He then refers to the persecution and calumnies he had been exposed to from the profession, who looked upon him as a pestilent fellow, and a setter forth of strange doctrines; and adopts the noble saying of Titus Tacitus, in reply to Metellus— "It is easy to speak against me when I make no reply; you have learned to speak evil; I, my conscience bearing me witness, have learned to despise evil-speaking; you are master of your tongue, and can make it utter what you list; I am master of my ears, and can make them hear without being offended." And, after making the reference we have already mentioned, to his method having had the sanction and assistance of Locke, he thus concludes in regard to the ultimate success of his newly discovered way— that being specifically different, require a different treatment. The word carduus, or thistle, is applied to several herbs, and yet a botanist would himself with a generic description. Furthermore, be inaccurate and imperfect who would content when this distribution of distempers into genera has been attempted, it has been to fit into some hypothesis, and hence this distribution is made to suit the bent of the author rather than the real nature of the disorder. How much this has obstructed the improvement of physic, any man may know. In writing, therefore, such a natural history of diseases, every merely philosophical hypothesis should be set aside, and the manifest and natural phenomena, however minute, should be noted with the utmost exactness. The usefulness of this procedure cannot be easily overrated, as compared with the subtle inquiries and trifling notions of modern writers; for can there be a shorter, or indeed any other way, of coming at the morbific causes, or of discovering the curative indications, than by a certain perception of the peculiar symptoms? By these steps and helps it was, that the father of physic, the great Hippocrates, came to excel. His theory, swgia, being no more than an exact description or view of Nature. He found that Nature alone often terminates diseases, and works a cure with a few simple medicines, and often enough with no medicines at all. If only one person in every "As concerns the future, I cast the die, not over-careful how it may fall, for, since I am now no longer young, and have, by the blessing of the Almighty, a sufficient provision for the remainder of my journey, (tantum mihi est viatici, quantum restat viæ,) I will do my best to attain, without trouble to myself or others, that measure of happiness so beautifully depicted by Politian-age 'Felix ille animi, divisque simillimus ipsis, Quem non mendaci resplendens gloria fuco Sollicitat, non fastosi mala gaudia luxus. Sed tacitos sinit ire dies, et paupere cultu Exigit innocua tranquilla silent a vitæ.” We shall now give more fully his peculiar views, and in order to render him due honor for originating and acting upon them, we must remember in the midst of what a mass of errors and prejudices, of theories actively mischievous, he was placed, at a time when the mania of hypothesis was at its height, and when the practical part of his art was overrun and stultified by vile and silly nostrums. We must have all this in our mind, or we shall fail in estimating the amount of independent thought, of courage and uprightness, and of all that deserves to be called virtue and magnanimity, which was involved in his thinking, and writing, and acting as he did. "The improvement of physic, in my opinion, depends, 1st. Upon collecting, as genuine and natural, a description or history of diseases as can be procured; and, 2nd, Upon laying down a fixed and complete method of cure. With regard to the history of diseases, whoever considers the undertaking deliberately, will perceive that a few such particulars must be attended to: 1st, All diseases should be described as objects of natural history, with the same exactness as is done by botanists, for there are many diseases that come under the same genus, and bear the same name, had accurately described, and consistently cured, but a single disease, and made known his secret, physic would not be where it now is; but we have long since forsook the ancient method of cure, founded upon the knowledge of conjunct causes, insomuch that the art, as at this day practiced, is rather the art of talking about diseases than of curing them. I make this digres sion in order to assert, that the discovering and assigning of remote causes, which now-a-days so curious inquirers, is an impossible attempt, and much engrosses the minds and feeds the vanity of that only immediate and conjunct causes fall within the compass of our knowledge." Or, as he elsewhere pithily states it:-"Cognitio nostra, in rerum cortice, omnis ferme versatur, ac ad To or sive quod res hoc modo se habeat, fere tantum assurgit; To dior, sive rerum causas, nullatenus attingit." the case more clearly or sensibly. It is this doctrine of "conjunct causes, this necessity for watching the action of compound and often opposing forces, and the having to do all this not in a machine, of which, if you have seen one you have seen all, but where each organism has often as much that is different from as common with all others; it is this which takes medicine