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the house this chest accompanied him and and an old-fashioned secretary served as a was set with impressive caution on the desk and as a medicin and instrument table where it was lookt upon by the cabinet as well as for a bookcase. family as the repository of the arcanum. The stock of medicin, however, was di*Needless to say, this was the doctor's minishing in quantity and prescriptions

medical case, which, while it did not con- written in “hog Latin were often sent tain a great variety of remedies, did con- to the village druggist. These mystified tain some extremely nauseating ones. It the people who could not understand the was a veritable purgatory with latent “lingo,'' and it is to be feared sometimes misery and death therein.

led to tall guessing on the part of the drugOver the door was a sign painted by the gist. kind hearted painter who painted the fur- A short time later an opening occurring niture with green paint. The letters were in a neighboring town, a house was bought nearly a foot high, and having done busi- and a small wagon load of household goods ness for a few days for the purpose of not and chattels was transferred to this new injuring the kind painter's feelings, it was abode. This was an ideal office, for it was removed and replaced by a more modest so situated, altho a part of the house, that sign nailed to the door.

patients gained access to it without passThis humble office served for several ing thru the house. Every physician years, but as patients increast in number, realizes the convenience of that, for the a more pretentious office was taken in a office-in-the-house plan causes much inlarger building. Since that day the first convenience to the family and much wear office, which still stands, has served in and tear. turn for a succession of barbers and dress- Then came a more decided change; the makers, thús maintaining its prestige, for house was sold to another person, and an are not barbers and dressmakers both office was taken on the field of battle amid “cutters?''

the thunder of artillery, the shriek of The simple furniture of the first office shell and the rattle of muskets. This was moved to the second, which comprised office was sometimes in the open air, some- . two rooms in the second story of a “block.” times in a tent, sometimes in a farmhouse, A few more instruments had been added shot torn and battle riddled. by this time; the case of herbs and drugs Sometimes the office was vacated in a had disappeared since a druggist had come hurry without time to collect even personto town, and an atmosphere of comfort al belongings. As I write, a volume of pervaded the surroundings. A number of Gross' Surgery lies open before me with books had been added, and one or two some of its pages torn and bloodstained, medical journals were conspicuously dis- just as they were left on the battlefield of played on the table.

Seven Pines, where the book was captured, A square of carpet made this office more June 1, 1862, a book which was returned homelike, and a cheap, carpet covered

-to me some twenty years later by the lounge invited one to rest, but was deceit- surgeon who captured it. ful inasmuch as there were no springs and This was indeed a sad school of experia great many slats.

ence in a life of hardship and toil, and it Up to this time board and lodging had was with sincere thankfulness that pracbeen outside. This had some advantages. tise was again resumed in civil life where For example, generous patients would the environment, while arduous, was at often ask a doctor to dinner or supper. least peaceful. But the lounge suggested to the doctor A city house was bought in what was that he take up his abode in his office, then an aristocratic section. As is the especially since the number of patients was custom to-day, there were, a number of increasing and night calls were frequent. physicians who chose this locality for their

The next office was on a far more elab- abiding place, and this street was popularorate scale than had yet been attempted. ly called Pill Row. Now this was the It was in fact a whole house with a dear day when large hospitals did not exist, helpmate to take care of it, a wife who and these physicians supplemented their shared joy and sorrow and lent her aid and medical work by much minor surgical support in the struggle for success. This work. house al had a barn in which the doctor A few years later, a City hospital was took care of his horse. The green table instituted and this diverted many patients and chairs were banisht to the kitchen, from the private physician. Business was



also creeping up into Pill Row, and one closed in an alcove was decorated with by one the physicians left for quieter chemical apparatus and bottles of reagents. situations.

In one corner was a medicin cabinet with The next office was in a quiet park, and enuf medicin in concentrated form to kill it took thirty years for the din of traffic to or cure an army. disturb its tranquillity. Then as one family The walls were decorated here and there after another moved away it became a with framed engravings, while bronzes and site for select lodging houses and a new articles of virtu adorned the mantle shelf, office became necessary.

under which, in cold weather, an open fire As each office was taken a new sign was sparkled merrily. thought necessary, and it was curious to On the floor was a heavy Wilton carpet. see how, as the office enlarged in size and On the walls was a rich and cheerful paper, became more luxurious, how as success while from the tinted and decorated ceilwas obtained, the signs diminisht in size ing hung a brilliant chandelier. and number and were plainer in appear. With all this luxury, life was no less ance. Still there was a uniformity, for all arduous than in the days of the little these signs were in gilt letters on a black white-coated, green-shuttered office in the sanded ground, this being considered the nearby village, when time hung heavy on correct thing among physicians. Then, the doctor's hands and enforced idleness signs notified passers-by in all points of was irksome. the compass, that a doctor's office was Toil brought success both professionally within, and at one time box signs were and financially, but with it came fatigue put up on the cross streets, on the lamp and ceaseless care. In the quiet village posts; but as physicians multiplied there there was no competition; it was a case of was not room enuf on the lamp posts for “me or nobody;" in the city it was a conthe signs, and as the city fathers did not stant struggle to maintain prestige, and desire to appear partial, those already words of calumny, even from brother phy. placed were ordered to be removed. sicians, embittered honeyed praise.

