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

NEXT ANNUAL MEETING.

..verpool was fixed as the place for the next annual meet-
ing, upon the motion of Dr. WATERS of Liverpool, seconded
by Dr. C. R. HALL, of Torquay.
Dr. LANKESTER, of London, did not oppose the motion,
but could not resist expressing regret that Dublin bad not
been selected. He said it ought to be the policy of the British
Medical Association to break new ground. Annual meet_
ings have already been held in Liverpool, but there has
never been a meeting in Dublin, and in that city the asso-
ciation had only two members. Many new members would
be added to the list if the association met in Ireland, and it
is by increasing numbers and embracing the great mass of
the profession in the three kingdoms that power and influ-
ence will be gained and good achieved.
Professor SIMPSON supported Dr. Lankester's views, and
expressed a hope that in 1860 the meeting would be in
Dublin.

Dr. LEES, of Dublin, thought that if everything were
satisfactorily arranged a prosperous meeting might be held
in Dublin ; but it was not to be concealed that mistaken ideas
were entertained in Dublin as to the part which the
British Medical Association had taken in regard to the
recent medical reform agitation. "I fear," said Dr. Lees,
" that it is felt in Dublin that your triumph is our defeat."
Dr. Lees proceeded to say that so far as he had the power
he would endeavour to promote a comfortable and success•
ful meeting in Dublin in 1860.
Dr. MAHOOD, of Enniskillen, said that Dr. Lees had
spoken as if the whole Irish profession was represented by
the Colleges of Physicians and Surgeons of Dublin. This
was not the case—the fellows of these bodies were very far
from being the majority, and, indeed, were not even the
minority. (Roars of laughter.) In Ireland the profession,
as a whole, were three to one in favour of the Medical
Reform Bill, which had been carried through the influence
of the association, and they would all unite in giving a right.
hearty welcome to the British Medical Association when-
ever it should come to Dublin. (Cheers.)
It seemed to be understood, after some further conversa-
ion, that in 1860 the association would meet in Dublin.

PRESENT STATE OP THERAPEUTIC SCIENCE.
Dr. CHRISTISON, amidst immense applause, commenced
his address on the present state of therapeutics. We regret
that we can only give au 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 •ccasion. If any physician of experience and

candour will dispassionately examine himself, he canno
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 att, and compared with the
other 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 remedies, and to the
nervous system as the mechanism for developing the neces-
sary 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 em-
pirical quackeries of the coarsest kind, and success
with them was a compound ratio of fortunate lying

and slavish 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 homceopathy took his measures
better. He came at a lucky hour when neither his creed
nor he himself had aoy popular rival to contend with. He
knew medical human nature well, and was quite aware that
the theoretical had 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. 1
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 alto 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 do 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 be dangerous;
and 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 influent ein acute rheumatism and
gout, 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 an 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 whole string
of unascertained facts, of great importance to the successful
use of a remedy which has been very long iu everybody's
hands. Professor Christison then illustrated in a similar
manner the want of agreement among physicians as to the
properties of sarsaparilla, &c. lie likewise toucbed upon

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 scieuce by one who was acknowleged
to be the greatest living authority in it. To those who had
like him (Dr. Davies) listened iii former years to the
academic and hospital lectures of Dr. Christison on the
materia medica and therapeutics, 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. Bonnar, 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.

working. Formerly one of the most painful tasks con-
nected with our art was the diagnosis of injuries and
performance of operations on patients of tender years;
and sometimes the sympathies of our common nature
may have temptel to a hasty and imperfect execu-
tion of the task, out of mere compassion to the writhing
sufferer. Now, the utmost deliberation and care are in all
cases within our reach ; the patient passionless ; and the
risk of casualty notoriously small. In the case of adults, I
desire to express my own conviction that a complete anms-
thesis by inhalation ought to be had recourse to only in
obedience to the requirement of stern necessity. My belief
is unqualified in the law of tolerance here. If the circum-
stances arc such as to demand the remedial agent, that may
he readily administered, in the expectation that the system
will not suffer permanent damage in its use, and that the
ultimate result will be in no respect untoward. But if the
circumstances of the case be not so imperative, then I have
no confidence in the anaesthetic, and will fear a casualty at
every turn. This is no fancy or superstition. It is the
working out of a law of Nature which permeates the
whole range. " Quod necessarium, tutuni." The thera-
peutic objects of the =esthetic agent I take to be—the
abrogation of intense and exhausting pain, the diminution
of shock, and the relaxation of muscular action ; the last,
perhaps not the least important. In any formidable sur-
gical procedure in which, the attainment of one or all of
these objects seems highly expedient, if not absolutely neces-
sary—as in amputations, lithotomy, dislocations, hernia,
&c., I would not hesitate to anaesthetise ; but in any minor
procedure in which pain or risk of shock is inconsiderable,
or in which muscular relaxation and absolute impassivity
are not required, I would be slow to humour the patient's
fancy, or quiet his unnecessary alarm at the expense of
running counter to the law of tolerance, and so incurring
ri-k of serious casualty. It becomes me to take this oppor-
tunity of stating that when chloroform was first brought
into use here, I was a great enthusiast in its praise.
I esteemed it to be as safe and manageable as it was bene-
ficial, and thought that it could hardly be used too often or
too freely. I committed these thoughts to written words,
and, as I wrote, my pen warmed with an honest enthusiasm.
But siotsequent events have chastened and subdued my
tone; and my present " surgical experience of chloroform"
amounts to this—never to withhold its use when that use
SEEMS to be imperatively required, and never to sanction its
use unless this seems to be absolutely demanded, always con-
ducting it administration with the utmost prudence and
caution, so as to avoid those terrible results which error or
excess, even under the protection of an existing tolerance,
may not fail to produce, and from which, as experience has
too fully shown, even faultless administration is not altoge-
ther free. Into the question as to whether ether or chloro-
form be the safer anaesthetic, Ido not enter. Both are im-
perfect; and ere long an agent superior to both may pro-
bably be discovered.
At half-past eight p.m. a conversazione was held at the
College of Physicians. The spacious rooms were overflow-
ing. The excellence of the entertainment both to mind and
body gave universal satisfaction. In the course of :the
evening Dr. G. Wilson, professor of technology in the uni-
versity, delivered a brilliant lecture upon the " Indestructi-
bility of Force." Force might be transmuted or trans-
ferred, or lost, so far as its use and application were
concerned, but it was never lost in the sense of its being
annihilated. He illustrated his remarks by a comprehen-
sive analysis of the investigations into the laws of heat,
electricity, &c., from the period of Rumford and Davy down
to the time of Herschel!, Faraday, Joule, and W. H.
Thompson. The general conclusion from these inquiries
being that terrestrial force was almost entirely derived from
solar heat; the last-named philosopher having carried his
investigations so far as even to compute how long that
source of power might last.

JULY 31.
The Medical Missionary Society and a numerous party
' the British Medical Association breakfasted together at
eight a.m. At 11 o'clock the association reassembled.