proved nearly fatal. In March, 1862, he became able to travel, and the menacing attitude of the rebel iron-clad, the Merrimac, making it advisable to transfer as many of the wounded as possible, he was sent North. A new shaft had at that time replaced the parts of the humerus which had been removed, and, with motion at the shoulder-joint, the limb promised well. Ankylosis, however, took place subsequently; but, notwithstanding this, his arm has been and is still useful, the scapula, as you see, permitting of quite extensive movements. He can put his hand to his head, and, although the deltoid is atrophied and the upper arm is small, the forearm is as well developed and as muscular as the right. The arm is but a trifle shorter than its fellow.

COMMON SENSE VERSUS HYPOTHETICAL MEDI

CATION.

By JONATHAN KNEELAND, M. D., of Onondaga County.

Read by Title, November 19, 1884.

THE readiness with which thinkers, as well as the masses of men, embrace new doctrines of medicine, and the credulity which leads them to believe in and to swallow pretentious proprietary drugs, are outgrowths of the antiquated error that medicines are curative.

The term vis medicatrix naturæ, otherwise known as the constitutional powers, the force of nature, or the laws of organic life, denotes a principle which presides over normal growth and development, together with all the actions taking place in the vital organism in health and the restorative processes when degeneration results from decay or disease. These different names point to the same great truth; namely, that cures are but the renewed normal actions which have been averted or perverted by disease. This statement does not conflict with the assertion that the wise physician may give remedies and thereby aid the recuperative efforts of nature. But wherever the judicious regulation of air, food, and other hygienic conditions is the chief aid in recovery from disease, let us admit their claims and not attribute to the dynamic potency of nonentities, or to potions, pills, and pellets, results which are due to the self-regulating power of nature, established by an all-wise Creator.

The renowned Hunter, in a consultation with a younger physician, advised that all medicines be discontinued; and the patient, who had for many weeks been medicated, was fed on

new milk only, in doses of a spoonful each hour, when awake, whether retained or rejected. After a few days, larger quantities were given, at longer intervals, and after ten days a little farinaceous food was added.

The patient completely recovered, says the chronicler.

Had this patient swallowed placebos, or minute doses of a hypothetical medicine, the cure would have been attributed to these.

Fifty-two years have passed since John Eberle and Daniel Drake, the two greatest physicians of the West, held a consultation in the sick-room of an invalid who had had Asiatic cholera ten weeks before, who was reduced in weight from 140 to 72 pounds, and who was unable to turn in bed, as the result of chronic diarrhoea. The patient's senses were acute, and his recollection of the scene is, at this distant period, most vivid.

"He needs no more medicine," said Eberle. "I think otherwise," said Drake; "but since the case is so nearly hopeless, and you," addressing Dr. Eberle, "as consulting physician, are responsible, I shall be governed by your views in the treatment." Dr. Eberle then ordered the nurse to give no medicine except a decoction of dewberry-root in milk. This, and only this, was given for food, drink, and medicine, for two days; then, a little panada, consisting of potato-starch and arrow-root prepared with milk, was added. Slow restoration was aided, perhaps, by removing the patient, on his bed, from Cincinnati, Ohio, to central New York, a distance of over nine hundred miles, mostly by water. The patient so far recovered-chiefly by aid of wise hygiene, proper food, and horseback-exercise-that, giving medicine to such as needed it, and taking very little himself, he has practiced medicine over the hills and vales of Onondaga County, N. Y., for forty-four years. I may appeal to a gentleman present, the Honorable Commissioner of Lunacy, Dr. Stephen Smith, to verify the facts stated with regard to this case. I do not, however, desire to be understood to say that medicine was not used in this case to aid nature in obviating diseased conditions resulting from dyspepsia, catarrh, malaria, or accidental injuries.

Some forty years ago, a case of disease, which baffled the skill of the local physicians in one of the counties of central New York, led to calling in the aid of Dr. S., then the great "medicine-man" of that region. The doctor believed in medicine, and, if the right kind were not at hand, he could improvise it.

He found the patient, a girl of sixteen years, in an open bedchamber, from which the windows had been removed, the season being March and the weather cold. Several strong male attendants relieved one another every few minutes in turning the crank of a fanning-mill, so arranged as to throw a strong current of cold air upon the face of the patient. Dr. S. obtained from the attending physician the history of the case and examined the patient thoroughly. He then arose, called for six pails of water from the coldest well, and ordered all food and medicine discontinued and the wind-mill stopped. "But," said the patient's brother, "she can't breathe when we stop fanning her." "Stop the mill," said Dr. S. He was reluctantly obeyed, and she did stop breathing. The doctor dashed water over her, and she caught her breath, but it stopped. Again and again he dashed it over her. After three pails of water had been used, she caught her breath and held it fast.

My informant, many years afterward, assured me that this patient was then living, and that, no medicine being given, the recovery was rapid.

The case was believed to have been chronic peritonitis.

I shall not tire your patience by giving cases from my own long country-practice, to illustrate how much more may often be done to cure or ameliorate suffering in chronic surgical cases by rational mechanical supports and adjustments than by medicines. New York city has given to the medical profession a man who has proved himself a worker of surgical cures by common-sense external supports, without the help of which, appropriate remedies "to meet the indications of each case" could have done little good. In conclusion, I may cite a case known to you all, in proof of how much can be done, where little can be

certainly known, to prolong life and add to its comfort by common sense put into practice:

The sympathy, science, and curiosity of men and women, wise or otherwise, were more called forth by the bullet of Guiteau than by any missile ever sped on a fatal errand. Nélaton and electric probes, the antennæ of spiritual and mesmeric seers and feelers, poked and punched in vain; and, while only one man (an old navy surgeon) partly guessed its direction or situation, Bliss, Hamilton, Agnew, and their confrères received thousands of letters suggesting remedies, many of them assuring certain cure if they were used. I myself, even, ventured to urge that food be so prepared as to be assimilated without in the least overtaxing the digestive powers, that the least possible medicine be given, and that, as the case lingered on, Mr. Garfield be removed. The preservtion of his life for eighty days was doubtless due, in great part, to the wise cooling of the air, the enforcement of quiet, suitable food, and the avoiding of hurtful medication.

In seeking illustrations of my doctrine-that common sense is a better guide than hypotheses, however plausible, in treating chronic diseases-I have found but few clear and definite examples. Some physicians, as well as most other people, believe that medicines always cure disease, if it be cured at all. As a consequence, when their patient fails, they shift their tactics, call counsel, or, last and most to be deplored, they let him pass into the hands of an empiric or become a vortex for cure-all concoctions. Now, if from either of these last resorts the sufferer should get a remedy amounting to little or nothing but labeled with a high-sounding name, and if, from the curative aid of food, exercise, and renewed hope, he should recover, the credit is lost to the rational means used and is given to the empiric and his potions.

Few sick are ever restored without either aid or hindrance from medicine; and wisely prescribed medicine often has power to accelerate the cure in chronic diseases, but never to cure, unaided by rational hygiene.