CHAPTER XI.

MEANS OF REMOVING QUACKERY.

Ir must be obvious to any one who observes the wide influence which quackery maintains in its various forms in the community, amid all the efforts which are made to overthrow it, that there has as yet been discovered no adequate remedy for this evil. It is common for physicians to say that there is no remedy-that there is, and always will be, a class of persons who must, from the very character of their minds, be addicted to quackery; and that it is of no avail to attempt to deliver them from their errors, but they must be left to go from one delusion to another, as they choose, all their lives. If quackery were confined to such persons, it would, I allow, be idle to talk of any remedy. But it is not so confined. We every day see men, who are intelligent and judicious on other subjects, perfectly deceived and captivated with the false pretensions of empiricism. If these individuals were ignorant, and were easily influenced by merely plausible reasoning, or were enthusiastic, or over fond of novelty and change, then I should despair of making any impression upon them. But as this is not the case, I am led to the conclusion, that there must be some defects in the mode in which truth on the

subject of medicine has been presented to their minds; and that the sources of error have not been so plainly revealed to their view in this, as they have been in other fields of enquiry.

Efforts, it is true, have been made by the medical profession to correct the tendency to empiricism, which is so rife in the community. But I believe that it can be satisfactorily shown that these efforts have, to a great extent, been made with wrong means, and in a wrong direction; and that for this reason they have failed to strike at the root of the evil.

Much reliance has been placed upon giving to the people a knowledge of anatomy, physiology, dietetics, &c. For this purpose books have been published, journals of health have been issued, and lectures have been delivered. All this is very well. Valuable information has thus been communicated. Still, it leaves the great sources of empiricism nearly, if not quite, untouched. These are pouring forth their destructive streams more abundantly than ever, notwithstanding the great increase of late of popular knowledge on medical subjects.

And this is as we should expect it would be from the nature of the case. For the knowledge, which one obtains from popular books and lectures, of the human system as a piece of mechanism, can have but little influence upon his notions in regard to the operation of remedies, on that system; for the operation of remedies, for the most part, lies beyond the mere mechanical principles of the organization, and therefore cannot be materially elucidated by a knowledge of those principles. For example, the knowledge, which the dyspeptic gains, from popular instruction, of the situation and the shape of the stomach, of the number of its coats, and of the process of digestion, cannot enlighten him in re

gard to the treatment of his disease, and will therefore not guard him against delusion on this subject. He will be just as ready, as he was before he acquired this knowledge, to take some patent medicine, or to resort to some boasting empiric.

None of the common popular errors can be removed by the knowledge referred to. If a man should adopt the notion, that the blood is the seat of all disease, and therefore that remedies relieve disease by purifying the blood, would it be possible to dislodge that error, simply by showing him the heart, and describing to him minutely the circulation? The mechanical contrivances of this beautiful and wonderful piece of machinery have manifestly no reference to the state of the blood contained in it. How can he know, from an examination of the heart and the arteries and the veins, whether he is right in attributing all disease to a corrupt state of the life-giving fluid? Or what light will this examination give him in relation to the remedies which he supposes enter the circulation and rectify the blood, by neutralizing whatever it contains which is bad?

I will even take a case in which one would suppose that a knowledge of the mechanical structure of the body would be of essential service, as an antidote to quackery. I refer to a belief in the skill of the natural bone-setter. How often does the knowledge referred to entirely fail to dislodge this error. You may show the believer in it the structure of the joints, and demonstrate to him by a clearness of proof which would satisfy him on any other subject, that it is as necessary to understand this structure, as it is any other piece of mechanism, in order to be skilful in detecting the nature of the injuries which it receives, and in repairing them. And yet, he will reply, 'all this looks right, to be sure; but still here is the fact that the bone-setter does set bones some how or other.' You will have to do something

more, to convine him that his confidence is misplaced. You must show him, how it is that the ignorant bone-setter acquires a reputation, in spite of his ignorance, and his consequent blunders. And this can be done by facts. In commenting on these facts you can make use of the knowledge, which your friend may have of anatomy, as an auxiliary in pressing your point; and it may thus prove of great service, though it is wholly unavailing when appealed to alone. For a full view of this subject I refer the reader to the chapter on Natural Bone-Setters.

While a popular knowledge of anatomy and physiology has but little influence in restraining quackery, it sometimes evidently increases it, by giving its possessor an exalted idea of his medical acumen. He upon whom it has had this effect is much disposed to adopt opinions and theories on slight and plausible grounds, and in this way is constantly led into error. The physician meets persons of this character every day. They are always ready to talk with him, and they seem to feel quite at home on medical subjects, and some of them have really acquired considerable information on these subjects; but they have built upon it a superstructure of untenable theories and notions, and they are commonly carried about by every wind of doctrine in medicine.

The quack aware of the prevalence of this superficial knowledge of medicine, gathered from popular books and lectures, often makes provision for the taste thus engendered. He hires some one, perhaps a medical student, to prepare for him a disquisition on some of the principles of medical science, which is to accompany the certificates setting forth the virtues of his nostrums. This disquisition may all be correct, though it is more commonly a mixture of truth and fallacy, so combined, that the superficial reader does not separate the one from the other. It answers the

purpose for which it is intended. It convinces most people who read it, that the author (whom they suppose to be the proprietor of the medicines) really has a great knowledge of medical science, and that, therefore, though other patent medicines may be impositions, his cannot be. There is often in these disquisitions page after page of physiological discussions, in learned guise, which have no sort of bearing upon the nature of the medicines recommended, though they do have most manifestly upon their sale, as the result shows.

Let me not be understood to mean, that none but physicians ought to know anything about the human system; nor that the knowledge of it, which is obtained from popular books and lectures, can be of no advantage in the warfare with empiricism. Though, when it is relied upon as the chief, almost the only, weapon in this warfare, it is, as you have seen, of little avail, and is often even turned against the cause of truth and science; yet, as an adjuvant to other means in removing quackery, it may prove very valuable. What then, let us enquire, are those other means?

I have shown in another chapter, that the principal popular errors in medicine arise from partial views of the operations of disease and the effects of remedies, and are false conclusions in regard to the relation of cause and effect. These false conclusions are, as you have seen, the basis of quackery; and therefore one of the chief means of removing quackery is to be found in the exposure of the fallacy of these conclusions.

But it will perhaps be said, that this has often been attempted, and with so slight success, that there is very little encouragement for repeating such attempts; and that it is best on the whole to let the community find out their errors by their own experience, sad as it sometimes is. Those