By Oliver Wendell Holmes
I. HOMEOPATHY AND ITS KINDRED DELUSIONS
II. THE CONTAGIOUSNESS OF PUERPERAL FEVER
III. CURRENTS AND COUNTER-CURRENTS IN MEDICAL SCIENCE
IV. BORDER LINES OF KNOWLEDGE IN SOME PROVINCES OF MEDICAL SCIENCE
V. SCHOLASTIC AND BEDSIDE TEACHING
VI. THE MEDICAL PROFESSION IN MASSACHUSETTS
VII. THE YOUNG PRACTITIONER
VIII. MEDICAL LIBRARIES
IX. SOME OF MY EARLY TEACHERS
The character of the opposition which some of these papers have met with suggests the inference that they contain really important, but unwelcome truths. Negatives multiplied into each other change their sign and become positives. Hostile criticisms meeting together are often equivalent to praise, and the square of fault-finding turns out to be the same thing as eulogy.
But a writer has rarely so many enemies as it pleases him to believe. Self-love leads us to overrate the numbers of our negative constituency. The larger portion of my limited circle of readers must be quite indifferent to, if not ignorant of, the adverse opinions which have been expressed or recorded concerning any of these Addresses or Essays now submitted to their own judgment. It is proper, however, to inform them, that some of the positions maintained in these pages have been unsparingly attacked, with various degrees of ability, scholarship, and good-breeding. The tone of criticism naturally changes with local conditions in different parts of a country extended like our own, so that it is one of the most convenient gauges of the partial movements in the direction of civilization. It is satisfactory to add, that the views assailed have also been unflinchingly defended by unsought champions, among the ablest of whom it is pleasant to mention, at this moment of political alienation, the Editor of the Charleston Medical Journal.
"Currents and Counter-Currents" was written and delivered as an Oration, a florid rhetorical composition, expressly intended to secure the attention of an audience not easy to hold as listeners. It succeeded in doing this, and also in being as curiously misunderstood and misrepresented as if it had been a political harangue. This gave it more local notoriety than it might otherwise have attained, so that, as I learn, one ingenious person made use of its title as an advertisement to a production of his own.
The commonest mode of misrepresentation was this: qualified propositions, the whole meaning of which depended on the qualifications, were stripped of these and taken as absolute. Thus, the attempt to establish a presumption against giving poisons to sick persons was considered as equivalent to condemning the use of these substances. The only important inference the writer has been able to draw from the greater number of the refutations of his opinions which have been kindly sent him, is that the preliminary education of the Medical Profession is not always what it ought to be.
One concession he is willing to make, whatever sacrifice of pride it may involve. The story of Massasoit, which has furnished a coral, as it were, for some teething critics, when subjected to a powerful logical analysis, though correct in its essentials, proves to have been told with exceptionable breadth of statement, and therefore (to resume the metaphor) has been slightly rounded off at its edges, so as to be smoother for any who may wish to bite upon it hereafter. In other respects the Discourse has hardly been touched. It is only an individual's expression, in his own way, of opinions entertained by hundreds of the Medical Profession in every civilized country, and has nothing in it which on revision the writer sees cause to retract or modify. The superstitions it attacks lie at the very foundation of Homoeopathy, and of almost every form of medical charlatanism. Still the mere routinists and unthinking artisans in most callings dislike whatever shakes the dust out of their traditions, and it may be unreasonable to expect that Medicine will always prove an exception to the rule. One half the opposition which the numerical system of Louis has met with, as applied to the results of treatment, has been owing to the fact that it showed the movements of disease to be far more independent of the kind of practice pursued than was agreeable to the pride of those whose self-confidence it abated.
The statement, that medicines are more sparingly used in physicians' families than in most others, admits of a very natural explanation, without putting a harsh construction upon it, which it was not intended to admit. Outside pressure is less felt in the physician's own household; that is all. If this does not sometimes influence him to give medicine, or what seems to be medicine, when among those who have more confidence in drugging than his own family commonly has, the learned Professor Dunglison is hereby requested to apologize for his definition of the word Placebo, or to expunge it from his Medical Dictionary.
One thing is certain. A loud outcry on a slight touch reveals the weak spot in a profession, as well as in a patient. It is a doubtful policy to oppose the freest speech in those of our own number who are trying to show us where they honestly believe our weakness lies. Vast as are the advances of our Science and Art, may it not possibly prove on examination that we retain other old barbarisms beside the use of the astrological sign of Jupiter, with which we endeavor to insure good luck to our prescriptions? Is it the act of a friend or a foe to try to point them out to our brethren when asked to address them, and is the speaker to subdue the constitutional habit of his style to a given standard, under penalty of giving offence to a grave assembly?
"Homoeopathy and its Kindred Delusions" was published nearly twenty years ago, and has been long out of print, so that the author tried in vain to procure a copy until the kindness of a friend supplied him with the only one he has had for years. A foolish story reached his ears that he was attempting to buy up stray copies for the sake of suppressing it. This edition was in the press at that very time.
Many of the arguments contained in the Lectures have lost whatever novelty they may have possessed. All its predictions have been submitted to the formidable test of time. They appear to have stood it, so far, about as well as most uninspired prophecies; indeed, some of them require much less accommodation than certain grave commentators employ in their readings of the ancient Prophets.
If some statistics recently published are correct, Homoeopathy has made very slow progress in Europe.
In all England, as it appears, there are hardly a fifth more Homoeopathic practitioners than there are students attending Lectures at the Massachusetts Medical College at the present time. In America it has undoubtedly proved more popular and lucrative, yet how loose a hold it has on the public confidence is shown by the fact that, when a specially valued life, which has been played with by one of its agents, is seriously threatened, the first thing we expect to hear is that a regular practitioner is by the patient's bed, and the Homoeopathic counsellor overruled or discarded. Again, how many of the ardent and capricious persons who embraced Homoeopathy have run the whole round of pretentious novelties;—have been boarded at water-cure establishments, closeted with uterine and other specialists, and finally wandered over seas to put themselves in charge of foreign celebrities, who dosed them as lustily as they were ever dosed before they took to globules! It will surprise many to learn to what a shadow of a shade Homoeopathy has dwindled in the hands of many of its noted practitioners. The itch-doctrine is treated with contempt. Infinitesimal doses are replaced by full ones whenever the fancy-practitioner chooses. Good Homoeopathic reasons can be found for employing anything that anybody wants to employ. Homoeopathy is now merely a name, an unproved theory, and a box of pellets pretending to be specifics, which, as all of us know, fail ignominiously in those cases where we would thankfully sacrifice all our prejudices and give the world to have them true to their promises.
Homoeopathy has not died out so rapidly as Tractoration. Perhaps it was well that it should not, for it has taught us a lesson of the healing faculty of Nature which was needed, and for which many of us have made proper acknowledgments. But it probably does more harm than good to medical science at the present time, by keeping up the delusion of treating everything by specifics,—the old barbarous notion that sick people should feed on poisons [Lachesis, arrow-poison, obtained from a serpent (Pulte). Crotalus horridus, rattlesnake's venom (Neidhard). The less dangerous Pediculus capitis is the favorite remedy of Dr. Mure, the English "Apostle of Homoeopathy." These are examples of the retrograde current setting towards barbarism] against which a part of the Discourse at the beginning of this volume is directed.
The infinitesimal globules have not become a curiosity as yet, like Perkins's Tractors. But time is a very elastic element in Geology and Prophecy. If Daniel's seventy weeks mean four hundred and ninety years, as the learned Prideaux and others have settled it that they do, the "not many years" of my prediction may be stretched out a generation or two beyond our time, if necessary, when the prophecy will no doubt prove true.
It might be fitting to add a few words with regard to the Essay on the Contagiousness of Puerperal Fever. But the whole question I consider to be now transferred from the domain of medical inquiry to the consideration of Life Insurance agencies and Grand Juries. For the justification of this somewhat sharply accented language I must refer the reader to the paper itself for details which I regret to have been forced to place on permanent record.
BOSTON, January, 1861.
A SECOND PREFACE.
These Lectures and Essays are arranged in the order corresponding to the date of their delivery or publication. They must, of course, be read with a constant reference to these dates, by such as care to read them. I have not attempted to modernize their aspect or character in presenting them, in this somewhat altered connection, to the public. Several of them were contained in a former volume which received its name from the Address called "Currents and Counter-Currents." Some of those contained in the former volume have been replaced by others. The Essay called "Mechanism of Vital Actions" has been transferred to a distinct collection of Miscellaneous essays, forming a separate volume.
I had some intention of including with these papers an Essay on Intermittent Fever in New England, which received one of the Boylston prizes in 1837, and was published in the following year. But as this was upon a subject of local interest, chiefly, and would have taken up a good deal of room, I thought it best to leave it out, trusting that the stray copies to be met with in musty book-shops would sufficiently supply the not very extensive or urgent demand for a paper almost half a century old.
Some of these papers created a little stir when they first fell from the press into the pool of public consciousness. They will slide in very quietly now in this new edition, and find out for themselves whether the waters are those of Lethe, or whether they are to live for a time as not wholly unvalued reminiscences.
March 21, 1883.
PREFACE TO THE NEW EDITION.
These Essays are old enough now to go alone without staff or crutch in the shape of Prefaces. A very few words may be a convenience to the reader who takes up the book and wishes to know what he is likely to find in it.
HOMOEOPATHY AND ITS KINDRED DELUSIONS.
