THE PHILOSOPHY OF MEDICINE, DEDUCED FROM A SERIES SELF-EVIDENT PROPOSITIONS, DEVELOPING SELF-EVIDENT PRINCIPLES FOB ILLUSTRATING THE MEDICAL SCIENCES INTUITIVE DEMONSTRATION. By EZEKIEL WEBB, M, D. ^* OF MOBILE, ALABAMA. ganization for sanatary phenomena; and to show the baneful consequences which have so obviously ensued from such misapprehension. These baneful consequences need no enu- meration here;—our business is exclusively with the philo- sophy of medicine;—on the true comprehension of which, depends our ability for appropriately designating to the pub- lic authorities, the institution of the most efficient measures, for preventing and removing, or meliorating their causes, both as they are subject to our observation in the noxious agents, or their sources, and in the constitutions of those ex- posed to, or receptive of them. We have thus indicated the true premonitory symptoms of cholera to the recognition of all intelligent physicians who may have predilection for them,—and shown that the true pathological phenomena constituting it, are philosophically indivisible into stadia. The beneficial consequences which would result to society, from recognizing and appreciating this important portion of the philosophy of medicine are too easy of apprehension to need enumeration. We proceed therefore to observe, that with the exception, perhaps, of the sudor anglicus, no other pestilence has ever occurred in our world, which generally from the primary entrance and fixity of the noxious stimuli causative of it, has so overwhelmingly prostrated, even in the general run of the mildest cases of it, such an extensive department of 131 the organization. The noxious agents, to a greater or less extent, strike at once, even generally, in the mildest cases, with such torpidity, not only the ganglionic department of the nervous organization in the assimilative regions of vitali- ty, but the very cerebro-spinal radicles of total vitality are affected generally with such torpid and paralytic conditions, that they are rendered utterly incapable of instituting any actions, having any similitude to favourable recuperative ex- citations. The extremities of all the vessels, of all the nu- trient organs, are quickly opened and converted into sluices for draining off the waters of life; and the sensorial energies so paralyzed, that they are completely incapacitated, even generally in the mildest grades of this disease, from raising any effective recuperation; and in the medial grades gene- rally, nothing more than the feeblest and most inefficient fe- brile or inflammatory recuperation, in concomitancy with occasional tremors, twitchings, and cramps, or spasms and convulsions, which are nothing more nor less than such abor- tive attempts as are made by the torpid, sensorial, and spi- nal radicles, to institute more favourable recuperative exci- tation. And it is to be particularly remarked and noted, that this position is unequivocally demonstrated by an ap- propriate consideration of the fact, that in the highest grades of this malady, the central energies of the organization are totally paralyzed, to the preclusion of exciting even these abortive spasmodic manifestations of recuperation. In these highest grades, paralysis of the total organization has so fix- edly and irremovably occurred, that the central radicles of vitality are so overwhelmed by the noxious stimuli,—that they are deprived of the power of instituting even such fee- ble movements in the nutrient region of vitality, as to ena- ble the extreme vessels to pour out the vital fluids by vomit- ing or purging. In such cases, confirmed paralysis has seized the organization,—a total occlusion, or blocking up of its vital powers has occurred, and total death either takes place instantaneously, or, if it be feebly protracted a few hours, none of the pathological conditions characterizing the 132 milder and medial grades are to be seen, or in any manner recognized;—and if in any such cases, recuperative move- ments are to be discerned at all, they will be exclusively manifested in the last gaspings for the continuance of life, by convulsions. These observations are applicable exclusively to the very highest, among the highest grades of cholera, when termi- nating life instantaneously, or nearly so. In other cases amongst the highest grades, but not quite as high, where life lasts a few hours, both pathological and recuperative phe- nomena will be manifested,—but exclusively to philosophic observation. The intelligent practitioner will readily re- cognize, that during this short train of pathologic ravaging, none but the most ineffective and unfavourable recuperative excitations ean be raised by the torpid sensorial radicles of vitality. In fact, all the recuperative movements discernible in the organization when thus saturated by pathological ra- vaging, consist of occasional spasms and convulsions,—till toward the close of life, when they cease altogether, from total torpor of the innervating centres. In these cases, no febrile or inflammatory movements are to be recognized in the circulations, amounting to any thing in the similitude of reaction;—for the pulse is either more or less feeble, quick and contracted, or slow, laboured, and struggling, from the very commencement of the entrance of the noxious agents causing such pathological conditions; and the respiration equally laborious, oppressed, and struggling, evincing the nervous foundations of the organization to be affected by the poisonous stimuli to the preclusive extent of raising any other, than spasmodic or convulsive recuperation, or none at all. We have made these few observations on cholera for the purpose of showing how important it is, in estimating the character of any disease, to attend to its remote causative gradations, as well as the causative gradations manifested to philosophic observation, in the susceptibilities of the consti- tutions of those exposed to the noxious agent, or agents ori- 133 ginating it. We have made them also for the purpose of showing the true premonitory symptoms of this disease, in all such cases as exhibit them at all;—and for showing the true pathological phenomena constituting it, and separating them as they ought to be, from the premonitory phenomena; and finally, for showing the recuperative phenomena of the conservative powers, and separating them philosophically from the two former sets of phenomena. The indispensably philosophic necessity of all this showing, will not be denied or disputed, when we reflect on the immensely varied gra- dations exhibited by this epidemic pestilence:—that the premonitory symptoms are only conspicuously apparent to observation, in the very mildest grades;—in all the medial grades much less so;—and in the highest, not at all. That the pathological phenomena are conspicuously apparent in all the milder, medial, and many of the highest grades,— but in the very highest, not at all;—the organization being so paralyzed and deadened by the noxious stimuli, that it is incapable of action sufficient to develope its pathological con- dition by any signals that can be recognized by any other than the true philosophic practitioner:—and that the recupe- rative phenomena manifested in the mildest grades are the most favourable;—in the medial much less so;—and in the very highest, discernible only by spasms and convulsions, either occasionally or coexistently, with the total extinction of vitality ;—or by none at all, that can be rendered exhibi- tive to ordinary observation. From all this showing, we derive proof demonstrative, that the nervous system is the one and only system of man's organization;—for we see that the death of the circulations, respiration, and of all the functional operations, pertaining to all the organic structures, contained in the extensive de- partments of assimilative vitality, may take place prior to the total extinction of animal life,—as is evidenced in many cases of this disease, by spasms being excited by the senso- rial power of the cerebral centre, long after the total cessa- tion of vitality in the nutrient region of the organization ;— 18 134 showing conclusively, to philosophic observation, that the cerebral centre of the organization of man is the grand focus of radiation, for his mortal and immortal existence. The baneful consequences which ensue to the public, from being told by their physicians, that diarrhoea and vomiting, in their commencement, are to be considered by them as the phenomena precedent to cholera, we hope are now made ap- parent to their observation;—and that it is therefore of the very highest importance to the public safety, during the ra- vages of this epidemic, that their physicians should recog- nize, and philosophically appreciate and discriminate between the true pathological and premonitory phenomena. Although these incipient pathological phenomena may in general, in their very commencement, be eliminated from the system by appropriate medication, in constitutions which, previous to the^reception of the noxious stimuli, were tolerably sound and vigorous, yet such elimination from unsound constitu- tions must be considered totally impracticable, for obvious reasons, which we have fully presented to philosophic ob- servation and unavoidable recognition. The only effective procedure to be forthwith instituted for saving all such from destruction, is simply to apprize them of the indispensable necessity of applying for the best medi- cal aid, from the very instant of the commencement of the true premonitory symptoms. The least weariness or lassi- tude of feeling, during the existence of this pestilence, should not be overlooked or disregarded;—the physician should be at hand, who may then, nearly, in all cases, and in all con- stitutions, by appropriate treatment, vanquish the noxious agents, and prevent their actual entrance into the organiza- tion assailed, and thereby preclude the occurrence of that pathological phenomenon diarrhoea, which inevitably sends to swift destruction all those affected by it, who were pre- viously debilitated, from whatsoever causes;—and too many of those who were previously sound and vigorous, in de- spite of the most appropriately philosophic medication. When we consider that this incipient pathological phenomenon,— 135 this simple diarrhoea, as it is called and considered by many of our physicians,, when designating to the public authorities the premonitory symptoms, arises from the toneless patulous condition of the innumerable absorbing, secreting, and ex- haling vessels, of the alimentary region of vitality, the im- portance of discerning and distinguishing the true pathologi- cal from the premonitory phenomena, need not be insisted on. Indeed this simple diarrhoea, which has been consider- ed by a number of our distinguished practitioners as a pre- monitory symptom of cholera, is but the commencement of the toneless condition, frequently in fact, to a greater or less extent, of the total organization, but in all cases of the nu- trient organic department, and if not rapidly arrested, leads forthwith to the destruction of the life of the blood, and to the thorough arrest of all the vivifying operations pertaining to the alimentation of the organization. The vital fluid is soon separated into its constituent elements, and the serous, saline, and albuminous portions of it are profusely poured from the systenr, through the toneless myriads of the patu- lous extreme vessels of the alimonious region;—consequent- ly, those component parts of the vital fluid, most easily running into the putrefactive fermentation, being drained from the system, the susceptibility of the dead body to cor- ruption is very much retarded. This explains the reason of the slowness of the body in becoming assumptive of the pu- trefactive process after death, in all cases of this disease, when characterized by such profuse drainings of all the com- ponent parts of the vital fluid, except the fibrin, gelatin, co- louring matter, and some portion of the albumen, which be- come stagnant and coagulative in the large and deep-seated vessels near the heart, in the large vessels of the portal re- gion, venous synuses, &c. This separation of the blood into its component parts, and running out of the waters of life, explains the reason why cholera in all its grades thus characterized, is precluded from bringing into its list of pathological phenomena the haemor- rhages and black vomitings of yellow fevers, malignant 136 typhus, &c.—and the reason why they do not occur in the highest grades, is obviously attributable to the short duration of the disease, and the total paralysis of the organization. It should therefore be observed and philosophically considered and appreciated, that in these very highest grades of the dis- ease, where the issue of the waters of life has not occurred at all, or to partial extent, that putrefaction of the body may and does occur, as soon after death as in bodies dead from the most overwhelming grades of yellow fevers;—and in both cases, for reasons which will be fully recognized, by the philosophic practitioner. It should also be observed, that the extinction of vitality in these highest grades of cho- lera, is at once complete, thorough, total;—and consequent- ly, that the dead body does not longer retain its heat, than it does in bodies dead from yellow fever. The reason of which is, that in the more Jr'dinary run of choleras of the mildest and medial grades, characterized by profuse drain- ings of the vital fluids from the nutrient region of the or- ganization ;—the organic life of that region is totally extinct long before the animal life of the cerebral centre, which for several hours in many cases, continues operative to such ex- tent, as to prevent the body from passing totally under the dominion of physical laws. We have made these few observations on cholera for the purposes already mentioned, but more particularly for set- tling its premonitory sj^mptoms on such basis, as is demand- ed by true philosophy. We have assigned to these premoni- tory phenomena, (if they must be retained,) their legitimate- ly philosophic location; and shown, that they are to be con- sidered pathological, and not recuperative phenomena, for which they have been mistaken by many distinguished phy- sicians. But we have now further to observe, that no disease has ever elicited so much talk about premonitory symptoms as this has done, amongst the majority of the ablest practitioners both in Europe and our own country, except a very few amongst the very ablest and most experienced of them, who 187 can see no tenable philosophy for all this talk about such symptoms, when it is considered that the perfection of the disease, as it appears in its highest grades, is never preceded by any recognizable premonition. The truth is, that there are no premonitory symptoms belonging to this, or any other disease whatever. Strict philosophy requires, that all the symptoms should be considered as pathological or recupera- tive, from the very instant of any the least percipiency of deviation from the salutary actions of the organization. For the state or condition of healthy vitality is not a forced state. It is in every healthy system, a calm, equable reception, flow and distribution, of pleasurable and salutary sensibility, from the several salutary stimuli ordained by Deity, for the creation and preservation of man's organization;—and life can never be, with any show of philosophy, considered as a forced state, except when assailed by the causative agents of disease. From this instant, the true pathological phenomena commence, consisting in general of more or less sense of de- bility, dullness of sensation, lassitude and weariness of feel- ing, inaptitude for motion, &c.—accompanied, or sooner or later succeeded, by recuperative excitations, as manifested in the respiratory and circulatory departments of the organi- zation, in all cases in which the vital energies are not over- whelmed by the causative agents, to the preclusive extent of exciting such recuperative movements. The characteristics of the pathological phenomena will of course exclusively de- pend on the nature and action of the causative agents on the organization, and the abilities of the conservative powers for resisting their deleterious operations; and the recuperative phenomena will be philosophically characterized in corres- pondent manner. However slightly, therefore, the causative agents may affect any department of the organization with debility and depression of its nervous energies, and however easily they may be resolved and eliminated from the system by the vis conservatrix naturae, or appropriate medication, still, all such manifestations of nervous depression must be philosophically recognized as pathological phenomena, as 138 long as they remain thus deleteriously operative, on or in, the organization. Philosophically speaking, therefore, we cannot recognize premonitory symptoms as scientifically pertaining to any morbid sensibilities whatever, and they should be expunged from the philosophy of medicine. We have restricted them as above, exclusively where they ought to be, if retained at all, on account of the very great predi- lection of the profession for them;—but we reject them in toto,—because totally unphilosophical, and because their re- jection would aid the cause of philanthropy to much greater extent, than to recognize and found our humane exertions on the location we have given them, in consequence of the pre- dilection so eagerly manifested for them by the profession. Since writing the above, we have seen and attentively stu- died and treated a few cases of cholera, of every grade except the very highest,—from which experience we derive posi- tive confirmation of all the observations we have made re- specting the philosophy pertaining to this epidemic—and derive also proof positive, that from analyzing this, or any other morbid sensibility, arising from any other morbid agents, when concentratingly pathologizing the organization, we unfold forthwith to inevitable recognition the universal philosophy of medicine, as it should be, and is now, and must remain, till man be disenthralled from his terrestrial— and regenerated for his everlasting vitality. In closing our observations on cholera, we may remark, that some of our ablest practitioners, have viewed the term cholera for this disease, as a gross misnomer. Nosology is useless to the talented practitioner;—true philosophy, his unerring beacon. Cholera is a misnomer, and philosophically considered,—every disease however originated, has been erroneously nosologized;—but this has received a name quite as appropriate as any of the other morbid sensibilities, from any of the other causes. The ordinary cases of cholera arising sporadically, during the hot summer months, from ordinary causes, are usually, sooner or later, after the de- pressions of nervous energy constituting them have been re- 139 moved, either by nature, or art, characterized by copious discharges of bilious matter, more or less vitiated. In all such slight deviations from the salutary standard of action, thus characterized, this term for the disease, would on superficial examination, appear to be appropriately philo- sophical ;—but, whenever, the noxious stimuli act depres- sively of nervous power, to the extent of diminishing or sus- pending not only the biliary secretion, but in a greater or less degree, all the other secretions, and depraving the ela- borating energies of the organization to the prevention of eliminative recuperation;—the utter worthlessness, of all such nosologizing, as has been heretofore exhibited to the world, is at once recognized by the philosophic practitioner of medicine—and by him exclusively. Similar complaints of misnomers have been often made by the highest oracles of the profession, whenever epidemic yellow fevers have been committing their ravages in our cities. Would such complaints have been made by them under the recognition of the true philosophy of disease? Through all ages, the same complaints, from the same sources have been made, on the irruption of pestilential epi- demics. The sages of medicine have yielded such philoso- phy, as they had,—luxuriated in hypotheses, and resorted to experimental medication. Would such have been the case under the true philosophy of the laws regulating the salutary, as well as insalutary ope- rations of the organization of man, from whatsoever causes arising? No—true philosophy is never unsettled—steadfast as crea- tion's basis, it pursues a straight onward course to legitimate results;—to harmony of sentiment, concordancy of action, and to community of philanthropic exertions, in the cause of suffering humanity. Spurious philosophy—baseless as the fabric of a vision— restless as the whirlwind,—is unceasingly luxuriating in the wildest hypotheses, and sophistical argumentations for sus- taining them ;—and pursuing an infinity of devious coursing, 140 all leading to illegitimate conclusions,—to the confirmation of errors and prejudices, and to interminable wranglings, between brethren of the same profession. To proceed in the illustration of our philosophy beyond all contradiction, we shall examine a few of the highest grades, of a long catalogue of diseases, which have always been considered and denominated nervous by the nosologists. We have proved that true philosophy utterly rejects the re- cognition of premonitory phenomena, as pertaining to any diseases whatever:—our examination, therefore, must be ex- clusively confined to the causative agents, their pathological consequences, and recuperative excitations characterizing them. And here it is forthwith to be observed and noted, that all the medical philosophers and nosologists, who have written on this extensive class of morbid sensibilities, have uniformly blended and confounded the pathological and re- cuperative phenomena together, in one chaotic jumble,—or rather, particularly, in all their highest grades, have assigned all, or nearly all, their characteristic manifestations to the pathological department. They have invariably considered the irregular and tumultuous agitations of the nervous orga- nization, as exhibited to observation in the highest grades of these diseases, by twitchings, cramps, spasms, and con- vulsions, as exclusively pathological phenomena;—when in truth, philosophy demonstrably proclaims them to be nothing more nor less than recuperative phenomena;—abortive in general, we admit, but such and such only, as the percipient centre of the organization, under the depressive effects of the true pathological phenomena constituting these diseases, may possess the power of instituting. Let us examine a few of these diseases:—in the first place, tetanus, for in- stance, one of the highest grades of the class idiopathically or traumatically considered;—our business is to indicate the true pathological and recuperative phenomena;—to separate them, and assign them their respective provinces in the phi- losophy of medicine. The conservative or resisting power of the organization, will not in this philosophical age of me- 141 dicine, be denied by any of our most talented, experienced, and philosophic practitioners. They will readily recognize, and philosophically separate, the true pathological conditions constituting idiopathic tetanus, from the recuperative excita- tions raised by the conservative powers ;—we shall, there- fore, not examine and enumerate them, but bestow a few observations on the traumatic kind, because characterized by manifestations of deeper depressions and congestions of ner- vous- energy, and more, intensely and uncontrollably ardent recuperative excitations. What then are the pathological phenomena constituting the morbid sensibilities characteriz- ing traumatic tetanus ? We can be at no loss to answer this question, when we consider philosophically the nature of the lesion, operating in its effects, to the production of this species of tetanus. A large nail, for example, penetrates either through, or nearly through the foot, lacerating thou- sands of nerves.in the cutaneous, tendinous, and. other com- pact nervous structures,—the inevitable consequence of which must, in general, be in susceptible constitutions, par- ticularly in the hottest seasons of the hottest climates, pro- ductive of the deepest depression and congestion of the vital energies, in and surrounding the lacerated region, when not favourably cured, either by nature or appropriate medica- tion. It seems never to have been duly considered, that the ragged and jagged tearing asunder of so many thousands of nerves, and compact structural condensations of nervous power, must of necessity, originate the very highest grade of morbid sensibility, under the circumstances mentioned. But it seems only necessary now to mention this undeniable fact, to instantly insure its admission and philosophic appre- ciation. The morbid sensibility thus induced then, in and around the lacerated region, is of the most concentratedly congestive description. The lacerated structures are all, not only supplied with, but exclusively composed of, myriads of nerves, which have consequently become receptive of mor- bid sensibility, of the most overwhelming description. 