creeping into practice, and their unfitness thereunto. As to the
first, heretofore when they were Members of the Company of Grocers,
and dispersed in place, as well as in counsel, they then were wholy
subordinate to the Physicians, only keeping in their Shops, and
faithfully making the prescriptions they received from the Physicians,
and when made, sending them to the Patient by their men (as they still
continue to do in Foreign Countries) and not committing the
preparation to raw Boys, or Apprentices, which is the true interest of
the Patient they should do here likewise. But in process of time,
Physicians in acute diseases having taught them somewhat, sent them to
visit their Patients, to give them the best account they could of the
estate of their health, and effect of their Medicines. And of later
years some Physicians took them along with them in their Visits,
whereby they acquired a little smattering of diseases, by which means,
and their continual officiousness, they insinuated themselves into
Families, and by applying (right or wrong) the terms of Art they had
learned from the Physicians, they made people believe they had
acquired some skill in the Art, and afterwards began to venture a
little at practice, and but until these 10 years last past kept
themselves within some bounds and limits; but since that time have
daily more and more incroached upon our Profession, being assisted by
a greater familiarity of conversation with younger Physicians. And in
the Plague time they took upon them the whole Practice of Physic,
which ever since they have continued, being much helped also therein
by the dispersing of Physicians into places unknown to their Patients,
by the Fire, but above all by the burning of the College, by means
whereof their Government and view of their Shops have been omitted,
insomuch that now they are past all restraint, having insinuated and
(as they think) rooted themselves by the aforesaid Artifices, so that
there remains now no other real remedy but that proposed.
Now here I shall take occasion in a short digression, to discourse
briefly the reason, why in all Ages there have been so many pretenders
to Physic, and why some of them have got reputation in the World. One
hath been mentioned before, viz. the great charges sick men are put
to, caused by the separation of the Physician from the Apothecary. But
the principal reason is, the want of knowledge in most persons, both
of the materials used, and the grounds for which they are applyed.
Insomuch that there are but few that can judg, and distinguish rightly
of either, and no wonder therefore that in their reasonings they
commit more absurd mistakes, or Paralogisms then in any other Art
whatsoever, and censure Physicians by the success alone. Which my Lord
Verulam accounts the great unhappiness both of the States-man and the
Physician, both being alike censured by those that know not the bottom
and rise of their Actions and Counsels. For how can any man in either
make a sound Judgment without a full knowledge of the business it
self; and of all the circumstances thereunto belonging; nor in Physic
without the concurrent knowledg of the sick mans habit, disease,
cause, remedies, and many other particulars necessary to make a clear
judgment upon the success? Yet notwithstanding, many will censure and
grumble at the actions of the States-men, though their proceedings
have been never so wise, and prudent, and oft-times from muttering and
whispering, fall to down-right distast, and mutiny against their
Superiors. So that the good success, in State-affairs, of rash and
imprudent undertakers, have been extolled and preferred before the
wary, and prudent management, and guidance of the soberest and wisest
States-men. The same likewise happens between the bold Empiric, and
learnedst Physician. But in this way of censuring, the States-man hath
this advantage above the Physician, that 'tis possible he may meet
with a series of Business so circumstantiated, as seldom or never to
miscarry, especially having a greater power over subordinate persons
then Physicians have. But the irreversible statute of Heaven forbids
us to expect a constant recovery of our Patients, for 'tis appointed,
that all men must die. 'Tis sufficient therefore for us, to employ
those remedies God hath given to the Sons of men, to the utmost vertue
the Creator hath endowed them withal: since his eternal decree hath
limited their efficacy from making man immortal. Now since (if men
judg by the success alone) it cannot be otherwise, but that the most
learned Physician, and most sottish Empiric must be thought equal in
skill, by those that are not able to make a right judgment and
difference betwixt them on other principles. Hence it comes to pass,
that where some ignorant person hath cured accidentally a slight
disease, and a Physician hath a Patient dye of an irrecoverable Case,
here the Empiric shall be applauded, and the Physician decryed. Nay
many will say the disease is the same in both, whereas we daily see
most gross mistakes in such opinions, when the Cases differ totally in
their Nature, agreeing in one sign only common to both the Cases
proposed, nay to many other also. Furthermore, if a Patient dy under
an Empirics hand, the friends willingly conceal their Names, lest some
discredit should befal them for using such worthless practisers; but
if under the hands of a known Physician he shall be sure to be named,
and sometimes his attendance falsly fathered on him, when Mountebanks
only have been employed: but to besure if an Empiric hath first been
made use of, and afterwards an able Physician called in (when all
opportunity of doing good was past) and the Patient dy, the Mountebank
hath never been mentioned, but the Physician perhaps condemned though
he hath done whatsoever could have been thought on, rational in that
Case.
