A hygiene that claims to be new and of the greatest practicality, and certainly revolutionary in its application, would seem to require something of its origin and development to excite the interest of the intelligent reader. Methods in health culture are about as numerous as the individuals who find some method necessary for the health: taking something, doing something for the health is the burden of lives almost innumerable. Very few people are so well that some improvement is not desirable.

The literature on what to eat and not to eat, what to do and not to do, on medicines that convert human stomachs into drug-stores, is simply boundless. If we believe all we read, we must consider the location we are in before we can safely draw the breath of life; we must not cool our parched throats without the certificate of the microscope. We must not eat without an ultimate analysis of each item of the bill of fare, as we would take an account of stock before ordering fresh goods; and this without ever knowing how much lime we need for the bones, iron for the blood, phosphorus for the brain, or nitrogen for the muscles. In short, there is death in the air we breathe, death in the food we eat, death in the water we drink, until, verily, we seem to walk our ways of life in the very valley and shadow of death, ever subject to the attack of hobgoblins of disease.

How many lives would go down in despair but for the miracles of cure promised in the public prints, even in our best journals and monthlies, we cannot know. It is the hope for better things that sustains our lives; suicide never occurs until all hope has departed. Even our medical journals are heavily padded with pages of new remedies whose use involves the most amazing credulity. Perhaps it is well, in the absence of a sound physiological hygiene, that the people who are sick and afflicted shall be buoyed up by fresh, printed promises. Perhaps it is also well for the physician to be able to go into the rooms of the sick inspired from the advertising pages of his favorite medical journals.

Are they not new stars of hope to both physician and the people? Why should we not hope when new remedies are multiplying in such infinite excess over newly discovered diseases? New diseases? What is there essentially new that can be treated with remedies, in the coated tongues, foul mouths, high temperature and pulse, pain, discomfort, and acute aversion to food, that is to be found in the rooms of the sick? Are there really specifics for these conditions?

The hygiene to be unfolded in these pages is so new, so revolutionary, that its first impress has never failed to excite every form of opposition known to language, and yet its practicality is so great that it is rarely questioned by those who fairly test it. It has not been found wanting in its physiology, nor has it failed to grow wherever it has found lodgement.

The origin and development of this new way in health culture seem to require something of professional autobiography, that it may be seen that it is a matter of evolution and not of chance, not a fad that has only its passing hour.

After receiving my medical degree from the University of Michigan, and serving a term as house physician to the U. S. Marine Hospital at Detroit, Michigan, I entered one of the large army hospitals at Chattanooga, Tenn., at the beginning of the Sherman campaign in Georgia, where I found a ward of eighty sick and wounded soldiers fresh from the battle of Resacea. My professional fitness for duties so grave and so large in extent was of a very questionable order, and I did not in the least overestimate it.

It had not escaped my notice, even before I began the study of medicine, that whether disease were coaxed with doses too small for mathematical estimate, or whether blown out with solid shot or blown up with shells, the percentage of recoveries seemed to be about the same regardless of the form of treatment.

I was reared in a large family in a country home, several miles from a physician, where all but the severest sicknesses were treated with herb-tea dosage, and this was true of all other country homes. With all this in mind I had begun the study of medicine with a good deal less than the average faith in the utility of dosage, and it was not enlarged by my professor of materia medica.

I entered upon my serious duties as did good, rare, old Bunyan into his pulpit, with a feeling fairly oppressive that I was "the least of all the saints." My materia medica was in my vest pocket; my small library in my head, with its contents in a very hazy condition. With a weak memory for details, and marked inability to possess truth except by the slow process of digestion and assimilation, my brain was more a machine-shop than a wareroom; hence capacity of retail dealing was of the smallest. I was not in the least conscious at this time that a large wareroom amply stored by virtue of a retentive memory was not the most needed as an equipment for all the practical affairs of life. I have ever found it necessary to dodge some memories, when there was lack of time to endure a hailstorm of details.

That I did not become a danger to the hapless sick and wounded only less than their diseases and wounds, was wholly due to my small materia medica, to utter lack of pride in knowledge that had not become a power with me, and to that lofty ambition for professional success which moved me to seize aid from no matter where or whom, as the drowning man a straw.

