I have been in relation successively with the English and American evacuant and alterative practice, in which calomel and antimony figured so largely that, as you may see in Dr. Jackson’s last “Letter,” Dr. Holyoke, a good representative of sterling old-fashioned medical art, counted them with opium and Peruvian bark as his chief remedies; with the moderately expectant practice of Louis; the blood-letting “coup sur coup” of Bouillaud; the contra-stimulant method of Rasori and his followers; the anti-irritant system of Broussais, with its leeching and gum-water; I have heard from our own students of the simple opium practice of the renowned German teacher, Oppolzer; and now I find the medical community brought round by the revolving cycle of opinion to that same old plan of treatment which John Brown taught in Edinburgh in the last quarter of the last century, and Miner and Tully fiercely advocated among ourselves in the early years of the present.  The worthy physicians last mentioned, and their antagonist Dr. Gallup, used stronger language than we of these degenerate days permit ourselves.  “The lancet is a weapon which annually slays more than the sword,” says Dr. Tully.  “It is probable that, for forty years past, opium and its preparations have done seven times the injury they have rendered benefit, on the great scale of the world,” says Dr. Gallup.

What is the meaning of these perpetual changes and conflicts of medical opinion and practice, from an early antiquity to our own time?  Simply this:  all “methods” of treatment end in disappointment of those extravagant expectations which men are wont to entertain of medical art.  The bills of mortality are more obviously affected by drainage, than by this or that method of practice.  The insurance companies do not commonly charge a different percentage on the lives of the patients of this or that physician.  In the course of a generation, more or less, physicians themselves are liable to get tired of a practice which has so little effect upon the average movement of vital decomposition.  Then they are ready for a change, even if it were back again to a method which has already been tried, and found wanting.

Our practitioners, or many of them, have got back to the ways of old Dr. Samuel Danforth, who, as it is well known, had strong objections to the use of the lancet.  By and by a new reputation will be made by some discontented practitioner, who, tired of seeing patients die with their skins full of whiskey and their brains muddy with opium, returns to a bold antiphlogistic treatment, and has the luck to see a few patients of note get well under it.  So of the remedies which have gone out of fashion and been superseded by others.  It can hardly be doubted that they will come into vogue again, more or less extensively, under the influence of that irresistible demand for change just referred to.