Part 28
The cooper's crazy wife--crazy in the belief that she has committed the unpardonable sin--tries to drown her child, to save it from misery; and the poor lunatic, who would be tenderly cared for to-day in a quiet asylum, is judged to be acting under the instigation of Satan himself. Yet, after all, what can we say, who put Bunyan's “Pilgrim's Progress,” full of nightmare dreams of horror, into all our children's hands; a story in which the awful image of the man in the cage might well turn the nursery where it is read into a madhouse?
The miserable delusion of witchcraft illustrates, in a still more impressive way, the false ideas which governed the supposed relation of men with the spiritual world. I have no doubt many physicians shared in these superstitions. Mr. Upham says they--that is, some of them--were in the habit of attributing their want of success to the fact, that an “evil hand” was on their patient. The temptation was strong, no doubt, when magistrates and ministers and all that followed their lead were contented with such an explanation. But how was it in Salem, according to Mr. Upham's own statement? Dr. John Swinnerton was, he says, for many years the principal physician of Salem. And he says, also, “The Swinnerton family were all along opposed to Mr. Parris, and kept remarkably clear from the witchcraft delusion.” Dr. John Swinnerton--the same, by the way, whose memory is illuminated by a ray from the genius of Hawthorne--died the very year before the great witchcraft explosion took place. But who can doubt that it was from him that the family had learned to despise and to resist the base superstition; or that Bridget Bishop, whose house he rented, as Mr. Upham tells me, the first person hanged in the time of the delusion, would have found an efficient protector in her tenant, had he been living, to head the opposition of his family to the misguided clergymen and magistrates?
I cannot doubt that our early physicians brought with them many Old-World medical superstitions, and I have no question that they were more or less involved in the prevailing errors of the community in which they lived. But, on the whole, their record is a clean one, so far as we can get at it; and where it is questionable we must remember that there must have been many little-educated persons among them; and that all must have felt, to some extent, the influence of those sincere and devoted but unsafe men, the physic-practising clergymen, who often used spiritual means as a substitute for temporal ones, who looked upon a hysteric patient as possessed by the devil, and treated a fractured skull by prayers and plasters, following the advice of a ruling elder in opposition to the “unanimous opinion of seven surgeons.”
To what results the union of the two professions was liable to lead, may be seen by the example of a learned and famous person, who has left on record the product of his labors in the double capacity of clergyman and physician.
I have had the privilege of examining a manuscript of Cotton Mather's relating to medicine, by the kindness of the librarian of the American Antiquarian Society, to which society it belongs. A brief notice of this curious document may prove not uninteresting.
It is entitled “The Angel of Bethesda: an Essay upon the Common Maladies of Mankind, offering, first, the sentiments of Piety,” etc., etc., and “a collection of plain but potent and Approved REMEDIES for the Maladies.” There are sixty-six “Capsula's,” as he calls them, or chapters, in his table of contents; of which, five--from the fifteenth to the nineteenth, inclusive--are missing. This is a most unfortunate loss, as the eighteenth capsula treated of agues, and we could have learned from it something of their degree of frequency in this part of New England. There is no date to the manuscript; which, however, refers to a case observed Nov. 14, 1724.
The divine takes precedence of the physician in this extraordinary production. He begins by preaching a sermon at his unfortunate patient. Having thrown him into a cold sweat by his spiritual sudorific, he attacks him with his material remedies, which are often quite as unpalatable. The simple and cleanly practice of Sydenham, with whose works he was acquainted, seems to have been thrown away upon him. Everything he could find mentioned in the seventy or eighty authors he cites, all that the old women of both sexes had ever told him of, gets into his text, or squeezes itself into his margin.
Evolving disease out of sin, he hates it, one would say, as he hates its cause, and would drive it out of the body with all noisome appliances. “Sickness is in Fact Flagellum Dei pro peccatis mundi.” So saying, he encourages the young mother whose babe is wasting away upon her breast with these reflections:
“Think; oh the grievous Effects of Sin! This wretched Infant has not arrived unto years of sense enough, to sin after the similitude of the transgression committed by Adam. Nevertheless the Transgression of Adam, who had all mankind Foederally, yea, Naturally, in him, has involved this Infant in the guilt of it. And the poison of the old serpent, which infected Adam when he fell into his Transgression, by hearkening to the Tempter, has corrupted all mankind, and is a seed unto such diseases as this Infant is now laboring under. Lord, what are we, and what are our children, but a Generation of Vipers?”