19 142 When these overwhelming pathological phenomena have originated abortive spasmodic recuperation, in what manner can they be eliminated from the organization ? The lacerated region has dried up, and apparently healed, without the su- pervention of such inflammatory recuperation, as is in all such cases, indispensably necessary to the production of sup- puration, sufficiently profuse to insure the elimination of the morbid sensibility, and prevent the occurrence of this horri- ble malady. Under such circumstances, in susceptible or- ganizations, exposed to the morbid operation of excessive heat, in favoured localities, traumatic tetanus, in some form or other, will be most certainly manifested to observation. In what departments of the organization then, when thus deeply pathologized, are we to look for, or expect such sana- tary exertions of the conservative powers, as may prove ef- fectual to elimination of the morbid sensibilities? If the resisting powers in, and surrounding the lacerated region, have proved inadequate to elimination; or, if it has not been effected through appropriate medication, and we have confirmed tetanus arrayed before us in all its horrors; the resisting powers should be medicated to the production of such inflammatory and febrific recuperation as may, when aided by appropriate regulation of such salutary recupera- tion, resolve and expel the pathological conditions from the organization, through the appropriate secreting and excreting emunctories. The nervous radicles of the cerebro-spinal regions, the grand originators and distributors, through their messengers the nerves, of all the varied powers, required for the institution and continuance of all the varied functional operations, of the varied organic structures, compositive of the total organization, must be medicated in such philoso-. phic manner, as to be rendered capacitative to the origina- tion and distribution of such nervous power as may be re- quired, for the production of febrific recuperation in the res- piratory and circulatory departments of the organization, for resolving and eliminating such intensely morbid sensibility as characterizes this and all other diseases of highest grades, 143 from whatever causes, when overwhelming the nervous energies of the system, totally to the preclusion of such na- tural and favourable recuperative excitations, as are indispen- sably necessary to effect the elimination of all morbid sensi- bilities whatever. But the origins of vitality in this disease are so intensely percipient of the injury sustained by the nervous structures of the lacerated region, that all the recuperative excitations raised by them are exclusively characterized by spasms or convulsions, or both, so that the pathological and recupera- tive phenomena are equally operative to concomitant con- gestions of nervous power, resembling the congestions both pathological and recuperative, characterizing many of the highest grades of cholera, or other plagues. Tetanus has no fever; and never was, or ever will be cured, in any other way, than by medicating" the innervating centres of the pa- thologized organization to the production of more or less inflammatory and febrific recuperation, according to the exigencies required by the philosophy of the morbid sensi- bility constituting it. It is therefore of the highest importance that practitioners of medicine should thoroughly understand the'philosophy, which should be put in thorough .requisition* for the successful treatment of tetanus and many other spas- modic diseases, (as they are erroneously nosologized,) arising from causes productive of equal, or more highly intense and aggravated morbid sensibilities. There is therefore no febri- fic recuperation raised by*the conservative powers in tetanus, and no inflammatory, except such as arises in the capillary circulation of the morbid lesion, and in the immediate neigh- bourhood of the radicles of innervation, from the ardent ex- ertions made by them, for the production of more favourable. recuperation. The sensorial powers, both of the cerebral and, (whatever may be said to the contrary,) spinal radicles of the organization, percipient of the morbid sensibilities, originated in the lacerated region, are so intensely and ar- dently exerted, that their recuperative efforts are confined exclusively to spasms and convulsions, which, if not con- 144 trolled and subdued by appropriately philosophic medica- tion, must inevitably terminate vitality. To subdue, there- fore, these spasms and convulsions, and thereby extend the recuperative excitations to the circulations, secretions and excretions, the only legitimate outlets through which all pa- thological phenomena are to be eliminated, we must, after due preparation of the system, by such appropriately debili- tating medications, as are particularly demanded by the spe- cific exigencies of the case, exhibit antispasmodic and nar- cotic remedies in any quantities, no matter how great, which may be found philosophically necessary to subdue the spasms and convulsions, and extend the recuperative excitations to the requisite standard of constitutional operation for effecting elimination; without which, no case of traumatic or idiopa- thic tetanus ever was, or will be cured. This is the amount of such medical philosophy as should be put in full requisi- tion for successfully treating traumatic tetanus, and many other diseases of equal or superior intensity of pathological and recuperative congestions. It is not so much therefore, owing to the positively in- curable nature of traumatic tetanus, and many other of the highest grades of diseases, from whatever causes originating, that physicians are in general, so unsuccessful in their treat- ment of them;—as it is to their lack of true philosophy, to direct them to the adoption of the true therapeutical indica- tions. We have indicated in general terms, the nature of such pathological and recuperative philosophy, as charac- terizes tetanus;—and we may now further add, that nothing more is necessary to the thorough understanding of it, than to simply reflect on the nature of the consequences which may so easily ensue, particularly in hot climates, in suscep- tible constitutions, from a nail run through the foot, and consequently dividing and tearing asunder the many and va- rious structures composing it;—lacerating many thousands of nerves,—the nerves of the true skin, of the muscles and their fasciae, and tendons, which are nothing more nor less, than compact condensations of nervous power, 145 for strength and motion;—of the nerves of the ligaments, bursas mucosae, cartilages, membranes,—membranes covering the bones, and the bones themselves ;—which are all more or less compact condensations of nervous energy, for purposes too obvious to require enumeration. In the state of health, these variedly nervous structures, for reasons equally obvious, are more or less insensible;—but when wounded, often as- sumptive of the most exquisite sensibility, and of pathologi- cal phenomena, characterized by the utmost intensity of pain and torture;—evincing demonstrably their compact nervous organization. Surely this simple consideration must needs lead every reflectingmind,direct to the recognition of the intensely congestive nature of the pathology of tetanus. If we further reflect, that all the nervous structures thus la- cerated, on account of their excessive sensibility, are adverse to the institution of such favourable inflammatory recupera- tion as is required for eliminating the morbid sensibilities by suppuration, and thereby preventing the disease;—surely we cannot help understanding with equal plainness, the na- ture of the recuperative phenomena instituted by the radical powers of the organization, when the nervous energies in and surrounding the lacerated region, become incompetent to effect the resolution and elimination of the pathological phenomena. In this and all other local injuries, inflicted on any department of the organization, nature first raises such irri- tative or inflammatory recuperation in the immediate vicinity of the morbid lesion as she is capable of, for expelling the morbid sensibility by suppuration;—and is frequently suc- cessful, leven without medication, when structures favourable to suppuration are wounded, or otherwise pathologized;— but the injured parts now under consideration, being ad- verse to suppuration, are frequently unrelieved by such local recuperation, though struggling to effect it, for several days before the true pathological conditions are formed, which call for the aid of the general or radical powers of the orga- nization. Under such untoward circumstances, all the rea- sons why the innervating centres become so intensely perci- 146 pient of the unrelieved congestion of the vital energies of the lacerated region, and act so ardently, as to transcend the powers required of them for the production of eliminative recuperation, and therefore expend their energies exclusively in the excitation of spasms and convulsions, are philosophi- cally self-evident. Or if the vital radicles of the organiza- tion, while thus intensely percipient, and spasmodically re- cuperative, extend their powers at all to the true recupera- tive departments of the system, such .powers of course will be evidenced in the respiratory and circulatory depart- ments, in such an agitated and tumultuous, hurried and flurried, and spasmodic manner, as is correspondent with their own convulsive operations. Surely the philosophy therefore required for the most effective treatment of such fixed, and, by nature, irremovable, pathological, and recupe- rative congestions, is sufficiently apparent, and summarily comprehended in what we have said above. This philosophy was put in thorough operation during the treatment of a case of unusually aggravated traumatic te- tanus, in November, 1829, in consultation with our esteem- ed friend, Dr. S. Mordecai. This case occurred and rushed to the development of all its characteristic phenomena with uncommon celerity,—in a strong and previously healthy, vigorous, and athletic, negro-man, about thirty years of age. He had received, ten or twelve days previous to the mani- festations of his disease, a punctured wound in one of his feet, from a nail, which had been neglected, and suffered to heal spontaneously, or rather dry up, without appropriate se- cretion for eliminating the morbid sensibility sequent to the laceration of the nervous structures. He was presented for treatment with the following essen- tially characteristic phenomena. His abdominal muscles were tense and rigidly contracted;—organs of deglutition spasmed, nearly to the preclusion of swallowing;—maxil- lary and temporal muscles affected with such spastic rigid- ity as to nearly close his jaws,—and quite so, during the continuance of his spasms;—his head and trunk stiff and 147 fixed, and all the flexor and extensor muscles of his organi- zation, so equally affected with permanent spastic rigidity, that his whole system was perfectly rigid, stiff, and straight, to the thorough constitution of true traumatic tetanus,__at- tended with all its highest and most alarming symptoms, great tightness and contraction of the thoracic muscles,'vio- lent pain and contraction at the anterior extremity of his sternum, convulsively darting to his spinal region;__abdo- minal muscles violently retracted;—countenance hideously distorted;—eyes immovably fixed in their orbits, &c. Here were pathological and recuperative congestions of the very highest concentration, and totally irremovable by any other than the most potent and appropriate medication, most perseveringly and untiringly persisted in. The bite of the most venomous serpent, or rabid animal, succeeded by the most copious absorption of their poisons into the circula- tion, could not have pathologized the organization to more certain destruction, than would have befallen our patient, without appropriately philosophic medication. In this case the respiratory and circulatory departments of the organization were affected with such tumultuous ner- vous agitation as characterizes genuine hydrophobia; and which has often been mistaken for fever,—without however manifesting any one of the characteristics of febrific recu- peration. Our patient was excessively anxious and alarmed about his situation, as he had often seen the disease, and never known it to have been cured. He was so certain that death must inevitably be the issue of his case, that he posi- tively refused, and for a long time persisted in refusing, to attempt to take any medicine; alleging that it was impossi- ble for him to swallow any thing;—evincing, in fact, nearly the same repugnance to such attempt, as the hydrophobic patient. With much difficulty we surmounted this obstacle in the case, and commenced our treatment with copious bleeding, which was appropriately repeated several times during the first seven days from the commencement of treatment;. — 148 during which time he was blistered from the nape of the neck to the sacrum, and extensively on the abdomen, and blisters dressed with camph. mercur. ointment:—hs was thoroughly rubbed every two or three hours, regularly day ahd night,' wi.th the most pungent and stimulant liniments, and*his bowels were kept regularly soluble by castor oil, and injections of oil of turpentine, though given with great- est difficulty. A deep" incision was also made in place of the wound in his foot, and dressed with lint steeped in spirit of turpentine, and a cataplasm of mustard saturated with aqua ammon. In addition to this medication, we gave him from the commencement of treatment, during the two first days, two grains and a half of opium and five of calomel;—the next two days, four of opium and ten of calomel; and the three next, five of opium and ten of calomel, every three hours re- gularly day and night; which, on the expiration of the se- venth day, resulted in the production of a highly agitated and tumultuous species of salivation, but with little, or no alleviation, of pathological or recuperative congestion. We therefore omitted the calomel, and gave him ten grains of opium every three hours during the next four days;—and between each dose of opium, a table-spoonful of musk mix- ture, from a six ounce phial, containing three drachms of musk, and three of laudanum;—at this time very partial re- laxation of spasm in extremities was discerned; and we gave 'him fifteen grains of opium every third hour during the two next days and nights, which produced a little more relaxa- tion of the contraction in the extremities';—but his head, trunk, and neck continued affected with unabated spastic ri- gidity. We therefore gave twenty grains every third hour during the next thirty-six hours, which produced further re- laxation of spasm in the extremities, and some relaxation of the spasms of the head, neck, and trunk;—to insure our vic- tory, we now gave thirty grains every fourth hour, increas- ing also the musk and laudanum, which had been regularly continued from the commencement of our opium course, as 149 well as all the other remediate measures first enumerated;— until, on the evening of the seventeenth day from the com- mencement of the case, the spasms and convulsive agitations of his system were resolved, with the exception of the spas- modic rigidity of his abdominal muscles, which, by a conti- nuance of the same remediate course for two or three days longer, were also resolved;—the congestive recuperation al- layed, and the pathologized condition of the organization so far meliorated, that the nervous radicles of vitality were re- stored to such salutary condition, as enabled them to .trans- mit the requisite vital influence to the circulations, for effect- ing elimination of the morbid sensibility from the organiza-' tion, through the appropriate secretory and excretory depart- ments of it. It may be remarked in this case, that although the first course of calomel and opium was in nowise operative to the relaxation of spastic recuperation, yet philosophy recognized it as instrumental in the production of very considerable amelioration in anticipation;—as it elicited a much more hurried and tumultuous condition of the respiratory and cir- culatory departments of the organization, and a state of spu- rious salivation participative of correspondently tumultuous characteristics;—all evincing, that the obstacles to the inci- pient institution of the salutary recuperative excitations of the conservative powers, were in their progress to removal. To thoroughly allay, therefore, the inordinate and convul- sive operations of the nervous centres, and enable them to extend their powers to the production of salutary eliminative recuperation, further bleeding, and more diligent frictions were used, and thorough purgation by castor and terebin- thinate oils persisted in, for tranquillizing the organization down to the standard required, to enable it to act effectively curative of the morbid sensibilities,—and our main medicat- ing agent, opium, was therefore given, and gradually in- creased, to an extent which may appear enormous to most practitioners, but not greater than the true medicating philo- sophy legitimately pertaining to such concentrated patholo- 20 150 gical and recuperative congestions, rendered positively and indispensably necessary. And here it may not be inappropriate to observe, that the successful treatment of the above related unusually severe case of traumatic tetanus—a disease very seldom cured— presents us with a satisfactory and beautiful demonstration of the modus operandi of appropriately powerful and philo- sophic medication, in resolving the pathological and recupe- rative congestions, characterizing many of the highest grades of diseases, to such extent as to enable the conservative powers to institute the requisite febrific and inflammatory excitations, for eliminating the morbid sensibilities through their legitimate emunctories. Practitioners of medicine in all ages have been in utter darkness respecting the philosophy pertaining to the nature and characteristics of the highly concentrated pathological and recuperative congestions, constituting not only tetanus, but all other diseases of highest grades, from whatsoever causes arising; and however successful some of our most ta- lented and experienced physicians may have at times been, in the treatment of such diseases,—they have not been so, under the knowledge and guidance of the true philosophy pertaining to them. The pathological and recuperative phenomena pertaining to traumatic tetanus, it is to be observed, and particularly noted, are not only originated, but continued, by mechanical causes;—by solid substances dividing, compressing, lacerat- ing and wounding, in some way or other, the nervous struc- ture of some part or parts of the nervous organization;— consequently, there is no absorption of deleterious matter, either in a liquid or gaseous state, to render the innervating centres positively immedicable to the elimination of the morbid sensibilities, through the legitimate emunctories. Philosophy, therefore, does not proclaim the incurability of traumatic tetanus to be by any means so inevitably grounded, as those highest grades of morbid sensibilities arising from copious absorptions of virulent poisons, either of the animal 151 or vegetable kind;—for these, frequently, pathologize the organization to irreouperation,—to instant or inevitably ra- pid destruction. We thus unfold to practitioners such philosophy as will certainly enable them to institute such treatment as will, if appropriately persisted in, generally eradicate the morbid sensibilities constituting idiopathic tetanus from the organi- zation, when not arising from such overwhelmingly delete- rious remote causes,—from such virulently poisonous mias- mata as are frequently engendered by putrefaction, in the densely populated localities of miasmatic regions, and ren- dered inevitably operative to the pathologization of the or- ganization, totally beyond the power of recuperation, either by the efforts of nature or medication. Traumatic tetanus, therefore, when occurring in constitutions previously sound and vigorous, we see, may be cured by appropriate medica- tion persisted in to the extent required by the true philoso- phy pertaining to the pathologized condition of the organi- zation;—and we recognize with equal facility, the total phi- losophy pertaining to the idiopathic kind, which is indispen- sably necessary to be put in thorough requisition for elimi- nating the morbid sensibilities constituting it,—and that it may with certainty lead us to the institution of successful medication for all such cases occurring in healthy constitu- tions, when not remotely arising from poisonous stimuli pathologically saturating the organization to the total extent of irreouperation. Both kinds of tetanus, therefore, should be erased from the opprobrious list of diseases, because not arising from causes which pathologize the organization beyond redemp- tion, except under the circumstances which have been just mentioned and explained. We may consider ourselves as having now in palpable view the philosophy of the causes which render traumatic tetanus by appropriately potent medication so often curable, when occurring in sound constitutions, and so often incura- ble in constitutions previously debilitated from any causes. 152 And we may consider ourselves as having fully in view the causes which render all diseases arising from all causes that are subject to appreciable examination to much extent, cura- ble or incurable. To this conclusion we are inevitably con- ducted, by considering what should never for a moment be lost sight of by medical investigators, viz. that the central radicles of innervation in the healthy organization are un- ceasingly operative in preventing the intromission of noxious agents, by imparting to respiration and arterial circulation, such nervous powers as are respectively required by them for animalizing, vivifying, and elaborating all the various structures to their various healthy functional operations. These two grand agents of the nervous centres, while salu- tarily supplied with their appropriate powers, are incessantly engaged in elaborating the energies of the total organization to the reception of appropriate stimuli from without and within its own domain; elaborating them to the selection and reception of salutary stimuli from without, and within the organization, through its absorbent nervous power, exclu- sively inherent and operative in the capillary circulation, throughout all its varied organic structures, in the tegumen- tary envelopes within, and without, and in its various paren- chymatous structures. The capillary and venous circulations of the healthy organization are therefore constantly elaborated to an elective attraction, for salutary stimuli, by the nervous centres rendering themselves operative to such effect, through their vivifying apparatus of respiration and arterial circula- tion. They are thus rendered elective to appropriate stimuli from the physical creations, and to all the variously appro- priate stimuli elaborated, in consequence of such election, throughout its variously structured vital domain. Health, therefore, or an elective attraction for salutary stimuli, consists of the constant absorption, transmission, and distribution of appropriate salutary stimuli to the radical nervous centres, which distribute them in appropriate quan- tities to their vivifying, respiratory, and circulatory appara- tus, for elaborating all the varied energies required by the 153 varied organic structures, compositive of the total organiza- tion. It is therefore obvious, that as noxious agents must overpower this elective attraction, to effect their entrance into any department of the organization, they will proceed to greater or less ravaging extent, according to their malig- nancy of composition, and to the strength of the resisting powers of the organization; consequently, that the morbid sensibilities constituting all diseases, will be more or less mild or severe, more or less local or general, in degrees cor* responding in a strictly philosophical manner with the nature of the causative agents, and the predisposition or idiosyn- crasy of the constitutions receptive of them. As is there- fore, the nature of the causative agent and the condition of the organization receptive of it, such will inevitably be its effects. By the inductive process of reasoning, we have intuitive demonstration of the modus operandi of the agents produc- tive of both idiopathic and traumatic tetanus; and are forth- with conducted, by the continuance of such reasoning pro- cess, to the institution of such methodus medendi, as will eliminate the morbid sensibilities constituting them, through the appropriate emunctories, in all cases in which elimina- tion is rendered possible through appropriate medication. Man must sooner or later yield his terrestrial vitality to the causative agents of disease; yet in any, or every case of dis- tempered organization, arising from causes accessible to ap- prehension and appreciation, by appropriately estimating their effects, and the nervous energies remaining in the con- stitutions receptive of them, agreeably to the principles de- veloped by our philosophy, we may reach such diagnostic certainty, as will enable us to predict unerringly the con- sequences which will ensue from appropriate medication. We have made these few observations, for the purpose more particularly at the present time, of unrolling to the re- cognition of common sense, the true philosophy pertaining to hydrophobia. This disease, when arising from the recep- tion of a sufficient quantity of the rabid virus in a highly 154 matured state of malignancy, must in the present state of our knowledge, be considered incurable. In its highest grades it is incurable,—because, the poisonous virus causative of it, is absorbed into the circulations, and through them, the in- nervating centres, and every department of the organization become pathologized, to the total preclusion of resolving the convulsive recuperation characterizing it, by any medica- tion, to the requisite standard for enabling the conservative powers to eliminate the morbid sensibilities through the le- gitimate outlets. The rabid virus originating hydrophobia of highest grade is, therefore, so concentratedly malignant, as to poison the vital fluid, and consequently the total orga- nization,—beyond the power of any effective recuperation, by nature, or art. Until, therefore, (if it be possible,) some therapeutic agent, or agents, can be discovered, which will neutralize and expel the virus and its effects from the circu- lations, so that the morbid sensibilities may be eliminated through their only legitimate outlets, this disease must be considered incurable. The hydrophobic virus, however, like all other agents, acting deleteriously, when absorbed into the circulations, has its degrees of malignancy, and is there- fore operative to the production of pathological conditions, in correspondent degrees. The noxious stimuli originating yellow fevers, choleras, plagues, &c, of the very .highest grades, are as positively destructive of total vitality, as is the most malignant rabid virus; and equally require neu- tralizing, or antidotal medication, for their elimination from the organization. We plainly see, therefore, through the whole philosophy pertaining to this disease :—plainly see that the cases of it recorded to have been successfully treated, must inevitably have been originated by virus much less matured in malig- nancy, than such as originates the highest and incurable grades; for we may as readily recognize, and philosophically appreciate, the operativeness of appropriate medication in re- solving and eliminating the effects of the noxious virus cau- sative of what may be philosophically denominated, the 155 milder or medial grades of hydrophobia, as we can appreciate the efficacy of appropriate medication in resolving and elimi- nating the morbid sensibilities constituting the mild and me- dial grades of yellow fever, cholera, &c.