G THE ROMANCE OF MEDICINE. JYom Iandon Koclc'y. The Komnice of Medicine I Is It poasiblo that there is a particle of romance iu so unro mantlo a subject f I think there is; ami, in deed having looked at the subject in various ways' in reference to this paper, my gene ral feeling if that of dismay at the abun dance and variety of my materials, if I can only manure to transfer to my readers the feelings with which they have impressed myself. At the outset of the Bubject, I may say that I am well prepared for a general sneer against medicW, and with the feeling that prouip s H 1 confess I have a great sympathy. "I don't believe in medicine," it may be urged; and the beet do.to-i B1ve 03 ,iUle Amnn M they c an. Voltaire "used to, say that the doctors poured medicine of winch they know little, into a body of which they knew nothing. I dare cay doctors have not changed much Rince the times of Cervantes and Moliere, a thonjh tLeir mode, have shifted." Thus cinch the imaginary objector; and there is a rood deal of ground for this kind of imputa tion. I met a ma" the other day who was Tery indignant because his doctor had knocked off his bitter beer. lie said he should keep on changing his doctor until he met with one who would strougly recom mend bitter beer. He did not think he Bhould have far to go. Mow this ia a fair example of the wonderful inconsistencies of the medical profession. Take the case of a cold. One man will tell yon to drink a bottle of port; another man will tell you to drink slops; another man will tell you to drink ne thing at all, or restrict you to three t;a spoonstul of liquid in the course of the day. In reference to this dry system, which has the eminent authority of Dr. C. J. 15. Williams, the. popular belief will be that the remedy is wor.se than the disease. This is only taking a trivial instance of confusion and contradiction. Then what remarkable revolutions there have been in medical opinion, of which the conllict between the lowering treatment and the stimu lating treatment is an example. Again, did you ever know half--adozen medical men agreed on the treatment of cholera f In medicine, more than any other direction, science moves slowly, "working on from point to point." It wonderfully illus trates the marvels of our frame, that in the present day new discoveries relating to the human body are now and then being made; that medical men, as in the instance of Dr. Bright, are immortalizing their names by giv ing them to the new diseases they have de tected; that medical science is avowedly full of problems, some of which appear insoluble, while in the case of others we are slowly and tentatively moving towards a solution. To speak accurately, medicine is not a science, but an art, the art of the application of many sciences. It is a trne saying that the surgeon requires an eagle's eye, a lady's hand, and a lion's heart. The greater his acquaintance with the sciences and his own resources, and the habit of intercommunication with his brethren, the greater will be the ability of the medical man to perform his healing office. Only it is worth while, as a preliminary step, to settle our, notions of the place of medi cine in the' order of things. The medical man requires to be saved from his friends rather than from his enemies. There is a numerous class, chiefly women, children, and nervous people, who look on a doctor in the light of a deity. He is their director the mainspring of a system of lay popery who controls their actions with irresponsible power; andit is greatly to his credit that, in the pleni tude of his tyranny, he does not play vagaries to tax to their extreme limit the principles of credulity and nndue deference to authority, lien who see a good deal of this sort of thing become cynical, at least until they become ill. Let it be fairly understood that medi cine is an art beset with limitations and Imperfeotions; that cases can only gene rally be referred to classes, but each case has to be considered in its own cir cumstances; that medical men are liable to errors in observation and reasoning; and that even when these errors are minimized, there is uncertainty, and limitation, and obscurity about the medical means employed. . Then take the rational middle view, that in Bpite of all the empiricism that belongs to medicine, and all the mere theorizing, there exist also real principles and a safe experi ence, and mere sneers at medicine are .seen to be Ignorant and unphilosophical. Those are wise words in the Apocrypha: "Honor a physician with the honor due unto him for the uses which ye may have of him: for the Lord bath created him. The Lord hath created medicine out of the earth; aud be that is wise will not abhor them. Then give place to the physician, for the Lord hath created him; let him not go from thee, for thou bast need of him. There is a time when iu their hands there is good suocess." It is popularly said that after the age of forty every man is either a fool or a physician. I think, however, that there is a very nume rous class who are a little of both. That I may not be included in my own limb of the classiti cation, let me hasten to say that I am merely a layman and an outsider, and my remarks must be taken at their worth. The only practical advice which I shall venture to give Is, that if you really understand your own oase, and it is a simple one, don't be in too great a hurry to send for the doctor; but if you really feel yourself out of your depth, send for