such their liability to change from a thousand influences, and DR. Paine’s INTRODUCTORY LECTURE. 
according to the nature of those influences, and although nothing happen 
but under the direction of some everlasting lawr which operates according 
to the existing combination of causes, medicine is, nevertheless, the most 
profound, the most complex, the most difficult of all human pursuits. It 
was once thought to have been only worthy of the gods—and temples 
were consecrated to their disciples. 
But, the vital properties must have their instruments of action, through 
which the functions are performed, the being obtains his growth and nu- 
trition, his secretions elaborated from the universal alimentary fluid, and 
the morbid phenomena carried on. These instruments of action consist 
of the visible organization ; and in every part of this are the vital pro- 
perties implanted. 
It is obvious, therefore, that we can have no adequate knowledge of 
the functions of life, whether healthy or morbid, without a critical fami- 
liarity with the organization through which they are conducted ; and this 
will become more and more apparent as we advance in our inquiries. 
Nor is it alone a general outline of the human mechanism which will en- 
able us to comprehend the arcana of disease, or to apply its appropriate 
remedies. The vital properties are differently modified, in every organ, 
and in the different tissues of each organ, and often in the same parts of 
a continuous tissue, and they are not only constantly liable to different 
influences from remote causes, but according, also, to their natural modi- 
fications in different parts. They must, therefore, be liable to great dif- 
ferences in their results; whether physiologically, pathologically, or the- 
rapeutically considered. We must also be familiar with the sources from 
which the various organic viscera derive their nerves and bloodvessels, 
and how communications are established amongst the organs by these 
and other anatomical connections. 
The most important of these media of communication is the cerebro- 
spinal and ganglionic system, especially the sympathetic branch of it. 
The distribution of the sympathetic nerve should be well comprehended, 
as should also those cerebral nerves which are contributed to important 
vital organs, or others which associate themselves with the sympathetic, 
and thus establish intimate relations between the organs of animal and 
organic life. By these various nervous connections, the harmony of the 
entire machine is maintained, or the equilibrium of the whole disturbed 
when morbific causes may derange the action of one part or another. It 
is also through these connections, particularly, that remedial agents, 
whether applied to the stomach or to the skin, exert their salutary impres- 
sions upon diseased organs which may be remotely situated. The com- 
municating nerves, however, are often complex, and their analysis is not 
always of easy attainment. But, a knowledge of the nerves, with which 
the natural and morbid functions are so intimately associated, is less im- 
portant than that of the general tissues which compose each vital organ. 
The peculiar properties of the nervous system, which are known as sen- 
sibility and sympathy, have no other participation in organic processes 
than as they influence those processes. The nervous power is to be re- 
garded in the light of a vital stimulus, and regulator of the organic func- 
tions—sensitive to an inconceivable degree, and whilst itself a vital stimu- 8 
DR. Paine’s INTRODUCTORY LECTURE. 
lus, is capable of being acted upon and modified in its nature; but ope- 
rating in health without any remarkable demonstrations. But, its,consti- 
tutional nature is such for the maintenance of uniform and harmonious 
movements throughout the animal fabric, that when influenced by unusual 
causes, it may undergo a violent development, become modified in its na- 
ture, and may determine healthy or morbid changes in the organic pro- 
perties, or extinguish them in the twinkling of an eye. 
1 was not a little gratified at the manner in which our Professor of Sur- 
gery adverted to the prodigious results which are destined to flow from 
the discoveries of Sir Charles Bell ; and 1 will go perhaps even farther 
than he, and anticipate the time when those discoveries will be to medi- 
cine what the calculus is to mathematics. Encouraged by the brief, but 
comprehensive and philosophical reference which was made on Monday 
evening to the principles which are involved in this great triumph of 
physiology, 1 will also venture to predict, that the doctrine which 1 have 
just propounded for the first time in relation to the modification of the ner- 
vous power, will open to us the whole philosophy of remote sympathy in 
connection with pathology and therapeutics. It opens to us the whole 
philosophy of the operation of morbific and remedial agents upon organs 
that are remotely situated from the direct seat of their application. This 
supposed modification of the nervous power is in perfect harmony with the 
instability of the organic properties themselves, and is not only sustained by 
the whole force of this analogy, but by all the phenomena that relate to 
the principle of remote sympathy. That you may, however, the better com- 
prehend what I regard as modifications of the nervous power, according to 
the nature of the agents or causes by which it is developed, whether natural, 
morbific, or remedial, you have only to consider, farther, how electricity 
is modified by the galvanic apparatus, and how again by the organization 
of the torpedo; how each affects in peculiar modes the properties of 
life, or how each determines peculiar influences upon inorganic substances ; 
or how, again, perhaps, the magnificent conception may have been de- 
monstrated by our Professor of Chemistry, that the colorific, the calorific, 
and the deoxydizing rays of light are only modified states of a common 
substance. Think, also, of the wonderfully different attributes of each 
of these rays, and you will then have no difficulty, with the aid of the 
multifarious phenomena of sympathy, and the cerebro-spinal and ganglio- 
nic system, in comprehending how this poison or that, or this remedy or 
another, or joy or grief, shall so develope and modify the nervous power, 
that it shall be directed upon, and alter the organic properties of parts 
that are distant from the direct seat of the morbific or remedial action, in 
one case in one way, in another case in another way. 1 know of no ex- 
ception to the theory, and without it you cannot explain the remote in- 
fluences of remedial agents; whilst this construction of their modus ope- 
randi is in perfect harmony with the natural phenomena of sympathy. 
But, what may be the nature of the nervous power, or of the organic 
powers, no one can divine, any more than he can imagine the ?iaturc of 
the most tangible and ponderable substance. But this does not prevent 
us from knowing the existence of the substances, and their laws, and that 
each is radically different from the others. DR. Paine’s INTRODUCTORY LECTURE. 
9 
The practitioner, however, may come to acquire, by a diligent observa- 
tion of nature, an adequate apprehension of the vital influences which one 
part exerts upon others, without knowing, in detail, the special media of 
communication. But, his knowledge of these influences is vastly facili- 
tated by anatomical acquirements, pursued with a reference to this funda- 
mental point; and without this anatomical aid, conviction is slow, and 
success can only be obtained by a long and careful study of the pheno- 
mena of life, under their varied aspects of health and disease. This labor, 
too, with tlie best anatomical proficiency, must be always great before the 
laws of sympathy can be justly realized in their variously modified rela- 
tions, or in their practical bearings. 
Rare genius may analyze the phenomena of disease, often reduce 
them to generalizations, and apply the appropiatc remedies, without, 
perhaps, understanding the details of structure. We have examples of 
this nature among the fathers of medicine, of whom none is so remarkable 
as he who created the science, and expounded that system of rational 
philosophy, which, at a distant age, was consecrated by Bacon, and has 
since given to arts and sciences an impulse which is carrying them fast 
to the limit of any rapid improvements. But, though it be easy to ad- 
mire the genius which creates a science, we may not imitate it. Most of 
us must be contented to study its elements, and to advance, step by step, 
before we can grasp the principles already known, and reduce them to 
practice. Such, at least, has been my own laborious experience ; slowly 
gathered in the field of nature—or by consultation with others—or by un- 
wearied meditation. We must come, therefore, to the work of prepara- 
tion, not only with resolute purpose, but with a zeal that shall maintain 
that purpose. 
Although anatomy is at the foundation of practical medicine, it is only 
that of the great vital organs with which the physician is particularly in- 
terested ; and yet these are the ones which are most apt to be neglected. 
Such as relate to that division which is called animal life, the muscles, for 
instance, is to him comparatively unimportant. It is here that the sur- 
geon holds his empire, and to him this branch of anatomy is not less indis- 
pensable than the former is to the physician. The mere operative sur- 
geon may practise his art without knowing whether the stomach be com- 
posed of one or more tissues—whether it be seated in the abdomen or 
in the thorax. And with all this ignorance, he may acquire a far greater 
temporary renown by a stroke of the knife, than the most consummate 
philosopher in medicine. But he, who would embrace in the range of 
his usefulness the more exalted art of treating surgical diseases, and who 
prefers the conservative efforts of nature to the more summary process, 
must be skilled in the whole department of anatomy, and in the divina- 
tion and cure of internal disease. So, will you be told by one whom 
the world delights to honor. 
Considering, therefore, gentlemen, the importance of anatomy to your 
practical pursuits, I trust you will spare no effort in making an attainment 
which will exalt you above the ordinary grade of practitioners, and which 
will bring you a daily recompense in the conviction that your knowledge 
of disease reposes on one of the great foundations of nature—that your 10 
dr. paine’s introductory lecture. 
remedies are directed to an intelligible purpose, and, whether the issue be 
favorable or fatal, that you may equally rejoice in the consciousness that 
you have been guided by an enlightened understanding of the art, or that 
your efforts have not been frustrated by the imbecilities or the rashness 
of ignorance. 
We are now conducted to the immediate objects of inquiry in my lec- 
tures ; the first of which is physiology in its relations to the natural con- 
dition of organs. This is the beginning of a vast superstructure, which 
has been the progressive work of many ages, and which, more than any 
other pursuit, has enjoyed the laborious efforts of genius, and the un- 
wearied toil of a great, though humbler class of mankind. 
From physiology, we ascend to its application to pathology, and thera- 
peutics ; which, in their connected series, make up the vast fabric that 
reposes upon the structure of organs. 
Physiology, according to its Greek derivation and original import, em- 
braces the whole field of nature. The moderns, however, have restricted 
the word to the science of life. In this acceptation, it comprehends all 
that relates immediately to the powers and functions of organic beings. 
