museum of pathological anatomy, created almost entirely by the hands
of Dr. John Barnard Swett Jackson, and illustrated by his own printed
descriptive catalogue, justly spoken of by a distinguished professor in
the University of Pennsylvania as the most important contribution which
had ever been made in this country to the branch to which it relates.
When we look at the literature of mental disease, as seen in hospital
reports and special treatises, we can mention the names of Wyman,
Woodward, Brigham, Bell, and Ray, all either natives of Massachusetts or
placed at the head of her institutions for the treatment of the insane.
We have a right to claim also one who is known all over the civilized
world as a philanthropist, to us as a townsman and a graduate of our own
Medical School, Dr. Samuel Gridley Howe, the guide and benefactor of
a great multitude who were born to a world of inward or of outward
darkness.
I cannot pass over in silence the part taken by our own physicians
in those sanitary movements which are assuming every year greater
importance. Two diseases especially have attracted attention, above
all others, with reference to their causes and prevention; cholera,
the “black death” of the nineteenth century, and consumption, the white
plague of the North, both of which have been faithfully studied and
reported on by physicians of our own State and city. The cultivation of
medical and surgical specialties, which is fast becoming prevalent, is
beginning to show its effects in the literature of the profession,
which is every year growing richer in original observations and
investigations.
To these benefactors who have labored for us in their peaceful vocation,
we must add the noble army of surgeons, who went with the soldiers who
fought the battles of their country, sharing many of their dangers, not
rarely falling victims to fatigue, disease, or the deadly volleys to
which they often exposed themselves in the discharge of their duties.
The pleasant biographies of the venerable Dr. Thacher, and the worthy
and kind-hearted gleaner, Dr. Stephen W. Williams, who came after him,
are filled with the names of men who served their generation well, and
rest from their labors, followed by the blessing of those for whom
they endured the toils and fatigues inseparable from their calling. The
hardworking, intelligent country physician more especially deserves
the gratitude of his own generation, for he rarely leaves any permanent
record in the literature of his profession. Books are hard to obtain;
hospitals, which are always centres of intelligence, are remote;
thoroughly educated and superior men are separated by wide intervals;
and long rides, though favorable to reflection, take up much of the time
which might otherwise be given to the labors of the study. So it is that
men of ability and vast experience, like the late Dr. Twitchell, for
instance, make a great and deserved reputation, become the oracles of
large districts, and yet leave nothing, or next to nothing, by which
their names shall be preserved from blank oblivion.
One or two other facts deserve mention, as showing the readiness of our
medical community to receive and adopt any important idea or discovery.
The new science of Histology, as it is now called, was first brought
fully before the profession of this country by the translation of
Bichat's great work, “Anatomie Generale,” by the late Dr. George
Hayward.
The first work printed in this country on Auscultation,--that wonderful
art of discovering disease, which, as it were, puts a window in the
breast, through which the vital organs can be seen, to all intents
and purposes, was the manual published anonymously by “A Member of the
Massachusetts Medical Society.”
We are now in some slight measure prepared to weigh the record of the
medical profession in Massachusetts, and pass our judgment upon it. But
in order to do justice to the first generation of practitioners, we must
compare what we know of their treatment of disease with the state of the
art in England, and the superstitions which they saw all around them in
other departments of knowledge or belief.
English medical literature must have been at a pretty low ebb
when Sydenham recommended Don Quixote to Sir Richard Blackmore for
professional reading. The College Pharmacopoeia was loaded with the most
absurd compound mixtures, one of the most complex of which (the same
which the Reverend Mr. Harward, “Lecturer at the Royal Chappel in
Boston,” tried to simplify), was not dropped until the year 1801. Sir
Kenelm Digby was playing his fantastic tricks with the Sympathetic
powder, and teaching Governor Winthrop, the second, how to cure fever
and ague, which some may like to know. “Pare the patient's nails; put
the parings in a little bag, and hang the bag round the neck of a live
eel, and put him in a tub of water. The eel will die, and the patient
will recover.”