—and in a general sense considered, as respects the operation of noxious agents on the organization, on identical principles.. We can plainly see also, that many of the cases of hydro- phobia recorded to have been cured, must have been of the tetanic kind ;—must have arisen from wounded nerves, ten- dons, &c* without the absorption of the rabid virus into .the organization:—for it is plainly to be recognized, that this may often be the case, from the nature of the part bitten being little prone to absorption, as is evidently the case in many of the compact nervous structures most liable to be wounded by the rabid animal. We can see therefore through the medium of a light, as dazzlingly palpable to philosophic observation and apprecia- tion, as meridian sunshine,—all the causes which render all the diseases of the very highest grades, arising from the highest noxious stimuli, in their states of highest concentra- tion, so difficultly eliminated, and with equal clearness appre- ciate the reasons, which render appropriate medication so easily conductive to the elimination of all the morbid sensi- bilities constituting the milder grades arising from their cor- respondently mild causes. Tetanus and hydrophobia amongst all the diseases arranged by the nosologists under their class of neuroses, are, patho- logically considered, of the very highest grades,—and recu- peratiyely*considered, of the very lowest and most unfavour- able,—for which reason we have selected them, to settle such philosophy as pertains to them etiologically and recu- peratively. This we have indisputably effected. They are both unaccompanied by febrific er inflammatory recupera- tion, that can be rendered available to elimination, and neither of them can be cured, without raising such re- cuperation by appropriate medication. The speculations of authors respecting the inflammatory, or nervous character, 156 of hydrophobia, are totally unscientific, and at variance with all true philosophy pertaining to it, as we have unanswera- bly demonstrated. The tumultuous agitations manifested in the respiratory and circulatory departments, are spasmodic and convulsive actions;—or such abortive recuperative exci- tations, as the deeply pathologized organization is alone ca- pable of instituting;—and the marks of inflammatory action supposed to be discovered by post mortem examination,— and of sanguineous congestions, serous and sanguineous effu- sions, &c. are nothing more nor less than the marks charac- terizing the sequences, of intensely ardent convulsive recu- peration—both as they are exhibited to view in the neigh- bourhood of the morbid lesions, nervous centres, brain, lungs, &c. All such wounds as may become liable to originate either of these terrible maladies, should never be permitted to heal spontaneously. If not excised immediately, when practica- ble or expedient, and the poisonous virus thus prevented from entering into the system, or prevented by appropriate suction, by cupping, &c.;—the wounds should be freely en- larged, and such applications made to them, as will produce such inflammatory recuperation in, and surrounding the la- cerated regions, as may be required for eliminating the mor- bid sensibilities through copious suppuration. Wounds heal- ed in this manner are never prbductive of either tetanus or hydrophobia. When, however, from the neglect of this sim- ple medication, such diseases are fully formed, any applica- tions to the wounded regions, for the purpose of producing suppuration, are for reasons too obvious now to mention, ut- terly unavailing. The nervous power in and surrounding the lacerated regions, has expended all its eliminatiye agency without effect;—the morbid sensibility has become conges- tive of nervous energy in the highest degree, and the ner- vous centres have taken exclusively the charge of recupera- tion into their own power;—and these powers are convul- sively and. abortively exerted to the rapid expenditure of the vital energies of the system, without the possibility of ef- 157 fecting eliminative recuperation. In such deplorable patho- logical and recuperative congestions as characterize traumatic tetanus, we have seen, that true philosophy when put in thorough requisition, may often achieve a conquest;—a glo- rious conquest, of which the scientific practitioner may well be proud. It follows, therefore, that if it should be considered neces- sary, after traumatic tetanus is fully formed, to make any applications to the morbid lesion, they should be exclusive- ly of the emollient and anodyne kind:—consequently, such applications as were made to the lacerated region in the case of tetanus above related, were evidently useless, probably, posi- tively injurious—but certainly, not philosophically indicated. It is impossible to understand the philosophy of diseases, without studying them in their highest grades;—without thoroughly investigating the nature and characteristics both of the pathological and recuperative phenomena manifested by them, and understanding with equal thoroughness the ex- tent of departure of the pathological, from the healthy phy- siological phenomena;—and estimating with appropriately philosophical exactitude, the character of such recuperation as may be raised either by nature or art. Without such knowledge, we must forever grope about in darkness, and our practice be forever tentative and empirical;—but with it philosophical and effective, in all cases not by their nature positively incurable. True philosophy designates at once the curable from incurable cases;—and with equal facility desig- nates the appropriate remedies, with their requisite degrees of potency, and modes and quantities of exhibition, for effect- ing resolution of the congestions, and elimination of the mor- bid sensibilities. We have selected, therefore, for the illus- tration of our philosophy, some of the very highest grades of diseases, arising from their respectively and specifically varied causes, and found, that however different the causes and pathological conditions arising from them may be from each other, they are all either accompanied, or sooner or later succeeded,—or never,—by much homogeneity of re- 21 158 cuperation, viz. homogeneous, in the sense, that they are all, (however differently characterized in general, or modified in particular they may be,) such recuperative excitations, as the conservative powers in each and every case, are capable of raising, for effecting resolution and expulsion of the patholo- gical phenomena;—and are invariably manifested to our ob- servation, by irritations, inflammations, fevers, spasms, con- vulsions, or anomalous tumultuous agitations of the nervous vital powers;—or by none at all;—as is undeniably the case whenever the organization is rendered torpid or paralytic by the noxious stimuli, to the preclusive extent of exciting any recuperative action at all. Now, in what book or books is such philosophy to be gathered, as will lead the general run of practitioners to the adoption of such medication, as will most effectually resolve such overwhelming pathological and recuperative conges- tions, and effect elimination of the morbid sensibilities con- stituting diseases of highest grades, arising from whatsoever causes? We are unfolding such philosophy as recognizes the causes productive of such overwhelming congestions, and of the remediate measures best adapted to effect their resolu- tion, and to excite the requisite recuperation, for eliminating the effects of the morbific agents from the system. All effec- tive medication in such highly concentrated cases of morbid sensibility, and congestive recuperation, must consist of the most appropriately potent agents, and be exhibited with the most philosophic and untiring perseverance, to conduct them to successful results. The same therapeutical philosophy should be put in thorough requisition, for resolving the pa- thological and recuperative congestions from whatsoever eausative agents arising, and eliminating the ravaging conse- quences of the deleterious stimuli from the organization. All the higher grades of diseases, whether characterized by spas- modic or febrific recuperation, are to be medicated on simi- lar principles, to insure elimination of the morbid sensibili- ties constituting them. Spasmodic recuperation is to be re- solved and converted into the febrific, and the febrific to be 159 medicated to such secreting and excreting standard, as is positively and exclusively necessary, to insure the thorough expulsion of the effects of the noxious agents, through the legitimate outlets of the organization. The prominent characteristic of all the colics, mentioned by all the nosologists, is spasm;—considered by them, and all the rest of the medical world as the characteristic patho- logical phenomenon;—whereas, it is such congestive recupe- ration as pertains to the disease, and until it be resolved by appropriate medication, and febrific recuperation,instituted in the respiratory and circulatory departments of the organi- zation, these diseases cannot be conducted to successful issues. There never was a disease of this kind, of highest grade, conducted to successful result in any other way, than by re- solving the spasm,—and then conducting the energies of the system to the excitation of such febrific recuperation as may prove, under appropriate medication, thoroughly eliminative of the morbid sensibilities. For although colic be a restrict- edly local disease, and either primarily accompanied, or sooner or later succeeded, in mild cases, by irritative or slightly inflammatory recuperation, which may prove suc- cessful to elimination, even when, at the same time, accom- panied or intermixed with slightly spasmodic recuperation;— yet, whenever the pathological conditions are highly con- centrative, they are inevitably succeeded by such highly congestive spasmodic recuperation, that the local recuperative energies of the affected region are totally inadequate to the production of the series of curative processes, indispensably necessary to effect elimination. The spasms must therefore be resolved by appropriate medication, and the inflammatory recuperation medicated to the eliminating standard by vene- section, warm bathing, &c. and appropriate purgation, after spasms are allayed, &c. By such medication repeated and persevered in, according to the exigencies of the case, the pathological conditions will be so far allayed, and the spas- modic recuperation so far subdued, as to enable the conser- vative powers by the continuance of appropriate medication, 160 to institute the necessary febrific recuperation in the respi- ratory and circulatory departments of the organization;— which alone, by the continuance of such medication as is philosophically appropriate to the recuperative state thus in- duced, will produce thorough resolution of all the conges- tions, and eliminate the morbid sensibilities totally from the organization. It is therefore to be particularly noted, that the higher grades of these diseases cannot be medicated to successful results, except the pathological and recuperative congestions characterizing them, be so far resolved and al- layed, that the conservative powers may institute the neces- sary febrific excitation, for the production of thorough elimi- nation of the morbid sensibilities constituting them. Apoplexies, palsies, epilepsies, catalepsies, manias, &c. and all others of the higher grades nosologized as nervous by medical authors, are to be successfully medicated exclu- sively on the same philosophical principles. Such primary local pathological and recuperative congestions as characterize them, are to be so far subdued, as to permit the extension of the recuperative powers to the respiratory and circulatory organs, which alone can thoroughly subdue them, and elimi- nate the distempered sensibilities from the organization. All morbid sensibilities whatever of highest grades, oc- curring in any part or parts of the organization, characterized by pathological and recuperative congestions of high concen- tration, are to be medicated to successful results exactly and exclusively in a similar manner, in a general sense consider- ed, viz.—they must, however differently characterized they may be, as arising from different specific causative agents, be medicated to elimination through the secretory and ex- cretory departments of the organization. True philosophy unanswerably proclaims these to be the only outlets through which their elimination can be effected. All diseases exclusively local, however they may have been nosologized, are to be medicated to resolution and eli- mination, either by nature or art, through recuperative pro- cesses, in a general sense considered, exactly similar to each 161 other. These processes in the exclusively local diseases of every description consist of recuperative excitations in the capillary circulations, identical with those raised in the ge- neral circulations for eliminating the morbid sensibilities. The recuperative manifestations are the same in the one as the other, in a philosophical sense considered;—and their regular terminations in resolution, suppuration, and mortifi- cation the same;—and they are subject to identical anoma- lous terminations, from similar causes,—from the malignant nature of the noxious agents productive of them, or the un- healthy states of the constitutions receptive of them,—whe- ther the recuperative excitations are restricted exclusively to the capillary circulation, or extended to all the circula- tions. A very partial consideration bestowed on any disease lia- ble to remain local in the capillary circulation, or to be trans- mitted to the general circulations for elimination, will con- clusively illustrate this sweeping proposition to intuitive demonstration. We may take for instance a lacerated or gunshot wound. When restrictedly local, the inflammatory recuperation is beautifully manifested to observation during its whole progress, until it has effected the thorough elimi- nation of the morbid sensibility from the affected department of the organization, by appropriate suppuration. When such wounds are extensive, and characterized by deep depressions and congestions of the nervous energies of the parts impli- cated in the morbid sensibilities, the vital energies of the surrounding sound parts are inadequate to the production of their elimination through suppurative resolution, as it should be denominated;—and the innervating centres, therefore, institute recuperative excitations, not only in and through the general arterial circulations, which are propagated to the capillary, with the requisite momentum for raising the ne- cessary elaboration of pus, for effecting elimination locally,— but also for effecting general and thorough elimination of such morbid constitutional sensibilities as may have sympa- 162 thetically occurred, through one or more of the general se- cretions and excretions. Or the noxious agents may have occasioned such concen- trated depressions and congestions of the vital energies in and surrounding the lacerated region, that neither the local, or both sets of recuperative excitations conjunctively, can, even by the aid of the most appropriate medication, be made to terminate in such salutary suppuration as is indispensably necessary to cast off the effete and useless portions of the organization destroyed by the wound:—in consequence of which recuperative inability, in both the capillary and ge- neral circulations, whether acting too excessively or dimi- nishedly, mortification and death will be the inevitable se- quents. Mortification under such circumstances ensues, from the concentratedly malignant pathological phenomena over- powering both the local and general recuperative pheno- mena:—in which case, they gnaw away, and rapidly extend their festering ravages to the total destruction of both local and general recuperations, whether they be raised and exer- cised by the innervating centres too excessively in strong and vigorous constitutions, or in weak and debilitated con- stitutions, too deficiently. And here we may very appropriately observe, that medi- cal philosophers have never given due consideration to the causes of the different recuperative manifestations, either ac- companying or succeeding the different pathological pheno- mena, arising either from different noxious agents, or from salutary agents when acting in excess or deficiency, on and in the organization. All noxious agents invariably depress and congest the vital energies of that part, or those parts, of the organization, to which they are applied, or extended, through the operativeness of such mutuality of sensation as is inherent, and in a greater or less degree rendered active by morbid excitation received from noxious stimuli, in greater or less degrees throughout the various structures of the or- ganization. 168 It certainly is a perfect absurdity to suppose, that poisons can raise the vital energies of the organization, as long as they remain rankling in any of its departments. The pro- position, that all poisonous agents, when effecting their loca- tion on or in any part of the system, act invariably to the depression, congestion, and destruction, in a greater or less degree, according to the malignant nature of the poisonous agents, and the ability of the constitutions receptive of them, to resist their deleterious influences, needs but to be men- tioned to be unqualifiedly admitted. They never raise the vital energies of the organization:—the resisting, conserva- tive, recuperative powers of the constitution, raise all the excitement, irritative, febrific or inflammatory, or spasmodic and convulsive;—they raise all the reactive movements in each and every case that are raised;—for in many cases, no recuperative excitations are ever raised, either by nature or medication ;—proving incontestibly, that noxious agents, highly malignant in their composition, depress and congest, not raise and excite, the energies of the organization to in- creased actions, in any of its departments, or in a total sense considered. This proposition is self-evident and incontro- vertible ;—consequently, the only one which can lead us to the appropriate recognition and appreciation of the patholo- gical phenomena constituting all diseases whatever, and of the recuperative excitations raised by nature for their reso- lution and expulsion from the system. As is therefore the destructive nature of the noxious agents, such are and inevi- tably will be the peculiar and specific pathological conditions sequential to their entrance into any part or parts of the sys- tem. Such pathological conditions will be manifested to ob- servation by such symptomatic phenomena as are, and inevi- tably must be, 'strictly and philosophically consistent with the specific nature and operation of the noxious stimuli, and the specific functional operations of the specific organic structures invaded by them:—and the recuperative manifes- tations will be equally correspondent with the depressive effects of the noxious agents, and ability of the resisting 164 powers of the constitution;—and they will be raised in a more or less favourable manner accordingly, or not at all. Through the judicious application of the unerring princi- ples of this philosophy, we can most assuredly recognize and appreciate the reasons, which render the pathological pheno- mena characterizing jail, hospital, and camp fevers, as they are called, and all others, however nosologized, that are cha- racterized by adynamic and ataxic modifications, and ano- malous variations, of recuperative phenomena, so difficultly eliminated from the organization, either by nature or appro- priate medication. Whenever, therefore, the pathological phenomena origi- nate the low typhoid, or asthenic recuperative excitations, of the febrific and inflammatory kind;—or spasmodic and convulsive recuperations;—or recuperative excitations cha- racterized by the feeblest and most inefficient febrific and inflammatory action, intermixed more or less with nervous tremors, and agitations, subsultus tendinum,&c:—whenever and wherever we find such abortive attempts made by the conservative powers for elimination, we may be assured that the pathological phenomena have arisen from poisonous agents, highly matured in malignancy of composition;—and that whenever no recuperative excitations at all are raised, they must have arisen from poisonous stimuli, still higher matured in malignancy. By duly discovering and estimat- ing therefore the states or degrees of malignant concentra- tion of the noxious stimuli, which are productive of patho- logical phenomena so overwhelming the vital powers of the organization, we readily recognize the causes of all such feeble and unavailing recuperative phenomena, as must in- evitably, sooner or later, if at all, succeed them, whenever the powers of the nervous organization are not depressed and congested to the positive extent of irrecuperation. On the other hand we can as readily recognize the reasons why more energetic recuperation is raised by such patholo- gical phenomena as are originated by cold, or other more ordinary causes, operating on healthy and vigorous consti- 165 tutions;—or why more energetic recuperation is raised in vigorous constitutions, when receptive of the most virulent noxious stimuli in small quantities, or of noxious stimuli less matured, in malignancy in large quantities, &c. We thus develope the unerring philosophy pertaining to the nature and characteristics of all the inflammations;—that they are recuperative excitations, not diseased actions—that they are invariably, whenever the conservative powers are capable of raising them, sooner or later sequential to the pa- thological phenomena which originate them, as proximate causes, and are consequently characterized universally, in a manner corresponding with the depressive effects of the noxious agents, and the ability of the conservative powers to institute them. True philosophy requires us to consider inflammatory re- cuperation as invariably local, whether characterized by more or less sthenic or asthenic-action, and exclusively ope- rative in the capillary circulation, whether adequate to effect elimination pf the morbid sensibilities originating it through its own sanative efficiency, or whether the radical powers of the organization are summoned to its aid, in effecting febrific recuperation in the general circulations, for the purpose of producing thorough elimination of the morbid sensibilities from the organization. It is equally evident that inflammatory recuperation must in all cases,from whatsoever pathological phenomena originat- ing, remain local. It is evident also, that inflammatory or ir- ritative recuperation is universally the primary recuperation instituted by the conservative powers in the capillary de- partments of the organization;—because the noxious agents invariably pathologize the organization primarily, in some one or more of its peripheric departments;—therefore, and inevitably, originating primarily, irritative, or inflammatory recuperation, and secondarily, febrific recuperation, in the general circulations, to conduct the primary to the power of eliminating the pathological phenomena when they are not of themselves sufficient for the purpose:—febrific recupera- 22 166 tion must, therefore, be always secondary or sequential to the primary irritative or inflammatory;—consequently as se- condary recuperations are always supervenient to the pri- mary, idiopathic fevers are precluded from the recognition of our philosophy. This explanation of the modus operandi of the pathological phenomena, from whatsoever agents origi- nating, is perfectly consistent with all such recuperative phi- losophy as we have heretofore advanced; and will stand the test of the most scrutinizing analytic investigation;—-in what- ever part or parts of the organization the pathological phe- nomena are primarily located, whether in the external or in- ternal dermoid, or parenchymatous structures:—and will equally stand the test of such analysis, whether our re- searches be confined to the deleterious operations sequential to the application of causative agents exterior to the organi- zation, or to such as arise secondarily in the interior of the organization, however remotely derived, may be the causes of such interior pathologization. We proceed therefore to observe, that inflammatory recu- peration must inevitably, in all cases, be locally instituted, by the pathological phenomena; and invariably remain*local. Ii is utterly impossible that inflammation can ever be gene- ral,—pervading the total organization; as it is the direct se- quent of the pathological phenomena,—and cannot occur without their supervention. As long therefore, as the excit- ing causes of such inflammatory recuperation remain opera- tive in any part or parts of the organization;—as long as the morbid sensibilities, or pathological phenomena remain, in any part or parts of the organization, depressing, debilitat- ing, and deranging the physiological conditions of the said part or parts;—it is utterly impossible for the total organiza- tion to become assumptive of inflammatory action:—because inflammation in all its degrees, however sthenically or asthe- nically manifested to observation,—is invariably character- ized by one prominent symptom,—an afflux of fluids to the part or parts pathologized by the causative agents, sooner or later, according to the greater or less prostration of nervous 167 energy occasioned by them,—but in all cases prior to the in- stitution of febrific recuperation in the general circulations. All noxious stimuli, which on application to the organiza- tion do not instantaneously demolish its radical powers of total innervation, effect the intromission of their ravaging influences, more or less locally, through one or more of its departments, externally or internally considered, by over- powering their elective attraction for salutary stimuli;—and these ravaging influences, if not rapidly extended through sympathetic sensibility to all.the important organs preserva- tive of vitality,—are sooner or later succeeded by recupera- tive excitations, primarily irritative or inflammatory, which, if not sufficient to produce elimination of the pathological phenomena, are sooner or later succeeded by febrific recu- peration in the general circulations, or by spasmodic and convulsive recuperation, whenever the nervous centres be- come so intensely percipient of the morbid sensibilities as to preclude the extension of their recuperating powers to the general circulations, which alone, under such circumstances, are capable of effecting elimination. This is the indubitable deduction of veritable philosophy;—the total amount of such pathologic and recuperative philosophy, as becomes lumi- nously palpable to observation, in the direct line of such cause and effect, as is directly and inevitably sequential to the intromission and deleterious operation of the causative agents of disease, whether arising from noxious stimuli, in the physical department of creation, or from noxious stimuli secondarily elaborated in the interior of the organization, through the deleterious operation of a variety of causes re- motely operative to the production of such noxious stimuli as constitute the pathological phenomena characteristic of hereditary diseases, &c. This philosophy pertaining to the organization of man, when pathologized from whatsoever causes, not operative to the total inhibition of recuperative excitation, precludes the possibility of either idiopathic fevers, or inflammations in the general circulations, ever under any circumstances, be- 168 coming directly and primariry supervenient, to the operation of the causative agents of diseases. The different degrees of receptivity for stimuli of every description, of the different organic structures composing the total organization, conclusively preclude us from recognizing the possibility of its becoming assumptive simultaneously, throughout all its varied structures, of either universal patho- logization, or recuperation. If the total organization could be simultaneously affected by noxious agents, without extin- guishing its total vitality;—could idiopathic fevers or inflam- mations be instituted by the innervating centres of a system of vitality, thus universally assailed? If every individual tissue of the organization could be simultaneously affected with pathological conditions, would it not be so, to the total preclusion of any recuperation, and to the sudden or rapid extinction of total vitality;—or if any could occur, would it not be totally useless, and unavailing? Lightning in suf- ficient quantity, kills instantaneously, by destroying the ner- vous radicles of the total organization;—not the feeblest spasm occurring, after its reception. Many other noxious stimuli extinguish total vitality with nearly equal rapidity, without any other recuperative manifestation than a convul- sion or two, at the last gasp of expiring nature. The organi- zation in such cases may be considered as having passed from the vital, to the disposal of physical laws. We may there- fore with truth undeniable, conclude, that, if the constitution could throughout all its varied structures become simulta- neously receptive of pathological conditions, from any noxi- ous agents, it would be to such extent, as to positively pre- clude any inflammatory, or even spasmodic recuperation other than the feeblest and most unavailing. Are not fevers and inflammations and all other recuperative excitations there- fore, to be recognized as salutary and not diseased operations of the organization? And are not idiopathic inflammations and fevers in the sense contended for, by many authors to be recognized by veritable philosophy, as impossible crea- tions? 