It takes in, therefore, the whole vegetable, as well as the animal kingdom. 
Each of these kingdoms possesses in common the most important condi- 
tions of life, though existing in each under specific modifications or varie- 
ties ; not, however, very dissimilar, and intimately connected by a grada- 
tion of analogies, as we descend along the chain of either till we come at 
their connecting link in the lowest being of one or the other—as the 
sponge, for instance, which has enjoyed the distinguished honor of having 
been successively assigned to the three kingdoms of nature, and of being 
now exalted to the dignity of an animal. Other conditions are super- 
added to the nobler kingdom, which, with the differences of structure, 
and the modifications of their common properties of life, and their modes 
of subsistence, distinguish the two living kingdoms from each other. I 
shall enter largely into the consideration of these topics, as all rational 
medicine is intimately concerned with their knowledge. The importance 
which I have attributed to anatomy is predicated of these ulterior objects. 
It would be in vain that you comprehend the structure of organs, without 
knowing the nature of the powers and functions which they subserve, 
and the laws which they obey ; since all diseases consist essentially in 
certain alterations of the properties of life, which lead to all the modifi- 
cations of the laws and functions, and to every sensible result of a morbid 
nature. A knowledge of the whole is obtained through the phenomena 
as they are presented to our senses, and by nothing else. From these, 
we reason to the invisible existence, its changes, &c., with as much cer- 
tainty as to those which possess the most tangible characteristics. It is 
just so in respect to the mind, and the brain with which it is associated, 
whether in their natural or morbid aspects. 
Since, therefore, every disease consists fundamentally in some alteration 
of the properties of life, you will at once perceive that physiology is the 
most important element of medical education. Its knowledge necessarily 
involves that of anatomy, and all practice, which does not constantly re- 
fer to the tissues diseased and to the modified conditions of the vital pro- DR. Paine’s INTRODUCTORY LECTURE. 
perries, is purely empirical. Empiricism, however, may be of an en- 
lightened nature under the direction of rare genius; but, in all other 
hands, it embarrasses nature, and is a curse to mankind. Ol’ this you 
will meet with demonstrations in your professional intercourse. You 
will also occasionally witness the triumph of mind over the most absolute 
defects of education. In all such instances, however, you will see it 
glancing at tlie whole array of symptoms, and forming its conclusions 
from nicely balanced combinations of the whole with that store-house of 
experience which is garnered up as a necessary guide to the solution of 
every new problem. These problems are as various as every case of 
disease, and as every variation it may undergo during its decline, or in its 
advances to a fatal termination. Thence is it, that without our funda- 
mental requisites, genius, combined with observation, must be often at 
fault; and it may be difficult to say whether its success will compensate 
for its failures and mistakes. 
But, qualifications of this order are rare examples, and the most usual 
consequences of deficiency in anatomical and physiological acquirements, 
are the most appalling ignorance of disease and a frightful destruction of 
human life. 
Let us call up another large and better class of practitioners—educated, 
and often erudite men, but who make not a proper application of their 
knowledge—as was well said of Broussais, on Monday evening. The 
special evil with this class, if we except the Brousspians, consists,in not 
regarding the properties of life as they are naturally modified in the va- 
rious textures of the body, and in not considering disease as consisting 
essentially in morbid alterations of these properties. This class embraces 
many of the most distinguished men of our age, and their train of follow- 
ers, especially in Europe, makes up no small part of the profession. 
They have generally but an imperfect apprehension of the properties of 
life, and whilst they allow of their existence—nay, more, whilst many 
of them maintain the extraordinary doctrine of their existence in the 
elemenls of matter, by the strangest contradiction, and in violation of 
that fundamental principle in which prohibits an unnecessary 
multiplication of causes, they maintain that all the great vital processes, 
all the secretions, &ic., are carried on by the forces which govern dead 
matter, and of which the chemical are supposed to be mainly instrumental. 
This doctrine shuts out, of course, all true pathology ; and yet are 
these the philosophers who are now most ardently engaged in developing 
those lesions of organization which result from morbid processes, but in 
the production of which it would seem to be sufficiently obvious that to- 
tally different causes have been concerned, than such as prevail in the 
inorganic world. Many of them have also gone back to an opinion 
which prevailed in the dark ages, that all disease consists essentially in 
a primary lesion of organization, but without revealing to us any more 
than their benighted ancestors, how those changes of structure come to 
pass. But, as if for the purpose of multiplying causes, and of placing 
them in the same relative contradiction in which they have arrayed 
the vital and chemical forces, they have also gone back to the humoral 
pathology, and whilst they tell us that the essential cause of disease con- 12 
DR. Paine’s INTRODUCTORY LECTURE. 
sists in a lesion of organization, which is independent of all agency of 
the vital properties and of the forces of chemistry, t hey also affirm that 
its essential cause consists in a vitiated state of the blood. 1 will not now 
tell you of the practical conclusions which have been founded upon this 
utter confusion of causes. 
The 'physical doctrines of life have had their sway at various eras, 
though especially characteristic of our own age; and the humoral pa- 
thology had been an appendage of almost every system till the beginning 
of the last century. It was then that solidism began to rise with the 
radiant beams of that vitalism which gave animation to medicine from 
Hippocrates to Celsus, and before which the humoral pathology was but 
as a withered weed, until finally, after many centuries of stinted growth, 
it was plucked up and forgotten. The appearance of Hunter and Bichat 
swept away every vestige of that philosophy which had so often disfigured 
the science of medicine. Tiedemann, and other illustrious vital physiolo- 
gists, followed in the wake. Tou may know their philosophy by a 
single passage from the great German physiologist. “ Already,” he 
says, “ it has been more than once attempted to deduce life from the laws 
of mechanics, physics, and chemistry. This error has been committed,” 
he goes on, “ by physiologists and physicians of the iatro-mathematic 
and iatro-chemical schools. But. in every age, distinguished naturalists 
discovered this error and opposed it.” 
“ Amon g physical people,” says Hunter, “we find such expressions 
in common use, as, the humors are affected in the blood ; sharp humors 
in the blood; the whole blood being in a bad state; the whole blood must 
be altered, or corrected; and a variety of such expressions, without mean- 
ing. They even go so far as to have hereditary humors, as gout, scro- 
fula, &tc., and make us the parents of our own humors, saying that we 
breed bad humors. In short, the whole theory of disease has been built 
upon the supposition of humors in the blood, or of the blood itself being 
changed. 1 cannot conceive,” he adds, “ what is meant by it.” But, 
what Hunter avows he could not comprehend, is now consecrated as 
the science of medicine. 
But perhaps Hunter was dull of apprehension, though he studied or- 
ganic nature more extensively, and more laboriously, than any other man, 
before or since. If we consult the opinion of Bichat upon the same 
physical doctrines of life and disease, we shall still find that their successors 
are apt to consider dulness of apprehension to exist in the ratio of 
genius and observation. 44 To what errors have not mankind been led,” 
says Bichat, “ 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 humors prevailed. The 
expressions of diluents and attenuants were common before this period. 
When it was necessary to blunt the acrid particles, they created invis- 
cants, incrassants, &,c. Those who saw in diseases only a relaxation or 
tension of the fibres, the laxum 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 ex- 
cess or deficiency of caloric. The same identical remedies have been DR. PAINe’s INTRODUCTORY LECTURE. 
13 
employed wilder different names, according to the manner in which they 
were supposed to act. Deobstruent in one case, relaxant in another, re- 
frigerant in another, the same medicine has been employed 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 wildness of opinion.” 
But, what Bichat thus describes as having only successively prevailed 
at different eras of medicine, is now bodily incorporated into the science, 
and constitutes, in Europe, especially, its whole essential feature. Were 
this kind ol medicine truly founded in nature, you readily perceive that 
it would be useless for me to do more than simply to slate the facts, and 
that my course of instruction might properly terminate with this introduc- 
tory lecture. There would be no principles, no institutes, no laws, no 
variety to expound ; and we might lie down at once with Brandreth and 
Morison. 
Bichat, having drawn the portrait of his predecessors and of many co- 
temporaries, which I have just exhibited to your observation, is then led to 
apostrophize:—“Hence,” he says, “the vagueness and uncertainty our 
science presents at this day. An incoherent assemblage of incoherent 
opinions, it is, perhaps, of all the physiological sciences, that which best 
shows the caprice of the human mind. What do 1 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.” 
Such, then, was also Bichat’s obtuseness of apprehension. But, gen- 
tlemen, neither Hunter, nor Bichat, nor Tiedemann, nor any of their 
great compeers in the investigation of nature, w'ere the dunces which the 
hypotheses of our own day would declare them. An Augean work was 
then accomplished by a stream which may be now and then obstructed, 
but which will forever break up the barriers, and sweep away the offals 
that may accumulate in the dry channel below. 
Hunter expounded, more amply than his predecessors, the doctrines of 
life, and founded upon them the only true systems of pathology. His 
masterly analysis of inflammation exemplifies the whole range of disease, 
and its philosophy lies at the foundation of the whole ; though I by no 
means intend to imply that all diseases are inflammatory. But, if it be 
true that inflammation is essentially constituted by morbid changes of the 
vital properties and functions, then may the same affirmation be made of 
every other deviation from a state of health. This will be rendered ap- 
parent hereafter, when I come to speak at large of the laws and the 
analogies of nature. It was Hunter, also, who first disclosed the modifi- 
cations or peculiar conditions of the properties of life in their relation to 
different organs, and the different tissues of the same organ. 
Scarcely had this extraordinary man disappeared, when Bichat took up 
the great subjects, and carried the whole world before him. His doctrine 
of life, and the pathology which is founded upon it, recognizes no physical 
agencies beyond those foreign causes which maintain the vital powers in 
operation, or which convert them from their natural to morbid conditions. 
