cold shiverings, the experience of almost every case will tell you; but as your minds may be too much occupied with school theories to mark that fact for yourselves, I will give it to you in black and white in the words of Darwin. Speaking of some cases of the disease, he says: "The patients, after a few days, were both of them affected with cold fits like ague-fits, and their feet became affected with gout." To meet it in a proper manner, you must treat the disease purely as an ague. With quinine, arsenic, opium, and colchicum, I have cured it scores of times; and truth obliges me to say, I have in some cases failed with all. Now what can I say more of any other disease? Every day you hear people talk of the "principle" of a thing, but really without knowing what they are talking about. The true meaning of the word "principle" is UNITY-something simple or single to which you may specially refer in the midst of an apparently conflicting variety. That a perfect unity of type pervades all the variations of disease is indisputable, and of the correctness of a unity or principle to guide your treatment, there is as little doubt. What, then, are all your school-divisions but "flocci, nauci, nihili, pili!" I shall now give you a case or two which may perhaps suffice to show you my treatment of gout.

Case 1.-Colonel D, aged 60, had a fit of gout which came on every night, and for which leeches and purgation had been ineffectually prescribed, before I was called in. I ordered a combination of quinine and colchicum, but as this did not stop the fit, I changed it for arsenic, after taking which, the patient had no return.

Case 2.-Captain M, aged 56, had a fit of gout which recurred every night during his sleep. I prescribed arsenic without effect; I then gave him quinine, which acted like magic. The same gentleman, twelve months after, had a recurrence, but was much disappointed, on resuming the quinine, to obtain no relief. I then prescribed arsenic, which, though it failed the year before, this time perfectly succeeded! a lesson to such as would vaunt any remedy as a specific for any disease.

The influence of the passions in causing or curing gout is well known.One of many cases so cured comes just at this moment to my mind. A country clergyman was laid up with a severe attack of the gout-his wife having heard of the effect of surprise in cases of the kind, dressed up a large hare in baby clothes, and brought it to his bed-side, telling him how fearfully changed their child had become. The old gentleman eyed the animal with a look of terror, sprung out of bed, and complained of his foot no more! Now, Gentlemen, as gout, like ague, is a remittent disease, and curable in the same manner-whether by mental or physical agency-what right have we to assume that its cause is a "morbid ingredient in the blood," any more than that the cause of ague is? Still, let us suppose for a moment that it is the effect of a "morbid ingredient in the blood;" what, then, allow me to ask, is this morbid ingredient doing all the time of remission? Does it sleep or wake during this interval of immunity? and how comes it that arsenic, quinine, and colchicum so often neutralise its effects-while purgation and blood-letting, in too many instances, produce a recurrence? In a word, is not this "morbid ingredient in the blood" a mere crotchet of Dr. Holland's brain?-a goblin-a phantom-that, like other goblins and phantoms, disappears the moment the daylight comes in!

Having stated my reasons for dissenting from Dr. Holland's hypothetic view of the case of gout, it may not be out of place here to request your attention to some points of infinitely greater importance, upon which that physician and myself, by some curious fatality, maintained a remarkable COINCIDENCE of opinion. The following passages occur in his Medical Notes and Reflections.

"Has sufficient weight been assigned in our pathological reasonings to that principle which associates together so many facts in the history of disease, namely, the tendency, in various morbid actions, to distinct INTERMISSION

"The sub

of longer or shorter duration, and more or less perfect in kind ?" jection of so many diseased actions to this common law, establishes RELATIONS which could not have been learned from other sources, and which have MUCH VALUE EVEN IN THE DETAILS OF PRACTICE!"

Again, he says, "It will probably be one of the most certain results of FUTURE research, to associate together, by the connexion of causes of common kind, diseases now regarded as wholly distinct in their nature, and arranged as such in our systems of nosology. This remark applies very widely throughout all the genera of disease." "We can scarcely touch upon this subject of FEVER (particularly that which our present knowledge obliges us to consider as of idiopathic kind), without finding in it a bond with which to associate together numerous forms of disease, but withal a knot so intricate, that no research has hitherto succeeded in unravelling it."

