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We think the world is progressing in enlightenment; I suppose it is–inch by inch. But it is not easy to name an age that has cherished more delusions than ours, or been more superstitious, or more credulous, more eager to run after quackery. Especially is this true in regard to remedies for diseases, and the faith in healers and quacks outside of the regular, educated professors of the medical art. Is this an exaggeration? Consider the quantity of proprietary medicines taken in this country, some of them harmless, some of them good in some cases, some of them injurious, but generally taken without advice and in absolute ignorance of the nature of the disease or the specific action of the remedy. The drug-shops are full of them, especially in country towns; and in the far West and on the Pacific coast I have been astonished at the quantity and variety displayed. They are found in almost every house; the country is literally dosed to death with these manufactured nostrums and panaceas–and that is the most popular medicine which can be used for the greatest number of internal and external diseases and injuries. Many newspapers are half supported by advertising them, and millions and millions of dollars are invested in this popular industry. Needless to say that the patented remedies most in request are those that profess a secret and unscientific origin. Those most “purely vegetable” seem most suitable to the wooden-heads who believe in them, but if one were sufficiently advertised as not containing a single trace of vegetable matter, avoiding thus all possible conflict of one organic life with another organic life, it would be just as popular. The favorites are those that have been secretly used by an East Indian fakir, or accidentally discovered as the natural remedy, dug out of the ground by an American Indian tribe, or steeped in a kettle by an ancient colored person in a southern plantation, or washed ashore on the person of a sailor from the South Seas, or invented by a very aged man in New Jersey, who could not read, but had spent his life roaming in the woods, and whose capacity for discovering a “universal panacea,” besides his ignorance and isolation, lay in the fact that his sands of life had nearly run. It is the supposed secrecy or low origin of the remedy that is its attraction. The basis of the vast proprietary medicine business is popular ignorance and credulity. And it needs to be pretty broad to support a traffic of such enormous proportions.

During this generation certain branches of the life-saving and life-prolonging art have made great advances out of empiricism onto the solid ground of scientific knowledge. Of course I refer to surgery, and to the discovery of the causes and improvement in the treatment of contagious and epidemic diseases. The general practice has shared in this scientific advance, but it is limited and always will be limited within experimental bounds, by the infinite variations in individual constitutions, and the almost incalculable element of the interference of mental with physical conditions. When we get an exact science of man, we may expect an exact science of medicine. How far we are from this, we see when we attempt to make criminal anthropology the basis of criminal legislation. Man is so complex that if we were to eliminate one of his apparently worse qualities, we might develop others still worse, or throw the whole machine into inefficiency. By taking away what the phrenologists call combativeness, we could doubtless stop prize-fight, but we might have a springless society. The only safe way is that taught by horticulture, to feed a fruit-tree generously, so that it has vigor enough to throw off its degenerate tendencies and its enemies, or, as the doctors say in medical practice, bring up the general system. That is to say, there is more hope for humanity in stimulating the good, than in directly suppressing the evil. It is on something like this line that the greatest advance has been made in medical practice; I mean in the direction of prevention. This involves, of course, the exclusion of the evil, that is, of suppressing the causes that produce disease, as well as in cultivating the resistant power of the human system. In sanitation, diet, and exercise are the great fields of medical enterprise and advance. I need not say that the physician who, in the case of those under his charge, or who may possibly require his aid, contents himself with waiting for developed disease, is like the soldier in a besieged city who opens the gates and then attempts to repel the invader who has effected a lodgment. I hope the time will come when the chief practice of the physician will be, first, in oversight of the sanitary condition of his neighborhood, and, next, in preventive attendance on people who think they are well, and are all unconscious of the insidious approach of some concealed malady.