This has always been the means of opposing the progress of reason—the
advancement of natural truths—and the prosecution of new discoveries;
whilst, with effects no less baneful, has it perpetuated many of the
stupendous errors which have been already enumerated, as well as others
no less weighty, and which are reserved for future discussion.
To give general currency to an hypothetical opinion, or medicinal
reputation to an inert substance, requires only the talismanic aid of a
few great names; when once established upon such a basis, ingenuity,
argument, and even experiment, may open their ineffectual batteries. The
laconic sentiment of the Roman Satirist is ever opposed to our
remonstrance—“Marcus dixit?—ita est.”
“Did Marcus say ’twas fact? then fact it is,
No proof so valid as a word of his.”
A physician cannot err, in the opinion of the public, if he implicitly
obeys the dogmas of authority; in the most barbarous ages of ancient
Egypt, he was punished or rewarded according to the extent of his
success, but to escape the former, it was only necessary to shew that an
orthodox plan of cure had been followed, such as was prescribed in the
acknowledged writings of Hermes. It is an instinct in our nature to
follow the track pointed out by a few leaders; we are gregarious
animals, in a moral as well as a physical sense, and we are addicted to
routine, because it is always easier to follow the opinions of others
than to reason and judge for ourselves. “The mass of mankind,” as Dr.
Paley observes, “act more from habit than reflection.” What, but such a
temper could have upheld the preposterous system of Galen for more than
thirteen centuries; and have enabled it to give universal laws in
medicine to Europe—Africa—and part of Asia?[53] What, but authority,
could have inspired a general belief, that the sooty washings of
rosin[54] would act as an universal remedy? What, but a blind devotion
to authority, or an insuperable attachment to established custom and
routine, could have so long preserved from oblivion the absurd medicines
which abound in our earlier dispensatories? for example, the “_Decoctum
ad Ictericos_,” of the Edinburgh College, which never had any other
foundation than the doctrine of signatures, in favour of the _Curcuma_
and _Chelidonium Majus_;[55] and it is only within a few years, that the
_Theriaca Andromachi_, in its ancient absurd form, has been dismissed
from the British Pharmocopœia.[56] The CODEX-MEDICAMENTARIUS of Paris,
recently edited, still cherishes this many-headed[57] monster of
pharmacy, in all its pristine deformity, under the appropriate title of
“_Electuarium Opiatum Polupharmacum_.”
It is, however, evidently indebted for this unexpected rescue from
oblivion to a cause very remote from that which may be at first
imagined; not from any belief in its powers or reliance upon its
efficacy, but from a disinclination to oppose the torrent of popular
prejudice, and to reject what has been established by authority and
sanctioned by time. For the same reason, and in violation of their
better judgment, the editors have retained the absurd formula of Diest
for the preparation of an extract of opium; which, after directing
various successive operations, concludes by ordering the decoction to be
boiled incessantly for six months, supplying the waste of water at
intervals! Many of the compound formulæ in this new CODEX, it is frankly
allowed, possess an unnecessary and unmeaning, if not an injurious
complexity; and yet, such force has habit, and so paramount are the
_verba magistri_, that the editors are satisfied in distinguishing the
more important ingredients by printing them in _Italics_, leaving the
rest to be supplied at the whim and caprice of the dispenser, and thus
are the grand objects and use of a national Pharmacopœia defeated, which
should above all things insure uniformity in the strength and
composition of its officinal preparations.