Homoeopathy has proved lucrative, and so long as it continues to be so will surely exist,—as surely as astrology, palmistry, and other methods of getting a living out of the weakness and credulity of mankind and womankind. Though it has no pretensions to be considered as belonging among the sciences, it may be looked upon by a scientific man as a curious object of study among the vagaries of the human mind. Its influence for good or the contrary may be made a matter of calm investigation. I have studied it in the Essay before the reader, under the aspect of an extravagant and purely imaginative creation of its founder. Since that first essay was written, nearly half a century ago, we have all had a chance to witness its practical working. Two opposite inferences may be drawn from its doctrines and practice. The first is that which is accepted by its disciples. This is that all diseases are "cured" by drugs. The opposite conclusion is drawn by a much larger number of persons. As they see that patients are very commonly getting well under treatment by infinitesimal drugging, which they consider equivalent to no medication at all, they come to disbelieve in every form of drugging and put their whole trust in "nature." Thus experience,
"From seeming evil still educing good,"
has shown that the dealers in this preposterous system of pseudo-therapeutics have cooperated with the wiser class of practitioners in breaking up the system of over-dosing and over-drugging which has been one of the standing reproaches of medical practice. While. keeping up the miserable delusion that diseases were all to be "cured" by drugging, Homoeopathy has been unintentionally showing that they would very generally get well without any drugging at all. In the mean time the newer doctrines of the "mind cure," the "faith cure," and the rest are encroaching on the territory so long monopolized by that most ingenious of the pseudo-sciences. It would not be surprising if its whole ground should be taken possession of by these new claimants with their flattering appeals to the imaginative class of persons open to such attacks. Similia similabus may prove fatally true for once, if Homoeopathy is killed out by its new-born rivals.
It takes a very moderate amount of erudition to unearth a charlatan like the supposed father of the infinitesimal dosing system. The real inventor of that specious trickery was an Irishman by the name of Butler. The whole story is to be found in the "Ortus Medicinm" of Van Helmont. I have given some account of his chapter "Butler" in different articles, but I would refer the students of our Homoeopathic educational institutions to the original, which they will find very interesting and curious.
CURRENTS AND COUNTER-CURRENTS
My attack on over-drugging brought out some hostile comments and treatment. Thirty years ago I expressed myself with more vivacity than I should show if I were writing on the same subjects today. Some of my more lively remarks called out very sharp animadversion. Thus my illustration of prevention as often better than treatment in the mother's words to her child which had got a poisonous berry in its mouth,—"Spit it out!" gave mortal offence to a well-known New York practitioner and writer, who advised the Massachusetts Medical Society to spit out the offending speaker. Worse than this was my statement of my belief that if a ship-load of miscellaneous drugs, with certain very important exceptions,—drugs, many of which were then often given needlessly and in excess, as then used "could be sunk to the bottom of the sea, it would be all the better for mankind and all the worse for the fishes." This was too bad. The sentence was misquoted, quoted without its qualifying conditions, and frightened some of my worthy professional brethren as much as if I had told them to throw all physic to the dogs. But for the epigrammatic sting the sentiment would have been unnoticed as a harmless overstatement at the very worst.
Since this lecture was delivered a great and, as I think, beneficial change has taken place in the practice of medicine. The habit of the English "general practitioner" of making his profit out of the pills and potions he administered was ruinous to professional advancement and the dignity of the physician. When a half-starving medical man felt that he must give his patient draught and boluses for which he could charge him, he was in a pitiable position and too likely to persuade himself that his drugs were useful to his patient because they were profitable to him. This practice has prevailed a good deal in America, and was doubtless the source in some measure of the errors I combated.
THE CONTAGIOUSNESS OF PUERPERAL FEVER.
This Essay was read before a small Association called "The Society for Medical Improvement," and published in a Medical Journal which lasted but a single year. It naturally attracted less attention than it would have done if published in such a periodical as the "American Journal of Medical Sciences." Still it had its effect, as I have every reason to believe. I cannot doubt that it has saved the lives of many young mothers by calling attention to the existence and propagation of "Puerperal Fever as a Private Pestilence," and laying down rules for taking the necessary precautions against it. The case has long been decided in favor of the views I advocated, but, at the time when I wrote two of the most celebrated professors of Obstetrics in this country opposed my conclusions with all the weight of their experience and position.
This paper was written in a great heat and with passionate indignation. If I touched it at all I might trim its rhetorical exuberance, but I prefer to leave it all its original strength of expression. I could not, if I had tried, have disguised the feelings with which I regarded the attempt to put out of sight the frightful facts which I brought forward and the necessary conclusions to which they led. Of course the whole matter has been looked at in a new point of view since the microbe as a vehicle of contagion has been brought into light, and explained the mechanism of that which was plain enough as a fact to all who were not blind or who did not shut their eyes.
O. W. H.
BEVERLY Farms, Mass., August 3, 1891
HOMOEOPATHY AND ITS KINDRED DELUSIONS
[Two lectures delivered before the Boston Society for the Diffusion of Useful Knowledge. 1842.]
[When a physician attempts to convince a person, who has fallen into the Homoeopathic delusion, of the emptiness of its pretensions, he is often answered by a statement of cases in which its practitioners are thought to have effected wonderful cures. The main object of the first of these Lectures is to show, by abundant facts, that such statements, made by persons unacquainted with the fluctuations of disease and the fallacies of observation, are to be considered in general as of little or no value in establishing the truth of a medical doctrine or the utility of a method of practice.
Those kind friends who suggest to a person suffering from a tedious complaint, that he "Had better try Homoeopathy," are apt to enforce their suggestion by adding, that "at any rate it can do no harm." This may or may not be true as regards the individual. But it always does very great harm to the community to encourage ignorance, error, or deception in a profession which deals with the life and health of our fellow-creatures. Whether or not those who countenance Homoeopathy are guilty of this injustice towards others, the second of these Lectures may afford them some means of determining.
To deny that good effects may happen from the observance of diet and regimen when prescribed by Homoeopathists as well as by others, would be very unfair to them. But to suppose that men with minds so constituted as to accept such statements and embrace such doctrines as make up the so-called science of Homoeopathy are more competent than others to regulate the circumstances which influence the human body in health and disease, would be judging very harshly the average capacity of ordinary practitioners.
To deny that some patients may have been actually benefited through the influence exerted upon their imaginations, would be to refuse to Homoeopathy what all are willing to concede to every one of those numerous modes of practice known to all intelligent persons by an opprobrious title.
So long as the body is affected through the mind, no audacious device, even of the most manifestly dishonest character, can fail of producing occasional good to those who yield it an implicit or even a partial faith. The argument founded on this occasional good would be as applicable in justifying the counterfeiter and giving circulation to his base coin, on the ground that a spurious dollar had often relieved a poor man's necessities.
Homoeopathy has come before our public at a period when the growing spirit of eclecticism has prepared many ingenious and honest minds to listen to all new doctrines with a candor liable to degenerate into weakness. It is not impossible that the pretended evolution of great and mysterious virtues from infinitely attenuated atoms may have enticed a few over-refining philosophers, who have slid into a vague belief that matter subdivided grows less material, and approaches nearer to a spiritual nature as it requires a more powerful microscope for its detection.
However this may be, some persons seem disposed to take the ground of Menzel that the Laity must pass formal judgment between the Physician and the Homoeopathist, as it once did between Luther and the Romanists. The practitioner and the scholar must not, therefore, smile at the amount of time and labor expended in these Lectures upon this shadowy system; which, in the calm and serious judgment of many of the wisest members of the medical profession, is not entitled by anything it has ever said or done to the notoriety of a public rebuke, still less to the honors of critical martyrdom.]
I have selected four topics for this lecture, the first three of which I shall touch but slightly, the last more fully. They are
1. The Royal cure of the King's Evil, or Scrofula.
2. The Weapon Ointment, and its twin absurdity, the Sympathetic Powder.
3. The Tar-water mania of Bishop Berkeley.
4. The History of the Metallic Tractors, or Perkinism.
The first two illustrate the ease with which numerous facts are accumulated to prove the most fanciful and senseless extravagances.
The third exhibits the entire insufficiency of exalted wisdom, immaculate honesty, and vast general acquirements to make a good physician of a great bishop.
The fourth shows us the intimate machinery of an extinct delusion, which flourished only forty years ago; drawn in all its details, as being a rich and comparatively recent illustration of the pretensions, the arguments, the patronage, by means of which windy errors have long been, and will long continue to be, swollen into transient consequence. All display in superfluous abundance the boundless credulity and excitability of mankind upon subjects connected with medicine.
