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strain excessive action, and to restore, within limits, injured organs. This agent has been known and described in medical literature for ages as the vis medicatrix naturæ; plainly our reliance must be founded on this, and our efforts can only be effectual when acting in concert with this inherent agency; any attempt to benefit humanity in our office of physician outside and independent of this wondrous endowment would be to usurp functions and arrogate to ourselves powers which were never conferred upon us. If in any direction our science has made advance more signally than in any other, it has been in the more distinct and complete recognition of this fact; probably legitimate medicine may have been assisted to this recognition by the prevalence of some of the modern heresies. We would not hesitate to acknowledge our obligation to a system essentially heretical, nor would we fail to note the light, nor refuse to be led by it; let us not scorn even the dim light of a star from any quarter of the firmament if it conduct us to the daylight of truth.
We are not unaware that the acknowledgment of our inability to originate any new agencies for the combating of disease may be in direct opposition to many of the popular beliefs on the subject, and that being admitted, mysticism and superstitious veneration may have to vanish, and humiliation in popular estimation be the consequence; nevertheless this truth is so far fundamental that too much prominence cannot be given to it in our thoughts on medical subjects, and that our highest claim to efficiency is based upon our ability, with such means or agents as are furnished to us by nature, and by the appliances of science, to stimulate, repress, or direct the excitabilities and susceptibilities impressed upon or treasured up within the living organism, may be regarded or established beyond controversy.
The science of medicine, including in the phrase the various subdivisions of anatomy, physiology, practice of medicine, surgery, chemistry, materia medica, and obstetrics, has shared largely in the advance which knowledge has made in the last century, and, adopting an army phrase, it may be represented by an advance along the whole line, just as one corps or division may be, in the same terminology, said to support or reënforce another, and thus further the general object of a campaign. But while this may be, and doubtless is, strictly true, some of these corps have advanced further into the enemy's country, and explored regions far beyond others, and have returned laden with the spoils of conquest, or held their position to enjoy the trophies of their acquisition.
If in any way our science has been markedly distinguished, in the century just closed, from all its predecessors, perhaps it will be
found to be by broader generalizations, or by the adjusting of special facts or truths into their appropriate classes. The result of this process is thus set forth by Sir William Hamilton. He says: "When a fact is generalized, our discontent is quieted, and we consider the generality itself as tantamount to an explanation." Much of this ability thus to adjust facts in their proper genera has been attained through the medium of the knowledge of the physical sciences, and the application of that knowledge to medical questions. As an example of certitude and stability afforded by physical diagnosis, reference is made to a medical work now in course of publication; referring to the diagnosis between pleuritis and pneumonia, this is quoted as a remark occurring in one of the text books published so late as 1820: "It is clear, therefore, and indisputable, that there is no distinction between these diseases, and that we can and ought to discuss them both under the single term pleuroperi. So good an authority as J. P. Frank asserted, that " in their essential, nature, nor in their symptomatology, can these two inflammations ever be accurately differentiated from each other." To a practitioner of medicine of the present day, whose ear has been educated in a knowledge of the physical signs of the diseases of the chest, it is scarcely credible what inexplicable uncertainty hung around the diagnosis of the diseases of the chest. Now, by availing ourselves of the light af forded by the science of acoustics, the distinction is made so clear that mistake is improbable. But in the limits assigned to a short address, the impracticability will be apparent of dealing in particulars on subjects the details of which would fill volumes.
The progress which medicine has made may be said to be general, in that science has achieved victories over the foes of vitality. One of the most striking evidences of this advancement is referred to by a late German writer, under the head of infectious diseases. After reciting some of the disasters to which large masses of men are exposed, and some of which have destroyed whole armies, and others of which have operated to defeat and occasionally to change the direction of campaigns, he adds that the only example afforded by all history of a great war in which the sword has proved a greater destroyer of human life than pestilential diseases, is furnished by the late Franco-Prussian war, which gratifying result may be ascribed to the more accurate knowledge and strict enforcement of the laws of hygiene.
The last century has added some new branches to our knowledge, which have already proven themselves to be valuable acquisitions. Among these may be specified the science of Gynecology-which,
says a recent writer, is essentially a growth of the last half of the last century. To the diseases of women have been devoted great labor and research, which care and effort have already achieved much, and promise abundantly for the future. Want of time forbids reference to many other branches perhaps equally valuable and important.
