entrance of, the material necessary to the healthy organisation of every part of the human frame? To bleed or starve a person having a hereditary predisposition to spitting of blood or apoplexy, is the most certain method to develop these diseases in their worst forms! Yet this is the daily practice of the most eminent physicians! one among many proofs, that, in the medical profession, eminence is less frequently attained by successful results in practice, than by the dexterous employment of all those arts and intrigues with which mediocre but unscrupulous minds too often beat men of genius in the race. So far as practice is concerned, the eminent physician generally confines himself to the fashion of the day-the more especially, if that fashion be profitable to the apothecary; for in such cases he is sure to become the fortunate puppet of those whose bread depends, not so much upon the cures they shall effect, as the quantity of physic they shall manage to sell! What a happy nation of fools must that, be, which suppose that any class of mankind will put the interests of the public in competition with their own!— Benighted and misguided people! you call upon men to relieve you from your sufferings, while you hold out to them the most powerful of temptations to keep you on your sick beds! You pay for time, what you deny to talent; for a long illness, what you refuse to a speedy recovery! Do you think medical men angels, that you thus tamper with their integrity? Your very mode of remunerating them almost forces them to be corrupt-and that, too, at a moment when their numbers are so great, it is utterly impossible for one half of them to live honestly on their mere professional gains. Hear Mr. Abernethy on this subject:-"There has been a great increase of medical men, it is true, of late years; but, upon my life, diseases have increased in proportion." He might have added," And they are longer of being cured."

To return to the subject of Ruptured Blood-vessel. You will find that in every case, except where it has been produced by mechanical or other local agency, this disease is the effect or developement of general intermittent fever; the symptoms of which fever vary in their degree of severity with every case, in one being bold and well marked; in another, so softened and subdued, as almost to escape the patient's own observation;-curable, too, like the simplest ague, by the cold dash or an emetic given during the hot fit ;and to be prevented from recurring by chrono-thermal treatment during the interval of remission. One case will yield to opium or arsenic, another to copper, quinine, or prussic acid, and some few will trouble you to cure them at all-for what will agree with one constitution, may, as we have too often seen, disagree with another. I could give dozens of cases of every kind of constitutional hæmorrhage cured in this manner; but the details of one would be the details of all. Yes, Gentlemen, I repeat, by the early use of emetics, the proper application of heat and cold in the different morbid conditions of the body constituting the febrile fit, and by the judicious exhibition of the chrono-thermal medicines during its remission, I have successfully treated every kind of hæmorrhagic disease. The same system of treatment has enabled me effectually to cure many cases of Enlarged Veins-Varicose Veins, as they are termed and the mention of this recalls to my recollection the case of an aged female who had a painful varicose ulcer-that is, a sore with blood-vessels opening into it-for which I prescribed the internal use of arsenic, with almost immediate relief to her pain, and the subsequent cure of her ulcer. From the happy result of that and other similar cases, the surgical mechanic may learn that there are other and better modes of treating "varicose veins," than by bandages and laced stockings. Well, then, I have said all I mean to say upon the subject of Hæmorrhage, and I have anticipated something of what naturally belongs to the treatment of Diseases of the CHEST. Of these I must now speak at some length.

It has ever been the policy of teachers and professors to affect to penetrate farther into a millstone than their pupils; and, seeing that for the most part such professors know as little of their particular subject as those they pre

tend to enlighten upon it, so far as their own reputation is concerned, they are doubtless right! The great medical millstone of the present day is the CHEST, and Laennec's bauble, the divining rod by which our modern sages pretend to have obtained their knowledge of it. If you believe them, a hollow piece of stick they have nicknamed "the Stethoscope," is the greatest invention of these times! By means of it you may discover every motion and change of motion that ever took place in the organs within the cavity of the chest, and some that never could take place in them at all. What an invaluable instrument must it be, that stethoscope! The enchanter's wand was nothing to it! But, seriously speaking, just observe how gravely your hospital tyros hoodwink and hocus each other with the phrases hypertrophy" here, and 'atrophy" there; "caverns" in this place, and "congestions" in that—to say nothing of "rhoncus" and "râle," " egophony" and " 'sybilus"—and heaven knows what other sounds and signs besides sounds and signs which, in the greater number of cases, have as much of truth and reality as the roar of the sea with which the child deludes his fancy, when holding a shell to his ear!

