་་
T
*
T
33
J
DR. J
•
ま
​❤
な
​C.
کا میر ما
小
​10
fa
響​。
"
บท
A 578469
632
རྒྱཡིན ཡ
さむ​!

A. E. FO
109
ARTES
LIBRARY
1837
SCIENTIA
VERITAS
OF THE
UNIVERSITY OF MICHIGAN
PLURIBUS UNUM
TUEBOR
SI-QUAERIS PENINSULAM AMOENAM
CIRCUMSPICE
HOMOEOPATHIC
LIBRARY


{
461575-3
TS-Eh
POPULAR TREATISE
ON
MEDICAL PHILOSOPHY;
OR,
AN EXPOSITION OF QUACKERY
AND
IMPOSTURE IN MEDICINE.
(Read before the Phi Beta Kappa Society of Union College, at its Anniversary
Meeting, and, in conformity with a Resolution, published as a
part of its Transactions.)
BY CALEB TICKNOR, M. D.
AUTHOR OF
THE PHILOSOPHY OF LIVING.'
(No. 77 Harpers' Family Library.)
NEW YORK:
PUBLISHED BY GOULD AND NEWMAN,
CORNER OF FULTON AND NASSAU STS.
1838.
}

!
1.
Entered, according to Act of Congress, in the year 1838, by
GOULD & NEWMAN,
in the Clerk's Office of the Southern District of New York.
ANDOVER, MASS.
Gould & Newman, Printers.
1
f
To his two distinguished friends, Dr. Joslin of this city,
for sev-
eral years Professor in Union College, and late President of
the Phi Beta Kappa Society, and the Rev. Prof. Reed of Union
College, the author is under no small obligation; to the former
for reading portions of the following Treatise before the Phi
Beta Kappa Society, and to the latter for a copy of the resolu-
tion below.
Resolved, That the Treatise of Dr. Caleb Ticknor, be deposited
in the Archives of this Society, and published in its Transactions.
New York Alpha of the Phi Beta Kappa,
:
Anniversary Meeting, July 25, 1837.
ATTEST, EDWARD SAVAGE, Rec. Sec.
یا
182032
1

..
:
}
DEDICATION.
TO HIS
BRETHREN OF THE MEDICAL PROFESSION,
AND
TO ALL OTHERS,
WHO PREFER TRUTH TO ERROR,
AND
SCIENCE TO EMPIRICISM,
THESE PAGES ARE
RESPECTFULLY INSCRIBED, BY
THE AUTHOR.
7
1*
TO THE READER.
THE object of the following pages is to overthrow
quackery in medicine, by exposing its errors, its false pre-
tensions, and its unjust claims upon the community for
support. The only way to eradicate error is to plant the
germ of truth; and this the author has attempted, by pre-
senting to the public, in this volume, the elements of
medical science. He has however traversed but a small
part of the territory which his subject embraces; but he
flatters himself that he has gone over sufficient to con-
vince the reader that, to ensure success in the treatment
of disease, all the accumulated skill and science of past
ages is absolutely indispensable.
This volume does not profess to teach every man to
be his own doctor; but, on the contrary, it aims to show
that, to cure disease, something more is requisite than a
dose of patent medicine, whether it comes in the form of
pills, powders, syrups, steam, or natural bonesetters, or
any other natural character.
%
}
viii
PREFACE.
The anatomical descriptions in this work are such as
we have, generally, condensed from Meckel's Anatomy,
translated by our friend Dr. Doane of this city; to whom
the profession is indebted for the translation of many
excellent works.
With a sincere desire to contribute to the welfare of
the community, as well as to advance the honor and
dignity of that profession to which the author belongs, he
submits the present volume, with all its imperfections, to
the perusal of the public.
Chambers Street, May, 1838.
}
CONTENTS.
CHAPTER I.
THE ORIGIN OF MEDICINE-Its early history-Confined to
priests-Empiricism-The dupes of quacks—Prejudice against
dissection, and laws in relation thereto-An adventure of three
medical students
CHAPTER II.
page 13
GENERAL VIEW OF THE HUMAN BODY AND ITS DIVISIONS-
Proportion of solids and fluids-In what health and disease
་
consist
•
37
CHAPTER III.
ANATOMY OF THE DIGESTIVE ORGANS---Mouth--Salivary
Glands--Teeth-Pharynx--Esophagus--Stomach-Large
and small intestines-Liver-Pancreas-Spleen.
CHAPTER IV.
41
DISEASES OF THE DIGESTIVE ORGANS--
--Their number-Modi-
fied by circumstances--Medical treatment--1. Cathartics
-How they operate-Their character-Used by quacks-
History of a quack remedy-Its origin-Foreign quacks-
"From London"-" Graduate of Edinburgh"-How purga-
tives do injury-A case in which a quack remedy nearly
proved fatal-Story of the " 'big pills"-2. Emetics-what
they are Their danger-Their mode of operation--Vomit-
ing of bile accounted for-Lobelia-A dangerous remedy-
Instance of death and trial for murder---3. Sudorifics--
What they are Quantity of perspiration in twenty-four hours
▼
1
*
:
X
CONTENTS.
in Winter, Spring, Summer and Autumn-Effects of Sudorifics
-Cold and warm Bathing-Russian Bath-Vapour Bath-
Dangers of Bathing-Steaming, and Steam Doctors—Lobelia
and Cayenne pepper-Pepper given to a child instead of
Senna-4. Tonics-Stimulants-Their effects in doing good
and hurt--5. Alteratives--What they are and how they
operate-A common case of imposition of a quack—How a
celebrated nostrum obtained its popularity-6. Diet—a hack-
neyed subject-Appetite and reason are guides in diet-Re-
ligious fasting productive of diseases-Bran Bread-Does
injury-Prof. Averill-His disease aggravated by Bran Bread
-Discourse on his character by Prof, Reed
CHAPTER V.
47
ORGANS OF RESPIRATION---Description-1. Diseases of the
Lungs---Their number-Inflammation---Different tissues
affected-Consumption-Cathartics in diseases of the Organs
of Respiration-Their Effects-Dishonesty of an Empiric—
Method of obtaining signatures to certificates of Cure-Anec-
dotes-Emetics-Their Effects-Asthma-A vague Term-
Sudorifics-" Hot Slings, etc--Syrups-All contain Alcohol
-Drops, Tinctures, Elixirs-Affections of the Heart-Folly
of employing a quack--Tonics and Stimulants-Their bad
effects in Diseases of the Chest-Narcotics--Their Effects. 107
CHAPTER VI.
CUTANEOUS SYSTEM--Its Divisions-Form-Layers-Diseases
affecting it-Their different characters-Require diversity of
Treatment---Repelled Eruptions-Case of a Child--Salt-
Rheum-Case of a Lady-Case of a Gentleman-Another
Case--Remedies employed by Quacks-Their character,
135
etc.
CHAPTER VII.
OF THE EYE-Structure--Appendages-Coats--Humours--
Ducts-Diseases-Their Treatment
147
F
CONTENTS.
xi
CHAPTER VIII.
FEMALE COMPLAINTS-Differences of Sex-Habits of Females
-Their Diseases-Remedies-Case of a Lady
CHAPTER IX.
153
OF RHEUMATISM-Its Location-Chronic and Acute-Wanders
from one joint to another-Its treatment by Quacks-Mis-
taken for other Diseases-Case
159
CHAPTER X.
OF DEAFNESS—The Organ of Hearing-Its Structure-Causes
which derange its functions-Number and Variety of its Dis-
eases-Their Treatment-Quack Remedies, etc.
CHAPTER XI.
165
OF CANCER-Its Nature-Parts which it affects--Causes of
Cancer-Cancer Doctors-Cancer Plasters-Only Remedy,
etc.
•
CHAPTER XII.
175
OF MEASLES--Character of Measles--Bad Management of
Mothers and Nurses
CHAPTER XIII.
183
OF NATURAL BONE SETTERS-Natural Fools, etc.--Ignorance
of Natural Bone-Setters-Structure of the Shoulder Joint-Its
Dislocations-Elbow Joint--Its Injuries--Wrist and Hand—
Hip-Joint--Knee-Ancle and Foot--Cases illustrative of
189
Quackery
·
CHAPTER XIV.
OF THE COMPARATIVE POWERS OF VEGETABLE AND MINERAL
MEDICINES-Odium cast upon "Mineral Doctors"-Arsenic
xii
CONTENTS.
..
-Mercury-Antimony-Copper-Zinc, etc.-Oxalic Acid-
Prussic Acid-Elaterium-Croton Oil-Hellebore--Colchicum
-Opium and many others
. 209
CHAPTER XV.
Of the ErrorS, EXCLUSIVENESS, AND ULTRAISM, OF MEDICAL
MEN-AND THEIR INFLUENCE IN CAUSING AND PERPETUATING
EMPIRICISM
219
CHAPTER XVI.
INFLUENCE OF CLERGYMEN IN THE CAUSE AND SPREAD OF
QUACKERY-Signing Certificates of Cures--Interfering in
cases of Sickness-Existing Dissensions between Doctors,
etc.
267
:
1
MEDICAL PHILOSOPHY.
CHAPTER I.
THE ORIGIN OF MEDICINE · ITS EARLY HISTORY
NED TO PRIESTS
CONFI-
EMPIRICISM-IGNORANCE, &c. &c.
THE records of history do not furnish us with the pre-
cise time when medicine was first applied to the allevia-
tion of the pains, and ills, of life; but it is probable
that observation and reflection, called into requisition
by necessity the mother of invention suggested
something as a remedy for external injuries, or for in-
ternal disease. Experiment, thus commenced, would
be repeated, and varied; the good results remember-
ed, the facts communicated, and experimental, prac-
tical medicine would begin its existence. However
the art of Healing may have originated, we can
trace it, by authentic testimony, to the ancient Egyp-
tians; and, as in those early ages, the priests of the
temples were the depositaries of all learning, so with
them was lodged, in all probability, all knowledge of
medicine. The remedies they employed consisted most-
ly of magical incantations, and such other means as were
calculated to affect the imagination of the superstitious
:
2
14
MEDICAL PHILOSOPHY.
and ignorant. It is supposed, from what scanty records
can be obtained, that the contemporary nations derived a
knowledge of medicine, with the other arts and sciences,
from Egypt; and, from the same data, we are led to con-
clude that the priests were the practitioners of physic-
that their ostensible remedies were chiefly incantations and
magic, and that they were so applied as to impress all
who witnessed them with a belief in the supernatural pow-
er of the priests. Thus every thing was enveloped in a
thick cloud of mystery, or addressed to the imagination,
hopes, or fears of the patient. The practice of medi-
cine, in those remote ages, bears a close resemblance
to that which is common among the untamed Indians of
our western wilds. They have their priests who are also
their physicians. And, arrayed in a most grotesque man-
ner in the skins of beasts, they perform their round of
antics over the dying patient. This is not altogether
inert practice, for, not unfrequently when confidence is
reposed in the "medicine man," as he is called by them,
hope is inspired in the breast of the almost dying war-
rior, the flickering flame is rekindled, and the voice that
was sunk even beneath a whisper, is made again able
to make the forests reëcho with the horrid war-whoop.
With other nations, Greece also obtained her know-
ledge of the arts and sciences from Egypt; and as was
formerly our custom, and is yet, to go to Europe for our
medical education, so Greece sent her students to Egypt
to acquire such a knowledge of medicine as was then to
be obtained. The first Greek doctor, whose name has
been transmitted to us, was Chiron the centaur, a prince
of Thessaly, who lived about the thirteenth century be-
fore the Christian era.
MEDICAL PHILOSOPHY.
15
Esculapius, the pupil of Chiron, was the first who
made medicine a distinct pursuit, or profession. Divine
honors were paid to him, temples were erected, in which
he was worshipped as the god of Physic. His sons, Ma-
chaon and Podalirius, inherited their father's profession,
as was the custom in that age, and accompanied Aga-
memnon in his expedition against Troy.
The practice of medicine continued for a long time in
the family of Esculapius; his descendants were called
Asclepiadae, and officiated as priests in his temples.
These temples became a species of hospitals, to which
invalids resorted in great numbers, where they were sub-
jected to certain rites and ceremonies; and these, with
some dietetic regulations, such as ablutions, and absti-
nence from certain kinds of food, constituted the chief
remedial means employed. It was a custom of the inva-
lids, when they left the temples, to make a deposite of a
votive tablet, on which was inscribed the principal symp-
toms of their disease, and the remedies used in its cure;
and it is believed that Hippocrates profited not a little
by gleaning from these meagre records.
Many centuries elapsed during which the practice of
medicine was confined to the priesthood, and exercised
by them for the sake of emolument, or for the purpose
of retaining their influence over the minds of the igno-
rant and superstitious. But in the sixth century before
the Christian era the germ of true philosophy, an antago-
nist power to priestcraft and imposture, began to unfold.
itself in Greece; and as the former struck root, and
spread forth its branches, the latter, deprived of suste-
nance, felt its giant strength become weakened. A su-
16
MEDICAL PHILOSOPHY.
perstructure, once undermined, must fall into ruins:
thus it was with the power of the heathen priesthood.
Its hold relaxed, its grasp became less firm as the peo-
ple exercised for themselves the reasoning faculties that
their Creator bestowed upon them.
From the age of Pythagoras to the present day there
may be traced in Medicine a progressive improvement,
although at one time it may have remained for a consid-
erable period stationary, and at another it may have met
with temporary obstruction. Its light became dim and
obscure during the middle and dark ages, when it fell
again into the hands of priests, though of another char-
acter; but with the restoration of letters and science it
beamed forth with mid-day effulgence, imparting health
and comfort to suffering humanity.
About the three hundredth century before the chris-
tian era there occurred the great schism in medicine—
the division into the two rival sects of Dogmatists and
Empirics; since that time theory after theory, system
after system, has been constructed, warmly prais
ed by their friends, and denounced and repudiated by
their enemies. Some systems have indeed enjoyed al-
most universal favor, and seemed to have arrived at a
great degree of perfection; when some new luminary
has arisen to attract the gaze of the world, and all others
have sunk into oblivion. Such have been, for two thou-
sand years, the revolutions of medicine; and yet, the
science has been constantly improving. Such, in a
degree, will probably continue to be its revolutions, at least
while there are visionaries and enthusiasts to wander
into some new field of speculation-some unknown coun-
MEDICAL PHILOSOPHY.
17
try; and while there are those who will forsake the
well known paths of common sense, and follow in their
eccentric course.
The term Empiric did not originally convey the same
meaning that it does now. It was applied to those who
believed that the practice of medicine was based upon
experience alone, and that a knowledge of anatomy, or
physiology, was not necessary to the successful treat-
ment of disease. The dogmatists held a contrary opin-
ion, and believed that a knowledge of the structure and
functions of all parts of the body was indispensable, as
well as a knowledge of the operations of medicine in the
healthy and diseased state. The term empiric is, in
modern times, applied to those who administer or vend
secret remedies, nostrums, patent medicines, and the
like, or to those who administer the same remedy for
the cure of all diseases. Quackery, empiricism, and
charlatanry, are used synonymously; they are terms per-
fectly well understood by the community generally, and
by none better than those to whom they of right belong,
and by those who have unfortunately been their dupes.
These terms will be used as synonymous in the follow-
ing pages; and as empiric was once employed to denote
experience, quacks sometimes try to shake off the infa-
my which attaches to them, by saying that all are more
or less empirics, because all practise upon experience.
But this subterfuge cannot avail. Call himself by what
name he will, a quack is still a quack-and even if the
prince of darkness should assume the garb of heavenly
innocence, the cloven foot would still betray the real per-
sonage.
2*
18
MEDICAL PHILOSOPHY.
It is not my purpose to discuss here sectarian divisions
in the ranks of the profession; my object is rather to
deal with bold quackery, and unblushing quacks, who
not only procure a subsistence, but even accumulate for-
tunes by a species of piracy committed under a flag that
ought not to be so disgraced. One who is not well ac-
quainted with this subject would be incredulous in regard
to the extent and prevalence of quackery in this enlight
ened age.
He would hardly believe that every country
village, if it has not one empiric at least, has neverthe-
less a place for vending all kinds of nostrums and spe-
cifics for all kinds of diseases; and he would be still less
inclined to believe a true statement of the amount of mo-
ney received by some of the proprietors of patent medi-
cines. It matters little what the remedy may be, or what
the disease for which it is recommended; certificates of
cure are always procured, the medicine is sold and swal-
lowed, and the people are gulled.
In ancient times, when the people were groping their
way in the darkness of ignorance and superstition, it is
not to be wondered at that they should be deceived by false
appearances, by mystery, magic, and incantation-, and
by the various arts and devices of a cunning priesthood;
but it is most truly astonishing, that, with all the light of
the nineteenth century, people should be so impu-
dently cheated, when the imposture is so easily detect-
ed. It is neither the ignorant nor the superstitious alone
who are gulled by the designing; for in this country
such individuals are rarely to be found-and yet there
are plenty of subjects upon whom these harpies prey.
And who are they? They are not ignorant in matters
MEDICAL PHILOSOPHY.
19
not pertaining to themselves; they are, by no means
superstitious, or particularly credulous on other subjects
to which they give their attention. But of the struc-
ture of their own bodies, the laws which govern their
actions in health and disease, and the causes which de-
range their operations, they have no correct idea:
they have never, perhaps, seen a human skeleton,
and, in all probability, ninety-nine in a hundred of the
non-professional public, have never even seen a single
human bone. They know not how the circulation of
the blood is performed, in what vessels it runs its course,
nor what will hasten or retard its celerity; they know not
the difference between a muscle and a nerve-a tendon
and a vein; and those who pride themselves on their ex-
tensive acquirements, daily betray the grossest ignorance
when speaking of the human system. These are the
persons who are the dupes of quacks; and they fall a
prey to their arts, not from a general lack of information,
but for a want of it in regard to that in which they
are most deeply concerned-their health and comfort.
Were the positively ignorant the only supporters of
quacks, they would soon be driven from the field
by starvation; but unfortunately for the interests of
science, the universal ignorance of the human system
in health and in disease, propagates a race of unprin-
cipled empirics; and on this ignorance they grow
and fatten. Encouraged by success, it matters little
how gross the absurdity, or how glaring the impos-
ture, they attempt to practice; and if they envelope
their whole scheme in as deep a mystery as that which
involved the oracles of Pythian Apollo, so much the more
20
MEDICAL PHILOSOPHY.
likely are they to become equally celebrated. The his-
tory of the last half century will convince any one tha
there is no absurdity so great but what will be be-
lieved; no visionary in politics, religion, or philosophy,
who will not gain proselytes. The German Prince
Hohenloe professed to be able to cure disease at a given
time by means of prayer. He was resorted to by thou-
sands from all parts of Europe, and for aught I know,
from America; and he not only cured those who flocked
to him, but he cured others, equally well, hundreds of
miles distant, at a time agreed upon by himself and the
patient. Charms and magic have not been banished by
the increase and diffusion of knowledge; we often hear
of diseases being cured by the seventh son, by touch, by
saying some hocus-pocus, or by doing some other equal-
ly silly thing. To cure warts, you must do sundry
things of which every body has heard, and no one has
seen beneficial; to cure epilepsy, a bone from a partic-
ular part of a Fox is worn around the neck; a strip of
eel skin worn around the arm cures a numbness of the
hands; a red string worn around the neck prevents nose-
bleed; a black one causes the teeth of a young child to
cut through the gum without pain; and multitudes of
remedies, equally ridiculous, are believed to be effica-
cious by many who are foolish enough to employ them.
There can be no good reason assigned for this general
ignorance in regard to the human system, or why it should
continue to exist. It is not necessary that every man should
have a thorough knowledge of medical science; but it is
important that he should know something of its nature.
Knowledge of this sort would enable a man to preserve
MEDICAL PHILOSOPHY.
21
his health by avoiding the causes which derange it; and
it would be also useful in protecting him from the impo-
sitions of quackery. A very minute quantity of infor-
mation is quite ample for this latter purpose; because it
is sufficient to convince to demonstrate to any reason-
able mind, that a still greater quantity is necessary to be
successful in combating disease. The non-professional
public is to blame in a great measure for its own igno-
rance; although the eagerness with which popular works
on health have of late been sought for and read, give
indication that we may hope to see this fault removed.
Medical men are not entirely free from blame in the dis-
charge of their duty. Having too high a sense of hon-
or, and the dignity of his profession, to resort to the same
meanness and falsehood, to counteract imposture, that
the quack does to propagate it, the latter, by his assurance
and plausibility, succeeds in insinuating himself into the
confidence of the unsuspecting; while the high-minded
physician, perhaps disgusted with the credulity, or gulli-
bility, of the multitude, is willing they should suffer, and
gain wisdom by sad experience. Inasmuch, then, as
there is a common responsibility and obligation upon the
people and the medical profession, both should honestly
attempt the discharge of their duty. To keep a delicate,
complicated piece of machinery in order, it is not ne-
cessary that a man should be able to construct, or even
to repair it, when deranged or broken-he may be ac-
quainted with all the wheels and springs, and all its in-
tricacies, and yet have not skill sufficient to make or
mend one of them. But the knowledge he does possess
would satisfy him that to employ one less skillful, less
22
MEDICAL PHILOSOPHY.
knowing than himself, to repair his machinery, would
savour too much of madness or folly. A general know-
ledge of the structure of the human system, and of the
principles of Physiology, with the difficulties of practice,
can be attained with no great sacrifice of time or labor;
and if no other good results from this knowledge than
the ability to choose a skillful physician, when one is
needed, the sacrifice, whatever it may be, has not been
too great.
The curiosity of man, and his eager desire for novelty,
will lead him to brave the dangers of the ocean,-to
risk storm and shipwreck; it will impel him on to
seek adventures in foreign lands, to explore unknown.
climes, to wander among savages, and it forbids him to
leave any ruin of antiquity unsurveyed, or any ancient
battle field unvisited. He treads in the footsteps of he-
roes of olden time, he breathes the atmosphere they
breathed, views the scenery they loved to look upon;
and he feels his spirit kindle with a holy enthusiasm as
he makes his pilgrimage to those regions which were
once visited by the Saviour of the world, and contem-
plates those scenes in which he was so conspicuous.
A fragment of rock from an old and almost forgotten
castle, a twig from a tree over the grave of some long
buried great one, or any memento of a like kind,
is valued as above price. This may all be well enough.
Far be it from me to undervalue the pleasure and bene-
fits of travel; but while we are searching after curiosi
ties and novelties in far off and unknown lands, we might
find things quite as curious and novel nearer home,—
even in our own bodies. We shall there see a piece of
1
MEDICAL PHILOSOPHY.
23
mechanism far surpassing the ingenuity and invention of
man. Even in the minutest part, we shall find organs
of a complex and different character, performing differ-
ent functions, and each harmonizing with the other, and
all operating by fixed and regular laws. In short we
shall behold the last, and the most perfect work of God
-the master-piece of an Almighty hand. Judging from
appearances, we should conclude that the human body
is not always regarded with indifference; the care that
is taken to display its form, the study shown in 'decking
it with finery, and in arraying it in the extreme of fash-
ion, give evidence that our mortal bodies are valued, by
no means at a low rate; and, yet, however exalted our
self-esteem may be, all that we know of the tenement
which we inhabit, is, that it is something very pretty-
very much to be admired, and with it we have no further
concern than to ornament and garnish it, as fashion or
fancy dictates. The absolute ignorance of most peo-
ple, of the human structure, is really lamentable: many
suppose that the brain is about as large as a tea-cup—
that the lungs may be of the same, or any other size;
and they are quite as likely to transpose the organs-
locating the stomach in the chest, and the lungs in the
abdomen -as to give to each its own "local habitation."
For this ignorance, I again repeat, physicians are in
part to blame. They have not taken pains, and adopted
a right course, to spread information among the commu-
nity at large. Were it otherwise-had people but a
knowledge of general anatomy, as well as the prin-
ciples of physiology, and the nature of disease, they
would be enabled rightly to appreciate the pretensions
24
MEDICAL PHILOSOPHY.
of quackery, and the claims of the scientific physician-
to discriminate between the genuine, and the counterfeit,
coin. Every practical physician had much rather pre-
scribe for one enlightened on the subject in question,
than for one who is not.
Anatomy and physiology should constitute one of the
branches of study in all the higher seminaries of learn-
ing. And I am most happy in here stating that my
worthy, and distinguished friend, Prof. Joslin, late of
Union College, Schenectady, was the first to introduce
this study into a regular collegiate course, and has, for
several years past, pursued this plan with entire success,
and satisfaction to his pupils. If Dr. Joslin's plan could
be adopted in other colleges, a tone would, ere long, be
given to public sentiment, that could not fail, eventually,
to lead to most pleasing and useful results.
But before so desirable an object can be attained, an
inveterate, and almost universal popular prejudice must
be removed. I allude to the strong feeling against the
dissection of the human body. In ancient times, it was
the popular belief that the soul was doomed to wander
about restless and unhappy, and unable to cross the river
Styx to reach its final abode, while the body should re-
main unburied; and hence it was deemed a pious obli-
gation that the dead should be interred as soon as cir-
cumstances would permit; besides, every one who de-
sired the peace of his own soul when its separation from
the body should occur, would be prompt in setting an
example to those whose duty it would become to dispose
of his remains. Thus it was next to impossible that
human dissections should have been made; and hence it
25
MEDICAL PHILOSOPHY.
was that the earlier anatomists were compelled to cultivate
their infant science by studying the structure of the low-
er animals, and making such deductions from their dis-
coveries as analogy seemed to warrant. It is not surpri-
sing that their facts were few in number and uncertain;
that their ideas were limited; their speculations wild;
and their amount of knowledge extremely small.
Prejudices have been gradually overcome by the firm-
ness and determined perseverance of the professors and
friends of medical science. To a study of the struc-
ture of the healthy body by dissections, and to investi-
gations into the changes wrought by disease, by post
mortem examinations, are we indebted, more than to
all other facilities, for the great improvement in the
healing art for the last half century. And yet, rapid as
have been its strides towards perfection, compared with
its former imperceptible, snail-like pace, it is still far be-
hind what it would have been had there not existed legal
obstacles to impede its progress. There are in most, if
not in all the States, severe penalties annexed to the
crime (?) of procuring subjects for dissection. Our le-
gislators have, in their wisdom, deemed it expedient to
prescribe a certain routine of study for the medical stu-
dent, as well as to make him liable for all damages for
mal-practice, subsequent to the commencement of his
professional career. And yet strange inconsistency, or
rather, stupid, wilful ignorance, and blind superstition—
they raise a barrier in the only path which leads to the
knowledge that would enable him to avoid error. They
compel him to make bricks without straw. They extin-
guish the light, and then punish him for not seeing.
3
26
MEDICAL PHILOSOPHY.
Popular prejudice on this point is so strong that were
a doctor, for anatomical purposes, to disinter the vilest
wretch—one who had been a scourge to society-a pest
to all around him—who had been supported at the pub-
lic expense, and whom all had been glad to bury—there
are those who would raise a cry of alarm, hunt down the
doctor, and persecute him to an extreme but little short
of death. And little difference would it make whether
or not those who make the greatest ado about "violating
the grave,"
"have been most benefited by the skill of him
whom they seek to punish-they, or some member of
their family may have been snatched from the grasp of
death by his agency, yet, in their persecution, they are
unrelenting.
It is right that one who never did good while living,
who was an expense to the community, should be turned
to some useful account when dead, by affording the means
of instruction to preserve the lives and health of the liv
ing. What possible harm can it do to one, who has
"shuffled off this mortal coil," to be subjected, for a
longer or shorter time, to the knife of the dissector? He
will, in any event, become the prey of worms—a mass
of putrefaction--and be resolved into his elemental dust.
The knife inflicts no pain, and should not the reflection,
that good is to result to our species, eradicate the ancient
prejudice that may be opposed to this use of our bodies?
Many, perhaps most, believe that it is all selfishness
that prompts the doctor to manifest an eagerness to ex-
amine the bodies of the dead—that it is solely to accumu-
late wealth, and acquire fame, that they endeavor to
make themselves skilful. Such an imputation, the whole
MEDICAL PHILOSOPHY.
27
body of the profession will throw back, with contempt,
into the faces of those who make it. And again, others
think that doctors are amply remunerated now, and would
be glad if their fees could be diminished. Of what value
is life? How do such men estimate the value of a wife,
a child, or a parent? By dollars and cents, and but few
of them? Have they so much the spirit of a miser as to
think that medical men feel themselves paid, amply com-
pensated, by a few dollars more or less, for saving life?
We should suppose that they were misers indeed—did
not their extravagance in furniture and equipage belie
them-when they attempt to chaffer with their physician
and beat him down in his fees, when he has spent his
days in anxiety, and his nights in watching over their sick
couch, and perhaps performed the most menial and dis-
gusting services.* Still there are those who would im-
mure the doctor in a prison, and rob his children of
money, to pay a heavy fine, if he but dares to touch
the grave of an outcast whom they often repulsed from
their doors, refusing him the crumbs that fell from their
table.
It is supposed by a great majority of those who exer-
cise power in this country-the sovereign people-that
executed criminals furnish an ample supply of subjects.
for the schools of medicine, and for those engaged in
private practice. This erroneous idea is another strong
* It must not be supposed that the author is an advocate
for extortion, or exorbitant fees for medical services. There is
nothing more difficult than to fix the price for our professional
labor-to rightly estimate the value of a skilful physician.
28
MEDICAL PHILOSOPHY.
reason why public opinion should be corrected by the
only proper means-and that is, such a knowledge of
anatomy, as to show the absolute dependence of all med-
ical science, and professional skill, upon anatomy; and
to demonstrate, also, the necessity of repeated dissections
to preserve the knowledge once acquired, and to enable
the surgeon to become dextrous in his operations. Every
practical man knows how important it is that a mechanic,
or artist, to do justice to his work, must be in the frequent
and constant use of his tools and instruments; and that,
unless he does so, it is impossible that he should be able to
repair any delicate machinery, or to do any thing whatev
er creditable to himself. How much more important is
it, then, that one who attempts to repair the most delicate,
most complicated, of all mechanism-the human ma-
chine-should possess the adequate skill? And yet, one
who does not frequently use the dissecting knife upon the
dead body, is in no wise qualified to use the operating
knife upon the living.
The demand of subjects for dissection being so great,
it is clearly demonstrable that the supply from the gal-
lows is altogether too meagre. Had students and physi-
cians no other means of studying anatomy than such as
are afforded by our Oyer and Terminer courts, not one
in a hundred would ever see the structure of the human
body in a recent subject—where it must be seen to be
known,
In places where subjects for dissection are most easily
procured, medical science has taken a higher rank, and
assumed a more dignified aspect. Of late years, Paris
has taken the lead in the cultivation of medicine; and the
29
MEDICAL PHILOSOPHY.
sole reason is that there is no lack of facilities for ana-
tomical pursuits. Philadelphia, too, in our own country,
stands first and foremost in the ranks of our profession;
and it is not because she has more able men, or because
she has any superior advantage, save the single one of
abundant facilities for anatomical studies. An enlighten-
ed, and liberal minded legislative body-whether it was
the corporation of Philadelphia, or the State legislature
I know not-ordained that every pauper, who was not
claimed by some friend within a limited time after death,
should be given over to the medical faculty for dissec-
tion. This law at first created quite a sensation. But it
was soon understood, and appreciated; and it now gives
as perfect satisfaction as if every pauper were buried
with military honors.
A law very similar to the above was passed by the le-
gislature of Connecticut some few years since; and the
author takes some pride to himself from the fact that his
brother, a physician, was chiefly instrumental in doing so
much for science and humanity. Were all the States to
adopt such laws, we should have no more of fines and
imprisonment for "robbing the grave"-" body snatch-
ing," and the like; and although there might be, at first,
some opposition, yet, a little attention would bring people
to their senses, and teach them that such a course might
be the preservation of their own lives. Besides, it might
be the means of allowing their own bodies to rest undis-
turbed, to mingle with their mother earth; for anatomy
must, and will, be studied in spite of fire, imprisonment,
the stake, and the faggot.
Medical men, particularly of the younger class, and
3*
MEDICAL PHILOSOPHY.
30
students, and those of riper years who feel the responsi
bilities of their profession, will procure subjects at any
hazard. This may be taken for granted. Since public
opinion is such as it is on this point, it should never be
outraged, by selecting the bodies of those, who have a
large circle of friends, whose feelings would be lacerated
by the exposure. It is natural, it is right, and one of the
brightest and best traits in the human character, that af-
fection for the living still fondly clings to the dead; and
the fondness with which we dwell on the memory of the
departed ought always to be respected and cherished, as
one of the blessed influences designed by the Creator to
do us good. Sacred may it ever be held !—And may he
who wantonly trifles with it-no matter whether it be
founded in prejudice or not-be treated with the indigna-
tion that his want of sympathy with the afflicted deserves.
But this is not the objection in the case of those who
leave no friend with love sufficient to bury them; and
who, when living, met with hardly charity enough to
keep them from starvation.
The incident below will serve to illustrate the deter-
mined perseverance of students, as well as their teachers,
to acquire a knowledge of anatomy; and it also serves
to show the manner in which an educated, though pre-
judiced, and miserly individual, may show his hatred of
the living, and his regard for the dead. The story may
as well be told without names or dates.
A few years since there died, in a country town, one
who had for a long time led a dissolute and debauched
life, a scourge to the neighborhood, and an eye-sore to
all who knew him. During the latter part of his life, he
MEDICAL PHILOSOPHY.
31
was supported at the public expense. By one, who called
himself a gentleman and Christian, the poor vagabond
was not unfrequently, bad as he was, greatly abused.
At one time he was thrust into the streets, in the midst
of a dark and tempestuous night, at a distance from his
own miserable hut; and at another he was refused a
drink of water from the well, or a mouthful of food, and
threatened with personal chastisement. No one claimed
this poor creature as his kinsman; he had not a solitary
friend. He was buried like a dog, and totally uncared
for. The fact of his death was carried, not much less
than twenty miles, by a young physician to others of
his acquaintance; and arrangements were immediately
entered upon and completed to procure the body. A
pair of horses and sleigh were in readiness, the necessary
implements procured, and at ten o'clock, when all was
quiet, and all fear of being recognized on the road pre-
vented by the lateness of the hour, these three young doc-
tors started on their errand. The wind having blown
from a southerly direction for some hours it soon com-
menced raining; and the snow being thin upon the
ground, the issue of their expedition began to appear
somewhat doubtful. The rain poured-the sleigh shoes
grated harshly upon the gravel-the night was extremely
dark; and the faster the rain fell and the snow melted,
the more was their speed increased as far as was consis-
tent with safety over a bad road, with which they were
but little acquainted. Thus they contended with adverse
circumstances till they had accomplished nearly the whole
distance; and, now, on looking at what was before them
-considering the time necessary to accomplish their
32
MEDICAL PHILOSOPHY.
a
work—and to make the journey home over a road, now
almost cleared of snow-it was found impossible to pro-
ceed further. So with no little vexation from disappoint-
ment they faced about, and retraced their steps, meeting
with but one slight accident—an overturn in the mud-
on their way home, where they arrived, after making all
possible speed, at broad daylight. Two days after this, a
second attempt was made. The snow had now entirely
disappeared; and those who are acquainted with a New
England climate can judge of the state of traveling after
"January thaw," when the ground has been frozen to
a considerable depth. Thus it was now, when the devo-
tees to physic set out on their resurrection jaunt in a
lumber waggon; but, after proceeding a few miles, were
again compelled, by the depth of mud, which prevented
their going faster than a walk, to again abandon their
enterprise. Not disheartened, though twice disappoint-
ed, they started a third time. They now rigged out a
heavy lumber waggon, with four stout horses, owned by
a teamster, who, with his team was well known in all
that region of country; and to make the most of their
time, they set out, early in the evening, fully resolved
not to return without bringing with them their subject.
This third attempt proved completely successful; and
with making all possible speed, losing not a moment
by unnecessary delays, they reached home,-having per-
formed a journey of between thirty and forty miles in
a dark night, and accomplishing a fatiguing work to
which they were but little accustomed and had their new
friend fairly introduced into his new quarters as the day
dawned.
MEDICAL PHILOSOPHY.
33
f
Another burial was to take place in the same yard,
and on the day subsequent to which this nocturnal visit
was paid; and by some unlucky accident, or from lack
of proper caution on the part of the new grave-diggers,
something was discovered about the grave that had been
disturbed, which led to suspicion that its inhabitant had
not reposed in quiet. An examination took place, and
the body was found to be missing. A general search was
now commenced among the doctors; and foremost in
pursuit, and loudest in the cry, was the above named
worthy and enlightened gentleman. Unrelenting in his
persecution, and fierce as a blood-hound upon the heels
of his prey, no obstacle impeded him in seeking for the
carcass of that poor creature, at whose death he felt re-
joiced. So savage and vindictive was he, that he threat-
ened to have inflicted upon his family physician—the
father of a numerous family of children, and who had
been a friend and servant to his persecutor for years-
the severest penalties of a barbarous law. But his efforts
at discovery were fruitless; and after weeks spent in a
fatiguing and not very creditable search; after the ar-
rest and examination of half the doctors in the county;
and after spending more money than he had ever given,
in his whole life, in charity to the living; he gave over
the chase, and sneaked home to his kennel, a little wiser
than he left it-for he became convinced that he had
better leave every one to follow his own profession.
The practice of giving up the bodies of executed crim-
inals for dissection serves only to foster the prejudice
already existing; for it constitutes a part of punishment
--and the cultivation of science is its execution, and
34
MEDICAL PHILOSOPHY.
physicians are the executioners-assistants to the com-
mon hangman.
We should think that, inasmuch as our law-givers de-
mand of the regular-bred practitioners of medicine cer-
tain qualifications, and compliance with prescribed rules,
they would afford some little facility for complying with
what is required. But no such thing is done. At any
rate they might, with propriety and consistency, allow
him the privileges of legalized quackery. By the laws
of this State, a student is compelled to study three years
with some legal practitioner of medicine, to attend one
course of lectures at an incorporated medical school, and
to pass an examination, by a board of censors; to ob-
tain a license to practise his profession. In addition to
this, to obtain a degree, he must have attended two
courses of lectures, and sustained an examination by the.
professors; and all this is done at no trifling expense.
The same body of wisdom, the legislature, that prescribes
this course, allows any ignoramus to practise medicine
-to administer the most active and dangerous reme-
dies-whenever he can find a fool to swallow them.
Nay, quackery is protected by law; for the right of ad-
ministering drugs is secured by patent. He who is too
lazy to earn his bread by labor, or too stupid to do it by
any occupation that requires intellect, and who is so much
of a rogue as to desire to profit by the credulity and
ignorance of his fellows, has only to purchase a right
for the application of steam, and the administration of
lobelia, and cayenne pepper, and he is forthwith trans-
formed into a doctor-he is born Minerva-like, full
grown, and completely armed from the brain of this lẹ.
gislative Jupiter.
MEDICAL PHILOSOPHY.
35
ments?
Is it any wonder then that quackery flourishes when
it is guarded, protected, and cherished by legal enact-
Who would not be a quack, at the cheap rate
of twenty or thirty dollars for a "right," and the trouble
of reading a few pages, rather than sacrifice the time and
money necessary to acquire a good medical education?
Shame on any enlightened community that tolerates such
inconsistencies, such abuses! Abuses to science, to itself,
and to posterity.
The members of the profession ought to be untiring in
their efforts to inform the public mind, and to give a pro-
per direction to public opinion; and not the profession
alone, but all educated men are under obligation to lend
a helping hand in effecting a reformation. Legislatures
will then do their duty, if they hold their popularity too
dear to do it sooner. Pennsylvania and Connecticut
have set a noble example; and least of all should it be
said that the “Empire State" is a laggard in any cause
that has for its aim the good of humanity.
So inveterate is prejudice, or so closely does affection
cling to the departed, that it is comparatively rare that
physicians are allowed to make post mortem examinations
of their patients, even in the most interesting and instruc-
tive cases. One, of a family of several children, dies
with some obscure disease, and the physician desires to
make an examination; but his request is not listened to
by the afflicted parents. They are not aware that their
other children are likely to be attacked with the same
disease, and, therefore, do not see the benefit that may
result to the living by an inspection of the bodies of the
dead. It is universally the case that the most ignorant
36
MEDICAL PHILOSOPHY.
are the most obstinate in their opposition to seeking for
the seat of the disease, and the cause of the death of
their friends. The bodies of the kings of England have,
for centuries, been subjected to examination after death,
that the seat of their disease might be ascertained, and
the cause of death known and recorded. This custom
of the royal family of Great Britain ought to be imitated
by the noble and the ignoble in all countries; and consent
of the surviving friends ought not to be wrung from them,
but when the physician is not anxious, they should urge
it upon him as a part of his professional duty. The sur-
viving members of a family might in many instances be
most signally benefited in one important particular; and
that is, in being made acquainted with some hereditary
disease as well as the means of obviating its unhappy
results.
Were it the general custom for physicians to examine
the bodies of their deceased patients, they would be ena-
bled to retain their knowledge of general anatomy, and
to become better acquainted with disease, than it is possi-
ble for them ever to be without having this opportunity
afforded.
1
7.
CHAPTER II.
}
GENERAL VIEW OF THE HUMAN BODY AND ITS DIVISIONS.
SEC. I. The human body, like all organic matter, is
composed of solids and fluids; but the latter exists in
much the greater proportion. The solids of the body
are reduced by anatomists to twelve varieties*—bone,
cartilage, muscle, ligament, vessel, nerve, ganglion, folli-
cle, gland, membrane, cellular membrane, and viscus ;
under the latter term are included all the organs in the cav-
ities of the body, as the brain, lungs, liver, stomach, kid-
neys, etc.
These several tissues are again resolved, by
chemical analysis, into their constituent elements; as
carbon, nitrogen, etc.
The proportions of the solid and fluid parts of the body
are not the same at all periods of life; the latter dimin-
ishing from the commencement of fœtal existence till the
dust returns to dust. According to Richerand, the solids
exist in relation to the fluids as one to six-Prof. Chaus-
sier estimates them as one to nine in the adult.
Neither do the solids exist in the same proportion in
different individuals. The preponderance given to one
organ or another is one cause of the varieties of temper-
aments; and in this also consists the predisposition of
individuals to disease. Even in an individual the same
* Dunglison.
4
38
MEDICAL PHILOSOPHY.
relative proportion between the organs does not un-
interruptedly continue; but is modified, almost beyond.
belief, by diet, occupation, climate, epidemic influences,
and a variety of other causes, so that the constitution un-
dergoes almost an entire revolution.
Without adopting any scientific arrangement, it may
be sufficient to say that the fluids are divided into blood,
chyme, chyle, perspiration, tears, saliva, etc. The pro-
portion of the fluids like that of the solids varies in differ-
ent, as well as in the same persons; and this also aids
in the formation of the temperaments and in the predis-
position to disease.
SEC. II. Health and disease-in what they consist.
Health consists in a perfect harmony of all the organs
of the body, in all their acts and functions, so that each
shall be in unison with all the others. Disease consists
in the interruption of this concord-this harmonious play
of the organs; and since the human system is constantly
surrounded by so many causes which tend to its derange-
ment, there are few, comparatively, who may truly be
said to enjoy a state of perfect health. Every one,
from some particular circumstances, or from some pecu-
liar conformation of his system, may be in the possession
of that state which is health to him, but which would be
disease in one of a different constitution.