Then it was thought a good idea to paint Sometimes at the midnight hour, wearied the name in black on the ground-glass with his daily toil, books of reference were side-lights or on the fan-light above the laid aside for a moment, and gazing into door; but as this led to frequent false the fire, visions of the early days arose alarms and the unnecessary routing out of when the struggle was hard, when the the doctor in the middle of the night by fight was strong, and well-earned victory some belated or hilarious individual who brought a sense of elation. Then the walls mistook the sign for that of an all night dwindled to the little cosy office of the restaurant, this plan was soon discon- first days. The chandelier dimmed its tinued.

brilliancy until it glowed only with the One sign, if it can be called such, still feeble flame of the lard-oil lamp, and the remains, but all the others have past away. open grate gave place to the air-tight stove That one is a modest silver-plated door filled with wood which the doctor took as plate, an early investment that has en- credit, wood which he sawed and split dured and still announces to inquiring or himself to save money. Then, poor tho he curious people the name and occupation of was, he was a lord among the villagers, the owner whose door it graces.

revered and honored. In this last office the walls were lined Now a knock at the door for a moment with books that had accumulated almost starts him, and he thinks to himself: “I day by day, a striking contrast to the three must saddle Tom and ride out to Tim's;"! or four that had ornamented the cheap but as he comes back to the present he green table in the first office. This table realizes that the past has gone, and that on had given way to two desks. The its ruins he has built a lofty structure pinchairs

massive, leather.covered, nacled with success; but that true unstuffed, easy chairs, while an operating alloyed happiness is buried at the base of chair of the latest style with all the mod. the structure, along with the simple people ern improvements was a conspicuous ob- who were his first patients and his true ject. An instrument cabinet held a glitter- friends. ing array of keen-edged knives, polisht He may meet with grateful patients, sounds and probes and hundreds of other but none will ever come to him as did articles. A microscope stood ready for Farmer John in the early days, and with

a special table, while a sink in- tears in his eyes grasp the hand of the

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young doctor and with a trembling voice Dr. Waugh and Iron.-Dont's in Pneumonia. exclaim: "Doctor, I can never thank you Editor MEDICAL WORLD:-I know of no for what you have done; you have saved stronger or more brilliant writer, medical my daughter's life.” What matter if the or not, than William F. Waugh, M. D. fees were small, the office small, and the He is one man who has not lived, and is practice small; that made small things not living, in vain. But even he, with all grateful and joy bearing. No matter if he his practicality, and common-sense assertis now famed in medicin and holds po- iveness, and intrinsic forcefulness, will sitions of trust, they will never be quite as slip a cog occasionally. He has actually important as when he was one of the ventured to disagree with me in reference school committee in that little village. to the therapeutic sphere of iron! Now He has prospered beyond his most am- see me do him up. bitious wishes, and he is withal truly The basic proposition in Dr. Waugh's thankful; but he still reveres the memory argument inheres in the question : “Does of the good old days when he was young the removal of a cause necessarily reand began to fight his way, and above all move its effects and restore the situation he reveres the memory of his First Office. to what it was before the cause was put Massachusetts.

LEON NOEL. into operation !" Certainly not, doctor; [Next subject by the above writer, “ My First Borse." In only a miracle would do that, and a next issue.-ED.)

miracle is an impossibility. This causeA Dream,

and-effect question is festooned with a An angel had been sent to call the doctor very dizzy tangle of subtleties--a fact that from labor to reward. He had served the is old to Dr. Waugh. The truth is, every people faithfully and well; had gone to cause pays itself out in a series of causes see them at all hours of the day and night, and effects. To illustrate: A number of in all kinds of weather; had made mod- workmen will complete a house and deerate charges and waited patiently for his part. The workmen were the mechanical pay; had sympathized with them in their cause, and the placement of material, the afflictions, mourned with them in their mechanical effect. The initial cause is sorrows, and rejoiced with them when re- gone, but its effect is said to persist. stored to health. Before leaving for heaven, This, however, cannot be true (in the the doctor askt if he could visit the every-day sense of the phrase, cause and regions below. Permission being granted,

Permission being granted, effect), for the moment the last touch is while the angel waited outside, the doctor put upon the house, it as a totality, bewent in to look around.

