the
times when disease had been looked upon as an entity to be exorcised,
but it was still so far regarded as a material thing that it was to be
starved out.

But the century was not out of its second decade when signs of an
awakening from this lethargy began to show themselves. The first steps,
naturally, were along preparatory lines, and for those we are largely
indebted to the physicists, the chemists, and the botanists. Gross
anatomy became better known, owing for the most part to more enlightened
legislation on the subject of the dissection of the human body; minute
anatomy (histology) sprang into existence as the result of improvements
of the compound microscope. Physiology took on something of the
experimental; and medication was rendered far less gross and repulsive
by the isolation of the active principles of medicinal plants. But it
was long after all this that the telling strides were taken. Up to
within the memory of many men who are now living, "peritonitis" tortured
its victims to death, said "peritonitis" being often interpreted as a
manifestation of rheumatism, for example, and no well-directed
interposition was attempted against it, whereas we now know perfectly
well that the vast majority of cases of peritonitis are due to local
septic poisoning and for the most part quite readily remediable by the
removal (with a minimum of danger) of the organ from which such
poisoning arises--almost always the vermiform appendix. "Appendicitis,"
of which we hear so much nowadays, is no new disease; it is simply the
"peritonitis" that killed so many people in former times. But while no
well-informed person would now maintain that this disease was a new one,
there are many, and those, too, among the best instructed, who find it
difficult to avoid the conclusion that, if not new, it must at least be
of far more frequent occurrence than formerly. It must be borne in mind,
however, that in the great majority of instances in past years it ended
spontaneously in recovery and was forgotten.

Two features of the progress in medicine in the Nineteenth Century,
negative as they may seem to have been, were undoubtedly potent in the
promotion of advance. They were the recognition of the fact that many
dangerous diseases are self-limited, and the experiment of the so-called
"expectant treatment." The result of the first of them was to teach men
to desist from futile attempts to _cure_ the self-limited diseases, in
the sense of