PRESIDENT'S ADDRESS.

THE MUTUAL RELATIONS OF THE PUBLIC AND THE REGULAR MEDICAL PROFESSION.

R. HUBBARD, M.D., BRIDGEPORT.

Gentlemen and Members of the Connecticut Medical Society:

It is but natural that, in matters pertaining to such momentous interests as human life and health, mankind should have made, both within and without our profession, the most strenuous efforts to discover some complete science of medicine, or universal law of cure, by which to determine all measures adopted for their protection. These efforts hitherto have been, and I think always must be, from the nature of things, futile.

Although we frequently use the term science as a convenience of language, in the sense of accumulated knowledge upon some particular subject or art, and, accordingly, to characterize medicine; still much more than this is required to elevate any branch of learning to the dignity of a science.

Sir William Hamilton briefly but tersely defines science to be "A complement of cognitions, having, in point of form, the character of logical perfection, and, in point of matter, the character of real truth."

In the sense of completeness and unity of parts implied in this definition, medicine is not a science, but rather a combination of sciences covering, scientifically, only parts of the broad field of duty we are obliged to occupy, and exhibiting here and there numerous wide chasms to be bridged over by rules for action deduced from rational experience.

We hear much denunciation of Empiricism, and the term, with its ugly sound, is hurled at the devoted head of quackery with as much confidence as though it were the most convincing syllogism in our language.

Now I ask whether this is not inconsiderate, and inconsistent with the etymological or better sense of the term in which it is frequently employed? I have no quarrel with any one on account of his condemnation of charlatanism, but so long as we have not sufficient demonstrated theories to cover the whole ground we must occupy, Rational Empiricism-or experience-must supply the deficiency.

Rapid as has been the progress, and numerous and brilliant as have been the discoveries, especially during the last twenty-five years, by our profession and their co-laborers, by means of instruments of precision in diagnosis; the great attainments in physiological chemistry; the rapid advances of the sciences of physiology and pathology, of which we may well be proud; we still are obliged to find our way in many directions by the fainter light of experience, or rational empiricism.

Daily the practical physician is obliged to accomplish some of his best, and not infrequently, I apprehend, the best, of his results by this method, however unsatisfying it may be to be deprived of that God-given palliation of the primitive curse which doomed man to earn his bread by the sweat of his brow,-the delight of comprehending the philosophy which underlies and fully explains the principles of his art or profession.

If the practitioner should refuse to administer a dose of ipecac or rhubarb to his patient when either was clearly indicated, until he could comprehend its modus operandi, he would never give it.

And this is equally true in regard to a majority of the articles of the Materia Medica, notwithstanding the praiseworthy and invaluable labors of Headland, who has done so much in his efforts to make a scientific classification of remedies based upon their modes of accomplishing their results.

While we should in nowise relax our efforts in scientific investigation, we may profitably imitate the habits and close and patient observation of the phenomena of disease at the bedside by our brethren of the past, who were almost solely dependent on precedents established by experience for guidance in their practical duties.

Imperfections do not alone pertain to medicine, but are manifest in all systems of human knowledge, many of which are admitted to come within the definition of true sciences; as witness the mutations in botany, chemistry, etc.

For instance, many individuals in botany have been frequently

shifted from one genus to another within our recollection, and numerous chemical compounds whose constituents and modes of combination were supposed to have been accurately determined, have been obliged to submit to a similar correction.

Acknowledging thus briefly the imperfections of our art, and deprecating the disposition of the public to judge us by the criterion of scientific perfection, I proceed to consider some of the mutual relations of the regular medical profession and the public and other systems of practice to show, in some degree, what it has done for it, and what its representatives have a right to expect in reciproca

tion.

To establish and foster institutions for the benefit of the sick, the unfortunate, and the vicious; to influence legislation so as to promote public health and morals; in fine, to aid in every good word and work, have been accepted as cardinal obligations by our profession from the earliest period in which it can be said to have had any organization.

Time would fail me to indicate in detail the rich harvest which the public have reaped from this field.

The regular medical profession has alone, from the earliest times hitherto, stood between the public and all sorts of medical pretenders and impostors.

In fact this is one of the prominent obligations imposed upon us by our code of ethics. In the infancy of systematic medical training the Asclepiada imposed the most rigid restrictions upon all practitioners in the profession; and in these were included all who had taken the Hippocratic oath; not only to prevent them from performing certain duties for which they were unqualified, but also, especially, to furnish a reason for curtailing the doings of the quacks and charlatans who infested society.