Let me first speak to you of

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DISEASES OF THE HEART.

Do not the subjects of every kind of Heart-affection tell you they are one day better, another worse? How shall we speak of diseases of this organ? of palpitation and temporary cessation or remission of its action?-disorders constantly misunderstood, and as constantly maltreated. Complain but of flutter or uneasiness in any part of the Chest, the stethoscope-the oracular stethoscope--is instantly produced. Astonished—in many instances terrified-the patient draws his breath convulsively-his heart beats rapidly-and the indications obtained by means of this instrument, at such a moment of doubt, anxiety, and fear, are registered and recognised as infallible. "Have we not had too much talk of Heart-Disease since the stethoscope has come so gene rally into vogue?" That was a question asked some years ago by the late Dr. Uwins. Let Dr. James Johnson answer it. For reasons which I shall by-and-bye make you acquainted with, I prefer his evidence here to that of any other physician. In one of the numbers of the Lancet, he is stated to have said at a Medical Society 'It was a common error in young practitioners to consider the heart as organically diseased when its functions only were much interfered with, and this error has become more general, he was sorry to say, since the STETHOSCOPE has come into use." Dr. Johnson confines his observation to young practitioners-himself not coming under that head--but I have seen men as old as he make the same mistake, and those, too, enjoying a great reputation for stethoscopic sagacity.

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Patient after patient,-medical as well as non-medical,-have come to me with the fatal scroll of the stethoscopist-their hearts palpitating, their limbs trembling, as they gazed in my face, expecting to read there nothing short of a confirmation of their death-warrants; yet of these patients, many are now living and well, and laugh, as I hope to make you laugh, at both the instrument and its responses. How little must that man know of his duty as a physician, who would deprive a fellow creature in distress of the balm of hope-how little can he appreciate the influence of the depressing passions on the bodily sufferings of the sick! Yet with these eyes have I seen, hands of the patient, the written announcement of his doom, an announcement which afterwards turned out to be utterly unprophetic and false. How un warrantable in any case to intrust the patient with such a document !

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Let the practitioner withdraw his eye, for a time, from a mere symptom; let him observe how other muscles of his patient palpitate at times, like the heart, and act, like that, convulsively finding these symptoms to be remittent in every case, and complicated with others, all equally rémittent, would

he still persist in his small bleedings, his repeated leeches, his purges-measures of themselves sufficient for the production of any and every degree of organic change, he already fancies he has detected! Would he not rather reflect with horror on his past treatment, and endeavour, by another and a better practice, to enable his patient to escape the sudden death to which, in his imagination, he had devoted him? How many a physician, by such a prognostic, has obtained unmerited credit for foresight and sagacity, while he only taught the patient's friends to be prepared for an event, he himself was materially contributing to hasten! Truly, in this case at least, prophecies do tend to verify themselves!

Gentlemen, I have seen two stethoscopists examine a patient with supposed Heart-disease, and come to the most opposite conclusions,-one declaring the organ to be enlarged, the other assuming with equal confidence that it was the reverse! The utter absurdity of attempting to distinguish, during life, one form of Heart-affection from another by any particular sign or symptom, is sufficiently proved by this one fact, that mere functional variation of its motions may produce every symptom of a real change in the structure of the organ itself. But even could such a distinction be effected to the nicety of a hair, the knowledge of it would not be worth a rush for any practical purpose; inasmuch as the remedies for every kind of chest-disease come at last to the same agency, whether that agency be directly applied to the surface of the body in the shape of cold or heat, or be externally or internally administered in the form of medicines that electrically influence the corporeal motions through the medium of the brain and nerves. By the chrono-thermal system of practice, I have successfully treated every kind of Heart-disease which ever came, or could come, under the notice of the physician-setting aside, of course, original malformation of the organ. I will give you some cases in illustration:

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A gentleman, age 30, had been ill for a long time, particularly complaining of his heart, the action of which organ was generally below the healthy standard, and it also palpitated occasionally. So great was his mental depression, that the smallest trifle produced tears. The temperature of his body generally was below that of health, and he suffered much from coldness of feet; remissions he of course had, being better at particular times. As he did not improve in the country, he thought he would try a London doctor; so he came to town and consulted the late Dr. Hope, author of a work "Diseases of the Heart." The stethoscope in this case was as usual applied to the chest; its annunciation was sepulchral. HOPE here told no flattering tale," for not only was the heart pronounced to be enlarged, but a fatal result was prophetically expressed. The treatment prescribed was not ill calculated to verify the prediction-carscarilla and ammonia,-with aperients! and a bleeding every month, or six weeks!! The patient's health, as you may readily suppose, got worse and worse daily; he became much emaciated in his person, and completely prostrate in mind. To sum up all, he had a tendency to fainting fits; in which state, by the advice of Dr. Selwyn of Ledbury, he came to me. You already guess the practice I adopted-chrono-thermal, of course. Yes, Gentlemen, I ordered him first a combination of prussic acid and creosote, which I afterwards followed up by arsenic and quinine. I also prescribed a generous diet, with wine. Well, what was the effect of this?-Why, notwithstanding the depletion to which he had been subjected, he improved daily, and in about six weeks had become so well as to be able to resume his profession-the law, which he had been obliged to leave off. Indeed, a letter I afterwards received from Dr. Selywn, gave me the news of his marriage. Yet this patient, according to the stethoscope, should have been dead and buried long ago!

Gentlemen, in confirmation of the value of Arsenic in disease of the heart, the details of a case from Darwin, who wrote, be it remembered, in the last century, may not be deemed unimportant :-" A gentleman, 65 years of age,

had for about ten years been subject to an intermittent pulse, and to frequent palpitations of his heart. Lately the palpitations seemed to observe irregular periods, but the intermission of every third or fourth pulsation was almost perpetual. On giving him four drops of a saturated solution of Arsenic about every four hours, not only the palpitation did not return, but the intermission ceased entirely, and did not return so long as he took the medicine." The cases I shall now give are three of many such which have occurred in my own practice :

Case 1.-A young lady was afflicted with palpitation of the heart, occasional cough, and so great a difficulty of breathing as to be unable to sleep, except when supported with pillows. She had frequent shivering fits; her abdomen and legs were much swelled, and her symptoms altogether so distressing, as to leave her friends with scarcely a ray of hope. Nevertheless, by the employment of silver, quinine, and prussic acid, she did eventually recover, to the surprise of all who knew her. Remissions were well marked in this case.

Case 2.-A young gentleman, aged 16, had violent palpitation of the heart, headache, craving appetite, and some thirst, with great depression of spirits. He was much emaciated, and had a tendency to eruption of the skin. His hands and feet, which were generally cold by day, became during the night so hot, as frequently to keep him from sleeping. By a course of cold-plunge baths, alternated with the shower bath, and by the use at the same time of quinine and iron in combination, this young gentleman was completely restored to health-every one of the above symptoms having disappeared in a few weeks. He is now serving with his regiment in India, having reached

the rank of lieutenant.

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Case 3.-Major M‘P. -'s heart palpitated so violently at times, that could see the motions in a distant part of the room. This was the case when I was asked to see him. I ordered him prussic acid and musk, which stopped the palpitation in about two minutes after he took it. In the middle of the night he had a threatening of the complaint, but it was at once arrested by the same medicines. A continuation of them for about Six weeks cured him completely.

Before dismissing affections of the Heart, I must tell you that the greater number of these complaints depend less on any defect in that organ than upon a weakness or want of power in the Brain to control the motions of the heart -and of this you may easily convince yourselves by putting the question to the patient: How do you feel when anything disturbs your mind? The answer will almost invariably be, "Oh, it brings on the palpitation at once," or the pain, as the case may be. Gentlemen, strengthen the brain, and in few instances will you have any trouble about the heart. The Brain is the great controller of every function-it is the true key to all good treatment. We now come to consider

PULMONARY CONSUMPTION, OR DECLINE.