out of the category of exact sciences, and puts it into that which includes politics, ethics, navigation, and practical engineering, in all of which, though there are principles, and those principles quite within the scope of human rea His friend Locke could not have stated son, yet the application of these principles must, in the main, be left to each man's skill, presence of mind, and judgment, as to the case in hand. It is in medicine as in the piloting of a ship-rules may be laid down, principles expounded, charts exhibited; but when a man has made himself master of all these, he will often find his ship among breakers and quicksands, and must at last have recourse to his own craft and courage. Gaubius, in his admirable chapter, "De disciplina Medici," thus speaks of the reasonable certainty of medicine as distinguished from the absolute certainty of the exact sciences, and at the same time gives a very just idea of the infinite (as far as concerns our limited powers of sense and judgment) multiplicity of the phenomena of disease:-" Nec vero sufficit medicum communia modo intueri; oportet et cuivis homini propria, quæ quidem diversitas tam immensa occurrit ut nulla observationum vi exhauriri possit. Solâ denique contemplatione non licet acquiescere, inque obscuris rebus suspendere judicium, donec lux affulgeat. Actionem exigit of ficium. Captanda hinc agendi occasio, quæ sæpe præceps, per conjecturam cogit determinare, quod per scientiam sat cito nequit. Audiant hæc obtrectatores, et cum didicerint scientias puras, ab iis quas applicatas vocant, contemplativas à practicis, distinguere, videant quo jure medicinam præ aliis, ut omnis certi expertem, infament." It would not be easy to put more important truth into clearer expression. Conjecture, in its good sense, as meaning the throwing together of a number of the elements of judgment, and taking what upon the whole is the most likely, and acting accordingly, has, and will ever have, a main part to play in any art that concerns human nature, in its entireness and in action. When in obscure and dangerous places, we must not contemplate, we must act, it may be precipitately. This is what makes medicine so much more of an art than a science, and dependent so much more upon the agent than upon his instructions; and this it is that makes us so earnest in our cautions against the supposition that any amount of scientific truth, the most accurate and extensive, can in medicine supersede the necessity of the recipient of all this knowledge having, as Richard Baxter says, by nature "a special sagacity,-a naturally searching and conjecturing turn of mind." Moreover, this faculty must be disciplined and exercised in its proper function, by being not a hearer only, but also a doer, an apprentice as well as a student, and by being put under the tutorage of a master who exercises as well as expounds his craft. This native gift and its appropriate object have been so justly, so beautifully described by Hartley Coleridge in his "Life of Fothergill," that we cannot refrain from closing our remarks on this subject by quoting his words. Do our readers know his "Biographia Borealis ?" If they do, they will agree with us in placing it among the pleasantest books in our language, just such a one as Plutarch, had he been an Englishman, would have written :-"There are certain inward gifts, more akin to genius than to talent, which make the physician prosper, and deserve to prosper; for medicine is not like practical geometry, or the doctrine of projectiles, an application of an abstract, demonstrable science, in which a certain result may be infallibly drawn from certain data, or in which the disturbing forces may be calculated with scientific exactness. It is a tentative art, to succeed in which demands a quickness of eye, thought, tact, invention, which are not to be learned by study, nor, unless by connatural aptitude, to be acquired by experience; and it is the possession of this sense, exercised by patient observation, and fortified by a just reliance on the vis medicatrix, the self-adjusting tendency of nature, that constitutes the true physician or healer, as imagination constitutes the poet, and brings it to pass, that sometimes an old apothecary, not far removed from an old woman, and whose ordinary conversation savors, it may be, largely of twaddle, who can seldom give a rational account of a case or its treatment, acquires, and justly, a reputation for infallibility, while men of talent and erudition are admired and neglected; the truth being, that there is a great deal that is mysterious in whatever is practical." But to return to our author. He was the first to point out what he called the varying "constitutions" of different years in relation to their respective epidemics, and the importance of watching the type of each new epidemic before settling the means of cure. In none of his works is his truly philosophical spirit, and the subtlety and clearness of his understanding, shown more signally than in his successive histories of the epidemics of his time. Nothing equal to them has ever appeared since; and the full importance of the principles he was the first to lay down is only now beginning to be fully acknowledged. His