knows the composition of the chemical compound. The skilled physician ought to know the true composition of each of his patients; that he may adapt the treatment to the conditions whether it harmonizes with a given theory of medicine or not. Yet, strange as it may seem, almost every physician in practice, observes much more closely the principles of his creed in medicine, than the hereditary tendencies of his patient. I hold, then, that every human being is a combination in himself or herself, and each differing from all others, structurally, vitally, and, when sick, pathologically; that each differs in size, weight, expression of features, tone of voice, and even in gait, and other qualities that might be mentioned. Each differs in the duration of life, in the tendency to the development of certain forms of disease, in their character and symptoms. The vast difference in the degree of suffering and the susceptibility which each patient experiences in the various ailments, are due, if not wholly, at least principally, to hereditary influence; admitting that some exceptional cases may exist. There is no disease which may attack the human organism, which this hereditary defect will not in proportion to its strength aggravate; and the almost endless phases of disorder are brought out by, and are the true expression of this hereditary, influence. The extraordinary part which it plays in the inception, progress and results of disease, have never been taken into account by the medical profession, in proportion to its importance. This has been a great mistake—a mistake that has kept the science of medicine still imperfect. It is the rock upon which all systems and creeds of medicine have foundered and disappeared. This is the rock upon which the present systems are foundering, and I believe must also pass away. Thirty years ago the Eclectic Practice of medicine, when in the vigor of its youth and glory of its success, threatened to absorb all other schools of medicine in existence in the United States. But it failed, at least in a measure, because the extraordinary influence of hereditary defect and the power it exercises in all forms of disease, were not taken into account. It was the professed purpose of many of the Eclectics to select the best of many ideas and remedies from all sources in medicine. They were successful in this, and they have also discovered many new and valuable remedies; and by their selections and additions, have been so far successful in practice as to compel the modification and improvement of the methods employed by other schools in medicine, thus bringing all medical creeds more closely together. But they failed, in that they had not appropriately adapted, in practice, their excellent selections and discoveries, so as to be in harmony with the great fact of hereditary defect, and its influence in all forms of disease. It is impossible to do anything like justice to a subject so important and expansive as that which was assigned to me, in the brief space alloted to an ordinary address. I have but briefly touched upon a few of the leading and more important points in the subject, and have of necessity presented you with an unfinished production, and as such I commit it to your consideration. MENTAL AND PHYSICAL EXHAUSTION. GENTLEMEN:-The duty assigned me, on this occasion, is difficult of satisfactory fulfillment. My subject, allied to every phase of society and interwoven with every tangled web of life, is but little understood and much less observed. EXCESS AND DEFICIENCY OF BODILY EXERTION. We know that a certain amount of exercise is essential to the well-being of a healthy person and that an excess or deficiency of labor may induce disorder. Persons are said to "rust out" as well as "wear out." Those who are deprived of exercise for any considerable length of time, or who indulge in laziness, become weak and anæmic. A deficiency of healthy blood disorders the nervous centres. The muscles become soft and flabby; the fat accumulates in the areolar tissue; the countenance assumes a pallid hue; and the functions of organs are more or less deranged. Deficiency of exercise may influence the organs of digestion and thus interfere more directly with the function of hæmatosis. Loss of appetite, sooner or later, follows bodily inactivity and this must inevitably produce poverty of the blood; which unquestionably reduces the supply of nutrient matter followed by hypalbuminosis and its sequelæ. It is a wellknown law that a reasonable amount of exercise quickens digestion, and, therefore, we cannot be far wrong in attributing anæmia, produced from lack of exercise, to an exhaustion from want of proper nourishment. To die from inanition is to die from exhaustion, and hence fatigue is produced from a cenosis as well as from excess. EVILS OF EXCESSIVE EXERTION. Having recognized the fact that a considerable degree of tension in the mental and physical systems is essential to the maintenance, growth, and development of our being, prolonged exertion tends to bring on fatigue and disorder. Locke said that "the mind once jaded by an attempt above its power is very hardly