We see plainly manifested the different constitutions,
and predispositions to disease, if we observe closely the
dissimilar maladies that a single given cause may pro-
duce, when a number of individuals are subjected to
its influence. Thus twenty persons may be equally
exposed to the same extreme degree of cold; one will
MEDICAL PHILOSOPHY.
39
have an attack of acute inflammation of the lungs, a se-
cond will have pleurisy, a third inflammation of the bow-
els, a fourth inflammation of the liver; each may have
a different disease, and some may escape altogether.
Dr. Good, in his "Study of Medicine," enumerates
about four hundred and fifty diseases, or varieties of dis-
ease, that affect the human system of both sexes. When
we take into consideration the fact that it is but seldom
that one organ is alone diseased-but that others are
also involved—and when we also have in view the end-
less variety of individual peculiarities, as well as the
causes which produce and modify disease—we shall
not be surprised to find, that every case is compara-
tively a new disease. In this classification Dr. Good
does not reckon diseases that come under the head of
Surgery; so that if we take them into the account, and
bear in mind that no two accidents or injuries happen ex-
actly alike, and rightly estimate also the variously dis-
eased states of the system they involve, we must see
clearly that the multitude of ills to which the human fami-
ly is subject, is infinitely beyond our comprehension.
CHAPTER III.
ANATOMY OF THE DIGESTIVE ORGANS.
THE digestive apparatus consists of an alimentary ca-
nal, comprising the mouth, pharynx, esophagus, stomach,
and intestines. In connection with this canal, there may
be reckoned the salivary glands, the liver, and pancreas,
the fluids of which are more or less immediately con-
cerned in the process of digestion.
1. Mouth.
The parts which compose the mouth are the lips,
cheeks, palate, tongue, teeth, and salivary glands. The
form of the mouth is not always the same, but undergoes
remarkable changes from the earliest period of life to
extreme old age.
2. Salivary glands.
There are three glands about the cavity of the mouth
and lower jaw which secrete, or form, the saliva; and are
hence called the salivary glands—they are the parotid,
sub-maxillary, and sub-lingual glands.
3. Teeth.
The teeth are the hardest parts of the body, and in
their chemical character they resemble bone. They are
4*
42
MEDICAL PHILOSOPHY.
1
composed of two parts, the bony substance and the ena-
mel, and their number in an adult is thirty-two. Their
most important office is to masticate the food; and the
want of teeth, or the neglect of using them, is a very
common cause of disordered digestion.
4. Pharynx.
The pharynx is a muscular bag at the back of the
mouth, of a funnel shape; its use is to convey the mas-
ticated food into the stomach. It derives its name from
its office; its length is about four inches, and its greatest
diameter, when moderately distended, one inch.
5. Esophagus.
The esophagus is that portion of the alimentary tube
included between the pharynx and stomach. At its up-
per part it is situated behind the trachea, or windpipe ;
its diameter in its greatest dilatation does not exceed an
inch.
6. Stomach.
The stomach, with the small intestine, liver, spleen
and pancreas, comprehends the middle region of the di-
gestive system, which is the most important portion, be-
cause in it the process of digestion is performed. The
stomach is the broadest part of the alimentary canal, and
is situated at the upper part of the abdominal cavity, un-
der the left false ribs, and is included between the upper
portion of the intestines and the esophagus. The stom-
ach is a membranous sack, having the form of an elon-
gated cone, a little curved, and resembles, somewhat, a
MEDICAL PHILOSOPHY.
43
bagpipe. The stomach has two orifices; the one, the
cardiac, which admits the food, the other the pylorus, or
the pyloric orifice, through which its contents pass into
the intestines. The size of the stomach, from its possess-
ing the power of contracting and dilating, is various at
different times in the same individual, as well in health
as in disease. When not immoderately distended, in a
person of ordinary size, this organ is about ten inches in
length, and three or four in diameter.
Although the stomach is called a membranous sack, it
is composed, according to Meckel, of four distinct coats.
The first, externally, is the serous coat-so called be-
cause it secretes, or exhales, a serous, or watery fluid.
The second is the muscular, which is very strong;
and this again is composed of three distinct layers of
muscular fibres.
The third is the vascular coat, and lies internal to the
other.
The fourth is the villous coat, which is thin, soft, and
spongy; it is also called the mucous membrane, be-
cause it secretes a mucous, semi-fluid substance. This
latter membrane is continuous with the whole of the ali-
mentary canal-from the mouth to the other extremity-
though in the stomach it assumes a more villous, or vel-
vet-like appearance.
The stomach presents sexual differences; being larger,
shorter, and broader in the male; smaller, narrower,
and longer in the female. Dr. Soemering has shown
that the stomach of the negro is different from that of
the European, being of a more rounded form, approach-
ing that of the ape.
44
MEDICAL PHILOSOPHY.
7. Valve of the Pylorus.
At the pylorus is situated a valve, formed by the fold-
ing in of the membranes, which closes this orifice during
digestion, and performs the office of Janitor or door-
keeper; for it allows the food in the stomach to pass,
through in proportion as it is digested.
8. Small Intestine.
The small intestine is divided into duodenum, jejunum,
and ileum, and is the narrowest portion of the alimenta-
ry canal. It is included between the stomach and large
intestine, and is uninterruptedly continuous with both al-
though separated by two valvular folds.
The commencement of the small intestine is called
the duodenum, and sometimes the second stomach, and
is situated in the right half of the abdomen.
9. Functions of the small Intestines.
"The inner membrane of the small intestine secretes
the intestinal mucous, and intestinal liquid, which proba-
bly form one and the same fluid. In passing through
the small intestines, but particularly through the duo-
denum, and from the influence of bile, aided by the
pancreatic juice, the chyme is separated into two por-
tions, the chyle a whitish fluid, similar in its chemical
properties to the blood, and the fecal matter. The chyle,
which is the food now digested and fitted for nutrition, is
absorbed and carried into the blood, and with that trans-
mitted to all parts of the system.”
10. Large Intestine.
The large differs from the small intestine in form,
MEDICAL PHILOSOPHY.
45
situation, attachments, etc. Its functions are similar
to those of the small intestine, and its different por-
tions are known by the names of coecum, colon, and rec-
tum.
11. Liver.
The liver is the largest gland in the body, and is situ-
ated chiefly in the right side directly under, sometimes
projecting below, the short ribs; in females it extends fur-
ther to the left side than in males. The transverse diame-
ter of the liver is from ten to twelve inches, and in the adult
it weighs about four pounds, so that its weight may be es-
timated as one thirty-sixth part of the whole body, and
in young children its relative weight is much greater.
The function of the liver is the secretion of bile. The
gall-bladder is situated in a depression on the lower face
of the liver.
12. Pancreas.
The pancreas is the largest of the salivary glands. It
is six inches long, and one inch thick; and is situated
transversely at the upper part of the abdominal cavity
behind the stomach.
13. Spleen.
The spleen is situated in the left of the abdominal
cavity, behind the large end of the stomach. It is gen-
erally about four inches long, three broad, and a little
less than one thick.
Besides the above organs there are situated in the ab-
domen the kidneys, bladder, and in females, the impor-
46
MEDICAL PHILOSOPHY.
tant organs peculiar to their sex. All these, from the
difference of function they are designed to perform in the
animal economy, are of different organization, the tis
sue of each being peculiar to itself.
CHAPTER IV.
DISEASES OF THE DIGESTIVE ORGANS.
It
DR. Good enumerates one hundred and forty-seven
varieties of diseases that affect the digestive organs.
is but seldom that one of these affections appears alone,
and under its own peculiar, distinctive, features; for all
parts of the digestive apparatus being closely associated
by nervous communication, it so happens that when one
important organ is diseased, others are also involved by
sympathy. Age so modifies the same variety of disease.
that it presents a different aspect in childhood from that
which it exhibits in middle life, or in one still more advan-
ced in years. Temperament also varies the disease; and
the maladies that affect the digestive organs, as well as
those of other parts of the system, are all modified, or
more or less changed in their appearance and nature, by
climate, season, locality, occupation, habit, sex, and by
the multiplicity of circumstances with which man is sur-
rounded.
.A
The causes of disease are as various as the circum-
stances which modify and change its aspect; and among
the most prominent of those which induce affections of
the digestive organs may be reckoned, exposure to cold
and wet in any manner, improprieties in diet, both as re-
gards quantity and quality, eating at irregular and unsea-
48
MEDICAL PHILOSOPHY.
sonable hours, imperfect mastication, passions and affec-
tions of the mind, fatigue, and other influences equally
injurious. The multiplicity, and varied forms, of the dis-
eases in question, have been well established by the ef
fect of medical treatment, observations upon the living,
and, more than all, by examinations of the dead.
SEC. 1. Medical Treatment. When disease, from a
multiplicity of causes, and the influence of circumstances,
assumes an alınost endless variety of forms, it need be no
matter of wonder that the healing art has not yet arrived
at that perfection where we can say to it, "thus far
shalt thou go and no farther, and here shall thy ravages
be stayed." More, probably, has been learned during
the last quarter of a century towards increasing our skill
in the treatment of diseases affecting the organs of diges-
tion, than was known before; but this, with all previous.
knowledge, is not yet sufficient to cure all cases that fall
into the hands of the most enlightened physician. The
great variety of forms under which diseases of those
organs concerned in digestion appear, the different plans
of treatment absolutely necessary to effect a cure, and
sundry other causes, have led to empiricism and imposi-
tion, shameless and disgraceful in the extreme-equally
so in those who practise it, and in those who offer them-
selves victims to the imposture and quackery.
When speaking of empirical or quack remedies, nos-
trums, etc., we mean those secret remedies or drugs which
are sold as certain cures and specifics for all manner of
disease or for any certain class of ills that" flesh is
heir to." It is quite unnecessary for our present pur-
pose to enumerate the thousands of articles that are
MEDICAL PHILOSOPHY.
49
.
known, puffed, and swallowed, as quack medicines; but
they may be, all, each in its own kind, found in one of
the following classes; to wit-Cathartics-or those which
produce purging; Emetics-those which cause vomiting;
Tonics-Sudorifics-Alteratives.
1. Cathartics are those medicines which increase the
evacuations from the bowels downwards. They pro-
duce their effect in two ways: first, by increasing the
secretions from the inner surface of the bowels; and
2d, by increasing the vermicular or worm-like motion of
the bowels from above downward. This motion consists
in a contraction of the circular fibres of the intestines,
commencing at their upper portion and progressively ex-
tending itself to the lower extremity; and it is this inor-
dinate contraction that is commonly called griping,
often experienced after taking an active cathartic, and
which in other cases is called colic.
Under the head of cathartics are classed laxatives,
whose nature and effects are in no respect different from
the former, save in the degree of violence with which
they operate-the latter being much the less active.
The activity of carthartics is believed to depend very
materially upon their solubility in the alimentary canal;
some being dissolved in the stomach and affecting the
whole length of the intestines in their passage through,
while others remain undissolved till a short distance be-
fore their reaching the lower extremity of the canal. A
knowledge of this important fact is indispensable in mak-
ing a judicious prescription; and ignorance in regard
to it may lead to the most disastrous and fatal results.
5
50
MEDICAL PHILOSOPHY,
Carthartics are obtained from both the vegetable and
mineral kingdoms; and although popular credulity has
been abused by being made to believe that the former are
always safely taken, and the latter are always hurtful and
dangerous, we shall at present make no distinction between
them. In another place the comparative merits of vege-
table and mineral medicines shall receive due attention.
As the alimentary canal has been, not inaptly, styled
the "store-house of diseases," so it has been made the
magazine and receptacle of all manner of remedies for
their cure.
And because cathartics may be as useful as
any one class of remedies they have been employed in
the hands of the designing, unskilful, and ignorant, as the
only curative means for all diseases, however opposite
their characters. The quack remedies that are sold
at all the shops, puffed in the papers, and taken
by all whose credulity is equal to the impudence and
ignorance of the empiric-all the multitude of "pills,"
detergents," "deobstruents," " purifiers of the blood,”
are similar in their effects, and all belong to the class of
medicines under consideration.
66
The history of one of these celebrated nostrums is
curious; and as it is interesting, it shall be given to the
reader. An individual, who for the present shall be Mr.
A., had by his extravagance and inattention to business,
become reduced from competence to a state bordering
upon poverty. After trying various resources, and ex-
pedients, to regain his lost position, without success, one
of his boon companions with whom he was conversing in
regard to his condition, suggested as a dernier resort, he
might become a Doctor, as he called it. " A Doctor?”
!
MEDICAL PHILOSOPHY.
51
:
says Mr. A. "Why yes," says B. "A Doctor, to be
sure—is there any thing wonderful in that ?”
“There would be something wonderful in my being
a Doctor-what do I know about medicine ?"
"And what do you need to know about it? I hope you
don't think it necessary to study, or to know any thing,
to make money by selling pills. I'll just explain to you
what I mean. Invent some sort of pill that will be
good physic, get some handbills struck off, go to adver-
tising, and depend upon it you can't fail to grow rich.”
"The thought is a good one," says Mr. A. "But then
how can I invent a pill-and then who will be the first
to take it ?"
66
Why, go to Dr. Hartshorn and tell him you want a
prescription for the most active pills he can give you ;
and as for taking it, I can do that myself. There is anoth-
er thing necessary—you must get certificates of cures to
be published and circulated far and wide."
66
Well, suppose nobody gets cured; what then is to
be done?"
"Trust me for that, I'll be outrageously sick; and I
can hire Sam Jones, and Bill Johnson, to be half dead
for six months, and cured in three days with your medi-
cines; and their certificates will be as good as any other
person's to start with. Besides, if they are not sufficient,
I can get thirty more in a fortnight's time."
C6
Suppose people are foolish enough to take the pills
and get killed instead of cured, what am I to do in that
case?"
(6
Nothing; only say they didn't take enough-that
the disease had existed so long that it was incurable, or
52
MEDICAL PHILOSOPHY.
tell some other story to suit circumstances. On the whole,
think we had better enter into partnership; you shall
superintend the manufacture of the article and all in-
door concerns; I will see to the printing, puffing, and
selling, appointing agencies and other matters requiring
attention."
66
The bargain between these two worthies was accord-
ingly struck. Mr. A. obtained a prescription from Dr.
Hartshorn, and on the same night his friend, able coun-
sellor, and now valuable partner, was taken suddenly
and violently ill, agreeably to his promise. Doctor A.
was sent for, administered his medicine, and wrought a
wonderful cure. Sam Jones and Bill Johnson were both,
at a premium of five dollars each, as sick as men need
be; they took the medicine, were speedily cured, and
certified that they had been ill many months, had been
under the care of the most skilful Physicians, and
given up," and one box of Dr. A's pills effected a res-
toration to perfect health. The newspapers were soon
filled with Dr. A's advertisements, and certificates of
cures; his pills were sold in all parts of the country, and
sought after and greedily swallowed by invalids of all
ages, classes, and descriptions. The learned Doctor and
his wily associate prospered beyond their most sanguine
expectations. In two years they set up their coaches
and lived at an expense of ten thousand a year, and now,
scarcely six years from their commencing practice, they
count their half million each. A large establishment has
been erected where the pills are manufactured by steam,
and half of the population of the Northern States have
been physicked by Dr. Hartshorn's pills; while the pro-
*
1
MEDICAL PHILOSOPHY.
53
prietors laugh at the blind credulity of those at whose
expense they have been made wealthy.
If the history of the quack medicines, so much in
vogue at the present day, could be accurately ascer-
tained, there is little doubt that a tale, similar to the above,
could be told of nearly all.
It is an indisputable fact that, in this city, and the same
is probably true of other cities in the United States,
a great majority, if not four fifths of the Quacks are of
foreign origin; writing after their names, "Graduated
at Edinburgh," "having studied at Glasgow," "recent-
ly from Paris," "Licentiate of the Royal College at
London," "of the University of Halle ;" but many, we
believe, might with more propriety be dubbed renegades
from Botany Bay, or Graduates of Old Bailey. We mean
this as no reproach to worthy foreigners, or to the medi-
cal institutions of Europe; our object being merely to
state the fact, for the sake of showing that Quackery is
more prevalent in Europe than on this side of the Atlan-
tic, and that it finds an easy prey in the republicans of
North America. It is difficult to decide which affords
the most fit subject for our astonishment, the unblushing
impudence of the empiric, or the downright stupidity, or
as it is sometimes called, gullibility, of those who take
his nostrums. People who claim to have common sense,
and who manifest it on most other occasions, men who
are educated and enlightened, and who feel as though
they occupy no small space in society, and wield no little
influence over their fellow men, are quite as prone to fol-
low in the wake of some notorious quack, and to sing
hosannas to his name, as those of less pretensions.
5*
54
MEDICAL PHILOSOPHY.
It may also be questioned which should be deemed
most instrumental in the spread and propagation of
Quackery, and who should be considered most culpable
for its ill effects in Society-Quacks themselves, or those
who, by eagerly taking their medicines, afford en-
couragement to their predatory operations. So eager
are some to patronize empiricism, that the most palpable
absurdities are received as gospel truths, and the asser-
tions and dogmas of a nostrum-vender have as great
weight as the most self evident facts. Why it is that an
unlettered, unprincipled charlatan, one who makes his
ignorance his boast, and who prides himself upon his
unblushing effrontery and impudence, should receive the
countenance and support of those who claim to be first
and foremost in society is not easily accounted for.
Generally, however, ignorance and assurance accom-
pany each other, and in an equal proportion; while
modesty and doubt attend extensive knowledge, espe-
cially in a science so uncertain as that of medicine.
Thus the mind is compelled to yield credence to state-
ments, facts and promises, that could emanate only from
one incapable of distinguishing truth from error, or from
one whose design is to deceive, cheat, and make vic-
tims of, his fellow men.
We do not say that cathartic remedies, empirically ad-
ministered, always produce injurious results; but as there
are many of the diseases of the digestive organs that are
aggravated by irritating their lining membrane, it follows,
therefore, that purgatives, being irritants, are in all such
cases decidedly improper. Diseases that are bene-
fitted by cathartics judiciously prescribed, are by their
MEDICAL PHILOSOPHY.
55
exclusive employment, made to assume a more for-
midable appearance, or rendered absolutely incurable.
This is more particularly the case with regard to
those chronic, troublesome affections, known by the
name of dyspepsy, indigestion, bilious complaints, and
other terms equally vague and unmeaning. Maladies
of this class are characterized by an almost number-
less train of distressing symptoms; and so unhappy
and perfectly wretched do they render their victims
that they eagerly seize upon any means that afford
the most distant prospect of relief, and that too, with-
out calculating the chances, or ever dreaming of a
possibility, of being made worse.
In a large proportion, if not in a majority of the dis-
eases to which the digestive organs are subject, the mu-
cous lining membrane will be found to be the seat of the
malady; and the disease itself is found by examinations
after death to consist in a greater or less degree of in-
flammation.
Inflammation of the mucous membrane of the stomach,
is characterized in most cases by tenderness directly at
the bottom of the breast bone, extending over a space,
about equal to the size of a dollar. The degree of
pain caused by pressure in this region, is in propor-
tion to the degree of inflammation. Sometimes an individ-
ual thus affected is compelled to wear the dress inordi-
nately loose, and when gentle pressure is made with the
points of the fingers he experiences the most acute pain.
Whoever is thus afflicted may rest assured that his dis-
ease will be aggravated by a frequent repetition of
active purgatives.
56
MEDICAL PHILOSOPHY.
..
It is not the design of the Author to enter minutely
into the details of diseases, to give minutely a history of
their symptoms and method of cure; but to expose more
briefly than he could thus do the fallacy of the notion
that leads to the empirical and exclusive administration
of cathartics.
It is an unquestionable fact that cathartic remedies
produce their effect in two ways only, as has been be-
fore stated; first, by an increase of the secretions, or the
natural fluids that are found in the cavity of the alimen-
tary canal. These secretions, like those of all other or-
gans, are supplied by the blood; and whenever they are
increased in quantity the supply of blood to the part is
increased in an equal ratio. Thus the supply is con-
stantly proportioned to the demand occasioned by an
irritating purgative. If, then, the mucous membrane be
inflamed, purgatives only add to the flame already exist-
ing. The lining of the stomach and bowels in this case,
is in a state resembling exactly an inflamed eye, where
there is more or less pain and an increased secretion of
Any person of the least observation would per-
ceive at once, the injury likely to result from the appli-
cation of an acrid, irritating substance for the sake of in-
creasing still further the secretion of tears; and so any
man, who knows the effect of remedies, would see in
prospect the mischief likely to result from repeated
purging, after the bowels are once cleared of irritative
matters. The bad effects of active cathartics do not end
here nor do the ill effects of improper remedies to an
inflamed eye cease with the increased flow of tears—in
the latter case the eye is not unfrequently disorganized,
tears.
1
MEDICAL PHILOSOPHY.
57
and the sight lost forever. In the former, change of
structure is also the result, with sometimes ulceration
that ends in a perforation of the intestine, causing imme-
diate death.
Another effect is occasionally produced by active
cathartics when the bowels are in an irritable or in-
flamed condition. And that is the rupture of one or
'more blood vessels, allowing a quantity of blood to es-
cape that has proved fatal. A lady in this city, not
'long since, who had been for some time affected with
deranged digestion, was induced to take the pills of a
notorious Quack, who is accumulating his thousands by
preying upon and leading captive silly women. These
pills are represented by certificates, either forged or
genuine, to be a certain and sovereign cure for all the
ills and ailments that ever escaped from the box of Pan-
dora. One dose was taken without any beneficial re-
sult, then another, and soon the contents of a box had
disappeared in like manner. The man, self-dubbed
Doctor, told her to take another box, as the first had only
prepared the system for a final cure. A second box
was paid for, which shared the fate of the first. Not-
withstanding the patient had been reduced from tolerable
health and strength to an extreme degree of emaciation
and debility, a third box was as strongly recommended
as the others had been, which, after some remonstrance,
the invalid reluctantly carried home. After a severe
and long continued operation from the first dose, there
ensued a bleeding from the bowels which threatened to
prove speedily fatal; but being in a neighborhood where
medical assistance was promptly and speedily rendered,
58
MEDICAL PHILOSOPHY.
t
the bleeding was for a time suppressed; although it fre-
quently recurred, with diminished violence, for several
succeeding months.
In another instance, where diarrhea had existed for
some time, a single dose of the same medicine resulted
in a similar alarming occurrence.
There is one other important fact that should be borne
in mind by all the lovers of "powerful physic"-and
that is, that oftentimes each successive dose must be
greater than the one preceding. So that after a long
course of purging, five, or ten times as much medicine
is required as was necessary at first. It is unnecessary
to explain why so many different effects are produced
by the same cause; or in other words, why there shall
result from a repetition of cathartics in one case, diar-
rhea, in another, ulceration, and in a third obstinate
constipation. It is sufficient for our present purpose to
know that these results, and many others, do ensue.
In a former page it is stated that the external coat of
the alimentary canal is termed the serous, perform-
ing different functions from the inner mucous coat. This
coat is also affected somewhat differently from the inner
one as well by inflammation, as by the action of reme-
dies. When the former is affected with inflammation,
motion, by whatever means it is caused, produces the
most exquisite pain.
The second manner in which cathartics operate is by
increasing the contractions of the intestines from above
downwards; and this, technically called, peristaltic, or
vermicular action of the bowels causes one, suffering
under acute inflammation of the serous coat of the in-
MEDICAL PHILOSOPHY.
59
J
testines, to cry out with anguish. It is a spasmodic con-
traction of some portion of the bowels which occasions
the severe pains in colic, and the same griping and
sensation of twisting of the intestines, is induced when
their external coat is in a state of inflammation. The
disease is thus aggravated by every active cathartic,
and even when the external coat is in a healthy state,
disease is often induced in it, and propagated to it from
the internal coat, by the unwise, excessive administration
of purgative remedies.
We have seen that the digestive system consists in a
number of organs, grouped together and complicated in
such a manner, that for the performance of their destin-
ed functions, they are more or less dependant upon each
other. Thus the action of the bowels cannot be duly
and healthily performed without the concurrence of the
liver; and this latter organ is deranged when the former
are suffering under disease. One common effect, never
dreamed of by wholesale dealers in physic, is the ease
with which inflammation is propagated through the whole
extent of one organ, or from one organ to the adjacent,
which are connected by a continuous membrane. The
duct which conveys the bile from the liver into the in-
testines is lined with a prolongation, or extension of the
same membrane, which lines the latter organs; or if the
membrane is not precisely the same, it is similar both in
structure and function. Thus it is that when any por-
tion of the mucous, as well as the serous coat of the in-
testines, is inflamed, the inflammation is liable to extend,
as it often does, throughout their whole extent. And
the lining of the biliary duct, being continuous with that
V
60
MEDICAL PHILOSOPHY.
of the intestines, is generally diseased when the latter is
so where the duct enters it. The membrane lining the
duct, is again extended and ramified in the substance of
the liver, so that this organ becomes greatly deranged
in function, and permanently remains so after the
primary disease in the intestine shall have subsided.
But this mischief does not stop here. The bowels, re-
ceiving from the liver, bile of a depraved character, or too
much, or too little in quantity, cannot perform their
healthy functions; and the very thing that caused the
evil is again administered with a view to effect a cure.
Fuel is only added to the flame; and the more the use
of purgatives is persevered in, the more is the disease
aggravated, and the greater seems to be the need of their
employment, till the poor patient is physicked out of ex-
istence.
It must not be understood, from the preceding obser-
vations, that the most active cathartic medicines are
always hurtful, or improper, when administered by a
judicious and skilful hand. But we have no more rea-
son to believe that remedies of this class, indiscriminate-
ly administered by any one, much less by him to whom
all knowledge of the human system is as a riddle, are
adapted to all diseases, than we have to believe that the
same garment will fit, indiscriminately, all the inhabi-
tants of the city of New York. Neither is it true that
medicines vended by Quacks, do, in all cases, prove
injurious; but on the contrary, they are sometimes pro-
ductive of the best effects. Such cases, however, are
only those where medicines of this character are indi-
cated; and strange, indeed, it must be, if a successful
MEDICAL PHILOSOPHY.
61
application is not now and then made. Although, even
here, the good that is done is not attributable to the spe-
cific virtue of any particular nostrum, for the same result
would most likely have occurred if any other medicine
of the same nature, had been administered. There are
few, indeed, if any, cases of disease in which it is not
proper, and indispensably necessary to administer reme-
dies that evacuate the bowels; but to accomplish this, it
is by no means expedient to resort to the pretended and
secret inventions of Quacks. Any of the common arti-
cles known to every person over ten years of age,
rhubarb, or castor oil for instance, produce their effect
with the utmost safety and gentleness, and are equal in
efficacy to the most active combination of purgatives
ever invented by the most notorious Quack.
An empiric of the first water, not many years ago,
had made himself famous for the cure of all human mala-
dies, by the administration of peculiarly large pills of his
own invention. What contributed not a little to the in-
crease and spread of his reputation was the fact, that he
used frequently to tell his patients, that, from their symp-
toms, he was confident some particular substances were
lodged in a portion of the alimentary canal. At one time
he would tell a patient that he had apple seeds retained
in his bowels; and again he would tell another, that he had
kernels of different fruits, and grains, in his stomach, and
if by questioning gentlemen he could ascertain that they
were fond of shooting, it was not seldom that he attribut-
ed their complaints to having accidentally swallowed a
few shot. As nothing could so conclusively prove his
prognostics correct, as the simple fact of finding the arti-
6
62
MEDICAL PHILOSOPHY.
cles named, so the old gentlemen's character for wisdom
and skill became more and more firmly established; for
the identical causes of mischief were invariably dis-
covered after taking a dose of the "big pills." At
length, a lady of the first respectability, having suffered
a long time from deranged digestion, applied to the cele-
brated doctor for assistance. After a few questions, he
told her very promptly that he understood her complaint,
that he knew what ailed her, and more than all that, her
doctor was a fool, and assured her that his big pills would
effect a cure. Neither of these assertions she exactly
credited, but nevertheless, concluded to try his remedy
if he would make known to her the complaint. "Why,"
says he, "you have got lemon seeds in you—you must
take some of my big pills and get rid of them, and
you'll be perfectly well again." "Why, Doctor," said
the lady in amazement, "I have not eaten a lemon for
six years; and what you say is altogether impossible."
"No matter, madam, if you have not eaten a lemon
for twenty years, the fact is just as I tell you, and if you
will take the pills you can be satisfied of it."
The pills were taken, and to the utter astonishment of
the patient, the lemon seeds were found; a second dose
was taken and still more seeds made their appearance.
A thought now flashed upon the lady's mind. One pill
was yet left which she examined, and behold! a lemon
seed in its centre-the secret, truly, of the Doctor's as-
tonishing wisdom, and successful practice.
2. Emetics. Emetics are those substances which pro-
duce vomiting from some specific property they possess,
independently of any unpleasant taste or smell. There
MEDICAL PHILOSOPHY.
63
is no danger that any thing, short of the most perfect in-
fatuation, will ever render medicines of this class of so
general employment in the hands of Quacks, as those to
which we have previously given our attention. Their
operation is attended with such distressing, and not un-
frequently alarming sickness, that few comparatively
can be induced to submit to this practice; and thus the
speculation is generally unprofitable to the empiric who
is so bold as to engage in it.
No article can produce vomiting but such as causes
an irritation of the stomach, and most substances that
do so, like the active cathartics, possess acrid, stimula-
ting properties. In gastric affections where digestion is
deranged, there is often experienced a sensation of dis-
tension, or of a load at the pit of the stomach; and an
attempt is made to remove this load, as it is called, by
an emetic. To the surprise however, of the suffering
party, nothing is vomited but a small quantity of mucous,
watery fluid, quite inadequate to account for the previous
symptoms, and accordingly another emetic is administer-
ed, but with no better effect. The relief afforded in
such cases, if there be any, is merely temporary; and
there is soon the same necessity for a repetition of the
medicine as there was at first.
The sensation of a load in the stomach at such times
is not caused by any quantity of matter, but is the sole
result of the diseased membrane lining its internal cavity,
giving a sensation which is purely deceptive, and when
relief is afforded by an emetic it is because the diseased
action is temporarily changed or superseded. But even
a temporary remission is not always procured, the dis
64
MEDICAL PHILOSOPHY.
کو
ease, being immediately and permanently, and often in-
curably, aggravated. At the commencement of an illness,
before it assumes any regular and tangible form,
when the nicest judgment is requisite in the choice and
administration of remedies, much evil is done by the
use of emetics; and what physician is there who has not
found some of his most obstinate cases induced by the
injudicious or empirical employment of emetics?
An individual, after unusual fatigue, or exposure to
wet, or cold, night air, or any other cause sufficient to
derange the health, complains of lassitude, more or less
headache and chilliness, loss of appetite, nausea, tender-
ness at the pit of the stomach on pressure, pain in the
back and loins, and other symptoms that generally usher
in a febrile attack. An emetic is now administered with-
out affording the anticipated relief, but is followed by an
obvious aggravation of all the preceding symptoms; the
remedy is perhaps repeated, with a still more decidedly
bad and unhappy result. The ultimate effect in this case
is inflammation of the stomach, which, by proper treat-
ment, might, with great certainty, have been prevented.
Such is not always the effect of an emetic; but it is so
often so, that remedies of this nature ought never to be
administered without the utmost caution and circumspec-
tion. And who shall be the person to prescribe them;
one who has made medicine his study, one who has de-
voted years to the investigation of the diseased and
healthy condition of his species, or one who boasts of his
ignorance, and treats all knowledge and science with
contempt ?
When bile is vomited with violent retching towards
MEDICAL PHILOSOPHY.
65
the latter part of the operation of an emetic, it is con-
sidered as proof postive, equivalent to actual demonstra-
tion, that the remedy was the very thing needful. The
previous unpleasant symptoms are then attributed to the
presence of bile in the stomach, and when they recur, as
they often do, the medicine is repeated. The theory
and practice in such cases are equally erroneous, and
are followed by disagreeable consequences; but the
truth may be explained in few words, and most easily
comprehended. The lower orifice of the stomach, that
which opens into the upper portion of the intestine, and
the orifice of the duct which conveys the bile into the
same portion of intestine, are but a few inches distant
from each other. In vomiting, the peristaltic action of
the stomach is inverted, the motion being from below up-
ward; and sometimes this inverted order of action is
communicated to the whole length of the alimentary
canal. In less severe cases however this action is only
communicated to that part of the intestine more imme-
diately connected with the stomach-that part into which
the biliary duct enters and deposites its contents. When,
therefore, this portion of the bowel acts in sympathy with
the stomach, whatever quantity of bile is poured into it
must be evacuated upward instead of downward. And
farther, the action of vomiting, if it does not actually in-
crease the secretion of bile, nevertheless assists in dis-
charging it from the liver and gall-bladder. And thus its
flow is temporarily greatly augmented, and being evacu-
ated by the mouth, confirms the previous predictions of
those who knew no better, that bile had accumulated in
the stomach which it was necessary to dislodge.
6*
66
MEDICAL PHILOSOPHY.
or.
In persons of plethoric, or full habit, there is great
danger in the administration of emetics. Individuals of
this description are generally of the sanguine tempera-
ment, prone to hemorrhages and inflammatory diseases;
and as the violent spasmodic actions in the efforts to
vomit cause a determination of blood to some
gan, the rupture of a blood vessel may be produc-
ed, or the engorgement may continue after the vomit-
ing has ceased, and terminate in a more or less active
inflammation. Apoplexy is thus caused; blood being
effused into the substance of the brain by the rupture of a
vessel and from this cause have occurred alarming
bleedings from the lungs, stomach, and other of the vis-
cera.
There is, generally, more or less of headache in most
cases where empirics think proper to use their favorite
remedy; and in cases where the head is affected, the
danger is infinitely magnified.
Again, there are those of such peculiar constitution,
and they are by no means rarely met with, in whom an
emetic occasions more or less general convulsions, ex-
treme prostration, or something still more alarming. In
some a small dose of a given medicine will occasion
effects tenfold as great as in others; thus, in one, a fourth
part of a grain of tartar emetic will produce excessive
vomiting, while another would require five or six grains
to produce nausea. So different are constitutions, even
in members of the same family, that of two brothers with
whom the author is acquainted, one is readily vomited
with the sixteenth of a grain of tartar emetic, and the
other has taken four ordinary doses, in immediate suc-
1
MEDICAL PHILOSOPHY.
67
cession, without having experienced the slightest degree
of nausea. So peculiar is the latter brother in this res-
pect, that his stomach has always resisted every attempt
to excite vomiting, and at no time in his life does he
remember to have had it nauseated. In a stomach like
this, where medicine is administered by an empiric with
a view to excite vomiting, it is most probable that in-
flammation would ensue before he would have attained
his end.
Besides the vomiting caused by articles of this class,
there is yet another effect upon the bowels; and that is
their operation as cathartics. This is not universal;
although it is generally produced by most medicines of
this class. And when there is a predisposition of the
bowels to be easily affected, there is often induced a
diarrhea and diseased condition of the intestines that is
not easily subdued.
Again, in some cases where emetics have been
frequently repeated, an effect is produced upon the
stomach totally different from that produced in the bow-
els by cathartics; and that is the facility with which
vomiting is produced. Thus, one who has been in the
habit of taking cathartics will find, after a time, that the
dose must be doubled, quadrupled, or increased still
further, to produce the desired effect; but one who has
been in the habit of taking emetics will find that the ori-
ginal dose must be reduced in proportion to the frequen-
cy of the repetition of the medicine. In the former case
the susceptibility to the impression of medicine is dimin-
ished; in the latter it is increased.
Lobelia Inflata, commonly known by the name of
68
MEDICAL PHILOSOPHY.
Indian tobacco, is the only article that has of late done
much mischief as an emetic in the hands of Quacks. It
is one of the most powerful vegetable poisons, and de-
signing, ignorant impostures have succeeded in inspiring
many with confidence in its efficacy as a remedial agent,
and in its applicability to all varieties of disease. Phy-
sicians have universally rejected it as too powerful to be
used as an emetic in general practice. Doubtless,
Quacks have sometimes done good with this, but the
good has been in no proportion to the evil; and the same
is unquestionably true of all their nostrums.
The United States Dispensatory, a good authority as
exists in any language, thus discourses of lobelia :
"The leaves or capsules when chewed for a short
time, occasion giddiness, headache, general tremors, and
ultimately nausea and vomiting. When swallowed in
the full dose, the medicine produces speedy and severe
vomiting, attended with continued and distressing nausea,
copious sweating, and great general relaxation. Its
effects in doses too large, or too frequently repeated, are
extreme prostration, great anxiety, and distress, and ulti-
mately death, preceded by convulsions. Fatal results
have been experienced from its empirical use. These
are more apt to occur where the poison, as sometimes
happens, is not rejected by vomiting. In its operation
upon the system, therefore, as well as in its sensible
properties, lobelia bears a close resemblance to tobacco.
As an emetic, it is too powerful, and too distressing as
well as hazardous in its operation for ordinary use."
The following example of the ignorance and wicked-
ness of those who are most fond of prescribing lobelia is
`taken from Beck's "Medical Jurisprudence."
MEDICAL PHILOSOPHY.
69
"A melancholy instance of death occasioned by the
use of this plant in the hands of a Quack is detailed in
the sixth volume of the Massachusetts Reports, in the
trial of Samuel Thompson, an empiric practising in
Beverly, for the murder of Ezra Lovett. In this trial, it
appeared that the patient, being confined by a cold, sent
for the pretended physician, who gave him three powders
of lobelia in the course of half an hour, each of which
vomited him violently, and left him in a great perspira-
tion during the night. The next day two more powders
were administered, each of which operated by vomiting,
and occasioned great distress. In like manner two
other powders were given the subsequent day, leaving
the patient in a state of great prostration. Several days
after this the physician (?) came again, and finding his
patient still worse, administered several more powders,
which occasioned great distress, and at length ceased to
operate. Finding that the stomach was not sensible to
the emetic effect of the lobelia, the physician (?) repeat-
ed the dose, and when the patient complained of great
distress at the breast, and said he was dying, the doc-
tor (?) assured him the medicine would soon get down,
or operate as a cathartic. However, on the same
evening, the patient lost his reason, and became convul-
sed, so that two men were required to hold him. To re-
lieve which, the doctor forced down two more of his
powders, and the patient, as was expected, grew worse,
and continued so until he expired,
"The doctor, who had thus terminated the disease and
the patient at once, was arrested and put upon trial for
murder. But the homicide proving a legitimate one,
70
MEDICAL PHILOSOPHY.
4
from the want of a sufficient evidence of malice pre-
pense, he was acquitted and set at liberty.'
""*
The empiric Thompson either did, or did not, cause
this man's death; and the bare narration of facts speaks
trumpet-tongued in the affirmative. It is, indeed, a self-
evident proposition that admits of no argument, or no
proof. If Thompson then actually caused the man's
death, if he is not legally, he is at least morally, guilty
of murder. If he knew the legitimate effect of the medi-
cine when administered in too large doses, he ought to
have been held amenable to the laws; for we conceive
that there can be but little difference in the degree of
guilt attached to two acts, when in one, evil is designed,
and, in the other, it is known that evil will certainly result.
If Thompson did not know the effect of his medicine,
then he erred either through ignorance, or derangement
of intellect. If from the former, he knew less than his
fellow men in general. For it is the common under-
standing that Indian tobacco is a deadly poison; and
society-the sovereign people, the makers of laws—owe
it to themselves, to their safety, to provide enactments
making it penal for such men thus to sacrifice life. If it
was from mental derangement, then the same power
should provide a residence for such characters in some
comfortable asylum for the insane, or effect a cure of
the malady by administering their own medicine.
3. Sudorifics. Before entering upon the consideration.
of Sudorifics, it is expedient to premise a few observa-
tions in regard to the functions of the skin.
Bigelow's American Botany, Vol. I. p. 131. Tyng's Massa-
chusetts Reps. Vol. VI. p. 134. Commonwealth vs. Thompson.
MEDICAL PHILOSOPHY.
71
The whole surface of the skin has been estimated to
contain from thirteen to eighteen square feet; but the
general opinion seems to be that it amounts to sixteen
square feet. From its whole surface, though much
more from some parts than others, there is constantly
exhaled a watery vapour. When this passes off in-
sensibly it is called insensible perspiration; but when it
is not evaporated, or when it is so condensed as to form
a fluid, it is called sweat. The quantity of perspiration
varies according to the difference of climate, season,
occupation, diet, state of the atmosphere as regards hu-
midity, and sundry other circumstances; it is indeed as
various as the evaporation of water from the surface of
the earth.
Many experiments have been instituted with a view
to ascertain the exact quantity of perspiration from a
healthy individual; but so constantly variable is it that
approximations to the truth have only been made.
The indefatigable Sanctorius, for a space of thirty
years, weighed all his food and drinks, and all the evacu-
ations from the body, with a view to ascertain the quan-
tity of pulmonary and cutaneous exhalation. We may
contrast the patient investigation of this physiologist with
the management of empirics both in and out of the pro-
fession; the object of the former being knowledge, that
of the latter, money.
Rye, who made his experiments at Cork in latitude
51° 54′, found the daily average estimate of perspiration
as follows, for the different seasons.
Winter,
Spring,
53 Ounces.
60
66
72
MEDICAL PHILOSOPHY.
M
Summer,
Autumn,
63 ounces.
50
Thus making the daily average of perspiration through-
out the year to be 56 ounces-or three and a half pints.
Keil makes the average daily perspiration thirty one
ounces. His experiments were made at Northampton,
England, lat. 52° 11′.
Hartmann, when the solid and liquid food and drinks
amounted to eighty ounces, found the perspirable matter
forty five, or forty six ounces. Von Gorter, in Holland,
where the food and drink amounted to ninety one ounces,
found the perspiration to amount to forty nine ounces.
Dodart, in France, estimates the average daily per-
spiration at thirty three ounces and two drachms; and
Sauvages, in the south of France, found that when the
aliment was sixty ounces, the perspiration amounted to
thirty three ounces.
Haller constructed the following table showing the
amount of perspiration for each month daily in the year,
in ounces.
December,
January,
February,
•
42
39
37
March,
April,
May,
43
47
58
June,
71
July,
86
August,
70
September,
77
October,
40
November,
40
MEDICAL PHILOSOPHY.
73
After Haller, no experiments were made to ascertain
the amount of perspiration till Lavoisier and Seguin
instituted theirs, the most celebrated of all preceding.
But one only, of the interesting conclusions to which they
arrived need be given in this place, to wit: from the
average of all the experiments, it seems, that the insen-
sible perspiration amounts to eleven grains per minute,
equivalent to thirty-three ounces, or a little over two
pints, in the twenty-four hours.*
Sudorifics, perspiratives, or diaphoretics, are those
substances which increase the quantity of exhalation
by the skin. The articles which produce this effect
are numerous, and of greatly diversified character, from
the most active stimulant to those whose operation is di-
rectly the reverse. Some medicines produce perspiration
by relaxing, and debilitating the general strength of the
system, some by simply refrigerating properties, and
others again by the heat they communicate when either
externally or internally applied.
