ne of the most common signs of something at fault either with the body or the mind is headache. now headache, like wakefulness or nervousness, so often associated with headache, is an effect of some error, not a cause of it, and the wise sufferer will seek the cause even before he treats the effect.

we call ourselves the most enlightened nation of the earth to-day, and it is true that a little knowledge has been more generally diffused among our people than among other peoples of the world. but we should not forget that “a little knowledge is a dangerous thing” largely because a little knowledge frequently proves to be no real knowledge at all. for example, the “little knowledge” generally possessed in regard to opiates.

coal-tar was once a waste product, but toward the end of the last century a german chemist discovered that from it could be derived a drug, acetanilid, which would greatly lower temperature in fever. this discovery was hailed as a boon to humanity, and many other by-products of coal-tar were soon placed on the market, and regarded as of equal value with acetanilid. physicians used them for a time without questioning, and the people took to them gladly. wherever there was a persistent headache, some one of the coal-tar products was used, and “headache powders” multiplied.

but a little further knowledge led physicians to question the expediency of using acetanilid, phenacetin, antipyrin, or any of the coal-tar preparations in other than exceptional cases. heart-failure and other dangerous results so frequently followed their use that the wisdom of using them at all became doubtful. as our knowledge increases, we are likely to find both the wisdom and necessity entirely disappearing.

in the meantime, those who have heard that temporary relief from pain may be had by using these drugs will go on using them, often in patent medicines, ignorant of what these nostrums contain, and the number of deaths resulting from their use continues to increase. the only way to protect such people from the result of their little knowledge, which is really ignorance, is by making it illegal to sell these drugs, except by prescription from a physician, who, in turn, should be held responsible for results.

this is, of course, an interference with the individual’s right to do as seemeth best to him, and to get his experience in his own way. herbert spencer says, “the ultimate result of shielding men from the effects of folly is to fill the world with fools.” but it is the same sort of interference that makes us hold a man by main force from throwing himself on the track before an approaching train, and not the sort that would forcibly put an overcoat on him when he did not care to wear it. one may be no more justifiable than the other, but it seems more excusable.

all sleeping doses are to be viewed with distrust; most of them contain opium or morphine, some still more deadly drugs: nature “sets up a tolerance” for them so that, to obtain the effect, the dose must be increased, until, if the sufferer does not retreat in time, an almost incurable drug habit is formed, often more terrible than the liquor habit, which it sometimes supplants. nor do they bring true sleep.

r. clarke newton, in his treatise on “opium and alcohol,” says “sleeplessness means not merely unrest, but starvation of the cerebrum. the only cause for regret in these cases is that the blunder should ever be committed of supposing that a stupefying drug which throws the brain into a condition that mimics and burlesques sleep can do good. it is deceptive to give narcotics in a case of this type. the stupor simply masks the danger. better far let the sleepless patient exhaust himself than stupefy him. chloral, bromides, and the rest of the poisons that produce a semblance of sleep are so many snares in such cases. sleeplessness is a malady of the most formidable character, but it is not to be treated by intoxicating the organ upon which the stress of the trouble falls.” the late dr. alonzo clark, who for years stood at the head of his profession as a consulting physician in new york city, is quoted as saying, “all curative agents, so called, are poisons, and, as a consequence, every dose diminishes the patient’s vitality.” i doubt whether this view of drugs would be seriously contested by any of his professional brethren of good standing.

the venerable professor joseph m. smith, m.d., said: “all medicines which enter the circulation poison the blood in the same manner as do the poisons that produce the disease. drugs do not cure disease.” john bigelow, in the “mystery of sleep” , adds: “with drug-poisons should be classed nearly, if not quite, all fermented drinks—the most costly part of some people’s diet who indulge in them at all—coffee, tea, tobacco, spices, and most of the constantly multiplying tonics and condiments of the table. all of them have a tendency, directly or indirectly, to discourage or impair sleep, and, as such, are77 ‘hostes humani generis’ (enemies of the human race). their interference with sleep, though perhaps the most serious, is very far from being their only pathogenetic influence.”

mr. bigelow then cites from jahr’s “manual of medicine” the fearful disturbances of sleep caused by fifteen drugs, all taken as samples from the list in their order under the single letter “a.” contrary to the general belief, sleeplessness is more often a consequence of insanity than a cause of it. (see appendix a.)