The Sun.
London, England, 1858-08-03 00:00:00

PRESENT STATE OF THERAPEUTIC SCIENCE.

Dr. ClintszisoN, amidst immense applause, commenced
his address on the present stale of therapeutics. We regret
that we can only give an outline of the masterly and
most interesting discourse of the learned professor.
He said when the council of this association did him the
honour of inviting him to deliver an address on the occasion
of its visit to Edinburgh, and confided to him the selection
of a subject, his choice fell where it may appear to
many to have been too ambitious. Therapeutics—the doc-
trine of remedies—the theory and practice of cures, the final
and most effectual part of the art of healing— that
branch of medical learning to which every other is merely
prefatory, subordinate, or fundamental ; without which
everything else in physic, anatomy, physiology, pathology,
nosology, are all alike practically useless—the science which
teaches the actions and modes of action, the effects on
health and disease, the special uses of the thousand articles,
medicinal, dietetic, and regiminal, which have been estab-
lished as the tools of the physician during the experience
of 2,000 years,—that was the subject, which in its
widest sense he was called on to discuss, according to his
fancy, on that occasion. If any physician of experience and
candour will dispassionately examine himself, he cannot
fail to confess, if he have not previously come to the conclu-
sion, that therapeutics, considered as a branch whether of
medical science or of medical art, and compared with the
ether branches of medicine, whether fundamental or prac-
tical, is in a backward and unsatisfactory condition. It is
not enough to admit that for a good many years past medi-
cine can point neither to a single great authority, nor to a
single plausible or generally admitted theory as to the ac-
tions of remedies. Even our therapeutic facts are far too
often scanty, vague, or insecurely founded. In the history
of physic it was long the fashion to be never without a
popular therapeutic theory. As every one knows, there was
a time when the medical world, almost with one accord,
believed in the doctrines of solidism, as ruling the
nature of diseases, and not less the mode o
curing them. At another time the doctrines of
humoralism, not less prevalent, concentrated the atten-
tion on the fluids of the body as the seat of diseases, and the
medium to be influenced by remedies. Afterwards in this
country the theory of Cullen taught us to look to peculiar
states of the capillary circulation as the source of disease,
and the proper object of the action of rerned!es, and to the
nervous system as the mechanism for developing the neces-

nary action. A great revulsion had followed, and facts alone
had come into demand,and though a tendency had been ex-
hibited, in regard to some diseases, to fall back on a kind of
humoralism,no therapeutic theory had for many years taken

firm hold of professional favour, or outlived an ephemeral

existence. It was to this unpreoccupied state of the profes-
sional world that they owed the partial success in these
days of the grandest imposture in the history of modern
therapeutics. (Hear, hear.) All other quackeries which
daily flourished and perished before them were simply cm-

pirical quackeries of the coarsest kind, and success
with them was a compound ratio of fortunate lying
and !lavish advertising. Hence it was that such

quackeries presented little or no attraction to the
medical mind ; it was rare that a medical man had
adopted any quack nostrum except his own. (Laughter.
But the famous author of homoeopathy took his measures
better. He came at a lucky hour when neither his creed
nor be himself bad any popular rival to contend with. He
knew medical human nature well, and was quite aware that
the theoretical bad invincible charms for the imaginative
He had a prurient invention, and struck out at once what
must be admitted to be a grand hypothesis—that like was
to be cured by like—that disease was to be encountered by
a parallel—and therefore neutralising artificial disease. l
was true that he had tremendous errors to maintain in order
first to found, and afterwards to apply this hypothesis. But
still they were not so great as to be beyond reception by the
credulous, and, had he been content with stopping there,
his Homion Pathos might have flourished. Intoxicated,
however, with his first success, he ventured a bolder
stroke, and professed also the doctrine of doses so in-
finitely attenuated as to defy the external senses, surpass
comprehension, and outrage common sense. (Applause.)
Had he been somewhat more temperate in his " dilutions ;'
if, instead of dealing with billionths, trillionths, and de-
cillionths of a grain, he had been content with palpable and
visible hundred tbsor even thousandths, Hahnemann escap-
ing the shafts of ridicule, and descending from the heights
of impossibility would have made many more converts
among the credulous in his profession. He might have
founded a long-lived sect instead of finding only a few
fleeting admirers. Instead of a passing meteor he might
have become a comet in the firmament of physic, brilliant
though erratic, nebulous, indeed, and unsubstantial, but
"perplexing nations." (Laughter.) Let them be thankful

