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5^, 




A '"> ' - r 



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V 



THE 



UNITY OF DISEASE 



ANALYTICALLY AND SYNTHETICALLY PROVED: 



WITH 



FACTS AND CASES 



SUBVERSIVE OF THE 



RECEIVED PRACTICE OF PHYSIC. 



By SAMUEL DICKSON, M.D. 

FORMERLY A MEDICAL OFFICER ON THE STAFF. 



" La Science qui inBtruit et la Medecine qai guerit sont fort bonnee 
sans doute ; mais, la science qui trompe et la medecine qui tue sont 
mauTaises : Apprenez-nous done les a distinguer." — Rousseau. 



LONDON : 

SIMPKIN AND MARSHALL : 
JOHN ANDERSON, JUNIOR, EDINBURGH: MILLIKEN 

AND SON, DUBLIN. 



MDCCCXXXVIII. 



£^J. . 



TO THE RIGHT HONORABLE 



William Lord Viscount Melbourne, 



FIRST LORD OF HER MAJESTY'S TREASURYi 



&C. &C. &C. 



My Lord, 

When a patriotic Lady, of 
the last age, introduced '•te. this country a 
great medical improvement for her day — the 
SMALL-POX INOCULATION, — shc was happily sup- 
ported by a Princess of the Blood. If, with that 
powerfiil aid, and the prestige of her own high 
birth and beauty, the genius of Mary Wortley 
Montague all but sunk under the difficulties of 
the undertaking, — ^how perilous for an individual, 
possessing no distinction beyond his academic 



IV 

honors, the still more daring attempt to subvert 
the entire fabric of British Medicine 1 

Undeterred by the magnitude of the enterprise, 
I fearlessly throw down the gauntlet to my op- 
ponents. The Prime Minister of England has 
permitted me to inscribe to him my work : this 
permission could only have been granted in a 
liberal age. Under his high and distinguished 
auspices, I anticipate such a reception for my 
labours, as may enable me, not only, to neutralize 
the enmity of my adversaries ; but, to extend the 
beneficial influence of an art which, it has been 
the delight of my maturer years, to cultivate. 
I have the honor to subscribe myself. 

My Lord, 

Your Lordship's obliged and obedient servant, 

S. DICKSON. 

Cheltenham : 15, Imperial Square, 
September 22d, 1838. 



CONTENTS. 



PAGB 
TU 
1 

8 

4 

6 

12 



Intbobtjction .... 

PiJiT 1. — Comprising — Health and Disease 
Health, Phenomena of . 
Disease, Nature of . . . 

Causes of Disease, External, not Internal 
Intermittent Fever, the Type of all Disease 
Sleep, an Intermittent Palsy of the Neryes of the Five Senses 13 
Death, a Permanent Palsy of every Organic Perception . 14 
Aphonia or Loss of Voice, Cases of, Cured by Quinine . 19 
Palsy, Cases of, successfully treated by Hydrocyanic Acid, &c. 21 
Carved Spine, Nature of with Case . . .26 

Squint, Mode of Cure . . . . .28 

Amaurosis, Case of Cure of, by Hydrocyanic acid . 29 

Deafness, Remittent Nature of . . . .80 

Anaesthesia, or Loss of the Sense of Touch . .31 

Tic Douleuroux, Cases of. Cured by Quinine 32 

Excessive Appetite, Case of . . . .34 

Thirst, its nature ...... 34 

Spasmodic Stricture, Case of. Cured by Quinine • 37 

Spitting of Blood . . . . . .88 

Mania ....... 42 

Epilepsy ....... 43 

Disease of Heart, Case of, successfully treated . . 44 

Di£Sculty of Breathing, Case of. Cured by Quinine . 46 
Stethoscope, Value of . . . . ,50 

Continued Fever, so called, nature of . . .53 

Consumption, nature of, with Cases . . .55 

Gout— its nature — Rheumatism . . . .61 

Stone — How Formed . . , . .62 

Tumors — How Developed . . . .64 

Eruptive Diseases . . . . .67 

Plague ....... 70 

Yellow Fever— Jaundice . . . .72 

Cholera ......* 75 



VI 



Inflammation 

Hysteria and Hypochondria 

Diseases of Females 

Fregaanej 

Parturition 

Abortion, Prevention of • 



Part II. — Comprising — Rbmediss and their Mode of Action 89 

By the Senses ...... 91 

By the Passions ...... 98 

Baths, Gold Affusion . . . .101 

Mineral Waters ....*. 102 

Exercise, Change of Air . • . • .103 

Plasters, Bandages ..... 107 

Medicine and Poison, Identical . . .110 

Emetics . . . . . .114 

Purgatives . . . .117 

Mercury . . . . .119 

Peruvian Bark, Quinine . .124 

Prussic Acid ...... ISO 

Tar, Creosote . . . • .135 

Opium, Morphia ..... 136 

Alcohol ... ... 138 

Musk, Valerian, Camphor, Assafcetida . . .139 

Sulphur ...... 139 

Colchicum, Guadac, Turpentine, Copaiba, Cubebs, Cantha- 
rides. Squill, Digitalis, Iodine, the Mineral Acids, the 
Earths, tiie Alcalis, and their Combinations . 140 

Strychnia, Brucine 

Silver 



PAGE 

76 
80 
84 
86 
87 
88 



Copper . 

Iron 

Lead 

Arsenic 

Bloodletting 

Abstinence 
Conclusion 
Appendix 



143 

144 

147 

147 

149 

152 

160 

186 
188 
196 



THE 



UNITY OF DISEASE. 



INTRODUCTION. 

"The acute understanding,** says Sir James 
Mackintosh, "is the talent of the logician; and 
its province is the detection oi fallacy. The com- 
prehensive understanding discovers the Identity 
of facts which seem dissimilar, and binds together 
into a system the most apparently unconnected 
and unlike results of experience." 

I know not that I could offer a more felicitous 
quotation to such of my readers as might feel dis- 
posed to quarrel with me at starting, on the score 
of the title. The propriety of its adoption will 
be more readily admitted, after an attentive pe- 
rusal of the work itself. 

We daily hear of the march of intellect — of the 
progress or perfection of many sciences. Has 
Medicine kept pace with the other arts of life — 

B 



Vlll 



has it fallen short or excelled them, in the rivalry 
of improvement ? This question will be variously 
answered. The more youthful and inexperienced 
members of the profession will naturally assign a 
high degree of excellence to their favorite pur- 
suit ; — some of them will even smile at a question 
which they suppose to have been long settled. 
These rely for the most part on two great sources 
of error — the boasting assertions of their teachers 
— and the misrepresentations of the medical press, 
which, like the newspapers of the day, is too 
often the mere organ of a party — crushing down 
or mystifying every truth, that militates against 
the interests of a particular college or school. 
The late Sir William Knighton was a gentleman, 
and a scholar ; — to the observation and experience 
of the physician he joined a perfect knowledge 
of the literature and science of his age. His 
opinion of the later state of our art will, there- 
fore, be listened to with respect: — "It is some- 
what strange," he says, "that though in many arts 
and sciences, improvement has advanced in a step 
of regular progression from the first, in others it 
has kept no pace with time, and we look back to 
ancient excellence with wonder, not unmixed 
with awe. Medicine seems to be one of those 
ill-fated arts whose improvement bears no pro- 
portion to its antiquity. This is lamentably 



IX 



true, although anatomy has been better illus- 
trated, the materia medica enlarged, and chemis- 
try better understood." 

If we believe Heberden, — "The practice of 
physic has been more improved by the casual ex- 
periments of illiterate nations, and the rash ones 
of vagabond quacks, than by all the reasoning of 
all the once celebrated professors of it, and theo- 
retic teachers in the several schools of Europe ; 
very few of whom have furnished us with one 
new medicine, or have taught us better to use our 
old ones, or have in any one instance at all im- 
proved the art of curing disease. Hence, though 
they have been applauded during the lives of their 
disciples, yet disinterested and impartial posterity 
has suffered each succeeding master of this sort 
to be gathered to his once equally famous prede- 
cessors, and to be, like them, in his turn, equally 
unread and forgotten." — Heberden^s Comment 
taries. 

The mechanic views of Boerhaave, the spas- 
modic notions of Hoffman and CuUen — the putrid 
doctrines of Pringle — the sympathetic theory of 
Darwin — each has had its day — each, among 
others, has influenced, and ceased to influence 
the medical practice of Europe ! How long may 
we expect the Pathological doctrines at present pre- 
vailing in the schools, to maintain the supremacy 



which the fashion ©f the time has assigned to 
them! 

Celsus observed long ago : — " Morbi non elo- 
quentia sed remediis curantur.^* Yet, strange 
to say, since his time, professors of physic have 
almost one and all been as forward to adopt new 
names and distinctions, as they have ever shewn 
a holy horror of innovation in the shape of reme- 
dies. Under the influence of the schoolmen, the 
Parliament of Paris, in 1566, declared it penal to 
prescribe antimony as a medicine ; simply because 
it was a metal with whose virtues those who de- 
cried it were unacquainted ; and so late as 1693, 
Dr. Groenvelt was committed to Newgate, by war- 
rant of the president of the College of Physicians, 
for administering Cantharides internally — a prac- 
tice now universal. When the invaluable bark 
was first introduced by the Jesuits, the medical 
hypocrites of the time made that circumstance 
their chief reason for excluding it from the Ma- 
teria Medica, under the pretence that being a 
Popish remedy, it must necessarily be of the 
Devil's invention I 

With these facts before our eyes, can we won- 
der that many should doubt the art of medicine ? 
or, can we blame those who fly to the charlatan 
for that aid which the schoolman, having pro- 
mised, so often fails to accord? 



XI 



The integrity of the physician has been sus- 
pected — ^nay, it has become a matter of ques- 
tion-unfortunately. too, with more than a mere 
show of reason. 

Lady M. W. Montague, for example, held no 
very high opinion of medical disinterestedness. 
In one of her letters from Adrianople, she intro- 
duces the subject of small-pox inoculation 
in the following words : — ** I am patriot enough 
to take pains to bring this useful invention into 
fashion in England; and I should not fail to 
write to some of our Doctors very particularly 
about it, if I knew any one of them that I 
thought had virtue enough to destroy such a con- 
siderable branch of his revenue for the good of 
mankind. But that distemper is too beneficial 
to them, not to expose to all their resentment, 
the hardy wight that should undertake to put an 
end to it." That she did not judge too harshly 
of the profession of her day, may be gleaned 
from the following extract from anecdotes of her 
life, by Lord Whamcliffe : — " Lady Mary,** says 
his Lordship, " protested, that in the four or five 
years immediately succeeding her arrival at home, 
she seldom passed a day without repenting of 
her patriotic undertaking; and she vowed that 
she never would have attempted it if she had 
foreseen the vexation, the persecution, and even 



Xll 



the obloquy it brought upon her. The clamours 
raised against the practice, and of course, against 
her, were beyond belief. The faculty all rose 
in arms to a man, foretelling failure and the 
most disastrous consequences. The clergy de- 
scanted from their pulpits on the impiety of thus 
seeking to take events out of the hands of Provi- 
dence ; the common people were taught to hoot 
at her as an unnatural mother, who had risked 
the lives of her own children ; and, notwith- 
standing that, she soon gained many supporters 
amongst the higher and more enlightened classes, 
headed by the Princess of Wales, (Queen Caro- 
line) who stood by her firmly, some, even of 
her acquaintances were weak enough to join in 
the outcry. 

"We now read in grave medical biography, 
that the discovery was instantly hailed, and the 
method adopted by the principal members of that 
profession. Very likely they left this recorded — 
for whenever an invention or a project — and the 
same may be said of persons — has made its way 
so well by itself as to establish a certain reputa- 
tion, most people are sure to find out that they 
always patronized it from the beginning ; — and a 
happy gift of forgetfulness enables many to be- 
lieve their own assertion. But what said Lady 
Mary of the actual fact and actual time ? Why, 



Xlll 



that the four great physicians deputed by govern- 
ment to watch the progress of her daughter's 
inoculation, betrayed, not only such incredulity 
as to its success, but such an unwillingness to 
have it succeed^ such an evident spirit of rancour 
and malignity, that she never cared to leave the 
child alone with them one second, lest it should, 
in some secret way, suffer from their interference." 

When Jenner, the greatest medical discoverer 
of any age, and the most noble benefactor of the 
entire human race, first promulgated his doctrine 
of Vaccination, he was scarcely listened to by the 
profession. Nay, after the benefits which his 
practice had conferred upon mankind, were 
brought to the level of the meanest capacity by 
demonstrative truth, there were not wanting 
men to oppose him with all the rancour of abuse, 
and the studied invective of personal malignity. 
The Bible itself was made an engine of attack 1 
Erhmann, of Frankfort, among others, made this 
his chief ground of charge, attempting "to prove 
from quotations of the prophetical parts of Scrip- 
ture, and the writings of the fathers of the 
Church, that the vaccine was nothing less than 
Antichrist !'* — Di\ BarovUs Life of Jenner. 

Can anything be more painful to the feelings 
of men pretending to a liberal profession, than 
disclosures like these ? — or xsxxMsXwe be compelled 



XIV 



to the humiliating confer3ioii, that the professors 
of our art difiFer, in no respect, from the rest 
of mankind, who, according to Mr. Hazlitt, 
"generally stick to an opinion that they have 
long supported and that supports them /" 

Medicine, nevertheless, when stripped of the 
verbiage and vain distinctions which practically, 
even to the practitioner, render it a useless study, 
will be found to be, not only a simple, but a satis- 
factory art. For the elucidation of this, it is 
necessary to give a different explanation to many 
facts from what has been usually assigned to 
them. Let not the reader start at this declara- 
tion. Facts can only have a value when properly 
represented. " Nothing," says Velpeau, " can lie 
like Sijact. Who has not understood facts a thou- 
sand times different from what they really are ? 
It is, if I may use the expression, because they 
are the greatest hypocrites in the world : they pre- 
sent themselves every day to our eyes under the 
most deceitful appearances — they seem to court 
all those that approach them, and hasten to adopt 
the language most pleasing to each. From the 
time of Hippocrates to the present, they seem to 
wish to deceive all mankind. Pinel referred to 
facts to prove that all diseases originate in the 
solids — to me, these very facts demonstrate that, 
many affections commence in the fluids. In a 



XV 



certain hospital, faxjts would lead us to believe that 
antiphlogistics may prevent, or even cure cancer 
of the womb ; while, to my thinking, they inti- 
mate a result precisely the reverse ; they permit, 
on one side, the assertion of the cure of white 
swelling — the advantage of amputation of the 
neck of the uterus — on the other side they con- 
tradict it. Enquire the treatment of Erysipelas : — 
According to one authority, the best practice is 
the application of mercurial ointment ; another 
recommends the lancet; a third, nitrate of sil- 
ver; a fourth, blisters. Facts would prove to 
me that all these practitioners are mistaken.** 

Take another example — Pulmonary Consump- 
tion. "One writer (Stohl) attributes the fre- 
quency of consumption, to the introduction of 
Peruvian bark ; another (Morton) considers the 
bark an effectual cure ; a third (Reid) ascribes 
the frequency of the disease to the use of mer- 
cury ; a fourth (Brillonet) asserts that it is only 
curable by this mineral ; a fifth (Rush) says that 
consumption is an inflaimnatory disease, and 
should be treated by bleeding, purging, cooling 
medicines, and starvation ; whilst a sixth (Salva- 
dor!) says it is a disease of debility, and should be 
treated by tonics, stimulating remedies, and a gene- 
rous diet. Galen recommended vinegar as the best 
preventive of consumption. Desault and others 



XVI 



assert that consumption is often brought on by a 
common practice with young people, of taking 
vinegar to prevent obesity. Dr. Beddoes recom- 
mended foxglove as a specific in consumption; 
Dr. Parr found foxglove more injurious in his 
practice than beneficial.** — Sh^ Arthur Clark. 

Now what are we to infer from all this ? Not 
as some might be tempted to believe, that the 
profession is dishonest or deceptive throughout, 
but that its members, to this very hour, know 
nothing of the true principles upon which reme- 
dies act; and as little of the true nature of the 
diseases of which they treat. To my mind, it 
verifies the vulgar adage that — "What is one 
man's meat, is another man's poison." For al- 
most all the remedies which these authors have 
either lauded or decried, may, as we shall here- 
after shew, cure, cause, aggravate, or ameliorate 
any given case of disease, according to the dose 
and constitution of the respective patients for 
whom they may be prescribed. 

^^li false facts J* says Lord Bacon, "be once on 
foot, what, through neglect of examination, the 
countenance of antiquity, and the use made of- 
them in discourse, they are scarce ever retracted." 
We have but too many such facts in medicine. — 
The late Dr. Gregory, a high authority, used 
ex cathedray to declare that ninety-ninc out of 



XVll 



a hundred medical facts, were medical lies — and 
that medical doctrines were generally "little better 
than stark-staring nonsense!" This, then, is a key 
to the difficulties which beset the study of physic 
— for what so difficult to understand as nonsense ? 
or, when clothed in phrases which now admit 
one sense, now another, what so difficult to re- 
fute? "Nothing, says Sir Humphry Davy, has 
so much checked the progress of philosophy, as 
the confidence of teachers, in delivering dogmas 
as truthsj which it would be presumptuous to 
question. It was this spirit which for more than 
ten centuries made the crude physics of Aristotle 
the natural philosophy of the whole of Europe. 
It was this spirit which produced the imprison- 
ment of the elder Bacon, and the recantation of 
Galileo. It is this spirit, notwithstanding the 
example of the second Bax^on, assisted by his re- 
proof, his genius, and his influence, which has, 
even in later times, attaxjhed men to imaginary 
systems, to mere abstracted combinations of 
WORDS, rather than to the visible and living 
world, and which has often induced them to de- 
light more in brilliant dreams, than in beautiful 
and grand realities." 

The mere student, accustomed to these "ab- 
stracted combinations of words" of the schools, 
will find it difficult to divest himself of the 



XVlll 



erroneous and mystical distinctions of his teachers. 
For "in the physical sciences,** — I again quote Sir 
H. Davy — " there are much greater obstacles in 
overcoming old errors, than in discovering new 
truths — the mind in the first case being fettered 
— ^in the last perfectly free in its progress.** 

In the early history of every people we find the 
priest exercising the functions of the physician. 
The traces of this clerical influence on our art are 
not yet extinct in England; for though our church- 
men have long ceased to arrogate to themselves the 
power of healing, an Archbishop of Canterbury 
is still permitted by the laws of his country to con- 
fer degrees in physic ! Nor does he fail, even in 
these days, to avail himself occasionally of his pre- 
rogative. We will not enter upon a consideration 
of the numerous theories and systems that have 
alternately flourished and fallen since medicine 
ceased to be practised exclusively by the priest- 
hood. It is enough to mention a few of the 
notions that have, among others, influenced for a 
time the treatment of disease. The causes of dis- 
order have been successively supposed to be a hti- 
mor to be expelled by purgation, sweating, &c. ; 
an acrimony to be blunted by sweeteners and tem- 
perants ; a crudity to be solved by diluents ; an 
acidity to be chemically neutralized ; a putridity 
to be conquered by antiseptics. The greater 



xix 



number of the modems look upon disease as the 
result of inflammation, which can only be subdued 
by leech or lancet. Practitioners of all ages have 
spoken of the cause of disorder as an entity or 
essence — a something noxious to be removed or 
eliminated from the body. The terms " eradica- 
tion, extirpation," &c., would lead us to doubt 
whether the most eminent professors of the pre- 
sent day, hold any other opinion. Be this as it 
may, we shall, in the sequel, shew that the most 
perfect unity or identity pervades all morbid 
action, whatever be its cause or character — and, 
by consequence, the vanity of the disputes which 
daily occur in practice, whether disorders resem- 
bling each other, and amenable to the same treat- 
ment, should be called by one name or another. 
In the language of Hobbes — "Words are wise 
men's counters — ^they do but reckon by them, 
but they are the money of fools that value them 
by the authority of an Aristotle, a Cicero, a 
Thomas Aquinas, or any other doctor whatsoever.*' 
It is surely full time that disputes about the 
nature of morbid action should cease to resolve 
themselves into discussions about vowels and con- 
sonants. Can any thing be more absurd than to 
discuss whether particular phenomens^ should be 
termed Gout or Rheumatism — the one being 
merely a corruption of the French word goutte^ 



XX 



a drop or humour ; the other, a derivation from 
the Greek, of identical import and signification. 
Men who indulge in such puerilities, take their 
ideas from the humoral school. When they think 
to excel as physicians, they only shew themselves 
to be contemptible philologists ! 

Were the cultivation of the dead languages^ 
and the dissection of dead bodies^ equivalent to 
an acquaintance with living action, we should not 
have so often to deplore the unseemly disputes that 
to this hour agitate the schools of medicine. But, 
as scarcely any two of these agree upon a medical 
point, even where they are imanimous in a 
medical name ; it is to be feared, that the very 
terms applied to disordered states, together with 
a too minute attention to pathological distinc- 
tions, have contributed more to set the profession 
by the ears, than to the proper end of the me- 
dical art itself — the amelioration of the condition 
of suffering man. 

How can the laws of living action, morbid 
or sane, be discovered, but by a close attention 
to the phenomena of health and disease, during 
life? ** Without this philosophical view of the 
parts and functions of the living body, practice is 
not experience; and grey hairs and length of 
years bespeak only stubbornness in prejudice, and 
ill-founded claims to deference and respect." — 
J. Bell 



XXI 



In the course of my professional career, I was 
early staggered with the inadequacy of "received 
doctrines," either to explain disease or cure it. 
I therefore determined to read anew the Book of 
Nature rather than trust to the reports of the 
commentators. To this investigation I came with 
a diflferent spirit from that with which I entered 
the schools of physic. In my noviciate, I yielded 
implicit faith to my teachers. In my later re- 
searches alter truth, I had to guard myself as 
much against a too rigorous scepticism of their 
facts, as a too great contempt of their opinions. 

I have thus heen enabled to place before the 
profession a doctrine of disease, which when its 
novelty shall have ceased to startle, will, from its 
simplicity and universality of application, not (I 
hope) unfavorably contrast with the chaos of con- 
tradiction which professors have so long imposed 
upon themselves and the world, in lieu of true 
medical science and philosophy. 

The most perfect theory is on all hands allowed 
to be that which can reconcile the greatest num- 
ber of facts. Till my readers shall detect one real 
fact militating against the truth of the views 
which I am now about to develope; let them 
not vaguely charge their author with innovation 
as a crime! Hippocrates, Galen, Boerhaave, 
CuUen, were every one of them innovators, nay. 



xxu 



REVOLUTIONISTS in Medicine. The revolution I 
meditate, unlike those of some of my predecessors, 
is at least free from the imputation of being san- 
guinary in its character. 

Can all the men, who, from the time of Hip- 
pocrates to the present, have made disease their 
study, be in darkness and error ? Such a ques- 
tion will only shock the superficial ; — ^it will only 
prove a stumbling-block to those who know not 
the contradictory nature of the opinions and 
practice of the reputed masters of the medical 
art. 

The schools of Egypt and Arabia — ^the emi- 
nent men of Greece and Rome — ^the great ana- 
tomical teachers and philosophers of the middle 
ages, knew not the Circulation of the Blood. 
How wild were their theories, how fanciful their 
hypotheses, may be gleaned from their naming 
certain blood-vessels, arteries or a?r-vessels, — 
tubes which you have only to wound to see 
them spout out the living current in jets, 
were for ages supposed to contain airl What 
innumerable fallacies must have entered into 
reasoning, founded upon such premises. Yet it 
was not tiU the seventeenth century, that the illus- 
trious Harvey demonstrated the true nature of the 
arteries, and the manner in which the blood cir- 
culates through the body. The more immediate 



XXUl 



reward of his discovery was, calumny, misre- 
presentation, and loss of his professional prac- 
tice ; — the vile and venal of his medical brethren 
made it a pretext for declining to meet him in 
consultation ! He lived, nevertheless, to neutra- 
lize the malice of his enemies, and to become the 
successive physician of two monarchs — the first 
James, and the martyr Charles. 

The more you explain and make easy the prin- 
ciples of any science, the more that science is 
found to approach perfection. The true philoso- 
pher has always studied to simplify the apparently 
wonderfiil — the schools, on the contrary, have as 
invariably endeavoured to perplex, and make the 
most simple things difficult of access. Any expo- 
sition of the simplicity which pervades a particular 
science, will be sure to meet the censure of schools 
and colleges ; nor wiU their disciples always for- 
give you for making that easy which they them- 
selves, after years of study, have declared to be 
incomprehensible! "In the intellectual, as in 
the physical, men grasp you firmly and tenaciously 
by the hand, creeping close at your side step by 
step, while you take them into darkness — but 
when you lead them into sudden light they start 
and quit you.*' — W. Savage Landor. 



THE 



UNITY OF DISEASE. 



Part I. 



