THE MONTHLY

HOMEOPATHIC REVIEW.

DR. ANDREW CLARK ON THE PRESENT STATE OF THERAPEUTICS.

SOME three years ago we entitled one of our leading articles "The Medical Barometer," in which we glanced at the opening lectures delivered at the principal metropolitan medical schools, and deduced from the statements there enunciated the views on the state of therapeutics which were current in the old-school. In the present article we propose to inquire what progress can be reported after this lapse of time. If we look to the opening lectures for this year, we are at once struck with the almost entire-we might have said entire-silence on this all-important subject. Only one lecturer seems to think that therapeutics are worth any notice whatever, and this gentleman, in his few remarks, informs us that he "does not pretend to cure disease." He simply watches his case, and sees that matters go on "as well as can be expected." Surely such silence is ominous, since if any progress could be reported, there is little doubt that we should have duly heard of it; while the admission that the physician does not "pretend to cure disease" is akin to giving up therapeutics as hopeless.

No. 11, Vol. 23.

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We turn, then, to what ought to be an equally reliable "barometer," the report of the addresses delivered at the annual meeting of the British Medical Association held in August at Cork.* There we find Dr. ANDREW CLARK, as President of the Section of Medicine, gives the opening address. Dr. ANDREW CLARK'S position as a physician of the highest eminence in the metropolis, justifies us in taking his opinion of the present state of therapeutics, as indicating those held by the leading members of the old-school.

His address does not in the least surprise us, as he could not have honestly described the present position of medicine otherwise than he has done, but the perusal of it cannot fail to astonish us when we consider that such a "beggarly account" is all that he has to offer the profession, and the public who care to read it, in this nineteenth century, while the greatest medical truth ever discovered is quietly ignored. Truly there is no simpler plan of becoming blind than to shut one's eyes. It is a marvel, and some day it will become a curious psychological study, and an illustration of the mode in which truth is received by those whom it most concerns.

Dr. CLARK commences his address by indulging in a piece of gentle satire at the expense of his predecessors in the Presidentship. He describes the addresses of his predecessors as so many "stately hymns of praise," setting forth the dignity of medicine, the greatness of her achievements, her increasing services to mankind, the spirit in which she is to be cultivated, and the self-sacrifice of the cultivators, while they pass over her "defects" and "errors." He deprecates the spirit of "self-satisfaction," as an "obstacle to progress and a prelude to decay."

Dr. CLARK then proposes to discuss three questions; the state of medical education, the present state of therapeutics,

Brit. Med. Journ., August 9th, 1879.

Homoeopathic

and the prospects of experimental inquiry in this country. His remarks on the former we do not mean to discuss, but shall confine our observations to his estimate of the two latter.

When commencing the discussion of the present state of therapeutics, Dr. CLARK thus speaks :

"When, but a little while ago, Sir WILLIAM HAMILTON asked quite seriously if the practice of medicine had made a single step in advance since the time of HIPPOCRATES; when we hear that the leaders of medicine, both here and abroad, are sceptical of the curative influence of drugs upon disease; and when we know that experienced practitioners are divided in opinion as to the effects upon the body of the commonest medicines, we cannot doubt that this, the highest department of our art, and one of its chief ends, is in a backward and unsatisfactory condition, and demands, like the question of education, the serious consideration and action of the profession. Beyond the inherent difficulties of the subject, which are undoubtedly many and great, the reasons of this lie near at hand, and are not difficult to discover."

The first step towards the remedying of a defective and unsatisfactory state of matters in any cause, is certainly to discover the reasons for such. But before glancing at Dr. CLARK's reasons for the state of therapeutics at the present time in the old-school, let us stop for a moment, and consider the premises of his argument. When Dr. CLARK "hears" that the leaders of medicine both here and abroad are sceptical of the curative influence of drugs upon disease, and this after nearly nineteen centuries of practice, one naturally comes to the conclusion that the profession are somehow working on the wrong tack in the attempt to combat with disease.

That all "medicinal" substances have an injurious action on a healthy body in certain doses is admitted as a matter of course, and is a fact known to the merest tyro,

and if at this time of day the "leaders of medicine" are sceptical of the curative action of drugs which show such a marked effect on a healthy body, the conclusion is irresistible, that as yet the "leaders of medicine" have not discovered the key to the relation between drugs and disease.

Nor is such a state of opinion as Dr. CLARK "hears of” wonderful at all, when we find him next stating that he "knows that experienced practitioners are divided in opinion as to the effects upon the body of the commonest medicines."

How can a workman be certain of producing a piece of work worthy of the name unless he understands the uses and capabilities of his tools? And can it be otherwise, that when ignorance prevails among "experienced practitioners" as to the action of the "commonest medicines," scepticism as to their value in the cure of diseases should exist? This is evidently the turning point in the advancement, or standstill-which is the same thing as retrogression-of therapeutics. It cannot advance till the action of medicines in health and disease, and the relation between the one and the other, is fully understood. There must be a definite relation of a fixed nature between the effects of medicines on the body in health and in disease; it is out of harmony with all that we know of nature, and of God's beneficent arrangements for His creatures, to suppose otherwise.

This, then, must be the starting point. The effects of drugs in health must first be ascertained, and then the connecting link discovered between these effects and those in disease. It is clear that the key to such a definite relation has not been discovered by the old-school, and till it is obtained, therapeutics will periodically call forth such a lament as that of Dr. CLARK.

Let them, now, ponder on the meaning of what he will see in our school. We have got a principle for our guidance

in treatment which we believe to be the key to the hitherto unsolved problem. There is no doubt that it does harmonise, and in a beautiful way, the effects of drugs in health and in disease. It is, moreover, the only key to the problem which has stood the test of fifty years of practice, in the hands of thousands of educated practitioners. Secondly, we know, in a wonderfully full and accurate manner, the effects of drugs on the healthy body, and we find that these effects are, with the help of our key, the guide to the use of these drugs in disease. We have but to ascertain the effects on the healthy body of any new drug, and we can at once tell what it will be good for in disease. And thirdly, as a result of this knowledge, our school are not sceptical of the curative influence of drugs upon disease. The contrast in this point between the two schools is very remarkable, and we may add that it is the followers of HAHNEMANN only, out of the whole profession, who can boast of a sincere belief in such curative power in drugs.

Let us now glance at Dr. CLARK's eight reasons why therapeutics in the old-school are so "backward and unsatisfactory." First, he says there is but one book on therapeutics, "in the full sense of that term." It is materia medica and not therapeutics which is taught in the schools, and this at a period in study when therapeutics cannot be fully appreciated. The one book referred to is, we fancy, Dr. RINGER'S Manual of Therapeutics, and we all know how full of homoeopathy this is, and that much of the original matter in it is to be found, without acknowledgment in most instances, in all homœopathic works, from HAHNEMANN downwards. This dearth of good books on therapeutics is, however, as any one may see, a consequence and not a cause of the "backward and unsatisfactory" state of therapeutics in the old-school. Let there