Again，thecomplaintisoftenheardthatthenativepopulationisnotincreasingsorapidlyasinformergenerations。ThebreedingandnursingperiodofAmericanwomenisoneofpeculiardelicacyandfrequentinfirmity。Manyofthemmustrequireaconsiderableintervalbetweenthereproductiveefforts，torepairdamagesaridregainstrength。Thismatterisnottobedecidedbyanappealtounschoolednature。Itisthesamequestionasthatofthedeformedpelvis，——oneofdegree。Thefactsofmal-vitalizationareasmuchtobeattendedtoasthoseofmal-formation。Ifthewomanwithatwistedpelvisistobeconsideredanexempt，thewomanwithadefectiveorganizationshouldberecognizedasbelongingtotheinvalidcorps。Weshuddertohearwhatisallegedastotheprevalenceofcriminalpractices；ifbackofthesetherecanbeshownorganicincapacityorovertaxingoftoolimitedpowers，thefactsbelongtotheprovinceofthepracticalphysician，aswellasofthemoralistandthelegislator，andrequirehisgravestconsideration。
Taketheimportantquestionofbleeding。Isvenesectiondonewithforever？SixyearsagoitwassaidhereinanintroductoryLecturethatitwoulddoubtlesscomebackagainsoonerorlater。AfortnightagoIfoundmyselfinthecarswithoneofthemostsensibleandesteemedpractitionersinNewEngland。Hetookouthiswalletandshowedmetwolancets，whichhecarriedwithhim；hehadnevergivenuptheiruse。Thisisapointyouwillhavetoconsider。
Or，tomentiononeoutofmanyquestionableremedies，shallyougiveVeratrumVirideinfeversandinflammations？Itmakesthepulseslowerintheseaffections。Thenthepresumptionwouldnaturallybethatitdoesharm。ThecautionwithreferencetoitonthisgroundwaslongagorecordedintheLectureabovereferredto。SeewhatDr。
JohnHughesBennettsaysofitintherecenteditionofhisworkonMedicine。Nothingbutthemostcarefulclinicalexperiencecansettlethisandsuchpointsoftreatment。
Theseareallpracticalquestions——questionsoflifeanddeath，andeverydaywillbefullofjustsuchquestions。Taketheproblemofclimate。Apatientcomestoyouwithasthmaandwantstoknowwherehecanbreathe；anothercomestoyouwithphthisisandwantstoknowwherehecanlive。Whatboy’splayisninetenthsofallthatistaughtinmanyapretentiouscourseoflectures，comparedwithwhatanaccurateandextensiveknowledgeoftheadvantagesanddisadvantagesofdifferentresidencesintheseandothercomplaintswouldbetoapractisingphysicianIsawtheotherdayagentlemanlivinginCanada，whohadspentsevensuccessivewintersinEgypt，withtheentirereliefofcertainobscurethoracicsymptomswhichtroubledhimwhileathome。Isaw，twomonthsago，anothergentlemanfromMinnesota，anobserverandamanofsense，whoconsideredthatStateasthegreatsanatoriumforallpulmonarycomplaints。Ifhalfourgrownpopulationareorwillbemoreorlesstuberculous，thequestionofcolonizingFloridaassumesanewaspect。EvenwithinthebordersofourownState，theveryinterestingresearchesofDr。Bowditchshowthatthereisagreatvariationintheamountoftuberculousdiseaseindifferenttowns，apparentlyconnectedwithlocalconditions。ThehygienicmapofaStateisquiteasvaluableasitsgeologicalmap，anditisthebusinessofeverypractisingphysiciantoknowitthoroughly。TheyunderstandthisinEngland，andsendapatientwithadryirritatingcoughtoTorquayorPenzance，whiletheysendanotherwithrelaxedbronchialmembranestoCliftonorBrighton。Hereisanothergreatfieldforpracticalstudy。