^^^»»^^^'»^%^»^%^>^»*»^>i^^>^l^^^^^»#M^^>^^'»»V^^»W^^ 



coKPBisnta 



THE PHENOMENA OF 



HEALTH AND DISEASE 



To understand aright the varying phases of 
Disease, the student should first become acquainted 
with the phenomena of Health, technically termed 
physiology. Can this be learned from vivisec^ 
tion,— from cruel experiments on anhnals, whose 
various functions must all be more or less disor- 
dered by their dying agonies? Study rather 
the habitudes of living man in his separate and 
conjoint relations, and you will have little diffi- 
culty in comprehending the true nature of 

HEALTH. 

In this state, an equable and medium tempera- 



2 THE UNITY 

ture prevails throughout the hody. The volun- 
tary and other muscles ohey with alacrity the 
several necessities that call them into action. 
The mind neither sinks nor rises hut upon great 
emergencies ; the respiration easy and continuous, 
requires no hurried effort, no lengthened sigh. 
The heart is equal in its heats, and not easily 
disturbed; the appetite moderate and uniform. 
At their appointed time and occasion, the various 
secretmg organs perform their office. The struc- 
tures of the body, so far as bulk is concerned, 
remain to appearance unchanged ; their possessor 
being neither cumbered with obesity, nor wasted 
to a shadow. His sensorium is neither painfully 
acute, nor morbidly apathetic. He preserves in 
this instance, as in every other, a happy mode- 
ration. His sleep is tranquil — ^refreshing. 

If we analize these various phenomena, we 
shall find them all to consist of a series of alter- 
nate actions, — actions for the fulfilment of which, 
various spaces of time are requisite, — some being 
diurnal, some returning in a greater or lesser 
number of hours, while others are in constant 
or momentary succession. 

In health, man rests from his labour; — ^he 
sleeps, — ^he wakes to labour and sleep again — ^his 
food and drink, nutritious one hour, become ex- 
crementitious the next — every appetite and neces- 



OF DISEASE. 3 

sity periodically alternating* His lungs now in- 
spire air, now expel it — ^his heart successively 
dilates and contracts — ^his blood brightens in 
one set of vessels only again to darken in another. 
M^at is the sum total of our common lot, but a 
succession of petty joys and sorrows, hopes and 
fears ? The very process by which we colne into 
the world, parturition — ^is a series of pains and 
remissions. 

Every particle of the material body is constantly 
undergoing a revolution or alternation ; — ^fluid one 
hour, it becomes solid the next — ever and anon 
varying its properties, colour, and combinations, 
as in brief, but regular succession, it assumes the 
nature and character of every tissue and texture 
entering into the composition of the corporeal 
frame. It is *' all things by Jits and nothing long.'' 

Those who ascribe the source of animal heat 
exclusively to the action of the lungs, have for- 
gotten this fact — ^they have forgotten that in the 
constant mutation of its atoms, every organ, nay, 
every particle of the body, being ever in motion, 
must equally contribute to this end. For, accord- 
ing to the universally admitted axiom in physics, 
there can be no motion in matter without change 
of temperature ; and no change of temperature 
without motion in matter. 

"In the course of life man appears in the 



4 THE UNITY 

changes to which his frame is subjected, to go 
through several types of configuration. The 
same individual, who had once in the womb 
of his parent the shape of a worm, and, that 
subsequently, rapidly traversed the types of other 
gradations of the lower animals, and became 
an mfant breathing the surrounding ah-, is by 
no me«B to be Jog^ <« idenL with the 
Vigorous man Of thirty.five. His physigonomy 
alone points out the change effected on him." — 
Ashhurner. 

We shall now enter upon a consideration of 
the nature of 

DISEASE. 

Disease is neither a devil to cast out, a hu- 
mour to be expelled, nor an acrimony to be 
blunted ; neither is it an acidity to be neutralized, 
nor a putridity to be chemically solved. It is a 
state to he improved — a corporeal variation 
reducible like health, into a series of particular 
mutations, — ^mutations, in the course of which, 
the matter of the same body, by a sunple difference 
in the amount of its action and temperature, 
occasionally alters its character and combinations. 

We shall first speak of the more simple devia- 
tions from health. 

From the early derangement of the corporeal 
temperature, the patient complains of partial or 



OF DISEASE. 5 

general heat or cold ; — Im muscles less undei; the 
control of their respective influences become tre- 
mulous, spasmodic — or wearied, palsied the func- 
tions of particular muscles cease* The breathing 
is hurried on slight exertion, or it is maintained 
slowly and at intervals, and with a long occa- 
sional inspiration, that scarcely makes up for 
interrupted .pulmonary action. The heart is 
quick, palpitating, or languid, and remittent in 
its beats, — ^the appetite craving, capricious, or 
lost. The secretions are either hurried and in- 
creased in quantity, or sluggish or suppressed ; 
the body wastes or becomes, in part or in whole, 
pretematuraUy tumid and bloated. Alive to the 
slightest stimulus, the patient is easily impassioned 
or depressed ; his mind, comprehending in its 
various relations, every shade of imreasonable 
sadness or gaiety, prodigality or cupidity, vacil- 
lation or pertinacity, suspicious caution, or too 
confident security, with every colour of imagina- 
tion, from highly intellectual conception, to the 
dream-like vagaries of hallucination I His sen- 
sations are perceptibly diminished or increased. 
Light and sound, for example, confuse and dis- 
tract him. Like the soft sybarite, a roseleaf 
ruffles him. With the smallest increase of tem- 
perature, he becomes hot and uncomfortable, and 
feels chilled and shivery in the slightest breeze ; 



6 THE UNITY 

or, as you sometimes behold him, in extreme 
age or idiocy, equally insensible to excess of 
light, sound, heat, or cold. His sleep is bro- 
ken, crowded with dreams ; or, so perfectly lethar- 
gic, it is difficult to rouse him. 

Let the reader contrast simple disease with 
what we have said of healthy and he will, at a 
glance perceive, that the difference consists in 
mere variation of the sum or amount of the na- 
tural corporeal action and temperature. Struc- 
tural lesion so frequently but erroneously asso- 
ciated with disease as a cause, is not even neces- 
sary to the production of disorder ; nor is it 
necessary to a fatal termination. It is a pheno- 
menon which may or may not arise in the course 
of a malady, according to the constitution of the 
individual 

CAUSES OF DISEASE. 

The causes of disease are infinite — ^they affect 
the body principally from without— acting upon it 
in the first place through the different modifica- 
tions of nervous perception* — and seldom, if 
ever, originating in any one organ of the body— 
for before a vital part can be materially impUcated, 
all must be more or less involved. " I conceive 

* By perception I mean more than mere sensation. The system 
may perceive and be acted upon by any agent — mercury for ex^ 
ample — without any of ike five senses being made aware of it. 



OF DISEASE. 7 

(with Hobbes) that nothing taketh beginning from 
itself, but from the action of some immediate agent 
without itself." The Pathological schools preach 
a different doctrine. 

The too exclusive spirit in which morbid ana- 
tomy has been for a long period cultivated, not in 
England only, but throughout Europe, has given 
rise to a class of medical materialists, who, hoping 
to find the origin of every disorder made manifest 
by the scalpel, are ever mistaking effects for causes. 
Loth to believe that death may take place without 
even a palpable change of structure, these gentle- 
men direct their attention to the minutiss of the 
dead, and finding in their search some petty en- 
largement, some trifling engorgement, or it may 
be, some formidable tumor or abscess, hastily set 
this down as the first cause of a disease of which 
it was only a developement 1 

'^ The great error of these localisms of disease 
(says the late Dr. Uwins,) is putting consequence 
for eause, incident for source, change in the con- 
dition of blood vessels for powers producing such 
change. It is an error which has its origin in the 
blood and filth of the dissecting room ; and which 
tends to degrade medicine from the dignity of a 
science, down to the mere details of an art." 

With this view of the matter, Mr. Travers 
completely concurs. " The effect of morbid ana- 



8 THE UNITY 

tomy holding the first, and afanost the only place 
m the mind of the medical enquirer, (says that 
gentleman) is to substitute effect for cause, the 
laws of physics for the laws of life — to confound 
the cause of death with the cause of disease ; and 
in short to obscure by attempts at simplification.'' 
Let those who haye most sedulously engaged in 
the cultivation of pathology tell us what has been 
the result of their labours. They will refer, 
doubtless, to change of eyery kind and character, 
and learnedly enter into the detail of each. But 
what advantages can they shew us ; has this kind 
of study contributed to the healing art ? May 
not these be fairly summed up in two lines of 
Gray's Odd Story ?— 

" Rich windows that exdade the light, 
And passages that lead to nothing.*' 

Indeed, so great a stumbling-block to a proper 
knowledge of medicine is this exclusive, and too 
minute cultivation of morbid dissection that Dr. 
Baillie, its greatest patron, confessed on retiring 
from practice, his total want of faith in physic. 
In other words, he admitted his entire ignorance 
of the principles of a profession by which he had 
amassed a fortune I The experience of his whole 
life was equally a satire on morbid anatomy, 
and the value attaching to medical reputation* 
The celebrated Brown, long ago, cautioned his 



OF DISEASE. 9 

disciples against an error which the over zealous 
investigators of diseased structure, even in his 
day, but too successfully propagated. Do not, he 
says, look for the causes of disease in dead bodies! 

The earth, the air, the degrees of temperature, 
dryness, and moisture of each, the nature and ex- 
tent of our food and drink, our various modes and 
means of obtaining these, with all the other 
chances and changes of our social and individual 
position — these are the elements to which we 
must look for the variations betwixt health and 
disorder. 

HaviQg alluded to the errors of the Pathologi- 
cal school, we may now glance at the doctrines of 
another class of exclusives — those, who, with the 
quantity or quality of our food or air, associate 
every disorder. The late Mr. Abemethy, to 
whom science nevertheless owes much, was an 
example of the first. To the stomach and bowels 
he almost invariably pointed as the cause of every 
disturbance. He forgot his own observation that 
a passion or a blow could alter the secretions of 
both. He ascribed the first link in the chain of 
causes to a feature which could only be improved 
by an agent affecting the nervous or perceptive 
system, in which that and every other symptom 
could alone have their origin. 

But what shall we say of those who attribute 



10 THE UNITY 

every disorder (particularly if they have disco- 
vered the phenomenon of remittency of its symp- 
toms) to malaria, or marsh-masma? — as if there 
could be no such change in the constitution, in- 
dependent of change ci air I Man is not an iso- 
lated bemg, without food and air he cannot 
exist, — ^but his success in life, his reception from 
friend or foe, the state of his family or finances, 
will equally periodically excite, depress, and dis- 
orfer hi, ^.u. orgJs .nd ^«n^ » a de- 
privation or depravity of the food he eats, or the 
air he breathes. An unexpected reverse of for- 
tune, good or bad, may lay the foundation of 
many Ldes of dke«e f 4 we a« not without 
examples of mdiTidoal, imtantajieously eximring, 
both from too intense grief and joy. 

^^It has been too much the fashion in philoso- 
phy, to refer operations and effects to single agen- 
cies, but there are, in fact, in nature^ two grand 
species of relationships between phenomena;— in 
one, an infinite variety of effects is produced by a 
single cause ; in the other, a great variety of 
causes is subservient to one effect.'* — SirH. Davy. 

All this applies equally to disease, and the 
causes of disease. 

Let the student carefully examine outward 
parts, he will find that no variation in these, — ^not 
even the most minute, is unax^companied by con- 



OF DISEASE. 11 

stitutional disorder; but the local derangement 
which may principally attract the eye, is for the 
most part a mere symptom or feature in com- 
mon : seldom the first — though sometimes a se- 
condary cause of general disorder. If a man 
wound his hand with a knife, and he at the 
same time in health, it will speedily heal by rest 
and attention to position. Should the wound de- 
generate into an ulcer, that man shall be chilly 
and heated by turns; you will find him more 
than usually anxious about trifles, with capricious 
appetite and dispositions : in a word, all his va- 
rious functions, varying at least a shade from 
those of health — some being diminished, others 
exalted; and the greater the variation, the worse 
the disease. Here your exclusively anatomical 
physicians wiU fix upon some internal organ as 
the cause of all this. One will apply himself to 
the stomach, another to the liver ; and, as these 
viscera cannot be altogether right, where so much 
is wrong, it were strange, if by pressing or per- 
cussing, they do not compel their patient to ac- 
knowledge pain or tenderness in the particular 
structure which they maltreat the most, and then 
stigmatize as the most offending part. To this, 
and this only directing their attention, they will 
be at no loss, should the patient die, to find what 
each particularly desires. One will detect hepa- 



12 THE UNITY 

tic change; another, gastric congestion. In the 
full enjoyment of his own opinion, each departs 
triumphant I Should the patient recover, the 
success of the treatment will he vaunted in confir- 
mation of the error. Mercury, possihly, has, in 
some of its comhinations, heen administered. 
The first maintains it has induhitahly improved 
the liver; the second, that it has exerted some 
mysterious influence over the stomach. Do phy- 
sicians forget that this metal can cure general dis- 
ease ; can arrest disorder arismg solely from an 
external agent, such as cold ? Let them recur to 
the symptoms — ^they will find the patient laboured 
under a general derangement, which some call one 
thing, some another : but which, I am perfectly 
contented to term loss of health: or, if my 
reader will not be satisfied without a medical name 
— Fever, aye, and Remitting ; for there is no 
corporeal state, morbid or sane, that can be said 
to be constant or unremittingly fixed. If human 
life has been truly stated to be " a Jitful fever,'* 
we shall not be astonished to find 

INTERMITTENT FEVER THE TYPE OF ALL 

DISEASE. 

The beautiful unity which pervades organic 
structure, throughout the numerous varieties of 
animal existence, has been already satisfactorily 
demonstrated, both by foreign and domestic 



OF DISEASE. 13 

writers. To the discovery of this universal type 
of organization, Comparative Anatomy owes its 
elevation to the dignity of a science. A similar 
primitive type of miity will be found to prevail 
throughout all the various changes which we re- 
cognize as morbid in man. " All diseases,'' says 
Hippocrates, " have a resemblance in their form, 
invasion, march, and decline." Far from being a 
fanciful analogy, this similitude when rigidly scru- 
tinized, will be found to resolve itself into a per- 
fect unity of symptom ; one man's disease differ- 
ing from that of another only in the general 
constitutional shade, or in the mere difference of 
organization of the tissue, which shall shew the 
greatest tendency to general or partial decomposi- 
tion in its course. 

When treating of the phenomena constituting 
health, we took occasion to call the attention of 
the reader to the periodic action anJ rest exhi- 
bited in their diurnal and other revolutions. What 
is sleep but a periodical palsy of the nerves of the 
five senses.* What is death? A permanent 

* When the leg or arm labours under temporary palsy, it is in 
common discourse said to be asleep. During somnambulism some 
of the senses must be awake — sight and the power of volition must. 
Judgement, decidedly not. The phantasmagoria of a dream re- 
semble the hallucinations of mania. The acts of mania and som- 
nambulism are often one and the same. The somnambulist will 
see the water and walk into it — so will the maniac— and both are 
drowned. 



14 THE UNITY 

palsy of every organic perception. The body un- 
der disease exhibits revolutions analogous to those 
in health — it shews a similar tendency to alternate 
motion and repose ; for periods more or less regu- 
lar are observed to mark the approach, duration, 
and interval of recurrence of the morbid phases. 
These revolutions, in the language of the schools, 
are termed the paroxysm and remission ; but so 
far from having been recognized as a law of uni- 
versal occurrence, periodicity has been vaguely 
supposed to stamp the disorders in which it has 
not been overlooked as the exclusive ofispring of 
a malarious or miasmatic atmosphere. . The word 
AOUE, synonymous with intermittent fever, is 
the phrase which popularly embraces all diseases 
in which the patients have chills and heats with 
periodic exemption from both. We shall, in the 
sequel, establish that no disorder, however named 
or caused, is deficient in either of these respects ; 
thati in a word, there is no morbid state that is 
not preceded or accompanied by alternations of 
temperature, or that does not exhibit remissions 
and paroxysms of a more or less periodic kind 
throughout its course. 

In the succession of phenomena which indicate 
intermittent fever, the philosophic physician will 
readily detect the type of that unity of action, 
which, in the sequel, we hope to demonstrate, 
pervades all the various shades of human disease. 



OF DISEASE. 15 

The ague-patient, as every body knows, has, 
among other symptoms, a chill, heat, and sweat, 
alternating with a comparatiye state of health. 
During the phases of the paroxysm, all or nearly 
all the various functions of the body are dis- 
ordered. The ascertainable temperature is one 
hour deficient, another raised above the healthy 
standard. The muscles become tremulous or 
spasmodic, the secretions increased or decreased, 
the mental powers depressed or deliriously ex- 
alted. Of such morbid variations, you may have 
many shades. 

The following case exemplifies some of the less 
common phenomena : — " Miss * * * , aged nine- 
teeny had bathed a few times, about a month 
before, in a cold spring, and was always much 
indisposed after it. She was seized with sick- 
ness and cold shuddering, with very quick pulse, 
which was succeeded by a violent hot fit. During 
the nsxt cold paroxyism she had a convulsion fit, 
and after thai symptoms of insanity , so as to 
strike and bite the attendants, and to speak furious 
language." — Darwin. Nobody, I presume, will 
attribute this lady's disease to marsh-miasma ; 
yet, here we have most of the characteristics of 
ague, including remission and exacerbation^ with 
MANIA superadded. 

D 



16 THE UNITY 

The next case is somewhat similar, though 
arising from another and very different cause : — 
*^A young lady was ahout to he married to a 
gentleman who was accidentally kiUed on the even- 
ing hefore the morning on which the marriage 
was to have been solemnized. She became de- 
ranged and was confined to a lunatic asylum. 
The paroxysm made its attack every day at the 
same time, and continued several hours, but dur- 
ing the remainder of the day she appeared per- 
fectly sane.*^ — A. T. Thomson. In this, a case 
illustrative of disease from the passions, we fibad 
the most perfect periodic remission and exacerba- 
tion. The nairator says nothing respecting tern- 
perature, but, if we have any doubt on this head, 
wc need only look into a lunatic asylum, and 
we shall find the patients, when in the paroxysm, 
exhibiting every stage of temperature characteris- 
tic of the Jit of intermittent fever. Sir William 
Ellis, whose great experience in maniacal cases, 
entitles him to credit, informs us that he seldom 
ever examined the head of a lunatic without find- 
ing the temperature greater than natural. 

A remarkable case of ague from the passions is 
briefly alluded to by Mr. Moore, in his Life of 
Lord Byron. Speaking of the poet's mother, he 
says — '* So sadly characteristic was the close of 



OF DISEASE. 17 

the poor lady's life, that a fit of ague, brought on 
it is said by reading the upholsterer's bills, was 
the ultimate cause of her death 1" 

Every experienced surgeon is aware of the 
constitutional effects of external injury. To say 
nothing of the graver accidents and operations 
which occur in practice, how often has he been 
compelled to witness all the phenomena of ague, 
from the simple introduction of an instrument into 
the urethra. The faintingfit which occasionally 
follows this bloodless operation, is an extreme 
shade of the cold stage j and the fever, or reac- 
tion, which, for the most part succeeds it, is 
typical of the hot. Dr. Davis, in his account 
of the Walcheren ague, says, he has "known 
paroxysms to come on with syncope, and a sud- 
den debility that was really alarming.'' A mar- 
ried lady, the mother of seven children, lately 
consulted me for fainting fits : she had one every 
second day at the same hour. Quinine, arsenic, 
hydrocyanic acid, all successively failed; — ^musk 
at once eflFected a cure. " The fevers (says Mr. 
Abemethy) produced by local disease, [injury] 
are the very identical fevers which physicians 
meet with where there is no external injury." Is 
not this a sufficient admission of their intermit- 



18 THE UNITY 

tent nature ? We shall, in the sequel, show that 
there is no feyer without remission. 

The occurrence of remission and paroxysm in 
disease, then, so far from being exclusively con- 
nected with malaria or miasma, as a cause, is a 
UNIVERSAL law; — changcs of temperature, pas- 
sions, injuries, being equally followed by inter- 
mittent disorders: nay, the various poisons, 
whether vegetable or mineral — those very agents 
successfully employed in the treatment of inter- 
mittent fever, are no exception to the rule. Speak- 
ing of these. Dr. A. T. Thomson observes,^— 
" Some produce their effects in paroxysms ; for 
example, strychnia and veratria. Some admit of 
exacerbations and remissions^ namely, arsenious 
acid, [arsenic] which, indeed, sometimes even ex- 
hibits intermissions." The tremors which arsenic 
occasionally excites, are typical of the shiverings of 
ague, — the very disorder for which we so often 
successfully prescribe this metal in practice! 
The agents of death, then, are the agents of life! 
Similia similihus curantur. So far, but no far- 
ther, as we shall in the sequel shew, the homoB- 
opathists are right. 

The analogy subsisting between tremor and 
spasm has been a source of speculation to many 



OF DISEASE. 19 

thinkingmen. Analyze tremor^ and it will be 
found to be merely a rapid succession of incom* 
plete spasms. Palsy shews a loss of muscular 
power greater than either. 

The following case of periodic aphonia, or 
paralysis of muscles, necessary for the function of 
speech, will shew how palsies may, like every other 
form of disorder, exhibit the most perfect inter* 
missions : — *^ A peasant girl was attacked in the 
following manner: speechlessness came on eve^y 
day at four o*clocky p. m., accompanied by a 
feeling of weight about the tongue, which re- 
mained a quarter of an hour. The patient, while 
it lasted, could not utter any sound, but occasion- 
ally made an indistinct hissing noise. Conscious- 
ness did not appear at all impaired during the 
fit. She ascribed her inability to speak, to a 
feeling of weight in the tongue. The paroxysm 
went off with a large evacuation of watery urine, 
accompanied by perspiration and sleep. Ten 
such attacks had occurred when Dr. Richter, of 
Wiesbaden, was called to see her. He ordered 
her considerable doses of sulphate of Quinine 
with immediate good effect from the first day : the 
attack returned, but in a mitigated form ; and on 
the second day no trace of it was visible, except 
a certain degree of debility and fatigue felt at the 



20 THE UNITY 

usual hour of its coming on." — Heckei^s Journal 
and Dublin Journal. 

In the above case, the corporeal temperature 
during the attack is not stated ; the periodic re- 
mission is sufficiently remarkable. The case 
which I am now to give, occurring in a patient 
of the other sex, will illustrate the variations and 
intermissions of temperature ; but whether re- 
mission was at all observable in the paralytic 
muscles, is not stated. Both cases throw light 
upon each other, and go far to explain the man- 
ner in which this and other palsies become de- 
veloped in the course of remittent disorder : — 
" James Milward, a weaver, aged 34, while at 
breakfast, was affected suddenly with a tremblings 
attended by a feeling of coldness and numbness 
from the pit of the stomach up to the throat, and 
soon afterwards it was found that he could titter 
no sounds although the lips and tongue could be 
moved with the usual ability. He is perfectly 
sensible, and answers negatively or affirmatively, 
by a motion of the lips. He can swallow with 
perfect ease. He has by turns, heats and chills ; 
and when the former occur, a diffused rash anses 
about the extremities, and the face is at the 
same time flushed." Under the application of 
leeches to the temples, purgatives, and ammonia. 



OF DISEASE. 21 

the patient recovered his speech in about a fort- 
night from the time of the attack. — Midland 
Reporter. 

Since I commenced this volume, I have it in 
my power to record the case and cure of a young 
married woman, who laboured under periodic 
hemiplegia: — Sarah Warner, aged 25, had suf- 
fered some months from a periodical loss of 
speech and palsy of one side. Every three or 
four days, (I use her own words,) the malady 
came on about the same hour. Various remedies 
were ineffectually prescribed by her medical at- 
tendants, who all looked upon her disease as 
apoplectic. When she applied to me, I ordered 
her a combination of quinine and iron, which she 
continued for a week, and never afterwards had 
another fit. 

The following case is illustrative of the accom- 
plishment of a cure in palsy long considered hope- 
less: — Mrs. Sargent, aged 40, a married woman, 
and the mother of several children, residing in 
Milsom-street, Cheltenham, had been for eight 
years confined to bed with palsy of the lower ex- 
tremities. She had been imder the treatment of 
eight or nine different physicians of the Chelten- 
ham Dispensary, one of whom, Dr. Cannon, had 
attended her for nearly four years. Such, at least. 



22 THE UNITY 

waB the woman's statement, confirmed to me by 
many people of respectability, who had visited 
her from the commencement of her illness. 
When I first saw her, her voice was an almost in- 
audible whisper ; she was liable to frequent retch- 
ings; complained of spasms, pain of the back 
and limbs, and of much vaginal discharge. She 
had irregular chills and flushes, and some days 
had more power in her limbs than others. Her 
last Dispensary medicine, mercury — ^which she 
believed had been given her by mistake — ^had 
produced salivation, but with decided aggravation 
of her symptoms. In this case I prescribed a 
combination of remedies, the principal of which 
were hydrocyanic acid and cantharides. Under 
this treatment her voice returned in about a week, 
her recovery from every symptom was complete 
in six weeks ; and she has had no return in the 
two years that have elapsed since she was under 
my care. 

