A man of parts was the doctor of the woods and farms, and it is to his credit that he recognized the importance of his mission and felt that it should be recognized by others. It is pleasant to dwell upon his varying personality, which so many still living can recall. Sometimes he was more or less imposing and austere. Still bearing the trace of mud or dust or snow, according to the season, he approached the bedside. Most anxiously the good wife, if she herself were not the patient, searched the face of the great man when husband or child lay in the grasp of some disease, for already had the trial of all home remedies been made. Very grave the doctor looked and, not improbably, he shook his head; for, the shaking of the head means much and nothing in particular, and the good cheer of the modern physician had not yet been understood and recognized as a part of treatment. At the portentious look and the headshake, the family fairly quaked. Then, when the medicine-case was opened there was consternation, though now mingled with faith and hope. Then administration of the prescription, and confidence restored. The patients of those days had faith, and that aided mightily in the

cures.

Varied were the prescriptions of the doctor so far removed from any source of medical supplies. Among his remedies were not a few whose utility had been tested before the white man had found the western hemisphere, and others the merits of which had been learned by students, like him, of the properties of the flora of a new world.

It is more than possible that in our confidence in the surpassing value of modern ways we do not give due credit to the merits of the herbs and simples of the woods and fields and gardens. In rhubarb, the oldtime country doctor put especial trust, and he pondered long over the differing virtues of pennyroyal, burdock-root, wild-cherry bark, and golden-seal and smartweed and lobelia, and other products of the kindly earth, all at his hand. In many a family of today is handed down the tradition of his liberal prescription of boneset tea, and there are still survivals of the boneset-cult. In his softer moods, the old fashioned doctor prescribed infusions and decoctions of cammomile, blackberry and raspberry leaves, red clover and, to induce sleep, scotch-cap tea and sometimes a hop pillow. He was a good doctor! Yet, hard as was the pioneer doctor's life, it had its compensations. There was compensation in even the sometimes arduous work involved in gathering the roots and plants whose virtues found an aid in the accepted remedies obtained at long

adventures and the enjoyments of the forest trail, the glory of spring and summer, the wild flowers and the birds and the barking squirrels and the startled deer and the ruffled grouse and the wild turkeys and quail, besides all the other creatures that made the old woods anything but agreeable, but which, furthermore, on occasion added not a little to the pleasures of the table. More than one of the early doctors found in the abundance of game some offset to the expense of living for one who had no time to clear and cultivate his land, if he possessed any, and whose income from his profession must be, under any local circumstances, limited. More than one, as well, among these patient students of the woods developed into a keen botanist or naturalist, and the contributions to the general knowledge, not less than to the materia medica, of these exploiters of new fields have long been recognized for their merit and importance.

The qualities that are in a man must count, wherever he may be or whatever his occupation, and the early country doctors improved their opportunities. It so happened, too, that occasionally, their profession practically lost one of them. Covering a wide area the doctor, in his professional journeys, necessarily made a host of acquaintances, and such acquaintance might be of a character more than casual.

Given such a man of natural force of character, one having a broad interest in other men and in affairs, and it was inevitable that he should become something of a power in the community and that it might, as a matter of course, sometimes happen that he would be called upon to represent his fellow citizens in framing their legislation. Who so familiar as he with their circumstances and their public needs? So, it not infrequently came to pass that the country doctor became the member of the legislature from his district-that is, if he had not fallen too completely under the spell of his botanical and nature studies, or, possibly, built up a practice more remunerative than the income of a legislator, or too rheumatic from exposure to all weather at all seasons and it often happened, as well, that his career as a law maker did not end within the limits of his own state. There have been strong men among the country doctors who have been sent to congress, and the profession has reason for pride in the quality of its representation in that distinguished body.

Occasionally, too, the country doctor, familiar with the nature of the varying forests, became the owner of tracts of pine land, and, so, in some instances a man of wealth; though, needless to

say, these instances were not common. As a general rule the doctor never abandoned his profession, and he very rarely changed his field of action. He was a fixed part of the developing community, a notable factor in its steady progress. This is the idyl of a man of opportunities.

But times were changing. Rarely was now the country doctor seen on horseback, for so passable had become the roads that the gig or buckboard became available, and there are far worse ways of getting about than by gig or buckboard. In the old days there was much discussion as to the relative merits of these two vehicles. The twowheeled gig was supposed to have somewhat of a professional character about it and, besides, could be turned about within its own length, which was of considerable importance when narrow roads and lanes must be traversed; but the long, low, more swinging and easy four-wheeled buckboard was a practicable conveyance that would endure rough usage or carry a load.

Interestingly curious were some of the road problems of the day, but they were rapidly disappearing as the farmers organized their school districts and the "postmaster" began his duties in an humble way. Already mayweed had displaced the fireweed on the strip between fence and road, and the white clover was soon to come. The stumps on the fields were gradually disappearing, and the Devon and the Durham sometimes appeared among the cattle. The wolves had been destroyed and sheep now were being reared, and in the flocks were occasionally seen, even in the 50's, the broad back of the Leicestershire or the black nose of the Southdoun. Civilization and progress were advancing all along the line. Even the doctor's gig and buckboard were abandoned.

