IfthereisanyStateorcitywhichmightclaimtobetheAmericanheadquartersofthenature-trustingheresy，provideditbeone，thatStateisMassachusetts，andthatcityisitscapital。Theeffectwhichthesedoctrineshaveupontheconfidencereposedintheprofessionisamatterofopinion。Formyself，Idonotbelievethisconfidencecanbeimpairedbyanyinvestigationswhichtendtolimittheapplicationoftroublesome，painful，uncertain，ordangerousremedies。Nay，Iwillventuretosaythis，thatifeveryspecificweretofailutterly，ifthecinchonatreesalldiedout，andthearsenicmineswereexhausted，andthesulphurregionswereburnedup，ifeverydrugfromthevegetable，animal，andmineralkingdomweretodisappearfromthemarket，abodyofenlightenedmen，organizedasadistinctprofession，wouldberequiredjustasmuchasnow，andrespectedandtrustedasnow，whoseprovinceshouldbetoguardagainstthecausesofdisease，toeliminatethemifpossiblewhenstillpresent，toorderalltheconditionsofthepatientsoastofavortheeffortsofthesystemtorightitself，andtogivethosepredictionsofthecourseofdiseasewhichonlyexperiencecanwarrant，andwhichinsomanycasesrelievetheexaggeratedfearsofsufferersandtheirfriends，orwarntheminseasonofimpendingdanger。Greatasthelosswouldbeifcertainactiveremediescouldnolongerbeobtained，itwouldleavethemedicalprofessionthemostessentialpartofit’sduties，andall，andmorethanall，itspresentshareofhonors；foritwouldbethedeath-blowtocharlatanism，whichdependsforitssuccessalmostentirelyondrugs，oratleastonanomenclaturethatsuggeststhem。
Thereisnooffence，then，ordangerinexpressingtheopinion，that，afterallwhichhasbeensaid，thecommunityisstilloverdosed：Thebestproofofitis，thatnofamiliestakesolittlemedicineasthoseofdoctors，exceptthoseofapothecaries，andthatoldpractitionersaremoresparingofactivemedicinesthanyoungerones。“[Dr。JamesJacksonhaskindlypermittedmetomakethefollowingextractfromaletterjustreceivedbyhimfromSirJamesClark，anddatedMay26，1860：“Asaphysicianadvancesinage，hegenerally，Ithink，placeslessconfidenceintheordinarymedicaltreatmentthanhedid，notonlyduringhisearly，butevenhismiddleperiodoflife。“]TheconclusionfromthesefactsisonewhichtheleastpromisingofDr。Howe’spupilsinthementaldepartmentcouldhardlyhelpdrawing。
Partoftheblameofover-medicationmust，Ifear，restwiththeprofession，foryieldingtothetendencytoself-delusion，whichseemsinseparablefromthepracticeoftheartofhealing。Ineedonlytouchonthecommonmodesofmisunderstandingormisapplyingtheevidenceofnature。
First，thereisthenaturalincapacityforsoundobservation，whichislikeafaultyearinmusic。Weseethisinmanypersonswhoknowagooddealaboutbooks，butwhoarenotsharp-sightedenoughtobuyahorseordealwithhumandiseases。
Secondly，thereisinsomepersonsasingularinabilitytoweighthevalueoftestimony；ofwhich，Ithink，fromaprettycarefulexaminationofhisbooks，HahnemannaffordsthebestspecimenoutsidethewallsofBedlam。
Theinveteratelogicalerrorstowhichphysicianshavealwaysbeensubjectarechieflythese：