comes a cause. Now unless there is no difHaving been gone an unusual length of erence between cause and effect, the house time, the angel went to look for him, and cannot be simultaneously a cause and effect. found the doctor seated fanning himself The house, in entirety, is a cause, the effect and watching a lot of people burning in of which is all that makes up the concept one of the hottest fires in the place, while of a house; i. e., the effect of a house is a look of supreme bliss lighted his face.

houseness. This houseness, in turn, beThe angel lookt, and over the door was comes a cause, and because cause and efthe sign: "These are the people who did fect are different, the house is ablated. not pay the doctor." The angel toucht Houseness is a sprangling cause whose him and said, “Come, let us go.” With

With sprangling effects consist of relationships, a radiant smile the doctor said, “You go each of which will of course be dissipated on; this is heaven enuf for me."

in the causeness of its effectness, and there A WORLDITE.

you are.

In the ultimate, effect is but projected Many subscriptions always expire with our December cause whose intrinsicness undergoes a issue. Notitication is inclosed to those to whom this applies. As a rule our subscribers are in the habit of renewing

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vironmental pressures. After all then, will be fewer than ever. Also, to avoid the bother of renew. ing every year, our rate of four years for $3 is at your service. effect is cause and cause is effect, and More of our patrons have taken advantage of this during the We expect it flood of four year

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question clear before proceeding to the WORLDS in Binder at first of year; as each number comes, discussion of its other features. put it in the Binder, and then you will always have your copies together in their regular order, and when the year I will be pardoned, I trust, if I now get closes, your volume is already bound and ready to be placed in your library. Then begin the next/year with a new Binder. down onto a more practical plane. The

past year than ever before.

vaporization of the Doctor's cider-barrel existence ceases simultaneously with the illustration is incidental to the foregoing abolition of its cause.

A person has a cause-and-effect exposition. But lest it malarial intermittent fever. We will say, shall have escaped the reader's attention, for the nonce, that the plasmodium is the I will make the matter even more plain. cause. Quinin is the enemy of this plasThe Doctor asks: “If a cider barrel has modium. We give it.

We give it. It destroys the lost its contents by leakage, will mending cause, and that instant which witnesses the leak fill the barrel again?” I am the destruction of the plasmodiums, witforced to confess that it will not. But if nesses the destruction of their effect-the the cider were an element of the barrel, intermittent. I know how fixt and stuband the barrel were an animal, I should born is the habit among physicians, to have to answer yes. As it stands, we have theoretically prolong the existence of an nothing to do with the cider. It is normal effect beyond that of its cause. It has and needs no physician. It is the barrel done immeasurable harm by constraining that is ailing, its disease being a hole. them to treat at an imaginary effect. It is We stop the hole and the barrel is cured. bad enuf to attempt to treat a real effect. See? This is a fair, if homely illustration No medicin will repair the damage a diseas of the modus operandi in the cure of disease. may have wrought. This truth should be Cure is prevention-the prevention of a burned into the consciousness of every disease's further progress. To cure a practising physician. If it is satisfactory disease is to bring it to an end. Nature to you to look upon the damage as an will do the rest if given a chance. No

No effect, why do so; but this will only medicin is needed after the disease is gone, strengthen the reason why you should not and convalescence h. set in. You see treat it. there is a sense in which one can be not I have great reverence for the force and well, and still have no disease. That state dignity of Niemeyer, and the strong is represented in convalescence. Shall we straight-outness of Gross; but have not give a convalescing patient medicin ? and they--so far as therapeutics is concerned if so, why? What would we direct our been, in the main, prayerfully shelved? medicin against, there being no disease for What up-to-date physician is controlled it to impinge upon ? I know that a vast by their therapeutic dicta ? What landnumber of doctors give medicin all thru slides of rugged eloquence have occurred convalescence, but not one of them can in behalf of salivation and extreme venegive a sane reason for it. If it is only section, but there is nothing left of them possible that medicating a diseased person but a rhetorical memory.

The whole may be right, what will justify medicating world is moving forward, and medicin is an undiseased person? There are tedious catching its share of the grand impulse. convalescences, but as convalescence is not As to iron. I do not know how many a disease, shall we treat it with drugs? different medicinal preparations of it there Will you try to cure the sequelæ of measles are, but there are hundreds of them. or scarlatina, or the scar left by a burn? Now, unless iron is a panacea (under Many diseases leave invisible scars. These slight modifications), what is the excuse scars are all of them equally ineradicable. for more than one preparation of it? How many doctors are, even now, in this How many have figured out why the tinctblazing edge of the twentieth century, ure of the chlorid of iron is the best? medically piddling with scars?