"From the time of Edward the Confessor to Queen Anne, the monarchs of England were in the habit of touching those who were brought to them suffering with the scrofula, for the cure of that distemper. William the Third had good sense enough to discontinue the practice, but Anne resumed it, and, among her other patients, performed the royal operation upon a child, who, in spite of his, disease, grew up at last into Samuel Johnson. After laying his hand upon the sufferers, it was customary for the monarch to hang a gold piece around the neck of each patient. Very strict precautions were adopted to prevent those who thought more of the golden angel hung round the neck by a white ribbon, than of relief of their bodily infirmities, from making too many calls, as they sometimes attempted to do. According to the statement of the advocates and contemporaries of this remedy, none ever failed of receiving benefit unless their little faith and credulity starved their merits. Some are said to have been cured immediately on the very touch, others did not so easily get rid of their swellings, until they were touched a second time. Several cases are related, of persons who had been blind for several weeks, and months, and obliged even to be led to Whitehall, yet recovered their sight immediately upon being touched, so as to walk away without any guide." So widely, at one period, was the belief diffused, that, in the course of twelve years, nearly a hundred thousand persons were touched by Charles the Second. Catholic divines; in disputes upon the orthodoxy of their church, did not deny that the power had descended to protestant princes;—Dr. Harpsfield, in his "Ecclesiastical History of England," admitted it, and in Wiseman's words, "when Bishop Tooker would make use of this Argument to prove the Truth of our Church, Smitheus doth not thereupon go about to deny the Matter of fact; nay, both he and Cope acknowledge it." "I myself," says Wiseman, the best English surgical writer of his day,[Edinburgh Medical and Surgical Journal, vol. iii. p. 103.]—"I my self have been a frequent Eye-witness of many hundred of Cures performed by his Majesties Touch alone, without any assistance of Chirurgery; and those, many of them such as had tired out the endeavours of able Chirurgeons before they came hither. It were endless to recite what I myself have seen, and what I have received acknowledgments of by Letter, not only from the severall parts of this Nation, but also from Ireland, Scotland, Jersey, Garnsey. It is needless also to remember what Miracles of this nature were performed by the very Bloud of his late Majesty of Blessed memory, after whose decollation by the inhuman Barbarity of the Regicides, the reliques of that were gathered on Chips and in Handkerchieffs by the pious Devotes, who could not but think so great a suffering in so honourable and pious a Cause, would be attended by an extraordinary assistance of God, and some more then ordinary a miracle: nor did their Faith deceive them in this there point, being so many hundred that found the benefit of it." [Severall Chirurgicall Treatises. London.1676. p. 246.]
Obstinate and incredulous men, as he tells us, accounted for these cures in three ways: by the journey and change of air the patients obtained in coming to London; by the influence of imagination; and the wearing of gold.
To these objections he answers, 1st. That many of those cured were inhabitants of the city. 2d. That the subjects of treatment were frequently infants. 3d. That sometimes silver was given, and sometimes nothing, yet the patients were cured.
A superstition resembling this probably exists at the present time in some ignorant districts of England and this country. A writer in a Medical Journal in the year 1807, speaks of a farmer in Devonshire, who, being a ninth son of a ninth son, is thought endowed with healing powers like those of ancient royalty, and who is accustomed one day in every week to strike for the evil.
I remember that one of my schoolmates told me, when a boy, of a seventh son of a seventh son, somewhere in Essex County, who touched for the scrofula, and who used to hang a silver fourpence halfpenny about the neck of those who came to him, which fourpence halfpenny it was solemnly affirmed became of a remarkably black color after having been some time worn, and that his own brother had been subjected to this extraordinary treatment; but I must add that my schoolmate drew a bow of remarkable length, strength, and toughness for his tender years.
One of the most curious examples of the fallacy of popular belief and the uncertainty of asserted facts in medical experience is to be found in the history of the UNGUENTUM ARMARIUM, or WEAPON OINTMENT.
Fabricius Hildanus, whose name is familiar to every surgical scholar, and Lord Bacon, who frequently dipped a little into medicine, are my principal authorities for the few circumstances I shall mention regarding it. The Weapon Ointment was a preparation used for the healing of wounds, but instead of its being applied to them, the injured part was washed and bandaged, and the weapon with which the wound was inflicted was carefully anointed with the unguent. Empirics, ignorant barbers, and men of that sort, are said to have especially employed it. Still there were not wanting some among the more respectable members of the medical profession who supported its claims. The composition of this ointment was complicated, in the different formulae given by different authorities; but some substances addressed to the imagination, rather than the wound or weapon, entered into all. Such were portions of mummy, of human blood, and of moss from the skull of a thief hung in chains.
Hildanus was a wise and learned man, one of the best surgeons of his time. He was fully aware that a part of the real secret of the Unguentum Armarium consisted in the washing and bandaging the wound and then letting it alone. But he could not resist the solemn assertions respecting its efficacy; he gave way before the outcry of facts, and therefore, instead of denying all their pretensions, he admitted and tried to account for them upon supernatural grounds. As the virtue of those applications, he says, which are made to the weapon cannot reach the wound, and as they can produce no effect without contact, it follows, of necessity, that the Devil must have a hand in the business; and as he is by far the most long headed and experienced of practitioners, he cannot find this a matter of any great difficulty. Hildanus himself reports, in detail, the case of a lady who had received a moderate wound, for which the Unguentum Armarium was employed without the slightest use. Yet instead of receiving this flat case of failure as any evidence against the remedy, he accounts for its not succeeding by the devout character of the lady, and her freedom from that superstitious and over-imaginative tendency which the Devil requires in those who are to be benefited by his devices.
Lord Bacon speaks of the Weapon Ointment, in his Natural History, as having in its favor the testimony of men of credit, though, in his own language, he himself "as yet is not fully inclined to believe it." His remarks upon the asserted facts respecting it show a mixture of wise suspicion and partial belief. He does not like the precise directions given as to the circumstances under which the animals from which some of the materials were obtained were to be killed; for he thought it looked like a provision for an excuse in case of failure, by laying the fault to the omission of some of these circumstances. But he likes well that "they do not observe the confecting of the Ointment under any certain constellation; which is commonly the excuse of magical medicines, when they fail, that they were not made under a fit figure of heaven." [This was a mistake, however, since the two recipes given by Hildanus are both very explicit as to the aspect of the heavens required for different stages of the process.] "It was pretended that if the offending weapon could not be had, it would serve the purpose to anoint a wooden one made like it." "This," says Bacon, "I should doubt to be a device to keep this strange form of cure in request and use; because many times you cannot come by the weapon itself." And in closing his remarks on the statements of the advocates of the ointment, he says, "Lastly, it will cure a beast as well as a man, which I like best of all the rest, because it subjecteth the matter to an easy trial." It is worth remembering, that more than two hundred years ago, when an absurd and fantastic remedy was asserted to possess wonderful power, and when sensible persons ascribed its pretended influence to imagination, it was boldly answered that the cure took place when the wounded party did not know of the application made to the weapon, and even when a brute animal was the subject of the experiment, and that this assertion, as we all know it was, came in such a shape as to shake the incredulity of the keenest thinker of his time. The very same assertion has been since repeated in favor of Perkinism, and, since that, of Homoeopathy.
The same essential idea as that of the Weapon Ointment reproduced itself in the still more famous SYMPATHETIC POWDER. This Powder was said to have the faculty, if applied to the blood-stained garments of a wounded person, to cure his injuries, even though he were at a great distance at the time. A friar, returning from the East, brought the recipe to Europe somewhat before the middle of the seventeenth century. The Grand Duke of Florence, in which city the friar was residing, heard of his cures, and tried, but without success, to obtain his secret. Sir Kenehn Digby, an Englishman well known to fame, was fortunate enough to do him a favor, which wrought upon his feelings and induced him to impart to his benefactor the composition of his extraordinary Powder. This English knight was at different periods of his life an admiral, a theologian, a critic, a metaphysician, a politician, and a disciple of Alchemy. As is not unfrequent with versatile and inflammable people, he caught fire at the first spark of a new medical discovery, and no sooner got home to England than he began to spread the conflagration.
An opportunity soon offered itself to try the powers of the famous powder. Mr. J. Howell, having been wounded in endeavoring to part two of his friends who were fighting a duel, submitted himself to a trial of the Sympathetic Powder. Four days after he received his wounds, Sir Kenehn dipped one of Mr. Howell's gaiters in a solution of the Powder, and immediately, it is said, the wounds, which were very painful, grew easy, although the patient, who was conversing in a corner of the chamber, had not, the least idea of what was doing with his garter. He then returned home, leaving his garter in the hands of Sir Kenelm, who had hung it up to dry, when Mr. Howell sent his servant in a great hurry to tell him that his wounds were paining him horribly; the garter was therefore replaced in the solution of the Powder, "and the patient got well after five or six days of its continued immersion."
King James First, his son Charles the First, the Duke of Buckingham, then prime minister, and all the principal personages of the time, were cognizant of this fact; and James himself, being curious to know the secret of this remedy, asked it of Sir Kenelm, who revealed it to him, and his Majesty had the opportunity of making several trials of its efficacy, "which all succeeded in a surprising manner." [Dict. des Sciences Medieales.]
The king's physician, Dr. Mayerne, was made master of the secret, which he carried to France and communicated to the Duke of Mayenne, who performed many cures by means of it, and taught it to his surgeon, who, after the Duke's death, sold it to many distinguished persons, by whose agency it soon ceased to be a secret. What was this wonderful substance which so astonished kings, princes, dukes, knights, and doctors? Nothing but powdered blue vitriol. But it was made to undergo several processes that conferred on it extraordinary virtues. Twice or thrice it was to be dissolved, filtered, and crystallized. The crystals were to be laid in the sun during the months of June, July, and August, taking care to turn them carefully that all should be exposed. Then they were to be powdered, triturated, and again exposed to the sun, again reduced to a very fine powder, and secured in a vessel, while hot, from the sunshine. If there seem anything remarkable in the fact of such astonishing properties being developed by this process, it must be from our short-sightedness, for common salt and charcoal develop powers quite as marvellous after a certain number of thumps, stirs, and shakes, from the hands of modern workers of miracles. In fact the Unguentum Armarium and Sympathetic Powder resemble some more recent prescriptions; the latter consisting in an infinite dilution of the common dose in which remedies are given, and the two former in an infinite dilution of the common distance at which they are applied.
Whether philosophers, and more especially metaphysicians, have any peculiar tendency to dabble in drugs and dose themselves with physic, is a question which might suggest itself to the reader of their biographies.
