sumption is an inflammatory disease, and should be treated by CHAP. IX. bleeding, purging, cooling medicines, and starvation. With a greater show of reason, Salvadori maintained the disease to be one of debility, and that it should be treated by tonics, stimulating remedies, and a generous diet. Galen, among the ancients, recommended vinegar as the best preventive of consumption. Dessault, and other modern writers, assert that consumption is often brought on by a common practice of young people taking vinegar to prevent their getting fat. Dr. Beddoes recommended fox-glove as a specific in consumption. Dr. Parr, with equal confidence, declared that he found fox-glove more injurious in his practice than beneficial! Now, what are we to infer from all this? Not, as some of you might be tempted to believe, that the science is deceptive or incomprehensible throughout, but that its professors, to this very hour, have neglected to make themselves acquainted with the true principles upon which remedies act, and know as little of the true nature of the diseases whose treatment they so confidently undertake." Such are the views of a modern critic. In mania, bleeding used to be most frequently resorted to. In this disease excessive power is manifested: what better, says the antipathist, than bleeding, which lessens power? What, however, is the testimony of Dr. Brown, who has had the most extensive experience in treating this disease? 66 Depletion in mania has the following disadvantages: "1st, It materially retards the recovery; 2nd, It gives a tendency to dementia; 3rd, It is sometimes directly fatal; 4th, It debilitates at a period of depresssion, and in no degree facilitates the operation of other remedies. That even in such patients as have been bled, but are ultimately cured, a state of imbecility approaching to fatuity separates the period of excitement from that of convalescence; dementia follows directly, and obviously great evacuations and copious blood-letting, where no symptoms of alienation pre-existed. There is a case under my care, where incurable dementia succeeded the loss of blood in pneumonia. The fatal consequences of bleeding in delirium tremens have not suggested any warning. Depletion, while the nervous system is in a state of high excitement, proves fatal in various ways: I have seen it induce convulsions, during which the CHAP. IX. patient died. More frequently the weakness which supervenes is so great, and so little under the controul of medicine or diet, that after passing through every stage of prostration and emaciation, the patient sinks from debility or from some acute disease, or, as it were, actually worn out by the irritation of the mental disease. While writing these remarks, a copy of the Annual Report of the Northampton Asylum has been transmitted to me, in which a table, showing the causes of death, contains the corroborative item: Exhaustion from previous depletion, two deaths.'" In reference to the celebrated Dr. Armstrong's treatment of scarlatina maligne, Professor Maunsel remarks: "In such practitionery, we know no better advice than that of the judicious Huxham, at least to peruse the sixth commandment." Brera, a most celebrated continental physician, referring to the treatment of pneumonia, notes: 100 cases treated without bleeding 14 only died Kieser, a high authority on the continent, remarks :— 66 "A great many diseases are healed only by nature, and in the greatest part of acute diseases, all that the physician has to do is to remove and prevent pernicious influences, and set aside the abnormous over-action of some of the organs. When he does more, either to satisfy the patient's longing for medicine, his own dogmatic theories, or his eagerness of gain, mischief ensues. By this means, frequently, artificial diseases are produced, and, in many cases of medical treatment, we can truly assert, that chronic diseases that have followed them have been caused by the physician. In the present state of the practice of medicine, then, both in Germany and the neighbouring lands, the sick man should be warned against medicines as the most dangerous agents." The same writer adds: "The history of medicine especially teaches this, for it shows that every separate, and thence one-sided theory of medicine, has required a number of victims greater than the most destructive plagues or the longest war." With Kieser's statement, the experience of Dr. Rush agrees. CHAP. IX. He remarks: "We have not only increased the number of diseases, but we have made them more fatal. Even the principles founded on just observation are made hurtful by a wrong application of them. We are obliged to investigate errors, perhaps forty or fifty years after the time at which they prevailed, to comprehend their absurdity." 