vation, and the other the paying too much. By far the greater numbers, however, fall into the first of these errors, and the various fallacies by which they seek to defend their inattention are passed in review by the author; but, as these are capable of refutation at the hands of any professional man, we need not advert to them. "After a long exercise of my profession," says M. R.-P., "I am convinced that health is that of which men talk most and care least. Business before every thing is, as I have said, their ruling maxim. We are all of us engaged in a cause against Nature, which must be decided before long, and yet scarcely any of us will take the trouble of properly examining the documents upon which so important a decision must rest. Why is this? It is because we eternally forget the grand principle that, it is a hundred or a thousand times more easy to prevent, than to cure diseases." be It may be laid down as a fundamental principle that "health consists in a normal equilibrium of organic excitement and excitability;" and, whenever the conditions of the economy exceed or fall short of the limits of such equilibrium, health is menaced. However various organs may be, they all agree in this, the possession of an inherent excitability, which would however remain inert and powerless if not developed into action by the agency of another power, usually of external origin, which in its ensemble may termed excitation or excitement. Although, however, each organ possesses its special stimulus, yet all are united in one consentaneous chain of action, which constitutes that balance between excitement and excitability whence health results. The numerous relations and varying proportions of excitability and excitement, then, constitute the different conditions of the human body, and consequently of its health. In order to better appreciate them, we must not lose sight of the fact that, excitability may be accumu lated in any organ if the stimulant be defective. But after the normal relation is once established, if the stimulus is continued or increased, the excitability becomes diminished and exhausted, and the organ, and eventually the general health, becomes impaired. In the first of these cases, excitability being in excess, and excitement defective, we have the direct debility of Brown: but where there is diminution and exhaustion of the excitability by the excess and continuance of stimulus, there is indirect debility-a more dangerous condition of the economy than the former, since excitement may always be reproduced, while, when excitability is exhausted by age or excess, life becomes extinguished. Among other examples cited is the following. If a man possessing good eye-sight passes from the light into the dark, his eyes fall into a state of extreme excitability or debility they then become sensible to the slightest ray of light: gradually they become accustomed to this, and support the degree of light suitable to their actual condition. There is a due relation. But let the light be increased in intensity, duration and activity, and the eye will soon become fatigued its excitability is exhausted by excess of stimulus, its structure undergoes alteration, and its functions are disturbed or cease, unless such excitement is interrupted. “In reference to the great influence which this relation exerts on the economy, it may be observed that, however numerous the causes of disease may be in appearance, they may yet be reduced to three principal ones, wounds, poisons, and moral or physical organic super-excitement. These causes may act singly or 1846.] THE EQUILIBRIUM OF HEALTH. 151 in concert, but the last must be considered as the most dangerous and most frequent. The reason of this is simple and evident. Man avoids the two former as well as he is able; but he frequently advances to meet the other, without reflecting that, in multiplying the intensity of excitement by pleasure or labour, he loses the secret of maintaining the equal proportions of his organic capacity. The allurement of pleasure is especially the rock upon which he splits. Man, great baby as he is, seems continually to be crying out give me too much." : * * Nature furnishes us with a warning of the violation of the physiological law, whose hygeienic consequences we are now considering, viz., in satiety. The power which the economy possesses of accommodating itself to different impressions, acts as a remedy held in reserve by nature for the majority of the accidental evils which external agents can induce. Sometimes this is the natural remedy against pain, of which the perception becomes less vivid according to its duration sometimes it is a kind of counterpoise (although too often an insufficient one) to that perpetual desire for stimulation which exists in man. However this may be, when excitement has taken place to a certain point, and is repeated, sensation or emotion becomes blunted. What is called the piquancy of novelty and the freshness of impression disappears; but, if the excitement continues, indifference, repulsion, and then disgust and the surgit amari of pleasure soon begin to manifest themselves. Now, one of two things takes place : either we desist, and conforming ourselves to the physiological law await the return of excitability, that is we recal the appetite by abstinence—a safe, excellent method, the true economy of life and happiness; or we imprudently continue the excitation. The organism is soon brought into relation with this, and can no longer do without it-without the production of a painful sensation, which is again sought to be relieved by renewed stimulation. This is habit, the continued source of unperceived and involuntary acts-a singular, capricious, and incomprehensible condition for those who have not studied the laws of life. Prior to engendering this disposition, man, from an excess of excitability, perceives the necessity of a stimulant, which is a natural want; but if he continue this, or augments its quantity or intensity, he is obliged to have recourse to it almost against his will. This is a factitious want, the forms of which are infinitely multiplied in our social state. The one disposition dominates over man at least as much as the other; so that the habits form, so to speak, the tissue of our lives woven by us around ourselves. It is a second nature added to the first, and just as tyrannical and as powerful. In fact this second nature, which becomes general in the economy, assumes the condition of an acquired temperament, and frequently