When Bishop Berkeley visited the illustrious Malebranche at Paris, he found him in his cell, cooking in a small pipkin a medicine for an inflammation of the lungs, from which he was suffering; and the disease, being unfortunately aggravated by the vehemence of their discussion, or the contents of the pipkin, carried him off in the course of a few days. Berkeley himself afforded a remarkable illustration of a truth which has long been known to the members of one of the learned professions, namely, that no amount of talent, or of acquirements in other departments, can rescue from lamentable folly those who, without something of the requisite preparation, undertake to experiment with nostrums upon themselves and their neighbors. The exalted character of Berkeley is thus drawn by Sir James Mackintosh: Ancient learning, exact science, polished society, modern literature, and the fine arts, contributed to adorn and enrich the mind of this accomplished man. All his contemporaries agreed with the satirist in ascribing
"'To Berkeley every virtue under heaven.'
"Even the discerning, fastidious, and turbulent Atterbury said, after an interview with him, 'So much understanding, so much knowledge, so much innocence, and such humility, I did not think had been the portion of any but angels, till I saw this gentleman.'"
But among the writings of this great and good man is an Essay of the most curious character, illustrating his weakness upon the point in question, and entitled, "Siris, a Chain of Philosophical Reflections and Inquiries concerning the Virtues of TAR WATER, and divers other Subjects,"—an essay which begins with a recipe for his favorite fluid, and slides by gentle gradations into an examination of the sublimest doctrines of Plato. To show how far a man of honesty and benevolence, and with a mind of singular acuteness and depth, may be run away with by a favorite notion on a subject which his habits and education do not fit him to investigate, I shall give a short account of this Essay, merely stating that as all the supposed virtues of Tar Water, made public in successive editions of his treatise by so illustrious an author, have not saved it from neglect and disgrace, it may be fairly assumed that they were mainly imaginary.
The bishop, as is usual in such cases, speaks of himself as indispensably obliged, by the duty he owes to mankind, to make his experience public. Now this was by no means evident, nor does it follow in general, that because a man has formed a favorable opinion of a person or a thing he has not the proper means of thoroughly understanding, he shall be bound to print it, and thus give currency to his impressions, which may be erroneous, and therefore injurious. He would have done much better to have laid his impressions before some experienced physicians and surgeons, such as Dr. Mead and Mr. Cheselden, to have asked them to try his experiment over again, and have been guided by their answers. But the good bishop got excited; he pleased himself with the thought that he had discovered a great panacea; and having once tasted the bewitching cup of self-quackery, like many before and since his time, he was so infatuated with the draught that he would insist on pouring it down the throats of his neighbors and all mankind.
The precious fluid was made by stirring a gallon of water with a quart of tar, leaving it forty-eight hours, and pouring off the clear water. Such was the specific which the great metaphysician recommended for averting and curing all manner of diseases. It was, if he might be believed, a preventive of the small-pox, and of great use in the course of the disease. It was a cure for impurities of the blood, coughs, pleurisy, peripneumony, erysipelas, asthma, indigestion, carchexia, hysterics, dropsy, mortification, scurvy, and hypochondria. It was of great use in gout and fevers, and was an excellent preservative of the teeth and gums; answered all the purpose of Elixir Proprietatis, Stoughton's drops, diet drinks, and mineral waters; was particularly to be recommended to sea-faring persons, ladies, and men of studious and sedentary lives; could never be taken too long, but, on the contrary, produced advantages which sometimes did not begin to show themselves for two or three months.
"From my representing Tar Water as good for so many things," says Berkeley, "some perhaps may conclude it is good for nothing. But charity obligeth me to say what I know, and what I think, however it may be taken. Men may censure and object as they please, but I appeal to time and experiment. Effects misimputed, cases wrong told, circumstances overlooked, perhaps, too, prejudices and partialities against truth, may for a time prevail and keep her at the bottom of her well, from whence nevertheless she emergeth sooner or later, and strikes the eyes of all who do not keep them shut." I cannot resist the temptation of illustrating the bishop's belief in the wonderful powers of his remedy, by a few sentences from different parts of his essay. "The hardness of stubbed vulgar constitutions renders them insensible of a thousand things that fret and gall those delicate people, who, as if their skin was peeled off, feel to the quick everything that touches them. The tender nerves and low spirits of such poor creatures would be much relieved by the use of Tar Water, which might prolong and cheer their lives." "It [the Tar Water] may be made stronger for brute beasts, as horses, in whose disorders I have found it very useful." "This same water will also give charitable relief to the ladies, who often want it more than the parish poor; being many of them never able to make a good meal, and sitting pale, puny, and forbidden, like ghosts, at their own table, victims of vapors and indigestion." It does not appear among the virtues of Tar Water that "children cried for it," as for some of our modern remedies, but the bishop says, "I have known children take it for above six months together with great benefit, and without any inconvenience; and after long and repeated experience I do esteem it a most excellent diet drink, fitted to all seasons and ages." After mentioning its usefulness in febrile complaints, he says: "I have had all this confirmed by my own experience in the late sickly season of the year one thousand seven hundred and forty-one, having had twenty-five fevers in my own family cured by this medicinal water, drunk copiously." And to finish these extracts with a most important suggestion for the improvement of the British nation: "It is much to be lamented that our Insulars who act and think so much for themselves, should yet, from grossness of air and diet, grow stupid or doat sooner than other people, who, by virtue of elastic air, water-drinking, and light food, preserve their faculties to extreme old age; an advantage which may perhaps be approached, if not equaled, even in these regions, by Tar Water, temperance, and early hours."
Berkeley died at the age of about seventy; he might have lived longer, but his fatal illness was so sudden that there was not time enough to stir up a quart of the panacea. He was an illustrious man, but he held two very odd opinions; that tar water was everything, and that the whole material universe was nothing.
Most of those present have at some time in their lives heard mention made of the METALLIC TRACTORS, invented by one Dr. Perkins, an American, and formerly enjoying great repute for the cure of various diseases. Many have seen or heard of a satirical poem, written by one of our own countrymen also, about forty years since, and called "Terrible Tractoration." The Metallic Tractors are now so utterly abandoned that I have only by good fortune fallen upon a single one of a pair, to show for the sake of illustration. For more than thirty years this great discovery, which was to banish at least half the evils which afflict humanity, has been sleeping undisturbed in the grave of oblivion. Not a voice has, for this long period, been raised in its favor; its noble and learned patrons, its public institutions, its eloquent advocates, its brilliant promises are all covered with the dust of silent neglect; and of the generation which has sprung up since the period when it flourished, very few know anything of its history, and hardly even the title which in its palmy days it bore of PERKINISM. Taking it as settled, then, as no one appears to answer for it, that Perkinism is entirely dead and gone, that both in public and private, officially and individually, its former adherents even allow it to be absolutely defunct, I select it for anatomical examination. If this pretended discovery was made public; if it was long kept before the public; if it was addressed to the people of different countries; if it was formally investigated by scientific men, and systematically adopted by benevolent persons, who did everything in their power to diffuse the knowledge and practice of it; if various collateral motives, such as interest and vanity, were embarked in its cause; if, notwithstanding all these things, it gradually sickened and died, then the conclusion seems a fair one, that it did not deserve to live. Contrasting its failure with its high pretensions, it is fair to call it an imposition; whether an expressly fraudulent contrivance or not, some might be ready to question. Everything historically shown to have happened concerning the mode of promulgation, the wide diffusion, the apparent success of this delusion, the respectability and enthusiasm of its advocates, is of great interest in showing to what extent and by what means a considerable part of the community may be led into the belief of that which is to be eventually considered' as an idle folly. If there is any existing folly, fraudulent or innocent in its origin, which appeals to certain arguments for its support; provided that the very same arguments can be shown to have been used for Perkinism with as good reason, they will at once fall to the ground. Still more, if it shall appear that the general course of any existing delusion bears a strong resemblance to that of Perkinism, that the former is most frequently advocated by the same class of persons who were conspicuous in behalf of the latter, and treated with contempt or opposed by the same kind of persons who thus treated Perkinism; if the facts in favor of both have a similar aspect; if the motives of their originators and propagators may be presumed to have been similar; then there is every reason to suppose that the existing folly will follow in the footsteps of the past, and after displaying a given amount of cunning and credulity in those deceiving and deceived, will drop from the public view like a fruit which has ripened into spontaneous rottenness, and be succeeded by the fresh bloom of some other delusion required by the same excitable portion of the community.
Dr. Elisha Perkins was born at Norwich, Connecticut, in the year 1740. He had practised his profession with a good local reputation for many years, when he fell upon a course of experiments, as it is related, which led to his great discovery. He conceived the idea that metallic substances might have the effect of removing diseases, if applied in a certain manner; a notion probably suggested by the then recent experiments of Galvani, in which muscular contractions were found to be produced by the contact of two metals with the living fibre. It was in 1796 that his discovery was promulgated in the shape of the Metallic Tractors, two pieces of metal, one apparently iron and the other brass, about three inches long, blunt at one end and pointed at the other. These instruments were applied for the cure of different complaints, such as rheumatism, local pains, inflammations, and even tumors, by drawing them over the affected part very lightly for about twenty minutes. Dr. Perkins took out a patent for his discovery, and travelled about the country to diffuse the new practice. He soon found numerous advocates of his discovery, many of them of high standing and influence. In the year 1798 the tractors had crossed the Atlantic, and were publicly employed in the Royal Hospital at Copenhagen. About the same time the son of the inventor, Mr. Benjamin Douglass Perkins, carried them to London, where they soon attracted attention. The Danish physicians published an account of their cases, containing numerous instances of alleged success, in a respectable octavo volume. In the year 1804 an establishment, honored with the name of the Perkinean Institution, was founded in London. The transactions of this institution were published in pamphlets, the Perkinean Society had public dinners at the Crown and Anchor, and a poet celebrated their medical triumph in strains like these:
"See, pointed metals, blest with power t' appease The ruthless rage of merciless disease, O'er the frail part a subtle fluid pour, Drenched with invisible Galvanic shower, Till the arthritic staff and crutch forego, And leap exulting like the bounding roe!"