169 We are not engaged in writing a treatise on inflammation__ we are engaged in simply unfolding in the most general terms, the outlines of the philosophy of medicine;—not in giving the subject of inflammation, a thorough philosophic discussion. We shall therefore at present, neither advert to the differing characteristics of the pathological phenomena originating inflammatory recuperation,as arising from its numerous and variant causes';—nor to the differing charac- teristics of which the pathological phenomena become as- sumptive, when occupying the differently varied structures of the organization, and correspondently modifying the in- flammatory recuperations, primarily sequential to them;— nor to the different terminations of the different inflamma- tions, thus differently originated and characterized;—be- cause, all such variations will be readily recognized, by all philosophic practitioners, as legitimately and specifically, arising from their respectively varied causative specificities, both as respects the causative agents, and the constitutions receptive of them. It may not be however inappropriate on the? present occasion, to observe, that, the conflicting opi- nions of medical philosophers, respecting the actual state, or condition and nature, of the action of the vessels concerned in the production of such afflux of the vital fluids, as promi- nently characterizes inflammatory recuperation, are easily re- conciled. The arterial circulations elaborate all the creative, pre- servative, and recuperative energies;—consequently, increas- ed actions in the vessels is primarily and ultimately to be ob- served and recognized in all inflammatory recuperations, terminating in expulsion of the morbid sensibilities origi- nating them through resolution. The* action of the vessels concerned in the production of such inflammatory recupera- tion as terminates in suppuration, are both in the incipient and intermediate states of the inflammatory progress, in- creased much beyond their natural actions;—but in the ulti- mate stage of it, their actions are diminished below their natural standard. They then become slower, in consequence 170 of such engorgement as occurs from the effusion of such coagulable lymph and serum, as are necessarily supervenient to the formation of the suppurative resolution, required for eliminating the pathological phenomena from the organiza- tion. The actions of the vessels also operative to the pro- duction of such inflammatory recuperations, as are to termi- nate in mortification, are, during the incipient and interme- diate states of the process, very much increased beyond their natural standard of action, both in the sthenic and asthenic species:—they are so violently increased in both species by the pathological phenomena originating them, that they run to the production of such indirect debility in the structures of the part or parts, assumptive both of the pathological phe- nomena and recuperative excitations, as terminates in the death of the entire region thus affected. It is primarily and consecutively considered, a state of inflammatory recupera- tion, altended with much increased arterial action, which is ultimately considered, overpowered by the pathological phe- nomena to the production of such recuperative congestion, as permits them to terminate the combat in disorganization and destruction of the affected region exclusively, or of the total organization, according to the nature of the vitality of such departments of it as are pathologized. And here we consider it not inappropriate to observe, be- cause illustrating conclusively the fundamental proposition supportive of our philosophy,—that by a wise provision of nature the tendency of pus, as well as of the products of in- flammation, leading to resolution, are to the surface of the organization. This.is easily explained by appropriately re- cognizing and appreciating the nervous system to be exclu- sively the creative, cohtinuative, and preservative system of the total organization of man. The innervating centres of the nervous organization are the sources from whence ema- nate, in a more or less direct or indirect manner, all the various kinds of vitality, pertaining to the various structures of the organization, and operative in its healthy condition to the production of one beautiful harmonious whole system, of 171 vitality, philosophically irresolvable into divisibility or insu- lation of parts. Through the mediation of the nerves origi- nating in the central radicles of vitality, in a more or less direct manner, all the vital influences necessary to the pro- duction of such harmonious whole system of vitality, are in requisite degrees dispensed and distributed throughout the external and internal tissues of the organization in such por- tions, ways and manners, as they severally need, from these central radicles of vitality externally and internally consi- dered, to the Circumference of the system. Their action is invariably, from the centre to the circumference of the sys- tem, more or less immediately or mediately, according to their more or less direct origination in the cerebro-spinal centres, or in, or from the nervous plexuses and ganglia. We thus recognize the causes which determine the favourable products of inflammatory recuperation in whatever depart- ments of the organization occurring, from the centre to the periphery of the organic structures. This important consideration, based on recognizing the nervous organization, as acting to the production of one beautiful and harmonious whole system of vitality, although composed of such varieties of structures, and for correspon- dent varieties of functional operations;—developes forthwith, to common sense and reason, such principles as should be put in requisition for arriving at the knowledge of such the- rapeutic philosophy, as may guide and direct us to the adop- tion of the most efficient remediate measures for resolving and eliminating all morbid sensibilities from whatsoever causes arising. It leads us direct to the adoption of the most appropriate and efficient medication, for eliminating all the specifically varied kinds of pathological phenomena, arising from their specifically varied causative agents, and to the most appropriate medication for each and every different grade of pathologic condition thus specifically originating, by appro- priately appreciating the nature and action of the recupera- tive phenomena, sooner or later, sequential to them, in all 172 cases which are not rendered positively irrecuperable by the overwhelming action of the causative agents, • The labours of many distinguished anatomists and physi- ologists, and pathologists, are rapidly clearing the way, for proving incontrovertibly, to the whole medical world, that the nervous system is the only and whole system of man;— and that on its varied actions, both in health and disease, should be founded the total philosophy pertaining to the therapeutic department of the science of medicine. This philosophy, when thoroughly understood and appreciated, will, when put in appropriate requisition, result in all the further improvements, of which the science of medicine is ever destined to become receptive. Some of the improve- ments readily suggested by our philosophy, will be briefly mentioned under the head of the few observations we design to make on the treatment of diseases. We have made a few observations on what are erroneous- ly denominated by the nosologists inflammatory diseases, and demonstrated that they are not diseases, but recupera- tive excitations, never involving the total organization in in- flammatory action. We have demonstrated, that in all the inflammations, the pathological and recuperative phenomena are in close grapple with each other—and that the organiza- tion from no cause, or combination of causes, can be render- ed totally assumptive of pathological ravaging, and recupera- tive excitation, simultaneously. The most partial examination of any one, or of all the in- flammatory diseases, as they are called, will conclusively substantiate these observations, beyond the possibility of de- nial, or successful refutation. Gastritis, for example, is fre- quently restrictedly local in the capillary circulation', and when arising from slight causes, requiring nothing more than mild irritative Or inflammatory recuperation in the ca- pillary circulation, in and immediately surrounding such lo- cation, as the pathological phenomena have assumed, as will result in the production of thorough resolution and elimina- 173 tion, frequently, without any medication:—or, if nature should need any assistance, nothing more than appropriately mild and soothing remedies can be philosophically indicated for eliminating such mild pathological phenomena. Or the morbid sensibilities constituting this disease, may be of much higher grade, and by sympathetic sensibility, more or less extended to such contiguous parts as are connected with this viscus—the stomach,—through the influence of such ap- propriate vascularly nervous organization, as may become operative to the production of such extension;—in which case, a restrictedly local, and primary recuperation, becomes inadequate to the production of elimination:—therefore, the sensorial powers percipient of such inadequacy, in the capil- lary circulation, raise the general circulations not to inflam- matory, but febrific recuperation, for eliminating the patho- logical phenomena, not only through the legitimate outlets pertaining to the primarily pathologized region; but like- wise through some one or more of the secerning and excern- ing departments of the organization,—for the purpose of eliminating such pathological phenomena as had become su- pervenient to the primary through nervous sympathy. In these cases, both the pathological and recuperative pheno- mena are stUl restrictedly local, or more or less so:—total pathologization and recuperation separately or conjunctly considered, as long as vitality remains, are to be philosophi- cally considered as totally incompatible with the varied ope- rations pertaining to the varied nervous structures compos- ing the nervous organization of man. But it is to be particularly noted, that gastritis may arise from such highly concentrated malignant agents, as it does, in many cases of yellow fever, and other pestilential epide- mics, as to deaden, not only the vital energies of the highly sympathetic viscus affected, entirely beyond the power of its becoming assumptive of inflammatory recuperation in the capillary circulation;—but through sympathetic sensibility, the central radicles of innervation may become paralyzed 23 174 beyond the power of instituting any recuperative excitation at all. In such cases, and thousands of others that might be men- tioned, as arising from the deleterious operations of various noxious agents, when not only some one or more of the im- portant vital organs themselves, are paralyzed beyond con- servative redemption by nature, but the very nervous radi- cles of vitality through sympathetic sensibility rendered nearly powerless;—it is to be particularly remarked, and noted, that the powers of philosophic medication when ap- propriately applied and exhibited, with appropriate perse- verance, may, at least occasionally, prove successful in em- powering the nearly lost energies of the innervating centres of the organization, to institute both the primary and conse- cutive series of recuperative excitations, which are in all cases indispensably necessary for eliminating the pathologi- cal effects of the poisonous agents from the constitution. And how does appropriate medication effect all this indispensably necessary recuperative series, for elimination? It does it by using philosophically such appropriately potent medication, as will unlock the highly concentrated congestions, of the highly important vital organs involved in the pathological phenomena, to such standard, or approach to it4 of salutary action, as is required by the cerebro-spinal radicles of the organization for instituting both efficient primary, and se- condary recuperations, for the production of elimination of the morbid sensibilities:—because it must be noted, that if the noxious stimuli had not paralyzed the organization be- yond the power of instituting such recuperative excitations in the capillary and general circulations, they would sponta- neously and unavoidably have taken place, in a manner phi- losophically corresponding with the unerring laws of action pertaining to the organization, in all cases, when not patho- logically affected to the irrecuperative degree. It is to the study of these highest grades of diseases that we must resort for effectively reaching the true philosophy 175 of medicine,—the very arcana of which, both pathologically and recuperatively considered, are concentered in such dis- eases,—which must be unlocked, and unrolled, to the palpa- ble observation of medical investigators, to enable them to recognize and appreciate the total philosophy pertaining to such concentrated morbid sensibilities. An eternity of ob- servation, directed exclusively to the milder and medial grades of diseases, arising from whatsoever causes, would not result in recognizing and appropriately estimating and realizing the beautiful principles composing the true philo- sophy of medicine. Irritations, inflammations, and fevers, in a general or re- cuperative sense considered, are identical conservative exci- tations;—the first, characterized by more or less ardent, more or less sthenic, or asthenic actions of the vessels, in the capillary circulations, by a more or less rapid afflux of fluids into the vessels, in and surrounding the pathologized region;—the latter, by increased actions in both the general and capillary circulations, but never arising to such intensity of action as characterizes exclusively inflammatory recupera- tion ;—which must therefore be philosophically recognized to be more or less local. How is it possible for any practitioner of medicine capa- ble of profiting by observation, and reasoning appropriately respecting all the pathological and recuperative phenomena respectively characterizing the exanthematous diseases, as they are called, without recognizing the truth of all our pro- positions, and the demonstration which inevitably results from an appropriate application of the principles developed by them ? How is it possible for him not to see, and admit, that the irritations, inflammations, and fevers, recuperatively characterizing these diseases, are not pathological pheno- mena ? It is not to be expected that he should be able to see and subject either the contagious effluvia primitively origi- nating the small-pox, or the palpably contagious pustular matter, characteristic of the elimination of the poisonous sti- muli from the organization, into their constituent elements;— 176 but, it is to be expected, that he should philosophically re- cognize both the primary and consecutive pathological and recuperative phenomena, characterizing this disease. It is to be expected that he should recognize the noxious stimuli to be primarily operative in the capillary circulation of the gastric department of the organization, as the symptomato- logy of the disease inevitably evinces this to be the case, during its incipient period. The pathological phenomena and recuperative excitations raised by them in the capillary circulation, during the incipient period, are rendered palpa- bly presentive to observation, by all the symptoms at this time manifesting themselves;—and it should be particularly noted, and philosophically estimated, that the pathological phenomena constituting the mildest grades of this disease, are frequently eliminated by irritative and inflammatory re- cuperation, without any assistance from recuperative excita- tion in the general circulations. The salutary operations of nature in raising irritative, inflammatory, or febrific recupe- ration, in such manners and degrees as are respectively ne- cessary to eliminate the pathological phenomena respectively constituting the different grades of the distinct species or variety, as it is called, of this disease, are too palpable to be denied, with any show of philosophic plausibility. We ob- serve, therefore, that the mildest grades need little, if any aid from medication;—they are eliminated principally through the resolving efficacy of such mild irritative or inflammatory recuperation, as is invariably, in all such cases, sooner or later sequential to the slight pathological phenomena elicited by the noxious stimuli. And here it may not be inappro- priate to observe, that although the elementary materials of the malignant contagion originating this disease, either in its invisible, intangible, miasmatic state, or in its more palpa- ble, pustulous condition, after having been elaborated for elimination, by the recuperative energies of the organization, are to be considered as irresolvable into their component essences;—yet they are, during their operations on, and in, the organization, productive of a series of more palpably pa- 177 thological and recuperative phenomena, than those elicited by any other causative agents of disease whatever__produc- tive, indeed, of a series of such phenomena as develope to inevitable recognition, the total philosophy of diseases, which we are now unrolling to such palpable observation. What talented practitioner of medicine can note the pri- mary irritative or inflammatory recuperation, which is suc- cessfully operative in eliminating the pathological conditions constituting the mildest grades;—and the consecutive febrific recuperation, which is supervenient to the primary, in the medial and higher grades of the distinct variety, for eliciting the eruption of the morbid effects of the poisonous stimuli, and locating them for elimination, in the dermoid structures of the organization, externally and internally considered also, to much extent of appreciation,—without having a per- spective view at least of the beautiful philosophy of medi- cine :—and when he further considers that in the milder grades, after the eruption is completed, the recuperative ex- citations which elaborated it, entirely cease in the general circulations, and leave the maturation and elimination of the morbific matter to the salutary operation of such primary irritative or inflammatory recuperation as is supervenient to such cessation;—and when he considers, that in many of the medial and higher grades of the distinct variety, after the eruption becomes fully developed, that much remission of feJbrific recuperation occurs, but not a total cessation ;—and that it is continued operative in such degree as to appro- priately assist the recuperative excitation in the capillary circulation, to maturate and eliminate the morbific matter from the organization:—and when he finally notes that in all cases where febrific recuperation has entirely ceased, and the inflammatory recuperation in the capillary circulation becomes inadequate to produce maturation and elimination, febrific recuperation termed secondary or suppurative fever by authors, is reinstituted by the conservative energies for appropriate maturation and elimination,—will he not inevita- bly recognize in this duplicate series of primary and conse- 178 cutive pathological and recuperative phenomena, the beauti- ful principles of the philosophy of medicine opening palpa- bly to his view? Will he not fully comprehend the causes which render the organization spontaneously eliminative of the pathological phenomena constituting the mildest grades, and see that the medial grades will require appropriate me- dication, because arising from causes either of higher matu- rity, or occurring in constitutions more predisposed to the reception of the noxious stimuli ? But it is from an appropriate analysis of the very highest grades of this disease,—of the confluent variety that we have unfolded to palpable view, the richness and beauty of the true philosophy of medicine. Constitutions of strong and vigorous powers of resistance, when affected by the patholo- gical phenomena characterizing this disease, in a very de- pressive and congestive manner, may, and do, institute cor- respondently ardent inflammatory and febrific recuperation, for elimination;—which, if suffered to progress unchecked by appropriate medication, will run to the production of such secondary congestions of nervous energy, as exhibit to the palpable view of philosophic observation, the conquering march of the pathological phenomena to disorganizations and destructions;—but if appropriately philosophical treatment be adopted, may be rendered conductive to thorough elimi- nation of the morbid sensibilities through their appropriate outlets. On the other hand, when the pathological phenomena have occurred to the production of highly concentrated depres- sions and congestions of nervous energy of the parts recipi- ent of the noxious stimuli, and in constitutions previously weakened and debilitated from any causes, or in aged and debilitated systems;—the inflammatory and febrific recupera- tion for evolving the poisonous eruption, and fixing it for elimination in the dermoid structures, will be weak, feeble, and unavailing; and the recuperative excitations for conduct- ing the eruption to favourable suppuration, will be manifest- ed in a correspondently feeble, and inefficient manner;—and 179 spasnjs and convulsions, subsultus tendinum, comatose, apo- ple'ctic, pulmonary congestions, &c. will be presented to ob- servation, during the progress of such unfavourable recupera- tion, until all the conservative energies of the organization are overpowered by the pathological phenomena. In some cases also, of this disease, as in other highest grades from other noxious agents, there is nothing but morbid sensibility to be recognized;—no recuperative phenomena ever appear- ing, or if any, manifested exclusively by occasional convul- sions, or some other tumultuous agitations of nervous power, occasionally elicited by the oppressed and enfeebled inner- vating centres of the organization. The cases of this dis- ease characterized by high sthenic recuperation, when not philosophically medicated, terminate in disorganizations, and mortifications,—as well, as those, characterized by asthenic recuperation;—the first, from too excessive, the last from too diminished excitement, raised by the conservative powers;— both, blocking up, and suffocating all the secretory and ex- cretory processes, pertaining to elimination;—and very often, dissolving the vital fluid, and promoting its copious exuda- tion from various sources, &c. Do the causes productive of hemorrhagic diseases, act to the depression and congestion of the vital energies of the or- gans respectively, and specifically, receptive of them? Most undeniably:—excessive high living for example, produces in strong and healthy constitutions excessive nutrition, succeed- ed by such plethoric condition of the system, as depresses and congests, deranges and debilitates, the salutary physi- ological phenomena to such extent, as induces the conserva- tive powers to the institution of primary inflammatory recu- peration in the capillary circulation of the organ, or organs, receptive of the pathological phenomena, and consecutive febrific recuperation, in the general circulations, which are so ardently exerted, as to cause the effusion of the vital fluid, either by rupturing one, or more, of the vessels, or occasion- ing the exudation of it through the extreme vessels in the capillary department of the affected region, rendered suf- 180 • ficiently toneless by excessive action, for such effusignj— unless the recuperative excitations, be prevented from pro- ceeding to such hemorrhagic extent, by appropriate medica- tion. High living then, is, in this case, the remote cause of the disease; and its consequence plethora, the pathological phenomenon, or proximate cause, of such recuperative exci- tations, as terminate in hemorrhagy, if not prevented by ap- propriate medication:—but, when thus prevented, the patho- logical conditions are resolved and eliminated from the con- stitution, through one or more of the legitimate outlets, for the elimination of morbid phenomena,from whatsoever causes arising. Violent exertions of various kinds, produce such pathological conditions in organs predisposed to hemorrhagy, as to cause the innervating centres to institute the necessary primary, and consecutive recuperations, to produce their eli- mination from the organization. Such hemorrhagies may be denominated idiopathic, but such as are sequential to the deleterious operations of ulcers, calculi, &c. are not philoso- phically entitled to such appellation. Hemorrhages are characterized, like all other morbid sen- sibilities, arising from all other causes, by recuperative phe- nomena assumptive of more or less sthenic or asthenic action, according to the strength and vigour of the constitutions respectively receptive of the pathological conditions consti- tuting and originating them. Malconformation is a pathological state of the constitu- tion;—the remote causes of it far off;—but to be satisfacto- rily traced to an assimilative defectiveness of the original inceptive germs of reproduction, of one, or of both parents. Hemorrhages from this cause may, therefore, be included among the idiopathic;—but such as arise from lesions origi- nated by the destructive action of rough calculi, erosions of ulcers, &c. and such as arise during the progress, or near the termination of malignant fevers, from the pathological phe- nomena constituting them, gnawing their way to destruction, and rendering the extreme vessels toneless and patulous, are not entitled to such appellation; because sequential to the 181 deleterious operations of the pathological phenomena respec- tively pertaining to the diseases in which such hemorrhages occur; and they should therefore be denominated symptoma- tic. The diseases in which such symptomatic hemorrhages occur, are either primitively, or consecutively, and ulti- mately considered, characterized by the asthenic diathesis of recuperation in its highest degree. We thus see that the most partial analysis of the patholo- gical and recuperative phenomena, characterizing diseases arising from whatsoever causes, results in the complete con- firmation of our philosophy. There is not a single pathological or recuperative pheno- menon that can be made presentive to observation, through the depressive operations of any causes acting on the organi- zation, which will oppose any thing like a barrier to our arriving at such philosophical confirmation. If there be any, let it be brought forward for examination and refutation. Although it be impossible, through such observations as may be deduced from dissections, vivisections, stethoscopical explorations, or any other investigating processes within the reach of man's ability, to arrive at the knowledge of the ultimate essences of the causes of diseases;—yet, through the inductive process of ratiocination, we may attain such know- ledge concerning the respective malignancy of composition pertaining to the causative agents, as will enable us to phi- losophically put in requisition appropriate measures for pre- venting in all cases, to much extent, much of such malig- nancy of