Contents -BIBLIOGRAPHIC RECORD

S. Austin Allibone, comp. Prose Quotations from Socrates to Macaulay. 1880.

Physicians

A wealthy doctor who can help a poor man, and will not without a fee, has less sense of humanity than a poor ruffian who kills a rich man to supply his necessities. It is something monstrous to consider a man of a liberal education tearing out the bowels of a poor family by taking for a visit what would keep them a week.

Hippocrates seldom mentions the doses of his medicines, which is somewhat surprising, because his purgatives are generally very rough and strong.

Physicians are some of them so pleasing and conformable to the humour of the patient, as they press not the true cure of the disease; and some are so regular in proceeding according to art for the disease, as they respect not sufficiently the condition of the patient. Take one of a middle temper; or if it may not be found in one man, combine two of either sort; and forget not to call as well the best acquainted with your body, as the best reported of for his faculty.

If the just cure of a disease be full of peril, let the physician resort to palliation.

A gentleman fell very sick, and a friend said to him, “Send for a physician:” but the sick man answered, “It is no matter; for if I die, I will die at leisure.”

It is very evident that a man of good sense, vivacity, and spirit may arrive at the highest rank of physicians without the assistance of great erudition and the knowledge of books; and this was the case of Dr. Sydenham, who became an able and eminent physician, though he never designed to take up the profession till the civil wars were composed, and then, being a disbanded officer, he entered upon it for a maintenance, without any learning preparatory for the undertaking of it. And to show the reader what contempt he had for writings in physic, when one day I asked him to advise me what books I should read to qualify me for practice, he replied, “Read Don Quixote: it is a very good book. I read it still.” So low an opinion had this celebrated man of the learning collected out of the authors his predecessors. And a late celebrated physician, whose judgment was universally relied upon as almost infallible in his profession, used to say, as I am well informed, that when he died he would leave behind him the whole mystery of physic upon half a sheet of paper.

Galen would not leave the world too subtle a theory of poisons; unarming thereby the malice of venomous spirits.

In ancient times, and in all countries, the profession of physic was annexed to the priesthood. Men imagined that all their diseases were inflicted by the immediate displeasure of the Deity, and therefore concluded that the remedy would most probably proceed from those who were particularly employed in his service. Whatever, for the same reason, was found of efficacy to avert or cure distempers was considered as partaking somewhat of the Divinity. Medicine was always joined with magic: no remedy was administered without mysterious ceremony and incantation. The use of plants and herbs, both in medicinal and magical practice, was early and general. The mistletoe, pointed out by its very peculiar appearance and manner of growth, must have struck powerfully on the imaginations of a superstitious people. Its virtues may have been soon discovered. It has been fully proved, against the opinion of Celsus, that internal remedies were of very early use.

No men despise physic so much as physicians, because no men so thoroughly understand how little it can perform. They have been tinkering the human constitution four thousand years, in order to cure about as many disorders. The result is, that mercury and brimstone are the only two specifics they have discovered. All the fatal maladies continue to be what they were in the days of Paracelsus, Hippocrates, and Galen,—“opprobria medicorum.” It is true that each disorder has a thousand prescriptions, but not a single remedy.

The Chinese, who aspire to be thought an enlightened nation, to this day are ignorant of the circulation of the blood; and even in England the man who made that noble discovery lost all his practice in consequence of his ingenuity; and Hume informs us that no physician in the United Kingdoms who had attained the age of forty ever submitted to become a convert to Harvey’s theory, but went on preferring numpsimus to sumpsimus to the day of his death. So true is that line of the satirist, “a fool at forty is a fool indeed;” and we may also add on this occasion another line from another satirist:

Our physicians have observed that, in process of time, some diseases have abated of their virulence, and have, in a manner, worn out their malignity, so as to be no longer mortal.

The first aphorism of Hippocrates is, “Life is short, and the art is long; the occasion fleeting, experience fallacious, and the judgment difficult. The physician must not only be prepared to do what is right himself, but also to make the patient, the attendants, and externals co-operate.”

When I consider the assiduity of this profession, their benevolence amazes me. They not only, in general, give their medicines for half-value, but use the most persuasive remonstrances to induce the sick to come and be cured. Sure there must be something strangely obstinate in an English patient, who refuses so much health upon such easy terms! Does he take a pride in being bloated with a dropsy? does he find pleasure in the alternations of an intermittent fever? or feel as much pleasure in nursing up his gout as he found pleasure in acquiring it? He must! otherwise he would never reject such repeated assurances of instant relief. What can be more convincing than the manner in which the sick are invited to be well? The doctor first begs the most earnest attention of the public to what he is going to propose; he solemnly affirms the pill was never found to want success: he produces a list of those who have been rescued from the grave by taking it. Yet, notwithstanding all this, there are many here who now and then think proper to be sick:—only sick did I say? there are some who even think proper to die!… though they might have purchased the health-restoring specific for half a crown at every corner.

A physician ought to have his shop provided with plenty of all necessary things, as lint, rollers, splinters: let there be likewise in readiness at all times another small cabinet of such things as may serve for occasions of going far from home; let him have also all sorts of plasters, potions, and purging medicines, so contrived that they may keep some considerable time, and likewise such as may be had and used whilst they are fresh.

Once upon a time, says Herodotus, in the land of the wise there were no doctors. In Egypt and Babylon the diseased were exposed in the most public streets, and passers-by were invited to look at them, in order that they who had suffered under similar complaints and had recovered might tell what it was that cured them. Nobody, says Strabo, was allowed to go by without offering his gratuitous opinion and advice. Then, since it was found that this practical idea did not work to perfection, the Egyptian priests made themselves students of medicine, each man binding himself to the study of one sole disease.

