In a former paper I have given a sketch of the progress of the Chirurgical
profession, relating the many difficulties its members had to encounter in
their endeavours to attain that degree of perfection to which surgery has
risen; a perfection which we have every reason to believe will still
continue to be improved by the daily discoveries of the Physiologist,
whose labours may be considered the theoretical guide of the practitioner.
The history of medicine is equally fraught with much interest, since its
being a science more or less conjectural, it has opened a vast career to
the speculative mind, and a wide field for the ambitious. Having been long
considered a divine inspiration, priesthood in every age considered this
science an attribute of their vocation, adding to their spiritual and
temporal power.
In a rude state of society it is more than probable that the art of curing
diseases, as well as that of healing injuries, did not constitute a
special profession, but was practised indiscriminately by all persons
whose experience and position in the midst of their uncivilized kinsfolks,
gave some weight and importance to their advice. Warriors attended their
wounded companions in arms. Parents sought to relieve their offspring, and
children endeavoured to alleviate the sufferings of their aged and infirm
sires. Thus, I may say, was the art of healing instinctively taught, and
not unfrequently the brute creation guided the efforts of humanity; when
man contemplated the means animals resorted to when labouring under
disease. Plutarch affirms that it is to these instinctive efforts of
animals that we are indebted for the knowledge of the various properties
of plants. The wild goats of Crete pointed out the use of the _Dictamus_
and vulnerary herbs--dogs when indisposed sought the _Triticum repens_,
and the same animal taught to the Egyptians the use of purgatives
constituting the treatment called _Syrmaism_. The hippopotamus introduced
the practice of bleeding, and it is affirmed that the employment of
enemata was shown by the ibis. Sheep with worms in their liver were seen
seeking saline substances, and cattle affected with dropsy anxiously
looked for chalybeate waters. This study might therefore have been called
an instinctive school.
Herodotus tells us that the Babylonians and Chaldeans had no physicians,
and in cases of sickness the patient was carried out and exposed on the
highway, that any persons passing by who had been affected in a similar
manner, might give some information regarding the means that had afforded
them relief. Shortly, these observations of cures were suspended in the
temples of the gods, and we find that in Egypt the walls of their
sanctuaries were covered with records of this description. The priests of
these shrines soon considered these treasures as their property, and
turned their possession to a good account. Amongst the Hebrews we find
that the Levites were considered as the only persons who could cure
leprosy, and the practice of medicine became their province.
The priests of Greece adopted the same practice, and some of the tablets
suspended in their temples are of a curious character which will
illustrate the custom. The following votive memorials are given by Gurter:
"Some days back, a certain Caius, who was blind, learned from an oracle,
that he should repair to the temple, put up his fervent prayers, cross the
sanctuary from right to left, place five fingers on the altar, then raise
his hand and cover his eyes. He obeyed, and instantly his sight was
restored amidst the loud acclamations of the multitude. These signs of the
omnipotence of the gods were shown in the reign of Antoninus."
"A blind soldier named Valerius Apes, having consulted the oracle, was
informed that he should mix the blood of a white cock with honey, to make
up an ointment to be applied to his eyes, for three consecutive days: he
received his sight and returned public thanks to the gods."
"Julian appeared lost beyond all hope, from a spitting of blood. The god
ordered him to take from the altar some seeds of the pine, and to mix them
with honey, of which mixture he was to eat for three days. He was saved,
and came to thank the gods in presence of the people."
The _Ex volos_ of modern times suspended at the altars of saints in
Catholic churches, are similar testimonials of superstitious credulity,
and priestly fraud, and constitute a lucrative branch of business, more
particularly to waxchandlers, who fabricate simulacra of every organ or
member of the body that may be diseased.
Such was the study and practice of medicine, until the days of
Hippocrates, justly named the father of medicine. But even this great man
in his study of the problematic science, attributed to divine influence
all that could not be comprehended and explained, giving the appellation
of sacred, to that which appeared prodigious and inexplicable. This divine
influence which was considered as invincible, setting at nought all human
speculation and mortal efforts, he denominated the [Greek: to theion] the
_Divinum quid_, he also fancied that the principle of fire was the source
of all animation; for the which opinion, more modern writers pronounced
him an atheist, amongst other bigots, who thus accused him, we find
Gundling and Drelincourt, and even Mosheim; while on the other hand, Will
Schmidt, Fabricius, and Bellunensi have sought to reconcile his doctrine
with the scriptures; and so far from this accusation being founded, it is
well known that Hippocrates had such an implicit belief in the power of
the gods, that he got himself initiated in the Eleusinian mysteries at
Athens. We find in his Praenotum the following singular passage:
"Nevertheless, there does exist in all diseases something of a divine
nature, and the physician who is able to foresee their results, must be
admired for his judgment."
This divine _something_, has been the subject of much research and angry
disputation. Galen considered it to reside in the atmosphere. Fernel
considered it the principle of putrefaction and disorganization.