Several of the old subdivisions, under which medicine has been studied, have been so modified by the acquisition of new facts and the unfolding of new principles, as to be hardly recognized as the same branches of knowledge. This may be affirmed of chemistry, that invaluable handmaid to medicine. Its aid has been made available in more directions than one, viz., as a means of diagnosis: from an analysis of the blood and the secretions, we are advised when this fluid or any of its products is deficient or redundant in any of the normal elements, and again by furnishing the therapeutist with the agent by which this redundancy or deficiency may be reduced to the normal standard. The materia medica has been enriched immensely by the contributions of the chemist. But chemistry is a science of comparatively recent date, and, more particularly still, animal chemistry, which is of most essential importance to our science, is the growth of the last half century. And while doubtless much remains for chemistry to reveal of vital processes, and many weapons for it to furnish to the armamentarium of the practitioner, it would be highly improper should we fail to acknowledge the obligation we are under to it.
Surgery, that other branch of our science, which, on account of the more apparent and tangible results from its exercise, brings greater éclat to its professor and practitioner, dressed in its present garb, would need a formal introduction to the practitioner of that art of a century ago. We say art, advisedly, for it was long since. the beginning of the century just closed before it could be dignified by the name of a science. I quote from the preface of a surgical work, printed in London but little more than a century ago. Says this author: "In the description of diseases I have only mentioned their distinguishing appearances, and have not once dared to guess at that particular disorder in the animal economy which is the immediate cause of them; indeed the uncertainty there is in conjectures of this intricate nature, and the little service that can accrue to surgery from such speculative inquiries, have entirely deterred me from all pretence to this sort of theory; and since the most ingenious men hitherto have not, by the help of hypotheses, done any considerable service to surgery-may, for the most part, have misled young surgeons from the study of the symptoms and cure
of disease to an idle turn of reasoning and certain style in conversation, which has very much discredited the art among men of sense -I hope I am right on that head." But now this branch has been rescued from the ignoble position of scarcely more than a mechanical art, to be a highly scientific pursuit. And the surgeon who would undertake to practise his noble profession, and ignore "that particular disorder of the animal economy" or constitution which is often the immediate cause of the local diseased action, would be ranked simply as a butcher; and now, to the honor of surgery be it said, in fact many of our most accomplished physiologists and therapeutists are found among the practitioners of surgery.
These remarks might be extended indefinitely to embrace all the other departments of our noble science, but I am admonished that the time allotted for this exercise has already been transcended, and it will be closed by the suggestion, which I hope will not be regarded as beyond the bounds of propriety, that—in view of the limited possibilities of the science and art we love and practise, and of the fact that in the conflict above alluded to, between the physical and the vital powers, in the end the victory must inevitably and unavoidably be with the physical-we submit ourselves reverently to the teachings of that Doctor who taught as never man taught, and that we devoutly consult the Great Physician whose hand dispenses the leaves of the tree of life, which are for the healing of the nations.
Benjamin Lee, Treasurer, in account with the Medical Society of the State of Pennsylvania.
June 10. To balance
Nov. 1. 66 46 18. 66
cash received from Erie Co. Med. Soc., balance for 1874
Mifflin Co. Med. Soc., in full for 1875
Cumberland Co. Med. Soc.,on account
Fayette Co. Med. Soc., for 1875
Venango Co. Med. Soc., for 1875
Clearfield Co. Med. Soc., for 1875
from Montgomery Co. Med. Soc., for 1875
66 Crawford Co. Med. Soc., for 1875
Luzerne Co. Med. Soc., bal. for 1875.
Mercer Co. Med. Soc.,on acc't for 1875
Westmoreland Co. Med. Soc., for 1875
Lehigh Co. Med. Soc., on account for
Butler Co. Med. Soc., for 1875.
"6 Blair Co. Med. Soc., for 1875 .
$1167 46 3.00 1 30
32.00 5 20
30.00 31 20 26.00 10.40
9 60 39.00
44 20 1 30
9 75 53 30
13.00 10.50 18 20
16.00 15 60