He analyzed the vital principle more extensively than had been done by 
Hunter, and though deeply indebted to this philosopher, he pays no tri- 14 
DR. Paine’s INTRODUCTORY LECTURE. 
bute to bis unexampled labors or bis exalted services. But nothing can 
impair the claim which mind establishes to its own property. It is as im- 
mortal as the spirit which gives it birth ; and though it be for ages entw in- 
ed in the laurels of others, it will ultimately light on the memory of him 
who enriched mankind in enriching himself. 
Bichat, however, makes the capital and contradictory mistake, like 
most other vitalists, of regarding life as an effect, or as consisting of the 
assemblage of those phenomena which result from the operation of the 
vital properties, in their connection with the instruments of action. This 
construction, as we shall see hereafter, is not only philosophically wrong, 
but practically bad. If, for instance, life be made up of the functions of 
organization, we should regard disease with a simple reference to the 
functions, and these are so clearly effects, there would be no tangible 
cause through which our remedies might operate, whilst no office ap- 
pears to be assigned to the admitted vital properties. But, as there must 
be clearly something altered from its natural state anterior to functional 
derangement, we must allow that the primary cause consists in a change 
of the properties which preside over the functions. 
Bichat, however, was sometimes inconsistent, and perhaps more so 
upon the great subject before us than upon any other; for, although he 
endeavors to show that life is constituted by the functions, he argues that 
disease (which is only an unnatural state of life), is constituted by a mor- 
bid change of the vital properties. Nay, in the following extract he makes 
life itself to consist in the vital properties, and regards the functions merely 
as effects, of which the vital properties are the cause. Thus :— 
“Examine,” he says, “all the physiological and all the pathological 
phenomena, and you will see that there is no one which cannot be ulti- 
mately referred to some one of the vital properties of which I have just 
spoken. The undeniable truth of this assertion,” he goes on, “ brings 
us to a conclusion not less certain in the treatment of diseases—namely, 
that every curative method should have for its object the restoration of the 
altered vital properties to their natural type. Every remedy, which, in 
local inflammation, does not diminish the augmented irritability; and 
which does not. diminish animal contractility in convulsions, and elevate it 
in paralysis, fails in its object, and is contraindicated.” 
Here, then, Bichat teaches the philosophy which will be fundamental 
in my lectures. It was essentially at the foundation of all his pathologi- 
cal writings ; and it is therefore the more remarkable that he should have 
been so speculative and contradictory when treating specifically of life. 
Bichat’s career was brilliant, and though dead at 31, he lived, like 
Hunter, to enjoy the ripest fame. He was, however, but a meteor-light; 
dazzling for a moment, and then extinct. He was one of the last of a 
galaxy, who had so illuminated the field of medical philosophy, as left 
but little else for the aspirations of ambition—following the beaten path of 
nature—than to accumulate facts and to arrange them under established 
principles. This occupation is too humble for the restive ardor of genius, 
and too servile for the purposes of renown ; and facts had already amount- 
ed to an encumbrance. It is not, therefore, remarkable, that when the 
great work had been brought near the verge of completion, giants should DR. Paine’s INTRODUCTORY LECTURE. 
15 
spring up to overthrow the fabric, and erect a new edifice upon its ruins. 
The revolution began simultaneously in different parts of Europe, and 
under different aspects. But, so many powerful and ambitious minds bad 
been in operation for ages, ingenuity had not only exhausted fundamental 
principles, but every imaginable hypothesis. The former being the last 
in the series, it only remained to reproduce exploded and forgotten doc- 
trines. The most important of these were the physical and chemical 
doctrines of life, and the humoral pathology. Chemistry, too, was now 
in the ascendancy amongst sciences ; and the brilliant discoveries which 
it was pushing in the inorganic world promised a harvest of fiction, if not 
ol fact, in behalf of the crude hypotheses of darker ages. Physiologists, 
therefore, became practical chemists, and chemists became speculative 
physiologists; and for more than twenty years past, the study of organic 
life, and the philosophy of disease, have been mainly carried on in the 
test-glass and crucible. The blood, the secretions, and every part of the 
animal fabric, have again and again passed the ordeal of the laboratory, 
in the vain expectation of discovering the springs of life, or the essence ol 
disease. The laboratory now copes with nature in its artificial compounds 
for the digestion of food, and the very furnace is brought into operation to 
manufacture a fluid which, it is pretended, is not inferior to that product 
ol the stomach which results from an organization as various as the spe- 
cies of animals, and according to their habitudes in respect to food, and 
whose contrivance for this specific, variously modified, vital fluid, required 
the Mind of an Almighty Being. And this is but a fair example of the 
modest ambition of chemistry. 
But, who are the philosophers that thus invade the sanctuary of life ? 
Learned, laborious, and useful ; but are they familiar with organic beings ? 
Do they study their phenomena ? Can they tell you a stomach from the 
bladder, when both are before them ? Can one in a thousand distinguish 
pneumonia from enteritis? The replies are too obvious to be stated. 
They live in the laboratory, which, in their estimation, monopolizes all 
the vitality that is worth a philosopher’s attention. They will solve you 
any of the most hidden secrets of organic beings. Are you curious to 
know how the various unique constituents of the bile are elaborated out 
of blood ? Nothing, say they, is easier. Here are they all—picromel, 
cholesterine, asparagin, ozmazome, resin, bovin, oleate, acetate, margarate, 
cholate, bicarbonate,.phosphate, sulphate and hydrosulphate of soda, pot- 
ash, &.c.—all here in the blood—when, in simple truth, not one of them 
have an existence in that fluid. So is it admitted by some of the che- 
mists, and so is it proclaimed by the laws of organic beings. They are 
no more in the blood than -is the poison of the viper or the ink of the 
cuttle fish. 
Then the admirable simplicity of the manner in which we are told 
these exact constituents are separated from the blood to make up the bile 
—whose final causes illustrate so strikingly the evidences of design, is 
worthy our special notice ; though it may be rationally supposed, that 
since the constituents are assumed to exist in the blood, it is also assumed 
that they are merely mechanically strained off by the liver; whose or- 
ganization is as various and as specific as the hundreds of thousands of 16 
DR. Paine’s INTRODUCTORY LECTURE. 
animals whose species are distinct. It was undoubtedly owing to pre- 
vailing doctrines of this nature, that many distinguished chemists, whom 
I have quoted on another occasion,* have let slip the severest censure of 
the chemical and physical doctrines of life—even such as practise organic 
chemistry in defiance of their acknowledged and direct opinions to the 
contrary. They universally allow, indeed, that “ the laws of inorganic 
chemistry are utterly inapplicable to the phenomena of lifeand that, 
though “ there is a chemistry of life, of that chemistry we know nothing.” 
It is therefore all assumption; and this reputed “chemistry of life,” of 
which it is admitted the chemist “ knows nothing,” is exactly the thing 
of which the physiologist professes to know something. 
Confining ourselves to philosophers who are entitled to our profound 
respect, you will readily concede that Bichat comes far within the limit 
which is here prescribed, and that his opinion should also weigh in pro- 
portion to the decision with which it is given. Let us, then, hear the 
great French philosopher. 
“ The organic chemistry of the laboratory,” he says, “ is the dead 
anatomy of the fluids, not a physiological chemistry. The physiology 
of the fluids should he composed of the innumerable variations which 
they experience according to the different (vital) states of their respec- 
tive organs.” “ The instability of the vital powers is the quicksand on 
which have sunk the calculations of all the physicians of the last hundred 
years. The habitual variations of the living fluids,” he adds, “ depen- 
dent on this instability of the powers of life, one would think, should be 
no less an obstacle to [he chemical physicians of the present age.” 
“ Again, had physiology been cultivated by men before physics, I am 
persuaded that many applications of the former would have been made 
to the latter. Rivers would have been seen to flow from the tonic action 
of their banks, crystals to unite from the excitement which they exercise 
upon their reciprocal sensibilities, and planets to move because they mu- 
tually irritate each other at vast distances. All this would appear unrea- 
sonable to us, who think of gravitation only in consideration of these 
phenomena. And why should we not in fact be as ridiculous when we 
come with this same gravitation, with our chemical affinities and chemical 
compositions, and with a language established upon their fundamental 
data, to treat of a science with which they have nothing whatever to do. 
Physiology would have made a much greater progress, if all those who 
studied it had set aside the notions which are borrowed from the accessory 
sciences as they are termed. But these sciences are not accessory ; they 
are wholly strangers to physiology, and should be banished from it wholly.” 
“ To say that physiology is made up of the physics of animals, is to give 
a very absurd idea of it. As well might we say that astronomy is the 
physiology of the stars.” 
It has ever happened, as an inevitable consequence of the fundamental 
alliance between healthy and morbid processes, that, whenever chemistry, 
or physics in a more general sense, has invaded organic nature, the phi- 
losophy of disease and of therapeutics has followed in abject submission. 
* See Medical and Physiological Commentaries, Vol. 1st, pp. 36—40,75, etc. Vol. 2, p. 114—122, etc. DR. Paine’s INTRODUCTORY LECTURE. 