The same devotion to authority which induces us to retain an accustomed
remedy for pertinacity, will always oppose the introduction of a novel
practice with asperity, unless indeed it be supported by authority of
still greater weight and consideration. The history of various articles
of diet and medicine will prove in a striking manner, how greatly their
reputation and fate have depended upon authority. It was not until many
years after _Ipecacuan_ had been imported into Europe, that Helvetius,
under the patronage of Louis XIV. succeeded in introducing it into
practice: and to the eulogy of Katharine, queen of Charles II. we are
indebted for the general introduction of Tea into England.[58]
That most extraordinary plant,[59] _Tobacco_, notwithstanding its powers
of fascination, has suffered romantic vicissitudes in its fame and
character; it has been successively opposed, and commended by
physicians—condemned, and eulogised by priests and kings—and proscribed,
and protected by governments; whilst at length this once insignificant
production of a little island, or an obscure district, has succeeded in
diffusing itself through every climate, and in subjecting the
inhabitants of every country to its dominion. The Arab cultivates it in
the burning desert—The Laplander and Esquimaux risk their lives to
procure a refreshment so delicious in their wintry solitude—the Seaman,
grant him but this luxury, and he will endure with cheerfulness every
other privation, and defy the fury of the raging elements; and in the
higher walks of civilized society, at the shrine of fashion, in the
palace, and in the cottage, the fascinating influence of this singular
plant commands an equal tribute of devotion and attachment. The history
of the Potatoe is perhaps not less extraordinary, and is strikingly
illustrative of the omnipotent influence of authority; the introduction
of this valuable plant received, for more than two centuries, an
unexampled opposition from vulgar prejudice, which all the philosophy of
the age was unable to dissipate, until Louis the XVth wore a bunch of
the flowers of the potatoe in the midst of his court, on a day of
festivity; the people then for the first time obsequiously acknowledged
its utility, and ventured to express their astonishment at the apathy
which had so long prevailed with regard to its general cultivation; that
which authority thus established, time and experience have fully
ratified, and scientific research has extended the numerous resources
which this plant is so wonderfully calculated to furnish; thus, its
stalk, considered as a textile plant, produces in Austria a cottony
flax—in Sweden, sugar is extracted from its root—by combustion its
different parts yield a very considerable quantity of potass,—its
apples, when ripe, ferment and yield vinegar by exposure, or spirit by
distillation—its tubercles made into a pulp, are a substitute for soap
in bleaching,—cooked by steam, the potatoe is the most wholesome and
nutritious, and, at the same time, the most economical of all vegetable
aliments.[60]—by different manipulations it furnishes two kinds of
flour, a gruel, and a parenchyma, which in times of scarcity may be made
into bread, or applied to increase the bulk of bread made from grain,—to
the invalid it furnishes both aliment and medicine; its starch is not in
the least inferior to the Indian arrow root, and Dr. Latham has lately
shown that an extract may be prepared from its leaves and flowers, which
possesses valuable properties as an anodyne remedy.[61]
The history of the warm bath[62] presents us with another curious
instance of the vicissitudes to which the reputation of our valuable
resources are so universally exposed; that which for so many ages was
esteemed the greatest luxury in health,[63] and the most efficacious
remedy in disease, fell into total disrepute in the reign of Augustus,
for no other reason than because Antonius Musa had cured the Emperor of
a dangerous malady by the use of the _cold_ bath. The most frigid water
that could be procured was, in consequence, recommended on every
occasion: thus Horace, in his epistle to Vala, exclaims—
“——Caput ac stomachum supponere fontibus audent.
Clusinis, gabiosque petunt, et frigida rura.”—_Epist._ xv. _Lib._ 1.
This practice, however, was doomed but to an ephemeral popularity, for
although it had restored the Emperor to health, it shortly afterwards
killed his nephew and son in law, Marcellus; an event which at once
deprived the remedy of its credit, and the physician of his popularity.
The history of the Peruvian Bark would furnish a very curious
illustration of the overbearing influence of authority in giving
celebrity to a medicine, or in depriving it of that reputation to which
its virtues entitle it. This heroic remedy was first brought to Spain in
the year 1632, and we learn from Villerobel that it remained for seven
years in that country before any trial was made of its powers, a certain
ecclesiastic of Alcala being the first person in Spain to whom it was
administered in the year 1639; but even at this period its use was
limited, and it would have sunk into oblivion but for the supreme power
of the Roman church, by whose auspices it was enabled to gain a
temporary triumph over the passions and prejudices which opposed its
introduction; Innocent the Tenth, at the intercession of Cardinal de
Lugo, who was formerly a Spanish Jesuit, ordered that the nature and
effects of it should be duly examined, and upon being reported as both
innocent and salutary, it immediately rose into public notice;[64] its
career, however, was suddenly stopped by its having unfortunately failed
in the autumn of 1652 to cure Leopold, Archduke of Austria, of a Quartan
Intermittent; this disappointment kindled the resentment of the prince’s
principal physician, Chifletius, who published a violent philippic
against the virtues of Peruvian Bark, which so fomented the prejudices
against its use, that it had nearly fallen into total neglect and
disrepute.