Mercuriali placed it in sideral influence, while Professor Martianus
maintained that Hippocrates had a firm belief in demons and malevolent
spirits. It would be endless to recount all the idle disquisitions on this
matter, which have too frequently converted universities into
Pandemoniums.
The earliest teachers of medicine were the philosophers, amongst whom we
must remark Pythagoras, who founded the school of Crotona, where assuming
the sanctity of the priesthood he obtained such an authority over his
disciples, that it gave rise to the common expression of _jurare in verba
magistri_. This truly wonderful man had learnt in Egypt the secret
symbolic mode of writing of the priests, and he certainly did apply his
extensive acquirements to the welfare of his country and the benefit of
mankind; according at least to his views of the subject, which we have
every reason to believe were conscientious. From his youth, when he bore
away the prize in the Olympic games, his lofty ambition, which scarcely
knew any bounds, constantly urged him on in a career of perfection in
every branch of learning, which ultimately placed him on the highest
ground that ever philosopher attained.
After Pythagoras, we find medicine taught by Anaxagoras, Democritus,
Heraclitus; but Hippocrates was justly considered the father of medicine,
and deserved the name of _great_--every line of his immortal works
breathes a deep knowledge of the phenomena of nature, and an ardent desire
to release the most important of all human sciences from the degrading
trammels of ignorance and imposture. Nothing can afford a more convincing
proof of the purity of his motives, and the integrity of his principles
than the formula of the oath which he exacted from his disciples, and
which runs as follows:
"I swear by Apollo, by Esculapius, by Hygeia, and all the gods, to fulfil
religiously the solemn promise which I now do make.
"I will honour as my father, the master who shall teach me the art of
healing, and convince him of my gratitude, by endeavouring to minister to
all his necessities. I will consider his children as my own, and will
gratuitously teach them my profession should they express a desire to
follow it.
"I shall act in a similar manner to all my brethren who are bound by a
similar engagement, but shall not admit any other to my lessons, my
discourses, or the exercises of my profession.
"I shall prescribe to my patients, such a course of regimen as I may
consider best suited to their condition, according to the best of my
judgment and capacity, seeking to preserve them from any thing that might
prove injurious.
"No inducement shall ever lead me to administer poison, nor shall I ever
give a criminal advice, or contribute to an abortion.
"My sole end shall be to relieve and cure my patients, to render myself
worthy of their confidence, and not to expose myself, even to the
suspicion of having abused this influence, more especially when a woman is
in the case.
"I shall seek to maintain religiously both the integrity of my conduct,
and the honour of my art.
"I will not operate for the stone, but leave that operation to those who
cultivate it.
"To whatever dwelling I may be called, I shall cross its threshold with
the sole view of succouring the sick, abstaining from all injurious views
and corruption, especially from any immodest action.
"If during my attendance, or even after a recovery, I happen to become
acquainted with any circumstances of the patient's life which should not
be revealed, I shall consider this knowledge a profound secret, and
observe on the subject a religious silence.
"May I as a rigid observer of this my oath, reap the fruit of my labours,
enjoy a happy life, and obtain general esteem--should I become a perjurer,
may the reverse be my lot."
At this period the physician who founded a school taught every branch of
the science, and after examining his disciples, gave them a permission to
practise the profession when properly qualified. Hippocrates was succeeded
by his sons Thessalus and Draco.
The school of Hippocrates was followed by that of Plato who founded the
dogmatic sect, but his speculative views were succeeded by the more sound
doctrines of Aristotle, who was one of the first philosophers who applied
himself to practical anatomy in the frequent dissections of various
animals, and he struck out the important path which his successor
Herophilus was fortunate enough to follow for the welfare of mankind, by
submitting human bodies to the scrutinizing scalpel under the protection
of Ptolemy Lagus, a protection which became the more necessary as he had
been actually accused of having dissected living subjects. Tertullian
affirms that he had thus sacrificed six hundred victims; but what faith
can we place in such an absurd charge, which very probably arose from envy
or prejudice; although his successor Erasistratus, was accused of a
similar offence, and in more modern times Mondini, who was the first to
reintroduce human dissections was exposed to a like charge. It was
Herophilus who founded the celebrated school of Alexandria, where under
the auspices of Ptolemy Philadelphus, Erasistratus succeeded him, followed
by Strabo of Berytus, Strabo of Lampsacus, Lycon of Troas, Apollonius of
Memphis, and many other distinguished philosophers.
It was at this period that physicians began to practise surgery, which was
first taught with great repute in the Alexandrian school, and where
Ammonicus and Sostrates, surnamed the lythotomists, first distinguished
themselves by this important operation.