one. Bir Henry Holland has an essay, "On Points where a Patient may judge for himself;" and a little experience and common sense would Cave medical men much trouble. At the present day there is a great deal of general medical dis cussion, at least among people who havu arrived at a certain time of life. I think it is Mr. Car lyle -who says that a man who has a perfectly healthy stomach does not know that he has a stomach. But there comes a time when a man xaakes the appalling discovery that he has a Stomach, not to mention liver and lights, and fall bi cl na?ionable things. Then men ui S l-helr mattering of physiology People gregw ne vou affui solid fiesh would melt I" Ut tUl3 too to The other day, the Lancet sUi-ii . a different cue The pubno a a 0D falling into the habft of us?ng ffi&nt? People do not become intoxicated after thl grand gentlemanly manner of their forefather, who took their bottles of port after dinner but an day long they are taking sherry or brandyin aerated drinks. Our wiue-irWoo are much too large, and we use cylindrical chamf agne-glanses which must be tossed off at once. Th gonoral result is, that there is a good deal of vague medical talk just now. Obesity is a misfortune, although nature pro bably gives tVe additional covering because she sees that suli is wanting; and there may be a good deal oHj-uth iu the present crusade against beer and brandy aud soda. Hut when once this becomes a popular topic there is a great deal ot exaggeration used, and other matters, equally or more important, become overlooked. Nature is not such a very bad guide after all; the via mtdkalrix nulurve, as the doctors call it, is a THE DAILY EVENING TELEGRAM rillLApELrniA, UllTiDAY, SEPTEMBER 19, 1SG7. wonderful agency, devising the most curious contrivances for remedying or modifying au evil. Ihe excellency of a medical man lies in the fact that he is able to interpret and sueoor nature, and iu this lies the groundwork of the proverb cited above which is, nevertheless, a confession of the shortcomings of medical science thnt the best doctors give the least medicine. The best law of medicine is that the intelligent man should follow nature, and should live naturally. The prophylactic power of medicine is one of its most important aspects. It is far better to keep yourself well by simple moans than to recover health on the most elaborate sys tem. A broken vase, though mended, is not so good an article as the vase nnbrokon. The truck that used to carry ten tons, alter it has been repaired can only carry six. There is a medical theory that if a man will only take sufficient caro of himself, his corporal mechanism will la.st out till the wheels volun tarily 6top through sheer use and duration. Nothing is clearer than that our frames are only lent lis for a terminable period, aud that, without the intervention of positive disease, our life attains its kindly natural pause. How Tithonus regrets the lot of "Happy men who have the power to die, And giussy barrows of tho happier Uoiul." We remember the imagery of Lucretiu", that he who lias feasted at the banquet of life Bhould be contented, as a satisfied guest, to take his departure. "Men fear death," says Bacon, "as children fear to go into the dark," and to die is, after all, as natural an act as to be born. The real horror of death is quite independent of physical considerations. Sir Benjamin Brodie pays, aud the observation of most medical men coincides with his, that the physical act of decease is rarely accompanied with pain. We accept nature's kindly law. We are tenants for life, or rather tenants at will, and the usufruct, but not the absolute possession. To quote the noble line of Lucre tius: "Vitaque mancipio nulll datur, omnibus nsul." Of the romance that attends the history of medicines there can be no doubt. Many are the strange events that have occurred before, to use the quaint language of an old author, they have passed "from the bowels of the earth to the bowels of the patient." We are able to point to positivo achievements of me dicine, and the lair hope of achievements to come. "Who can tell the power of the hidden herb f" asks Spenser, in the "Faery Queen." Much has medical science done in the way of specifics, the discovery of remedies, whose exact action may not, perhaps, be understood or explained, but whose healing effects are hap pily known. Think of the Jesuits, who, hap pily for humanity, discovered the bark of the chinchona tree, which is the sheet-anchor in ague. There is reason to hope that we may yet discover a specifio against other frightful diseases. Most persons know the Btory of Waterton's wanderings in South America in search of the secret of the wourall poison an eminent example of the enterprise of medical dis covery. Then take Jenner's discovery of inoculation for small-pox. I am sorry to hear that there are persons in this country who violently attack inoculation. I heard of a poor woman the other day who, per suaded by the talk of ignorant people, re fused to have her child vaccinated, and shortly afterwards the poor little thing lost its eyesight by small-pox. Our own age has made several remarkable discoveries. Look at the grand discovery of chloroform, which has saved thousands of hours of help less agony. There is no tale of daring aud discovery more remarkable than the narrative of the hours which Professor Simpson and his friends in Edinburgh spent in testing various narcotic agencies, until they become lirst ex hilarated