Curiosities of Medical Experience Part 22

To what can this unjust, this illiberal feeling be attributed? Simply to vanity and pride. Illness and death level all mankind. The haughty n.o.bleman, who conceives himself contaminated by vulgar touch, can scarcely bring himself to believe that he is placed upon the same footing as a shoe-black. All _prestiges_ of grandeur and worldly pomp vanish round the bed of sickness; and the suffering peer would kneel before the humblest peasant for relief. Then it is that money would be cheerfully lavished to mitigate his sufferings. But how soon the scene is changed! The patient is well, thrown once more in the busy vortex of business or of pleasure. He had been slightly indisposed; his natural const.i.tution is excellent: the doctors mistook his case; thought him very ill, forsooth; but nature cured him.

Could the ambitious mother admit for one moment that her daughter had been seriously ill?--a sick wife is an expensive article! If her medical attendant unfortunately hinted that the young lady had been in danger, he is considered a busy old woman, exaggerating the most trifling ailment to obtain increase of business; in fact, a dangerous man in a family where there are young persons--to be provided for. Nor can we marvel at this. No one likes to be considered morally or physically weak, excepting hypochondriacs, who live upon groans, and feel offended if you tell them that they do not look miserable. The soldier will describe the slightest wound he received in battle as most severe and dangerous; a feeling of pride is a.s.sociated with the relation. The bold hunter will boast of a fractured limb; the accident showed that he was a daring horseman. Nay, the agonizing gout is a fashionable disease, which seems to proclaim good living, good fellowship, and luxury: it is, in short, a gentlemanly disease. But the slow ravages of hereditary ailments, transmitted from generation to generation with armorial bearings, the development of which may be averted by proper care, or hurried on by fashionable imprudence!

how difficult even to hint to a family the presence of the scourge, when, through the transparent bloom of youth and beauty, our experienced eye reads the fierce characters of death in the prime of years. The aerial coronet floats in fond visions before the doting mother's ambitious eyes.

A man would be a barbarian, nay, a very brute, to deprive the darling girl of the chances of Almacks, the delights of the pestiferous ball-room, or the galaxy of court or opera!

To attend the great is deemed the first stepping-stone to fortune, and patronage is considered as more than an equivalent of remuneration. Too frequently does the physician placed in that desirable situation forget what Hippocrates said of the profession. "The physician stands before his patient in the light of a demi-G.o.d, since life and death are in his hands."

Curious anecdotes are related of this unbecoming subserviency. A courtly doctor, when attending one of the princesses, was asked by George III. if he did not think a little ice might benefit her. "Your majesty is right,"

was the reply; "I shall order some forthwith." "But perhaps it might be too cold," added the kind monarch. "Perhaps your majesty is right again; therefore her royal highness had better get it warmed."

This absurd deference to rank and etiquette by a physician who at the moment is superior to all around him, reminds one of an account given by Champfort of a fashionable doctor. "D'Alembert was spending the evening at Madame Du Deffand's, where were also President Henault and M. Pont de Vesle. On this flexible physician's entering the room, he bowed to the lady with the formal salutation, '_Madame, je vous presente mes tres humbles respects_.' Then, addressing M. Henault, '_J'ai bien l'honneur de vous saluer_.' Turning round to M. de Vesle he obsequiously said, '_Monsieur, je suis votre tres humble serviteur_;' and at last, condescending to speak to D'Alembert, he nodded to him with a '_Bonjour, Monsieur_!'" On such occasions a condescending smile from power is considered a fee.

Reluctance in remunerating medical attendants was also manifested by the ancients; and Seneca has treated the subject at some length. The difficulty in obtaining remuneration has unfortunately rendered many physicians somewhat sordid, and loth to give an opinion unless paid for.

In this they are unquestionably right, as gratuitous advice is seldom heeded; and one of the most distinguished pract.i.tioners used to say, that he considered a fee so necessary to give weight to an opinion, that, when he looked at his own tongue in the gla.s.s, he slipped a guinea from one pocket into another.