Wiseman, the great surgeon, was discoursing eloquently on the efficacy
of the royal touch in scrofula. The founder of the Ashmolean Museum at
Oxford, consorting with alchemists and astrologers, was treasuring
the manuscripts of the late pious Dr. Richard Napier, in which certain
letters (Rx Ris) were understood to mean Responsum Raphaelis,--the
answer of the angel Raphael to the good man's medical questions. The
illustrious Robert Boyle was making his collection of choice and safe
remedies, including the sole of an old shoe, the thigh bone of a hanged
man, and things far worse than these, as articles of his materia medica.
Dr. Stafford, whose paper of directions to his “friend, Mr. Wintrop,” I
cited, was probably a man of standing in London; yet toad-powder was his
sovereign remedy.
See what was the state of belief in other matters among the most
intelligent persons of the colonies, magistrates and clergymen. Jonathan
Brewster, son of the church-elder, writes the wildest letters to John
Winthrop about alchemy,--“mad for making gold as the Lynn rock-borers
are for finding it.”
Remember the theology and the diabology of the time. Mr. Cotton's
Theocracy was a royal government, with the King of kings as its nominal
head, but with an upper chamber of saints, and a tremendous opposition
in the lower house; the leader of which may have been equalled, but
cannot have been surpassed by any of our earth-born politicians. The
demons were prowling round the houses every night, as the foxes were
sneaking about the hen-roosts. The men of Gloucester fired whole flasks
of gunpowder at devils disguised as Indians and Frenchmen.
How deeply the notion of miraculous interference with the course of
nature was rooted, is shown by the tenacity of the superstition about
earthquakes. We can hardly believe that our Professor Winthrop, father
of the old judge and the “squire,” whom many of us Cambridge people
remember so well, had to defend himself against the learned and
excellent Dr. Prince, of the Old South Church, for discussing their
phenomena as if they belonged to the province of natural science.
Not for the sake of degrading the aspect of the noble men who founded
our State, do I refer to their idle beliefs and painful delusions,
but to show against what influences the common sense of the medical
profession had to assert itself.
Think, then, of the blazing stars, that shook their horrid hair in the
sky; the phantom ship, that brought its message direct from the other
world; the story of the mouse and the snake at Watertown; of the mice
and the prayer-book; of the snake in church; of the calf with two heads;
and of the cabbage in the perfect form of a cutlash,--all which innocent
occurrences were accepted or feared as alarming portents.
We can smile at these: but we cannot smile at the account of unhappy
Mary Dyer's malformed offspring; or of Mrs. Hutchinson's domestic
misfortune of similar character, in the story of which the physician,
Dr. John Clark of Rhode Island, alone appears to advantage; or as
we read the Rev. Samuel Willard's fifteen alarming pages about an
unfortunate young woman suffering with hysteria. Or go a little
deeper into tragedy, and see poor Dorothy Talby, mad as Ophelia, first
admonished, then whipped; at last, taking her own little daughter's
life; put on trial, and standing mute, threatened to be pressed to
death, confessing, sentenced, praying to be beheaded; and none the less
pitilessly swung from the fatal ladder.
The cooper's crazy wife--crazy in the belief that she has committed the
unpardonable sin--tries to drown her child, to save it from misery;
and the poor lunatic, who would be tenderly cared for to-day in a quiet
asylum, is judged to be acting under the instigation of Satan himself.
Yet, after all, what can we say, who put Bunyan's “Pilgrim's Progress,”
full of nightmare dreams of horror, into all our children's hands; a
story in which the awful image of the man in the cage might well turn
the nursery where it is read into a madhouse?
