thus allied to belles-lettres, he is allured into the domain of science by
a still more direct sympathy. To how many has the study of the materia
medica, and the culling of simples, proved the occasion of botanical
research; and hence, by an easy transition, of exploring the entire field
of natural science. Thus Davy was beguiled into chemical investigation;
and Abercrombie, by the vestibule of physiological knowledge, sought the
clue to mental philosophy; while Spurzheim and Combe ministered to a great
charity by clearly explaining to the masses the natural laws of human
well-being. It is an evidence of the sagacity of the Russian Peter, that
he sought an interview with Boerhaäve; for by these varied links of
general utility the medical office enters into every branch of social
economy, and is only narrowed and shorn of dignity by the limited views or
inadequate endowments of its votaries. The Jewish physician preserved and
transmitted much of the learning of the world, after the fall of the
Alexandrian school.[13] Life-insurance and quarantines have become such
grave interests, that through them the responsibility of the physician to
society is manifest to all; that to individuals is only partially
recognized. How Cowper and Byron suffered for wise medical advice, and
what ameliorations in states of mind and moral conditions have been
induced by the now widely-extended knowledge of hygienic laws! Charles
Lamb reasons wisely as well as quaintly in this wise:--'You are too
apprehensive of your complaint. The best way in these cases is to keep
yourself as ignorant as the world was before Galen, of the entire
construction of the animal man; not to be conscious of a midriff; to hold
kidneys to be an agreeable fiction; to account the circulation of the
blood an idle whim of Harvey's; to acknowledge no mechanism not visible.
For once fix the seat of your disorder, and your fancies flux into it like
bad humours. Above all, take exercise, and avoid tampering with the hard
terms of art. Desks are not deadly. It is the mind, and not the limbs,
that taints by long sitting. Think of the patience of the tailors; think
how long the Lord Chancellor sits; think of the brooding hen.'
In literature the doctor figures with a genial dignity; he has affinities
with genius, and a life-estate in the kingdom of letters: witness Garth's
poem of _The Dispensary_; Akenside's _Pleasures of the Imagination_;
Armstrong's _Art of Health_; Cowley's verses, Sprat's life of him, and
Currie's of Burns; Beattie's _Minstrel_; Darwin's _Botanic Garden_;
Moore's _Travels in Italy_; Zimmerman's _Solitude_; Goldsmith's _Vicar_
and _Village_; Aikin's _Criticisms_; Joanna Baillie's gifted brother, and
Lady Morgan's learned husband. Burke found health at the house of the
benign Dr. Nugent, of Bath, at the outset of his career, and married the
daughter of his medical friend. 'Les médecins sont souvent tout a la fois
conseillors, arbitres et magistrats au sein des familles.' The best
occasional verses of Dr. Johnson are those that commend the humble virtues
of Levett, the apothecary.[14] Dr. Lettson wrote the life of Carver, the
American traveller, and his account of that adventurous unfortunate led
to the establishment of the Literary Fund Society. Among the graves near
Archibald Carlyle's old church at Inveresk, where that handsome clerical
and convivial gossip is buried, is that of the sweet versifier, beloved as
the 'Delta' of Blackwood, Dr. Moir, who so genially united the domestic
lyrist and the good doctor; a Delta framed in bay adorns the pedestal of
his monument. Rousseau, an invalid of morbid sensibility, recognizes the
professional superiority of the physician as a social agent:--'Par tous le
pays ce sont les hommes les plus véritablement utiles et savants.' The
_Médecin de Campagne_ of Balzac, and the _Dr. Antonio_ of Ruffini, are
elaborate and charming illustrations of this testimony of the author of
_Emile_. What a curious chapter would be added to the _Diary of a
Physician_, had Cabanis kept a record of his interviews with those two
illustrious patients--Mirabeau and Condorcet. The social affinities of the
doctor prove indirectly what we before suggested, that it is in the
character more than in the learning, in the mind rather than the technical
knowledge, that medical success lies. One of the shrewdest of the
profession, Abernethy, declared thereof,--'I have observed, in my
profession, that the greatest men were not mere readers, but the men who
reflected, who observed, who fairly thought out an idea.' Almost intuitive
is the venerable traditional ideal of the physician; among the aborigines
of this continent, the 'medicine man' was revered as nearest to the 'Great
Spirit.' 'I hold physicians,' said Dr. Parr, 'to be the most enlightened
professional persons in the whole circle of human arts and sciences.' In
our own day, Lever's Irish novels, and in our own country the writings of
Drake, Mitchell, Holmes, Bigelow, Francis, and others, indicate the
literary claims of the profession. Think of Arbuthnot beside Pope's
sick-bed, and the latter's apostrophe:--
'Friend of my life, which did not you prolong,
The world had wanted many an idle song;'
of Garth ministering to Johnson, and Rush philosophizing, with Dr.