The next case is equally interesting: — Charles 
Overbury, aged 10, also of Cheltenham, had 
been in the following state for some months pre- 
vious to my first visit. I found him lying on a 
couch, every muscle of his face in such curious 
repose that his countenance seemed quite idiotic: 
his arms and legs were powerless. If you held 



OF DISEASE. 23 

him up his legs doubled under him like those 
of a drunken person, and upon whichever side 
you plax^d his head, he was unable to remove 
it to the other; — ^his deglutition was rather diffi- 
cult, but the heart and respiratory muscles per- 
formed their respective offices correctly. The 
patient laboured under complete loss of speech 
the entire night and nearly the whole day. About 
the same time daily — ^noon — he could utter the 
monosyllables yes and noj but this power re- 
mained with him for half an hour only. He had 
a nightly succession of epileptic spasms. The 
temperature of his body varied in the course 
of the twenty-four hours. The remedies to 
which I resorted in this case, were minute doses 
of calomel and quinine, with hydrocyanic acid ; 
the last the most effi^ctual. In less than three 
weeks he was running about, well in every r^ 
spect, and the change in his countenance from 
apparent idiocy to intelligence, was as complete 
a transformation as it is possible to imagine. 
Has the reader marked the periodic remissions 
which characterised the case ? 

The following are cases illustrative of the cure 
of palsy of a single limb : — 

Case 1st. — Mary Boddie, aged 18, from the 
age of eleven, had weakness of the back and 



24 THE UNITY 

loins, and she gradually lost the use of her 
right leg. In this state she remained for three 
years. Sixteen months she was an in-patient at 
the Gloucester Infirmary, (in which establishment 
her mother held the situation of nurse); but 
cupping, leeching, blistering, &c., were all equally 
ineffectual. The patient complained of having 
suffered from shivering-fits, followed by heats 
and sometimes perspirations. Her catamenia 
had never been regular. The same mode of 
treatment, with the addition of a galbanum 
plaster to the loins, in which she complained of 
coldnesSf was adopted and followed with equal 
success, as in the above case. She had scarcely 
been a fortnight under my care before she com- 
pletely recovered the use of her paralized limb, 
and she has had no relapse during a period of 
four years. The greater part of this time she 
has been in service. 

Case 2nd. — ^Esther Turner, aged 30, when in 
the service of Mr. Ward, the master of a respect- 
able boarding school at Painswick, fell down stairs, 
and from that moment lost the use of her left leg. 
After a period of eleven years, during which she 
had been, ineffectually, under treatment in various 
hospitals and infirmaries, she came on crutches to 
my house. She explained that she was subject to 



OF DISEASE. 25 

severe shivering fits, with occasional convulsions ; 
her spirits were much depressed, and her cata- 
menia had always been more or less disordered. 
Her leg, she said, had more feeling on certain 
days than others. After trjring her for some time 
with the hydrocyanic acid and tincture of cantha- 
rides without any improvement, I prescribed a pill 
containing a combination of quinine, silver, and 
colchicum, night and morning. She progressed 
from that day. In about six weeks she refi^ained 
theperfec.uLo(he,liMb,n»y,Ae,e.u^ed.o 
her service at Mr. Ward's, which she only lately 
left to get married. Her cure has been complete 
for the last four years. 

I could here give numerous other cases equally 
explanatory of the remittent manner in which 
palsy, of almost every muscle of the body may be 
developed, and also of its mode of cure. For the 
present I shall content myseK with recording my 
views of a disease, which, so far as I am aware, 
has never been supposed to be of this kind — the 
curved or crooked spine. By most authors this 
disorder has been imagined to be under all cir- 
cumstances an affection of the bones. Mr. Aber- 
nethy and a few others have vaguely referred it to 
some peculiarity of nervous action. What this is 
we shall now proceed to demonstrate. 



26 THE UNITY 

The mast of a ship is kept erect by the side 
ropes or shrouds. If you cut or loosen these on 
one side, the mast falls in an opposite direction. 
The human spine in health is kept upright by a 
similar apparatus — the muscles. If any of these 
muscles become paralysed on any side, the spine, 
from the want of a proper supporting power must 
necessarily drop at that particular place. Being 
composed of many moveable pieces, the vertebrcBy 
it can only take the form of a curve or obtuse 
angle ; and the degree of this curvature will de- 
pend upon the number and particular locality of 
the muscles so paralysed. The disease or " de- 
formity," under all its uncomplicated variations of 
external and lateral curvature, is the result of 
palss, ; which palsy is a feature or association of 
general remittent disorder ; and whether compli- 
cated with vertebral disease or not, is no more to 
be influenced by issues, setons, blisters, moxas, 
&c., except in so far as these almost invariably 
confirm it, by further deteriorating the general 
health of the patient. 

In the commencement of palsies generally, the 
patient has more power in the affected muscles one 
day than another ; and I have never had such a 
patient who has not confessed to being the subject 
of heats and chills. Take the following case of 



OF DISEASE. ^ 

external curvature of tlie spine : Mrs. Crad- 
dock, aged 25^ had for upwards of eighteen 
months great weakness about the upper third 
of the back, where a swelling, to use her 
phrase, made its appearance ; gradually increas- 
ing in size. According to her statement, she had 
been an in-patient in^ the Gloucester Infirmary 
for seven months, during which, she had been 
treated by issues, and other local measures, but 
with no good effect. When I first saw her she 
could not walk without assistance. Upon exam- 
ination, I found a considerable excurvature, in- 
volving the third, fourth, and fifth dorsal ver- 
tebrae ; which vertebrsB, were also painful and en- 
larged. The patient was extremely dispirited, 
shed tears upon the most trifling occasion, and 
was subject to tremblings and spasms. Her back 
was generally chilly, and she suffered from cold- 
ness of feet. Some days she thought the ^^ swell- 
ing" of her back was not so great as upon others ; 
and upon those days she remarked that her spirits 
were not so low. I directed the issuss to be dis- 
continued, and ordered her a combination of 
hydrocyanic acid and tincture of cantharides, 
three times a day. These medicines she had 
scarcely taken for a fortnight, when the improve- 
ment in her general appearance was remarkable : 



28 THE UXITY 

the protuberant part of the spine very consid- 
erably diminished, as her health became amelior- 
ated ; and in less than! a month, her cure was ac- 
complished. A permanent curve, slight when 
compared with her former state still remains. 

Equally efiectual haye I found this mode of 
treatment in that particular muscular palsy, which 
gives rise to squint Parents who have children 
thus afiected, will tell you that some days the de- 
formity is scarcely, if at all perceptible ; yet you 
will hear medical men say this disease must be 
owing to worms, gastric, irritation, &c.; and then 
they will purge and blister the child into convul- 
sions or confirmed squint. By attending to the 
remitting, nay, the periodical nature of the disor- 
der, I have been exceedingly successful in its 
treatment. With quinine, iron, hydrocyanic acid, 
calomel, &c., in extremely minute doses, I have 
scarcely ever failed in accomplishing the desired 
object in the early stages; and I have almost 
always ameliorated the case, even when it had 
been of considerable duration. In a case which 
lately came under my notice, the boy squinted 
every second day ; he was cured by qmnine. 

To the medical reader, I need not point out 
the nigfit and dot/ blindness as familiar instances 
of the intermitting palsy of the nerves of sight. 



OF DISEASE. 29 

The following case of amaurosis of both eyes is 
remarkable for the accomplishment of a cure, 
after the case had been considered utterly hope- 

Charles Enmis, aged 25, formerly residing in 
Winchcomb-street, now in Milsom-street, Chel- 
tenham, stated to me that he had been completely 
blind for upwards of nine years, four of which he 
passed in the Bristol Asylum ; where, after having 
been under the care of the medical officer of the 
estabUshment, he was taught basket-making, as 
the only means of earning his subsistence: he 
had been previously an in-patient in the Wor- 
cester Infirmary, under Mr. Pierepoint, but left 
it without any benefit. Some days he perceived 
flashes of light, but could not even then discern 
the shape or shade of external objects. Before 
he became quite blind, he saw better and worse 
upon particular days. When he first consulted 
me, his general appearance was very unhealthy, 
his face pale and emaciated, his tongue clouded, 
appetite defective and capricious ; and he de- 
scribed himself as being subject to chills and 
heats, palpitations, and tremblings. His spirits 
were always he said depressed. My first pre- 
scription quinine disagreed ; my second, nitrate 
of silver, was equally unsuccessful ; with my third, 



80 THE UNITY 

hydrocyanic acid, he gradually r^ained his vision, 
being, after an attendance of four months suffi- 
ciently restored to enable him to read large print 
with facility. Such has been his state for the last 
two years. I need not say his general health has 
materially improved ; his appetite is now he says 
too good for his circumstances.* 

If patients who have been subject to deafness 
be questioned upon the point of remittency, they 
will, in the great majority of instances, admit the 
fact ; and at the commencement, or in the early 
stages, will universally acknowledge the chills and 
heats with which they are affected. Attention to 
this will sometimes enable the physician to im- 
prove patients under the most unpromising cir- 
cumstances. 

I am* now attending a gentleman, who has 
been for three years, more or less, the subject of 
ague. The disease latterly has come on in the 
middle of the night, during his sleep, regularly 
every week, about the same hour. After shiver- 
ing intensely, he has a hot fit ; during which he 

* While upon the subject of the Eye, I may as well state here, 
that in the commencement of Cataract the patient sees better one 
day than another. I have just been consulted by Diana Dark, aged 
29, for incipient cataract. She tells me her sight alters two or three 
times in the same day ; and she confesses to being nervous, affected 
with tremblings, low spirits, and heats chills. 



OF DISEASE. 31 

complains of violent pain of side and back, and 
he becomes exceedingly deaf; he has then a 
sweat with relief ; and the next morning he is 
yellow all over, but with little or no deafaess 
remaming. The most eminent men of Dublin, 
have attended him ; their opinion is that gall 
stones are the cause of all this ; from which I 
altogether dissent. The regularity of the pa- 
roxysm and mtennission.-the recurrence of the 
fit during sleep, could not be produced by gall 
stones. The temporary jaundice is a mere effect 
of spasm of the gall ducts, developed during the 
aguish paroxysm, which in him the day before is 
preceded by listlessness, &c. ; the pain of side and 
back being not precursory, but coming on in 
succession. No gall stones have been seen. 

Cases of AruBsthesia^ or loss of the sense of 
touch, and also of partial or general numbness 
will almost always be found to have run a course 
of remittency. So will the greater number of 
instances of that exalted degree of sensibiUty. 
known by the various names of tic douleuroux^ 
sciatica, &c., according to the locality of the 
various nerves supposed to be their seat. Look 
at the history of these diseases. What have your 
surgical tricks done for their relief, — ^your moxas, 
your blisters, your division of nerves 1 The only 

£ 



32 THE UNITY 

remedies to which these diseases have yielded, 
have been the bark, arsenic, iron, pmssic aeid, &c.; 
the remedies in a word of acknowledged efficacy 
in ague. We shall here present the reader with 
a case from the London Medical and Surgical 
Joumalj illustrative of the nature of fic, when in- 
volving the nerves of the face. It is radier affect- 
edly styled by the narrator '< Suborbital Neuro^ 
pathy. The pain first supervened after a fright. 
It returned every day at two o'clock, commencing 
at the origin of the suborbital nerve, extending 
along its course. The fit lasted from half an hour 
to an hour. Two grains of sulphate of quinine, 
given every two hours for three days, produced in 
so short a period, a complete cure. The same 
prompt and favourable effects were observed in 
another case of frontal neuralgia that appeared 
without any known cause.** 

The following case abbreviated frt>m the Gazette 
MedicalSy is an instance of this affection involving 
a part of the body, seldom observed to be the 
situation of tic : — «N****, a married woman, 
aged 48, habitually constipated, and suffering 
from disordered menstruation, felt one morning a 
pain in the left side^ as if in consequence of an 
exertion. It extended under the false ribs, from 
the vertebral column, and was felt to the extent 



OF DISEASE. S3 

of four fingers. It returned at intervals, and was 
very severe piercing and burning. The abdomen 
became at the same time tumid with flatus. The 
patient had vomiting, and a flow of high-coloured 
urine, voided with pain. The^fc came on every 
night, from one o'clock to six or seven in the 
morning. During the paroxysm, the patient com- 
plained of spasms of the side, the painful part of 
which was sKghtly swelled, and of a higher tern'- 
perature than the rest of the body. The face was 
sallow and clay-coloured. This case on the dis- 
covery of its intermittent nature, was treated with 
quinine, to which it at once yielded, with com- 
plete restoration of the patients general health.^* 

A similar case occurring in a patient of my 
own, — a lady, of about 50 years of age, yielded 
to half grain doses of nitrate of silver, after having 
successively resisted quinine and prussic acid. 
She had been for six weeks previously the patient 
of a gentleman, who, after exhausting the usual 
routine of leeches, blisters, blue pill, &c., left her 
in a worse state than when he found her. 

Cases of depraved appetite, and also of defective 
taste, depend equally upon constitutional inte- 
grity of cause. The following example of Bu- 
limia taken from the lectures of the late Mr. 
Abemethy, is instructive: — " There was a woman 



34 THE UNITY 

in this hospital who was eternally eating ; they 
gaye her food enough yon wonld have thought to 
haye disgusted any hody, but she crammed it all 
down ; she neyer ceased hut when her jaws were 
fiitagued. She found out Uiat when she put her 
fiet in cold water ^ she ceased to he hungry.'' 
What could be this woman's inducement to put 
her feet in cold water in the first instance ? Was 
it not their high temperature, — the feyer under 
which she laboured ? 

The various degrees of thibst, from which so 
many invalids suflfer. depends entirely on tte tern- 
perature of the body. Colonel Shaw, in his 
'* Personal Memoirs and Correspond^ioe,'' has 
this remark : — ** I had learned from my walking 
experience, that to thirsty men, drinking water 
only gives a momentary relief; but if the l^s 
are wetted^ the relief, though not at first apparent, 
positively destroys the pain of thirsf 

Thus fer we haye confined our examples of 
DISEASE, and its intermittent nature to functional 
or simple disorder. All diseases at the com- 
mencement are strictly functionaL I do not, of 
course, speak of mechanical, or othar immediate 
organic injury; I speak of disease generally, 
where it is only during repeated exacerbations 
or paroxysms, that organic change becomes de- 



OF DISEASE. 35 

veloped. Enquire the sequelcs of those agues 
for which the usual routine of medical treat- 
ment has proved unavailing. Do they not com- 
prise every structural change to which nosolo- 
gists have given a name? The enlarged, soft- 
ened, or otherwise disorganised heart, liver, 
sple^i, and joint, the dropsical and haemorrhagic 
diatheses all occur in the course of intermittent 
fever. Dr. Parr mentions epilepsy and apo- 
plexy, as not unfrequently preceding its fatal 
termination. Formerly, the structural lesions, 
found on dissection of the hodies of ague patients, 
were looked upon as causes. A better patho- 
logy has set them down as developements ; and it 
were well could we persuade our readers that all 
similar lesions are nothing more than effects, or 
associations of constitutional derangement, — a 
term often vaguely used, but which, when fairly 
scrutinized, will be found to comprehend, if the 
disease be recent or a^cute, the bolder features 
of intermittent fever ; and if chronic^ or of long 
standing, the more subdued symptoms, or shades 
of symptom of that universal disease. 

Every individual corporeally as weU as mentaUy 
has his weaJc point — his predisposition to a par- 
ticular localism of disorder. This may either be 
hereditary or accidental. Apply a given cause 



36 THE UNITY 

of disease, such as a sudden stun, or exposure to 
intense cold or heat, and you have partial or gene- 
ral revolutions of temperature, with more or less 
constitutional derangement, comprehending most 
of the various shades of functional disorder al- 
ready enumerated — of which you may take fever 
as the type or emblem — and the weak point of 
the individual constitution, or localism of the 
schools, will be gradually superadded in the course 
of successive exacerbations. In one you will have 
epilepsy, apoplexy, bleeding at the nose ; — in ano- 
ther asthma, spitting of blood ; a third complains 
of splenic fuhiess, or hsemorrhoids ; a fourth of 
varicose veins of the limb, degenerating into bleed- 
ing ulcer. In all those, so styled, different disor- 
ders you have remissions — ^in the beginning of 
regular recurrence — ^less remarkably so as the dis- 
ease becomes habitual. Darwin, and others of 
his school, were not without a knowledge of 
this. Indeed, their treatment so different from 
the sanguinary and inefficient practice of the 
modems was principally, though vaguely, founded 
on this observation. Taking advantage of the 
remission to ward off the anticipated attack, their 
custom was to prescribe bark or opium. 

Among the diseases which Darwin ranked 
as remittent, we find "arterial hsBmorrhages" — 



OF DISEASE. 37 

"hsBinorrlioids" — "hcemoptoe" — "hoemoptysis" — 
"tussis ferina" — " raphania, or convulsions of the 
limbs*' — " asthma" — " epilepsy*' — " apoplexy*' — 
« palsy** — " insanity**— " rheumatism**— " pleu- 
risy.*' "The periods of pleurisy,** he says, "re- 
cur with exacerbations of the pain and fever about 
sunset. The same may be said of the " inflam- 
matory rheumatism.** "The fits of convulsive 
asthma return at periods^ and so far resemble the 
access of an intermittent fever. ^* — Zoonomia. 

All these diseases I have very generally cured 
or alleviated by sulphate of quinine; failing 
which, I have successively resorted to opium, 
iron, arsenic, prussic acid, &c. ; and with one or 
other, or two or more in combination, have had 
no reason to complain of ill success in their 
treatment. 

Sir Benjamin Brodie details the case of a gen- 
tleman afflicted with spasmodic stricture of the 
urethra, which came on every second night. The 
symptoms yielded at once to the internal exhibi- 
tion of sulphate of quinine. Is not this an ana- 
logical confirmation of my previous statements ? 

The following case is sufliciently interesting to 
warrant my recording it at length: — 

"A strong man, aged 27, suffered on alternate 
days from very violent bleeding at the nose, 



38 THE UNITY 

which oontinaed from four to six hours, and could 
neither be stopped nor diminished by the usual 
styptics, nor by any of the other means commonly 
employed in similar cases. Taking into account 
the remarkable periodicity of the bleeding, the 
treatm^it was changed, and a large dose of qui- 
nine, with sulphuric acid, administered. During 
the twenty-one days following, the bleeding recur- 
red but twice, and was then readily stopped. 
The patient subsequently continued quite well. — 
Med. Zeitung, No. 33, 1836. 

The reader will now, I have no doubt, be 
prepared to question the propriety of the usual 
murderous treatment adopted for what is called 
"rupture of a blood yessel,** or spitting of blood. 
Is not the lancet in almost every such case, the 
first thing in requisition — and death the too fre- 
quent result of the measure! What say the 
older authors on this subject ? Listen to Heber- 
den, a physician who for upwards of thirty years 
had the highest and most extensive practice in 
London : — " It seems probable (says this veteran 
in medicine) from all the experience I have had of 
such cases, that where the haemorrhage proceeds 
from the breach of some large vein or artery, 
there the opening of a vein will not stop the efflux 
of blood ; and it will stop without the help of the 



OF DISEASE. 89 

lancet when it proceeds from a small one. In 
the former case, hleedmg does Tio good; and m 
the ktter, by an unnecessary waste of the patient's 
strength, it will do harm. But if the opening of 
a vein be intended to stop a hsBmorrhage, by de- 
privation or revulsion^ may it not be questioned 
whether this doctrme be so clearly established as 
to remove all fears of hurting a person who has 
ah-eady lost too much blood, by a practice aU 
tended with the certain loss of more ?** 

As a mere matter of experience, I may be here 
permitted to state that the primary employment 
of quinine, arsenic, opium, hydrocyanic adid and 
medicines of a similar kind, has enabled me to 
dispense entirely with bloodlettmg, in the treat- 
ment of haemorrhages ; — ^indeed, I do not remem- 
ber to have lost one patient affected with spitting 
of blood, or other hsamorrhage of a constitutional 
kind, since I gave up the lancet in my practice. 
Sometime ago two cases of this affection came 
under my care, within a few days of each other. 
The subject of one was an old gentleman, of 70, 
who was, moreover, afflicted with habitual asth- 
ma ; the other, a servant girl aged twenty-five. 
Hydrocyanic acid cured the girl after her case 
had resisted quinine. The gentleman, on the 
contrary, recovered by the use of this prepara- 



40 THE UNITY 

tion of the bark, afiter the hydrocyanic acid had 
in like manner, been ineflfectuaJly tried. 

With each of these medicines I have accom- 
plished the reduction of recent haemorrhoids, and 
also of varicose veins ; and the mention of this 
recalls to my recollection the case of an old 
woman with a painful varicose ulcer, for whom I 
prescribed the internal use of arsenic, with almost 
immediate reUef from the pain, and subsequent 
cure of the ulcer. 

All these forms of haemorrhagic developement 
may be observed to take place in the course of in- 
Ja..«.t fever._whieh fever. « we ha,. d™«i, 
stated, however well marked in the early stages, 
when chronic or of long standing will for the 
most part be so shaded and subdued as to be only 
recognized by practitioners whose attention has 
been particularly called to it. <* Sometimes (says 
DarwL) the hemorrhage recurs by daily periods, 
accompanying the hot fits of fever or in the inter- 
missions. This is to be removed by curing the 
febrile paroxysm.** We have sufficiently esta- 
blished the value of quinine, hydrocyanic acid, 
arsenic &c. for that indication. Magendie has 
detailed a case of severe hssmorrhage, which, 
after having resisted repeated bleedings at the 
arm, at once yielded to prussic acid. 



OF DISEASE. 41 

On the subject of the peruvian bark, the pro- 
fessor of materia medica in the London univer- 
sity, expresses himself thus — ** The cinchona bark 
and the salts of its alkahoids may be prescribed 
advantageously in all diseases which assume an 
intermittent type, whether they appear as gout, 
rheumatism, the exanthemata, eruptive fevers, 
catarrh, or even phthisis." 

What a comprehensive list of intermittent dis- 
eases I But this is not all. Enquire of the sub- 
ject of goitre or other external glandular tumors, 
such as are generally denominated scrofulous — 
a term, by the way, like every other of the humo- 
ral school, only calculated to mislead both patient 
and practitioner ; — question the unfortunate indi- 
vidual afflicted with cancerous sores; — interrogate 
the patient who labours under an abscess, or who is 
afflicted with the true aneurysmal tumor of an ar- 
tery, and each and all will admit that they are one 
day better, another worse — that their swellings at 
intervals decrease — that their ulcers become peri- 
odically less painful — that the size of both varies 
with the variations of heat, cold, dryness, or mois- 
ture of the weather, — ^that, in the commencement 
at least, there are days, nay, hours of the same day, 
when their diseases are little if at all troublesome — 
that they all suffer more or less from heats and 



42 THE UNITY 

chiUs — some referring these last to the head or 
back, while others associate them with the chest, 
loins, arms, or feet. Do not the ophthahnic, the 
ulcerated, the dropsical, nay, the subjects of every 
kind of heart disease, tell you that they are one 
day better, another worse ? Has not the maniac in 
every form of hallucination his lucid intervals — ^his 
remissions ? Your schoolmen, your pathologists, 
your profound medical reasoners speak of mad- 
ness and other diseases, as if they were entities or 
fixed states ; they tell you these diseases are cu- 
rable or not according to the cause ; they look in 
the dead body for the causes of a living action ! 
for the origin of mania and epilepsy I — diseases 
which in all probability they have already as- 
certained to have had their date from cold or a 
passion I These outward accidents then were the 
causes, not the structural deviations detected 
within by the scalpel. Students of medicine! 
youi^ men honorably ardent in the pursuit of 
science I for the sake of your future patients, en- 
deavour to think for yourselves! Pause, then, 
before you give a slavish assent to the dicta of 
your teachers. When these tell you that madness 
is an inflammation of the brain, or that it de- 
pends upon some cerebral tumor or abscess, ask 
them how they reconcile lucid intervals — hours of 



OF DISEASE. 43 

sanity and sense with a cerebral structure even 
thus partiaUy, but permanently disorganised. 
How can the catise of an intermittent disease 
be an eniity or state permanently fixed ? Let 
no sounding words, no senseless sophistry cheat 
you of a reply to this question. 