17 
I cannot now conduct you through the astonishing details, which, taken 
one by one, would show you that organization—aye, that intellectual 
being whose divine portrait was so vividly drawn on Tuesday evening— 
is practically regarded, as it is theoretically pronounced, a mere chemical 
laboratory,* composed of tubes of various calibre, amenable to the laws 
of chemistry, which, it is imagined, may yet be imitated by the hand of 
man, and that with the aid of the vital properties in the elements of mat- 
ter (and of course, by analogy, the soul also), whose primeval existence 
in this relation is maintained for contingent purposes, the confident hope 
is promulgated that the laboratory will yet be able to exert the highest 
Prerogative of Creative Power. Already, indeed, it has been given out, 
ex cathedra, that nothing is easier than the accomplishment of digestion 
by artificial mixtures, in the preparation of which, as I have said, the 
furnace is sometimes instrumental—that nothing is easier than the artifi- 
cial fabrication of those organic compounds which are elaborated by an 
unfathomable organization that was designed for this specific purpose by 
the Divine Mind—but, not till the alimentary material has been vitally 
decompounded and its elements recombined in a mysterious manner by 
the gastric juice—then subjected to the farther organizing effects of the 
bile and other organic products—passed through the wonderfully vivify- 
ing lacteals—carried forward and subjected to the whole animating influ- 
ence of the pulmonary system—perfected in its exalted endowments by 
the whole labyrinth of the circulatory organs—and lastly, though not least, 
determined from the blood in one everlastingly exact manner by other 
complex living systems—but how, no imagination can form the most re- 
mote conception, but through the instrumentality of those specific proper- 
ties of life, which were the only power concerned from the beginning 
to the ending of the astonishing series of unvarying changes;—and, as 
might be inferred from the utterly groundless pretensions, aspirants have 
lately appeared with animals, composed of nerves, stomachs, respiratory 
organs, eyes, ears, instinct, &c.—both male and female, as on a former 
occasion, and now, as then, made out of the elements of matter—though 
in the modern case, galvanism is the creative spirit. These offsprings 
of the ingenuity of man, it is true, after having been duly added to the 
trophies of chemical science, were ultimately suspected of having been 
the work of another Pow'er, and even by those philosophers w'ho embla- 
zoned their scientific journals, in Europe and in America, with pictured 
illustrations of these supposed creations of the laboratory, and who 
once “ saw that it was good ” But, l will not neglect saying, that the 
pretended creation, independently of the living organization, of any one 
real organic compound, however simple, is not less fallacious, and arro- 
gant, and irreverent, than was the pretended creation of insects out of 
silex by the spirit of galvanism. 
I shall not farther speak of the moral and religious tendencies of these 
speculative invasions upon nature. They must be sufficiently obvious 
to every reflecting mind ; however they may be offensive to one, or ad- 
mired by another. My present interest lies in their philosophical merit, 
* See my Medical and Physiological Commentaries, Vol. I., p. 36. 18 
DR. Paine’s INTRODUCTORY LECTURE. 
and in their practical bearing upon health and disease. They are up- 
rooting every intelligible principle which relates to the former, and are 
converting the latter into the confusion of chaos. The humoral patholo- 
gy, especially, has ranged itself under the auspices of the all-potent 
science; and, although as wide spread as Christendom (if we except the 
common empiric who has never relinquished his hold upon the same doc- 
trines as taught during the long decline of medicine in the dark ages), 
its modern ascendancy has been, as it were, the work of a day. Davy, 
having accomplished his wonderful discoveries in the mineral kingdom, 
the credulous, the zealous, or the ambitious, built upon these achievements 
a hope that something would turn up for the benefit of a favorite hypothe- 
sis in medicine, or something for the advancement of reputation. The 
world was crowded, beyond example, with learned men, and with an in- 
terminable audience—constituted morally and intellectually just as they 
were when Pope wrote his “ Essay on Man ” and the “ Temple of 
Fame,” and that other delineation of men and manners, which is called 
the “ Dunciad.” 
After a long and laborious investigation, however, of the imputed con- 
nections of chemistry with organic philosophy, I have seen no reason to 
qualify the declaration which I have more publicly made, that I know of 
no solitary fact contributed by chemistry, which has thrown a ray of 
light upon the philosophy of life or the arcana of disease ; and, as con- 
curring in this sentiment 1 have been most happy to refer to the opinion 
of my learned associate who presides in the inorganic kingdom, and who 
so justly surrenders to the physiologist an interpretation of the living de- 
partment of nature. We may therefore hope for an enlightened co-ope- 
ration from this philosopher, in my efforts to place you on the right road 
of inquiry, should he think it sometimes expedient to travel out of his in- 
organic dominions to regale himself at the fountain of life. I shall 
therefore have less hesitation in speaking of the illusory and seductive na- 
ture ol the experiments in organic chemistry, and more especially of their 
application to the laws of organic beings—so seductive, indeed, that they 
beguile our senses, and cheat us of our understandings. You must look 
upon all these doings as upon the arts of legerdemain—apparently real, 
but most grossly deficient in their pretended elements. Notwithstanding 
the recent triumphs of chemisty in the inorganic kingdom, and the vast 
multiplication of its powerful resources, it has left the whole science of 
life and disease just where it abandoned them when it was in a compara- 
tive infancy—or, with only the difference in the relative amount of error, 
and the exertions which are now necessary to its exposure and defeat. 
But, of this subject I shall speak more fully hereafter, and shall only 
now add for the purpose of securing your attention to the important 
questions before us, that the farther chemistry pushes its investigations, 
the more it multiplies proofs that the whole subject of life and disease 
belongs to another department of philosophy. We find, indeed, that 
chemistry is everywhere against the hypotheses which have been founded 
upon its own principles; and, in this negative sense, it will have greatly 
contributed to the science of life. All that is now necessary to obtain 
the full benefit of the light which has been thus reflected, is the permis- DR. Paine’s INTRODUCTORY LECTURE. 
19 
sion of chemists that it shall take its natural direction. But, it has been 
said with a justice applicable to all ages, that “every new system of 
philosophy, true or false, must be embraced and introduced into medical 
science.” Asclepiades explained all by the Epicurean or corpuscularean 
philosophy ; Galen and his disciples by the philosophy of Aristotle; 
another eminent sect by the mechanical philosophy of Newton, who, says 
Bryon Robinson, “ discovered the cause of muscular motion and secre- 
tion, and furnished materials for explaining digestion, nutrition, and res- 
piration ”—whilst Sir Humphrey Davy and numerous followers also 
think it “ possible that one law alone (of a physical nature) may govern 
and act upon all matter; a law,” continues the great chemist, “which 
might be called the law of animation.” Hence, it was well said by 
Bichat, that “ chemists and mechanical philosophers, accustomed to 
study the phenomena over which the physical forces preside, have car- 
ried their spirit of calculation into the theories of the vital laws.” The 
principle is well exemplified by the metaphysician, Dr. Reid, who says 
that “ Mr. Locke mentions an eminent musician, who believed that God 
created the world in six days, and rested on the seventh, because there 
are but seven notes in music. I myself,” the Doctor continues, “ knew 
one of that profession who thought that there could be only three parts in 
harmony, because there are but three Persons in the Trinity. A chemist 
imagined that he had the felicity of having discovered a principle (not 
that of Newton’s or Davy’s), which would expound all the phenomena 
of organic beings. The physiologist, after listening to his philosophy, told 
him that there was but one circumstance adverse to his discovery, which 
was, that the physiological facts were all exactly the opposite of what he 
had supposed. The chemist then begged the physiologist to state what 
the facts were, that he might explain them by his system. And, to the 
same effect we have the opinion of Lord Bacon, who says of Cicero, 
that “he went about to prove the sect of Academiclcs to be the best; 
for, saith he, ask a Stoic which philosophy is true, he will prefer his own. 
Then ask him, which approacheth next the truth, he will confess the 
Academiclcs. So deal with the Epicure, that will scarce endure the 
Stoic to be in sight of him ; so soon as he hath placed himself, he will 
place the Academicks next him.” The reasoning of Cicero is as good 
for the physiologist as for the Academicks—for so soon as the iatro-chemical 
or the iatro-mechanical philosophers have placed themselves, each, and all 
other sects who build up a spurious philosophy of life, will place the 
physiologist next. 
The metaphysician, Brown, admonishes us emphatically against the 
propensity of carrying the theories relating to favorite pursuits into other 
sciences. And thus, Lord Bolingbroke, as if in rebuke of Reid, and 
Locke, and Brown :— 
“Metaphysical writers,” he says, “counsel us sometimes very gravely 
to silence imagination, that we may attend to experience, and hearken to 
the voice of reason. The advice is good, and they would neither puzzle 
themselves, nor perplex knowledge, if they took it as they give it.” 
This is the evil ; and as well said by Mr. Lawrence, “ what we are 
to guard against in our professional researches and studies, is the influence 20 
DR. Paine’s INTRODUCTORY LECTURE. 
of partial and confined views, and those favorite notions and speculations 
which, like colored glass, distort all things seen through their medium.” 
We must build upon facts, and facts alone. Nor is this all that is neces- 
sary. We must have the last as well as the first in the series ; for the 
last fact may be necessary to determine the proper application of the 
whole, and establish a sound generalization, or theory as it is called. 
Hypothesis, on the contrary, rests upon a partial array of facts ; and this 
is the reason that, whatever is hypothetical grasps at a thousand shadows, 
and perverts a thousand realities. But, in no inquiries is the mind so apt 
to go astray, and to carry its hypothetical conclusions into other depart- 
ments of nature, as in the science of chemistry. Here, everything seems 
demonstrative, and yet everything may be essentially deceptive. The 
enlightened chemist will confess you this ; and whilst he fears that the 
fabric of inorganic chemistry may be overthrown, he hopes to be more 
permanently associated with organic nature. That he is right in his fears, 
every day is supplying proof upon proof. Sometimes the proof is posi- 
tive, sometimes negative; and of the latter we have just had a remarka- 
ble exemplification in the proclamation by the celebrated Professor Chris- 
tison, that he had converted the compound substance known as cyanogen, 
and renowned for the mischief it has done in organic philosophy, into the 
simple element called silicium, and which is not only a simple substance, but 
utterly different from either of the elements of cyanogen. This is only 
an exemplification of the bold positions which are now rapidly taken by 
chemical philosophers; and, had it turned out as represented by the pro- 
fessor, it would have struck a fatal blow at every principle in chemical 
science. Indeed, upon the strength of this supposed metamorphosis of 
nature, a learned friend told me that it was not in)probable that the hal- 
cyon days of alchemy were about to be realized in a substantial manner, 
and that we should soon have our furnaces for the transmutation of iron 
into gold, and the famous “ tincture of all-flowers ” into the never-failing 
“ elixir of life.” 