confession as to his entirely failing to discover what made one epidemic so to differ from another, has been amply confirmed by the whole with such exquisite order, that, as all all succeeding observers. He says, "I have carefully examined the different constitutions of different years as to the manifest qualities of the air, yet I must own I have hitherto made no progress, having found that years, perfectly agreeing as to their temperature and other sensible properties, have produced very different tribes of diseases, and vice versa. The matter seems to stand thus: there are certain constitutions of years that owe their origin neither to heat, cold, dryness, or moisture, but upon a certain secret and inexplicable alteration in the bowels of the earth, whence the air becomes impregnated with such kinds of effluvia as subject the human body to distempers of a certain specific type." the evils of nature eminently conspire to complete the harmony of the whole work, so every being is endowed with a divine direction or instinct, which is interwoven with its proper essence, and hence the safety of mankind was provided for, who, notwithstanding all our doctoring, had been otherwise in a sad enough plight.' Again,-' He would be no honest and successful pilot who were to apply himself with less industry to avoid rocks and sands, and bring his vessel safely home, than to search into the causes of the ebbing and flowing of the sea, which, though very well for a philosopher, is foreign to him whose business it is whose province it is to cure diseases, be able to to secure the ship. So neither will a physician, do so, though he be a person of great genius, who bestows less time on the hidden and intricate method of nature, and adapting his means there than on curious and subtle speculations.'' The following is honest enough: "Indeed, if I may speak my mind freely, I have been long of opinion that I act the part of an honest man and a good physician as often as I refrain entirely from medicines, when, upon visiting the patient, I find him no worse to-day than he was yesterday; whereas, if I attempt to cure the patient by a method of which I am uncertain, he will be endangered both by the experiment I am going to make on him and by the disease itself; nor will he so easily escape two dangers as one.' As to the early treatment of a new epi-to, demic, he says,-"My chief care, in the midst of so much darkness and ignorance, is to wait a little, and proceed very slowly, especially in the use of powerful remedies, in the meantime observing its nature and procedure, and by what means the patient was relieved or injured;" and he concludes by regretting the imperfection of his observations, and hoping that they will assist in beginning a work that, in his judgment, will greatly tend to the advantage of mankind. Had his successors followed in his track with equal sagacity and circumspection, our knowledge of these destructive and mysterious incursions of disease would, in all likelihood, have been greatly larger and more practical than it is now. Sydenham is well known to have produced a revolution in the management of the smallpox, and to have introduced a method of treatment upon which no material improvement has subsequently been made. We owe the cool regimen to him. Speaking of the propriety of attending to the wishes of the sufferer, he says, with equal humanity and good sense "A person in a burning fever desires to drink freely of some small liquor; but the rules of art, built upon some hypothesis, having a different design in view, thwart the desire, and instead thereof, order a cordial. In the meantime the patient, not being suffered to drink what he wishes, nauseates all kinds of food, but art commands him to eat. Another, after a long illness, begs hard, it may be, for something odd, or questionable; here, again, impertinent art thwarts him and threatens him with death. How much more excellent the aphorism of Hippocrates- Such food as is most grateful, though not so wholesome, is to be preferred to that which is better, but distasteful. Nor will this appear strange, if it be considered that the all-wise Creator has formed "That practice, and that alone, will bring relief to the sufferer, which elicits the curative indications from the phenomena of the diseases themselves, and confirms them by experience, by which tal. And had the art of medicine been delivered means the great Hippocrates made himself immorby any one in this wise, though the cure of a disease or two might come to be known to the common people, yet the art in its full extent would then have required men more prudent and skillful than it does now, nor would it lose any of its credit; for as there is in the operations of Nature, (on the observations of which a true medical praxis is founded,) more of nicety and subtlety than can be found in any art supported on the most specious hypothesis, so the science of Medicine which Nature teaches will exceed an ordinary capacity in a much greater degree than that which mere Philosophy teaches." servation, in its strict sense, is not every There is much profound truth in this. Obman's gift, and but few men's actual habit of mind. Newton used to say, that if in any one