medical essays-第75部分

按键盘上方向键 ← 或 → 可快速上下翻页，按键盘上的 Enter 键可回到本书目录页，按键盘上方向键 ↑ 可回到本页顶部！
————未阅读完？加入书签已便下次继续阅读！


or　shall　it　be　borne　across　the　Atlantic　and　reach　the　banks　of　the　Charles；　where　Agassiz　and　Wyman　have　taught；　where　Hagen　still　teaches；　glowing　like　his　own　Lampyris　splendidula；　with　enthusiasm；　where　the　first　of　American　botanists　and　the　ablest　of　American　surgeons　are　still　counted　in　the　roll　of　honor　of　our　great　University？

Let　me　add　a　few　words　which　shall　not　be　other　than　cheerful；　as　I　bid　farewell　to　this　edifice　which　I　have　known　so　long。　　I　am　grateful　to　the　roof　which　has　sheltered　me；　to　the　floors　which　have　sustained　me；　though　I　have　thought　it　safest　always　to　abstain　from　anything　like　eloquence；　lest　a　burst　of　too　emphatic　applause　might　land　my　class　and　myself　in　the　cellar　of　the　collapsing　structure；　and　bury　us　in　the　fate　of　Korah；　Dathan；　and　Abiram。　　I　have　helped　to　wear　these　stairs　into　hollows；stairs　which　I　trod　when　they　were　smooth　and　level；　fresh　from　the　plane。　　There　are　just　thirty…　two　of　them；　as　there　were　five　and　thirty　years　ago；　but　they　are　steeper　and　harder　to　climb；　it　seems　to　me；　than　they　were　then。　　I　remember　that　in　the　early　youth　of　this　building；　the　late　Dr。　John　K。　　Mitchell；　father　of　our　famous　Dr。　Weir　Mitchell；　said　to　me　as　we　came　out　of　the　Demonstrator's　room；　that　some　day　or　other　a　whole　class　would　go　heels　over　head　down　this　graded　precipice；　like　the　herd　told　of　in　Scripture　story。　　This　has　never　happened　as　yet；　I　trust　it　never　will。　　I　have　never　been　proud　of　the　apartment　beneath　the　seats；　in　which　my　preparations　for　lecture　were　made。　But　I　chose　it　because　I　could　have　it　to　myself；　and　I　resign　it；　with　a　wish　that　it　were　more　worthy　of　regret；　into　the　hands　of　my　successor；　with　my　parting　benediction。　　Within　its　twilight　precincts　I　have　often　prayed　for　light；　like　Ajax；　for　the　daylight　found　scanty　entrance；　and　the　gaslight　never　illuminated　its　dark　recesses。　　May　it　prove　to　him　who　comes　after　me　like　the　cave　of　the　Sibyl；　out　of　the　gloomy　depths　of　which　came　the　oracles　which　shone　with　the　rays　of　truth　and　wisdom！

This　temple　of　learning　is　not　surrounded　by　the　mansions　of　the　great　and　the　wealthy。　　No　stately　avenues　lead　up　to　its　facades　and　porticoes。　　I　have　sometimes　felt；　when　convoying　a　distinguished　stranger　through　its　precincts　to　its　door；　that　he　might　question　whether　star…eyed　Science　had　not　missed　her　way　when　she　found　herself　in　this　not　too　attractive　locality。　　I　cannot　regret　that　weyou；　I　should　sayare　soon　to　migrate　to　a　more　favored　region；　and　carry　on　your　work　as　teachers　and　as　learners　in　ampler　halls　and　under　far　more　favorable　conditions。

I　hope　that　I　may　have　the　privilege　of　meeting　you　there；　possibly　may　be　allowed　to　add　my　words　of　welcome　to　those　of　my　former　colleagues；　and　in　that　pleasing　anticipation　I　bid　good…by　to　this　scene　of　my　long　labors；　and；　for　the　present　at　least；　to　the　friends　with　whom　I　have　been　associated。






APPENDUM

NOTES　TO　THE　ADDRESS　ON　CURRENTS　AND　COUNTER　CURRENTS　IN　MEDICAL　SCIENCE。

Some　passages　contained　in　the　original　manuscript　of　the　Address；　and　omitted　in　the　delivery　on　account　of　its　length；　are　restored　in　the　text　or　incorporated　with　these　Notes。