Themodeofinferenceperenumerationemsimplicem，inscholasticphrase；thatis，countingonlytheirfavorablecases。ThisistheoldtrickillustratedinLordBacon’sstoryofthegiftsoftheshipwreckedpeople，hungupinthetemple——Behold！theyvowedthesegiftstothealtar，andthegodssavedthem。Ay，saidadoubtingbystander，buthowmanymadevowsofgiftsandwereshipwreckednotwithstanding？Thenumericalsystemisthebestcorrectiveofthisandsimilarerrors。Theargumentscommonlybroughtagainstitsapplicationtoallmattersofmedicalobservation，treatmentincluded，seemtoapplyrathertothetabulationoffactsillobserved，orimproperlyclassified，thantothemethoditself。
Theposthocergopropterhocerror：hegotwellaftertakingmymedicine；thereforeinconsequenceoftakingit。
Thefalseinductionfromgenuinefactsofobservation，leadingtotheconstructionoftheorieswhicharethendeductivelyappliedinthefaceoftheresultsofdirectobservation。TheschoolofBroussaishasfurnisheduswithagoodexampleofthiserror。
Andlastly，theerrorwhichSirThomasBrownecallsgiving“areasonofthegoldentooth；“thatis，assumingafalsehoodasafact，andgivingreasonsforit，commonlyfancifulones，asisconstantlydonebythatclassofincompetentobserverswhofindtheir“goldentooth“
inthefabulouseffectsofthehomoeopathiemateriamedica，——whichconsistsofsugarofmilkandanomenclature。
Anotherportionoftheblamerestswiththepublicitself，whichinsistsonbeingpoisoned。Somebodybuysallthequackmedicinesthatbuildpalacesforthemushroom，sayrather，thetoadstoolmillionaires。Whoisit？Thesepeoplehaveaconstituencyofmillions。Thepopularbeliefisallbutuniversalthatsickpersonsshouldfeedonnoxioussubstances。Oneofourmemberswascallednotlongsincetoamanwithaterriblysoremouth。Oninquiryhefoundthatthemanhadpickedupaboxofunknownpills，inHowardStreet，andhadproceededtotakethem，ongeneralprinciples，pillsbeinggoodforpeople。Theyhappenedtocontainmercury，andhencethetroubleforwhichheconsultedourassociate。
Theoutsidepressure，therefore，isimmenseuponthephysician，tendingtoforcehimtoactivetreatmentofsomekind。Certainoldsuperstitions，stilllingeringinthemindofthepublic，andnotyetutterlyexpelledfromthatoftheprofession，areatthebottomofthis，orcontributetoitlargely。Oneofthemostancientis，thatdiseaseisamalignantagency，orentity，tobedrivenoutofthebodybyoffensivesubstances，asthesmokeofthefish’sheartandliverdrovethedeviloutofTobit’sbridalchamber，accordingtotheApochrypha。Epilepticsusedtosuckthebloodfromthewoundsofdyinggladiators。[PliniiHist。Mundi。lib。xxviii。c。4。]TheHon。RobertBoyle’slittlebookwaspublishedsometwentyorthirtyyearsbeforeourlatePresident，Dr。Holyoke，wasborn。[ACollectionofChoiceandSafeRemedies。TheFifthEdition，corrected。London，1712。Dr。Holyokewasbornin1728。]Initherecommends，asinternalmedicines，mostofthesubstancescommonlyusedasfertilizersofthesoil。His“AlbumGraecum“isbestleftuntranslated，andhis“ZebethumOccidentale“isstillmoretranscendentallyunmentionableexceptinastrangedialect。Itsoundsodiouslytoustohearhimrecommendfordysenteryapowdermadefrom“thesoleofanoldshoewornbysomemanthatwalksmuch。“
Perhapsnobodyhereeverheardoftyingastocking，whichhadbeenwornduringtheday，roundtheneckatnightforasorethroat。Thesameideaofvirtueinunlovelysecretions！[Theideaisveryancient。“Sordeshominis““Sudoreetoleomedicinamfacientibus。“——
Plin。xxviii。4。]