and then insensible while testing chloroform, and awoke to the conviction that they had now become acquainted with the most powerful anaesthetic known or conceived. The whole history of anesthetics, from the days of Sir Humphrey Davy, or rather from Cavendish and Priestley, form one of the most remarkable chapters in the history of human progress. It is possible, according to Dr. Antsey's "Narcotics and Stimulants," that the wonderful properties of the Peruvian coco may be made extensively useful in this coun try. The discovery of cod-liver oil has been a boon of the most inestimable kind. Dr. Wil liams states that iu a certain he prescribed it in eleven thousand cases, and in ninety-live per cent, with beneficial results. It is now known that consumption is curable in its earlier stages. It was stated in the re cent Hunter trial, in the Court of Queen's Bench, th.t the average length of consumptive cases, which used to be two years, i3 now prolonged to five years. Even where medicine cannot heal, it obtains one of its greatest triumphs in palliating a disorder. There never was a time in the history of me dicine when its soothing and alleviating side was so assiduously and successfully culti vated as at the present time. Then the knowledge of the human frame daily grows more extensive and exact. Look at Laennec's wonderful discovery of the stetho scope. It is now known that of the three orgars which make the tripod of life brain, lungs, and heart (according to Biohat's theory, now generally received, death always issues from one of these three avenues) diseases of the heart, which were once considered ex ceedingly rare, are the most common, and probably the least hurtful. It is half the battle with disease to know accurately what is really the matter with the patient. There appears to be no reason to doubt that the average length of human life is more extended than it used to bo, aud some share in this is to be set down to medicine, especially in its sanitary and prophylactic side. The progress of knowledge, the scientific insight into disease, form the basis and pledge of subsequent pre vention, cure, or alleviation. I take from Mr. Bowman's "Address in Surgery" (18UU), state ments of the facts of medical progress so mar vellous that they belong to "the fairy tales of science"or the romance of medicine. "Harvey bad heard the healthy sounds of the heart; but its morbid sounds inform us now of the nature of its structural defects. The sounds of breathing must, countless times ere this, have met the ear ; but it was reserved for our owu days to study them so often as to enable every tyro to nay what is the state of those great organs hidden from our view, but so indispensable to life. Aud so with percussion. Nay, with our eyes we can now beholl, for the first tinit, in its living acts, that marvol Ioub mechanism in its most exquisite and joy inspiring movcm.i.is, as well as when it s oppress bv .Ksense, which stands as a seiani.d at the orifice of the air passages, der.?? ull U' v,,i(" au'1 primarily ffi't, V . liy that modern which t ! .TV compound microscope, elements of r ' 'A Wt,rol amo,,S the very Structure-, w,,Vi.i . niuimeuti ot organiu gard, though U l a, Lu rt to lightly re has inUnitl UauuiK1?" A"""' practitioner, even , Zt11 " ,t',u"lte' only cons. iei.Uouhly alert ,7h K' u,a say with coMid.n, ot e a0u;lc "urrva'!t. fu wasting fmuM lio.- him l1, 1 ?' iu lM out of h: UsLt, wKteL and is the seat of no pain, 'This glanl has been certainly pawing through this or that d"stniclive change; it is now so and so; I can accomplish this, or probably only this, for its relief; and this, or this, will be tlu end.' " The reproach which Bacon iu his timo threw upon medicine, that those who pro fessed It did not seek lor specific remedies, U bow taken away, for this is the era of inces sant experiment, and medicine now rests on a found basis, Mid no limits can be placed to its expansion in far-of ages. Many of the phenomena presented by dis ease are exceedingly curious, and even roman tic. Take, for instauce, bronchitis. Some times it happens that a bronchial tube be-, comes cainil'u d at one end, or is filled by some substance. The result is that the tube is converted into a musical instrument. It gives a flute-like pound. It coos like a wood-dove. Sometimes the bronchial tube acts differently. The sound resembles the noise made by a loud snorer. Then it mimics the noise of an infu riated tom-cat. Cullen's celebrated account of the phenomena of a fever might well de serve a place in the romance of medicine, deeply and painfully interesting as it is. From the many thousand cases that are on record in medical journals, many might be cited involving matters very curious in a scientific point of view, and narratives of per sonal history of the most dramatic kind. Cases of insanity especially possess horribly grotesque character. In the work of M. E.