Add to the former reasons, the bold and confident brags, and promises
of Empirics, that they have cured worse diseases, and will in few
hours free them from their maladies, especially where sober Physicians
have pronounced doubtfully of the event. No wonder that these pleasing
promises to persons in danger and distress bring them into employment
even with a rejection of the former sober Physician.
Besides, a foolish opinion prevails with some ignorant persons, that
they will deal only with such as will undertake the Cure, (that is)
contract with them for a sum of money, one half whereof to be payed in
hand, and the other the Cure being done, and so are usually cheated of
one half of their money; and such people will have nothing to do with
such Physicians as will not undertake them in this sence.
Another Stratagem is, to give strange and hard names to their
Medicines, such as are Pilulæ radiis Solis extractæ, and in English is
no more then Pills dryed to that consistence by the Sun-Beams, which
ignorant people have thought were made of the Sun Beams. Others
commend their Extract of the Soul of the Heathen Gods. One sets up
with a receipt received from Van Helmonts own hands; Another hath
received from a Jew the shining of Moses Face; nay I have heard a
Pseudochymist blasphemously brag, he saw in the making of a grand
Elixir, the Quintessence of the Trinity in Unity, and infinite other
pitiful captivations of silly people, to be seen on every Gate and
Post of this City; such as are the Spirit of the Salt of the World,
Panchymagogon, and other ten-footed Greek names, and some other
Mongrel non-sensical ones compounded of several Languages; promising
certain, speedy, and concealed Cure of incurable Diseases.
And no less ridiculous and absurd to considering persons are, their
cantings of themselves, wherewith they no less befool, amuse, and
beguile the people; as that by long prayer, and seeking of God, they
have had many secrets revealed to them from Heaven. Another by long
Travels through Hungary, Poland, &c. hath attained great secrets from
Kings and Emperours. Another a Gentleman lately come from Oxford, or
Cambridg, Cures the Pox, Running of the Reins, &c. in Capital Letters,
at all which what sober man cannot but laugh? Yet such as these are
inducements to many to resort to them; moreover some of them are
Astrologers, Physiognomers, Fortunetellers, Professors of Palmistry
and such other vain Arts; much applauded by the weaker sort of people.
Besides, the former they have their Emissaries, Scouts, and Setters up
and down, to cry up the skill And feigned Cures done by them, Nurses,
Good-fellows, Midwives, &c. to make up the cry and full noise.
Now it being natural to most people to admire what they understand
not, and for Admiration to infer Love, and Love Praise, and Praise the
use especially of such things as are set off with high and lofty
expressions, it necessarily follows that such persons will cry up, and
make use of, those that by these means captivate their understandings,
especially their credits being ingaged also; but above all, if they
proceed from meaner persons, of whom they are most credulous, having
in suspition wiser men, believing the former are not able, and that
the wiser are able; and therefore will deceive them. All which appears
in some with us cryed up above any Physician that ever was in England,
though for pitiful, dangerous, nay sometimes mortal Medicines, whereby
great sums of money have been gained in a short time; I shall instance
first in Lockyers Pills made of Antimony, discovered to be so by some
of my Collegues, and my self, at the first selling of them. A Medicine
as ill made as any of that Mineral, and no Physician though meanly
versed in Chymistry, but could have excelled it. Yet so great a Vogue
this Pill had for some time, that infinite people resorted to him, and
purchased them for their lives, both for themselves, and Families, and
(as I have heard) for their posterities too. Though a common Chimney
in a little time would have made enough of it to have served the whole
Nation for some years to come, and that at very small charges. But
Experience, the Tutor of too many, hath in a short time brought these
Pills into a dis-use, if not a total Oblivion, even amongst the
vulgar.
A second cryed up Medicine was Mathews's Pills, made of Opium (to
which the virtue of the whole Composition must be attributed) of white
Hellebor Roots, and Oyl of Turpentine, whereto some add Salt of
Tartar, which will puzzle the most knowing Naturalist to declare why
these should be thus jumbled together; unless to obscure the Opium.
'Tis indeed a very cunning Composition, for by giving rest and ease it
may easily decoy people into the use of them, though by long taking of
them, diseases become far more uncurable then they are in their own
Nature.
A third Universal Medicine was Hughes's Powder, sold by him at 10 s.
the Grain, and 3 l. 10 s. the Dose, made doubtless of Gold and
Quicksilver. The tast and weight of it manifestly discover the former
to be an ingredient into it, and the effect, viz. Salivation proves
the latter to be part of the compound. Besides I have made of these
two dissolved, and digested in their peculiar Menstruums, in no long
space of time, a Medicine that had the same effect with his, and in
the same Dose, and having a View of his Cabinet left after his Death,
containing a large quantity of the said Powder (being all he left
behind him) there was found crude Gold, and Quicksilver in the same
Cabinet. Now these three Notorious Universal Medicines were put to
sale by most ignorant persons. Add hereunto the forementioned Mr.