While the science of medicine thus flourished in Greece and Egypt it was
scarcely known in Rome, where the first physician who ventured to practise
was Archagathus from Peloponnesus. At first the bold adventurer was
favourably received, but his operations having shocked a people who
constantly glutted their eyes in scenes of horror, and who beheld the
blood of gladiators flowing in their arena or streaming under the lictors
axe! the imprudent practitioner was stoned to death by the populace, and a
hundred and fifty years elapsed ere another physician could be induced to
visit the ungrateful country, nor was it until the time of Pompey and of
Caesar that any medical men dared to visit the "eternal city."
The first of these was Asclepiades, who commenced by giving lessons of
rhetoric, which were succeeded by lectures on physic, in the first school
of medicine which he founded in Rome. It was on these benches that
Aufidius and Nico, Artonius and Niceratus were initiated in the art of
healing, while Asclepiades formed his celebrated disciple Themison founder
of the sect of the Methodists or Solidists. To this school are we also
indebted for the learned Celsus justly called the _Cicero of medicine_.
Under Trajan and Adrian the medical profession had attained great
celebrity and splendour, and under M. Antoninus, and Marcus Aurelius the
world became indebted to the glorious labours of Galen--but the bright
days of the healing art were sinking with the star of Rome in the dark
horizon of barbarism, and the works of these illustrious masters were
sacrificed at the shrine of astrology, magic, and Eastern theosophy.
From this period we find Eastern superstitions mingled with the early
practices and creed of Christianity, when, to use the words of Sprengel,
"An allegorical explanation of words and even of the scriptures, was
carried so far by the Jews that it was considered the utmost perfection of
human learning. The essence of every science, and the only method of
obtaining, without laborious studies, and in a state of idle
contemplation, a degree of wisdom beyond the reach of all other mortals.
It is thus that during the first century of our era the science of Cabala
arose, a tissue of all the chimeras of Zoroaster, Pythagoras, and the
Jews, and which in time, to the shame of human intellect, invaded the
domain of learning, and became closely connected with medicine."
In the commencement of the second century of the church, Acibba published
a work called _Jezirach_, and Cimeon-Ben-Ischai wrote his book entitled
_Sohan_, in which their cabalistic labours sought to prove, that there
existed a supreme being from whom emanated ten angels, who formed the
first world, in which resided three personified abstractions--knowledge,
intelligence, and wisdom.--Besides this first or primitive world, there
existed three others moving in concentric circles--the world created, the
world formed, and the world constructed! So united, so constructed, that
whatever might happen in the last of these worlds had already existed in
imagination in the first. From this theory it was maintained that the
practice of physic was to call into action all the powers of the superior
worlds; a problem that could only be solved by a cabalistic physician, who
by his piety and contemplation had succeeded in rendering himself worthy
of a communication with celestial agency.
Facts and observations recorded by long experience were now considered
useless and contemptible _data_, and all terrestrial knowledge despised.
Anatomy was deemed worse than useless, and the established doctrines of
various schools a dead letter. Chaldean, Phoenician, Hebrew words with
mystic significations were introduced as symbolic illustrations of
science: no language that could be understood, was deemed intelligible,
and any system that could bear the test of reason was denounced as
impious.
Thus was the career opened to the craft of priests boundless. It had been
believed that the apostles were gifted with the power of healing by the
mere apposition of their hands, and their self-named descendants pretended
to possess the same divine attributes--and not only beatified monks cured
with various oils and ointments; but their very mortal remains, became
precious in the hands of their monastic successors. When their mouldering
bones had been sold wholesale and retail as precious relics, their very
sepulchres and their shadows brought hosts of pilgrims to herd round their
shrines.
The study of medicine destroyed with the glories of Rome, was revived in
Egypt, where Zeno of Cyprus delivered courses of lectures at Alexandria, a
school which soon after dwindled into decay, sinking into obscurity with
the once famed academies of Greece.
The Roman empire dismembered, Persia became an asylum for fugitive
philosophy, and the Nestorians founded a medical school at Edessa in
Mesopotamia, while other sectarians equally oppressed by ostensible
orthodoxy, sought a refuge in the city of Dschondi-Sabour, where numbers
of Persian and Arabian students flocked to learn their doctrines, and thus
we have the origin of the celebrated school of Bagdad under the protection
of their caliphs.
This regeneration of science was soon communicated to the shores of
Europe, and the Caliph Alhakam founded a school at Cordova possessing
upwards of 300,000 volumes, and Seville, Toledo, Saragossa, and Coimbra
followed the bright example. Thus was a science, banished from Europe by
bigoted and misguided Christians, restored to its former seat by
Mohammedans.
The progress of the science of medicine under the Moorish government was
so rapid in Spain, that we find one hundred and fifty medical writers in
the schools of Cordova, and sixty-two in Murcia. While the Moors thus
encouraged these important studies, the priests in the western states kept
the nations under their control in a state of dense ignorance, and the
practice of medicine such as it was, was confined within the cloisters of
monasteries and nunneries. There does still exist a treatise of medicine
written by Hildegarde, Abbess of a convent at Rupertsberg. Monks opened
medical schools in several cathedrals, and we find Gregory I. sending one
of these medical propagators to Canterbury, where Theodore, one of its
archbishops, practised the healing art.