-s-quiros alone there is a remarkable collection of very singular cases. It is to be noted that in sanity is a physical disease of which several hundred people die annually. The curious disease commonly known as St. Vitus' dance (chorea), presents some remarkable phe nomena. It is generally painless, aud most frequently attacks boys and girls, and very rarely has a fatal termination. The patient be comes a merry Andrew, and twists the face into all kinds of ridiculous forms. It is im possible for the lookers-on not to be amused, but any such unworthy feeling would certainly cease when they become acquainted with the horrible and most distressing forms which the disease can assume. The name of chorea, which signifies a dance Hunter calls it rotatio is derived from the dancing phenomena which are not uncommonly found with it the insanity of the muscles, as it has been called. St. Vitus is supposed to have been a worthy saint, who was much alllicted this way, to whom a chapel is dedicated at Ulm in Swabia. A case is mentioned in which a young woman would dance on one leg and hold the other in her hand. When a drum sounded a kind of air she would dance up to the drum and con tinue dancing till the drummer was out of breath. Another would leap, exactly as a fish might do, from the top of a wardrobe five feet high. Another patient, a little girl, would twirl round on her feet like a top. She would spin for six or seven hours at a time, the evolutions being sixty a minute. Another patient was continually walking backwards, receiving many falls and bruises. "Such histories," says Sir Thomas Watson, "would sound very like romances, if they were met with in the old authors alone, or if they were not attested by unimpeachable authority." Such diseases are morbid affections ot the nerves, and are well called "the dark corners of pathology." The whole subject of the in fluence of the nervous system on the organic functions is replete with curious memorabilia. Here is a curious case, mentioned by Mr. Paget: "A lady who is subject to attacks of what are called nervous headaches always finds next morning that some patches of her hair are white as if powdered with stasch. The change is effected in a night; and, in a few days alter, the hairs gradually regain their dark-brownish color." Dr. Carpenter explains the famous mirnnl or the thorn, which is such a leading event in the history of Port Royal, where. an advanced fistula lacrymalis was undoubtedly healed through the influence of the nervous system. He says that there is scarcely a malady to which, according to well-grounded medical opinion, amendment has not been produced "by practices which can have had no other effect than to direct the attention of the suf ferer to the part, and to keep alive his con fident expectation of the cure." Among such curious instances may be recalled the servant maid, whom Coleridge quotes, who, in the ravings of fever and the ravings of fever are always more or less remarkable repeated long passages from the Hebrew, which she did not understand, aud could not repeat when well, but which, when living with a clergyman, she had heard him read aloud. Dr. . Forbes Winslow's work on the "Obscurer Diseases of the Brain," gives many highly curious cases, and Dr. Maudsley's philosophical work, re cently published, is an extremely thoughtful work, enriched with notes of great literary in terest. Dr. Maudsley's collection of fifty cases of insanity, which he has had under his own care, is both striking and instructive, and many similar cases might almost be entitled "Studies for Stories." I have just noted a curious case reported by Dr. Fitzpatrick, of London, for the Pathological Society of Dub lin. A man wasted away in hospital as if for consumption. On post-mortem examination it was found that a small fishbone of a plaice had passed into the left lung, and the pre sence of this foreign body had made a cavity. A surgeon was performing a simple operation in the neck, when suddenly a slight hissing sound was heard. The air had forced Its way into a vein, and death was the result. But such curious cases might be multiplied ad libitum; a collection might easily be formed by any reader of current medical literature. Tho human interest is even greater than the scien tific interest, and it must be noted, to the credit of practitioners, that they exemplify Bishop Butler's law, that their sympathies, being accompanied with active goodness, in stead of being dulled by the multiplicity of the phenomena of suffering, constantly become more tender and acute. Something might be said in contradiction to the theory mentioned just now, that an organi zation will act regularly till worn out by long use. At the same time there can be no doubt that carelessness is the origin of most diseases. Medical men also hold that foolish people who follow their own whims have hardly a chance of recovery when visited by serious disease. Nine-tenths of the doctors' work would be done if people were only consistently prudent and cautious. Only it is so hard to be habitually cautious. On abundant occasions a man may be most elaborately prudent, and then, to his utter astonishment, he dangerously imperils his health by some startling impropriety. When he has used every imaginable pains lie Is always amenable to the force of nooident. There is another plausible theory, strongly antagonistic to the one we have named, to the effect that every man has the seeds of some particular disease In his constitution, au4 some tilllli'g accident will come, sooner or later, which will have for him the same elleot as a match falling upon gunpowder. Moilical men explain this en theories of constitutional tendencies, or of some poison latent in the system. The fatal accident, to one man is the merest accident for another. Two men while walk ing get well soaked by the raiu. One man shakes off the water pretty much as a dog or a duck might do, aud rather enjoy his shower bath than not. Another man is tak"U ill of inflammation ol th ' lun-. and prol.al.lv die. Tb doctors cannot