THE ST. LOUIS CLINICAL REVIEW.

PHILO G. VALENTINE, A. M., M. D., EDITOR.

By the above heading I mean to designate the practices of those who, like Declat, undertake to kill the microphytes which it is generally admitted are present in the blood and other tissues in a number of diseases, and are supposed by many to cause them, though the proof is not yet positive. Declat claims to accomplish his purpose by the introduction of phenic acid into the system in quantities sufficient to destroy the microphytes, yet with safety to the parties experimented on. Other drugs have been tried, but this is the most popular.

Now, I am aware that to conduct an experiment properly the result should not be anticipated, and I am also aware that no amount of reasoning or argument will affect the real result of any experiment; but I believe that reason and common sense should be exercised in the direction of experiment. For instance, I believe that reason should guide a man not to attempt to lift himself by his boot-straps. In the practice of medicine, especially, should experiment be conducted with the best of judgment and common sense, because of the ob

scurity and uncertainty of results. Coincidence is so liable to be mistaken for the relation of cause and effect, and general conclusions are so liable to be drawn from a few or a single instance, that the most extensive experience affords far from positive proof of any hypothesis. I have only to remind you of the various doctrines that now seem to us absurd, but have been believed true in former times by men of just as good parts as any we have now, to convince you that experience in the practice of medicine may be delusive and that the scientific moguls of the present are as likely to be mistaken as the eminent practioners of old, who imagined that they eliminated all disease by venesection and copious drenching with hot water. To be more specific, I will refer to the decline of Listerism, the most rational phase of the antiseptic system, which two years ago was regarded as the biggist thing out, with no possible doubt of the justness of the claims of its advocates.

men.

So I hope to be pardoned if I make a mistake in attacking from a common sense stand-point the doctrine which is turning the heads of so many eminent and supposably logical The greater part of the microphytes that have been discovered in the blood endure extremes of heat and cold that would be fatal to the human organism, and some of them will live for years buried in the ground. Most of them resist the action of corrosive acids and alkalies that are destructive to living human tissues. The tests to which they have been subjected show that they are no exceptions to the rule that the lower forms of life have a greater power of resistance than the more complex and delicately organized. We know that the lower animals with relatively stronger vegetative natures will endure violence or changes of condition that would be fatal to the human animal. Even an animal so highly organized as a crawfish will grow a new leg if we pull one off. There is no doubt but what the lower forms of life are harder to kill and hold out longer against

fatal measures than the higher. Yet some of the most respected and honored physicians are attempting to saturate the tissues of the most highly organized animal with poisons strong enough to kill the lower forms of vegetable life. What explanation of their conduct is to be made? Do they imagine that the human is tougher because he is bigger, or are they like the hunter who so loaded his gun that it would hit what he shot at if it was a deer, but would miss it if it was a goat? In my estimation the whole plan is like leaving your house to get the rats out of it, only to have the rats go off to somebody else's house after you are gone; and I'll miss my guess if a good many patients do not think so before the craze subsides.

Perhaps some of you are waiting to tell me that it is pretty well established that quinine kills the bacilli of malaria, and that mercury kills the cocco-bacteria helicomonas in syphilis. I would like to ask what becomes of the microphytes when these diseases are cured, as they undoubtedly have been, by attenuated drugs which certainly could not kill anything?

The answer to this question, in my opinion, disposes of the whole matter. That mysterious vitality that we do not understand and never will, built up the body in spite of all difficulties; it kills thousands of germs with every breath or morsel of food, some of which would flourish in the body and cause disease if the vitality were not the stronger; and it is the only antagonist capable of overcoming in its own way the microphytes in the tissues, and the myriad other enemies it has to contend with in the universal struggle for life, and the physician makes a grave mistake who imagines he is to usurp the place of this vitality, and convert the temple of its building into a chemist's pot, and will find that what is at best a two-edged sword is not the panacea. A louse, a tape worm, or any other parasite accessible from the exterior may receive an application strong enough to kill it

without its general admixture with the substance of the body, but I do not believe that the system can be saturated for a length of time sufficient to permeate all the tissues with a poison strong enough to kill the microphytes without the patient's having been dead sometime first. I do not deny that some patients may be cured by efforts that are supposably made in accordance with this system, but they occur because the drug used excites the vital force to do the business and not because the practitioner has a theory in the head.

As long ago as I can remember I read in the almanacs that this, that and the other mixture entered the system, ransacked every part of it, and swept away every vestige of disease. What is to hinder the adoption of a Yankee almanac by Declat and his disciples? They would only need to insert the name of their system in place of some timehonored mixture less heroic.

Before closing I wish to allude to one drug which I think has been experimented with sufficiently for a basis for a conclusion. It is alcohol. We know this to be one of the best antiseptics, and Grauvogl found it more destructive than any other agent to mould, which is closely allied to the microphytes found in the blood, and we have all seen the human system as thoroughly saturated with it as it is possible to do it with any drug, yet is not regarded as a specific for any of the germ diseases. I have seen a man so full of whisky that a bed he slept in once smelled strongly of fusil oil two weeks afterward, yet he was not cured of syphilis.

The negative evidence afforded by alcohol is important. Dr. Edmonds.-Fortwo years I have opposed the doctrine which the essayist calls Declatism. It is crude and unphysiological and, in my opinion, will be retired to the background by experience. Lister himself turned the tide of opinion upon this subject at the British Congress. I have been thoroughly disgusted with the practice of those surgeons who have applied strong preparations of carbolic acid

to the delicate human tissues. It has always seemed to me. absurd for any one to spray the peritonial cavity with its great distribution of splanchnic nerves. The shock produced by the application of carbolic acid to these extremely sensitive parts must be profound, and in my opinion injurious though the atmospheric germs that might sometimes cause trouble be destroyed. I believe the essayist has taken the right ground.

Dr. Kent.-Dr. Edmonds has not offended me in his remarks relative to the use of carbolic acid in operations. I knew that I had had as good results as were claimed by Lister's advocates, and saw no necessity for going to such extremes in the use of carbolic acid as many surgeons did. Listerism has its sphere in surgery, but in popular opinion the limits of that sphere have been contracting for some time. Declatism, or the use of antiseptics within the system, will ultimately have some place in the practice of medicine, but experience will probably show that the claims of its present advocates are mild. Some part of the profession goes off on a tangent every little while. A few years ago

chloral hydrate would cure every case of whooping cough and all spasmodic complaints. It was looked upon as marking a newer era in the practice of medicine; but little is heard of it now. Later, Listerism was in fashion, but it has been on the wane for some time. When it was dominant I put up flaps dry with as good success as any of them. Carbolic acid is of value where there is gangrene or septic influences, but healthy tissues with good surroundings can protect themselves. Of Declatism I have no direct knowledge. shall not condemn it until I see what may come of it. I do not believe that phenic acid goes into the tissues and chemically destroys the microzymes there. Whatever action it may have is probably vital, as Dr. Morgan says.

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Dr. de Cailhol.-Declat's method is not homœopathic, and I can understand how an exclusive homœopath would