The man who has a lucid interval is curable m 
many instances ; the epileptic, who. at any time 
of the day or night, enjoys a freedom from c<hi- 
vulsion, may be equaUy susceptible of improve, 
ment from well devised remedial means. The 
modem routine treatment of both being essen- 
tially aggravant, can we wonder that these dis- 
eases are so often pronounced hopeless, or that a 
sceptic smile should be the reward of the mdi- 
vidual, who tells you, that in his hands at least, 
they have ceased to be the opprobria mediciruB t 

But how shall we speak of diseases of the heart, 
of palpitation and temporary cessation, or remis^ 
sion of its action, disorders constantly misunder- 
stood, and as constantly maltreated I Complain 
but of flutter and uneasmess in any part of the 
chest, the stethoscope, — the oracular stethoscope 
is immediately produced ! Astonished^in many 
instances, terrified — the patient's heart beats ra- 
pidly — he draws his breath convulsively, and the 
indications obtained by means of this instrument, 



44 THE UNITY 

at such a moment of doubt» anxiety, and fear, are 
r^^tered and reoognized as infallible! The 
mo6t extraordinary prognostics are consequently 
given ; extraordinary, if they did not by the sub- 
sequent treatment, like prophecies, tend to verify 
themselves* Let the practitioner withdraw his 
eye for a time firom a mere symptom ; let him 
observe how other muscles of the individual pal- 
pitate at times as well as the heart, and act like 
that convulsively, finding these symptoms to be 
remittent in every case, and complicated with 
others all equally remittent, would he still persist 
in his small bleedings — ^his repeated leeches — his 
purges, measures of thefnselces^ sufficient far the 
production of anjfy and every degree of organic 
lesiony he already fmcies he has detected ! Would 
he not rather reflect with horror on his past treat- 
ment, and endeavour by another and a better 
practice, to enable his patient to escape the sud- 
den death to which he had in his mind's eye 
devoted him ? How many a physician by such a 
prognostic has obtained unmerited credit for 
foresight and sagacity, while he only taught the 
patient's friends to be prepared for an event he 
himself was materially contributing to hasten I 

The foUowiog case I extract from my own 
notes : — R. H., Esquire, aged 30, had for a long 



OF DISEASE* 45 

period been labouring under despondency of spirits 
even to the shedding of tears ; — he suffered fre- 
quently from chilliness — ^particularly complaining 
of the coldness of his feet. He had also occasional 
palpitation of the heart — ^the action of which organ 
was generally much below the healthy standard. 
He was better and worse upon particular days. 
An eminent London physician, whom he con- 
suited) after carefully examining him with the 
stethoscope, pronounced his heart to be enlarged. 
This gentleman prescribed for him carscarilla 
and ammonia, with aperients, and ordered him 
to be bled ; — the bleeding to be repeated every 
month or six weeks. So far, however, from de- 
riving benefit under this treatment, the patient's 
health deteriorated greatly — he became much 
emaciated, and a tendency to feinting fits came 
on, with occasional confusion of his senses. His 
pulse was generally forty in the minute, but fre- 
quently intermitted. He complained of liability 
to spasm, and of a peculiar repugnance to the 
slightest exertion. 

Such being the state of the patient when he 
consulted me, I prescribed a combination of by- 
drocyanic acid and creosote, which I afterwards 
followed up with arsenic and quinine ; — and in 
about six weeks his health became so completely 



46 THE UNITY 

re-established, as to enable him again to foUow 
his profession — the law ; which he now continues 
to do with ardour, and without a complaint of any 
kind. 

In confirmation of the yalue of arsenic in dis- 
ease of the heart, the following case from Darwin, 
who wrote, be it remembered, in the last century, 
will not be deemed unimportant. 

*^ A gentleman, 65 years of age, had for about 
ten years, been subject to an intermitting pulse, 
and to frequent palpitations of his heart. Lately 
the palpitations seemed to observe irregular pe- 
riods ; but the intermission of every third or 
fourth pulsation was almost perpetual. On giving 
him four drops of a saturated solution of arsemCf 
about every four hours, not only the palpitation 
did not return, but the intermission ceased en- 
tirely^ and did not return so long as he took the 
medicine.*' Zoonomia. 

The next case which I shall present to the 
reader's notice, exhibits a succession of phe- 
nomena, well worthy of attention. The patient's 
symptoms were " difficult respiration, dry cough, 
or stringy expectoration, pulse full. The disease 
commenced with an intense fit of shivering, fol- 
lowed by heat and a severe cough. Every day at 
noon, there was an exacerbation of all the symp- 



OF DISEASE. 47 

toms, commencing with very great shivering, 
cough, and intolerable pain in the chest, a fit of 
suffocation^ and finally perspiration. At the end 
of an hour the paroxysm terminated. Ammo- 
niacal mixture was first given, then two grains of 
quinine every two hours. The very next day the 
fit was scarcely perceptible ; — the day after there 
was no fit at all. An observation worthy of re- 
mark is, that the symptoms of pleuro-pneumonia, 
which continued throughout in a very slight de- 
gree it is true in the intervals of the paroxysms, 
disappeared completely, and in a very short time 
by the effect of the sulphate of quinine." — Medi- 
cal Gazette. 

Contrast this case and its result with the case 
and treatment of an individual whose omnipotent 
power of setting a theatre in a roar, may be still 
fresh in the recollection of some of my readers — 
the celebrated Joe Grimaldi. The very name 
perhaps, has already excited a smile. On this 
occasion the poor clown would seek for sympathy. 
« Thi^ months afterwards." says his biographer, 
"his second benefit occurred. Monday the 9th of 
October was the day fixed for it, but on the pre- 
ceding Saturday he was suddenly seized with 

pediment in his breathing. Medical assistance 
was immediately called in, and he was hied until 

F 



48 THE UNITY 

nigh fainting ; this slightly relieved him, but 
shortly afterwards he had a relapse (exacerbar 
tion?) and four weeks passed before he recovered 
sufficiently to leave the house. There is no doubt 
but that some radical change had occurred in his 
constitution, for previously he had never been 
visited with a single days illness, while after its 
occurrence he never had a single day of perfect 
health." If the reader reflects that medical relief 
was immediately called in, he may, perhaps, be 
inclined to look upon poor Grimaldi's damaged 
constitution not so much as the effect of disease as 
of the sanguinary treatment adopted for his relief. 
The generality of practitioners, in detailing the 
most strikingly remittent phoenomena, will for 
the most part so word them, that you cannot dis- 
tinguish whether they be remittent or not. The 
more intelUgent non-medical writer, wiU often 
convey in his unsophisticated English, the precise 
bearings of a case. Take an instance from Cap- 
tain Hall's account of the illness of the Countess 
Purgstall : — " Our venerable friend (he says) 
though she seemed to rally, and was certainly in 
a. 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 pos- 



OF DISEASE. 49 

sible to believe her dying, in spite of her constant 
assertion to that effect." — Schloss Hainjield. 

Now, in such a case as this, would not the 
responses of the stethoscope differ materially ac- 
cording to the time they were taken ? The in- 
dications obtained through its medium, could not 
possibly be the same by night as by day. 

It was the fate of a former work of mine, upon 
the subject of remittency in disease, to be re- 
viewed in two quarterly medical periodicals, ( The 
Medico- Chirurgical^ and British and Foreign 
Medical Reviews,) the Editors or Authors of 
which would appear to have rivalled each other 
in the scurrility of the language with which they 
thought it necessary to denounce my pages. Not 
content with mis-stating and mis-representing the 
doctrines of the book, they had recourse to per- 
sonal abuse of the author. My open contempt of 
their wooden oracle, the stethoscope, would appear 
to have fired them with a common indignation; 
for, while Messrs. ConoUy and Forbes, with a 
rare courtesy, made this a reason for pointing out 
to me " the advantages of common sense over the 
want of it,** — Dr. James Johnson, in an equally 
gentlemanlike manner, charged me with "pro- 
found ignorance and inveterate prejudice." To 
the Editor of the Lancet I was indebted for an 
opportunity of replying to both. 



50 THE UNITY 

Permit me, I said, to these gentlemen, to ask 
you a single question : — since mediate ausculta- 
tion (to use your jargon) has become the fashion, 
has the medical student, or have you, my Critics, 
been able to bring pectoral or other disease to a 
more favorable termination? Hitherto I had 
never obtained but one answer to this question, 
and that was in the negative. Oh ! but you have 
been taught (you tell me) to distinguish and dis- 
criminate one disease from another. Admitting 
for the present that such is the fact, — which al- 
low me to doubt, — of what use, again I ask, is 
such discrimination — such change of one piece 
of pompous verbosity for another, if it lead to no 
diflFerence or improvement in practice, — if your 
remedial means for all shades and variations of 
pectoral disorder come at last to the same agents? 
Of what use is it to distinguish severe bronchitis 
or catarrh from phthisis^ if quinine or hydrocy- 
anic acid be equally beneficial in all. If you say it 
is a satisfaction to know whether the case be cura- 
ble or not, my reply is, each of these diseases may, 
under certain circumstances, admit of cure ; and 
all of them to your and my sorrow may prove the 
reverse ! Dr. Thomson tells you that these dis- 
orders are every one of them remittent. Is not 
quinine then, I ask, or iron, or arsenic, under 
such circumstances, of more avail than all the dis- 



OF DISEASE. 51 

cussion and discrimination of all the doctors that 
ever mystified disease by their vain nosologies ? 
" Have we not (asks Dr. Uwins) had too much 
talk of Heart-Disease since the stethoscope has 
come so generally into vogue?*' One of my 
Critics even, Dr. James Johnson, with a strange 
forgetfulness of his previous abuse of me on this 
head, is reported [^Lancetl^ to have spoken in the 
following manner at a medical society : — " It was 
a common error of young practitioners to consi- 
der the heart as organically diseased when its 
function only was much interi'ered with-and this 
error had become more general, he was sorry to 
say, since the stethoscope had come into use!^ 

So much for its value as a diagnostic instru- 
ment in Heart-Disease. We shall now examine at 
length its merits in the detection of Consumption. 

" Rush, Portal, and the most judicious physi- 
cians (says Dr. Hancock) have constantly re- 
garded consumption to be a disease of the con- 
stitution, 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, Bennett, and others, was not regarded 
as an incurable disease.'* — London Medical and 
Surgical Journ^il. 



52 THE UNITY* 

Let us, nevertheless, for argument's sake, allow 
that a knowledge of the exact amount of pectoral 
lesion could be turned to a useful or practical ac- 
count, are my Reviewers so certain that the ste- 
thoscope is of itself adequate to the detection of 
this ? Andral, one of the best living authorities on 
pathology, candidly admits its deficiency. " With- 
out other signs, he says, the stethoscope does 
not reveal with certainty phthisis and inflam- 
mations of the heart." And Dr. Latham, who 
has taken no small pains to advocate its employ- 
ment admits that the best auscultators even have 
been led to a wrong prognostic by it. " To most 
patients, (he addi^) 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 his 
cardiac and respiratory movements, so as to neu- 
tralize the whole indications presented by them, 
but must actually aggravate the state of the 
patient throughout. As the discovery of the de- 
gree of organic lesion, then in no instance leads 
to practical improvement, I am content to judge 
of it from the patients general appearance, the 
number of his respirations and the sounds emitted 
when he speaks, breathes, and coughs, as appre- 
ciable by the naked ear. From an instrument, 
whose employment troubles and distresses the 



OF DISEASE. 5S 

majority of patients, I look for no superior infor- 
mation ! 

It is truly amusing to find men playing the 
Reviewer, without the smallest pretension to the 
knowledge requisite for such an office. So igno- 
rant wajs my Critic of the Medico- Chirurgical Re- 
view , of one of the most universal laws of disorder, 
as to accuse me of limited views of my profes- 
sion in making Fever, — "not Fever in the large 
sense of the word, hut only remittent fever" my 
{»imitive tjrpe of all disease. He chuckled at the 
discovery that there exists such a thing as Con- 
tiniced Fever — " fever in the large sense of the 
word. ** But according to an authority to whom 
I already owe numerous obligations. Dr. Thom- 
son, — " in CONTINUED fever in almost every case, 
there is an exacerbation towards mid-day, and 
another towards the evening, and the remission 
towards morning.*' An intermittent, (says Dr. 
Shearman,) is the most perfect form of fever, 
having the most complete periods of accession 
and intermission. The continued fever as it is 
caUed, diflFers from this only in its periods being 
less perfect, and the stages of its curriculum less 
obvious." — Medical Gazette. 

Now as there is no kind of disease, however 
named, or by whatever caused, of which the most 
perfect intermitting examples might not be given, 



54 THE UNITY 

[See Appendix] the only difference betwixt such 
a form and the more apparently continued cases is 
that the periods of these last are less perfect, and 
the stages of their curriculum not so well marked 
as the former. No physician will doubt that a 
perfectly periodical or purely intermittent disease, 
whatever be its nosological name or character, 
partakes of the nature, and is more or less ame- 
nable to the treatment successfally followed in 
ague. Why, then, deny that the same disease 
under other circumstances, partakes of that va- 
riety of ague misnamed continued fever ? — seeing 
that all disorders like it have remissions of some 
kind or other, however imperfect or irregular 
their revolution. What are such diseases but 
varieties of the more purely intermittent type? 
The remedies to which any disease has ever been 
known to yield, have all, as I shall in the sequel 
shew, an equally salutary influence over the most 
perfect ague. 

We shall now enquire a little into the nature 
of PULMONARY CONSUMPTION, — a discasc whichf 
under certain circumstances, is not only curable, 
but in which the physician might more often 
bring about this desirable end, were he somewhat 
better acquamted with the principles of his art, 
than these are at present taught by schools and 
colleges. 



OF DISEASE. 55 

The following case is from the pen of the 
patient, himself a physician : " J. C., aged 27» 
with black hair and a ruddy complexion, was 
subject to cough from the age of puberty, and 
occasionally to spitting of blood. His maternal 
grandfather died of consumption under thirty 
years of age, and his mother fell a victim to this 
disease (with which she had long been threatened) 
in her forty-third year and immediately after she 
ceased to have children. In the severe winter of 
1783-4 he was much affected with cough, and 
being exposed to intense cold in the month 
of February, he waa seized with peripneumony. 
The disease was violent and dangerous, and after 
repeated bleedings, as well as bUsterings, which 
he supported with difficulty, in about six weeks 
he was able to leave his bed. At this time the 
cough was severe, and the expectoration difficult ; 
a fixed pain remained in the left side where an 
issue was inserted. Regular hectic came on every 
day about an hour after noon, and every night 
heat and restlessness took place, succeeded to- 
wards morning by general perspiration. 

" The patient having formerly been subject to 
AGUE, was struck with the resemblance qf the 
febrile paroxysm with what he had experienced 
under that disease^ and was willing to flatter him- 
self it might be of the same nature. He there- 



56 THE UNITY 

fore took bark in the interval of the fever, but with 
an increase of his cough»_i>ar«;^n. This gen- 
tleman eventually recovered by the use of horse 
exercise, a remedy extolled by Sydenham, — one 
one whose mode of action it will puzzle the patho* 
logi$ts to reconcile with their particular notions 
of the nature of consmnption, and their particu- 
lar doctrines as to the manner in which it should 
be treated. 

The circumstance of the bark having not only 
failed in this case, but actually aggravated the 
symptoms, might be looked upon by many as con- 
clusive of its being contra^indicated in consump- 
tion. To this I have only to answer that I do not 
mean to cry up bark as a specific for phthisis any 
more than for uncomplicated ague, in which latter 
disease we are often obliged to dismiss it for ar- 
senic, iron, mercury, or some other agent not so 
generally influential in the treatment of the disease. 

In the thirteenth volume of the MediccU Qor 
zettCj the reader will find the detailed case of 
a man labouring under this disease, for whom the 
narrator, Mr. Maclure, prescribed generous diet 
and quinine. Dr. Marshall Hall examined the 
patient with the stethoscope, and pronounced an 
unfavorable prognostic. Even after commencing 
the quinine, and when a considerable improve- 
ment had taken place in the appearance of the 



OT DISEASE. 67 

patient, Dr. Hall still held that the case would 
be fatal. ^' Again the stethoscope was consulted, 
again it uttered the same sepulchral responses, 
and, according to it the poor patient ought by this 
time to have been moribund — his pulse, good 
looks, muscular firmness, appetite, and high 
spirits notwithstanding. I need hardly add (says 
Mr. Maclure) that our judicious friend, the doc- 
tor, was much surprised as well as gratified to 
witness his appearance,'^ — alluding to the change 
after the cure had taken place. It is but fair to 
Dr. Hall, to say that in another number of tins 
journal, he questions the cure. It is enough for 
our purpose that he admits the suspension of the 
disease while the patient was taking the bark. 

With quinine, arsenic and hydrocyanic acid, 
I am satisfied I have cured — ^repeatedly cured 
Phthisis ; and I would have given cases in this 
place, did I not feel assured the patholc^cal 
gentlemen would object that I could not be cer- 
tain of their real nature, as I had not used the 
stethoscope! 

Like bark and arsenic, the hydrocyanic acid is 
a most potent remedy in ague. The bitter al- 
mond emulsion which owes its taste and pro- 
perties to this acid, has been successfully used in 
intermittents, even where the bark has failed ; 
and Dr. Brown Langrish used to cure agues with 



58 THE UNITY 

the distilled water of llie prunus lauro^cercLsuSf 
the curative effects of which depend upon the 
hydrocyanic acid it contains. 

That the same medicine has positively cured 
consumption is only douhted by ill-informed prac- 
titioners. Magendie, no mean authority, ex- 
pressly states ^^ a great number of observations 
induce the belief that it may effect a cure in the 
early stage ;" and '^ he asserts and maintains" in 
another place, that with this acid he has cured 
individuals, "having all the symptoms of incipient 
phthisis; and even those in a more advanced 
stage!'* Dr. Frisch, of Nyborg, in Denmark, 
has also successfully employed this remedy in 
several cases of phthisis. Magendie^s Formulary. 

But the possibility of curing phthisis, has been 
admitted even by gentlemen of the Pathological 
school. Sir James Clark, for example, has the 
foUowing observation :_«That pulmonary con- 
sumption admits of cure is now no longer a 
matter of doubt. It has been clearly demon- 
strated by the Researches of Laennec, and other 
modem pathologists.'* — 

"Pathological anatomy," says Dr. Carswellf 
has, perhaps, never afforded more conclusive 
evidence in proof of the curability of a disease 
than it has in that of tubercular phthisis J^ 

" Can consumption be cured ?" asked the late 



OF DISEASE. 59 

Mr, Abemethy, — adding, in his own sarcastic 
manner—*' Odd bless me ! that's a question 
which a man who had lived in a dissecting room 
would laugh at. How many people do you exa- 
mine who haye lungs tubercular, which are other- 
wise sound. What is consumption ? It is tuber- 
cle of the lungs — ^then if those tubercles were 
healed, and the lungs otherwise sound, the pa- 
tient must get better. But if the enquirer shift 
his ground, and say * It was the case I meant of 
tubercles over the whole lungs,' why then he 
shifts his ground to no purpose ; for there is no 
case of any disease which when it has proceeded 
to a certain extent, can be cured." 

I have been occasionally asked by patients, 
**What is tubercle?** I take this to be the 
proper answer — the true explanation. For the 
requisite lubrication of the bronchiro and air-cells, 
minute and almost imperceptible glands abound 
throughout the healthy pulmonary tissue. The suc- 
cessive enlargement and disorganization of these 
glands, as those changes become developed in the 
course of general constitutional disorder, con- 
stitute tubercular consumption. Messieurs the 
Critics wil^ perhaps, say otherwise ;_b«t what- 
ever be their opinion on this head, I think I have 
said enough to convince the more candid mem- 



60 THE UNITY 

bers of the profession, that consumption is not 
absolutely incurable in particular stages.* 

Dr. Wilson Philip assumes dyspepsia^ or indi^ 
gestiou to be the remote cause of a variety of 
phthisis. Direct your attention, he says, to the di- 
gestive organs, and you will ameliorate the state of 
the patient. With all due submission to an author, 
from whom nothing but a sense of duty would lead 
me to dissent, I must here enter my protest against 
any symptom or class of symptoms being looked 
upon as the cause of any other symptoms. May you 
not as well say cure the consumption and the di- 
gestive powers will improve— -as cure the indiges- 
tion and you will stop the phthisis? Medical 
men constantly talk of indigestion as if it were 
an essence or entity, having features separate and 
distinct from all other disorders. Can any per- 
son, I ask, become the subject of any disease with- 
out exhibiting symptoms of indigestion ? Tell a 
man bad news before dinner, has he not immedi- 
ately symptoms of dyspepsia 1 You hear that such 
a man is ill, very ill, but thank heaven his appe^ 



* In the report of the trial of a case in the Worcester Journal, 
Stallard v. Eagle Insurance Company, Dr. Selwyn, of Ledbury, the 
prindpal witness for the Company in his cross-examination, stated 
on his oath, his belief in the curability of consumption. Dr.Selwyn*s 
well-knoiini talents and probity, are a sufficient assurance of the 
(ruth of bis statement. 



OF DISEASE. 61 

tite 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 fix>m being what is termed good, nay, excel- 
lent, is morbidly voracious and craving ; — ^having 
as much resemblance to the appetite of health as 
the diabetic increase of urine has to a useful and 
perfect secretion from the kidneys. The medi- 
cines recommended by Dr. Philip for ^'dyspectic 
phthisis'' may cure or aggravate every duorder 
physician ever treated, according to the state and 
constitution of the patient. No man can be the 
subject of disease of any kind without his diges- 
tive organs partaking in the general totality of 
derangement. 

Is GOUT nothing more than a developement in 
the course of remittent constitutional disorder — 
gout which takes according to received opinion, 
shapes as many and protean as there have been 
physicians to write about it I What is gout? 
If it means any thing at all, it is an enlargement 
or tendency to decomposition of the smaller joints 
of the lower extremities. When you hear of gout 
in the brain, gout in the stomach, &c. the indivi- 
dual who talks in this manner, only mystifies 
himself and his hearers, by ^^an abstracted 
combination of words." The enlargement of any 
joint, whether of the knee or of the great toe, 



62 THE UNITY 

cannot take place without constitutional change, 
in the first place. My Critics of the British and 
Foreign Medical Review^ would appear to ques- 
tion this; — ^these gentlemen, while they admit 
remission, deny the fever. They are lucky to 
have never experienced gout Dr. Darwin has 
at least as good a claim to be looked upon as an 
authority in this disease, as my critics ; — -he bears 
me out to the full extent, so far as regards the 
symptoms of ague: — "The patients (he says) 
after a few days, were both of them affected with 
cold fits, like ague-fits, and their feet became 
affected with gout.'' An equally honest and ac- 
curate observer, Heberden, speaking of this dis- 
ease, remarks, "the pams are sometimes preceded 
either by a considerable Jever, or by slight feels 
of illness, which for a few days make the sleep 
less sound, or in a small degree abate the vigour 
of the appetite, spirits, and strength.'' That the 
swelled foot is a developement, and not a cause of 
such fever, is proved by the non-existence of 
swelling at the febrile approach. What are the 
remedies for gout? Are they not the remedies 
for ague? I myself have cured it with arsenic, 
colchicum, quinine, mercury, &c. and I am bound 
to say I have failed with aU. 

But the STONE? My readers will doubtless 
ask me whether I look upon this also as a result 



OF DISEASE. 63 

of intermittent fever. Assuredly there are times 
of the day when the subject of it is better and 
worse, and this not altogether to be referred to 
the period of micturition. A " fit of the stone" 
is as common an expression as a fit of the ague. 

Drs. Prout and Roget, who have paid much 
attention to calculary diseases, state that while 
medicines styled lythontriptics exert but little in- 
fluence in such cases, tonics have almost univer- 
sally ameliorated the condition of the patient. 
Are not the medicines usually termed tonics^ the 
best remedies for ague? In the sequel we hope 
to prove this. 

Whether Gout and Rheumatism be remittent 
diseases, or whether they be remarkable for the 
changes of temperature and action termed fever, 
nobody but such as prefer books of nosology to 
the Book of Nature, would be so ignorant as to 
question. The calculary depositions which occa- 
sionally take place in different tissues, in the 
course of these affections, suggested to medical 
men, even at an early period, the analogy sub- 
sisting betwixt them and stone. During consti- 
tutional disorder, calculary deposition may be 

developed in any structure of the body Salivary 

calculi are common ; — ^pulmonary calculi I have 
seen; — these were expectorated by a consumptive 
patient. How often the liver, gall bladder, 

G 



64 THE UNITY 

and kidney are the seat of stone, I need not tell 
the medical reader. Occurring in the course rf 
an artery, stone is erroneously termed ossification. 
That the false cartilages found in joints are also 
developements in the course of intermittent fever, 
I think the following case will be looked upon as 
as a proof: — A soldier of the 30th foot, had a fit 
of ague every alternate day* Among his other 
complaints was a sudden occasional inability to use 
the elbow joint, an annoyance that came on and 
went oflF he knew not how. My assistant in the 
hospital supposed him to be malingering. One 
day, however, the patient directed my attention to 
a substance in the joint, which, upon examination, 
finding to be a false cartilage I immediately cut 
down upon and extracted. This was loose and 
unconnected ; — a second cartilaginous substance 
which adhered by a thread-like pedicle to the sur- 
face of one of the bones I also removed. The 
arm got well but the man continued subject to oc- 
casional ague fits, and in about a year afterwards 
I had again to perform a similar operation for 
him. From the same joint I extracted another 
cartilaginous substance, which was attended with 
some difficulty in the removal, as it adhered by 
a considerable part of its surface to the capsular 
ligament. 