It therefore ceases to be remarkable, that chemistry should have pushed 
for laurels far into the labyrinth of organic life. The perpetual blast of 
the furnace, however, the frequent jeopardy of life and limb from explo- 
sive mixtures, and the pursuit of other devices by day and by night, to 
turn the whole organic kingdom into the laboratory, can leave no doubt 
that what may have been originally the prompting of ambition grows into 
enthusiastic delusion. We see, therefore, the puzzle of the philosopher 
who “ observed to Crito how unaccountable it was, that men, so easy to 
confute, should yet be so difficult to convince. Make a point never so 
clear, it is great odds that a man, whose habits and the bent of whose 
mind lie in a contrary way, shall be unable to comprehend it.” Never- 
theless, “ we have among us moles that dig deep under ground, and 
eagles that soar out of sight. We can act all parts, and become 
all opinions; putting them on or off with great freedom of wit and 
humor.” 
But, is there no fundamental guide which may enable the inquirer after 
truth to perceive, at the glance of an eye, the wide gulf which separates 
chemistry from physiology ? A gulf so vast should be everywhere stud- DR. Paine’s INTRODUCTORY LECTURE. 
21 
ded with insignia in all its surrounding outskirts. I have already told 
you of many ; but 1 will now show you the gulf itself. 
Inorganic nature is at rest. Its great characteristic is vis inertia. Here, 
then, are no phenomena to denote the forces and law's by which its inter- 
nal constitution is governed. But, it so happens that chemistry may set 
its forces in motion, overthrow' its composition, examine its elements, and 
elicit a train of phenomena which declare its fundamental laws and forces. 
These, therefore, are proper and necessary experiments, since they are 
concerned with the forces of nature, and are the only mode by which we 
can reach their phenomena. 
Let us now turn to the other side, and see how it is with organic na- 
ture. In all things exactly the reverse. Here, everything is in mo- 
tion—in creative motion. Its powers and laws are open to the observa- 
tion of all, through their perpetual and endless phenomena—and to which 
there is nothing remotely analogous in those results which are obtained by 
the chemist when he sets in motion the forces of the inorganic world. 
In the laboratory, then, we have experiments upon nature in her state 
of torpidity. In the organic body we have the experiments of nature 
herself. Consider, too, that in the former case, they are meagre, uncer- 
tain, and at the mercy of every breeze. In the latter—in the individuals 
of every species, they are inexhaustible in variety, and in all the hundreds 
of thousands of species varied according to the varieties of organization— 
but all concurring to demonstrate a near identity of forces and law's; and 
coming directly from nature, they cannot deceive. Will you, therefore, 
prefer the experiments of man upon organic nature when deprived of its 
peculiar properties and laws, and subjected to forces unknown to the or- 
ganic being—and worse than all, when that being is broken up in its very 
structure and elements ? Do you not see the absurdity of such distor- 
tions of nature ? Are you not rather contented with her own endless ex- 
periments—so endless that you may unceasingly study them for the span 
of your life, and yet you shall have only entered, upon their variety. 
What other experiments can w-e require than such as are thus perpetually 
presented by the organic being—varied as the species, varied as every 
moment, varied as disease from health, and the phenomena alw'ays true 
to the fundamental laws? Or, if something may be yet artificially 
elicited, should it not be done through the living organization, that its 
own appropriate forces and laws may have their share in the extorted re- 
sults? Do you not instinctively answer, yes? I was certain that you 
would, and have so written it down. 
Here I had intended to have made a hiatus in my discourse ; but the 
patience with which you have listened encourages me to persevere to the 
last. I have been admonished by kind friends, within and without the 
profession, that a doctor’s discourse should never trespass beyond the 
good old limit of an hour; and this being my first address to a public au- 
dience, I had almost determined to surrender my wmnted habits of think- 
ing for myself. But it certainly appears to be an established rule, that a 
professor of medicine can hazard only an hour—whilst the more bountiful 
allotment of two hours is assigned to the parson (w'hen he chooses to 
take it), six hours to the lawyer, and from twelve to forty-eight hours to a DR. paine’s introductory lecture. 
22 
member of Congress. Whilst each beeps himself within the limits, re- 
spectively, the rule is—never to leave the room, nor to snore aloud. For 
myself, I shall only ask for “ the benefit of clergy.J? 
I will now cursorily glance at some other mischievous consequences 
which have resulted from the restoration of the physical doctrines of life. 
One of the most important, and most productive of evil, is the prevailing 
hypothesis which assigns, as the cause of inflammation, a stagnation or 
interruption of the circulation of blood in the small vessels, which carry 
on the processes of disease ; and this doctrine is now extended by distin- 
guished writers even to idiopathic fever. It takes away all agency from 
the vital properties, all function from the instruments of disease, and re- 
solves all the remarkable, unique, and diversified phenomena of those two 
great classes of disease, which swallow up all the important human mala- 
dies, upon purely physical principles; as physical and as lifeless as if the 
being were positively dead. The hypothesis, therefore, offers no light to 
the practitioner, nothing to guide his hand, no cheering consciousness that 
he strives with a disease which the mechanic could not as well control. 
But, we shall find, gentlemen, that it is all exactly otherwise, and that 
these diseases which make up the great amount of human suffering, and 
form the principal outlet of life, are under the same great laws which de- 
termine all healthy processes—only, however, partially modified by cer- 
tain primary alterations of the properties of life. Were the mechanical 
doctrine true, of what use to us would he our knowledge of physiology ? 
Where would he its application to disease ? It would have no remote 
bearing upon the subject, and the whole scheme of pathology could be 
written out upon a quarto page. But, the vital properties, in inflamma- 
tion and fever, so far from being paralyzed, as it is called, are exalted in 
power, altered from their natural state, and are the fundamental cause of 
all the phenomena that are seen or felt. The blood is neither stagnant 
nor coagulate ; but moves in the instruments of disease with increased 
velocity, and in an augmented quantity. With these facts before us, 
there is something for philosophy to contemplate, something consonant 
with the laws of life, and something to encourage the practitioner in a ra- 
tional treatment and with the hope of success. 
Are you anxious to know the origin of a doctrine so derogatory to phi- 
losophy, so contradictory of fact, so subversive of all rational principles in 
medicine ? I will tell you, then. Like all our other prevailing physi- 
cal hypotheses, the mechanical doctrine of inflammation is only the 
ghost of darker ages—shorn, however, of what was originally considered 
its animating and indispensable attribute. It was the conception of one 
Vacca, an Italian physician of vivid imagination, who never pretended 
that it rested on a solitary fact. It was considered, indeed, so utterly 
baseless, that Hunter does not refer to its existence. But, what was thus 
originally the project of imagination, now professes to rest upon experi- 
ment. It is also a curious coincidence, that all the exploded doctrines of 
antiquity which have been recently brought forward to decorate an age 
which boasts of its originality, never were advanced under even the pre- 
tended auspices of fact. But, as I have already said, the most remarkable 
appendage to Vacca’s hypothesis, and which the inventor considered in- 
dispensable, is studiously kept out of sight. DR. Paine’s INTRODUCTORY LECTURE. 
Vacca maintained a debility of the bloodvessels, in consequence of 
which they were said to lose their power of propelling the blood, and, as 
another consequence, the blood is supposed to stagnate and coagulate 
within them. So far his followers. But here their pathology stops ; and 
as to their principles of cure, they are of course as mechanical as the 
pathology. But, a great majority do not even allow of independent ac- 
tion to the bloodvessels, in their natural state, but refer the whole move- 
ment of the blood to the propelling power of the heart, and perhaps, also, 
to hydraulic pressure. They only recognize, therefore, in inflammation, 
a mere physical relaxation of the coats of the vessels—just as leather is 
relaxed by soaking in water, and probably much in the same way. Their 
diameters being thus enlarged, the current of blood is said to stagnate 
like water in the wide channels of muddy and shallow rivers—this being, 
verbatim, their philosophical comparison. 
Vacca, however, had the sagacity to perceive that mere passive relaxa- 
tion of the vessels, and stagnation of blood, would never explain the ex- 
alted temperature of the part inflamed, and its various other morbid phe- 
nomena. He therefore boldly assumed that a real combustion, an abso- 
lute fire takes place in the blood as a consequence of its stagnation in the 
vessels; nor have we any other ground for this opinion, than that injlam- 
mation signifies a fire. There are, he says, four principal fluids in the 
body ; namely, the blood, the serum, the fat, and the nervous fluid. The 
serum, he says, is too watery to burn, but the blood burns tolerably well, 
and the fat burns after its well-known manner. This, you will also pro- 
bably surmise, is the origin of our doctrine of spontaneous human combus- 
tion—which is one of the present embellishments of physiology. The 
nervous fluid is said by Vacca to be so volatile that it escapes the confla- 
gration ; and it is left undecided whether it be combustible or not. It 
therefore remains a fair'subject for experimental inquiry ; and it is diffi- 
cult to divine why it has been so utterly neglected by the chemist. It is 
also a fundamental principle with our projector of the now prevailing 
doctrine, that no inflammation can take place without the presence of at- 
mospheric air to ignite the contents of the bloodvessels. The antece- 
dent stagnation, he maintains, lets in the atmosphere, which draws the in- 
flammable parts into the vessels, and there ignites them. The tumefac- 
tion of the part is said to be considerably owing to an evolution of gas 
generated by the process of combustion, and this swelling gives room to 
a farther ingress of combustible matter. 