explain the diligent 'issue, uuu ui-y wouiu niso iq very much puzzled to puftiacury account ot the pneumonia itself. They will, indeed. PeiiHrallv e villain diseases by theories more or less plausible, and practice has been built upon theory, and theory has, no doubt, sacrificed a nunib-r of nnman lives. Xet medicine must have its dogmatic system, And without it medicine be comes little better than empiricism. Some time ago it was the theory that the type of disease had changed; and, indeed, it ia difficult to believe that there are not substantial grounds for such an opinion. Dr. Watson once held this opinion very strongly, but of late years he seems entirely to have withdrawn his adhe rence; and the simple fact is that the charac ter of diseases Is better understood now than was the case once. We have seen, even of late years, works where the tendency of cer tain diseases to death, and the tendency of certain diseases to convalescence, is much In sisted on; but I imagine that such a classifica tion would now be exposed to rigorous criti cism. The history of medicine reveals to us a succession of so-called "systems," some of them mixed up with theories of the universe and visionary mysticism, like the gases of van iieimont or the Vortices of Descartes. and often issuing in rules and practices as simple and as sanguinary as that of San- graao. tuperstition and mysticism and mere notions are now discarded for the results of exact science and patient ex periment. It is now understood that patho logy and physiology fade into each other, and that the processes of disease are in accordance with those which belong to the structure and functions ot Healthy organs The study of such a work as Dr. Williams on the "Principles of Medicine," to which the late Mr. Buckle was so largely indebted, will indicate the present state of medical science and supply a line of reasoning susceptible of being followed by every thoughtful and edu cated mind. The recollection of by gone systems of medi cine might supply us with abundant curiosi ties of prescriptions. They are curious enough In modern medicine, as, for instanoe, air Charles Hastings' brochure on the use of the serpent in phthisis. Ihe following regimen of Brown's for the treatment of a hypochon driac ratient is rrobablv uniaue amone Dm scriptions. Its absurdity should not blind us to the fact that there are real merits in the Brunonian system, as it is called. With many people such regimen as the following would be popular enough: "For breakfast, toast and rich soup made on a slow fire, a walk before breakfast and a good deal after it; a glass of wine in the fore noon from time to time; broth or soup to dinner, with meat of any kind he likes, but always the most nourishing; several glasses of port or punch to be taken after dinner, till some enlivening effect is perceived from them, and a dram after everything heavy; one hour and a half after dinner another walk; between tea time and supper a game with a cheerful com pany at cards, or any other play, never too prolonged; a little light reading; jocose, hu morous company, avoiding that of popular Presbyterian ministers and their admirers, and all hypocrites and thieves of every de scription. Lastly, the company of amiable, handsome, and delightful young women, and an enlivening glass." Dr. Russell, to whom we are indebted for the quotation, might well say that "John Brown's prescriptions seem a caricature of his system." Dr. Russell also mentions the great Sydenham's plan, "Ue Methodo tnedr-ndi niot bos ;xr Accubitum Junioris." Sydenham, though a theorist, was a great man, and his name is justly regarded with a high degree of vene ration, lie mentions several cases in which he cured the diseases of elderly people by making young people sleep with them. The practice has Biblioal authority, and we believe is even now pursued in foreign countries. Another Dr. Brown of Edinburgh, the author of the "Iorw Subseciva," shall supply us with a further anecdote of prescriptions: "Many years ago a countryman called on a physician in York. He was in the depth of dyspeptio despair, as often happens with the chaw bacons. The doctor gave him some plain advice as to his food, and ended by writing a prescription for some tonic, saying, "Take that and come back in a fortnight." In ten days Oiles came In, blooming and happy, quite well. The doctor was delighted, and not a little proud of his skill. He asked to see what he had given him. Giles said he hadn't got it. "Where was it ?" "I took it, sir," "Took it 1 What have you done with the prescription !" "I ate It, sir. You told me to take it." Dr. Brown's view of the human constitution we mean the Dr. Brown whose "system" almost made a medical revolution half a cen tury ago is thus ingeniously set forth by his disciples, and in its main illustrations may be accepted: "Suppose a fire to be made in a grate, filled with a kind of fuel, not very com bustible, and which could only be kept burn ing by means of a machine containing several tubes placed before it, aud constantly pouring streams of air into it. Suppose, also, a pipe to be placed in the back of the chimney, through which a constant supply of fresh fuel was gradually let down into the grate to repair the waste occasioned by the flame kept up by the air machine. The grate will represent the human trame; the iuei in it tne matter of life, the excitability of Dr. Brown, and the sensorial power of Dr. Darwin. The tube behind supplying fresh