quently, his
midnight oil expended, while he peruses the observations, and profits by
the researches of others. Again, the advertising quack is frequently an
unlettered, never a well-informed man, at least on medical topics: his
education, his habits, his purposes, are all foreign to science; the
first has not been devoted to the accomplishment of a particular duty;
the second have not received that polish, or acquired that delicacy so
necessary in the hour of sickness and distress; and the third are
directed solely to the purposes of gain, rather than to the noble aim of
assisting his fellow-creatures; and yet such a character finds support.
To the individual who can depend upon his abilities we may exclaim,
"tibi seris, tibi metis," and so dismiss him to his fate.

After all that has been said of the exertions of the charlatan to abuse
the confidence of mankind, particularly as far as dyspepsia is
concerned, it is due to the medical profession, to state what claims
they may fairly advance, to entitle them to the good opinion of the
public, in the cure of this much talked of affection.

A physician, who understands what he is about, knows very well, when a
case of this nature comes before him, that it may proceed from a variety
of causes; that it may arise in the stomach from a want of digestive
power, from the small intestines by a partial failure in the process of
chymification; that it may depend upon the morbid action of the large
intestines, or exist merely as a symptom of an affection in other
organs. Sedentary habits, or irregularities of diet, are causes which
may be supposed to act locally on the digestive organs themselves; but
the history of a case will generally show that the derangement of the
digestive organs is secondary. When it arises from local irritation, it
can only be produced through the medium of the sensorium; when it is
idiopathic, it frequently originates in causes which affect the nervous
system primarily; such as anxiety, too great exertion of body and mind,
and impure air; in many instances, the nervous irritation which has
induced the disease, being trivial, is only kept up by the reaction of
its effects. Thus says Abernethy, one of the luminaries of modern
medical science.

The first duty of a physician, therefore, is to ascertain from what
source indigestion proceeds, and to frame his treatment accordingly. To
act upon one system of cure, like our friend Mr. Halsted, in a disease
aris