In Galen’s time, respectable physicians would not undertake small cases, but they had acquired the habit of compounding secret nostrums, which continued in full force for generations, and was common also in the sixteenth century, when all classical customs were revived. Aetius complains much, in his writings, of the immense price asked for respectable nostrums. Nicostratus used to ask two talents for his isotheos, or antidote against the colic. At last Valentinian established in Rome fourteen salaried physicians to attend gratuitously on the poor, and obliged, by the same law, every other physician to accept the voluntary donation of every other patient, when he had recovered from his disease, without making express charge, or taking advantage of any promises rashly made under suffering. Here we have not the fee system, but most probably the groundwork of it. This model of after-payment remained for many centuries the custom of the empire. A physician of the fifteenth century, Ericus Cordus, complained much of the reluctance of his patients to reward him properly when they were well, for service done to them in sickness.

In this country there are, at this time, three classes of men following the healing art,—physicians, surgeons, and those who are best defined under the name of general practitioners. Elsewhere there are two classes only. Celsus and Galen both of them lay down the divisions of the profession distinctly. There were first the men who cured by study of the processes of nature in the human body, and by adapting to them regimen and diet: these were the original physicians, nature-students as their name pronounces them. Secondly, there were the chirurgeons or surgeons (hand-workers is the meaning of their name), who attended to the wounds and other ailments curable by hand. Thirdly, there were the pharmacists, who cured by drugs. Some of the first class of practitioners used drugs; but by many the use of them was repudiated. This triple division of the healing art was still acknowledged in the sixteenth century, when there were few great physicians who wrote books and did not write on diet and the art of cookery. Thus the physicians were, at first, in close alliance with the cooks. Sometimes, indeed, the alliance was more close than wholesome.

The advice and medicine which the poorest labourer can now obtain, in disease or after an accident, is far superior to what Henry the Eighth could have commanded. Scarcely any part of the country is out of the reach of practitioners who are probably not so far inferior to Sir Henry Halford as they are superior to Dr. Butts. That there has been a great improvement in this respect Mr. Southey allows. Indeed, he could not well have denied it. “But,” says he, “the evils for which these sciences are the palliative have increased since the time of the Druids, in a proportion that heavily overweighs the benefit of improved therapeutics.” We know nothing either of the diseases or the remedies of the Druids. But we are quite sure that the improvement of medicine has far more than kept pace with the increase of disease during the last three centuries. This is proved by the best possible evidence. The term of human life is decidedly longer in England than in any former age respecting which we possess any information on which we can rely. All the rants in the world about picturesque cottages and temples of Mammon will not shake this argument! No test of the physical well-being of society can be named so decisive as that which is furnished by bills of mortality. That the lives of the people of this country have been gradually lengthening during the course of several generations, is as certain as any fact in statistics; and that the lives of men should become longer and longer, while their bodily condition during life is becoming worse and worse, is utterly incredible.

Let the physicians a little excuse the liberty I take, for by this same infusion and insinuation it is that I have received a hatred and contempt of their doctrine. The antipathy I have against their art is hereditary. My father lived threescore and fourteen years, my grandfather sixty-nine, my great-grandfather almost fourscore years, without ever tasting any sort of physick; and with them whatever was not ordinary diet was instead of a drugg. Physick is grounded upon experience and examples, so is my opinion. And is not this an express and very advantageous experience? I do not know that they can find me in all their records three that were born, bred, and died under the same roof who have lived so long by their own conduct. They must here of necessity confess, that if reason be not, fortune at least is on my side; and with physicians fortune goes a great deal further than reason: let them not take me now at a disadvantage; let them not threaten me in the subdued condition I now am, for that were treachery. And to say truth, I have got enough the better of them by these domestick examples, that they should rest satisfied. Human things are not usually so constant: it has been two hundred years save eighteen that this trial has lasted, for the first of them was born in the year 1402.

Order a purge for your brain: it will there be much better employ’d than upon your stomach. One asking a Lacedæmonian, who had made him live so long, he made answer, the ignorance of physick. And the emperor Adrian continually exclaim’d as he was dying, that the crowd of physicians had kill’d him. An ill wrestler turn’d physician. “Courage,” says Diogenes to him, “thou hast done well, for now thou wilt throw those who have formerly thrown thee.” But they have this advantage, according to Nicocles, that the sun gives light to their success, and the earth covers their failures: and, besides, they have a very advantageous way of making use of all sorts of events: for what fortune, nature, or any other causes (of which the number is infinite) produce of good and healthful in us, it is the privilege of physic to attribute to itself. All the happy successes that happen to the patient must be deriv’d from thence. The occasions that have cur’d me, and thousands others, physicians usurp to themselves, and their own skill: and as to ill accidents they either absolutely disown them, in laying the fault upon the patient, by such frivolous and idle reasons as they can never be to seek for…. Or, if they so please, they yet make use of their growing worse, and do their business that way which can never fail them: which is by buzzing us in the ears, when the disease is more inflam’d by their medicaments, that it had been much worse but for those remedies…. Plato said very well, “that physicians were the only men that might lye at pleasure, since our health depends upon the vanity and falsity of their promises.”

Should any man argue that a physician understands his own art best, and therefore, although he should prescribe poison to all his patients, he cannot be justly punished, but is answerable only to God?

Such an aversion and contempt for all manner of innovators as physicians are apt to have for empirics, or lawyers for pettifoggers.

I had reasoned myself into an opinion that the use of physicians, unless in some acute disease, was a venture, and that their greatest practicers practised least upon themselves.