It was my great professional fortune that the medical staff of this hospital of more than a thousand cots was of a very high order of ability and experience, and that I entered at the beginning of a campaign in which for more than three months there was a fitful roar of artillery and rattle of musketry every day; hence a continuous influx to cots vacated by deaths or recoveries.

In all respects it was the best equipped hospital for professional experience of any that I knew anything about. There was one rigid rule that I believe was not carried out in any other hospital: post-mortems in all cases, numbering from one to a dozen daily, and all made with a thoroughness I have never seen in private practice.

The features of my hospital service that impressed me most were the post-mortem revelations and the diverse treatments for the same disease. I soon found that, no matter what the disease, every surgeon was a law to himself as to the quality, quantity, and times of his doses, with the mortality in the wards apparently about the same.

Post-mortem examinations often revealed chronic diseases whose existence could not have been suspected during life, and yet had made death inevitable.

Another advantage in army hospital practice was the stability of the position and the absence of the harassing anxiety of friends, thus affording the highest possibilities of the judgment and reason. And still another advantage was the high social relations existing between the medical officers, due to the absence of all causes for jealousy, neither the position nor salary depending on superior endowments or professional success.

I was aware that, in spite of my lack of experience and the presence of a most painful sense of general insufficiency, my sick and wounded were about as safe in my hands from professional harm, even from the first, as the patients of the most experienced medical officer in the hospital.

With high professional ideals, with no ability to make use of hazy conceptions or ideas, having no pride in knowledge that had not become my own, I began at once to reinforce myself from the experience and wisdom of my brother officers, whose advisory services were always readily and kindly rendered.

From the first and all through my military service my severely sick had the advantage of all the borrowed skill and experience I could command. As for surgical operations, they were all performed in the presence of most of the medical staff, some of whom were of great experience.

The surgery of the army hospitals of 1864 was of the highest character in skill and in careful attention to all the details involved, and the fatalities were generally due to the gravity of the wounds requiring operations and lack of constitutional power for recovery, rather than to the absence of the germ-killer. At that time the microbe was not a factor in the probabilities of life or death. In all else the care of the wounds could hardly be surpassed.

As for the medicinal treatment of my sick, it was unsatisfactory from first to last. After all the years since I cannot believe that, except for the relief of pain, any patient was made better by my dosage; and in all fatalities the post-mortem revealed the fact that the wisest dosage would have been without avail.

But in the study of the history of disease as revealed by symptoms my hospital experience was invaluable. I have since found that my greatest service at the beds of the sick is as an interpreter of symptoms rather than a vender of drugs. The friends of the sick read indications for good or bad with wonderful acuteness, as a rule; and I have rarely found myself mistaken in my ability to read the condition of patients in the faces of the friends, even before I enter the rooms of the sick.

As my experience enlarged so did my faith in Nature; and, since there was no similarity in the quality, sizes, and times of the doses for like diseases, my faith in mere remedies gradually declined.

After a year and a half of large opportunities to study the diseases of men in the early prime of life, in the care of the simple surgery of shot and shell, I left the army with such familiarity with grave diseases and death in various forms as to enable me ever after to retain complete self-possession in the presence of dying beds in private practice.

I began the general practice of medicine in Meadville in the autumn of 1866. Among the many physicians located in the city at that time were men of ability and large experience. There were those who administered with sublime faith doses too small for mathematical estimate; those who with equal faith administered boluses to the throat's capacity for deglutition; those who fully believed in whiskey as nourishment, that milk is liquid food, and who with tremendous faith and forceful hands administered both until human stomachs were reduced to barren wastes and death would result from starvation aggravated by disease.

Most of the cases of disease that fall to the care of the physician are trivial, self-limited, and rapidly recover under even the most crucifying dosages; Nature really winning the victories, the physician carrying off the honors.

This is so nearly true that it may be stated that, aside from the domain of surgery, professional success in the general sense depends upon the personal qualities and character of the physician rather than the achievements of the materia medica.

People have a confidence in the power of medicine to cure disease scarcely less than the dusky warrior has in the Indian medicine-lodge of the Western wilderness, and a confidence about as void of reason.

The physician goes into the rooms of the sick held to the severest accountability in the matter of dosage; and the larger his own faith in medicines the greater his task; and, if he is of my own, the so-called "old school," or Allopathic, the more dangerous he is to the curing efforts of Nature.