The system is not, at all times, in a condition to be
beneficially affected by the same remedy; on one day
suffering under great febrile excitement, and on another,
laboring under a severe chill. When the former of
these two states is present, nothing is more of a popular
remedy than hot sling, or hot herb tea; and the same
remedies are also administered when the system is in an
opposite state—when the skin is cold and the hands and
feet are cold also. But the consideration of the propriety
* See Prof. Dunglinson's Physiology for much that is inter-
esting in relation to this subject.
ļ
17
74
MEDICAL PHILOSOPHY.
of this practice we propose to defer till we come to speak
of the effects of remedies in diseases of the lungs.
There is one remedy belonging to this class, which,
from its activity, as well as from the favor it receives
from the public, deserves our notice-we allude to bathing,
under the various forms of cold, shower, warm or hot,
and vapour baths.
We have seen that there is a quantity of fluid exhaled
from the skin equivalent to, at least, from one to two
pints every twenty-four hours; and so important is it
that this exhalation should take place that, to checked
perspiration is attributable a great proportion of all the dis-
eases for which physicians are called upon to prescribe.
When the perspiration becomes suddenly suppressed,
the blood retires from the skin and the more superficial
parts of the body, and is thrown, in an unusual quantity,
upon the more internal organs, whose functions become
more or less deranged, and which attempt to perform for
the skin what that organ is unable to do for itself. Thus
then it is, that in nearly all the cases of what are called
colds, the first link in the chain of disease is suppressed
perspiration; and the consequences of this are various
affections of the bowels, lungs, kidneys, etc.
When the determination of blood takes place to the
mucous membrane of the intestines, there is often diarr-
hea; when to the lining membrane of the lungs, hemorr-
hage, or mucous expectoration; and when to the kidneys
there will be an increased quantity of their natural
secretion. Restoring health by recalling the circulation
of blood to the surface of the body, and exciting per-
spiration, is purely philosophical treatment; but philoso-
MEDICAL PHILOSOPHY.
75
phical discernment, instead of blind empiricism, should
prescribe the remedy. Hardly any system of medical
practice is capable of accomplishing more good in inva-
lids laboring under the numerous diseases of the digestive
organs than bathing, in some one of its forms; and that
which is most likely to produce very much of either a
good or bad result, is cold bathing. This is not a thing,
of which it may be said, that, if it does no good, it can do
no harm; but, on the contrary, we may pretty certainly
predict that if it does no good, it will most likely do positive.
mischief. The practice of the Russians is frequently
quoted to prove that great changes of temperature may
be experienced with impunity. They enclose themselves
in heated apartments till a profuse perspiration breaks
out, and in this state, allow buckets of cold water to be
dashed over their persons, or they plunge headlong into
the snow, and then proceed to their usual occupations.
It must be borne in mind that they are healthy individu-
als who thus sustain the rapid change from heat to cold,
and vice versa; and we should also not forget that they
have been accustomed to this from early infancy.
What, in their case, is felt to be only a luxury, would, in
invalids, or those of delicate constitutions, cause a shock
from which the system in many instances would never
recover. That ill effects should follow a reduced tem-
perature it is necessary that the circulation of the blood
in the surface of the body, and especially in the skin,
should be rendered less than it is in health; but, although
the Russians emerge from a room at a temperature of
140 degrees, and plunge into the snow, the vigor of their
circulation is such that it is continued in the skin; or, if
76
MEDICAL PHILOSOPHY.
it is temporarily thrown internally, it soon resumes its
wonted flow, and the skin its healthy functions. The per-
spiration does not become in them positively checked, it
is so only relatively—it is less than it was when in the
heated apartment, but not so little as it would be were
they to remain in the snow, or cold water, a little longer,
or did not their subsequent active exercise counteract the
effect of the reduced temperature.
In those laboring under chronic affections of the di-
gestive organs, cold bathing should be employed with
the greatest caution; for, to be productive of any good
result, reaction ought to succeed its application. The
subsequent elevation of the temperature of the skin ought
to be in proportion to the degree of chilliness, or general
shock given to the system; and if there be much internal
disease, it is only aggravated, and the anticipated good is
a real evil. Again, there may be but little disease, with
much general debility and a feeble constitution; in some
such cases, too, no reaction follows general cold bathing,
and its effects are decidedly injurious.
The preceding remarks are intended to apply to the
immersion of the body in cold water, and not to the cold
shower bath. The latter, however, is pretty nearly the
same thing in its nature and general effects; it differs
only in degree, bearing the same relation to the former
that a mighty giant does to a puny stripling. The
shock caused by the latter is much more sudden and
powerful; and has been known to produce the most
alarming, and fatal prostration. A remedy like this
ought seldom, if ever, to be prescribed for those whose
nervous systems are susceptible to slight impressions ;
MEDICAL PHILOSOPHY.
77
·
and least of all should it be indiscriminately employed
by an empiric.
The tepid, or warm bath, is of late much more in use
than formerly; and it is to be regretted that an appara-
tus for warm bathing is not attached to every house; the
expense would be but trifling at first, while it would be
afterwards saved, many times over, if we rightly esti-
mate health and comfort. The only possible danger in
the use of the warm bath is that its temperature may be
too elevated; and it may, therefore, be commended to
all who can have it in their houses, with a desire that
others, also, may partake of its benefits in some public
establishment.
The vapour bath consists in the application of steam
to the surface of the body till a more or less copious
perspiration is produced; its general effects are simi-
lar to those of the warm bath, while both produce
the same result, perspiration, in a different manner
from the cold, or shower bath. In the latter the heat
of skin, that is, the temperature of the body, is first
reduced, then the vessels react, and perspiration is the
consequence. In the former there is no reduction of
temperature at all, but on the contrary it is elevated by
the direct application of heat; a perspiration ensues
which becomes profuse in proportion as the heat is in-
creased. A great degree of heat applied to the body by
means of the vapour bath will do much less injury to the
system than when the body is immersed in water at the
same temperature; but when the perspiration flows
freely for a length of time in the vapour bath, the ulti-
mate result, in cases where it is proper to be used, is not
**
78
MEDICAL PHILOSOPHY.
always as favorable as is anticipated. It is supposed, in
regard to this as to other remedies, that if a little is good,
more is still better; and, therefore, when the perspira-
tion is suppressed,-where the skin is dry and torpid, it
is erroneously believed that benefit is to be derived in
proportion to the quantity of perspiration, rather than to
a healthy, natural, performance of its functions. The
perspiration, as well as the other fluid evacuations
from the body, are derived from the blood; so that the
vapour bath acts as a direct depletive and debilitant, by
reducing the quantity of blood upon which the system.
depends for nutriment and strength. A state of debility
may be thus induced, as well, and nearly as rapidly, as
by opening a vein in the arm; and frequently copious.
perspiration in delicate individuals has been followed by
long protracted fainting. There is danger, too, in the use
of this remedy, in those who are predisposed to affections
of the head, and in those of a plethoric habit; for the heat
may be so great as to cause a rupture of a blood vessel
in the brain, or in some other important organ; and the
same result may follow from a hot water bath.
In those diseases of the digestive organs where the va-
pour bath is most applicable, there is also required the great-
est caution in its employment. The cases to which I allude
are those in which, from the long continuance of the dis-
ease, from lack of nutriment by derangement of the di-
gestive function, and perhaps other causes, there is
positive debility, with a cold and dry skin from a want
of determination of blood to the surface. In an invalid
presenting these symptoms there can be no question of
the utility of the vapour bath, provided it be used with
MEDICAL PHILOSOPHY.
79
discretion; but if employed immoderately, either by a
too frequent repetition of it, or by causing too great a flow
of perspiration at any one time, injury instead of benefit
will be sure to follow.
Medicated vapour baths, in diseases of the digestive
organs, are of no special benefit, save to the proprietors,
to increase, by a captivating name, the number of their
patients; they differ from the common vapour bath only
by having the vapour passed through a quantity of aro-
matic herbs.
We might here drop the subject of bathing, in all the
forms in which it is employed, had not this country been
overrun, of late, with a race of men denominated
"Steam Doctors," whose course, like that of the Indian
Cholera, has been marked by death. It is not by the
steam of hot water alone that they perpetrate their rava-
ges on the confiding and credulous; but they summon
to their aid two most potent articles, and thus armed,
they bid defiance to disease. If, perchance, one patient
is blessed with strength of constitution sufficient to with-
stand their incendiary treatment, his fortunate escape
from immolation is considered a most miraculous cure ;
and, stimulated by this, the steamers proceed in extermina-
ting their patients and the disease at a single blow.
When this is the case, their sins are hidden in the grave,
and they prowl on, seeking other victims; their murders,
like that of the infamous Thompson, are considered legal,
because there can be found no
"malice prepense." It
would be unjust to deny that the steam doctors have ever
done good, to assert that they have never effected cures
by their practice; but where one instance of good can
80
MEDICAL PHILOSOPHY.
be pointed out, there may be found ten where the results
have been most lamentable. We make no other appeal
than to facts, and the common sense that the God of na-
ture has given to all mankind; and when they know the
properties of the articles used by steam doctors, and their
effects upon the human system, we leave the question to
all our fellow men to decide, whether they shall die by
the hands of steaming quacks, or by some more direct,
and more expeditious, suicidal means.
The two articles employed by steamers in conjunc-
tion with the one from which they derive their name,
are Lobelia and Cayenne pepper. Of the former of which
some account has already been given. The nature and
properties of Cayenne pepper are readily understood, and
duly appreciated, by those who have once eaten it on
their food; and its character as a stimulant will not be
forgotten by one who has smarted from its external ap-
plication. It produces the most intense inflammation
when moistened with water or vinegar and applied to
the skin; and when it produces such an effect used ex-
ternally, we may conclude, a fortiori, that the same
effect will be magnified when used internally, where it
comes in direct contact with the delicate, sensible coats
of the stomach. In fact, we need not have recourse to
logical deductions to arrive at this conclusion; the naked
fact speaks for itself beyond the possibility of doubt or
contradiction.
When the stomach and bowels are in an inflamed or
irritated condition, can any person, who lays claim to an
ordinary share of common sense, raise the question in
his own mind, whether such an article can be safely ad-
'
MEDICAL PHILOSOPHY.
81
:
ministered? But those who prescribe it are as ignorant of
the actual state of the diseased organs, as they are desti-
tute of the sense of moral obligation, or the responsibili-
ties they are under to their fellow men; how then should
they be able to anticipate its effects? A case occurred,
not long since, in the practice of my friend Dr. Gunn of
this city, that demonstrates the nature of Cayenne pepper.
The Doctor was called to prescribe for a child who was
slightly indisposed with derangement of the digestive or-
gans; he ordered a foot bath with a quantity of pepper
to be added to it; and a cup-full of the infusion of
senna and manna to be administered in the course of the
night. The mother, who was a native of the Emerald Isle,
committed a most unfortunate mistake; she bathed her
child's feet in the senna tea, and forced it to drink the
pepper, and when the Dr. called next morning to see his
patient, he found it suffering the most intense anguish,
which, in a few hours, terminated in death.
The Cayenne pepper does less injury when its adminis-
tration is followed by the vapour bath, in the hands of
the quacks, than when given alone; for the inflammation
it excites is in a great degree remedied, or its effects ob-
viated and counteracted, by the profuse perspiration.
The lobelia also operates as a counter agent; its effects
have been shown to be of a debilitating character, pros-
trating the strength even to such a degree that it cannot
be again restored; thus we have two powerful agents to
combat the pepper, both acting in direct opposition to it.
And well would it be for the community, that part of
it at least who fall into the hands of "Steam Doctors," if
the soi-disant doctors would, in all cases, administer an
82
MEDICAL PHILOSOPHY.
antidote sufficiently powerful to counteract their own
mischief.
How much laborious investigation, how much toilsome
study, how many years devoted to research, how much
money bestowed on the cultivation of medical science,
what a sacrifice of health and life to anatomical pursuits,
could all have been saved and prevented if the dis-
covery of the steam practice had been sooner made.
But so it is, improvements are even tardy in being
adopted and rendered generally useful; although, in
relation to this subject, it seems that the facility with
which a knowledge of steam and lobelia are acquired
and applied to use, will compensate for their having been
so long hidden from mankind.
A single instance of modern doctor-making will serve
as a specimen of the general character for science, and
medical knowledge, of the whole genus of steam doctors.
An only son of a kind hearted, and indulgent father, had
trifled away his time till, at the age of five and twenty,
he found himself without any profession or occupation,
and with too little energy or manliness to obtain one. It
so happened that his resources had sadly diminished,
when a steam quack was sent as a scourge upon the re-
gion of country in which our future Esculapius resided.
The fame of this knight of red pepper, steam and lobelia,
had preceded him, so that he was heartily welcomed by
the expectant disciple. An acquaintance was soon formed
between the two worthies; and, for ten dollars, in a single
night the spoiled child became a full fledged doctor,
stocked with all the wisdom, science, and skill, necessary
to the cure of all diseases. Strange what a metamorpho-
MEDICAL PHILOSOPHY.
83
•
sis was here effected; an ignoramus retires at night, un-
certain how he is to procure an honest livelihood even
for a single day; but, before the revolution of another
twenty-four hours, he has attained the end of the hopes,
and ambition of thousands-he has procured the means,
not of transmuting metals into gold, but of transferring
gold from the pockets of others to his own. In other
words, he has bought a small duodecimo volume con-
taining the whole of medical science—the plan of steam-
ing-and he sallies forth, like a knight-errant, even a
veritable Don Quixote, to relieve all unhappy damsels,
distressed widows, and sick children. Like a harpy,
he scents his prey at a distance; and wherever he can
hear of a sick person, no matter whether he is attended
by a physician or not, thither he directs his course; and
by impudence, promises of a certain cure, and denuncia-
tions of "apothecary doctors," attempts to impose upon
the patient, and his friends, his homicidal quackery. This
is not all, for sometimes he is successful in perpetrating
his practice upon the credulous; and happy is the patient
who lives to boast of his recovery.
A steaming quack, of a stamp like the one above des-
cribed, made an effort to introduce the steam and red
pepper practice into the family of his friend, who had
four children lying sick with scarlet fever, of a most in-
flammatory character. The father, a man of extraordi-
nary sense, could not submit to the dishonour of dismiss-
ing his regular physician, who had long been his firm
friend and faithful servant, at the instigation of a selfish
impostor, and, to place in hands so unworthy, the lives of
so many of his children. No one who has in his head a
!
84
MEDICAL PHILOSOPHY.
single correct principle of the philosophy of the human
system in health or disease, or who knows any thing of
scarlet fever, would dare, for any consideration, or under
any circumstances, to prescribe such incendiary reme-
dies, or even to think of so doing. To expect a favorable
result from such practice, would be as philosophical as
to expect to cure a wound by making it still deeper, to
effect union in a broken bone by fracturing another, or
to cure a burn by the application of boiling water.
We need not in this place dwell longer on the subject of
steam doctors; those of our readers who have not be-
come experimentally acquainted with them, probably
will not, and those who have, and have watched their
progress, can attest to the fact of their destructiveness—
to their having been palpably and ostensibly the cause of
putting a brief period to their patients' existence. If the
same charge is brought against the regular bred physician,
we can, in this place, only reply, that his doing wrong
does not excuse or palliate the errors of another—that
each one is answerable for himself; and that in due
time, the merits of the regular bred physician will receive
from us ample attention.
4. Tonics. Under this head are ranked those medicines
which impart tone and vigour to the system; and, as
medical writers say, which do not possess any stimulating
properties. There is, unquestionably, a difference be-
tween the action of a diffusible stimulant like alcohol,
ammonia, or ether, and Peruvian bark, iron, or any other
tonic usually employed; but when we analyze the man-
ner in which tonics produce their effects, we shall find,
that, if nature speaks intelligibly, tonics are nothing more
MEDICAL PHILOSOPHY.
85
nor less than stimulants. They are, indeed, less active in
their operation, though not the less sure; and their
effects upon the system, either good or bad, are much
more permanent. It is, in fact, almost impossible that
there can be an active tonic, one that is capable of
exciting any appreciable action in the body, which is not
more or less, either a local or general stimulant, accord-
ing to the dose in which it is administered, or some cir-
cumstances that influence its operation. If they do not
act, generally, by increasing the frequency of pulse,
heat of skin, and the activity of the circulation through-
out the body, they yet produce a local effect which may,
perhaps, be denominated irritation; and that irritation,
if increased in degree only, might terminate in inflamma-
tion. Tonics, when they produce their legitimate effect,
cause a tendency to an inflammatory diathesis; or in
other words, they induce that state of the system in which
inflammation is excited with more than ordinary facility.
And in those habits where the inflammatory diathesis
already prevails, or where there is some local chronic
affection, tonics cannot be administered to any extent
with impunity. Therefore, in diseases of the digestive.
organs, and in all cases of stomach affection, where this
inflammatory tendency exists, medicines of this class are
most decidedly injurious; and, coming directly in con-
tact with the mucous membrane when the stomach is
diseased, the mischief is thus doubly increased. Unlike
active stimulants, which may only temporarily aggravate
the disease, tonics fasten it more firmly where it is al-
ready seated, and are followed by a long sequel of suf
fering.
8
86
MEDICAL PHILOSOPHY.
To the class of tonics belong all the multitudinous
forms of "bitters," "bracing medicines," "stomach
bitters," "tonic pills," "strengthening medicines," and
nearly all the nostrums, which do not cause increased
evacuations from the body, and are palmed upon the
community as cures for dyspepsy and other ailments.
These medicines, or their more active constituents, are
found to possess tonic properties; doing good of course
when they are indicated, but doing much mischief when
they are contra-indicated.
With these views, it may not be inconsistent with the
philosophy of the subject, to associate with tonics the
more active stimulants-those articles which more rapidly
produce excitement, and exhilaration of spirits; for the
two are not unfrequently combined in the practice of
charlatanry. As an instance of this combination of
tonic and stimulant we may mention wine bitters, or
bitters to which spirit of any sort is added; the activity
of the compound being thus increased, its capability for
good or ill is also augmented.
It is believed, by many medical men foremost in the
ranks of the profession, that all diseases, of whatever or-
gan, are of an inflammatory character; if this be true,
then, tonics are not only unnecessary, but are positively
hurtful. However this may be, one thing is certain, that
medicines of a stimulating and tonic nature are of essen-
tial service in the restoration of health, and invigorating
the strength of the constitution. When they are thus
beneficial, it may be that there is present no actual dis-
ease, but rather a state of general debility, where all the
powers, to use an expressive and well known phrase, are
1
MEDICAL PHILOSOPHY.
87
below par, or below the standard of health. We may
thus grant all that any one may be disposed to ask, to
wit: that tonics are necessary and useful; there will
still remain a great majority of cases in which they can-
not be administered with safety, or any reasonable hope
of benefit.
In many diseases of acute inflammation, where copi-
ous, and perhaps repeated, bleeding is necessary, and
where it is indeed the sheet anchor-the only remedy on
which reliance is to be placed-is to be seen the greatest
prostration of strength, the most perfect and complete
apparent debility. The most casual and common ob-
servers, not in the ranks of the profession, must have
witnessed instances of this kind themselves; they must
have seen the most robust individuals, who, from a state
of vigour able to endure any fatigue, have been in a few
hours so prostrated by disease as not to be able to walk,
or to sit. This state they have seen removed, and the
patient able to raise himself in bed, or to walk across the
room, after the abstraction of a large quantity of blood.
Where was the strength, the muscular power, and why
is it that taking blood, which debilitates an individual in
health, restores strength to another? The appearances in
these cases are deceptive; the strength is overpowered
by disease, not annihilated; muscular power is, for the
time, paralyzed, oppressed, not destroyed-it results from
the diseased condition of some important organ, and they
stand in relation to each other as cause and effect; and,
therefore, when the cause is removed by the loss of
blood, the strength is at once restored.
A great majority of chronic diseases, of whatever
88
MEDICAL PHILOSOPHY.
name, or wherever located, being more or less inflamma-
tory, are more or less productive of what is commonly,
though erroneously called debility, or weakness, which
is attempted to be removed by a course of tonic medi-
cines. Who has not witnessed the increase of debility, a
general aggravation of all the ailments of an invalid, by
taking tonics? And who does not know that it is a frequent
complaint of invalids that they cannot "bear bracing”
—they can take nothing to give them strength, for every
thing stimulating or bracing, makes them a great deal
worse? Many, by the advice of their friends, or merely
to gratify their own caprice, take first one article of this
class, then another, and thus go the rounds of these, as
they do of other nostrums, and finally come to the con-
clusion that medicine is all a humbug, and those who
practice it impostors.
It is not to be inferred, from the preceding remarks,
that all chronic, or even acute diseases are to be cured
by bleeding; the question is, how are they not to be
cured? And the answer we have endeavoured to give is
"not alone by tonics;" and in regard to this matter, let
the physician, and not the quack, be the sole judge.
5. Alteratives. By the term alteratives, are recog-
nized those articles of the materia medica, which do not
produce any immediate, perceptible, operation in the
animal economy, but whose effect is to change, or alter
the action of one or more of the organs. The term is
one of vague import; and the profession would suffer no
detriment if it were at once expunged. Still, it is ex-
pressive of the character of a class of remedies, or rather
of the action of many medicines when administered in a
MEDICAL PHILOSOPHY.
89
certain dose; for many of those, which are valuable, as
alteratives, are also most valuable, as evacuants. It
might perhaps be more proper, and more consistent with
medical philosophy, to say that alteratives are those
medicines which operate mildly as evacuants, according
to the dose in which they are administered, and to the
disease they are intended to remove. Let this be
illustrated. Calomel is a most potent evacuant when
administered in a sufficiently large dose; it is then
called a cathartic. When administered in a minute
dose, so that no effect shall be perceptible from
one day to another, but so that it shall eventually
restore some deranged function to a healthy state, it is
called an alterative. But this latter action is effected by
altering the secretions, by increasing their quantity; so
that, eventually, though not perhaps till several days, it
exhibits all the characters of an evacuant by increasing
the discharge from one or more organ. Again, it may
be doubted whether all articles belonging to this class do
in reality act, either slowly or rapidly, as evacuants; but
it must be borne in mind, that, as disease approaches in
so insidious a manner as not to be perceptible, when one
organ is affected, some other, whose function is analagous
to its own, is made to act as its substitute and perform its
duties; so, on the other hand, health may be restored as
gradually as it was lost, till the organic actions are equally
balanced. When phenomena like these occur in the
progress of a disease, and when the morbid state is re-
moved by medicine acting imperceptibly for a season,
we have good reason to conclude that the remedy oper-
ates upon one organ as an evacuant, while it produces a
į
8*
90
MEDICAL PHILOSOPHY.
¡
:
contrary effect in some other. For instance; an individ-
ual may have chronic diarrhea, and, as is almost uniform-
ly the case, a parched, dry skin, indicative of too little
perspiration. A remedy may be here administered
which will, in the course of a few weeks, without any
alteration from day to day, restrain the diarrhea, and
render the skin perspirable; here an excessive evacu-
ation is moderated, and one too scanty is increased,
and thus the remedy acts, at one and the same time, both
as an astringent and an evacuant. Thus, then, an altera-
tive differs, ultimately, in many instances in no respect
from an active evacuant, save, only, in degree of activity,
which is made to depend upon the dose in which it is ad-
ministered; and although its operation is slow, it is
none the less certain or effectual in doing either good or
evil, as it is wisely or injudiciously prescribed.
In the class of alteratives may be reckoned all the
"Panaceas,' 29.66
Mixtures," "Pills,' ""Tinctures," and all
nostrums that promise, by their sponsors, to cure all
"humours," to purify the blood, and to cure all the dis-
eases with which the race of Adam was ever afflicted.
These medicines are generally pleasant to the taste, and
as they are not very active, require to be continued for a
long time; and, where the sale of the article is the chief
object, the empiric gains his end, provided he contrives
that his patients shall find a little hope in the bottom of
each bottle.
A gentleman in this city had been, for sometime, ren-
dered uncomfortable by a chronic disease, which had
proved so obstinate as to baffle the best directed efforts for
its removal. After availing himself of the advice of the
MEDICAL PHILOSOPHY.
91
most eminent of the faculty, as well as trying the virtues
of many nostrums, with which he made his acquaintance
through the medium of the newspapers, he at last placed
himself in the hands of a notorious quack, and who may
with propriety be styled the Prince of Quacks. The pa-
tient continued to take the medicine, bottle after bottle,
without any interruption for several months, till hope was
nearly extinguished. One day he entered the "Doctor's"
shop to protest against any farther continuance of the
medicine; but the "Doctor" by his peculiarly persuasive
powers, and by the most unblushing assurances, induced
him to take the ninth bottle, at the usual price of five dol-
lars a bottle. After he had retired, probably congratu-
lating himself once more on the prospect of a speedy re-
covery, a third person who happened to be present, and
who understood the secrets of the craft, remonstrated
with the self-dubbed Doctor for such downright imposition.
"Ah, ha, Monsieur," says the knight of the pestle and
pill box," de most people in dis country be very foolish-
dey will be imposed upon, and I may as well profit by
their credulity as others. My medicine is parfaitly
inert; it can do him no harm, and while he is amused
with taking it and pursuing a proper regimen, time may
cure his disease as it does others; and then I have the
credit of working another wonder.”
All medicines, however, of this class, are not inert; and
such as do possess efficacy are indebted for it to some ac-
tive, powerful, ingredient, whose character is concealed
by some other article that obscures or covers its sensible
properties. The virtues of calomel are tacitly acknowl-
edged by its enemies, or rather pretended enemies; and
1
+
92
MEDICAL PHILOSOPHY.
they practice the most perfect jesuitism in the composi
tion and sale of their drugs. No one disputes the fact
that there exists against this potent agent a wide spread
and almost invincible popular prejudice; and this is used
as a shield with which charlatans protect themselves in
their crusade upon the credulity of the populace, a mask
with which to conceal their base designs. They pro-
claim through the public papers that their medicines
contain no calomel-no mercury-nothing of the kind;
and if, perchance, it happens that chemistry detects their
fraud, they, yet, with the most brazen effrontery deny it,
and even when the metal itself is exhibited before their
eyes, they persist in their assertions with the most bare-
faced mendacity.
A mechanic, in a region of country not more than a
hundred miles from this city, was afflicted with a certain
disease, to get rid of which he applied to a physician
of eminence; he was accordingly furnished with a pre-
scription which wrought a most perfect and expeditious
cure. So well pleased was the patient with the issue of
his own case, that he procured the same medicine for
some of his acquaintances labouring under the same
complaint; and a like happy result followed its adminis-
tration. The operative was so well pleased with the
effect of his medicine, that he procured the differ-
ent ingredients of which the compound consisted, and
learned from his Doctor the art of preparing the medi-
cine for himself. He now set zealously at work; and
his friends and acquaintances, who had tasted the bene-
fits of his prescription, became his coadjutors; they circu-
lated the reputation of what they called the newly dis
MEDICAL PHILOSOPHY.
93
covered remedy, others purchased it, and thus its fame
rapidly extended. A name was now sought for the bant-
ling, which was duly recorded in the newspapers of the
day; it obtained an increased sale-its proprietor re-
ceived orders from abroad, and he now at once left the
workshop, and assumed to himself the name, title, and
honors, of a Doctor. This Doctor has continued from
that time, and with great rapidity, to accumulate wealth;
he can now count his millions, and laughs at the creduli-
ty and gullibility of those who have contributed to raise
him from obscurity to eminence, and from poverty to
princely independence.
The medicine that acquired such celebrity is such as is
almost daily prescribed by many physicians; and had
been in extensive use in this, and other countries, long be-
fore the birth of this notorious quack. He had only
given it another name, and added some new substances
to it for the sake of blinding and misleading those who
might seek to ascertain what were its ingredients, and in
what consisted its remedial virtues. Another piece of
deception, and downright imposition that he practised,
was to declare in his handbills and advertisements, that
his nostrums contained not a particle of mercury in any
of its forms. From the effect of the medicine in various
instances, there could be no reasonable doubt of the pres-
sence of this article; for its specific and peculiar charac-
ter was manifested by profuse and obstinate salivation,
which ceased and recurred, as the medicine was discon-
tinued or resumed. And when the mercury was found
by the chemists, and reduced to its metallic state, the ma-
ker and vender of the medicine denied its being a com-
94
MEDICAL PHILOSOPHY.
ponent part of his nostrum. Arsenic was also found,
but no acknowledgment was made that it was ever placed
there by mortal agency.
The efficacy and value of this remedy in cases where
its employment is indicated is not questioned; like every
other good thing it is good in its place, and like every good
thing too, it is capable of doing mischief when it falls
into unskilful hands, or is injudiciously administered.
It has one peculiarly bad effect upon the public mind-
to wit: that of destroying confidence in so valuable a
remedy as mercury, in its various preparations, by the
injury it does when improperly administered.
A friend of the Author was induced by the patentee of
this nostrum to make trial of it for a complaint with
which he had been long afflicted; after being repeatedly
assured that it contained no mercury, he commenced ta-
king it, and persevered in its use till a profuse salivation
occurred, which, with the consequent aggravation of the
disease, so shattered the constitution that years will be
required for its restoration. It seems hardly necessary
to repeat, that, aside from the specific effect of mercury
upon the salivary glands, there are many diseases of the
digestive organs, in which it acts like a virulent poison,
rather than as a salutary remedy. And, again, in those
who have been unfortunately salivated, either from acci-
dent or necessity at some time long previous-it may be
years are rendered so susceptible to the action of mer-
cury, that a minute, an almost inconceivably small por-
tion of this substance, will reproduce the salivation.
Other nostrums that were said to contain no mercury
have produced the specific effects of this remedy, as we
MEDICAL PHILOSOPHY.
95
have repeatedly witnessed; and, although other articles.
may, under some circumstances, cause a profuse flow of
saliva, there is yet nothing that can cause that peculiar
state of the system which results from the free use of
mercury.
The conclusion to be drawn from the preceding argu-
ment then, is, that with regard to alteratives under the
name of "
panaceas, ""mixtures," etc. inasmuch as there
is great deception practised in their composition, there
need to be the greatest judgment and discrimination used
in their selection and employment. And as a knowledge,
of the articles is necessary to decide these points, and
this knowledge is retained a secret within the breast of
the proprietors, there is no certainty that benefit will re-
sult in a given case, but the chances are equal at least
that mischief will ensue, from their employment.
6. Diet. Hardly any subject in regard to health has
become more hacknied, in these latter days, than that of
diet. Lecturers have arisen who have perambulated the
country proclaiming, without reason, their dogmas to
multitudes of greedy listeners, prescribing to them rules
of eating and drinking, and setting to them limits, beyond
which they are forbidden to pass. Books have been
written, fraught with precepts of abstinence, and urging
upon all, the robust and healthy, a regimen fit only for
invalids, and indeed but a small minority of them.
Whoever, when in the enjoyment of health, has allowed
himself to be influenced by such contemptible quackery,
has cursed the day, if his strength of constitution has en-
abled him to sustain the rash and unwise experiment,
that he ever turned a deaf ear to the dictates of nature,
f
:
96
MEDICAL PHILOSOPHY.
as indicated by the wants of the system-the demands
of appetite. Many, and a vastly greater number than
would at once be believed, have had their health im-
paired, their constitution undermined; and from being
hale and hearty have become pale-faced, weak and ema-
ciated, and incapable of pursuing their usual avocations
till a return to the forsaken path has restored their for-
mer vigor.
Any cool observer who has witnessed the excesses
and extravagances, the ultraism and fanaticism, of the
last five years, cannot have failed to see numerous in-
stances of their unhappy influence; and not the weak-
minded alone have been brought under the sway of the
impostor; but the strongest intellects, the most philoso-
phical and learned among us, have been led away
captive.
Nothing sooner impairs, and finally destroys health,
however paradoxical it may seem, than overweening
anxiety, and unnecessary efforts, to preserve it; and we
believe we speak the sentiments of nine tenths of our
profession, when we say, that every healthy individual
who commences a system of dieting, is, sooner or later,
rendered dyspeptic. We have never seen a person who
commenced dieting in health who was not injured by it;
and we have never seen a healthy individual recommend
it to others. They who are most famous for holding
forth orally, and through the press, on the subject of
eatables, are confirmed dyspeptics; and like the drunk-
en man who fancies any one else drunk, they prescribe
their system, which, perhaps, is best for them, invalids as
they are, to all with whom they chance to come in con-
MEDICAL PHILOSOPHY.
917
tact. Why not, on the same principle, set any healthy
man, one who never knew an hour's sickness, every hod-
carrier, farmer, and mechanic, to taking glauber's salts
or rhubarb?"The well need not a physician ;" and least
of all a physician who prescribes starvation as a universal
panacea for prolonging, ad infinitum, the thread of hu-
man existence.
1
We have alluded to appetite as a guide in matters of
diet. Nature has given to man a discriminating taste-
a relish for her bounties-of which there is an ample
supply for its gratification. And if nature has given an
appetite, and supplied the most ample means for its in-
dulgence, it has also fixed the limits, beyond which, that
indulgence is incompatible with the well being of the
system. While no inconvenience, or any greater ill
effects result from the gratification of the appetite for
food, there can be no impropriety in obeying its com-
mands; but every man is blessed with reason sufficient
to convince him of errors in this respect, and with will
sufficient to restrain his desires. To say to a man that
he shall not regard the promptings of nature within him,
that he shall go counter to the dictates of appetite and
the demands of the system, is the most utter nonsense,
the merest quackery; and they who assume to them-
elves the task of countervailing the operations of nature,
are placing upon their own shoulders a fearful amount
of responsibility. It might be expected that the unhappy
results of their experiments, so often seen, in the ema-
ciated frames, wan countenances, and hollow eyes, the
feeble step and unsteady gait of their disciples, would
convince them of the ruinous tendency of their visionary
}
་
9
ち
​:
98
MEDICAL PHILOSOPHY.
schemes; but after all, so wedded are these priests of
starvation to their theory, so firmly seated are they on
their hobby, that were troops of ghosts of the starved to
come from another world, hardly would they be induced
to return to reason and common sense.
Were it necessary, hundreds, nay thousands, of in-
stances, might be enumerated, where the health has been
impaired and irrecoverably lost, at those institutions, and
in those regions, where learned professors have had an
opportunity of lecturing, and where by the influence of
their names people have been induced to follow their
precepts; but not a single instance has ever come to the
knowledge of the author in which even a well man has
been made more well by weighing his food, or confining
himself to bran-bread and vegetables.
A writer in Johnson's Medico-Chirugical Review, for
Oct. 1836, says, "in periods of religious fastings, some
persons, who are rigid in the observance of these, are
always more or less afflicted with cough, and an affection
of the breathing. We have for some years past been in
the habit of attending many of the members of a sect,
which is unusually austere in all its penances; animal
food is interdicted among them, and now and then a rigid
fast is exacted. Often have I had occasion to observe
troublesome coughs, difficult breathing, and even bleed-
ing at the lungs, induced in the more delicate of the de-
votees. Fortunately, in most cases, the troublesome
symptoms were readily curable by the use of a generous
diet and of tonic medicines."
In another place* we have discussed this subject
* The Philosophy of Living. No 77, Harper's Family Library.
$.
MEDICAL PHILOSOPHY.
99
more fully, and shown the influence of diet upon health;
and as our object now is to show its effect upon disease,
we forbear further remark, although to say less was im-
possible.
If a system of dietetics can be so prolific of mischief
in health, so if applied with judgment, it may be made
one of the most powerful means for the removal of many
complaints that would otherwise baffle all the art and
skill of the profession. And if many healthy per-
sons are injured by too abstemious a diet, so are many
also injured by the other extreme as well in disease as
in health. But it by no means follows as a necessary con-
sequence, that an abstemious diet is the panacea for all
complaints of the digestive organs, that all are to be
cured by a purely vegetable, or animal diet, or by a
strict confinement to the use of bran bread and cold
water.
The constitutions and temperaments of individuals are
vastly different; so that while one can subsist, and enjoy
perfect health, on vegetables, another requires a pro-
portion of animal food; and while one may indulge in
the use of stimulating drinks with perfect impunity,
another cannot take them in the smallest quantity with-
out experiencing some ill effect. Thus it is in disease;
the same peculiarities are manifested then as in health,
although they may be increased, diminished in degree or
altered in their characters. Were this not the case, we
might bid farewell to all scientific investigation, to all
pathological research, and to what have been called, and
fondly believed to be, improvements in the healing art.
We should then have only to say that such an one has
Dor M
3
-.
•
100
MEDICAL PHILOSOPHY.
.
dyspepsia, and that abstinence is to cure him; or that
a vegetable diet is his only remedy; or that he has no
hope left but in a strict adherence to the use of animal
food, or by confining his indulgences in gastronomic
matters to the notorious bran bread.
•
Diseases of the digestive organs assume such a variety
of forms, they manifest such a multitude of appearances
in different individuals, and even in the same individual,
that the wisest medical philosophers, the best practical
physicians, are obliged repeatedly to change the diet
during the treatment of a single case. The actual con-
dition of the stomach, in the complaint denominated
dyspepsia, is by no means the same in all cases; one
person may not be able to digest meat, another can eat
nothing but meat; one will eat sweetmeats, sugar, mo-
lasses, and the like, while another cannot bear the small-
est quantity of any saccharine substance. The ill effects
of an exclusive diet, as prescribed by quacks, may be.
illustrated by stating briefly a few examples; but it is
necessary to premise that the popular belief is that dys-
pepsia is an entity, almost a tangible thing, and always
the same identical affection in all cases. Every practi-
cal physician knows the importance attached, by people
in general, to the name of a disease; and no matter
what it is called, no sooner is the disease christened than
they seek a specific for it. And thus it is with dyspep-
sia; no matter whether the stomach alone is affected, or
whether the adjacent organs are diseased, or whether all
are involved in the disorder; it is quite sufficient if the
complication is styled dyspepsia. Specifics are now
sought after with the greatest avidity.
{
MEDICAL PHILOSOPHY.
101
A gentleman who had been somewhat inclined to in-
dulge in the luxuries of the table, and whose occupation
was sedentary, found himself affected with much gas-
tric derangement. When complaining one day to a
friend, the latter replied, "why you have got the dys-
pepsia; you must eat meat, and nothing else, and drink
plenty of brandy and water. Dr. A. cured me by this
plan in a very short time." The Doctor spoken of was
a notorious empiric. However, the friend's advice was
taken, and consequently the disease was aggravated till
it became alarming. After a long course of suffering,
this case was finally cured by a restriction, for several
weeks, to a purely farinaceous diet.
Another individual who had been suffering a long time
with deranged digestion, had employed many physicians,
and more quacks, had taken nostrums of all kinds, and in
almost all quantities; at length he resolved to try a sys-
tem of dieting, and accordingly commenced with vege-
tables. He was soon worse than ever, and continued to
grow worse while he continued this kind of diet. A
change to a diet composed of tender animal food, and
stale bread alone, with a small quantity of brandy and
water soon restored him to complete health.
Another person affected in a similar manner to the
one last mentioned, and to appearance as much so as
ever one case is like another, was compelled to restrict
himself almost exclusively to a diet of milk.
in
It must be understood that there is no medicinal virtue
any kind of diet here mentioned; the chief benefit re-
sulting from either consisting in its being easily diges-
ted, thus affording nutriment to the body, while the
9*
102
MEDICAL PHILOSOPHY.
organs of digestion, by not being irritated, or disturbed,
in their operations, are allowed to recover their healthy
tone and condition. Although the good qualities of diet.
are rather of a negative, than positive, character, it is
nevertheless true that the body as a whole, in all its parts,
solids as well as fluids, may be greatly influenced, and
the organic actions modified, by any particular diet, that
may be persisted in for any length of time.
'There is one article of diet, which, from the extrava-
gant praises it has received from certain quarters, and
from the high estimation in which it is held by popular
consent, deserves notice by itself. But this is not the
only reason that gives it a claim to our special attention
at this time; it has the power, when indiscriminately
employed, of doing that mischief which neither its friends
or enemies, or both combined, can ever remedy. We al-
lude to bread made of unbolted flour--bran bread.
It is a fact, well known to thousands, that this bread,
in a costive habit, will almost invariably produce a con-
trary state of the bowels. It does this not by any medi-
cinal property, but by the mechanical irritation it excites
in the digestive canal-the whole length of the stomach
and bowels. But however its specific effect is produced,
whether by mechanical or other means, the fact is be-
yond question, that, in healthy individuals and in costive
habits, when disease is present, it operates as a laxative.
How much greater then will be its effect in those cases
where diarrhea is the most troublesome and prominent
complaint?
A most melancholy and interesting instance of the per-
nicious effect of this bread, in a case of the latter charac-
MEDICAL PHILOSOPHY.
103
ter, came recently under the author's own observation;
and as the unfortunate victim was his most intimate and
estimable friend-the late lamented Prof. Averill of Un-
ion College-he takes this occasion to pay a passing
tribute to his memory.
Prof. Averill, and the writer of these pages, were fel-
low students when preparing for college, in the delight-
ful village of Stockbridge-now rendered classic by the
genius of Miss Sedgewick-where an intimacy and friend-
ship commenced, which increased, and struck deeper
root as they knew each other better. They entered the
same class in college together, had their examination at
the same time, and while the author continued a mem-
ber of college were room mates. After our connection
with college had ceased, a correspondence was as punc-
tually kept up as circumstances would permit; and im-
mediately after his graduation, he became an instruc-
tor in the institution where he had, for four years,
been receiving instruction. As a student, Averill was
not excelled; and it is no disparagement to others to say
that he was not equalled by any member of his class-
for at his first entrance he stood at its head, and when he
graduated there he yet remained. As a scholar we have
never known his equal; no matter what the subject, or
however arduous the task he undertook, his comprehen-
sive and powerful mind overcame the greatest difficul-
ties. As a companion Averill was beloved by all who
knew him-by the learned and unlearned, old and young,
and by people in all conditions of life;—he could draw
from his own resources something agreeable, interesting,
or instructive to all. As a friend he was most sincere,
104
MEDICAL PHILOSOPHY.
single hearted, and devoted; any thing in his power to do,
was done cheerfully; his friend's welfare was his own,
and he never tired in his efforts to promote it. In his la-
bors as an officer of college he was unwearied, and
strove most zealously, and beyond his strength, to ad-
vance the interests of the young men committed to his
charge. The hundreds who have enjoyed the bene-
fits of his instruction, and his wise counsel, and who were
admitted to the privileges of his friendship, will long
cherish his memory with gratitude and admiration; in
their hearts he has built for himself a monument to be, of
all others, the most highly prized. Worn out with fa-
tigue, anxiety, and toil, he left the scene of his literary
career to seek repose, to recruit his health, and to enjoy
the affections of his friends, in his native town on the
borders of New England; and there he found repose in-
deed for he sleeps amid the romantic scenery of those
hills once so dear to him, and upon which he so delighted
to gaze-and we had almost said he fell a victim to quack-
ery.
During the warm season of each year, for several
years previous to his last illness, Prof. Averill had been
annoyed by a complaint of the bowels, which, agreeably
to popular custom, he had called dyspepsia, and, in ac-
cordance with the fashion of the times, he commenced
the use of bran bread.