Vacca affirms that these are essential requisites, and that without them 
there can be no inflammation. He published this nonsense in 1765, in a 
work entitled “ De Inflammationis rnorbosae Natura, Causis,” etc., and its 
mechanical part is the now prevailing doctrine of inflammation ; whilst 
one of its vital consequences, pus, is considered, as it anciently was, a 
mere chemical decomposition of the tissues inflamed. 
Why is this doctrine so extensively embraced ? Because it is capti- 
vating, like Brown’s and Broussais’ theories of disease, by a simplicity 
which exempts the mind from all laborious reflection, either as to the re- 
mote causes, the pathology, its contingent influences, or the mode of treat- 
ment. But, with Vacca’s embellishment, there was a factitious analogy 24 
DR. Paine’s INTRODUCTORY LECTURE. 
with the immense latitude over which the science of disease naturally 
stretches. There was, at least, abundant room for the riot of imagination, 
and something to give a show of plausibility to the stinted mechanical part 
of the hypothesis. Living Nature, gentlemen, is full of poetry, and man 
gets all his best poetry from her—just as the physiologist obtains from her 
all his doctrines of life and disease. But, as there is a poetry of the im- 
agination as well as of nature, so, also, are there imaginary as well as 
real physiological doctrines. Those which are real are the natural poetry, 
as well as the basis of medicine—and they shrink, instinctively as it were, 
from all physical and mathematical calculations. 
There is another wide spread and fatal disease, which I regard as in- 
flammatory, and upon the philosophy of which I shall have something to 
say hereafter. It has attracted but little attention either in respect to its 
pathology, or treatment, but which, perhaps more than any acknowledged 
inflammatory affection, is supposed to be under the dominion of physical 
laws. This disease is Venous Congestion; appearing under simple forms, 
or complicated with idiopathic fever. In the former case, it exists as an 
independent affection of the veins, but constantly liable to involve other 
tissues, or the whole system, in sympathetic influences. When connected 
with idiopathic fever, it still maintains the character of a local and dis- 
tinct disease. The two, co-existing, mutually influence and exasperate 
each other, just as do local inflammations of other tissues and idiopathic 
fever, when they co-exist. 
In respect to Venous Congestion, it is remarkable that even during the 
ascendancy of vitalism, or when pathology was generally considered in 
its true relations to nature—it is remarkable, I say, that even then, ve- 
nous congestion was regarded in a mechanical sense. It was then, as 
now, supposed to depend upon some obstruction to the venous current, 
and a consequent stagnation of blood in the congested veins. Since the 
general revival of the physical doctrines of life, this disease has attracted 
more attention, and has been more extensively expounded upon mechani- 
cal principles. The vital properties and vital actions have been univer- 
sally excluded as elements in its pathology ; and it has served as a re- 
cruiting force to the analogous pathology of inflammation. Remedial 
agents have been therefore applied upon physical principles, and their 
effects, if salutary at all, are construed in conformity with the same 
philosophy. 
Considering, then, that inflammation, fever, and venous congestion, 
comprise most of the maladies we are required to treat, it may be safely 
said of medical science, that “there is nothing stirring but stagnation.” 
Nevertheless, I shall ultimately show that congestion of the veins, like 
all other diseases, falls under the common law of dependence upon an 
altered state of the vital properties of the venous parietes—that there is 
no obstruction, no stagnation of blood in the case, but that it flows in the 
congested veins as freely as in health. The philosophy of this disease is 
of vast magnitude, since it is scarcely less prevalent than the common 
forms of inflammation, whilst it is more complex in its influences upon 
the system at large, of far more difficult treatment, and much more fatal. 
It forms the predominant feature in the yellow fever, and in the conges- DR. PAINe’s INTRODUCTORY LECTURE. 
25 
tive fevers of this climate, and throughout the southern and western 
States. It is the great source of their obstinacy, and the main cause of 
their fatality. 
You hear much, gentlemen, of the great advances of medicine in re- 
cent times. And so it has advanced ; but only so in the accumulation of 
facts. There is scarcely one physiological, or pathological, or therapeu- 
tical doctrine now advocated by the “ reformers,” as they call them- 
selves, which was not more or less in vogue at degenerate ages of our 
science. Whether they be anatomical, chemical, or mechanical, they 
have all had their day, and have all been exploded as utterly contradicted 
by the phenomena of life and disease, and by all that is known of or- 
ganic philosophy. And this I say, as due to the great cause of which I 
am an humble advocate. 
It is not here, however, on American soil, that those seeds of darkness 
have taken root. With a few rare exceptions, our own medical philoso- 
phers have gone on cultivating philosophy. You will not soon forget 
that spirit-stirring reference, which was made by our professor of surgery, 
to the revolution of empires—and upon which, as 1 imagine, as well as 
upon the facts which I have now announced, he founded his conclu- 
sion, that the city of New York may yet be destined to supply Europe 
with her medical philosophers ; and that, too, not unlikely, within a cen- 
tury hence. 
But, there is one physiological heresy of which I have not spoken, and 
with which we have been also favored by the physical speculators, which 
surpasses all others in its degrading tendencies—for it overthrows the 
science of physiology and medicine at its very foundation. Like all the 
rest, however, it was a doctrine of the dark ages. It appears to have had 
its revival in the laboratory, though not exactly within the prerogatives 
of that modest handmaid of Nature. It has, however, won its way ex- 
tensively into medical favor, and chemistry is, as usual, thanked for the 
blessing. 
This doctrine supposes that the fluids circulate in the small vessels by 
capillary attraction—just as oil ascends in a lamp-wick, or water is 
imbibed by a sponge. So we are told by Liebig, for instance, the great 
organic chemist, and by many others. The doctrine, I say, is necessarily 
subversive of all physiological, pathological, and therapeutical principles— 
since it is one of mere mechanics. All the important vital processes 
being carried on by the small vessels, it must be perfectly apparent, upon 
the doctrine of capillary attraction, that nothing of a vital nature can be 
performed by these vessels. In short, I know of no doctrine so deroga- 
tory to medical philosophy as this one of capillary attraction. 
The ignorant pretender will tell us that all this is unimportant; though 
no one is so much directed by hypothesis, or theory, as this very pretend- 
er himself. Does not every empiric in the land prescribe his drastic ca- 
thartics for the purpose of cleansing the blood of its supposed impurities ? 
Are they not exactly on a par, in their doctrines, and in their practice, 
with the most speculative of our enlightened humoralists ? Nay, have 
the ignorant portion of that sect, our Brandreths, our Morisons, et id 
omne genus, any reference whatever to facts or experience ? Is it not all 26 
DR. PAINe’s INTRODUCTORY LECTURE. 
hypothesis, and, therefore, all a reckless waste of human life? How is it 
with the homoeopath ? Certainly all hypothesis, and never a fact but 
such as demonstrate his errors—if nothing worse. Mount up the scale, 
and you shall find at every step of your ascent, from him who prowls 
about the outskirts of the profession, to him who directs the all-potent 
drug with the most consummate skill, that each and all mainly rely upon 
their conceptions of the philosophy of disease. But you shall also find, 
that in proportion as Nature has been taken for their guide, and as medi- 
cal principles are founded upon the absolute phenomena of life, in their 
healthy and morbid aspects, there will always be the greatest reference to 
facts and experience. How momentous, then, that we should follow Na- 
ture, and that our theories should be derived from her observation alone. 
The human mind will have its theories upon all subjects; and the 
whole history of medicine is a perpetual exemplification, that in no in- 
quiries do theory and hypothesis abound so universally as in the healing 
art. This arises, in part, from the intricacies of the subject, but mostly 
so from the constitution of the mind itself. The Almighty designed it 
for theoretical conclusions, and set us the example in those stupendous 
Theories upon which the Universe, and all it contains, are founded. And 
what else are, or should be, our theories, than finding out and adopting 
those of which He is the Author? What other theory in the natural 
world can there be, than such as are instituted by the Almighty Being? 
And shall we hesitate to embrace, and to act upon such theories ? And 
yet it is one of the improvements of our day, to insist upon nothing but 
facts, and to denounce all principles in medicine; as if the Almighty had 
not ordained principles and laws as well as facts—which are mere emana- 
tions from the former. 
But, who are they that would thus convert our noble and stupendous 
science into its barbarian infirmities? They are the greatest theorists of 
the age—promulgating their speculations under cover of this pretension. 
This propensity of the mind to theorize is strikingly illustrated, for exam- 
ple, in the writings of Louis (a distinguished Parisian physician), who, 
although condemning theory and generalizations in medicine, is the great- 
est speculatist of any era ; nay more, he has embodied in a work which 
purports to be a simple record of facts, a greater number of hypotheses 
than can be gathered from the whole field of medical literature. 
