pupil is told that the protecting virus unites with the supposed dangerous substance, and by its presence preoccupies the place which might otherwise have been open to the small-pox. It is suggested that thus it is easier to understand the cessation of the protection after a period of years, and that it is more in accordance with the analogy of nature for a base to be set free by the wearing away in time of its acid, than for a destroyed substance once gone to be created anew. In all matters medical the high court of appeal is clinical experience. Arguing from this, some have suggested that theory is superfluous altogether, and that all to be done is to use what has previously been found to be useful. This would make all progress to consist wholly in accident. Before the almost infinite combinations of bodily derangement which are daily presenting themselves newly to the sight of the observant practitioner, he would feel utterly powerless, or else he must shut his eyes to any but the very simplest types of disease. This were folly in any body, but in a consultant it is dishonest, for he is called in for the express reason that the case is one difficult from its novelty or rarity. As a matter of fact, however, few of these objectors ever do prescribe for a sick person without theorising, and when they have to put their reasons into words, very wild and absurd they will sometimes be found. The only originator of action can be theory, and the choice lies between one that is taken up haphazard and one that is adopted on rational grounds. But the high court of appeal is experience. Yes, the poet of the Greek race-course was quite right, "Tis the trial proves the man.' Clinical researches and empirical decisions must always hold the most honourable post of any department of medicine. Never, probably, was there a time when they were so highly appreciated as now; so that, with much confidence, we can leave to be estimated by this measure the restorative system of therapeutics which we have augured to be so rapidly prevailing among our teachers of medicine. The almost universal adoption by all hospitals of a system of registration and case-taking renders the dicta of experience of late years, not only much more accurate, but much more rapid than in former times: it also guards against the fallacy of statistics collected for the special purpose of proving a particular point. A few hundred instances, carefully observed and tabulated, will produce an impression more distinct than many thousands loosely remembered and scattered through a generation, while unconscious documentary evidence is the strongest that can be had. An attempt also is being made by the British Medical Association to render available the cases occurring in private Vol. 126.-No. 252. 2 P practice, practice, by issuing printed schedules to be filled up in an uniform manner. The idea is a grand one, and whether successful or not, the Association merits the blessing of all time for trying thus to utilise the waste of daily experience. We must not despise the results of judiciously appropriated accident, leading to the discovery of the use of remedies. Melampus the soothsayer, physician to one of the obscurer kings of Thrace, observed, during one of his country rambles, that goats which had grown morbidly frisky were calmed after having instinctively or accidentally browsed on a plant since called Melampodium. So, on his patron's daughters falling into a somewhat similar state, he administered it and effected a cure. A metropolitan hospital physician, a short time ago, ordered a baby under two years old, in a peculiar morbid state, what he considered the large dose of four drachms (fl 3 iv) of rum. By mistake the prescription was read four ounces (fl 3 iv); and so the infant, instead of a tablespoonful, had three glasses a day of this powerful spirit. It throve wonderfully; but it was not till the end of the week that the prescriber discovered what a fortunate error had been committed. Now, in either of these cases, would the accident have given instruction, had it not chimed in with a rational theory in the mind of the observer? Deductions from accident offer an instance of the striking combination of experience and theory. It is no reproach to the goodness of the road, that there are quicksands, into which those who follow the guidance of restorative medicine may easily fall, if they are careless walkers. Those from which at present we foresee most danger are 'Efforts of Nature,' ' la médecine expectante,' and Alcohol. The attribution of disease to efforts of Nature has already been alluded to as a valuable reform upon absolute Galenism. Sydenham assumed that these efforts are necessarily good, and that the principal duty of the physician is to aid them in expelling morbific material, or at all events not to hinder them doing so. Good for the type, good for the race, good for the kind, good for the kin, perhaps reverence for what Nature really means will induce us to acknowledge those efforts to be. We will allow that to the case of man the lessons of scarped cliff and quarried stone' do not apply, for supernatural means have been taken to inform us that our type is already moulded on the highest model and worthy of the highest care. But to the individual Nature is merciless. And it is with the individual that the physician has to do. Will the mother resign to the grave her cross-grained deformed first-born, because it would be better for the race, nay better for her own immediate kin, that the family should be continued by his younger brother? Many Many a cumberer of the ground, when laid on a sick-bed, feels that so far from his being missed, his place will be more worthily filled up, after sundry efforts of Nature for the good of mankind have been successful; yet he elects to stay. Many a patient knows that science would be immensely enlightened by a sight of his remains-but he had rather not. Before we assist efforts of Nature, we must have evidence that their end is not our extinction, not a capital punishment for neglecting to use our reason. La médecine expectante is simply a disbelief in the utility of all interference. A young man hears his elders point out the harm done by some previously popular treatment, but he fails to understand what is substituted for it. So, knowing that a certain percentage of his patients will recover if he does nothing, he takes that course. Let him reflect that possibly the very case before him may be the one which makes a difference in the percentage, which, naturally