The convergence of the natural sciences upon the condition of civilized mankind constitutes the science of medicine, and this has for its main object the art of medicine; and this art of medicine naturally is divided into hygiene or preventive medicine and therapeutics. Therefore, practically, and from a utilitarian point of view, therapeutics is the art of medicine, as Trousseau has well said.

Therapeutics is eminently a progressive art; and its progress depends upon the extent of the knowledge of disease, and the accuracy of the observations through which disease may be modified or controlled. These conditions, being very variable in quantity and quality, give to therapeutics what often seems to be a very uncertain standing as it follows more or less closely upon more or less extensive knowledge and more or less accurate observation to make up the experience upon which it is based. Hence it is that modern therapeutics may be usefully divided into three kinds, which run insensibly into each other, but whose broadest distinction is to be found in the value they give to drugs.

A very large proportion of the profession seem so dissatisfied with their knowledge or skill, or with the results of their application of these, that they are in restless search for new drugs which are to be tried in order to find specifics. The therapeutic knowledge of this part of the profession is accepted from the ingenious and plausible drummer who leaves it with his samples for trial,-or from the flood of advertising papers, statements, certificates and cases published in this interest. In this spirit of empiricism everything seems worth a trial; or, rather, the only reasoning that is accepted is that

every new thing should be tried, in order that there be no risk of missing a valuable agent. To this class nothing seems absurd, nothing incredible, and it therefore becomes an easy prey to mercantile enterprise.

Another class consists of the altogether incredulous. Drugs and the experience upon which their action and uses are based, are together rejected, and the natural recuperative tendencies alone are trusted. A very few agents to relieve some of the expressions of diseased action is all they need or will accept, and the claim is that this alone is rational medicine. This class is not large, and is, perhaps, smaller than it would be if more accessible to professional or mercantile enterprise.

Fortunately, however, there is an intermediate class ready to apply the accurate methods of observation and research to the positions assumed by the other classes. These are supported by a principle of action which is based upon the corrected and recorrected observations and experience of the past. Their agents are not tried one after another in an empirical way, nor because they are new and well advertised, nor are they rejected because their action cannot be mathematically demonstrated, but they are used as definite means to definite ends, just as mechanical means are used to obtain mechanical results. The ultimate source of power or mode of action may be as little known as is the mechanical origin of life itself, whilst the operations and reactions may have been as well studied, and, therefore, be as well known, as those of mechanics or of chemistry.

The great advances made in therapeutics within the past ten years are well shown in the modified acceptation of the word "cure." No thoughtful physician who watches the progress and the leading of modern experience and investigation, and who properly sifts the results, will talk much of curing in the old acceptation of the idea; and one who does look upon diseases as specific entities to be cured by specific drugs-or, one who believes in specifics-at once places himself and his art upon a very low level, and his name is soon found among the multitude who certify to the novelties and fashions of the day in the almost universal drugging that now prevails. The doctrine involved in the idea that this is pneumonia and that is the drug which cures it, and, if not cured, that some new drug must be tried, must still long hold a diminishing ground among the masses, both professional and lay, but with the more intelligent, reading and thinking physician of the time it is a doctrine of the past. The

popular hold upon it is doubtless very strong, and will long be supported by the collateral money making interests involved in it, but slowly or rapidly it must die out.

If it could be promptly and generally recognized that the laws of health were as certain in their nature and operation as the laws of gravity, or any other physical laws, and that disease was mainly an expression of some violation of these laws, very much would be gained, because this is the true principle which underlies the whole medical art, and it would soon be practically realized that whatever does not accord with this underlying principle must be wrong. But suppose another step could be taken, and diseases, as simple violations of the laws of life and health, could be regarded, as they are, as mere loose combinations or groups of erratic or disturbing phenomena called symptoms, simple or complex, in proportion to the violation of law which they express, and named for mere convenience sake from the frequency with which certain prominent phenomena occur together or succeed each other, then another great gain would follow, for it would be easily seen that to return to the laws of health, and restore their operations, would constitute the only rational art of medicine. And if a rational art of medicine be clearly recognized, the irrationality of applying a drug to mend a broken or perverted law would be as clearly seen, and the irrational and hurtful part of the universal system of popular drugging would cease. The newspapers and journals would display their headings and publish their certificates of cures in vain. All these enormous sums of advertising money would be lost to them, and be gained or saved to the community at large; where, if expended in better food, better exercise, better dwellings and better clothing-or, in other words, in supporting and obeying, instead of violating the laws of life and health-the beneficent results would soon be apparent.