We must, therefore, have theories in medicine ; and, therefore, let us 
have the right ones. Right or wrong, they grow irresistibly out of the 
constitution of the mind and the fundamental laws of nature. Let not 
the mind indulge its great natural propensity without a constant reference 
to those laws, through the medium of their phenomena. The elements 
of the former are simple, immutable, and easily known by their manifes- 
tations. These manifestations are the facts, and form the substantial 
ground of all intellectual acquirements. As they relate to organic beings, 
to their laws, their properties, their functions, whether morbid or healthy, 
they are to be found in the organic being himself-—not in the workshops 
of the chemist or of the mechanical philosopher. But, even where the 
mind admits this proposition, if prone to speculation, it too often regards 
each fact by itself, and rears up hypotheses wrong in themselves, and in dr. paine’s introductory lecture. 
conflict with each other. Facts should therefore be compared before 
they are reduced to theory ; or, where they may conflict with acknow- 
ledged principles, they should remain in an isolated state till their true na- 
ture may be better understood, or till the principles which they appear to 
contradict may be shown to be erroneous. Had this consideration been 
duly regarded, had the Attributes of the Almighty been properly respect- 
ed, or the thousand facts in physiology, our age had not been stained with 
animal magnetism. 
Should you meet with some fact which appears to indicate the depen- 
dence of life upon chemical or any other physical forces, the evidence to 
the contrary is so various and conclusive, that that fact must be considered 
as deficient in some of its elements, which, if known, would readily bring it 
under a well-established principle in physiology. These absent elements 
are some other facts which escape our observation, perhaps through ne- 
cromancy or imposture ; and thus what is truly fact, in an abstract sense, 
is made the groundwork of important error. And did those of you, 
who venerate the Mosaic Record of Creation as the Word of God Him- 
self, never entertain a hope that Geology may yet discover other facts 
which shall bring such as are known into better harmony with the Word 
of God ? May we not believe, as we shall soon see has been often the 
case with hypotheses founded upon partial facts, that a solitary discovery 
may yet show us that our geological premises have been deficient in a 
most fundamental element? Should we not tremble over the ruins of 
about one hundred theories of Creation, which, by a recent decision of 
theoretical geology, even in the metropolis of France, are pronounced 
“ unscriptural and unworthy of record ” ? Would it not be safer to rest 
upon our facts, and be contented for the present to Icnoiv, that “ In the 
beginning God created the heaven and the earth and, in believing this, 
to think it also possible that the subsequent annunciations are equally true ? 
It strikes me, at least, that this is not only the safer, but the philosophical 
course. 
But leaving sacred, for our more appropriate subjects, there are princi- 
ples which are not as clearly confirmed by an observation of nature as 
the laws of life; and, in such instances, it may be that the supposed prin- 
ciple and the conflicting fact should mutually stand the ordeal of inquiry. 
This will be accomplished by a full revision of the facts of which the 
principle had been predicated, and by the multiplication of other facts. 
It may be found that they do not all harmonize with each other, or it 
may happen, as with organic beings, that there is a perfect coincidence. 
In the former case the principle is prima facie false; in the latter, it is 
prima facie true; but neither induction will be certain till the newly dis- 
covered fact is reconciled to those upon which the principle had been 
founded, or is shown to be in absolute opposition. In the former case, 
the principle stands, and derives farther confirmation ; in the latter, it is 
more or less shaken, or may be overthrown and the facts become assem- 
bled under a new doctrine. 
It sometimes happens that the discovery of a new fact will overthrow 
the most brilliant theory. Had Christison succeeded in that higher pre- 
tension than was ever made by the alchemists—that of converting cyano- 28 
DR. Paine’s INTRODUCTORY LECTURE. 
gen into siliciurn, he would have upset the whole science of chemistry— 
and in this respect he would have rendered a service to physiology. In 
the instances, however, to which I am now referring, the theory is gene- 
rally of a compound nature, and some of its elements rest upon facts 
which nothing can invalidate. In such cases, also, the facts are of a 
demonstrable nature, and that which invades the theory is clear, specific, 
and liable to no uncertainty. Lavoisier, for instance, laid down the 
doctrine that oxygen gas is a supporter and the only supporter of com- 
bustion. The former part of this doctrine must remain forever true; the 
latter was only good till some other substance should be discovered, which, 
like oxygen, would maintain combustion. It was so far a hazardous prin- 
ciple, as it was concerned about abstract facts, and might or might not, 
therefore, be a fundamental law of Nature. The very next revelation 
of the laboratory might show that this part of the theory was a mere as- 
sumption—as it certainly was. A single fact was only necessary to the 
purpose ; and already not less than three other agents are known to be 
supporters of combustion. Some have even supposed that all cases of 
intense chemical action, where heat and light are developed, are instances 
of combustion ; and then we have spontaneous human combustion, for 
which no theory has been assigned. But, the universal doctrine, which 
respects heat and light abstractedly, rests principally upon the two facts 
just stated, and is otherwise deficient in the analogies which relate to 
true combustion. It is, therefore, like Vacca’s doctrine of inflammation, 
and that of spontaneous human combustion, probably nothing but an 
assumption. 
Again, it was supposed to be a law that oxygen was essential to 
acidity; and although it be generally true that this substance is the acidi- 
fying principle, others are now known to exist. Here, this great agent 
placed the same theorist in another predicament corresponding exactly 
with the calamity which befel the doctrine of combustion. The theory 
was partly true, and partly false; whilst its universality was overthrown 
by a single fact. In all such instances, where the laws have no great 
range of phenomena, it is unphilosophical to theorize beyond the absolute 
facts in possession. But, here also, other theories, of the same latitude 
and uncertainty as that which supposes combustion in all cases of intense 
chemical action, when light and heat are developed, have sprung up— 
some chemists supposing that acidity often arises from the associated effect 
of several elements. 
In the examples before us, therefore, we not only see how readily cer- 
tain doctrines, which rest upon abstract facts, may be overthrown by a 
single discovery, but with what readiness the mind starts off upon hypothe- 
ses when .opportunity arises for the exercise of ingenuity. It is the pe- 
culiar misfortune of science to generalize too hastily ; and it often happens 
that the explosion, or the introduction, of one error, is the parent of many 
others. It is also astonishingly true, as we have especially seen of the 
doctrines of life and disease, that a few phenomena are abstracted from 
the whole, of which they may be only sequences of the others, and are 
made the ground of doctrines which are in perfect conflict with other and 
better theories that are instituted upon the more fundamental facts;—and dr. paine’s introductory lecture. 
29 
thus a blind disregard of consistency is permitted to prevail, till a most 
incongruous series of assumptions is presented to us as the science which 
Nature teaches. 
Although facts are the only foundation of theory, it is not unfrequently 
the case that certain existences, and the laws by which they are governed, 
may be fully demonstrated without any knowledge of the nature of the 
fundamental subject to which they refer. This, for instance, is true of 
light; for, although we know not the condition in which it exists, or 
whether it produce its impressions by impulses and oscillations, or by pro- 
jections, &sc. (from near or remote objects), the laws of reflection and re- 
fraction are permanently fixed. The same affirmation may be made of 
electricity, and the laws which this remarkable agent obeys. And so, 
also, of heat. These laws, and those in relation to light, are founded 
upon such facts as cannot be shaken ; and when, therefore, apparently 
conflicting phenomena may arise, we may be certain that they will be ulti- 
mately reconciled to the established principles. Least of all can any 
theory of the nature of light, heat, or electricity, or of the modes in which 
they are developed, affect the laws which have been founded upon their 
phenomena. And though it be possible that light, electricity, and heat, 
are modified states of a common substance, their phenomena, and the 
laws which are predicated of those phenomena, declare that some pecu- 
liar, but unknown imponderable substance exists, upon which those phe- 
nomena depend. They declare it to be sui generis, differing as much 
from all things else in Nature, as was its distinct and specific Act of Crea- 
tion, when the Almighty said—“Let there be light, and there was light.” 
We know it to be different from every other existence, because it is dis- 
tinguished from all others by its phenomena and laws. 
Just so is it, gentlemen, in respect to the powers and the laws of or- 
ganized beings—the whole animal and vegetable kingdoms. It matters 
not whether the principle of life, whose elements we denominate the vital 
properties or vital powers, be ponderable or imponderable, tangible or in- 
tangible, or, like the soul, immaterial; for, like the soul, and light, it has 
its infinitely diversified and peculiar phenomena, and its peculiar laws. 
Like the soul, and the principle of light, therefore, it must have a real 
existence—as real as was that other specific Act of the Almighty Being 
by which He superadded the vital principle to man, when He breathed 
into his inanimate structure the breath of life ;—and therefore, by analogy, 
by Unity of Design, and by some analogous process (of which the fore- 
going annunciation is probably metaphorical for its greater intelligibility), 
into all other organic beings. How stupendous the conception—how 
corroborated by all the phenomena and laws of life—how atheistical the 
doctrine which engrafts those vital properties upon the elements of mat- 
ter, that they may rob the Almighty of His highest of all Prerogatives— 
the creation of living, intelligent beings! And may it not be that the 
announcement of the creation of “the breath of life,” subsequently to 
the institution of the organic structure, was especially intended to prohibit 
this very doctrine which ascribes to the elements of matter the essential 
requisite for organizing themselves ? 
We may be ignorant of the principle of life, yet understand its 30 
DR. Paine’s INTRODUCTORY LECTURE. 
whole government; and the objection is perfectly futile, that we cannot 
reason about that principle because we cannot demonstrate its nature. 
Will you deny the existence of the soul because you cannot see it ? 
Will you deny the Almighty because the eye cannot see Him that 
made it ? What else do we know of the most tangible substances, 
than that they exhibit certain phenomena? Did not Berkeley reject 
the testimony of his senses, because he could not comprehend the 
nature of matter ? But, did not consciousness compel him to recognize 
the immaterial soul, when he denied the existence of the body which it 
inhabits? Do you go to Revelation for your proof of an Almighty Be- 
ing? Then, by the same rule your faith must repose upon the declara- 
tion, that man was first created an inanimate structure, and that animation 
was superadded as a distinct Act of Creation. Take either ground, Re- 
velation, or the phenomena of Nature, and you must be consistent. Here, 
as in most things, Revelation and Nature mutually illustrate and sustain 
each other. Their annunciations are equally direct upon the subject 
before us, and open to the understanding of all. Our conclusions, there- 
fore, flow irresistibly from ivhichever premises you may select. 
