Colon, of France, incidentally brought out the fact that schools had been established on the sewage farms, and that there was not an unusual amount of sickness among the pupils in consequence. In regard to the saturation of the soil and the failure of the mineral constituents to neutralize the organic substances, the fact that the city of Edinburgh has used one sewage farm continuously for so long, and that neither experience there or at Danzig or Berlin supports the assumption, is sufficient answer to this objection. The fear that these farms may become a source of disease seems absolutely unfounded. Dr. Littlejohn testified that in the year 1865-66, when cholera raged in Edinburgh and London, the inhabitants of the respective sewage farms remained free from the disease. The sewage farms of Berlin are the largest in the world. Statistics have been preserved relative to their sanitary condition extending over a period of fifteen years, according to a system elaborated by Virchow. These statistics show that the inhabitants of sewage farms and their neighborhood maintain an average health in advance of that of Berlin. Moreover, mortality among children living upon these farms has been less than that among children in the city. As to dysentery, intermittent fever, measles, and scarlatina, the percentage of sickness and of death has also been lower on the sewage farms. Moreover, Prof. Virchow affirms that in no instance could cases of typhoid fever be ascribed to infection from these farms, except in instances in which the patients had drunk the sewage water. The vegetables and various products of these farms are not only used for food by the people who inhabit them, but are sold in the markets of the neighboring villages and towns. Even lettuce and celery have not been charged with having conveyed disease. In conclusion, I will say that the physician should be a sentinel on the watch-tower of public opinion with reference to all matters about which his superior special education and training make him best fitted to advise the people. He enjoys exceptional opportunities, and should use them with a wise forethought, so that when he has run his race he may, in looking back over his pilgrimage, see that the society in which he moved has been elevated and improved. "Such life as his can ne'er be lost; It blends with unborn blood, And through the ceaseless flow of years Moves with the mighty flood." We, as American citizens, are justly proud of our orators, statesmen, and soldiers, but shall not the achievements of our statesmen succumb at last to the pitiless logic of events? Shall not the voice of our orators grow fainter with coming ages? Shall not the victories of our soldiers be found at last only in the libraries of students of military campaigns, while the fame of the medical sanitarian, like the everwidening waves of the inviolate sea, shall be wafted to the utmost shores of time, hailed alike by all nations in all ages for having lessened the burden and prolonged the span of human life? As a result of his life and labors, there goes forth a benediction to every home in the known world; from every hearthstone in Christendom there returns a blessing to his memory and last resting-place. "There scatter'd oft, the earliest of the year, By hands unseen, are showers of violets found; There will be no need of "storied urn or animated bust." Heightened health and increased longevity will be his enduring monument, and euthanasia will be his immortal epitaph. This monument will rise like the piled cairn over our warriors of old—each man casting his stone; and let each of us, in sacred memory of our fellow-workers in the cause for suffering humanity, with the true feelings of greatness pay tribute at the shrine of genius; and joy will come oftener than grief, victory oftener than defeat, smiles oftener than tears, and many a cheerful ray of glad sunshine will burst through the clouds of a stormy sky, and hope itself will find the unknown quantities of time in the equations of eternity. HUMPHREY, KY. MEDICAL CERTIFICATES IN FRANCE.-Some time ago the Gazette hebdomadaire de medecine et de chirurgie published a report from the civil tribunal of the Seine to the effect that the judgment of the court had been that all medical certificates must be written from the personal knowledge of the physician making the report. This year the court has rendered a judgment in a case which makes it a misdemeanor for a physician to certify to a lesion which would incapacitate the injured person from any labor for a considerable length of time when in reality the injury was slight. And if, in consequence of such a false certificate, an insurance company has paid an indemnity to the third person, the physician is liable for damages if sued by the company.-New York Medical Journal. SUGGESTIVE THERAPEUTICS. BY WILLIS I. COTTEL, M. D. The first instance of the employment of suggestive therapeutics of which we have any definite data we find recorded in the first part of the third chapter of Genesis. There we are told that the serpent was more subtle than any beast of the field which the Lord God had made, and that, having some theories concerning the therapeutic effects of the fruit of a certain tree, which grew in the midst of the garden, upon the optic nerve and the retina, he prescribed it—suggesting its effects to the first woman. Its miraculous effects being appreciable, she, womanlike, tried it on her husband. Who can estimate the result of this first essay of this enterprising practitioner? If we did not possess the knowledge of good and evil, what beasts we would be! It is the one attribute which elevates us above the beasts of the field. But we will not wander into the bypaths of speculation. Since that time, even down to the present age, with its scientific, semi-scientific, and vulgar vagaries, mankind has gazed in open-eyed wonder on the astonishing miracles wrought by suggestion—the effects of the mind over diseased and disordered conditions of the body. The