Medical Essays, 1842-1882. Oliver Wendell Holmes

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Medical Essays, 1842-1882 - Oliver Wendell Holmes


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given some account of his chapter “Butler” in different articles, but I would refer the students of our Homoeopathic educational institutions to the original, which they will find very interesting and curious.

       CURRENTS AND COUNTER-CURRENTS

      My attack on over-drugging brought out some hostile comments and treatment. Thirty years ago I expressed myself with more vivacity than I should show if I were writing on the same subjects today. Some of my more lively remarks called out very sharp animadversion. Thus my illustration of prevention as often better than treatment in the mother's words to her child which had got a poisonous berry in its mouth,—“Spit it out!” gave mortal offence to a well-known New York practitioner and writer, who advised the Massachusetts Medical Society to spit out the offending speaker. Worse than this was my statement of my belief that if a ship-load of miscellaneous drugs, with certain very important exceptions,—drugs, many of which were then often given needlessly and in excess, as then used “could be sunk to the bottom of the sea, it would be all the better for mankind and all the worse for the fishes.” This was too bad. The sentence was misquoted, quoted without its qualifying conditions, and frightened some of my worthy professional brethren as much as if I had told them to throw all physic to the dogs. But for the epigrammatic sting the sentiment would have been unnoticed as a harmless overstatement at the very worst.

      Since this lecture was delivered a great and, as I think, beneficial change has taken place in the practice of medicine. The habit of the English “general practitioner” of making his profit out of the pills and potions he administered was ruinous to professional advancement and the dignity of the physician. When a half-starving medical man felt that he must give his patient draught and boluses for which he could charge him, he was in a pitiable position and too likely to persuade himself that his drugs were useful to his patient because they were profitable to him. This practice has prevailed a good deal in America, and was doubtless the source in some measure of the errors I combated.

       THE CONTAGIOUSNESS OF PUERPERAL FEVER.

      This Essay was read before a small Association called “The Society for Medical Improvement,” and published in a Medical Journal which lasted but a single year. It naturally attracted less attention than it would have done if published in such a periodical as the “American Journal of Medical Sciences.” Still it had its effect, as I have every reason to believe. I cannot doubt that it has saved the lives of many young mothers by calling attention to the existence and propagation of “Puerperal Fever as a Private Pestilence,” and laying down rules for taking the necessary precautions against it. The case has long been decided in favor of the views I advocated, but, at the time when I wrote two of the most celebrated professors of Obstetrics in this country opposed my conclusions with all the weight of their experience and position.

      This paper was written in a great heat and with passionate indignation. If I touched it at all I might trim its rhetorical exuberance, but I prefer to leave it all its original strength of expression. I could not, if I had tried, have disguised the feelings with which I regarded the attempt to put out of sight the frightful facts which I brought forward and the necessary conclusions to which they led. Of course the whole matter has been looked at in a new point of view since the microbe as a vehicle of contagion has been brought into light, and explained the mechanism of that which was plain enough as a fact to all who were not blind or who did not shut their eyes.

      O. W. H.

      BEVERLY Farms, Mass., August 3, 1891

       Table of Contents

      [Two lectures delivered before the Boston Society for the Diffusion of Useful Knowledge. 1842.]

      [When a physician attempts to convince a person, who has fallen into the Homoeopathic delusion, of the emptiness of its pretensions, he is often answered by a statement of cases in which its practitioners are thought to have effected wonderful cures. The main object of the first of these Lectures is to show, by abundant facts, that such statements, made by persons unacquainted with the fluctuations of disease and the fallacies of observation, are to be considered in general as of little or no value in establishing the truth of a medical doctrine or the utility of a method of practice.

      Those kind friends who suggest to a person suffering from a tedious complaint, that he “Had better try Homoeopathy,” are apt to enforce their suggestion by adding, that “at any rate it can do no harm.” This may or may not be true as regards the individual. But it always does very great harm to the community to encourage ignorance, error, or deception in a profession which deals with the life and health of our fellow-creatures. Whether or not those who countenance Homoeopathy are guilty of this injustice towards others, the second of these Lectures may afford them some means of determining.

      To deny that good effects may happen from the observance of diet and regimen when prescribed by Homoeopathists as well as by others, would be very unfair to them. But to suppose that men with minds so constituted as to accept such statements and embrace such doctrines as make up the so-called science of Homoeopathy are more competent than others to regulate the circumstances which influence the human body in health and disease, would be judging very harshly the average capacity of ordinary practitioners.

      To deny that some patients may have been actually benefited through the influence exerted upon their imaginations, would be to refuse to Homoeopathy what all are willing to concede to every one of those numerous modes of practice known to all intelligent persons by an opprobrious title.

      So long as the body is affected through the mind, no audacious device, even of the most manifestly dishonest character, can fail of producing occasional good to those who yield it an implicit or even a partial faith. The argument founded on this occasional good would be as applicable in justifying the counterfeiter and giving circulation to his base coin, on the ground that a spurious dollar had often relieved a poor man's necessities.

      Homoeopathy has come before our public at a period when the growing spirit of eclecticism has prepared many ingenious and honest minds to listen to all new doctrines with a candor liable to degenerate into weakness. It is not impossible that the pretended evolution of great and mysterious virtues from infinitely attenuated atoms may have enticed a few over-refining philosophers, who have slid into a vague belief that matter subdivided grows less material, and approaches nearer to a spiritual nature as it requires a more powerful microscope for its detection.

      However this may be, some persons seem disposed to take the ground of Menzel that the Laity must pass formal judgment between the Physician and the Homoeopathist, as it once did between Luther and the Romanists. The practitioner and the scholar must not, therefore, smile at the amount of time and labor expended in these Lectures upon this shadowy system; which, in the calm and serious judgment of many of the wisest members of the medical profession, is not entitled by anything it has ever said or done to the notoriety of a public rebuke, still less to the honors of critical martyrdom.]

      I.

      I have selected four topics for this lecture, the first three of which I shall touch but slightly, the last more fully. They are

      1. The Royal cure of the King's Evil, or Scrofula.

      2. The Weapon Ointment, and its twin absurdity, the Sympathetic Powder.

      3. The Tar-water mania of Bishop Berkeley.

      4. The History of the Metallic Tractors, or Perkinism.

      The first two illustrate the ease with which numerous facts are accumulated to prove the most fanciful and senseless extravagances.

      The third exhibits the entire insufficiency of exalted wisdom, immaculate honesty, and vast general acquirements to make a good physician of a great bishop.

      The fourth shows us the intimate machinery of an extinct delusion, which flourished only forty years ago; drawn in all its details, as being a rich and comparatively recent illustration of the pretensions, the arguments,


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