composition, as they would become assumptive of without recourse to such measures; and to greatly meliorate their operations on the organization of man, when they can- not be, to such favourable extent, prevented, by the appro- priate use of such antiseptic agents within the respective spheres of their respectively deleterious operations, as through experimental elicitation, have been found most phi- losophically appropriate to the production of such meliora- tion. After thus far ascertaining all the knowledge of the respective causative agents of diseases, the respective patho- 182 logical phenomena sequent to their operations on the organi- zation in the direct series of causes and effects, become tho- roughly cognizable to intuitive demonstration, through the unerring recognition arising from the application of the self- evident principles developed by our philosophy. An examination of any of the diseases nosologized as ca- chectic, by Cullen, will result in similar confirmation. The remote causes of these diseases are to be recognized as arising from noxious agents, without the organization in the physical creations, operating to the deterioration of the solids and fluids, and producing debility, emaciation, and cachectic vitiation of the component elements of the organic structures of the constitution;—or they are to be recognized as arising from morbid stimuli secondarily engendered in the interior of the system, and producing similar con- sequences;—although strict philosophy requires that the formation of such stimuli should be considered sequential to the malignant influences of their respectively more or less remote causes, without the organization;—to such causes, for instance, as are productive of hereditary vitiation, malcon- formation, &c. However variably characterized by their respectively cau- sative variations these diseases may be, both pathologically and recuperatively considered, they are all to be cured, when curable, through the sanative operations of nature, or through appropriately philosophic medication, conducting the nervous energies of the organization to the institution of the requisite series of salutary recuperations, to produce elimination of the pathological phenomena respectively originating them, through the only legitimate outlets—the secretions and ex- cretions. Both the remote and predisposing causes of phthisis, for instance, are generally to be found in constitutional parental vitiation, or malconformation, or both. However.numerous under such circumstances may be the exciting causes which develope to observation the deplorable pathological pheno- mena characterizing this disease, we shall now mention but 183 one the most common,—cold. This agent applied to the mucous membranes of any of the departments of the pulmo- nary region, debilitates, (but not by its sedative operation,) depresses and congests, their nervous energies. This conges- tive condition of the lungs is relieved for the time, by the conservative powers instituting such slight inflammatory re- cuperation, as is necessary to eliminate the pathological phe- nomena by resolution, as evidenced by more or less copious mucous expectoration. The lungs once pathologized in this manner, are liable to become so repeatedly afterwards, from the slightest application of. the same cause; and they do therefore, usually become repeatedly in this manner affect- ed, and similar recuperative excitation is as repeatedly insti- tuted, for eliminating the pathological phenomena in the same manner, but each time with more and more difficulty, until the pathological conditions become incapable of re- moval by similar means;—when the radical centres of vital- ity institute febrific recuperation, to aid the local in effecting elimination of the pathological phenomena. This elimination may be, and often is, thus effected by resolution, for several times in succession, on every fresh application of the causa- tive agent; until, at length, the recuperative excitations, un- der the most appropriate medication, become unable to dis- lodge and expel the pathological phenomena by resolution. The pathological phenomena become thus far eliminated for the time being, by the recuperative excitations, but not tho- roughly,'for a reason to be soon mentioned. After this they are expelled still more and more imperfectly, for a few times, by more or less copious mucous and purulent expec- toration, till the suppurative termination becomes ultimately fixed in one or both lungs. This suppuration is now the re- sult of the best recuperative effort that can be made by the conservative powers; and is available under appropriate me- dication in protracting existence, in many cases, for a great many years:—but the total eradication of the pathological phenomena becomes, from their primary.formation, from the nature of the causes remotely productive of them, impossi- 184 ble;—because the constitution is vitiated and depraved by the hereditary noxious stimuli, to the preclusive extent of exciting such salutary recuperative excitations, as will result in effective elimination, aided ever so much by appropriate medication:—the fluids are deteriorated and poisoned be- yond the- power of salutary recuperation; and unless they, and the solids, which are similarly saturated with the noxious stimuli, could by some medication be neutralized, and their baneful consequences expelled from the system; the disease thus arising, must be philosophically considered incurable:— because, all the recuperative agents of the organization are participative of the noxious stimuli, and therefore rendered incapable of effecting thorough elimination;—and for the same reasons, that the poisonous effects ensuing from the operation of many other noxious agents cannot be eradicat- ed:—those, for instance, originating genuine hydrophobia, and those cases of yellow and other malignant and pestilen- tial fevers, when arising from highly concentrated stimuli entering the circulations, and poisoning them to the irrecu- perative extent;—besides, malconformation of itself, or in combination with hereditary vitiation, proves in all such cases an effective bar to salutary recuperation. The remote and predisposing causes of scrofula of highest grade, are to be philosophically recognized and appreciated, in parental organic vitiation. Syphilis is in like manner transmissible, by either one or both parents, to their off- spring;—like causes produce like effects;—and there is no difficulty in recognizing the transmissibility of such diseases by parents to their offspring,—when it is considered that the orgasmal products from their venereal congress, must of necessity be deeply saturated with their respectively vitiat- ing causes. It is self-evidently impossible, that the reproduc- tive germs thus vitiated, should progress to the maturity of healthy organization. These diseases, therefore, and many others, when hereditary, and consequently of highest grades, are not to be cured, except by and through the agency of such medication, as will neutralize their respective poisons, 185 and eliminate their morbid effects from the system, by both appropriate local and general recuperation. These diseases must undeniably, therefore, be considered as specific dis- eases. It most assuredly will not by any medical philoso- pher be denied, that hydrophobia is a specific disease,—oc- casioned by the absorption of a specific noxious virus into the circulations, and vitiating the organization to the preven- tion of instituting any such primary, consecutive and recu- perative excitations, as under appropriate medication might lead to elimination. Nor will it be denied, that the diseases originated by the poisons of venomous serpents entering the circulations, are specific;—or that those arising from the noxious agents causative of small-pox, measles, scarlet fever, &c. are specific. These will all be admitted to be specific morbid sensibilities, or diseases, because obviously arising from their respectively specific morbid stimuli. But true philosophy does not award respective specificity of character to these diseases, with more undeniable cer- tainty than it does to all other morbid sensibilities whatso- ever, and from whatsoever causes arising. We have most assuredly, therefore, presented to the in- evitable recognition and appreciation of the talented and ex- perienced members of the medical profession, the universal philosophy of medicine,—have examined a sufficient number of the highest grades of diseases, arising from their respec- tively causative agents, to prove beyond the possibility of refutation, the self-evidency of all our propositions, and the principles deduced from them,—and found them conclu- sively operative in elucidating to the unerring certainty of intuitive demonstration, all the physiological phenomena pertaining to the nervous organization in its salutary condi- tion, and the nature and action of all such physiological or recuperative phenomena as are manifested to observation during the pathologized condition of the organization from whatsoever causative agents arising. We shall therefore conclude, that as all the numerous noxious stimuli are specifically different from each other in 186 malignancy of composition, and that consequently whenever they effect their entrance into the organization by over- powering its elective attraction for salutary stimuli, exclu- sively operative in the capillary department of it, both in- ternally and externally considered, they will consequently originate correspondently specific pathological phenomena, which will be proximately operative to the production of correspondently specific recuperative phenomena,—the de- duction is inevitable, that all the noxious stimuli are pro- ductive of diseases, unequivocally entitled to specificity of character, etiologically, pathologically, and recuperatively considered. We conclude also from evidence equally subject to obser- vation, and appropriate recognition and appreciation,—that all the diseases occasioned by all the salutary stimuli, from without and within the organization, when acting either ex- cessively, or deficiently, far above, or beneath, the normal standard, are characterized by pathological phenomena spe- cifically, different and variant from each other, and therefore to be philosophically considered as specific diseases. And lastly, we have equally undeniable evidence to con- duct us to the conclusion, that all the morbid sensibilities primitively originated by causes far remote,—as those pro- ductive of hereditary vitiation, malconformation, &c.—or those engendered by secondary causes acting specifically de- leteriously on the fluids, or the dermoid and parenchymatous structures of the organization, &c. however remote or near their primitive or original causes maybe,—are all specifical- ly different from each other, and indubitably entitled to the appellation of specific diseases:—and so are all the diseases arranged under the heads of surgery, midwifery, &c. equally specific;—and all the peculiar diseases pertaining to women and children, and to men and women, in the different pe- riods of life, from differences of organization, and functional operation, &c. and from an infinite variety of causes specifi- cally different from each other, acting to specific pathologiza- tion of organizations more or less specifically differing from 187 each other in composition and action, normally and abnormal- ly, equally entitled to the appellation of specific. True philosophy, therefore, considers all diseases whatso- ever that ever did, or ever can occur, from whatsoever va- riety of causation, as specific. As, therefore, all the patho- logical phenomena characterizing all diseases arising from all causes, operate to the derangement, depression, and con- gestion of the salutary physiological conditions of the part or parts of the organization recipient of them, so they are all philosophically entitled to be denominated congestive. All diseases are therefore specific and congestive, or specifically congestive. This simple corollary comprises our enunciation of the total philosophy of medicine, and is irresistibly sequential to the inductive ratiocination which we have presented to consideration, from a beautiful series of self-evident propo- sitions, commencing with the will of Deity, for their pri- mary link. We are now therefore prepared to unfold such General Therapeutic Philosophy pertaining to the Science of Me- dicine, as should be put under appropriately specific requi- sition, for the appropriately specific medication of all diseases, from whatsoever causative agents arising. We have thus approached as near to positively mathema- tical demonstration, as the true philosophy pertaining to the nervous organization of man will now or ever permit. This truth will meet with unavoidable admission, when it is con- sidered that man is self-evidently not a machine to be re- solved into analytic demonstration, but a mortal and immor- tal being;—therefore neither sufficiently terrestrial, for che- mical, or celestial, for psycological analysis;—consequently, that positively mathematical demonstration is unattainable through either or both processes of investigation. But not- withstanding such demonstration from the various functional operations pertaining to the variously structured organs of the nervous organization of man be now and forever impos- sible, yet, through the inductive process of reasoning, we 188 have reached such intuitive demonstration as the varied exi- gences of the organization when assumptive of pathological conditions, from whatsoever causative agents, can ever re- quire, for directing us to the institution of such medication as will be the most appropriately adapted to effect their reso- lution and expulsion from the system, and restoring it to its elective attraction for, and elaboration of, such salutary sti- muli as are required both from without and within the orga- nization, for the production of healthy excitations. We are therefore prepared to institute for our regulation and guidance, the one and only therapeutic axiom, that the exigences of the organization when pathologized from what- soever cause or causes, can now or ever require:—for, that the philosophy of nature is one and the same, both now and forever, in a general sense considered, is a self-evident pro- position. ; And as our philosophy indubitably recognizes and conclu- sively appreciates, that the total science of medication con- sists in appropriately regulating and controlling the recupe- rative excitations raised by the conservative powers for re- solving and eliminating the morbid sensibilities from the organization, from whatsoever causative agents originative,— and in raising and conducting appropriate recuperative exci- tations by appropriate medication, to the elimination of mor- bid sensibilities, whenever the conservative energies of the pathologized organization are inadequate to the production of such eliminative excitations;—and in resolving pathologi- cal and recuperative congestions and disorganizations, when- ever they have been suffered to occur, either through unphi- losophical medication, or the unchecked operations of the conservative powers:—so it follows, that all medicating agents, for the treatment of all diseases, should possess the power of acting on, or in, the organization, in a manner suf- ficiently stimulant, to overpower the morbid stimulant ope- rations of the causative agents, and thereby eliminate them, and the pathological conditions induced by them from the organization. This is the legitimate corollary of legitimate 189 philosophy, and universally applicable for scientifically effect- ing the elimination of all diseases whatever from the organi- zation. Simple as this therapeutical axiom may appear to be, it is the only one required by true philosophy,—the Only one which will be recognized as available at the bed-side of the afflicted by every talented and experienced practitioner of medicine, whether he admits the truth of our philosophy to its fullest extent or not. But how is it possible for any such practitioner not to admit the truth of this philosophy ? He certainly must often have arrived at the point of such recog- nition, from the frequent reflections and trains of reasoning, which he must have instituted, while investigating the causes of diseases,—their pathological effects on, and in, the orga- nization, and the salutary excitations elicited by the conser- vative powers for their elimination. And particularly, when- ever such practitioner has succeeded, by appropriately potent medication, exhibited and applied in appropriately philoso- phical manner, and with appropriate perseverance, in un- locking the organization, when irrecuperatively pathologized by noxious agents,—to the production of such inflammatory and febrific recuperations as, through the continuance of ap- propriate medication have been rendered conductive to the elimination of the morbific agents; and their deleterious con- sequences, through the resolving efficacy pertaining to the restoration of appropriate secretion and excretion;—he must have been on the very point of such recognition,—and from having adopted the same train of reasoning which has enabled us to unfold the true and total philosophy of medicine. It is to such talented practitioners,—such practical medi- cal philosophers, that we address our present outlines of the pRilosophy of medicine for candid perusal and merited ap- preciation. We are not writing for routinists and empirics, and court not their approbation;—to them, all we have writ- ten, or may write, will be but as dead letters. We confidently address therefore exclusively the merito- 25 190 rious practical philosophers of our profession, who are alone, capable of testing the merits of the philosophy which we are unfolding to them. All the intelligent members of our pro>- fession who have duly profited by sufficiently ample experi- ence, must admit that we have indicated in general terms the total science of all such varied medication as should be put in appropriately thorough requisition, for the resolution and expulsion of all morbid sensibilities whatever from the organization ;-*-whether they be more or less restrictedly local, or more or less extensively, (though still locally,) im- plicating a greater or lesser number of its departments, how- ever varied they may be, in their organic structures, or func- tional actions. They will also admit, that we have instituted and proclaimed the one and only therapeutical axiom, ne- cessary to be recognized as philosophically operative and di- rective at the bed-side of the afflicted, to the appropriate se- lection of such remediate agents as are required for fulfilling the specific indications there presenting themselves;—and that such remediate agents should in all cases be more than fully correspondent in their stimulant operation, with the sti- mulant operation of the causative agents, which have, patho- logized the organization. It should never for a moment be forgotten, that in all cases, of all diseases, the causative agents are still in action;—that they have originated the patholo- gical conditions through morbid stimulant action;—and that it is self-evidently impossible, that their elimination from the system can be effected, in any other way, than through the agency of such superior stimulation, as will overpower the stimulant operation of the causative agents,—and eliminate them, and their effects, from the organization. To this rule of medication there can be no exception;__ for there is no sedative agent in nature. It is utterly absurd to suppose, that, because lightning, prussic acid, digitalis, opium, &c. will in sufficient quantities kill, either instantly or nearly so,—that they produce such effects through their sedative operations. Is lightning, because it totally destroys all the radical vital 191 powers of the organization instantaneously, when recipient of it in sufficient quantity,—a sedative agent? Like all other physical agents it is a gtimulant,—and a sti- mulate of the very highest gra.de;—but, it is to be noted, that it is at the same time a poisonous stimulant of very highest grade, in its most concentrated state. Let us examine this important portion of the philosophy of medicine a little more in detail. It will not he denied that this agent in very small quantities, particularly when not highly matured in malignancy, acts stimulantly on the system receptive of it,— and to ordinary observation may appear to raise and exalt its vital powers. But this is not the case:—as a noxious sti- mulus, the cerebral radicle of vitality becomes instantaneous- ly percipient of its injurious operation, and raises with nearly equal celerity increased actions in those departments of the organization that effect elimination of all morbid sensibilities whatsoever;—raises recuperative excitations for eliminating it, and its pernicious effects, from the system:—it is there- fore, an agent in a general sense considered, operating in the same injurious and poisonous manner as alcohol in a slight dose, when taken by a person unaccustomed to it. Both these poisons when thus applied in small quantities, do not affect the organization to much perceptible depression of its nervous energies, not so much so, as #to prevent the conser- vative powers from instituting recuperative excitations coex- istently, or nearly so, with the entrance of the noxious agents;—because these noxious stimuli are among the most instantaneously diffusible noxious agents, and consequently incite the nervous organization to operate with correspondent celerity to the production of recuperative excitations, when- ever it becomes thus slightly pathologized by them. As is the celerity of action of noxious diffusible stimuli, such will be the celerity of recuperative excitation succeeding their application to the organization, in such small quantities, as produce very slight depressions of its nervous energies:— hence the utility of such diffusible noxious stimuli as reme- diate agents, when administered in such small quantities, as 192 may prove so slightly depressive of nervous energy, that the conservative powers may be rendered instantaneously operative to recuperative excitation. Either of these noxious agents when applied to the organ- ization in somewhat larger quantities, produce depressions and congestions of nervous energy, which become more pal- pable to observation;—consequently, not so rapidly succeed- ed by recuperative excitations. When they are applied in still larger quantities, they are productive of pathological conditions characterized by still deeper depressions of nervous energy;—and the resisting powers of the organization thus pathologized, must be strong and vigorous, or they will not recover from it so thoroughly, as to institute free, open and ardent sthenic recuperation:— and if still more deeply pathologized, recuperation will either be not raised at all, or if raised, feebly and ineffectively. But it may be observed, that although the recuperative excita- tions in such aggravated congestions of vital power, be so in- efficiently raised by the conservative powers of nature;— they may still in many cases, be so favourably raised by ap- propriate medication, as to be rendered conductive to the elimination of the noxious stimuli, and their effects from the organization, through the legitimate outlets. Have these noxious ^stimuli therefore, applied in the seve- ral degrees mentioned, displayed to philosophical recogni- tion, any sedative operation? Have they not effected their entrance into the system by their stimulant operation,—by overpowering its elective attractiveness for salutary stimuli? And are they not poisonous stimuli,—and consequently, in- stantaneously on their entrance depressive of the nervous energy of the nervous organization, according to the quanti- ties or qualities received, and the powers of nature to resist the extension of their deleterious operations? And when they enter the organization in still larger and more malig- nant quantities, and poison its centres of innervation to in- stant destruction,—can philosophy recognize it to have been effected through their sedative influences? 193 These questions need no answers. The same reasoning applies to the operations of all the noxious agents, however differently and specifically productive they may be of speci- fically different pathological conditions;—they all act sti- mulantly, but poisonously, depressively, and congestively, never sedatively,—never to the exaltation of the powers of the organization;—for such exaltations or recuperations whenever they are raised at all, are always raised by the conservative powers of nature for eliminating the pathologi- cal phenomena through the legitimate emunctories. As long as life lasts, it lasts through the operation of stimuli,—and exclusively through the operation of such salutary stimuli, as the organization is capable of receiving and elaborating, both in its salutary and pathologized conditions. We have proved to intuitive demonstration, that no one of the highest poisonous agents ever act sedatively on the organization,—and however ably and meritoriously, in many respects, any of the writers on sedation and debility may have canvassed this important subject, they have not done so under the recognition of true philosophy. Antimony, lead, digitalis, &c.