D Vi? i\\ L^ IM5 Columbia IBntberjSSttp mtht€xmtMt\»fotk (Haih^ of piyaatrtana anb 0«rgrona iA^Unntt Stbrarg n.^ "C^c— -j-^ THE STCECHIOLOaiCAL CUEE OF CONSUMPTION AND DISEASES OP THE RESPIRATORY ORGANS. SOME OF THE OPINIONS OF THE PRESS ON DR. CHURCHILL'S DISCOVERIES. " That the introduction of these medicines has been a great gain to the better treatment of consumption IS a point we regard as fully established, and Dr. Churchill deserves well of mankind for what he has done." — The Practitioner. "The Society sees that the results announcfd and obtained by Dr. Churchill go beyond anything which has hitherto been done in the treatment of this fatal disease." — Report to the Brussels Royal Society of Medical Sciences by Dr. Bougaed, Vice-President. "After laying before tlie same Society reports of forty-two cases treated by himself, Dr. Tirifahy con- cluded as follows : — These facts establish the action of the hyj>ophosphite of lime in jihthisis. One thing is evident ; it has given me a number of cures such as no doubt every other mode of treatment will look upon with envy. I therefore advise the use of this remedy against pulmonary tubei'culosis tre all striges of the complaint."— Keport by Dr. Tirifahy to the Brussels Royal Society of Medical Sciences. " Dr. Churchill's woi'k records a body of no less than one hundred and thirty-three fully detailed cases of phthisis, the rexu/t of which, certainly appears amply to bear out hi,s views so fur as regards the efficacy vf tlie treatment." — LANCET. " Tlie hj'jiophc.siihites burst suddenly on the world some few years ago as a panacea for the commonest of all diseases. They were hastily and scantily tried, found not in every case to be successful, and as hastily abandoned. We submit that the subject was far too soon put out of court, that some published experiments are painfully inconchisive, and tliat others look as if the observer had already judged the case unfavourably before he began. Facts of a positive cliaracter are coming to light which should correct our prima f licit views. One such may be cited in the communication of Dr. Tirifahy to the >Iedical Society of Brussels. He relates in detail, and with most convincing impartiality, the results of forty-two cases treated by himself, and freely admits that any formula hitherto in use may envy these results. This opinion will, we can state most positively, be contirmed by competent observers in England." — Medical Tlmes and Gazette. " On my arri\-al in Paris to attend the Medical Congress, I was glad to accept Dr. Churchill's invitation and verify by personal investigation at his public dispensary the reality of the facts he had published. I examined by means of auscultation and percussion a large number of jiatients who had been ill for variable periods of time. After such proof I think there can be no absurdity in asserting, as I do most conscien- tiously, that at Dr. Churchill s dispensurt/ I saw patients entireli/ cured of tuberculosis, after having shown, in some cases for several years, all the progressive symptoms of the sfcw'l, and in some cases even of the liTst stage of phthixn:." — Dr. Fedeli (who published au iLaliau Translation of Dr. Churchill's French ■\Vork on Consumption). " The reception of so important a discovery has not been encouraging, The hypophosphites h&ve been used not according to Dr. Churchill's rules, and he has then been biamed for the resulting failures ! In other quarters his remedies have been used in secret, and the cures liave been attributed to other causes. ' This,' says Dr. ChurcliiU, ' is the last ordeal of the inventor before his apotheosis. Among artisans it is called rattetu'yij ; in science it constitutes the well-known process which the French call the conspiracy of silence.' What inventor or discoverer cannot confirm this from his own experience?" — Chemical News. " There are few scientific men, in the true sense of the word, who will be able to read this book without pleasure and profit, and without recognizing the profundity, the acutcness, and the originality of tiio author." — The Quarterly Journal of Science (Edited by William Crookes, F.R.S.). "Dr. Churchill declares pulmonary consumption can be successfully treated. Tliis opinion is sup- ported by physicians in all the principal cities of Europe, and copious extracts from their observations on the different cases are given, the cures always following closi ly upon tlie use of liypophospliites by the sufferers. One lias only to note the names of seveial well-known English physicians who attest the value of this remedy, to be convinced that the discovery of Dr. Churchill is an immense benefit to the world. Such a great benefaction is not sufficiently acknowledged." — The Echo. "A book which explains to us in all its bearings the discovery of the cure for consumption made twenty yiars ago by Dr. Churchill, and explains it too in a manner so simple that any person of education may master its general bearings, and which furnislies not only every practitioner, but almost every liead of a family, with the means of battling successfully against one of the greatest foes of the human race, ought not to be neglected by the jmblic at large. 'The hypojihosiiliites are still far from being administered .scientifically in this country, and although known and constantly used by the leaders of the ]irofessi(ni — such men, for example, as l-hysicians of tlie London Hosiiital.s— their real merits are still unrecognized by the rank and file of the medical profession, the very men by whom the public at large are guided and attended in sickness." — Thk Hoor. "Dr. Churcliill has )iublished a work which must take rank among the most imjiortant books of our time from the originality r)f its views, the vigour of its style, and the mass of information presented in it to thi', inil>lic, concerning a sutiject painfully familiar to almost every family in this country. In this work Dr. Churchill not only expounds the princiiilcs u]pon which he bases his method of curing, and, as he avers, of 'st:imi)iiig out' consumption; but he also states that, ]irocee(ling upon the same principles which carried him to the discovery of a 'scientifically conditioiieil sjiecillc for consumption,' he has arrived at the discovery of a .series of compounds wliich act as specifics for all the inflammatory diseases of tlie breathing apjiaratus, of which bronchitis, pleurisy, and diphtheria are the most fatal and the most common."— Thh Law Journal. " I consider the treatment of consumption by liypophospliites as the most rational, the least disagree- able for tlie sufferer, and certainly, as far as concci iis the chance of recovery, the most to be reconinicnded. I could mention many cases in my own practice wliere their use has been followed by the most surprising results." — Dr. J. J. Kkkbisht, Ue I'ijdspiegel, The Hague. THE STCECHIOLOGICAL CURE OF CONSUMPTION DISEASES OF THE RESPIRATORY ORGANS. FROM LETTEKS TO A PATIENT. BY JOHN FRANCIS CHUKCHILL, M.D. THIBD EDITION LONDON" : DAVID STOTT, 370, OXPOED STEEET, W. 1893. All rights reserved. LONDON : HENOKKSON AND bFALDING, LIMITED, l-RINTKKb, 3 AND 5, MARVLEBONK I.ANE, \V. THE STCECHIOLOGICAL CURE CONSUMPTION & LUNG COMPLAINTS. Since tlie publication of the first edition of my book, entitled Letters to a Patient on Consumption, the public has been startled and thrown off its mental balance by the announcement that Dr. Koch, the discoverer of the bacillus of tubercle, had likewise succeeded in finding its antidote. For many months the almost daily account of the experiments upon patients by Dr. Koch or his assistants, kept not only the public but the whole scientific and medical world in a fever of expectation and hope. Patients and physicians rushed from all parts in hundreds to Berlin. This was not only a new thing in a special line, but was to be a new departure in every direction. According to some enthusiasts, almost every disease was to be treated by inoculation, and almost every- body was to be inoculated beforehand, over and over again for almost every kind of disease. The Sanitary Millennium was to begin in full swing, and everybody without distinction, ill or well, was to live under the doctor's thumb. Unfortunately, these hopes have ended in disappointment. Dr. Koch's process of iv Tlie Stcechiologicnl Cure of inoculation has now been abandoned and relegated among the things which have blossomed and borne no fruit. The starting-point of all these researches with regard to systems of inoculation was the practice of inoculation for the prevention of small-pox with the virus taken from mild cases of the disease which