rEBETJAEY 5, 1897.] 



SGIENGE. 



201 



results accomplished, must be placed in 

 advance of therapeutics. Where thousands 

 have been saved by the timely administra- 

 tion of suitable medicines, or by the skill- 

 fully performed operation of the surgeon, 

 tens of thousands have been saved by pre- 

 ventive medicine. And preventive medicine 

 is to-day established upon a strictly scientific 

 foundation. If our practice was pari passu 

 with our knowledge infectious diseases 

 should be almost unknown in civilized 

 countries and those degenerative changes 

 of vital organs which result from excesses 

 of various kinds would cease to play a 

 leading part in our mortuary statistics. 

 But while our knowledge is still incomplete 

 in some directions, and while individuals 

 and communities constantly fail to act in 

 accordance with the well-established laws 

 of health and the scientific data which 

 furnish the basis of preventive medicine, 

 the saving of life directly traceable to this 

 knowledge is enormous. 



Small-pox no longer claims its victims in 

 Any considerable numbers except in com- 

 munities where vaccination is neglected ; 

 the last extended yellow fever epidemic in 

 the United States occurred nearly twenty 

 years ago ; cholera has been excluded from 

 our country during the last two widespread 

 epidemics in Europe and its ravages have 

 been greatly restricted in all civilized 

 countries into which it has been intro- 

 duced; the deadly plague of the 17th and 

 18th centuries is no longer known in Eu- 

 rope, and the prevalence of typhus (so- 

 -called ' spotted ' or ' ship fever ') has been 

 greately limited. Typhoid fever, tubercu- 

 losis and diphtheria are still with us and 

 claim numerous victims, but we know the 

 specific cause of each of these diseases ; we 

 know where to find the bacteria which 

 cause them and the channels by which 

 they gain access to the human body ; we 

 know how to destroy them by the use of 

 disinfecting agents ('antiseptics'); and in 



the case of diphtheria we have recently dis- 

 covered a specific mode of treatment which 

 when promptly applied reduces the mortal- 

 ity from this dread disease to a compara- 

 tively small figure. 



The brilliant success which has attended 

 the carrying out of modern antiseptic and 

 aseptic methods in surgical and obstetrical 

 practice are too well known to call for ex- 

 tended remark. 



Sir Edwin Arnold in an address deliv- 

 ered in 1895 at St. Thomas' Hospital, upon 

 ' Medicine, its past and future,' says : 



"One of the high authorities already quoted has 

 furnished a calculation of the salvage of life effected 

 even during the early years of the present reign by 

 the commencing improvements in preventive and 

 curative medicine. In the five years from 1838 to 

 1842, London with an average population of 1,840,- 

 865 persons, had an average annual mortality of 2,557 

 in every 100,000. In the five years from 1880 to 1884 

 the average metropolitan population was 3,894,261, 

 and the average annual death-rate 2,101 in each 100,- 

 000. A calculation will show that these figures rep- 

 resent a saving or prolonging of lives during that lus- 

 trum to the number of 96,640. The mean annual 

 death-rate has now been reduced to a point lower than 

 shown in these figures. It was 22.16 per 1,000 for 

 England and Wales at the commencement of the reign, 

 and it is to-day better than 19.0 per 1,000, while in 

 Her Majesty's army and navy the diminution of 

 mortality apart from deaths from warfare has proved 

 even more remarkable, and in India, where we used 

 to lose 69 per 1,000 yearly, this has been reduced to 

 16 per 1,000." 



Having thus briefly referred to the pres- 

 ent status of scientific medicine I shall de- 

 vote the remainder of my time to a consid- 

 eration of the second theme included in the 

 title of this paper, viz.: Pseudo-science in 

 medicine. 



History shows us that the development 

 of each branch of science has been accom- 

 panied by unfounded inferences, based 

 upon partial knowledge, which have been 

 abandoned by the learned as the science 

 has become established upon a basis of 

 ascertained facts, but which have continued 

 to pass current among the ignorant, often 