Thus there exists a fashion in medicine, as in the other affairs of
life, regulated by the caprice and supported by the authority of a few
leading practitioners, which has been frequently the occasion of
dismissing from practice valuable medicines, and of substituting others
less certain in their effects and more questionable in their nature. As
years and fashions revolve, so have these neglected remedies, each in
its turn, risen again into favour and notice, whilst old receipts, like
old almanacks, are abandoned until the period may arrive, that will once
more adapt them to the spirit and fashion of the times. Thus it happens
that most of our “_New Discoveries_” in the Materia Medica have turned
out to be no more than the revival and adaptation of ancient practices.
In the last century, the root of the _Aspidium Filix_, the Male Fern,
was retailed as a secret nostrum by Madame Nouffleur, a French empiric,
for the cure of tape worm; the secret was purchased for a considerable
sum of money by Louis XV. and the physicians then discovered that the
same remedy had been administered in that complaint by Galen.[65]
The history of popular medicines for the cure of Gout, will also furnish
us with ample matter for the illustration of this subject. The
celebrated Duke of Portland’s Powder was no other than the
_Diacentaureon_ of Cælius Aurelianus, or the _Antidotos ex duobus
Centaureæ generibus_ of Ætius,[66] the receipt for which a friend of his
Grace brought from Switzerland; into which country it had been probably
introduced by the early medical writers, who had transcribed its virtues
from the Greek volumes soon after their arrival into the western parts
of Europe. The active ingredient of a no less celebrated remedy for the
same disease, _the Eau Medicinale_,[67] has been discovered to be the
_Colchicum Autumnale_ or Meadow Saffron; upon investigating the
properties of this medicine, it was observed that similar effects in the
cure of the gout were ascribed to a certain plant, called
_Hermodactyllus_[68] by Oribasius and Ætius, but more particularly by
Alexander of Tralles,[69] a physician of Asia Minor in the fourth
century; an inquiry was accordingly instituted after this unknown plant,
and upon procuring a specimen of it from Constantinople, it was actually
found to be a species of _Colchicum_.
The use of Prussic acid in the cure of Phthisis, which has been lately
proposed by Dr. Majendie, and introduced into the _Codex
Medicamentarius_ of Paris, is little else than the revival of the Dutch
practice in this complaint; for Linnæus informs us, in the fourth volume
of his “_Amænitates Academicæ_,” that distilled Laurel water was
frequently used in Holland for the cure of pulmonary consumption.
The celebrated fever powder of Dr. James was evidently not his original
composition, but an Italian nostrum invented by a person of the name of
Lisle, a receipt for the preparation of which is to be found at length
in _Colborne’s Complete English Dispensatory for the year 1756_.
The various secret preparations of Opium, which have been extolled as
the invention of modern times, may be recognized in the works of ancient
authors; for instance, Wedelius in his _Opiologia_ describes an acetic
solution; and the _Magisterium_ of Ludovicus, as noticed by Etmuller,
was a preparation made by dissolving Opium in vinegar, and precipitating
with Salt of Tartar;[70] Van Helmont recommends a preparation, similar
to the black drop, under the title of _Laudanum Cydoniatum:_ then again
we have Langelott’s Laudanum, and Le Mort’s “_Extract out of Rain
water_,” preparations which owe their mildness to the abstraction of the
resinous element of opium.
The works of Glauber contain accounts of many discoveries that have been
claimed by the chemists of our own day; he recommends the use of
muriatic acid in sea scurvy, and describes an apparatus for its
preparation exactly similar to that which has been extolled as the
invention of Wolff; he also notices the production of _Pyro-acetic
Acid_, under the title of “_Vinegar of Wood_,” so that the fact of the
identity of this acid and Vinegar, so lately announced by Vauquelin as a
_New Discovery_, was evidently known to Glauber nearly two centuries
ago.