has been in use in the East, almost, as it would seem, from time immemorial. This was first introduced into England by Lady Mary Wortley Montague at the beginning of last century, and then was perfected by Jenner's magnificent discovery of vaccination. In our own time, Pasteur has opened up a new field of the same kind by his discovery of the prevention of rabies by the inoculation of an attenuated virus. But when physicians thought that they were going to wipe out the disease already existing in a consumptive patient by a similar mode of treatment, they overlooked several very imjDortant considerations. The virus of rabies is concentrated in its action chiefly on the spinal marrow, which seems to have for it a specially attractive power. In small-pox, the skin is the part mainly affected, and although, of course, in both these instances the blood and fluids of the body must be impregnated with the poison, the disorganization produced by the disease is not apparent in large organs of vital importance to the system. In Tuberculosis the case is different. Almost every part of the body may be the seat of the tubercular deposit caused by the microbe. And above all, in Consumption and Liuig Complaints. v Phthisis — that is, Consumption of the lungs— the de- struction almost always goes so far as permanently to incapacitate these organs from fulfilling their functions. After death, a consumptive lung is often found stuffed with tuhercular matter, which was destroying or has destroyed large portions of it, as full as a rich plum- pudding is stuffed with currants and plums. Small-pox and rabies are maladies which have a marked and regular course of evolution. When once the disease is established it goes through certain phases, and ends either in death or recovery within a definite period of time. It is not so vdth Tuberculosis, at least in the human subject : its duration in some instances may be any number of times as long again as in some others, and there is no constant and definite regularity in the evolution of its successive stages. Again, small-pox is very seldom repeated in the same individual, while patients may not only have Consump- tion twice, but almost any number of times ; nay, the tubercular diathesis which is the necessary condition in which the bacillus can find entry into the system, and live and propagate when it is there, this constitutional condition may exist for years, or revert almost indefinitely, and can only be efficiently counteracted by the persistent and methodical use of the Hypophos- phites. Instances of this kind may be seen every day in growing children and in all patients where there is ■waste of energy without corresponding repair. I too often meet with cases where the disease which had been checked or prevented, perhaps not only once, but vi The Stcechiological Cure of several times, has been at last allowed to have its own way, through either the neglect or the ignorance of the patient or of those about him. There is another and essential difference between rabies and small-pox on the one hand, and tuberculosis on the other, which was not taken into account. The inoculation for rabies and small-pox is only efficient as a preventive : it has little or no power when once the disease is developed. Dr. Koch's inoculation for tuberculosis was expected not to prevent, but to cure the disease when established, although some phj^sicians, without even waiting for the results of his experiments, were already advocating the usefulness and necessity of the universal inoculation of Koch's fluid as a preventive in healthy persons. Dr. Koch's merits as an original investigator and discoverer occupy too lofty a position to be reached by any backwa ve of ill success. He has been fortunate in the fact that his claim to scientific fame was not originally founded upon some improvement or some discovery in the treatment of disease. Had it been so, there is little doubt that whether his discoveries were real or not, the result to him would have been the same so far as the action of the medical profession is concerned. Like all who have gone before him in the path of therapeutics, the least he could have expected would have been, if not active and acute malevolence, the iron and pitiless conspiracy of silence. That it was very unlikely that Dr. Koch's method would have the success which was expected from it Consumption and Lung Complaints, vii must liave occurred to almost every pathologist suf- ficiently acquainted with the processes of Tuberculosis, for several reasons which cannot fail to appeal to any physician after due reflection. I have never been able to understand how physicians who have seen at post-mortem examinations what was the condition of a tubercular lung, could for one moment suppose that the destruction of the bacillus would do away with such a state of disorganization, even admitting, as was thought at the time, that the bacillus could be wiped out of existence as easily as a written word is wiped off a slate with a wet sponge. In a common-sense view, to expect such a result is about the same as to contend that if you only put out a fire, no matter what its intensity and duration, the building involved will stand just as it stood before the fire began. I know that Dr. Koch himself has not claimed for his treatment any such influence over the advanced stages of the disease, but many, not to say most, of his disciples have not hesitated to do so, and this was certainly the expectation of the public. Dr. Koch him- self only claimed that it would cure Consumption in its initial stages. In that case it would only have done what has been done for thirty-five years past, and is being done every day, all the world over, by my discovery of the medicinal action of the Hypophos- phites made by me in 1855, and published to the world without reserve in 1857.* The action of the * See two papers read by me : one in the Memoiis of the Paris Academy of Medicine, July 21st, 1857 ; the other in those of the Paris Academy of Sciences, May 31st, 1858. viii The JStoechiological Cure of Hypophosphites is such that they not only cnre the disease when not advanced beyond a certain point, hut, what is perhaps more important still, they act as a sure preventive against it in the case of all who are predisposed to the complaint. I therefore consider that it is not only a right, but a duty incum- bent upon me to call the attention of the public at large to my discovery of the specific treatment for Consumption : the more so as during the thirty-six years which have elapsed since I published it, I have been constantly engaged in improving the treatment of the advanced stages of the disease, and I think that I have now carried it to a point which will hardly be surpassed until we have found the means of supplying new lungs. The proof of this is apparent from the latest results obtained at my Public Free Dispensary, where, out of forty patients who were fully and methodically treated with the complete means now at my disposal, sixteen were cured, fifteen improved, six were re- maining under treatment, three followed the treat- ment for too short a time to allow of any marked result being produced, and and not one died. I do not think that any success approaching this has ever been obtained before at any hospital or in any private practice.* The means by which these last results were obtained * My London Dispensary was open for six years, and was then closed tor reasons which are of no interest to the reader. It was free to all patients without any charge, and at all times to the inspection of members of tlie medical profession. Reports of the cases were regularly published. The following are the results obtained in the treatment of Consumption and Lung Complaints. IX I have, after mature reflection, decided not to make public for the following reasons : — First, because, as Dr. Koch stated with regard to his inoculating liquid, every inventor has an inde- feasible right to his own discovery ; and it is not only his right, but his positive duty to guard it against the effects of hasty, prejudiced, and too often malevolent misrepresentation, founded upon ignorant, superficial, or biassed experiments. Secondly, because in so doing I am only following the acknowledged and universal practice of the most eminent members of the Profession, whose pubKc utterances are almost always confined to points of pathology, but who are entirely silent as to modes of treatment, except occasionally, when their object is to Consumption during the six years from 1885 to 1891 by the use of the Hypophosphites and other Stcechiological Remedies : — Total Cases Treated. 