While the study of medicine had become a privilege of ignorant friars, it
was destined to assume a semblance of learning in Italy, where some
intelligent Benedictines founded a school at Salerno. Here the works of
the Greeks, and Romans, and Arabian physicians were once more brought to
light, and in the eighth century we find Salerno crowded with students,
pilgrims, and invalids. In the eleventh century, this school had obtained
a pre-eminence over every other medical institution, and at the period of
the crusades its fame was universal--not that the ignorant and barbarous
crusaders were capable of shedding any light on the improvement of their
several countries from what they might have learned in Holy Land, but many
of them who had happily returned to Europe, and been landed in the kingdom
of Naples, were cured of their wounds and infirmities by these Benedictine
doctors, who themselves owed much of their erudition to an African of the
name of Constantine, who had studied at the school of Bagdad, and
translated for the monks, who had offered him an asylum, Greek, Latin, and
Arabian works, which to them were sealed volumes. Amongst the celebrated
adventurers of rank who had escaped from the holy wars, was Robert, son of
William the Conqueror, who was cured at Salerno of a supposed incurable
wound in the arm. In this manner was the fame of the Salernian school
spread far and nigh, and soon Ferdinand II. founded universities at Naples
and Messina.
The course of studies in the school of Salerno was three years of logic,
and five years of medicine and surgery. At the expiration of these
sessions, the student was admitted to examination, and after having
passed, was still obliged to practise for another year under the
immediate eye of an experienced physician. It was only upon his
certificate as to his professional capacities, that a licence to practise
was granted, upon his engaging himself by oaths, to observe the laws of
the college, to attend the poor gratuitously, and to report to the
magistracy all apothecaries that adulterated their drugs or neglected the
proper preparation of medicines prescribed.
The custom of granting academic dignities may be traced to the Nestorians
and the Jewish professors in the East, where it was carried into the
Moorish possessions in Spain. The school of Salerno was the first
collegiate body that adopted it in the western Christian institutions. The
degree they conferred was that of _Magister_. Previous to the granting of
this distinction seven years study were required, and the candidate was to
be upwards of one-and-twenty years of age. He had to explain in a public
meeting the _Articella_ of Galen--a passage of the _Aphorisms_ of
Hippocrates, and of the first book of Avicenna, after which he was
examined in the works of Aristotle, he then received the degree of
_Magister Artium et Physices_. It was only the professors who bore the
title of Doctors.
In this manner did the science of medicine struggle for several centuries
with obstacles that appeared insurmountable--in turn practised and
persecuted--anathematized by the clergy, and soon after becoming a
lucrative privilege of the church--prejudice, superstition, and ignorance
had closed anatomical theatres, and from the days when flourished the
school of Herophilus until the fourteenth century, the dissection of
animals was alone permitted, and it was only by stealth that the student
sought some knowledge of the human structure, from mouldering bones
purloined from the cemetery. A brighter era arose in the year 1315, when
Mondini de Luzzi, Professor of Anatomy at Bologna, ventured to dissect
human bodies--a bold attempt, as seventeen centuries had elapsed since
this investigation of the book of nature, the only record where errors can
be detected and truth sought for, had been prohibited. The example of
Mondini, who had written a practical anatomical manual was followed in
various other schools, but a barber was the person charged with the
opening of the subjects, and with no other instrument then his razor he
endeavoured to demonstrate the parts which Mondini's work described.
From this period we may date the revival of medicine, although in the
following century it made but little progress, still clogged by
astrological absurdities and Arabic errors--and a Florentine physician,
Marcillo Ficin, obtained a high repute by promulgating the doctrine that
the vital spirits of man were similar to the ether which filled space and
directed the planets; concluding that if man could obtain this ethereal
principle he might prolong his days beyond human conception, he
recommended the use of preparations of gold to obtain longevity and even
advised the aged to drink youthful blood to prolong their precarious life.
These absurdities were refuted by Chancellor Gerson, and the faculty of
Paris condemned the Florentine's visions as diabolical and perilous--but
what could have been the facilities offered at that time for the study of
anatomy when we find Professor Montagnana, of Padua, boasting of having
examined _fourteen_ subjects.
However the fifteenth century was destined to witness a remarkable event
in the annals of medical learning, Emmanuel Chrysolore, embassador of
Emmanuel Paleologus, arrived in Italy, to solicit means from the Christian
powers against the inroads of the Turks. Chrysolore, during a protracted
residence at Venice, employed the leisure which his diplomatic occupations
left him to deliver lectures on various branches of science, and not only
did he encourage the study of the Greek language, but corrected the many
errors that teamed in the Arabic translation of classic works. It was to
this learned man that the succeeding century were indebted for their
knowledge of the works of Hippocrates, and we find that his doctrine
formed the groundwork of medical studies over Europe.