Strange indeed it is, and inexplicable, that a man of his
intellect, of his peculiarly philosophical and investigating
mind, should be thus led astray; but he had dyspepsia,
or at least a disease so named, and bran bread was the
sovereign remedy. This was the only bread he used
MEDICAL PHILOSOPHY.
105
for a long time; and often, when he visited where a sup-
ply of the bread was not to be procured, he carried a
quantity for his use. The last six months of his life he
had a constant and uncontrollable diarrhea; and yet, so
completely infatuated was he in regard to diet, that he
ate bread made of no other than unbolted flour. There
need be little wonder that his complaint was unchecked,
that it was obstinate, and persisted in its progress in spite
of occasional medical treatment; for one principal exci-
ting cause was in continual operation, producing its legit-
imate result. And thus his disease continued gradually
to undermine his strength, and waste his flesh, till he was
but the shadow of what he once was-till he became
emaciated to a mere skeleton; nevertheless he persisted
in the use of bran bread, and did persist in it till almost
the last day of his existence.
Such was the nature of Prof. Averill's disease, and
such the nature of his diet, and the evidence in regard
to his case brought before our own observation, that we
have no hesitation in declaring that his disease was ag-
gravated, and his death hastened, by the use of bran
bread. We may not be far from a right conclusion,
then, when we say that no one system of diet is adapted
to all diseases of digestion, nor to all cases of disease that
may go under the same appellation; and that, least of all,
itinerant lecturers, or dyspeptic book-makers, should be
countenanced in their efforts to extend their quackery,
by introducing it into public notice and popular favor.
I have thus passed briefly over the most important
plans of medical treatment, for diseases of the digestive
organs, that are pursued by the most prominent empirics
106
MEDICAL PHILOSOPHY.
of the present day; to have entered into detail, and dis-
cussed the merits of the different articles belonging to
each class, would have covered more ground than was
the author's original intention; and besides, to establish
a general principle, with reflecting minds, is more desi-
rable than to enter into minutiae.
NOTE. Since these pages were written, Prof. Reed
of Schenectady has published a memoir of his colleague,
Prof. Averill, under the title of a "Discourse," of which
the "New York Review" of January speaks, in the fol-
lowing terms. "Professor Reed in his brief, but beauti-
ful piece of biography, has well discharged the office of
friendship, and has given us a chaste and manly portrai
ture of a character that deserves to be remembered. All
who knew Prof. Averill will thank him for the faithful-
ness of the delineation."
.
•
CHAPTER V.
ORGANS OF RESPIRATION.
THE lungs, or, as they are called in the inferior ani-
mals, lights,' are the only organs of respiration, and com-
municate with the atmosphere by the trachea, or wind-
pipe. They have the form of an irregular cone with the
base looking downward, and are situated in the chest or
thorax. The lungs are divided into two lobes, the right
and left, and have the heart lying between them.
The trachea is about four inches in length, and is mi-
nutely ramified as it enters the lungs to form the air cells.
It is lined by a mucous membrane, which is extended
throughout all its branches into the substance of the lungs.
The external surface of the lungs is covered by the
pleura, a delicate serous membrane, which is reflected so
as also to line the whole cavity of the chest. In their
natural state the lungs fill the entire cavity of the thorax,
so that that portion of the pleura which covers the lung,
and that which lines the chest, are in contact with each
other, and are kept moist, and lubricated, by their secre-
tion of a fluid designed for this special purpose.
Besides the mucous membrane which lines the whole
internal structure of the lungs by forming the air cells,
and the serous membrane, the pleura, which covers their
external surface, the other tissues that are combined in
ப
108
MEDICAL PHILOSOPHY.
forming the respiratory system, are the fibrous tissue, the
muscular tissue, cartilage, blood vessels, including veins
and arteries, lymphatic glands and vessels, and nerves.
To enter into a description of these is unnecessary;
it is sufficient to say that they differ from each other ma-
terially in their anatomical characters, and in the several
parts they perform in the animal economy. And yet
these tissues, so different in their structure and function,
are all combined to form a whole-the respiratory sys-
tem—and although each is but a part of the whole, nev-
ertheless, each is liable to its own peculiar diseases, as
different in their nature as each tissue is different from
the other tissues in its anatomical character, and physio-
logical office.
The function of the lungs is respiration; and by this
act, the blood, as it returns to the heart, to be again dis-
tributed through all parts of the body, is changed, by the
action of the atmosphere in its passage through the lungs,
from a dark purple, to a scarlet color, and is thus puri-
fied and fitted for the uses of the system.
1. Diseases of the lungs. Dr. Good enumerates up-
ward of forty diseases that are peculiar to the respiratory
system; and among this number there are some, the
most formidable, the most obstinate, the most certainly,
and the most extensively, fatal of any that afflict our spe-
cies. Among so many there must necessarily be a great
diversity of character even when they appear singly;
but seldom, indeed, is it that one tissue remains for any
length of time alone affected. Others, the most adjacent,
or the most analogous in structure or function, or the most
closely allied by nervous sympathy, soon become involv-
F
MEDICAL PHILOSOPHY.
109
C
ed; and they again propagate disease in those tissues
most susceptible to their influence.
A disease in one tissue does not wear the same appear-
ance, nor does it retain the same character throughout
its progress, that it at first exhibited; it is in fact so
changed, so altered in its very nature, that it demands a
modified, or perhaps an entirely different, treatment. In
thus adapting remedies to the different stages of disease;
in knowing the actual condition of the organs affected-
by the state of the patient-the history of his case-and
an acquaintance with the nature of the disease under
which he may be laboring-consists the skill of the physi-
cian; here is shown the triumph of our science. It may be
that this skill does not avail to effect a cure; yet it may
be sufficient to predict the ultimate result; and if it can-
not restore the father or the mother to their weeping,
heart-broken children, it may yet assuage the pangs of
suffering, prepare the patient for his final exit, and ease
his passage to the other world.
The term inflammation of the lungs would seem to im-
ply, and is generally understood to mean, by those who
are not well acquainted with the subject, a disease which
is always the same, both in its character and the
parts affected. But, than this, there can be no more
palpable error-no greater misconception. Each of the
tissues named as constituting a part of the respiratory
apparatus, may be separately affected, although not usu-
ally so observed in practice; the terminations of the dis-
ease will be entirely different, and yet in each tissue it
will be inflammation. The character of this disease de-
pends upon that of the part affected by it; and its results
10
110
MEDICAL PHILOSOPHY.
t
will be entirely different, although it is still inflammation.
Thus, in inflammation of the mucous membrane lining
the air passages and air cells, there may be an increased
discharge of the natural secretion; and this may be so
abundant as to relieve the diseased part, and perhaps re-
move the disease from it. If the substance of the lungs
-the parenchyma as it is called—is inflamed, the disease
may terminate in induration of the portion of lung dis-
eased, thus rendering it completely impervious to air, and
making it useless in respiration. If the serous membrane
is inflamed-the membrane covering the lung externally
-the disease may terminate by an increased discharge
of a thin watery fluid, its natural secretion, thus consti-
tuting dropsy of the chest.
And thus the same reasoning might be extended to all
diseases of the respiratory system, each having some pe-
culiarity in its different stages, that would render some
change, or modification in its treatment, of the greatest
importance.
Consumption is a disease that is almost as certain to
move on to a fatal termination as that the sun will con-
tinue to perform his rounds; and yet by proper treatment
the fatal day may be greatly protracted, the strength
preserved, and the disease kept at bay. And if science
and skill, judiciously applied, can be of such avail as to
predict, and to defer, a fatal disease, ignorance and em-
piricism, on the contrary, can neither foresee the one
nor accomplish the other.
Diseases of the respiratory organs, or rather of the or-
gans contained in the chest, are of a diametrically oppo-
site nature, and may require a totally different treatment ;
MEDICAL PHILOSOPHY.
111
although to an empiric they may seem exactly similar,
A
and appear to demand the same remedial measures.
person, for instance, experiences great difficulty in
breathing, attended with cough, and hurried respiration
on any sudden movement; an empiric, a vender of nos-
trums, would consider these symptoms to indicate clearly
some "lung complaint," the nature of which would be
incomprehensible to him, but at any rate to be cured by
his most precious specific. Every well informed physi
cian, on the contrary, would carry his investigations far-
ther; and he would find that, of two cases, pronounced
by some quack to be exactly alike, and both easily cured,
the one would be an incurable and organic disease of the
heart, and the other would be the first stage of tubercular
consumption
The better to illustrate the effects of quack remedies
in diseases of the lungs, and of the respiratory system, we
have thought it expedient that they should be classified
according to the mode of their operating, as was done
when speaking of diseases of the digestive organs; each
remedy can then be ranked according to its action in the
system, and the propriety of its employment thus deter-
mined.
1. Cathartics. Many observations that were made in
regard to the effect of cathartics upon diseases of the di-
gestive organs, are equally applicable to complaints of
the organs now under consideration; our remarks there-
fore will be of a less general nature, and pointed at the
peculiar influence of remedies upon certain diseases. In
affections of the lungs, cathartics, as a general thing, are
less useful than in diseases of the alimentary canal; and,
112
MEDICAL PHILOSOPHY..
on the other hand, they are less likely to do injury, ex-
cept in diseases of long standing, and where the constitu-
tion has become greatly enfeebled.
The mucous membrane, forming the air cells in the
lungs, has had its extent of surface variously estimated;
but, with some probability of approximating the truth, we
may compute it to cover a surface equal to 20,000 square
inches. From this membrane there is constantly going
on an exhalation, or transpiration, of a vapour similar to
that which we have noticed as being exhaled from the
skin. So intimate is the sympathy between the mucous
membrane of the lungs, the skin, and the lining of the
alimentary canal, that when the function of secretion, or
transpiration, is increased or suspended in either, the
same function is performed invariably by one or both of
the other organs. Thus when a diarrhea is the primary
disease, the skin will be found to be dry and husky, and
in a parched condition; if the skin is excited to undue
action the diarrhea will be checked, and if profuse per-
spiration is long continued, costiveness may be induced.
The sympathy of the lungs is analogous to this; when
the secretion from the lining of the alimentary canal is
increased, the exhalation from the lungs is diminished,
and it may be so scanty that respiration shall be per-
formed with pain and labour; and if perspiration is
checked, the balance of circulation is lost-too great a
quantity of blood is thrown upon the lungs, and they en-
deavor, by a natural process—that of increased exhala-
tion or secretion of mucous-to free themselves from the
unnatural burden.
From the preceding facts the following consequences
result.
MEDICAL PHILOSOPHY.
113
1. Cathartics, injudiciously administered, in affections
of the chest, have a powerful tendency to determine the
blood from the surface of the body to the internal organs.
The lungs being, as is often the case, predisposed to dis-
ease, have thus an amount of labor imposed upon them
which they are, by no means, able to accomplish; and
that disease, to which they are most predisposed, becomes
fully developed. Few practitioners, indeed, there are,
who have not seen cathartics lend a potent agency in the
production of acute inflammation, as well as in that
dreaded disease, pulmonary consumption.
2. When the lungs are already laboring under dis-
ease, cathartics prevent the sympathetic action of the
skin, by which the lungs are most permanently, and most
naturally, relieved; substituting, in its stead, diarrhea,
which may also prove troublesome and obstinate. The
exhalation and expectoration—the process which na-
ture adopts to effect her own cures are thus suspend-
ed; and, instead of being made better, the disease is
greatly aggravated. In all affections of the lungs, at-
tended with a cough, the best medical writers and prac-
titioners insist upon the expediency of using remedies to
make the cough loose; or in other words, to promote
and increase the exhalation from the lungs. And every
individual, who has ever been afflicted with a cough,
knows the relief he has experienced by a free expectora-
tion; and, when this cannot be obtained, by a free and
perspirable state of the skin. He who rashly adminis-
ters a remedy, that operates contrary to reason, experi-
and the dictates of nature, knows little of the laws
that govern the human system, and cares still less about
ence,
10*
114
MEDICAL PHILOSOPHY.
the responsibilities he assumes in constituting himself a
medical adviser. Physicians who have observed for
themselves, and who have rightly appreciated the effect
of remedies, must have now and again seen a compara-
tively easy respiration in disease of the lungs, changed,
by the operation of a cathartic, into a process the most
difficult and laborious; and in so great a degree is this
sometimes witnessed that the patient is threatened with
immediate suffocation. These are indeed comparative-
ly rare cases; but they serve to show the tendency of
cathartics, in analogous lung affections, in a degree pro-
portioned to the character of the disease, the length of
its duration, the strength of the patient, his constitutional
peculiarities, and other circumstances exercising a con-
troling influence. But unfortunately for the credulous
invalid, and his too yielding friends, these circumstances
are not taken into account by the designing, mercenary
empiric. Caring nothing for his own reputation, and
much less than nothing for the interest and advancement
of science, he affirms, with the dogmatic earnestness
characteristic of his tribe, that his "pills" are a univer-
sal remedy, an absolute specific; and that all diseases
of the lungs, consumption not excepted, are made to dis-
appear, like frost before the morning sun, by their all-
pervading and all-conquering medicine. Not contenting
themselves with their own assertions, or, suspicious of the
credulity of their customers, they endorse their stories of
wonderful cures with multitudes of statements certified
by respectable names. We shall not call in question the
honesty or sincerity of those who so readily certify to
their having been cured of some particular disease, by
MEDICAL PHILOSOPHY.
115
some particular remedy, the like of which was never
known, but whose virtues ought to be proclaimed through
the whole inhabited world; for their statements are made
with the utmost candor, and with the fullest belief that
they are religiously true. But their knowledge we do mean
to question; nay, we mean to say that nine times in ten
they have no knowledge in relation to the disease of
which they certify to have been cured. They desire to
benefit and relieve suffering humanity; and for this god-
like benevolence they deserve all praise; but if they
know to what use their certificates would be perverted,
if they knew the eagerness with which empirics seize
upon every thing said in their favor, and throw it out as
a lure, a trap, a bait, with which to catch their prey, they
would, assuredly, be more chary of the aid they unwit-
tingly afford in the destruction of their fellow men. The
ignorance of the kind-hearted individuals of whom we
are speaking, is not their fault; and therefore let us hold
them in a measure blameless. Diseases are so similar in
their nature, so analogous in their external characters,
that it is not surprising, when the most enlightened and
experienced are uncertain and in doubt, if one, complete-
ly uninformed, should be led into error; and his mistake
is the more easily committed if a designing impostor can
once entangle him in his wiles. An individual may have
a cough, some shortness of breath, and many other symp-
toms simulating an incurable disease of the lungs, of
which some one of his acquaintances may have died.
He applies to a notorious quack, and relates his case,
and also his fears that he may not recover; and the
quack unhesitatingly pronounces him to have consump-
+
116
MEDICAL PHILOSOPHY.
tion firmly and fully fixed upon him-but, to the unspeak-
able comfort of his patient, he adds, that his medicine
will most certainly effect a cure. By the help of his own
fears, his imagination, and the quack's assurance, the
poor man is really made to believe that he has consump-
tion, that he is verging toward the grave; that he truly
feels the cold hand of death, and its unrelenting grasp,
fastened upon him. His disease, in fact, is not consump-
tion, nor any thing that resembles it except in appear-
ance; it is cured, and cured too, by the empiric's nos-
trum. The patient, happy to have retained his "mortal
coil," and grateful to be permitted to live a little longer
on this side the grave, in the fulness of his heart pre-
pares a certificate, or signs one already prepared at his
hand. It is the appearance of the disease that deceives
the patient, and may be, also, the charlatan; many com-
plaints possessing the same symptoms in common, and
yet being entirely unlike in reality. A kind-hearted man
who had been cured of some complaint by a quack rem-
edy, called to see a sick female friend, and urged her to
use the same remedy that did him so much good; and
so determined was he on her making trial of it that he
carried a box of pills in his pocket. In the midst of
their discussion of the merits of the medicine, the lady's
physician was announced, and soon entered the room.
The good neighbor immediately opened his battery of
pills, and insisted that the patient should forthwith com-
mence their use; he was sure, quite sure, positively cer-
tain, that they would cure her, for they had cured him
of a disease exactly like hers. The Doctor stared, and
asked him if he was certain that their diseases were alike.
MEDICAL PHILOSOPHY.
117
"Yes," says he, " precisely; and if she will take the
medicine she will get well, as I did.'
""
"If your disease was like hers," said the Doctor," you
have been the mother of a large family."
Hardly a day elapses that physicians, in ordinary prac-
tice, do not hear people tell of having had a disease ex-
actly like that which some other person has; and they
are always sure of it, perfectly confident, although the dis-
eases may be as unlike, as black and white, light and
darkness, or any two opposites in nature.
There is, probably, no hazard in saying that diseases
of the lungs are generally as speedily, and certainly fa-
tal, as those of any organ in the body; and if this be the
fact, it is, therefore, the more important that no time be lost
in meeting them with prompt treatment. A disease is
much more readily cured at its commencement, or du-
ring its first stage, than at any subsequent period; and
he who does not face the enemy at the door, and at once
repel him, will find it a much more difficult task to expel
him from the house after he shall have entered and taken
possession. And thus it is, that by using quack reme-
dies of a cathartic nature in affections of the lungs, if no
positive injury is done by the action of the remedy, the
unfortunate sufferer is led on by the delusive hope-an
ignis fatuus—that he will ultimately be restored to health,
till the line is passed that he can never recross-till a
step is taken that can never be retraced.
A young lady of this city, after exposure to cold, was
affected with cough, shortness of breath, pain in the side,
and all the more prominent symptoms that indicate seri-
ous disease of the lungs; she used the proper remedies
i
118
MEDICAL PHILOSOPHY.
and in a few days enjoyed again her usual health. In
about six weeks after a second exposure there was a re-
currence of the first complaint; the symptoms were as
analogous at this time to those previously exhibited, as
are ever seen under like circumstances; and there is
every reason to believe that the same, or a similar, plan
of treatment would have again succeeded in removing
the complaint. But by some strange infatuation of the
mother, who ought to have known better and acted differ-
ently, and whose mind had been taken possession of by
an idea that a certain quack remedy was a universal
panacea, insisted that her daughter should take the "in-
fallible specific pills." The medicine was employed, and
the patient grew worse; and when the friends remon-
strated, the mother insisted that the pills would eventually
effect a cure. Her confidence in the remedy was for-
tified by the multitude of certificates put forth in the news-
papers, to some of which were attached respectable
names; and the puffs, written and paid for by the pro-
prietor and venders of the pills, had no little influence
with the good mother in causing her to persist in her ob-
stinacy. The affectionate and credulous woman really
believed that the certificates were all genuine, that those
who gave them had been cured of the diseases with
which they so solemnly proclaimed to the world to have
been afflicted; and she had the most implicit faith that
the physician's skill, and apothecary medicine, were not
half so well adapted to her daughter's case, as the vaun-
ted and far-famed "pills." And so the pills were con-
tinued the patient continued to be ill-and to grow
worse; till, at length, her obstinacy equalled, and over-
MEDICAL PHILOSOPHY.
119
matched that of her mother. The pills were now only
taken by her, to be thrown into the fire. Finally, the af-
fection of the mother prevailed over her firmness; she
consented to call the family physician, although she still
declared to her daughter that the pills would cure her if
she would but take enough.
Mother," says the poor girl, "how many more will
it take to cure than to kill me?-the latter is almost ac-
complished."
Suffice it to say that a judicious course of medical
treatment was commenced, and after the lapse of two
months, the disease began to yield. If a proper course
had been adopted at the commencement of this young
person's illness, there is every prospect, that, instead of
months of suffering, at the hazard of a fatal termination,
a few days would have been ample time to have wrought
a perfect recovery.
Perhaps the reader, particularly if he be predisposed
to pulmonary complaints, may be induced to inquire
whether or not consumption can be cured? This query
involves points that require too long a discussion to be
settled in this place; nevertheless, it may be briefly an-
swered in a manner satisfactory to most minds.
Consumption is a name vaguely applied to a number of
diseases possessing some external characteristic in com-
mon; yet so widely different are they in their seat and na-
ture, that they by no means always affect the lungs, and
instead of these organs being ulcerated, as in genuine
consumption, they are found, on dissection, to have no
ulceration whatever. If an individual be only emaciated,
if his strength fail, either with or without a cough, or if
1
120
MEDICAL PHILOSOPHY.
2.
there be any one symptom that is generally known to be
prominent, or to be present, in consumption in conjunc-
tion with emaciation, the disease is unhesitatingly pro-
nounced consumption by the non-professional observer.
And if an invalid recover after once having been pro-
nounced to be in a "decline," or to have consumption,
the cure is considered little short of miraculous, no mat-
ter by what agency it may have been effected, whether
by some quack remedy, animal magnetism, homopathy,
allopathy, or no pathy at all. Ulcerations of the lungs
have unquestionably got well; or if the reader choose,
they may occasionally have been cured; post-mortem ex-
aminations, in a few instances, seem to establish this fact.
But these cases of cure are the anomalous and rare efforts
of nature, rather than the triumphs of medicine; they serve
to show the imperfect and uncertain state of our profes-
sion, and the greater need there is of perseverance and
assiduity in its cultivation and improvement. By seeing
what may be done, and what is done as it were sponta-
neously, we should be stimulated to greater diligence in
our endeavors to alleviate distress, to mitigate suffering,
and prolong the space of human existence. And he who
studies to flatter one, laboring under a disease neces-
sarily and uniformly fatal, with the false hope of a recov
ery; who aims to delude and cheat the sufferer till the
lamp of life is burnt nearly out—who lures him on, step
by step, till his hold on life is almost gone, hoodwinking
him till about to step into the grave that has been pre-
paring for him; and, excluding all consideration of an-
other world, and the fate that awaits him there-is little
better than one who assaults a traveller on the high-way,
or who robs his neighbor's house by night.
MEDICAL PHILOSOPHY.
121
It may, we believe, with safety be said that pulmonary
consumption, after having advanced to the ulcerative stage,
is, in the present state of medical science, an incurable
disease; and all pretensions to the contrary, all boasted
specifics, all vaunted nostrums, are but as a plank thrown
to a drowning man, when dashed and hurried along by a
furious torrent.
Previous to the stage of ulceration, consumption may
be, as it often is, prevented, even in those who are most
predisposed to it, both by temperament and inheritance ;
but there is no one article, no particular remedy, that is
omnipotent in the prevention of a disease that singles out
for its victims the fairest, brightest, and most intellectual
of our race. But this, like all other complaints for which
medical men are called to prescribe, is to be treated on
scientific principles; and, therefore, modifications of treat-
ment are found to succeed, as various in their character
as the variety of constitutions and temperaments in which
the disease occurs. All quackery and humbug in relation
to the cure of consumption may be at once discarded;
for they who expect that to be accomplished by blind and
ignorant empiricism, which enlightened science, applied
by philosophical principles, fails to perform, are sure to
meet with disappointment proportioned to their unfounded
hopes.
2. Emetics. Articles of this class are used, probably,
the most extensively of any other for pulmonary com-
plaints, both by empirics and by members of the profes-
sion. They are not always, however, given in the quantity
sufficient to cause vomiting; but are administered in
doses so small as to increase the secretion from the
11
122
MEDICAL PHILOSOPHY.
By
membrane lining the lungs. The effect of emetics gene-
rally, when judiciously employed in diseases of the lungs
uncomplicated with affections of the stomach, is most
salutary, whether the act of vomiting be induced or not;
and so, too, on the other hand, when improperly employed,
they possess equal power to do mischief.
We have stated, in a previous page, that the heart is sit-
uated in the cavity of the chest, between the two lobes of
the lungs. This is an anatomical fact, which, with the
relations existing between these two organs, is perfectly
unknown to the empiric; or, if known, not regarded in
the administration of his nostrum.
Asthma is a name applied by the ignorant to a variety
of diseases possessing one characteristic, prominent, symp-
tom in common; and that is, difficulty of breathing. When-
ever this symptom is present, no matter what the disease
may be in fact, it passes under the denomination of asth-
ma; and therefore the remedies are addressed to the
name, rather than to the morbid condition of the organs.
This name is used very much in the same manner, and
means in truth much the same thing when applied to dis-
ease, as the word sin when employed to denote all kinds
of wickedness. Asthma is used to denote all errors of ac-
tion of the heart and lungs, and sin to denote the errors in
the life and conduct; and yet there are many species in
cluded under these two generic heads. Sins are as mul-
titudinous as are the conceptions of the
mind of man;
and asthma is the result of any cause that obstructs the
circulation of the blood through the lungs. The princi-
pal organ in the circulation of the blood is the heart;
and this being subject to frequent and various affections
MEDICAL PHILOSOPHY.
123
that destroy its activity, force, and power, a congestion
of blood, therefore, takes place in the lungs, closing the
air cells, and making it difficult to inhale sufficient of the
atmosphere to perform the functions of life. This effect
is as easily comprehended, as that a stream, dammed
and obstructed in its course, should fill its channel and
flow back towards its source. Post-mortem examinations
have made us acquainted with the fact, that a great ma-
jority of asthmatic affections have their seat in the heart
or its appendages, that they are dissimilar in their nature,
but that most consist in alteration, a change of structure
in the organ itself, and are therefore incurable. In many
of these cases, it is useless to employ active remedies
with the hope of effecting a cure; for instead of seeing.
our anticipations realized, we shall meet with disappoint-
ment. Lobelia was first introduced to the notice of the
profession for its agency in the cure of asthma; or, in
other words, for the removal of difficult breathing-im-
peded respiration. But farther than this we are not in-
formed; we are yet ignorant whether the disease that was
attended by this symptom, was located in the heart, or
lungs. Supposing, however, that all cases of impeded
respiration were the result of one and the same cause,
and this cause itself consisting in some mysterious influ-
ence, physicians as well as empirics have continued.
blindly to administer lobelia, and other remedies of a
like nature. The efficacy of this drug, in cases to which
it is adapted, is not denied or doubted, nor need it be
questioned; and, on the other hand, it is just as certain
that no one, who is not intimately and thoroughly ac-
quainted with the operations of the respiratory organs in
V
*,
124
MEDICAL PHILOSOPHY.
health, and their derangement of function in disease, and
changes of structure as exhibited under the dissecting-
knife-in short, no one who is not well versed in medical
science-need hope to prescribe for affections of the chest
with any prospect of success. Diseases of the respira-
tory organs are so obscure, notwithstanding all the light
that has been thrown upon them by improvements in our
science, that the nicest discrimination is necessary in their
treatment; and few, indeed, there are in the profession,
who feel and appreciate the responsibilities resting upon
them, who have not found themselves, like a mariner
without a compass, at a loss what course to pursue.
Doubt and uncertainty are increased by a class of dis-
eases yet to be named-and those are aneurisms, or di-
latations of the larger blood vessels connected with the
lungs and heart. This disease may also cause a diffi-
culty of breathing; and may be, as it often is, called
asthma; and one of limited experience and knowledge,
and certainly one who possesses neither, would be unable
to recognize, and not very likely to suspect, a complaint
of this peculiar character. These latter diseases, and
the organic affections of the heart, often prove sud-
denly, instantaneously fatal, by a slight cause, such as
coughing, sneezing, a jar of the body by a mis-step,
mental excitement, depression, or agitation. And we
ought always to be suspicious of these complaints when-
ever asthma is present, no matter what circumstances
indicate the contrary, and no matter whether a physician
or an empiric deny its existence; for a sudden death,
and subsequent examinations, have often afforded the
clearest demonstrations of the most grievous and lament-
able errors.
MEDICAL PHILOSOPHY.
125
The violent straining, and often spasmodic action of
the muscles attending vomiting, produce greater agitation
in the system, and are greater obstacles to a free circu- *
lation of the blood, than either of the causes of sudden
death just mentioned; and therefore they,are, a fortiori,
likely to prove more speedily fatal.
With these facts staring us in the face, we must be at
once convinced of the absurdity and ill effects of the
practice of indiscriminately employing emetics, where
they even seem to be indicated, and absolutely necessary;
and we see also the utility of a perfect acquaintance with
anatomy, with the operations of the organs in health and
disease, as well as the comparative value of science
and ignorant assurance.
3. Sudorifics. To this class may be considered as
belonging all those articles that increase the exhalation
from the skin. The general character and effects of these
remedies having been considered when treating of the
diseases of the digestive organs, they may therefore be
passed over in this place by simply referring the reader
to that part of the volume.
It will be recollected that there are two general char-
acters, of a diametrically opposite nature, belonging to
sudorifics; the one is stimulant, possessing the power of
exciting the action of the heart-of increasing the vigor
and rapidity of the circulation. The other has a debili-
tating, depressing tendency; so that while the former
would elevate the pulse from eighty to ninety beats in a
minute, the latter would reduce it to seventy; thus in one
case elevating the pulse above, and in the other reducing
it below, the healthy standard. In proportion as the cir
2.
11*
126
MEDICAL PHILOSOPHY.
culation, which is indicated by the pulse, is made to de-
viate from a state of health, in a corresponding degree
do the functions of the different organs fail to be per-
formed as health requires. Stimulants, even if their ac-
tion or effect be but temporary, produce a condition of
the system analogous to inflammation; and if their effect
be permanent, or too long continued, actual and violent.
inflammation may be the result.
Nearly, if not quite, all the diseases of the respiratory
system are, more or less, of an inflammatory nature ;
and this is the more manifest, generally, in proportion as
the system is affected by fever. Sometimes, however,
extensive changes take place in the organs, when the
disease makes its approach insidiously, and as it were by
stealth; and these changes are the result of an inflam-
matory action so silent in its commencement, and so
gradual in its progress, that it is not revealed till too late
for a remedy. However violent may be an inflamma-
tory disease, or however silently it may make its inroads
and work its ravages in vital organs, a stimulant admin-
istered when the fire is smothered, but not extinguished,
will cause the disease to break forth with fearful energy.
We see this effect when hot slings, or other stimulating
drinks, are administered in severe colds attended with a
cough, pains in the limbs, chest, or head. The person is,
at such a time, laboring under an affection of the mucous
membranes of an inflammatory nature; and a single
dose of a stimulant, a small quantity of hot punch, or hot
sling, is oftentimes quite sufficient to cause an excitement
that bleeding, and the most active treatment, is required
to allay. Pleurisies are frequently induced by the popu
MEDICAL PHILOSOPHY.
127
lar but erroneous notion, that bad colds are to be cured by
a stimulating remedy that will produce a "sweat." The
perspiration, in such cases, is beneficial, but the means
are decidedly improper; inasmuch as if they do not ex-
cite perspiration, they aggravate the disease they are in-
tended to cure.
A great proportion of those who die from consumption,
date their illness from the time they took a severe cold.
They say, and with truth, that their complaint was at first
nothing but a cold, and that in spite of all they could do
it continued to grow worse; and when it is ascertained
what remedies were used, they will, in a great majority
of cases, be found to have been of a stimulating charac-
ter.
Not only are stimulants improper at the commence-
ment of an inflammatory affection, but are equally inju
rious during any stage of its progress. Consumption is
decidedly a disease of inflammation. It is, according to
modern investigations in morbid anatomy, an inflamma-
tion and ulceration of tubercles in the lungs, which are
solid roundish substances, of a size from that of a grain
of wheat, or smaller, to one many times larger. Indu-
ration of the lung, a change of its structure, by inflamma-
tion, into a state impervious to air, constitutes what Laen-
nec denominates "dry consumption."
The many syrups that are recommended by the kind-
ness of friends, are rather more likely to do injury than
to produce any good result. They contain, generally,
more or less of stimulating ingredients; and, the sugar
being added, it becomes necessary that something should
be done to prevent fermentation, that it should not be-
:
.
128
MEDICAL PHILOSOPHY.
;
come acid. Therefore it is that all syrups, without ex-
ception, contain a proportion of alcohol; and no matter
what assertions are made to the contrary, by the quack,
or by the affectionate friend, while the laws of chemistry
exist, syrups containing saccharine matter will ferment,
unless alcohol be an ingredient. From one fourth to one
eighth part of alcohol is necessary to prevent working or
fermentation; and this proportion of a dose of these medi-
cines, is quite too large a quantity for one laboring under
an inflammatory affection of the organs of the chest.
When syrups are prepared by empirics on a large scale,
to be sent to different and distant parts of the country, to
prevent loss by preserving the medicine, a much greater
quantity of alcohol is necessary. And a combination of
articles thus prepared, that may be proper, and perhaps
the best of any thing that could be prescribed, are, by
the addition of the alcohol, changed in character and ren-
dered decidedly injurious.
All the drops, tinctures, elixirs, and nostrums of a like
character contain a proportion of spirit; it may not be
used under the form of pure alcohol, and therefore it is
denied by the inventors, venders, and proprietors, that
alcohol enters into the compound. But all assertions to
the contrary notwithstanding, a chemical analysis would
show the thing itself to be there, although it may have
gone in under the name of brandy, gin, rum, or some
other appellation.
The only guide in the administration of medicines of
all kinds, and in all diseases, should be a physician-one
regularly and thoroughly educated, and possessing all
that is important in aiding him to arrive at right conclu-
MEDICAL PHILOSOPHY.
129
sions when health and life are the questions to be deci-
ded. It seems that no further argument is necessary to
enable the reader to decide for himself in relation to the
subject before us; still, it may be possible, that, like others
of our fellow men, he may have his mental vision so dis-
torted as to see no lack of philosophy, no danger, no im-
propriety in the use of a secret remedy, in all cases of
disease, when an ignorant empiric or some kind, but too
officious, friend declares it to be a specific.
The other class of sudorifics-those whose action is
the contrary of stimulants-are less frequently adminis
tered by empirics, and are also of a less dangerous ten-
dency at the commencement of a disease. They are,
indeed, so seldom used that the author need not extend
his remarks in regard to them; but the general argument
applied to the former class is, caeteris paribus, applica-
ble to these also.
There is yet another method of producing perspiration
that cannot be passed over in silence; and that is the ap-
plication of steam, combined with the internal use of lo-
belia and cayenne pepper. This practice is considered
by its friends and advocates as one of a most wonder
working character; and, unquestionably, it possesses a
power to kill or cure, one of which ends it accomplishes
whenever its use is persevered in. It is most emphati-
cally a kill or cure remedy; and the reason why physi-
cians have discarded it from regular practice, is, that
other remedies are equally powerful in removing disease,
without being attended with the risk of doing irreparable
mischief.
In chronic affections of the chest, one who practices
.
130
MEDICAL PHILOSOPHY.
1.
his profession upon known, and philosophical principles
would never use a remedy, violent in its operations. It
is an established law, and generally understood, that one
extreme in the human system is followed by another-
an excitement is followed by a depression-a chill by
fever any unnatural evacuation by a corresponding de-
gree of scantiness—and this change to an opposite state
is called reaction. This law we see manifested in pul-
monary diseases when the remedy in question is employ.
ed. Relief may be temporarily afforded to the suffering
organ, by a determination of blood to the skin, and the
depletory effect of the perspiration; but when this free
evacuation is suspended, a rush of blood to the lungs
takes place; the complaint is aggravated; and the diffi-
culty of removing it is increased. And the oftener the
remedy is repeated, the more is the trouble augmented.
The strength is wasted by the vomiting, and poisonous
effect of the lobelia-the general powers of the sys-
tem are weakened, reduced below par, by the excessive
evacuation by sweat-and a new disease is superinduced
upon that already existing, by the inflammation excited
in the stomach by the cayenne pepper. Thus it requires
a vigorous constitution to sustain the operation, and to
withstand the consequent effects of the lobelia and steam
practice; and the chances are that an invalid, who com-
mences its use, when debilitated by previous disease, will
succumb under its influence.
The use of the common vapour bath, uncontaminated
by the lobelia and red pepper, is quite another matter;
although even it, if indiscriminately employed, produces
effects analogous to the practice just mentioned, in pro-
MEDICAL PHILOSOPHY.
131
i
portion as it approximates it in violence, duration, and
frequency of repetition. The principle of exciting the
skin to increased action-to promote perspiration-is
founded on true philosophy; but, like other good princi-
ples on which correct practice is founded, in the hands
of empirics it has been most grievously abused.
In affections of the heart simulating diseases of the
lungs, stimulants, whether they produce perspiration or
not, are like the direct application of fuel to a raging fire.
In these cases quackery is unable to make the discrimi-
nation necessary to guide the choice of remedies; and
although the most impudent and ignorant quacks, who
roam up and down, to and fro upon the earth, pre-
tend to be able to point out the differences, their asser-
tions are not to be credited. When science and skill,
aided by years of experience and constant investigation,
both in private practice and in hospitals, are at fault-
when they, with all the combined lights of the profession,
are liable to err-and when they do make lamentable
mistakes-is there not downright folly in placing confi-
dence in a quack—in one who never saw a dissection of
the human body-who never saw an organ of the body
in health, or in a diseased state-who does not even know
on which side the heart is situated, nor to what diseases
it is subject? Who would employ a blacksmith to repair
a watch, a barber to shoe a horse, a ship-carpenter to
make bonnets, or a milliner to build a church? Or who
would send a son to a dumb man to learn elocution, or to
one born deaf to be taught music? And yet it is quite
as reasonable and philosophical to do one of these things,
as to expect that the human system should be repaired by
one who knows nothing of it.
..
132
MEDICAL PHILOSOPHY.
I
4. Tonics and Stimulants. The general effects of
remedies belonging to these classes so closely resemble
each other, that they may be ranked together. The ef-
fect of stimulants is to excite the activity of the circula-
tion; that of tonics, to render the excitement permanent.
Many of the "balsams," "elixirs," "cough drops,"
and all remedies that render the cough dry, or make it
more tight, as it is generally expressed, every thing that
is said to be " bracing," possesses, to a greater or less
extent, tonic or stimulating properties; and when admin-
istered indiscriminately in pulmonic complaints, ninety-
nine times in a hundred do mischief. Articles belonging
to this class may be, and are, used with great advantage,
occasionally, by scientific and judicious physicians; but
even then their use cannot be long continued; and they
are generally prescribed only for temporary effects.
The merits of stimulants, when speaking of stimulating
sudorifics, received perhaps their due share of attention ;
and under that head we saw the importance, as well as
difficulty, of recognizing the difference between affections
of the heart and those of the lungs.
The employment of tonics, in diseases of the former
organ, will do mischief that will be permanent in spite of
all that may afterward be done to counteract its effect;
and in these cases too, a stimulant will be followed by a
greater aggravation of the complaint than when it pro-
duces perspiration, or some other evacuation from the
system. Apoplexy, sudden effusion of water into the
chest, rupture of the heart, or some equally fatal result,
has occurred after the improper use of tonic or stimulat-
ing medicines in affections of the heart or lungs.
MEDICAL PHILOSOPHY.
133
5. Narcotics.
There is another class of remedial
agents that enter into the composition of many cough
nostrums, and specifics for consumption, and all pulmo-
nary complaints-and these are narcotics, or anodynes.
They possess the property of allaying pain, diminishing
irritability, and producing sleep; to this class belong opi-
um and all its preparations, and many others possessing
analogous properties. A violent cough may be readily
appeased by an anodyne, so that a person who has been
afflicted and tormented for many days and nights in suc-
cession, may, by a single dose, be relieved, and obtain
many hours of quiet and refreshing sleep. This is all
very good, and greatly to be desired. But another effect
of narcotics is to suspend secretion from the lungs, by
which the cough is relieved, and thereby to increase the
congestion that already exists. The cough may be
allayed by the continued use of some article of this sort,
and the invalid may thus be lulled into a belief that his
disease is about to be cured-that he is on the high road
to certain recovery. Comforting himself with these fond,
yet delusive hopes, he is at length, and perhaps in a very
short time, convinced that his strength is gradually fail-
ing; that his other symptoms are not mitigated; that he
is, in fact, in no better, but rather in a worse condition.
Superadded to his troubles there may be constipation of
the bowels, diminution of the appetite, headache, and all
the peculiar results that are consequent upon the use of
narcotic drugs.
Again, we repeat that these articles are a principal
ingredient in the composition of all nostrums for the cure
of" coughs," "colds," "asthmas," and all other affections
12
134
MEDICAL PHILOSOPHY.
of the lungs, heart, etc. No remedies that are used to
remove the ills of our species are more valuable, or
beneficial when rightly applied; and on the other hand,
few are less useful, or more decidedly injurious when
administered by the hands of ignorance and imposture.
CHAPTER V.
CUTANEOUS SYSTEM.
"THE Cutaneous system forms a sac which constitutes
a general envelope to all the other organs. It may be
divided into two large sections, the external and internal
cutaneous systems. The former is usually called the
skin, or the common integument. The second is the sys-
tem of the mucous membranes. Although they differ
much, they are only modifications of one and the same
type, as they are uninterruptedly continuous with each
other, and in fact are similar in form, in composition, in
qualities, and in functions.”
"The external form of the system is that of a sac turn-
ed on itself and consequently double. From this ar-
rangement openings are formed both in the upper and
the lower half of the body, by which the exterior and in-
ternal cutaneous systems communicate, and are continuous
with each other. These openings generally lead into the
chief partitions of the mucous membrane. The latter
form a tube which extends from the mouth the whole
length of the trunk, and form the alimentary canal."
The mucous membrane commences also at the nose and
extends into the trachea or windpipe, and lines the whole
respiratory apparatus.
The skin is composed of several layers, or tissues,
different in their organization.
"The derma is the strongest, the firmest part, and the
136
MEDICAL PHILOSOPHY.
base of the whole cutaneous system.
Always united to
the adjacant systems, it adheres to the muscles, in the in-
ternal skin by its external face, and in the external skin
by its internal face."
"The papilliary tissue which is applied to the loose
surface of the dermis is in reality only a greater develop-
ment of it, being composed of numerous tissues, of
vessels, and of nerves; it has the form of small, regularly
arranged tubercles which vary extremely in the different
parts of the cutaneous system in volume and form. The
extreme sensibility of the skin depends upon them."
“The rele mucosum is a mucous and semi-fluid sub-
stance having an immense number of capillary blood
vessels." On this tissue depends the color of the indi-
vidual; varying from the white of the fairest Circassian
to the jet black of the African.
“The epidermis is whitish, solid, brittle, without vessels
or nerves, and entirely insensible." This is the external
layer of the skin; and is often called scarf skin.
Besides these tissues there are found in various parts
of the skin "simple glands, denominated sebaceous
glands."
The hair and nails are considered as modifications of
the cutaneous system, or appendages of the epidermis.
Thus we see that the skin-is not the simple covering
that it is generally believed to be; but that it is an organ
of a compound, complicated, and delicate nature. How-
ever much we have learned of the structure and functions
of the skin during the last few years, it is yet evident
that our knowledge in regard to it is far from perfect;
and that anatomy has much to do in making us intimate-
MEDICAL PHILOSOPHY.
137
=
ly acquainted with an organ so complex, and so important
in the animal economy.
Each organ, and each tissue of the body, is affected by
disease in a manner peculiar to itself; and in various
organs affected with a similar complaint, a modified treat-
ment will be necessary, from the different aspects which
the disease assumes. Comparing the skin with other
organs composed of a variety of tissues, and reasoning
from analogy, we should be led to the conclusion that its
different tissues would be obnoxious to diseases of differ-
ent characters externally, as well as of absolutely oppo-
site natures; and that they would not all be cured by the
same remedial means; nor by the same general plan of
treatment. Such we find, experimentally, to be the fact.