brought to exert its force again." Exhausting mental and bodily labor, especially conjoined with want of proper food and other privations is undoubtedly capable of inducing anæmia; thus laying the foundation of many acute and distressing diseases as neuroses, mania, ramollissement, etc. The terms exhaustion and fatigue are, however, 'relative; their meanings cannot be the same with all persons, because there can be no absolute standard of mental and physical measurement. No two persons are alike; their capacities all differ; they do not possess the same stamina-the same vis a tergo. A tough and vigorous constitution can go through more excessive and prolonged exertion without injury, than the more frail. One can bear up under pain from disease or from surgical operations better than another; even in our therapeutical measures, we often observe great differences in the action of the same remedies and doses upon the different individuals. Hence, we may reasonably conclude that the laws of fatigue depends somewhat upon the inherent diathesis of the individual. The human organization is a self-feeding and self-adjusting piece of mechanism, and the mental and physical part of the machinery is not fatigued so much by the intellectual and muscular activity as it is from the emotional agitation. It is when the feelings are deeply absorbed that the general stability is endangered. The history of those who have become insane, or committed suicide, or have otherwise suffered from mental imbecility, are but corroborative evidences of these facts. In nine cases out of ten the cause can be traced to the anxieties and perplexities of life-to the apprehensions and future calamities; to blasted hopes, lost ambitions, envies, strifes, jealousies and disappointments. These do more to consume the neural power than all things else. THE RIGHT PRINCIPLE. So long as mental and muscular activity conforms to rhythmic nutrition, the bulk and effective power of mind and muscle is maintained. A muscle in a state of activity demands an extra supply of pabulum for its support. The losses to be restored consist mainly in oxygen and in the compounds of carbon and hydrogen. In every muscle, there is an energyproducing substance-a complex chemical agent we call inogen; and during contraction this substance is resolved into the albuminoid, myosin, which is retained within the muscular fasciculæ, whilst the non-azotized products, such as carbonic acid and phosphoric acid, are removed by the blood. The albuminoid material is not decomposed in muscular contraction; the activity demands a constant supply of plastic blood, and hence there is a continual appropriation of myosin and in proportion to the amount of contraction or exercise there will be increase of bulk. Thus we arrive at the well-known law that muscular activity, when within the bounds of rhythmic nutrition, increases rather than diminishes muscular tissue. THE BRAIN. Life is attended with many embarrassments and perplexities, and but few people learn how to override these without more or less fatigue. All vital phenomena have at least two sets of conditions for their maintenance: first, an organized structure possessing peculiar properties; secondly, stimuli by which these properties are called into action. The brain has a life of relation with external objects through the inlet of the senses, and a life of relation with the organs of the body through the media of nervous ramifications. It has also a life of nutrition through which the statical equilibrium is restored after each display of energy. The extent of nutritive repair is determined by the extent of waste. The material waste in the nerve-circuit, which the activity of an idea implies, is replaced by the vegetative function according to the mold or pattern of the idea. This organic process of repair is attended by a continued excess or draft upon the blood. Now, then, when the nutritive process becomes insufficient for the demand, the organs engaged are jaded and must necessarily encroach upon the conscious being. The nutritive process of repair is usually not attended with consciousness. When all is well the organs proceed without exciting sensations; but under conditions of disorder the sensations become cognizant by the feeling of oppression or fatigue, and often results in actual pain. So the organic life of the brain, which in health passes along peaceably without exciting consciousness, may under conditions of fatigue, thrust itself forward into consciousness and produce anomalous effects. The cerebral hemispheres are not sensitive in the sense of abnormal sensation; they display their fatigue in involuntary emotional ideas, either in a state of consciousness or unconsciousness according to the degree of exhaustion. There may be a simple manifestation of lassitude, or there may be confusion of thought; and this confusion may burst forth into delusion, illusion, or hallucination. The statical potentiality becomes an energy by reason of an abnormal stimulus from the inner life. Take, for an example, the stimulation of alcoholic spirits. During a certain stage of the effects of alcohol upon |