Now, what does Idiopathic mean? It means peculiar or PRIMARY—in opposition to SYMPTOMATIC disease, or diseases of long standing. The profession, then, according to Dr. Holland-and he is quite right-have been all perfectly in the dark in regard to the beginning of the disease. The "knot" they have for so many centuries been trying to unravel, I hope he, they, and every body else will now consider as completely untied; but not, as I shall in a few minutes prove, in consequence of Dr. Holland's " prediction."

When speaking of the influenza and other epidemics, Dr. Holland says: "I may briefly notice the singular analogy to the milder forms of Typhus and intermittent fever which these epidemics have occasionally presented." Why be puts typhus BEFORE intermittent fever, I know not; but this I do know, that except where badly treated, the influenza seldom takes the "typhoid" shape. However, Dr. Holland admits he has prescribed bark in influenza with very great advantage.

On the subject of temperature, the same physician thus speaks:-" The patient may almost always choose a temperature for himself, and inconvenience in most cases, positive harm in many, will be the effect of opposing that which he desires; his feeling here is rarely that of theory, though too often contradicted by what is merely such. It represents in him a definite state of the body, in which the alteration of temperature desired is the best adapted for relief, and the test of its fitness usually found in the advantage resulting from the change. This rule may be taken as applicable to all fevers, even to those of the exanthemateous kind." By such terms, medical men understand small-pox, chicken-pox, measles, and scarlet fever. Some include the plague.

Dr. Holland asks: "Is not depletion by blood-letting still too general and indiscriminate in affections of the brain, and especially in the different forms of paralysis? I believe that the soundest medical experience will warrant this opinion. The vague conception, that all these disorders depend upon some inflammation or PRESSURE which it is needful to remove, too much pervades and directs the practice in them; and if the seizure be one of sudden kind, this method of treatment is often pursued with an urgent and dangerous activity." "Theory might suggest that in some of these various cases, the loss of blood would lead to mischief. Experience undoubtedly proves it; and there is cause to believe, that this mischief, though abated of LATE YEARS, is still neither infrequent, nor small in amount.' It is now the fashion of fashionable practitioners to say, "Oh, there has certainly been too much bleeding," and "Oh, we don't bleed as we used to do;" but it is not so convenient for them to tell who opened their eyes to their errors.

* *

Now, Gentlemen, if any of you be disposed to question by whose influence this abatement of mischief was principally brought about, I may suggest that, from numerous letters I have received ftom medical men, long before Dr. Holland's volume first appeared, my writings must at least have in something contributed to it. Dr. Holland's work, from which I quote, was published by Messrs. Longman and Co., in 1839. Mark that date, and mark also, if you

please, that it was in the year 1836, THREE YEARS before, that the same pub lishers brought out my work The Fallacy of Physic as taught in the Schools, wherein I stated :

1. "We hope to prove, even to demonstration, that FEVER, Remitlent or Intermittent, comprehends every shape and shade which disorder can

assume."

2. "That many cases of disorder have been observed to partake of the nature of Remittent Fever, and to derive benefit from the modes of treatment adapted to that periodic distemper, we are sufficiently aware. But we have yet to learn that any author, ancient or modern, has detected that TYPE, and advocated that TREATMENT in every shade and variety of disease."

3. "That attention to Temperature is the end of all medicine."

4. "That Blood-letting might be advantageously dispensed with in all diseases, even in APOPLEXY."