that this extravagance of his pretensions had laid bare their
imposture; and let them leave him to the repose into which
he and his doctrines were quietly subsiding. (Applause.)
We can scarcely say what is the prevailing theory of
therapeutics in the present day. In these times a theory,
to be attractive and lasting, must be a faithful generalisation
of facts, but he (Professor Christison) was afraid that the
facts of therapeutics must be allowed to accumulate
before they can be generalised into a sound theory. It is
not enough to admit that we have no well established theory,
we must also confess that our facts are far from being satis-
factory. Here Professor Christison illustrated his meaning
by reference to some examples. He pointed out great
and serious gaps in the existing knowledge of the important
and familiar remedy—foxglove; and then stated that these
gaps arise simply from ignorance of facts, which dp not ap-
pear particularly difficult to settle. He took colchicum as
another example :-1. We do not positively know which
part of the plant, the seed or the bulb, is the more power-
ful, and which the more. uniform. 2. We do not know,
although it is assumed that we know, the season of the
year at which the bulb is most active. 3. Some prefer a
tincture of the seeds—and this preparation is probably both
most energetic and most easily made uniform in energy
others prefer a vinous solution of the bulb; others an
ascetic solution of the bulb; others of the seed; and we do
not yet positively know who is right. 4. Some administer
drachm doses several times a-day, which others—of whom
he (Dr. Christison) was one—have found to he dangerous;
ad some obtain all the benefits for which colchicum is given
by administering doses of one-third of that amount. 5. In
order to attain its curative influenc sin acute rheumatism and
goat, some have observed that it must be given so as to
develop in a moderate degree its well-known physiological
action on the bowels, not that this action is necessary for
the therapeutic action, but merely because it is the best
evidence of the remedy having been administered to the ne-
cessary amount. Others again say that no such evidence is
wanted, and that the action of colchicum in gout and rheu-
matism is something peculiar and specific—a therapeutic
action quite apart from all apparent physiological influences.
The world is not yet agreed as to the safety of arresting the
paroxysm of gout by colchicum. This appeared to him (Dr.
Christison) to be au error, but every one knows that many phy-
sicians of credit have supposed that ultimately the practice
undermines the constitution. Thus here again is a vvhole string
of unascertained facts, of great importance to the successful
use of a remedy which has been very long in everybody's
hands. Professor Christison then illustrated in a similar
manner the want of agreement among physicians as to the
properties of sarsaparilla, &c. He likewise touched upoa

the sources of fallacy arising from the shameful adulteration
of many drugs, and glanced at the wonderful uses of
anwsthesca as an illustration of progress in our knowieoge
of the useful application of some the most potent az Veles of
the Materia Medics. He attributed the present low con-
dition of therapeutics simply to the want of cultivators.
The truth was that the extraordinary interest excited for
some time past by the science of pathology had attracted to
that branch of the practice of physic almost every original
inquirer of note who had appeared in the ranks of medical
practice for fully 40 years. Pathology 40 years ago was in
a deplorably backward state, but now it stood out prominent,
with the dignity of a systematic and favoured science; and
it was well that things had so fallen out, inasmuch as the
thorough cultivation of pathology was an essential prelimi-
nary to the thorough cultivation of therapeutics; and what
might they not hope for therapeutics should the time arrive
when the same engrossing ardour which had been long applied
to pathological researches should be turned in the direction
of therapeutic physiology and practice. As yet, however,
this transfer had not begun to take place; hut, on the con-
trary, great discouragement had been held out in this country
from the highest quarters to the cultivation of therapeutics.
Ever since the foundation of medical schools in the Univer-
sities of Scotland, therapeutics, as the principal branch of
the Materia Medica, had occupied a conspicuous place in
medical tuition ; and in this University, in which the course
of instruction in Materia Medica had invariably been a six
months' course, one should think that the department of
therapeutics must occupy about two-thirds of it. In the
hands of Cullen the chair of Materia Medica became little