100 1886 1887 • 96 1888 101 1889 88 1890 87 1891 (Nine months) 40 Cured. 18 14 11 12 18 16 Improved. Remained Under Treatment- Died. Nil. . 31 .. . 21 ... 5 .. . 25 . 21 .. . 22 .. 3 . . oti . 36 .. . 29 .. 3 . . 22 .. 25 .. . 27 .. 8 . . 16 . 32 .. . 15 .. 5 . . 17 .. 15 .. 6 .. . . 3 IMPEOVBD means that the disorganization or destruction of lun^ tissue was too considerable to have disappeared in the time the patient was under treat- ment. "NIL means that the patients were under treatment too short a time to produce any marked effect (usually less than a fortnight). Note. — A smaller number of patients were treated in 1891, because, as many of them in former years had left off the treatment as soon as they felt better — they were made to give a promise that they would continue the treatment as long as the physician thought the case required — with the result, that only three cases out of forty are marked as nil, instead of the larger proportion noted in former years. X Tlie StoecMological Cure of controvert or deny the value of that proposed hy some- body else.* Thirdly, because it is certain, from what has already occurred with regard to the Hypophosphites, that by making known my secondary treatment, which com- pletes that of the Hypophosphites, I should be acting, not only against my own interest, but against the interest of the public, and ultimately to the disparage- ment of medical science. A short account of what has happened with regard to the Hyj)ophosphites will make this clear. When I first published my discovery, and declared that Consumption, which was then the most fre- quent, and had proved until then to be the most incurable, of all diseases, could always be cured under certain ascertained conditions, nothing was too hard or too bad to be said of me or my treatment. It was tried at the special hospitals and declared * This is well shown by Dr. Buniey Yeo who says: "Every accomplished and intelligent physician and medical practitioner possesses a series of therapeutic facts and observations, many of which he has acquired for himself, many he owes to a sort of unwritten tradition, and these for the most part he keeps to himself. I intentionally state it as a reproach that the jjhysicians in the largest practices rarely communicate anything to the profession as to their modes of treatment. They will read elaborate papers and lectures on more or less disputed pathological doctrines, but, as to the theraiioutic methods they practise, as to the therapeutic observations they have made in the course of their vast experience, they are for the most part as silent as their own door-plates." — Introductory Lecture delivered at King's College Hosjiital by Dr. Burney Yeo, Physician to the Hospital ami Professor of Clinical Therapeutics in King's College. — The Lancet, Feb. 6t/i, 1886. Consumption and Lung Complaints. xi to be utterly useless. Uuackery, which waits upon medicine as its shadow, was the most venial of the crimes I was accused of. Now, the Hjpophosphites are used all the world over. They are in the Pharma- copoeia of every civilized country. They form the avowed basis or secret ingredient of every remedy for Consumption. In the United Kingdom alone there are a large number of different firms or persons who make a speciality of selling, or more frequently of quacking, the Hypophosphite salts, either under their own name or under some disguise : and the Hypophosphites being, as I pointed out, not only a specific for Consumption, but the best and most certain of all tonics, all kinds of combinations and mixtures, all sorts of foods and beverages, all containing Hypophosphites, are sold to the public for the cure of all kinds of diseases. At the time I published my discovery a pound weight of a Hypophosphite salt, ready made, could probably not have been got in London for a pound weight of gold. These salts only existed as laboratory samples. I have it upon the highest pharmaceutical authority that the quantity of Hypophosphites now made in Grreat Britain for pharmaceutical purposes, without counting those used for foods and beverages, amounts to three tons a year. The result of this has been that while the mortality from Consumption in England and Wales was in 1855 one in 354 persons living, and the propor- tion of the mortality from Consumption was one in eight to the total number of deaths from all diseases ; in 1889 it had fallen to one death from Consumption to ^ii The StoecJiiological Cure of 648 of the population, and one death from Consumption to 11 '5 deaths from all other diseases.* The proof of the efficiency of my discovery rests, however, not only on the fact of the steady decline of the mortality fi'oni Consumption in England, coincident with the increased use of the Hypophosphites either as a medicine against Phthisis, or as a vital stimulant, but also upon a complete and persistent consensus of medical opinion. Since the publication of the first hasty adverse trials made at the outset of my discovery in 1858 and 1859, all the medical testimony published has been favourable. Not one of the points I had established has been shaken, and many of the sources of error and misapplication of my treatment which I had indicated have been confirmed by other observers. (See Letter Y. in Letters to a Patient.) This was shown again quite recently by several communications made at the meeting of the British Medical Association in 1891. The complete efficiency of the Hypophosphite treatment against Phthisis, within the scientific limits which I had pointed out at the origin, was proved by the results of the cases treated at the * Table showing THE Decbease in the Moktality FIIOM Consumption. 1855. Death to 1 ] n every ,354 persons living. 18fiO. >> jj 390 „ 1865, ) f} 393 „ 1870. 414 „ 1875. 452 „ 1880. f ) t 5:« „ 1885. tt >> 570 „ 1SS9. >i •> 648 Cotisumption and Lunrj Com]jlaints. xiii Oity of London Hospital for Diseases of the Chest. One point is particularly worthy of notice. I had shown by my researches that the various Hypophosphite salts could not be all used indifferently in the treatment of Phthisis, and that more especially some of these salts are so injurious that they may be called fatal in Consumption. This was one of the points that was specially urged upon the attention of the meeting.* Now wiU it be believed that there are preparations of Hypophosphites which are extensively used, and even largely prescribed in cases of Consumption by the medical profession which contain these very Hypo- phosphite salts, that ought never to be used in Con- sumption ? I am constantly meeting with patients who have been treated in this way, and who after showing improvement for a time have fallen away through the production of haemorrhage and destruction of lung tissue, owing to the use of the very salts which I have expressly stated over and over again, for more than thirty years past, should never on any account be given to consumptive patients. One of the reasons of this is that the Hypo- phosphites are not employed solely for the treat- ment of Consumption. The different salts have distinct properties, and are specially efficacious in other diseases depending upon the general condition which underlies what is called a deficiency in vital power. Their specific action in these cases was pointed * British Medical Journal, Oct. 17, 1891, p. 837. xiv Tlie Stoechiological Cure of out bj me at the very outset of my discovery, as were also the other diseases, besides Consumption, against which I found them efficacious ; but I stated at the same time that my object was not to introduce a quack medicine useful in almost all ailments, but to show that Consumption, hitherto looked upon as the most incur- able of all diseases, was always amenable to treatment under the scientific conditions which I had described.