fuel, will denote the power of all living systems constantly to regenerate or reproduce excitability; while the air-machine of several tubes denotes the various stimuli applied to the excitability of the body, and the name drawn forth in conse quence of that application represents life, the product of the exciting powers acting upon the excitability." This illustration has a shadowy resemblance to the famous cave image iu Plato. The whole subject of medical jurisprudence Is an exemplification of the Romance of Medi cine. ' The great authority on this subject is, of course, Dr. Alfred Swayne Taylor, whose work on medical jurisprudence Is much more fascinating reading than most novels are. 1 he English public are unfortunately only too familiar with medico-legal cases. We have cenerally some great Oyer and Terminer oase KOing on, where poison had been the agency employed, and medical men are exhaustively discussing the scientific aspect of tue case. Such trials as those of Palmer, Madeline Smith, Smethurst, Pritchard, and others, have made the publio nnwholesomely familiar with toxicology. In cases of circumstantial evi dence medical men are freq ueutly 'the leading witnesses. It was long a disputed scientific question Whether a person can die of poison, and yet no trace be found in the body. When a very celebrated physician declared that he was ac quainted with several vegetable poisons which absolutely left no trace at all, we are credibly informed that he was inundated with letters from persons entreating him to say what those poisons were. We may be sure that a thirst for scientific knowledge, or a mere curiosity, I dictated the 'great wans of those letters; but at the same time thoro may be donMful sprcu- i lations as to the motives which actuated some of these inquiries.. Some very curious cases, tinning ou minute points, occasionally arise in medical juiispruden e. Such Is the case of the M.tack ou the Duke of Cumberland by his valet, Scllis, who afterwards committed suicide; some vnguc popular suspicion at tached to the duke, aud Sir Edward Home made a joint in the case in the duke's ,favor on the distinction between venous and arterial blood. We notice that, in his Index, Dr. Taylor gives no less than three allusions to the case of the Due de Praslin. Dr. Taylor alao discusses ti e oase of General I'ichegru, who was found strangled in prison through the ligature of his neck being tightened by a twisted s'.ick. A strong suspicion of murder was excited, and it was thought that death had been caused through an order of the Emperor Napoleon. Dr. Taylor states that the evidence of this having been au act of homicide is very weak, and that, so far as the medical circumstances ex tend, there is no reason to doubt that it was an act of suicide. There was a remarkable case of strangula tion which happened in London mauy years ago, and which many may recollect. There was an unfortunate man who used to ex hibit himself publicly In the act of hanging, and at a certain point released himself without having sustained any injury. One day the poor fellow continued the ex periment a little too far, and was hanged in real earnest. The curious fact is, that a gap ing mob surrounded him all the time, and allowed him to hang for thirteen minutes before the suspicion was entertained that some thing might be wrong. Every medical man is constantly liable to be called into the witness-box in cases of violence, poisoning, and that numerous and most melancholy class concealment of birth. Dr. Taylor advises him to make his antecedent examinations most carefully, and to be very careful as to the kind of figure which he cuts in the witness-box. Dr. Taylor speaks rather severely of counsel. and at times counsel have spoken rather severely of Dr. Taylor; he inclines towards a contemptuous feeling in reference to juries, with which it is impossible not to feel some measure of sympathy. I he most remarkable cases which occur in medicaid urisprudence are unquestionably those of chromo poisoning. At the present time there appears to be a fearful race between the art of the poisoner and the art of detecting poison. Ihe history of the processes employed to test for poisons Is highly curious, and ot much scientific in terest. Dr. Taylor says that persons have died from the effects of poison eleven months after the poison had been swallowed, and that there is no reason to doubt that instances may occur of a still more protracted nature. "The occurrence of such cases as these suggests grave reflections on the insecurity of life, when poison is used with skill and cunning, and on the inefficiency of the present system of registering causes of death. The editor of the Law Magazine has truly said, in commenting upon the Smethurst case, "All that is requisite for future murderers by poison to do is to use small doses, combine the use of various destructive drugs, and subpoena the proper witnesses. If the judge and jury should, nevertheless, be convinced that the skilful poisoner was guilty, it is then open to him to work the papers and 'public opinion,' get other doctors' evidence, and apply to the Home Office. That this will be the course pursued by future poisoners i3 highly probable; hence the characters of chronic poisoning have acquired a special interest for the medical jurist." The single subject of frauds upon insurance offices opens up a wide field of medical jurisprudence. The publio obtained glimpses of this in the case of Palnier, but the