leaves no power whatever to reason. This factitious, importunate, exacting want is renewed every instant by virtue of the physiological law, that an organ being excited, and become in consequence more excitable, solicits the frequent return of the excitation, and that in an infinite progression. But if the power of a superior will, or external circumstances, do not vanquish this want which has sprung from habit, indirect debility or exhaustion from excess of stimulation, will occur, especially when the grosser instincts of animal life have been resorted to." The author particularly points out that this excessive excitement may not only result from the indulgence in gross and sensual passions, but also from the inordinate pursuit of objects every way proper in themselves, or indeed of the most elevated character. "The austere pleasures of science themselves are in nowise guarantied from the effects of excessive excitement, and are just as dangerous as the others, when prudence opposes no boundaries or limits their strength or duration. The passion for know. ledge or for art is as devouring, although a far nobler passion than these ; and the agitation induced by it produces the same appearance and effects as that arising from love or excessive ambition." The passion which seems to predominate in the greatest excess at our own epoch, "and which seems to gnaw away and waste our existence, enfeebling and exhausting it, is the poignant desire for the rapid acquisition of riches, even at the risk of not being able to enjoy what has been gained or accumulated." "Never was there seen to the same extent as now the ardent desire to gain, accumulate, and bequeath riches. So is it to be remarked that, certain diseases, as aneurisms of the heart, cerebral congestions, morbid affections of the nervous system, mental alienation, &c., are infinitely more frequent at the present time than formerly, especially in large towns, where they reach a frightful figure. At least in some descriptions of excess prudence struggles, and old age intervenes, and with a man endowed with a little good sense, reason does not entirely loosen hold of the reins, although she sometimes holds them lightly enough. But when ambition, honours, gain, and avarice are in question, the too-much is never enough. Age never tempers it; illness scarcely arrests it; and death alone can say 'here are your limits." But whether we deliver ourselves up to unbridled pleasures, and expose ourselves to the gross slavery of the animal passions, or whether we abandon ourselves no less foolishly to excessive labours of mind and body for the furthering our interests and the acquisition of lucre, it is no less true that, in transgressing the normal type of excitement and excitability, our health be comes compromised in proportion to the degree of excess and constitutional peculiarity." The following are the applications deducible from the adoption of this equilibrium between excitement and excitability as the law of health. 1. Moderation in every thing. 2. Active exercise of organs. 3. Careful self-study. 4. The special study of preponderating organs. 5. The avoidance of a too uniform life. 6. There should never be several vivid and simultaneous causes of excitement in operation. 7. After vivid excitement the equilibrium should be re-established by intervals of repose proportioned to the intensity and duration of the excitement, and the individual disposition upon which it is exerted. 8. Let habits be acquired or discontinued gradually. 9. The influence of slight causes in the production of important effects on the health must not be lost sight of. 10. Whatever may be the social position of the person hygeienic laws must be observed. All these positions are illustrated at considerable length, and with great felicity. On the Characteristics of Eclectism in Medicine. "Eclectism is one of the happiest terms which medicine has borrowed from philosophy, because it so perfectly expresses the end in view-to choose; and to choose with discernment, after consulting experience, reason and reflection. It is the philosophy of the well-intentioned; of men of a free and pure judgment, who regard every spirit of sect or system as a form of tyranny. The eclectic school is the positive school of our art, the realism of medicine. Well then might we be astonished on reading in the Annales de la Médicine Physiologique, that eclectism is the opprobrium of medicine. This is the language of a man who has the interests of a system to fight for and defend. Eclectism has indeed always been the cause of dread to the most opposite doctrines, and alike to those systematizers who wish to change the entire face of science, and those who obstruct its progress, or who obstinately deny this. Both agree in repelling this method they maintain that eclectism is a word void of meaning, and incapable of definition. In spite of this assertion we shall endeavour to propose one. 1846.] ON ECLECTISM IN MEDIcine. 153 According to our view, Eclectism is the art of estimating the extent and value of proofs;" and if we mistake not, this definition unites the two characters necessary for a good definition, brevity and clearness. In adopting it we see at once the immense advantages of this method-the sole basis of medical philosophy." The eclectic method is an impartial one, flattering neither the prejudices or vanities of systematizers. It examines what is true and what is false, rash, or unproven in a system. It demands evidence. It is on its guard against the seductions of talent and imagination, and is anxiously occupied in indicating the means of detecting such, by the collection and comparison of facts, independently of the influence of great names and reputations. It admits no doctrine as perfect or exclusively true, but gives its preference according to the extent and value of the proofs that can be adduced. The inventors of systems adopt a different course. They first lay down a general principle, according to which the various facts and consequences are adjusted with more or less success. They all profess to have consulted facts, the very same facts are adduced in defence of the most opposite hypotheses, and twisted and turned to suit the purposes of the preconceived construction. And it is also true that every system may count its cures and its victories; for, first, all is not false in any system; next, we know with what ingenuity reverses are dissimulated or explained; and, lastly, a vast number of patients are so happily organized as