But the study of the phenomena of nature founded on experience and
observation was not sufficiently visionary and mystic, and soon we see
cabalistic calculation and judicial astrology again subverting all
doctrines that might lead to sound conclusions. Cornelius Agrippa of
Cologne traversed the fairest cities of Europe, to expound the philosophy
of Zamolxis and Abaris; maintaining that every Hebrew character had a
natural signification, the Hebrew being, according to his ideas, not only
the most ancient but a sacred language. He asserted that the language of
demons was the Hebraic, and that all Hebrew letters being either
favourable or hostile to these evil spirits, they might be conjured by a
proper knowledge of their powers.
This visionary not only fancied that letters possessed this influence, but
that it was shared by numbers. Thus to cure a tertian fever he directs the
use of Verbena, to be cut at the third articulation of the plant; but in
the treatment of a quartern, the disease would only yield to the fourth
joints. He added that every man was under the influence of three
demons--a sacred demon (a divine gift)--an innate demon--and a
professional demon, sent us by the constellations and the celestial
intelligences.
These reveries, however, were interrupted by the still greater absurdities
of Paracelsus, a man whose ignorance could only be equalled by his vanity,
since he maintained that as the genius of Greece had produced Hippocrates,
the genius of Germany had created him for the salvation of mankind. He
further assured his disciples that all the universities in the world had
less knowledge than his beard, and that every hair of his head was more
learned than all their writers.
Paracelsus was perhaps one of the most singular enthusiasts that ever
swayed the schools of medicine, or assumed a despotic stand in science. To
superstition, credulity, and disreputable living, he certainly did add a
certain degree of genius, but more particularly a _tact_ which established
such a reputation, that, without much presumption, he might have claimed
the title which he assumed, of "_Prince of Medicine_," to which he added
the pompous appellation of _Aureolus, Philippus, Paracelsus Theophrastus
Bombastus ab Hoppenheim_.
This strange personage was born in 1493, at Einsidlen, a village near
Zurich; he studied under Fugger Schwartz, a celebrated professor of what
was then called the _Spagyristic_ school, or _Hermetic Medicine_, founded
on a visionary doctrine that I shall shortly notice. He subsequently
travelled over the greater part of Europe, chiefly courting a motley
society of physicians, philosophers, old women, and barbers, culling all
that he could from pretended science or unblushing ignorance. After having
visited the German mines, where he became tainted with the superstition of
the credulous workmen, he repaired to Russia, when he was made prisoner by
a party of Tartars, who conducted him to their Cham. Taken into favour by
their chief, he accompanied his son to Constantinople, where he pretended
to have discovered the philosopher's stone. On his return to his native
country, the magistrates of Bale appointed him to the chair of medicine;
and in 1527 we find him delivering a course of lectures in the German
tongue, being but an indifferent scholar. This sedentary life did not suit
his roving habits; and being, moreover, likely to bring his ignorance into
its proper light, he set out for Alsace with another enthusiast of the
name of Oporinus, with whom however he shortly quarrelled. He continued to
wander from town to town, scarcely ever sleeping, or changing his linen,
clad in the most slovenly manner, and generally in a state of
intoxication, until at Saltzburg in 1541 he was taken ill at a miserable
inn and died in the 48th year of his busy life.
He no doubt had obtained during his adventurous career much experience,
having for a long time followed armies and attended at sieges, and during
epidemic maladies; but he sought to disguise his want of a proper
education by the assumption of a supernatural influence. One of his
wildest flights of fancy was, perhaps, his receipt to make a man without
conjunction.
His doctrines were founded upon Judicial Astrology, Alchymy, Cabal, and
Chemistry. Grossly ignorant in the last science, he pretended that all our
diseases depended upon its combinations,--the combustion of sulphur, the
effervescence of saline particles, and the coagulation and stagnation of
mercury in our humours: all under the influence of the _Ens Astrorum_, the
_Ens Deale_, the _Ens Spirituale_, the _Ens Veneni_, and the _Ens
Naturale_. _Mercury_ was evacuated through the pores of the skin;
_sulphur_ emanated from the nostrils; _deliquescent sulphur_ was
discharged by the intestines; a _watery solution of sulphur_ arose from
the eyes, while _arsenic_ oozed out of the ears. When these evacuations
did not take place, the humour became putrid, and putrescency was
_Localiter_ or _Emunctor labiter_--as the humours were either retained or
excreted.
This humoral doctrine of Paracelsus, strange to say, obtained for upwards
of a century, and many were the learned men who distracted their brains
and that of their disciples to multiply his errors, since we find
Sanctorius calculates 90,000 morbid alterations in these peccant humours.
