MEDICAL PROFESSION. 



649 



tion to the matter, are hardly aware that they do 

 riot obtain a permanent reputation. Hence, they 

 are ready to believe, that there may be some com- 

 plaints, which quacks can cure better than physi- 

 cians. It is worthy of remark, however, that the 

 particular remedy in favour, is never for any con- 

 siderable length of time the same. At one time it 

 is a cure for consumption, at another for rheuma- 

 tism, at another for dyspepsia, or it is a panacea, 

 and cures every thing. Each has its day, and 

 passes by and is forgotten ; or else like a worn-out 

 fashion, it descends from the higher to the hum- 

 bler walks of life, to struggle on, by the aid of in- 

 terested puffs and forged certificates, a little time 

 longer. Whether it be that the cures which give 

 it celebrity result only in temporary relief, or that 

 its failures, or its injurious effects, as well as its 

 cures, at length creep into notice, or that the mys- 

 tery which attended its introduction being dissi- 

 pated, it proves to be but an old remedy with new 

 pretensions, we stop not novv to inquire. The 

 truth of the remark itself will not be disputed by 

 any who have made themselves at all conversant 

 with the subject. This circumstance alone is 

 enough to show what degree of importance is to 

 be attached to remedies the reputation of which is 

 so evanescent, and to free the physician from any 

 just imputation if he is not in great haste to adopt 

 them before their merits are tested, notwithstand- 

 ing the high-sounding promises with which they 

 are introduced to notice. 



It were easy to explain, how it may happen that 

 a remedy shall acquire for a time a high reputation 

 which it does not possess merit enough to sustain. 

 This circumstance is by no means peculiar to the 

 remedies of irregular practitioners. The whole 

 history of the medical profession is full of analo- 

 gous instances. The habits of rigorous investiga- 

 tion which prevail at the present day in all the 

 sciences, do not indeed now suffer inefficient medi- 

 cines to acquire a very general reputation. But 

 there have been times, when medicines have been 

 in very extensive use, which are now universally 

 regarded as nearly or quite inert. 



No one but a physician (and it is scarcely possi- 

 ble even for him) can sufficiently appreciate the 

 difficulty of discriminating between the effects of 

 remedies upon a disease, and the spontaneous 

 changes of the disease itself. Most diseases have 

 a natural tendency to disappear, sooner or later, of 

 themselves, if not improperly interfered with ; and 

 those which have not this tendency often undergo 

 changes, which are unexpected, and for which no 

 specific cause can be assigned. Hence it happens, 

 that the reputation of curing a disease, or of mak- 

 ing a great impression upon it, is ascribed to a me- 

 dicine simply because its use had preceded one of 

 these spontaneous changes. Often, while a phy- 

 sician is congratulating himself upon a successful 

 prescription, he finds that although his patient is 

 cured, his medicine, from some accident, was not 

 administered. 



How, then, it will be asked, are we to judge of 

 the value of remedies, if not by their effects ? 

 Certainly from their effects ; but not as they are 

 observed in a solitary case, and in a general man- 

 ner, in reference only to a final result. There 

 must be a series of observations in which the phe- 

 nomena are compared in the several cases, and the 

 influence of each remedy observed, upon the parti- 

 cular symptoms, as well as its general effect upon 

 *he disease as a whole. And before the evidence 



can be regarded as complete, these observations 

 must have been repeated by different persons, in 

 order that allowances may be made for the influ- 

 ence of a natural partiality for a newly discovered 

 or favourite remedy. 



Few, if any, empirical remedies are ever sub- 

 jected to a trial like this.. The secrecy which is 

 observed in regard to their true character, and 

 which is secured, or aimed at, by oaths arid sub- 

 scriptions in some cases, and by variations in the 

 composition of the medicine, to elude the results 

 of analysis, in others, necessarily prevents a full 

 investigation of their real merits. It is a fair in- 

 ference, that the authors of these remedies are not 

 unconscious that such an investigation would not 

 enhance their reputation. Undoubtedly they act 

 wisely, in respect to the accomplishment of their 

 purposes, in insisting upon this secrecy, notwith- 

 standing the unfavourable inferences to which it 

 subjects them. The mystery, which attends the 

 concealment, forms no small part of the causes of 

 their success. 



In the profession, no such concealments are 

 practised or permitted. The whole profession and 

 the public are considered as fairly entitled to the 

 fruits of the knowledge of all its members ; and if 

 valuable observations or discoveries are made by 

 any, they are freely communicated for the general 

 good. Their knowledge is thrown into one com- 

 mon stock, from which each may draw according 

 to the wants of his patients, and his own skill in 

 applying it ; but which no one is permitted to appro- 

 priate exclusively to himself. The profession does 

 not recognise the right of any individual member 

 to hoard up his discoveries, whether real or pre- 

 tended, for his own private emolument. Among 

 liberal, educated men, it is not to be supposed that 

 any such attempt will be made. But if any one 

 should act so unworthily, he would be at once ex- 

 cluded from the profession. Hence the reason, 

 that none of the boasted discoveries of universal or 

 specific remedies are made by physicians. The 

 name of some distinguished physician is indeed 

 often attached to them ; but it is done without his 

 consent or approbation. 



Whenever the composition of a secret medicine 

 has been made known, it has almost always turned 

 out, that it contained no agents, which had not 

 been before known and in use among physicians. 

 Some unimportant modification of their composi- 

 tion, and a general and confident administration of 

 them without regard to the particular character of 

 the disease, constitute its only peculiarity. The 

 same thing is nearly true, in regard to all the ex- 

 ternal remedies, the different modes of applying 

 friction and fermentations, which have of late 

 become so fashionable. Physicians do not rely 

 upon these so exclusively, as do some empirics, and 

 as they cannot generally go through the mechani- 

 cal operation themselves, they may not always give 

 the full effect to their application of which it is capa- 

 ble ; but there never has been a time, from the age 

 of Hippocrates to the present day, when they have 

 not been regarded as important auxiliaries in the 

 cure of diseases. 



In chronic complaints, remedies lose much of 

 their efficacy when the system has become accus- 

 tomed to their action, so that almost any change, 

 or even leaving off medicine altogether, will many 

 times produce some degree of improvement, which 

 is indeed often only temporary. Practitioners of 

 experience are well aware of tbis>, and regulate 