EvennowtheHomoeopathistshavebeenintroducingthevenomofserpents，underthelearnedtitleofLachesis，andoutraginghumannaturewithinfusionsofthepediculuscapitis；thatis，ofcourse，asweunderstandtheirdilutions，thenamesofthesethings；forifafine-tooth-combinsectweredrownedinLakeSuperior，wecannotagreewiththeminthinkingthateverydropofitswaterswouldbeimpregnatedwithallthepedicularvirtuestheysohighlyvalue。
Theyknowwhattheyaredoing。Theyareappealingtothedetestableoldsuperstitiouspresumptioninfavorofwhateverisnauseousandnoxiousasbeinggoodforthesick。
Again，wealloccasionallymeetpersonsstainedwithnitrateofsilver，givenforepilepsy。ReadwhatDr。Martinsays，aboutthewayinwhichitcametobeused，inhisexcellentaddressbeforetheNorfolkCountyMedicalSociety，andtheevidenceIcanshow，buthavenottimefornow，andthensaywhatyouthinkofthepracticewhichonsuchpresumptionsturnsawhitemanasblueasthedouble-tattooedKingoftheCannibalIslands！[NoteA。]
Ifmedicalsuperstitionshavefoughttheirwaydownthroughalltherationalismandscepticismofthenineteenthcentury，ofcoursethetheoriesoftheschools，supportedbygreatnames，adoptedintothepopularbeliefandincorporatedwiththegeneralmassofmisapprehensionwithreferencetodisease，mustbeexpectedtomeetusateveryturnintheshapeofbadpracticefoundedonfalsedoctrine。AFrenchpatientcomplainsthathisbloodheatshim，andexpectshisdoctortobleedhim。AnEnglishorAmericanonesaysheisbilious，andwillnotbeeasywithoutadoseofcalomel。Adoctorlooksatapatient’stongue，seesitcoated，andsaysthestomachisfoul；hisheadfulloftheoldsaburralnotionwhichtheextremeinflammation-doctrineofBroussaisdidsomuchtorootout，butwhichstillleads，probably，tomuchneedlessandinjuriouswrongofthestomachandbowelsbyevacuants，whenalltheywantistobeletalone。Itissohardtogetanythingoutofthedeadhandofmedicaltradition！Themortmainoftheoristsextinctinscienceclingsascloseasthatofecclesiasticsdefunctinlaw。
Onepracticalhintmaynotbeoutofplacehere。Itseemstobesometimesforgotten，bythosewhomustknowthefact，thatthetongueisverydifferent，anatomicallyandphysiologically，fromthestomach。Itsconditiondoesnotintheleastimplyasimilaroneofthestomach，whichisaverydifferentstructure，coveredwithadifferentkindofepithelium，andfurnishedwithentirelydifferentsecretions。Asilversmithwill，foradollar，makeasmallhoe，ofsolidsilver，whichwilllastforcenturies，andwillgiveapatientmorecomfort，usedfortheremovaloftheaccumulatedepitheliumandfungousgrowthswhichconstitutethe“fur，“thanmanyaprescriptionwithasplit-footedRxbeforeit，addressedtothepartsoutofreach。
IthinkmoreofthislittleimplementonaccountofitsagencyinsavingtheColonyatPlymouthintheyear1623。EdwardWinslowheardthatMassasoitwassickandliketodie。Hefoundhimwithahousefulofpeopleabouthim，womenrubbinghisarmsandlegs，andfriends“makingsuchahellishnoise“astheyprobablythoughtwouldscareawaythedevilofsickness。Winslowgavehimsomeconserve，washedhismouth，scrapedhistongue，whichwasinahorridstate，gotdownsomedrink，madehimsomebroth，dosedhimwithaninfusionofstrawberryleavesandsassafrasroot，andhadthesatisfactionofseeinghimrapidlyrecover。Massasoit，fullofgratitude，revealedtheplotwhichhadbeenformedtodestroythecolonists，whereupontheGovernororderedCaptainMilesStandishtoseetothem；whothereupon，aseverybodyremembers，stabbedPecksuotwithhisownknife，brokeuptheplot，savedthecolony，andthusrenderedMassachusettsandtheMassachusettsMedicalSocietyapossibility，astheynowareafactbeforeus。Somuchforthisparenthesisofthetongue-scraper，whichhelpedtosavetheyoungcolonyfromamuchmoreseriousscrape，andmaysavetheUnionyet，ifaPresidentialcandidateshouldhappentobetakensickasMassasoitwas，andhistonguewantedcleaning，——whichprocesswouldnothurtagoodmanypoliticians，withorwithoutatyphoidfever。