And yet hygiene and preventive medicine can never arrest the progress of therapeutics; much less can they ever render therapeutics unimportant or unnecessary. Diseases are, most of them, of the nature of injuries and accidents, and, as such, must always occur, and must demand some system of therapeutics acting through external counteracting agents, and the more rational and the more definite the system the better for mankind.

THE NEWSPAPERS AND THE NEW CODE OF ETHICS.

The newspapers, as representatives of intelligent public opinion, have had much to say upon the new code of medical ethics, and it has been almost all said on one narrow side of the question, and through misapprehension they have not done full justice to either side of the controversy. If they be the makers and leaders of public opinion, then in this case, at least, they have not taken the trouble to fully comprehend the issue, and in this "doctors' squabble," as they sometimes call it, have failed to recognize it as a matter of very grave public interest.

In ordinary topics of similar importance, the newspapers are generally found to take different and opposing views, and thus all sides of the subject are presented, and the danger of misleading the public is diminished. Again, most subjects are discussed by them upon some underlying principle, but here a most superficial view has been taken, and the assumed leading points have not been those of the true issue.

The following article, from the editorial columns of "The New York Evening Post," of June 9th, is reproduced here as a favorable example of what has been editorially written upon the subject, with unintentional though with a maximum ability to mislead; and it, perhaps, fairly shows the position taken in behalf of the lay public in regard to the profession of medicine in general, although the article is written from an exclusively homœopathic point of view.

The position taken appears to be that all who pretend to cure disease belong to the general profession, and that it is a mere matter of individual liberty to choose between the individuals of a general profession just as in the choice of a lawyer. No distinctive fundamental principles are recognized in medicine as in the sciences, law, theology, etc., but all seems to be regarded as hap-hazard empiricism wherein there should be absolute freedom of choice as to which empiric should be selected, and absolute equality and fraternity between all the empirics, quite independent of any underlying princi. ples of action.

A reply to the above-mentioned article, by this writer, in which an attempt was made to correct some of the misapprehensions, was published by the "Post," on the first page of its issue, of June 30, with a paragraph of editorial comment. These are also reproduced

here, in order that the articles may be read together for whatever influence they may have toward a correct understanding of the subject.

[From the "Evening Post" of June 9, 1882.]

DOCTOR AND PATIENT.

The action of the American Medical Convention, at St. Paul, in excluding the New York delegates, seems to have been from a professional point of view unavoidable. The New York State Medical Society had at its meeting in last February passed a vote permitting practitioners of the "regular" school to hold consultations with homœopathists. This vote was in conflict with the rules of the American Society, which had nothing to do but to punish the New York branch for its violation of them.

The action of the Association will probably lead to a new discussion of the matter in the New York Society, its action in February being regarded by its members as by no means conclusive. The view taken of the matter by the physicians who support the "code of ethics," as stated by one of them in an interview this morning, is that "no possible good could result from consultations in which there could by no possibility be an agreement;" and that "so long as they (the homœopaths) insist on the dogma that like cures like, we cannot but regard them as irregular, and no member of the regular profession can with dignity recognize them."

Now, if it could be proved in any way that it was true that "no good" could come of any such consultations, the position of the regular practitioners would not be worth disputing about. But it can only be true if homeopathic practice can be shown to be pure quackery. If homeopaths are mere quacks, who practice upon the credulity of the public, like astrologers or "weather prophets," then the regular physicians are performing a public service by discrediting them in every way that they can, and it is not merely undignified, but dishonest to consult with them.

But the homœopaths are not in this position at all. They constitute an important and growing branch of the medical profession. They have obtained legal recognition for their chartered institutions, and they have plenty of them. There are some 8,000 homoopathic physicians in the United States, and a dozen homoeopathic colleges, turning out a couple of hundred new physicians every There are, year. of course, no statistics to show how many families or individuals are dependent upon this body for medical advice and care, but it embraces a very considerable proportion of the population, whom it would be appalling and absurd, too, to think of as given over entirely to the care of quacks and cheats.

The fact is that medical science is not in a condition which entitles any one to say that the profession of a particular dogma like that of the homeopaths makes him an impostor. What little is known about the effect of drugs upon the human body is the result