Many of his remedies are at least harmless, but his pedantry and utter want of judgment betray themselves everywhere. He piles his prescriptions one upon another, without the least discrimination. He is run away with by all sorts of fancies and superstitions. He prescribes euphrasia, eye-bright, for disease of the eyes; appealing confidently to the strange old doctrine of signatures, which inferred its use from the resemblance of its flower to the organ of vision. For the scattering of wens, the efficacy of a Dead Hand has been out of measure wonderful. But when he once comes to the odious class of remedies, he revels in them like a scarabeus. This allusion will bring us quite near enough to the inconceivable abominations with which he proposed to outrage the sinful stomachs of the unhappy confederates and accomplices of Adam.
It is well that the treatise was never printed, yet there are passages in it worth preserving. He speaks of some remedies which have since become more universally known:
“Among the plants of our soyl, Sir William Temple singles out Five [Six] as being of the greatest virtue and most friendly to health: and his favorite plants, Sage, Rue, Saffron, Alehoof, Garlick, and Elder.”
“But these Five [Six] plants may admitt of some competitors. The QUINQUINA--How celebrated: Immoderately, Hyperbolically celebrated!”
Of Ipecacuanha, he says,--“This is now in its reign; the most fashionable vomit.”
“I am not sorry that antimonial emetics begin to be disused.”
He quotes “Mr. Lock” as recommending red poppy-water and abstinence from flesh as often useful in children's diseases.
One of his “Capsula's” is devoted to the animalcular origin of diseases, at the end of which he says, speaking of remedies for this supposed source of our distempers:
“Mercury we know thee: But we are afraid thou wilt kill us too, if we employ thee to kill them that kill us.
“And yett, for the cleansing of the small Blood Vessels, and making way for the free circulation of the Blood and Lymph--there is nothing like Mercurial Deobstruents.”
From this we learn that mercury was already in common use, and the subject of the same popular prejudice as in our own time.
His poetical turn shows itself here and there:
“O Nightingale, with a Thorn at thy Breast; Under the trouble of a Cough, what can be more proper than such thoughts as these?”...
If there is pathos in this, there is bathos in his apostrophe to the millipede, beginning “Poor sowbug!” and eulogizing the healing virtues of that odious little beast; of which he tells us to take “half a pound, putt 'em alive into a quart or two of wine,” with saffron and other drugs, and take two ounces twice a day.
The “Capsula” entitled “Nishmath Chajim” was printed in 1722, at New London, and is in the possession of our own Society. He means, by these words, something like the Archxus of Van Helmont, of which he discourses in a style wonderfully resembling that of Mr. Jenkinson in the “Vicar of Wakefield.” “Many of the Ancients thought there was much of a Real History in the Parable, and their Opinion was that there is, DIAPHORA KATA TAS MORPHAS, A Distinction (and so a Resemblance) of men as to their Shapes after Death.” And so on, with Ireaeus, Tertullian, Thespesius, and “the TA TONE PSEUCONE CROMATA,” in the place of “Sanconiathon, Manetho, Berosus,” and “Anarchon ara kai ateleutaion to pan.”
One other passage deserves notice, as it relates to the single medical suggestion which does honor to Cotton Mather's memory. It does not appear that he availed himself of the information which he says he obtained from his slave, for such I suppose he was.
In his appendix to “Variolae Triumphatae,” he says,--
“There has been a wonderful practice lately used in several parts of the world, which indeed is not yet become common in our nation.
“I was first informed of it by a Garamantee servant of my own, long before I knew that any Europeans or Asiaticks had the least acquaintance with it, and some years before I was enriched with the communications of the learned Foreigners, whose accounts I found agreeing with what I received of my servant, when he shewed me the Scar of the Wound made for the operation; and said, That no person ever died of the smallpox, in their countrey, that had the courage to use it.
“I have since met with a considerable Number of these Africans, who all agree in one story; That in their countrey grandy-many dy of the small-pox: But now they learn this way: people take juice of smallpox and cutty-skin and put in a Drop; then by'nd by a little sicky, sicky: then very few little things like small-pox; and nobody dy of it; and nobody have small-pox any more. Thus, in Africa, where the poor creatures dy of the smallpox like Rotten Sheep, a merciful God has taught them an Infallible preservative. 'T is a common practice, and is attended with a constant success.”
What has come down to us of the first century of medical practice, in the hands of Winthrop and Oliver, is comparatively simple and reasonable. I suspect that the conditions of rude, stern life, in which the colonists found themselves in the wilderness, took the nonsense out of them, as the exigencies of a campaign did out of our physicians and surgeons in the late war. Good food and enough of it, pure air and water, cleanliness, good attendance, an anaesthetic, an opiate, a stimulant, quinine, and two or three common drugs, proved to be the marrow of medical treatment; and the fopperies of the pharmacopoeia went the way of embroidered shirts and white kid gloves and malacca joints, in their time of need. “Good wine is the best cordiall for her,” said Governor John Winthrop, Junior, to Samuel Symonds, speaking of that gentleman's wife,--just as Sydenham, instead of physic, once ordered a roast chicken and a pint of canary for his patient in male hysterics.