* The decrease of the mortality from Consumption in England by the use of the Hypophosphites is therefore due to two causes— partly to their being prescribed by the medical profession as a cure for the disease, and partly because owing to their general use under their own name, or under some disguise, as general stimulants of vitality, they act as a preventive of the disease. As I said when I published my discovery, the use of the Hypophosphites produces in the system a peculiar state of things which does away with the diathesis or general condition characterized by languor and weakness which precedes and allows of Consumption. Now, in the light * See my different works. De la Cause immediate de la Phthisie Pulmonaire. Paris, 1858, pp. 225, 226. The second edition of the same work. Paris, 1864, p. 676. Consumption and the Hypophosphites. London, 1875, p. 65. Also Lancet, Nov. 20, 1861, p. 518. Quite recently (May 10, 1893) I have received valuable testimony in a letter from the celebrated Professor, Dr. Zdekauer of St. Petersburg, Physician to the Emperor of Russia, in which he says: "In my practice I have verified your statement of the powerful efficacy of the Hypophosi)hites in all cases where the disease had not passed the second stage and was limited to one lung : also at the age of puberty, and as a preservative in cases of heredity." Dr. Zdekauer was the first to intaodiice the Hypophosphites into Piussia on the publication of my discovery. See p. xxviij. Consumption and Lung Complaints. xv of Dr. Kocli's discovery of the tubercle bacillus, it may be said that the Hjpophosphites produce in the system a condition which either prevents the intro- duction of the bacillus or kills it off when it has been introduced. After the bacillus has had free play for a certain time, and has produced sufficient local destruction and transformation of tissue to constitute for it a sort of nidus or refuge of diseased surroundings, it becomes isolated from the living parts, and is, to a great extent, independent of the general condition of the system. The Hypophosphites, then, no longer possess the same efScacy as in the earlier stages of the disease, and this new state of things requu-es other modes of treatment, either with or without the Hypophosphites, according to circumstances. As already said, I have now, by means of organic substances which I have discovered, and which I make synthetically, acquired the power of more than doubling the favourable results obtained with the Hypophos- phites alone. This discovery, which is based upon the principles of Stoechiology, embraces a considerable number of new substances, which have a sjpecific action in other diseases besides Consumption.* * See Stcecliiological Medicine (the only scientific basis of medical treatment which I have been teaching for thirty years), London, 1884, and Letter to the Registrar-General on the Increase of Cancer in England, London, 1888, Appendix, p. 56. The resnlts I have now attained are, unless I am much mistaken, as important as the discovery of the action of the Hypophosphites as a specific remedy for Consumption, and may already be divided into three classes. Certainties: Under this head come specifics for Diphtheria, b xvi Tlie StcecMoTogical Cure of This special problem of the cure of Consumption, as likewise that of diphtheria and whooping cough, which I have fully worked out upon the lines of Stoechiology,* is owing to the great prevalence of these diseases, a matter which at any moment may come home with pressing urgency to every one, high or low, either for himself or for some one near or dear to him. Every now and again we have instances of some person in exalted station or prominent position who, through his own fault or that of others, thus meets with a premature fate which might have been avoided. We are on the borders, although we have not yet crossed its threshold, of an era of discovery to which the past. AVhooping Cough, Gout, Rheumatism, Neuralgia, Heai't Disease, Gravel, Bright's Disease, and immunity from trojiical fever. Proha- hilities : Here are included Typhoid Fever, Cholera, and Diabetes. These in their turn open \ip a view of Fossibilitics too numerous to mention. The doctrine of Stoechiology is as yet ignored ; but Dr. Brown- Sequard's ' ' Sequardine " as a rej uvenator is on the lines of Stcechiology . So is the thyroid treatment of Myxcedema recently invented by Mr. George Murray. See Appendix above quoted, p. 57 ; my j^amphlet on Stcechiology, p. 8 ; and Doctrine Stcechiologiqice du Cholera, par Dr Rullier-Beaufond (Paris, 1866). There is this difference between what I have done respecting the Hypoi)hosphites and my work concerning these new remedies : the Hypophosphites were not discovered or first made by me, but bj' Dulong, as far back as 1816. AVhat I did with regard to them was to introduce their use as medicinal agents : to show that they were not poisons, as had been thought until then, and to prove that by their action upon the system they supjilied the want of an element the deficiency of which I considered was tiie cause or necessary con- dition of Consumption. My now remedies are new organic compounds, which I have made by synthesis, which did not exist before, and which exist only M'hen 1 make them. (See Eejjorts of my Dispensary.) * See First Report of my Disiicnsary, pp. 18-19. Consumption and Lunq Complaints. xvii however great this century maj have been, will have nothing to compare. This advance must take place upon two lines : one, the line of man's power over the forces of nature, the other, the line of his knowledge and control of the conditions of his own existence. Of these two the latter is certainly of equal importance vdth the first, and sometimes, as far as the individual is concerned, j)9'i"9'™ouiit to it. The effect of any increase or imj^rovement in the means of comfort and happiness will he limited or marred by suffering from disease. The prevention and cure of diseases should therefore he a matter of vital importance, not only to every individual, hut to the community. " Ah ! what avail the largest gifts of Heaven, When drooping health and spirits go amiss ? How tasteless then whatever can be given ! Health is the vital principle of bliss." Thompson. That medicine is one of the most backward of all the applied sciences is a matter of public notoriety, and of almost daily public reproach. That it is so depends upon the fact that all innovations have to go through a period of probation, the length of which varies with the difficulty of the problem to be solved and the moral and intellectual development of the class whose duty it is to solve it.* *]\Ir. Lecky says : " Hardly any other of the great branches of human knowledge is at present so backward, tentative, and empirical as medicine, and there is not nauch doubt that the law of supply and demand is a main cause of the defect. Almost all the finer intellects 62 xviii Tlie StoecJiiolor/ical Cure of It is a well-established fact that all innovations require a certain time, often a very long time, before they are accepted. Even such a discovery as Newton's Law of Gravitation was not accepted on the Continent for nearly a century, and almost any number of instances of a similar kind might be given from all branches of knowledge. There is, therefore, nothing special in this to the medical profession. Still, it may, which are devoted to this subject are turned away from independent investigations to the lucrative paths of professional practice. Their time is engrossed with cases, most of which could be treated quite as well by men of inferior capacity, and they do little or nothing to enlarge the bounds of our knowledge." The Lancet, October 22nd, 1892, in answer to this, says that this difficulty will be overcome by endowments. I am afraid that the establishment of endowments would only supply means of observation : it would not of itself produce either the capacity for rinderstanding what was observed, or for carrying the science beyond the facts themselves. The talent or ])ower of invention cannot be manufactured on demand. Perha]»s the time may come when man will be able to invent inventors, but until now they can only be discovered. They are like novelties in horticulture — sports, freaks of nature. Before he can be endowed, tlie inventor must be sought for and found. Like the hare whose fate his own too often resembles, he must be caught before he can be sjiitted and roasted. The establishing of endowments would only enable those who hold them to keep down tlie discoveries of all outside of their own circle. The only way to avoid this is to create a public office with a scientific head, whose duty it should be to examine all claims to discoveiies or inventions brought before him, particularly by qualitied persons, and to investigate and follow with the assistance of a jury of experts the proofs afforded by the inventor himself, or persons by him appointed. This, of course, means expense, trouble, worry, disajjpoint- ment. But that is only requiring that the community or a delegated portion of it should be subjected to an ordeal similar to what some inventors spend their lives in going through, :ind with a similar result: most frequently a failure, but every now and again a success which wipes out all the past and compensates for it a hundredfold. This will some day be done, and whichever civilized country first adopts Consumption and Lung Oomj>lainfs. XIX and to many people it must appear extremely singular that the medical profession should not form an excep- tion to this general rule. Certainly no class of men are individual!