The miserable delusion of witchcraft illustrates, in a still more
impressive way, the false ideas which governed the supposed relation of
men with the spiritual world. I have no doubt many physicians shared in
these superstitions. Mr. Upham says they--that is, some of them--were
in the habit of attributing their want of success to the fact, that an
“evil hand” was on their patient. The temptation was strong, no doubt,
when magistrates and ministers and all that followed their lead were
contented with such an explanation. But how was it in Salem, according
to Mr. Upham's own statement? Dr. John Swinnerton was, he says, for
many years the principal physician of Salem. And he says, also, “The
Swinnerton family were all along opposed to Mr. Parris, and kept
remarkably clear from the witchcraft delusion.” Dr. John Swinnerton--the
same, by the way, whose memory is illuminated by a ray from the genius
of Hawthorne--died the very year before the great witchcraft explosion
took place. But who can doubt that it was from him that the family had
learned to despise and to resist the base superstition; or that Bridget
Bishop, whose house he rented, as Mr. Upham tells me, the first person
hanged in the time of the delusion, would have found an efficient
protector in her tenant, had he been living, to head the opposition of
his family to the misguided clergymen and magistrates?
I cannot doubt that our early physicians brought with them many
Old-World medical superstitions, and I have no question that they were
more or less involved in the prevailing errors of the community in which
they lived. But, on the whole, their record is a clean one, so far as we
can get at it; and where it is questionable we must remember that there
must have been many little-educated persons among them; and that all
must have felt, to some extent, the influence of those sincere and
devoted but unsafe men, the physic-practising clergymen, who often used
spiritual means as a substitute for temporal ones, who looked upon a
hysteric patient as possessed by the devil, and treated a fractured
skull by prayers and plasters, following the advice of a ruling elder in
opposition to the “unanimous opinion of seven surgeons.”
To what results the union of the two professions was liable to lead, may
be seen by the example of a learned and famous person, who has left on
record the product of his labors in the double capacity of clergyman and
physician.
I have had the privilege of examining a manuscript of Cotton Mather's
relating to medicine, by the kindness of the librarian of the American
Antiquarian Society, to which society it belongs. A brief notice of this
curious document may prove not uninteresting.
It is entitled “The Angel of Bethesda: an Essay upon the Common Maladies
of Mankind, offering, first, the sentiments of Piety,” etc., etc.,
and “a collection of plain but potent and Approved REMEDIES for the
Maladies.” There are sixty-six “Capsula's,” as he calls them, or
chapters, in his table of contents; of which, five--from the fifteenth
to the nineteenth, inclusive--are missing. This is a most unfortunate
loss, as the eighteenth capsula treated of agues, and we could have
learned from it something of their degree of frequency in this part of
New England. There is no date to the manuscript; which, however, refers
to a case observed Nov. 14, 1724.
The divine takes precedence of the physician in this extraordinary
production. He begins by preaching a sermon at his unfortunate patient.
Having thrown him into a cold sweat by his spiritual sudorific, he
attacks him with his material remedies, which are often quite as
unpalatable. The simple and cleanly practice of Sydenham, with whose
works he was acquainted, seems to have been thrown away upon him.
Everything he could find mentioned in the seventy or eighty authors he
cites, all that the old women of both sexes had ever told him of, gets
into his text, or squeezes itself into his margin.
Evolving disease out of sin, he hates it, one would say, as he hates its
cause, and would drive it out of the body with all noisome appliances.
“Sickness is in Fact Flagellum Dei pro peccatis mundi.” So saying, he
encourages the young mother whose babe is wasting away upon her breast
with these reflections:
“Think; oh the grievous Effects of Sin! This wretched Infant has not
arrived unto years of sense enough, to sin after the similitude of the
transgression committed by Adam. Nevertheless the Transgression of Adam,
who had all mankind Foederally, yea, Naturally, in him, has involved
this Infant in the guilt of it. And the poison of the old serpent, which
infected Adam when he fell into his Transgression, by hearkening to the
Tempter, has corrupted all mankind, and is a seed unto such diseases as
this Infant is now laboring under. Lord, what are we, and what are our
children, but a Generation of Vipers?”
Many of his remedies are at least harmless, but his pedantry and
utter want of judgment betray themselves everywhere. He piles his
prescriptions one upon another, without the least discrimination. He is
run away with by all sorts of fancies and superstitions. He prescribes
euphrasia, eye-bright, for disease of the eyes; appealing confidently to
the strange old doctrine of signatures, which inferred its use from the
resemblance of its flower to the organ of vision. For the scattering of
wens, the efficacy of a Dead Hand has been out of measure wonderful. But
when he once comes to the odious class of remedies, he revels in them
like a scarabeus. This allusion will bring us quite near enough to the
inconceivable abominations with which he proposed to outrage the sinful
stomachs of the unhappy confederates and accomplices of Adam.