else than a chair of therapeutics. About thirty-five years
ago, the Edinburgh College of Surgeons for the first time
added Materia Modica to the requirements for its diploma,
and the example was afterwards followed by the Londo❑
colleges. But more recently the Londo❑ boards of educa-
tion resolved on a sudden that they had hitherto attached
too much consequence to this department, and declared by
their regulations that a three months' course in summer
was sufficient for the teaching of Materia Medics—
equivalent to about one-sixteenth of the whole medical
curriculum. I t was simply ridiculous to talk of teaching
a subject so comprehensive in the space of three months.
But to add to the discouragemcnts thereby given to
• therapeutics, it must also be confessed that it was a branch
of medical science peculiarly difficult to cultivate. After
adverting to the numerous difficulties of the phartnaeopoeist
Professor Christison went on to say that the difficulties
which arose in the way of therapeutics from the condition
of its accessory branches of knowledge, were as nothing
from those inseparable from the observation of the essential
phenomena of therapeutic action itself, arid from the fact
that the results had to be contributed by a multitude of un-
connected observers, differing in accuracy of observation,
soundness of judgment, mental culture, in prejudices to be
overcome, and in fidelity and conscientiousness to record.
The wonder, after all, rather was that so much had been
done to elevate therapeutics to the rank of a medical science;
and, had time permitted, lie might have consoled them with
a retrospect of much that had been accomplished, in spite of
many and great impediments. In conclusion, he expressed
his belief that important discoveries awaited him who would
now enter expressly on therapeutic inquiry, uninfluenced
by the seductions of pathology, by the prejudices of educa
tional boards, or by the inhtrent difficulties of the haves
gation.

Dr. CONOLLY, in brief and eloquent terms, proposed a
vote of thanks to Dr. Christison for his very able address.
It exhibited the same love of truth, and the same high
talent which had characterised the author from his student
life onwards.

Dr. DAVIES, of Bath, seconded the motion. To all pre-
sent the address of Dr. Christison bad afforded great grati-
fication, as it was an exposition of the most important
department of medical science by one who was ackaowleged
to be the greatest living authority in it. To those who had
like him (Dr. Davies) listened in former years to the
academic and hospital lectures of Dr. Christison on the
materia medica and therapentics, the 'present address had
recalled old days most pleasantly.

The PRESIDENT then in due form returned the thanks
of the association to Dr. Christison.

VARIOUS PAPERS.

Papers were read by Mr. Humphrey, of Cambridge, on
the proportions of the human frame at different periods of
life; by Dr. Alexander Wood, of Edinburgh, on the treat-
ment of neuralgic pains by narcotic injections; by Mr.
Jonathan Hutchinson, of London, on the means of recog-
nising in after life the subjects of inherited syphilis; by Mr.
G. L. Bonner, of Cupar Fife, on the topical treatment of
neuralgia; by Dr. Edward Smith, on the effect of tem-
perature upon the system in relation to food; and by Mr
I. B. Brown, on vesico-vaginal fistula.

MEDICAL BENEVOLENT FUND.