—all act stimulantly, but in degrees inferior to many other noxious agents;—therefore in appropriate quantities, in such pathological and recupera- tive conditions of the organization as are appropriate to them, may be used beneficially as remediate agents;—but most assuredly, the depressing passions, as they are errone- ously called, cannot be philosophically considered as seda- tive agents:—they are pathological phenomena, in 'many- cases, occurring so concentratedly as to extinguish total vi- tality almost instantaneously;—but they effect this through their stimulating, and at the same time depressive and con- gestive effects on the organization,—and arise from their re- spectively specific causes, like all other pathological condi- tions—and therefore, might philosophically be denominated the depressed,—but not, depressing passions. Are not au- thors therefore very unphilosophically and unprofitably en- gaged, while enumerating and enrolling the long list of these 194 depressed passions,—these pathological conditions, amongst the veritable causes of diseases? And are not physicians very unprofitably, as well as unphilosophically engaged, during the prevalence of baleful epidemics, whilst proclaim- ing to the inhabitants the necessity of preserving themselves exempt from the operation of these depressed passions? Should they not rather forbear to mention at all these de- pressed passions on such calamitous occasions, and incite them to the use of all the means most philosophically adapt- ed to keep all their affective emotions in the calm and equa- ble tenor of salutary operation? These questions are easily answered:—for it is unques- tionably highly unphilosophical, as well as unphilothropical, to proclaim during the prevalence of plagues, yellow fevers, choleras, or other malignant pestilences, that fear will most certainly invite the entrance of the noxious agents into the organization. They have already entered, and produced their most pro- minent pathological phenomenon,—fear,—which imperiously demands such appropriate medication as may eliminate it, and its causative agent, forthwith from the system;—or it's resisting powers will be rapidly mastered to the extent of irreouperation, and consequent destruction. An appropriate joyous excitation of the system is indispensably necessary to the production and continuance of it in a healthy condition; but by many causes it may be so inordinately excited, as to terminate vitality almost instantaneously;—or, according to the varied degrees of super-excitement, correspondently va- ried pathological conditions will become supervenient and excitative to the production of correspondently varied recu- perative excitations, for effecting their elimination from the organization. If then, this super-joyous excitation from appropriate causes,—from salutary causes acting in excess,—may end in pathological conditions;—it is equally evident, that a lower- ed condition of the healthy joyous excitation of the organi- zation, may occur from a variety of causes acting stimulant- 195 ly, but at the same time depressively, on it, to the produc- tion of pathological conditions, more or less concentrative and fixed, according to the nature of the causes thus patho- logically operative, and the predisponent condition of the system receptive of them. This is the only true philosophy pertaining to these de- pressing passions, as they are so unphilosophically denomi- nated:—they are all pathological conditions, arising respec- tively from their appropriate causes, and to be eliminated from the organization by super-stimulant recuperative excita- tion, or appropriate medication;—for there are no sedative agents to be found in nature, or prepared by art, to medicate to elimination such, or any other, pathological phenomena, from any other causes arising. But there are stimulant me- dicating agents to be found in nature, and prepared by art, to enable the organization when pathologized by causes pro- ductive of ab-excitation, to become operative to the pro- duction of such recuperative excitations, as by the continu- ance of medication appropriate to such recuperative state of the organization, may eliminate them, and their pathological effects;—and there are also such stimulating medicating agents to be found, and prepared, as by appropriately philo- sophical management may be rendered operative in lower- ing the pathological conditions which have arisen from causes productive of super-excitation, to the standard points required by the central powers of the nervous organization, to the elicitation of effective recuperative eliminations. All medicating agents therefore, act stimulantly in curing dis- eases from whatsoever causes arising. It is owing to ignorance, or want of attention to this phi- losophy, on which our therapeutical axiom is based, that the too prevalent and fashionable Broussaian plan of medication is so unsuccessful, particularly in resolving and eliminating the morbid sensibilities, constituting not only the highest grades of diseases, pertaining to southern and intertropical, but to all other climates. This "fashionable medication consists almost exclusively, 196 in adopting the same train or routine of inefficient ontological medical entities, as they may be philosophically denominated, for the elimination of all diseases, from all causes arising, however palpably mild or severe, or complicatedly conges- tive, they may be presented to observation by their severally varied pathological and recuperative manifestations. Let us examine this ontological system of medication a little more in detail—ontological, because recognizing gas- tritis or gastro-enteritis as a presiding deity, regulating and controlling all the morbid and salutary actions, sequential to the operation of the causative agents, and moulding them into fac similes, for characterizing nearly all the ills that flesh and blood are, or can be made,heir to;—and inevitably therefore leading all its votaries to the most worshipful adoption of a routine of feeble, frivolous, and utterly ineffi- cient medicating entities for eradicating nearly all the patho- logical phenomena to which the organization may become subject, from whatsoever morbid causes;—whether such phenomena be accompanied or succeeded by the favourable irritative, inflammatory and febrific, or by the unfavourable and abortive spasmodic and convulsive recuperative mani- festations, or by none at all. Locating the morbid actions constituting particularly all the diseases considered by them as febrile and inflammatory exclusively in the mucous membranes of the alimentary canal, they prescribe for all the grades of such diseases, a nearly similar routine of frivolous and inefficient medicating agents, consisting now and then of general bleeding, but al- ways to a similarly sparing extent, without any appropriately philosophical recognition or discrimination, between the different grades of the pathological and recuperative pheno- mena constituting the different cases subjected to their me- dication;—but in almost all cases, relying exclusively on topical detractions of blood by leeching and cupping, ptisans and emollient enemata, and acidulated solutions of gum and ice waters. In the opinion of Broussais, and certainly his numerous servile train of worshippers, this totally unphilo- 197 sophical routine of medication is all sedative, and adapted to the cure of all diseases, of all grades, from all causes;—and they believe that the exhibition of any of the ordinarily ac- knowledged stimulant remedial agents to the mucous mem- branes, already stimulated by the causative agents as near the point of vital endurance as the organization can sustain, would be rapidly productive of its total destruction. Let us examine the condition or conditions of the gastric department of the organization when under the influence of pathological phenomena from any cause, and we shall readily discover that this fashionable creed, so ignominiously aped, to greater or less extent throughout the medical world, is naught but vaporous nothingness, totally devoid of any physiological or pathological philosophy for its support. Its superstructure is seen to be perfectly baseless, by the slight- est philosophical examination. When the pathological condition constituting gastritis is very slight, as when it has occurred in a very mild form, from slight cause, there will be such a slight deviation from the healthy standard of gastric action, that nothing more than simple irritative recuperation becomes raised for its removal from the stomach by resolution. In such slight disease, ptisanning and gum-watering may be practised or not, because the irritative recuperation raised by the vis. conserv. naturae, is all sufficient for eliminating the patholo- gical condition of the affected organ. Let it not be said, be- cause authors do not describe such mild cases of gastritis, that they do not occur. Authors restrict their descriptions almost exclusively to the medial grades, characterized by prominent pathological and recuperative phenomena, and neglect noticing both the mildest and highest grades. This ontological method of describing diseases, running through all the systems of practice yet published to the world, is totally prohibitive of ever arriving at the philosophy of dis- eases, and inevitably precludes all the bibliothecal practi- tioners from recognizing, at any rate, any of the mildest or highest grades of diseases arising from the same causes as 26 198 the medial grades,—and leads them to an empirical and hacknied practice;—for without true philosophy to guide them to appropriate recognition of all the grades of patholo- gical and recuperative phenomena arising from identical causation, they can never practice in any other manner. Light causes therefore invariably produce light effects, in constitutions previously sound,—and mild cases of gastritis are as liable to occur in the mucous membrane of the sto- mach, as any other mild diseases from mild causes, in any other departments of the organization;—and they do in fact occur, from a variety of light causes almost daily;—and it is necessary now to notice the fact, to show that the plan of medication practised by Broussais and his worshippers for the treatment of this and all other febrile diseases as they are called, is utterly futile, and in fact absurd, because contrary to the plainest suggestions of the common sense of even the uneducated part of mankind. Their plan of treating diseases by the exhibition and application of a few frivolous ontolo- gical entities, is totally inadequate to produce the elimination of the morbid sensibilities constituting any of them, except the mildest grades. Now although these milder grades would be in all cases eliminated by the recuperative excita- tions of the conservative powers,—yet, as we are willing to admit to the fullest extent the value of their routine prac- tice,—we consider it our bounden duty to proclaim to the medical profession, that their value is to be exclusively con- sidered as auxiliary to the recuperative excitations of na- ture,—never positively curative, of the pathological condi- tions constituting even any of the mildest grades of diseases; and they are not even entitled to this extent of auxiliary consideration of utility, through the recognition of any true pathological philosophy. Irritation in the capillary circula- tion surrounding the slight pathological condition in the mu- cous membrane of the stomach, or any other portion of the organization, eliminates it by resolution, without medica- tion ;—but, when the pathological phenomena have occurred to the production of considerable depression of the vital en- 199 ergies, irritation is first raisedin the capillary circulation for resolving and expelling them, but in general proving inade- quate to effect it, the conservative powers institute febrific recuperation in the general circulations, by which means an additional momentum is given to the capillary circulation in and adjacent to the pathologized condition;—and, if the se- cretions should be not much increased or deranged beyond their normal action, resolution may still be effected through the secretions and excretions pertaining to the affected re- gion, be it where it may, and without medication. In such case we admit, that the recuperative institutions might be benefited by the ptisanning and gum-watering plan of medi- cation ;—-but this is no more nor less than what would be prescribed by all experienced practitioners,—not with the view of their acting positively curable, but as auxiliary and soothing applications to the affected region. But, when the causative agents have produced such deep depressions and congestions of the parts recipient of them, as are sooner or later succeeded, in strong and vigorous constitutions, by free, open, and ardent inflammatory recuperation, in the parts thus.pathologized, and by a correspondently free, open, and ardent recuperative excitement in the general circula- tions, ofwhat avail other than auxiliary, can be the routine of frivolous medication inculcated by the Broussaian school? When the stomach is the recipient of such deep depression and congestion of its nervous energies, other important vital organs are in general, through sympathetic sensibility, quick- ly recipient of them, and the contest forthwith becomes in- tensely ardent between the pathological and recuperative phenomena. The brain is frequently manifested to be in a phrenzied condition,—the stomach, liver, and other viscera, to be phlogosed entirely beyond the powers of secretion or excretion,—the mucous membranes to be coated with de- praved, viscid, ropy mucus,—the duodenum and stomach loaded with acrid, vitiated bile previously Secreted and ex- creted,—the capillary department of the organization raging and burning to the extent of thorough non-secretion,—and 200 even the urinary secretion nearly suspended,—and in many Cases, as in yellow fevers and other pestilences, quite so. Can such ardent contention between the conservative and pathological phenomena be witnessed and philosophically recognized by any experienced practitioner, be his medical creed what it may, without resorting to more effective me- dication than ptisanning, emollient enemata, &c? Such in- tensely phlogosed excitations of the conservative powers, prove incontestibly, that the pathological phenomena which originated them cannot be resolved and eliminated, except by a medication correspondently potent and appropriate. To attempt the elimination of such intensely morbid sen- sibilities from the organization by topical' detractions of blood, teas, enemata, &c.—would be as fruitless as an at- tempt to extinguish the fiery vomiting of a volcano by sprinkling water on it. And yet such medication is daily resorted to by Broussais and his worshippers;—and what are the consequences of such criminal neglect of appropriate medication in such cases? First, additional congestions and obstructions,—and lastly, and that quickly,—disorganiza- tions and total destructions. If the Broussaian plan of medication for such grades of dis- eases as we have thus far mentioned be so totally ineffica: cious,—how much more unphilosophical and inefficient must such medication be considered when used for the treatment of diseases of much higher grades, arising from causes pro- ductive of such overwhelming effects of the radical energies of the organization, as to prevent the innervating centres from instituting any recuperative excitations at all, even in constitutions previously sound and vigorous,—or if any, no- thing more than occasional faintly glimmering irritations or fevers, or tremors and agitations, cramps and twitchings, or spasms and convulsions? Gastro-enteritic inflammatory and febrile diseases, as they are erroneously called, when arising from highly malignant miasmata, are either assumptive of such weak and unavail- ing asthenic recuperation, or of none at all,—that they can 201 never, in any sense whatever considered, be benefited by the Broussaian plan of medication carried to its utmost ex- tent. This pseudo-philosophy therefore cannot be made ope- rative to the elimination of any of the medial or highest grades of diseases,—and cannot be considered as operative to the elimination of the very mildest, through the recogni- tion of any show of the true philosophy pertaining to dis- eases arising from any causes, whatsoever. We conclude therefore, that this fashionable method of medication must inevitably be considered by all talented practitioners of much experience, as totally unphilosophi- cal,—because recognizing exclusively the doctrine of seda- tive medicaments,—and prescribing very much the same unmodified routine of them, for the treatment of all the va- ried grades of diseases, arising from all their correspondent- ly varied causative agents;—whereas, they are exclusively adapted, if at all, to the treatment of the very mildest grades of diseases,—and not to them, through the recognition of true philosophy. If this Broussaian plan of medication can therefore be phi- losophically considered as operative to the elimination of any morbid sensibilities whatever, from any causes, it must be recognized to be thus operative through stimulant operation; and all the bleedings, cuppings, and leechings, resorted to for preparing the conservative powers for' eliminating the noxious agents and their effects from the system by acidu- lated gummous solutions, and ice-waterings, and emollient poultices and enemata, are undeniably insufficient to elimi- nate any other than the very mildest grades of diseases,— and they would be eliminated without them, by the recupe- rative powers of the organization. A doctrine of medication, which inculcates the carefullest detention and strictest husbandry of the vitiated secretions and feculent matters, so copiously engendered and aggre- gatedly accumulated for rankling operations in the alimen- tary canal, by the organization when concentratedly patholo- gized from any causes,—and totally proscribes appropriate 202 purgatives, diaphoretics, &c. from the list of medicating agents, which through all time, have been justly considered as indispensably necessary agents, under appropriate manage- ment, for eliminating all morbid sensibilities from whatso- ever causes arising, cannot be long sanctioned by any expe- rienced and philosophic practitioner of medicine, or by any other person of common sense, resident either within the pale of cultivated or barbarous, life. We are therefore confident, that all our ablest and most experienced practitioners will admit, that no medical philo- sopher of ancient or modern time, has wandered further astray from just conceptions of the legitimate, physiological, and pathological operations pertaining to the organization of man, than the present medical chieftain of physiological me- dication, who is endeavouring to wield the sceptre of domi- nion over the whole medical world, by denouncing all other systems, except his own, as erroneous, ontological, and fraught with doctrines which lead to incendiary and perni- cious practices. But this renowned medical magician, who is essaying to rule with such despotic sway, cannot be considered in any other light, than as being himself the very prince of the most audacious and arrant ontology, and the most devoted worshipper of a more numerous host of metaphysical enti- ties, than any of those whom he has denounced with such acrimonious vituperation, ever conjured up. For his doc- trines are so strongly tinctured and imbued with the deifica- tion of chimerical essences, and delivered in such dogmati- cal, imposing, and captivating manner, as to have apishly enslaved a very considerable proportion of the brightest me- dical luminaries, both in Europe and our own country, and fast chained them down to a philosophy chiefly restricted to the consideration of mucous membranes,—and led them to the adoption of such feeble and inefficient medication, as is not applicable in any other, than an auxiliary sense, to even the mildest grades of diseases,—and utterly nugatory, una- vailing, and in fact worse than useless,—when applied to 203 the treatment of all the higher grades of diseases, (gastritis, or any other,) and further removed from the true philosophy of thorough medication, than that of any one of his philoso- phical predecessors. The truth is, that every experienced and intelligent prac- titioner of medicine in all time,—before the time of Brous- sais,—knew quite as much about the necessity of preserving the integrity of the mucous membranes during their treat- ment of diseases, as himself,—and adopted a much more philosophic medication for preserving their integrity than he has taught;—and consequently far less entitled to the ap- pellative reproaches of incendiary and pernicious. It is also true, that all the ablest practitioners of medicine during all prior and present time, while treating and curing by appropriate medicating agents, diseases characterized by the deepest depressions and congestions of the nervous ener- gies of the nervous organization,—must have made a near approach to the recognition of such knowledge, as consti- tutes the true philosophy of medicine, both now and forever. We therefore observe, that all l,he acrimonious denuncia- tions of this arrogant philosopher so profusely lavished against other systems, and other practitioners, will be con- sidered by all our ablest physicians as recoiling upon his own system, and his own practice;—and that there, they will sooner or later, and deservedly, rest in oblivion. That this system of medication, certainly the most pertur- bating, incendiary, and pernicious, ever yet conjured up by any medical philosopher, should have been imported as a fashion, and rendered instruct!ngly operative in our own medical institutions, is matter of much astonishment as well as regret, to all the most intelligent and judicious phy- sicians of our country;—and their exertions should be united- ly subjected to all reasonable requisition, for staying its cor- rupting progress. Thousands of the French nation are an- nually sacrificed by this deluding system of medication, and thousands have been, and will continue to be, sacrificed in our own country, by the junior members of the profession 204 who have imbibed its delusive and pernicious doctrines in some of our medical seminaries of highest reputation;—for, they will all render them operative in their several practices for some time,—those of them, who are intelligent, discern- ing, and discriminating, not for a long time,—because, they will discover their futility, and recognize the necessity of adopting a practice more conformable to science and common sense:—but those of them who relinquish their studies when they leave their schools, as is unfortunately the case with a great proportion of them, will not even halt in their destructive career, but pursue their slaughtering course, till death releases them from committing further devastation of human life. This cannot be deemed by our ablest practitioners an over- wrought representation of the baleful consequences inevita- bly supervenient to the adoption of this false philosophy. But we may console ourselves with the certainty, that this philosophy contains within itself the seeds of its own de- struction,—that it cannot be long made to vegetate to per- fection in any richly intellectual soil,—and that it will soon be blasted in its sproutings, and dissolved into its fruitless elements. The doctrine has attained its culminating point, and will be respectfully lowered to its just deserts, by the meritorious practical philosophers pertaining to our profes- sion. No philosophy of medicine will be recognized and appre- ciated as true, unless founded on such self-evident proposi- tions as unfold the principles necessary for clearly explain- ing and illustrating all the varied, physiological, pathologi- cal, and conservative phenomena incident to the varied ope- rations, pertaining to the varied organization of man, both in health and disease, wherever he is found in the habitable regions of the earth. If man be a being destined for eternal duration,—and that he is,—"all nature cries aloud through all her works,'7—he must be made so through the inevitable operations pertaining to such material organization as Deity has given him;—and 205 he must possess in such organization such operative powers as render him a whole being, destined for time and eter- nity:—therefore, the first link in the chain of all true medi- cal philosophy must inevitably consist of the will of Deity in organizing man for mortal and immortal existence,—and the medium through which such will is exclusively manifested to observation must, and can be no other, than the nervous sys- tem, the whole and only system of man's organization, through the operations of which, under the appropriate ex- citements of natural morality, corrected and perfected by re- velation,—man can be enabled in time, to prepare himself for his destined eternity,—of happiness. The recognition of this primal link in the series of propo- sitions composing our philosophy is unavoidable. Man therefore emanates primarily from the will of Deity, and during his probationary detention here in time, is anticipa- tively connected with him, through his exclusively nervous organization; and through the operations of the same media- torial power, after having shuffled off his mortal coil, re- turns to the same divine source from whence he emanated,— for everlasting blessedness. Our medical philosophy therefore, consists of such a series of self-evident propositions, as develope forthwith to reason and common sense, all the principles, which are now, or ever can be, rendered operative to the evolution of all the varied physiological actions of the organization of man in its healthy condition,—to all the varied pathological phenomena charac- terizing all its varied deviations from the healthy standard of action,—and to all the respectively varied recuperative phenomena instituted by the conservative powers for restor- ing the pathologized organization to its salutary physiologi- cal standard of action. It is therefore a whole system of medical philosophy, and universally applicable,—now and forever,—and every where,—for unfolding to philosophic comprehension and appreciation, all the physiological, pathological, and conser- vative phenomena pertaining to the organization of man, 27 206 both in its salutary and diseased conditions. It is a system of universal philosophy recognizing the inevitable instru- mentality of all the powers governing and regulating all ani- .mal, and to much extent of appreciation, all vegetable exist- ences;—recognizing the appropriately philosophical subjec- tion of the organization of man for support in time, to the various and multiform modifications of physiological and pa- thological phenomena, arising from their correspondently varied and multiform physical causes, as manifested to ob- servation through all the habitable portions of the earth;— recognizing therefore, not only the general causes which af- fect the organization pathologically in all parts of our crea- tion, but leading us directly to the institution of such inves- tigations and observations, as will unfold to us the causes which vary the pathological phenomena in different coun- tries, and in different districts of different countries, and enable us to adopt the most efficacious means for either pre- venting, or removing them, when produced. Our philosophy being therefore universally operative in elucidating the varied characteristics of the varied patholo- logical phenomena affecting the organization of man in every department of creation,—recognizes and reprobates the ab- surdity of subjecting the science of medicine, which in its general principles considered, is one and indivisible,—to the capriciousness of fashion,—and of importing and adopting such fashion, and making it operative in our own medical institutions. We recognize and deplore therefore, the deleterious con- sequences which have already arisen, and must hereafter arise, from instructing our youth exclusively in the frivo- lous routine of sedative medication, as it is considered by the fashionable, but totally erroneous and unphilosophical Broussaian system now in vogue;—because they will endea- vour to render it operative in their respective practices wherever they may be located, however variously and dis- similarly characterized may be the pathological phenomena which they will be called on for eliminating. 