Изображения страниц
PDF
EPUB

agreed with his health generally, or who had a wife_continually scolding him, and making him miserable? In such cases, need I say, it will be difficult to give even temporary benefit to a consumptive patient.

There is a phrase at present so much in fashion, that were I all at once to tell you it was absolute and indisputable nonsense, you would, in all probability, stare with astonishment. Gentlemen, did any of you ever hear of Brain-cough, or Ear-cough, or Eye-cough? No! But you have, of course, heard two doctors discussing with the greatest gravity imaginable, whether a particular complaint was incipient consumption or "Stomach-cough;" as if people in these days coughed with their stomachs instead of their lungs! Only let a fashionable physician give currency to this kind of false coin, and it will pass for genuine, till some suspicious character like himself shall submit it to analysis at the mint of Common Sense-and then-what then? Why people will scarcely even then believe the evidence of the whole of their five senses put together; for, as some one says, when the gullible public once get hold of a lie, they become so enamoured of it, that nothing but death will make them part with it. Who first introduced the phrase "stomach-cough," I do not know; but Dr. Wilson Philip, at all events, insists that "indigestion or dyspepsia" is the remote cause of a variety of consumption; and in proof of this, he tells us he has cured it with minute doses of mercury. Now, if that were any proof of the origin of a disease, every disease in existence might be termed a "stomach affection;" for I know very few chronic complaints, however grave, which I have not myself cured by the same medicine; ay, and have seen aggravated by it too. In the latter case, of course, the complaint could not be a "stomach disease." Direct your attention, says Dr. Philip, to the digestive organs, and you will improve the subject of "dyspeptic phthisis." And so you may, if you direct your attention to any other part of the body of a consumptive patient-for what part of the body of such a patient performs its functions correctly? In this disease, the feet and hands feel cold and hot by turns, the skin one moment harsh and dry, is at another bedewed by a cold and clammy sweat. Are these causes or coincidents ?May you not as well say, Cure the consumption, and the digestive powers will improve, as, Cure the indigestion, and you will stop the consumption? Medical men constantly talk of indigestion as an essence or entity, having features separate and distinct from all other disorders. Can any person, I ask, be the subject of any disease without his digestion being more or less implicated? What becomes of your digestion in FEVER? or when you get bad news just as you are about to eat your dinner? Though you were as hungry as a hawk a moment before, your appetite would leave you then.Gentlemen, have we a brain, or have we not? Give a man a blow on that, and see what becomes of his digestion! How much the workings of this organ have to do with the functions of the stomach, we have a lesson in the play of Henry VIII. Mark what the fiery monarch says to Cardinal Wolsey, when surprising him with the proofs of his treachery

[blocks in formation]

Do you doubt that the breathing of a man thus suddenly and unceremoniously surprised, would be as much affected at such a moment as his appetite? See then the absurdity of placing naturally coincident circumstances in the light of cause and effect! Shakspeare knew the influence of a passion upon the totality of the body better than half the faculty, and I am not sure that he could not have prescribed to better purpose than them all put together. Do you think in cases of this kind he would have troubled his head about the digestive organs, or that he would have said, like many of the great doctors of the day, "we must put the stomach and bowels to rights!" Certainly not; he would have made the Brain his first care; he would have first tried to soothe and comfort that, and then he would have expected the