While all these things were going on, Mr. Benjamin Douglass Perkins was calmly pocketing money, so that after some half a dozen years he left the country with more than ten thousand pounds, which had been paid him by the believers in Great Britain. But in spite of all this success, and the number of those interested and committed in its behalf, Perkinism soon began to decline, and in 1811 the Tractors are spoken of by an intelligent writer as being almost forgotten. Such was the origin and duration of this doctrine and practice, into the history of which we will now look a little more narrowly.
Let us see, then, by whose agency this delusion was established and kept up; whether it was principally by those who were accustomed to medical pursuits, or those whose habits and modes of reasoning were different; whether it was with the approbation of those learned bodies usually supposed to take an interest in scientific discoveries, or only of individuals whose claims to distinction were founded upon their position in society, or political station, or literary eminence; whether the judicious or excitable classes entered most deeply into it; whether, in short, the scientific men of that time were deceived, or only intruded upon, and shouted down for the moment by persons who had no particular call to invade their precincts.
Not much, perhaps, was to be expected of the Medical Profession in the way of encouragement. One Dr. Fuller, who wrote in England, himself a Perkinist, thus expressed his opinion: "It must be an extraordinary exertion of virtue and humanity for a medical man, whose livelihood depends either on the sale of drugs, or on receiving a guinea for writing a prescription, which must relate to those drugs, to say to his patient, 'You had better purchase a set of Tractors to keep in your family; they will cure you without the expense of my attendance, or the danger of the common medical practice.' For very obvious reasons medical men must never be expected to recommend the use of Perkinism. The Tractors must trust for their patronage to the enlightened and philanthropic out of the profession, or to medical men retired from practice, and who know of no other interest than the luxury of relieving the distressed. And I do not despair of seeing the day when but very few of this description as well as private families will be without them."
Whether the motives assigned by this medical man to his professional brethren existed or not, it is true that Dr. Perkins did not gain a great deal at their hands. The Connecticut Medical Society expelled him in 1797 for violating their law against the use of nostrums, or secret remedies. The leading English physicians appear to have looked on with singular apathy or contempt at the miracles which it was pretended were enacting in the hands of the apostles of the new practice. In looking over the reviews of the time, I have found little beyond brief occasional notices of their pretensions; the columns of these journals being occupied with subjects of more permanent interest. The state of things in London is best learned, however, from the satirical poem to which I have already alluded as having been written at the period referred to. This was entitled, "Terrible Tractoration!! A Poetical Petition against Galvanizing Trumpery and the Perkinistic Institution. Most respectfully addressed to the Royal College of Physicians, by Christopher Caustic, M. D., LL. D., A. S. S., Fellow of the Royal College of Physicians, Aberdeen, and Honorary Member of no less than nineteen very learned Societies." Two editions of this work were published in London in the years 1803 and 1804, and one or two have been published in this country.
"Terrible Tractoration" is supposed, by those who never read it, to be a satire upon the follies of Perkins and his followers. It is, on the contrary, a most zealous defence of Perkinism, and a fierce attack upon its opponents, most especially upon such of the medical profession as treated the subject with neglect or ridicule. The Royal College of Physicians was the more peculiar object of the attack, but with this body, the editors of some of the leading periodicals, and several physicians distinguished at that time, and even now remembered for their services to science and humanity, were involved in unsparing denunciations. The work is by no means of the simply humorous character it might be supposed, but is overloaded with notes of the most seriously polemical nature. Much of the history of the subject, indeed, is to be looked for in this volume.
It appears from this work that the principal members of the medical profession, so far from hailing Mr. Benjamin Douglass Perkins as another Harvey or Jenner, looked very coldly upon him and his Tractors; and it is now evident that, though they were much abused for so doing, they knew very well what they had to deal with, and were altogether in the right. The delusion at last attracted such an amount of attention as to induce Dr. Haygarth and some others of respectable standing to institute some experiments which I shall mention in their proper place, the result of which might have seemed sufficient to show the emptiness of the whole contrivance.
The Royal Society, that learned body which for ages has constituted the best tribunal to which Britain can appeal in questions of science, accepted Mr. Perkins's Tractors and the book written about them, passed the customary vote of thanks, and never thought of troubling itself further in the investigation of pretensions of such an aspect. It is not to be denied that a considerable number of physicians did avow themselves advocates of the new practice; but out of the whole catalogue of those who were publicly proclaimed as such, no one has ever been known, so far as I am aware, to the scientific world, except in connection with the short-lived notoriety of Perkinism. Who were the people, then, to whose activity, influence, or standing with the community was owing all the temporary excitement produced by the Metallic Tractors?
First, those persons who had been induced to purchase a pair of Tractors. These little bits of brass and iron, the intrinsic value of which might, perhaps, amount to ninepence, were sold at five guineas a pair! A man who has paid twenty-five dollars for his whistle is apt to blow it louder and longer than other people. So it appeared that when the "Perkinean Society" applied to the possessors of Tractors in the metropolis to concur in the establishment of a public institution for the use of these instruments upon the poor, "it was found that only five out of above a hundred objected to subscribe, on account of their want of confidence in the efficacy of the practice; and these," the committee observes, "there is reason to believe, never gave them a fair trial, probably never used them in more than one case, and that perhaps a case in which the Tractors had never been recommended as serviceable." "Purchasers of the Tractors," said one of their ardent advocates, "would be among the last to approve of them if they had reason to suppose themselves defrauded of five guineas." He forgot poor Moses, with his "gross of green spectacles, with silver rims and shagreen cases." "Dear mother," cried the boy, "why won't you listen to reason? I had them a dead bargain, or I should not have bought them. The silver rims alone will sell for double the money."
But it is an undeniable fact, that many persons of considerable standing, and in some instances holding the most elevated positions in society, openly patronized the new practice. In a translation of a work entitled "Experiments with the Metallic Tractors," originally published in Danish, thence rendered successively into German and English, Mr. Benjamin Perkins, who edited the English edition, has given a copious enumeration of the distinguished individuals, both in America and Europe, whose patronage he enjoyed. He goes so far as to signify that ROYALTY itself was to be included among the number. When the Perkinean Institution was founded, no less a person than Lord Rivers was elected President, and eleven other individuals of distinction, among them Governor Franklin, son of Dr. Franklin, figured as Vice-Presidents. Lord Henniker, a member of the Royal Society, who is spoken of as a man of judgment and talents, condescended to patronize the astonishing discovery, and at different times bought three pairs of Tractors. When the Tractors were introduced into Europe, a large number of testimonials accompanied them from various distinguished characters in America, the list of whom is given in the translation of the Danish work referred to as follows:
"Those who have individually stated cases, or who have presented their names to the public as men who approved of this remedy, and acknowledged themselves instrumental in circulating the Tractors, are fifty-six in number; thirty-four of whom are physicians and surgeons, and many of them of the first eminence, thirteen clergymen, most of whom are doctors of divinity, and connected with the literary institutions of America; among the remainder are two members of Congress, one professor of natural philosophy in a college, etc., etc." It seemed to be taken rather hardly by Mr. Perkins that the translators of the work which he edited, in citing the names of the advocates of the Metallic Practice, frequently omitted the honorary titles which should have been annexed. The testimonials were obtained by the Danish writer, from a pamphlet published in America, in which these titles were given in full. Thus one of these testimonials is from "John Tyler, Esq., a magistrate in the county of New London, and late Brigadier-General of the militia in that State." The "omission of the General's title" is the subject of complaint, as if this title were sufficient evidence of the commanding powers of one of the patrons of tractoration. A similar complaint is made when "Calvin Goddard, Esq., of Plainfield, Attorney at Law, and a member of the Legislature of the State of Connecticut," is mentioned without his titular honors, and even on account of the omission of the proper official titles belonging to "Nathan Pierce, Esq., Governor and Manager of the Almshouse of Newburyport." These instances show the great importance to be attached to civil and military dignities, in qualifying their holders to judge of scientific subjects, a truth which has not been overlooked by the legitimate successors of the Perkinists. In Great Britain, the Tractors were not less honored than in America, by the learned and the illustrious. The "Perkinistic Committee" made this statement in their report: "Mr. Perkins has annually laid before the public a large collection of new cases communicated to him for that purpose by disinterested and intelligent characters, from almost every quarter of Great Britain. In regard to the competency of these vouchers, it will be sufficient simply to state that, amongst others whose names have been attached to their communications, are eight professors, in four different universities, twenty-one regular Physicians, nineteen Surgeons, thirty Clergymen, twelve of whom are Doctors of Divinity, and numerous other characters of equal respectability."