Franklin, and the friendship of Pope and Cheselden. Bell's comments on
art, Colden's _Letters to Linnæus_, and Thatcher's _Military Journal_, are
attractive proofs of that liberal tendency which leads the physician
beyond the limits of his profession into the field of philosophical
research. The bequest of Sir Hans Sloane was the nucleus of the British
Museum. We all have a kind of affection for Dr. Slop, who, drawn from Dr.
Burton, of York--a cruel, instrumental obstetrician,--is the type of an
almost obsolete class, as the doctor in _Macbeth_ is of the sapient
pretender of all time. As to ideal doctors, how real to our minds is that
Wordsworthean myth Dr. Fell, the physician of Sancho Panza, and the Purgon
of Molière; while Dulcamara is a permanent type of the clever quack, Dr.
Bartolo of the solemn professor, and Sangrado of the merciless
phlebotomist. To think it 'more honourable to fail according to rule than
to succeed by innovation,' is a satire of no local significance, but the
constant creed of the medical pedant. Satirized years ago by the French
comic dramatist, the profession was caricatured the other day by a young
disciple of Esculapius, who in a clever drawing represented the votary of
homoeopathy with a little globule between thumb and finger, engaged in a
kind of airy swallowing; the allopathic patient in an easy-chair is making
wry faces over a large spoonful of physic; the believer in hydropathy sits
forlorn and shivering in a sitz-bath, with a large goblet of water raised
to his lips; while the Thomsonian victim is writhing and nauseating in
anguish; and in the midst a skeleton, with a syringe for a baton, is
dancing in a transport of infernal joy. Southey took a wise advantage of
the popular idea of a doctor, in the genial and speculative phase of the
character, when he gave the title to his last rambling, erudite, quaint,
and charming production. Men of letters accordingly are wont to fraternize
with the best of the profession; and there has always been a reciprocal
interchange between them, both of affection and wit. Thus Halleck tells
us, in _Fanny_,--
'In Physic, we have Francis and M'Neven,
Famed for long heads, short lectures, and long bills;
And Quackenboss and others, who from heaven
Were rained upon us in a shower of pills;
They'd beat the deathless Esculapius hollow,
And make a starveling druggist of Apollo.'
The record of our surgeons in the war for the Union is alike honourable to
their patriotism, humanity, and skill.
Popular writers have indicated the claims and character of the profession,
not only in a dramatic or anecdotal way, but by personal testimony and
observation; and those who have had the best opportunities, and are
endowed with liberal sympathies, warmly recognize the possible usefulness
and probable benevolence of a class of men more often satirized than sung.
The privations and toil incident to country practice half a century ago
are scarcely imagined now. Sir Walter Scott tells us,--'I have heard the
celebrated traveller Mungo Park, who had experienced both courses of life,
rather give the preference to travelling as a discoverer in Africa, than
to wandering by night and day the wilds of his native land in the capacity
of a country practitioner.' Dr. Johnson, a livelong invalid, and not apt
to overlook professional foibles, gives a high average character to the
doctor. 'Whether,' he observes, 'what Sir William Temple says be true,
that the physicians have more learning than the other faculties, I will
not stay to inquire; but I believe every man has found in physicians great
liberality and dignity of sentiment, very prompt effusion of beneficence,
and willingness to exert a lucrative art where there is no hope of lucre.'
It is a nervous process to undergo the examination of a Parisian medical
professor of the first class. Auscultation was first introduced by one of
them, Laennec, and diagnosis is their chief art. In their hands the
stethoscope is a divining-rod. So reliable is their insight, that they
seem to read the internal organism as through a glass; and one feels under
Louis's inspection as if awaiting sentence. The laws of disease have been
thoroughly studied in the hospitals of Paris, and the philosophy of
symptoms is there understood by the medical _savans_ with the certainty of
a natural science, but the knowledge and application of remedies is by no
means advanced in equal proportion. Accordingly, the perfection of modern
skill in the art seems to result from an education in the French schools,
combined with experience in English practice; thorough acquaintance with
physiology, and habits of acute observation and accurate deduction, are
thus united to executive tact and ability. And similar eclectic traits of
character are desirable in the physician, especially the union of solidity
of mind with agreeableness of manner; for in no vocation is there so often
demanded the blending of the _fortiter in re_ with the _suaviter in modo_.