In another part of this work, I have related the absurdities of Van
Helmont, another visionary of the seventeenth century. Endless would be
the task of recording the many systems and doctrines that have in turn
ruled the schools of medicine, and been supported both by professors and
disciples with a degree of virulent hostility as implacable as religious
controversies; and still, while we read with contempt the absurd doctrines
of our forefathers, and smile at the folly of their visions, we ourselves
are advocating systems which, after a lapse of some few years, will appear
just as ridiculous and preposterous to our successors in the doubtful
career.
One question naturally arises from all this controversial discrepance--has
society benefited by the successive revolutions which have overthrown
schools and doctrines, chairs and professors? have the advocates of
Sangradian phlebotomy, and those who considered that the lancet has
committed greater havoc than the sword--have the employers of antimony,
and those who would have sent to the scaffold opponents who gave an
antimonial preparation--have either of these enthusiasts diminished, in
any sensible manner, the scale of mortality, or have they influenced the
prevalence of disease? This is a most important question, and, however
ungracious may be the task, I shall endeavour to consider it.
It is but too true, that, with the exception of the introduction of
inoculation and the cowpox, the bills of mortality do not appear, at any
period, to have been influenced by the prevalence of any one medical
system. This circumstance, however, cannot be admitted as invalidating the
claims of medical men to a due consideration of their respective merits. I
have endeavoured to show, in a preceding article, that the laws of nature
appear to have regulated the equilibrium of life and death and the
progress of disease with such harmony, indeed, that we might say that our
existence was regulated with arithmetical accuracy. If this is admitted,
it might be alleged, that if such be our fated tenure of life, recourse to
medical aid becomes useless, and the efforts of physicians must prove
effete. Such a deduction would be fatalism in its most absurd form; for,
admitting that our days are thus numbered, the human frame may be assailed
by many ailments, that may not prove fatal, but admit of relief, if they
cannot be cured. It is, therefore, obvious, that the services of a
physician are of great value, if he merely can alleviate our sufferings,
and render a painful existence tolerable. Daily facts corroborate this
assertion, and the most cruel pangs are constantly relieved by
professional aid, although it is not equally evident that the same skill
can prolong the patient's life, if "his hour is come;" but, as we know not
when that fatal moment may strike, we must clearly seek to wind up the
marvellous machinery, and keep it "going" as long as we can. We constantly
behold individuals whose existence is most precarious, and yet who linger
on for years, frequently to the disappointment of expectant heirs; for
there is much truth in the old saying concerning those invalids who are
considered to "have one foot in the grave," they find _that foot_ so very
uncomfortable, that they hesitate for a long time ere they thrust in its
fellow.
There is little doubt but that much mischief has been done by ignorant
men, yet, perhaps, if the truth were known, more vital injury has been
inflicted on mankind by enthusiastic science--ignorance gropes its way, so
long, at least, as modesty allows to doubt; but, so soon as presumption
leads the way, then ignorance assumes dogmatic assurance, and places the
hardy practitioner on the same line as presumptive science--or, at least,
what is considered such. It is then that enthusiasm, combined with
interested motives, seeks to maintain an acquired influence by
experimental proofs of supremacy; and, as it has been truly said, "There
is no writ of error in the grave," mother earth shrouds the fallacies, and
every disease that the eminent practitioner cannot cure is deemed
incurable.
On the other hand, the Creator has gifted mankind with an innate and
latent power of resisting noxious influence--a power called by the schools
the _vis medicatrix naturae_, and which is generally sufficient to throw
off morbid attacks, when this principle is not exhausted, and the
functions not impeded by organic derangement which involves the healthy
equilibrium of life; then it is, that the prudent and experienced
physician will carefully watch this precious faculty, and instead of
counteracting the efforts of nature, assist her bounteous labours. This
watchful practice, which may, however, be sometimes too inert, has been
called _expectant medicine_--a slow and tardy process for the energetic
practitioner, who, assuming the reins of life in his bold hands endeavours
to goad and drive on nature in spite of herself; this practice has
obtained the name of _active medicine_, of which our British practitioners
are accused, by the _expectant_ continental physicians, who, to use a
French expression, "_voient venir_," and the French themselves are so well
aware of the imprudence of this hesitation in assisting nature, that they
say "_Your physicians kill their patients, whereas ours let them die_."
There is more truth in this remark than we perhaps are willing to believe.
The power of nature in the cure of diseases has been acknowledged by the
most experienced and wise physicians. Stahl, in his dissertation, "_De
Medicina sine Medico_," perhaps exaggerated the influence of this faculty.
Bordeu maintains that out of ten patients, two-thirds are cured without
assistance, and come within the circle of all those minor ailments to
which flesh is the constant heir. The illustrious Boerhaave doubted
whether the successful practice of the small number of able physicians was
a compensation for the evils that arose from the errors of the ignorant;
and, in this sad calculation, he seems disposed to think that it would
have been better for mankind that the science of medicine had never
existed.