We have within the last few years heard much of the efficacy of Henbane
fumigations in the tooth-ache, an application which may be easily shewn
to be the revival only of a very ancient practice.[71]
But while we might thus proceed to annul many other claims for
originality, we ought not to close our eyes to the fallacies to which
such investigations are peculiarly exposed. Nothing is more easy than to
invest the doubtful sentence of an obscure author with an interpretation
best adapted for the support of a favourite theory, and instances might
be adduced where the medical antiquarian[72] has by violence and
distortion forced the most contradictory passages into his service;
treating, in short, the oracles of Physic just as Lord Peter treated his
father’s will in the _Tale of a Tub_,—determined to discover the word
“_Shoulder Knots_,” he picks it out, letter by letter, and is even at
last obliged to substitute C for K in the orthography.
Nor has Fashion confined her baneful interference to the selection of
remedies; she has ventured even to decide upon the nature of Diseases,
and to change and modify their appellations according to the whim and
caprice by which she is governed. The Princess, afterwards Queen Anne,
was subject to Hypochondriacal attacks, which her Physicians pronounced
to be _Spleen_, _Vapours_, or _Hyp_, and recommended Rawleigh’s
Confection, and Pearl Cordial, for its cure: this circumstance was
sufficient to render both the Disease and Remedy _fashionable_; no other
complaint was ever heard of in the precincts of the court but that of
the _Vapours_, nor any medicine esteemed but that of Rawleigh. Some
years afterwards, in consequence of Dr. Whytt’s publication on “_Nervous
diseases_,” a lady of Fashion was pronounced to be _Nervous_—the term
became general, and the disease _fashionable_; and _Spleen_, _Vapours_,
and _Hyp_ were consigned to oblivion: the reign of Nervous Diseases,
however, did not long continue, for a popular work appeared on Biliary
Concretions, and all the world became _bilious_. We have not patience to
pursue the history of these follies; a transient glance at the ephemeral
productions of the last twenty years would furnish a sad display of the
versatility of medical opinions, and of the instability of the practice
which has been founded upon them: and they will no doubt furnish the
future historian with strong and forcible illustrations.
THE ASSIGNING TO ART THAT WHICH WAS THE EFFECT OF UNASSISTED NATURE, OR
THE CONSEQUENCE OF INCIDENTAL CHANGES OF HABIT, DIET, &c.
Our inability upon all occasions to appreciate the efforts of nature in
the cure of disease, must always render our notions, with respect to the
powers of art, liable to numerous errors and multiplied deceptions.
Nothing is more natural, and at the same time more erroneous, than to
attribute the cure of a disease to the last medicine that had been
employed; the advocates of amulets and charms[73] have even been thus
enabled to appeal to the testimony of what they call experience, in
justification of their superstitions; and cases which, in truth and
justice, ought to be considered most lucky escapes, have been
triumphantly pronounced as skilful cures; and thus have medicines and
practitioners alike acquired unmerited praise, or unjust censure. Upon
Mrs. Stephens offering her remedy for the stone to Parliament,[74] a
committee of professional men was nominated to ascertain its efficacy; a
patient with stone was selected, and he took the remedy; his sufferings
were soon relieved, and upon examining the bladder in the usual way, no
stone could be felt, it was therefore agreed that the patient had been
cured, and that the stone had been dissolved; some time afterwards this
patient died, and on being opened, a large stone was found in a pouch,
formed by a part of the bladder, and which communicated with it. When
the yellow fever raged in America, the practitioners trusted exclusively
to the copious use of mercury; at first, this plan was deemed so
universally efficacious, that in the enthusiasm of the moment, it was
triumphantly proclaimed that death never took place after the mercury
had evinced its effect upon the system: all this was very true, but it
furnished no proof of the efficacy of that metal, since the disease, in
its aggravated form, was so rapid in its career, that it swept away its
victims long before the system could be brought under mercurial
influence, while in its milder shape it passed off equally well without
any assistance from art.
Let us then, before we decree the honours of a cure to a favourite
medicine, carefully and candidly ascertain the exact circumstances under
which it was exhibited, or we shall rapidly accumulate examples of the
fallacies to which our art is exposed; what has been more common than to
attribute to the efficacy of a mineral water, those fortunate changes of
constitution that have entirely or in great measure, arisen from
salubrity of situation, hilarity of mind, exercise of body, and
regularity of habits, which have incidentally accompanied its potation.