appetite to return. Now, that is what ought to be done in all complaints, indigestion and consumption included. Every organ of the body is of importance in our economy, but the Brain is so important an organ that people cannot live a moment without it; and whatever affects it, for good or for evil, equally, for good or for evil, affects every other part of the body,-the lungs as much as the stomach. Through the medium of the Brain and nerves only, can mercury or any other medicine influence the diseases of these two last-mentioned organs, whether advantageously or the reverse; and, as I have already told you, mercury can do both, according to the correspondence and fitness it hath for individual bodies, and the scale or degree in which it may be administered. But upon the subject of appetite the greatest nonsense prevails, even in the profession. You hear that such a one is ill-very ill,-but, thank Heaven! his appetite still keeps "good." How, then, is it that the patient continues day by day to waste and become skeleton-like? It is because that man's appetite, so far from being "good-nay, excellent," is morbidly voracious and craving, having as much resemblance to the appetite of health as the diabetic flow of urine has to a useful-that is, a moderate-secretion from the kidneys. No man can possibly be the subject of disease of any kind without his digestive organs partaking in the general totality of derangement. Whatever can improve the general health in one case, may do the same in the other. Now, though the chrono-thermal remedies, judiciously administered during the remission, may of themselves singly cure almost every kind of disease,-yet it is my custom to combine and alternate them, as I have already said, with such medicines as experience proves have more or less affinity to the particular parts of the body most implicated in a given case,-mercury, iodine, and emetics, for example, inasmuch as the cure may thereby, in many instances, be at least accelerated. The well-ascertained influence of mercury and iodine on the glandular and assimilative nerves, naturally points to those two medicines as being the most proper for consumption; and I feel it my duty to state to you that I have often availed myself of their beneficial influence in that disease. That they can produce it in cases where they prove constitutionally injurious, you will scarcely doubt, when you consider that whatever may injure the health of persons predisposed to chest-disease, may as certainly bring out that weak point of their frame. Instances produced by both, more particularly mercury, I have too often been compelled to witness.

Medical practitioners, when detailing the most strikingly remittent phenomena, in general manage so to word them that you cannot distinguish whether they be remittent or not. The more intelligent non-medical writer will often convey in his unsophisticated English the precise bearings of a case. Take an instance from Captain Hall's narration of the illness of the Countess Purgstall: "Our venerable friend," he says, "though she seemed to rally, and was certainly in as cheerful spirits as ever, had gotten a severe shake; her nights were passed in coughing, high fever, and sharp rheumatic pains, -but in the day-time she appeared so well, that it was scarcely possible to believe her dying, in spite of her constant assertion to that effect." [Schloss Hainfield.] Now, in such a case as this, would not the responses of the stethoscope differ materially according to the time they were taken? The indications obtained through its medium could not possibly be the same by night as by day.

When I first published my sketch of the Chrono-Thermal System of Medicine, I had the misfortune, among other things, to find myself at issue with certain medical critics on this very subject of the stethoscope. My undisguised contempt for their wooden idol fired two of them, at least, with a common indignation; for while Dr. Forbes, in his Review, made this a reason for pointing out to me the advantages of common sense over the want of it," I found myself charged, on the same score, in the pages of Dr. James Johnson, with “ profound ignorance and inveterate prejudice." To the strictures of both reviewers I replied in the Lancet. The utter inutility of

the instrument in diseases of the Heart having, as you have seen, been since acknowledged by Dr. James Johnson himself, I will only now detain you with a few remarks as to its value in Pulmonary Consumption.

Permit me, I said to my very polite critics, to ask you a very plain question. Since the stethoscope first came into fashion, have you or any other physician been able to bring this or any other disease of the chest to a more favourable termination than formerly? Hitherto, I never could obtain but one answer to this question, and that answer was always a negative. But softly, you will say Has it not taught us to discriminate and distinguish one disease from another? Admitting for the present, that such is the fact, (which however, I shall shortly disprove,) of what use, I again ask, is such discrimination, such change of one kind of verbiage for another, if it lead to no difference or improvement in practice-if our remedial measures, for all shades and variations of pectoral disorder, come at last to the same agency? What is it but a vain waste of time in splitting straws to attempt to distinguish by some nice auricular sign, severe disease of one tissue of the pulmonary substance from another, if the proper treatment of every kind of lung disorder be the same? If you reply, It is a satisfaction to know whether the disease be CURABLE or not, I give you for rejoinder the fact, that where the symptoms are so grave as to be with difficulty distinguished from true tuberculous consumption, the disease, in that case, may either, like such consumption, under certain circumstances, admit of cure, or, like the same disorder in its very advanced stages, as certainly terminate in death.