To consider themselves in proper hands, patients must incur expenses, and as much physic as possible be poured down. Malouin, physician to the Queen of France, was so fond of drugging, that it is told of him, that once having a most patient patient, who diligently and punctually swallowed all the stuff he ordered, he was so delighted in seeing all the phials and pill-boxes cleaned out, that he shook him cordially by the hand, exclaiming, "My dear sir, it really affords me pleasure to attend you, and you _deserve_ to be ill." Our apothecaries must surely meet with incessant delight!

The most extraordinary remuneration was that received by Levett, Dr.

Johnson's friend and frequent companion. It was observed of him that he was the only man who ever became intoxicated from motives of prudence. His patients, knowing his irregular habits, used frequently to subst.i.tute a gla.s.s of spirits for a fee; and Levett reflected that if he did not accept the gin or brandy offered to him, he could have been no gainer by their cure, as they most probably had nothing else to give him. Dr. Johnson says "that this habit of taking a fee in whatever shape it was exhibited, could not be put off by advice or admonition of any kind. He would swallow what he did not like, nay, what he knew would injure him, rather than go home with an idea that his skill had been exerted without recompence; and had his patients," continues Johnson, "maliciously combined to reward him with meat and strong liquors, instead of money, he would either have burst, like the dragon in the Apocrypha, through repletion, or been scorched up, like Portia, by swallowing fire." But though this worthy was thus rapacious, he never demanded any thing from the poor, and was remarked for his charitable conduct towards them.

Various professional persons have sometimes endeavoured to remunerate their medical attendants by reciprocal services: thus an opera-dancer offered to give lessons to a physician's daughters for their father's attendance upon him; and a dentist has been known to propose to take care of the jaws of a whole family to liquidate his wine bill. One of the wealthiest merchants of Bordeaux wanted to reduce the price of a drawing-master's lessons, on the score of his taking his children's daubs with him to sell them _on account_. This arrangement, however, did not suit the indignant artist, who left the Croesus in disgust.

A singular charge for medical attendance was lately brought before the court of requests of Calcutta, by a native pract.i.tioner. He demanded 314 rupees for medicine alone, and in the items of drugs appeared pearls, gold leaf, and monkeys' navels!

In one of the old French farces there is an absurd scene between Harlequin and his physician. The motley hero had been cured, but refused to remunerate his Esculapius, who brought an action for his fees, when Harlequin declares to the judge that he would rather be sick again; and he therefore offers to return his health to the doctor, provided he would give him back his ailments, that each party might thus recover their own property. This incident was perhaps founded on an ancient opinion of Hippocrates, who frequently mentioned salutary diseases. In 1729, a Dr.

Villars supported a thesis on this subject, ent.i.tled "_Dantur-ne morbi salutares?_" and Theodore Van Ween has also written a learned dissertation on the same subject.

A celebrated Dublin surgeon was once known to give a lesson of economy to a wealthy and fashionable young man remarkably fond of his handsome face and person. He was sent for, and found the patient seated by a table, resting his cheek upon his hand, whilst before him was displayed a five-pound note. After some little hesitation he removed his hand, and displayed a small mole on the cheek. "Do you observe this mark, doctor?"--"Yes, sir, I do."--"I wish to have it removed."--"Does it inconvenience you?"--"Not in the least."--"Then why wish for its extirpation?"--"I do not like the look of it."--"Sir," replied the surgeon, "I am not in the habit of being disturbed for such trifles; moreover, I think that that little excrescence had better remain untouched, since it gives you no uneasiness; and I make it a rule only to take from my patients what is troublesome to them." So saying, he took the five-pound note, slipped it into his pocket, and walked out of the room, leaving the patient in a state of perfect astonishment.

