Medical Essays, 1842-1882 Part 22

In addition to the evidence as to methods of treatment furnished by the ma.n.u.scripts I have cited, I subjoin the following doc.u.ment, to which my attention was called by Dr. Shurtleff, our present Mayor. This is a letter of which the original is to be found in vol. lxix. page 10 of the "Archives" preserved at the State House in Boston. It will be seen that what the surgeon wanted consisted chiefly of opiates, stimulants, cathartics, plasters, and materials for bandages. The complex and varied formulae have given place to simpler and often more effective forms of the same remedies; but the list and the manner in which it is made out are proofs of the good sense and schooling of the surgeon, who, it may be noted, was in such haste that he neglected all his stops. He might well be in a hurry, as on the very day upon which he wrote, a great body of Indians--supposed to be six or seven hundred--appeared before Hatfield; and twenty-five resolute young men of Hadley, from which town he wrote, crossed the river and drove them away.

HADLY May 30: 76

Mr RAWSON Sr

What we have recd by Tho: Houey the past month is not the chiefest of our wants as you have love for poor wounded I pray let us not want for these following medicines if you have not a speedy conveyance of them I pray send on purpose they are those things mentioned in my former letter but to prevent future mistakes I have wrote them att large wee have great want with the greatest halt and speed let us be supplyed. Sr Yr Sert WILL LOCHS.

(Endorsed)

Mr. Lockes Letter Recd from the Governor 13 Jane & acquainted ye Council with it but could not obtaine any thing to be sent in answer thereto. 13 June 1676.

I have given some idea of the chief remedies used by our earlier physicians, which were both Galenic and chemical; that is, vegetable and mineral. They, of course, employed the usual perturbing medicines which Montaigne says are the chief reliance of their craft. There were, doubtless, individual pract.i.tioners who employed special remedies with exceptional boldness and perhaps success. Mr. Eliot is spoken of, in a letter of William Leete to Winthrop, Junior, as being under Mr.

Greenland's mercurial administrations. The latter was probably enough one of these specialists.

There is another cla.s.s of remedies which appears to have been employed occasionally, but, on the whole, is so little prominent as to imply a good deal of common sense among the medical pract.i.tioners, as compared with the superst.i.tions prevailing around them. I have said that I have caught the good Governor, now and then, prescribing the electuary of millipedes; but he is entirely excused by the almost incredible fact that they were retained in the materia medica so late as when Rees's Cyclopaedia was published, and we there find the directions formerly given by the College of Edinburgh for their preparation. Once or twice we have found him admitting still more objectionable articles into his materia medica; in doing which, I am sorry to say that he could plead grave and learned authority. But these instances are very rare exceptions in a medical practice of many years, which is, on the whole, very respectable, considering the time and circ.u.mstances.

Some remedies of questionable though not odious character appear occasionally to have been employed by the early pract.i.tioners, but they were such as still had the support of the medical profession. Governor John Winthrop, the first, sends for East Indian bezoar, with other commodities he is writing for. Governor Endicott sends him one he had of Mr. Humfrey. I hope it was genuine, for they cheated infamously in the matter of this concretion, which ought to come out of an animal's stomach, but the real history of which resembles what is sometimes told of modern sausages.

There is a famous law-case of James the First's time, in which a goldsmith sold a hundred pounds' worth of what he called bezoar, which was proved to be false, and the purchaser got a verdict against him.

Governor Endicott also sends Winthrop a unicorn's horn, which was the property of a certain Mrs. Beggarly, who, in spite of her name, seems to have been rich in medical knowledge and possessions. The famous Thomas Bartholinus wrote a treatise on the virtues of this fabulous-sounding remedy, which was published in 1641, and republished in 1678.

The "antimonial cup," a drinking vessel made of that metal, which, like our qua.s.sia-wood cups, might be filled and emptied in saecula saeculorum without exhausting its virtues, is mentioned by Matthew Cradock, in a letter to the elder Winthrop, but in a doubtful way, as it was thought, he says, to have shortened the days of Sir Nathaniel Riche; and Winthrop himself, as I think, refers to its use, calling it simply "the cup." An antimonial cup is included in the inventory of Samuel Seabury, who died 1680, and is valued at five shillings. There is a treatise ent.i.tled "The Universall Remedy, or the Vertues of the Antimoniall Cup, By John Evans, Minister and Preacher of G.o.d's Word, London, 1634," in our own Society's library.

One other special remedy deserves notice, because of native growth. I do not know when Culver's root, Leptandra Virginica of our National Pharmacopoeia, became noted, but Cotton Mather, writing in 1716 to John Winthrop of New London, speaks of it as famous for the cure of consumptions, and wishes to get some of it, through his mediation, for Katharine, his eldest daughter. He gets it, and gives it to the "poor damsel," who is languishing, as he says, and who dies the next month,--all the sooner, I have little doubt, for this uncertain and violent drug, with which the meddlesome pedant tormented her in that spirit of well-meant but restless quackery, which could touch nothing without making mischief, not even a quotation, and yet proved at length the means of bringing a great blessing to our community, as we shall see by and by; so does Providence use our very vanities and infirmities for its wise purposes.

Externally, I find the pract.i.tioners on whom I have chiefly relied used the plasters of Paracelsus, of melilot, diachylon, and probably diaphoenicon, all well known to the old pharmacopoeias, and some of them to the modern ones,--to say nothing of "my yellow salve," of Governor John, the second, for the composition of which we must apply to his respected descendant.

The authors I find quoted are Barbette's Surgery, Camerarius on Gout, and Wecherus, of all whom notices may be found in the pages of Haller and Vanderlinden; also, Reed's Surgery, and Nicholas Culpeper's Practice of Physic and Anatomy, the last as belonging to Samuel Seabury, chirurgeon, before mentioned. Nicholas Culpeper was a shrewd charlatan, and as impudent a varlet as ever prescribed for a colic; but knew very well what he was about, and badgers the College with great vigor. A copy of Spigelius's famous Anatomy, in the Boston Athenaeum, has the names of Increase and Samuel Mather written in it, and was doubtless early overhauled by the youthful Cotton, who refers to the great anatomist's singular death, among his curious stories in the "Magnalia," and quotes him among nearly a hundred authors whom he cites in his ma.n.u.script "The Angel of Bethesda." Dr. John Clark's "books and instruments, with several chirurgery materials in the closet," a were valued in his inventory at sixty pounds; Dr. Matthew Fuller, who died in 1678, left a library valued at ten pounds; and a surgeon's chest and drugs valued at sixteen pounds.'

Here we leave the first century and all attempts at any further detailed accounts of medicine and its pract.i.tioners. It is necessary to show in a brief glance what had been going on in Europe during the latter part of that century, the first quarter of which had been made ill.u.s.trious in the history of medical science by the discovery of the circulation.

Charles Barbeyrac, a Protestant in his religion, was a pract.i.tioner and teacher of medicine at Montpellier. His creed was in the way of his obtaining office; but the young men followed his instructions with enthusiasm. Religious and scientific freedom breed in and in, until it becomes hard to tell the family of one from that of the other. Barbeyrac threw overboard the old complex medical farragos of the pharmacopoeias, as his church had disburdened itself of the popish ceremonies.

Among the students who followed his instructions were two Englishmen: one of them, John Locke, afterwards author of an "Essay on the Human Understanding," three years younger than his teacher; the other, Thomas Sydenham, five years older. Both returned to England. Locke, whose medical knowledge is borne witness to by Sydenham, had the good fortune to form a correct opinion on a disease from which the Earl of Shaftesbury was suffering, which led to an operation that saved his life. Less felicitous was his experience with a certain ancilla culinaria virgo,--which I am afraid would in those days have been translated kitchen-wench, instead of lady of the culinary department,--who turned him off after she had got tired of him, and called in another pract.i.tioner. [Locke and Sydenham, p. 124. By John Brown, M. D. Edinburgh, 1866.] This helped, perhaps, to spoil a promising doctor, and make an immortal metaphysician. At any rate, Locke laid down the professional wig and cane, and took to other studies.

The name of Thomas Sydenham is as distinguished in the history of medicine as that of John Locke in philosophy. As Barbeyrac was found in opposition to the established religion, as Locke took the rational side against orthodox Bishop Stillingfleet, so Sydenham went with Parliament against Charles, and was never admitted a Fellow by the College of Physicians, which, after he was dead, placed his bust in their hall by the side of that of Harvey.

What Sydenham did for medicine was briefly this he studied the course of diseases carefully, and especially as affected by the particular season; to patients with fever he gave air and cooling drinks, instead of smothering and heating them, with the idea of sweating out their disease; he ordered horseback exercise to consumptives; he, like his teacher, used few and comparatively simple remedies; he did not give any drug at all, if he thought none was needed, but let well enough alone.

He was a sensible man, in short, who applied his common sense to diseases which he had studied with the best light of science that he could obtain.

The influence of the reform he introduced must have been more or less felt in this country, but not much before the beginning of the eighteenth century, as his great work was not published until 1675, and then in Latin. I very strongly suspect that there was not so much to reform in the simple practice of the physicians of the new community, as there was in that of the learned big-wigs of the "College," who valued their remedies too much in proportion to their complexity, and the extravagant and fantastic ingredients which went to their making.

During the memorable century which bred and bore the Revolution, the medical profession gave great names to our history. But John Brooks belonged to the State, and Joseph Warren belongs to the country and mankind, and to speak of them would lead me beyond my limited--subject.

There would be little pleasure in dwelling on the name of Benjamin Church; and as for the medical politicians, like Elisha Cooke in the early part of the century, or Charles Jarvis, the bald eagle of Boston, in its later years, whether their practice was heroic or not, their patients were, for he is a bold man who trusts one that is making speeches and coaxing voters, to meddle with the internal politics of his corporeal republic.

One great event stands out in the medical history of this eighteenth century; namely, the introduction of the practice of inoculation for small-pox. Six epidemics of this complaint had visited Boston in the course of a hundred years. Prayers had been asked in the churches for more than a hundred sick in a single day, and this many times. About a thousand persons had died in a twelvemonth, we are told, and, as we may infer, chiefly from this cause.

In 1721, this disease, after a respite of nineteen years, again appeared as an epidemic. In that year it was that Cotton Mather, browsing, as was his wont, on all the printed fodder that came within reach of his ever-grinding mandibles, came upon an account of inoculation as practised in Turkey, contained in the "Philosophical Transactions." He spoke of it to several physicians, who paid little heed to his story; for they knew his medical whims, and had probably been bored, as we say now-a-days, many of them, with listening to his "Angel of Bethesda," and satiated with his speculations on the Nishmath Chajim.

The Reverend Mather,--I use a mode of expression he often employed when speaking of his honored brethren,--the Reverend Mather was right this time, and the irreverent doctors who laughed at him were wrong. One only of their number disputes his claim to giving the first impulse to the practice, in Boston. This is what that person says: "The Small-Pox spread in Boston, New England, A.1721, and the Reverend Dr. Cotton Mather, having had the use of these Communications from Dr. William Dougla.s.s (that is, the writer of these words); surrept.i.tiously, without the knowledge of his Informer, that he might have the honour of a New fangled notion, sets an Undaunted Operator to work, and in this Country about 290 were inoculated."

All this has not deprived Cotton Mather of the credit of suggesting, and a bold and intelligent physician of the honor of carrying out, the new practice. On the twenty-seventh day of June, 1721, Zabdiel Boylston of Boston inoculated his only son for smallpox,--the first person ever submitted to the operation in the New World. The story of the fierce resistance to the introduction of the practice; of how Boylston was mobbed, and Mather had a hand-grenade thrown in at his window; of how William Dougla.s.s, the Scotchman, "always positive, and sometimes accurate," as was neatly said of him, at once depreciated the practice and tried to get the credit of suggesting it, and how Lawrence Dalhonde, the Frenchman, testified to its destructive consequences; of how Edmund Ma.s.sey, lecturer at St. Albans, preached against sinfully endeavoring to alter the course of nature by presumptuous interposition, which he would leave to the atheist and the scoffer, the heathen and unbeliever, while in the face of his sermon, afterwards reprinted in Boston, many of our New England clergy stood up boldly in defence of the practice,--all this has been told so well and so often that I spare you its details. Set this good hint of Cotton Mather against that letter of his to John Richards, recommending the search after witch-marks, and the application of the water-ordeal, which means throw your grandmother into the water, if she has a mole on her arm;--if she swims, she is a witch and must be hanged; if she sinks, the Lord have mercy on her soul!

Thus did America receive this great discovery, destined to save thousands of lives, via Boston, from the hands of one of our own Ma.s.sachusetts physicians.

The year 1735 was rendered sadly memorable by the epidemic of the terrible disease known as "throat distemper," and regarded by many as the same as our "diphtheria." Dr. Holyoke thinks the more general use of mercurials in inflammatory complaints dates from the time of their employment in this disease, in which they were thought to have proved specially useful.

At some time in the course of this century medical practice had settled down on four remedies as its chief reliance. I must repeat an incident which I have related in another of these Essays. When Dr. Holyoke, nearly seventy years ago, received young Mr. James Jackson as his student, he showed him the formidable array of bottles, jars, and drawers around his office, and then named the four remedies referred to as being of more importance than all the rest put together. These were "Mercury, Antimony, Opium, and Peruvian Bark." I doubt if either of them remembered that, nearly seventy years before, in 1730, Dr.

William Dougla.s.s, the disputatious Scotchman, mentioned those same four remedies, in the dedication of his quarrelsome essay on inoculation, as the most important ones in the hands of the physicians of his time.

In the "Proceedings" of this Society for the year 1863 is a very pleasant paper by the late Dr. Ephraim Eliot, giving an account of the leading physicians of Boston during the last quarter of the last century. The names of Lloyd, Gardiner, Welsh, Rand, Bulfinch, Danforth, John Warren, Jeffries, are all famous in local history, and are commemorated in our medical biographies. One of them, at least, appears to have been more widely known, not only as one of the first aerial voyagers, but as an explorer in the almost equally hazardous realm of medical theory. Dr. John Jeffries, the first of that name, is considered by Broussais as a leader of medical opinion in America, and so referred to in his famous "Examen des Doctrines Medicales."

Two great movements took place in this eighteenth century, the effect of which has been chiefly felt in our own time; namely, the establishment of the Ma.s.sachusetts Medical Society, and the founding of the Medical School of Harvard University.

The third century of our medical history began with the introduction of the second great medical discovery of modern times,--of all time up to that date, I may say,--once more via Boston, if we count the University village as its suburb, and once more by one of our Ma.s.sachusetts physicians. In the month of July, 1800, Dr. Benjamin Waterhouse of Cambridge submitted four of his own children to the new process of vaccination,--the first persons vaccinated, as Dr. Zabdiel Boylston's son had been the first person inoculated in the New World.

A little before the first half of this century was completed, in the autumn of 1846, the great discovery went forth from the Ma.s.sachusetts General Hospital, which repaid the debt of America to the science of the Old World, and gave immortality to the place of its origin in the memory and the heart of mankind. The production of temporary insensibility at will--tuto, cito, jucunde, safely, quickly, pleasantly--is one of those triumphs over the infirmities of our mortal condition which change the aspect of life ever afterwards. Rhetoric can add nothing to its glory; grat.i.tude, and the pride permitted to human weakness, that our Bethlehem should have been chosen as the birthplace of this new embodiment of the divine mercy, are all we can yet find room for.

The present century has seen the establishment of all those great charitable inst.i.tutions for the cure of diseases of the body and of the mind, which our State and our city have a right to consider as among the chief ornaments of their civilization.

The last century had very little to show, in our State, in the way of medical literature. The worthies who took care of our grandfathers and great-grandfathers, like the Revolutionary heroes, fought (with disease) and bled (their patients) and died (in spite of their own remedies); but their names, once familiar, are heard only at rare intervals. Honored in their day, not unremembered by a few solitary students of the past, their memories are going sweetly to sleep in the arms of the patient old dry-nurse, whose "blackdrop" is the never-failing anodyne of the restless generations of men. Except the lively controversy on inoculation, and floating papers in journals, we have not much of value for that long period, in the shape of medical records.

But while the trouble with the last century is to find authors to mention, the trouble of this would be to name all that we find. Of these, a very few claim unquestioned preeminence.

Nathan Smith, born in Rehoboth, Ma.s.s., a graduate of the Medical School of our University, did a great work for the advancement of medicine and surgery in New England, by his labors as teacher and author, greater, it is claimed by some, than was ever done by any other man. The two Warrens, of our time, each left a large and permanent record of a most extended surgical practice. James Jackson not only educated a whole generation by his lessons of wisdom, but bequeathed some of the most valuable results of his experience to those who came after him, in a series of letters singularly pleasant and kindly as well as instructive.

John Ware, keen and cautious, earnest and deliberate, wrote the two remarkable essays which have identified his name, for all time, with two important diseases, on which he has shed new light by his original observations.

I must do violence to the modesty of the living by referring to the many important contributions to medical science by Dr. Jacob Bigelow, and especially to his discourse on "Self-limited Diseases," an address which can be read in a single hour, but the influence of which will be felt for a century.

Nor would the profession forgive me if I forgot to mention the admirable museum of pathological anatomy, created almost entirely by the hands of Dr. John Barnard Swett Jackson, and ill.u.s.trated by his own printed descriptive catalogue, justly spoken of by a distinguished professor in the University of Pennsylvania as the most important contribution which had ever been made in this country to the branch to which it relates.

When we look at the literature of mental disease, as seen in hospital reports and special treatises, we can mention the names of Wyman, Woodward, Brigham, Bell, and Ray, all either natives of Ma.s.sachusetts or placed at the head of her inst.i.tutions for the treatment of the insane.

We have a right to claim also one who is known all over the civilized world as a philanthropist, to us as a townsman and a graduate of our own Medical School, Dr. Samuel Gridley Howe, the guide and benefactor of a great mult.i.tude who were born to a world of inward or of outward darkness.

I cannot pa.s.s over in silence the part taken by our own physicians in those sanitary movements which are a.s.suming every year greater importance. Two diseases especially have attracted attention, above all others, with reference to their causes and prevention; cholera, the "black death" of the nineteenth century, and consumption, the white plague of the North, both of which have been faithfully studied and reported on by physicians of our own State and city. The cultivation of medical and surgical specialties, which is fast becoming prevalent, is beginning to show its effects in the literature of the profession, which is every year growing richer in original observations and investigations.

To these benefactors who have labored for us in their peaceful vocation, we must add the n.o.ble army of surgeons, who went with the soldiers who fought the battles of their country, sharing many of their dangers, not rarely falling victims to fatigue, disease, or the deadly volleys to which they often exposed themselves in the discharge of their duties.

The pleasant biographies of the venerable Dr. Thacher, and the worthy and kind-hearted gleaner, Dr. Stephen W. Williams, who came after him, are filled with the names of men who served their generation well, and rest from their labors, followed by the blessing of those for whom they endured the toils and fatigues inseparable from their calling. The hardworking, intelligent country physician more especially deserves the grat.i.tude of his own generation, for he rarely leaves any permanent record in the literature of his profession. Books are hard to obtain; hospitals, which are always centres of intelligence, are remote; thoroughly educated and superior men are separated by wide intervals; and long rides, though favorable to reflection, take up much of the time which might otherwise be given to the labors of the study. So it is that men of ability and vast experience, like the late Dr. Twitch.e.l.l, for instance, make a great and deserved reputation, become the oracles of large districts, and yet leave nothing, or next to nothing, by which their names shall be preserved from blank oblivion.

One or two other facts deserve mention, as showing the readiness of our medical community to receive and adopt any important idea or discovery.

The new science of Histology, as it is now called, was first brought fully before the profession of this country by the translation of Bichat's great work, "Anatomie Generale," by the late Dr. George Hayward.

The first work printed in this country on Auscultation,--that wonderful art of discovering disease, which, as it were, puts a window in the breast, through which the vital organs can be seen, to all intents and purposes, was the manual published anonymously by "A Member of the Ma.s.sachusetts Medical Society."

We are now in some slight measure prepared to weigh the record of the medical profession in Ma.s.sachusetts, and pa.s.s our judgment upon it. But in-order to do justice to the first generation of pract.i.tioners, we must compare what we know of their treatment of disease with the state of the art in England, and the superst.i.tions which they saw all around them in other departments of knowledge or belief.

English medical literature must have been at a pretty low ebb when Sydenham recommended Don Quixote to Sir Richard Blackmore for professional reading. The College Pharmacopoeia was loaded with the most absurd compound mixtures, one of the most complex of which (the same which the Reverend Mr. Harward, "Lecturer at the Royal Chappel in Boston," tried to simplify), was not dropped until the year 1801. Sir Kenelm Digby was playing his fantastic tricks with the Sympathetic powder, and teaching Governor Winthrop, the second, how to cure fever and ague, which some may like to know. "Pare the patient's nails; put the parings in a little bag, and hang the bag round the neck of a live eel, and put him in a tub of water. The eel will die, and the patient will recover."