me. That
the effect of this has been ruinous in English practice I cannot doubt,
and that in this country the standard of practice was in former
generations lowered through the same agency is not unlikely. I have seen
an old account-book in which the physician charged an extra price for
gilding his rich patients' pills. If all medicine were very costly, and
the expense of it always came out of the physician's fee, it would really
be a less objectionable arrangement than this other most pernicious one.
He would naturally think twice before he gave an emetic or cathartic
which evacuated his own pocket, and be sparing of the cholagogues that
emptied the biliary ducts of his own wallet, unless he were sure they
were needed. If there is any temptation, it should not be in favor of
giving noxious agents, as it clearly must be in the case of English
druggists and "General Practitioners." The complaint against the other
course is a very old one. Pliny, inspired with as truly Roman horror of
quackery as the elder Cato,--who declared that the Greek doctors had
sworn to exterminate all barbarians, including the Romans, with their
drugs, but is said to have physicked his own wife to death,
notwithstanding,--Pliny says, in so many words, that the cerates and
cataplasms, plasters, collyria, and antidotes, so abundant in his time,
as in more recent days, were mere tricks to make money.

A pretty strong eddy, then, or rather many eddies, setting constantly
back from the current of sober observation of nature, in the direction of
old superstitions and fancies, of exploded theories, of old ways of
making money, which are very slow to pass out of fashion.

But there are other special American influences which we are bound to
take cognizance of. If I wished to show a student the difficulties of
getting at truth from medical experience, I would give him the history of
epilepsy to read. If I wished him to understand the tendencies of the
American medical mind, its sanguine enterprise, its self-confidence, its
audacious handling of Nature, its impatience with her old-fashioned ways
of taking time to get a sick man well, I would make him read the life and
writings of Benjamin Rush. Dr. Rush thought and said that there were
twenty times more intellect and a hundred times more knowledge in the
country in 1799 than before the Revolution. His own mind was in a
perpetual state of exaltation produced by the stirring scenes in which he
had taken a p