But the profession of medicine never could reach its full development until it became entirely separated from that of divinity. The spiritual guide, the consoler in affliction, the confessor who is admitted into the secrets of our souls, has his own noble sphere of duties; but the healer of men must confine himself solely to the revelations of God in nature, as he sees their miracles with his own eyes. No doctrine of prayer or special providence is to be his excuse for not looking straight at secondary causes, and acting, exactly so far as experience justifies him, as if he were himself the divine agent which antiquity fabled him to be. While pious men were praying--humbly, sincerely, rightly, according to their knowledge--over the endless succession of little children dying of spasms in the great Dublin Hospital, a sagacious physician knocked some holes in the walls of the ward, let God's blessed air in on the little creatures, and so had already saved in that single hospital, as it was soberly calculated thirty years ago, more than sixteen thousand lives of these infant heirs of immortality. [Collins's Midwifery, p. 312. Published by order of the Massachusetts Medical Society. Boston, 1841.]
Let it be, if you will, that the wise inspiration of the physician was granted in virtue of the clergyman's supplications. Still, the habit of dealing with things seen generates another kind of knowledge, and another way of thought, from that of dealing with things unseen; which knowledge and way of thought are special means granted by Providence, and to be thankfully accepted.
The mediaeval ecclesiastics expressed a great truth in that saying, so often quoted, as carrying a reproach with it: “Ubi tres medici, duo athei,”--“Where there are three physicians, there are two atheists.”
It was true then, it is true to-day, that the physician very commonly, if not very generally, denies and repudiates the deity of ecclesiastical commerce. The Being whom Ambroise Pare meant when he spoke those memorable words, which you may read over the professor's chair in the French School of Medicine, “Te le pensay, et Dieu le guarit,” “I dressed his wound, and God healed it,”--is a different being from the God that scholastic theologians have projected from their consciousness, or shaped even from the sacred pages which have proved so plastic in their hands. He is a God who never leaves himself without witness, who repenteth him of the evil, who never allows a disease or an injury, compatible with the enjoyment of life, to take its course without establishing an effort, limited by certain fixed conditions, it is true, but an effort, always, to restore the broken body or the shattered mind. In the perpetual presence of this great Healing Agent, who stays the bleeding of wounds, who knits the fractured bone, who expels the splinter by a gentle natural process, who walls in the inflammation that might involve the vital organs, who draws a cordon to separate the dead part from the living, who sends his three natural anaesthetics to the over-tasked frame in due order, according to its need,--sleep, fainting, death; in this perpetual presence, it is doubtless hard for the physician to realize the theological fact of a vast and permanent sphere of the universe, where no organ finds itself in its natural medium, where no wound heals kindly, where the executive has abrogated the pardoning power, and mercy forgets its errand; where the omnipotent is unfelt save in malignant agencies, and the omnipresent is unseen and unrepresented; hard to accept the God of Dante's “Inferno,” and of Bunyan's caged lunatic. If this is atheism, call three, instead of two of the trio, atheists, and it will probably come nearer the truth.
I am not disposed to deny the occasional injurious effect of the materializing influences to which the physician is subjected. A spiritual guild is absolutely necessary to keep him, to keep us all, from becoming the “fingering slaves” that Wordsworth treats with such shrivelling scorn. But it is well that the two callings have been separated, and it is fitting that they remain apart. In settling the affairs of the late concern, I am afraid our good friends remain a little in our debt. We lent them our physician Michael Servetus in fair condition, and they returned him so damaged by fire as to be quite useless for our purposes. Their Reverend Samuel Willard wrote us a not over-wise report of a case of hysteria; and our Jean Astruc gave them (if we may trust Dr. Smith's Dictionary of the Bible) the first discerning criticism on the authorship of the Pentateuch. Our John Locke enlightened them with his letters concerning toleration; and their Cotton Mather obscured our twilight with his “Nishmath Chajim.”
Yet we must remember that the name of Basil Valentine, the monk, is associated with whatever good and harm we can ascribe to antimony; and that the most remarkable of our specifics long bore the name of “Jesuit's Bark,” from an old legend connected with its introduction. “Frere Jacques,” who taught the lithotomists of Paris, owes his ecclesiastical title to courtesy, as he did not belong to a religious order.
Medical science, and especially the study of mental disease, is destined, I believe, to react to much greater advantage on the theology of the future than theology has acted on medicine in the past. The liberal spirit very generally prevailing in both professions, and the good understanding between their most enlightened members, promise well for the future of both in a community which holds every point of human belief, every institution in human hands, and every word written in a human dialect, open to free discussion today, to-morrow, and to the end of time. Whether the world at large will ever be cured of trusting to specifics as a substitute for observing the laws of health, and to mechanical or intellectual formula as a substitute for character, may admit of question. Quackery and idolatry are all but immortal.