scientific student of rational psychology is often puzzled and confused; he is at times unable to explain the phenomenal results obtained; sometimes he, too, is at loss, so much so that he often joins the credulous crowd and declares they are supernatural, or perhaps the manifestation of a divine power. One of the most brilliant writers of our time likens the mind of man to the clearing which a pioneer has made in a new country. He says: "This clearing is just large enough to support a family; the remainder of the farm is still forest in which snakes crawl and wild beasts occasionally crouch." It is thus with the average man. There is a little patch just large enough to practice medicine with or sell goods or practice law or preach with, or do some other kind of business sufficient to obtain food and shelter for a family, while all the rest is primeval forest in which lie coiled the serpents of superstition and the wild beasts of prejudice. While we medical men may feel like sneering at the absurdities and many of the theories of the ignorant, of the fanatic, of the clairvoyant, the hypnotist, and other workers of seeming miracles, would it not be well for us to clear away some of the underbrush of prejudice which circumscribes the confines of our little clearing and study their methods, or at least give them careful consideration. If we find them useful, why not employ them? If they are venomous serpents or wild beasts, let us destroy them. Mayhap we may use their tails for whips or their pelts for clothing for ourselves. The average practitioner of medicine is to-day groping through the wilderness of ready-made therapeutics. He is surrounded by an underbrush of highly advertised pharmaceutical products (remedies of unknown composition and too often worse than worthless). If the physician will pause in his blind and unquestioning search for specifics and investigate, perhaps he will find that these remedies which he dispenses with a free hand-which he helps to advertise by prescribing, and which he often vaunts in gratuitous testimonials - owe their power and efficacy to his skill at suggestion and to the mental suggestibility of his patients. Is not the medical man often really a miracle-worker, or more properly a suggestive operator, "unbeknownst" to himself? Over twenty years ago it was my good fortune to sit at the feet of an ideal instructor in therapeutics, Prof. L. P. Yandell, jr., of the Medical Department of the University of Louisville. He was a skeptic on the subject of medical specifics; his motto was the advice of Paul to the Thessalonians, "Prove all things: hold fast that which is good." He advised a wise conservatism in the employment of any new method or remedy, even though highly recommended by the seemingly scientific. Twenty-one years of practice and observation have served to convince me of the soundness of his teachings. Were there more teachers of his caliber in the world, or perhaps had he not been called away so early in his career, there had been less experiment of an absurd quality, less unwise polypharmacy in the medical world to-day. Early in my experience as a physician I met with a specific. A child of ten years was brought to me suffering from nocturnal enuresis. I gave the regular treatment all the way from A to U, restricted the quantity of water ingested, and even had watches to awaken her at night to relieve her incontinent viscus of the inclement accumulation. I failed. She was taken to a homeopath. To my surprise, and I might add to my discomfiture, he cured her in one day. As he was a friend of my boyhood, a personal friend, I learned the facts concerning his treatment of the case. He gave her sepia, sixth potency, one pill (No. 25 size) every half hour. He impressed it upon her mind that she was to follow the directions implicitly, and informed her that it would so affect her that when she had a desire to pass water she would awaken. It worked a miracle. Arming myself with a supply of this by no means "high potency" of the excretion of the squid, I treated "piss-a-beds" for several years with variable success, my experience in these cases almost converting me to homeopathy. It was not until several years after that I read Bernheim's Suggestive Therapeutics; then I realized the secret of our successes. Since then I have used simple sugar pellets with even better results. It is a fact that a majority of mankind can be hypnotized, and that each one of us is influenced by suggestion. The physician who would employ hypnosis indiscriminately among his patients would be a consummate fool. Complete hypnosis is admissible in only a few cases, and should only be used as a last resort, but every physician should understand it. The careful study of the mental constitution of the patient is as necessary as an investigation of the conditions of his body; it is often of more importance. Since the mind perceives pain, and pain reacts on the mind, it follows that influencing the mind, especially in suggestible subjects, often avails where the most skillfully applied medication fails. In general practice the main point is to gain the confidence of your patient. If the physician is successful in securing this, in ninety-nine cases in a hundred the battle is won; nature will do the rest; in the hundredth the result is usually a case for the undertaker. The above paragraph looks a little hard in cold print, but I believe it to be the truth. Modern practice, with its uncertain tablets and readymade concoctions of unknown quality, its ready-made therapeutics, and its hosts of practitioners too lazy to formulate their own prescriptions, can be little else than guess-work. I have no intention of becoming a reformer, but I wish to register a protest against this growing evil. Why should we allow any one to make our therapeutics? The success of nearly all specifics and panaceas is due to the credulity of those who employ them, to suggestion or auto-suggestion. What a host of motley humbugs have been the fad and ceased to be, |