66 Sydenham, whose acuteness of observation none can doubt, records his conviction thus :- It often happens that the aspect of a disease varies according to the varying method of cure, and many symptoms are due not so much to the disease as to the physician.' Hahnemann remarks: "The majority of cases for the treatment of which a physician is called, are of acute diseases, that is, aberrations from health which have only a short course to run before they terminate either in recovery or death. If the patient die, the physician follows him modestly to the grave; if he recover, then must his natural strength have been sufficient to overcome both the force of the disease and the mischief of the drugs he took; and the natural strength does often suffice to overcome both. In epidemic dysentery, just as many recovered of those who followed the indications afforded by nature, without taking any medicine at all, as of the others who were treated on the best principles of Brown, of Stoll, of Hoffmann, of Richter, of Vogler, of any other or by any other system. Many died, too, both of those treated by all these methods, and of those who took no medicine; on an average, just as many of the one as of the other. And yet, all the physicians and quacks who attended those who recovered, boasted of having effected a cure by their skill. What is the inference? Certainly not that they were all right in their mode of treatment; but perhaps that they were all equally wrong. What presumption for each to claim, as he did, the credit of curing a disease, which in milder cases Sæpe accidit ut facies morbi variet pro vario medendi processu, ac nonnulla symptomata, non tam morbo quam medico debeantur. CHAP. IX. uniformly recovered of itself, if gross errors in diet were not committed." Even the writers in the periodical antipathic press often acknowledge the injuries inflicted by the treatment of those pursuing the old system. The following acknowledgement is taken from the Lancet, in a review of a book published by a surgeon named Brown :: "When I read the reports of cases in the journals of the day, the blood freezes within me, so horror-struck am I at what the patients suffer at the hands of the doctor; and I am never astonished at finding an account of the post mortem, for which, I confess, I often look down to the bottom, in advance, seeing, from the first day or two's treatment, that all is up with the patient. That the patient, in the present case, had a narrow escape, is palpable, and it is equally so that her surviving the treatment is to be attributed entirely to a more than human constitution. But the lady recovered, and the recovery is called a cure, and the cure, so called, is ascribed to the treatment, though it is evident, on the face of the report, that the cure, if such it was, was effected by an accidental occurrence, which the treatment was calculated to prevent, and which was unlooked for and unexpected by the author, namely, the suppurative inflammation of the sac. "Mr. Brown is evidently an indulgent doctor, for it seems that he allows his patients, at their own requests,' notwithstanding 'hot skin,' 'flushed face,' 'pulse at 120,' and so on, whatever they like in the way of beer, brandy, and wine. "It is true, he throws in, at the same time, out of his own shop, for reasons best known to himself, a mixtum gatherum of a draught, every four hours, and a rattling purgative at night into the bargain, although the bowels be already distended with flatus, and the abdomen sore from the brisk operation of purgatives and other sorts of doctors' stuff. Oh, this quartâ q. q. horâ system! What in the world do these doctors think that human bowels are made of? The thickest leather breeches that ever a huntsman put on, if made into bowels for the patients of some of these doctors, could not hold out against the batteries of stuff, as killing as grape-shot, which our blue-bottle doctors discharge at their patients." Even poets have seen the folly of the old-system drugs. CHAP. IX. Goethe testifies to the injuries resulting from drugs : Thus with our hellish drugs, Death's ceaseless fountains Worse than the very plague we raged : I have myself to thousands poison given, And hear their murderer praised as blest by Heaven, Because with Nature strife he waged. Goethe's Faust. A few special illustrations of the injuries, resulting from the old-system practice, may be given. A case where the ulceration of the mucous membrane of the internal passage, and one where the symptoms of phthisis were produced by the use of iodine, are recorded by Mr. Rawson, of Keyworth, in the Lancet.* A case is recorded in the same volume,† in which death was caused from the use of colchicum. The following statement exhibits blindness and death from the use of a violent purgative : "In the spring prior to his [Professor Davis's] decease, an attack of TOTAL BLINDNESS, which lasted about five minutes, supervened during a violent vomiting, induced unintentionally by a purgative. This left behind double vision, in certain positions of objects only, which continued for about six weeks. He showed symptoms of rapid failure of health during the ensuing summer; he nevertheless, until the last month of his summer course, continued to throw the same interest into his lectures, and to address his class apparently with the same spirit as heretofore. He recovered in some degree his strength and energies by a brief residence at the sea-side, sufficiently to induce him, on the October following, to re-commence his duties, which it was now destined he should enter upon for the last time." Only a few days since, the writer was sent for into Essex, to see a patient dangerously ill. The patient had been confined about a fortnight. She was going on very well in every respect. The surgeon accoucheur, who had attended her in her confinement, called to see her, and observed that "she Lancet, vol. II. (1842-3), p. 444, published in the Appendix. N |