The absence of faith in positive remedies that obtains in Europe is very
striking to an American visitor, because it offers so absolute a contrast
to the system pursued at home. I attended the funeral of a countryman a
few days after reaching Paris, and on our way to Père la Chaise his case
and treatment were fully discussed; his disease was typhus fever. Previous
to delirium he had designated a physician, a celebrated professor, who
only prescribed _gomme syrop_. For a week I travelled with a Dominican
friar, who had so high a fever that in America he would have been
confined to his bed; he took no nourishment all the time but a plate of
thin soup once a day, and when we reached our destination he was
convalescent. Abstinence and repose are appreciated on the Continent as
remedial agencies; but they are contrary to the genius of our people, who
regard active enterprise as no less desirable in a doctor than a steamboat
captain.
Veteran practitioners have demonstrated that certain diseases are
self-limited, that the art of treating diseases is still 'a conjectural
study,' and avowed the conviction that 'the amount of death and disaster
in the world would be less if all disease were left to itself, than it now
is under the multiform, reckless, and contradictory modes of practice.' A
conscientious student, of high personal character, entered upon the
profession with enthusiastic faith; experience in the use of remedies made
him sceptical, and he resorted to evasion by giving water only under
various pretexts and names. His success was so much greater than that of
his brethren, that he felt bound to reveal the ruse; but continued
thenceforth to assert that, all things being equal, more patients would
survive, if properly guarded and nourished, without medicine than with.
The influence of the mind upon the body is, in some instances, so great,
that it accounts for that identity of superstition and medicine which is
one of the most remarkable traits in the history of the science. Sir
Walter Raleigh's cordial was as famous in its day as Mrs. Trulbery's water
praised by Sir Roger de Coverley. In Egypt, old practitioners cure with
amulets and charms; among the Tartars they swallow the name of the remedy
with perfect faith; and from the Puritan horseshoe to keep off witchcraft,
to Perkins' tractors to annihilate rheumatism, the history of medical
delusions is rife with imaginary triumphs. As late as the seventeenth
century, when Arabian precepts and the Jewish leech of chivalric times had
disappeared, when the square cap and falling beards had given place to
the wig and cane, in some places the mystic emblems of skull, stuffed
lizards, pickled fetus, and alembic gave a necromantic air to the doctor's
sanctum.
The unknown is the source of the marvellous, and the relation between a
disease and its cure is less obvious to the common understanding than that
between the evidence and the verdict in a law case, or religious faith and
its public ministration in the office of priest. The imagination has room
to act, and the sense of wonder is naturally excited, when, by the agency
of some drug, mechanical apparatus, or mystic rite, it is attempted to
relieve human suffering and dispel infirmity. Hence the most enlightened
minds are apt to yield to credulity in this sphere, much to the annoyance
of the 'regular faculty,' who complain with reason that quackery, whether
in the form of popular specifics or the person of a charlatan, derives its
main support from men of civic and professional reputation. Think of Dr.
Johnson, in his infancy, being touched for king's evil by Queen Anne, in
accordance with a belief in its sovereign efficiency, unquestioned for
centuries. Sir Kenelm Digby was as much celebrated in his day for his
recipe for a sympathetic powder, which he obtained from an Italian friar,
as for his beautiful wife or his naval victory; and the good Bishop
Berkeley gave as much zeal to the _Treatise on the Virtues of Tar-water_
as to that on the _Immateriality of the Universe_.
Shakspeare has drawn a quack doctor to the life in Caius, the French
physician, in the _Merry Wives of Windsor_, and uttered an impressive
protest against the tribe in _All's Well that Ends Well_:--
'_King._ But may not be so credulous of cure,
When our most learned doctors leave us; and
The congregated college have concluded
That labouring art can never ransom nature
From her inaidable estate: I say we must not
So stain our judgment, or corrupt our hope,
To prostitute our past-cure malady
To empirics; or to dissever so
Our great self and our credit, to esteem
A senseless help, when help past sense we deem.'