I shall now speak of Tumors. It is a common 



OF DISEASE. 65 

error on the part of medical men to state in their 
Reports of Cases, that a healthy person presented 
himself with a particular tumor in this or that 
situation. From this, it is ohvious, that while 
teachers busy themselves with artificial distinc- 
tions, they neglect to imbue the student with a 
proper knowledge of what t>, and what is not 
health. Numerous cases of tumor of every kmd 
and description have I witnessed during my pro- 
fessional career, but I have never met a solitary 
case where the constitution of the patient was not 
at fault. Chills and heats have been confessed 
to in almost every instance, and the great majority 
of patients have remembered that in the earlier 
stages the tumor was alternately more and less 
voluminous. 

Every individual we have already shewn, has a 
predisposition to disease of a particular tissue. 
Whatever will derange the general health may 
bring out the weak point of the previously healthy, 
and this may be a tendency to tumor in one or 
more tissues. The diflference of the organic ap- 
pearance of different textures will account for any 
apparent difference of the tumors themselves ; and 
where tumors appear to differ in the same tissue, 
it wiU be found to be only in the amount of the 
matter entering into such tissue, or in a new 
arrangement of some of the elementary principles 



G(i THE UXITV 

composing it. Some tumors partake most of the 
sanguiferous tissue, fundus fuematodes for ex- 
ample — some of the glandular, and these are 
usually termed scrofulous ; some are adipose,* or 
aqueous ; some hony or cartilaginous, while others 
again are a confusion of all ; and these, from 
their real or supposed incurability are termed 
cancerous or malignant 

Search the records of medicine upon the sub- 
ject of tumors, you will find that the medicinal 
agents by which these have been cured or dimin- 
ished, come at last to the substances of greatest 
acknowledged efficacy in the treatment of ague. 
One practitioner (Carmichael) lauds iron ; ano- 
ther ( Alibert) speaks favourably of the bark ; the 
natives of India prefer arsenic : while most prac- 
titioners have found iodine and mercury, more or 
less serviceable in their treatment. Reader, do 
you require to be told that these substances have 
all succeeded and failed in ague ! Wonder not 
then that each has one day been lauded, another 
decried for every disease which has obtained a 



* It !s a law in the animal economy, that when any secretion is 
deficient, another, to a certain extent, supp lies its place. If you do 
not perspire, you will find the secretion from the kidneys, or some 
other organ, in excess. I have a patient, at this moment, whose 
breasts have become enormous from adipose deposition i.e. secretion. 
Her urine is scanty, and she never sweats. Such is her statement. 



OF DISEASE. 67 

name — tumors of every description among the 
number I 

What a fine thing to be able to master the 
CUTANEOUS DISORDERS of Willan and Bateman 1 
How useful and necessary for the successful treat- 
ment of skin disease, to be able to distinguish 
psoriasis from lepra^ erythema from erysipelas, 
&c. — diseases only diflfering from each other in 
their being acute or chronic, or from being sim- 
ply more or less extensively developed ; all de- 
pending too upon the same constitutional unity 
and integrity of state ; all more or less amenable 
to identical agency ! What ! I shall be asked, is 
Erysipelas nothing more than a result of ague ? 
Hear what Sir James Mackintosh says when de- 
scribing his own case. Its accuracy will scarcely 
be questioned, if it be remembered that previously 
to his entering on his legal career, he had not 
only studied but taken his degree in medicine. 
" We had an imusually cheerful day,** he says, 
" but just as I was going to bed I was attacked 
hy Si Jit of shiveringy which in the morning was 
followed by a high fever y and in two days by an 
erysipelas in the face. The disease went through 
its course mildly, but it is liable to such sudden 
turns (fits ?) that one is always within six hours 
of death.'* For the value of quinine or bark in 
this disease, I could cite many authorities. 



68 THE UNITY 

Every surgeon of experience is aware of the 
severe, and occasionally fatal operations resorted 
to for the purpose of obtaining a reunion of frac- 
tured bones in particular constitutions ; — of the 
setons which have been passed betwixt their ends, 
and of the knives and saws by which they have 
been scraped and pared — those horrible local 
means for constitutional causes ! T>r. Colles, of 
Dublin, and Mr. Bransby Cooper, deserve weU of 
mankind for the introduction of a constitutional 
mode of treatment in such cases. In the hands 
of these gentlemen, mercury internally exhibited, 
has enabled patients of this kind to obtain a per- 
fect re-union of their fractures. Several years ago, 
while serving in the East Indies, it was my for- 
tune to obtain the same satisfactory result in the 
case of a soldier of the 30th foot, by the admi- 
nistration of quinine. The man had diurnal 
FEVER, — the true constitutional reason why frac- 
tured bones occasionally refuse to unite under or- 
dinary means. 

I forget the particular operative eminent who 
thanked God he knew nothing of physic 1 Such 
a confession was very proper for a butcher — ^for 
the barber-surgeons of former ages ; but the man 
who prefers the honest consciousness of saving 
his patient from prolonged suffering, or mutila- 
tion, to the spurious brilliancy of a name for 



OF DISEASE. 69 

"operative surgery/* will blush for the indivi- 
dual whose only title to renown was the bliss of 
his boasted ignorance, and a dexterity of hand 
unenviably obtained by the unnecessary waste of 
human blood! 

In the great majority of instances, the local 
disorder — I speak in the common acceptation of 
the word, Jrom which physicians almost invari- 
ably name disease, and to which they almost as 
invariably confine their attention, is only one, — 
and that not always the most prominent, — of 
many features of universal disturbance. So far 
from being the causes of such disturbance, the 
local tendencies to disorganization are merely 
hereditary or accidental developements occurring 
in its course ; — developements, expressive for the 
most part, of the weak points of individual con- 
stitution, though sometimes determined by cli- 
mate, or other speciality of cause. These, in the 
first instance, seldom require local treatment; 
when they do, it is because the disease involves 
parts, the disturbance of which materially in- 
terferes with the more immediate functions of 
life, — such as croup, and some other cases of 
cynanche. Local measures become more parti- 
cularly necessary in habitual or long-standing 
disease. In such cases, those remedies will be 
found most useful which tend to the improve- 



70 THE UNITY 

ment of the temperature of the part most affected. 

Injuries, passions, poisons, then, are each ca^ 
pable of producing the same constitutional dis- 
turbance, with every kind of organic complication. 
The difference in the seat of these last, as we 
have just hinted, has sometimes a reference to 
the special cause, but it more frequently relates to 
individual predisposition. To use a homely illus- 
tration : — "Wlien the whole house shakes, the 
worst room suffers most" And this of course 
differs with every house. A blow on the head, 
nay, an injury to so minute a member as a finger, 
may produce general remittent disorder, — end^ 
ing in abscess of the lungs or Uver, according to 
the constitutional predisposition of the patient. 
In the course of the contagious fevers. Small- 
pox for example, we daily find every kind of or- 
ganic lesion developed — ^lesion which no man in 
his senses, not even Clutterbuck or Broussais 
would place in the light of a cause. These fevers 
all partake of the intermittent, and in the com- 
mencement cannot be distinguished from fever 
produced by a blow or a passion. 

Is the PLAGUE an intermittent fever? The 
case of Corporal Farrell, as detailed by Dr. 
Calvert, in his remarks on the plague at Malta, 
[^MedtcO'Chirurg. Transactions,'] will be a suf- 
ficient answer to the question : — " This man had 



OF DISEASE. 71 

been standing in the sea on the 10th of November, 
upwards of an hour, to wash and purify his clothes 
according to an order to that effect. On coming 
out of the water he was seized with violent shi- 
vering and headache, succeeded by heat of skin 
and afterwards by sweating which alleviated the 
distressing symptoms. On the following day the 
paroxysm was repeated. He was permitted to 
remain in the barracks from a belief that his com- 
plaint was an intermittent fever. The next day 
his fever returned as usual, but now it declared 
itself to be the plague by a bubo (swelling) aris- 
ing in the groin, while the seat of the pain seemed 
to be suddenly transferred from the head to that 
part. The paroxysm was again followed by an 
intermission or remission. But the next morning 
while dressing himself to go to the Lazaret, he 
dropped down and expired." 

A French writer, quoted by Sir John Pringle, 
detailing the symptoms of the plague, as it ap- 
peared at Marseilles, says : — ** II arrive mais rare- 
ment que le mal se masque par tons les signes 
d'une fievre double tierce, et ce deguisement dure 
tout au plus jusques au troisieme acces, et alors il 
se demasque par tous les symptomes susdites de 
peste tant interieurs qu'exteriurs."* 

* **It happens sometimes, though rarely, that the disease assumes 



72 THE UNITY 

Disputes still exist as to the contagious nature 
of plague. On which ever side truth lies, there 
can be no difficulty as to the proper treatment. 
The indications, as in simple intermittent feyer, 
are to moderate the temperature in the cold and 
hot stages; and to prolong the remission by 
quinine, arsenic, &c., according to particular con- 
stitutions. Treated in this manner, the disease 
could not possibly be more fatal than we are told 
it is under the routine practice at present adop- 
ted. " In all our cases" says Dr. Madden, " we 
did as all other practitioners did, we continued to 
bleed, and the patients continiied to die r — Mad* 
derCs Constantinople^* 

From the same candid author, I find that the 
YELLOW FEVER of the Wost Indies is not less 
remarkable for its periodical remissions and exa- 
cerbations, than for the shiverings and alterna- 
tions of temperature, characteristic of every other 
disorder. The yellow appearance of the patient, 
like the milder jaundice of our own climate, is 
the simple effect of spasm of the gall ducts. — 
Jaundice then is a symptom — ^not a disease; — it 
is the result of spasm developed in the course of 



the mask of a double tertian fever^and it may maintain this dis- 
guise even to the third paroxysm, and then it developes itself 
by all the usual symptoms of plague whether external or Internal.* * 



OF DISEASE. 73 

fever.* The difference of locality has afforded 
nosologists an opportunity of mystifying the sub- 
ject of spasm. When it affects the lachrimal duct, 
they term it Epiphora or Fistula lachrimalis ;t 
the windpipe or bronchia, Dyspnwa or Asthma. 
When this irregular action of muscles is mani- 
fested about the jaws and throat, with loss of 
consciousness, the disease is styled Epilepsy. 
Taking place in the ilium or small gut, spasm is 
called Iliac Passion ; in the colon or large gut 
Colic ; and in the urethra. Spasmodic Stricture. 
That all these various diseases are merely modifi- 
cations of the same action is still further proved 
by each and all of them having been observed to 
assume the most perfectly intermittent type in in- 
dividual cases, and by all beinff more or less 
^enable to the ^e ota of medicines which 
have proved available in the treatment of simple 
ague. People will say: — "Oh, but you would not 
give quinine or bark in jaundice !" I can only 
say, I have found these remedies more beneficial 

* It may also be the result of a gall-stone, but this is rare ; and 
the gall-stone could not have been developed without fever, in the 
first instance. 

t Fistula lachrimalis is more frequently the effect of thickening 
or enlargement of the mucous membrane, lining the lachrimal 
duct. The same general treatment will very often succeed in both, 
though in the latter kind of fistula, the knife and style must occa- 
sionally be resorted to. 



74 THE UNITY 

than mercury in many cases of this disease ; and I 
shall in the sequel, quote other authority in their 
favour. Dr. Madden details a case of yellow 
fever, cured hy quinine^ a case in which he says 
** had the gentleman heen hied after the fashion 
of the country, I think in all prohabality, he 
would have died ; or had he survived, that he 
would have had left a debilitated constitution, 
and a dropsical diathesis to encounter in his 
convalesence." 

Previous to my embarkation for the East In- 
dies, where it wa« my chance to serve five years 
as a medical officer of the army, I read Dr. 
James Johnson's book on the Diseases of Tropical 
Climates. Imbued with his doctrines I put his 
sanguinary treatment and his scruple doses of 
calomel to the test. So far from confirming his as- 
sertions, my own experience led me to nearly the 
same conclusions as Dr. Madden. Captain Owen 
too, who could neither have a theory to support, 
nor any interested end to serve by his evidence 
one way or the other, details at great length the 
mortality among his people in the expedition 
which he commanded when employed to survey 
the African coast : — " It may in fact be ques- 
tioned (says the intelligent navigator,) whether 
our very severe losses were not in some measure 
attributable to European medical practice, — bleed- 



OF DISEASE. 75 

ing and calomel being decidedly the most deadly 
enemies in a tropical climate. During the whole 
time of the prevalence of the fever we had not one 
instance of perfect recovery, after a liberal appli- 
cation either of the lancet or of this medicine." 
Captain Owen further states that he himself 
recovered without either bleeding or calomel, 
while the ship doctor fell a martyr to his medical 
faith ; — ^he bled himself, took calomel, and died ! 

Cholera, the scourge of nations, — ^will cholera 
be found to partake of the same universal type of 
disease — the ague ? Let the reader judge when 
we draw our parallel. 

Tremulous and spasmodic action are equally 
s3ncnptoms of ague and cholera. Vomiting or 
nausea characterise both. The ague patient oc- 
casionally labours under diarrhoea or looseness ; 
oppression at the chest, and coldness of the ex- 
tremities, are the primary symptoms of each. 
The increased flow of pale urine so often remarked 
in ague, is sometimes a symptom of the epidemic 
cholera. In more than one instance of cholera 
which came under my own observation, while 
serving in the East, that secretion passed involun- 
tarily from the patient a short time before death. 
Suppression of urine, so common in the late epi- 
demic, was a frequent symptom of the Walcheren 
ague. When there is no re-action, death is 



76 THE UNITY 

usually preceded by stupor in both. You have 
ague, too, with hot skin and bounding pulse — a 
state analagous to English cholera, or cholera 
without asphyxia. When not fatal, cholera, like 
ague, has a hot and sweating stage. Lastly, when 
ague has terminated life by a single paroxysm, 
dissection shews the same appearances as in 
cholera. Phrenitic, hepatic and splenic change, 
with dysentery and dropsy, to say nothing of epi- 
lepsy and apoplexy, have been the occasional se- 
quelae of each. 

Let us now advert to what is technically called 
INFLAMMATION. Volumcs havc been written up- 
on this one word, yet no two authors agree upon 
it. If the student will only use his eyes, he shall 
find that inflammation is not a stable entity or 
state, but that like all the phenomena of the hu- 
man frame, whether under health or disease, it 
resolves itself into a succession of alternations, in 
the course of which its character and combina- 
tions are widely at variance with each other. 
What, then, is inflammation ? The word signi- 
fies Jire— flame. It is a metaphor merely. It 
means nothing more than a higher action and 
temperature of a part than are compatible with 
the healthy organization of that part. During 
the tendency of any structure of the body to de- 
composition there is more or less redness, throb- 



OF DISEASE. 77 

bing, tumefaction, and pain, in that structure. 
Medical men retain the term inflammation even 
in the absence of one or more of these pheno- 
mena. Like every other localism, inflammation 
is a developement in the course of general con<- 
stitutional disturbance. I do not speak of local 
inflammation produced by a chemical or mechani- 
cal injury. I leave that to the surgeons to 
elucidate or mystify according to their particular 
inclinations. I talk of inflammation from a 
general or constitutional cause. Has an indi- 
vidual, for example, exposed himself to cold or 
any other widely injurious influence, he shi- 
vers, fevers, and complains of pain, tension and 
throbbing in the brain, chest, or abdomen, — ^phe- 
nomena gradually developed according to the 
patient's predisposition to organic change in this 
or that locality. Fhrenitis, pneumonia, peri- 
tonitis take place as consequences or features 
-^not causes of the constitutional disorder. But 
are the symptoms of inflammation in such parts 
equally intermittent as in the inflamed joint 
termed gout or rheumatism? Listen to Lalle- 
mand. — ^'In inflammation of the brain (he says,) 
you have spasmodic symptoms, slow and progres- 
sive paralysis — the course of the disorder being 
intermittent.** Even according to Dr. Connolly, 
one of my most unfavorable critics, " diurnal re- 



78 THE UNITY 

missions are distinguishable in every attack of in- 
flammation/' Inflammation then difiers in no- 
thing from every other morbid action. Whether 
you recognize it as erysipeloid, gouty, rheumatic, 
scrofulous, it is still remittent; and, if you 
question the patient, he will, in almost every 
case, admit that it was preceded or accom- 
panied by chills and heats. Will inflammation 
then yield to bark? Dr. Wallace maintained 
the aflirmative, dwelling more particularly on 
its good effects in that disorganizing inflam- 
mation of the eye, termed iritis^ in which dis- 
ease he preferred it to all the routine measures 
which, on the strength of a theory^ medical men 
have from time to time recommended as anti- 
phlogistic. In my own practice the happiest 
results have followed its employment in the 
various inflammations which affect the lungs, 
liver, and testis. " The Peruvian bark,** savs 
Heberden, ** has been more objected to than any 
of these medicines [bitters] in cases of consider, 
able inflammation, or where a free expectoration 
is of importance — ^for it is supposed to have, be- 
yond every other stomach medicine, such a strong 
bracing quality as to tighten the fibres still more, 
which were already too much upon the stretch in 
inflammation, and its astringency has been judged 
to be the likely means of checking or putting a 



OF DISEASE. 79 

stop to inflammation. All this appeared much 
more plausible when taught in the Schools of 
Physic, than probable when /attended to fact and 
experience. The unquestionable safety and ac- 
knowledged use of the bark in the worst stage of 
inflammation, when it is tending to a mortifica- 
tion, aflbrds a sufficient answer to the first of these 
objections ; and I have several times seen it given 
plentifully in the confluent small-pox without les- 
sening in any degree the expectoration." 

AH this reasoning will equally apply to arse- 
nic, hydrocyanic acid, opium, &c. ; and, however 
modem theories may oppose their employment in 
particular inflammations, experience will assu- 
redly bear out the practical man in prescribing 
these agents in every inflammatory disease, pro- 
Tided he give them durmg fte reSssioB. tL 
the following case of indubitable and palpable in- 
flammation as an instance of the value of opium 
in such cases: — acute ophthalmia. An old of- 
ficer, Major F — , 89th foot, who had previously 
lost one eye, had the other attacked in a similar 
way to the first, with great pain, redness, &c. I 
found him leaning his head over a chair, his face 
indicative of intense agony. For ten nights he 
assured me he had been unable to tolerate any 
other position, and it was only in the morning 
when overcome by suffering, that he could at last 

H 



80 THE UNITY 

obtain a transitory sleep. The pain came on at 
bed-time in an aggravated degree, and remitted 
only for a short period of the afternoon. Three 
grains of opium which I ordered him to take half 
an hour before the expected paroxysm, procured 
him a whole night of profound sleep, and his 
eye in the morning, to his astonishment, was free 
from pain, and only slightly vascular. He had 
been repeatedly bled, leeched, and blistered, with- 
out even temporary benefit; — ^indeed the practi- 
tioner who attended him in the first instance, 
plumed himself on the activity of his treatment ! 
Let me now turn to such forms of disorder as 
in the male have been termed hypochondria, 
and m the female hysteria. In common prac- 
tice you will hear medical men say "Oh! there is 
nothing the matter with this man ; he is only hip- 
ped,*' — and if a female, " she is only hysterical," 
or " she has the vapours.** Having no inflamma- 
tory entity to treat, and really not knowing what 
to do, the generality of practitioners content them- 
selves with prescribing placebos or purgatives in 
such cases. Now, I must deprecate all this em- 
piricism. No man or woman indulges in whims 
and fantasies without being positively ill. If the 
physician will enquire, he wiU find that the sub- 
ject of the group of symptoms whether termed 
hypochondria or hysteria, suflFers from chills and 



OF DISEASE. 81 

heats — that exacerbation and remission charac- 
terize these diseases in every form, and that the 
hysteric or hypochondriac whim diflfers from hal- 
lucination and mania in shade merely, and the 
chilk and heats from the cold and hot stages of 
fever in nothing but degree. Look at an hys- 
terical or chlorotic female— there is not a func- 
tion of her whole body properly performed — ^but 
the mere circumstance of a particular organ, the 
womb, being part of her economy, her disorder 
is vaguely associated with this as a cause, and 
from its Greek derivation is named hysteria I — in 
the same way that a man similarly affected is said 
to be hypochondriac because he has a stomach 
or liver! How ridiculous in medical men thus 
to fasten on one organ as the cause of disorder in 
every other ! These diseases are mere variations 
of chronic or habitual low fever. By treating 
them as such I have had a success which at an 
earlier period of my life I could not have dared to 
anticipate. In these, as in every other chronic 
disorder, the practitioner should act on the brain 
in various manners and with various remedies ; 
for, generally speaking, no single remedy will long 
retain its beneficial power in chronic disease. 
He should therefore rapidly substitute one medi- 
cine and combination of medicines for another — 
now acting through the medium of the stomach 



82 THE UNITY 

and digestive organs, now through the outer sur- 
face of the hody. To-day a mild emetic will 
give relief — to-morrow iron, opium, quinine, or the 
hath. One week arsenic will he a divine remedy ; 
-the next, having lost its power, it may he dis- 
missed for prussic acid, silver, creosote or stry- 
chnine. Change of air and scene, — than which 
nothing can afford a more rapid succession of 
mental novelty, — exercise of various kinds, — at- 
tention to dietetics (more to call the patient's at- 
tention from himself than to any influence of the 
particular diet itself) — ^baths, cold and hot, will 
alternately suggest themselves to the pains-taking 
and philosophical physician. Above all things 
let him not exclusively pin his faith on any single 
remedial means ! 

I have already said that hypochondria and 
mania differ but in shade or degree. It is no 
unusual thing for a hypochondriac patient to tell 
me that he has had the most dreadful mental feel- 
ings to combat, — such as the wish to commit sui- 
cide or murder ; and in the case of the female, I 
have been told she desired to fly from her home 
or husband, she knew not why, and she cared not 
whither ! All these individuals have confessed to 
shiverings; — all to heats and chills. Mens sana 
in corpore sano I 

The following case from the Annales d^Hygiine 



OF DISEASE. 83 

puhlique et de MMecine legale, is sufficiently in- 
teresting to give entire : — " M. R — , a chemist, 
naturally of a gentle disposition, voluntarily claim- 
ed admission into a mad-house, in the Fauxbourg 
St. Antoine. He was tormented with a desire to 
commit homicide. He threw himself at the foot 
of the altar, and implored the Almighty to deliver 
him from such a horrid propensity. He could 
give no account of the origm of his mental disor- 
der. When he felt the accession of the fatal de- 
sire he was in the habit of running to the Head 
of the Establishment ; and requesting to have his 
thumbs tied together, with a ribbon. However 
slight the ligatiu'e, it sufficed to calm the unhappy 

R , though in the end he made a desperate 

attempt upon the life of one of his keepers, and 
perished in a paroxysm of fury." 

The remittent nature of this man*s disease is 
sufficiently obvious. Nothing is said of the 
temperature of his body, but the efficacy of the 
ligature, as a temporary alleviation, will at once 
suggest to the informed physician, the affinity of 
the disorder to ague, in which affection as well 
as in epilepsy, the ligature applied to the legs or 
arms is well known to have in many instances the 
effect of arresting the anticipated fit. When the 
late Dr. Mackintosh advocated blood-letting, at 
the accession of the ague fit, may he not have 



84 THE UNITY 

been deceived by his own experience? Before 
venesection could be attempted, the ligature was 
necessarily applied to the arm. To this novel 
mode of influencing the brain, rather than to the 
few ounces of blood drawn, I am inclined to as- 
cribe any benefit (temporary for the most part) 
observed to be derived from it. Is not this view 
of the subject further borne out by the beneficial 
influence of the proceeding being greatest when 
it was adopted before, or at the very commence- 
ment of the shivering fit? In other words, before 
Dr. Mackintosh's imputed cause, — Congestion(I 
call it the effect) could have existed. Dr. Parr, 
in his Dictionary, states that he has frequently 
succeeded in arresting the fit of Asthma, by the 
application of the ligature, and merely scratching 
the skin with the lancet, but without letting a 
drop of blood ! 

All that I have already said upon the subject 
of hypochondria and hysteria, will equally apply 
to the disorders of the female embracing cata- 
menial irregdarity. 