It is well that the treatise was never printed, yet there are passages
in it worth preserving. He speaks of some remedies which have since
become more universally known:
“Among the plants of our soyl, Sir William Temple singles out Five [Six]
as being of the greatest virtue and most friendly to health: and his
favorite plants, Sage, Rue, Saffron, Alehoof, Garlick, and Elder.”
“But these Five [Six] plants may admitt of some competitors. The
QUINQUINA--How celebrated: Immoderately, Hyperbolically celebrated!”
Of Ipecacuanha, he says,--“This is now in its reign; the most
fashionable vomit.”
“I am not sorry that antimonial emetics begin to be disused.”
He quotes “Mr. Lock” as recommending red poppy-water and abstinence from
flesh as often useful in children's diseases.
One of his “Capsula's” is devoted to the animalcular origin of diseases,
at the end of which he says, speaking of remedies for this supposed
source of our distempers:
“Mercury we know thee: But we are afraid thou wilt kill us too, if we
employ thee to kill them that kill us.
“And yett, for the cleansing of the small Blood Vessels, and making way
for the free circulation of the Blood and Lymph--there is nothing like
Mercurial Deobstruents.”
From this we learn that mercury was already in common use, and the
subject of the same popular prejudice as in our own time.
His poetical turn shows itself here and there:
“O Nightingale, with a Thorn at thy Breast; Under the trouble of a
Cough, what can be more proper than such thoughts as these?”...
If there is pathos in this, there is bathos in his apostrophe to the
millipede, beginning “Poor sowbug!” and eulogizing the healing virtues
of that odious little beast; of which he tells us to take “half a pound,
putt 'em alive into a quart or two of wine,” with saffron and other
drugs, and take two ounces twice a day.
The “Capsula” entitled “Nishmath Chajim” was printed in 1722, at New
London, and is in the possession of our own Society. He means, by these
words, something like the Archxus of Van Helmont, of which he discourses
in a style wonderfully resembling that of Mr. Jenkinson in the “Vicar
of Wakefield.” “Many of the Ancients thought there was much of a Real
History in the Parable, and their Opinion was that there is, DIAPHORA
KATA TAS MORPHAS, A Distinction (and so a Resemblance) of men as
to their Shapes after Death.” And so on, with Ireaeus, Tertullian,
Thespesius, and “the TA TONE PSEUCONE CROMATA,” in the place of
“Sanconiathon, Manetho, Berosus,” and “Anarchon ara kai ateleutaion to
pan.”
One other passage deserves notice, as it relates to the single medical
suggestion which does honor to Cotton Mather's memory. It does not
appear that he availed himself of the information which he says he
obtained from his slave, for such I suppose he was.
In his appendix to “Variolae Triumphatae,” he says,--
“There has been a wonderful practice lately used in several parts of the
world, which indeed is not yet become common in our nation.
“I was first informed of it by a Garamantee servant of my own, long
before I knew that any Europeans or Asiaticks had the least acquaintance
with it, and some years before I was enriched with the communications
of the learned Foreigners, whose accounts I found agreeing with what I
received of my servant, when he shewed me the Scar of the Wound made for
the operation; and said, That no person ever died of the smallpox, in
their countrey, that had the courage to use it.
“I have since met with a considerable Number of these Africans, who
all agree in one story; That in their countrey grandy-many dy of the
small-pox: But now they learn this way: people take juice of smallpox
and cutty-skin and put in a Drop; then by'nd by a little sicky, sicky:
then very few little things like small-pox; and nobody dy of it;
and nobody have small-pox any more. Thus, in Africa, where the poor
creatures dy of the smallpox like Rotten Sheep, a merciful God has
taught them an Infallible preservative. 'T is a common practice, and is
attended with a constant success.”