A new era had opened for the doctor when he ceased either to compound a portion of his own medicines or was no longer compelled to carry the material for his prescriptions with him, although in remote districts he long continued the practice by virtue of necessity. With the village druggist as an ally, he now began to travel about in a neat top-buggy, using two horses, turn and turn about. His house now had porches and low windows, and inside of it were comfortable furniture, books, and attractive pictures. He also sent his children to the best schools, and the adolescent sons, in many instances, to college. His equipment no longer involved an attic hung with herbs, while his place of consultation had become a cheerful room, with all the requisite aids to diagnosis.

But, more than that had taken place, and something that exerted its effect in a more compre

hensive way. The physician himself had changed, if not in basic personality, at least in the possession of such knowledge as might come from broader acquirement. Medical colleges had come

great colleges, some of them, with master minds in their faculties, and he who would become a doctor now found no such preliminary hardship in the way of his ambition as his predecessor had been forced to undergo. Opportunity was present, and all depended now upon the man. Profoundly educated, not in the science of medicine alone, but in the different branches of learning, might be any country doctor-although now the town, of whatever size, usually was his homeand his ideas and methods were extending with his expanded field of thought. Some famous physicians were produced along about the middle. of the century, men fully deserving of the reputations that for them are lasting.

Then came another change that had a tremendous effect, immediately and universally, upon the profession, and which was of a character that could not have been conceived in ordinary forecast. The most destructive civil war in all history broke out, and the doctor was drawn into the maelstrom together with his fellow citizens. As a private in the ranks, as an officer in command, he went; but it was the fact that thousands of doctors became surgeons and assistant surgeons and labored in the field throughout the years of bloody struggle that made its impress on the professions as a whole, and for all future.

The end of the war released to civil life a host of physicians whose original learning had been supplemented by practice in a stern school. They had "walked the hospitals" of battlefields; they had guarded the health of laboring multitudes in trenches; they had fought the malaria of the swamps; they had stopped the dysentery of the camp; they had encountered all the harms and diseases to which a soldier's life subjects him; and they had learned-how much they had learned and what experience did they not bring back with them! Assuredly, the civil war had its effect upon the medical profession in America. It tought a thousand lessons.

To tell anything of the story of the present, to attempt anything like a study of the character of the American physician of today, is a work out of the question. He is the splendid product of a development as natural, in its way, as it has been phenomenal in its gradation and expansion. But, what has not been phenomenal in attainment among the important things in this new country, and what has surpassed in advancement that of the medical professions?

ence of a nidus of bacteria, yet we may be the host for years for one or more varieties of bacteria, and seemingly be none the worse for it. On the other hand, a person may pick up a few bacteria, and in a very short time this person is ill, his illness directly traceable to the invasion of a definite infection, either single or mixed.

In the latter case, advance of the infection is not due to the degree or virulence of the infection, but the lowered power of the individual to resist invasion of the bacterium.

The individual whose power to resist bacterial invasion is par or better, is in little danger from infections of various kinds, and may be classed as immune.

Of all the pathogenic bacterium we have to deal with, the bacillus turberculosis is one of the most common, and at autopsies it is rare to find a person at 20 years or over who does not present evidence of a tubercular infection of either the bronchial or peri-bronchial glands.

Treatment.

The sole aim of the physician should be directed toward increasing the power of resistance of the patient, and as soon as this appears, your patient will begin to improve, and the means best suited for this purpose are exercise, food, fresh air and sunlight. It might be well to suggest that it is not always what you do, so much as how you do it that counts for your success.

Astounding and incredulous as it may seem, if your patient is able to walk, the treatment may be administered to him or her, and if they are faithful in carrying out the treatment as outlined, in from four to six weeks improvement will be noticed.

From this time on, you will have no trouble to have your patient do as you wish, and most likely, a mild restraint might be advisable.

Have your patient breathe the outside air at all times, either by sleeping outdoors, or by means of a window tent. After rising, let him take a cool sponge bath, to the entire body, followed by a friction rub. He should stand erect, head back and chest forward, then take one deep breath, hold breath while counting three, then exhale slowly. Breathing exercises thrice daily before eating; the first day one deep inhalation, the second day two, third day three, and so on. The reason for deep breathing is obvious.

Walking is imperative. The majority of tuberculus patients are languid, and disinclined to do any thing but sit around. No matter how they protest in the beginning, insist on their walking, morning, noon and evening, unless the weather is too hot. They can dress for all other kinds of weather.

This should not be more than a city block and return for the first walk, and should be done thrice daily before meals for a period of three days. Increase the distance about the distance of a city block every third day, until two or more miles are done before eating.

After returning from each walk, the patient should lie down and fully relax until rested.

