.

Presumptions are of vast importance in medicine, as in law. A man is
presumed innocent until he is proved guilty. A medicine--that is,
a noxious agent, like a blister, a seton, an emetic, or a cathartic
--should always be presumed to be hurtful. It always is directly
hurtful; it may sometimes be indirectly beneficial. If this presumption
were established, and disease always assumed to be the innocent victim
of circumstances, and not punishable by medicines, that is, noxious
agents, or poisons, until the contrary was shown, we should not so
frequently hear the remark commonly, perhaps erroneously, attributed to
Sir Astley Cooper, but often repeated by sensible persons, that, on the
whole, more harm than good is done by medication. Throw out opium, which
the Creator himself seems to prescribe, for we often see the scarlet
poppy growing in the cornfields, as if it were foreseen that wherever
there is hunger to be fed there must also be pain to be soothed; throw
out a few specifics which our art did not discover, and is hardly needed
to apply [ Note C.]; throw out wine, which is a food, and the vapors
which produce the miracle of anaesthesia, and I firmly believe that if
the whole materia medica, as now used, could be sunk to the bottom of
the sea, it would be all the better for mankind,--and all the worse for
the fishes.

But to justify this proposition, I must add that the injuries inflicted
by over-medication are to a great extent masked by disease. Dr. Hooker
believes that the typhus syncopatia of a preceding generation in
New England "was often in fact a brandy and opium disease." How is a
physician to distinguish the irritation produced by his blister from
that caused by the inflammation it was meant to cure? How can he tell
the exhaustion produced by his evacuants from the collapse belonging to
the disease they were meant to remove?

Lastly, medication without insuring favorable hygienic conditions is
like amputation without ligatures. I had a chance to learn this well
of old, when physician to the Broad Street district of the Boston
Dispensary. There, there was no help for the utter want of wholesome
conditions, and if anybody got well under my care, it must have been
in virtue of the rough-and-tumble constitution which emerges from the
struggle for life in the street gutters, rather than by the aid of my
prescriptions.

But if the materia medica were lost overboard, how much more pains would
be taken in ord