The following remarks, though confined by their 
author to amenorrhea, wiU be found of equal 
solidity in Menorrhagia. "It has been too much 
the custom,'* says Dr. Ramsbottom, " as is well 
observed by Sir Charles Clarke, to treat Ame- 
norrhea, as an ideopathic disease j whereas it 



OF DISEASE. 85 

is much more frequently merely symptomatic of 
general or local derangement ; and as this eva. 
cuation is a secretion, we might expect that like 
all the secretions of the body, it would be most 
duly formed when the general health is the 
least impaired. The best means, therefore, of 
eliciting the discharge is by restoring a healthy 
state to the system generally. We know that in 
that constitutional derangement called fever, the 
secretions from the Uver, salivary glands, skin, 
and all the mucous surfaces are suspended or 
lessened; but that they return with the decline 
of the febrile paroxysms. Would any person in 
his senses attribute the fever to the want of all 
or any of these secretions? Would he endea- 
vour to relieve the patient by exhibiting specific 
medicines to stimulate each of these organs for 
the purpose of re-establishing their functions? 
Certainly not : he would look upon the fever as 
the cause, not the consequence, of the suppres- 
sion, and he would restore the secretions by 
removing the fever. But change the case — let 
obstruction be a feature in the disease — the pa- 
tient is impressed immediately with the idea 
that the obstruction is the cause of all her suf- 
fering, — and she will frequently succeed in pro- 
ducing the same impression on the mind of her 
medical attendant. From that time he disregards 



86 THE UNITY 

the primary cause, and directs all his attention 
to the restoration of peculiar functions by stimu* 
lating remedies. Nothing can be more unphilo- 
sophical than such a proceeding — ^no practice 
can be more injurious. It sinks the Science o* 
Physic beneath the level of the commonest me- 
chanical art, and degrades it to the meanest em- 
piricism. It must lower it in the estimation of 
the public, and disgrace it in the eyes of the pro- 
fession.*' 

Pregnancy has been defined to be a natural 
process. So is disease — so is death! I term it a 
disorder, and one very clearly exemplifying the 
unity of type which characterizes disease gene- 
rally. During the early months, the brain, in at- 
tending to the new production, must, of necessity, 
to a certain extent, be withdrawn from the influ- 
ence it otherwise possesses over the fimctions of 
the mother. You have, consequently, the same 
alternations of temperature — the same shades of 
disease that may arise from any other agency affect- 
ing the brain in any unusual manner. Thus, like 
a blow on the head, loss of blood &c., Pregnancy 
is ushered in by vomiting — ^in most instances, 
periodic and intermittent. The pregnant female 
complains of chills and heats — and blood drawn 
from her arm exhibits the identical crust which 
writers have delighted to enlarge upon as the 



OF DISEASE. 87 

peculiarity of inflammatory fever I Nay, the 
hereditary or constitutional tendency to derange- 
ment or decomposition of a particular organ, is 
often developed during the early months of preg- 
nancy. Among the particular shades of disease 
which have come under my own observation, let 
me name epilepsy, apoplexy, loss of speech, and 
other palsies — consumption, spitting of blood, 
with many other glandular and varicose afiec- 
tions — also mania. Some of these very disorders 
have been remarkably and favourably influenced 
by this state. The disease most familiarly known 
to the profession as capable of being suspended, 
and in some instances cured, by pregnancy is 
Consumption. Where all other remedial means 
have failed, it is the duty of the physician to 
announce the possibility of a cure by marriage. 

Parturition we have already defined to 
be a series of pains and remissions. The com- 
mencement of labour is preceded by shiverings. 
" Sometimes," says Dr. Ramsbottom, " they are 
sufficiently intense to shake the bed on which the 
patient lies, and cause the teeth to chatter as if 
she were in the cold stage of an ague fit; and 
although she complains of feeling cold, the sur- 
face may be warm, and, perhaps, warmer than 
natural." Who is so ignorant as not to know 
that this chilly sensation is often complained of 



88 THE rxiTY 

by ague patients even in the hot stage ? Preg- 
nancy and parturition then are intermittent fe- 
vers. When the foetus is fairly developed in the 
one case, and the labour completed in the other, 
health is the general result — ^but in the course of 
both every kind of disease may shew itself, and 
even terminate in fatality. 

Abortion I need scarcely say is in every case 
preceded by the same constitutional symptoms as 
pregnancy and parturition. In most cases it 
may be prevented by the early administration of 
remedies proper for the intermittent. A lady 
who had been married several years, but who 
had never borne a living child, although she had 
had frequent abortions, consulted me upon the 
subject. Her miscarriages having taken place at 
nearly the same period of gestation — about the 
end of the third month, — I desired her when she 
should again become pregnant to send for me 
within a fortnight of the time she might expect 
to miscarry. She did so, telling me at the same 
time she knew she should soon be taken ill, as 
she had already had shiverings. I directed her 
to use an opium suppository nightly, which she 
did for a month, and she was thus enabled to 
carry her child to the full time. It is now a year 
old, well and thriving. I have succeeded in simi- 
lar cases with the internal exhibition of quinine, 
hydrocyanic acid, &c. 



THE 



UNITY OF DISEASE 



Part II. 



COMPRISING 



REMEDIES, AND THEIR MODE 

OF ACTION. 



Having, we hope, satisfactorily demonstrated 
that ALL DISEASES, in the words of Hippocrates, 
not only "resemble each other in their form, in- 
vasion, march, and decline ;** — ^but that whatever 
be its remote origin. Morbid Action is still, 
under every circumstance, essentially the same, — 
partaking throughout the whole of its various 
shades and revolutions, of the nature and simpli- 
city of the xmcomplicated intermittent; we 
shall now enter upon the consideration of some 
of the various means which accident or experi- 
ence has shewn to be adequate to its alleviation 
or cure. 



90 THE UNITY 

Turn over the records of the profession, and 
mark well the remedies upon which authors dilate 
as being most beneficial in any form of disease, — 
you will find them to be, one and all, agents 
having either the power oi preserving or control- 
ling temperature ; — of exalting or depressing this 
in the stages of exacerbation ; or of continuing or 
prolonging the more healthy and moderate de- 
grees of it characteristic of the period of remis- 
sion. 

The CAUSES of disease, as already mentioned, 
can only affect the body, through one or other of 
the various modifications of nervous perception. 
Through the same medium^ and in the same 
manner only, do all our Remedial Measures 
exert their salutary influence on the human firame. 
The Brain and Spine are the grand centres up- 
on which they act, — and mant/ are the roads by 
which these may be approached. A man may 
fall from a height upon his feet, and be as cer- 
tainly stunned as if he had alighted on his head. 
A smart blow on the knee or elbow, may produce 
the same effect, — ^nay, each of these different ac- 
cidents, has been occasionally followed by the 
same constitutional affection, as by any active 
power introduced into the stomach; — the brain 
in both cases being influenced in a novel or un- 
usual manner. By each of the five senses may 



OF DISEASE. 91 

the brain be beneficially, or banef ully approached. 
Sight. The presence of a strong light will ex- 
cite head-ache with some ; — a flash of lightning has 
caused and cured "the palsy.** The effects of 
sudden light on a friend of mine is almost always 
a fit of sneezing. Laennec mentions the case of a 
gentleman who, in riding on horseback arrived at 
an extensive plain. As he proceeded upon it, he 
perceived a sense of suffocation; — ^he turned back 
and the sensation went off; — he agam attempted 
to proceed, but the return of the dyspnoea forced 
him to abandon his journey. Change of scene 
has in this way cured many otherwise intractable 
diseases. To the waving motion of the hands in 
what are termed " the passes," I attribute all the 
phenomena which Animal Magnetism is said to 
induce in patients who submit to this mummery. 
Such motions appeared to me to be influential in 
a case of epilepsy. Authors on the other hand, 
mention vertigo and epilepsy as having been in- 
duced by gazing for a length of time upon a 
running stream I Vertigo and a sense of sick- 
ness are conmion effects of looking from a great 
height. The view of a varied and pleasant 
country, will, of itself, improve the state of many 
invaUds. 

Hearing. A loud noise has caused and cured 
an infinity of disorders. Fevers that would yield 



92 THE UNITY 

to no internal remedy, have been remarkably and 
advantageously influenced by the music of some 
long remembered song. The well known Swiss 
air the " Ranz des Vaches/' has removed and 
given rise to many a malady. Sounds which set 
the teeth on edge have been familiar to all. Dr. 
Baron, in his Life of Jenner, states that at one 
period of his life, the subject of his biography 
became ^^ remarkably sensitive to external impres- 
sions, but most of all to sounds of a certain de- 
scription. Those that were dull and obtuse he 
little regarded, but the sharp harsh click, for in- 
stance, of a knife upon a plate, produced an efiect 
as if he had an electrick shock sent through his 
frame." 

Smell. There are individuals, in whom the 
odour of certain flowers, such as the tube-rose 
aad the heUotrope, mil bring on a paroxysm of 
asthma. Even the smell of the rose, has occa- 
sionally been followed by a fainting fit. How 
often through the same medium — the sense of 
smell do we recall patients from this very state 
by the use of burnt feathers, hartshorn, and other 
olfactory substances. 

Taste. Sweets are not alike pleasing to all. 
Sugar, so grateful to the European palate, is re- 
jected by some tribes of Esquimaux with disgust. 
The negro, in particular forms of sickness, like 



OF DISEASE, 93 

the pregnant woman, takes delight in the most in- 
edible and repugnant substances, such as clay, &c. 
The bitters and acrids occasionally produce nau- 
sea aiid vomiting. A shudder or sMver is their 
more common effect. There are some individuals, 
nevertheless, who seem to enjoy them. 

Touch. If a smart dash of cold water on any 
part of the body may cause syncope or con- 
vulsion, it has cured both. Titillation or tick- 
ling, which may readily produce convulsive mo- 
tions has been employed by Mr. Wardrop, as a 
remedy for convulsion. The simple operation 
of passing an instrument into the urethra,_and 
that even without exciting pain, — ^may be followed 
by a host of affections. Under my own eye it 
has produced ague, fainting fits, and the most 
perfect form of cholera asphyxia ; in some in- 
stances it has been followed by a rash all over 
the body. I am not sure that ague might not 
be cured by passing a bougie. If so, this might 
serve to explain the manner in which the general 
health, and by consequence local affections have 
been sometimes improved under the hands of 
professional quacks, who treat all applicants for 
their assistance, whatever be their complaint, for 
urethral stricture. 

The Passions. We have already, to a cer- 
tain extent, demonstrated the influence of par- 



94" THE UNITY 

ticular passions in the production of disease. We 
have further proved that the same morbid ac- 
tions which we recognize under so many diffe- 
rent names when arising from a blow or a poison 
may be equally the result of a mental impres- 
sion. We have established their absolute iden- 
titt/y by curing them with the same agents 1 I 
care not what be the nature of the passion, — joy, 
grief, or fear, — the constitutional circle of actions 
is still the same. Thus, in all these different 
passions, as from palpable physical agency, the 
muscles may become tremulous, spasmodic, pal- 
sied,— respiration convulsive, or otherwise dis- 
turbed — and each and all of the secretions, more 
or less vitiated and varied. If we have ameliora- 
ted or cured the subjects of disease, originating 
in a mental impression, by physical means ; so 
also does the History of Medicine present us with 
innumerable instances of the beneficial influence 
of these very passions in every kind of disorder, 
whatever may have been the nature of the pri- 
mary cause. 

Few medical men will dispute the influence of 
a passion in the cure of ague. Mention any men- 
tal impression, such as faith, fear, grief, or joy, 
as having been successful in this affection, and 
they doubt it not ; but superadd to the patient's 
state a palpable change of volume or structure. 



OF DISEASE. 95 

such as an ulcer or the King's-evil, and they smile 
in derision at the efficacy of a charm. Extremes 
in scepticism and credulity are disease. The heal- 
thy mind is ever open to conviction ; and he who 
can helieve that the Ohi charm, or the magic of a 
monarch's touch, can so operate upon the hrain 
and nerves, as to interrupt or avert the mutations 
of action and temperature, constituting an ague fit, 
should pause hefore he denies their in^jience over 
an ulcer or a tumour, which can only he developed 
or removed by, or with, change of temperature. 
And no individual can possibly be the subject of 
any mental impression, without experiencing a chill 
or a heat, a tremor or a spasm, with a greater 
or less change in all the atomic relations of every 
organ, and consequently of every organic volume 
and secretion. 

Baron Alibert gives the case of a Parisian lady 
of fortune, who had a large wen on the neck — a 
goitre^ which, from its deformity, occasioned her 
much annoyance. That tumour which had re- 
sisted every variety of medical treatment disap- 
peared during the Reign of Terror — a period when 
this lady, like many others of her rank, experi- 
enced the greatest mental agony and suspense. 
In my own experience, abscesses of considerable 
magnitude have been cured both by fear and joy. 
Few surgeons, in much practice, have been with- 

I 



96 THE UNITY 

out the opportunity of satisfying themselves that 
purulent swellings may recede under the influ- 
ence of fear. They have assured themselves of 
the presence of matter — they propose to open the 
tumour — the frightened patient hegs another day, 
but on the morrow it has vanished ! How is all 
this effected ? Sir H. Davy has weU answered 
the question : — " We cannot entertain a doubt 
(he says) but that every change in our sensations 
and ideas must be accompanied with some cor- 
responding change in the organic matter of the 
bo4y/' That change relates to motion and tem- 
perature. 

The effect of terror in removing the pain of 
gout and tooth-ache is so familiar to many who 
have suffered from either, that I only recall it to 
notice in this place, to induce people to pause 
before they ascribe the former disease to some 
mystical essence, or humor ; or, in the latter, con- 
sent to the extraction of a tooth that in many in- 
stances might have been usefully preserved by the 
employment of well-directed constitutional reme- 
dies. With quinine, arsenic, &c., I have enabled 
many a sufferer from tooth-ache to escape the 
dexterity of the dentist. Far be it, however, from 
my intention, to condemn the operation of extrac- 
tion in all circumstances ; — the removal of a de- 
cayed tooth being, in many instances, followed by 



OF DISEASE. 97 

the same good consequences as the removal of a 
bullet or other extraneous body, when acting pre- 
judicially on the whole corporeal frame. 

The influence of the mind in disease, is often 
powerfully exerted, in the case of the wounded of 
contending armies. The same description of in- 
juries which heal with rapidity, when occurring in 
the persons of the victors, often prove intractable, 
or even fatal to the vanquished ! 

Medical men, while they generally, but vaguely, 
profess their belief that the body may be influ- 
enced through the medium of the mind, have yet 
been slow to avail themselves of the passions in 
the cure of disease. Often, indeed, and not al- 
together disinterestedly, do many of the subor- 
dinate class of practitioners take advantage of 
their patients' fears against a too speedy recovery. 
Until the general practitioner obtain a fairer and 
more equitable mode of remuneration for his ser- 
vices, than what he can procure by ordering and 
charging for unnecessary medicine, it is vain to 
expect that he will put his patient's interests 
against his own, and cure him by the happier 
influence of mental impression. And, here let 
me observe, if some legislative enactment do not 
speedily rectify this among other medical abuses, 
I fear the profession of physic will shortly become 
one which a gentleman shall be ashamed to fol- 



98 THE UNITY 

low ! Let our senators and legislators reflect for 
a moment on such a possibility. With their daily- 
experience of human nature, — ^with their know- 
ledge of the past history of men of every class 
and country, — ^let them imagme the consequences 
of medical practice being left entirely in the 
hands of illiterate and interested tradesmen. The 
result of such a state of things will be, that the 
petty doctor like the petty lawyer, will be in less 
hurry to relieve the applicant for his assistance, 
than cunning in his mode of prolonging and turn- 
i„g tie embLr««nent of i^rid^ to hi- own 
private pecmiiary advantage.* 

From this digression let me again revert to the 
beneficial agency of the mind. In times compa- 
ratively modem, it wa« a common practice to pre- 

* The late Dr. Parry, of Bath, alluding to men of this stamp, 
has the following remarks : — "A man shall be grossly ignorant of 
the whole science of medicine ; yet, if he has a certain degree of 
assurance aided by an adequate number of fashionable phrases — 
some speciousness in decorating mystery, with a determined reso- 
lution of flattering his patients by an appearance of great zeal and 
attachment, and by confirming the good opinion which they enter- 
tain of their own discernment in the choice of the medicine and 
diet which they most like, — that man shall grow popular and rich, 
under the hourly dereliction of every principle of truth, honour, 
and conscience, and become accessary to the daily destruction of 
his fellow creatures. This is the reason why a large party of all 
ranks is always inclined to favor the most uneducated of the me- 
dical profession." Do we require to go to Bath to see such cha- 
racters ? 



OF DISEASE. 99 

scribe live toads, moss from the deaxi man's skull, 
viper's and puppy's flesh, &c. That such means 
occasionally accomplished the end for which they 
were directed, is to be attributed not so much to 
any intrinsic virtue of their own, as to the 
emotions which they naturally inspired. The hor- 
ror, the disgust, nay, the shudder of the patient 
are all sufficient proofs of their manner of action. 

Even in our own days we hear of the dead 
malefactor's hand being applied to wens — and we 
have known spider web cure the ague. With 
regard to the latter, I am not sure that its action 
is entirely mental, for it has been occasionally 
found to be eflfectual, even where the patient was 
in ignorance of the nature of his remedy. Like 
musk, castor, and some other animal secretions, 
the spider-web may act in a physical manner 
upon the brain and nerves independent of mental 
influence. 

" Les amulettes et les charmes furent en vogue' 
de tout temps — ^les pretres et les rois qui ce sont 
tour-a-tour dispute le gouvemment des hommes 
furent aussi ceux qui s'attribuerent la prerogative 
de les distribuer. Avant meme que les Grecs 
eussent pense a faire un code de M6decine, leurs 
hierophantes formaient des amulettes de toutes 
les substances les plus singulieres que I'imagina- 
tion put leur suggerer — Qu : Sever : Simonicus 



100 THE UNITY 

inventa ensuitc le mot baroque Abacadabra pour 
guerir la fievre hemitritie. Les Juifs attribuer- 
ent la meme vertu a leur mot Abracalan. Les 
Arabes long tems apres vanterent leur talismans ; 
les Europeans Tattouchement de leur rois et de 
leur reliques ! La consideration de la croyance 
des hommes sur ce point ofire le tableau singu- 
lierement varie de leur faiblesse."* 

In Ireland, even at this hour, exorcism is re- 
sorted to, for the cure of epilepsy, by the Catholic 
clergy, who are supposed, not only by the credu- 
lous of their community, but, by many of the more 
enlightened members of the Roman Church, to 
be invested with the power of healing among 
other miracles. The more fanatical the priest, 
the more surely will he obtain the dominion, over 
the mind of his patient, necessary to secure the 
faith that produces the required beneficial result 

* ''Amulets and charms have been resorted to from the earliest 
ages. Priests and Kings, who by turns have disputed the govern- 
ment of mankind, have also been those who arrogated to themselves 
the privilege of tlieir distribution. Before the Greeks had even 
dreamed of reducing medicine to a system, their hierophanta formed 
amulets from substances the most extraordinary that imagination 
could suggest. Qu : Sever : Simonicus invented the ridiculous 
word abacadabra to cure the hemitritie fever. The Jews attributed 
the same virtue to their word abracalan. The Arabs, long after 
this, boasted their talismans ; — Europeans the touch of their Kings 
and their relics ! The consideration of man*s credulity upon this 
point, presents a singular picture of his feebleness and folly.** 



OF DISEASE. 101 

of his exorcism. Who, after this, will question 
the Hohenloe miracles; or, who can be in any 
kind of doubt as to the mode and mediiun of their 
accomplishment? A highly gifted clergyman of 
the Church of England informs me, that he has 
been very recently asked for a piece of silver 
(sacrament money,) to be worn round the neck, as 
a charm against epilepsy ! While the Patholo- 
gical School sneers with contempt at the influence 
of mind on matter, the Caffre Rain-maker and 
the Copper- Indian sorcerer, with their charms and 
simples, work changes in the constitution that put 
the boasted science of all the schools together to 
shame ! We laugh at the vulgar for their simpli- 
city and superstition ; but, the records of every 
people bear testimony to the efficacy of charms I 

Baths, cold affusion, &c. What disease has 
not been cured or alleviated by the bath — the 
first and favorite prescription of the ancient phy- 
sician ? Need I say, that the efficacy of this re- 
medy, whether hot or cold, medicated or mineral, 
entirely relates to the improvement which, directly 
or indirectly, it is capable of affording, to the tem- 
perature of the patient ? I have seen a chilly 
hypochondrisu) dash into the cold plunge-bath, 
and, in a minute or two after leaving it, become all 
in a glow. While in this state, flights and fancies, 
and real and imaginary pains have in most cases 



102 THE UNITY 

been put to, at least, a temporary flight. In re-i 
peated instances, I have even known such diseases 
to be cured by a few successive plunges. Numerous 
cases of chronic rheumatism have, in my experi- 
ence, yielded to the cold bath, after every other 
remedy had been tried in vain. The same means 
have materially assisted me in the treatment of 
particular cases of dropsy and heart-disease. Suc- 
cessively alternated with the hot air-bath, and the 
tepid shower-bath, cold bathing may be made 
generally useful in almost every kind of chronic 
disease. 

The cold affasioriy as a general measure, is 
better adapted to hospital practice than to the 
treatment of private patients. I have, neverthe- 
less, with the aid of this powerful means, cut short 
many a fever, which, under the bleeding and 
starving systems, would have fiUed the pocket of 
the medical attendant. I regret to be obliged to 
make such an allusion, but certamly the interests 
of the profession generally, have not hitherto led 
them to question the utility of measures to which 
custom, rather than a curative necessity, has recon- 
ciled the majority of patients. 

Mineral waters, whether chalybeate, sulphu- 
reous, or indeed under any combination in which 
nature presents them to us, have been celebrated 
in every form of disorder j and who can doubt 



OF DISEASE. 103 

that particular constitutions have derived benefit 
from every description of mineral spring ! 

Having practised in Cheltenham sufficiently 
long to test the efficacy of its waters, it might 
be expected that I should here enter into some 
particulars regarding them ; but, so many ana- 
lyses have been made of their component parts, 
and so many books and guides detail these at 
length, that I shall content myself for the present 
by simply stating, — that combined with the baths, 
amusements, and novelties of the place, together 
with the beautiful and varied scenery which sur- 
rounds, or lies contiguous to, a town unequalled 
in England for salubrity, the waters of Chelten- 
ham have been of infinite service to almost every 
description of invalid. Like every good thing, 
however, they have been occasionally taken under 
circumstances which ought to have counter-indi- 
cated their employment. They ought never to be 
drank but under the superintendence of physi- 
cians, thoroughly acquainted with both their vir- 
tues and their vices — ^for to say that they want the 
latter, would be to strip them of every thing like 
value in the eyes of all thinking persons. 

Exercise, change of air, &c. I have said 
there can be no motion without change of tem- 
perature. This is the secret of the benefit to be 
derived from exercise and gestation. 



lOif THE UNITY 

A gentleman affected with habitual asthma, 
breathed freely when in his gig. Another, afflic- 
ted with vertigo, is immediately "himself again,'* 
when on horseback. I have ah*eady given the 
reader, at fuU length, a case of consumption, cured 
by horse-exercise. A dropsical female, who came 
many miles to consult me, not only felt corpo- 
really better when she got into the coach, but 
her kidneys acted so powerfully as to be a source 
of much inconvenience to her during the journey. 
This corporeal change she experienced every time 
she came to see me. I have had cases of all these 
various diseases, where aggravation was the re- 
sult of gestation. 

Exercise of the muscles, in any manner cal- 
culated to occupy the patient's whole attention, 
wiU often gready improve patients suflering un- 
der every kind of chronic disease. Dr. Cheyne 
was not above taking a useful hint on this point 
from an Irish Charlatan. " This person,*' says 
Dr. Cheyne, " ordered his [epileptic] patients 
to walk, those who were not enfeebled, twelve, 
fifteen, or even twenty miles a day. They were to 
begin walking a moderate distance, and they were 
gradually to extend their walk, according to their 
ability. In some of the patients, a great improve- 
ment took place, both with respect to digestion 
and muscular strength ; and this was so apparent 



OF DISEASE. 105 

in a short time, that ever since this luminary 
shone upon the metropolis of Ireland, most of our 
patients affected with epilepsy, have been with our 
advice peripatetics." 

Discrimination, I need not say, is especially re- 
quired in all cases where exercise is ordered. It 
is from the neglect of this, that particular reme- 
dies have been praised in one age, aud decried 
in another. Physicians too often appear to have 
lost sight of the fact, that, what will cure one 
patient will frequently not only fail, but have even 
an opposite effect in another, though the nature of 
the disease and its cause may have been one and 
identical. In the moral world we see the same 
thing take place daily. If a soft answer, for ex- 
ample, very frequently turns away wrath, we are 
yet compelled to witness cases, which so far from 
alleviating, it only adds to the paroxysm of rage ; 
and rage, after all, like every other passion, is the 
mere manifestation of corporeal change. Let us 
confess, then, with Hofiman, that our diflSculties 
in practice arise, not so much from multiplicity of 
disease, as from variety of constitution. The same 
cause, whether chemical, moral, or mechanical, 
has given rise to every shade of disorder. May 
not these shades then, though all at first sight so 
different, be each, so far as nomenclature is con- 
cerned, beneficially treated by a given remedy? 