De-laun's Pill, whereof I shall say nothing, being mentioned under the
Name of the Pilule ex duobus, in the London Dispensitory, though some
make them of the Extract of Coloquintida. The last of any Fame with
us, were Dr. Goddard's Drops, a good Medicine, but not so universal,
and superlative as he would have made the World believe, and was
nothing else but what some Physicians many years since enjoyed. I well
remember that in the late troubles, a Person then in great Authority,
having cryed up this above all the Medicines in the World, a round
wager was offered, that the Doctor should not distinguish his own from
two others that should be brought him, both which were but Spirit of
Harts-horn. But the wager would not be accepted of. Furthermore, that
this Medicine of his was Spirit of Harts-horn, some relations plainly
argue; One whereof was the following.
A certain person in Norfolk having sent for as much as came to a 11 l.
and dying upon the 2d. dose of it, and by accident most part of the
remainder being spilt; there comes in a friend to the House, of some
skill, who supposing it to be Spirit of Harts-horn, told the Widow he
would endeavour to gain back the money for her. And thereupon went to
a Chymist, and bought as much of the said Spirit, as would make up the
quantity purchased of Dr. Goddard, who after Tryal of it by smell, and
tast, acknowledged it to be his, and honestly payed back the sum 'twas
first sold for; which I think few of the Mountebanks do. Sure I am
that a Quack sold 21 Pills for 20 l. whereof the Patient took 4 at two
doses, to the great hazard of his life, who then repairing to me for
my advice, I by Tryal of one of them found them to be Mercurial, and
wished him to return them back, but the Quack would not give him 10 s.
for the 16 remaining.
The inference and sum of what hath been said, is to shew briefly by
what Artifices people are deceived in their Healths, and Purses, and
how easily the ignorant are couzened, and such practices used, that
Physicians, men of honesty and repute, would be ashamed to own, and
must by using them in a short time be ruined and discredited. And such
Cheats as these, the College of Physicians are bound by the Laws of
the Land to decry, and punish (though by so doing it hath often
incurred the censure and clamor of the vulgar) Besides the Statute of
the 14th. and 15th. of Henry the Eighth injoyns us to it, declaring
that 'tis good for the Common-wealth of this Realm, and therefore
expedient, and necessary to provide that no person of the College of
Physicians (for all practisers then were of the said body) be suffered
to exercise, and practise Physic, but only those persons that be
profound, sad, and discreet, groundly learned, and deeply studyed in
Physic. Now certain it is, that none of the said body did or dare use
any of the forementioned frauds and deceits, but will constantly
indeavour (since 'tis impossible but there will be Cheatees;
(according to the old Proverb, Populus vult decipi, The People will be
deceived) to abridge the number of the Cheaters, who answer to the
former part of the Proverb, Decipiatur, Let them be couzened.
I shall end this discourse by returning from my digression to the
Apothecaries, who may and do use some of the tricks before-mentioned,
and shall here briefly recite some great advantages they have, and
make use of above Physicians. One is, that they live in this City 7 or
8 years as Apprentices, as also by their retail Trade, and by living
in open Shops, by frequent converse with their fellow Citizens,
whether in Commerce or Offices, by many friendly and Neighbourly
mutual kindnesses and actions, wherein they spend their whole lives,
and are never diverted by studies, and ingenuity from their proposed
way of gain, by all which means they get into a fixed familiarity and
good opinion with their Neighbours, and a large acquaintance in the
World. Now for their skill, besides what hath been before-mentioned,
and common to them with the Mountebank, viz. Vapouring and braging of
their skill, and decrying Physicians, by talking above the Capacity of
those they converse with, who therefore take all they say to be
authentick, though never so absurd, and trivial, and many times to set
off themselves they will venture to speak Latine commonly as false as
the matter, although some of them at Coffee-Houses, and in other mixt
Companies, by venturing so boldly have been met with and baffled, and
made to depart thence with shame and discredit enough, which their
friends and acquaintance take little notice of. Add hereunto their
exposing to view their Compositions of Treacle, Mithridate,
Diascordium and Alkermes, which all their friends, and neighbours one
time or another must see; (being set off by some very curiously) and
seeing cannot but admire the great charge, art, and labour of the
Apothecary, and perhaps hear his learned Lecture upon them, whereby
they imply their great skill, knowledg in the virtues of these
ingredients, and consequently an ability to practise with them; all
which are below the dignity of a Physician; and therefore a long time
is necessary for him to gain acquaintance, wanting the fore-mentioned
opportunities the Apothecaries enjoy. Lastly, Their painted Pots and
Glasses, with false Titles on them, more win the vulgar then a
Physicians Library of far greater value.