Few ailments to which the human body is liable are less
understood, are more perplexing, or less successfully
treated. Doubtless, one reason for this is that the skin
has been too much considered as a simple, instead of a
complicated, organ-one that is composed of parts or
layers, in either of which a disease may be located, and
yet appear to be seated in any other. A remedy that
would cure promptly an eruption having its origin in
one tissue, might produce, if the disease happen to be in
another, no good, but an injurious, effect.
Again, the diseases that commence in one layer or
tissue of the skin do not continue there; they are not
limited to it; but they spread to the other layers, assum-
ing a different aspect in each, and unfortunately for the
patient and physician, may require for their cure a
different remedy for each tissue.
The difficulty attending this subject, and frequent
:
-
12*
138
MEDICAL PHILOSOPHY.
want of success, are indeed serious obstacles in the way
to improvement; but, instead of disheartening, they
should stimulate to greater efforts, to more assiduous and
unwearied perseverance on our part, and should awaken
a dread of quackery on the part of the patient.
In a work translated from the French by Cazenave
and Schedel, there are enumerated not far from one
hundred and fifty varieties of disease, affecting the skin
in its various layers or tissues. These may, indeed, in
some instances, be but different grades or degrees of the
same affection; and they may be confined to a small
portion, or some particular part of the skin, or extended
over a greater part, or the whole, of its extent. No one
who possesses a particle of reason can believe that all
these diseases are to be cured by one plan of treatment,
or by a single article; and no one who is not either a
lunatic, a fool, or a knave, will pretend that he has a
specific for all cutaneous affections. It so happens, how-
ever, that there are quacks who boast of their nostrums,
their "certain cures," for all these complaints; and they
find, too, a plenty of patients on whom to inflict their
ignorance and knavery. It is, in fact, no difficult matter
to remove most eruptive diseases, or in the language of
quackery to cure them-but many of such cures are the
cause of the patients' death-they are really "cured to
death."
We have seen that anatomy teaches us that the skin,
and lining membrane of the digestive and respiratory
organs are similar in structure; and physiology teaches
us that they are also analogous in function. We learn
also from the observations of our predecessors, for ages
MEDICAL PHILOSOPHY.
139
3
past, as well as from the facts we daily witness, that a dis-
ease commencing in a part of any tissue, is easily propa-
gated throughout its whole extent. And, therefore, an
irritation commencing in the mucous membrane of the
stomach or bowels, lungs, or any other of the internal or-
gans, may, as it often does, by this facility of transmission,
show itself upon the skin. Again, affections that prima-
rily make their appearance upon the skin are, by the
same law, transferred to internal organs; and by a rapid
and sudden retrocession, in a short time, prove fatal.
What mother, or what nurse, has not seen children sud-
denly die from an affection of the lungs, or of the brain,
caused by the sudden disappearance of some seemingly
trifling cutaneous eruption?
Many, if not a large majority of the diseases of the
skin, owe their origin to some derangement of the diges-
tive organs; and while this cause continues to operate,
the disease is absolutely invincible, by any safe medical
treatment. They who know nothing, fear nothing-and
a quack, who knows not that danger attends his practice,
fears not to encounter it. Most of the remedies that are
empirically employed in eruptive diseases are such as
remove rather than cure, repel rather than eradicate; or,
in common parlance, they "strike the complaint in."
Such a result is most easily obtained; and from the
similarity of structure of the internal mucous membranes
to that of the skin, eruptive diseases have almost as
great an affinity for the one as the other. When diseases
are repelled from the surface of the body, there is no
certainty what part they may choose for their location;
but one thing is certain—that on the skin they are com-
*
140
MEDICAL PHILOSOPHY.
-
paratively free from danger, and that after they have
attacked an internal organ, life is in jeopardy.
The ill effects of a sudden disappearance of disease
from the skin show themselves at different times, from a
few minutes, to days or weeks. Such variations depend
much on the organ which the disease has attacked; if,
for instance it be the lungs, there will be at first, but a
slight cough, gradually increasing till it terminates in
consumption; or it may speedily produce a bleeding
from the lungs, and run its course much sooner. Again,
it may attack the stomach or bowels, producing derange-
ment of digestion, diarrhea, and the various forms of dis-
ease to which those organs are liable, or it may seize
upon the brain, producing various shades of insanity, or
doing its work much more speedily by terminating in
apoplexy, or inflammation.
Affections of the skin become chronic; and in pro-
portion to the length of time they may have continued,
is their removal rendered both more difficult and danger-
ous. So habituated to their presence does the system
become, that it is often inexpedient and hazardous to at-
tempt a cure; lest a harmless, though troublesome, com-
plaint be converted into one of a most alarming aspect.
Diseases of this character should be viewed through
another medium. While located in the skin, they in fact
serve to ward off other and dangerous diseases from in-
ternal organs—they serve as a quarantine for the sys-
tem—a certificate, or endorsement of health; they are
often a substitute for that which would destroy life.
Physicians of eminence often regard eruptions in chil-
dren as a warrant for health-they consider them as en-
MEDICAL PHILOSOPHY.
141
joying a better chance to arrive at maturity than those
whose skin is smooth. Cutaneous eruptions seem to
serve as a rallying point for disease; for when a cause,
sufficient to destroy the balance of health, is applied,
there is often only an aggravation of the complaint.
They serve the same purpose, when not excessive, that
blisters, issues, setons etc. do when the internal organs
are diseased; they localize irritation, and render that
harmless which, under other circumstances, would be
dreadful.
Any physician of no more than ordinary practice
must have seen many cases of obstinate and severe
disease consequent upon repelled eruptions; and he
who has experienced it knows full well how to appre
ciate the difficulty of recalling these affections to their
original location. And indeed there is no hazard in say-
ing that the danger and obstinacy of a disease, conse-
quent upon a retrocession of a cutaneous affection, is
increased many-fold.
An interesting child of eighteen months old, had an
eruption on the face, and behind the ears, as is very com-
mon among children of that age; its mother had impor-
tuned the family physician to cure it, and he, very wisely,
advised her to be patient, telling her that the change
from the hot to the cold season would probably accom-
plish what she desired. The mother, however, became
impatient--she thought the child's appearance was ren-
dered unpleasant and less interesting, although its health
continued perfectly unimpaired. Contrary to the advice
that she had repeatedly received from her physician, and
being fully warned of the danger, she procured a nos-
142
MEDICAL PHILOSOPHY.
trum, with which she succeeded, to her entire satisfac-
tion, in healing the sores. Scarcely a single day had
been allowed her for self-congratulation before the child
was seized with convulsions which proved fatal in a few
hours.
A lady had, for several successive winters, been
afflicted with what is called salt rheum. It always ap
peared on the hands, at the commencement of cold
weather, and never took its departure till the warm
season in the spring. It was always troublesome from
its peculiar itching, burning, and smarting sensations
that accompanied; and not unfrequently was it so pain-
ful that it was necessary to resort to poultices to obtain
relief. A succession of remedies had been tried in vain,
with the hope of effecting a cure; and all the specifics
and "certain cures" of quacks, and kind hearted friends
had been equally unavailing.
Remonstrances were
urged by a physician against this presumptuous course,
with little effect; and, at last, a remedy was applied at
night, which, by next morning, had wrought a most
miraculous cure. The panacea had now been found-
that which had been most earnestly desired was at length
obtained, and the lady thought she had fairly extinguish-
ed her hateful and disagreeable tormentor.
Her joy
however was but short-lived; in less than twenty-four
hours she was attacked with violent pain of the head,
pain in the side, with a chill, the precursor of a rag-
ing fever. For a few days this patient seemed in im-
minent danger of dying from inflammation of the brain;
then, suddenly, the disease left the head and attacked the
lungs. There now occurred an obstinate and troublesome
MEDICAL PHILOSOPHY.
143
cough, which was, sometimes for hours, almost incessant ;
and to this was superadded all the prominent and char-
acteristic symptoms of pulmonary consumption. This
state continued for two or three days, when all disease at
once vanished from the lungs, and seized upon the bow-
els; here for a few days it played off its vagaries, and
after threatening to terminate the existence of the patient,
sought another domicile in the glands of the neck. Here
it finally stayed; and after a suppuration of the glands,
and discharge of matter from the throat internally, and
from the neck externally, during three weeks, the patient
began to recover-and in just two months after the ap-
plication of the remedy to the hands, and after having
her life despaired of for weeks in succession, she was in
a condition to leave her room. It must not be supposed
that no effort was made in this case to recall the salt
rheum to the hands; for every thing was done that skill,
and medical science could do; but all attempts were
unavailing.
A gentleman somewhat advanced in life had been, for
many years, troubled with an eruption on one of his
lower limbs; he made no complaint of this, only, that it
took too much of his time to scratch, and this in fact
ought not to have been regarded as much of an evil,
since he was in independent circumstances, and could
well afford the time. He had been rather urgent to have
it cured; but his physician had dissuaded him from ma-
king any considerable attempt. His impatience increased,
and he applied to a quack with whom he had become
somewhat acquainted; and as is usual with gentry of his
description, he promised a speedy and safe cure. Oppo-
144
MEDICAL PHILOSOPHY.
•
sition was made by the gentleman's family and friends;
his physician warned him of the evil consequences-that
in one of his age, apoplexy would be likely to ensue.
Remonstrances were lost upon him—the remedy was used
—and all went on well for a time. But the train was laid
-the match had been applied—and an explosion was
soon to follow. Numbness, and a prickling sensation,
were first experienced in the foot of one side—then a
weakness and loss of control over the foot when walk-
ing; and subsequently voluntary motion was lost-the one
half of the body became paralytic, and the unfortunate
man, on the fifth day of being unwell, died of apoplexy.
But quacks and nostrum venders are not always suc-
cessful in curing sores or eruptions, although they seldom
fail to promise a cure within a given time. A robust man
applied to a surgeon for advice in relation to a sore near
the ancle. It appeared about the size of a quarter of a
dollar, was not painful, and occasioned no inconvenience.
The surgeon told him it could be cured, but that he must
have a little patience, for it would be a few weeks be-
fore it would be entirely well. This advice was not ex-
actly what a person, who has such a companion, would
relish; and through the persuasion of friends, he con-
sulted a notorious quack.
"Oh, yes, monsieur," says he, "I can cure de sore-
in two, tree weeks you shall be one well man; yes, sare,
in two weeks I promise you shall be cured. You pay
me ten dollar now, to-day; I give you my medicine;
when you take it you pay for it too, and in two weeks
you shall be well man.”
So the ten dollars were paid, and medicines to the
MEDICAL PHILOSOPHY.
145
amount of seven dollars more were taken; and when the
two weeks had expired the sore was in a worse state
than when he commenced. The man now returned to
the surgeon whose advice he first sought, and with shame
and contrition for being so easily gulled, candidly con-
fessed the whole affair, and begged to become his
tient. In a few weeks the ulcer was healed.
pa-
From the preceding observations we may conclude
that diseases of the skin are at least but imperfectly
understood by those who have studied them most; that
they are of a complicated character, and generally only
dangerous when transferred to an internal organ.
The remedies employed by quacks in diseases of the
skin are, generally, of an astringent nature-operating
in such a way as to repel the disease to some internal
organ. The hundred specifics for salt rheum have this
effect; and so do the multifarious nostrums for "pimples
on the face," sores behind the ears in children, and the
like. But this is not the worst of their character; for
they not unfrequently contain poisonous materials, such
as arsenic in some of its forms, lead, etc.; and all cos-
metics, and applications for beautifying the skin, and
improving the complexion, are worse than useless.
The cutaneous affections for which external applica-
tions are employed are, generally, dependent upon in-
ternal disease; they are caused by it, and while that
exists the external disease can seldom if ever be cured,
let the remedy be what it may. Thus, pimples on the
face, and salt rheum as it is called, are but indications
of deranged digestion; and if injury is not done by the
13
146
MEDICAL PHILOSOPHY.
absorption of the poisonous substances applied, the origi
nal complaint is at least aggravated.
Again, affections of the skin, are perhaps more fre-
quently hereditary than most other diseases-and this
renders the prospect and chance of a cure more doubtful.
It is supposed, from their peculiar obstinacy, that there
is some original, congenital, malformation, or defect in
the skin-that the different tissues or constituent parts
do not bear that relation to each other-do not exist in
that proportion-that constitutes a normal, healthy con-
dition. If it be thus, as is conjectured by the best medi-
cal men of the present age, then the success of any
medicine indiscriminately administered is most uncertain ;
and to use it thus is unphilosophical and unsafe.
Affections of the skin of entirely different natures, so
closely resemble each other, that a practised eye alone
can make a discrimination between them; and a remedy
that has been successful in one or more of these diseases
whenever applied, may in all cases of another do mis-
chief. The best, and most experienced physicians often
are mistaken, so completely does one disease simulate
another; and from causes hitherto inscrutable are they
also frequently foiled in the success of their treatment,
with a multiplicity of remedies. Is it possible then for
an ignorant man, or a weak member of the sisterhood, to
be able to cure all diseases of the skin with a single
favorite nostrum ?
CHAPTER VII.
OF THE EYE.
1
I. Structure of the Eye, and its appendages.
THIS includes the eyebrows, eyelids, and globe of the
eye.
Eyelids. These consist, 1st of a layer of thin loose
transparent skin; 2d, of a portion of muscle; 3d, of
fibrous membrane; 4th, of cartilages on the edges of the
lids; 5th, of glands beneath the cartilages, having ducts
that open near the borders of the eyelids; 6th, of the
conjunctiva, a mucous membrane, which lines the eyelids
and covers the globe of the eye to the transparent cornea.
Globe of the Eye. This is composed of membranes
and humours.
Membranes. These are the sclerotic, cornea, choroid,
the iris, hyaloid, and retina, to which may be added the
ciliary circle and processes.
1. Sclerotic. This occupies the posterior four fifths
of the eye. It is a hard, opaque, fibrous membrane, and
is what is called the white of the eye.
2. Cornea. This is a transparent membrane, com-
posed of six plates placed on each other. It occupies
the anterior fifth of the eye and is fixed into the opening
of the sclerotic somewhat as a crystal is set in a watch.
3. Choroid, situated in the posterior part of the eye
2
148
MEDICAL PHILOSOPHY.
between the sclerotic and retina. Is composed of a vast
number of arterial and venous ramifications, united by a
delicate cellular tissue.
4. Ciliary ligament.
5. Ciliary processes.
6. Iris. Situated at the anterior part of the globe of
the eye in the middle of the aqueous humour. It is of a
circular figure, being pierced in the centre by an open-
ing called the pupil, or sight of the eye. On this depends
the various colors of the eyes.
7. The retina or internal membrane of the eye; soft,
pulpy, transparent and very thin.
Humors of the Eye. These are three; the aqueous,
vitreous, and crystalline lens; each enclosed in its
membrane.
Lachrymal Apparatus. This consists 1st, of the
lachrymal gland which secretes the tears, and is situated
behind the upper eyelid and in a depression of the bone
which forms the upper part of the orbit. The tears are
poured out upon the surface of the eye by canals lead-
ing from the gland.
2. The lachrymal ducts. These are two; one com-
menicing in each lid near the inner corner of the eye.
They convey the tears into the lachrymal sac, which is
a small membranous oval pouch; situated at the inner
angle of the eye in a groove formed by the bones at the
root of the nose.
3. The nasal duct. This is a narrow canal, formed
by the bones of the nose, and lined by a prolongation of
the membrane which forms the lachrymal sac.
MEDICAL PHILOSOPHY.
149
II. Diseases of the Eye.
Were we to reason from analogy we should be com-
pelled to adopt the conclusion that an organ, composed
of such discordant materials as the eye, and so important
to the whole system, contrived with such ingenuity and
such wisdom, would be affected with a multiplicity of
diseases. Such a conclusion observation confirms-it
demonstrates the fact.
Each of the membranes, each of the glands, ducts,
and each of the component parts may be affected when
the others are not; though generally more than one
suffers at the same time. Physiology teaches us that
each of the tissues of the eye has its own peculiar func-
tions to perform; and anatomy has shown us that they
are different in their organization, each one is part of a
whole, and all contribute to the same end; and, there-
føre, when one is incapacitated from performing its
office, the use of the eye is more or less impaired.
Thus we see the importance of preserving this organ in
a state of integrity; and as we use it to watch with, so
we should watch over, and guard it against interference
from the ignorant and unskilled.
All parts of the eye are subject to inflammation, which
produces different effects as it may visit the different
tissues, or appendages. In some it runs its course rapid-
ly, doing mischief in twenty-four hours that cannot al-
ways be repaired in as many days; and giving occasion
to those, who are so unfortunate as to thus suffer, to
exercise repentance for their remissness during a long
13*
150
MEDICAL PHILOSOPHY.
life. Disease of the more internal parts may occur,
which one not thoroughly acquainted with the eye would
not be able to recognize; and if this should be allowed
to go on, or if it should be aggravated by improper
remedies, the eye might be forever destroyed. The
slightest disease if allowed to exist and leave its effects
in the fine transparent membranes would impair vision,
if it did not entirely obstruct it.
An inflammation sufficient to destroy the sight of the
eye may exist without a person himself even suspecting
any thing wrong; and while these pages were preparing
for the press, a case came under the author's observation,
where the eye was rendered useless without the patient
having been aware that it was diseased. She was not
conscious, in fact, that it was not as perfect as the other;
and when told to close the other she was astonished to
find that the power of seeing with this was lost.
Thus, we perceive, that if a disease so slight as not to
be perceived, may ruin the eye, others that are perceived,
and which are troublesome, may produce equal injury.
And it is in those diseases of the eye which are incon-
venient, rather than in those of a more aggravated
character, where nostrums are employed, and where the
advice of quacks is sought. If the disease be simple, and
free from all prospect of danger, an improper remedy
may speedily convert it into one of a formidable aspect.
We have seen an intense inflammation of the eye, in-
duced in a few hours, by a stimulating lotion injudicious-
ly applied, which it required several days to remove.
Inflammations of the different parts of the eye do not
all require the same treatment-neither the same reme-
MEDICAL PHILOSOPHY.
151
dies-nor the same general plan; at one stage they may
require depletion, and at another a contrary course.
Again there are constitutional, or hereditary affections
of the eyes; and to investigate their nature-to appre-
ciate their character-and to prescribe a proper remedy,
require all the learning and skill of the profession.
The nostrums most in use by quacks, and those most
common in the shops, are either of an astringent, or
stimulating character-both of which are decidedly in-
jurious in all cases of recent inflammations, and in many
of longer standing. They are sold and known under the
names of "eye-water"-" eye-ointments"-" lotions,"
etc.
3
CHAPTER VIII.
FEMALE COMPLAINTS.
}
THERE are some differences, so striking and manifest
between the sexes, that they do not fail to be perceived
by the most casual observer; and the more intimately
the constitutional peculiarities are known, the greater do
they seem. Carrying our investigations still further, we
find other peculiarities, and other differences that were
not at first observed; and we find that females are prone
to nearly all the diseases of the other sex, besides multi-
tudes of others that afflict theirs alone. It need not
be wondered at, that such is the case. They have a part
in life allotted to them that is full of danger in itself, and
fraught with a variety of ills on every side. Besides,
nature has so ordained that the functions of this sex
cannot be performed without collateral circumstances,
themselves being the source of suffering and ill health.
The habits and avocations of women predispose to
disease, aside from any sexual consideration; they are
less exposed to the healthful influences of the open air,
take less exercise, and are generally less able to resist
any attack of disease. Nature has wisely made pro-
vision in respect to the proportions between the sexes by
ordaining that the births of females shall exceed those of
males, in all parts of the world.
It is neither expedient nor proper to enter at all
154
MEDICAL PHILOSOPHY.
minutely into the character of diseases peculiar to the
gentler sex; such of them as honor these pages with a
perusal will readily comprehend the whole of what is
intended. The different nature of complaints in females
is owing rather to organization than to any specific char-
acter of the diseases themselves; thus, an inflammation
in one organ produces symptoms, and is followed by a
train of consequences, of a character opposite to those
resulting from an inflammation in any other organ. Al-
though the diseases depending upon sexual difference
have traits peculiar to themselves, and sufficiently so to
make them a class distinct from others, they are yet so
much like all other complaints and affections of the sys-
tem, that they readily respond to the same general
remedies, and feel their influence, whether that be good
or bad.
Many, if not a very large proportion, of the diseases of
females are, in some stage, of an inflammatory character;
and the remedies that remove inflammation in the other
sex will do so in females also; and those articles which
aggravate inflammatory complaints in males, will also
aggravate them in females.
A disease may be of an inflammatory nature, and yet
so confined to a single organ, or to a particular part of
the body, that it shall not be felt by the system generally.
Thus we often see in females a congestion, or determina-
tion of blood to an organ, when there will be severe
local pain, and pain in the back with great weakness;
so great, indeed, is the debility that it is difficult to walk,
or keep the body for a long time in the erect position
without the mechanical support afforded by plasters.
MEDICAL PHILOSOPHY.
155
When this "weakness" has been complained of for
years where it has been considered as pure debility,
and treated as such-patients have been astonished to
find their strength immediately improved, by the loss of
a few ounces of blood by cupping or leeches. In al-
most every case of weak back, and debility, complained
of by ladies, there is more or less of a determination of
blood, or inflammation, about the back, or the internal
organs adjacent; and this may in a great majority of
cases be known by tenderness when pressure with the
fingers is made on the spine, or near to it. This test is
seldom fallacious; and we believe it is present in nine-
teen cases in twenty when "weakness" or debility is
complained of. It so happens that almost invariably
these cases are considered as pure weakness by quacks,
and too often by medical men, members of the profes-
sion; and the obvious plan of treatment in debility is to
restore the strength by tonics, stimulating drinks, and a
generous diet. The tonic regimen only increases the
difficulty; and not one in ten of those females who are •
thus affected can bear either tonics or stimulants, in the
smallest quantity, without an aggravation of their com-
plaint. After trying one remedy, they have recourse to
another; then another; and thus they go the round of
nostrums, and derive equal benefit from all—and that is
just none at all. When wearied with the internal use of
medicines they try external applications. These are far
better, for they do not add to existing disease; and, yet,
the relief they afford is but temporary, and the hope
they inspire is delusive. The most good that strengthen-
ing plasters do is by the mechanical support they afford
156
MEDICAL PHILOSOPHY.
1
to the muscles that retain the trunk in its erect position ;
they may also be of some little use as counter-irritants,
but their medicinal properties are of value only as they
are food for hope. "Strengthening plasters" are the most
innocent of all things pertaining to quackery; for it is
hardly possible that they can do any mischief; in most
cases they add to the comfort and ease of the patient.
Every lady, therefore, who has a weak back may wear
a plaster, or as many plasters as she thinks fit, without
risk of being made worse; and with very little prospect
of being made permanently better.
We well know that the word "debility" is a great
bugbear in the estimation of most females; and they be
lieve that if a person is absolutely unable to walk, and
is perhaps bed-ridden, it is proof positive that debility is
actually present; and any attempt to make them believe
the contrary would be considered downright imposition.
But appearances are exceedingly deceitful—and never
more so than in diseases of females. For the sake of
illustration we cannot forbear to introduce the following
case; and many parallels to it could be cited if necessary.
A lady had been ill for upwards of ten years, and had
passed through the hands, or rather had been subjected
to the practice, of many of the faculty, as well as a
multitude of quacks, besides having taken all the "cer-
tain cures" of all the good ladies that had never failed to
cure them and their relations. Still she grew progress-
ively worse, complaining at one time of pain in the bow-
els, dyspepsia, dysentery, and certain other irregularities
that rendered her whole life most wretched. As she
never experienced pain in the back unless from direct
1
MEDICAL PHILOSOPHY.
157
pressure, that was never suspected as being the seat of
the real mischief; and therefore remedies were address-
ed to those organs that seemed most to suffer. During
the whole time of her illness she had been under the
care of one or more who professed themselves skilled in
medicine, and it may be supposed that she made a fair
trial of tonics, cathartics, and in fact, any thing that
was prescribed. Another physician was now consulted.
He found her with a pale, and to appearance, almost
bloodless skin, and confined to her bed three fourths of
the time, solely because she was too weak-too debili-
tated-to sit up. On examining the back it was found.
tender to a great degree on pressure; and when it was
proposed to have leeches applied, or to have the back
cupped, she flatly refused. She protested against such
practice, because, as she said, she had been hardly able
to exist by the use of "bracing medicine;" and she felt
that bleeding would kill her outright. After much per-
suasion, however, she consented to be cupped. Only a
few ounces of blood were taken, which afforded the most
prompt and decided relief from all the distressing,
harrassing symptoms. This operation was repeated in a
few days; and from this time she began decidedly to
mend. So confident was she that cupping would cure
her, that she begged to have it repeated oftener than was
proper; and declared that she felt stronger after every
operation. As the disease subsided the blood returned
to the skin-her color improved-and in a few months
she was able to walk some distance-to ride-and in
fact, enjoyed better health than she had done for years.
This, to be sure, is an extreme case; but it is the same,
14
158
MEDICAL PHILOSOPHY.
2
precisely, except in degree, with very many cases of
weakness and debility in females.
Besides the weakness, and some complaints, peculiar
to the sex, there are others common to both males and
females. We allude to affections of the digestive or
gans; and, being combined as they are with a disease
peculiar to the sex-being sympathetic with it-and de-
pendent upon
it-it exists in spite of remedies while the
original disease continues. In the case narrated, the
patient suffered, year after year, the worst forms of
dyspepsia, for which multitudes of remedies were employ-
ed in vain. When the stomach and bowels sympathize
to any considerable degree-as they invariably do in
proportion to the primary complaint-they are apt to be
considered as the organ first affected; their disease is
thought to be the primary one; and, accordingly, remedies
are addressed to them while the real mischief is over-
looked.
To conclude these remarks, then, on the complaints
of females, we may be allowed to repeat, that the pa-
tients themselves are, in a vast majority of cases, ignorant
of the true nature of their malady; and the debility fre-
quently misleads a superficial physician, and more es-
pecially an unlettered empiric. The practice, founded
on this misapprehension which, almost always in chronic
cases, consists in the free administration of tonics, and
not unfrequently of stimulants, and, being the result of
error, must end in mischief.
1
CHAPTER IX.
OF RHEUMATISM-ITS EMPIRICAL TREATMENT, ETC.
THERE are few diseases, the existing cause of which
is to be found in climatorial influence, which are more
tedious and painful, and which are, frequently, attended
with greater danger than that protean malady called rheu-
matism. This disease is located by the best pathologists
in that tissue denominated fibrous; such as the mem-
brane covering the bones, the ligaments about the differ-
ent joints, the pericardium, or heart-case, one of the
membranes enclosing the brain, the sclerotic coat of the
eye, the sheaths of the muscles, and perhaps, the muscles
themselves. All those different parts are liable, though
not equally so, to attacks of this disease; and as some
are more important to the well being of the system than
others, so, of course, the danger is greater, in proportion
as the organ affected is more essential to vitality.
While, for instance, the disease attacks, and continues
în, the joints alone the pain may be as acute, and the
suffering as great, as when the disease is located in the
head or heart, although the danger would be but, com-
paratively, trifling.
Rheumatism has been divided by writers into acute,
or inflammatory, and chronic. The first form of the
disease is characterized by those general symptoms that
indicate other inflammatory complaints; while, at the
160
MEDICAL PHILOSOPHY.
same time, it possesses some traits of character peculiar
to itself. The division into acute and chronic is in fact
arbitrary and artificial; for they are both but different
degrees of the same disease; and, yet, they are so dis-
tinctive in their features, that a different or modified
treatment is necessary in the two forms of the complaint.
Any one who has experienced rheumatism in his own
person, or seen it in others, has felt or seen the skin
covering the joints, in the acute form, red, hot, and the
whole joint swollen, exquisitely tender and painful. In
the chronic form of the disease, on the other hand, in-
stead of the joint being red and hot, it is pale and inor-
dinately cold; and instead of the fever that is met with
in the acute form, in this it may be entirely absent
Common sense alone would teach any person that
two states of the system, so diametrically opposite in
their whole appearance, could not be cured by the same
plan of treatment-that a remedy which would cool one
part, in one individual, would not be very likely to warm
the same part in another person.
In accordance with the nature of the disease, its
diversified traits of character, etc., the plan of treatment
most successful is that based on general principles, and
so modified as to be adapted to the individual features of
each case.
Sometimes the most violent attack is cut
short, and the patient cured, by a repetition of copious
bleeding. This practice, proper only in robust individ-
uals, and those of strong constitutions, would, in others,
prove highly dangerous, if not fatal. And therefore,
another course must be adopted, which, though not so
efficacious, is, at least, free from danger. Where bleed-
MEDICAL PHILOSOPHY.
161
ing is improper, medicines that excite perspiration may
be next best; or cathartics may be indicated, or perhaps
neither. The choice of a medicine, or the general
course to be pursued in this, as in all diseases, should
depend upon the age, sex, temperament, hereditary
predisposition, actual state of the patient, and many
other circumstances that can be justly appreciated only
by a comprehensive, philosophic mind.
There is one peculiarity in rheumatism, which, for-
tunately, does not belong to many of the diseases that
afflict our race; and that is a tendency to change its
location-to wander from one part of the body to another.
It will sometimes attack one ankle, and, after remaining
there for a day or two, seize upon the ankle of the other
limb. Then it will return to the knee-joint of the limb
first affected, and after a time show itself in the other
knee. So it will go, alternately, till each joint in the
body has in its turn been visited. But it does not only
ramble from one joint to another, it goes from a less to a
more important organ-from one of the smaller joints to
the eye, the brain, or the heart. When rheumatism is
thus transferred, it becomes one of the most formidable
and obstinate of all the maladies in the catalogue of hu-
man ills. When it attacks the membrane covering the
brain, mental derangement is not an unfrequent conse-
quence; and whoever has once experienced it, knows
well that the pain is most dreadful. This disease assumes
the worst appearance when it affects the membrane
lining the cavities of the heart. It then produces violent.
palpitation, difficult respiration ossification of the heart's
14*
162
MEDICAL PHILOSOPHY.
valves, enlargement of the heart, and finally, either
general dropsy, or dropsy of the chest, which terminates
the “ sad eventful history."
When a disease possesses such a fondness for wander-
ing-when its very nature is that of a vagrant, here to-
day, and in another place to-morrow, now affecting one
part, and in a single hour, perhaps, fixed in some other
-the greatest danger is to be apprehended from any im-
proper application. We are taught by the observation
of facts, that rheumatism may be driven, as well as go
voluntarily, from one organ to another; and that when
it is thus driven, it is by no means as easily recalled.
Death has been known to result in a short time from the
sudden translation of rheumatism from the limbs to the
heart, in spite of the most active revulsive remedies that
could be employed. It follows, therefore, that, to pre-
scribe judiciously in this disease, an intimate knowledge
of its nature, in all its phases, is not only requisite and
necessary, but indispensable. Is it safe, then, that it
should be treated by quacks? Are the nostrums—the
(C ointments,'
""embrocations" the "liniments," and the
thousand and one specifics—all " certain cures”—proper
or safe to be indiscriminately employed? It is very cer-
tain that an application which will cure chronic rheuma-
tism will aggravate the disease when it assumes the acute
form. Nostrums are recommended for rheumatism,
without regard to its character in any particular case;
and the chances are, if the remedy is one of power, that
injury is quite as likely to follow its use as benefit. An
invalid, with chronic rheumatism, is advised to use a
stimulating application, with external heat, to his painful
joints; he does so, and is greatly relieved. He calls to
MEDICAL PHILOSOPHY.
163
see an acquaintance confined to his bed with rheumatism,
and hardly able to move a finger; and, without knowing
that the disease is of a different character from that
which affected him, he urges the sick man to try his
remedy. It is tried, with a ten fold aggravation of all
the suffering.
Rheumatism, by those who are not informed, is be-
lieved to be the same thing in all cases; and if the ap-
plication of Cayenne pepper, mustard, hot alcohol, or a
heated smoothing iron cures one, it will cure another.
And so, too, if the inventor of a nostrum can cure a few,
he may think that he can cure all; at any rate, if he is
disposed to be somewhat of a rogue, and practice upon
the credulity, hopes, and fears of invalids, he may know
that a great proportion of rheumatics will at least try his
remedy. Thus he finds a market for his invention; and
if he has not the good luck to acquire a fortune, he must
content himself with less success, or set his genius to
work in another direction.
Rheumatism may be, and indeed often is, mistaken
for other and more serious affections of the joints; and
where this is the case, the use of an improper remedy,
or the neglect to use efficient means may terminate in
the death, or permanent lameness of the patient. As an
instance of mischief resulting from ignorance, and conse-
quent neglect, we may adduce the case of a young lad
of this city, who, for several months, complained of pain
in one of his lower limbs, and other symptoms indicative
of rheumatism. His complaint was, of course, considered
by his parents as rheumatic, and by them treated as
such, till it had increased to such a degree that they very
164
MEDICAL PHILOSOPHY.
wisely called for medical advice. But it was now too
late. This disease was a scrofulous affection of the hip
joint; and it had made such progress, during the period
that it had been mistaken for something else, and when
perhaps it might have been arrested, that it was beyond
the reach of medical science. The boy fell a victim to
disease, because his parents thought he had rheumatism,
and being only rheumatism, they thought he would get
well.
The very fact that rheumatism too often baffles the
skill of the wisest and best physicians, is with many a
sufficient reason for placing themselves in the hands of
quacks, and submitting to the impositions of the most
ignorant charlatans.
The reason that leads people to act thus would be
called little else than madness if applied to other subjects.
If for instance a skillful jeweller cannot repair a pearl, or
diamond ornament, would a stone mason, or carpenter
be any more likely to do it, because they can build a
splendid house?
1
CHAPTER X.
OF DEAFNESS-THE ORGAN OF HEARING ITS STRUCTURE
-CAUSES WHICH DERANGE ITS FUNCTIONS- NUMBER
AND VARIETY OF ITS DISEASES-THEIR TREATMENT-
QUACK REMEDIES, ETC.
Few organs in the human machine are more useful
than the ear; and the loss of any of the senses is not
more to be dreaded than the loss of the sense of hearing.
Meckel calls this "the most noble and intellectual of all
the senses." The ear may be less complicated in its
structure than the eye; yet, on examination, we shall
find it an extremely delicate organ, and its functions
deranged by slight causes.
Deafness is but a symptom, or rather the result of a
variety of diseases, or of disease, affecting the different
tissues that contribute to the formation of the organ of
hearing. Deafness is too often considered as a disease
by itself a simple thing; and, accordingly, prescribed
for without a knowledge of the structure of the ear, or
the laws which govern its functions. On the other hand,
a loss of hearing has been considered as an incurable
malady; and one who has been so unfortunate as to be
thus afflicted, has been pronounced as past help, past
hope, when, perhaps, a simple remedy would have re-
stored to him that which is above price.
The organ of hearing is divided by anatomists into
34
166
MEDICAL PHILOSOPHY.
J
three parts; the external ear, the middle ear, and the
internal ear.
1. "The external ear, embraces the cartilage, and
the auditory passage.
2. The middle ear is formed by the cavity of the
tympanum and its appendages.
3. The internal ear is formed by a series of cavities
known as the labyrinth."
A very brief description of the middle and internal
ear is all that is necessary in this place.
Membrane of the Tympanum.
This is a thin, elliptical membrane, which separates
the external auditory passage from the middle ear. It is
stretched across the long canal so as to be a partition.
Its analogy both in situation and function to the head of
a drum is very close.
Тутрапит.
The tympanum or drum is a narrow,
rounded cavity.
It forms the central part of the ear, and presents numer-
ous depressions and elevations, which are connected with
the labyrinth. It encloses the little bones of the ear,
the cord of the tympanum, and is lined throughout by a
mucous membrane which is continuous with that of the
throat. All the numerous depressions, elevations, open-
ings, etc. of the tympanum have each their anatomical
name and description; but which would be little edifying
to the non-professional reader, and may therefore be
omitted.
MEDICAL PHILOSOPHY.
167
Eustachian Tube.
The Eustachian tube is a canal of about two inches
long running from the top of the throat, or posterior part
of the mouth, to the cavity of the tympanum.
Bones and Muscles of the Ear.
The bones of the ear are the smallest bones in the
body. There are three; the hammer (malleus,) the
anvil (incus,) and the stirrup (stapes ;) and in the early
periods of life a fourth, the orbicular bone. These form
a chain, and extend from the membrane of the tympa-
num to the labyrinth. These bones are articulated or
form joints with each other, and have four muscles
attached to them by which they are moved whenever an
impression is made upon the membrane of the tympa-
num. These muscles, like the bones, are the smallest in
the body.
The Labyrinth.
The labyrinth is divided into the vestibule, semi-circu-
lar canals, of which there are three of about half a line
in breadth; the cochlea, which takes its name from the
shell-fish which it perfectly resembles; the aqueducts
—the aqueduct of the vestibule, and the aqueduct of
the cochlea. A part of the labyrinth is called the
membranous labyrinth, and contains in its cavity a fluid,
called the lymph of Cotugno.
Auditory Nerve.
This nerve upon which depends the faculty of hearing,
enters the auditory passage and is distributed to the
168
MEDICAL PHILOSOPHY.
:
membranous labyrinth. Its branches are sent to the
vestibule, semi-circular canals, and cochlea; and they
terminate in the pulp, or fluid, which fills those cavities.
In addition to the organ of hearing, as above described,
there are the mastoid cells-irregular cavities in the
large bony prominence behind the ear-which in some
manner contribute to the perfection of the sense of
hearing.
Physiology of the Sense of Hearing.
The sonorous vibrations of the atmosphere are con-
ducted by the external auditory passage to the mem-
brane of the tympanum; this conveys the impression to
the chain of small bones, which, being put in operation
by means of their muscles, transmit the impression to the
cavities in the labyrinth, in the fluid of which the audi-
tory nerve terminates, and by this nerve the impression.
is carried to the brain. The drum of the ear, like any
other drum, to be able to emit any sound must have a
communication from its interior with the external air,
that its membranes may be allowed to vibrate. This
communication is permitted by means of the eustachian
tube; and whenever this is obstructed, as it frequently
is, by inflammation and swelling of the throat, or by
thickening of the membrane lining its internal surface,
the sense of hearing is impaired or wholly destroyed.
Diseases of the Ear.
To any one who should take but a single glance at
the organ of such complexity as the ear, it would seem
that its diseases should be many, and also of a complica-
MEDICAL PHILOSOPHY.
169
ted character. Such indeed is the fact. Without tak-
ing into consideration injuries done to the ear by ex-
ternal violence, and congenital imperfections, the follow-
ing may be reckoned the most important diseases to
which the organ of hearing is liable. They are taken
from Cooper's Surgical Dictionary.
I. 1. Auditory passage obstructed by thickened or
hardened cerumen (wax.)
2. Imperfect secretion of wax.
3. Discharges from the auditory passage.
4. Excrescences in the auditory passage.
5. Herpetic, ulcerous eruptions in the auditory
passage.
II. Affections of the Tympanum.
1. Perforation of the tympanum by sloughing conse-
quent upon scarlet fever, acute inflammation, etc.
2. Fungus of the tympanum.
3. Caries, or ulceration of the bones of the tym-
panum.
4. Relaxation of the membrane of the tympanum.
5. Tension of the membrane of the tympanum.
6. Chronic thickening of the membrane of the tym-
panum.
7. The cavity of the tympanum intersected by nu-
merous membranes that impede the motions of the
small bones.
III. Obstructions of the Eustachian Tube.
1. Obstruction from thickened mucous in a severe
cold.
2. Obstruction from thickening of the lining membrane
in inflammation.
15
170
MEDICAL PHILOSOPHY.
3. Obstruction, and permanent deafness, by the heal-
ing of sores in the throat when the tube is obliterated.
4. Obstruction from swelling of the tonsils, in quinsy,
scarlet fever, etc.
IV. Obliteration or obstruction of the mastoid cells
from thickened mucous, inflammation, etc.
V. Diseases of the Labyrinth.
1. Disease of the fenestra ovalis, and fenestra rotun-
da, as ulceration, thickening, etc.
2. Inflammation of the mucous membrane which
lines the cavities of the labyrinth.
3. Alteration of the liquor of Cotugni, or Cotunnius.
4. Deficiency of the same fluid.
VI. Affections of the auditory nerve.
1. Diminution of size.
2. Change of structure, as hardening, etc.
3. Paralysis.
VII. Disease of the brain, or its membranes, in the
part from which the auditory nerve originates.
It is not within the power of credulity to believe that
such a variety of diseases are to be treated, successfully,
by the same general plan; much less that they are to
be all cured by the same remedy. When diseases of
the ear are of a decidedly inflammatory character, they
are most readily cured by the antiphlogistic, or "re-
ducing" method, carried to such an extent as all the
circumstances of the case seem to render necessary.
These modifying, or controling circumstances are,
1. The violence of the disease.
2. The particular part affected.
3. Duration of disease.
MEDICAL PHILOSOPHY.
171
4. Cause of disease.
5. Age of the patient.
6. Constitution and strength of the patient. ·
7. Hereditary predisposition.
8. Occupation.
9. Sex.
These, and other equally important considerations,
must render the practice materially different in any two
similar affections of the ear, or its appendages; and
however alike they may be, the skilful, observant, prac-
titioner will yet see such difference in their characters as
to modify his prescriptions to suit each individual case.
The same disease in the organ of hearing, like a disease
of any other part, does not require the same treatment
throughout its course; but when the disease abates, or in
any other particular changes its character, the remedies
must be changed also.
The depleting, or reducing plan consists in bleeding
from the arm, leeching, cathartics, etc. Now, it so hap-
pens that a copious bleeding from the arm is occasionally
necessary in the commencement of the treatment of in-
flammation of the ear, or any other organ; and it is
necessary to repeat this, and not unfrequently is it also
necessary to apply leeches once and again, in the same
case, till the force of the disease is subdued. But when
this is done, it would be unwise to pursue the same vig-
orous measures; for instead of curing, they would probably
kill the patient. The practitioner, therefore, if he under-
stands what he is about, will resort to other means less
active, but sufficiently so, to continue the impression al-
ready made.
172
MEDICAL PHILOSOPHY.
To rightly understand the diseases of the ear, it is
necessary to be intimately acquainted with its structure-
with all its complexity; and he who attempts to repair
this organ without a knowledge of its anatomy will be
altogether more likely to do irreparable mischief than to
do good.
There has been one remedy, much used of late, from
which have resulted the most happy effects. It is the
injection of air, or fluid, into the internal, or middle ear,
or tympanum, through the eustachian tube. Deafness
of many years standing, has thus been cured; but like
all remedial means, it can only be applied in certain
cases with any reasonable hope of success.
Various remedies have been used in affections of the
organ of hearing by being applied to the membrane of
the tympanum through the auditory passage; these, too,
are adapted to particular cases only, and much care is
requisite in their choice, lest the delicate organization be
injured.
