Vol. XXV. No. 6.] 
POPULAE SCIEI^CE E"EWS. 
93 
[Abridged from Boston Medical and Surgical .Tournal.] 
AMERICAN INVEXTIONS AND DISCOVER- 
IES IN MEDICINE, SURGERY, AND PRAC- 
TICAL SANITATION. 
BY DK. JOUX S. BILLINGS, U. S. A. 
In connection- with this celebration of a cen- 
tury's work of the American Patent System, I 
have been requested by the Advisory Committee 
to prepare a brief paper upon inventions and dis- 
coveries in medicine, surgery, and practical sanita- 
tion, .with special reference to the progress that 
has been made in this country in these branches 
of science and art. It would be impossible to pre- 
sent on this occasion such a summary as would be 
of any special interest or use of the progress 
which has been made in medicine and sanita- 
tion during the century, either by the world at 
large or by American physicians and sanitarians 
in particular; and I shall therefore confine my 
remarks mainly to the progress which has been 
made in these branches in connection with me- 
chanicid inventions and new chemical combina- 
tions, devised by American inventors, — which 
will require much less time. 
Tlie application of the patent system to medi- 
cine in this country has had its advantages for 
certain people, has given employment to a consid- 
crable amount of capital in production (and to a 
much larger, amount in advertising), has contribu- 
ted materially to the revenues of the government, 
and has made a great deal of work for the medi- 
cal profession. 
So far as I know, but one complete system of 
medicine has been patented in this country, and 
tliat was the steam, Cayenne pepper, and lobelia 
>ystem, — commonly known as Thomsonianism,— 
to which a patent was granted in 18;W. The right 
to practise this system, with a book describ- 
ing the methods, was sold by the patentee for 
twenty dollars, and perhaps some of you may 
have some reminiscences of it connected with 
your boyish days. I am certain I shall never for- 
get the eifects of " Composition Powder," or of 
" Number Six," which was essentially a concen- 
trated tincture of Cayenne pepper, and one dose 
of which was enough to make a boy willing to go 
to school for a month. 
From a report made by the Commissioner of 
Patents in 184i), it appears that eighty-six patents 
for medicines had been granted up to that date; 
but the specifications of most of those issued be- 
fore 1836 had been lost by fire. The greater num- 
ber of patents for medicines were issued between 
1850 and 1860. Tlie total number of patents 
granted for medicines during the last decade 
(1880-1890) is 540. This, however, applies only to 
" patent medicines," properly so-called, the claims 
for which .are, for the most part, presented by 
simple-minded men who know very little of the 
ways of the world. A patent requires a full and 
unreserved disclosure of the recipe, and the 
mode of compounding the same, for the public 
benefit when the term of the patent shall have 
expired ; and the Commissioner of Patents may, 
if he chooses, require the applicant to furnish 
specimeaa of the composition and of its ingredi- 
ents, sufficient in quality for the purpose of ex- 
periment. The law, however, does not require 
the applicant to furnish patients to be experi- 
mented on, and this may be the reason why the 
commissioner has never demanded samples of the 
ingredients. By far the greater number of the 
owners of panaceas and nostrums are too shrewd 
to thus pul)lish their secrets, for they can attain 
their purpose much better under the law for regis- 
tering trade-marks and labels, designs for bottles 
and packages, and copyrights of printed matter, 
which are less costly, and do not reveal the arca- 
num. These proprietary medicines constitute the 
great bulk of what the public call "patent medi- 
cines." 
The triide in patent and secret remedies has 
been, and still is, an important one. We are a 
bitters and pill-taking people; in the fried pork 
and saleratus-biscuit regions the demand for such 
medicines is unfailing, but everywhere they are 
found. I suppose the chief consumption of them 
is by women and children, — with a fair allowance 
of clergymen, if we may .judge from the printed 
testimonials. I sampled a good many of them 
myself when I was a boy. Of course, these re- 
marks do not apply to bitters. One of the latest 
patents is for a device to wash pills rapidly down 
the throat. 
I am sorry to say that I have been unable to ob- 
tain definite uiformation as to the direct benefits 
which inventions of this kind have conferred on 
the public in the way of cure of disease or pre- 
venting death. Among the questions which were 
not put in the schedules of the last census were 
the following, namely : Did you ever take any 
patent or proprietary medicine? If so, what and 
how much, and what was the result? Some very 
remarkable statistics would no doubt have been 
obtained had this inquiry been made. I can only 
say that I know of but four secret remedies which 
have been really valuable additions to the re- 
sources of practical medicine, and the compo- 
sition of all these is now known. These four are 
all powerful and dangerous, and should only be 
used on the advice of a skilled physician. 