As to their incapacity for Practice, 'tis manifest by their education,
and ignorance of all those things which are required in an able
Physician, viz. the knowledg of Arts and Languages; by the former
whereof men learn the way and rules of observing, and improvements to
be made thereon; by the latter, what the learned searchers of Nature
have in all Ages taken notice of, necessary, and little enough in an
Art so difficult as that of Physic. They are wholy ignorant also of
all Philosophy, and the very Elements of the Art, and therefore
unskillful in knowing diseases; and more surely their causes, whereto
respect is to be had, as well as to the diseases, to which, fit
remedies are to be applyed. For want of Anatomy know neither the part
affected, nor how 'tis affected; much lets any thing of Chirurgical
directions. And through their ignorance in Philosophy, and Arts, they
have not skill enough to advise a diet sutable to diseases; a thing
most necessary, as well in curing diseases as in preserving of health,
and which requires a great insight into the nature of things; nor the
true grounds and reasons of compounding, practising their way rather
by rote then by rule; with better reason may a Brick-layer or
Carpenter pretend to be a Mathematical, or a Common Fidler to be a
Musick Reader in the Universities, or Gresham-College, since both
these have the practical part of those Sciences, which Apothecaries
have not in Physic, in the least measure.
And to conceal their mis-actings, they generally do all by word of
mouth, and not enter their prescriptions into their Books, being haply
ashamed any knowing men should discover their sins of omission, as
dangerous many times in point of life and health, as those of their
commission. Whereas Physicians Bills are on the File, or registred in
Order in their own Books, which is their justification from all
misrepresentations.
Again, they sufficiently confess their ignorance, by calling in
Physicians when their own, or any of their relations healths are
concerned, and the same all people acknowledge, when they are in
distress and danger. And very few understanding persons, and none that
are learned and knowing, will trust them at all. But I shall refer the
Reader to the forementioned Writer against the Apothecaries, viz. Dr.
Daniel Coxe, who permitted me to name him here; by whom this and many
other things here but briefly touched, are judiciously handled, and
more largely.
And as for their skill in practice, we daily see their gross errours
and omissions, being called where they have given Medicines. I shall
instance only in one that hapned at the writing hereof; viz. that an
Apothecary gave strong Purging Pills on the Fit day of a gentle
Quartan Ague, which turned it into a violent Fever, to the great
hazard of the Patients life.
And at how easie rate they practise, many of their Bills brought and
complained of to our College, (in some whereof I have seen Fees set
down for Visits) witness, wherein upon a slight disease 5 l. hath been
demanded for four days practice. And I have heard one of them brag,
that he commonly had from 20 to 100 l. besides presents, for cure of a
Clap (as they call it) which might have been more speedily and
securely performed for a manifold lesser sum.
I now come to answer some slight objections; as first, that Physicians
are unskillful in the Art of making Medicines; but sure those that
thus object cannot deny them that ability which Ladies, and almost all
ordinary women have; viz. of distilling of waters of all sorts, making
of Syrups, Conserves, Preserves, Powders, Trochiscs, Electuaries (and
what not) and as many think, more cleanly and neatly then the
Apothecaries; and some of them Ointments, and Plasters, in which two
lyes their main skill. Some whereof, to those that understand not the
way of dissolution of bodies, and the nature of their mixture may be
difficult. Yet this defect they may supply by lessening the number of
ingredients, and may perform more with 2, or 3 Simples, then with the
larger Compositions, as 'tis manifest in the use of Galbanum alone,
now used and found better then Emplastrum Hystericum, consisting of 21
ingredients.
And though as matters now stand, Physicians have not the honour to be
counted superiour to Apothecaries in their Art, yet every one knows
that they alone are the prescribers and directors of the Apothecaries
in what they know; and are able to puzzle them in infinite things that
concern their Trade, besides in Chymical preparations, whereof most of
them are totally ignorant; and should Physicians withdraw themselves
from their conversation, few pretenders to Physic would appear more
unskillful then they, neither knowing how to deal with a new Simple,
nor a new disease. And for all their pretences of skill in Drugs, 'tis
most certain that the State makes Physicians not Apothecaries, Judges
of them; and the Statute of Henry the VIII. appoints the College
Censors upon Oath, not the Apothecaries to judg, and condemn false and
sophisticated Medicines.
A second objection wherewith they flatter themselves, is, that the
great expence of time in preparing Medicines will keep Physicians from
this course. I answer, that the Physician needs not spend much more
then half an hour in a day, one with another, on this work, and may
faster dispense them then the Apothecaries to Hospitals, who in an
afternoon can provide for 100, nay sometimes 200 sick men, and carry
them to the Hospital, and dispose them to each single person, which
takes up much time, which the Physicians Servants need not be put to.