to be enabled to resist the effects of whatever treatment they are subjected to. The following parallel may be perused with advantage : "The systematizer, like the sectarian, rejects every thing which does not proceed from the source he has chosen; there is something bigoted in the plenitude of his conviction. He first asks for the true, then for the probable, and at last admits the absurd. The eclectic endeavours to proceed from the doubtful to the probable and thence to the certain, fortifying himself whenever he can by evidence. Do not ask him under whose colours he serves, to what master he attaches himself, or what is the ensign of his school. A passing visitor, he does not remain wherever he may be carried by a system, but only where reason, experience, and the love of truth, conduct him to. "The systematic having always his master and his doctrine, its progress and its obstacles, before his eyes, struggles in but one direction, and for him the integrity of the dogma is all and all. Ipse dixit is the maxim of a slave, says the eclectic, and being neither for Apollos nor Cephas, his enthusiasm is excited neither pro nor con. He welcomes the truth from whatever quarter, but he must be sure of its recognition. He must see it, examine every fraction and particle, and convince himself that it is really the truth and not its phantom. "The fanatical systematic praises or criticizes without reserve, according to the interests of his system; but the eclectic according to the interests of science, and without exceeding a just moderation. With him, pale envy never conceals herself under the mask of the critic. He can recognise important truths in Brown, and delights in attributing to Broussais a rare sagacity in pathological research, and in the art of generalizing facts; but he will not allow that this last author has created medicine as some of his fervent disciples yet love to state. "The systematic always proceeds from doctrines to facts, while the eclectic does just the contrary, endeavouring to follow the method of the mathematicians, certum ab incerto, inventum ab inveniendo. The systematic listens and adopts; the eclectic reasons and deduces: the former engages his obedience and medical faith; the latter never yields his reason to any usurper: the one thinks through an intermedium; the other is always the author of his own judgments. What I believe is the truth, says the systematic. That only is true which has been demonstrated, replies the eclectic. My master declares it is so, says the syste matic. What says experience? rejoins his adversary. But, the systematic will exclaim, cannot I see and observe as well as yourself, cannot I apply my faculties to the examination of controverted questions, and conclude in favour of the doctrine I have adopted? No, the eclectic may reply, you neither do nor can see as I do; a systematic prejudice perverts your understanding, and it is impossible for you to judge with completeness, coolness, and full knowledge of the cause. secret inclination, a certain tendency, leads you always to see in facts other than they contain. By the aid of subtlety you can extort from them whatever you please and what even they do not yield. The best disposition for finding the truth is to commence with the destruction of every prejudice, and to become persuaded of one's entire ignorance. Is your judgment pure and disinterested enough to allow of this? A "We may see from this parallel the vast difference that may sometimes exist between two practitioners, supposing them equally well instructed and of equal good faith. And let it not be believed that such a picture is the mere work of fancy; it is the history of the last epoch of science, it was but recently the subject of the most exciting interest in the daily practice of medicine; we read of it every day in our books and in our journals, we have heard it in our schools and our academies. We may also predict which of these two adversaries will eventually triumph. The systematic has on his side the piquancy of novelty, the facility of explanation, and the enthusiasm and number of his adepts. The eclectic relies on time, his most powerful ally, and seldom in vain. The records of science present the most manifest proof that every doctrine, every exclusive system, eventually disappears, in a variable period of time, which upon an average may perhaps be stated at twenty years. We can scarcely except any other than Galenism, and that because it prevailed during the barbarism of the middle ages. The eclectic will be justified by the progress of science; his triumph is founded on the nature of things. He judges but is not judged: because he only clings to that which is demonstrated, and remains in doubt as regards the rest. If he affirms a thing he may be believed, not because he always knows the truth, but because he has taken every pains to assure himself of it, and only affirms what he knows for certain. He may sometimes employ the perhaps of the wise man, but at all events he does not seek to impose his own opinions and ideas. And why should he? Does he not know that such opinions must sink or flourish according to the degree of value; and that, as the truth only extends by slow undulations, the circle, enlarging more and more, will in the end excite the attention of enlightened men? Time and perseverance only are wanted. The systematics declare, that however well-looking eclectism may be upon paper it is destitute of practical applications. The author replies to this by exhibiting several instances in which such have been advantageously made. Thus, although they allow that in many cases essential fevers are but phlegmasia with resulting general irritation, the eclectics maintain that an intermittent fever is something very different from this. They admit the localization of many fevers but reject the Broussaian doctrine of gastro-enterite as a general explanation. They have indicated also that chronic gastritis, which recently created so much attention, has often been mistaken for gastralgia. In reference to tubercles, again, eclectism is as impartial, for while denying their origin in the irritation of the pulmonary lymphatic ganglions, it admits that inflammation performs a certain part, as yet not to be appreciated, in their development, progress, &c. Eclectism acknowledges the importance of the organic lesions observed after death, but it will not allow that pathological anatomy should be made the sole basis of medicine-to the neglect of the primary changes which the |