We can find most of the old beliefs alive amongst us to-day, only having changed their dresses and the social spheres in which they thrive. We think the quarrels of Galenists and chemists belong to the past, forgetting that Thomsonism has its numerous apostles in our community; that it is common to see remedies vaunted as purely vegetable, and that the prejudice against “mineral poisons,” especially mercury, is as strong in many quarters now as it was at the beginning of the seventeenth century. Names are only air, and blow away with a change of wind; but beliefs are rooted in human wants and weakness, and die hard. The oaks of Dodona are prostrate, and the shrine of Delphi is desolate; but the Pythoness and the Sibyl may be consulted in Lowell Street for a very moderate compensation. Nostradamus and Lilly seem impossible in our time; but we have seen the advertisements of an astrologer in our Boston papers year after year, which seems to imply that he found believers and patrons. You smiled when I related Sir Kenelm Digby's prescription with the live eel in it; but if each of you were to empty his or her pockets, would there not roll out, from more than one of them, a horse-chestnut, carried about as a cure for rheumatism? The brazen head of Roger Bacon is mute; but is not “Planchette” uttering her responses in a hundred houses of this city? We think of palmistry or chiromancy as belonging to the days of Albertus Magnus, or, if existing in our time, as given over to the gypsies; but a very distinguished person has recently shown me the line of life, and the line of fortune, on the palm of his hand, with a seeming confidence in the sanguine predictions of his career which had been drawn from them. What shall we say of the plausible and well-dressed charlatans of our own time, who trade in false pretences, like Nicholas Knapp of old, but without any fear of being fined or whipped; or of the many follies and inanities, imposing on the credulous part of the community, each of them gaping with eager, open mouth for a gratuitous advertisement by the mention of its foolish name in any respectable connection?
I turn from this less pleasing aspect of the common intelligence which renders such follies possible, to close the honorable record of the medical profession in this, our ancient Commonwealth.
We have seen it in the first century divided among clergymen, magistrates, and regular practitioners; yet, on the whole, for the time, and under the circumstances, respectable, except where it invoked supernatural agencies to account for natural phenomena.
In the second century it simplified its practice, educated many intelligent practitioners, and began the work of organizing for concerted action, and for medical teaching.
In this, our own century, it has built hospitals, perfected and multiplied its associations and educational institutions, enlarged and created museums, and challenged a place in the world of science by its literature.
In reviewing the whole course of its history we read a long list of honored names, and a precious record written in private memories, in public charities, in permanent contributions to medical science, in generous sacrifices for the country. We can point to our capital as the port of entry for the New World of the great medical discoveries of two successive centuries, and we can claim for it the triumph over the most dreaded foe that assails the human body,--a triumph which the annals of the race can hardly match in three thousand years of medical history.
THE YOUNG PRACTITIONER
[A Valedictory Address delivered to the Graduating Class of the Bellevue Hospital College, March 2, 1871.]
The occasion which calls us together reminds us not a little of that other ceremony which unites a man and woman for life. The banns have already been pronounced which have wedded our young friends to the profession of their choice. It remains only to address to them some friendly words of cheering counsel, and to bestow upon them the parting benediction.
This is not the time for rhetorical display or ambitious eloquence. We must forget ourselves, and think only of them. To us it is an occasion; to them it is an epoch. The spectators at the wedding look curiously at the bride and bridegroom; at the bridal veil, the orange-flower garland, the giving and receiving of the ring; they listen for the tremulous “I will,” and wonder what are the mysterious syllables the clergyman whispers in the ear of the married maiden. But to the newly-wedded pair what meaning in those words, “for better, for worse,” “in sickness and in health,” “till death us do part!” To the father, to the mother, who know too well how often the deadly nightshade is interwoven with the wreath of orange-blossoms, how empty the pageant, how momentous the reality!
You will not wonder that I address myself chiefly to those who are just leaving academic life for the sterner struggle and the larger tasks of matured and instructed manhood. The hour belongs to them; if others find patience to listen, they will kindly remember that, after all, they are but as the spectators at the wedding, and that the priest is thinking less of them than of their friends who are kneeling at the altar.
I speak more directly to you, then, gentlemen of the graduating class. The days of your education, as pupils of trained instructors, are over. Your first harvest is all garnered. Henceforth you are to be sowers as well as reapers, and your field is the world. How does your knowledge stand to-day? What have you gained as a permanent possession? What must you expect to forget? What remains for you yet to learn? These are questions which it may interest you to consider.