Once change the habit of mind so long prevalent among practitioners of medicine; once let it be everywhere understood that the presumption is in favor of food, and not of alien substances, of innocuous, and not of unwholesome food, for the sick; that this presumption requires very strong evidence in each particular case to overcome it; but that, when such evidence is afforded, the alien substance or the unwholesome food should be given boldly, in sufficient quantities, in the same spirit as that with which the surgeon lifts his knife against a patient,--that is, with the same reluctance and the same determination,--and I think we shall have and hear much less of charlatani** in and out of the profession. The disgrace of medicine has been that colossal system of self-deception, in obedience to which mines have been emptied of their cankering minerals, the vegetable kingdom robbed of all its noxious growths, the entrails of animals taxed for their impurities, the poison-bags of reptiles drained of their venom, and all the inconceivable abominations thus obtained thrust down the throats of human beings suffering from some fault of organization, nourishment, or vital stimulation.
Much as we have gained, we have not yet thoroughly shaken off the notion that poison is the natural food of disease, as wholesome aliment is the support of health. Cowper's lines, in "The Task," show the matter-of-course practice of his time:
"He does not scorn it, who has long endured A fever's agonies, and fed on drugs."
Dr. Kimball of Lowell, who has been in the habit of seeing a great deal more of typhoid fever than most practitioners, and whose surgical exploits show him not to be wanting in boldness or enterprise, can tell you whether he finds it necessary to feed his patients on drugs or not. His experience is, I believe, that of the most enlightened and advanced portion of the profession; yet I think that even in typhoid fever, and certainly in many other complaints, the effects of ancient habits and prejudices may still be seen in the practice of some educated physicians.
To you, young men, it belongs to judge all that has gone before you.
You come nearer to the great fathers of modern medicine than some of you imagine. Three of my own instructors attended Dr. Rush's Lectures. The illustrious Haller mentions Rush's inaugural thesis in his "Bibliotheca Anatomica;" and this same Haller, brought so close to us, tells us he remembers Ruysch, then an old man, and used to carry letters between him and Boerhaave. Look through the history of medicine from Boerhaave to this present day. You will see at once that medical doctrine and practice have undergone a long series of changes. You will see that the doctrine and practice of our own time must probably change in their turn, and that, if we can trust at all to the indications of their course, it will be in the direction of an improved hygiene and a simplified treatment. Especially will the old habit of violating the instincts of the sick give place to a judicious study of these same instincts. It will be found that bodily, like mental insanity, is best managed, for the most part, by natural soothing agencies. Two centuries ago there was a prescription for scurvy containing "stercoris taurini et anserini par, quantitas trium magnarum nucum," of the hell-broth containing which "guoties-cumque sitit oeger, large bibit." When I have recalled the humane common-sense of Captain Cook in the matter of preventing this disease; when I have heard my friend, Mr. Dana, describing the avidity with which the scurvy-stricken sailors snuffed up the earthy fragrance of fresh raw potatoes, the food which was to supply the elements wanting to their spongy tissues, I have recognized that the perfection of art is often a return to nature, and seen in this single instance the germ of innumerable beneficent future medical reforms.
I cannot help believing that medical curative treatment will by and by resolve itself in great measure into modifications of the food, swallowed and breathed, and of the natural stimuli, and that less will be expected from specifics and noxious disturbing agents, either alien or assimilable. The noted mineral-waters containing iron, sulphur, carbonic acid, supply nutritious or stimulating materials to the body as much as phosphate of lime and ammoniacal compounds do to the cereal plants. The effects of a milk and vegetable diet, of gluten bread in diabetes, of cod-liver oil in phthisis, even of such audacious innovations as the water-cure and the grape-cure, are only hints of what will be accomplished when we have learned to discover what organic elements are deficient or in excess in a case of chronic disease, and the best way of correcting the abnormal condition, just as an agriculturist ascertains the wants of his crops and modifies the composition of his soil. In acute febrile diseases we have long ago discovered that far above all drug-medication is the use of mild liquid diet in the period of excitement, and of stimulant and nutritious food in that of exhaustion. Hippocrates himself was as particular about his barley-ptisan as any Florence Nightingale of our time could be.
