FACTS VS. THEORY.

There is, to some extent, a mutual dependence existing between fact and theory; yet, while no man can prove or demonstrate a single position theoretically, without facts upon which to base his conclusions, he may demonstrate any doctrine he wishes upon facts, even though he may have no theory upon the subject, or even the most distant notions of its philosophy. This we find to be most beautifully illustrated in the practice of the healing art— especially in regard to the use of medicine for the removal of disease. The following extract, which we make from the writings of one of our Eclectic contemporaries, so fully expresses our views on this subject, that we transfer it to our pages:

"A physician is he who endeavors to understand the functions of this complex organism, and to relieve it of pain and disease when it is not in a physiological condition-whose knowledge of anatomy and physiology enables him to comprehend the extent of a pathological condition, to perceive the therapeutic indications, and whose knowledge of the materia medica enables him to substititute a healthy for a diseased system. And he is the best, most skilful and trustworthy physician who loses fewest patients in practice-who, knowing the frailties of the flesh, ministers in kindness to us, whether appreciated or not, and whose sense of correct motives is so predominant that he will treat with indifference every remark which might tend to destroy the equanimity of his mind and judgment; thus lessening the value of his opinions. We do not believe that the most learned physicians are necessarily the most skilful practitioners. Indeed, we know that such is by no means the case; and we account for the fact, by supposing that no amount of learning can compensate the deficiency which attaches itself to a man of mere theory, who has had no experience. A physician may be able to analyze any article in the materia medica―aye, even to determine the proximate principles which enter into its composition; yet, with all his knowledge of physiology and therapeutics, he will be but little conversant with the real therapeutic action of special agents unless he shall stand by the bedside of his patients, and there observe for himself those minor facts in medicine which are all important to the successful practitioner. Even now, some physicians, no matter how ex

tended their opportunities nor how profound their learning, seem never able to learn the symptoms of disease; or, if they do, are unable to adopt those means by which alone the disease may be broken up. There are theoretical physicians and there are practical physicians. Teachers, we fear, are too often to be classed with the former; and practitioners too often hold in contempt the mere pratings of theory. We do not feel disposed to place our lives in the hands of a man who has had little or no practice in his art, nor are we willing to trust ourselves to the chance practice of one who makes no pretensions to a knowledge of the theory of medication. Whatever takes place in this world of causes and effects is determined by certain precise laws; and whoever understands those which preside over the actions of medicine has made himself familiar with the phenomena of effects, so as to recognize the operating causes-who has a correct knowledge of physiology and pathology-has very nearly found the philosopher's stone of the healing art. If, under such circumstances, a physician is an unsuccessful practitioner, and no adverse conditions pertain to his business, such as the employment of impure or inert agents, we may safely conclude that the defect is in his mental constitution, and that physic is not his province. So much for our opinion of the science of medicine and those who practice the art.

"Nineteen twentieths of the physicians of America would, most probably, admit the justness of our remarks; and, in truth, have painted some similar picture as their beau ideal of that standard by which medical men ought to measure their motives. A large part of the non-medical community will, however, contend that our picture is a freak of the imagination, drawn to please ourselves, and that it is as new to us as to themselves. It is not a reason that such is the case, however; for, though all do not see motives in the same light, and many judge of others by themselves, yet does every phase of the physician's mission clearly prove that when he departs from our standard the fault is with those who trammel him, and oblige him to do that to please others which his own better judg ment condemns."

The following extract of a letter just received from Dr. William Hewitt, of Tennessee, contains some suggestions on the subject worthy of notice, and we have concluded to present them to our

readers, hoping some of them will take the hint and act accordingly:

"Is it not a waste of time to seek the cause or causes of the so-called contagious diseases? I have never seen a demonstration of the physical entity of contagious diseases, and can form no other opinion than that disease is a metaphysical nonentity, solely presentable by its lamentable effects. It is not divisible into numbers, not distinguishable by color, sound, weight, volume or odor. It is incapable of analysis or synthesis. Let the gifted intellects of the profession cease to chase the etiological phantasm-animalculi, fermentation, geological and astrological concatenations and give us a well arranged classification of statistical facts in relation to the peculiar effects of disease, the remedies made use of to combat the effects, and the success obtained. Such a course, I think, would be far more serviceable to man than the fine-spun theories of the most imaginative minds.

ROUTINE TREATMENT.