What has come down to us of the first century of medical practice,
in the hands of Winthrop and Oliver, is comparatively simple and
reasonable. I suspect that the conditions of rude, stern life, in which
the colonists found themselves in the wilderness, took the nonsense out
of them, as the exigencies of a campaign did out of our physicians
and surgeons in the late war. Good food and enough of it, pure air
and water, cleanliness, good attendance, an anaesthetic, an opiate,
a stimulant, quinine, and two or three common drugs, proved to be the
marrow of medical treatment; and the fopperies of the pharmacopoeia went
the way of embroidered shirts and white kid gloves and malacca joints,
in their time of need. “Good wine is the best cordiall for her,” said
Governor John Winthrop, Junior, to Samuel Symonds, speaking of that
gentleman's wife,--just as Sydenham, instead of physic, once ordered a
roast chicken and a pint of canary for his patient in male hysterics.
But the profession of medicine never could reach its full development
until it became entirely separated from that of divinity. The spiritual
guide, the consoler in affliction, the confessor who is admitted into
the secrets of our souls, has his own noble sphere of duties; but the
healer of men must confine himself solely to the revelations of God
in nature, as he sees their miracles with his own eyes. No doctrine
of prayer or special providence is to be his excuse for not looking
straight at secondary causes, and acting, exactly so far as experience
justifies him, as if he were himself the divine agent which antiquity
fabled him to be. While pious men were praying--humbly, sincerely,
rightly, according to their knowledge--over the endless succession
of little children dying of spasms in the great Dublin Hospital, a
sagacious physician knocked some holes in the walls of the ward, let
God's blessed air in on the little creatures, and so had already saved
in that single hospital, as it was soberly calculated thirty years ago,
more than sixteen thousand lives of these infant heirs of immortality.
[Collins's Midwifery, p. 312. Published by order of the Massachusetts
Medical Society. Boston, 1841.]
Let it be, if you will, that the wise inspiration of the physician was
granted in virtue of the clergyman's supplications. Still, the habit
of dealing with things seen generates another kind of knowledge, and
another way of thought, from that of dealing with things unseen; which
knowledge and way of thought are special means granted by Providence,
and to be thankfully accepted.
The mediaeval ecclesiastics expressed a great truth in that saying,
so often quoted, as carrying a reproach with it: “Ubi tres medici, duo
athei,”--“Where there are three physicians, there are two atheists.”
It was true then, it is true to-day, that the physician very commonly,
if not very generally, denies and repudiates the deity of ecclesiastical
commerce. The Being whom Ambroise Pare meant when he spoke those
memorable words, which you may read over the professor's chair in the
French School of Medicine, “Te le pensay, et Dieu le guarit,” “I dressed
his wound, and God healed it,”--is a different being from the God that
scholastic theologians have projected from their consciousness, or
shaped even from the sacred pages which have proved so plastic in
their hands. He is a God who never leaves himself without witness, who
repenteth him of the evil, who never allows a disease or an injury,
compatible with the enjoyment of life, to take its course without
establishing an effort, limited by certain fixed conditions, it is true,
but an effort, always, to restore the broken body or the shattered mind.
In the perpetual presence of this great Healing Agent, who stays
the bleeding of wounds, who knits the fractured bone, who expels the
splinter by a gentle natural process, who walls in the inflammation that
might involve the vital organs, who draws a cordon to separate the dead
part from the living, who sends his three natural anaesthetics to the
over-tasked frame in due order, according to its need,--sleep, fainting,
death; in this perpetual presence, it is doubtless hard for the
physician to realize the theological fact of a vast and permanent sphere
of the universe, where no organ finds itself in its natural medium,
where no wound heals kindly, where the executive has abrogated the
pardoning power, and mercy forgets its errand; where the omnipotent is
unfelt save in malignant agencies, and the omnipresent is unseen and
unrepresented; hard to accept the God of Dante's “Inferno,” and of
Bunyan's caged lunatic. If this is atheism, call three, instead of two
of the trio, atheists, and it will probably come nearer the truth.