}^ more ready and more in the daily habit of postponing their own personal interest to that of others. But this remark applies only to individuals ; as soon as we look at them as a collective body, we find that they tliis plan will leave all the rest far beliind unless they make haste to follow close upon its heels. As I wrote years ago, ''inventors have made the world what it is, and if they only shut their hands the world would stand still" {Consumption and the Hypophosphites, chaps, ix. and x.). As far as I myself am concerned, I stated several years ago that I, as an inventor, had gone upon strike. I have prosecuted my researches and discoveries, and shall continue them, but will not make them public, happen what may, until justice has been done me for the Hypo- lihosphites, and I advise, as I did in 1875, all inventors— particularly inventors in medicine— to do the same. Let them place their dis- coveries upon record, and go out of the world with them. Mankind will thus in time be taught what is the value of invention and inven- tors by the only way in which such a lesson can be taught. Lecky's opinion refers evidently to medicine less as a branch of biology than as a practical means of curing disease. So far, almost all inventors in this line have been looked upon by the profession as enemies against whom everything was justifiable. All the endowments founded for the purpose of favouring discovery have been used to prevent or discourage it. The Small Pox Hospital did all it could to prevent the introduction of vaccination and to ensure its failure. After Jenner's discovery was fully admitted, and rewarded by a parliamentary grant of £40,000, a society was formed to propagate vaccination, but Jenner was not accepted as a member of it when he api.lied to be so, and the College of Physicians thought it would be a disgrace for them to admit him among them (see Consumjition aiid the Hypophospldtcs, p. 320). The special hospitals founded for the express purpose of improving the treatment of Consumption have for many years, with the exception of the City of London Hospital, been doing the same thing. See Reports of the Brompton Hospital in my book, Consiimptio7i and the Hypo2)hosphites, pp. 14, 363. XX The Stoechiological Cure of are, like all corporations, impervious to argument, and to every appeal to their better selves. The whole history of medical improvement, as a practical art, tells the same story. From Harvey, who found that his discovery of the circulation of the blood injured his practice, and left him almost without a friend, down through "Wells, Morton, and Jackson, the inventors of etherization, two of whom out of despair committed suicide,* to Semmelweis, who died as recently as 1865, all discoveries in the practice of medicine present the same uniform feature — neglect or perse- cution of inventors during their life time, tardy or no recognition until after their death. This story of Semmelweis, which is the most recent, is a conspicuous instance. Child-bed fever which medical men of my genera- tion can recollect as ravaging whole wards of hospitals, was discovered by him to be caused by infection con- veyed by the physicians themselves to the patients, t and Semmelweis showed that by proper precautions and antiseptic means this could be prevented. What was his reward ? He was hounded out of Vienna, and idtimately was so much affected by the neglect shown for himself and his teaching that he went mad, and died in a lunatic asylum. * See Consumption and the ITypophosphites, p. 406 and following. t So bad was tlie mortality from puerperal fever in Dr. K 's ward in the maternity department of the Great Gcnei-al Hospital at Vienna, that patients on finding themselves inmate.s of the dreaded clinique, fell on their knees, and with clasped hands begged to be allowed to return to their homes. — Lancet, Oct. 29th, 1892, p. 1003. Co7isumj^tion and Lung Complaints. sxi On the 24tli of last October a meeting was held at the Eoyal College of Physicians, for the purpose of promoting subscriptions for a monument which is to he erected to his honour at Buda Pesth.* Among the learned, well read, and practical men there present, how is it there was no one found to say with Gray — " Can Honour's voice provoke the silent dust ; Or Flattery soothe the dull, cold ear of Death"? They were truly met to do what the Scripture says : " If your son ask for bread, shall ye give him a stone ?" Semmelweis only asked for a little encouragement, a little appreciation, a little sympathy, which are the bread of life to the discoverer, and he gets nothing but a stone, and even that only after he is dead.f If such a monument means anything at all, it is. simply a monument to the disgrace of the medical profession. The proper inscription to place upon it would be, " To the Memory of Semmelweis, the "Discoverer of the Cause and Eemedy of Puerperal * See Lancet, Oct. 29, 1892. t At this meeting the President of the College of Physicians, Sir Andrew Clark, said : "In regard to his tremendous moral heroism, in spite of every conceivable difSculty, in spite of persecution, he continued his labours, imtil crowned with a full clearing up of the difficulties. As to his martyrdom there is not such a history " (Lancet, Oct. 29th, 1892). To the mind of a man of such intellectual eminence as Sir Andrew Clark, it must surely have occurred that there is no necessary connection between martyrdom and innovation in science, particularly at a time when there is none between martyrdom and change in religion as it was only two centuries ago. xxii The StoecJiioIogical Cure of "Fever. He died a victim to the hatred and jealousy " of his professional contemporaries. Among the most "prominent of his persecutors were Doctors So- " and-so." Their names might easily be found, and ought to be handed down to posterity. To me it would appear, and no doubt it will to many other people, that a monument of this kind really says : " If you do, or attempt to do, as I have done, you must expect to receive the same treatment as I have received." If I might be allowed to make a suggestion tending to the practical cure of such a state of things, I should wish that some member of a similar meeting to that held in honour of Semmelweis would propose the following resolution : " Seeing how often it has occurred in medical science that discoverers of impor- tant truths have been ignored, boycotted, and persecuted, and that the appUcation of valuable improvements has thus been delayed for a considerable time, to the loss of humanity and the disparagement of the medical profession, the individual members of which are, with a few exceptions, personally innocent in the matter : We, the members of this meeting, in order to testify in a practical manner of our regret for the misdeeds of the past, and to prevent as far as possible the recurrence of similar calamitous consequences, have decided that steps shall be taken for calling upon the Government to appoint a Commission, whose duty it shall be to inquire whether there may not be at the present time one or more cases of a similar kind to that which we have just considered, and the past effects of which we Consurnjption and Lunrj Complaints. xsiii deplore the more deeply as now they are beyond remedy." * It is but fair and right to say that the difficulties in the way of a settlement of this question of the cure of Consumption are very great, and, like all complicated issues, leave room for honest difference of opinion, and unfortunately still more for dissent, which is not always so. The art of therapeutics — that is, the treatment of disease — is in such an inchoate and uncertain state that there is no rule or standard for measuring and regulating the effects of medicines. This is in a great measure due to the fact that in its present state of historical development this crowning branch of * Some may think that the reception accorded to Pasteur's aud Dr. Koch's inoculations proves that the medical profession is always ready to accept and impartially examine new discoveries. I am atraid, however, thata little rejection will show that therewere peculiar circum- stances attending Pasteur's and Koch's systems of inoculation, which will account for the action of the pi-ofession in this instance, without attributing to it any of the qualities of freedom from prejudice which has liitherto been belied by its conduct in all similar instances of new discoveries in therapeutics. The following are some of them : — Pasteur is not a medical man, and so excites no professional animus. Before his discovery of the inoculation for rabies he was already a member of the French Institute, and had made himself famous all the world over by unveiling the conditions of fermentation. Rabies is a rare disease which few medical men ever meet with ; it is nearly always fatal, and brings tlie physician neither fame nor profit. Pasteur's preventive treatment is efficacious and short, and no one has an interest in its failure. Koch's system was on the lines of Pasteur's discovery of inoculation for rabies, the success of wliich has produced a perfect mania for inoculations of every kind. Koch as a bacteriologist was already eminent in a new lino of study of which the profession knew little or nothing, and of course they took as other people — Omiie -ignohwi pro xxiv The StcecJnological Cure of medicine, that for wtiich all its other branches are instituted, cannot be said to have as yet any scientific status.