[ocr errors]
[ocr errors]

Rush, Portal, and the most judicious physicians," says Dr. Hancock, have constantly regarded Consumption to be a disease of the constitution, not consisting merely of ulceration or loss of substance in the lungs—of course not to be disposed of by stethoscopes or any oracular mummery. Hence, too, we see the reason that consumption formerly, in the times of Morton, Sydenham, Bennet, and others, was not regarded as an incurable disease." Let us, however, for argument's sake allow that a knowledge of the exact amount of lung-decomposition could be turned to some useful or practical account; are my critics so certain that the stethoscope is adequate to the detection of this? Andral, an authority to whom " pathologists" on all occasions implicitly bow, candidly admits its deficiency. "Without other signs," he says, "the stethoscope does NOT reveal with certainty consumption and inflammations of the heart." And Dr. Latham, who has taken no small pains to advocate its employment, admits that the best Auscultators even the technical term for those who use it-have been led to a wrong prognostic by it. "TO MOST patients," he adds, "I fear it is a TROUBLE and DISTRESS.' Now this is just the reason why I repudiate its assistance; whatever TROUBLES and DISTRESSES the patient must not only alter all the movements of his heart and lungs, so as to neutralise the whole indications presented by them; but must actually aggravate the state of his system throughout; and, by consequence, instead of tending to the relief of the part most implicated, must further increase its diseased state. Well, then, as the information obtained from the stethoscope must from the nature of things, be as hollow and empty as the toy through which it proceeds-and as the discovery of the degree of organic change, even could it be known to a nicety, can, in no instance, lead to practical improvement, I am content to judge of it from the patient's general appearance, the number of his respirations, and the sounds emitted when he speaks, breathes, and coughs, as appreciable by the naked ear. From an instrument whose employment TROUBLES and DISTRESSES the MAJORITY of patients, I look for no superior information; for, I repeat, whatever troubles and distresses people's brains, will assuredly trouble and distress their bodies, particularly the weaker parts of them.

Gentlemen, we are all liable to trust too much to our ears. In Diseases of the Chest, as on most occasions, we should do well to examine things with our eyes. When consulted about disorders of that cavity, our business is to

watch well the countenance of the patient, to mark whether his breathing he hurried, or the reverse, whether he has lost flesh, or begins to gain it; and from whatever part of the lungs the matter expectorated may proceed, we can be at no loss for the proper principle of treatment; our eyes will soon tell us whether he gets better or worse, and whether a particular medicine should be continued or changed for another. In the case of any very material change in the lungs, such as an abscess, cavern, or solidification of a part of their substance, if large, such local disease will get smaller as the general health improves,—if small, it will grow larger should that get worse. than this,

There need no words, nor terms precise

The paltry jargon of the Schools,

Where Pedantry gulls Folly:-we have EYES!

More

With these, then, let us recur to Nature, and we shall have no need to ask of professors and other great persons whether consumption and other chestaffections, be remittent disorders or not. When once satisfied of that, you, Gentlemen, may be sure that quinine, opium, and the other Chrono-Thermal medicines, will be of infinitely more avail for their cure than all the discussion and discrimination of all the doctors that ever mystified disease by their vain nosologies! What cares the patient about the alphabetical combination, by which you baptize his disease, if you cannot make him better; and if you succeed in curing him, what does it signify, whether you call it one name or another? But the name, it may be said, has to do with the prognostic. To that I reply, Even when despairing of success, you will do well to guard yourselves against a too decided prognostic in any case. How often have I heard patients, who had formerly suffered from chest-disease, boast that they had lived to cheat their doctor of the death to which he had theoretically doomed them,-ay, and that doctor a stethoscopist!

It is truly amusing to find men playing the critic, without the smallest pretension to the knowledge reisite for such an office. So ignorant was my Medico-Chirurgical Reviewer, Dr. James Johnson, of one of the most universal laws, both of Health and Disorder, as to accuse me of a limited grasp of my profession, for making Fever,-"not Fever in the large sense of the word, but only Remittent fever,"-my primitive type of all diseases. He chuckled that he could confront me with the school-boy term, "Continued Fever," "Fever in the LARGE sense of the word;" but according to a living professor, Dr. A. T. Thompson, in Continued Fever, in almost every case, there is an Exacerbation towards mid-day, and the Remission towards morning. Another contemporary, Dr. Shearman, says, "an Intermittent is the most perfect form of fever, having the most complete periods of accession and intermission. The Continued Fever, as it is called, differs from this only in its periods being less perfect and the stages of its curriculum less obvious."Cullen long ago said the same thing in nearly the same words; and almost every other writer on fever since his time has noticed it. But so great a blunder, in the eyes of Dr. Johnson, was my preference of the perfect rather than the imperfect form of fever, for my type of all disease, that he not only condemned my doctrine in toto, as a Pyrexy-Mania, or fever madness, but he assured his readers my madness had a method in it. Gentlemen, whether or not Dr. James Johnson's own practice does better deserve to come under the head of madness,-savouring, too, of a rather sanguinary and homicidal type of it-I shall by-and-by have an opportunity of showing you. Meantime I may observe, that—