An American member of the medical profession[15] has traced in the great
bard of nature a minute knowledge of the healing art, citing his various
allusions to diseases and their remedies. Thus we have in Coriolanus the
'post-prandial temper of a robust man,' and the physiology of madness in
Hamlet and Lear. The wasting effects of love, melancholy, the processes of
digestion, respiration, circulation of the blood, infusion of humours,
effects of passions on the body, of slow and swift poisons, insomnia,
dropsy, and other phenomena described with accuracy. Cæsar's fever in
Spain, Gratiano's warning, 'creep into a jaundice by being peevish;' the
physical effects of sensualism in Antony and Cleopatra, the external signs
of sudden death from natural causes in Henry VI., and summary of diseases
in Troilus and Cressida, are described with professional truth. How
memorable his Apothecary's portrait! while the medical critic assures us
that, in a passage in _Midsummer-Night's Dream_, the 'accessories of a
sickly season are poetically described,' and that Falstaff admirably
satirizes the 'ambiguities of professional opinion,' while, in Mrs.
Quickly's description of his death, and the dying scene of Cardinal
Beaufort, as well as the senility of Lear, the mellow virility of old
Adam, the 'thick-coming fancies' of remorse, and Ophelia's
aberration--every minute touch in the memorable picture of 'a mind
diseased'--indicate a profound insight, and suggest, as no other poet can,
how intimately and universally the 'ills that flesh is heir to,' and the
vocation of those who minister to health, are woven into the web of human
destiny and the scenes of human life. Who has so sweetly celebrated
'Nature's sweet restorer' and the 'healing touch'? or more emphatically
declared, 'when the mind's free the body's delicate,' and--
'We are not ourselves
When nature, being oppressed, commands
The mind to suffer with the body.'
The memoirs of celebrated men abound with physiological interest; their
eminence brings out facts which serve to vindicate impressively the phases
of medical experience, and the relation of the soul to its tabernacle.
Madden's _Infirmities of Genius_ is a book which suggests an infinite
charity, as well as exposes the fatal effects of neglecting natural laws.
Lord Byron used to declare that a dose of salts exhilarated him more than
wine. Shelley was a devoted vegetarian. Cowper spoke from experience when
he sang the praises of the cups 'that cheer but not inebriate.' Johnson
had faith in the sanative quality of dried orange-peel. When Dr. Spurzheim
was first visited by the physicians in his last illness, he told them to
allow for the habitual irregularity of his pulse, which had intermitted
ever since the death of his wife. George Combe used to tell a capital
story, in his lectures, of the manner in which a pious Scotch lady made
her grandson pass Sunday, whereby, while outwardly keeping the Sabbath, he
violated all the rules of health. Two of the most characteristic books in
British literature are Greene's poem of the _Spleen_, and Dr. Cheyne's
_English Malady_; and another is the history of the _Gold-headed Cane_, or
rather of the five doctors that successively owned it. The cane, indeed,
was ever an indispensable symbol of medical authority. The story of Dr.
Radcliffe's illustrates its modern significance; but the association of
the walking-staff and the doctor comes down to us from mediæval times. 'He
smelt his cane,' in the old ballads, is a phrase suggestive of a then
common expedient; the head of the physician's cane was filled with
disinfectant herbs, the odour of which the owner inhaled when exposed to
miasma. Even at this day, in some of the provincial towns in Italy, we
encounter the doctor in the pharmacist's shop, awaiting patients,--his
dress and manner such as are reproduced in the comic drama, while the
quack of the Piazza is recognized on the operatic stage.
How unprofessional medicine is becoming may be seen in current literature,
when De Quincey's metaphysical account of the effects of opium, and
Bulwer's fascinating plea for the Water-Cure, are ranked as light reading.
To the lover of the old English prose-writers there is no more endeared
name than Sir Thomas Browne, and his _Religio Medici_ and quaint tracts
are among the choicest gifts for which philosophy is indebted to the
profession; while the classical student owes to Dr. Middleton a _Life of
Cicero_. The vivacious Lady Montagu is most gratefully remembered for her
philanthropic efforts in behalf of inoculation for smallpox; and our
Brockden Brown has described the phenomena of an epidemic, in one of his
novels, with more insight though less horror than Defoe.
It is in pestilence and after battle that the doctor sometimes rises to
the moral sublime, in his disinterested and unwearied devotion to others.
It must, however, be confessed that, notwithstanding these incidental
laurels, the authority of the profession has so declined, the _malades
imaginaires_ so increased with civilization, and the privileges of the
faculty been so encroached upon by what is called 'progress,' that a
doctor of the old school would scorn to tolerate the fallen dignity of a
title that once rendered his intercourse with society oracular, and
authorized him with impunity to whip a king, as in the case of Dr. Willis
and George the Third.