It cannot but excite our notice and surprise that the number of clergymen both in America and Great Britain who thrust forward their evidence on this medical topic was singularly large in proportion to that of the members of the medical profession. Whole pages are contributed by such worthies as the Rev. Dr. Trotter of Hans Place, the Rear. Waring Willett, Chaplain to the Earl of Dunmore, the Rev. Dr. Clarke, Chaplain to the Prince of Wales. The style of these theologico-medical communications may be seen in the following from a divine who was also professor in one of the colleges of New England. "I have used the Tractors with success in several other cases in my own family, and although, like Naaman the Syrian, I cannot tell why the waters of Jordan should be better than Abana and Pharpar, rivers of Damascus; yet since experience has proved them so, no reasoning can change the opinion. Indeed, the causes of all common facts are, we think, perfectly well known to us; and it is very probable, fifty or a hundred years hence, we shall as well know why the Metallic Tractors should in a few minutes remove violent pains, as we now know why cantharides and opium will produce opposite effects, namely, we shall know very little about either excepting facts." Fifty or a hundred years hence! if he could have looked forward forty years, he would have seen the descendants of the "Perkinistic" philosophers swallowing infinitesimal globules, and knowing and caring as much about the Tractors as the people at Saratoga Springs do about the waters of Abana and Pharpar.
I trust it will not be thought in any degree disrespectful to a profession which we all honor, that I have mentioned the great zeal of many clergymen in the cause of Perkinism. I hope, too, that I may without offence suggest the causes which have often led them out of their own province into one to which their education has no special reference. The members of that profession ought to be, and commonly are, persons of benevolent character. Their duties carry them into the midst of families, and particularly at times when the members of them are suffering from bodily illness. It is natural enough that a strong desire should be excited to alleviate sufferings which may have defied the efforts of professional skill; as natural that any remedy which recommends itself to the belief or the fancy of the spiritual physician should be applied with the hope of benefit; and perfectly certain that the weakness of human nature, from which no profession is exempt, will lead him to take the most flattering view of its effects upon the patient; his own sagacity and judgment being staked upon the success of the trial. The inventor of the Tractors was aware of these truths. He therefore sent the Tractors gratuitously to many clergymen, accompanied with a formal certificate that the holder had become entitled to their possession by the payment of five guineas. This was practised in our own neighborhood, and I remember finding one of these certificates, so presented, which proved that amongst the risks of infancy I had to encounter Perkins's Tractors. Two clergymen of Boston and the vicinity, both well known to local fame, gave in their testimony to the value of the instruments thus presented to them; an unusually moderate proportion, when it is remembered that to the common motives of which I have spoken was added the seduction of a gift for which the profane public was expected to pay so largely.
It was remarkable, also, that Perkinism, which had so little success with the medical and scientific part of the community, found great favor in the eyes of its more lovely and less obstinate portion. "The lady of Major Oxholin,"—I quote from Mr. Perkins's volume,—"having been lately in America, had seen and heard much of the great effects of Perkinism. Influenced by a most benevolent disposition, she brought these Tractors and the pamphlet with her to Europe, with a laudable desire of extending their utility to her suffering countrymen." Such was the channel by which the Tractors were conveyed to Denmark, where they soon became the ruling passion. The workmen, says a French writer, could not manufacture them fast enough. Women carried them about their persons, and delighted in bringing them into general use. To what extent the Tractors were favored with the patronage of English and American ladies, it is of course not easy to say, except on general principles, as their names were not brought before the public. But one of Dr. Haygarth's stories may lead us to conjecture that there was a class of female practitioners who went about doing good with the Tractors in England as well as in Denmark. A certain lady had the misfortune to have a spot as big as a silver penny at the corner of her eye, caused by a bruise, or some such injury. Another lady, who was a friend of hers, and a strong believer in Perkinism, was very anxious to try the effects of tractoration upon this unfortunate blemish. The patient consented; the lady "produced the instruments, and, after drawing them four or five times over the spot, declared that it changed to a paler color, and on repeating the use of them a few minutes longer, that it had almost vanished, and was scarcely visible, and departed in high triumph at her success." The lady who underwent the operation assured the narrator "that she looked in the glass immediately after, and that not the least visible alteration had taken place."
It would be a very interesting question, what was the intellectual character of those persons most conspicuous in behalf of the Perkinistic delusion? Such an inquiry might bring to light some principles which we could hereafter apply to the study of other popular errors. But the obscurity into which nearly all these enthusiasts have subsided renders the question easier to ask than to answer. I believe it would have been found that most of these persons were of ardent temperament and of considerable imagination, and that their history would show that Perkinism was not the first nor the last hobby-horse they rode furiously. Many of them may very probably have been persons of more than common talent, of active and ingenious minds, of versatile powers and various acquirements. Such, for instance, was the estimable man to whom I have repeatedly referred as a warm defender of tractoration, and a bitter assailant of its enemies. The story tells itself in the biographical preface to his poem. He went to London with the view of introducing a hydraulic machine, which he and his Vermont friends regarded as a very important invention. He found, however, that the machine was already in common use in that metropolis. A brother Yankee, then in London, had started the project of a mill, which was to be carried by the water of the Thames. He was sanguine enough to purchase one fifth of this concern, which also proved a failure. At about the same period he wrote the work which proved the great excitement of his mind upon the subject of the transient folly then before the public. Originally a lawyer, he was in succession a mechanician, a poet, and an editor, meeting with far less success in each of these departments than usually attends men of less varied gifts, but of more tranquil and phlegmatic composition. But who is ignorant that there is a class of minds characterized by qualities like those I have mentioned; minds with many bright and even beautiful traits; but aimless and fickle as the butterfly; that settle upon every gayly-colored illusion as it opens into flower, and flutter away to another when the first has dropped its leaves, and stands naked in the icy air of truth!
Let us now look at the general tenor of the arguments addressed by believers to sceptics and opponents. Foremost of all, emblazoned at the head of every column, loudest shouted by every triumphant disputant, held up as paramount to all other considerations, stretched like an impenetrable shield to protect the weakest advocate of the great cause against the weapons of the adversary, was that omnipotent monosyllable which has been the patrimony of cheats and the currency of dupes from time immemorial,—Facts! Facts! Facts! First came the published cases of the American clergymen, brigadier-generals, almshouse governors, representatives, attorneys, and esquires. Then came the published cases of the surgeons of Copenhagen. Then followed reports of about one hundred and fifty cases published in England, "demonstrating the efficacy of the metallic practice in a variety of complaints both upon the human body and on horses, etc." But the progress of facts in Great Britain did not stop here. Let those who rely upon the numbers of their testimonials, as being alone sufficient to prove the soundness and stability of a medical novelty, digest the following from the report of the Perkinistic Committee. "The cases published [in Great Britain] amounted, in March last, the date of Mr. Perkins's last publication, to about five thousand. Supposing that not more than one cure in three hundred which the Tractors have performed has been published, and the proportion is probably much greater, it will be seen that the number, to March last, will have exceeded one million five hundred thousand!"
Next in order after the appeal to what were called facts, came a series of arguments, which have been so long bruised and battered round in the cause of every doctrine or pretension, new, monstrous, or deliriously impossible, that each of them is as odiously familiar to the scientific scholar as the faces of so many old acquaintances, among the less reputable classes, to the officers of police.
No doubt many of my hearers will recognize, in the following passages, arguments they may have heard brought forward with triumphant confidence in behalf of some doctrine not yet extinct. No doubt some may have honestly thought they proved something; may have used them with the purpose of convincing their friends, or of silencing the opponents of their favorite doctrine, whatever that might be. But any train of arguments which was contrived for Perkinism, which was just as applicable to it as to any other new doctrine in the same branch of science, and which was fully employed against its adversaries forty years since, might, in common charity, be suffered to slumber in the grave of Perkinism. Whether or not the following sentences, taken literally from the work of Mr. Perkins, were the originals of some of the idle propositions we hear bandied about from time to time, let those who listen judge.
The following is the test assumed for the new practice: "If diseases are really removed, as those persons who have practised extensively with the Tractors declare, it should seem there would be but little doubt of their being generally adopted; but if the numerous reports of their efficacy which have been published are forgeries, or are unfounded, the practice ought to be crushed." To this I merely add, it has been crushed.
The following sentence applies to that a priori judging and uncandid class of individuals who buy their dinners without tasting all the food there is in the market. "On all discoveries there are persons who, without descending to any inquiry into the truth, pretend to know, as it were by intuition, that newly asserted facts are founded in the grossest errors. These were those who knew that Harvey's report of the circulation of the blood was a preposterous and ridiculous suggestion, and in latter later days there were others who knew that Franklin deserved reproach for declaring that points were preferable to balls for protecting buildings from lightning."
Again: "This unwarrantable mode of offering assertion for proof, so unauthorized and even unprecedented except in the condemnation of a Galileo, the persecution of a Copernicus, and a few other acts of inquisitorial authority, in the times of ignorance and superstition, affords but a lamentable instance of one of his remarks, that this is far from being the Age of Reason."
"The most valuable medicines in the Materia Medica act on principles of which we are totally ignorant. None have ever yet been able to explain how opium produces sleep, or how bark cures intermittent fevers; and yet few, it is hoped, will be so absurd as to desist from the use of these important articles because they know nothing of the principle of their operations." Or if the argument is preferred, in the eloquent language of the Perkinistic poet:
"What though the CAUSES may not be explained, Since these EFFECTS are duly ascertained, Let not self-interest, prejudice, or pride, Induce mankind to set the means aside; Means which, though simple, are by Heaven designed to alleviate the woes of human kind."