cases were not fully gone into, as a conviction was obtained in the indictment respecting Cook. It may, however, be said that the insurance cases of which the publio obtain glimpses are few when oompared with the insurance cases of which the publio know nothing. A collection of such cases would form one of the most curious and fearful books of the age. It sometimes happens that an office has no moral doubt, though it has little legal proof; and if they venture to resist a claim, it will probably happen that the claim will not be insisted upon. We give the fol lowing anecdote on the authority of a medical friend. A woman insured one or two lives in an office, and the lives rapidly fell In. When this happened with a third life, the office having seen some reasons for suspicion, de murred as to the payment of the policy. The woman called at the office, and said angrily to the manager, "Do you think I poisoned my own relation ?" A sudden thought struck the manager. He walked up to the' woman, put his hand on her shoulder, and looking fixedly at her, sald,"We knoie you did." The woman, in great agitation, left the office, and was never seen there again. Very much that is very remarkable belongs to the diagnosis and prognosis of a case. No two medical cases exactly resemble one an other any more than two human faces are ex actly alike, or any two blades of grass even. A man can no more be a physician by reading book than a man can be an artist by reading all extant publications on form and color. Each case is a separate study ia itself. Now this diagnosis is 'exceedingly troublesome work. Patients often cause a a good deal of this trouble. They send for a medical man, and at once expect him to explain what is the matter, and to write them a prescription. If a medical men will not do this off-hand, they lose confidence in him, and will apply to some other practitioner. It is per fectly wonderful now a London physician m extensive praotiee will examine and prescribe in a very few minutes. But, as a rule, alman ought to have an opportunity of studying achronlo case minutely before he adopts any decided treatment. Invalids have also another way of proceeding, whioh Is a sore trouble to some medical men. They make a round of the London physicians, and taKe a morwa aia light in discovering conflict of medical opi nion. They go to some doctor, and when they have extracted an opinion from him, they suddenly turn round and say that his views are totally at variance with those of the re nowned Sir Kappa Chi, and derive little coun tenance from the views of Dr. Lambda. Some doctors become reticent in their opinions, and are afraid to deliver a judgment until they know what may be the opinion of the great authorities. But, for the most part, the general practitioner will give his own views; and if they are at variance with those of the great authorities he will declare that the great authorities are in the wroug. I do not think, however, that the patient has been in the w rong. In the multitude of coun sellors there is wisdom, and an obscure case has the fullest chance of being properly under stood w hen it has been submitted to different medical lights. The diagnosis Is the making out of what Is exactly the matter with the patient; the prognosis is the judgment made, with more or less certainty, of the issue of the dipnse. Some doctors attain a wonderful skill in both respects. They can almost complete both diugnosli and prognosis by locking at a jntieut'H luce. 'It' is aver' c'.'ifbnlt c.:-e." uid a civ.iwi me Uy W ft eat, ' hul I 111 tell you ove thing for your consolation, which is tnni you will well." Tins proved to be the case, but, singularly enough, the ivat inSn himself died suddenly before he the patient ugain. .As a man for the first t f mo was entering a physician's consulting-room, the i;:uer -inspired io a ii lend, "Case of great p:iin, I am sure muscle adhering to bone chronic and hopeless" as it proved. The same man was walking downs street, and at tho door of an hotel was a smiling landlord, portly, fresh-colored, and apparently robust'. 'J he friend made some casual remark, to the effect that there was a typical Briton, er some thing of that kind. "You think so," said the doctor. "That man is safe to die within a twelvemonth." The diagnosis, sometimes tasy enough, is occasionally perplexing iu the extieme. The great majority of cases are patent enough; au experienced physician will . see it all in live minutes; but others are ex ceedingly obscure, and the medical man is tever quite al.le to clear up the obscurity. Sometimes there is some little circumstance, unexpected and out of harmony with other circumstances, which baflles all the calcula tions. "In every respect the patient is going on extremely well," said a doctor to an anxious member of a family; "but I confess there is a little twiching over the eye which I do not at all like." The case terminated fatclly. It sometimes happens that when a patient, by all the rules ot art, ought to be getting better or worso, he persists in getting worse or better. 