. It is best because its chemical associate is Altho, under a strained method of reas- a positive and comprehensive medicin oning cause and effect may be made to So it is with all iron preparations; their appear identical, the evidences of prac- merits are measured by the merits of the tical life contradict such a conclusion. non-ferruginous elements of the preparaCause and effect are at once distinct, and tion. The iron serves as merely a damag; inseparable. Otherwise, to treat an effect ing chemical back-stop, and as an eternal would be to treat its cause. I do not reminder of chemical versatility and therbelieve that the profound perspicacity of apeutic preterism and conservatiem. If Doctor Waugh can be brought into an this is not true, then the limits of iron's affirmative relationship with the propo- therapeutic sphere are coinciden t with the sition that cause and effect may exist in- limits of pathology, for there is no malady dependently of each other. The position in which it has not been enthu siastically is inexorably and irrecusably self-stultify- used by men with high forehe ads. The ing. An effect is not an effect, unless its same is exactly true of mercury, which. however has therapeutic value, and a very there is fever. You want to husband the considerable curative range. With all patient's vitality-a blister is scarcely less the devilment the latter has been made to devitalizing than is bleeding. Remember do, I believe the former has been made to this, too; anything placed upon the chest do more. Mercury, being medicinal, enters is no nearer the lungs, in a therapeutic into combinations with therapeutic help- sense, than it would be if placed upon the fulness. Not so, iron. It can do nothing nates. There is an empty space between but add its one lone medicinal element to the chest walls and the lungs. Countera preparation-astringency. Dr. Gross's irritation is practicable only where there great mind-without our modern helps is a continuty of tissue. The mush jacket caught a glimpse of the truth. He saw is an immitigable abomination. It largely that the chalybeate element of the tinct- increases the patient's susceptibility to ure of the muriate of iron, cut a very chill, with its dangers. It forces the pasmall, if any but a harmful, figure in the tient to lift, with his respiratory muscles, , preparation.

from 14,000 to 30,000 pounds every twentyAccording to my experience (and I four hours! Besides, poultices are proper have had thirty-five years of it), iron is in surface inflammations alone. Save your strongly contraindicated in all cases not poultices for boils and such ; they will at requiring an astringent. I have used least pleasingly entertain the patient. great quantities of it, and have, with most Amm. carb. is much affected in pneumonia conscientious studiousness, watcht its by a class, but if it is any more to the paaction. For the last ten years I have tient than a whip is to a tired horse, I made a special study of it. I have used don't know what it is.

don't know what it is. Under rational it many times in anthrax, and many treatment, not more than 5 per cent. of scores of times in erysipelas. I have used pneumonia cases-taking them as they it hundreds of times in anemia. I solemn- come-should die. As I have two or three ly declare that I have never seen one in- times given in THE WORLD what I constance in which it did any good not de- sider a rational treatment of this disease, pendent upon its one medicinal quality-- I will not repeat it here. However I will astringency. I have treated many iron append a few dont's with reference to cases (such by common agreement) with pneumonia. iron preparations minus the iron, and Don't bleed. Unless it is a fact that always got better results than I did in the average person in health has too much corresponding cases in which the com- blood, it cannot be a fact that a sick perplete iron preparations were used. Has son has too much. The blood (whatever Dr. Waugh tried these experiments ? I its character) is the life. To extract it is

sure he has not, for, being a brainy to extract that much life. and broad and fair man if he had done so Don't blister. To blister is to at once he would have been driven away from his deplete, and to set up a great source of idol, even as I have been. I have not the nervous irritation. Besides, if these obslightest doubt that Dr. Waugh and I jections did not exist, what do you expect agree perfectly in regard to the action of to accomplish by blistering, seeing that the quinin in periodic malaria, mercury in lungs are inaccessible to counter-irritation? primary syphilis, and iodid of potassium or Don't use a mush jacket. that combined with mercury, in tertiary Don't use an antipyretic, no difference syphilis. Why do we disagree in regard how high the temperature may get. Reto the merit of iron in anemia, anthrax, member that fever is only an effect, and erysipelas, amenorrhea, etc., etc., etc.? that to treat an effect is to lose precious

Dr. Baskerville asks for comments upon time, and reduce the patient's chances of his, and another man's treatment of a recovery. Drug antipyresis is toxic devicase of pneumonia. Both treatments were talization. unphilosophic, harsh and medieval to the Don't use ice packs. Cold drives the last degree. Don't get angry, Doctor, for blood to the centers, increasing what you I love you just the same, if you do miscue want to avoid--congestion. It shocksa little on pneumonia. Quinin has no another thing you want to avoid. Only logical place in pneumonia. It is barely the vigorous can get well in spite of this conceivable that 'pathological movements treatment, and the only reason why they might create a temporary opportunity for can resist its deadly tendency is because Dover's powder. Strychnia is inadaptable they are vigorous. Reduce the temperato any acute condition, especially where ture by tepid sponging.


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