Though I hope not hence unscathed to go,
Who
conquers me shall find a stubborn foe!
The time hath been when no harsh sounds would fall
From lips that now would seem imbued with gall,
Nor fools, nor follies tempt me to despise

The meanest thing that crawls beneath mine eyes;

But now so callous grown, so changed since youth,
I've learned to think, and sternly speak the Truth,—
Learned to deride the CRITIC's starch decree,
And break him on the wheel he meant for me;
To spurn the rod a scribbler bids me kiss,

Nor care if courts or crowds applaud or hiss.-BYRON.

Having already adverted to

GLANDULAR DISEASE,

I will just shortly observe, that complaints of this kind, whether involving some large gland such as the Liver, Pancreas, or Spleen,-if the last mentioned viscus be indeed a gland-or taking place in the glandular apparatus of canals, the lachrymal and biliary ducts, the eustachian, salivary, and urinary passages, for example, such disorders may all be advantageously treated by the various Chrono-Thermal medicines, and more certainly so, if combined with minute doses of Iodine, Mercury, and other remedies which have a well known glandular affinity. Disorders of the smaller glands, whether situated in the neck, arm-pit, or groin, or in the course of the mesentery, are for the most part termed "scrofula," and by some practitioners presumed to be incurable, than which nothing can be more erroneous, unless it be the system which renders them so; namely, the application of leeches to the tumours, and the purgatives so unsparingly employed by many in their treatment. All these various diseases are features or effects of Remittent Fever; by controlling which with the chrono-thermal agents, they may all, in the earlier stages, be at once arrested; and some, even of a chronic character, perfectly cured by a combination of these remedies with mercury or iodine. I could give cases innumerable in proof of this, but as I have so well established the principle in structural disease, and have still further to illustrate it in the disorders we are about to enter upon, I shall not detain you further on this matter.

CONSUMPTIVE DISEASES OF JOINTS.

Very much akin to Consumption of the Lungs, are various diseases, which, from their external manifestations, have been too long left under the exclusive dominion of the Surgeons; namely, those destructive affections of the Joints, which so often bring the subjects of them to the amputating table. I forget the particular operative eminent who thanked God he knew nothing of physic! Such a confession was very proper for a butcher-for the barbersurgeons of former ages; but the medical man who, by well-directed remedies, prefers the honest consciousness of saving his patient from prolonged suffering and mutilation, to the spurious brilliancy of a name for “ Operations," will blush for the individual whose only title to renown was the bliss of his boasted ignorance, and a mechanical dexterity of hand unenviably obtained by an equally unjustifiable waste of human blood. It is truly atrocious in the legislature of this country to permit the present hospital system,—a system that only encourages ignorance, presumption, and heartless cruelty. No man in his senses would put himself under the care of an "Hospital Surgeon," if he knew that scarcely one of those self-conceited creatures is in the very least acquainted with physic. What would some of these supercilious mechanics say to the following cases?

Case 1.-Harriet Buckle, seven months old, had what is called a scrofulous elbow. The joint was much enlarged, red, painful, and previous to the probe, with discharge. The patient was the subject of diurnal fever. Notwithstanding the assurances of the mother that amputation had been held out as the only resource by two "hospital surgeons," under whose care the child had previously been, I confidently calculated on success. A powder containing calomel, quinine, and rhubarb, in minute doses, was directed to be taken every third hour. The case was completely cured in a fortnight, without any external application.

« ПредыдущаяПродолжить »