207 All the philosophies of medicine have been founded on fancied recognitions of some one or more fantastic meta- physical entities,—but we may confidently consider ours as founded on a series of self-evident propositions, developing the principles necessary for conclusively unfolding and elu- cidating the causes of all the more general, or particular pa- thological phenomena, with all their multiplicities of varia- tions and modifications, incident to the organization of man wherever he may be found in our world;—and as far as hu- man agency can be of any avail, suggests the most appro- priate means, for either preventing the formations of such pathological phenomena,—or, whenever they are produced, eliminating them by the most appropriate and philosophical medications. And as we are confident that, many a talented practitioner while treating . successfully by appropriate medication, diseases characterized by such highly concentrated depres- sions and congestions as were totally preclusive of the insti- tution of recuperative excitations by the conservative powers, or the more ordinary routine of medication in such cases re- sorted to,—has often been on the point of recognizing our philosophy to its fullest extent;—so we are equally confident that it will be duly recognized and appreciated by all such practitioners,—and that they will render it incalculably ope- rative in relieving and eliminating the sufferings of huma- nity, from whatsoever causative agents arising. If after all our copious elucidation of such philosophy of medication as should be put in requisition for the treatment of all the corporeal and mental sufferings to which the orga- nization is now, or under any circumstances, can ever be, rendered subject,—it should still be inquired in what man- ner is such extensive alleviation of human misery to be rea- lized by this philosophy in preference to any other,—we unhesitatingly assert, without any fear of successful contra- diction, that it will irresistibly conduct every talented prac- titioner, under the appropriate appreciation of it, in very many, very material respects, to a radical change of medica- 208 tion, and of medication legitimately scientific,—for nearly all the ills that flesh and blood are heir to. Our philosophy recognizes to demonstrative appreciation, that to whatever extent the morbid sensibilities constituting diseases, may have been primarily received, or through sym- pathetic sensibility, consecutively transmitted,—to such ex- tent, the total organization of the part or parts thus involved in the morbid sensibilities, becomes pathologized. The ner- vous system is therefore the only, and whole system of man;—and its innervating centre becomes instantaneously percipient of these morbid sensibilities, and raises recupera- tive excitations to eliminate them from the organization, sooner or later,—or never,—in a manner invariably corres- ponding with the greater or lesser depression and congestion of the. vital powers of that portion, or those portions, of the vital part or parts of the organization, to which the causative agents have been applied and transmitted. All morbid sensibilities, therefore, constituting all dis- eases arising from all causes, are to be considered as positive depressions and congestions of nervous energy, arising from the causative agents overpowering the elective attraction for salutary stimuli, in the part or parts invaded and entered by them. These depressions and congestions, whether originat- ed by causative agents acting from without or within the organization, become more or less transmissible through sympathetic sensibility, according to the ravaging power of the causative agents, and the constitutional powers of the system receptive of such pathologization. For the elimina- tion of morbid sensibilities thus originated and transmitted, recuperative excitations are instituted by the conservative powers, viz.—by the sensorial percipiency of the cerebral centre, (in a strictly philosophical sense considered, in a more or less direct manner, the exclusive innervating radicle of vitality in the mature and healthy organization,)—conse- quently, these sensorial percipiences will institute more or less favourable recuperative excitations, according to the na- ture and effects of the causative agents, and the remaining 209 powers of vital resistance in the pathologized organization. The morbid sensibilities, therefore, must be specifically and indefinitely varied and modified, and the sensorial perci- piences originating the recuperative excitations will be ma- nifested to philosophic observation, in a correspondently specific and diversified manner. The total philosophy of medication consequently recog- nizes the indispensable necessity of adopting, in each and every case of morbid sensibility, such remedial agents as are most appropriately indicated, for resolving and eliminating it from the system, wherever located, and to whatever ex- tent it may have been transmitted, through sympathetic sen- sibility. Can the science of medicine as thus portrayed to the un- avoidable recognition of every reasonable and intelligent physician, be any longer considered a conjectural art, or trade of cunning, based on chicanery? The science of medi- cine is based on the immutable laws pertaining to the ner- vous organization now, and through all time,—conducting us by appropriate study, physiologically, pathologically, and recuperatively, or therapeutically considered, to the certainty of intuitive demonstration,—therefore utterly disclaiming all cunning, trick, and sophistry. Let it be particularly noted and remembered, therefore, that all our therapeutical indications are to be exclusively formed from due observance and consideration of the specific ravaging effects of the causative agents, and of the corres- pondently specific recuperative excitations raised by the conservative powers in each and every case of morbid sensi- bility. And as the recuperative excitations are manifested in all cases, either by irritations, inflammations, and fevers, or tremors, twitchings, cramps, spasms, or convulsions, or by partial or total paralyses of the organization, amounting to no recuperative excitation at all,—so a particular, and specifically appropriate species of medication will be philo- sophically required for each and every case of morbid sensi- bility,—although arising from the same general cause or 210 causes,—because different organizations are differently affect- ed by identical causes, in identical quantities;—but it is sel- dom the case, however, that different organizations are re- ceptive of identical quantities, because of the differing powers of resistance, in the different constitutions. Viewed, there- fore, in every sense, and through every medium of light, true philosophy requires us to consider all diseases, from all causes, and all diseases arising in different organizations, from identical causes, as more or less specifically different. As all diseases are therefore specific, because arising from specific causes, producing specific pathological phenomena, in specific departments of the organization, both primarily and consecutively through sympathetic sensibility consider-' ed;—it follows, that the recuperative phenomena, (whenever they are raised,) whether coexistently or sequentially to the pathological, are exclusively, and correspondently specific, and require therefore, correspondently specific medications. Can such philosophy based on such luminous self*evidency, as arises from scientifically recognizing the operations of the nervous organization of man, offer any inducements to the skeptic or sophist, for stigmatizing the science of medicine as a conjectural art, or ignominious species of handicraft? The science of medicine based on such self-evident foun- dations as we have assigned to it, or as it has been, and is still, practised by our ablest physicians, is the noblest, as well as most useful, of all the avocations of man. The practice of medicine therefore, is or should be, exclusively the practice of its philosophy;—which is comprehensively comprised in a thorough knowledge of the causes of dis- eases,—the pathological phenomena manifested in the orga- nization by the operation of these causes, and the recupera- tive excitations raised by the conservative powers for their expulsion. The causes in many cases, may be investigated from,—but the pathological and recuperative phenomena ex- clusively, at the bed-side of the afflicted,—where their sepa- ration from each other, should be thoroughly understood; — because, without recognizing such separation we shall be 21t groping about in darkness, and practising in a routine, em- pirical, tentative manner. As our remedies are to be ex- clusively exhibited, and applied, for the purpose of control- ling and regulating the efforts of nature to resolve and elimi- nate the pathological phenomena, or to raise such efforts when nature is too much depressed to raise them, the neces- sity of making such separation, is obvious. As all medica- tion which cures diseases of all kinds, from all causes, how- ever more or less locally, affecting the organization, operates in assisting the recuperative excitations to resolve and expel the pathological phenomena from the system through one, or more, or all, of the secretions and excretions;—so, all me- dication whatever, consisting of whatsoever variety of agents, that may be found appropriately philosophical for the pro- duction of such expulsion, or elimination, is entitled exclu- sively, to the appellation of expulsive or eliminative medica- tion :—for most assuredly, every species of medication which enables the conservative powers of the organization, to insti- tute the necessary processes for producing such critical eva- cuations, as are required for expelling the morbid sensibili- ties constituting diseases through their legitimate outlets— the secretions and excretions, are philosophically entitled, to such appellation,—and to such only. All the bleedings, general and local, or other remediate measures that may be required for thus rendering the recuperative powers effectual to the production of these necessary secretions and excre- tions,—are most assuredly, entitled to the appellation of ex- pulsive medications;—because, in a great variety of diseases, they are indispensably necessary, to conduct the operations of the organization to such approach to salutary action, as will enable the secretory and excretory organs to act elimi- natively of the morbid sensibilities. And all other medicat- ing agents, whether acting specifically stimulantly as eme- tics, cathartics, diaphoretics, expectorants, emollients, ano- dynes, diuretics, &c. and all the varied external revulsive medicating agents, however specifically operative they may be, all tend, when appropriately used, in each and every 212 case of morbid sensibility requiring them, to its expulsion and elimination from the system ;—consequently, all appro- priately philosophical medicating agents whatever, that have already, or may hereafter be discovered, are expulsive me- dicaments, operating specifically stimulantly. We thus open to palpable observation, and unavoidable acknowledgment, the principles to be put in requisition, for composing the one, and one only therapeutical book, that is now, or ever can be»required by true philosophy, for direct- ing the practitioner to the institution of his remedial indica- tions, and the agents for appropriately fulfilling them, from the commencement to the termination of all diseases from all causes:—and it is evident, that such book may be richly stored with true philosophy, unchangeably operative through all time, to the exclusion of much useless nonemclatural ver- bosity. The true philosophical practice of medicine, therefore, consists in the use of all the remediate means, best adapted in each and every case of morbid sensibility to conduct the recuperative excitations to the production of appropriately critical evacuations, through the secretory and excretory ap- paratus of the organization. In no other way /than through these natural and legitimate outlets, can the morbid sensibi- lities constituting any disease, (be the recuperative manifes- tations what they may, or none at all,) become eliminated from the system. Slight pathological conditions of any part of the organization, will be generally either accompanied, or soon succeeded by such mild recuperative excitation, as to require little or no medication,—the secretions being so little deranged by the causative agents, that the recuperative exci- tations are not raised higher than necessary to render them effectively operative to the expulsion of the pathological phenomena. The pathological conditions from whatsoever causes arising, are the proximate causes of the recuperative phenomena, whatever they may be;—therefore, whenever the recuperative phenomena are raised in a high and ardent manner, the proximate causes will be found to consist of de- 213 pressions and congestions of the nervous energies of the part or parts of the organization implicated in them, which have arisen from causative agents acting in a correspondently ar- dent degree, in constitutions previously sound. Such high and ardent recuperative excitations deranging and vitiating the secretions, or rather proving, that the causative agents have acted to such vitiation, will require such stimulant me- dication as will lower, regulate, and preserve the operations of the organization to the salutary standard of action neces- sary for effecting elimination of the morbid sensibilities through their legitimate outlets; and whenever the patholo- gical phenomena have occurred from causative agents acting to the production of -highly concentrated depressions of nervous energy, the recuperative manifestations will be cha- racterized by such feeble and inefficient asthenic or typhoid, or ataxic or adynamic action, as to require such appropriately stimulant medication, as will strengthen and regulate, raise and preserve the powers of the organization to the necessary secretory standard of elimination. As are the causative agents, such will be the patholo- gical phenomena; and as are the pathological, such will be the recuperative phenomena;—and they will both be speci- fically and variantly characterized, in a manner specifically correspondent with the nature and action of the causative agents, and the nature and action of such predisposition or idiosyncrasy, as may be existent in the constitutions recep- tive of them. Irritative and inflammatory recuperation in the capillary circulation, exclusively eliminates the mildest diseases;—and all diseases of higher grades are eliminated by inflammatory and febrific recuperation;—and it should be kept in perpe- tual remembrance, that all the recuperative excitations, which, by appropriate medication, may be rendered elimina- tive of pathological phenomena, are characterized by a more or less sthenic or asthenic diathesis, according to the nature of the causative agents, and the ability of the conservative powers for raising and sustaining them,—until all the resisting 28 214 energies are overwhelmed by the causative agents, beyond the power of instituting any other than spasmodic and con- vulsive, or no recuperation at all. From the primary invasion, till the entrance of the causa- tive agents from without, into any department of the orga- nization, or from the incipient formation of causative agents within the organization, there is a constant contention, more or less palpably manifest to philosophic observation, between the pathological and recuperative phenomena;—and the whole philosophy of medicine, under appropriate recognition, results in the necessity of appropriately estimating this con- test, and of discerning and distinguishing the pathological from the recuperative phenomena, and separating them from each other, in order to arrive at appropriate remedial indica- tions. Until this be done, the practice of medicine is em- pirical and tentative; and when it is done, it affords the most noble, delightful, soul-satisfying reflections, that man is ca- pable of receiving this side of that eternal duration to which he is destined by the beneficence of his Creator, through the instrumental operativeness of that noble nervous organiza- tion, which he has given him for mortal and immortal existence. It is to the remaining powers of salutary operativeness in this noble organization, when assailed and pathologized by causative agents, that all our remedies should be directed;— consequently, when its nervous centres in strong and vigor- ous constitutions, are impelled to the institution of such ardent sthenic recuperation as far transcends the powers of normal secretion, they are to be medicated, or lowered down to the secreting and excreting standard, necessary for effect- ing elimination of the morbid sensibilities,—and kept so, until the various vitiated secretions, and feculent materials in the alimentary canal, already engendered by the causa- tive agents, can be expelled by appropriately stimulant me- dication, and kept so until the conservative powers, through the continued aid of appropriate medication, can be ren- dered operative to the expulsion of the pathological pheno- mena through the legitimate outlets of the organization. 215 But on the contrary, when the causative agents, either in weak and feeble, or strong and vigorous organizations, have been applied in such concentrated degrees, that the conser- vative powers are precluded from instituting any other than asthenic recuperation,—medication must consist of such re- mediate agents, as will appropriately evacuate the vitiated secretions, and feculent materials, under such circumstances copiously engendered, and aggregatedly retained in the ali- monious department of the organization,—that its powers of action may be released, relieved, and rendered operative to the institution of such efficient recuperative excitations, as by the continuance of appropriate medication, will eliminate the morbid sensibilities, through their natural outlets. All diseases, whether more or less restrictedly local, or more or less general, (though still more or less local,) whe- ther the recuperative excitations be confined to the extremi- ties of nervous power in the capillary department of the or- ganization, internally or externally considered,—or whether they be extended to the nervous centres, and through them to the general and capillary circulations, are to be medicated on similar principles, in appropriate correspondence with their respective recuperative diatheses. As long as life lasts, it lasts by stimulus;—and whenever the organization be- comes so deeply pathologized, that it cannot receive and dis- tribute the necessary stimuli, to produce recuperative exci- tations in the respiratory and circulatory departments of it, and is thereby rendered preclusive of the power of institut- ing any other, than occasional spasmodic and convulsive recuperation, or none at all, the principles of treatment are not altered;—the powers of the constitution are to be ren- dered operative, by appropriately potent medication, to eli- mination of the morbid phenomena through a greater or lesser number of similarly legitimate outlets, as the nature of the specific case may require,—by subduing the spasmodic and convulsive recuperation, and thereby enabling the cen- tres of vitality to extend their recuperative exertions to the general circulations, and to be then medicated to appropri- ately critical evacuations through the legitimate emunctories. 216 As long as life lasts, it lasts through the reception and sa- lutary elaboration of salutary stimuli,—and even when the organization is pathologized far beyond the power of recupe- ration,—when it is almost totally torpid and paralytic, and its innervating centres so overwhelmed by the causative agents as to be nearly inoperative, the principles of treat- ment are not altered:—by appropriate medication philosophi- cally instituted and perseveringly persisted in,—the organi- zation may still, in very many cases, utterly hopeless under all ordinary medication, be unlocked to the production of such recuperative excitations, as are in all cases of morbid sen- sibilities from whatsoever causes arising, required by na- ture for eliminating the pathological phenomena through the appropriate secretory and excretory emunctories. Is it possible to witness the series of curative phenomena arising from appropriately potent medication in such hope- less cases, leading to elimination of the causative agents and morbid sensibilities occasioned by them, without acknow- ledging the truth of our philosophy to its fullest extent? Does not evidence thus elicited, inevitably compel us to ac- knowledge the nervous system to be the sole system of man? And does it not forthwith lead us to the rejection of all empirical and routine medication, and to the selection and adoption of all such legitimately philosophical medication as has been found, (no matter when, or where,) most effectively eliminative of morbid sensibilities ? It leads, therefore, nearly to a total revolution in the practice of medicine, by enabling us forthwith to select the good and reject the bad reme- dial agents required for the treatment of all diseases what- soever. It teaches us the indispensable necessity in all cases, of all diseases, however local or general they may be,__of selecting in each and every case, such appropriate remediate agents, as will keep the alimonious department of the orga- nization free from all acrid, corroding, and poisonously sti- mulant materials, whether consisting of depraved chymous and chylous matters, or the various vitiated and corroding secretions and excretions, or other feculent substances,__ which if retained and husbanded with Broussaian care, must 217 unavoidably increase the rankling operations of the causative agents, and compel the conservative powers to a correspon- dent increase of the identical inflammatory and febrific recu- peration, so much dreaded, not only by the fashionable phi- losophy,—but by all the philosophies which have been fabri- cated during the thousands of years that the subject of medi- cine has been under investigation. Under the recognition of the nervous power being the whole power of the organi- zation, we are instructed in all cases of super-ardent recupe- ration, to medicate it down to the secretory standard of ac- tion, and keep it so by appropriately philosophical agents; and in all cases of deficient recuperation, to raise and strengthen it to the same standard by appropriate agents. These constitute all the therapeutical indications required by true philosophy for medicating to most effective elimina- tion, all the ills that flesh and blood are heir to ;—and all philosophic practitioners under the recognition of our funda- mental proposition so often mentioned, will need no instruc- tion, as to the selection of such appropriately specific medi- cating agents as will be required for fulfilling them, to the fullest extent demanded by our philosophy, which leads every intelligent practitioner with the certainty of intuitive de- monstration to the selection of such medication, as will cure thousands of diseases, of which, before such recognition, he had no conception. The time is certainly rapidly approaching, when all talent- ed practitioners will find themselves unable to resist acknow- ledging the self-evidency of our fundamental proposition,— the labours of many distinguished investigators of the medi- cal sciences are rapidly analyzing the organization of man to the production of such results as will inevitably lead to such recognition. They will then, if not before, recognize the self-evidency of all our propositions, and the principles de- veloped by them;—and when they apply this philosophy to the consideration that like causes in like quantities produce like effects, only in like organizations,—and that different causative agents are productive of specifically different mor- bid effects, they will acknowledge the specificity of diseases, 218 and the necessity of adopting a correspondent specificity of medication, for each specific morbid sensibility, whether it originate irritative, inflammatory and febrific, or spasmodic and convulsive, or paralytic, or no recuperation at all. They will, under the unerring guidance of this true philosophy, see that diseases in every sense considered are specific, and that they are general, exclusively in the sense, that they all consist of morbid sensibilities or depressions.and congestions of the nervous or vital energies of the organic structures im- plicated in them. The practice of medicine is or should be therefore, the practice of its philosophy. This philosophy we have so clearly unrolled to the observation of common sense, that its applicability to the most successful manage- ment of all morbid sensibilities from whatsoever causes arising, and Whatever departments of the organization in- vading, externally or internally, becomes forthwith and irre- sistibly obvious. And we cannot too often repeat, that the appropriate appreciation of this philosophy directs the expe- rienced practitioner with the unerring certainty and celerity pertaining to intuitive demonstration, to the institution of his remediate indications,—directs him in all cases to clear, and keep clear, in appropriate degree, the assimilative de- partment of the organization, and to strengthen and regulate, or lower and regulate, the recuperative excitations to the eliminating standard, and keep them so;—that, by the con- tinuance of appropriate medication, they may be rendered conductive to the thorough elimination of the causative agents, and their morbid consequences;-—and when no recu- perative excitations are raised, directs the practitioner with equal promptitude to the exhibition of such internal, and application of such external medications, as the specificity of the morbid sensibilities may require, for resolving, and so far meliorating and relieving, the depressed energies of the organization, as will enable its innervating centres to insti- tute such appropriate recuperation, as under appropriate me- dication, may eliminate the specific morbid sensibilities. By subjecting this philosophy to judicious requisition, thousands of diseases may be rapidly eliminated from the 219 system, which under such ontological treatment as has been prescribed for them by all previous philosophies of medi- cine, were so unavailing ? Why has rheumatism in particular, and a long list of ana- logous diseases, arising from similar causes, never been so thoroughly cured by any remediate measures which have been indicated by any of the philosophies which have been promulgated to the world, as it should have been, and may be? Obviously, because the authors of such philosophies knew nothing at all about the pathologized condition of the organization constituting the disease. Why have some few intelligent practitioners lately succeeded in rapidly and effectively curing this disease by the appropriate exhibition of internal and application of external medicating agents ? Because, some slight approach to the philosophy of the pa- thological condition constituting it, has been reached by a few distinguished physicians, who have directed their inves- tigations with more than ordinary attention to the operations of the nervous system, although exclusively in such an in- sulated, divisible, and circumrotatory manner, as will for- ever preclude them from realizing the total philosophy of the total nervous organization of man. They have therefore cured the disease by appropriate medication, without reach- ing the beautiful total philosophy pertaining to it;—but we have cured numerous cases of all grades, both of the acute and chronic kind, as they are unphilosophically denominated, under the recognition of the true philosophy of the nervous organization, by means nearly similar, producing resolution and expulsion of the pathological phenomena, and their effects, in a few hours after appropriately preparing the assi- milative department for their appropriate curative operations. The paralyzed and toneless condition supervenient to the torpescent operation of cold, on the sentient extremities of the nerves supplying the various compact structures of the articulations, are sooner or later succeeded in acute rheuma- tism occurring in vigorous constitutions, by such super-ar- dent recuperation as far transcends the secreting standard necessary to effect elimination of the morbid sensibilities by 220 resolution. To aid the recuperative excitations to effect elimination, the nutrient region must be appropriately clear- ed, by appropriately specific medication, and the circulations appropriately lowered and regulated by appropriate vene- section, to such secretory standard as is indispensably re- quired for eliminative operations;—then the nervous centres supplying the parts implicated in the morbid sensibilities