It is related of a physician who received his daily fee from a rich old miser, who had it clenched in his fist when he arrived, and turned his head away when he opened his hand for the doctor to take it, that, on being informed his patient had died in the morning, not in the least disconcerted he walked up to the dead man's chamber, and found his clenched fist stretched out as usual; presuming that it still grasped the accustomed remuneration, with some difficulty he opened the fingers, took out the guinea, and departed.

The Egyptian physicians of old were paid by the state, but they were not prevented from accepting remuneration from individuals, and they were allowed to make demands for their attendance except on a foreign journey, and during military services.

When we compare the value of money it appears probable that the fees of olden pract.i.tioners were more considerable than the remuneration of the present day. Attendance upon royalty and the court seems also to have been more profitable. Dr. Radcliffe says, that he received from King William 200_l._ a year more than any other physician in ordinary--this monarch upon his appointment, gave him moreover, 500 guineas out of the privy purse for his attendance on the Earl of Portland, and the Earl of Rochford. When the same physician went to Hanau to attend Lord Albemarle, he received 1200_l._ from the king, with 400 guineas from his patient, besides a valuable diamond ring.

Dr. Radcliffe's fortune must have been considerable, as appears from his legacies, bequeathing 5000_l._ for the improvements of University College--4000_l._ for the building of a library at Oxford--and 500_l._ yearly for the amelioration of the diet of St. Bartholomew's hospital.

Radcliffe had not been a year in London when he received 20 guineas daily, and he mentions that his fee for a visit from Bloomsbury Square to Bow, was five guineas.

We do not exactly know what was the exact honorarium of Doctors in former days, yet Baldwin Hammey informs us that in 1644, Dr. Robert Wright who had only been settled three years in London, was in the habit of receiving a thousand broad pieces (22 shillings) in the course of the year.

The following is a curious account of a puritan's consultation with Dr.

Hammey.

"It was in the time of the civil wars when it pleased G.o.d to visit him with a severe fit of sickness, or peripneumonia, which confined him a great while to his chamber, and to the more than ordinary care of his tender spouse. During this time he was disabled from practice; but the very first time he dined in his parlour afterwards, a certain great man in high station came to consult him on an indisposition--(_ratione vagi sui amoris_,) and he was one of the G.o.dly ones too of those times. After the doctor had received him in his study, and modestly attended to his long religious preface, with which he introduced his ignominious circ.u.mstances, and Dr. Hammey had a.s.sured him of his fidelity, and gave him hopes of success in his affair, the generous soldier (for such he was) drew out of his pocket a bag of gold and offered it all at a lump to his physician.

Dr. Hammey, surprised at so extraordinary a fee, modestly declined the acceptance of it; upon which the great man, dipping his hand into the bag himself, grasped up as much of his coin as his fist could hold, and generously put it into the doctor's coat-pocket, and so took his leave.

Dr. Hammey, returned into his parlour to dinner, which had waited for him all that time, and smiling (whilst his lady was discomposed at his being absent so long), emptied his pocket into her lap. This soon altered the features of her countenance, who telling the money over, found it to be thirty-six broad pieces of gold: at which she being greatly surprised, confessed to the doctor that surely this was the most providential fee he ever received; and declared to him that during the height of his severe illness, she had paid away (unknown to him) on a state levy towards a public supply, the like sum in number and value of pieces of gold; lest under the lowness of his spirits, it should have proved a matter of vexation, unequal to his strength at that time to bear; which being thus so remarkably reimbursed to him by Providence, it was the properest juncture she could lay hold on to let him into the truth of it." It has been supposed, that the sanctimonious sufferer was no other than Ireton, Cromwell's son-in-law.

During the imprisonment of Dr. Friend in the tower, Dr. Head attended his patients, and on his liberation he presented him with 5000_l._ the amount of the fees received on his account. Dr. Meade's practice averaged from 5000_l._ to 6000_l._ per annum. It is somewhat strange, that this celebrated physician whose evenings were generally spent in convivial meetings at Batson's Coffee-house, used in the forenoon to receive consulting apothecaries at a tavern near Covent-garden, prescribing for the patients without seeing them at half-a-crown fee.