Thus, the celebrated John Wesley, while he commemorates the triumph of
‘Sulphur and Supplication’ over his bodily infirmity, forgets to
appreciate the resuscitating influence of four months repose from his
apostolic labours; and such is the disposition of the human mind to
place confidence in the operation of mysterious agents, that we find him
more disposed to attribute his cure to a brown paper plaister of egg and
brimstone, than to Dr. Fothergill’s salutary prescription of country
air, rest, asses milk, and horse exercise.[75] The ancient physicians
duly appreciated the influence of such agents; their temples, like our
watering places, were the resort of those whom medicine could not cure,
and we are expressly told by Plutarch that these temples, especially
that of Esculapius, were erected on elevated spots, with the most
congenial aspects; a circumstance which, when aided by the invigorating
effects of hope, by the diversions which the patient experienced in his
journey, and perhaps by the exercise to which he had been unaccustomed,
certainly performed many cures. It follows then that in the
recommendation of a _watering place_, something more than the
composition of a mineral spring is to direct our choice,—the chemist
will tell us, that the springs of Hampstead and Islington rival those of
Tunbridge and Malvern, that the waters of Bagnigge Wells, as a
chalybeate purgative, might supersede those of Cheltenham and
Scarborough, and that an invalid would frequent the spring in the
vicinity of the Dog and Duck, in St. George’s Fields, with as much
advantage as the celebrated Spa at Leamington; but the physician is well
aware that by the adoption of such advice, he would deprive his patient
of those most powerful auxiliaries to which I have alluded, and above
all, lose the advantages of the “_Medicina Mentis_.” On the other hand,
the recommendation of change of air and habits will rarely inspire
confidence, unless it be associated with some medicinal treatment; a
truth which it is more easy and satisfactory to elucidate and enforce by
examples than by precept—let the following story by Voltaire serve as an
illustration.—“Ogul, a voluptuary who could be managed but with
difficulty by his physician, on finding himself extremely ill from
indolence and intemperance, requested advice:—‘Eat a Basilisk, stewed in
rose-water,’ replied the physician. In vain did the slaves search for a
_Basilisk_, until they met with Zadig, who, approaching Ogul, exclaimed,
‘Behold that which thou desirest;’ ‘but, my Lord,’ continued he, ‘it is
not to be eaten; all its virtues must enter through thy pores, I have
therefore enclosed it in a little ball, blown up, and covered with a
fine skin; thou must strike this ball with all thy might, and I must
strike it back again, for a considerable time, and by observing this
regimen, and taking no other drink than rose-water for a few days, thou
wilt see, and acknowledge the effect of my art.’ The first day Ogul was
out of breath, and thought he should have died from fatigue; the second
he was less fatigued, and slept better: in eight days he recovered all
his strength; Zadig then said to him, ‘There is no such thing in nature
as a Basilisk! but _thou hast taken exercise and been temperate, and
hast therefore recovered thy health_!’ But the medical practitioner may
perhaps receive more satisfaction from a modern illustration; if so, the
following anecdote, related by Sydenham, may not be unacceptable. This
great physician having long attended a gentleman of fortune with little
or no advantage, frankly avowed his inability to render him any farther
service, adding at the same time, that there was a physician of the name
of Robinson, at Inverness, who had distinguished himself by the
performance of many remarkable cures of the same complaint as that under
which his patient laboured, and expressing a conviction that, if he
applied to him, he would come back cured. This was too encouraging a
proposal to be rejected; the gentleman received from Sydenham a
statement of his case, with the necessary letter of introduction, and
proceeded without delay to the place in question. On arriving at
Inverness, and anxiously enquiring for the residence of Dr. Robinson, he
found to his utter dismay and disappointment, that there was no
physician of that name, nor ever had been in the memory of any person
there. The gentleman returned, vowing eternal hostility to the peace of
Sydenham; and on his arrival at home, instantly expressed his
indignation at having been sent on a journey of so many hundred miles
for no purpose. “Well,” replies Sydenham, “are you better in
health?”—“Yes, I am now quite well, but no thanks to you,”—“No,” says
Sydenham, “but you may thank Dr. Robinson for curing you. I wished to
send you a journey with some object of interest in view; I knew it would
be of service to you; in going you had Dr. Robinson and his wonderful
cures in contemplation; and in returning, you were equally engaged in
thinking of scolding me.”