106 THE UNITY 

The most successful physicians have employed 
the same medicines in every form of disorder; 
and assuredly there is no one remedy which may 
not prove advantageous in all. But for this, the 
calomel of the Eastern practitioner, Ahemethy's 
pill, Perkin's Tractors, and Mesmer's Magnetism, 
had alike been vaunted in vain ! Nay, but for 
this, the nostrum of the Charlatan would be as 
seldom profitable to its propounder, as to its pur- 
chaser. But, containing in many instances, an 
energetic substance, is it wonderful that the secret 
remedy should occasionally accomplish cures in 
cases which the routine practitioner, to the pre- 
judice of the profession and his art, has aggra- 
vated by what the fashion of his day has been 
pleased to term scientific treatment ! That the 
various pansu^ese of the quack have done so is un- 
deniable ; for, there are few substances that may 
not accomplish a change, for better or for worse, 
in every deviation from health, under whatever de- 
nomination you may please to place it. Quackery 
in and out of the profession, carefully conceals the 
number and extent of its victims ! 

Return we to Exercise. The advantages de- 
rived ^om travelling are partly to be ascribed to 
the necessary movement, and partly, to change 
of air and scene. Like every mode of treatment 
that presents frequent novelty, travelling promises 



OF DISEASE. 107 

the greatest advantages to patients afflicted with 
chronic or habitual disease. How often, alas 1 do 
we find it recommended, as a last resource under 
circumstances, where it must inevitably hasten the 
fatal catastrophe ! The breath that might other- 
wise have fanned the flame, now only contributes 
to its more rapid dissolution. — Est modus in 
rebus ! 

Plasters, bandages, &c. The beneficial in- 
fluence obtained from all such local applications, 
depends upon the change of temperature which 
they are capable of producing. Their results will 
vary with constitutions. Sir R. A — told me 
that while serving in Portugal, he became the 
subject of severe ague, which resisted all the re- 
medies prescribed for him by numerous medical 
firiends. One day when riding out, he was seized 
with a paroxysm. The inmate of a little shop 
where he dismounted till the fit should be over, 
suggested to him to try the barber-surgeon of his 
neighbourhood. Willing to be cured by any body 
or by any thing. Sir R — at once agreed* The 
ambidexter man of medicine came — ordered him 
a large plaster to the back, and the ague was 
forthwith cured I Instructed by this fact, I have 
advantageously prescribed plasters in many cases 
of chronic disease. The improvement of the 
temperature of the spine under such treatment, 
has been followed by the alleviation in most cases. 



108 THE UNITY 

and the cure in many, where the symptoms had 
previously resisted every kind of internal treat- 
ment Most patients, who suffer from chronic 
disease, will point to a particular spot as the 
locality where they are most incommoded with 
" cold chills." This is the point for the applica- 
tion of the galhanum or other " warm plaster." 
A plaster of this kind to the loins has enahled 
me to cure a dropsy that had previously resisted 
every other mode of treatment. The same appli- 
cation to the chest, when the patient complained 
of chilliness in that particular part, has mate- 
rially aided me in the treatment of many cases of 
phthisis. In hoth instances where heat was the 
more general complaint, cold sponging has been 
followed by an equally beneficial effect. 

How can you apply a bandage or other ligature 
with any degree of tightness to any part of the 
body, without altering the motion of that part — 
without equally changing the temperature ? In 
such cases you find ulcers, &c. benefitted or the 
reverse, much in the same way as, they may be 
daily seen in hospitals after the application of hot 
or cold water dressings. The ingredients of sur- 
gical ointments, lotions, &c. — ^what are they but 
combinations of the agents with which we com- 
bat fever? They have no other influence but 
through the medium of temperature. 



OF DISEASE. 109 

Having thus far explained the action of the 
more early and obvious means of relief to which 
mankind resorted in the hour of sickness, we 
shall now turn to a consideration of the principal 
substances which modern practitioners have, from 
time to time, adopted for the treatment of disorder 
— and all of which the London College of Phy- 
sicians has publicly and officially sanctioned, by 
including them in their later pharmacopeise. 

From the History of Medicine we learn that 
after charms came simples. The accumulated 
experience of ages has since discovered to physi- 
cians the remedial power of many substances, 
which the early pra<5titioners of medicine, in com- 
mon with the vulgar of every time and country, 
were accustomed to condemn as only dangerous 
or deadly. The use in practice of the more ac- 
tive poisonsy such as arsenic and prussic acid, is 
comparatively speaking, a modem improvement. 

"Wherefore** asked Pliny, "has our mother, 
the earth, brought forth so many poisons, but that 
man in his distress might make away with him- 
self." Such was the very natural feeling of men 
who lived in an age when it was considered a 
greater proof of philosophy to meet suicide than 
to endure suffering. A better reason will be given 
in the sequel. The first maxim of the more en- 
lightened medical man is, Ubi virtus^ ibi virus. 



110 THE UNITY 

Linneus well observes " medicine and poison 
ARE identical'* ; which being interpreted, means 
that any earthly agent may become either a re- 
medy or a poison, according to the dose or degree 
in which it may be administered ; — taking into ac- 
count, of course, the constitution of the patient. 
The base and selfish of all ages have ruled man- 
kind by terror. By this the priest has trampled 
down reason — the despot, the rights of a people. 
It is to this passion the ignorant medical practi- 
tioner appeals, when he employs the word poison 
as a bugbear, to preserve his practice from the 
inroads of the true cultivators of the science of 
medicine. It may not, therefore, be without use 
to several of our readers to explain its proper 
meaning in this place. In its popular sense, this 
word signifies any substance which taken into the 
stomach in small quantity, may shorten or other- 
wise prove injurious to life. It is then a relative 
term — a term applicable only to bulk or volume. 
But what is there, imder Heaven, when tried by 
the mere test of volume, may not deserve the 
name of poison? The domestic fire may become 
the source of a general conflagration — the water 
we drink has inimdated a city, — shall we banish 
them henceforth from our hearths and homes? 
Shall we eschew the air we breathe, because the 
ill-clad or incautious have suffered from exposure 



OF DISEASE. Ill 

to its unmitigated influence in all weathers? Shall 
we make it an insurmountable objection to the 
employment of rhubarb or jalap^ that an infant at 
the breast has been, accidentally, poisoned^ by the 
dose that would scarcely produce any effect upon 
an adult ? Shall opium cease to soothe the pil- 
low of the wretched, because the suicide has, im- 
der its influence, Settled his last account with man 
and his Maker ? Shall we repudiate the curative 
aid of arsenic in ague, because the poisoner and 
the cut-throat have, with a thousand times the 
volume adequate to that desirable end, drugged 
the cup of their unsuspecting victim ? Shall we 
suffer our patients to die a lingering death by 
consumption, rather than try to cure them by the 
measured exhibition of prussic acid^ because the 
dog and other inferior animals have, in the labo- 
ratory of the chemist, perished by concentrated 
doses of this valuable medicine? Shall we, in 
fine, prefer sickness and sadness to the blessings 
of healthj^-^eath to life, for the prejudice of a 
name ! Every remedial agent, however benefi- 
cial in one volume, may become poisonous in 
another. Medicine, then, is a power for good or 
for evil, for life or for death, according as it is well 
or ill-directed. Of this fact, the general reader 
may be certain, there is no such thing as an 
absolutely safe substance in the whole Materia 

K 



112 THE UNITY 

medica. What remedy can be worth a rush, that 
in aU conceivable states and proportions possesses 
no innocuous quality ? The amount of opium, 
prussic acid or arsenic, may be so adjusted to a 
given volume of fluid that you might drink of the 
mixture to a greater extent, and with more im- 
punity, than from an equal volume of wine and 
water of common strength. 

The diflference betwixt Medicme and poison 
then is a mere question of quantity or degree ; 
for, what is there which pertains to earth or air, 
that may not be converted to the use of man ? If 
he, in his ignorance or depravity, turns a given 
substance to evil accoimt instead of to good, shall 
blame be imputed to the Almighty, who bestowed 
it upon him as a boon ! When you hear a medical 
practitioner decrying a medicine as being a " strong 
medicine,'' or a ^^poison,*^ you may be certain of 
one of two things — either that that man is in utter 
ignorance of the nature of the agency he himself 
employs in physic, or that he is endeavouring by 
disingenuous means to injure the reputation of a 
successful rival, whose better sense and more ex- 
tensive practice, have taught him to administer 
in safe and efficient doses, substances which the 
other, with well-dissembled horror, aflects to look 
upon as only destructive to life. The Charlatan, 
when he puffs his nostrum, tells you it contains 



OF DISEASE. 113 

no mercury — ^he goes so far as to boast that it may 
be taken in any quantity ! 

The infinity of substances which have been ap- 
plied to remedial purposes, whether derived from 
the animal, vegeta^ble, or mineral kingdom, like the 
various causes of the diseases for which we admin- 
ister them, will, upon investigation, be found to have 
the most perfect unity in their mode of action. 
Their influence relates solely to temperature ; 
differing, where they do differ, simply, in their 
power of influencing in this respect, the atomic 
relations of a particular locality, but in no other 
way presenting a doubt or difficulty as to their 
modus operandi. What John Hunter said of 
poisons, applies of course to remedies. They 
"take their place in the body, as if allotted to 
them/' One substance wiU most rapidly affect 
glandular structure ; another will be more gen- 
erally influential in muscular parts. Through 
the medium of the nerves of a part, a particular 
substance, even when injected into the veins, will 
produce its particular effect, good or bad, upon 
that part. Is not this the best of all proofs, that 
the Deity intended poisons, so called, for the use 
of man? When thus administered, antimony, for 
example, will prove equally emetic as when intro- 
duced into the stomach — rhubarb, equally purga- 
tive, and opium as certainly soporific ! Ask the 



114 THE UNITY 

schoolmaii the reason of all this ; and he will tell 
you he knows the fact, but nothing more. Had 
his acquamtance with the book of nature, practi- 
cally, been equal to his knowledge of scholastic 
literature, he would long ago have satisfied us 
upon this head. But for the last two hundred 
years, professors have done little more than split 
strawSj and quarrel about words, equally mis- 
leading themselves, their pupils, and the pub- 
lic I It is only in relation to the difference of the 
office of particular organs, and to the power with 
which particular remedial agents influence the 
temperature^ and consequent motion of these, that 
they produce effects apparently different from each 
other. Opium, antimony, rhubarb, then, have 
but one primitive mode of action— their ultimate 
and, apparently, unlike results only differing in the 
dissimilarity of the functions of the organs which 
they respectively influence. Change of tempera, 
ture, without any other agency, can produce every 
constitutional and local change, every vitiation 
and variation, — whether spasmodic or secretive, 
— which has ever formed the subject of medical 
observation. Having premised this much, we 
shall now speak of the action of 

Emetics. When the various doctrines which 
attributed all diseases to "acrimonies,** "peccant 
humors," " crudities," &c. prevailed in the schools. 



OF DISEASE. 115 

Emetics were among the principal remedies to 
which physicians very naturally resorted as a pre- 
liminary means of cure. The acknowledged be- 
neficial effect of vomiting in the early stage of 
almost all disorders, was, of course, urged in con- 
firmation of theories, which, even in the present 
day, are not without their influence on the minds 
of medical men. The primary action of emetics 
we hold to be cerebraL Whatever will influence 
the brain in any unusual or novel manner, by 
changing its temperature and atomic motion, must 
necessarily contribute to change the whole cor- 
poreal state, whether it be at the time in health 
or disease. Have we not this familiarly exempli- 
£ed in sea-sickness — in the sickness produced by 
the rotatory-chair, and in the morning vomitings 
of early pregnancy ? Anything that will diminish 
the brain's influence over the stomach, such as 
a blow on the head, loss of blood, or a division 
of the nerves that supply it, will produce vomit- 
ing. Experience every day shews us, that the 
shivering or shudder liable to be occasioned by 
one cause, may be averted or cut short by agents 
which under different circumstances, can of 
themselves produce shivering, tremors, &c. It is 
thus that the emetic exerts its salutary influence 
in disease. No man can take a vomit without 
every part of the body undergoing some change 



116 THE UNITY 

during its operation. He feels a creeping sensa^ 
tion in every part — a sensation demonstrative of 
the rapid revolution and alteration of every cor- 
poreal atom. Under the influence of such an 
agency you may see the reddened and swollen eye 
or testis hecome in a few minutes of nearly its 
natural appearance, — ^nay, a complete abatement 
of pain in each of these organs may be an equally 
rapid result. A gentleman of the medical pro- 
fession sent for me at midnight. I heard his 
groans before I reached his chamber. He had, 
immediately on leaving a crowded theatre, been 
so imprudent as to take his place on the top of 
one of the night coaches, where he had not been 
long seated before he was seized with repeated 
shivering, followed by fever and exquisite pain 
in the back and loins — ^in medical phrase, lum^ 
bago. When I saw him he had all the symptoms 
which are termed, in the Schools, high inflanmia. 
tory fever, and complained of agonizing pain 
in his back. His wish was to be bled, but I pre- 
scribed an emetic instead, and this relieved him 
in the briefest space imaginable. From the 
moment he vomited his back became easier, and 
in a few minutes he was quite free from pain — a 
result equally pleasing and astonishing to the 
patient, who, on a previous occasion, had been 
confined six weeks to bed with a similar attack. 



OF DISEASE. 117 

notwithstanding repeated bleedings, leechings, 
and blisters. Another patient lately under my 
care, experienced a like relief from the use of an 
emetic in nearly the same circumstances. In the 
case of the first gentleman, I followed up the 
emetic with hydrocyanic acid. In the case of the 
second, I prescribed quinine and sulphuric acid 
— the latter, my more general mode of treatment 
in acute disease. Cases without number could 
I give of the beneficial influence of this practice 
in acute ophthalmia, cynanche, pneumonia, rheu- 
matism, &c. — diseases which, under the usual or 
orthodox measures, would have kept the physi- 
cian in attendance for weeks, and then, perhaps, 
have defied both his aid and his art. With the 
same practice I have had equal success in the 
treatment of haemorrhages, eruptive fevers, &c., 
and I might here give cases corroborative of my 
assertion, were I not borne out by many of the 
older writers, particularly Heberden and Parr, 
who found emetics followed by bark to be the 
best prima,7 treatment of disorder generaUy. In 
physic, as in every thing else, there is a fashion ; 
but the men of our day, notwithstanding all their 
assertions, would do well, in many instances, to 
imitate the practice of their forefathers. 

Purgatives. The action of a purgative medi- 
cine upon the bowels has often been made a power- 



118 THE UNITY 

fill means of influencing diseased states, through 
the medium of the hrain — ^but, like every other 
remedial agency, it has been too frequently con- 
yerted into a cause of disease and death. The 
physician who proceeds, day by day, to purge away 
" morbid secretions,** "peccant humors,** &c., is a 
mere humoralist, who neither knows the manner 
in which his medicines operate, nor understands 
the nature of the wonderful machine whose dis- 
ordered springs he pretends to rectify. Do not 
let us be understood to deprecate purgative me- 
dicines. — As a remedial means they are inferior 
to emetics ; — when combined with these, they are 
among the best means with which to commence 
the treatment of diseases generally. 

It has been my fate to witaess no inconsiderable 
amount of sufiering induced by a mistaken per- 
severance in purgative measures. Will nothing 
open the eyes of gentlemen of the hmnoral school? 
Surely it will stagger them to be told that in an 
evil hour the exhibition of a purge has been fol- 
lowed by a paroxysm of gout? Yet nothing is 
more true or better avouched. Reasoning upon 
this simple fact. Dr. Parr says, the humoral theory 
of gout is altogether untenable. When I say I 
have known fatal fever produced by medicines of 
this class, many will be sceptical ; but few will 
doubt their power to produce Dysentery y which. 



OF DISEASE. 1 19 

in the words of Cullen, is an " inward fever." — 
According to Sydenham's celebrated description 
of dysentery, "the patient is attacked with a chil» 
liness and shakings which is immediately suc- 
ceeded by a heat of the whole body. Soon after 
this, gripes and stooh follaw.^* What is this but 
ague with a discharge from the bowels, instead of 
the skin? "A dose of rhubarb (says Dr. Thom- 
son) has produced every symptom of epilepsy, and 
in an instance within my own observation, the 
smallest dose of calomel has caused the most alarm- 
ing syncope.** Let us use^ not abuse, purgative 
medicines 1 

Mercury. — The frequency with which mer- 
cury and its preparation. Calomel^ enter into medi- 
cal prescription — its beneficial and baneful influ- 
ence in the practice of our art, render a know- 
ledge of the true action of this metal, and the 
proper mode of its exhibition, matters of no or- 
dinary importance. 

What are the forms of disorder in which mer- 
curials are supposed to be most useful? The 
records of the profession answer, fever, iritis, 
erysipelas, dysentery, rheumatism, cutaneous, os- 
seous, and glandular disturbances. To the same 
records, I appeal for testimony to the truth of my 
statement, that ignorantly and incautiously admi- 
nistered, it has too frequently produced those very 



120 THE UNITY 

maladies in all and every of their forms and varia- 
tions. According to Sir Charles Bell, mercury 
has set up "a scrofulous diathesis in the very hest 
constitutions." " I have seen a person,** says Dr. 
Graves, " labouring under mercurial irritation, 
seized with common fever ^ which afterwards be- 
came typhu^j and proved fatal in five days. 
Still you will hear persons say, that if you get 
a fever patient under the influence of mercury, 
you will cure the disease, and that mercurial irri- 
tation will protect a man against fever. I have 
known jaundice to appear during a course of 
mercury" — jaundice, for which you hear some 
say it is specific I 

The value of every medicine has more or less 
relation to the quantity prescribed. Upon this 
subject, I think it material to speak regarding 
mercury; — for it is in the enormous doses which 
have been exhibited by certain pseudo-practi- 
tioners, — certain writers on Infantile and Tropi- 
cal disease, that this substance, instead of being 
a blessing to humanity, has recently become one 
of the chief agents in man's destruction I 

You daily see medical men — ^men, who never re- 
flect upon the effect of any medicine — prescribing 
four, five, and six grains of calomel to children — 
to infants I Can you wonder at the frightful 
number of deaths that take place under seven 



OF DISEASE. 121 

years of age ? Look at the bills of infantile mor- 
tality ; and if you consider the quantity of calo- 
mel that children take, you will assuredly be 
compelled to declare, not how little medicine has 
done for the prolongation of life — but how miich 
it has done to shorten it I 

Many years have now passed since Mr. Abeme- 
thy first advocated the employment of mercury in 
moderate doses. Dr. Wilson Philip has recently 
written a book upon the same subject, and he has 
demonstrated the value of calomel in doses so 
minute as the twelfth, sixteenth, and twentieth 
part of a grain. For thirteen years of my life, I 
have been in the habit of prescribing calomel in 
this manner; and I feel a pleasure in stating, 
that my inducement to do so was the observation 
of its happy efifects in the practice of a gentleman 
who, after taking the highest rank as a surgeon in 
Edinburgh, has since removed to London, where 
he will not receive his just reward, if he be not 
equally fortunate ; — need I name Mr. Liston, of 
the North London Hospital ? 

The following case is one of many, which I 
could furnish from my own experience, illustra- 
tive of the value of calomel in minute doses when 
combined with an equally minute quantity of sul- 
phate of quinine : — Harriet Buckle, seven months 
old, had caries of the bones of the elbow, which 



122 THE UNITY 

joint was mach enlarged, red, painfiil, and per- 
vions to the probe. She was the subject of dmr- 
rud Jever. Notwithstanding the assurance of the 
mother that amputation had been held out as the 
only resource by Mr. Minster and Mr. Whitmore, 
two surgeons of the Casualty Hospital of Chelten- 
ham, where the child had been for a considerable 
period a patient, I confidently calculated on suc- 
cess. The sixteenth part of a graio of calomel, 
the same proportion of quinine, with not quite a 
grain of rhubarb, were prescribed to be tak^i 
every third hour. The case was completely cured 
in a fortnight, without any external appUcation. 

In this manner I have beneficially treated every 
kind of diseased joint, includiog nimierous cases 
of hip-disease, in all its stages. In such cases, 
where disorganization had not previously taken 
place, I have frequently obtained the most perfect 
result; — I need not say I dispensed with leeches, 
setonsy blisters, issues, &c., those relics of a bar- 
barous age; — measures which never could in any 
way influence the constitutional integrity/ t^ cause 
except to make the result more surely unfavorable! 

If:with™eh«d.uted™«of,neI^,.hepr.e. 
titioner may obtain the most excellent effects, — 
what shall we say to the exhibition of five-grain 
doses of calomel to infants? What language can 
be sufficiently strong to denounce the equally da- 



OF DISEASE. 193 

ring practice of ordering scruple doses of the 
same powerful mercurial for adults? That many 
individuals have recovered from serious disease, 
afiber the unsparing use of calomel in such dosea, 
is no more an argument in favor of such a mode 
of treatment, than that many a man has been 
knocked down by a blow, and lived to laugh at 
a description of accident to which others have 
succumbed. 

I heg it to be at the same time understood, that 
I have no objection to calomel as a purgative, — ^in 
which case, a full dose is necessary. But how 
often do you see this substance given in enor- 
mous and repeated doses, with the view of cor- 
recting morbid secretions, and to cure so called 
syphilitic disorders, which enquiry, might have 
satisfactorily traced to the previous maladminis- 
tration of calomel itself. Calomel, like every 
other remedial means, is a medicine or a poison, 
according to the quantity of the agent, and the 
constitution of the patient. It has no exclusive 
relation to nomenclature ; yet you will hear prac- 
titioners say, " It is not proper for this disease, 
but it is proper for that ;*' ^^ it is good for jaun- 
dice, but bad for consumption." All this is mere 
scholastic folly, based upon ^< the baseless fabric*' 
of a theory ! There is no disease, however named, 
where the administration of mercury, in some of 



124 THE UNITY 

its preparations, may not be advantageously ex- 
hibited, or the reverse, according to particular 
doses and ideosyncracies. How frequently, in 
the course of our recorded cases, have we shewn 
that similar, nay, identical diseases, — diseases 
produced by identical causes, refuse to yield to 
the same remedies. 

I shall conclude my observations upon mer- 
cury, with a remark which applies to this metal 
and its preparations, in common with all lema- 
dial agents — ^namely, that diseases caused by mer- 
cury, mat/ J after a certain time, even yield to mer- 
cury itself. So has the delirium of the drunkard 
been subdued by alcohol j but where the remedy 
has failed in either case, it has only aggravated 
existing symptoms. 

Peruvian bark, and its salt the sulphate of 
quinine, With many of the beneficial effects of 
the bark, the reader is already well acquainted. 
The deservedly high rank which it held in the 
estimation of the older writers, contrasts strangely 
with the little regard paid to it by many of the 
modems. To the errors of the Pathological 
School, I attribute the prevalent reluctance of 
practitioners to employ it in the early treatment 
of disease. To the equally erroneous views which 
these schools have propagated as to its mode of 
action, I am inclined to ascribe the general want 



OF DISEASE. 125 

of success attending its exhibition in the later 
stages. 

The celebrated CuUen, however we may now 
feel inclined to smile at his nosology, — a nosology, 
by the way, which has enslaved the medical 
schools of Europe for upwards of half a century, 
— was no mean adept in the practice of physic. 
To the value of the bark he bears his unequivocal 
testimony in scrofula, skin disease, osseous alter- 
ations, in rheumatism, gout, dysentery ^ and gan- 
grene. He extols it, moreover, as a diuretic, and 
diaphoretic-praises it a* a remedy for smaU-pox, 
and admits it to be advantageous in the treatment 
of spasms, convulsions, and haemorrhages. His 
objection to its use in phthisis was founded upon 
the h3rpothetical assumption that the ^^ phthisis pul- 
monalis is accompanied by an inflammatory state." 
Dr. Thomson, nevertheless, recommends it "even 
in phthisis ;'* and I myself can speak to its bene- 
ficial influence in many cases of the same disorder. 

"I have, (says Baron Alibert,) been able to 
follow and appreciate the salutary results of the 
employment of this substance in cancerous affec- 
tions, in scrofulous tumours of the glands, (ac- 
cording to the recommendation of Fordyce,) in 
many cutaneous diseases, and principaUy in lep-ra. 
elephantiasis, and in certain cases oi jaundice^ 
arising from diminished tone in the secretary 



126 THE UNITY 

organs of the bile — ^in the alterations affecting the 
osseous system, such as ricketts, spina bifida, &c. 
With the bark we may also advantageously com- 
bat certain lesions of the nervous system, such as 
epilepsy, hypochondria, hysteria, &c. Many au- 
thors recommend it in hooping cough, and the 
various convulsive coughs. No remedy, accord- 
ing to them, is so efficacious in strengthening the 
organs of respiration, and in preventing the state 
of debility induced in the animal economy by the 
contractiLe and reiterated movement of the lungs. 
The most part of those who employ it in like 
cases are, nevertheless, of opinion, that the admi- 
nistration of it is imprudent, without some pre- 
vious preparation, according to the particular 
stage of disease. These practitioners would, in 
some sort, mitigate the ferocity of the paroxysms 
by sweeteners and temperants — often even by 
evacuants, such as emetics and bleedine^s. To 
pment imt«i«.^ the, writ until the ^^h h« 
been absolutely struck down. Murray, however, 
differs from them altogether on this point. In 
his opinion, the bark is equally adapted to the 
cure of convulsive and periodic coughs as to the 
cure of intermittent fevers. He has witnessed an 
Epidemic, in which these maladies were effica- 
ciously met by this powerful remedy from the 
commencement. He has thus proved that there 



OF DISEASE. 127 

is no advantage in retarding its administration ; 
and that to permit^ in the first place^ so great a 
waste of the vital power j ordy renders the symp- 
tarns more rebellious, and their consequences 
more fatal P* — New Elements of Medicine. 