With the people the disease is simply an attack, and not the summing up of the results of violated laws going on perhaps from birth. With the people the symptoms are merely evidences of destruction, and not the visible efforts to restore the normal condition. Hence the failures to relieve always raise more or less questioning, among friends in painful concern, as to the ability of the physician to discharge his grave duties.

This unreasoning, unreasonable "blind faith" in remedial means is as strong in the most intelligent as in the most ignorant, and it has ever given me more trouble than the care of the sick. Another serious complication of the sick-room arises from near-by friends who are very certain that their own physicians are better fitted by far for the serious work of prescribing for the sick.

In addition to the serious work of attacking the symptoms of disease as so many foes to life, there is also a care as to what unbidden food shall go into unbidden stomachs, that the system shall be supported while life seems to be in the hands of its greatest enemy.

The universal conception of disease as a foe to life, and not as a rational process of cure; the boundless faith in remedies as means to resist the attack, revealed by symptoms, makes the professional care of the sick the gravest of all human occupations, and the most trying to both head and heart.

With all these taxing conditions confronting me, I opened an office in a field which seemed to be more than occupied by men of large experience.

With all my army experience I still had a hazy conception as to Nature in disease. That the vital forces needed the support of all the food the stomach of the sick could dispose of, was not a question of the remotest consideration. That medicine did in some way act to cure disease I could not fully question.

I was now to enter a service in which, from the care of infancy in its first breathings to old age in its last, every resource of the materia medica, of the reason, judgment, and of the soul itself, was to be called in in every grave case, and to be held to a responsibility measured by preposterous faith in medicines.

I entered upon my duties with a determination to win professional success by the most thorough attention to all the details of service upon the sick and their friends, and I confined my efforts almost wholly to acute cases. None of my professional colleagues were winning laurels by the treatment of chronic diseases, and not having faith in drugs for such I had my scruples about fees for failures that seemed inevitable.

And yet with the most painstaking service fortune would play with me at times in the most heartless manner. At one time four of my adult patients were awaiting burial within the radius of a half mile. As they were all physical wrecks, and died after short illnesses, there could be no question raised in any just sense as to the character of my services, but the fatalities were scored against me. Such fortune would be annihilating but for the fatalities inevitable with all practitioners.

For full ten years I visited the sick and dosed them according to the books, but with far less force of hands and faith than any of my brethren, and all were enjoined to take nourishment to keep up the strength for the combat with disease.

My doses were confined to only a few Sampsons of the materia medica, and these were administered with a watching for favorable results that could hardly be surpassed, and yet always with disappointment.

I was innocent enough to believe that a large practice could only be built up by the most painstaking and persistent effort; later on I found that a large practice was but little dependent upon the skill and learning displayed in the sick-room. One physician could immediately secure a large patronage because she was a woman; another, because he belonged to this or that nationality, or there was something in the personal outfit rather than in the professional that incited large hopes for the ailing.

In all my cases of acute sickness there was always a wasting of the body no matter how much they were fed; a like increase of general strength when a normal desire for food occurred no matter how little they were fed. I saw this with eyesight only; but I saw with insight that a large practice could be carried on by doctors too ignorant to know that there was an alphabet in medical science.

I was not then so fully aware of the depths of ignorance among the people as to what cures disease, did not know that faith in doses was so large, as child-like even with the most cultured as with the ignorant. I was not so well aware, as I became later, that the physician himself must have such energy of faith in the materia medica as to reveal it in every line of his countenance when in the rooms of the sick.

As the years went on, my faith in remedies did not increase; but I had to dose to meet the superstitious needs of the people. My practice, though far short of what it seemed to merit from the pains bestowed upon it, was large enough for all the needs of profitable study had I been in a condition for thought and reflection. It was not to my encouragement that there were those doing a far larger business with doses simply crucifying, and because crucifying, a far larger attendance was the direct result.

I now see, as I did not then so clearly, that Nature's victories are often won against the desperate odds of treatments that are simply barbarous; and yet Nature is so powerful, so persistent in the attempts to right all her wrongs, that she wins the victory in the great majority of cases no matter how severely she may be taxed with means that hinder. The great majority of the severely sick of a hundred years ago recovered in spite of the bloody lancet and treatments that are the barbarism of to-day.

---