Notwithstanding the complexity of this organ, and the
multiplicity of diseases to which it is subject, and the di-
versity of their character, as well as the variety of treat-
ment necessary for their cure, we yet see those who are
totally ignorant of the whole subject, boasting of their
"certain cures," for " deafness." To cure deafness, it is
necessary to know what part of the organ of hearing is
in fault; and yet the quack knows not that it consists of
more than one part.
It is a part of the system of quackery to be able to
give a rationale-the philosophy-of all disease that it
professes to cure. A quack, or any one who rides his
MEDICAL PHILOSOPHY.
173
hobby, will make one, as ignorant of the subject as him-
self, believe that he knows all that he pretends. He will
talk learnedly about the physiology of this and that organ,
and the operation of medicines; he will discourse wisely
on the nature and cure of disease, and his auditors will
listen with great attention, and drink in with greedy ears
every syllable uttered by this oracle, and be about as
much edified as an assembly of ladies with a Hebrew
oration at a college commencement.
All the "cures" for deafness may occasionally do
good; but when the remedy is a secret, it is always un-
certain what the effect will be. It is like striking at ran-
dom at an unseen enemy; if the blow is successful, it is
the result of good luck rather than of a sure aim.
15*
:
•
7
CHAPTER XI.
OF CANCER-CANCER DOCTORS, ETC.
THIS disease takes the Latin name of the crab,
from its fancied, or real, resemblance to that animal. It
affects many parts of the body, as the breast, lips, skin-
particularly of the face-stomach, or rather its pyloric
orifice, etc.
The first that is discovered of this disease is, generally,
a hard tubercle or tumour, of a greater or less size,
sometimes having the feel under the skin of a sliot, or not
unlike that of a marble. The resemblance to a crab
consists in what may be termed prolongations from the
central tubercle; they are bands of diseased cellular
membrane, and, diverging as they do, a fertile imagina-
tion has likened them to the legs of the sea crab.
It is not every lump felt in the breast, or any other part
of the body that is a cancer; and, again, tumors that are
at first harmless assume a malignant appearance and
become cancerous. To distinguish at all times, and with
accuracy, between what is originally simple, and what
malignant, and to decide with certainty that the simple is
not to become malignant, is a degree of perfection to
which medical science has not yet attained. This much,
however, may be considered as settled-that when a
tumour does not disappear under the most appropriate
treatment, and particularly, if it shows any disposition to
:
176
MEDICAL PHILOSOPHY.
་
increase or to become painful, or otherwise troublesome,
it should be at once freely removed with the knife.
This is safe, but little painful, and if the disease is local,
the constitution being unaffected, is pretty sure of success.
A cancerous tumour is most generally discovered by
accident, so that it is probable that it may have existed
for a long time, without in any degree disturbing the
health. But immediately after discovery, it may com-
mence a rapid march in its progress to maturity. This
is, doubtless, accelerated by mental anxiety in regard to
the suspicious character of the tumour; and the frequent
handling, with, perhaps, stimulating or irritating applica-
tions, contributes in no small degree to the same result.
When speaking of the treatment of this disease we shall
see that whatever irritates, aggravates it; and the more
frequently such remedies are applied, in the same pro-
portion do the chances of a cure diminish.
The exciting causes of cancer are various; among
which are blows, pressure, etc. An injury, which results
in cancer, is not unfrequently done in assisting females
to alight from a carriage, or other height, by placing the
open hands under each arm. This must, necessarily,
bring both thumbs in contact with the breasts; and as
way are generally either
those who are assisted in this
consequently, so
Many, who have
delicate, or in feeble health, they are,
much the more likely to be injured.
suffered from cancer, can trace the first uneasy feelings
they have experienced to a slight hurt on being assisted
to alight from a carriage in this manner; and little was
thought of it, because no danger was apprehended from
MEDICAL PHILOSOPHY.
177
so slight a cause, till the disease proclaimed itself in so
audible a voice that it would be heard.
Pressure from a tight dress is another frequent exciting
cause of cancer; and so it is of pulmonary consumption,
dyspepsia, and a host of other maladies that render the
life wretched-and, yet, it is foolishly, madly, persisted
in. The constant, and long continued pressure of a
hickory, or steel busk, will, invariably, in one predisposed
to cancer, excite an irritation that will develope the
disease.
Cancer is said, and believed by the best writers to be,
hereditary-which means that a child inherits, not cancer
itself, but a constitution, a temperament which predis-
poses to the disease, and in which the disease may be
produced by slight causes. Those who have had a
parent afflicted with cancer are often apprehensive that
they will be afflicted also; and if they do believe that
they inherit the taint, cancer rises up to their imagination,
like a spectre which is said to haunt a murderer, to em-
bitter all their days. The mind works on the anticipated
evil; search is made, much too frequently, for a tumour,
and if not found, its appearance is waited for with the
greatest uneasiness. The anxiety of mind adds to the
predisposition already existing, and renders the occurrence
of cancer the more certain.
Even where the hereditary constitution exists, it does
not render it positively certain that the disease is to be
developed; for by adopting a proper course for the
regulation of the whole life, the inherent tendency may
be greatly counteracted or entirely obliterated.
Cancer has, very justly, been considered as one of the
178
MEDICAL PHILOSOPHY.
1
opprobria medicorum-one, that under all or any circum-
stances, has small chance enough of being permanently
cured. And because it calls for, and too frequently
baffles, the skill of the profession, like other diseases it
has afforded a most excellent opportunity to the empiric,
to enrich himself, without affording to his patient any
reasonable hope of benefit. The more certainly fatal,
and consequently, the more alarming the disease with
which a person is afflicted, the more is he disposed to
trust himself to the uncertainties of charlatanry. Cancer
may be, as it frequently is, cured by extirpation with the
knife-the only certain and only safe remedy. External
applications have also been used, and, sometimes, with
temporary, or it may be, permanent good effect; and
these are the remedies most constantly employed by the
empiric. The cancer-doctor professes to be in the pos-
session of a secret specific for this disease; he works
upon the fears of those who have, or believe they have
cancer, and who, being desperate, like a drowning person
grasping at straws, seize upon the frail hope that is
offered by the hand of ignorant charlatanry. The em-
piric decries the surgeon's knife and professional skill;
he boasts of his cures, and unparalleled success, and in
confirmation of his arrogant pretensions presents certifi
cates of cures signed by names of unquestionable veracity.
The applications most commonly employed by quacks
for the extirpation of a cancerous tumour, are plasters
into which enter, as a principal ingredient, some one of
the mineral escharotics. A preparation of arsenic is
more frequently used than any other. The patient is
made to believe that the pain arising from the applica-
MEDICAL PHILOSOPHY.
179
tion of a caustic substance, and the consequent suffering,
is much less than that caused by the knife, which is just
as true as to affirm that the prick of a cambric needle is
more dangerous than a stab from a bowie knife, or a
thrust from a bayonet.
The "
cancers," that are cured by cancer-doctors, are
not cancers, though they may resemble them, and may
have been pronounced such by eminent professional men.
Their close resemblance to cancer, and their cure,
answer all the purposes of the empiric-to gull the
people and obtain their money. A man of gross habit,
who is more likely to be affected with tumours in the
has a
skin, or other parts usually the seat of cancer,
lump in the cheek which creates no little anxiety; he
consults a physician who assures him that the disease
has no appearance of cancer, and prescribes a course
that will, in all probability, remove the unwelcome
visitor. But not satisfied with this, he hears of some
famous cancer-doctor who has wrought most marvellous
cures, more especially in those whom the doctors had
given up, and forthwith, he seeks out the quack to test
his skill upon himself. A pretty liberal price, in advance,
is always sure to elicit such an opinion and prescription
as will harmonize with the preconceived notions of the
patient; if he believes it is a cancer, then the cancer-
doctor pronounces it so at once; if he thinks otherwise
the cancer doctor thinks so too, unless it is for his inter-
est to think differently. If the tumour is decided by the
quack to be a cancer, an application of some caustic
substance-something that destroys the part to which it is
applied-is made; and if the thing be really a cancer
:
180
MEDICAL PHILOSOPHY.
there is a possibility that it may be cured, while there
is a great probability—many chances to one-that it will
not only not be cured, but that it will be so aggravated
that it can never be successfully removed by a surgical
operation. When a cancer is cured by plasters, or when
any tumour is thus removed, it is done by the intense
inflammation excited either in the tumour itself, or the
adjacent parts, or it may be both; this terminates in a
sloughing, or casting off of the diseased part, leaving only
an ordinary ulcer which soon heals.
Cancer, if it be at first a purely local disease, the
constitution uncontaminated, shows an invincible tenden-
cy to extend itself to the neighboring glands, and to de-
velope itself in them. If, for instance, it appears in the
breast, it soon affects the glands in the arm-pits; they
become involved in the disease, and if they do assume
the cancerous nature, the patient generally becomes a
victim. Hence it is, that in all treatment for cancer,
irritating applications and stimulating medicines should
be studiously avoided; and, therefore, every caustic that
does not cure, invariably does mischief, by adding fuel to
the flame. When a tumour, whether it be cancerous or
not, is cured by the application of a caustic plaster, it is
generally removed whole; and if there are prolongations,
or offsetts, from the central body, these not unfrequently
come away at the same time. The cancer-doctor then
boasts of the triumph of his skill; and the patient, not
knowing that his life has been placed in jeopardy by the
rash means of cure, readily believes all that is told to
him. The disease is named cancer, the cure is pro-
claimed far and wide, and the cancer-doctor reaps a fresh
harvest of glory and-cash.
MEDICAL PHILOSOPHY.
181
1
But while one is cured of cancer by quackery, forty
are killed; and when death is the result, the cancer-
doctor, though he be as ignorant as a baboon, attributes
it to any thing else rather than to his want of skill, or
ignorant interference. The fame of cancer-doctors is
acquired by curing bad ulcers, and by removing sus-
picious tumours that might perhaps have become cancer-
ous, and by also removing simple tumours that would
never have become malignant. These are all named
cancer, and hence the reputation consequent upon curing
them, which would be no more than is justly due, were
the claims founded in truth and justice. An empirical
mode of treatment of cancer is, in any case, without ex-
ception, when the disease is not recent, and the tumour
small, and confined to a single spot, positively hurtful;
and every irritating application, and every day of delay,
is increasing the danger and diminishing the chances of
a recovery.
There seems to be a tendency, in the minds of most
people, to magnify the dangers of disease. If a child is
sick, its parents think it very sick; and if the doctor
looks upon it as a little dangerous, they think the danger
imminent. And so it is with adults themselves; they
like to be thought dangerously ill, when perhaps they are
only moderately indisposed; and they perhaps take
offence if their disease is not regarded by their friends as
it is by themselves. It is not an unfrequent occurrence
that a physician, when he perfectly understands a case,
and is treating it wisely and successfully, is dismissed in
disgrace, if he does not concur with the patient and his
friends as to the degree of danger. To account for this
y
16
182
MEDICAL PHILOSOPHY.
M
obliquity of the mind is not our purpose; but it is used
as a most powerful lever, by more than cancer-doc-
tors for the furtherance of selfish, and disreputable ob-
jects. It is this strange feature in the mental character
that accounts in great measure for the easy credulity
of those who happen to have any tumour that resembles
cancer; they help to cheat themselves even to their own
most serious detriment.
We here subjoin an extract from an epitaph on a
cancer-doctor, written by Dr. Hopkins, of Waterbury,
Conn. many years ago.
"Go readers gentle, eke and simple,
If you have wart, or corn, or pimple,
To quack infallible apply,
Here's room enough for you to lie.
His skill triumphant still prevails,
For death's a cure that never fails,"
CHAPTER XII.
OF MEASLES-BAD MANAGEMENT OF MOTHERS AND NURSES.
THE measles is a disease, which, though not often
treated by quacks, or quack remedies, is yet frequently
treated in such a manner that the patient is sacrificed to
some popular remedy. It is our intention only to glance
at this disease, for the sake of noticing one or two great
errors that we have, too often, seen lead to fatal results.
This is a complaint of childhood. It is contagious,
and one of those diseases which visits us generally but
once in our lives. But it occasionally happens that a
person may be exposed to measles, hundreds of times, in
all the stages of childhood and youth, and yet escape,
till, perhaps, in advanced life a fresh exposure is followed
by the disease in a most aggravated form. Infants at
the breast do not usually contract this disease; though
to this there are frequent exceptions.
The measles is observed to run a pretty uniform
course, in all cases, after exposure to the contagion.
There will be the same catarrhal symptoms-the sneez-
ing, coughing, watery eyes, pain in the head, etc. succeed-
ed by chilliness, pains in the back, and bones, fever and
eruption. These symptoms do, indeed, differ in degree
—that is, the disease is more violent in some than in
others, though in all it has the same characteristics-its
own peculiar features. When it shows itself with great
A
184
MEDICAL PHILOSOPHY.
violence it may be mitigated by medical treatment; but
it must run its determinate course-it must pass through
its several stages; and he who would attempt to avert it
in its course- -to cure it before the period of efflorescence,
might as well, and as wisely,
"Seek to fetter flame with flaxen band,
Or stem the raging stream with sand."
All that can be done is to change its character from a
dangerous to a safe disease, and watch it carefully during
its progress to a happy termination.
From one to two weeks, generally, after exposure to
contagion, the catarrhal symptoms commence; and
about four days later the eruption makes its appearance.
About the fifth or sixth day it begins to fade, and gradu-
ally disappears, so that by the tenth or eleventh day the
skin has resumed its healthy aspect. Though the disease
is in fact the same at all times and seasons, it is much
worse at one time than another. It usually prevails
more extensively in the winter and spring than at any
other season; and at this time, too, it is most violent.
But it assumes the worst appearance, and proves the
most fata!, when it appears as an epidemic-spreading
over a great extent of country; then it is that it makes
sad havoc among the youthful population.
The point that we desire to impress most forcibly upon
the minds of our readers is this-that the eruption is al-
ways proportioned to the degree of fever; and therefore,
whatever aggravates the latter, increases the former.
With the fever commences the danger in measles; and
as the eruption is the measure of fever, so we may con-
MEDICAL PHILOSOPHY.
185
sider it to indicate the degree of danger. But, unfor-
tunately, this is not so with the mass of "the people."
With them it is directly the reverse. They think the
greater the quantity of eruption, the better the child has
the disease. Misled by this most erroneous and fatal
notion, and desirous of bringing all the measles out, they
accordingly force the child to swallow large quantities of
hot herb tea, gin toddy, cider, and other drinks of a
kindred nature; and not satisfied with thus setting on
fire the habitation-and expelling the enemy, they con-
fine the patient in an overheated apartment, smouldering
under a heap of bed clothes. And now the mother or
nurse will express her wonder to the doctor why her
child should be so sick, with so much fever, or delirious,
when the measles have come out so well;" and, to
show how well they have come out, she carefully re-
moves the bed covering, exposing the patient as red as a
boiled lobster. If it so happen that a physician is not
opportunely called in at this time, the same stimulating
treatment is continued, with a design to bring out all the
measles; and the disease thus aggravated-forced into
violence-attacks some vital organ, and speedily ter-
minates existence. Every practitioner of medicine has
seen many such cases within his sphere of observation;
we believe we shall be borne out by the concurrent
testimony of the profession, when we say, that a large
proportion of deaths from measles result from neglect of
appropriate treatment during the stage of febrile excite-
ment.
A principal reason why physicians are not sooner,
and more generally called in this disease, is the popular
16*
186
MEDICAL PHILOSOPHY.
opinion that they can do no good in measles, because the
disease will run a definite course in spite of medicine.
This error is as general and as fatal as the administra-
tion of alcoholic, and other stimulating drinks. It by no
means necessarily follows, that if the measles cannot be
stopped short, and perfectly cured, like pleurisy, at their
commencement, they cannot be mitigated and rendered
free from danger.
The organs most likely to become immediately in-
volved in disease, in measles, are the lungs, or rather
the mucous membrane lining them, and the whole res-
piratory apparatus. They are affected during, and
subsequently to, the measles, with a peculiar inflamma-
tion-different in its nature from inflammation conse-
quent upon exposure to cold, or that resulting from any
other cause, less under the control of the physician, by
any treatment that he may adopt, and, of course, more
likely to prove fatal.
Great caution is required, after the eruption has
disappeared, that a relapse is not induced; for this is al-
ways more dangerous than the original disease, and is
- very apt to follow a slight exposure to cold or a trans-
gression in diet that, at other times, might be committed
with impunity.
The conclusion, then, in regard to measles, is, that it
is a disease not to be trifled with; that if medical advice
is sought at all, with the hope of being benefited thereby,
it should be in the early stage of the disease; and that all
the medical treatment employed by mothers, should be
confined to a dose or two of castor oil, bathing the feet
in warm water, and giving the patient to drink either
MEDICAL PHILOSOPHY.
187
toast water, or warm flax seed tea. We do not say that
there are not cases where other, and more efficacious
means are not requisite to bring the eruption to the sur-
face; we know that cases do occur that require the
most energetic remedies to save the patient from the
dangers of a local inflammation. But these remedies
are not to be prescribed by an ignorant head, or ad-
ministered by an unskilful hand. This, like all dis-
eases where the issue may be doubtful, and which we
know do sometimes terminate fatally, had better be left
to the management of the family physician. If the pa-
tient requires but little or no attention, then this attention
costs but little; and if one or two professional visits
prevent a protracted or dangerous illness, a great point
is gained.
}
CHAPTER XIII.
OF NATURAL BONE-SETTERS-NATURAL FOOLS, Structure
OF THE JOINTS, ETC. ETC.
THE world has always been blessed with a goodly num-
ber of those who claim to have acquired extraordinary, if
not supernatural power. Some have claimed to be pro-
phets, having been divinely inspired; and professing to
have held communication with the Almighty and receiv-
ed revelations from him, claim to possess a knowledge of
all things past, present, and to come. Some are said to
be born with these powers. The seventh son was, and
is yet, believed by many to possess the power of curing
some diseases by touch, and to be in fact a natural doc-
tor-being born into the world with a taste for physic,
and a fondness, and faculty, for prescribing it. We
have seen, in the former part of this volume, that the
practice of medicine in the early ages consisted in the
performance of incantation, and in working "mighty
magic ;" and we have seen, too, that such practice was
agreeable to the ignorant and superstitious people of those
primitive times.
But all such fooleries and mummery no more than
equal the arrogance, and pretentions of some few char-
acters of our own day and generation. There are some
few cases on record, of children being born with a good-
ly quantity of hair and nails; others are known to have
190
MEDICAL PHILOSOPHY.
made their entrè with a few teeth; and a fewer number
still have exhibited a goodly set of double teeth in both
jaws. A little girl might have been born with a tolerably
fair knowledge of music, dancing, and sundry other ac-
complishments; or she might have made her first appear-
ance with her tender head well stocked with a know-
ledge of domestic duties. But such an instance has nev-
er come to the writer's knowledge; nor has he ever
heard of a boy who commenced his pilgrimage here
with a knowledge of the dead languages, or even with a
smattering of his vernacular tongue. It is said, in my-
thological fable, that Minerva leaped from the head of
Jupiter full grown, and completely armed; but there
has not been a single instance known, in our day, of a
child having been born even booted and spurred.
Some few, however, assert that they are born with a
knowledge of anatomy and surgery; that if not adult in
in stature, they are, at least, adults in medical science;
if not full grown men, they are full grown doctors—in
short natural bone-setters. People have different tastes,
and different faculties for acquiring knowledge; but we
may, just as reasonably, expect one child to be born
with an intimate knowledge of navigation, or clock-
making, as for another to possess an acquaintance with
medical science. But natural bone-setters find na-
tural believers in their extraordinary skill; and like all
other quackery, the more magic the more money.
A certain gentleman, pretty extensively known as a
teacher of writing, advertised to teach his art, and to
make his pupils first rate penmen in a very short space
of time. He succeeded in obtaining the number of
MEDICAL PHILOSOPHY.
191
scholars he desired. One of his competitors resolved to
make an experiment upon the gullibility of the public,
and accordingly, put forth an advertisement, in which he
magnified his own abilities as a teacher of penmanship,
and professed to accomplish his pupils in the art of
writing in the incredibly short space of five minutes.
The bait took, and, big as it was, some easily, and
gladly, swallowed it. The advertiser meant it for a joke
-a burlesque upon one whom he considered a quack ;
but notwithstanding its palpable absurdity, pupils offered
themselves for instruction.
It is the boast of these self-styled natural bone-setters
that they never saw a human skeleton, or even a single
human bone; and they probably never so much as
dreamed of dissecting the human body. To study the
bones of a dry skeleton, alone, does not afford sufficient
knowledge of the joints to make one skilful in reducing
them when dislocated. In the living body the ends of
all the bones which form joints are covered with a
cartilage; and this is never seen in the dry skeleton.
There are ligaments also whose use is to retain the bones
in contact, and preserve the integrity of the joints. They
are very firm and strong; and there is always more or
less rupture of these ligaments in dislocation. They
interfere, too, with the operations of the surgeon in his
efforts to replace a dislocated bone; so, that, without a
knowledge of their existence, and their particular rela-
tions with the joint, much more pain and suffering to the
patient is caused, if in fact, the bone can be reduced at
all. The tendons of muscles, too, pass over some of the
joints in such a manner as to make the reduction or
192
MEDICAL PHILOSOPHY.
:
setting, of a dislocated bone extremely difficult; for they
are put upon the stretch, and firmly retain the bones
where accident may have placed them. The position of
a limb most favorable to the reduction of a dislocation,
or fracture, is a point too frequently overlooked by the
best surgeons—and unknown to the empiric, or natural
bone-setter. For instance, a joint may be dislocated,
which always puts some of the muscles upon the stretch.
Now the ends of the bones are so situated that they must
be separated before they will slip into their proper places;
and this is to be accomplished in only one of two ways,
to wit—either by directly extending the limb by force, or
by placing it in such a position as to relax those muscles
already upon the stretch. The muscles can be stretched
only to a certain extent; and, if their tension is already
carried to the utmost, it is quite clear that they can be
stretched no more. It is often the case that after the
force of three or four men has been repeatedly applied
in vain, to a dislocated limb, under the direction of an
ignoramus, and sometimes, too, under the supervision of
those who ought to know better, a skilful surgeon has,
by placing the limb in a proper position, and without any
assistance, slipped the bone into its place in an instant.
The most remarkable instance of oversight in this par-
ticular, that we can recollect to have heard occur to an
eminent surgeon, was related to us by Dr. Stevens of
this city, who is as distinguished for his unpretending
manners, and his total want of arrogance, as for his
good judgment and practical talent in the profession to
which he is devoted, and to which he does great honor.
When in Europe, a few years since, the doctor visited
MEDICAL PHILOSOPHY.
193
!
one of the principal hospitals in company with the attend-
ing surgeon of the establishment. A patient had just
been brought in with a compound fracture of the leg, the
broken extremity of bone projecting an inch or two
through the skin. The foreign surgeon made an
attempt to replace the bones; he directed several assist-
ants to extend the limb with all their power, but it was
not sufficient-the bones were immovable. After re-
peated, ineffectual, trials of this kind, the doctor gave it
up as an impossibility, and said he would remove the
ends of the bones with a bone forceps. While crossing
the hospital yard with Dr. Stevens to procure the instru
ment, Dr. S. said to the surgeon in his quaint way, that
he had often found flexing the limb to have a good effect.
Stop," says the other, "that's a good thought, let
us go back and try it." So they returned; the surgeon
put the limb in a proper position, and in less than a
minute the bones were in their place. So much for one
of the largest European hospitals, and one of the most
eminent European surgeons.
((
The following account of the structure and diseases of
the joints was prepared, at the author's request, by his
brother Dr. B. Ticknor, Surgeon in the United States
Navy, and Fleet Surgeon of the South Sea Surveying
and Exploring Expedition.*
Structure of the Shoulder Joint.
The shoulder-joint is formed by the junction of two
bones, namely: the shoulder-blade, and the arm-bone.
The former is a broad flat bone, and so connected with
He has since resigned the office of Fleet Surgeon.
17
194
MEDICAL PHILOSOPHY.
the trunk, through the medium of muscles, as to be quite
movable, and thus allow a greater extent of motion to
the arm, than it could otherwise have. In this particular,
the connection of the upper extremity with the body
differs from that of the lower extremity; for the latter is
connected with the body through the medium of a bone,
which itself has no motion, and allows less freedom of
motion to the lower extremity than the arm enjoys.
The articulating cavity of the shoulder-blade is so
shallow as to receive only a very small segment of the
head of the arm-bone; and were it not for the ligaments
and muscles which surround this joint, it would be ex-
tremely insecure, and dislocations would be liable every
moment to happen. That part of the shoulder-blade in
which the articulating cavity is situated, is connected
with the body of the bone by a neck, which, though
short and thick, is nevertheless liable to fracture. It is
important to mention this, since a person not well ac-
quainted with the anatomy of these parts, might easily
mistake the fracture just mentioned, for dislocation of the
shoulder, and treat it as such; the consequences of
which would be more serious.
The head of the arm-bone being nearly round, and
being received into a very shallow cavity; the arm en-
joys a much greater extent and freedom of motion than
it otherwise could.
The security of this joint depends, almost entirely, as
we have said, upon the ligaments and muscles which
surround it. The most important ligament concerned in
the structure of this joint, as indeed of all other movable
joints, is the capsular. It is of a very firm texture, is
A
MEDICAL PHILOSOPHY.
195
firmly attached to the neck of the shoulder-blade, and to
the arm-bone just below its head, and thus surrounds the
joint like a sack. It is loose, in order to admit of the
freedom of motion which it is necessary the arm should
enjoy.
The greatest security of this joint, however, depends
upon the strong muscles which surround it. There are
four of these whose office it is, to draw up the arm and
keep the head of the bone from being thrown out of its
shallow socket. There are also four muscles connected
with the arm-bone in such a manner as to draw it down-
ward. It is important to understand the situations and
offices of these several muscles, in order to understand
fully what takes place in a dislocation of the joint, and
the scientific and proper manner of reducing a disloca-
tion. Without a correct knowledge of the anatomy of
these parts, it is impossible that any one can know pre-
cisely what obstacles he has to overcome, before he can
replace the dislocated bone. This will be rendered evi-
dent from the few words we shall say upon
Dislocations of the Shoulder-Joint.
No joint of the body is so liable to dislocation as the
shoulder, as any one acquainted with the structure of the
joint might suppose. The arm-bone is liable to be dis-
placed in three different ways; 1. downward into the
arm-pit; 2. downward and forward, with the head of the
bone under the large muscle of the breast; and 3. down-
ward and backward. Of these three kinds of dislocation,
the first is much the more frequent; and next to this the
second is the most common. A dislocation upward
196
MEDICAL PHILOSOPHY.
་
A
cannot take place, without a fracture of a bony process
of the shoulder-blade, which covers the upper part of the
joint in the form of an arch.
It has been mentioned that a fracture of the neck of
the shoulder-blade sometimes takes place, which it is of
the utmost importance to distinguish from dislocation.
This cannot be done, however, without a knowledge of
the anatomy of the parts.
The character and design of this work, does not rẻ-
quire that the signs by which the several kinds of dislo-
cation of the shoulder-joint, and of the fracture just
mentioned may be known, should be enumerated; or
the mode of proceeding detailed, suited to each particu-
lar case.
All that is aimed at here is, to show, that since
the shoulder-joint is liable to several kinds of dislocation,
each of which has its peculiar characteristics, and re-
quires peculiar management, according to the change
that has taken place in the anatomical relations of the
parts; so it is impossible for any one, who has not
accurately studied the anatomy of the joint, to treat its
injuries upon scientific principles, or with any certainty
of success.
The shoulder is very liable to become injured by
blows and falls, and to become swollen in such a manner
that an ignorant pretender to surgery might mistake such
a case for dislocation, and treat it accordingly; the
consequences of which would be distressing and danger-
ous.
Before dismissing this subject, we deem it useful to
observe, that the blood-vessels and nerves which take
their course through the arm-pit, become sometimes so
!
1
او
MEDICAL PHILOSOPHY.
197
much involved in the changes which take place by the
head of the arm-bone being thrown out of its socket,
and resting upon them, that an attempt to replace the
bone has proved fatal. To understand and know how to
manage a case of this description, an accurate knowledge
of all the parts concerned, is indispensably necessary.
Structure of the Elbow-Joint.
Three bones form the elbow-joint, viz: the lower end
of the arm-bone, and the upper ends of the two bones
of the fore-arm. The bone which is principally con-
cerned in forming the joint has a long process, or point
at its upper extremity, which forms the point of the
elbow, and which effectually prevents a dislocation for-
ward, without a fracture of this process.
The only motion which this joint admits of, is flexion,
and extension, and owing to this limited motion, and to
the peculiar structure of the joint, which indeed is the
cause of its limited motion, dislocations here, are much
less frequent than those of the shoulder-joint. This joint
has also a capsular ligament, which envelopes the heads
of the three bones that form it; but the security and
strength of the joint depend principally upon the lateral
ligaments, which bind the bones firmly together on each
side. In every case of dislocation, all these ligaments
must be more or less lacerated.
Injuries of the Elbow-Joint.
Dislocations of this joint are not frequent, but they do
sometimes occur, and they may be of four different
kinds; first, backward; second, forward; third, out-
:
17*
198
MEDICAL PHILOSOPHY.
ward; and fourth, inward.
The first is the most com-
mon; the second is always attended with a fracture of
the process which forms the point of the elbow; and the
two last, are extremely uncommon.
There is less difficulty in knowing when the elbow is
dislocated, and in determining the kind of dislocation,
than in knowing how to manage it. A knowledge of
anatomy is here also necessary; for without that, it is
impossible to know what injury the soft parts surround-
ing the joint have sustained, or what particular obstacles
are to be overcome in returning the dislocated bone to
its place.
The second kind of dislocation, that attended with
fracture, as mentioned above, is particularly difficult to
manage, and no one can do it successfully, who is
not fully acquainted with the structure of the parts, and
the action of certain muscles whose office it is to extend
the fore-arm; and whose action in this case must be pre-
vented, by scientific and skilful management, or de-
formity, and a great degree of lameness will be the con-
sequence.
The fracture just mentioned, may take place without
dislocation, which is an injury that is followed by an al-
most entire loss of the use of the arm, if not treated
scientifically.
There may also be a fracture of the arm-bone so near
the joint of the elbow, as to be mistaken for dislocation
by one ignorant of anatomy, and treated as such, to the
great distress and injury of the patient.
The elbow-joint, like the shoulder, is liable to suffer
from sprains, bruises, etc., in such a manner, that a quack
•
MEDICAL PHILOSOPHY.
199
in surgery might commit a blunder, that would subject the
unfortunate patient to an immense amount of useless
suffering.
Structure, and Injuries of the Wrist, and Hand.
The wrist is composed of eight bones, which are so
closely fitted to one another, and so firmly bound to-
gether by ligaments, and tendons, that it is impossible
for a complete dislocation of one or more of these bones
to take place, without a great laceration of the bands
which connect them together.
A partial dislocation, however, of one or more of the
bones of the wrist, may take place, which is readily de-
tected and easily reduced by one who understands the
structure of the part; but which would be likely to es-
cape the notice of one not acquainted with anatomy, and
be treated in an improper manner.
The joint formed by the lower extremities of the two
bones of the fore-arm, and the bones of the wrist, is lia-
ble to dislocation; and this is a case which ought to be
treated by one possessing anatomical, and surgical know-
ledge, especially if some time have elasped before an
attempt at reduction.
The bones of the hand, which are four in number, and
very firmly connected with the bones of the wrist, by
ligaments, and tendons; and therefore cannot be com-
pletely dislocated, without an extensive laceration of
these connecting bands. They may become partially
dislocated, however, at the wrist-joint; and the same re-
mark is applicable here, as to partial dislocations of the
wrist.
$
·
200
MEDICAL PHILOSOPHY.
The bones of the wrist and hand are not liable to
fracture, except from a degree of direct violence, which
does great injury to the soft parts, and is followed by
swelling and inflammation, which is likely to mislead an
ignorant practitioner. Sprains also, and the consequent
swelling, effusion, and painful motion of the joint, may
easily lead the surgical quack, to suspect dislocation
where none exists, and to act accordingly, to the great
suffering and injury of the patient.
Structure of the Hip-Joint.
The hip-joint is formed by the round head of the
thigh-bone being received into a deep socket of the hip-
bone, and is therefore called a ball and socket joint.
The hip-bone with which the thigh-bone is connected, is
immovably united to the trunk, indeed forms a part of
it; so that the motions of the lower extremity are more
limited than those of the upper.
The structure of this joint, independently of the liga-
ments and muscles which surround it, renders it much
more secure, and less liable to displacement, than the
shoulder-joint. But it has great additional security in the
strong ligaments and muscles which surround it. As in
other joints, there is here a capsular-ligament which in-
closes it completely, and is extensively ruptured when-
ever a dislocation takes place.
Injuries of the Hip-Joint.
The injury to which this joint is most liable, is frac-
ture of the neck of the thigh-bone; for the head of this
bone is connected to the body of it by a part called the
MEDICAL PHILOSOPHY:
201
1
*
neck, which stands off from the body of the bone almost
at right angles, and is therefore quite liable to fracture.
It is of the greatest importance to distinguish this injury
from dislocation, since the means that are proper to be
employed in a case of dislocation, are extremely im-
proper in a case of fracture. But even a good anato-
mist, and an experienced surgeon, may mistake the one
for the other in certain circumstances; it must be evi-
dent, then, that it would be the height of imprudence to
entrust such a case to one destitute of the necessary
qualifications.
The head of the thigh-bone is liable to be displaced
in four different ways, each of which has its peculiar
signs, by which it may be distinguished from the others.
It is not necessary that we should speak particularly of
these several kinds of dislocation; because all that is
useful to the popular reader, is such a knowledge of
these injuries as shall make it evident to him, that they
are so difficult to manage as to require surgical skill,
which can result only from a knowledge of anatomy;
and for this purpose, a description in general terms is
sufficient.
Owing to the structure of the hip-joint and the sur-
rounding parts, and to the position and strength of the
muscles attached to the upper part of the thigh-bone
its head becomes so situated after being thrown out of
its socket, that a great degree of extending force is ne-
cessary to replace it; but unless directed by a knowledge
of the facts, and the character and degree of injury
which the soft parts have sustained, and the precise
obstacles to be overcome, no amount of force that could
1
202
MEDICAL PHILOSOPHY.
#
be used, would be successful. In each kind of disloca-
tion of the hip-joint, the head of the displaced bone
occupies a different position in relation to its natural
situation; and in each case, the means employed must
be directed accordingly. We have hitherto been speak-
ing of dislocations which are the result of external
violence; but there is sometimes a dislocation of this
joint, which is the result of disease, a case which none
but a scientific surgeon can duly understand and properly
treat. There is hardly any case that comes under the
care of the surgeon more difficult to manage than this;
nor is there any, probably, where the surgical quack is
more likely to be employed, or where he is more likely
to do injury.
But without dislocation, the head of the thigh-bone is
sometimes so affected by disease in its socket, as to
cause a lengthening of the limb, which might be mis-
taken for a sign of dislocation and lead to the use of
means for its reduction, which would occasion the pa-
tient extreme torture, and perhaps cost him his life.
Structure and Injuries of the Knee-Joint.
The knee, like the elbow, is a hinge joint, and admits
only of flexion and extension. Three bones enter into
the formation of this joint, namely; the lower extremity
of the thigh-bone; the upper extremity of one of the
bones of the leg; and the knee-pan. This joint, being
extremely liable to the action of those causes which tend
to produce dislocation, is well provided with strong liga-
ments and tendons; all of which are so arranged as to af-
ford the utmost security.
MEDICAL PHILOSOPHY.
203
But notwithstanding all these means of security against
dislocations, they do sometimes happen, and when they
do, so much injury is unavoidably done to the soft parts
about the joint, that it becomes a very serious accident,
and one from which the patient is a long time in re-
covering.
•
Dislocation of the knee-joint may take place in four
different ways, and so great is the deformity in each
case, that there is no difficulty even to the new preten-
der to surgery in distinguishing it; but after the swelling
takes place, which quickly follows such extensive lacera-
tion as always attends a complete dislocation of this joint,
it is not so easy to decide upon the nature of the injury.
In these cases, as much as in any others that have been
mentioned, anatomical knowledge is necessary, in order
to their successful management. It is true, that in a
case that has just occurred of dislocated knee, before the
lacerated soft parts have become inflamed, a sufficient
degree of extending force exerted without any exact
knowledge of the structure of parts, may prove success-
ful; but it is certainly owing to accident and not to skill
that they do so, and no prudent person would risk the
management of a serious accident in such a manner, if
he could help it. There is often as much knowledge and
skill required, in deciding properly upon the question,
whether the means necessary for the reduction of a
dislocated bone, ought to be employed or not, as in
using these means successfully; and in no case is it
more necessary to decide this question correctly, and
upon the sound principles of science, than in that now
under consideration. When, therefore, circumstances
204
MEDICAL PHILOSOPHY.
do not absolutely forbid it, none but the scientific sur-
should be entrusted with the management of such
geon
cases.
The knee-joint is also liable to sprains and bruises,
and to white-swellings, the effects of which might lead
an ignorant practitioner to pursue a course of measures,
that would be altogether improper, and put the life of
the patient to great hazard.
The knee-pan is also liable, both to dislocation and
fracture; and in either case, it is best that the treatment
should be directed by a knowledge of the structure of the
parts concerned, whether unusual difficulties attend or
not; but where they are present, it is indispensably ne-
cessary.
Structure and Injuries of the Ancle and Foot.
The joint of the ancle is formed principally by three
bones, namely; the lower extremities of the two bones
of the leg, and one of the seven bones which form the
back part of the foot. This joint is made very strong by
numerous and very firm ligaments, for no joint of the
body requires greater strength than this; but yet it is
liable to displacement, and when dislocated, the case
frequently becomes very difficult to manage. Com-
pound dislocations here are more frequent than of any
other joint, that is, dislocations accompanied with a
wound of the soft parts communicating with the joint.
These are cases of serious importance, and unless man-
aged in a proper manner, such a manner as is known
only to the scientific surgeon, incurable lameness, if not
a result still worse, is the consequence.
23
MEDICAL PHILOSOPHY.
205
The small bone of the leg forms the outer ancle, and
a fracture of this bone is often associated with dislocation
of the ancle, which renders the case more difficult to
manage, and consequently the agency of the real surgeon
becomes more necessary.
The seven bones which form the back part of the foot,
or the tarsus, like the small bones of the wrist, are liable
to a partial displacement, and are then easily replaced;
but they cannot be completely dislocated, without such
an injury of their connecting ligaments, and of the in-
teguments which cover them, as renders the case one of
serious importance, both on-account of the difficulty of
replacing the bone, and of the effects which are apt to
follow from the injury done to the soft parts. The re-
marks that have been made upon dislocation of the long
bones of the hand, and upon the effects of sprains,
bruises, etc. are applicable to similar injuries of the foot.
The two cases which follow may be considered as
fair illustrations of the science, and skill, of natural bone-
setters, as well as the ignorance, and susceptibility to
imposition, of those who claim at least an ordinary share
of intellect.
A young lad of this city received an injury of the
elbow-joint, which, under the most judicious surgical
treatment, terminated in permanent stiffness. The pa-
rents had heard of a natural bone-setter, who had made
himself notorious by reputed great feats of skill, and be-
lieving him to possess some preter-natural power, had
him called to see their unfortunate child. The natural
bone-setter, without hesitation, at once declared that the
18
206
MEDICAL PHILOSOPHY.
joint was dislocated; and forthwith preparations were
made to “set the bones." The limb had been placed
by the surgeon, who attended the boy during his confine-
ment, in a semi-flexed position; and thus it remained
till the bone-setter was called in, when no force that
could be used with safety was sufficient to straighten it.
The bone-setter however, was not to be foiled by any
obstacle of the kind; and, augmenting his force in pro-
portion to the resistance to be overcome, he finally suc-
ceeded in straightening the limb. This was a great
triumph for him, a gratification to the parents, and the
most exquisite torment to the poor, suffering, child.
But the consequences of this natural foolery, and, on the
part of the parents, very unnatural madness, were to
follow. The force employed to reduce the pretended
dislocation had ruptured tendons, ligaments, and nerves;
and, in short, inflicted a far worse injury than the one
originally received. The child's life was in jeopardy,
and was saved only by the timely amputation of the arm
by one of our most distinguished surgeons; and the
child is now a living monument of the skill of a "natural
bone-setter."
What the feelings of parents are, on such an occasion,
they can best answer.
The second case was that of a boy also. This was
what is commonly called a hip-disease-or, in other
words, an inflammation and ulceration of the hip joint.
The complaint had existed for some time, and produced
a great degree of emaciation of the affected limb, which
gave to the joints an unusual prominence; and, as is
common in this disease, the limb was in a flexed position.
:
་
MEDICAL PHILOSOPHY.
207
This patient had been attended by a respectable prac-
titioner, who understood the disease, who was competent
to manage it, and who had done all that the art can do
in this much dreaded complaint. But the natural bone-
setter was sent for. He pronounced the hip, the knee,
and ancle dislocated; and straightway commenced
furiously pulling at all these joints to get them in place.
The boy shrieked, and entreated him to desist. The
diseased parts being exceedingly tender, and painful, on
the slightest motion, the complaints of the boy only made.
his tormentor the more confirmed in his opinion, and the
more persevering in his efforts to "set the bones." He
did persevere till the child repeatedly fainted from such
torture; and being fearful that he had cured the patient
to death, or killed him outright, at length concluded
his manipulations, by saying that he had got the bones all
into their places. The disease was so aggravated by
this cruelty that in a few days the child's sufferings were
at an end,
Cases like the above might be narrated to any amount,
but to recount instances of such reckless ignorance, and
cold-blooded cruelty, such savage barbarism, is too re-
volting to humanity; and the reader is, probably, al-
ready satisfied,
A
CHAPTER XIV.
OF THE COMPARATIVE POWERS OF MINERAL, AND VEGETA-
BLE MEDICINES.
THERE seems to be an universal disposition, among all
descriptions of medical quacks, to abuse, decry, and most
foully slander, all medicines obtained from the mineral,
while they at the same time, extol the properties of those
belonging to the vegetable, kingdom. To accomplish
an unworthy, or unlawful, purpose with community, it of-
ten, if not always, becomes necessary to inflame existing
prejudices, and where they are wanting, to excite, and fos-
ter such as may best subserve the desired end. That there
has been a general prejudice against a few of the mineral
medicines—some remains of which are yet too frequently
met with—past experience bears ample testimony. Cal-
omel is the great bug-bear-the raw head and bloody
bones-that has been used by designing knaves, and
others who deserve compassion for their weakness, to
frighten those who have been selected as fit subjects for
imposition. With Calomel, all minerals have been drag-
ged in, and received the same sentence of condemna-
tion, for no reason but belonging to the same family-
for being found in bad company; or, perhaps, for another
reason, deemed sufficient by the ignorant, viz. that they
are medicines of great power; and, therefore, are capa-
ble of doing injury. That medicines of the mineral
事
​18*
210
MEDICAL PHILOSOPHY.
