Vol. I.] ARTICLE I. NEW-YORK, JANUARY, 1844. The Mysteries of the Faculty. [No. I. ing it with most of the articles of the pharmacopoas; but we shall not, probably, advance in the treatment, until we deduce pathological principles, from cautiously marking the rise and progress of the symptoms, and exploring their seals and effects.-DR. ARMSTRONG. "The whole science of healing is built upon fortuitous and chance discoveries. Like the Physicians of learning and experience know that no dependence can be placed on the old astrological symptoms, by which they have been taught to distinguish tubercular disease, nor on the common imbecile alchemists of old, we have discovered a remedies for it, as is seen by the following thousand valuable things, where we never declarations of the distinguished professor, thought of looking for them; and while uselessly seeking for talismanic gold, we have M. Lugol, of Paris, to the students of medi-lighted on a pearl of great price. Every cine, 1841*. thing, in fact, is presented to us as the result of experiment; and, in the treatment of disease, higher origin than its more humble neighbor." the most valuable remedy can boast of no -G. B. CHILDS. In addition to the testimony of the distinquished physicians above mentioned, is the following extract from the London Lancet, for January 14, 1843, to the same effect; and this brief paragraph is only one of the many evidences afforded by that very high medical authority, and indeed by the medical literature of the day, that a brighter era is beginning to dawn upon this momentous subject: "Tubercles may exist in parenchymatous organs, may even partly annihilate them, without their existence being revealed by any external symptoms. Our want of success in the use of the ordinary means of diagnosticating tubercles, proves that those means are inadequate, that we follow an erroneous course in our investigations, and that we must resort to new modes if we wish to be successful. The numerous checks and repeated deceptions to which physicians are daily exposed in the diagnosis and treatment of tuberculous dis ases, do they not prove that it is neces ary to leave the beaten track of inquiry and pursue some other which is less fallible?" Few physicians, however, will leave the old beaten track for a new one, until they are driven from it by public opinion; no matter what the consequences may be to their patients. "Wherever we have any thing like principles to guide us, our prescriptions are extremely limited; wherever we have no fixed principles to guide us, our prescriptions accumulate with empirical rapidity. But what, it may be reasonably enquired, is the principal cause of all this complexity of formulæ in chronic diseases? Undoubtedly it arises from that vagueness of opinion which exists respecting the nature of these diseases in their onset, and in the greater part of their progress; and so long as we attempt to cover our ignorance by such terins as nervous, billious, dyspeptic, spasmodic, and the like, so long shall our practice be mere experiment in most chronic affections. We may make a sort of druggist's Mr. Wakley, M. P., in his editorial artishop of the stomach of every patient laboring cle, in the same number, advises the memunder chronic disease, by alternately cram-bers of the medical profession, to commence The professors of our medical colleges, like the "How much have we yet to learn, how little do we really know, of the nature and rational treatment, not only of the diseases of the cerebro-spinal system, but of diseases in general! Assuredly, the uncertain and most unsatisfactory art that we cali medical science, is no science at all, but a jumble of inconsistent opinions; of conclusions hastily drawn; of facts badly arranged; of observations made with carelessness; of comparisons instituted which are not analogical; of hypotheses which are foolish: and of theories which, if not useless, are dangerous. This is the reason why we have our homœopathists, our celestialists!" (and he might have added and our hydropathists; our mesinerists and an army of arrant quacks.)- DR. EVANS. EDINBURG. ancient astrologers, who were physicians, priests and collecting facts, in their several districts, de astronomers, pretend to distinguish chronic diseases by feeling the pulse, the aspect of the urine, the odour novo, on which to found, at a future period, of the stools, &c. &c., and they will continue to teach a rational and effectual mode of treating such nonsense as long as it is of any value in the market. diseases. ARTICLE II. The illiberality with which I have been treated, by many of the leading men of the Symptoms of Tubercular Disease. profession, while I have been alone engaged, Tubercula, or Scrofula, is invariably disthrough a long series of years, in establish- tinguished by pain, more or less severe in ing the true character and great importance proportion to the intensity of the disease, of the new symptoms and remedies, in produced by pressure on the ganglions of the chronic diseases, and in the only way in spinal nerves, in the intervertebral spaces which I could hope for success, will fully along each side of the spine: no matter justify me, in thus exposing to the public in what name may have been given to the the years of my triumph, the heartless im- malady by physicians, nosologists, or other positions those men are constantly practis-medical writers. These ganglions are organs ing. of sensation, and are connected with the The following observations upon the mys-skin and serous membranes, as well as the teries and fallacies of the faculty, are from serous surfaces, in every part of the body, one of the most intellectual men of the age. through the posterior spinal nerves; while Observers of passing events cannot have the anterior and motor spinal nerves, are failed for some years past to recognize the ap- connected with the mucous membranes, and proach of a new era in the science of medicine. The practitioner who has imbibed his mucous surfaces in every part of the body; dogmas during his hospital pupilage, who, and this arrangement of the nerves of sensafrom inertness, indifference, or incompetency, tion and motion, was obviously necessary, rejoices in the conjectural nature of his art, who contemns its principles, closes his ears both to the inception and existence of the against its reasoning, and his understanding animal creation, to prevent the irritating to its improvements, may proceed self-suffi effects of the