ENTHUSIASM.

Enthusiasm, from its derivation, might in strictness be called a _fixity of idea in divinity_; but Locke has given a better definition of this morbid state of our intellectual faculties in considering it as a heated state of the imagination, "_founded neither on reason nor divine revelation, but arising from the conceits of a warmed or overweening brain_." I shall not venture to take the field of controversy to support this doctrine against that of some metaphysicians, who most probably would consider this mental aberration as an original and natural judgment inspired by the Almighty, founded not on reason or reflection, but an instinctive impulse of the powers of the mind.

The Hebrews named this impulse _Nabi_ [Hebrew], (plural _Nebiim_,) "to approach or enter," on the surmise that the spirit pervaded the prophets, who were called _Roeh_ [Hebrew], or _Seeing_, hence _Seers_.

Plato divided enthusiasm into four cla.s.ses. I. _The Poetical_, inspired by the Muses. II. _The Mystic_, under the influence of Bacchus. III. _The Prophetic_, a gift of Apollo; and IV. _The Enthusiasm of love_, a blessing from Venus Urania. This immortal philosopher was not the visionary speculatist which some writers have represented him; his logic did not consist of frivolous investigations, but embraced the more useful subject of correct definition and division, as he sought to reconcile practical doctrines of morality with the mysticism of theology by the study of Divine attributes. Whatever some of the Eclectic philosophers might have a.s.serted, Plato considered that our ideas were derived from external objects, and never contemplated the extravagant doctrine of imbodying metaphysical abstractions, or personifying intellectual ideas.

To this day, the attentive observer will find Plato's cla.s.sification of enthusiasm to be correct. The ecstatic exaltation of religion and of love are not dissimilar; only the latter can be cured, the former seldom or never admits of mitigation: the fantastic visions of the lover may be dispelled by infidelity in the object of his misplaced affection; the phantasies of fanaticism can only yield to an improbable state of infidelity. Shaftesbury has justly observed, "There is a melancholy which accompanies all enthusiasm, be it of love or religion; nothing can put a stop to the growing mischief of either, till the melancholy be removed, and the mind be at liberty to hear what can be said against the ridiculousness of an extreme in either way."

Our poet Rowe has beautifully pointed out the facility with which a n.o.ble and martial soul can free itself from love's ign.o.ble trammels.

Rouse to the combat, And thou art sure to conquer; war shall restore thee: The sound of arms shall wake thy martial ardour, And cure this amorous sickness of thy soul, Begot by sloth, and nurs'd by too much ease.

The idle G.o.d of Love supinely dreams Amidst inglorious shades and purling streams; In rosy fetters and fantastic chains He binds deluded maids and simple swains; With soft enjoyment woos them to forget The hardy toils and labours of the great: But if the warlike trumpet's loud alarms To virtuous acts excite, and manly arms, The coward Boy avows his abject fear, On silken wings sublime he cuts the air, Scar'd at the n.o.ble horse and thunder of the war.

The only trumpet that can arouse the religious enthusiast from his ascetic meditations is the war-whoop that calls him to destroy all those who impugn his doctrines in a battle-field, where each champion seeks pre-eminence in cruelty, and rancorous persecution.

When we contemplate the miseries that have arisen from fanaticism, or fervid enthusiasm, although it is but a sad consolation, yet it affords some gratification in our charitable view of mankind, to think, nay to know, that this fearful state of mind is a disease, a variety of madness, which may in many instances be referred to a primary physical predisposition, and a natural idiosyncrasy. It is as much a malady as melancholy and hypochondriacism. In peculiar const.i.tutions it grows imperceptibly. Lord Shaftesbury has made the following true observation: "Men are wonderfully happy in a faculty of deceiving themselves whenever they set heartily about it. A very small foundation of any pa.s.sion will serve us not only to act it well, but even to work ourselves in it beyond our own reach; a man of tolerable goodnature, who happens to be a little piqued, may, by improving his resentment, become a very fury for revenge."