As to diet, I always have patients adhere to a milk and egg diet where possible, to which is added some alcoholic stimulant-either cognac, brandy, Jamaca rum, whiskey or sherry wine, in the order named, and in sufficient quantity so the patient will know he has taken a stimulant, but never to the point of confusion. This may be one teaspoonful to two tablespoonfuls, or even more, and may be given alone immediately after eating if preferred, suitably diluted.

The proportion of egg to milk is retained throughout the milk diet, that of one egg to one pint of milk, as this will lessen the tendency to intestinal putrefaction. Beginning on one pint of the milk and egg, gradually increasing until three or more pints are taken at each meal. Ten to 25 percent cream may be added to the milk to an advantage, as well as some acceptable flavoring.

There may be need, however, for some medical attention. There are digestive disturbances to contend with, and at times, intestinal disorders of a fermentative or putrefactive nature to contend with. Gastric fermentation is easily corrected with lime water or chloroform water in suitable quantities.

Intestinal troubles are best combatted by withdrawing all food for a day, and cleaning out the patient with a saline laxative, and omitting the walk.

If cough and night sweats are not too weakening, I pay no attention to them, other than to consider them a barometer to the condition of the patient. They are nature's efforts to rid the patient of bacterium and poisonous toxines.

To secure sleep if coughing prevents, veronal in 5 to 10 grain doses may be given. If sweating is so profuse as to weaken the patient, it can be checked by giving one or two granules of agaricin 1/12 grain, at bedtime.

To encourage this line of treatment I will mention one of my patients who was so weak that she was not able to stand up long enough to wash the dinner dishes, and had not swept a room for weeks. She was so emaciated that she was ashamed to have people see her, yet within a year, she walked across the city to my office, a distance of over three miles. This was in 1910, and she is alive and well today.

The lesson of lessons has been that there is no universally applicable method of treatment, no easy road to success. Every case presents peculiarities that compel a personal study and demand treatment fitted to that particular person. Time and again I have thought a specific had been discovered, but each time it proved to be specific only for certain forms of the malady. Nevertheless, each of these several methods has approved itself as the remedy for a certain percentage of the patients; and as all in all there are only one hundred percent, the proportion of unresolved problems diminishes.

Neither bromides, bromides, hyoscine, physostigmine, pilocarpine, quinine, strychnine, picrotoxin, codeine, emetine, solanine, gelseminine, sparteine, cicutine, the Towne-Lambert method, or the better system of elimination relied upon by Pettey and myself is applicable to everybody alike. But, if each of these fifteen "cures" is helpful-as we may roughly estimate to six percent of all patients presenting themselves, then and there remain only ten percent to be treated by other methods.

In these twenty-three years of practice I have had to record but one death among the patients under treatment. This fatal result followed the use of ammonium bromide; and then the prescribed doses had been quadrupled by an impatient wife during my unavoidable absence.

Quite recently I have had occasion to study my failures, in order to ascertain the causes therefor, and to see whether later experience had shown how they might have been avoided. And this is what I ascertained:

Some of the patients stopped treatment at my suggestion: they had an incurable disease that precluded the disuse of the drugs; or there were such evidences of mental instability, of weakened willpower that the chances for a permanent cure were too small to justify me in advising the trial. For years I rejected all cocaine-addicts, on account of their loss of the moral sense, that took from

these unfortunates all real desire to be cured. Of those who were cured of their habits and returned to their homes, happy, hopeful, healthy in mind, morals, and physique, few have relapsed.

In every instance where there was a relapse, the cause was the same too speedy return to the trials and duties of life. While the patient is with us he feels well and fit, even elated; he eats voraciously, digests rapidly all his stomach can accommodate, sleeps like the proverbial top, and begins to hunger for his work. And, so, he insists upon returning home. Here, however, he finds accumulation of work, business neglected or mismanaged, household worries, pressing demands of every description. For all these past years this man has been accustomed to meet unpleasant conditions by entrenching himself behind his narcotic; now he must meet them all in the open, unassisted, unprotected. His newly acquired strength is as yet but a sham, a makebelieve. Nature, outraged for years, does not fit a man to cope with such unusual conditions in the short space of a few weeks. The restoration of nerve-power, of vital endurance, of the capacity to bear strain is a matter of months or maybe years.

Take a violin-string and steep it in whisky for twenty years can you expect to put it in tunetension and not have it break? Why, then, expect more of a human nerve? Or, how can you demand a nervous system that has been functioning for twenty years under the dominance of morphine to work doubly as hard without the master drug?

Truly, as Voltaire said, "a doctor is an unfortunate gentleman, who is expected to perform miracles every day."

Too often the patient applies for treatment only when his means have been exhausted and he has no money left to buy his habit-drugs, let alone meeting the expense of a cure. Such persons should go to the county institutions, and not impose themselves upon the specialists. Instead of this, though, they borrow a little money and go to the people who in flamboyant advertisements guarantee a cure inside of four days.

Can they do it? Sure-if you are willing to call cutting off the supply of the drug "curing" the disease.

Should it be done that way? Well, we are assured that fools rush in where angels fear to