'It 13 a question of the pa tient's previous history and constitution; a slight attack in one case beiug more dangerous even than a dangerous attack in another. I remember being very much amused with the case of a young doctor and his first patient. It was a child afflicted with hydrocephalus. According to all the rules the child ought to die. Nevertheless, the untoward infant per sisted in not dying. The doctor went from his books to the bedside, and from the bedside to his books. He confidentially asseverated to me that the infant ought to die, and mani fested a not altogether friendly feeling towards the infant because it did not die. His treat ment was altogether better than his prognosis: at the time w hen my knowledge of the case teiminated, it was going on well. It is very hazardous lor a doctor to give a prognosis; if he openly gives an unfavorable prognosis, and the case terminates favorably, his reputation is wellnigh gone. But you will not often find a medical man doing this sort of thing. As a rule, the doctor always takes the most cheerful view possible of a case, and even hopes against hope. In the last illness of George IV, the physicians were also pro nouncing him better, and in the midst of tha "betternesa" he died. Other doctors, how ever, there are, morbidly disposed, from whom you may take every grain of comfort they give, and something more. It is curious that a doctor cannot always be trussed with tha diagnosis and prognosis of his own case. The great Dr. Baillie is said to have been a case of this. He is said to have died of consumption, and' yet to have denied that he was con sumptive. He did not experience any diffi culty in breathing, and argued that, while his breathing was good, his lungs could not be bad. But no medical man now takes this as decisive. Nature, in her bounty, provides a larger space of lung than is necessary, and will long go on with a very small amount of lung, and with very little difficulty in breath ing. . Another noteworthy case of lung disease is a very different person, the noto rious empiric, St. John Long. He professed to cure consumption, but in reality, like other similar quacks, he only cured cases of cough and bronchitis with symptoms imitative of those in phthisis. He unquestionably caused death in several instances by a treat ment which would be perfectly harmless in most cases, but which was fatal to many delicate women. He was himself struck down by consumption, and died at the early age of thirty-seven. One of our most pro mising doctors In chest complaints, Dr. Hope, who at an early age had reached almost the summit of his profession, was prematurely cut off by consumption. There are few volumes more affecting than the narrative of his life; and it is impossible to resist the impression that his fatal illness was in great measure due to extreme and unmitigated devotion to intel lectual labor. . Medicine has often very startling surprises in store, which are frequently gloomy enough, though sometimes of a pleasant nature. We will, in' the first place, select some of the former. A clergyman in the neighborhood of Mount Edgecumbe was one day walking very fast, when he was met by his doctor. He ex plained, in conversation, that he was suffer ing from pains of indigestion, and was in the habit of taking long walks in order to get rid of them. The medical man insisted on exa mining him, and then explained to him that he was in fact suffering from aneurism of the heart, and that these long walks were the worst things possible for him, and was obliged to add that the disease would some day prove suddenly fatal. The statement was sadly verified. In the midst of a sermon; at a very emphatio passage, the preacher fell down from his pulpit, and life was found to be quite extinct. The congregation broke up ia the utmost consternation and terror. A man was in company with another, and from some casual circumstance he took off his stockings. His friend took the liberty of observing that one of his feet was really very black. It was discovered that from some cause the foot was mortified. In former times it would have been theught necessary to amputate it, but medical art has contrivances whereby this is avoided. A very remarkable case is men tioned by the pious Bishop Newton, In the valuable fragment, of the "Antobigraphy" which has come down to us. A young noble man in the country was dangerously ill with a fever. Physicians were bummoned from difi'erent quarters, and the bishop relates that no Jess a sum than seven hundred guineas was paid to them as fees. All the means used were unavailing, and the patient sank raoidlv. When he was quite given over, and left alone to die, he w as heard to muimur a request for beer. A larpe goblet, containing nearly a quart of small beer was handed to him which he drained at a draught, and then' drank again. He recovered. I think I recollect also a similar case Iu one of the London hospitals. A mau was talking one day at a dinner-table with a physician! and he mentioned a particular circumstanoe occurring in his own iustance. "I do not mind mentioning to a man like you " said th doctor "that that Is a sign of the existence of a cavity In the lung." A man who had been adiLg tor a long time was persuaded by a friend to consult an tmiuent physician. He X.norTl inglywept to t he conning ro0ni and an animation he was significantly ask.d by as pestilence () the other hand the utmost happiness had been caused when men had made up their minds for the worst and had then been dit,ibuKed of some mistaken notion. Suoh an ncui.ciice is not uutiequMnt. One of the latest fees ever known iu the profession was iun to W, Astley Cooper, wh UUht ...... - i'"ujto mas, no only liveii a fiirt wKh f ?T'in,'f n1 L7e U -aot a c Jein wluh he died of the doctor rather than of disease; tor the panic destroy nlmnaf i.
Significant historical Pennsylvania newspapers