way he differed from other men, it was in his power of continued attention-of faithful, unbroken observation; his ladder had all its steps entire, and he went up with a composed, orderly foot. It requires more strength and fineness of mind, more of what deserves to be called genius, to make a series of genuine observations in Medicine, or any other art, than to spin any amount of nice hypotheses, or build any number of "castella in aere," as Sydenham calls them. The observer's object is, and it is no mean one,— "To know what's what, and that's as high As Metaphysic wit can fly." chronic, it must be owned there is an inscrutable dov, a specific property which eludes the keenest anatomy." He then goes on to say, that as Hippocrates censured the abuse of anatomy, so in his own day there were many who, in like manner, raised hopes for Physic from discoveries in Chemistry, which, in the nature of things, never could be realized, and which only served to distract from the true Hippocratic method of induction; "for the chief deficiency of medicine is not a want of efficacious medicine. Whoever considers the matter thoroughly, will find that the principal defect on the part of physic proceeds, not from a scarcity of medicines to answer particular intentions, but from the want of knowing the intentions to be answered, for an apothecary's apprentice can tell me what medicine will purge, vomit, or sweat, or cool; but a man must be conversant with practice who is able to tell me when is the properest time for administering any of them." Sydenham adds, "Nor will the publication of such observations diminish, but rather increase the reputation of our art, which, being rendered more difficult, as well as more useful, only men of sagacity and keen sound judgment would be admitted as physicians." How true to the spirit of his great master in his Novum Organum, "Nature is only subdued by submission!" "The subtilty of nature is far beyond that of sense, or of the understanding, and the specious meditations and theories of mankind are but a kind of insanity, only there is no one to stand by and observe it." There is a very remarkable passage in Sydenham's "Treatise of the Dropsy," in which, after quoting this curious He is constantly inculcating the necessity passage from Hippocrates, "certain physi- of getting our diagnostic knowledge at first cians and philosophers say that it is impossi- hand, ridiculing those descriptions of disble for any man to understand medicine withease which the manufacturers of "Bodies out knowing the internal structure of man; of Medicine" make up in their studies, and for my part, I think that what they have which are oftener compositions than portraits, written or said of nature pertains less to the or at the best bad copies, and which the medical than the pictorial art," he asserts young student will find it hard enough to not only his own strong conviction of the identify in real life. There is too much of importance of a knowledge of minute anato- this we fear still; and Montaigne, who remy to the practitioner, but also his opinion joices in giving a sly hit to his cronies, the that what Hippocrates meant was to caution doctors, might still say with some reason, against depending too much on, and expect-like him who paints the sea, rocks, and ing too much help from anatomical researches, to the superseding of the scrupulous observation of living phenomena, of successive actions.* For in all diseases, acute and *As far as the cure of diseases is concerned, Medicine has more to do with human Dynamics than Statics, for whatever be the essence of lifeand as yet this T Eov, this nescio quid divinum, has defied all scrutiny—it is made known to us chiefly by certain activities or changes. It is the tendency at the present time of medical research to reverse this order. Morbid anatomy, microscopical investigations, though not confined to states or conditions of parts, must regard them fully more than actions and functions. This is probably what Stahl means when he says, "ubi Physicus desinit, Medicus incipit;" and in the following passage of his rough Tudesque Latin, he plainly alludes to the tendency, in his day, to dwell too much upon the materials of the human body, without considering its actions "ut vivens." The passage is full of the subtilty and fire and depth of that wonderful man. "Undique hinc materia advertitur animus, et quæ crassius in sensum impingit conformatio, et mutua proportio corporea consideratur; motuum ordo, vis, et absoluta havens, and draws the model of a ship as he sits safe at his table; but send him to sea and he knows not how or where to steer: so doctors oftentimes make such a description of our maladies as a town-crier does of a lost dog or donkey, of such a color and height, such ears, &c.; but bring the very animal before him, and he knows it not for all that." Everywhere our author acknowledges the vis medicatrix naturæ, by which alone so many diseases are cured, and without or against which none, and by directing and helping which medicine best fulfills its end. magis in materiam energia, tempora ejus, gradus, vices, maxime autem omnium, fines obiter in animum admittuntur." The human machine has been compared to a