4
kingdom have done mischief by not having been judi-
ciously administered, may be true; and that a prejudice
should arise in consequence, is very natural. Such mis-
fortunes have been turned, by quacks, to their own ac-
count; they have raised a hue and cry against all min-
erals, and in the hope of throwing ridicule upon the pro-
fession they term us, "Mineral Doctors." They cry
mad dog, and set out upon the chase; and happy are they
if they can succeed in deluding a few weak sisters to join
with them in the pursuit, and chime in with their cry.
The reason of this uncompromising hostility on the part
of quacks, and some of their disciples, to mineral medi-
cines, is, that they are efficacious when employed-and
that when misused, they do injury. The same argu-
ment, if such a notion can be dignified with the appella-
tion of argument, can be applied to any thing that we eat
or drink; or to any power that we employ in the ordi-
nary concerns of life. Fire destroys our dwellings—
water drowns us-steam boilers explode and destroy life
-horses take fright and run away-excess in eating the
simplest viands, produces disease and death; and, there-
fore, according to the logic of quackery, all these things
are to be condemned. If medicines have been misap-
plied, it would be the dictate of true wisdom to learn a
lesson from error, and profit from misfortune, rather
than condemn the thing for a fault which justly belongs
to the hand that administered, or the head that pre-
scribed it.
And if medicines obtained from the mineral kingdom
possess such tremendous potency, pray what are vegeta-
ble medicines? If minerals are poisonous are vegetables
any the less so ?
MEDICAL PHILOSOPHY.
211
66
With the word vegetable, are associated many deli-
cious articles of food; and when we are told of a vegeta-
ble pill, the idea, perhaps insensibly occurs, that it is
something eatable. Vegetables are nutritious, they
are wholesome articles of food; every body eats them,
we eat them every day-these are vegetable pills—no
minerals here, no poison-they can't hurt you, because
they are vegetable." This is the language and logic of
empiricism; and with those who are not at the trouble of
thinking for themselves-who close their eyes, and swal-
low whatever is thrust into their mouths-it is believed
with the greatest sincerity. Let the pill be what it may—
whether it be the most active, acrid, irritating poison, so
it only be called "vegetable," no further questions are
asked, and nothing more is desired. Before we proceed
further on this subject, we will just state here, that noth-
ing of the mineral kingdom possesses any thing of the
activity, or power, that vegetables do-that while mine-
rals require hours, or perhaps, days, to produce fatal
effects, vegetables will cause the same result in a far less
space of time, or even in a few moments.
We shall now mention a few of the most active of the
mineral medicines, and some of those of the vegetable
class, and the reader can judge for himself which possess
the greatest activity-in other words which are the most
poisonous.
Arsenic. This is, occasionally, prescribed in various
diseases, and is one of the most violent of the mineral
poisons. In Beck's Medical Jurisprudence, the earliest
time of which he speaks of death from taking arsenic is
"five, six, or ten hours ;" and this is probably the shortest
212
MEDICAL PHILOSOPHY.
period at which it can take place. It kills by exciting an
intense inflammation of the mucous membrane lining the
throat and the whole alimentary canal, which terminates
in mortification. Death may ensue without this inflam-
mation; but this is its general operation.
Mercury. The most active and poisonous of the
preparations of this metal is corrosive sublimate; but
many others may, if too freely administered, induce dis-
eases that may in a short time, or after weeks or months
of suffering, terminate in death. Corrosive sublimate
destroys life, according to Dr. Christison, in "ordinary
cases, in from twenty-four to thirty-six hours;" but it
may produce death much sooner.
Antimony. Against this remedy there was once so
strong a prejudice that the faculty of Paris procured an
edict of the French Parliament prohibiting the use of all
its compounds; and they were not restored to favor till
one of the kings was cured by its means. Its use was
again permitted in 1666.
Tartar emetic may produce death, but not as speedily
as corrosive sublimate, or arsenic; it acts by exciting
irritation and inflammation. Other preparations of anti-
mony produce the same effect as tartar emetic, though
in a much less degree.
Copper. This mineral is but little used, in any of its
forms, as an internal remedy. It may produce death
within twenty-four hours. It acts as an irritant and
causes inflammation.
Zinc. The sulphate of zinc, or white vitriol, is oc-
casionally used as an internal remedy, and is capable of
destroying life in the same manner as the one last named.
•
!
MEDICAL PHILOSOPHY.
213
Nitrate of Silver, Chloride of Gold, and Subnitrate
of Bismuth, are irritating poisons, and cause death.
They are seldom used internally.
Iron. The Sulphate and Muriate, are irritating poi-
sons, and may destroy animal life in twenty-six hours.
Lead. Only one preparation of this mineral, the
acetate, or sugar of lead, is used in medical practice;
and those who have used it most deny its ever producing,
or being capable of producing unpleasant results.
To this catalogue may be added Sulphuric, Nitric,
and Muriatic acids; and these constitute the most active
mineral remedies in the practice of the healing art. Let
us look now at the vegetable remedies, which are said
to be so very harmless, and which, at the same time, are
capable of destroying life.
Acetic Acid. (Vinegar.) Killed a dog in an hour and
a quarter.*
Oxalic Acid. This acid exists in the common sorrel.
In its medicinal preparation it has destroyed life in ten
minutes. It operates like the other irritating poisons;
and, if not taken in sufficient quantities to produce death,
it may leave a diseased state of the alimentary canal
similar to that induced by the mineral poisons.
Prussic Acid. This is the most deadly poison known.
One or two drops has killed a strong dog in a few sec-
onds. Hufeland relates that a man, about to be taken
up as a thief, took prussic acid, staggered a few steps
and fell. The pulse could not be felt, and there was no
* Beck's Medical Jurisprudence, Vol. II. p. 304.
t
U. S. Dispensatory, p. 1093,
214
MEDICAL PHILOSOPHY.
trace of breathing. In a few minutes there was a single
violent expiration.
Orfila states that a servant girl swallowed a small
glass-ful of alcohol saturated with prussic acid. In two
minutes she fell dead.
nose.
A chemist in Paris applied a bottle of the acid to his
Alarming symptoms immediately commenced
which continued throughout the day.-(Beck.)
""
Bryony. "Pyl mentions a fatal case from taking
two glasses of an infusion of the root to cure an ague.'
Elaterium. (Wild cucumber.) This is so violent a
cathartic that medical men seldom use it.
A case is related in the Boston Medical Magazine,
and quoted by Dr. Beck, of a female in that city who
took six pills of elaterium and rhubarb by the advice of
a quack making in all, 23 grains of the extract of ela-
terium, and 16 of rhubarb.
after taking the last pill.
She died in thirty-six hours
Colocynth. (Bitter Apple.) This produces violent and
incessant vomiting and purging, and death in twenty-
four hours.
Castor Oil. The seeds from which this oil is ex-
tracted are capable of producing inflammation, ulcera-
tion, and death.
Croton Oil. A half a drop of this operates as a vio,
lent cathartic. Two or three drops rubbed over the skin
of the abdomen will also cause purging.
Jalap in large doses is an acrid poison.
Savin. This excites inflammation and causes death.
Poison Oak. (Ivy.) When applied to the skin this
excites a violent inflammation accompanied with an
MEDICAL PHILOSOPHY.
215
:
eruption of pustules. We have seen its effects remain
in the system for years.
L
Poison Sumach is still more deleterious than the last
named vegetable. It almost equals in virulence the
Upas-Tree; for it causes inflammation of the face and
eyes, terminating in blindness, by only handling it, or
being in a room where it is burning on the fire.
Lobelia. (Indian tobacco.) An acrid poison. Horses
and cattle are killed by it; and it often destroys life in
the hands of botanic quacks.
Opium. This drug and its various preparations belong
to the class of narcotic poisons. They cause death in
a few hours. Every one knows that the habit of taking
opium acts upon the system like a slow poison, destroy-
ing the health, undermining the strength, annihilating the
mental faculties, and rendering the individual a mere
vegetative animal-incapable of thinking, and scarcely
of moving. It is incredible to what extent this drug may
be taken by those who have been long accustomed to its
use. A single grain is an ordinary dose when taken
medicinally; and the effects of this remain for twenty-
four hours or upwards. But, after a time, the quantity
may be increased to drams, or to an ounce, and even to
a larger amount still-and this is persevered in for years,
perhaps, before the system finally succumbs to its
poisonous influence. It is related of the celebrated
Coleridge that, for a long time, he took daily a pint of
laudanum; this is equivalent to one ounce of solid opium,
and a pint of ardent spirits. It is stated by Madden in
his travels in the East that a regular opium eater seldom
lives to be more than thirty years of age.
น
216
MEDICAL PHILOSOPHY.
>
Hyosciaums. (Henbane.) A narcotic poison; and like
opium kills in a few hours.
Solanum. (Nightshade.) A narcotic poison.
Strong Scented Lettuce. The same as the last named.
Cherry Laurel, Peach Blossoms and Leaves, and bit-
ter almonds are poisons. Their deleterious property
being the prussic acid which they contain.
Wild Cherry, and Black Cherry, both contain the
prussic acid and occasionally kill animals.
Wild Orange is poisonous, and cattle that feed on its
leaves are killed.
Bitter Almonds. The essential oil destroyed a cat in
five minutes.
Peach Kernels. These are distilled for the purpose of
impregnating the moyeau cordial. Beck says the late
Duke of Lorraine nearly lost his life by swallowing a
small quantity of the liquor.
Belladonna. (Deadly nightshade.). Very properly na-
med deadly. A detachment of one hundred and eighty
French soldiers ate of the berries of this plant, many of
whom died.
The following articles are ranked by Dr. Beck, in his
Medical Jurisprudence, among the poisons; and he gives
instances of fatal results from the use of each one.
Datura Stramonium. (Thorn Apple.)
Nicotiana Tabacum. (Tobacco.)
Conium Maculatum. (Hemlock.)
Cicuta Virosa: (Water Hemlock.)
Cicuta Maculata. (Snake Weed.-American Hem-
lock.)
Enanthe Crocata. (Hemlock dropwort. Dead tongue.
MEDICAL PHILOSOPHY.
217
>
Ethusa Cynapium. (Common fool's parsley.)
Chaerophyllum Sylvestre. (Wild Chervil.)
Sium Latifolium. (Procumbent water-parsnip.)
Aconitum Napellus. (Monkshood, Wolfsbane, A-
conite.)
Helleborus Niger. (Black hellebore.)
Veratrum Album. (White hellebore.-Indian poke.)
Colchicum Autumnale. (Meadow Saffron.)
Digitalis Purpurea. (Purple Foxglove.)
Scilla Maritima. (Squill.)
Ipecacuanha.
Ruta Graveolens. (Rue.)
Anagallis Arvensis. (Meadow pimpernel.)
Aristolochia Clematitis. (Common Birthwort.)
Nerium Oleander. (Common Oleander.-Rose-Bay.
Asclepias Gigantea. (Milkweed.)
Mercurialis Perennis. (Mountain Mercury.-Dog's
Mercury.)
Strychnos Nux-Vomica. (Vomica Nut.-Quaker But-
tons.) Sometimes called " hop up." It is used to
poison dogs, and kills in a very short time.
Strychnos Ignatii. (Bean of St. Ignatius.) Its opera-
tion is similar to nux-vomica.
Laurus Camphora. (Camphor.)
Cocculus Indicus. (Indian Cockle.)
Coriaria Myrtifolia. (Myrtle leaved Sumach.)
(Mushrooms.)
Secale Cornutum. (Ergot.-Spurred Rye.)
(Spurred Maize.-Indian Corn.)
(Diseased Wheat.)
(Darnel.)
!
19
218
MEDICAL PHILOSOPHY.
(Alcohol.)
The essential oils of tansy, winter-green, cedar, and
others of this class.
There is also obtained from the common potatoe vine,
by evaporating the expressed juice, a most powerful nar-
cotic, which is used as a substitute for opium, and which,
doubtless, is capable of producing death in no very large
dose. There is a narcotic principle in the hop also dele-
terious, and fatal to life:
A very active cathartic is obtained from the common
butternut.
The catalogue of poisons, and active remedial agents,
belonging to the vegetable kingdom, might be increased
to infinity; and the one here given, though somewhat
extensive, is extremely limited.
66
It has not been our intention, by presenting this, to
frighten the reader by showing him that medicine is but
another name for poison. But we did intend to teach
him that the cry in favor of "vegetable" medicine was
the song of the syren; and we hope he has learned that
vegetables" are not the innocent, harmless things that
a set of notorious impostors would fain make the people
believe. They are as useful and as valuable as any
medicinal agents; and to prescribe them requires great
skill and more science than usually falls to the lot of an
ignorant empiric,
募
​CHAPTER XV.
OF THE ERRORS, EXCLUSIVENESS, AND ULTRAISM, OF MEDI-
CAL MEN-AND THEIR INFLUENCE IN CAUSING AND PER-
PETUATING EMPIRICISM.
THE age in which we live, is, most emphatically and
truly, an age of improvement. When we look at the
world, as it is at the present day, and contrast it with
its previous history, we shall have the most perfect de-
monstration that the onward progress in the arts and
sciences, as well as the more immediately useful inven-
tions in mechanism, has been vastly greater, since the
commencement of the nineteenth century, than during a
much longer space of time, at any other previous period,
in the history of man. The perfection that has been
given to the steam engine, and its various applications,
which, in its turn, is in a fair way to be eclipsed by the
discoveries in electro-galvanism, has wrought most mi-
raculous changes on our planet; it has in a measure
superseded manual labor, and has so approximated dis-
tant regions, and opposite climates, that time and space
are nearly annihilated. Stepping back a little into the
last century, we shall find that political revolutions, such
as the world never before witnessed, caused by the
growth and diffusion of liberal sentiments and informą-
tion, have changed the aspect of states and nations, and
disseminated light and knowledge, where they had not
220
MEDICAL PHILOSOPHY.
!
before existed. In fact, all the changes and improve-
ments of the present day are owing to the diffusion of
knowledge; they are but the legitimate effects of a pow
erful cause-a lever which moves the world.
Christianity has extended her influence to almost
every heathen nation; and by the Gospel, and the arts
and improvements of civilized life, the thick clouds and
mist of ignorance and superstition are dissipated, and
man is made to attain the eminence which his Maker de-
signed. The healing art, amid the general march of
improvement, has by no means remained stationary, but
has made rapid, and astonishing strides to perfection.
But, however pleasing the contemplation of the pro-
gressive improvement in the condition of the human fami-
ly may be, yet, the view is not one of unobstructed sun-
shine and beauty. Every new thing, or novel project,
is not an improvement, and every innovation, is not a
useful invention. With the valuable ore in a recently dis-
covered mine, there is often blended something that is
worthless, or that spoils the metal. If this age is char-
acterized by improvement, the march of intellect, useful
inventions, and boundless benevolence, it is no less
strongly marked by the wildest extravagance and fanati-
cism. Whatever scheme is undertaken, whether for the
profit or pleasure of ourselves, or for the good of others,
is carried far beyond the bounds which true philosophy
would assign to it. Religion, politics, the desire of amass-
ing wealth in various ways, the rage for speculation,
temperance, abolition, etc. all rage with the violence of a
tempest. They are pushed by their advocates to ex-
tremity, and not unfrequently, to a remarkable degree
MEDICAL PHILOSOPHY.
221
of absurdity. An abstract principle, right and good, and
pure in itself, and productive of the best fruits when wise-
ly acted upon, is adopted; and without regard to the in-
dividual cases to which it may be applicable, or careless
of consequences, or the circumstances which modify its
operation and influence, it is made the primum mobile of
all subsequent conduct. Like a quack medicine, that is
extolled as a sovereign cure for all the diseases that flesh
is heir to, or any valuable remedy in the hands of an em-
piric, an abstract principle is universally applied; and
if mischief results, the blame is attributed to any thing
else, rather than to the unskilfulness, or ignorance of him
who administers the remedy. The exclusiveness and
ultraism of the present age, is the result of that principle
which led Napoleon to such astonishing success in his
military career, and by which he achieved his multitude
of splendid victories. It is the concentration of force-
the union of effort—and an undivided attention to a given
object--which is certain to ensure success, where that is
practicable, in any undertaking, or enterprise, and which
is equally certain to degenerate into the wildest extrava-
gance, and the most grievous error, when the aim is mis-
directed. Much of the improvement, and extravagance
of the day, is, no doubt due to the study of a single sub-
ject to the devotion of genius to a particular pursuit-
which begets an exclusive, ardent, enthusiastic, and al-
most delirious attachment to the subject which so en-
gages the mind. Beneficial results will, most assuredly,
ultimately flow from the errors and vagaries that are
manifested, as well as from the discoveries that are made,
and the truths that are developed; but not till the errors
19*
222
MEDICAL PHILOSOPHY.
are perceived, and duly appreciated; they will then stand
as landmarks to the pilgrim of science, or as beacons on
the hidden rocks and quicksands, warning the mariner of
unseen danger. A succeeding, rather than the present,
generation will profit by the truth and the error that we
shall leave behind us; they will reap the fruits of our
labor when time, the only true test, shall have refined the
ore, and the dross shall have become separated from
the pure metal.
The preceding remarks are peculiarly applicable to
the medical profession. We have made discoveries and
improvements of the greatest benefit to our species, and
such as will be hailed with gratitude and joy, while oùr
nature is heir to infirmity and disease, and while medi-
cine shall be cultivated as a science, or followed as a
profession. We have made innovations that startle for a
season, but soon sink with their authors into merited con-
tempt and neglect—and even the most valuable of our
improvements are in danger, from the too ardent zeal of
their friends, of being considered as worthless, and cast
into the sea of oblivion. Like the principle of temper-
ance, which is right in theory and practice, as far as it is
necessary for health and comfort, or expedient for mor-
als, it may be led to include every article, either of food
or drink, whose abuse in the hands of the unprincipled
or unthinking can by any possibility do harm. Exclu-
siveness and ultraism seem to be the order of the day in
medicine, as well as in most other things; but there is
one thing which exclusives would do well to remember—
and it is this-that a good thing may be urged so far, as
to render its rejection certain. Most well regulated
i
MEDICAL PHILOSOPHY.
223
minds refuse to accede to a proposition, although it may
be based upon truth, whose tendency is to exclusiveness;
and spurning the narrow bounds prescribed them by
a want of philosophy, they refuse to acknowledge the
frenzy of a zealot, or the dogmas of a master.
If we consult the history of medicine, we shall find
that the most opposite theories have existed at the same
time, and have each been most zealously defended by
their advocates; and these, again, have given place to
others, with almost the frequency and regularity that one
crop of vegetation is succeeded by another, which have
been as warmly praised, and as soon exploded and for-
gotten as their predecessors.
Among those who have been contending for victory
and notoriety in our profession, there have occasionally
been seen some honest labourers after truth-those whose
primary object it was to clear away the rubbish of for-
mer theories, and amid their wreck, to seek whatever
material there might be fit for a more durable edifice,
and lay its foundations upon a wider, firmer, and more
permanent, basis. The theories that have been framed
to account for the proximate cause of typhus fever, and
the consequent treatment of the disease, may be adduced
to illustrate the fate of all, or nearly all fabrics of a
kindred character. The humoral doctrine of Boerhaave,
was succeeded by the nervous doctrine of Cullen, whose
splendid reign was in its turn terminated by the appear-
ance of the cerebral doctrine of Clutterbuck, which was
again destroyed by the omnipresence of the gastro-enteric
doctrine of Broussais; whose glory is already suffering
a partial eclipse by the dothinenteric doctrine of Bretton-
224
MEDICAL PHILOSOPHY.
-
neau, Bouillaud, and others of the French masters.* The
contrariety of practice consequent upon such discrepant
theories" the antisceptics and antacids of one school,
the anti-spasmodics and diaphoretics recommended by
another, the cordials and stimulants by a third"—whilst
the whole of these remedies are condemned by a fourth
class of physicians, whose chief remedy and sole hope,
consists in leeches to the head, or some region of the
abdomen, etc. is but a fair specimen of the uncertainty,
and fluctuation, that has ever attended the practice of the
healing art. Such an aspect of affairs may well excite
the attention of a philosophic mind, and raise the trite,
but important, query,
"who shall decide when doctors
disagree." It is needless in this place to take a more
extended view of the multitude of theories that have pre-
vailed since medicine became a science; they have all
shared the same fate, and like other remnants of antiqui-
ty—like the Indian mounds in the distant West of our
own country—or the crumbling walls, and moss-grown
ruins of other lands-serve as mementos of past ages.
Many of the causes which have heretofore operated
to retard the progress of medical science, have in later
days lost much of their influence; and it has now re-
ceived such an impulse that its career must be rapidly
onward.
Closet reasonings, dreamy speculations, and
* Boerhaave taught that fever was the result of a depraved
state of the blood-Cullen, that it was an affection of the nervous
system-Clutterbuck, that it was located in the brain-Broussais
that it consisted in an inflammation of the mucous membrane of
the stomach, and upper portion of the alimentary canal-while
Brettoneau and Bouillaud now teach that it consists in the in-
flammation and ulceration of certain glands in a portion of the
alimentary canal.
1
MEDICAL PHILOSOPHY.
225
$
3
conclusions drawn from false, or assumed facts, have,
in a great measure, yielded to the Baconian or inductive
philosophy. Experiment has superseded conjecture—
and experiment and fact are now, more than at any
previous period, the foundation of theory, instead of
theory being the foundation and ground work of fact and
experiment. To this reversed method of reasoning,
which has led to the cultivation of morbid anatomy, and
to close observation, is to be attributed most of the great
improvements in medicine which bless mankind.
The object at present is to take a glance at the state'
of medicine as it exists at the present time, and to notice
briefly some of the causes which operate, among the
members of the profession themselves, to obstruct its
still more rapid advance to perfection; as well as to
consider the influence they exert in causing and per-
petuating quackery.
The extension of Pathological research, if it has not
laid the foundation of a system, denominated the Physi-
ological system, has at least contributed to bring it to
greater perfection. A knowledge of Pathology, or of
the nature of disease, and the changes it induces in the
different tissues, is indispensable to its successful treat-
ment-it is what our fathers aimed at; what they
guessed at; and what they sought for; but what they
seldom attained; and to the adaptation of their practice
to the disease, either from knowledge or accident, they
are indebted for whatever success they met with. Pa-
thological research has removed many of the impedi-
ments that obstructed our course in the study and prac-
tice of our profession; and although our way is by no
i
226
MEDICAL PHILOSOPHY.
means clear and free from difficulties, we may yet, with
due caution, proceed with a firmer and a bolder step.
As it is one of the frailties incident to our nature that the
mind is apt to leap from one extreme to another—and at
different times to derive diverse conclusions from the
same premises,-so it has been true to itself in exhibiting
its character for inconsistency, as well in matters pertain
ing to medical science as in others of, perhaps, much less
importance. A great part of the medical world is led
captive by the brilliant and seductive discoveries, and the
exclusive pretensions of the French reformer Broussais;
but while we consider him the great medical reformer of
the age, we would not unhesitatingly pronounce him in-
fallible, or yield implicit credence to all his articles of
faith.
There are, and probably always will be, those, who
believe in the doctrine of essential, idiopathic fevers,
specific diseases, and contagion; and while they would
in some instances do mischief, by the mal-practice re-
sulting from their erroneous theory-by doing too much;
a Broussaian would be guilty of no less evil, by follow-
ing out the practice prescribed by his own theory-by
doing too little-or by omitting to do what circumstances
might imperiously demand should be done. While
Broussais teaches that the alimentary canal is the centre
and focus of all irritation-and that in its lining mem-
brane is located an inflammation in all febrile complaints
—that, in short, a gastro enterite" is the fons et origo
mali-and that leeches or cups, and gum water and
lavements," constitute the only proper treatment-we
MEDICAL PHILOSOPHY.
227
may expect nothing else than that the practice of his
disciples should degenerate into an inert, inefficient rou-
tine, and that their patients should fall a sacrifice to-
scientific speculation ?—NO-professional trifling.
We shall not take it upon us to decide the question
whether or not, where there is a general excitement,
the local disease of the stomach and bowels be a pri-
mary, coincident, or secondary, affection; but we may
well doubt whether such a disease always exists at such
a time, and that it continues till all febrile symptoms are
subdued. But granting that it is invariably present, and
that this is the disease itself to which are owing all the
symptoms, our doubts are redoubled when we are called
upon to believe, and subscribe to, the ultraism and exclu-
siveness of the Broussaian precepts in relation to practice.
Broussais is entitled to the everlasting gratitude of pos-
terity, for his indefatigable labour in Pathological investi-
gations, and for the facts he has accumulated; but many
of the practical inferences deduced from his conclusions
lead inevitably to the most inefficient, and empirical
routine. Medicines that have heretofore been found to do
good, in the most positive and direct manner, in a given
disease, are, under the same circumstances, condemned
as irritants, and, in the opinion of the disciples of
Broussais, likely to increase or excite "gastro enteritis ;"
and the accumulated experience of past ages is regarded
by them only as a mass of antiquated error.
A long
course of close observation must lead to some definite
conclusion; and when a course of medical practice has,
under given circumstances, produced the same general
result, we may safely infer that, under the same, or
228
MEDICAL PHILOSOPHY.
similar circumstances, it will continue to do so—and it
should not be considered as fully disproved merely be-
cause it does not happen to square with some precon-
ceived theory, or some fanciful speculation.
The doctrine of Broussais, it is well known-or the
doctrine of those who have out-Broussaised their great
master himself-admits of no specific disease; small
pox, according to their creed, is but an inflammation and
suppuration of the skin; measles, an inflammation of the
mucous membranes and skin; and scarlatina something
of the same kind; and all are preceded or attended by a
"gastro-enterite," and all are to be cured by depletion and
demulcents. We may not all attach the same meaning
to the term specific; but it is sufficient, on the present
occasion, to say that there is something peculiar in these
diseases as well as in some others that they have
characters which are not possessed by other diseases—
and that it remains to be yet proved that they are even
entirely cured by a disciple of the Physiological, or any
other school, by any kind of treatment, without running
a determinate or specific course. Their violence may be
abated; they may indeed be rendered comparatively mild,
by a proper treatment, but they cannot be arrested in
their progress, and permanently cured like simple in-
flammations, by any course that the genius of man has
yet devised. From Johnson's Medico-Chirurgical Review,
for July 1835, we make the following extract, which
goes to prove that fact comes in collision with the theory
in question. "I cannot," says M. Pelletan, the reporter,
and he doubtless expresses the sentiments of his precep-
MEDICAL PHILOSOPHY.
229
.
tor, Prof. Bouillaud,*
* 66 now boast, as I have hitherto
done, of the utility of the anti-phlogistic depleting course
of treatment in small-pox; there is a something else,
besides mere inflammation, present in this disease. This
something is of a specific nature. The blood has be-
come altered in its qualities; for, if we examine it after
it has been drawn from the arm, it will be found to be
not firm and dense, as in genuine inflammations, but soft,
diffluent, and having all the characters which it usually
presents in typhoid enteretis.” We cannot forbear to add
another quotation from the same Journal, for it contains
the sentiments of Prof. B. himself, and under his own
hand and seal. "The danger of measles is always pro-
portionate to the severity of the accompanying bronchitic
affection; but let it not be forgotten that the anti-phlogis-
tic treatment, although the only safe practice in such
cases, has not the same control over the pulmonic com-
plication of measles (which, and such like varieties of the
disease, might be appropriately called "peripnumonia
notha,” instead of the subacute form in old people,) that
it exerts over the open and idiopathic inflammations of
the lungs." (pp. 196-7.) His reviewer adds, "this is
an important concession on the part of a Broussaist.
We may soon expect a considerable modification of the
original tenets of this talented but one-sided physician."
It is by no means our intention to review Broussais ;
but merely to take so much notice of him as to show the
tendency of his doctrines to run into exclusiveness and
ultraism in practice. To say that little or no active
medicine should be given, by the mouth, in fever—or as
* A Broussaian dyed in the wool.
20
230
MEDICAL PHILOSOPHY.
Broussais would have it--in " gastro-enterite"-is to say
that the disease would in all cases be made worse by it;
an assertion that is, oftentimes, at direct war with fact.
Medicines should at all times be cautiously administered,
even when most unequivocally indicated, and when
found to disagree, or produce no decided good result,
should be discontinued; but when a mass of weighty and
unquestionable authority is adduced going to prove the
direct utility of medicine in a given case—even in the
omnipresent" gastro-enterite"-the lovers of gum water
and leeches, the Sangrados of the nineteenth century,
may at least pause and give it a candid hearing. It may
be conceded to the ardent Broussaians that their doctrine
is in many, and perhaps a majority of cases correct-
that they are also right in affirming that too much medi-
cine is generally given when the stomach is in an irritable
state-and that their principle of practice is the only
true and rational foundation for the treatment of disease.
But on the other hand, if there is any weight in human
testimony, something should be yielded to those, who
deny to the gastro-enteritic school, the exclusiveness and
infallibility which they are not backward in assuming.
One reason why the doctrine of Broussais is so eagerly
and so generally embraced as it is, and finds such zeal-
ous advocates, we believe to be its compatibility with,
and congeniality to, indolence. It is all easily under-
stood, both theory and practice; the stomach is the
centre of all disease, and the treatment consists in bleed-
ing, leeching, cupping, demulcents, and lavements, with
perhaps the application of a poultice or a fomentation of
hot milk and water. All thought and all reflection are
MEDICAL PHILOSOPHY.
231
*
unnecessary—the work is plain, and if physiological
treatment, as a Broussian understands it, cannot save the
patient, nothing in the world can.
To notice more minutely these or any other sects in
the profession would be needless, were this, indeed, a
fit occasion; and these are introduced rather as speci-
mens of the divisions, and different opinions, of the
medical world, with a view to direct attention to the sub-
ject as it shows to what extent exclusiveness, and utopian
doctrines may prevail. In addition to these general
diversities of sentiment individuals differ yet more-so
that their contrariety of opinion has become proverbial.
In many cases of disease it matters little what the theory
of the physician may be; common sense, if he but gives
heed to it, will be to him so faithful a guide that he will
not materially err; and were the patients ever left to
themselves they would ultimately recover. But it is in
the comparatively few cases, those of an anomalous and
complicated character, that the value of science is duly
estimated, and the skill of the physician put to the true
test-it is here that closet speculations, and exclusive
theoretical notions, are of little avail in arresting the
slow, but certain progress of disease, and in averting
threatened danger. How often is it that a patient is
rescued from the very grasp of death by a course that
one medical sect would condemn as being sure to do
irreparable mischief-thereby proving the importance of
not being spell-bound by the charms of an exclusive
theory. We may exhibit this idea a little more clearly
by illustrating it with a case.—A child two years old had
an affection of the brain which threatened to terminate
232
MEDICAL PHILOSOPHY.
in effusion; it had been most judiciously treated by
leeches, warm bathing, cold to the head, revulsives to
the extremeties and epigastrium, etc. with little or no
amelioration of the complaint. The case had been treat-
ed by not an obscure member of the profession, and
when it reached this stage he declined doing any thing
farther, and told the parents of the child that it must
inevitably die. It was proposed, by a brother practition-
er whom he had asked in to see the patient, to blister the
neck and administer calomel. To this he objected,
saying that the irritation of the blister would be trans-
mitted to the organ already affected and increase the
disease-that the calomel would stimulate and irritate
the gastro-intestinal mucous membrane, and also by
sympathy affect the brain; but the doctor offered to re-
linquish the case, choosing that it should either terminate
fatally according to his views, or recover under the
treatment, and in the hands, of another. The blister was
applied, and the calomel administered to the extent of
two grains every hour or two-the symptoms were soon
mitigated, and the patient entirely recovered.
Bleeding as a remedial agent, is one that has been
warmly praised and as warmly and unequivocally con-
demned. Its injudicious, but ardent friends, have prac-
tised and recommended it in almost every stage of almost
every disease to which man is obnoxious; and by their
untimely and indiscreet praises, they have forced sus-
picions upon the minds of their brethren, of its universal
sanitary powers, which have resulted in a disbelief in its
efficacy, and in its disuse. One practitioner of emi-
nence will tell you-and we could, were it expedient,
MEDICAL PHILOSOPHY.
233
enumerate multitudes of instances-could quote names
without number-that most diseases need not necessarily
prove fatal were bleeding performed as early as it should
One says
be and carried to a sufficiently great extent.
that he has had four hundred cases of a disease-that he
bled early, and largely, and repeated his bleedings-
that he lost but few patients, and those few in conse-
quence of neglecting to apply the remedy to a proper
extent. Another, in the same region of country, and
under similar circumstances, will tell you that he has
had the same number of cases of the same disease-
that he too bled early, and largely, and repeated his
bleedings-and that nearly all the cases thus treated
proved fatal-that the remedy, decidedly, in a majority
of cases, was injurious-and that nearly all whom he
subjected to a different treatment recovered. Were a
man to believe all that a lover of the lancet, or an ad-
mirer of phlebotomy should tell him, he would inevitably
come to the melancholy conclusion, that were he afflicted
with disease, he must infallibly die were he not almost
bled to death as a means of saving his life. And again
were he to hear the opinions of one who dreads the
sight of blood, and errs in the other extreme, and were
he to believe what such a practitioner says, he would as
readily conclude that life itself would be drawn with the
blood, and that with the extinction of his disease he must
cease to exist. The inveterate theoretical bleeder will
bleed in the most opposite states of the system; he will
bleed to check the circulation when it is too rapid, and to
subdue febrile excitement-when the circulation is de-
pressed he will bleed to restore it, and to increase the
20*
234
MEDICAL PHILOSOPHY.
heat of the body when it is below a healthy standard-
he draws blood to subdue reaction, and to excite it—he
calls bleeding a sedative, and again he says it is a stimu-
lant—with such a man bleeding is a sine qua non—it is
almost food and drink, and is about equivalent to vomit-
ing and purging-it is refrigerant in summer, and cale-
facient in winter-a hobby which he rides either rough
or smooth shod.
When the question was put to an ancient orator as to
what was most necessary to constitute a good speaker,
he replied action; when he was asked what was next
most important, again he replied action; and when the
question was reiterated the third time, the third time he
replied action. Were a modern Sangrado asked what
was most necessary in the treatment of disease, doubtless
he would reply, bleeding; should the question be repeat-
ed, undoubtedly he would repeat the same answer; and
should it be reiterated the third, or to the thirtieth time,
the same answer would be as often returned, unless,
perchance, it should be varied to "leeches," gum-wa-
ter,
"“ absolute diet,” or “lavements." Were the ques-
tion, on the other hand, what he considered the most
hurtful measure in the treatment of disease, put to his
antipode in practice, his answer would as certainly be
bleeding; and were the question repeated any number
of times, the same answer would be invariably made.
The error in this case lies equally with friend and foe;
the extravagant praises of the one, and the unconditional
condemnation of the other, are in the same degree un-
merited, and unphilosophical, and unbecoming a member
of the medical profession.
MEDICAL PHILOSOPHY.
235
There are also, even in the reign of " gastro-enterite,"
ardent friends and admirers of emetics; and the instan-
ces of patients who pass through their hands without a
taste of tartar emetic, are as rare as those who come
from the discipline of a thorough Broussaian, without his
fill of gum-water, or without carrying the marks of the
scarificator on his epigastrium. Emetics are adminis-
tered for a pain and irritation of the stomach, and they
are repeated to remedy the pain and distress which they
create. Like a mass of fuel thrown upon a fire, which,
for a time is checked, and then bursts out with tenfold
rage, emetics may temporarily smother a disease which
will reappear with increased violence. This is particu-
larly the case with gastritis in all its grades, and if the
disease prove fatal, as it not unfrequently does, under a
repetition of this treatment, the doctor does not recognize
the instrumentality of his own hand in the production of
the final result. He believes, in the innocency of pure
intention, and in the simplicity of his understanding, that,
if his favorite remedy had been employed to a greater
extent, his patient had been saved, and his own skill and
the reputation of his medicine, had not been questioned.
Another, on the contrary, would hardly administer an
emetic, under any circumstances; for he too believes,
in all honesty and sincerity, that they must inevitably
and without exception, cause gastritis when it does not
exist, and aggravate it when present, and always leave
the patient worse than it found him. Not long since a
practitioner, who had the most inveterate fear of emetics
before his eyes, was applied to by a patient who com-
plained of pain, tenderness, weight, and other symptoms,
236
MEDICAL PHILOSOPHY.
}
which, to him, clearly indicated gastritis; the usual
treatment was, of course, pursued for several weeks-
leeches, poultices, cupping, starvation, etc. with no good
effect. The patient repeatedly urged to be allowed to
take an emetic, but his physician as often placed before
him the great danger of so rash and hazardous a measure.
At length the doctor was surprised, after the lapse of
two days, to find his patient so greatly improved; his
disease seemed entirely gone, and he was in fact well.
This afforded the doctor a fine opportunity to extol his
exclusive theory, and the happy result of his practice, in
an oration of half an hour's length; but he was effectually
silenced when his patient told him that he had clandes-
tinely taken a large dose of tartar emetic and ipecac, and
from the moment of its operation he felt himself relieved.
Neither have cathartics escaped a due share of exag-
gerated praise and condemnation-the love of friends,
and ill will of enemies, proving about equally injurious,
as well in relation to medicine as in regard to most other
matters. We have too frequently, and what candid man
has not, seen cathartics prescribed when they were de-
cidedly indicated, and repeated till all the good they
could do had been done, and then continued till the dis-
ease they had been intended to relieve had been aggra-
vated, or one of a worse character induced. Purging is
many times continued till a sub-acute entritis is induced,
or aggravated, and the abdomen becomes painful and
distended; and than it is still further continued, under an
erroneous impression that a new disease has occurred,
to remove the very symptoms it has caused. Thus the
patient is finally purged out of existence, without the
-
MEDICAL PHILOSOPHY.
237
doctor once suspecting a possibility that he may be wrong,
or that something else, or some other treatment, would
be advisable. The error of superpurgation is quite
likely to occur in affections of the skin; cathartics ope-
rate as revulsives, and aided by the close sympathy be-
tween the skin and the mucous membrane of the alimen-
tary canal-caused by similarity of tissue and function-
they unexpectedly transfer the disease from the surface
to the interior of the body—an event which is always to
be dreaded, and if possible avoided. We have thus seen
erysipelas, by a repetition of cathartics, transferred from
the skin to the bowels, prove fatal in twenty-four hours.
Besides the division of the medical world into particu-
lar sects, and the devotion to exclusive theories, and the
practice founded thereon, particular articles of the Ma-
teria Medica have, also, from their first introduction into
use, to the present time, been highly extolled on the one
hand, and equally censured on the other. In this respect,
the history of one, is the history of all; each has, in its
turn, experienced revolutions, which have at one time
elevated it to the pinnacle of favor and confidence, and in
a brief space plunged it into disgrace and neglect. Medi-
cines which are by some considered of the utmost impor-
tance in the treatment of disease, are by others deemed
useless or positively injurious, and deserve to be striken
from the list of remedies; while others, of acknowledged
efficacy and usefulness, it is thought by a few, may be
entirely dispensed with, and a substitute employed.
The principle of adopting substitutes in medicine, its
tendency and ultimate results-the proposal to reject one
article and supply its place with another, deserves a most
:
238
MEDICAL PHILOSOPHY.
!
careful consideration. In the first place, the want of suc-
cess in our practice is, at least, circumstantial evidence
that we can do none too much good with all the remedies
now in general use; and by curtailing our powers-by
limiting our means, we circumscribe also in an equal pro-
portion the probability of accomplishing the end and aim
of our profession. It must be remembered that no one
article is universally condemned-each has its friends,
who bear positive testimony to its good effects, and, ac-
cording to the laws of evidence, we are bound to yield
due credence to their testimony-we must, therefore,
believe that the different articles in the Materia Medica
are useful, and that by expunging them we banish what
is sometimes an important and necessary aid.
In the second place, it must also be remembered that
a great majority, we may safely say, of the most potent
articles now in use are condemned to perpetual disgrace
and disuse by nearly equal authority. One says that a
certain article is injurious and should never be employed,
and quotes numerous cases to prove his assertion; but
he recommends a most excellent substitule. Another
extols the condemned remedy and quotes cases to prove
that he is right, and is in no wise sparing of his censures
of the proposed substitute; while a third will maintain
that both, under given circumstances, are equally useful
and indispensable, and will, therefore, reject neither.
Were we thus to go through the whole Materia Medica
and reject such articles as are condemned, on good au-
thority, as unworthy to retain a place in it, we should at
last find ourselves without a single remedy with which to
combat disease—like a soldier who goes into battle with
MEDICAL PHILOSOPHY.
239
not a solitary cartridge, or any weapon to defend himself.
And, on the other hand, were we to replace the expunged
articles by substitutes, recommended on equally good au-
thority, we should have all our disgraced remedies restor-
ed to favor. We may therefore infer, that testimony and
theory, no matter how respectable or plausible, that leads
to the above exclusive results, is false and inconclusive.
The simple fact that we are often compelled to use a suc-
cession of remedies of the same character proves that we
have none to dispense with-that all should be retained
to be used as occasion may render necessary.
Again it may be questioned whether any two articles
are so nearly alike in their properties and effects that they
can, under all circumstances, be substituted for each
other. To admit this we must admit that two things may
be alike, and yet not alike—that after the very best thing
is found, there is still a better in the estimation of some.
This may be more clearly illustrated by taking a single
article and tracing it through its phases of popularity-and
we will select one of a conspicuous character, one which
has received of late many thrusts and stabs, and sly shots,
and encountered the open and manly attacks of its ene-
mies-we mean ALCOHOL.
In speaking of this article it is necessary to premise
that the writer of these pages adopts the principle that
alcoholic liquors in any form, and under any name, are
entirely unnecessary in health; and that in all cases, if
used to any considerable extent, they are productive of
mischief. But it is well known that there are those
who occupy elevated places in the medical profession,
240
MEDICAL PHILOSOPHY.
PHILOS
and who exercise a commanding influence, who would
have alcohol, in all its forms, expunged from the catalogue
of remedial means, and if possible striken from existence-
completely annihilated. In relation to the abuses of this
article, and the immense evils it has wrought in the world,
we can, on this occasion, have nothing to say. The
-principle of condemning any thing of marked and exten-
sive utility, merely because it has been abused and per-
verted to work misery and death, requires a small share
of dispassionate, and philosophical consideration.
No one but a fanatic doubts the power and efficacy of
alcohol, and in many instances its good effect at least, if
not absolute necessity in prolonging or saving life; and
most practitioners who allow themselves to be guided by
common sense, common observation, and common ex-
perience, can bear evidence to its usefulness where noth-
ing, within their knowledge, could have been substituted
in its place when nothing else would have been as good.
The question now occurs, whether this article shall be
expunged from the materia medica, and some persons
allowed to die for the want of it, because some others die
from its excessive use? Shall the life of one be sacrificed
because another sees fit to commit suicide? If this
principle be a true one, it must hold good in relation to
other things as well as to alcohol-and we shall then find
our greatest blessings wrested from us, because they have
been perverted and abused, by the blind zeal of a band of
fanatics. What has caused a greater sacrifice of life,
what more bloody wars, more deadly hate, and bitter
persecutions, what greater horrors, and more fearful ca
lamities than the Christian Religion—not the Christian
MEDICAL PHILOSOPHY.