Hydropathy, Thompsonism, Botanicism, and other exclusive systems require only a passing notice, as these one-sided and inadequate theories no longer confront us in the general field of practice as competitors for public favor; therefore, as I do not propose to make a post-mortem examination of defunct systems, I pass on to a brief consideration of the attitude of our only two remaining opponents-Homœopathy and Eclecticism.

Towards the public the attitude of the former (Homœopathy) is, and has long been, one of hypocrisy; towards us, our principles and practice, one of unmitigated, persistent denunciation.

At first they made the hiatus between themselves and us as wide

as possible, characterizing our practice before the public as unphilo sophical, and even homicidal.

In the zeal of their new-born faith in the dogmas of the Hahnemannic system for a time they were guided in their practice by its theories, but soon began to discover that there is no royal road to success, even in medicine, and that the expectation of great results from inadequate causes was an absurdity, and could not be realized. As a comet in its eccentric wanderings, after reaching the natural limit of its course, is compelled by an inevitable law to draw nearer and nearer to the great center of attraction, so they have gradually more and more gravitated towards the only true and sensible system-that of rational medicine.

Homœopathy-to-day-tried by the criterion of its standard literature, does not exist; its votaries have long since, without a visible struggle, abandoned one of its only two distinctive dogmas, viz., that of the potency of infinitesimal doses of articles of the Materia Medica, and have made such rapid progress in the administration of the "raw material," that it requires a practitioner of no ordinary courage in the "Old School" to emulate their heroism.

I will give a single instance, among numerous similar ones, which have come under my own observation: A gentleman had been troubled with insomnia for several nights, until he was. driven to the verge of mania, and hoping to obtain relief by the diversions of a change, visited a brother in my vicinity. Doubtful of his ability to woo successfully "tired nature's sweet restorer," the latter proposed to his brother to consult some physician.

Accordingly they went to the office of an ex-president of the Connecticut Homœopathic Society, to whom the case was stated. In reply the doctor said, "That can be easily managed; I will give you a couple of Dr. Hammond's doses of bromide of potassium." He wrote for sixty grains of the bromide, to be divided into two powders; one to be taken at bedtime and the other in two hours, unless sleep was produced. The directions were implicitly obeyed, and notwithstanding the sixty grains of bromide of potassium, he passed an excited, wakeful night, and sent for the doctor in the morning, who wrote a prescription for a fluid ounce mixture, containing two grains of sulphate of morphine and two drachms of hydrate of chloral, in ordinary menstruum; and directed him to take a teaspoonful once in two hours until sleep was produced. respectfully submit whether there is among this audience a medical man who would order one-quarter grain doses of morphia and fifteen

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grains of chloral up to the eighth dose without taking his place at the bedside to protect his patient from the hazardous effects of swallowing two drachms of chloral and two grains of morphia within seven to nine hours. And yet this distinguished representative of infinitesimalism went about his ordinary business giving his patient carte blanche to swallow the contents of the bottle in cumulative doses in this short period of time.

And further, their assumed infallible law of cure-similia similibus curantur-does not seem to be free from danger of a violent death at the hands of its friends when the assertion is made by the public press, without contradiction, that the question is seriously discussed in their conventions whether they shall abandon that dogma also, and thus give the coup de grace to the whole system. And the representatives of this system-if it can be with propriety so called-are they who charge us with illiberality, bigotry, and even inhumanity because we refuse to meet them at the bedside of the sick.

Our answer to all this is simple, we believe the homeopathic system to be false in theory and pernicious in practice, and therefore that we have no moral right to pursue such a course as will indicate to the public that it is worthy of confidence. This is not stronger than the language of Hahnemann himself. He asserts in his preface to the "Organon" that the "old system" of medicine followed for the previous twenty-five hundred years was the "exact opposite" of his own newly-discovered, true healing art, as “ opposite as day is to night," and after grudgingly paying to the "old system" the dubious compliment of permitting one per centum of its victims to escape death, emphatically declares that there can be no compromise between the two schools.

He further adds: "Homoeopathy, if rightly apprehended, will be found so exclusive, and in that way only serviceable, that, as the doctrine is pure, so must the practice be also; and all backward straying to the pernicious routine of the Old School' is totally impossible."

The Eclectic System, our second and last competitor for public favor, is an outgrowth or culmination of Thompsonism and the Botanic System.

This, too, like all exclusive systems of medicine, offers no new principles that will bear critical analysis, but is characterized rather by an arbitrary selection of certain articles of the Materia Medica, giving preference without any good reason to those de