* I have shown how a general principle of treatment can be established and applied, and how as a consequence of this general method the use of the Hypophosphites in Consumption could be managed scientifically. Their successful application would thus be within the reach of every j)ractitioner who was careful to follow my rules, instead of being, as is too often the case with most remedies, the privi- onagnifico. The inoculation itself is a delicate operation which always demands the hand of the ph3'sician, whose constant and active superintendence is also required to regulate the action of the remedy. This action was almost always immediately followed by a very pei-ceptible and sometimes a very painful, or even an unfavour- able, effect, which, had the advantage of convincing the patient of the great power of the means that were being employed. And lastly, as the preparation of Dr. Koch's virus was a very difficult and delicate process, demanding considerable time, the special skill possessed only by himself and his assistants, and as it could be supplied only in vei-y limited quantities, it is hardly going too far to assume that here and there among the number who had hastened to hail the new discovery, more than one of them, parti:iularly among the tyros of the profession, who constituted the large majority, might reasonably Hatter himself that when he returned home with the wonder-working virus in his possession, each would be, for a time at least, the Koch of the walk ! A natural, legitimate, and honour- able ambition. See a very curious and interesting account of the sights then to be seen in Berlin in Dr. KocWs Treatment, ami the History of the C\ire of my oum Case of Consumption by Dr. Churchill's Methods, by General S., in the Russian Journal Niedjela for December, 1891. * This is an old and notorious complaint. As far back as 1866 in a paper read before the Medical Society of New York, Dr. Squibb said : "The accomplished diagnostician of the piesent day can in a large majority of cases decide witli great accuracy the essential character and stages of disease, but can claim no such skill or accuracy either in Consumption and Lung Complaints. sxv lege of the few endowed with a kind of medical instinct, which is not seldom the true secret of the successful physician. But this to the medical mind was, and still is, as startling a novelty as was at the time my claim to have found a remedy for Consumption. I know of no work on therapeutics where the rules I have thus laid down have been given. They have been passed over as of no account.* In surgery the minutest condition is carefully noted, as it is also in medicine in the diagnosis or recognition of diseases ; but in the treatment of them nothing can be more jejune, negligent, and sometimes actually disgraceful. tlieir i^revention or their cure, and, Avorse than this, appears determined to leave tliis field of labor, thus daily and so forcibly urged upon him, uncultivated." (Transactions of the Medical Society for the State of New York, 1866, p. 26). Twenty years later we find there is still the same thing, as is well shown by that very distinguished and acute observer, the Professor of Clinical Therapeutics in King's College, Dr. Burney Yeo : ' ' ^Nothing perhaps would surprise an intelligent lay inquirer into our systems of medical education more than to hear of the gi-eat number of subjects to which the student of medicine is compelled to give a large amount of attention, and to learn at the same time that the subject of therapeutics, the subject Avhich is specially concerned with the practical application of all these other subjects, for which alone they are taught, has been for most practical purposes omitted altogether." — Lancet, Feb. 6th, 1886. * Even such an evident thing as the purity of the medicines employed has been systematically ignored in the case of the Hypophos- phites. I had shown experimentally (see ConsumjJtmi and the Hypo- phospliitcs, p. 68) that they were only efficacious when chemically pure, and that they should never be mixed with other substances. In almost all those which are used this puritj' is wanting, and they are con- stantly given mixed up with other substances of all kinds from cod- liver oil to arsenic and strychnia. This essential condition of purity may alwaj's be secured by using the Hypophosphitcs prepared by Swann, of Paris. xxvi The Stcecliiological Cure of Almost every Consumptive patient now gets the Hypo- phosphites, but often too late, not the right thing, or not in the right way. The same has happened with other important remedies. (See my Letter on Cancer, and the striking instance below.*) Consumption may be called the disease of delusions. It is very plain that the issue of a malady which ends by destroying the lungs must depend, whatever the power of the remedy, upon the amount of destruction already produced when the treatment is begun. But of this the patient and his friends know nothing, they simply form their opinion of the case from the intensity of the symptoms : they may suppose that a common cold of some violence is a bad case of Consumption, or they may believe that a slow case of Consumption ia nothing but a common cold, and delay calling in the physician until irreparable damage is done. Now this is a point which it is not always easy to decide, even * The following instance fully bears out what is stated above. Many similar ones occur daily. but it is seldom they can be authenticated. There are few men who show the honest frankness of Dr. Burney Yeo. "One of the most remarkable gains," aa-ys Dr. Yeo, "in the treat- ment of disease in recent years has been the employment of large doses of iodide of potassium in the treatment of internal aneurism. In common with many physicians, I have seen more satisfactory results follow this mode of treatment than any other. Yet when I first began the use of iodide of potassium in the treatment of internal aneurism the results were disappointing, and my belief in the remedy slight. I found the same to be the case with some eminent physicians and surgeons whom I met in consultation. But in the year 1877, on the occasion of the meeting of the British Medical Association at Manchester, I was fortunate enough to see in the infirmary of that city a number of cases of thoracic aneurism which had been collected together by Dr. Simpson for the purpose of showing the members of Consumi>tion and Lung Complaints. xxvii for the physician himself. It is sometimes a difficult matter for a very skilled ausciilator, and one who has a thorough practical knowledge of lung diseases, to decide the extent of disorganization which has ah'eady been produced. It may thus happen that, owing to his mistake as to the damage already done, because he has neglected or been unable to determine the real condition of the patient, he may think that the effect of the Hypophosphites falls short of what he had a right to expect. In his application of the remedies he may not take sufficient account of acci- dental complications, or may consider disturbances pro- duced by them as indications of failure in the efficacy of the specific treatment. Again, in this, as in all chronic diseases, the success of the treatment depends as much upon the will of the patient himself as upon the physician. It too often happens that an accidental and temporary aggravation of the Association the vahie of the iodide of potassium treatment in snch cases. It was certainly a remarkable series of cases, and the results were excellent, and it was found that whereas in London I and others who had tried this treatment had