All these deductions are both unjust and unwise; for, as I have already
said, if physicians only possessed the means of affording relief, their
mission upon earth is of the utmost importance. At the same time, while
we watch the efforts of nature, it is our duty to rouse her energies when
they become torpid, or to check inordinate action which would soon exhaust
her power. Asclepiades very truly called the expectant practice of
medicine "_a contemplation of death_." The powers of nature may be, and
not inaptly, compared to those of the swimmer; however skilled in the art
of natation, and able under ordinary circumstances to baffle an adverse
tide, are we not to hasten to his succour, when we find that he is borne
away by an inevitable current, or deprived by a cramp, of the power of
stemming the stream?
We are also willing to forget, that the turbulence of passions, the "wear
and tear" of life, by excesses or irregularities, gradually tend to render
the "medicinal power" of nature of little or no avail; and it has been
truly said, that had we no cooks, we perhaps might not have needed
physicians. Man in fact, in a high state of civilization, seems determined
to counteract all the efforts both of nature and of art to relieve him
from the manifold curses of intemperance; and it is fortunate that his own
feelings of gradual decay prompt him more energetically to a reform in his
habits, than the most persuasive language his physician could employ.
In this illiberal view of the profession, how often do we lose sight of
hereditary transmissions--heir-looms of disease--ingrafting misery on the
variegated woof of our destinies--germs of fatal maladies which we
bring into the world--a scourge on our posterity!--and yet, strange to
say, our vain self-estimation blinds us in the contemplation of this
doom--for the gratification of our desires, we bring forth a fearful
generation--scrofulous, insane! Nay, we glory in the smiling offspring
blooming around us--heedless, that the very roses we admire on their
transparent cheeks, the coral hue that tinges their lips, are typical of
flowers scattered on a grave, and the joyful beams of their bright yet
languid looks are but the harbingers of the smile of death--the last kind
look on earthly things.--And the physician is expected to arrest the hand
of Providence--to eradicate germs struck before birth!
It must also be observed, that many of our maladies are, in fact,
reactions of nature, endeavouring to overcome other affections--a struggle
for harmonious unity--for healthy equilibrium. Thus do we see a burning
fever, tending to cast upon the surface exanthematic eruptions--a febrile
reaction which we call critical, and which too often, like a political
crisis, destroys in fruitless endeavours to save. "_Si natura non moveat,
move, tu, motu ejus_" was an ancient axiom; but how often, in seeking to
trim the expiring lamp of life, do we not extinguish the last vital spark!
In regard to the influence of medicine on population, can it be expected,
that when the most fatal pestilences do not thin it, the most erroneous
medical practice can be more destructive? And, if nine-tenths of cholera,
or pestiferated patients perish, on the other hand, nine-tenths of other
cases of a less serious character are cured without medical intervention;
and possibly, the chief study of a physician should be not to produce a
more obstinate disease by the means he employs to cure an affection less
formidable. Late years have proved that the effects of mercury were far
more dreadful than the disease it was supposed to eradicate.
In the animadversions that are accumulated upon the physician, an
insidious comparison to his disadvantage, has been made with the utility
of the surgeon--a utility which man is compelled, however reluctantly, to
acknowledge, since it is evident to his most gross senses--an amputated
limb--a reduced luxation--are before his eyes, while the favourable
changes operated on a morbid condition of the body are not self-evident,
and can only be recognised by sound and unbiassed judgment. In this
illiberal view, it is forgotten that the mere operative surgeon is nothing
more than a mechanical agent--a butcher could perform the same operation
with his rude knives and saws as the chirurgeon with his refined and
improved instruments; it is the judgment that we look to, and the skill in
attending to the general health of the patient, to bring him to a perfect
cure; in these functions, of much more importance than the dexterity of
the hand, the surgeon clearly assumes the duties of the physician; and it
is not possible for a man to excel in one part of the profession without
being conversant with the other; a surgeon must be a sound anatomist, and
an observant physiologist--without the knowledge of these fundamental
sciences, a surgeon and a physician might be compared to the bungler who
attempted to repair a watch, without a previous acquaintance with its
intricate machinery.
Let us hope that the mischievous distinction between surgery and medicine
may soon become an obsolete prejudice, that was never founded upon reason,
but simply based upon ambitious lucre. Let us hope that the graduate of an
university will not conceive it beneath his dignity to save a
fellow-creature's life by breathing a vein, and not esteem a vain and
pompous piece of parchment an immunity from humane feelings and
philanthropic duties.
As good often results from apparent evil, the converse must also be
frequently admitted. That much evil has occurred from errors in medical
doctrine is unfortunately but too true, yet this evil has never attained
the extent which is generally supposed. I have already alluded to the
curative powers of nature, ever tending, while still enjoying a portion
even of their energies, to repel obnoxious agents--this power has saved
the lives of many; and indeed, when we daily witness the excesses
committed by the sensualist and the drunkard with apparent impunity,
although exposed to destructive agencies more powerful than the generality
of medicinal substances, we must come to the conclusion that the kitchen
and the cellar are, at least, as formidable as the officinal preparations
of the pharmacopolist.