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Gentlemen, some of you may have read an anecdote of Dennis the Critic. Having invented a new mode of producing theatrical thunder, he submitted his discovery to the managers; but their high mightinesses only affected to laugh at it. Some weeks afterwards, he went to see a play, in which there was a thunder-scene. Now," thought Dennis, "is my turn-now I can afford to laugh at their thunder as much as they laughed at mine;" but judge his surprise, when, instead of the farcical squall he expected, his ears were saluted with a thunder as terrible and true as the "hurly-burly" of his own invention. Perceiving, in an instant, the trick that had been played him, he cried aloud, "By G-! that's my thunder!" This, or something like thisalways excepting the irreverent adjuration-was the sentiment that escaped me when I first perused the passages I have read to you from the Medical Notes and Reflections. These are MY doctrines," I said; "ay-the identical doctrines which Dr. James Johnson, physician-extraordinary to the King deceased, two years before, stigmatised as a PYREXY-mania, or FEVERmadness. How will he receive them now-now that they are patronised at "second hand" by an F.R.S. and a physician-extraordinary to the QUEEN that reigns?" That was my exclamation-and how did he receive them, Gentlemen? Why, he praised Dr. Holland to the skies; said he was this, and said he was that; and concluded by telling us that "it is impossible to lay down his book without an acquiescence in the decision of the public, which has placed him in the first rank among the practical physicians of the capital;" adding, moreover, that "his bearing toward his brethren is fair and open, and his candid mind, instructed by LIBERAL READING and polished by society, is willing to allow their meed of merit to all." But not a syllable did Dr. James Johnson say in condemnation of Dr. Holland's prophecy, that " FEVER” would one day be found to be "the bond with which to associate together numerous forms of disease;" nor did he remind him that when that prophecy was actually FULFILLED by me to the letter YEARS BEFORE he, Dr. Holland, took the trouble to make it, he, Dr. James Johnson, ridiculed it as a Fever-MADNESS! Gentlemen, if, in the course of his "liberal reading," the Author of the Medical Notes and Reflections NEVER saw the Fallacy of Physic as taught in the Schools-NOR the review of it by his patron Dr. Johnson! NOR Dr. Forbe's equally honest criticism of it!-NOR the controversy in the Lancet, to which the former gave rise !-NOR heard in "society" the remarks made by the laughter-loving part of the profession, when that controversy was concluded !-NOR met with the UNITY OF DISEASE-NOR the many reviews that were written upon it!!-you must acknowledge the "coincidence" to be curious--startling!!! And, further, you must admit that this "coincidence" affords another of many proofs of the truth of a DISCOVERY, which, when Dr. Holland--with the candor, I am willing, in common with Dr. Johnson, to allow him-takes into account dates, facts, and other similar trifles, I hope he will, in return, permit me now, henceforth, and for ever, to call MINE! Mean while, I have much pleasure in availing myself of

the testimony of a physician so eminent, in favour of its "VALUE, EVEN

IN THE DETAILS OF PRACTICE."

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[Shortly after the above observations made their appearance in print, Dr. Holland addressed to me a letter in "explanation." The correspondence which followed I am not quite at liberty to give, as the doctor expressed a wish that his communication should be kept "private." This much I may, however, state, that though couched in very polite, very diplomatic language, the "explanation" afforded by his letters did not appear to me to be any explanation at all. His observations might apply to this, that, or the other, or anything else! But seriously, if Dr. Holland intended to do more than shuffle me out of my discoveries, why did he send a “ private" answer to my published charge or insinuation, if he like it better? The concluding paragraph of his last letter is so adroitly worded, that, with or without his leave, must quote it. It gives me pleasure to know that you find anything of truth or useful sUGGESTION [suggestion!] in what I have published. And I shall be gratified by any opportunity which may hereafter occur of talking with you on these subjects, of common interest to us, out of print. [no doubt!] Ever, my dear Sir, yours faithfully, H. HOLLAND." New truths of a higher order," says an enlightened physiologist, "and of which the connexion is not seen with common and hackneyed doctrines, are scouted by all, and especially sneered at, denied, and abused by the base creatures who have just sense enough to see there really is something in them-who have just ambition enough to make them hate one who appears to know more than they do; and who have just cunning or skill enough to bias minds yet weaker than their own. To crown suitably such procedure, the doctrines at first denied are subsequently PILFERED with all the little art of which such minds are capable."-Alexander Walker on the Nervous System.] From this digression I now turn to

RHEUMATISM.

Like Gout, the word "Rheumatism" conveys nothing beyond the expression of the false theory which first gave rise to it. But as we are compelled, by long custom, to retain this among other equally unmeaning terms, I may tell you, that the profession of the present day class under it numerous affections of the great joints, particularly such as have come on suddenly, and are attended with much pain and swelling. You will find that these, in every case, have been ushered in by fever fits. The young and middle-aged are more liable to rheumatism than the extreme old. Like the gout, it is a remittent disorder, and Dr. Haygarth, long ago, wrote a work illustrative of the value of bark in its treatment. My own practice is to premise an emetic; this I follow up with a combination of quinine and colchicum. If that mode of treatment fail, I have recourse to opium, arsenic, guiaic, mercury, silver, turpentine, copaiba, arnica montana, aconite, or sulphur or combinations of them-all of which remedies have succeeded and failed in ague as well as in rheumatism. In most instance of acute rheumatism, the first combination will be found to answer perfectly; though in cases of long standing, you may have to run from one medicine and combination of medicine to another, before being able to bring about this desirable termination; and it is my duty to confess to you, that in some cases, particularly where either much depletion, or much mercury, or both, have been employed-as I grieve to say, they too often are in the primary treatment-you may fail with every means you may devise.