When you see a person harassed with cough, and losing his flesh, and if, at the same time, he complain of shortness of breath and pain of the chest, and begin to expectorate a muco-purulent-looking matter, you may certainly set down that man's disease as Consumptive; for not only is the general health in that case manifestly wrong, but the lungs are more or less implicated -and what does it signify in which of their tissues? what does it signify whether it be their mucous membrane, their glands, or their interstitial substance? Should the patient's general health improve under your treatment, he will naturally live as long as it continues to do so; if not, and if it as progressively continue to get worse, he must die! Any further discussion of the matter, quoad hoc, resolves itself into the interminable question of Tweedledum and Tweedle-dee!

"Can consumption be cured?" asked Mr. Abernethy, adding in his own sarcastic manner, "Odd bless me! that's a question which a man who lived in a dissecting-room would laugh at. How many people do you examine who have lungs tubercular which are otherwise sound? What is Consumption? It is tubercle of the lungs; then if those tubercles were healed, and the lungs otherwise sound, the patient must get better; but if the inquirer shift his ground, and say, 'It was the case I meant of tubercles over the whole lungs,' why then, he shifts his ground to no purpose, for there is no case of any disease which, when it has proceeded to a certain extent, can be cured.”

The next question is, what are tubercles? I take this to be the true answer :-For the requisite lubrication of the mucous membrane of the cells, and other air-passages of the lungs, there must be a certain amount of secretion. To supply this secretion, I need not tell you, there must be a glandular apparatus. A number of minute and almost imperceptible Glands, accordingly, do intersperse the entire tissue of the lungs-the pulmonary tissue, as it is called-and abound more particularly in the upper portion of it-that identical portion in which pathologists imagine they have detected the commencement of consumption. But what they call the commencement is nothing more than an EFFECT or development of general constitutional disorder. If it be the beginning, it is the beginning of the end-the end of previous repeated febrile paroxysms of greater or lesser intensity. During such constitutional disorder, and particularly during the course of severe fevers-such as a long remittent fever, the fevers termed small-pox, measles, and the like -these minute pulmonary glands become diseased, there being a previous predisposition of course; in other words, these glands being the original weak point of individuals having the consumptive tendency. Tubercles, then, are diseased pulmonary glands. How many people have traced the consumption of their children to the small-pox or measles; but would any man in his senses say the consumption was the cause of these fevers? Here it must have been the effect, and so also it may be the effect of any other kind of Fever, and in no case can it be the cause of such fever though, as in the giving way of any other part of the body, the local disease may in the course of time aggravate and keep up the febrile state. The affected gland is in this instance at first almost microscopically minute; but as the disease advances, it swells and becomes of a reddish grey colour, or it may at once take on a suppurative action-it may become an abscess varying from the size of a pea or less to that of a walnut or more; or it may go on enlarging to any extent without suppuration or becoming an abscess at all; the function of the affected lung in this case being, nevertheless, as completely disturbed as if it did take on the suppurative state; but in most cases of consumptive disease, both kinds of disorganization go on at the same time, one gland or cluster of glands suppurating, and sooner or later bursting and discharging their contents into the air-passages, rendering the lungs at the same time more or less cavernous and hollow; another gland or cluster of glands swelling and coalescing so as to fill up and solidify the air-cells of the part they occupy. These at least are among the principal changes to be found in the lungs of persons who die of consumption; and they are all, as I have already stated, more or less gradually produced in the course of repeated paroxysms of general remittent disorder. The matter expectorated by the patient consists of the contents of the tuberculous abscess, and more or less mucus, sometimes mixed with blood; while the cough may be either produced by a lodgment of matter in the air-passages, or be a spasmodic effect of the cold air coming in contact with the ulcerated surface of the diseased lungs; almost every patient, however, has it periodically more or less severe. To understand this subject in all its bearings, you have only to observe the more palpable changes which take place in the glands of the Neck of certain patients. These glands, in the healthy living subject, can neither be seen or felt; but apply any general influence that shall excite Fever in an individual