'The philosophy of medicine, I imagine,' observed Dr. Arnold, 'is zero;
our practice is empirical, and seems hardly more than a course of
guessing, more or less happy.' None have been more sceptical than
physicians themselves in regard to their own science: Broussais calls it
illusory, like astrology; and Bichat declares 'it is, in respect to its
principles, taken from most of our _materia medicas_, impracticable for a
sensible man; an incoherent assemblage of incoherent opinions, it is,
perhaps, of all the physiological sciences, the one which shows plainest
the contradictions and wanderings of the human mind.' Montaigne used to
beseech his friends that, if he fell ill, they would let him get a little
stronger before sending for the doctor. Louis XIV., who was a slave to his
physicians, asked Molière what he did for his doctor. 'Oh, sire,' said he,
'when I am ill I send for him. He comes; we have a chat, and enjoy
ourselves. He prescribes; I don't take it,--and I am cured.'
'There is a certain analogy,' says an agreeable writer, 'between naval and
medical men. Neither like to acknowledge the presence of danger.' On the
other hand, each patient's character as well as constitution makes a
separate demand upon his sympathy; for in cases where fortitude and
intelligence exist, perfect frankness is due, and in instances of extreme
sensibility it may prove fatal; so that the most delicate consideration is
often required to decide on the expediency of enlightening the invalid. If
it is folly to theorize in medicine, it is often sinful to flatter the
imagination for the purpose of securing temporary ease. A physician's
course, like that of men in all pursuits, is sometimes regulated by his
consciousness, and he is apt to prescribe according to his own rather than
his patient's nature; thus a fleshy doctor is inclined to bleed, and
recommend generous diet; a nervous one affects mild anodynes; a vain one
talks science; and a thin, cold-blooded, speculative one, makes safe
experiments in practice, and is habitually non-committal in speech. Almost
invariably short-necked plethoric doctors enjoy freeing the vessels of
others by copious depletion, and those more delicately organized advocate
fresh air and tonics; the one instinctively reasoning from the surplus,
and the other from the inadequate vitality of which they are respectively
conscious. I knew a doctor who scarcely ever failed to prescribe an
emetic, and the expression of his countenance indicated chronic nausea.
Medicine enjoys no immunity from the spirit of the age. Who does not
recognize in the popularity of Hahnemann's system the influence of the
transcendental philosophy, a kind of intuitive practice analogous to the
vague terms of its disciples in literature; those little globules with the
theoretical accompaniment catch the fancy; castor-oil and the lancet are
matter-of-fact in comparison. And so with hydropathy. There is in our day
what may be called a return-to-nature school. Wordsworth is its expositor
in poetry, Fourier in social life, the Pre-Raphaelites in painting. The
newly-appreciated efficacy of water accords with this principle. It is an
elemental medicament, limpid as the style of Peter Bell, free from
admixture as the individual labour in a model community, and as directly
caught from nature as the aërial perspective of England's late scenic
limner. Even what has been considered the inevitable resort to dissection
in order to acquire anatomical knowledge, it is now pretended, has a
substitute in clairvoyance. Somewhat of truth in this spiritualizing
tendency of science there doubtless is; but fact is the basis of positive
knowledge, and the most unwarrantable of all experiments are those
involving human health.
If the mental experience of a doctor naturally leads to philosophy, the
moral tends to make him a philanthropist. He is familiar with all the ills
that flesh is heir to. The mystery of birth, the solemnity of death, the
anxiety of disease, the devotion of faith, the agony of despair, are
phases of life daily open to his view; and their contemplation, if there
is in his nature a particle either of reflection or sensibility, must lead
to a sense of human brotherhood, excite the impulse of benevolence, and
awaken the spirit of humanity. Warren's _Diary of a Physician_ gives us an
inkling of what varieties of human experience are exposed to his gaze.
Vigils at the couch of genius and beauty, full of the stern romance of
reality, or imbued with tenderness and inspiration, are recorded in his
heart. He is admitted into sanctums where no other feet but those of
kindred enter. He becomes the inevitable auditor and spectator where no
other stranger looks or listens. Human nature, stripped of its
conventionalities, lies exposed before him; the secrets of conscience, the
aspirations of intellect, the devotedness of love, all that exalts and all
that debases the soul, he beholds in the hour of weakness, solitude, or
dismay; and hard and unthinking must he be if such lessons make no
enduring impression, and excite no comprehensive sympathies.
'The corner-stone of health,' says a German writer, 'is to maintain our
individuality intact;' and while the hygienic reformer has lessened the
bills of mortality, personal culture has emancipated society from much of
the ignorant dependence and insalubrious habits of less enlightened
times.
HOLIDAYS.