watch, and some hope that in due time doctors will be as good at their craft as watchmakers are at theirs; but watchmakers have not to mend their work while it is going; this makes all the difference. all. "For I do not think it below me or my art to | acknowledge, with respect to the cure of fevers and other distempers, that when no manifest indication pointed out to me what should be done, I have consulted my patient's safety and my own reputation, most effectually, by doing nothing at But it is much to be lamented that abundance of patients are so ignorant as not to know, that it is sometimes as much the part of a skillful physician to do nothing, as at others to apply the most energetic remedies, whence they not only deprive themselves of fair and honorable treatment, but impute it to ignorance or negligence." We conclude these extracts with a picturesque description. It is a case of "the hysterics" in a man. "I was called not long since to an ingenious gentleman who had recovered from a fever, but a few days before he had employed another physician, who blooded and purged him soundly, and forbade him the use of flesh. When I came I found him up, and heard him talking sensibly. I asked why I was sent for, to which one of his friends replied with a wink, wait and you'll see. Accordingly, sitting down and entering into discourse with the patient, I perceived his under lip was thrust outward, and in frequent motion, as happens to peevish children, who pout before they cry, which was succeeded by the most violent fit of crying, with deep and convulsive sobs. I conceived this was occasioned partly by his long illness, partly by the previous evacuations, and partly by emptiness; I therefore ordered him a roast chicken, and a pint of canary." In making these selections we have done our author great injustice, partly from having to give them either in Swan's translation or our own, and thereby losing much of the dignity and nerve-the flavor, or what artists would call the crispness of the original; partly also from our being obliged to exclude strictly professional discussions, in which, as might be expected, his chief value and strength lie. We know nothing in medical literature more exquisite than his letter to Dr. Cole on the hysterical passion, and his monograph of the gout. Well might Edward Hannes, the friend of Addison, in his verses on Sydenham, thus sing: "Sic te seientem non faciunt libri It would not be easy to over-estimate the permanent impression for good, which the writings, the character, and the practice of Sydenham have made on the art of healing in England, and on the Continent generally. In the writings of Boerhaave, Stahl, Gaubius, Pinel, Bordeu, Haller, and many others, he is always spoken of as the father of rational medicine; as the first man who applied to his profession the Baconian principles of interpreting and serving nature, and who never forgot the master's rule, “non fingendum aut excogitandum, sed inveniendum, quid natura aut faciat aut ferat." He was what Plato would have called an "artsman," science. as distinguished from a doctor of abstract in either the capacity or the relish for specuBut he was by no means deficient lative truth. Like all men of a large practical nature, he could not have been what he and often exercising the true philosophizing was, or done what he did, without possessing faculty. He was a man of the same quality of mind in this respect with Watt, Franklin, and John Hunter, in whom speculation was not the less genuine that it was with them a means rather than an end. This distinction between the science and the art or craft, or as it was often called the cunning of medicine, is one we have already insisted upon, and the importance of which we consider very great, in the present condition of this department of knowledge and practice. We are now-a-days in danger of neglecting our art in mastering our science, though medicine must always be more of an art than of a science. It being the object of the student of physic to learn or know some thing or things, in order to be able safely, effectually and at once, to do some other thing; and inasmuch as human nature cannot contain more than its fill, a man may not only have much scientific truth in his head, which is useless, but it may shut out and hinder, and even altogether render ineffectual, the active, practical, artistical faculties, for whose use his knowledge was primarily got. It is the remark of a profound thinker, that "all professional men labor under a great disadvantage in not being allowed to be ignorant of what is useless; every one fancies that he is bound to receive and transmit whatever is believed to have been known." This subject of art and science is hinted at, with his usual sagacity, by Plato, in a very singular passage in his Theaetetus:Particulars," he says, "are infinite, and the higher generalities give no sufficient direction in medicine; but the pith of all sciences, that which makes the artsman differ from the inexpert, is in the middle propositions, which, in every particular knowledge, are taken from tradition and experience." It would not be *Being anxious to see what was the context of this remarkable passage, which Bacon quotes, as if |