been content with giving five grain doses three times a day. Dr. Simpson had given twenty, thirty, and forty grain doses instead. Now, as soon as I began using these large doses of iodide of potassium in the treatment of internal aneurism, I realized its great remedial value, and I have had the happiness of seeing most admirable results follow the prolonged administration of theae large doses." — Lancet, Feh. 6th, 1886. The discovery of this mode of treatment is due to Dr. Chuckerbutty, of the Medical College Hospital, Calcutta, who published his first results in the British Medical Journal, 1862. I have obtained still better results in the treatment of heart disease and internal aneurism by some of my new remedies, following on the lines first opened up by Chuckerbutty. xxviii Tlie StcecJiioJogical Cure of the complaint, caused b;^ a cold ; a relapse, or a return of the disease, whicli is always possible in Phthisis, nay, even the very improvement which has been obtained, will make the patient remiss or negligent in following his physician's advice. Much more might be said upon this point which I omit. (See Letter YI. in Letters to a Patient.) In spite, however, of all these difficulties, and many others which I have not room to refer to, there are two or three peculiarities in the action of the Hypophosphites in Consumption which would enable any unprejudiced observer to arrive at a definite and unimpeachable •conclusion. The first of these is that, when the disease has not passed the second stage, and is limited to one lung, the proper use of the Hypophosphites almost always pro- duces a cure. (See my work Consumjytion and the Uypo- phoHphitcfi, p. 99.) The second is the effect of the Hypophosphites upon patients below the age of puberty. I say, deliberately and advisedly, that no child ought to die of Consumption at the present day. I have hardly lost a case for years. Even the most extreme cases in children can almost always be cured, while it is a well-known fact that, before my discovery of the specific action of the Hypophosj^hites in Consumption, it was always looked upon as being much more incurable in children even than in adults. Again, in cases of heredity, the methodical and habitual use of the Hypophosphites as a vital stimulant will preserve all the younger members of a family Consumption and Lung Complaints. xxix where all the others have been swept away hj the disease. These three points are of such prominent importance that they alone are sufficient to characterize and establish beyond controversy the specific efficacy of the Hypophosphites. (See note, p. xiv.) But besides the scientific difficulties, there is at the present time another general and permanent source of confusion in this matter. The Hypophosphites are in such common, I might almost say such universal, employ- ment, under all kinds of disguises, as tonics, foods, drinks, pick-me-ups, &c., that it very frequently happens that a patient takes them without knowing it, or without his doing so being known to his physician, and the result thus produced by the Hypophosphites is attributed either to some treatment employed, to the curative influence of some climate, or to some other cause which has had little or nothing to do with it.* * A very remarkable instance of this is the fonnding of Mentone as a winter resort. It had Irardly been lieard of until the year 1859, when all the world rushed there as they did a short time ago to Berlin, but, unlike what happened in Berlin, many of those who went to Mentone were cured. For several years the world was made to believe that this astonishing change in a hitherto incurable disease was cfl'ected by the wonderful all-healing climate of the place, but at last the truth came out, and the author of this splendid and to himself profitable piece o engineering confessed that the cures were due to the use of the Hypo- phosphites not onlj' in the case of the patients, but in his own also. See this curious story, which would be too laughable were it not a question of life or death to thousands, in my Consumption and the Hypojjlwsjjhitcs, p. 367. Every now and again we have the same thing done over again for some new place, in some new or old climate, where land is useless and therefore cheap, and can thus be made valuable by XXX The Stcechiological Cure of A subject like this is of such magnitude that it ought not to be looked upon as a personal matter, nor as a question of justice or injustice to an individual inventor, but as one which involves the life or death of thousands. The broad fact that the mortality from Phthisis has undergone a steady yearly decline since the j)ublication of my discovery of the curative action of the Hypo- phosphites in 1858 is undeniable, as is also the enormous decrease in the mortality from Consumption in the special hospitals. Coincident with this is the ever-increasing use of the Hypophosphites, not only as remedies by the profession, but as mere stimulants and tonics as well as in the shape of foods and drinks. If there is no connection between these two series of facts, then these effects must be due to some other cause, the discovery of which is of the most immediate interest to the 4%000 people who will die of this complaint within a year ; and a cause of such wide and general action must certainly not be very difficult of detection. So far only two explanations have been given, one is improvement in diagnosis, the other improved living ; but neither of these explanations would apply to the results obtained at the special hospitals. There is no reason to suppose that the diet in them is practically better than it was thirty years ago, or that the and for tlie projectors. AVhat is the real value of climate is well shown by the results obtained before the Hypophosphites were known (see p. xxxi.). See on change of climate a letter by Mr. Humphrey Marten, M.B., M.R.C.S. (of Ailelaide, South Aiistralia), in Lancet, March 2rith, 1893, p. 661, where he protests against patients beiug sent to die abroad, and Letters to a Patient, No. VII. Consumption mid Lung Complaints. xxxi physicians of the present day can diagnosticate a case of Phthisis any better than such men as C. J. B. WiUiams, Walshe, Clark, and Quain. Still, in spite of all these disturbing circumstances, there would be very little difficulty in having the ques- tion threshed out were there only scientific obstacles in the way. I have been pleading this cause of humanity and common sense for thirty-five years past, though possibly some readers may think the cause I am pleading is only my own. I little care whether they do so or not, I am used to such things. But if any one feels an interest in this question, either from personal motives, sympathy for relatives or friends, concern for the public welfare, or from the natural kindness of a benevolent disposition, he will find that the settling of it would be of more use than the endowment of many charities, and I would ask him to reflect upon the following facts, which sum up shortly what precedes. In 1855 Consumption was looked upon as the most incurable of all diseases. Dr. C. J. B. Williams, one of the founders of the Brompton Hospital, the introducer of cod liver oil into England, with Walshe, one of the leaders in the new practice of auscultation, and with him the highest authority then living in England for the treatment of this disease, publicly stated that out of 7,000 cases of which he had a record, and which had been treated by cod liver oil, change of climate, and other means, he had only cured seventy-five. The mortality in the Brompton Hospital in 1855 was ninety-six per cent. xxxii The Stceckiological Cure of It was then I published my discovery of the curative action of the Hypophosphites in Consumption.* At that time the action of these salts was unknown. It was thought to be highly poisonous, and it is nearly certain that a pound weight of any Hypophos- phite salt read// made could not then have been obtained in London or Paris in return for a pound weight of gold. Since the publication of my discovery the use of the Hypophosphites has been continually extending, and has been attended by a yearly continuous and corre- sponding decline in the mortality from Phthisis. In 1889 alone in England and Wales the number of patients * The following Tables show the decrease in the mortality from Consuuiption produced by the treatment since my discovery of the action of the Hypophosphites. See my book Coiismnptian and the Hypophosphites, p. 363. Dk. C. J. B. WiLMAMs' Cases. Cases Treated. Cm-ed and j^.^^^^ Mortality Improved. per Cent. 1855 ... 7,000 ... 75 . 6,925 ... 