sickness and mortality, is it not clearly the duty of the profession and the press to use all suitable means for its diffusion? The more enlightened the community become, generally, upon this subject, the less exposed they will be to imposition and quackery. Instead of blind superstition and credulity, a rational faith will grow up in the study and observance of the laws of health and life. The demand in the use of remedial means will be directed to the best skill and experience which can be found, that grows out of a profound knowledge of physiology and hygiene. Let the principles of science and the exercise of good common sense direct and control in all these matters. For it is in this way, and by this means only, that all kinds of empiricism and quackery, root and branch, can be eradicated. The public have infinitely more at stake in attempting to effect such a reform than the medical profession. The visions of the Alchemist in search after the "elixir of life" or the "philosopher's stone," may yet in some measure be realized by the diffusion of hygienic knowledge. For whenever the laws of hygiene have been faithfully observed, it has greatly improved not only individual health, but diminished the amount of sickness as well as of mortality. In certain localities in Great Britain, where these laws have been tested for a series of years, the Registration reports show a diminution of mortality from one-third to one-half. Such a result we should naturally expect. The more thoroughly the causes of disease are understood, the more and more are they found

traceable to a violation of hygienic laws. If the ravages of cholera, of yellow fever and typhoid may be controlled in a great measure by the observance of such laws, why may not scarlet fever, measles and whooping cough-those scourges of infant life be prevented, or very much limited? The prevailing sentiment that all children must necessarily have these diseases once, finds no support whatever in the nature of physiology or in the principles of hygiene. The fact is already well established, that the spread and violence of scarlet fever, by isolation, cleanliness and ventilation, are very much modified, and, in some instances, entirely prevented. We believe the time will come when scarlet fever, measles and whooping cough, which now destroy such multitudes of children, will become, in a measure, things of the past. It is not only the great amount of sickness and mortality occasioned directly by these diseases, but the impaired constitutions and other complaints consequent upon them, that may also be prevented. When the community realizes fully that the means of preserving health, especially in early life, are placed, in a great measure, in its own hands, a far higher estimate will be placed upon the value of human life, and the responsibility for its preservation will be found to depend in a great measure upon human efforts. For this sentiment of responsibility, which harmonizes with all the great principles of justice and accountability, increases just in proportion as the laws of physical organization are thus brought out and applied.

When disease, instead of being wrapt up, in its origin and progress, in a kind of mystery, can be traced to an intelligible source or cause; when it shall be clearly perceived that sickness and premature mortality are the results of violated law, then will our own interest in the subject be greatly enhanced; then will the responsibility be transferred from a "divine Providence" to human agency.

If the general diffusion of a knowledge of physiology, together with an application of hygienic laws, is to place in the hands of people themselves, to a far greater extent, the means of preserving health and thus diminishing disease, the problem arises, what is to be its effect upon

PRACTICAL MEDICINE.

This presents a question of particular interest to the medical profession, especially to its younger members. In the minds of some, doubts may arise whether any such changes will ever occur. But when we consider what great progress, within twenty or thirty years, has already been made in the diffusion of such knowledge, both in Great Britain and in our own country, that the interest is rapidly increasing in all matters pertaining to health, particularly with leading minds, and that there is a growing disposition on the part of people to take such matters into their own hands, it is very evident that it must result in important changes with reference to medicine. The seeming improbability of this statement vanishes when we take a retrospect of some points in the history of

medicine for the last forty or fifty years. What a surprising improvement has taken place in our knowledge of the nature and causes of disease! Pathology is comparatively a new science. The same may certainly be said of hygiene. It may safely be affirmed, we believe, that the nature, the causes, the laws or natural history of diseases, in all their forms and tendencies, cannot be thoroughly understood without a correct knowledge of these two sciences. It is not sufficient to understand the structure and function of an organ diseased, but what were all the agencies, internal and external, operating to produce this abnormal state; and the more thoroughly we understand these agencies, the more correct will be our diagnosis of disease. Such knowledge is, moreover, indispensable for its successful treatment.

The old theory that disease was some mysterious entity or unseen agency for evil, introduced into the body, has had a most pernicious influence. As one of its bad effects, it has tended to produce too much faith in the use of drugs alone. It has blinded inquiry as to the true nature of disease-has produced confused notions of its real causes, and led the mind to cast around every where, externally, to find some drug or compound for its cure. When the causes and the natural laws of disease were so imperfectly understood, not only the public demanded, but the profession inclined to depend too largely on drugs. As a result there was over-medication, and the evil has not altogether subsided. Some discriminating minds, see

ing the evils of excessive drugging, have been inclined to go to the other extreme-to decry the use of medicine and the profession altogether. Some very prominent medical men have come to such a conclusion, and expressed opinions which in the estimation of others have done injury.* If physicians have erred in over-medication, and people have injured themselves by too much dosing, it affords no evidence that medicines are not, at this day, just as good and necessary in the treatment of disease as they ever were. This depends upon the manner in which they are used. The true character of disease should first be clearly apprehended, together with the recuperative powers of nature; then let medicines come in as aids and helpers in overcoming, checking or alleviating disease, and not to violate or interfere with natural

"I will venture to say this, that if every specific were to fail utterly, if the cinchona trees all died out, and the arsenic mines were exhausted, and the sulphur regions were burned up, if every drug from the vegetable, animal and mineral kingdom were to disappear from the market, a body of enlightened men, organized as a distinct profession, would be required just as much as now, and respected and trusted as now, whose province should be to guard against the causes of disease, to eliminate them, if possible, when still present, to order all the conditions of the patient so as to favor the efforts of the system to right itself, and to give those predictions of the course of the disease, which only experience can warrant, and which in so many cases relieve the exaggerated fears of sufferers, or warn them in season of impending danger."-DR. O. W. HOLMES.

'I sincerely believe that the unbiassed opinion of most medical men of sound judgment and long experience is made up, that the amount of death and disaster in the world would be less, if all disease were left to itself, than it now is under the multiform, reckless and contradictory modes of practice, good and bad, with which practitioners of adverse denominations carry on their differences at the expense of their patients.' -DR. JACOB BIGELOW.

“As a physician advances in age, he generally, I think, places less confidence in the ordinary medical treatment than he did, not only during his early but even middle period of life."-SIR JAMES CLARKE.

"I declare as my conscientious opinion, founded on long experience and reflection, that if there was not a single physician, surgeon, apothecary, druggist nor drug on the face of the earth, there would be less sickness and less mortality than now prevails."-DR. JAMES JOHNSON.