The report, signed by the president of the fund, Sir James
Clark, was read by the secretary, and was to the following
effect :

"Commencing the year with a debt of about £l5
to their late respected treasurer, Mr. Newnham, the
committee were soon released froai all difficulty by a
munificent gift of 500 guineas from Mr. Toynbee. With
a plentiful balance to resort to, your committee
have thus been able to deal out bountiful aid in these dis-
tressing cases where immediate and liberal .pecuniary
assistance can alone he of service. They have accordingly
ventured to bestow larger grants than formerly, at the same
time that they have increased the numbers of the recipients
of their charity. In one instance they gave the sum of
£5O; it was to the widow and family of a medical man,
who, having struggled hard but unsuccessfully in ill-health
and in misfortune, died, !caving wholly unprovidcd for 11
orphans, and his poor widow about again to become a
mother. £3O was voted to each of two other cases, and
5 to each of two more. The sum of 1792 10s. was
expended in the assistance of urgent cases during the year,
while 1214 was given to annuitants, six of whom are living
rent free in Mr. Bailey's comfortable houses at Chippenham.
" Your committee have also the grateful satisfaction of
knowing that, by the careful investigation of the cases
brought before them, and then by placing the money they
have voted in the bands of some friend, who watched over
its disposal, they have been enabled to uplift the fallen from
a condition of degradation and misery, to one in which they
have successfully struggled to obtain a livelihood for them-
selves and their families.

"The experience of your committee confirms more and
more deeply the wisdom and beneficence of the founders
of the Medical Benevolent Fund and its subsequent sup-
porters, in delegating to a committee the duty of investi-
gating the applications for relief, and of distributing the
funds. Conscious that they are influenced only by a strong
desire to do 101 l justice to all, by giving aid according to the
real necessities of each case, they venture to express their
conviction that in selecting the true and worthy objects of
charity, by aiding them silently and as liberally as their means
permit, and afterwards by watching over them, the Medical
Benevolent Fund Approaehes,as near as a publiecharitycan ap-
proach, to that which it trusts never to supersede—the private
Christian charity which letteth not the left hand know what
the right hand doeth." Further than this, your committee
are happy in feeling that instead of superseding private
charity their operations tend to call it forth and foster it;
for in many instances the expression of their intention to
give aid, only as an addition to any that may be supplied
by friends, has called forth friends and their effective
assistance.

"The committee, nevertheless, do not conceal from them-
selves the serious difficulties which beset them in the perfor-
mance of their duties. To investigate every month the cha-
racter of so large a number of applicants for relief as come
before them, to decide upon those that are worthy of aid, and
then to administer the funds according to the claims of the
several cases, are duties attended by no ordinary anxiety and
responsibility; and the committee wish to impress upon the
subscribers and friends to the fund, that these difficulties
are greatly increased when the funds at their disposal are
very small.

"Sincerely thanking the subscribers for their liberal assist-
ance, the committee urge the necessity of constant exertion
on the part of those who have confidence in the unobtrusive
principles upon which the Medical Benevolent Fund is con-
ducted ; and they especially suggest to medical men that
they may do essential service by laying the present repert
before their friends and patients. By means of Mr. Toyn-
bee's large donation during the past year, and by the in-
crease of funds arising from the recent festival, at which its
chairman, Earl Granville, with equal sympathy and elo-
quence, most successfully advocated the claims of the fund,
the committee have at present, as will be seen by the trea-
surer's report, a considerable balance in band. This
balance is, however, liable to disappear, or at least
to be greatly diminished at any meeting where numerous
and urgent cases are brought forward, demanding large
and liberal aid. It is evident that without abundant means
the committee can no longer bestow the assistance which
has sa often elicited the touching, because heartfelt, ex-
pressions of gratitude from the downcast medical man,
his destitute widow, or orphan children; expressions of
gratitude, of which some are quoted in an appendix, be-
cause the committee wish the subscribers to feel, that as
they provide the bountiful aid, they also can enjoy the in-
expressible consolation of knowing

" That they have been
Themselves the fathers and the dealers out
Of some small blessings have been kind to such
As needed kindness."

ADDRESS ON THE PRESENT STATE OP SURGICAL