98-9 Brompton Hospital. Cases Treated without the Use of the Hypophosphites. Cases Treated. f "^'^'^ ^"f Died. Mortality Improved. per Cent. 1SG3 ... 6,001 ... 251 ... 5,750 ... 95-8 Brompton Hospital. Cases Treated loith the Use of the Hypophosphites. ^P°r*« Cases Treated. Cure.l and ^.^ Mortalit^y of Improved. per Cent. [gig}-- l.WO - 802 ... 198 ... 198 Since then no reports iiave, I believe, been pnl)lishcd by this Hospital CoiisuiiqdiOH and Luikj Complaints. xxxiii who would have died of Consumption under the old state of things would have heen 70,000. The numher who did die of the complaint, according to the Registrar- General's Report, was 44,738. There has thus been a saving, in one year, of upwards of 25,000 lives. Of the number who have died, I now say without hesita- tion that nine-tenths might have been saved by the scientific employment of the Hypophosphites as a pre- ventive in those who are predisposed, or as curative agent in the incipient stages of the disease. But to realize what this means, we should take into account not only the number of lives which might be saved, but the terrible amount of suffering, both mental and physical, entailed upon families by the long sickness of its members often when already grown up, the loss to the Cases Published BY ME. Year. Total Cases Treated. Cured. Improved. Died. 1856 35 9 11 14 1858 79 17 10 22 1SS5-6 75 18 31 5 1887-8 149 25 79 6 1889 88 12 25 8 1890 87 18 32 5 1891 40 16 Percentage, 15 1856 100 25-7 31-4 ... 40 1858 100 21-5 12-6 ... 27-8 1885-6 100 24-0 41-3 ... 6-6 1887-8 100 16-7 53-0 ... 4-6 1889'' 100 13-6 28-4 ,. 9-0 1890 100 20-6 36-7 ... 5-7 1891 100 40-0 37-5 .. GO The year of lutiueuza. c 2 xxxiv The Stcecliiological Cure of commiinity thus produced, and the spreading of the disease among the rest.* I unhesitatingly assert that at the present day almost every one who dies of Con- sumption does so through his own fault or his doctor's : his own fault in not applying for advice in time, or not following it, or his doctor's hy not using the proper means. Let us assume that the results which I have stated as now obtainable by my complete methods are true, and that out of forty patients thus treated not one died. Let us further recollect that mine were not selected cases, but that all who came to the Dispensary were put under treatment. It follows that all, or nearly all, the 45,000 persons who died of Consumption last year must, at some time or other, have been in a stage of the disease not more advanced than that in which were the forty patients who were treated at my Dispensary. There are uj)- wards of 30,000 medical practitioners in Grreat Britain. Let us suppose that some means had been found of inducing 1,000 of these to each take charge of forty patients and to treat them by the means I have dis- covered.! The question which was first raised by me in 1857, thirty-six years ago, would be fully solved in less * See Third Report of my Free Dispensary. t There is one fact which stands out prominently among the effects proiluced hy the addition to tlic Hypophosphites of my new stoechio- logical remedies, and that is the ahnost total disappearance of hiemorr- hage. With other modes of treatment than mine the fmpiency with which l>lood-spitting occurs vaiii-s between forty-five and sixty-two per cent, (see First Report of my Dispensary, p. 7). CoHsamjition and Lung Complaints. xxxv than thirty-six months, and, provisionally so at least, in less than thirty-six weeks ; and, as I foretold, thirty- six years ago, Consumption would he a thing of the past. Among all the mighty deeds effected by our modern civilization, is there one mightier and better than this ? And if our civilization is anything like what we fondly believe, is not this a matter worth more trouble and interest than nine-tenths of the questions, I care not what they may be, for which public opinion is every day stirred ? We may boast with truth that in this country there is more philanthropy running about seeking to do good, and more money to back it, than in any other country in the world ; but it runs in channels, its courses have already been marked out ; or if any of it is free and unappropriated, there are plenty of appliances on the watch ready to capture it and direct it to their own purposes. Any new claim upon its action, or even upon its mere attention, must be engineered, and this engineering can only be done through an organization of private solicitation, or through the action of the press. Now, the capa- city for invention in science does not confer upon a man any special talent for working either of these two kinds of social machinery ; rather the contrary. Accustomed as he is to converse with Nature, to listen to a voice which when it says Yea always means Yea, and when it says Nay always means Nay, he feels very unqualified to pick his way among the shifting aspects and delusive utterances of xxxvi The Stcechiological Cure of his fellow-men. If he sometimes attempts to do so, he can seldom bring himself to stoop as low or as often as might be required. He is wont to move in a sphere of things where he feels independent, and his mental habit is to rely upon himself. When, therefore, he is called upon, not to invent or to discover, but to work the means necessary for the propagation of the results he has attained, he too often withdraws from the attempt with a feeling of sadness not unmixed with disgust, and lets things be as they are. As our old poet Daniel says — " Seeing thus the course of things must run, Ho looks thereon not strange, but as fore-done." J. F. CHUECniLL. 82, WiMPOLK Strekt, London, W. Consumption and Lung Complaints. xxxvii SUMMARY OF WORK DONE AT DR. CHURCHILL'S FREE DISPENSARY. The results obtained from the opening of the Dispensary in December, 1885, to its close September 15th, 1891, were as follows : — The Hypophosphites used were in all cases those prepared by H. H. Swann, of Paris. Total number of Patients treated 1,518. Of these were suffering from Consumption Asthma and Bronchitis Nose and Throat Whooping Cough Various ... 512 584 258 34 130 Number of Attendances of Patients at Dispensary — DAILY. WEEKLY. 1886 to Dec. 31st. 5,576 1887 7,878 1888 7,407 + 170 1889 4,449 + 2,254 1890 3,288 + 2,518 *1891 to Sept. 15th. 1,304 + 1,490 29,902 + 6,432 == 36,334 7 d.^ 094- != Number of days' treatment ~£u^\jAi':t for weekly patients. 9Q 009 — Number of ditto for daily 4,V,i)\J4, patients. TA- Q9fi = Total number of days' < '±,f7.«u treatment. * A smaller number of Patients were treated in 1891, because, as many of them in former years had left oil the treatment as soon as they felt better — they were made to give a promise that they would con- tinue the treatment as long as the Physician thought the case required. — See note, pp. viij. and ix. For further particulars see Reports of Asthma, Bronchitis, and other Eesjiiratory Com plaints successfully treated by Stteclnological Remedies, and the Yearly Reports of my Dispensary. xxxviii Tlie Stoechiological Cure of Cons^imption. The following tables show the results obtained in the different classes of disease : — Consumption — of the 512 Patients treated were — Cured 89 Improved ... ... ■•• ... 160 Died 24 Remaining under Treatment 120 Nil 119 Asthma and Bronchitis — 584, of whom were — Cured 1(59 Improved ... ... ... ... 188 Died 3 Remaining under Treatment ... ... 119 Nil 105 Diseases of the Nose and Throat — 258, of whom wore — Cured ... 107 Improved ... ••• ... ••• 87 Died None Remaining under Treatment ... ... "23 Nil ... ■•■ ... -+1 Whooping Cough — 84, of whom were — Cured •■• 16 Improved ... ... ... ... 10 Died ... .• ... None Remaining under Treatment ... ... None Nil 8 Various, not classed — 130, of these were — Cured 42 Improved ... ... ... ... 43 Died None Remaining under Treatment .. . ... 13 Nil 32 Those under the heading "Various" comprised the following: — Gout and Rheumatism 28, Neuralgia 9, Heart Disease 23, Goitre 1, Eczema 1, Ajihonia 1, Hay Fever 7, Gastric Ulcer 2, Ana-mia 24, Ozffina 8, Pharyngeal Deafness 7, Dysphagia 1, Nasal Polypus 4, Otorrhcea I, Dyspepsia 1. (For the cases of Consumption, see note, p. xxxiii.) Nil means that the cases were slight, or that the ])atients were under treatment too .short a time to produce any niarked elfect (usually less than a fortnight). COLUMBIA UNIVERSITY 1 This bg^k is due on the date indicated below, or at the expiration of a definite period after the date of bon-owing, as provided by the rules of the Library or by special ar- rangement with the Librarian in charge. DATE BORROWED DATE DUE DATE BORROWED DATE DUE 1 C28'638)MB0 RG311 ^^'^ 1893 Churchill