This course of argument is so often employed, that it deserves to be expanded a little, so that its length and breadth may be fairly seen. A series of what are called facts is brought forward to prove some very improbable doctrine. It is objected by judicious people, or such as have devoted themselves to analogous subjects, that these assumed facts are in direct opposition to all that is known of the course of nature, that the universal experience of the past affords a powerful presumption against their truth, and that in proportion to the gravity of these objections, should be the number and competence of the witnesses. The answer is a ready one. What do we know of the mysteries of Nature? Do we understand the intricate machinery of the Universe? When to this is added the never-failing quotation,
"There are more things in heaven and earth, Horatio, Than are dreamt of in your philosophy,"—
the question is thought to be finally disposed of.
Take the case of astrology as an example. It is in itself strange and incredible that the relations of the heavenly bodies to each other at a given moment of time, perhaps half a century ago, should have anything to do with my success or misfortune in any undertaking of to-day. But what right have I to say it cannot be so? Can I bind the sweet influences of Pleiades, or loose the bands of Orion? I do not know by what mighty magic the planets roll in their fluid paths, confined to circles as unchanging as if they were rings of steel, nor why the great wave of ocean follows in a sleepless round upon the skirts of moonlight; nor cam I say from any certain knowledge that the phases of the heavenly bodies, or even the falling of the leaves of the forest, or the manner in which the sands lie upon the sea-shore, may not be knit up by invisible threads with the web of human destiny. There is a class of minds much more ready to believe that which is at first sight incredible, and because it is incredible, than what is generally thought reasonable. Credo quia impossibile est,—"I believe, because it is impossible,"—is an old paradoxical expression which might be literally applied to this tribe of persons. And they always succeed in finding something marvellous, to call out the exercise of their robust faith. The old Cabalistic teachers maintained that there was not a verse, line, word, or even letter in the Bible which had not a special efficacy either to defend the person who rightly employed it, or to injure his enemies; always provided the original Hebrew was made use of. In the hands of modern Cabalists every substance, no matter how inert, acquires wonderful medicinal virtues, provided it be used in a proper state of purity and subdivision.
I have already mentioned the motives attributed by the Perkinists to the Medical Profession, as preventing its members from receiving the new but unwelcome truths. This accusation is repeated in different forms and places, as, for instance, in the following passage: "Will the medical man who has spent much money and labor in the pursuit of the arcana of Physic, and on the exercise of which depends his support in life, proclaim the inefficacy of his art, and recommend a remedy to his patient which the most unlettered in society can employ as advantageously as himself? and a remedy, too, which, unlike the drops, the pills, the powders, etc., of the Materia Medica, is inconsumable, and ever in readiness to be employed in successive diseases?"
As usual with these people, much indignation was expressed at any parallel between their particular doctrine and practice and those of their exploded predecessors. "The motives," says the disinterested Mr. Perkins, "which must have impelled to this attempt at classing the METALLIC PRACTICE with the most paltry of empyrical projects, are but too thinly veiled to escape detection."
To all these arguments was added, as a matter of course, an appeal to the feelings of the benevolent in behalf of suffering humanity, in the shape of a notice that the poor would be treated gratis. It is pretty well understood that this gratuitous treatment of the poor does not necessarily imply an excess of benevolence, any more than the gratuitous distribution of a trader's shop-bills is an evidence of remarkable generosity; in short, that it is one of those things which honest men often do from the best motives, but which rogues and impostors never fail to announce as one of their special recommendations. It is astonishing to see how these things brighten up at the touch of Mr. Perkins's poet:
"Ye worthy, honored, philanthropic few, The muse shall weave her brightest wreaths for you, Who in Humanity's bland cause unite, Nor heed the shaft by interest aimed or spite; Like the great Pattern of Benevolence, Hygeia's blessings to the poor dispense; And though opposed by folly's servile brood, ENJOY THE LUXURY OF DOING GOOD."
Having thus sketched the history of Perkinism in its days of prosperity; having seen how it sprung into being, and by what means it maintained its influence, it only remains to tell the brief story of its discomfiture and final downfall. The vast majority of the sensible part of the medical profession were contented, so far as we can judge, to let it die out of itself. It was in vain that the advocates of this invaluable discovery exclaimed over their perverse and interested obstinacy,—in vain that they called up the injured ghosts of Harvey, Galileo, and Copernicus to shame that unbelieving generation; the Baillies and the Heberdens,—men whose names have come down to us as synonymous with honor and wisdom,—bore their reproaches in meek silence, and left them unanswered to their fate. There were some others, however, who, believing the public to labor under a delusion, thought it worth while to see whether the charm would be broken by an open trial of its virtue, as compared with that of some less hallowed formula. It must be remembered that a peculiar value was attached to the Metallic Tractors, as made and patented by Mr. Perkins. Dr. Haygarth, of Bath, performed various experiments upon patients afflicted with different complaints,—the patients supposing that the real five-guinea Tractors were employed. Strange to relate, he obtained equally wonderful effects with Tractors of lead and of wood; with nails, pieces of bone, slate pencil, and tobacco-pipe. Dr. Alderson employed sham Tractors made of wood, and produced such effects upon five patients that they returned solemn thanks in church for their cures. A single specimen of these cases may stand for all of them. Ann Hill had suffered for some months from pain in the right arm and shoulder. The Tractors (wooden ones) were applied, and in the space of five minutes she expressed herself relieved in the following apostrophe: "Bless me! why, who could have thought it, that them little things could pull the pain from one. Well, to be sure, the longer one lives, the more one sees; ah, dear!"
These experiments did not result in the immediate extinction of Perkinism. Doubtless they were a great comfort to many obstinate unbelievers, and helped to settle some sceptical minds; but for the real Perkinistic enthusiasts, it may be questioned whether they would at that time have changed their opinion though one had risen from the dead to assure them that it was an error. It perished without violence, by an easy and natural process. Like the famous toy of Mongolfier, it rose by means of heated air,—the fevered breath of enthusiastic ignorance,—and when this grew cool, as it always does in a little while, it collapsed and fell.
And now, on reviewing the whole subject, how shall we account for the extraordinary prevalence of the belief in Perkinism among a portion of what is supposed to be the thinking part of the community?
Could the cures have been real ones, produced by the principle of ANIMAL MAGNETISM? To this it may be answered that the Perkinists ridiculed the idea of approximating Mesmer and the founder of their own doctrine, that nothing like the somnambulic condition seems to have followed the use of the Tractors, and that neither the exertion of the will nor the powers of the individual who operated seem to have been considered of any consequence. Besides, the absolute neglect into which the Tractors soon declined is good evidence that they were incapable of affording any considerable and permanent relief in the complaints for the cure of which they were applied.
Of course a large number of apparent cures were due solely to nature; which is true under every form of treatment, orthodox or empirical. Of course many persons experienced at least temporary relief from the strong impression made upon their minds by this novel and marvellous method of treatment.
Many, again, influenced by the sanguine hopes of those about them, like dying people, who often say sincerely, from day to day, that they are getting better, cheated themselves into a false and short-lived belief that they were cured; and as happens in such cases, the public never knew more than the first half of the story.
When it was said to the Perkinists, that whatever effects they produced were merely through the imagination, they declared (like the advocates of the ROYAL TOUCH and the UNGUENTUM ARMARIUM) that this explanation was sufficiently disproved by the fact of numerous and successful cures which had been witnessed in infants and brute animals. Dr. Haygarth replied to this, that "in these cases it is not the Patient, but the Observer, who is deceived by his own imagination," and that such may be the fact, we have seen in the case of the good lady who thought she had conjured away the spot from her friend's countenance, when it remained just as before.
As to the motives of the inventor and vender of the Tractors, the facts must be allowed to speak for themselves. But when two little bits of brass and iron are patented, as an invention, as the result of numerous experiments, when people are led, or even allowed, to infer that they are a peculiar compound, when they are artfully associated with a new and brilliant discovery (which then happened to be Galvanism), when they are sold at many hundred times their value, and the seller prints his opinion that a Hospital will suffer inconvenience, "unless it possesses many sets of the Tractors, and these placed in the hands of the patients to practise on each other," one cannot but suspect that they were contrived in the neighborhood of a wooden nutmeg factory; that legs of ham in that region are not made of the best mahogany; and that such as buy their cucumber seed in that vicinity have to wait for the fruit as long as the Indians for their crop of gunpowder.
The succeeding lecture will be devoted to an examination of the doctrines of Samuel Hahnemann and his disciples; doctrines which some consider new and others old; the common title of which is variously known as Ho-moeopathy, Homoe-op-athy, Homoeo-paith-y, or Hom'pathy, and the claims of which are considered by some as infinitely important, and by many as immeasurably ridiculous.
I wish to state, for the sake of any who may be interested in the subject, that I shall treat it, not by ridicule, but by argument; perhaps with great freedom, but with good temper and in peaceable language; with very little hope of reclaiming converts, with no desire of making enemies, but with a firm belief that its pretensions and assertions cannot stand before a single hour of calm investigation.
It may be thought that a direct attack upon the pretensions of HOMOEOPATHY is an uncalled-for aggression upon an unoffending doctrine and its peaceful advocates.
But a little inquiry will show that it has long assumed so hostile a position with respect to the Medical Profession, that any trouble I, or any other member of that profession, may choose to bestow upon it may be considered merely as a matter of self-defence. It began with an attempt to show the insignificance of all existing medical knowledge. It not only laid claim to wonderful powers of its own, but it declared the common practice to be attended with the most positively injurious effects, that by it acute diseases are aggravated, and chronic diseases rendered incurable. It has at various times brought forward collections of figures having the air of statistical documents, pretending to show a great proportional mortality among the patients of the Medical Profession, as compared with those treated according to its own rules. Not contented with choosing a name of classical origin for itself, it invented one for the whole community of innocent physicians, assuring them, to their great surprise, that they were all ALLOPATHISTS, whether they knew it or not, and including all the illustrious masters of the past, from Hippocrates down to Hunter, under the same gratuitous title. The line, then, has been drawn by the champions of the new doctrine; they have lifted the lance, they have sounded the charge, and are responsible for any little skirmishing which may happen.