Although it be rather premature, 1 will carry on my illustration in re- 
spect to life, by supposing the existence of some principle analogous in its 
material nature to that of electricity, or light, though essentially different 
in its constitution. Grant this fact, and skepticism is at once dissipated. 
You see and feel the thing, and yield to your sight and touch where you 
would not to thousands of demonstrations which are less likely to deceive. 
You grant the principle of light as an imponderable substance, because it 
impresses the sight, and this is your only natural proof of its existence. 
But, when this solitary proof is withdrawn by the interposition of the 
moon between us and the sun, your belief in the existence of an univer- 
sal elastic medium, capable of being again rendered luminous by solar im- 
pulse, is in no degree affected. You go on to believe, though you do not 
even see, and have nothing but a dead analogy to impress the conviction. 
Supposing, then, that organized beings possessed a principle of life that 
could, like light, be seen—they would then be allowed to be governed by 
this agent, and we should be relieved of the encumbrance of the physi- 
cal and chemical hypotheses. But, though no such principle address 
itself to the sight like electricity or light, its existence is far more va- 
riously and conclusively attested by other phenomena. These phe- 
nomena, results, or facts, determine also the nature of the laws which 
prevail throughout the animated kingdoms ; and, being wholly different 
from such as rule in the inorganic world, it is yrima facie evident, that 
powers or properties of which they are predicated, carry on the processes 
of health and disease. But, it is not analogy alone which forces this 
conclusion. The facts of which it is affirmed are incomparably more nu- 
merous and specific than those which appertain to all other powers of 
Nature; whilst the scrutiny of ages has never produced a fact in 
opposition. 
Indeed, with so much light upon our subject, so much of fact to sub- 
stantiate our conclusions, it would seem highly probable that all facts 
which may be raised in opposition have no relative bearing, and that they 
are brought forward in the spirit of hypothesis. dr. Paine’s introductory lecture. 
31 
The more comprehensive a law may be, the more readily is it known 
and determined, and the less likely is it that apparently conflicting facts 
will arise. YVhenever such are produced, it is owing to a want of proper 
investigation. The facts are examined superficially ; and the specula- 
tive or the credulous mind seizes upon some prominent characteristic, 
and pushes its opposition to nature under the spur of novelty, or the de- 
light of discovery, or the goad of ambition. This, as we shall ultimately 
see, is emphatically true of the application of chemical forces to the 
processes of life, and of the more strictly physical to the interpretation 
of disease and therapeutics. 
Let us now apply these remarks in the way of another brief illustra- 
tion. When Crawford promulgated his doctrine of animal heat, which 
was founded upon chemistry, it should have been obvious that his indis- 
pensable facts were only assumptions ; since all analogy in relation to or- 
ganized beings rendered it in the highest degree probable that chemical 
agencies have no lot in the function of respiration, or in the production of 
animal or vegetable heat. The properties of life are too universally con- 
cerned with the results of organic beings to admit the probability that 
Nature is so inconsistent with herself—or, rather, the Almighty with 
Himself, as to have instituted a great system of government for the spe- 
cial economy of the organized kingdoms, and at the same time have ad- 
mitted the forces of inorganic matter to determine spme fundamental result; 
and that result, especially, having intimate alliances, and close affinities 
with all such as clearly depend upon the vital principle. 
Crawford’s doctrine, however, prevailed almost universally, till it was 
finally shown, by the chemist himself, to be defective in the necessary- 
facts. Chemistry then started off in pursuit of other hypotheses of ani- 
mal heat that should be conformable to its own habits and prejudices. It 
elaborated a now prevailing doctrine that heat is evolved by the conver- 
sion of the fluids into the solids, with some mysterious connection with 
atmospheric air. But, it overlooks the perfectly subversive fact, that 
adult warm-blooded animals have an uniform and exalted temperature, 
and that an exact equilibrium is preserved between the conversion of the 
fluids into solids and of the solids into fluids, whereby the temperature of 
all adult animals should be regulated by that of the surrounding atmos- 
phere ; whilst in infancy, the temperature is lower than in adults, al- 
though nutrition overbalances secretion. These facts are irresistibly con- 
clusive against the hypothesis, and are one of the numerous examples in 
which chemistry has introduced into organic philosophy doctrines which 
are in total opposition to its own well-established laws. Other hypothe- 
ses, of a similar nature, have sprung up upon the ruins of Crawford’s— 
neglecting all Unity of Design, sifting the facts for such only as are 
plausible, regardless of all the opposing phenomena of life, and scouting 
the grand principle in philosophy which forbids an unnecessary multipli- 
cation of causes. Before this invasidn of chemistry upon the vital doc- 
trine of organic heat, the phenomenon was expounded upon purely me- 
chanical principles, as digestion had been ; it being supposed to arise 
from the friction of blood upon the circulatory vessels. Here, however, 
was something which was merely contingent, and in no respect involving DR. Paine’s INTRODUCTORY LECTURE. 
a violation of principle ; and I would far sooner take this palpable error, 
than the absurdities of the laboratory. 
It will be a part of my agreeable task to exhibit the fallacies of the phy- 
sical hypotheses of life and disease, as well as to inculcate principles which 
exalt our science above the mere world of matter, render it consistent in all 
its details, and present it to your attention as a department of knowledge 
fundamentally distinct from all other pursuits. Then shall you feel the 
quickening influence of a philosophical knowledge which distinguishes 
you from the rest of your race—of a knowledge which led the great father 
of our art to affirm that “ a philosophical physician is like a god ”—when 
you shall have some ennobling glimpses at a system of principles and ac- 
tions of which the profound in other sciences have no just conception, 
and which you alone are qualified to direct to a great and specific result. 
And this carries me again back to the essential philosophy of disease. 
Assuming that morbid actions are carried on by the forces which govern 
the natural functions, we may rationally conclude that every pathological 
change consists in some new mode of action which has been induced in 
the vital powers by morbific causes, and that the object of therapeutics is 
to restore the natural condition of those powers. When, therefore, we 
hear that inflammation, fever, or venous congestion, are constituted by 
stagnation of blood, and that all their results are interpreted by physical 
agencies, we may be certain that such hypotheses have no foundation. 
But, allowing these remarkable exceptions to the ordinary course of na- 
ture, what would science be worth, what its advantages to mankind, when 
thus surrounded by exceptions which cover the whole fabric with doubt, 
and which divest the most important diseases of all ground for any intelli- 
gible treatment ? 
There is no practical pursuit, in which consistent and philosophical 
theory is so important as in medicine. Every practitioner, as I have 
said, is irresistibly influenced by theoretical views of disease, and none 
more so than they who are most ignorant of its merits. How important, 
therefore, that our first theoretical conceptions should be right—since, be- 
ing right or wrong, they will be either for good or for evil. Where medi- 
cal doctrines are not laid upon the broad basis of Nature, or where me- 
chanical or chemical philosophy is allowed to usurp the place of vital- 
ism, you will commonly find that theoretical views, and the application 
of remedies, are at the mercy of every prominent symptom. As new 
symptoms are constantly rising as the disease acquires exasperation, the 
hypotheses and the treatment undergo the most contradictory changes— 
being often within a few hours in absolute opposition. 
Thus, gentlemen, you perceive that neither the poorest nor the best of 
us can move without theory as well as experience for our guide ; and it 
behooves us, therefore, to lay well the foundation of medical doctrines. 
Whether true or false, they will surely operate ; and nothing is more diffi- 
cult than to correct the errors which we imbibe in the course of a medi- 
cal education. It is with a view to the importance of these objects, 
that I have addressed you in this general manner in my first lecture, as 
well, also, to give you some apprehension of the objects of my course, 
before we embark upon a consideration of the Materia Medica, which I DR. Paine’s INTRODUCTORY LECTURE. 
33 
shall teach you in its special relations to medical philosophy. The field 
over which we shall travel, is of boundless extent, but is everywhere 
marked by prominent outlines. These outlines I shall be mainly em- 
ployed in presenting to your attention, under the scrutiny of 
analysis. They have all an intimate association—beginning in simplicity 
and ending in unfathomable complexity; yet always true to the simple 
elements, and always determined by immutable laws. Beginning with 
what is simple, we shall ascend, step by step, to what is complex—till at 
last, and along a chain of the closest analogies, we attain the most intricate 
of the whole, and which embraces every part of our plan—the considera- 
tion of remedial agents, and their just application to disease. I shall en- 
deavor, therefore—feebly it is true—to teach you the Institutes of Medi- 
cine as they are founded in Nature, and with an undeviating view to the 
Materia Medica. And that this great ultimate object of all medical ac- 
quirements should have been taught in our schools apart from the Insti- 
tutes of Medicine, has always appeared to me an artificial and unnatural 
separation. I know not, indeed, how the Materia Medica can be intelli- 
gibly taught without being associated with extended instruction in the 
principles of physiology and pathology, to which the investigation of 
every article should have an unceasing reference. Isolated from these, 
the Materia Medica can, at best, consist only of a dry detail of facts, with- 
out a spark of the animation of which it is susceptible, with no associations 
to illustrate its vast and endless relations to disease, or to connect them 
with memory—nothing to govern their therapeutical application, but the 
monotony of an empiricism as sickening as the drugs themselves. 
[re-published from the boston medical and surgical journal.]