Vene

It is characteristic of the advancement of medical science, that the treatment of disease is becoming more rational, and less a matter of routine. Formerly, the treatment of almost every patient was conducted in conformity to rules which admitted only of limited modifications, according to the particular case. section was employed at the outset; even those whose exhausted energies seemed to call most loudly for a supporting treatment were not exempt from this universal remedy, And, although modifications in the type of diseases, and in the human constitution, have induced corresponding modifications of treatment among intelligent practitioners, there are, even now, not a few who still adhere to the lancet, as a necessary preliminary, in almost all cases, to the administration of drugs. After blood letting, followed an emetic, without much regard to the nature of the disease or the state of the patient's constitution. Mercury was formerly given regularly, in many diseases for which its use is now abandoned, though we fear, that even now, patients are occasionally salivated in typhoid fever, from an obstinate adherence to a long established custom.

Notwithstanding the great improvements in treatment, resulting from a general diffusion of enlarged and rational views, a strong tendency to routine practice still prevails. This is seen, in the abandonment of certain modes of treatment, rendered unpopular from the effects which have followed their abuse. There are practitioners who systematically abstain from depletion-who boast that they have not drawn blood for years, in a single case. The treatment of women after delivery, in ordinary cases, is quite a matter of routine. The swathe is tightly applied around the abdomen, a dose of castor oil is given on the second or third day, a diet of slops for a week, animal food often not for a fortnight, the horizontal posture, often eight or ten days, etc., which are adhered to with as much regularity as if all women and all labors were patterns of each other. The poor infant is often no less victimized by a prescribed treatment, as if congenital disease, no less than original sin, were the lot of mankind. Happy he who gets off with a dose of molasses and water; oftener castor oil is poured down his innocent throat, and we have actually known a nurse to administer a teaspoonful of urine to a new born infant, saying, that there was nothing like a little clean chamber ley for a baby.

Why must all patients with the same disease be treated alike? Why should a woman to whom child bearing is almost a trifling affair, be subjected to the rigid diet and close confinement appropriate only to those in whom the effects of parturition are more serious? Why should she take a dose of oil on the third day, when there are no symptoms which call for it; or have her breasts drawn, fomented and greased and kneaded, in order to prevent engorgements and abscess, means very likely to cause those very evils? Let us learn to be rational in our treatment; suit our remedies rather to the condition of the patient than to the name of the disease; to meet threatening and dangerous symptoms with prompt and energetic treatment when needful, and to avoid active. interference when the powers of nature are conducting the patient to a certain and speedy recovery, without any material assistance from medicine.

WEEDSPORT, N. Y., August 18, 1879.

DEAR SIR: A great deal of discussion among physicians exists as to the value of the various "emulsions" of cod liver oil.

Some claiming all emulsions are valueless, from the fact that they contain so small a percentage of the medicinal agent they wish to prescribe, viz.: the oil itself, that the emulsions are made up mostly of combinations of sugar, gum arabic and a small percentage of oil. They argue, perhaps not without reason, that a medicinal agent of so decided an odor and taste as cod liver oil, can never be emulsified into so palatable a preparation if the claimed amount of oil is added to the preparation.

Many elixirs and palatable preparations of medicine have been thrown on the market, and their virtues extolled by printed circulars which, in the hands of the physician, have proved valueless, from the fact that the manufacturers were not honest men, and claimed that each ounce or drachm contained so much of the medicinal agent, while experience has proven they could not contain that amount.

A few establishments have acquired a reputation for honesty in the preparation of medicine for physicians' use, which years of experience in prescribing them have proven, and the name of a certain firm on a bottle was all that was necessary to prove its genuineness.

This confidence between physicians and manufacturers is pleas ant. We, as physicians, wish to know what and how much of a certain agent we are prescribing. I have been led to make these remarks from the fact that, being only a "country physician," I have frequently found it necessary to call in consultation physicians from the adjacent cities.

In many cases of diseases of the lungs and debility, I had prescribed your emulsion of cod liver oil with phospho-nutritine, and invariably with good results. In no case did it ever disagree with the patient. Usually, although they admitted cod liver oil in some form was demanded, the purity of your preparations was called in question, from presumable evidence as to the comparative value of all preparations not of their own manufacture. As a consequence, your preparation would be substituted by an emulsion of their own originating, containing phosphoric acid, and the results have not been satisfactory to myself.

I think experience teaches us that in a disease like phthisis pul