Thus it is with enthusiasm, a malady which in its dreadful progress has been known to become contagious, one might even say epidemic. Vain terrors have seized whole populations in cities and in provinces; when every accident that happened to a neighbour was deemed a just punishment of his sins, and every calamity that befel the fanatic was considered the hostile act of others. Jealousy and dark revenge were the natural results of such a state of mind, when the furious fire of bigotry was fanned by ambition until monomania became daemonomania of the most hideous nature, and every maniac bore in his pale and emaciated visage the characteristic of that temperament which predisposes to the disease. Seldom do we observe it in the _sanguineous temperament_, remarkable for mental tranquillity, yet determined courage when roused to action. The _choleric_ and _bilious_, impetuous, violent, ambitious, ever ready to carry their point by great virtues or great crimes, may no doubt rush into a destructive career; but then they lead to the onset the atrabilious, men saturated with black bile, and const.i.tuting the _melancholy temperament_. Here we behold the countenance sallow and sad; the visage pale and emaciated, of an unearthly hue; gloom, suspicion, hate, depicted in every lineament; the mirror of a soul unfitted for any kind sentiment of affection, pity, or forgiveness.

Detesting mankind, and detested, they seek solitude, to brood upon their wretchedness, or to derive from it the means to make others as miserable as themselves. Such do we usually find the enthusiastic monomaniac. His ideas are concentrated into a burning focus, which consumes him like an ardent mirror. His life of relation is nearly extinguished. His external senses are rendered so obtuse and callous that he becomes insensible to hunger and thirst, to heat and cold however intense; and bodily injuries, which would occasion excruciating agonies in others, he bears without any apparent feeling. On this subject of religious enthusiasm the remarks of Evagrius are worthy of notice. "Contrarieties," he says, "are in themselves so tempered, and the grace of G.o.d maketh in them such an union of discordant things, that life and death, which are in essence so opposite to each other, seem to join hands and dwell together in them.

Happy are they while they live, and happier still when they depart." It has been known amongst these rigid ascetics that when a stranger visited them, they mortified themselves by entertaining him and partaking of the good cheer. Thus inventing a novel kind of fasting--eating and drinking against their will.

It is related of St. Macarius, that one day having killed a gnat that had stung him, he was struck with such compunction at the sight of blood, that by way of atonement, he threw off his clothes, and remained in a state of nudity for six months in a marsh exposed to the bites of every noxious insect. Sozomen in praising this mortification, a.s.sures us that this exposure to the inclemency of the weather, did so harden and tan him that his beard could not make its way through the skin.

It has been erroneously supposed that such individuals, being hostile to mankind, are p.r.o.ne to do evil,--this is not generally the case; they seem satisfied with their own sufferings, and only seek to inflict them upon others when roused from their concentration by fanaticism.

A late ingenious writer, in his work ent.i.tled "The Natural History of Enthusiasm," has somewhat overdrawn the portrait of these unfortunate but dangerous beings when labouring under the disease, which he thus defines: "It will be found that the elementary idea attached to the term in its manifold applications, is that of fict.i.tious fervour in religion, rendered turbulent, morose, or rancorous by junction with some one or more of the unsocial emotions; or, if a definition as brief as possible were demanded, we should say that fanaticism is enthusiasm inflamed by hatred. Fanaticism supposes three elements of belief: the supposition of malignity on the part of the object of our worship; a consequent detestation of mankind at large, as the subjects of malignant power; and then, a credulous conceit of the favour of Heaven shown to the few, in contempt of the rules of virtue."