with their appropriately vivificating influences,—in some cases by leeching, in more by cupping, and in all sooner or later, by blistering, may be rendered operative to the pro- duction of thorough resolution and elimination in a few hours. In all cases of chronic rheumatism, the indications of treatment are the same; and if appropriately executed, will in general speedily succeed,—and in all cases soon, if much disorganization should not have occurred from previous at- tacks, by ineffective natural recuperation, or by inappropri- ate medication;—and even when such disorganization has occurred, the general indications of treatment are not altered; and by due perseverance in appropriate medication, the impaired articular energies may be restored to considerable sanatary action, in all cases in which the constitution is 'not destroyed to the irrecuperative extent.. The same therapeutic philosophy, and no other, is scien- tifically operative to the formation of such curative indica- tions, as are required to be fully executed by appropriate medication, for the most successful treatment of the long list of neuralgic diseases. The general indication for their treat- ment is the same ;—but all their pathological and recupera- tive variations, from their correspondent causative varia- tions, must be met by medications, appropriately and speci- fically correspondent, for resolving and eliminating their re- spectively differing morbid sensibilities. The general indi- cations for treating all diseases whatever, however mildly, or concentratedly congestive of nervous energy they may be, arg the same;—subject to such variations, as the exigen- ces of each specific case may require:—the recuperative ex- citations, when they are raised at all by the conservative 221 powers, are to be raised or lowered to the secreting stand- ard ;—and if not raised at all by the natural powers of the organization, they are to be excited by appropriately potent medication, and conducted to the one and only standard of salutary action, necessary for eliminating all morbid sensibi- lities, from all causes. In all cases, the nervous radicles of the organization must be medicated, and kept so, to the appropriate cognizance of the pathological conditions;—that they may institute such irritative, or inflammatory, or febrific recuperations, as may be required for their elimination:—for such recuperative ex- citations, either of the primary or consecutive kind, must be excited by nature or art, for the cure of all diseases:—there- fore all the spasmodic and convulsive, and all the anomalous abortive recuperations are to be allayed by appropriately potent medications, to render the cerebro-spinal radicles originative of total innervation, operative to the production of the requisite recuperative excitations in the circulations, for the production of elimination through the legitimate out- lets of the organization:—and when the causative agents have paralyzed the organization completely to irrecupera- tion, such medication must be resorted to, as will resolve such paralysis, and stimulate and strengthen the nervous centres to the production and maintenance of such febrific recuperation, as by appropriate remediate management, may be rendered conductive to the expulsion of the pathological phenomena. We thus present to the medical profession a philosophic system of medication, applicable to all the pathological and recuperative phenomena that the organization of man can be rendered receptive of, from every possible variety of cause, that can under any circumstances assail him in every depart- ment of our creation, now and till time shall be no more. The practice of medicine is the practice of its philosophy,—and we have exhibited to palpable observation and appreciation, such universal philosophy, as will enable all intelligent and judicious practitioners to cure thousands of diseases, in a 29 222 rapid and thorough manner, because they can, under its appropriate recognition, understand and appreciate the pa- thological phenomena constituting all diseases, and the recu- perative phenomena raised for their resolution and expulsion. Through the inductive process of ratiocination, he will reach such knowledge of the series of most of the causes, leading to the production of pathological phenomena, as amounts to intuitive demonstration;—and will therefore see that the philosophy of practice consists in medicating the recupera- tive phenomena, (whenever they are raised,) to the neces- sary standard of secreting action, for eliminating the patho- logical phenomena;—and when such recuperative pheno- mena are not raised by the conservative powers, to raise them by appropriately potent medication, and conduct them by the continuance of medication appropriate to the recupe- rative excitations thus raised, to the secreting and excreting standard of action indispensably necessary for eliminating all morbid sensibilities whatsoever. And the intelligent practitioner, while practising such philosophy, should never lose sight of the undeniable fact,—that as all medicating agents act stimulantly, such appropriate agents must be se- lected in all cases, as will more than fully correspond in ef- ficacy, with the depressively stimulating operations of the causative agents. Our system is the philosophy of common sense, recognizing the nervous system to be the true and only system of man, and leading the practitioner direct to the exhibition and application of his remedies to such sys- tem, in a philosophical manner, with appropriate reference in all cases to the structural varieties of the organization and correspondent varieties of actions pertaining to them nor- mally and abnormally. The nervous system therefore,—the beautiful, harmonious, total system of man,—the exclusively reproductive and con- tinuative cause of all his corporeal and intellectual organiza- tion, is in its healthy physiological condition of action won- derfully adapted to the reception and transmission of all the different and varied degrees of appropriate stimuli furnished by the physical department of creation, for the performance 223 of all the different and varied functional operations, of all the different and varied organs constituting him this beautiful harmonious whole being. Hence the differently varied de- grees, of the differently varied sensibilities, of the differently varied departments of the system,—though all working in unison to the production and continuation of one beautiful harmonious whole, in the healthy physiological condition of the system, are to be scientifically noted and recognized, whenever the organization becomes pathologized from what- soever causes. And these causes are to be philosophically investigated, and appropriately estimated, because specifi- cally different in composition from each other,—therefore originating specifically different pathological phenomena;— and these pathological phenomena are not only different from each other as thus arising from causative differences, but dif- ferent according to the different functional operations of the different structures of the different departments of the orga- nization invaded by the causative agents, and the different powers of resistance manifested by such organization ;—and of course, the recuperative phenomena arising from such va- rieties of proximate causes, are to be considered as corres- pondently various, and requiring correspondently varied therapeutical indications, for eliminating the pathological phenomena. This view of the structural variety of man's organization in its salutary physiological state, acting to the completion of one beautiful harmonious whole, leads us inevitably to re- cognize both the specificity, and locality of diseases; and consequently in a greater or less degree, to the philosophical necessity of specifically appropriate medication, for their eli- mination. Therefore, in all cases, of all diseases, arising from all causes,—we are to have constantly in view, the rationale of the salutary operations of all the different structures of the organization, that we may appropriately estimate the patho- logized conditions of such structures of it, as have been in- vaded by the causative agents;—so that we may not only be conducted to the exhibition and application of such specific 224 remediate means as may be most philosophically indicated, by such knowledge of the salutary physiological actions of the parts implicated in the morbid sensibilities for effecting their elimination;—but at the same time, if the case should require it, to the use of such appropriate remedies, as may act appropriately for thorough elimination, on the organiza- tion generally,—as a whole system, a nervous system, with cerebro-spinal radicles, originating and conveying through their messengers the nerves, all the respective vital powers, to all the respective departments of the organization—to the production of harmonious unity of action. In such recognition consists the exclusive philosophy of all medication, for all diseases whatever, to which the orga- nization can be made subject, from every possible variety of cause, now, and forever. Under the recognition of this in- dubitable philosophy, thousands of diseases heretofore con- sidered, as belonging to the long roll of the opprobria me- dicorum, may be medicated to successful elimination in a rapid and thorough manner, perfectly astonishing to bibli- othecal practitioners,—by appropriately aiding the recupera- tive excitations, in i-estrictedly local diseases, manifested by the surrounding sentient nervous power in the capillary cir- culation of the distempered region,—and in more general diseases, by appropriately aiding the recuperative excitations manifested in all the circulations, by either raising or de- pressing the actions of the nervous centres;—or, when these nervous centres are, by the causative agents, rendered in- operative to the institution of any other, than spasmodic and convulsive recuperation, or none at all,—by resolving such abortive recuperation, by appropriate medication, and stimu- lating and strengthening the nervous radicles, to the produc- tion of the necessary recuperative excitations in all the cir- culations,—that by the continuance of appropriate medica- tion, the morbid sensibilities may be evacuated through their legitimate outlets. All talented and experienced practitioners of the science of medicine, will, under the appropriate recognition and es- timation, of the principles developed by this philosophy, be 225 conducted straight forward to such effective and appropriate scientific medication, as will soon shorten the long roll of diseases, for the unsuccessful management of which, physi- cians have been so tauntingly stigmatized, by the reproachful appellative above mentioned:—for, there are but few diseases, that from their very nature, can be philosophically admitted, to be positively incurable:—some of these we have mention- ed, and assigned appropriate reasons, for their incurability,— and the scientific appreciation of this philosophy, will readily indicate the reasons, of incurability, for all such as we have not mentioned. Therefore, intelligent, experienced, and judicious medical philosophers, through appropriate estimation of the self- evident principles developed by our philosophy, will, forth- with, institute with scientific precision, all the remediate measures most effectively adapted to eliminate all patholo- gical phenomena from the organization, which have not po- sitively depressed and congested its nervous energies to the extent of irreouperation, both by the conservative powers and appropriate medication. We have thus presented to the consideration of medical philosophers, the outlines of such philosophy of medicine, as are irresistibly demanded for recognition by nature,reason, religion, and common sense;—all demonstrably proclaiming man to be the connecting link between the celestial and ter- restrial creations, and that he is so made, exclusively through the instrumentality of his nervous organization, which con- nects him with his Creator—and time with eternity. We have reached this philosophy,,through such inductive process of reasoning, as can §pither be rejected nor derided. The primal and ultimate links composing the reasoning chain, which leads to the acquisition of the true philosophies, not only of medicine and religion, but of all other sciences, within the realizing reach of man, commence with, and ter- minate in, the will of Deity. Man, therefore, the direct product of the will of Deity, and organized for existence in time and eternity, is made so, exclusively through the in- evitable operations of his nervous organization,—endowed 226 with powers irresistibly compelling him to the reproduction of similar organizations, with similar powers for perpetuity in time and eternity. The philosophy, therefore, pertaining to the sublime beau- ties, both of natural and revealed religion, is exclusively re- cognizable, through the intellectual operations elicited by the nervous organization of man;—and the philosophy of medicine, with all its beauties, is exclusively discernible, through the operativeness of the same nervous power,—the direct product of Deity, as manifested in his original, present, and future creation of man. Both philosophies, therefore, and all other philosophies of all other sciences, within the reach of man, are founded exclusively on such operations, as are inevitably consequent to such organization as Deity has given man, for the governance and regulation of his conduct here in time,—to prepare for that eternity of duration of blessedness, which, through the operations of the very ground-work of his being,—he sees so clearly destined for him. We thus open for perusal, the basis of all the books which are necessary to be made and studied, for understanding the philosophies of all the sciences, which can be realized through the best directed and most perfected operations of the nervous organization of man in time. We may well, therefore, inculcate the indispensable neces- sity of studying the nervous organization of man, through the operations of which, he is made by Deity a sentient, motive, and intellectual being, for eternal duration. We settle then, not only the philosophy of medicine, but the philosophies of all the sciences, on the operations, in- evitably sequential to such organization, as Deity has given to man. This is self-evidently the constitutional foundation, on which they must all rest,—till time be merged in eternity. We utterly disclaim, therefore, all the visionary specula- tions of all the enigmatical and mystical metaphysicians and theologians, that have ever been subjected to the considera- tion of man,—because radically erroneous, unintelligibly 227 complicate, and utterly subversive of the exercise of all such powers, as are inherent in the nervous organization of man, and under appropriate direction, rendered inevitably opera- tive to the development of all the philosophy of all the know- ledge within the compass of man's attainment in his present state of existence. We set man straight onward in the path which conducts him to the acquisition of the true philosophy of all true mo- rality and religion;—and inculcate the indispensable neces- sity of his rationally and devoutly practising all the virtues pertaining to them,—to insure happiness in time and eternity. We are aware that this system of philosophy, although so simple and p^in that common sense unhesitatingly recog- nizes it to be conclusively applicable to the thorough expla- nation and satisfactory elucidation of all the physiological and pathological phenomena incident to the organization of man,—here and every where, through all time,—may be assailed, denied and controverted, but not disproved. We are fully aware of all the objections that may be raised for preventing its recognition and adoption, and respectfully solicit their presentment for refutation. We know that all our propositions—the principles deve- loped by them—and all the illustrations we have deduced from them, may be denied and controverted. We respect- fully solicit such denial and controversy—and the most rigid, scrutinizing analysis of our philosophy—from the beginning to the end of it. All the philosophy, of all the knowledge, within the power of man's attainment in time, must be brought for recognition and adoption to the unerring standard of common sense:—and to this, the only legitimate test, we have brought all our reasonings, all our explanations and conclusions;—and here they will remain unanswerably true through all time,—for what is true now will remain so for- ever. We are prepared for all objections from all sources, and have their refutation at hand. That God primarily created man for mortal and immortal existence, by endowing his organization with powers inevi- tably operative to the production of such effects, and with 228 powers for creating organized beings similar to his own, for similar existence and enjoyment in time and eternity, will not be denied;—and that this influence or power of the or- ganization of man for the production of his own kind,—for the production of mortal and immortal existences similar to himself,—can be nothing more nor less than the exertion of power equal in effect to such as was used by Deity in his primary formation of man, is self-evident. Deity therefore endowed the organization of man with this creative power, and it should be the first and last duty of philosophical man to recognize and appreciate it. This creative power of man, instrumentally operative in his organization through the will of Deity,—connecting him with heaven and earth,—with eternity and time,—must constitute him a whole being,— endowed with powers for existing in time and eternity. Can an organization thus endowed, be philosophically con- sidered other than a whole being, deriving its powers for existence here and hereafter, from one general vivificating principle inherent and exclusively operative in it, for exist- ence in both worlds ? Can such a noble being, therefore, as man, be considered with any plausible show of philosophy, as deriving his powers of mortal and immortal existence from a plurality of radical powers inherent and operative in his organization,—because nerves are not through dissections, or other investigating processes, to be sensibly traced in the compact structures of the organization, cellular membrane, &c. ? Do medical philosophers wait for a view of the compo- nent essences of the vitality of man, before they can recog- nize its unity of formation and action ? They may as well wait for the component essences of their Creator. Is not the philosophy of analogy to be consulted in forming our con- clusions respecting the structure and action of the organiza- tion of man,—and does not such analogy lead us self-evi- dently to all our conclusions ? Does not such knowledge as we already possess, respecting the structure and action of the system of man, lead us to an inevitable recognition of all our propositions and inferences from them,—to the irre- sistible light of intuitive demonstration ? 229 Can the divisible and circumrotatory method of anatomiz- ing and physiologizing man, so self-evidently destined for eternal existence, through the powers inherent and inevita- bly thus operative in his nervous organization, be much longer sanctioned? Do not natural and revealed religion, and common sense, proclaim the unphilosophicalness of such a method of studying an immortal being? Is it not strange,—passing strange, that such a noble be- ing as man should never have been recognized by any phi- losopher, in a philosophical sense considered, as having a head? We are told by eminent anatomists and physiologists, that it is matter of very little consequence where we begin to in- vestigate the organization of man; because, if we continue our researches long enough, we shall come round to the very same point whence we started. This is certainly a very deceptive, illusory, and unphilosophical method of proceed- ing, and utterly preclusive of our ever arriving at a know- ledge of the organization of man, as a whole, endowed with powers for everlasting existence. If medical philosophers will simply consider, and proper- ly appreciate, the nature of the energies exerted by the sexes for the reproduction of immortal existences similar to their own;—if they will simply reflect, that the total powers of their organizations are concentrated, for eliciting their ap- propriate germs of reproduction, and effecting their appro- priate conjunction in the vivificating apparatus of the fe- male;—and that from the instant of conception, or junction of these vital germs, in the matrical nidus of the female, there is a constant afflux to it, of all the appropriate sensi- bilities elaborated by her organization, for the inceptive and progressive fecundation, development and formation of the foetal vitality, till it attain a head, sufficiently matured for soliciting its expulsion—surely they will admit that a philo- sophical necessity exists for giving to man a head, and as- signing it for a startingpoint in all their medical investigations. And if they will further consider the progress of the foetal 30 230 vitality to its gradual maturity,—that the nutrient depart- ment of the new being, (without which it cannot be made,) is first formed,—the spinal column next,—and the cranium last,—to complete its ability for stimulating the uterus to the necessary contractions, or vital operations, for effecting its egress into time,—and probation for eternity;—surely they must admit, that man's organization is exclusively nervous, from his inceptive germ of vivification, until he is transmit- ted, through the extinction of his corporeal nature, to the ethereal creations of everlasting duration. Man, therefore, through the will of Deity, is a creative and reproductive being, exclusively through the instrumen- tality of his exclusively nervous organization. All creation implies the previous operation of sensation, or sensibility;—and all the necessary sensations, for all the necessary secretions, and absorptions, and all other vital elaborations, and therefore creations, of the nutrient, or or- ganic region of vitality, (as it is fashionably called,) are pri- marily furnished by the plastic and animalizing maternal sensibilities determined to the uterus and its appendages;— and by the continued operation of the maternal powers thus determined, and creatively operative, the spinal and cerebral centres for the total organization of the new being are form- ed in utero, and gradually increased in growth and strength, till it attains such maturity of animal life as to solicit its ex- pulsion. The foetal vitality has now terminated, and one of the most beautiful illustrations pertaining to the existence of man in time instantaneously opens to our view of the free, open, and palpably appreciative operations of the several ap- propriate physical stimuli for originating and continuing through the receptive, transmissive, and distributive opera- tions of the nervous organization of man, all the necessary sensibilities, for the continued formation, growth, and deve- lopment of the child, to its mature state of manhood. The fcetal vitality therefore is originated and perfected by the organic and animal sensibilities of the reproductive agents;—but is afterwards dependent for its growth, and 231 perfection to manhood, and continuance in time, on such sensibilities as it receives by and through the operations of its nervous organization, from the stimuli furnished for its use by the physical creations. We thus have incontrovertible evidence to prove that sen- sibility is the radical, creative, and continuative property of vitality. As are therefore the sensibilities of the reproductive agents during their venereal congress,—and as are the ma- ternal sensibilities during the formation and growth to fcetal maturity, such will be the characteristics of their offspring,— more or less virtuous, therefore more or less perfect,—more or less vicious, therefore more or less imperfect;—virtues and vices are consequently hereditary, as well as diseases. The sensibility pertaining to the organization of man, is more or less perfect,—exclusively in a comparative sense. The utmost extent to which the sensibility of the organiza- tion of man can exalt him, is to an expectant anticipative view, of the glories awaiting his translation to the eternal world, through the death of his corporeal nature in the pre- sent. The sensibilities pertaining to all existences between man and Deity, are more or less perfect, according to their gradation in the scale which reaches to absolute perfection in Deity. Perfect sensibility is the essence of Deity, from whence emanates all the God-like attributes of perfectibility, dis- played to man, and all other existences, destined for eternal duration in all his creations. We have thus finished a philosophy of medicine, irresisti- bly called for by nature, reason, common sense, and reli- gion:—such a philosophy, therefore, as cannot be stigma- tized with ontological reprobation, because exclusively found- ed on a beautiful series of self-evident propositions, develop- ing equally self-evident principles, conclusively applicable to the thorough solution of all the physiological, pathologi- cal, and recuperative phenomena, pertaining to the organi- zation of man, both in his healthy and diseased conditions, in whatever regions of our creation he may be found, under every possible variety of circumstances. We worship no 'ii/V u 232 other Deity than the omnipotent architect of universal crea- tion,—who has made the nervous organization of man, to be by its inevitable operations, the generator and continuator of our being here in time, and by its wonderful intellectual operations, the glorious causative anticipator of immortal fe- licities in the ethereal creations. Our philosophy clearly opens to scientific apprehension all the principles necessary for attaining all the certainty that the science of medicine, by the labours of man, can ever be made to reach in all its branches. The visionary notions of many medical philosophers about resolving the physiological or pathological operations per- taining to man, into positive mathematical demonstration, may be abandoned;—for man is not a machine to be analyzed into such demonstration,—but an immortal being emanating from Deity, and destined by the laws of vitality given to his nervous organization, (which both in health and disease, are rendered by true philosophy presentive to intuitive demon- stration,) to run a certain course to such dissolution here in time—as may permit his unincumbered translation to the ethereal regions of endless blessedness. This philosophy illustrating to intuitive demonstration all the salutary and insalutary phenomena pertaining to man,— will be exhibited more particularly to the medical profession in a future work on the practice of medicine. We shall conclude therefore this present work, with ob- serving, that our philosophy leads us direct to the adoration of the magnificent author of all the creations,—and to that of his creation of man in particular,—whom he has made but little lower than his angels,—to be a connecting link between his celestial and terrestrial creations,—the anticipative par- ticipator of the endless felicities of the first,—and positive participator of all the happiness of the second;—consequent- ly recognizes the whole philosophy of religion,—and incul- cates the exercise of all its virtues,—to insure to man his translation to the ethereal creations of endless blessedness. THE END- *