But, independently of any such grounds of active resistance, the subject involves interests so disproportioned to its intrinsic claims, that it is no more than an act of humanity to give it a public examination. If the new doctrine is not truth, it is a dangerous, a deadly error. If it is a mere illusion, and acquires the same degree of influence that we have often seen obtained by other illusions, there is not one of my audience who may not have occasion to deplore the fatal credulity which listened to its promises.
I shall therefore undertake a sober examination of its principles, its facts, and some points of its history. The limited time at my disposal requires me to condense as much as possible what I have to say, but I shall endeavor to be plain and direct in expressing it. Not one statement shall be made which cannot be supported by unimpeachable reference: not one word shall be uttered which I am not as willing to print as to speak. I have no quibbles to utter, and I shall stoop to answer none; but, with full faith in the sufficiency of a plain statement of facts and reasons, I submit the subject to the discernment of my audience.
The question may be asked in the outset,—Have you submitted the doctrines you are professing to examine to the test of long-repeated and careful experiment; have you tried to see whether they were true or not? To this I answer, that it is abundantly evident, from what has often happened, that it would be of no manner of use for me to allege the results of any experiments I might have instituted. Again and again have the most explicit statements been made by the most competent persons of the utter failure of all their trials, and there were the same abundant explanations offered as used to be for the Unguentum Armarium and the Metallic Tractors. I could by no possibility perform any experiments the result of which could not be easily explained away so as to be of no conclusive significance. Besides, as arguments in favor of Homoeopathy are constantly addressed to the public in journals, pamphlets, and even lectures, by inexperienced dilettanti, the same channel must be open to all its opponents.
It is necessary, for the sake of those to whom the whole subject may be new, to give in the smallest possible compass the substance of the Homoeopathic Doctrine. Samuel Hahnemann, its founder, is a German physician, now living in Paris, [Hahnemann died in 1843.] at the age of eighty-seven years. In 1796 he published the first paper containing his peculiar notions; in 1805 his first work on the subject; in 1810 his somewhat famous "Organon of the Healing Art;" the next year what he called the "Pure Materia Medica;" and in 1828 his last work, the "Treatise on Chronic Diseases." He has therefore been writing at intervals on his favorite subject for nearly half a century.
The one great doctrine which constitutes the basis of Homoeopathy as a system is expressed by the Latin aphorism,
"SIMILIA SIBILIBUS CURANTUR,"
or like cures like, that is, diseases are cured by agents capable of producing symptoms resembling those found in the disease under treatment. A disease for Hahnemann consists essentially in a group of symptoms. The proper medicine for any disease is the one which is capable of producing a similar group of symptoms when given to a healthy person.
It is of course necessary to know what are the trains of symptoms excited by different substances, when administered to persons in health, if any such can be shown to exist. Hahnemann and his disciples give catalogues of the symptoms which they affirm were produced upon themselves or others by a large number of drugs which they submitted to experiment.
The second great fact which Hahnemann professes to have established is the efficacy of medicinal substances reduced to a wonderful degree of minuteness or dilution. The following account of his mode of preparing his medicines is from his work on Chronic Diseases, which has not, I believe, yet been translated into English. A grain of the substance, if it is solid, a drop if it is liquid, is to be added to about a third part of one hundred grains of sugar of milk in an unglazed porcelain capsule which has had the polish removed from the lower part of its cavity by rubbing it with wet sand; they are to be mingled for an instant with a bone or horn spatula, and then rubbed together for six minutes; then the mass is to be scraped together from the mortar and pestle, which is to take four minutes; then to be again rubbed for six minutes. Four minutes are then to be devoted to scraping the powder into a heap, and the second third of the hundred grains of sugar of milk to be added. Then they are to be stirred an instant and rubbed six minutes,—again to be scraped together four minutes and forcibly rubbed six; once more scraped together for four minutes, when the last third of the hundred grains of sugar of milk is to be added and mingled by stirring with the spatula; six minutes of forcible rubbing, four of scraping together, and six more (positively the last six) of rubbing, finish this part of the process.
Every grain of this powder contains the hundredth of a grain of the medicinal substance mingled with the sugar of milk. If, therefore, a grain of the powder just prepared is mingled with another hundred grains of sugar of milk, and the process just described repeated, we shall have a powder of which every grain contains the hundredth of the hundredth, or the ten thousandth part of a grain of the medicinal substance. Repeat the same process with the same quantity of fresh sugar of milk, and every grain of your powder will contain the millionth of a grain of the medicinal substance. When the powder is of this strength, it is ready to employ in the further solutions and dilutions to be made use of in practice.
A grain of the powder is to be taken, a hundred drops of alcohol are to be poured on it, the vial is to be slowly turned for a few minutes, until the powder is dissolved, and two shakes are to be given to it. On this point I will quote Hahnemann's own words. "A long experience and multiplied observations upon the sick lead me within the last few years to prefer giving only two shakes to medicinal liquids, whereas I formerly used to give ten." The process of dilution is carried on in the same way as the attenuation of the powder was done; each successive dilution with alcohol reducing the medicine to a hundredth part of the quantity of that which preceded it. In this way the dilution of the original millionth of a grain of medicine contained in the grain of powder operated on is carried successively to the billionth, trillionth, quadrillionth, quintillionth, and very often much higher fractional divisions. A dose of any of these medicines is a minute fraction of a drop, obtained by moistening with them one or more little globules of sugar, of which Hahnemann says it takes about two hundred to weigh a grain.
As an instance of the strength of the medicines prescribed by Hahnemann, I will mention carbonate of lime. He does not employ common chalk, but prefers a little portion of the friable part of an oystershell. Of this substance, carried to the sextillionth degree, so much as one or two globules of the size mentioned can convey is a common dose. But for persons of very delicate nerves it is proper that the dilution should be carried to the decillionth degree. That is, an important medicinal effect is to be expected from the two hundredth or hundredth part of the millionth of the millionth of the millionth of the millionth of the millionth of the millionth of the millionth of the millionth of the millionth of the millionth of a grain of oyster-shell. This is only the tenth degree of potency, but some of his disciples profess to have obtained palpable effects from "much higher dilutions."
The third great doctrine of Hahnemann is the following. Seven eighths at least of all chronic diseases are produced by the existence in the system of that infectious disorder known in the language of science by the appellation of PSORA, but to the less refined portion of the community by the name of ITCH. In the words of Hahnemann's "Organon," "This Psora is the sole true and fundamental cause that produces all the other countless forms of disease, which, under the names of nervous debility, hysteria, hypochondriasis, insanity, melancholy, idiocy, madness, epilepsy, and spasms of all kinds, softening of the bones, or rickets, scoliosis and cyphosis, caries, cancer, fungua haematodes, gout,—yellow jaundice and cyanosis, dropsy,—"
["The degrees of DILUTION must not be confounded with those of POTENCY. Their relations may be seen by this table:
lst dilution,—One hundredth of a drop or grain.
2d " One ten thousandth.
3d " One millionth, marked I.
4th " One hundred millionth.
5th " One ten thousand millionth.
6th " One million millionth, or one billionth, marked II.
7th " One hundred billionth.
8th " One ten thousand billionth.
9th " One million billionth, or one trillionth, marked III.
10th " One hundred trillionth.
11th " One ten thousand trillionth.
12th " One million trillionth, or one quadrillionth, marked IV.,—and so on indefinitely.
The large figures denote the degrees of POTENCY.]
"gastralgia, epistaxis, haemoptysis,—asthma and suppuration of the lungs,—megrim, deafness, cataract and amaurosis,—paralysis, loss of sense, pains of every kind, etc., appear in our pathology as so many peculiar, distinct, and independent diseases."
For the last three centuries, if the same authority may be trusted, under the influence of the more refined personal habits which have prevailed, and the application of various external remedies which repel the affection from the skin; Psora has revealed itself in these numerous forms of internal disease, instead of appearing, as in former periods, under the aspect of an external malady.
These are the three cardinal doctrines of Hahnemann, as laid down in those standard works of Homoeopathy, the "Organon" and the "Treatise on Chronic Diseases."
Several other principles may be added, upon all of which he insists with great force, and which are very generally received by his disciples.
1. Very little power is allowed to the curative efforts of nature. Hahnemann goes so far as to say that no one has ever seen the simple efforts of nature effect the durable recovery of a patient from a chronic disease. In general, the Homoeopathist calls every recovery which happens under his treatment a cure.
2. Every medicinal substance must be administered in a state of the most perfect purity, and uncombined with any other. The union of several remedies in a single prescription destroys its utility, and, according to the "Organon," frequently adds a new disease.
3. A large number of substances commonly thought to be inert develop great medicinal powers when prepared in the manner already described; and a great proportion of them are ascertained to have specific antidotes in case their excessive effects require to be neutralized.
4. Diseases should be recognized, as far as possible, not by any of the common names imposed upon them, as fever or epilepsy, but as individual collections of symptoms, each of which differs from every other collection.
5. The symptoms of any complaint must be described with the most minute exactness, and so far as possible in the patient's own words. To illustrate the kind of circumstances the patient is expected to record, I will mention one or two from the 313th page of the "Treatise on Chronic Diseases,"—being the first one at which I opened accidentally.