I said in the beginning that I cannot, on this 
occasion, give any sufficient account of the pro- 
gress of invention and discovery in medicine and 
sanitation during the century just gone. l"he 
great step forward which has been made, has 
been the establishment of a true scientific founda- 
tion for the art upon the discoveries made in 
physics, chemistry, and biology. One hundred 
years ago the practice of medicine, and measures 
to preserve health, so far as these were really 
efficacious, were in the main empirical — that is, 
certain efTects were known to usually follow th" 
giving of certain drugs, or the application of cei- 
tain measures, but why or how these effects were 
produced was unknown. They sailed then by 
dead-reckoning, in several senses of this phrase. 
Since then, not only have great advances been 
made by a continuance of these empirical meas- 
ures in treatment, but we have learned much as to 
the mechanism and functions of different parts of 
the body, and as to the nature of the cause of 
some of the most prevalent and fatal forms of 
disease; and, as a consequence, can apply means 
of prevention or treatment in a much more 
direct and definite way than was formerly the 
case. For example, a hundred years ago nothing 
was known of the difference between typhus and 
typhoid fevers. We have now discovered that the 
first is a disease propagated largely by aerial con- 
tagion and induced or aggravated by over-crowd- 
ing, the preventive means being isolation, light, 
and fresh air ; while the second is due to a minute 
vegetable organism, a bacillus, and is propagated 
mainly by contaminated water, milk, food, and 
clothing ; and that the treatment of the two dis- 
eases should be very different. 
The most important improvements in practical 
medicine made in the United States have been 
chiefly in surgery in its various branches. We 
have led the way in the ligation of some of the 
larger arteries, in the removal of abdominal tu- 
mors, in the treatment of diseases and injuries 
peculiar to women,": in the treatment of spinal 
affections and of deformities of various kinds. 
Above all, we were the first to show the use of 
anresthetics — the most important advance in medi- 
cine made during the century. In our late war we 
taught Europe how to build, organize, and manage 
military hospitals; and we formed the best mu- 
seum in existence illustrating modern military 
medicine and surgery. 
As regards preventive public medicine and sani- 
tation, we have not made so many valuable con- 
tributions to the world's stock of knowledge, — 
chiefly because, until quite recently, we have not 
had the stimulus to persistent eftbrt which conies 
from density of population and its complicated 
relations to sewage disposal and water supplies ; 
nor have we had information relative to localized 
causes of disease and death which is the essential 
foundation of public hygiene, and which can only 
be obtained by a proper system of vital statistics. 
We can, howevei', show enough and to spare of 
inventions in the way of sanitary appliances, fix- 
tures, and systems for house-drainage, sewerage, 
etc. ; for the ingenuity of inventors has kept pace 
with the increasing demands for protection from 
the effects of the decomposition of waste matters, 
as increase of knowledge has made these known 
to lis. The total number of patents granted for 
sanitary appliances during the last decade (1880- 
1890) is about 1,175. 
No doubt the greatest progress in medical sci- 
ence during the next few years will be in the 
direction of prevention, and to this end mechani- 
cal and chemical invention and discovery must go 
hand in hand with increase in biological and medi- 
cal knowledge. Neither can afford to neglect or 
despise the other, and both are working for the 
common good. If the American patent system 
has not given rise to any specially valuable inven- 
tions in practical medicine or in theology, it must 
be due to the nature of the subjects, and not to 
f.ault of the system. 
*♦* 
[Medical Record.] 
HOT WATER AS A REMEDIAL AGENT. 
BY LEVIN J. WOOLEN, M. V>. 
Moist heat as a therapeutical agent has not re- 
ceived the attention from medical writers that 
its merits deserve. In the future the remedi^ 
effects of hot water are destined to play an im- 
portant part iR the relief of pain and the cure of 
disease. 
It is not necessary to allude in this paper to the 
use of hot water as a surgical dressing after am- 
putations, as that subject has been ably treated 
by Dr. Varick, of New Jersey. In the writer's 
opinion, hot water is excelled in such cases by 
diluted alcohol only. 
In some cases of cholera morbus copious 
draughts of hot water, conjoined with injections 
of the same, will afford marked and speedy relief. 
For many years past the writer has used this 
treatment with such good effect that in some cases 
it was unnecessarj' to prescribe any drug whatever 
— even the usual hypodermic injection of mor- 
phine being dispensed with. 
In a case occurring some years ago, the patient 
had been vomiting for three or four hours when 
the writer saw him. The cramps had become se- 
vere, causing him to utter agonizing cries. To 
relieve the severe straining produced by the vom- 
iting, he was directed to take a large drink of 
vvater as hot as he could swallow. This being 
ejected after a little while, a second draught was 
given which put an end to the emesis. As the at- 
tack had been caused by imprudence In eating. 