That the physician, guided by experience and sound observation, is able,
in very many cases to afford relief, must even be admitted by the most
hostile depreciator of his science, who refuses to admit that he possesses
the power of curing. This simple admission of daily facts, must entitle
him to some degree of weight in our confidence, whatever may be our
sceptical view of his doctrines.
While the real merits of a physician are so frequently overlooked, we
constantly see a blind confidence reposed in a quack. The cause is
obvious. A man of real merit seldom extols his own good qualities, nor
does he seek the fulsome adulation and praise of others. He rests upon his
own deserts; but how seldom are they rewarded: when modesty places her
light "under a bushel" who will bring it into view?
Duclos has explained in some measure this apparent anomaly.--"The desire,"
he says "to obtain a high stand in the estimation of society, has given
rise to reputation, celebrity, and renown,--the mainsprings of worldly
action--arising from a similar principle, but showing different means and
results. Both reputation and renown may be enjoyed at the same time and
yet be widely different. The public is not unfrequently surprised at the
reputations that it had itself created. It seeks to inquire into their
origin, but not being able to discover a merit which never did exist, it
gradually admires and respects a phantom of its own evocation. As society
thus bestows a reputation in a capricious manner, quacks will usurp one by
their intrigues or by a barefaced impudence, which cannot claim the
comparatively honourable denomination of proper pride and dignity. They
themselves proclaim their merit to the world--at first their impertinence
becomes a subject of derision, but they repeat the assertion of their
superior skill so frequently and confidently, that they end by imposing
themselves upon society. People forget where, whence, and from whom they
heard these flattering eulogies, to which at last they yield their
credence, and an adventurer who thus resolves to establish a reputation,
with perseverance and impudence seldom fails."
It must also be remembered, that most medical men owe their success to
woman's all-powerful aid. They are in general as blind and as pertinacious
in their partialities as in their dislikes; seldom bestowing much judgment
in either, but acting according to the impulses of their warm passions and
flexibility. Females, from their situation in the world, stand in constant
need of a friendly adviser, although they are rarely disposed to follow
any advice, if their pleasures are marred by the suggestion, but when art
and opportunity enable a man to turn their flexibility, their
_impressionability_ to a good account, with the combined aid of vanity and
weak nerves, he will in all probability succeed in obtaining a high
estimation in the mind of a loquacious dame, who will blazon his fame far
and near like the trumpeter of a mountebank. If this lady moves in an
elevated and influencial sphere of life, to question her recommendation is
to question her sense and power, both of which would be bold attempts; and
thus have we seen an intriguing noble dame forcing a physician even upon
royalty. Moreover, when we recollect that the wealthy send for a physician
for every trifling real or supposed indisposition, which fashion or
expediency may aggravate at will, to excite interest or carry a desirable
point, it is manifest that the _cures_ of such a practitioner must be most
numerous, since the attainment of any desire constitutes a _panacea_; and
frequently we have seen a box at the opera, a check on a banker, a new
carriage, or a diamond necklace, more efficacious than the most renowned
nostrum, while the expulsion of an unpleasant plain-spoken acquaintance,
or the kind reception of a dangerous and treacherous inmate, may produce
more sudden recoveries than the most approved specific. The great science
of such practitioners is to practise with equal success upon every branch
of the family, to whom in return for their confidence, they can ensure
peace and pleasure if they cannot bestow health. I cannot better conclude
this article than by quoting the following passage of the sceptic
Voltaire:
It is true that regimen is preferable to physic. It is also true that for
a long period of time, out of one hundred physicians were twenty-eight
quacks, and it is also true, that Moliere had very good reason to turn
them into ridicule. It is also certain that nothing can be more absurd
than to behold a crowd of silly women, and men, not less feminine in their
habits, whenever they are satiated with eating, drinking, gambling, and
late hours, calling in a physician for every trifling headache; consulting
him as though he were a divinity, and praying for the miraculous gift of
combined health and intemperance. It is nevertheless true, that a good
physician in a hundred cases may preserve life and limb. A man falls down
in an apoplectic fit, it will neither be a captain of infantry or a privy
councillor that will relieve him. A cataract obscures my vision; my
neighbouring gossips will not restore my sight; for here I make no
distinction between the physician and the surgeon. For a long time the two
professions have been inseparable. Men who would make it their study to
restore health to their fellow-creatures on the sole grounds of humanity
and benevolence, should be considered greater than the greatest man upon
earth, and bordering upon divine attributes, for preservation and
restoration stand next in rank to creation. The Romans were for upwards of
five hundred years without physicians. Their people, continually employed
in killing, thought but little of the preservation of life; what did they
do when they were attacked with a putrid fever, a fistula, a hernia, or a
pleurisy?--_They died._