fatal, may be healed by art, and we think he will be roused to action. Let him also observe that the evidence of history shows a progressive improvement in medicine; the denounced treatment was probably better than what was popular before it, and that better than leaving the patient to hurt himself by fallacious struggles for health. It is better, therefore, to do something of which he knows the imperfection than to do nothing at all. Asclepeiades very properly called all medical science, which does not end in action, 'a meditation upon death.' * Alcohol is perhaps the greatest danger of the three, inasmuch as its use involves questions of quantity and degree, the solution of which is always painful to superficial minds. Because, in small amounts and in selected cases, it is followed by an increase in the vital functions, there is a tendency to hope from these effects a pure gain of vital force, and to lean on it alone. Experience does not justify that hope; it shows that, while up to the limit of aiding perverted digestion, alcohol is a decided restorative and promoter of life; beyond that limit it actually arrests life in a degree proportioned to the dose.† The limit differs in every disease; so that, in this powerful agent, instead of having an easily-managed tool, we are wielding a weapon requiring great skill and foresight. Forewarned and forearmed against these perils, and kept straight by a constant appeal to experience, we feel sure that what we have made bold to call 'Restorative Medicine' cannot but prolong human life, and lighten its burdens. We have shown it to be unconsciously adopted by the rising teachers of the present θανάτου μελέτη. † See Chambers' Clinical Lectures,' Lect. L., 'On Alcohol,' for reference to experiments on which this statement is founded. 2 P2 and and future, and may confidently expect that at no distant time it will be put more distinctly into form as the true art of healing. Before we conclude we would take leave to say a few words as to the duty of the public, in performing their part in promoting the progress of which we have been trying to trace the footprints. Their principal duty bears, like all those which political economists class as virtues, a selfish character; it really may be summed up in an endeavour to set a higher value upon their lives than on their property. The proof of their doing this will be their taking steps to secure to that profession which guards those lives, opportunities for the highest and most protracted education, and means for carrying out its investigations into nature, This consummation is certainly far from being yet attained. A tale is told of a Scotch farmer, who protested loudly against the apparently modest item of half-a-crown a visit for attendance on his wife-Eh-it's just ruinous! Half-a-croon! And I can ha' a coo-doctor for three an' sax-pence!' Inasmuch as the human body is neither eatable nor saleable, he reckoned it as of inferior worth to the bovine. A not dissimilar spirit is shown in the unhesitating vote by Parliament of 30001. for the Cattleplague Inquiry, while not a penny was allowed for an investigation into the spread of leprosy in our colonies, while every item of expenditure for increasing the efficiency of the medical profession is haggled over, and every attempt to enforce a higher education looked at with coldness and suspicion, for fear the enhanced goodness of the article should entail a corresponding rise in its price. Surely this is a suicidal proceeding. Let each educated person examine for himself the kinds of knowledge needful for this profession of medicine, and he will not fail to be convinced that not shrewdness, or knack, or habit learned from tradition, can be the chief virtues of its students. There is scope in it for the highest and broadest intellects, and he is most suited to be your physician who is most worthy of the name of man. It is your business to give him every encouragement to make himself so by a leisurely and complete, and therefore expensive, education. ᎪᏒᎢ. ART. X.-1. A Bill to put an end to the Establishment of the Church of Ireland, and to make Provision in respect of the Temporalities thereof, and in respect of the Royal College of Maynooth. 2. The Irish Church. A Speech delivered in the House of Commons on March 1, 1869. By the Right Hon. W. E. Gladstone, M.P. London. 3. The Three Irish Churches. An Historical Address delivered at Sion College on January 28, 1869. By Arthur Penrhyn Stanley, D.D., Dean of Westminster. London. EFORE considering the Irish Church Bill now before say a few words upon that other policy, which the Quarterly Review' has always recommended, and which we still believe to be the only one that would bring peace to Ireland and satisfy the claims of justice. It is the policy which Mr. Pitt inaugurated, which the Tories and the Whigs alike adopted, which the House of Commons formally ratified by a majority of forty-three votes in 1825, and which every statesman of eminence, from the beginning of this century down to last year, has either openly advocated or secretly approved. In 1845, when the permanent endowment of Maynooth had conceded the principle of giving State support to the Catholic Church, and had prepared the way for a larger measure, we urged upon the Government and the Conservative party the duty and necessity of making a State provision for the Roman Catholic clergy as the only measure that now offers any reasonable prospect of tranquillising Ireland, and cementing and securing the prosperity of the empire.' It may be not without use to quote some of the considerations which we then urged : 'We begin by observing three remarkable peculiarities of this proposition. The first is, that though it seems destined to be the last in execution, it was-as it ought in all reason and justice to have beenone of the earliest objects of Catholic relief that came into contemplation. It was thought of in 1792, as a precursor to the first Irish Relief Bill, but it was unfortunately-by whose indiscretion or malevolence does not appear-connected with some idea of effecting it at the expense of the Irish Protestant Church; and was by Mr. Burke, then the great authority with both the Catholics and the Government, on that account, indignantly rejected. Another remarkable circumstance attending this measure is, that it has always been proposed by those amongst the advocates of the Catholic claims, who were most friendly to the interests and integrity of the Protestant Church; and has been, like the pending College Bill, opposed |