Shaftesbury had already said, that "nothing besides ill-humour, either natural or forced, can bring a man to think seriously that the world is governed by any devilish or malicious power." Such a fearful conviction const.i.tutes a clear case of daemonomania. Patients labouring under that malady are ever p.r.o.ne to injure themselves and others, prompted, as they constantly avow, by an evil spirit; but enthusiasts, who live in solitary mortification until a paroxysm of fanaticism draws them from their retreat, seldom or never meditate mischief to others, or indeed that hatred to mankind which our author considers a feature of their condition.

Society may become irksome, and may be shunned for ever, without a sentiment of hate. The gayest of the gay may be impelled by feelings more or less morbid to seek a voluntary endurance, to expiate real or imaginary offences, without experiencing a desire of a uselessly vindictive sentiment towards the former companions of their vices or follies.

Extremes of depravity and contrition do not infrequently meet; and it has been remarked in Eastern countries, where asceticism arose, that the gates of the most splendid and luxurious cities open upon desert wilds or mountainous solitudes, to which the penitent may flee from his former scenes of ambition and enjoyment.

Such enthusiasts, excepting when enjoying the beat.i.tude of ecstatic exaltation, are more to be pitied than feared. Persecution would most probably drive them to a dangerous state of fanatic rage; and the n.o.ble philosopher whom I have already quoted, very justly observes, "They are certainly ill physicians in the body politic who would needs be tampering with these mental eruptions, and, under the specious pretence of healing the itch of superst.i.tion, and saving souls from the contagion of enthusiasm, should set all nature in an uproar, and turn a few innocent carbuncles into an inflammation and a mortal gangrene."

Enthusiasts are supposed by their followers to be gifted with the faculty of prophecy; and it is somewhat strange that the ancients considered certain temperaments as best fitted for this inspiration. The atrabilious temperament took the lead; and this melancholy state was to be increased by abstinence, mortification, and more especially rigid continence. The latter privation, indeed, was deemed indispensable for prophets; and the Jewish Rabbins inform us that Moses abandoned his wife Zipporah the very moment that he was prophetically inspired. A physical reason has been adduced to prove the necessity of a chaste life, which I here must be allowed to pa.s.s over; but upon the same principle, emasculation was considered as rendering man totally unfit for prophetic revelation, or indeed any holy inspiration; and we find in the first of Deuteronomy that such subjects were not admissible to the service of the Temple.

Jesaias, and some other Jewish writers, have affirmed that Daniel belonged to that cla.s.s of beings; but it has been shown that the name of _Spado_, which he bore, merely gave him the high rank that eunuchs held at the a.s.syrian court. Potiphar bore the same t.i.tle among the Pharaohs. Baruch Spinosa maintained that temperaments should vary according to the nature of the prophecy; thus, a gay prophet would predict victory and happiness, a gloomy one misery and wars; peace and concord, if he is human; destruction and merciless events, if he were sanguinary: and, in support of his doctrine, he quotes the pa.s.sage in Kings, where Elisha, when brought before Jehosophat, called for a minstrel ere he predicted that victory should crown the arms of Judah.

Various artificial means have been resorted to at all periods to prepare the intellects for inspirations, by creating a heated imagination. Pliny informs us that, in his days, the root of the _Halicacab.u.m_, supposed to be a species of hyoscyamus, was chewed by soothsayers. Christopher D'Acosta relates that the Indians employ a kind of hemp called _Bangue_ for the same purpose: and in St. Domingo their supposed prophets masticate a plant called _Cohaba_. The priestesses of Delphi were also in the habit of chewing laurel-leaves before they ascended the tripod, which it is stated was originally formed of a laurel-tree root with three branches.

Sophocles calls the Sibyls [Greek: daphnephagos], laurel-eaters; and thus Tibullus,

Vera cano, sic usque sacras innoxia lauros Vescar, et aeternum sit mihi virginitas.

Auguries were drawn from the burning of the laurel-leaf. If it crackled and sparkled during combustion, the inference was favourable; the reverse, if it was consumed in silence. Propertius alludes to this belief: