Introduction | 18th Century Medicine

The improvements in Medicine, since the revival of learning, have by no means kept pace with those of the other arts. The reason is obvious. Medicine has been studied by few, except those who intended to live by it as a trade. Such, either from a mistaken zeal for the honour of Medicine, or to raise their own importance, have endeavoured to disguise and conceal the art. Medical authors have generally written in a foreign language; and those who were unequal to this task, have even valued themselves upon couching, at least, their prescriptions, in terms and characters unintelligible to the rest of mankind.

The contentions of the clergy, which happened soon after the restoration of learning, engaged the attention of mankind, and paved the way for that freedom of thought and inquiry, which has since prevailed in most parts of Europe with regard to religious matters. Every man took a side in those bloody disputes and every gentleman, that he might distinguish himself on one side or other, was instructed in divinity. This taught people to think and reason for themselves in matters of religion, and at last totally destroyed that complete and absolute dominion which the clergy had obtained over the minds of men.

The study of law has likewise, in most civilized nations, been justly deemed a necessary part of the education of a gentleman. Every gentleman ought certainly to know at least the laws of his own country: and, if he were also acquainted with those of others, it might be more than barely an ornament to him.

The different branches of Philosophy have also of late been very universally studied by all who pretended to a liberal education. The advantages of this are manifest. It frees the mind from prejudice and superstition; fits it for the investigation of truth; induces habits of reasoning and judging properly; opens an inexhaustible source of entertainment; paves the way to the improvement of arts and agriculture; and qualifies men for acting with propriety in the most important stations of life.

Natural History is likewise become an object of general attention. And it well deserves to be so. It leads to discoveries of the greatest importance. Indeed agriculture, the most useful of all arts, is only a branch of Natural History, and can never arrive at a high degree of improvement where the study of that science is neglected.

Medicine however has not, as far as we know, in any country, been reckoned a necessary part of the education of a gentleman. But, surely, no sufficient reason can be assigned for this omission. No science lays open a more extensive field of useful knowledge, or affords more ample entertainment to an inquisitive mind. Anatomy, Botany, Chymistry, and the Materia Medica, are all branches of Natural History, and are fraught with such amusement and utility, that the man who entirely neglects them has but a sorry claim either to taste or learning. If a gentleman has a turn for observation, says an elegant and sensible writer – Observations on the Duties and Offices of a Physician – surely the natural history of his own species is a more interesting subject, and presents a more ample field for the exertion of genius, than the natural history of spiders and cockle-shells.

We do not mean that every man should become a physician. This would be an attempt as ridiculous as it is impossible. All we plead for is, that men of sense and learning should be so far acquainted with the general principles of Medicine, as to be in a condition to derive from it some of those advantages with which it is fraught; and at the same time to guard themselves against the destructive influences of lgnorance, Superstition, and Quackery.

As matters stand at present, it is easier to cheat a man out of his life than of a shilling, and almost impossible either to detect or punish the offender. Notwithstanding this, people still shut their eyes, and take every thing upon trust that is administered by any Pretender to Medicine, without daring to ask him a reason for any part of his conduct. Implicit faith, every where else the object of ridicule, is still sacred here. Many of the faculty are, no doubt, worthy of all the confidence that can be reposed in them; but as this can never be the character of every individual in any profession, it would certainly be for the safety, as well as the honour of mankind, to have some check upon the conduct of those to whom they intrust so valuable a treasure as health.

Had other medical writers been as honest as this gentleman, the art had been upon a very different footing at this day. Most of them extol the merit of those men who brought Philosophy out of the schools, and subjected it to the rules of common sense. But they never confider that Medicine, at present, is in nearly the same situation as Philosophy was at that time, and that it might be as much improved by being treated in the same manner. Indeed, no science can either be rendered rational or useful, without being submitted to the common sense and reason of mankind. These alone stamp a value upon science; and what will not bear the test of these ought to be rejected.

I know it will be said, that diffusing medical knowledge among the people, might induce them to tamper with Medicine, and to trust to their own skill instead of calling a physician. The reverse of this, however, is true. Persons who have most knowledge in these matters, are commonly most ready both to ask and to follow advice, when it is necessary. The ignorant are always most apt to tamper with Medicine, and have the least confidence in physicians. Instances of this are daily to be met with among the ignorant peasants, who, while they absolutely refuse to take a medicine which has been prescribed by a physician, will swallow, with greediness, any thing that is recommended to them by their credulous neighbours. Where men will act even without knowledge, it is certainly more rational to afford them all the light we can, than to leave them entirely in the dark.

The veil of mystery, which still hangs over Medicine, renders it not only a conjectural, but even a suspicious art. This has been long ago removed from the other sciences, which induces many to believe that Medicine is a mere trick, and that it will not bear a fair and candid examination. Medicine, however, needs only to be better known, in order to secure the general esteem of mankind. Its precepts are such as every wise man would chuse to observe, and it forbids nothing but what is incompatible with true happiness.

Disgusting Medicine not only retards its improvement as a science, but exposes the profession to ridicule, and is injurious to the true interests of society. And art founded on observation never can arrive at any high degree of improvement, while it is confined to a few who make a trade of it. The united observations of all the ingenious and sensible part of mankind, would do more in a few years towards the improvement of Medicine, than those of the Faculty alone in a great many. Any man can tell when a medicine gives him ease as well as a physician; and if he only knows the name and dose of the medicine, and the name of the disease, it is sufficient to perpetuate the fact. Yet the man who adds one single fact to the stock of medical observations, does more real service to the art than he who writes a volume in support of some favourite hypothesis.

Very few of the valuable discoveries in Medicine have been made by physicians. They have, in general, either been the effect of chance or of necessity, and have been usually opposed by the Faculty, till every one else was convinced of their importance. An implicit faith in the opinions of teachers, an attachment to systems and established forms, and the dread of reflections, will always operate upon those who follow Medicine as a trade. Few improvements are to be expected from a man who might ruin his character and family by even the smallest deviation from an established rule.

If men of letters, says the author of the performance quoted above, were to claim their right of inquiry into a matter that so nearly concerns them, the good effects on Medicine would soon appear. Such men would have no separate interest from that of the art, They would detect and expose assuming Ignorance under the mask of Gravity and Importance, and would be the judges and patrons of modest merit. Not having their understandings perverted in their youth by false theories, unawed by authority, and unbiased by interest, they would canvass with freedom the most universally received principles in Medicine, and expose the uncertainty of many of those doctrines, of which a physician dares not so much as seem to doubt.

No argument, continues he, can be brought against laying open Medicine, which does not apply with equal, if not greater force, to religion; yet experience has shewn, that since the laity have asserted their right of enquiry into these subjects, Theology, considered as a science, has been improved, the interests of real religion have been promoted, and the clergy have become a more learned, a more useful, and a more respectable body of men, than they ever were in the days of their greatest power and splendour.

It may also be alledged, that laying medicine more open to mankind would lessen their faith in it. This would indeed be the case with regard to some; but it would have a quite contrary effect upon others. I know many people who have the utmost dread and horror of every thing prescribed by a physician, but who will, nevertheless, very readily take a medicine which they know, and whose qualities they are in some measure acquainted with. Hence it is evident, that the dread arises from the doctor, not from the drug. Nothing ever can or will inspire mankind with an absolute confidence in physicians, but an open, frank, and undisguised behaviour. While the least shadow of mystery remains in the conduct of the Faculty, doubts, jealousies, and suspicions, will arise in the minds of men.

No doubt, cases will sometimes occur, where a prudent physician may find it expedient to disguise a medicine. The whims and humours of men must be regarded by those who mean to do them service; but this can never affect the general argument in favour of candour and openness. A man might as well allege, because there are knaves and fools in the world, that he ought to take every one he meets for such, and to treat him accordingly. A sensible physician will always know where disguise is necessary; but it ought never to appear on the face of his general conduct.

The appearance of mystery in the conduct of physicians not only renders their art suspicious, but lays the foundations of Quackery, which is the very disgrace of medicine. No two characters can be more different than that of the honest physician and the quack; yet they have generally been very much confounded. The line betwixt them is not sufficiently apparent; at least it is too fine for the general eye. Few persons are able to distinguish sufficiently between the conduct of that man who administers a secret medicine, and him who writes a prescription in mystical characters, and an unknown tongue. Thus the conduct of the honest physician, which needs no disguise, gives a sanction to that of the villain, whose sole consequence depends upon secrecy.

No laws will ever be able to prevent quackery, while people believe that the quack is as honest a man, and as well qualified, as the physician. A very small degree of medical knowledge, however, would be sufficient to break this spell; and nothing else can effectually undeceive them. It is the ignorance and credulity of the multitude, with regard to medicine, which renders them such an easy prey to every one who has the hardiness to attack them on this quarter. Nor can the evil be remedied by any other means but making them wiser.

The most effectual way to destroy quackery in any art or science, is to diffuse the knowledge of it among mankind. Did physicians write their prescriptions in the common language of the country, and explain their intentions to the patient, as far as he could understand them, it would enable him to know when the medicine had the desired effect; would inspire him with absolute confidence in the physician; and would make him dread and detest every man who pretended to cram a secret medicine down his throat.

Men, in the different states of society, have very different views of the same object. Some time ago it was the practice of this country for every person to say his prayers in Latin, whether he knew any thing of that language or not. This conduct, though sacred in the eyes of our ancestors, appears ridiculous enough to us, and doubtless some parts of ours will seem as strange to posterity. Among these we may reckon the present mode of medical prescription, which, we venture to affirm, will some time hence appear to have been completely ridiculous, and a very high burlesque upon the common sense of mankind.

But this practice is not only ridiculous, it is likewise dangerous. However capable physicians may be of writing Latin, I am certain apothecaries are not always in a condition to read it, and that dangerous mistakes, in consequence of this, often happen. But suppose the apothecary ever so able to read the physician’s prescription, he is generally otherwise employed, and the business of making up prescriptions is left entirely to the apprentice. By this means the greatest man in the kingdom, even when he employs a first-rate physician, in reality trusts his life in the hands of an idle boy, who has not only the chance of being very ignorant, but likewise giddy and careless. Mistakes will sometimes happen in spite of the greatest care; but, where human lives are concerned, all possible methods ought certainly to be taken to prevent them. For this reason the prescriptions of physicians, instead of being couched in mystical characters and a foreign language, ought, in my humble opinion, to be conceived in the most plain and obvious terms imaginable.

Diffusing medical knowledge among the people would not only tend to improve the art, and to banish quackery, but likewise to render Medicine more universally useful, by extending its benefits to society. However long Medicine may have been known as a science, we will venture to say, that many of its most important purposes to society have either been overlooked, or very little attended to. The cure of diseases is doubtless a matter of great importance; but the preservation of health is of still greater. This is the concern of every man, and surely what relates to it ought to be rendered as plain and obvious to all as possible. It is not to be supposed, that men can be sufficiently upon their guard against diseases who are totally ignorant of their causes. Neither can the legislature, in whose power it is to do much more for preserving the public health than can ever be done by the Faculty, exert that power with propriety, and to the greatest advantage, without some degree of medical knowledge.

Indeed, men of every occupation and condition in life might avail themselves of a degree of medical knowledge; as it would teach them to avoid the dangers peculiar to their respective stations; which is always easier than to remove their effects. Medical knowledge, instead of being a check upon the enjoyments of life, only teaches men how to make the most of them. It has indeed been said, that to live medically, is to live miserably: But it might with equal propriety be said, that to live rationally is to live miserably. If physicians obtrude their own ridiculous whims upon mankind, or lay down rules inconsistent with reason or common sense, no doubt they will be despised. But this is not the fault of Medicine. It proposes no rules that I know, but such as are perfectly consistent with the true enjoyment of life, and every way conducive to the real happiness of mankind.

We are sorry indeed to observe, that Medicine has hitherto hardly been considered a popular science, but as a branch of knowledge solely confined to a particular set of men, while all the rest have been taught, not only to neglect, but even to dread and despise it. It will, however, appear, upon a more strict examination, that no science better deserves their attention, or is more capable of being rendered generally useful.

People are told, that if they dip the least into medical knowledge, it will render them fanciful, and make them believe they have got every disease of which they read. This, I am satisfied, will seldom be the case with sensible people; and, suppose it were, they must soon be undeceived. A short time will shew them their error, and a little more reading will infallibly correct it. A single instance will shew the absurdity of this notion. A sensible lady, rather than read a medical performance, which would instruct her in the management of her children, must leave them entirely to the care and conduct of the most ignorant, credulous, and superstitious part of the human species.

Indeed, no part of Medicine is of more general importance than that which relates to the nursing and management of children. Yet few parents pay a proper attention to it. They leave the sole care or their tender offspring, at the very time when care and attention are most necessary, to hirelings, who are either too careless to do their duty, or too ignorant to know it. We will venture to affirm, that more human lives are lost by the carelessness and inattention of parents and nurses, than are saved by the Faculty; and that the joint and well-conducted endeavours, both of private persons and the public, for the preservation of infant lives, would be of more advantage to society, than the whole art of Medicine upon its present footing.

The benefits of Medicine, as a trade, will ever be confined to those who are able to pay for them; and of course, the far greater part of mankind will be every where deprived of them. Physicians, like other people, must live by their employment, and the poor must either want advice altogether, or take up with that which is worse than none. There are not, however, any where wanting well-disposed people, of better sense, who are willing to supply the defect of medical advice to the poor, did not their fear of doing ill often suppress their inclination to do good. Such people are often deterred from the most noble and a praise-worthy actions, by the foolish alarms sounded in their ears by a set of men, who, to raise their own importance, magnify the difficulties of doing good, find fault with what is truly commendable, and sneer at every attempt to relieve the sick which is not conducted by the precise rules of Medicine. These gentlemen must, however, excuse me for saying, that I have often known such well-disposed persons do much good; and that their practice, which is generally the result of good sense and observation, assisted by a little medical reading, is frequently more rational than that of the ignorant retainer to physic, who despises both reason and observation, that he may go wrong by rule; and who, while he is dosing his patient with medicines, often neglects other things of far greater importance.

Many things are necessary for the sick besides medicine. Nor is the person who takes care to procure those for them, of less importance than a physician. The poor often perish in diseases for want of proper nursing, than of medicine. They are frequently in want of even the necessaries of life, and still more so of what is proper for a sick-bed: no one can imagine, who has not been a witness of these situations, how much good a well-disposed person may do, by only taking care to have such wants supplied. There certainly cannot be a more necessary, a more noble, or a more godlike action, than to administer to the wants of our fellow-creatures in distress. While virtue or religion are known among mankind, this conduct will be approved; and while Heaven is just, it must be rewarded!

Persons who do not chuse to administer medicine to the sick, may nevertheless direct their regimen. An eminent medicaI author has said, That by diet alone all the intentions of Medicine may be answered. No doubt a great many of them may; but there are other things beside diet, which ought by no means to be neglected. Many hurtful and destructive prejudices, with regard to the treatment of the sick, still prevail among the people, which persons of better sense and learning alone can eradicate. To guard the poor against the influence of these prejudices, and to instil into their mnds some just ideas of the importance of proper food, fresh air, cleanliness, and other pieces of regimen necessary in diseases, would be a work of great merit, and productive of many happy consequences. A proper regimen, in most diseases, is at least equal to medicine, and in many of them it is greatly superior.

To assist the well-meant endeavours of the humane and benevolent in relieving distress; to eradicate dangerous and hurtful prejudices; to guard the ignorant and credulous against the frauds and impositions of quacks and impostors; and to shew men what is in their own power, both with regard to the prevention and cure of diseases, are certainly objects worthy of the physician’s attention. These were the leading views in composing and publishing the following sheets. They were suggested by an attention to the conduct of mankind, with regard to Medicine, in the course of a pretty long practice in different parts of this island, during which the Author has often had occasion to wish that his patients, or those about them, had been possessed of some such plain directory for regulating their conduct. How far he has succeeded in his endeavours to supply this deficiency, must be left for others to determine; but if they be found to contribute, in any measure, towards alleviating the calamities of mankind, he will think his labour very well bestowed.