Again，seehowthe“bilious“theoryworksinevery-daylifehereandnow，illustratedbyacasefromactuallife。Ayouthfulpractitioner，whoselastmolarshavenotbeenagreatwhilecut，meetsanexperiencedandnotedphysicianinconsultation。Thisisthecase。Aslender，lymphaticyoungwomanissucklingtwolustytwins，theintervalsofsuctionbeingoccupiedonherpartwithpalpitations，headaches，giddiness，throbbinginthehead，andvariousnervoussymptoms，hercheeksmeantimegettingbloodless，andherstrengthrunningawayincompanywithhermilk。Theoldexperiencedphysician，seeingtheyellowishwaxylookwhichiscommoninanaemicpatients，considersita“bilious“case，andisforgivingarousingemetic。Ofcourse，hehastobewheedledoutofthis，arecipeiswrittenforbeefsteaksandporter，thetwinsareignominiouslyexpelledfromtheanaemicbosom，andforcedtotakeprematurelytothebottle，andthisprolificmotherissavedforfutureusefulnessinthelineofmaternity。
Thepracticeofmakingaprofitonthemedicineorderedhasbeenhelduptoreprobationbyoneatleastoftheoratorswhohaveprecededme。ThattheeffectofthishasbeenruinousinEnglishpracticeI
cannotdoubt，andthatinthiscountrythestandardofpracticewasinformergenerationsloweredthroughthesameagencyisnotunlikely。Ihaveseenanoldaccount-bookinwhichthephysicianchargedanextrapriceforgildinghisrichpatients’pills。Ifallmedicinewereverycostly，andtheexpenseofitalwayscameoutofthephysician’sfee，itwouldreallybealessobjectionablearrangementthanthisothermostperniciousone。Hewouldnaturallythinktwicebeforehegaveanemeticorcatharticwhichevacuatedhisownpocket，andbesparingofthecholagoguesthatemptiedthebiliaryductsofhisownwallet，unlessheweresuretheywereneeded。Ifthereisanytemptation，itshouldnotbeinfavorofgivingnoxiousagents，asitclearlymustbeinthecaseofEnglishdruggistsand“GeneralPractitioners。“Thecomplaintagainsttheothercourseisaveryoldone。Pliny，inspiredwithastrulyRomanhorrorofquackeryastheelderCato，——whodeclaredthattheGreekdoctorshadsworntoexterminateallbarbarians，includingtheRomans，withtheirdrugs，butissaidtohavephysickedhisownwifetodeath，notwithstanding，——Plinysays，insomanywords，thattheceratesandcataplasms，plasters，collyria，andantidotes，soabundantinhistime，asinmorerecentdays，weremeretrickstomakemoney。
Aprettystrongeddy，then，orrathermanyeddies，settingconstantlybackfromthecurrentofsoberobservationofnature，inthedirectionofoldsuperstitionsandfancies，ofexplodedtheories，ofoldwaysofmakingmoney，whichareveryslowtopassoutoffashionButthereareotherspecialAmericaninfluenceswhichweareboundtotakecognizanceof。IfIwishedtoshowastudentthedifficultiesofgettingattruthfrommedicalexperience，Iwouldgivehimthehistoryofepilepsytoread。IfIwishedhimtounderstandthetendenciesoftheAmericanmedicalmind，itssanguineenterprise，itsself-confidence，itsaudacioushandlingofNature，itsimpatiencewithherold-fashionedwaysoftakingtimetogetasickmanwell，I