atmosphere, of fluids, and ciently, and empirically, to the termination of his career. The practitioner of this stamp semi-fluids, or other non-solid substances, may boldly vaunt his experience as the infal- which are necessarily and constantly in conlible criterion of the means that are available by man in alleviating misery and prolonging tact with the mucous membranes, and mucous existence, and may continue to play upon the surfaces of sentient creatures. The followweaknesses and sufferings of humanity, and ing case, in which nearly all the the contingencies of life, regardless alike of the advancement of learning, and of the use-limbs were affected with tubercular disease at ful practical results which flow from it. the same time, not only gives a very clear But the disciples of a truly rational medi- view of the simplicity and accuracy of these cine, who are now daily filling the ranks of organs and the profession, who, being active, emulous, symptoms, but also conclusively demonstrates and competent, are watching with a vigilant a direct connection between the ganglions eye the progress of science, and are drawing of the spinal nerves, and the serous mem-continually from its tributary streams, for the means of rendering more complete their branes and surfaces:- Mrs. J. P., of good constitution, light com view it in all its relations, compare it with plexion, and naturally full habit, aged 22 previously discovered truths, fix its legitimate years. value, and assign its pioper locality,-who, Called to see her January 11th, 1835. slow to adopt crude theories, founded upon She has a swelling on the right side of her uncertain data; slower still in resorting to expedients of conjectural utility, both in me-neck and face, which commenced about the dicine and surgery; arrive, albeit, impercep- 10th of November last, and has been out of tibly, at unerring principles, as the basis of a considerate and cautions, but an energetic and health about three years. Suspecting tubercula, and without making further inquiries, and in the presence of a number of gentlemen and ladies, we commenced an examination of the lymphatic glands along both sides of the spine, and first with those of the first cervical vertebræ, and pressed with the finger upon one lying close to the right side of the vertebræ, and of the spasmodic pain, and darted violently into the size of a very small bean, which produced a uterus. Pressure on the sides of the other scream from severe spasmodic pain, which, vertebræ produced no pain or effect whaton every repetition of the pressure, darted ever. violently, and with the rapidity of lightning, We now inquired at what time she first disinto the external cervical and submaxillary covered tubercles or swellings on the side of tubercles, and into the upper jaw, ear, and her neck? She answered, about the first of right side of the head; and on her complain- June, or the first of July, her attention was ing of its darting also into her throat, we ex-first directed to one on the side of her face, amined it, and found two tubercles rising con- in front of the ear, that was very sore, and spicuously in the right tonsil, and one in the at times painful, and that at such times there gum of the upper jaw, all of which were was "soreness along the chords" of the very sore, and also painful under pressure. neck, but "never thought of examining We now applied pressure in the same way to there for tubercles." We now told her she these cervical and submaxillary tubercles on must have white swellings of some of her the side of the neck and the under-jaw, joints or limbs, besides that of the neck and which produced the same kind of pain in face, when she presented her left arm perthem, which, at every repetition of the pres-manently flexed into an obtuse angle. On resure, darted violently along the neck and un-moving the clothing from this arm, it preder the clavicle into the upper portion of the sented a white swelling of the elbow joint right lung. We now applied pressure to the and arm. The swelling of the arm was. left side of the first vertebra, on a still smaller united to that of the joint, and extended more tubercle, and she screamed again, and pointed than half way to the shoulder, and there was her finger to the spot the pain darted to, on plainly felt along the under side of this the upper portion of the left side of the neck, swelling, or under and inner side of the arm, and on examination, we found there a large a large or wide ganglia of tubercles, extendsubmaxillary tubercle, and on applying pres-ing from the elbow six or seven inches above sure to this, the scream was again repeated, it. These tubercles were of the size of and she at the same time applied her hand peas, near the elbow, but became gradually to the left breast or mamma, and then point- smaller, and of the size of small seeds where ed out the course of the pain from the tu- they were lost in the upper part of the bercle along the neck and under the clavicle swelling. into the breast. We now examined it, and We inquired now whether she had any other found it every where literally crammed with swellings about her, when she answered, tubercles of the size of peas; the breast" no, that's all," but I told her it would not one-third larger than the right; color of the do, she must have white swellings of the skin natural. The right breast flaccid every where, and neither gland nor tubercle felt in it. to be limbs and joints of the right side, as well as of the left; and after viewing me for a moment with an expression of hesitancy, she began to make preparations to show me her right leg. It was swelled from the ankle to the knee, and had an elastic and puffy feel, and I plainly felt along the front and sides of the tibia, small tubercles from the size of small seeds to that of a small pea. She now told me she would show me the other one. It was swelled, and in all respects like the right leg. The small tubercles along the right side of the other cervicle vertebræ were sore or tender, and pressure on the upper ones sent darting pains into the right side of the neck, and on the left side of the lower one into the region of the heart, and checked her breathing. Pressure applied now on the sides of the first, second, third, and fourth dorsal, produced pain which darted into the stomach; and on the second, third, fourth, Diagnosis, tubercula of the uterus, both and fifth lumbar, produced the most severe legs, left arm, left breast, heart, stomach, |