NOTE　A。　

There　is　good　reason　to　doubt　whether　the　nitrate　of　silver　has　any　real　efficacy　in　epilepsy。　　It　has　seemed　to　cure　many　cases；　but　epilepsy　is　a　very　uncertain　disease；　and　there　is　hardly　anything　which　has　not　been　supposed　to　cure　it。　　Dr。　Copland　cites　many　authorities　in　its　favor；　most　especially　Lombard's　cases。　　But　De　la　Berge　and　Monneret　（Comp。　　de　Med。　　Paris）；　1839；　analyze　these　same　cases；　eleven　in　number；　and　can　only　draw　the　inference　of　a　very　questionable　value　in　the　supposed　remedy。　　Dr。　James　Jackson　says　that　relief　of　epilepsy　is　not　to　be　attained　by　any　medicine　with　which　he　is　acquainted；　but　by　diet。　　（Letters　to　a　Young　Physician；　p。　　67。）　Guy　Patin；　Dean　of　the　Faculty　of　Paris；　Professor　at　the　Royal　College；　Author　of　the　Antimonial　Martyrology；　a　wit　and　a　man　of　sense　and　learning；　who　died　almost　two　hundred　years　ago；　had　come　to　the　same　conclusion；　though　the　chemists　of　his　time　boasted　of　their　remedies。　　〃Did；　you　ever　see　a　case　of　epilepsy　cured　by　nitrate　of　silver？〃　　I　said　to　one　of　the　oldest　and　most　experienced　surgeons　in　this　country。　　〃Never；〃　was　his　instant　reply。　　Dr。　Twitchell's　experience　was　very　similar。　　How；　then；　did　nitrate　of　silver　come　to　be　given　for　epilepsy？　　Because；　as　Dr。　Martin　has　so　well　reminded　us；　lunatics　were　considered　formerly　to　be　under　the　special　influence　of　Luna；　the　moon　（which　Esquirol；　be　it　observed；　utterly　denies）；　and　lunar　caustic；　or　nitrate　of　silver；　is　a　salt　of　that　metal　which　was　called　luna　from　its　whiteness；　and　of　course　must　be　in　the　closest　relations　with　the　moon。　　It　follows　beyond　all　reasonable　question　that　the　moon's　metal；　silver；　and　its　preparations；　must　be　the　specific　remedy　for　moonblasted　maniacs　and　epileptics！

Yet　the　practitioner　who　prescribes　the　nitrate　of　silver　supposes　he　is　guided　by　the　solemn　experience　of　the　past；　instead　of　by　its　idle　fancies。　　He　laughs　at　those　old　physicians　who　placed　such　confidence　in　the　right　hind　hoof　of　an　elk　as　a　remedy　for　the　same　disease；　and　leaves　the　record　of　his　own　belief　in　a　treatment　quite　as　fanciful　and　far　more　objectionable；　written　in　indelible　ink　upon　a　living　tablet　where　he　who　runs　may　read　it　for　a　whole　generation；　if　nature　spares　his　walking　advertisement　so　long。



NOTE　B。　

The　presumption　that　a　man　is　innocent　until　he　is　proved　guilty；　does　not　mean　that　there　are　no　rogues；　but　lays　the　onus　probandi　on　the　party　to　which　it　properly　belongs。　　So　with　this　proposition。　A　noxious　agent　should　never　be　employed　in　sickness　unless　there　is　ample　evidence　in　the　particular　case　to　overcome　the　general　presumption　against　all　such　agents；　and　the　evidence　is　very　apt　to　be　defective。

The　miserable　delusion　of　Homoeopathy　builds　itself　upon　an　axiom　directly　the　opposite　of　this；　namely；　that　the　sick　are　to　be　cured　by　poisons。　　Similia　similibus　curantur　means　exactly　this。　　It　is　simply　a　theory　of　universal　poisoning；　nullified　in　practice　by　the　infinitesimal　contrivance。　　The　only　way　to　kill　it　and　all　similar　fancies；　and　to　throw　every　quack　nostrum　into　discredit；　is　to　root　out　completely　the　suckers　of　the　old　rotten　superstition　that　whatever　is　odious　or　noxious　is　likely　to　be　good　for　disease。　　The　current　of　sound　practice　with　ourselves　is；　I　believe；　setting　fast　in　the　direction　I　have　indicated　in　the　above　proposition。　　To　uphold　the　exhibition　of　noxious　agents　in　disease；　as　the　rule；　instead　of　admitting　them　cautiously　and　reluctantly　as　the　exception；　is；　as　I　think；　an　eddy　of　opinion　in　the　direction　of　the　barbarism　out　of　which　we　believe　our　art　is　escaping。　　It　is　only　through　the　enlightened　sentiment　and　action　of　the　Medical　Profession　that　the　community　can　be　brought　to　acknowledge　that　drugs　should　always　be　regarded　as　evils。

It　is　true　that　some　suppose；　and　our　scientific　and　thoughtful　associate；　Dr。　　Gould；　has　half　countenanced　the　opinion；　that　there　may　yet　be　discovered　a　specific　for　every　disease。　　Let　us　not　despair　of　the　future；　but　let　us　be　moderate　in　our　expectations。　When　an　oil　is　discovered　that　will　make　a　bad　watch　keep　good　time；　when　a　recipe　is　given　which　will　turn　an　acephalous　foetus　into　a　promising　child；　when　a　man　can　enter　the　second　time　into　his　mother's　womb　and　give　her　back　the　infirmities　which　twenty　generations　have　stirred　into　her　blood；　and　infused　into　his　own　through　hers；　we　may　be　prepared　to　enlarge　the　National　Pharmacopoeia　with　a　list　of　specifies　for　everything　but　old　age；　and　possibly　for　that　also。



NOTE　C。　

The　term　specific　is　used　here　in　its　ordinary　sense；　without　raising　the　question　of　the　propriety　of　its　application　to　these　or　other　remedies。

The　credit　of　introducing　Cinchona　rests　between　the　Jesuits；　the　Countess　of　Chinchon；　the　Cardinal　de　Lugo；　and　Sir　Robert　Talbor；　who　employed　it　as　a　secret　remedy。　　（Pereira。）　Mercury　as　an　internal　specific　remedy　was　brought　into　use　by　that　impudent　and　presumptuous　quack；　as　he　was　considered；　Paracelsus。　　（Encyc。　　Brit。　art。　　〃Paracelsus。〃）　Arsenic　was　introduced　into　England　as　a　remedy　for　intermittents　by　Dr。　Fowler；　in　consequence　of　the　success　of　a　patent　medicine；　the　Tasteless　Ague　Drops；　which　were　supposed；　〃probably　with　reason；〃　to　be　a　preparation　of　that　mineral。　　（Rees's　Cyc。　　art。　　〃Arsenic。〃）　　Colchicum　came　into　notice　in　a　similar　way；　from　the　success　of　the　Eau　Medicinale　of　M。　Husson；　a　French　military　officer。　　（Pereira。）　Iodine　was　discovered　by　a　saltpetre　manufacturer；　but　applied　by　a　physician　in　place　of　the　old　remedy；　burnt　sponge；　which　seems　to　owe　its　efficacy　to　it。　　（Dunglison；　New　Remedies。）　As　for　Sulphur；　〃the　common　people　have　long　used　it　as　an　ointment〃　for　scabies。　　（Rees's　Cyc。　　art。　　〃Scabies。〃）　The　modern　cantiscorbutic　regimen　is　credited　to　Captain　Cook。　　〃To　his　sagacity　we　are　indebted　for　the　first　impulse　to　those　regulations　by　which　scorbutus　is　so　successfully　prevented　in　our　navy。〃　　（Lond。　　Cyc。　Prac。　　Med。　　art。　　〃Scorbutus。〃）　Iron　and　various　salts　which　enter　into　the　normal　composition　of　the　human　body　do　not　belong　to　the　materia　medica　by　our　definition；　but　to　the　materia　alimentaria。

For　the　first　introduction　of　iron　as　a　remedy；　see　Pereira；　who　gives　a　very　curious　old　story。

The　statement　in　the　text　concerning　a　portion　of　the　materia　medica　stands　exactly　as　delivered；　and　is　meant　exactly　as　it　stands。　　No　denunciation　of　drugs；　as　sparingly　employed　by　a　wise　physician；　was　or　is　intended。　　If；　however；　as　Dr。　　Gould　stated　in　his　〃valuable　and　practical　discourse〃　to　which　the　Massachusetts　Medical　Society　〃listened　with　profit　as　well　as　interest；〃　　〃Drugs；　in　themselves　considered；　may　always　be　regarded　as　evils；〃any　one　who　chooses　may　question　whether　the　evils　from　their　abuse　are；　on　the　whole；　greater　or　less　than　the　undoubted　benefits　obtained　from　their　proper　use。　　The　large　exception　of　opium；　wine；　specifics；　and　anaesthetics；　made　in　the　text；　takes　off　enough　from　the　useful　side；　as