Under the head of rheumatism, medical men also include certain muscular pains, which occur in various parts of the body, but which are unattended by any apparent morbid structural development. With nitrate of silver and prussic acid, I have often cured these pains; and with the cold plunge-bath, I have sometimes succeeded after every other means had failed. Of my mode of treating acute rheumatism, I will give you two examples.

Case 1.-A young man, aged 25, had been suffering severely from rheumatism for four or five days before I saw him. At this time, the joints of his wrists and ankles were much swelled and exquisitely painful; his heart laboured, and was in such pain as to impede his breathing; his tongue was foul and furred, and he had been occasionally delirious. I offered an emetic, which was some time in operating, but when it did, the relief was signal. I followed this up with pills containing a combination of quinine, blue pill, and colchicum, and in two days he was sitting up with scarcely any swelling remaining in the affected joints; in two days more he had no complaint.Not a drop of blood was taken in this case.

Case 2. A gentleman, aged 30, after exposure to wet and cold, had a shivering fit with fever, in the course of which almost every joint in his body became swollen and very painful. He was bled, leeched, blistered, and took mercury to no purpose, before I was called in. I ordered him a combination of quinine, colchicum, and opium, which agreed so well with him, that in three days I found him free from every symptom but weakness, which I presume was as much the effect of the former sanguinary treatment, as of the disease; at any rate, he had certainly suffered very severely. But, Gentlemen, like every other disease incident to man, rheumatism may not only be cured without loss of blood, but without any physic at all; and in evidence of this, I will read to you an extract from the writings of Sydenham: "As to the cure of rheumatism," he says, "I have often been troubled, as well as you, that it could not be performed without the loss of a great deal of blood; upon which account the patient is not only much weakened for a time, but if he be of a weakly constitution, he is most commonly rendered more obnoxious to other diseases for some years, when, afterwards, the matter that causes the rheumatism (Sydenham, like Hippocrates, was a disciple of the Humoral School) falls upon the lungs, the latent indisposition in the blood being put into motion by taking cold, or upon some slight occasion. For these reasons, I endeavour to try for some other method different from bleeding, so often repeated, to cure this disease; therefore, well considering that this disease proceeded from an inflammation, which is manifest from other phenomena, but especially from the colour of the blood, which was exactly like that of Pleuritis, I thought it was probable that this disease might be as well cured by ordering a simple, cooling, and moderately nourishing diet, as by bleeding repeated, and those inconveniences might be avoided, which accompanied the other method; and I found that a wheydiet, used instead of bleeding, DID THE BUSINESS. After last summer, my neighbour Matthews, the apothecary, an honest and ingenious man, sent for me; he was miserably afflicted with rheumatism, accompanied with the following symptoms. He was first lame in the hip for two days; afterwards he had a dull pain upon his lungs, and a difficulty of breathing, which also went off in two days' time (both remittent), after which his head began to pain him violently, and presently the hip of the right side which was first seized; and afterwards, according to the usual course of the disease, almost all the joints, both of the arms and legs, were afflicted by turns. He being of a weak and dry habit of body, I was afraid that by taking away much blood, his strength, before but infirm, would be wholly vanquished; especially the summer being so far spent, it was to be feared winter would come before he could recover his strength, weakened by frequent bleeding, and therefore I ordered that he should feed on nothing but whey for four days. Afterwards, I allowed him, besides the whey, white bread instead of a dinner, namely, once a-day, till he was quite well. He, being contented with this thin diet, continued the use of it for eighteen days; only I at last indulged him in bread at supper too; he daily drank eighteen pints of whey, made at home, wherewith he was sufficiently nourished. After these days, when the symptoms did no more vex him, and when he walked abroad, I permitted him to eat flesh, namely, of boiled chickens, and other things of easy digestion; but