241
Religion-we would not be so blasphemous. But such
results have sprung from its perversion and abuse. And
where shall the blame be laid? Or shall the Bible, and
Christianity itself, be utterly rejected and abolished?
Man, and all that pertains to him in this world, since
Adam's transgression, have been marked with frailty and
imperfection; and it has been wisely ordained that the
abuse of every good thing, shall invariably be followed
by an unpleasant result. To reject one blessing, be-
cause it may be perverted into a curse, argues weakness,
the greatest indiscretion, and a lack of philosophy; for
by the same reasoning nothing could escape the same
condemnation. We should rather, like the bee, learn to
extract sweet from bitter-we should retain for our use
the good and reject the bad; and if a thing is positively,
and universally, injurious in health, ought we not rather
to consider that as an indication that it was meant for our
good in disease? The author can, therefore, see no rea-
son why alcohol should be abandoned as a remedial
agent; and, as to a substitute, he positively denies that
there is any thing like it, in nature or art, or that can take
its place.
A moment's consideration in regard to another position
assumed by some medical men, in relation to this article,
and we leave it. It is asserted that alcoholic drinks are
not only unnecessary in health, but that in all cases, and
in the smallest quantities, they are positively injurious.
It is also said that it is not the last glass of liquor that kills
an intemperate man, but that every glass which the man
has ever drank, aids in doing this. This is an assertion
of the boldest kind, and one which cannot be substantiated
&
21
242
1
MEDICAL PHILOSOPHY.
*
by the least shadow of proof drawn from any law regula-
ting the animal economy, or based on any principle of
physiology. If this is true in regard to alcoholic drinks,
it is no less true in regard to food, or any of the necessaries
of life—which, in any small quantity more than is abso-
lutely required by the wants of the system, must tend
directly to the production of disease. Every thing, which
is not positively essential to life, must tend to its destruc-
tion. To reverse this assertion, and place the subject on
its true ground, it is only necessary to remember that the
system is provided with organs whose duty it is to guard
against causes, the effects of which are likely to prove
injurious. The Omniscient Creator of our bodies knew
where man would be most likely to err, and in what
manner he would be most apt to destroy the work of His
hands; and to render His own productions more complete
-to provide against emergencies-to remove the princi
ple of destruction which, otherwise, the body must carry
in itself, he has wisely provided an apparatus, and sub-
jected the whole machine to such laws that they shall, to
a certain extent, obviate all causes of disease. Thus the
body may enjoy health in a high or low temperature-it
may endure fatigue and hardship, or listlessness and
inactivity-and it may, also, from a superabundance of
nutriment, appropriate to itself sufficient to supply its
wants and necessities, and reject the remainder. It would,
therefore, be an exception to the general principle, a
great and strange anomaly indeed, if the same laws
should not apply, to a moderate extent, as well to alcohol
as to all things else. We would not seek to advocate
even the moderate use of intoxicating drinks, neither
MEDICAL PHILOSOPHY.
243
would we consent that the grossest errors should be
propagated through a mistaken zeal to promote the cause
of temperance. Truth is so powerful that it will prevail,
in all places, and under all circumstances, when it can
be fully understood and duly appreciated; and when it is
believed that error is used to accomplish even a good ob-
ject, or compass a laudable end, the motive is not un-
frequently doubted, and the truth itself rejected.
Calomel is another article for which there have been
proposed innumerable substitutes; and in the whole
Materia Medica, there is not another against which
there is arrayed such an universal, deeply rooted and
invincible prejudice. The general dislike of people
to mercury, in all its forms, is no doubt grounded on
sufficient reasons; they know its power and dread it,
for they have seen, for themselves, frequent instances of
its mischief when it has been incautiously or ignorantly
administered. And, doubtless, members of the profession
have found it for their interest to strengthen and perpetu-
ate those popular prejudices, instead of directing or giving
a more correct tone to public sentiment on a subject that
so intimately concerns the community. And physicians.
to advance themselves in the favor of their patients, have
even been so hypocritical as to flatter their prejudice
against any mercurial preparation, where it has been al-
ready so strong that they have been compelled to resort
to fraud and deception to cause it to be administered.
We have known a medical man condemn mercury as
the worst of all things, in the presence of his patient, and
his patient's friends-and in two days the same individual
was unceremoniously dismissed, for having unexpectedly
244
MEDICAL PHILOSOPHY.
*
induced a profuse salivation in his patient after a long and
unwarrantable administration of Calomel. This subject
might be extended to an indefinite length; and, indeed,
the consideration of popular objections to the different
articles of medicine would be a pleasant theme to engage
the attention, besides affording a wide field for investiga-
ting the causes to which they owe their origin.
By exclusiveness in medicine, there is shown a want
of that which should peculiarly characterize every indi-
vidual of our profession-viz. philosophy; which would
impel every professed inquirer after truth, impartially
and honestly to weigh testimony, and form his judgment
accordingly. We may now with profit consider some of
the causes which tend to the production of the discrep-
ancies, ultraism, and exclusiveness in medical opinions,
theories, and practice, to which we have briefly alluded.
Want of Education. To any one extensively ac-
quainted with the medical profession in this country, it
cannot fail to be clearly manifest that there is a general
lack, as well of preparatory, as of more classical,
and scientific education. The members of the profes-
sion are not altogether to blame for this, nor are they
quite excusable. We must attribute it, in a great
measure, to the compensation for medical services, which
from various causes, are too small to afford the hope of
remuneration to students, for being at great expense for
an academical or professional education. But small as
the compensation is, there are yet multitudes who enter
the lists as competitors for the small fee, the scanty pit-
tance, which they can ever expect for their services-
and we verily doubt whether the actual fear of starvation
MEDICAL PHILOSOPHY.
245
would deter such from longing after the honors which
they believe to rest on the shoulders of a doctor.
Many are influenced to enter the profession from the
great facilities, pecuniary as well as others, of acquiring
a diploma, or license to practice; little, in truth, being re-
quired, under some circumstances, besides a superficial
smattering of the rudiments of the profession, and that
at an astonishingly cheap rate. How often is it that one,
who has failed to succeed, or who may have saved means
sufficient, in some other occupation, has in three or four
short years, without being blessed with talents above
mediocrity, come out a full-grown, thorough-bred M. D.
He may, to be sure, have passed through a regular
course of medical study, attended lectures, and paid for
his diploma—and, yet, a little knowledge of medicine is
all to which he can lay claim, without being able to
put a sentence together agreeably to the rules of orthog-
raphy, etymology, syntax, or prosody. Many students
graduate with "signal and distinguished honors," who
have seldom taken a dissecting knife into their hand, or
who have often seen it used in the hands of another,
and go forth to assume the responsibilities of their pro-
fession; and even to sport with the limbs and lives of their
fellow men. Not trained to habits of study-entering the
profession as a last resort-and often then, compelled to
employ their time in other ways to obtain a livelihood—
it is not surprising that the science of medicine should,
from their hands, receive little or no cultivation—that
their opinions should be formed with the least expense of
purse, or labor of mind, and that their practice should be
21*
1
:
246
MEDICAL PHILOSOPHY.
of a character to correspond-an exclusive, empirical,
routine.
It is the peculiar excellence of our government, and
our pride and boast, that all who live under it are equal,
in point of privilege, and in respect to person. "Liber-
ty and equality," "democracy, and republicanism," are
the watchwords of the day, and on these foundations
thank Heaven, our institutions are reared; but there is
a limit beyond which liberty degenerates into licentious-
ness, and when democracy is but another name for the
rule, or rather misrule, of the rabble. It is not patriot-
ism, or love to our fellow men, which would confer the
same privileges on the learned and on the ignorant-on
the virtuous and on the vicious-it is not republicanism
which would lower the standard of the professions, and
open the portals of science for all to enter, whether qual-
ified or not. Instead of lengthening the term of study,
or requiring more qualifications of a candidate for grad-
uation, a cry of "aristocracy" is at once raised-the
poor cry, persecution;" they conceive their rights in-
vaded, and an effort is made to produce a generation of
doctors, of a character inferior to all their predecessors.
66
It is a fact that wealth always does, and ever will,
confer power; in commerce, agriculture, manufactures,
trade and speculation, capital is necessary. Those who
have it not find no fault with those who possess it, be-
cause they see that none of these operations can be
carried on without it. But, talk of matters of science,
and the necessity of capital-of the expenditure of time
and money to aid in its acquisitions—and the cry is, by
those in and out of the profession, "that will never do,
1
MEDICAL PHILOSOPHY.
247
}
it costs too much already to learn to be a doctor; you
must bring the professions within our reach; let the man
of three years' superficial reading enjoy all the honors
and privileges of one who has devoted ten times the
amount of labor to the same object; you must in fact
degrade science to suit our circumstances, and our con-
venience this is pure "democracy," this is "equality
is"
and republicanism." The facilities for acquiring a
medical education cannot be put equally within the reach
of all. To obtain a competent knowledge of the pro-
fession, time and money are both indispensably requisite.
The first of these is in a great measure supplied, or
provided for, by its annihilation, or by the short time of
study required of a candidate for a degree; the second
is made less necessary by rendering only the quid pro
quo, by giving knowledge equivalent to the worth of the
money only-by making up in parchment what ought to
be conveyed in some other form.
Many who now occupy the first rank in our profession
in this country have indeed risen from poverty and ob-
scurity, and attained their eminence by their own unaid-
ed efforts. And men of genius, enterprise, and industry,
will always rise, and rise above the bare qualifications
for an entrance into their profession. The commence-
ment of practice is their starting point in study; while
a majority of those who make the greatest noise about
equal rights," and " rich and poor," consider the goal
at that time already attained—their work done, for they
have their M. D.-there is no more for them to learn,
and the profession must be degraded-must be brought
below par, for their special accommodation. We assert,
66
*
248
MEDICAL PHILOSOPHY.
though we do it in sorrow, and without fear of contradic-
tion, that the medical profession in our country is be-
coming more and more prostituted, compared with the
general spread and increase of knowledge in the com-
munity, and its honors more common, and more easily
acquired.
The inability of people to compensate a physician for
his services, so that he shall be reimbursed for an ex-
pensive education, may, in part, excuse his ignorance ;
but nothing should be considered a palliation for indolence
or neglect to devote himself to the interest of his patients,
by cultivating a thorough acquaintance with his profession.
Wrong Education. What is equivalent to a lack of
education, or what virtually amounts to the same thing,
is a wrong direction not unfrequently given to the studies.
of a medical student. His preceptor has already his own
mind fixed; his opinions are formed, not to be changed
by improvements and discoveries, and he swears in the
dicta of some celebrated master; he can therefore train
his pupil to tread only in his own footsteps, and teach him,
by rote, his infallible precepts; while the language of
the pupil is, "lead on master, and I will follow, to the
last gasp, with truth and loyalty."
Thus error is perpet-
uated, and the mind, which was at one time clear and
equally ready to receive truth as falsehood, becomes
obscured and clouded, and the rays of a true philosophy
are never able to penetrate the gloom and mist in which
it is enveloped. In the hands of no class of men is a
little learning or bad learning so dangerous as when
possessed by physicians; they are then like the maniac
who madly discharges a blunderbuss at a crowd—some
must fall by his madness.
MEDICAL PHILOSOPHY.
249
One principal cause which tends to the production,
and perpetuation of error, and exclusiveness in medicine,
is the prejudice of the teacher in favor of fixed and es-
tablished habits and modes of practice. The vulgar
saying that "it is hard to learn old dogs new tricks,” is
most conspicuously manifest-the opinions of the older
class of practitioners being in general as unalterably es-
tablished as the laws of the Medes and Persians. By a
change of sentiment they virtually acknowledge their
fallibility—that they have been wrong—that their prac-
tice has consequently been wrong-and that therefore,
doubtless, they have done mischief; a concession which
human nature is not over ready to make. By a change
of opinion other concessions no more readily granted
than the preceding, are also implied-so that the mind
clings to its previous conclusions, although convinced.
that they may be wrong, rather than appear to be un-
stable and vacillating, by embracing a truth which must.
produce a revolution in sentiment-or in practice.
What," says the veteran in the healing art, “am I
wrong-have I been wrong all my life? No! it is im-
possible." Old errors are more fondly cherished, and
more easily propagated, than newly discovered truths.
Thus, then, it is to teachers, either public or private, that
medical students are indebted, in the first place, for what
they know either right or wrong in our profession; and
many of our errors we owe to their obstinately and blind-
ly yielding to the influence of their own prejudices.
Want of Success. It is too frequently the case that a
general principle, or a particular opinion is formed from
insufficient grounds, by which a man is governed through
250
MEDICAL PHILOSOPHY.
the whole course of his professional life. From a few
isolated applications or trials of a remedy-no matter
what were the circumstances which might modify its
administration, whether or not the doctor, from his lack
of education, might be capable of appreciating them—
conclusions have been formed as to its efficacy; and
upon such trials has its future destiny depended. A
knowledge of the operations of the human machine, and
their modifications in disease, is indispensable to one who
would timely, and judiciously apply his remedies; how
then can it be possible for him who has hurriedly, and by
stealth, obtained a place in the ranks of the profession,
to decide with any justice on the merits of a remedy, or
even to prescribe it with any reasonable hope of success ?
It is such that become exclusive and empirical in their
theories and practice-it is in such hands that remedies
are extolled beyond their deserts, or unjustly depreciated;
others, perhaps, echo the sentence-the non-professional
public join in chorus, and the judgment is confirmed.
Such is the fact in relation to one side of the subject, and
the same thing occurs in regard to the other, while each
party maintains its ground-hence the discrepancies,
quarrels, and contests for victory.
The fault attributed to remedies is more frequently duo
to an inaccurate diagnosis; misconception, ignorance,
and exclusiveness, fathering their sins upon an innocent,
inoffensive, and at the same time, useful, agent. From
improperly prescribing a remedy, and doing mischief
with it at one time, the most learned and eminent are
ever afterwards deterred from its employment, and ren-
dered ardent in their zeal to depreciate it in the estima-
MEDICAL PHILOSOPHY.
251
tion of others. As an illustration of this, we can now
call to mind the case of one of the most eminent men in
our profession in this country, who stated to the author of
this work, that he positively knew that he had done fatal
mischief in two or three instances with a particular arti-
cle-and that he could no longer use it himself, or recom-
mend it to others. Others, equally eminent, have not been
thus unfortunate with the same remedy, and are as warm
in its praise as he is in its condemnation; indeed, the article
in question is used almost daily by us, and by almost
every regular practitioner, without being followed by any
unpleasant result. It may be left now to the decision of
any candid mind whether, in this case, the medicine or
the doctor was most in fault.
Early Prejudice. It is not alone the prejudice of
those who have already entered the profession that tends
to error and exclusiveness, but also the prejudice of the
same individuals imbibed at an early age. Almost every
one in his more youthful days has experienced to a
greater or less extent, the pains of disease; and he too
well remembers the nauseous, unpleasant taste and effect
of the medicine he was thus compelled to swallow. To
some it would, perhaps, at first, seem incredible and
absurd, that these early likes and dislikes should influence
the practice of a learned doctor, through the whole course
of a long professional life. But such, nevertheless, is the
fact. Impressions, no matter of what sort, made in early
life, are the most enduring; and it is indeed wonderful
how the medical treatment of a sick boy will control the
prescriptions of the venerable, and gray headed doctor,
long-long after he shall have ceased to recognize, or
252
MEDICAL PHILOSOPHY.
perhaps, without once having suspected its influence.
Again, the young inherit the opinions of their parents
and those who have an influence in forming their minds;
they catch the popular sentiment, and without the exer-
cise of due philosophy or reason, it grows with their
growth and strengthens with their strength. There is a
medical gentleman of the writer's acquaintance, who, in
his childhood, was obliged by his physician to take fre-
quently, emetics. He became so susceptible to their
operation that, at length, the sight alone of the remedy
was sufficient to excite vomiting. His prejudice against
the whole class of emetics has remained invincible to
this day, although his better judgment, according to his
own confession, tells him that his patients occasionally
suffer in consequence. Such is the mind of man; yield-
ing a more willing obedience to the influence of the
feelings or the fancy, than to the convictions of reason.
Passions. It not unfrequently happens, even in an
honest inquiry after truth, and in an effort to do good,
that the human passions are allowed to influence our
judgment and actions. The ties of kindred will lead
a man to form conclusions contrary to the dictates of
reason. And the dicta of a favorite author, or a respected,
highly esteemed friend are taken for granted, without
examination or without suspicion. One mounts his hobby,
and another mounts and rides behind him. But as there
happens to be none too much of the kind, holy, feeling
of friendship in our profession, we must seek for another
cause which places the members of the faculty in the
relation of antipodes to each other. This is to be found
in the envy, jealousy, and ill will of different writers and
MEDICAL PHILOSOPHY.
253
practitioners. The heart of one is pained to see his
brother wear the palm of merit, and in a paroxysm of
spleen, he snatches at the wreath that encircles his brow.
No class of men, probably, however inconsistent it may
seem with their profession, exhibit more of the frailties
of our nature than physicians. Like the Divine physi-
cian they go about aiming to do good by healing the sick,
binding up the broken hearted, and carrying comfort and
happiness to the distressed and miserable. And while
they are performing their almost divine errand, how their
glory becomes dim by yielding to the impulse of those
passions which counteract the most holy object. Any
one, acquainted with the profession at home and abroad,
may call to mind the names of those who lay claim
to a large share of honesty and professional eminence,
who, at the expense of truth, and at no less a sacrifice
than the lives of their fellow men, would gladly, and
with alacrity, degrade their brethren from a just elevation,
if it would, even in a small degree, contribute to their
own advancement. Nay, more—they would, like the
hyena, pursue their prey to the tomb, and with a
sacrilegious hand steal the wreath from a dead man's
brow, and place it on their own. To such extent are
the feelings of hostility carried in the practice of medicine,
that one physician will not even use the remedies recom-
mended by one whom he dislikes, when his own reason
and conscience, besides his observation and experience,
tell, and demonstrate to, him that they are the best adapt-
ed in a given case. We could, were it expedient, cite
more instances than one, where a writer has warmly
praised one plan of treatment for a certain disease, and
22
254
MEDICAL PHILOSOPHY.
extolled particular remedies; and when he finds that
one whom he dislikes, or whom he considers his mortal
enemy, has done the same thing, he has changed his
notes of praise into tones of the most bitter denunciation.
Thus it seems that enemies, or rivals, cannot look with
complacency on the same object-what one likes the
other is certain to hate, and to malign-and the truth is
not believed, because he who speaks it is not a favorite,
or a friend.
·
Avarice. A hankering after dollars and cents-the-
auri sacra fàmes-has no small share in causing and
entailing exclusiveness and ultraism in medicine. To
avarice may be traced much of the quackery-many of
the contemptible practices-the low devices-the art
cunning and intrigue, that disgrace the profession.
And although its operation may be more indirect and
less perceptible than that of most other causes, it is none
the less efficient. There are, and we are proud and
happy to say it, but few comparatively in the medical
ranks, who would through love of money pursue a course
that would be deemed disreputable, or who would pur-
chase wealth at the expense of honor. While our pro-
fession ranks high, as a body, for benevolence, and
disinterestedness, and good will to man, there are yet
those among us who esteem wealth more highly than
reputation; and it is they who most readily embrace new
doctrines, and new notions; such as catch the popular
fancy, and give to the doctrines, and to themselves, an
ephemeral reputation. It is to such characters that new
and exclusive speculations are mainly indebted for their
short-lived popularity, no matter how ridiculous, or how
•1
MEDICAL PHILOSOPHY.
255
f
absurd they may be-and when the gloss of novelty be-
comes dim, they are as ready to adopt another new creed,
provided it bids fair to take with the people, as they were
to embrace those of an opposite character which they
have already forsaken. Not honest enough to confess
and abandon their mistakes, when they are perceived and
known, they persist in imposing upon the credulity of
those who are ignorant or blind enough to repose confi-
dence in their heartless, hollow pretensions.
- A love of money alone, of all motives that induce an
individual to practice the art of healing, is the most con-
temptible, mean, and disgraceful. He who deals out his
advice, and measures his services, in proportion to the
fee that he expects to receive, should more correctly
estimate his own deserts than to claim a rank with the
more honorable members of a liberal profession. The
line where we should claim a compensation for our
services, and where we should cease to do so, is not in
all cases easily drawn; but it may be left with safety to
a man's own conscience, which does not generally err to
a great extent; and when, therefore, he begins to feel his
“honor grip” he should be careful to look for no excuses
to silence the monitor within.
Ambition, when its end is laudable,-when its aim is
to advance the interest of the profession, and the good of
mankind-may be tolerated; but when, regardless of all
other considerations, it aspires to personal aggrandize-
ment, its effects are as pernicious in the scientific, as they
are in the political, world. To honest ambition, to a
sincere desire to excel in a professional life by doing
good, by being serviceable to our fellow men, are we in-
256
MEDICAL PHILOSOPHY.
1
debted for most of the improvements and useful dis-
coveries in medical science. But however honest the
intention, or however pure the motive with which we
set out, when we come to estimate our labors and in-
vestigations by the rules of loss and gain alone-whether
in a pecuniary view, or with an eye to fame—the original
enterprise is lost sight of and forgotten. Though physi-
cians are philosophers, or claim to be, they are but men,
and subject to the influence of all the passions that are
inherent to our nature; self interest must therefore,
philosophy to the contrary notwithstanding, more or less
occupy their thoughts, and govern their actions, to the
exclusion of the welfare of those around them.
The onward progress of our profession is, doubtless,
greatly retarded by the eccentric wanderings of its
followers. They deviate into unknown paths, captivated
with the flowery fields that fancy pictures to their view,
and confuse and bewilder themselves and their associates
by the reports of their pretended newly discovered
countries. Starting fresh in the contest, and filled with
the most delightful anticipations, it is the young and
enterprising who are most ardent in the pursuit of novel-
ties-who are most eager in the desire of making bril-
liant and astonishing discoveries—and it is the younger
members of the profession who are most apt to be led
astray, and, as far as their influence extends, most likely
to lead others with them. The many, and unexpected,
difficulties to be encountered in acquiring a professional
reputation, and a lucrative practice, stimulate the multi-
tude of competitors to adopt those means, with little re-
gard to their character or tendency, which are most
MEDICAL PHILOSOPHY.
257
likely to accomplish the desired end; and we need not
therefore wonder that such men ride their hobbies into
error and ultraism.
The word of an ambitious professional man-one who
is eager for distinction, and desirous of making a noise
in the world, without a corresponding wish to advance
the interest of science-should be taken, if received at
all, at a most liberal discount; he is in the position of a
witness in a court of justice, who is interested in the
issue of a suit—and who, in the eye of the law, is deemed
incapable of speaking the truth. Their intention may
not be to misrepresent, or deceive; but the infirmities.
of our nature, the passions, self-interest, perverted
judgment, or excess of zeal, may hurry them far beyond.
the bounds of veracity.
Gladly would we throw the mantle of charity over the
faults of all our brethren, and excuse them on the ground
of good intentions; but candor, and the honor, and good,
of our profession forbid it. We, of the medical profes-
sion, are not a perfect race of beings; and there are
those among us who are determined to rise, though in
their ascent they sacrifice honor and honesty on the altar
of their ambitious views, and trample under foot the
hard earned reputation of past, present, and future,
generations—they will build a temple to their own fame,
though it be based on falsehood, and reared amid the
ruins of truth. Like the descendants of Ishmael, their
hand is against every man-they lay waste and destroy
to the extent of their power, and, with fiendish delight,
survey the mischief which they accomplish. If we look
for the effect of a restless, ambitious spirit, we shall
22*
•
*
258
MEDICAL PHILOSOPHY.
nowhere see it more manifest than in a densely popula-
ted place, where a number of physicians are brought
into the same neighborhood. Here, in the proverbial
quarrels between doctors, and the no less bitter disputes
and misunderstanding of their friends, it works its own
perfect work-it bears its peculiar fruit.
Listlessness, carelessness, and indifference to the wel
fare of our profession, are too often witnessed among its
members. This state of mind is the chilling frost which
destroys all action, and freezes the soul against the
benevolent and kind affections which should warm us
into efforts to do good to our fellow men, by advancing
the character of the profession which we have espoused.
When we relax our industry, and cease to cultivate and
cherish our profession, we are like a man who abandons
the wife of his bosom, and proves recreant to all the
principles that adorn our nature-we are like an un-
natural parent who forsakes his offspring, leaving it to
the cold protection of strangers-or a child who deserts
an aged, needy parent. There are those among the
disciples of Esculapius who seem to imagine that the
degree of M. D. is the sole end and aim of a medical
student, and, when that is once obtained, nothing more
need be done; their parchment they consider a passport
to the confidence of the community, and their ulterior
study is how to accumulate the most wealth in the
shortest space of time, or how they may lead an easy,
professional life, free from the labor of thought and
reflection. They who are not by nature fond of study,
and by habit trained to it, almost invariably run into a
routine-exclusive-and empirical, doctrine and practice.
J
MEDICAL PHILOSOPHY.
259
They are disinclined to the labor of reading and reflection,
-and condemn any practice with which they are not al-
ready familiar; and therefore, confine their prescriptions.
within the narrowest possible range.
Doubtless, the
trouble of thinking, or incapacity to think, drives more
into quackery than any other cause. There are some
strong minds, capable of grasping large subjects, and
which seem unable to readily enter into the minutiae of
the practice of medicine-they cannot nicely consider
the characters of a disease—the peculiarities of constitu-
tion, temperament, season, and all the other circumstan-
ces by which it may be modified-and accurately weigh
the properties and qualities of the different remedies,
and then wisely and correctly choose those most appro-
priate to the case. It may be that a great mind cannot
stoop to the consideration of such small items; or, through
indolence and indifference, that it will not-but, till it
both can and does, the possessor of it is not qualified to
practice that profession of which he claims to be one of
the most learned and honorable members. Such a mind
adopts some favorite theory, and obstinately adheres to
it, be the consequences what they may; and if an indi-
vidual, thus mentally constructed, is by any circumstances,
placed where he sways a commanding influence, the
result of his favorite doctrine, or his indolence and in-
difference, cannot fail to be hostile to the progress of im-
provement.
Other pursuits and occupations not unfrequently en-
tice the medical man from his profession. Some are
compelled to engage in other business to increase their
income-some embark in speculations to gather to them-
S
1
་
1
260
MEDICAL PHILOSOPHY.
selves great wealth-and others, whose fortune is ample,
devote themselves to pleasure and amusement. Be the
occupation what it may, or whatever the reason that may
lead to it, the result is very nearly the same; the profes-
sion is neglected-much is forgotten-and the improve-
ments and discoveries made by others little noticed, or
perhaps never heard of. Such men remain stationary or
retrograde in their profession, while that is making rapid.
advances; so that in a few years they find themselves and
their juniors separated at a great distance in scientific
acquirements, and literary attainments, and their exclusive-
ness, and obstinacy, and comparative ignorance, are
generally in the proportion that they have neglected their
profession. To this quarter we may doubtless look for
one of the causes which produce the mutual jealousy
between the old and young members of the profession.
The young practitioner knows that the veteran has, for
some reason not perhaps the most creditable, neglected
to keep up his acquaintance with the improvements in
medicine, and therefore feels himself at least his equal;
while, on the other hand, he who has grown gray in the
practice of the healing art is conscious of his negligence,
though he endeavors to offset his experience against.
improvements and discoveries to which he is a stranger.
He, whose head is silvered with age, is, caeteris paribus,
more likely to have acquired a greater share of science
than a young man of twenty-five-but gray hairs alone,
though entitled to respect under all circumstances, are
far from being a test of profound knowledge, or profes-
sional skill. It seems that the term experience is often
understood to mean infallibility, and is synonymous
MEDICAL PHILOSOPHY.
261
with it—and the common idea is that it is impossible for
an old doctor to be mistaken. But there unhappily is
such a thing as experience in error; and persistence in
erroneous practice can never make it right-an error
repeated the five hundredth time is just as much an error
as when at first committed. Whoever, therefore, ceases,
from any cause, to cultivate his profession with diligence,
even for a few years, may with truth, honesty, and justice,
place himself-where others certainly will-in the scale
of merit below his well read juniors, though his head
should be whitened by the frosts of more than half a
century.
In being influenced, by the above causes, to adopt
erroneous and exclusive principles, and consequently to
pursue an empirical practice, there is shown a disregard,
or want, of the true spirit of philosophy-that sun,
which warms, animates, and enlightens, the medical
world. To insist that a particular disease, or a certain
class of diseases, are to be cured by the same remedies,
is to assume that the human system is a simple machine,
and what is rather anomalous, always affected in the
same manner by different causes. Let the proposition
be illustrated. A state of the digestive organs may be
induced, termed dyspepsia, by sundry causes-to wit,
excesses in both eating and drinking, cold, hunger, thirst,
fatigue of body, mental disquiet, etc. and yet an exclusive
-one who sees nothing in all this, but gastritis or subacute
gastritis-prescribes nothing but his depletives and
diluents; and the want of success in all cases, which
must inevitably attend such practice, only confirms him
in his theory, and stimulates him to further starvation and
262
MEDICAL PHILOSOPHY.
A
depletion. Such a man sees only an object, at a great
distance, which he is desirous of attaining; and with his
eye steadily fixed upon that, he is blind to the intervening
obstructions which encumber his path, or to the difficulties
which render it impossible to pursue his course.
philosophic practitioner takes a more comprehensive
view of what he is to encounter; he looks upon the
human system as a complicated machine, whose healthy,
as well as diseased, operations are to be known and
appreciated only by the closest scrutiny; and he knows,
too, that disorders of the nervous system may ensue
which are not always of an inflammatory character, and
not to be remedied by depletion.
If the lack of philosophy is not apparent in narrow-
mindedness, and voluntarily circumscribing the field of
mental vision, and intellectual labor, it must be more
glaringly manifest when the mind is allowed to be swayed
by prejudice or favoritism, or suffered to be affected by
the mould and rust of indifference or indolence. The
profession of medicine is based on the most benevolent
and ennobling features that adorn our nature—those
characteristics which liken us to that Divine Being, who
was Himself a most successful practitioner of the healing
art. Like Him too we should endeavor to do good to
our fellow men; and as much as in us lies, divest our-
selves of the gross passions and prejudices that obstruct
our well aimed efforts, and pervert the judgment. True
philosophy does not seek to acquire science for the sole
benefit of individuals to alone aggrandize, or render
famous, the erudite; but it aims to advance the happiness
and prosperity of the world-the whole family of man,
MEDICAL PHILOSOPHY.
263
How contemptible then does a man seem, who is a mem-
ber of a liberal and learned profession, professing himself
the disciple of an art whose nature is divine, laboring to
acquire wealth or fame at the sacrifice of truth-robbing
others of the well-earned meed of merit-or refusing to
listen to unimpeachable testimony. Still more insignifi-
cant and ridiculous does he appear, who would condemn
and proscribe a remedy, or a course of treatment, on his
own authority, which has received the sanction and
approbation of multitudes of his equals, and superiors in
talent, learning, and opportunities for experiment and
observation. And another must appear in the same light,
who would condemn all improvements, and regard them
rather as innovations, because forsooth, he is incapable
of giving them a just estimate.
There is yet another view to be taken of this subject.
When a man voluntarily engages in any undertaking-
when he adopts any occupation or profession-he virtually
pledges himself-he impliedly makes a contract, to
make the interest of the calling, which he of his own
accord chooses, his own interest. The welfare of each
is thus identical-one, and indivisible. A volunteer in
military service is bound by his honor to watch over,
protect, and promote the well being of the whole army.
Its cause becomes his cause, its interest his interest. In
the same light should a volunteer in the medical ranks
consider himself, for the cases of the two are analogous ;
the medical man claims to be skilled in the healing art,
and by implication, pledges himself to act no hypocritical
part, and to merit the confidence of the community, by
retaining and increasing his professional knowledge.
264
MEDICAL PHILOSOPHY.
*
Again, the medical man knows on what condition the
confidence of the public is bestowed. He knows it is be-
cause they believe him qualified to practice what he
professes to understand, and that he will continue to
understand it, by keeping pace in his knowledge with its
improvements, and by endeavoring with diligence to pro-
mote its objects. There is then an implied contract
between two parties; and it is a contract too, which
should be held most sacred, and should be most inviolably
observed, inasmuch as from the nature of the compact,
it must depend for its fulfilment upon the honor alone of
one of the contracting parties. But this is not all-the
stake involved in the issue of the compact is no less than
life itself. The man, who, for the paltry consideration of
dollars and cents, forfeits his pledged word is stamped by
common consent with eternal disgrace; and the soldier
who deserts his country's standard has the brand of in-
famy indelibly engraved upon his character, if, perchance,
he escape the ignominious death of a traitor or a coward.
In what estimation the medical man shall be held, who
neglects, and therefore dishonours, the profession from
which he seeks to derive honor; who, in truth, deserts and
disgraces the flag under which he claims protection, we
leave to the candid to decide. Let us suppose an instance
which is of frequent occurrence. A man is induced in
case of violent disease to entrust the life of an only child,
or a dear wife, to the hands of a doctor who has, by some
means, acquired the confidence of the patient or his
friends. The physician may be an aspiring, ambitious
man, who is desirous of having his name in every person's
mouth; or he may be of that class whose study it is to
MEDICAL PHILOSOPHY.
265
爨
​The sin of
acquire wealth; or one of a still more contemptible
character-who is too lazy to sigh for applause, or thirst
for money; the result may be anticipated-the patient is
sacrificed to the doctor's failing to discharge the responsi-
bility that he had voluntarily assumed.
omission, or rather of ignorance, in such
be winked at. We believe that he who
"best that circumstance allows" is equally guilty in the
sight of Heaven as one who knowingly and maliciously
prescribes a remedy which he believes will prove fatal.
cases is not to
fails to do the
There is, therefore, wanting a sense of honor as well
as responsibility and philosophy, in losing sight of the
great end and aim of medical science, and allowing the
mind to remain inactive, or to be influenced by fear,
favor, an invincible love of money, or an overweening
desire for popular applause.
The general effect in the community of the causes
above named, aside from those fatal results which the
grave conceals, is daily seen in the endless misunder-
standings and quarrels among physicians; these are not
confined to the faculty alone, but the friends of each of
the principals buckle on their armour and rank themselves
under their respective banners. Each one thinks his
doctor the most learned, and therefore the best, and least
fallible; the opinions of the respective principals are
adopted and closely adhered to, and a medical war is
carried on with the greatest vigor and animosity. Such,
at least, is almost constantly the fact in country towns;
and, while the same causes continue to operate, the same
spirit is transmitted from one generation to another.
The final result to medical science of this state of
23
266
MEDICAL PHILOSOPHY.
1
things is most unhappy; the profession is sadly impeded
in its onward progress, if indeed it is not made to retro-
grade. The mind, occupied with any thing rather than
a sincere desire to seek information for the sake of using
it to the benefit of our species, loses all relish and capacity
for scientific pursuits. One, whose thoughts are intently
bent on making money, or supplanting his brother in
popular esteem, or who is disposed to lead a life of in-
glorious ease, can do but little in advancing his profession
to that proud eminence to which it justly aspires.
*
CHAPTER XVI.
OF THE INFLUENCE OF THE CLERGY IN CAUSING AND PER-
PETUATING EMPIRICISM.
THE heading of this chapter may, at first, imply an
unpardonable heresy on the part of the writer, or a want
of due respect for the clerical profession; but, with all
reverence for those whose concern is with our spiritual
welfare, his object in this volume-which is to consider
the chief causes of quackery, and the obstacles to the
improvement of medical science-would not be fully
accomplished were he to leave this part of the subject
unnoticed. No one, who rightly appreciates the character
of a minister can doubt his influence on any subject in
which he takes an interest, whenever he chooses to exert
it. This is as it should ever be, and as it always has
been. Those who have eyes should lead the blind, but
they should always guide their footsteps in a right path.
The strong should sustain the weak, but not use their
power to destroy them. The wise should instruct,
counsel, and direct the less intelligent, but their lessons
should always be those of truth and wisdom.
The position in community of the clergy, and more
particularly of those who have in their charge a parish or
distinct society, must of necessity give them a command-
268
MEDICAL PHILOSOPHY.
ing, controlling, influence. The relation subsisting
between a pastor and people is one of close intimacy, and
when there is the mutual confidence that there ought to
be, the connexion is strengthened by the strong bonds of
friendship. The minister is admitted, second only to the
family physician, to domestic secrets, and is made fa-
miliarly acquainted with all the avenues to the heart, and
its inmost recesses. In the minister unlimited confidence
is reposed. His profession is to do the work of one,
"who went about doing good." In times of affliction
and distress he is the friend and counsellor; and to him,
when the heart is breaking with sorrow, we turn for
sympathy and consolation. And is it surprizing that
men thus esteemed, and thus confided in―men whose
sole aim and occupation is to do good-should in matters
not strictly professional, though with motives equally
pure, exert a powerful influence? It is far from the
author's intention to charge upon the clergy generally
any obliquity of purpose for what they do in regard to
medical affairs; for he believes them to be actuated by
genuine piety, and the best intentions, although, unques-
tionably, there may be some family interest, or some selfish
object to accomplish.
There are two ways in which clergymen are chiefly
instrumental in the propagation and spread of empiricism;
and there is yet another way in which they ought to
contribute to its overthrow, and to the establishment of
something better in its place.
The first way in which they aid and abet quackery is
by furnishing certificates of the efficacy of nostrums, to
MEDICAL PHILOSOPHY.
269
the inventors, or proprietors. Their certificates are
furnished in good faith, and bear evidence only of the
truth, with a sincere desire to benefit others by recom-
mending the remedy to general use. They may indeed
have been cured of some uncomfortable or dangerous
disease; but, ignorant as the rest of the world of the
nature of disease and the principles of physiology, they
do not know that what cures them may kill another with
a similar complaint. The certificate of a minister is
considered, by a quack, as invaluable; and when two
or three are procured from distinguished characters,
they insure a great sale of the nostrum, and of course,
a lucrative speculation to its inventor. When the clergy
take the pills or potions of a quack, the laity have little.
hesitation in following their example; and whoever con-
tributes to the extension of ignorance and error, or to
their perpetuation, by obstructing the progress of sci-
ence in fostering quackery by recommending secret
remedies, does injustice to society, and to society he
should be held responsible. If the remedy is one of
power, it may do hurt; if simple, and lacking in poten-
cy, confidence may be reposed in it, when active
treatment is necessary, till some fatal disease has made
He who trusts to a
too great progress to be arrested.
secret remedy is like one who places his fortune and
his life in the hands of a stranger-not knowing wheth-
er or not he may be murdered and robbed at the first
favorable moment. A hearty, robust boy, six years old,
was seized with an affection of the lungs attended with a
violent cough. A minister who frequently visited the family
:
23*
270
MEDICAL PHILOSOPHY.
urged the parents to give him a certain syrup that he had
known used in many cases "exactly like this" of course,
and he believed the syrup to be a certain cure—like all
other nostrums. The syrup was administered; the boy
grew worse; the quantity was increased-and so was
the disease; another bottle was used up-and so was the
boy. A post mortem examination proved the disease to
have been an acute inflammation of the lungs, which
might, in all probability, have been cured by prompt, and
efficient treatment.
The second manner in which the clergy aid in the
production of quackery is by interfering with people in
their choice of a family physician. This is a less direct
but quite as effectual a method, as the other; and it not
only contributes to the production of empiricism out of
the profession, but also in it. But the mischief stops not
here; feelings of ill-will, jealousy, and misunderstandings
which lead to open quarrels between different members
of the profession, and between patients and their friends,
not unfrequently result from the unwise intermeddling of
gentlemen whose profession teaches them better. Let us
take an instance to illustrate the position. A member of
a family in which a clergyman takes a deep interest is
sick; they have their physician in whom they have the
most implicit confidence, who has been for years their
firm friend and most faithful servant, and to whom, per-
haps, some one or more are indebted for their lives. The
clergyman has his favorite doctor also, in whom he has
confidence; he believes him to be superior in learning
and skill to all others; and besides, he believes him to
:
*
MEDICAL PHILOSOPHY.
271
be particularly skilful in the very disease with which the
patient is afflicted. By the importunity of the minister,
the physician in attendance is dismissed, and another is
called in; and perhaps the patient dies in consequence
of the change of treatment; for something different must
be attempted for the sake of appearance, however judi-
cious may have been the previous course; and then it
may be said that the second physician was called too late.
The minister's doctor may be an ignoramus compared
with the other; and if, as is not unfrequently the case,
he takes charge of the patient at a favorable moment, he
receives the credit of a cure which of right belongs to
another, and who has been dismissed in disgrace, and
who is repaid for his kindness with black ingratitude.
Here commence the quarrels and misunderstandings of
all parties concerned, which the exercise of a small share
of discretion would have prevented. The cause of all
this wrong doing lies in the ignorance, not the motive, of
the minister. And here the author begs leave to repeat,
that he does not believe all ministers, or even a majority,
are guilty of error in this respect; but there are some
who are, and they will know when these remarks are ap-
plicable to themselves. When the author speaks of ig-
norance of the clergy, he means ignorance as regards
matters pertaining to the medical profession; and how-
ever unpalatable it may be to gentlemen who are learned
in theology, and who believe themselves to be beyond the
reach of imposition, it is nevertheless a fact that the most
perfect dupes of quackery, those who are loudest and
longest in their praises of hobbies and humbugs, are
272
MEDICAL PHILOSOPHY.
members of the clerical profession. The reasons for
their being thus duped are to be found in their ignorance
of the principles of medicine, the data upon which to
form opinions—and their belief in the honesty of the de-
signing and unprincipled charlatan. In all the interfer-
ence of ministers with the practice of physicians they
may be actuated by the best motives; but inasmuch as
they are unacquainted with the physician whose dismis-
sal they procure, they are unjust towards him. The ques-
tion then arises, is it proper for a clergyman in any case
to give his advice, or to recommend a change of physi-
cians? Certainly it is. But before he insists that one
shall be dismissed and another called, let him make him-
self acquainted with the merits of the first, and see if they
do not at least equal those of the one whom he proposes as
a substitute. He may at all times recommend a consul-
tation; and to this no one concerned would object; and
then if the attending physician is in error he will be most.
likely to be corrected. Or, if a medical attendant is found
to be unworthy of confidence, after due investigation let
him at once be notified that his services are no longer
required.
From the position that the clergy occupy in society,
and the necessary influence of that position, we have a
right to expect, that they will exert all their influence for
good. One means of doing good would be to make
themselves acquainted with the human system, to a
greater or less extent, and the laws which govern it, as
well as the principles of physiology and therapeutics.
They would, thus, be enabled to aid greatly in the eradi-
MEDICAL PHILOSOPHY.
273
cation of prejudices from the minds of the populace, and
the overthrow of quackery and imposture. A little atten-
tion to the temporal habitation of that spiritual existence,
whose welfare it is their profession to seek, would prevent
dissensions in the profession which are now the direct
result of ill-timed, and injudicious, but well-meant advice
to their friends.
END.
·
す
​:
Filmed by Preservation 1990
>
..
:
UNIVERSITY OF MICHIGAN
3 9015 06441 0221
i

UNIV. OF MICH.
AUG 26 1908
34456
50199 br
6
Мес
E, OND