From my own experience, I could here give 
numerous instances of cure by the bark or its salt, 
of every -shade and variety of disease — disease 
which nosologists have so delighted to separate 
and classify in their systems. The only prepa- 
ratory means to which I have for a long time 
resorted, being an emetic, a purge, or both in 
combination ; — bloodletting, for reasons to be af- 
terwards mentioned, forming no part of my thera- 
peutics. 

To such as are only superficially acquainted 
with the practice of physic, it might appear, that 
possessed of a remedy so powerful, and, so far as 
nomenclature is concerned, one so universally ap- 
plicable as the bark, the physician need give him- 
self little trouble about the numerous other agents 
employed in medicine. But here I have to ob- 
serve, that however generally the bark may be 
found an efficient remedy, there are constitutions, 
for the diseases of which, it will not only prove 
altogether unavailing, but to which, even in mo- 
derate doses, it will be highly detrimental. 

The most perfect ague fit, within my own re- 

L 



128 THE UNITY 

membrance, appeared to me to have been the ef- 
fect of two grainB of quinine, which I prescribed 
for an asthmatic patient. I have fomud intermittent 
fainting-fits occur in a patient who had no such 
symptoms before she took it. Dr. Thomson men- 
tions the case of a patient of his in whom the 
sulphate of quinine brought on an attack of asth- 
ma : " When he was getting well, after seven 
or eight days, I again'' he says '^ began the 
sulphate of quinine, and the same attack was the 
result." Where this substance has, in my own 
practice, disagreed, the common complaints have 
been tremor, faintness, head-ache, nervousness, 
cramps and ^^all over-ishness.'' Ratier, in his 
Hospital Reports, mentions <^ nervous agitations" 
as the efiect of quinine. Now all of these, when 
proceeding from other causes it has been my good 
fortune to cure by this very medicine. My com- 
mon dose for an adult is two grains of the sul- 
phate, with an excess of acid — ^but I have, in a 
case of hypochondria, found it decidedly beneficial 
in a dose of fifteen grains. I once knew eight 
grains produce vertigo and delirium ; yet I am in 
the habit of ordering it to be taken, during the re- 
mission for these very affections, when proceeding 
from unknown causes ; and my success has been 
greater than by any routine treatment. The bark 
like many other medicines is termed by writers on 



OF DISEASE. 129 

Materia Medica, a tonic* All medicines are tonics, 
when they improve the health of the patient ; hut 
when, on the contrary, we have complaints of weak- 
ness or nervousness after using them, will any body 
say that in that case they are any thing but debili- 
tant ? Bark, like blood-letting, or apurge may cause 
both one and the other. To go on, day after day, 
prescribing this substance, and what are termed 
" strengtheners," not only without any manifest 
ameUoration, but with positive retrogression, is 
not giving a course of " tonics,*' but a succession of 
exhausting or debilitating agents. It is to pre- 
scribe a name for a name I 

What, then, is the mode of operation of the bark, 
when its action proves salutary ? Simply this : — 
it produces a new, but more subdued circle of 
motions throughout the body, though still a ve- 
ritablejfever ; and thus by engaging the attention — 
in other words — ^by altering the temperature of 
the brain, for a greater or less space of time, the 
remembrance of a former cause of action is there- 
by suspended or confused. It is in this manner, 
I apprehend, that the vaccine virus prevents 
smaU-pox. The masked or more mild form of 
small-pox, [according to Jenner] produced by 
this virus, has the power, if I may so express 
myself, of retaining the constitutional attention 
for so long a period that not one in a thousand 



130 THE UNITY 

forgets it,* This kind of memory is termed by 
French writers, "memoire machinale." You often 
find puhnonary consumption suspended during 
pregnancy ; the brain in this case is too busy with 
the foetus to remember the old corporeal action ; 
and even after delivery, it occasionally forgets it for 
ever. Thus, in some instances, pregnancy is of 
more avail in phthisis, than all the artificial or 
other agents, which have obtained a place in the 
materia medica. 

Prussic acid. The employment of this remedy 
having procured me a considerable share of abuse 
from some of my professional brethren in the par- 
ticular locality where I practice, I am necessi- 
tated, in self-defence, to adduce the following 
authority in its favour : — " Prussic acid, diluted 
in the way we are about to describe, is employed 
with success in all cases of morbid irritability of 
the pulmonary organs. It may be advantageously 
used in the treatment of nervous and chronic 
coughs, asthma and hooping-cough ; and in the 
palliative treatment of phthisis ; indeed, a great 
number of observations induce the belief that it 
may eflfect a cure in the early stage of the latter 

* The Contagion of small-po^y however inexplicable and aston- 
ishing, is not more wonderfal than that the magnet can make iron 
magnetic, or that Man has the power of reproducing man. One 
principh may some day be found to explain all. 



OF DISEASE, 131 

disease. In England it has been administered 
with success in hectic cough sympathetic of some 
other affection, and also in dyspepsia.* Dr. Elliot- 
son, both in hospital and private practice, has 
frequently employed medicinal prussic acid, pre- 
pared after the manner of Vauquelin. He has 
recorded more than forty cases of dyspepsia, with 
or without vomiting, and accompanied with con- 
siderable pain in the epigastric region, and with 
pyrosisy which were cured by this acid. The 
same physician quotes a case of colica pictonum, 
in which Dr. Prout gave the acid, and procured 
instantaneous relief. Dr. Elliotson also admi- 
nistered hydrocyanic acid, in a great number of 
pectoral affections ; and has almost invariably 
succeeded in allaying the troublesome cough. 
Applied externally in lotions, in different diseases 
of the skin, it has not, in Dr. Elliotson's practice, 
produced any decided effects. Dr.Thomson, how- 
ever, asserts that he has employed it, in lotions 
with constant success, in diminishing the itching 
and the heat so annoying in cutaneous diseases, 
and has cured several species of herpes.** 

"M. J. Bouchenel has published an interesting 
memoir on the employment of prussic acid in the 

* Why sympathetic of another affection P When a man's health 
is wrong throughout, some prominent symptom is seized upon, and 
considered to he the cause of all the others ! 



132 THE UNITY 

treatment of chronic pulmonary catarrh. He 
mentions four cases in which this remedy proved 
effectual. He concludes by urging that prussic 
a^id, when given m a small dose, is not more in- 
convenient than an ordinary linctus. M. Bou- 
chenel has also employed prussic acid in a case of 
Phthisis, but he only succeeded in allaying the 
cough for a time, which leads him to doubt the 
fact of its having really effected the cure of con- 
firmed Phthisis. / rfo, however f assert and main- 
tairiy that I have cured individuals having all the 
symptoms of incipient FHTHisis 'f and even those 
in a more advanced stageJ** 

" In Italy, the medicinal hydrocyanic acid has 
been used to allay excessive irritability of the 
womb, even in cases of Cancer." " Professor Brera 
extols its happy effects in Pneumonia; he recom- 
mends it also in rheumatic cases, and as an an- 
thelmentic. Since this professor has employed it 
in diseases of the heart. Dr. Macleod has admi- 
nistered it in the same diseases. He has found it 
allay nervous palpitations ; especially those which 
seemed to depend on derangement of the digestive 
organs.* He has also employed it in some cases of 
aneurism of the heart. Dr. Frisch, of Nybourg, in 
Denmark, has allayed the intolerable pain caused 

* How common this error of accusing one symptom of being th« 
cause of another ! 



OF DISEASE. 133 

by cancer of the breast» which had resisted all the 
antispasmodics, by washing the ulcerated surface 
with diluted prussic acid. He has also success- 
fully employed the remedy in several cases of 
Phthisis. Dr. Gu6rin, of Mamers, has obtained 
beneficial results from its employment in two cases 
of Brain Fever." Extracted from Magendie's 
Formulary. 

Shall I appeal in vain to the evidence of the 
first physician in France, and to some of the high- 
est authorities in the medical profession of this 
country, against the exclusive decision of jealous 
or defectively-educated pretenders 1 

To the above extracts from M. Magendie's for- 
mulary, I will here add a few observations of my 
own, in favour of the prussic acid. In the pro- 
portion of two drops with a drachm of the tinc- 
ture of lobelia inflata, in an ounce of the infusion 
of roses, it is one of the most effectual remedies for 
asthma, with which I am acquainted. I have also 
derived benefit from the same combination in 
spasmodic stricture of the urethra; and, generally 
speaking, from the administration of prussic acid 
in cramp and spasm wherever developed. In the 
low habitual fevers, whether misnamed dyspepsia, 
hysteria, or hypochondria, I have foimd it particu- 
larly valuable. I have also experienced its cura- 
tive influence in the treatment of dropsy ; more 



134 THE UNITY 

especially when complicated with difficult breath- 
ing. — In hemiplegia^ I have fomid it more suc- 
cessful than strychnia, I may here mention that 
it is my custom, in the treatment of disorder 
generally, to combine some universal power, such 
as quinine, hydrocyanic acid, or arsenic, with 
another power, whose influence has been well as- 
certained to be more particularly local. Thus, 
either of these may be advantageously combined 
with iodine, in glandular and skin afiections, — 
with colchicum or guaiac in rheumatism — squill 
or digitalis in dropsy — cantharides or copaiba in 
leucorrhoea — with squill in catarrh — purgatives 
where costiveness is a symptom ; and so on in like 
manner, according to the most prominent feature 
of a case. Combined in this way with tinc- 
ture of ginger, cardamoms, &c., I have found 
prussic acid extremely valuable in the treatment 
of flatulency and acidity of stomach. In all these 
disorders, prussic acid is valuable only in so far as 
it contributes to improve the temperature, and, con- 
sequently, the circulation of the subjects of them. 
Your patients, when obtaining its beneficial eflfects, 
will tell you "I have not had those heats and chills 
which used to trouble me,*' — or, " my hands and 
feet are not so cold or so burning as formerly." 
We have seen that prussic acid may be successfully 
employed in the most obstinate agues; yet, I 



OF DISEASE. 135 

remember the case of an Irish barrister, who, from 
a minute dose of the same medicine, experienced 
severe shivering and chilliness, with cramp, pain 
of stomach, and slight difficulty of breathing; — 
the very symptoms, the reader will remark, for 
which it is so often available in practice ! 

Tar, Creosote. Bishop Berkeley in his Trea- 
tise on Tar Water, has detailed the signal results 
of its employment in numerous diseases, — diseases 
which the routine practitioner is accustomed to 
view as the most opposite in their nature, and 
requiring treatment the most varied. He has the 
following among other observations : — "From my 
representing tar water as good for so many things, 
some, perhaps, may conclude it is good for no- 
thing ; but charity obligeth me to say what I 
know and what I think, howsoever it may be taken. 
Men may censure and object as they please, but I 
appeal to time and experiment ; — effects misim- 
puted, cases wrong told — circumstances overlooked 
— perhaps, too, prejudices and partialities against 
truth, may for a time prevail, and keep her at the 
bottom of her well, from whence, nevertheless, she 
emerges sooner or later, and strikes the eyes of all 
who do not keep them shut.** The good Bishop 
sums up the catalogue of its virtues by saying " It 
is of admirable use in Jevers.^^ 

From innumerable trials of Creosote, a prepa- 



136 THE UNITY 

ration of tar, I can bear him out in his assertions, 
simply observing, that like every other remedy it 
will occasionally fail or aggravate, whatever be the 
form of disorder for which it is prescribed. With 
creosote I succeeded in curing a case of amaurotic 
blindness of both eyes of a considerable standing. 
The dose was cautiously pushed from two to twenty 
drops three times a day. I have found the medi* 
cine valuable in hysteria, chlorosis, dropsy, chro- 
nic rheumatism, and all kinds of cutaneous dis- 
ease. Its control over temperature explains its 
general mode of action. 

Opium and its Salts of Morphia. These, like 
the bark, may be advantageously employed, as we 
have already stated, in prolonging the remission 
in every form of disease. The agency of opium 
appears to be, in the first place, principally confined 
to the nerves belonging to the five senses. With 
these we associate memory— and as every part of 
the body has, through the brain, a power of re- 
membrance, whatever will confuse or suspend the 
action of the senses, will equally suspend and con- 
fuse memory, and consequently conduce to the 
suspension or interruption of any habitual or pe- 
riodic action of any part of the body. While mi- 
nute portions of opium heighten the general per- 
ceptive powers, large doses diminish them. But 
a large dose is, after all, only a relative term — for 



OF DISEASE. 137 

the quantity, that would poison a horse, may be a 
moderate dose to the habitual opium eater I 

In addition to the beneficial effect of opium in 
diseases admitted on all hands to be purely ner- 
vous, I have found it more particularly useful in 
dropsy. Administered at that particular period of 
the day when the patients have confessed to amelio- 
ration of their feelings generally, it has, in my ex- 
perience, been frequently followed by a copious 
flow of urine after every kind of diuretic had com- 
pletely failed. Indeed, I do not know a form of 
disease that has not in some stages been benefitted 
by the exhibition of opium. By giving it in a large 
dose during the remission, I have kept many con- 
sumptive patients alive for months, and several for 
years, whose period of existence must assuredly 
have been shortened but for the beneficial influence 
of this drug. 

Travellers, who have witnessed its effects in the 
East, mention tremor, fever, dropsy, delirium, and 
restlessness as the consequences of the habitual 
use of opium. It has, nevertheless, contributed 
to the cure of all these symptoms when produced 
by other causes. In practice we find it give re- 
pose in one case and preclude all sleep in another. 
Like alcohol, mercury, &c., it may, under certain 
circumstances, relieve the symptoms it has itself 
produced. It has caused mania and cured it. 



138 THE UNITY 

Alcohol — can act upon the body, beneficially 
or the reverse, in no other manner than by changing 
the existing temperature of the brain. If a glass 
of brandy has arrested the ague fit and its shud- 
der, the army surgeon will bear testimony to the 
"horrors** and tremblings which its abuse too fre- 
quently induces in the previously healthy. Are 
not the chill, the shiver, the fever-fit, the epilep- 
tic, asthmatic, icteric, strictural, and other spas- 
modic paroxysms daily produced by potation ? 
How often have we known dropsy brought on by 
gin-drinking I— yet is not gin daily prescribed 
with the best effect for the dropsical ? See how 
differently alcohol affects different men — one it 
renders joyful, or gentle, — another, sullen and 
morose, — a third becomes witty; while a fourth, 
under its influence loses the wit he may have pre- 
viously possessed. 

Alcohol will make the brave man timid and la- 
chrymose — the coward capable of actions, the mere 
thought of which, in his sober moments, would 
have inspired him with terror. One man will first 
shew the effects of drunkenness in his speech — 
another in his diminished powers of prehension — 
some individuals will not betray the influence it 
has obtained until they try to walk ; their limbs 
may then fail them, though neither hands nor 
tongue shew any signs of inebriety. Now all this is 



OF DISEASE. 139 

done by the change of temperature which alcohol 
induces on various parts of the cerebrum of par- 
ticular individuals. It throws them into a state 
oi fever ; and the same phenomena may be wit- 
nessed in the course of fevers produced by cold or 
a blow. Dr. Jenner, in describing the effects of 
excessive cold on himself, says " I had the same 
sensations as if I had drank a considerable quan- 
tity of wine or brandy, and my spirits rose in 
proportion to this sensation. I felt, as if it were, 
like one intoxicated, and could not forbear sing- 
ing, &c." — BarorCs Life of Jenner. 

Musk, valerian, camphor, assafcetida — all 
highly valuable in ague. But for its expense, musk 
would be more extensively used in the practice of 
medicine. For myself, I place it in the same rank 
with quinine and arsenic in the treatment of what 
are termed the purely nervous affections. It is 
generally recommended in books to begin with ten 
grains ; — ^my own dose of two grains has been at- 
tended with the best effects in numerous cases. 
Much, however, depends upon the purity of the 
drug. I have lately succeeded with musk in a 
case of intermittent squint, which successively re- 
sisted quinine, arsenic, prussic acid, and iron. 

Sulphur — ^now seldom used except in diseases 
of the skin, was long a medicine of universal em- 
ployment in the practice of physic. With the 



140 THE UNITY 

vulgar it is still a remedy for ague. I introduce it 
in this place simply to chronicle my opinion of its 
value in Rheumatism, some cases of which, after 
resisting every medicine with which medical men 
are wont to treat it, yielded in my practice after 
the administration, for a few days, of sulphur, in 
drachm doses. I have found it useful in certain 
cases of painful leucorrhoea, and also as a purfifa- 

COLCHICUM, GUAIAC, TURPENTINE, COPAIBA, 
CUBEBS, CANTHARIDES, SQUILL, DIGITALIS, IODINE, 

the MINERAL ACIDS, the EARTHS, the ALKALIS and 
their Combinations. These agents have all more 
or less control over intermittent fever : they ex- 
ert, moreover, a special influence over particular 
organs, and, consequently, are capable of curing, 
causing, or aggravating diseases attended with cer- 
tain local peculiarities. Copaiba, cantharides, and 
turpentine afford us familiar instances of the cure 
and aggravation of rheumatism and of urethral 
and vaginal discharges by the same remedies. 
The error committed by most practitioners consists 
in pinning their faith too exclusively on one medi- 
cine. Colchicum, for example, is by some sup- 
posed to be a never failing remedy in rheumatism. 
No one is more inclined to put a high apprecia- 
tion upon colchicum, in the treatment of this dis- 
ease than myself; — ^yet, not only, have I found it 



OF DISEASE. 141 

fail, but aggravate many rheumatisms, — and the 
journals of the day will bear me out, when I say 
that pains of the joints and feet, are among the 
symptoms produced by this drug, when acciden- 
tally taken in poisonous quantities, by previously 
healthy persons. 

Iodine^ by some practitioners, is believed to be 
a specific for scrofula, and for every kind of morbid 
glandular developement. It behoves me to state, 
that I have been frequently obliged to countermand 
its exhibition in the treatment of bronchocele, and 
other enlarged glands, from the obvious increase 
of these tumors under its use. The patient in such 
cases, is sure to say " I do not feel so well in my- 
self — I have greater heats and chills ;" or, " I 
have more inward fever ;" or, " I perspire so on 
the least exertion." In my own practice quinine 
has been more generally successful in goitre than 
iodine. But, here I may observe, that a remedy 
generally applicable to a particular type of disor- 
der in one country or locality, may be found to be 
as generally prejudicial when applied to the same 
type in another. This, to a certain extent, will 
account for the encomiums which individual me- 
dicines receive from the profession one day, and 
the contempt with which they are very often 
treated the next. 

Let me caution practitioners against the too 



142 THE UXITV 

indiscriminate employment of Z>ig'ito//5. Are they 
generally aware that this suhstance has the power 
of sicspendingy as well as of increasmg, the secre- 
tion from the kidneys ? It is daily given to the 
prejudice of the patient in dropsy, from practi- 
tioners heing unacquainted with this fact. The 
same observation applies to squill. 

Copaiba has, in six or seven instances out of 
several hundreds in which I have prescribed it, 
produced a cuticular eruption, so like small-pox, 
that in two of these it was pronounced even by 
nurses to be that disorder. I do not remember 
to have met with a similar fact in the writings of 
any author.* 

We have constant disputes whether a particular 
remedy be stimulant or sedative. Opium, digi- 
talis, and prussic acid, have by turns become the 
subject of discussion. One theorist will take one 
side, another another, and each will bring you 
facts of equal cogency. Both are right and both 
are wrong. To reconcile this seeming paradox, 
we have only to observe that all remedies are either 
stimulant or sedative according to the dose and 
the constitution of the patient. 

* While this sheet was passing through the press, I read the fol- 
lowing in one of the yery excellent lectures of Dr. Sigmond, pub- 
lished in the Lancet:—*^ One of the effects of the administration 
of copaiba, has been an eruption of papulae, and sometimes of 
pustules, in large patches.** 



OF DISEASE. 143 

Strychnia, buucine — can each interrupt, and 
each produce fever. In an experiment upon a te- 
tanic horse, a watery solution of mis: vomica — the 
well-known source of the strychnia — ^produced, 
when injected into the veins, a shivering fit of some 
duration. I have, nevertheless, found the sul- 
phate of strychnia of great service in obstinate 
agues, and in many chronic diseases in which chil- 
liness, vertigo, and hallucination, or phantasy were 
symptoms. In the case of an amaurotic female 
for whom I successfully prescribed sulphate bf 
strychnia, the remedy deprived her, for about an 
hour, of the use of her limbs. The recovery of 
her sight, under its exhibition, amply compensated 
for this temporary accident. I have found it con- 
fuse the vision in a similar manner when prescribed 
for muscular palsies. In the treatment of epilepsy 
and many other spasmodic affections, this sub- 
stance may be advantageously combined with the 
sulphate of quinine. I have, notwithstanding this, 
on several occasions, been obliged to intermit its 
use, from the pains of which the patients com- 
plained while taking it ;— and this led me to make 
trial of the remedy in rheumatism, which, in some 
instances, it has cured. 

I have introduced Brucine in this place, more to 
enter a caution regarding its dose, than from any 
observation of its particular efficacy in disease. 

M 



144 THE UNITY 

It has been recommended by some physicians to 
commence with a grain of this substance. A case 
came under my own eye, where a giraitleman took 
not quite this quantity, and it produced not only 
a complete tetanic state with lock-jaw, but con- 
siderable difficulty of breathing, and cold sweats, 
— ^which last symptoms continued for some hours. 
The eighth of a grain is quite sufficient for an 
adult. For the same age, my usual dose of suL 
phate of strychnia is the sixteenth part of a grain, 
increasing it cautiously, according to the nature 
of the disease and the constitution of the patient. 

Silver. The occasional beneficial influence of 
Nitrate of Silver in epilepsy, led me to extend 
its use to other disorders of an equally spasmodic 
and periodic nature, such as hooping-cough, asth- 
ma, cramp, &c., and I am glad to have it in my 
power to bear testimony to its very great value in 
all of these affections. 

I have already said that tremor spasm, palsy, 
differ. but in degree. It will not be surprising, 
then, to find, that in all these disorders, silver 
maybe advantageously substituted for bark, prus- 
sic acid, &c. While engaged in prosecuting my re- 
searches upon the merits and demerits of silver, I 
found it to be one of the most powerful diuretics in 
the Materia Medica; a circumstance not altoge- 
ther unobserved by the older authors, particularly 



OF DISEASE. 145 

Boerhaave, who was accustomed to prescribe it 
with nitre in dropsy. It has, nevertheless, the 
power to suspend the urinary secretion. There 
is an affection to which young females are re- 
markably subject — a periodic pain of the side — or 
stitch. This disorder has been maltreated under 
a variety of names, according to the notion enter- 
tained by attending practitioners, as to its origin 
and nature. If gentlemen would only take the 
trouble to ask the patient whether the affected 
side be colder or hotter than natural, I do not 
think they would be so forward, as they usually are, 
to order leeches and cupping-glasses. In ninety 
cases out of a hundred, the sufferer will tell you 
that that side is always chilly! This at least 
might convince them inflammation is not the 
*^ head and front of offending.'' Such pain is the 
result of spasm of one or more of the intercostal 
muscles — ^which pain, when the patient is told to 
inspire, will assuredly increase. Beware of add- 
ing to it by blood-letting ! In numerous cases it 
wiU yield to half-grain d(«es of nitrate of silver- 
failing which, prussi^^ acid, quinine, or arsenic, 
may be successively tried ; and to one or other of 
these, it proves for the most part amenable. In 
pain of stomach after eating — also a disease of a 
spasmodic kind — I have found silver particularly 
valuable. In all the varieties of cough and 



146 THE UNITY 

catarrh, I have derived advantage from its em- 
ployment ; and I am sure it has, in my hands, 
contributed to the cure of indubitable phthisis. 
Let it be at the same time remembered that I do 
not exclusively rely upon this medicine in any one 
form of disease ; — for unless it be sulphur for psora 
I do not know a specific in physic ! 

There is a disorder to which aged individuals 
and persons who have suffered from mudi mental 
anxiety are liable — a disposition to Joint smdJiM — 
often mistaken, and fatally mistreated, under the 
name of " tendency to apoplexy/* The employ- 
ment of silver in this affection has, in my practice, 
been very generally successful. I have found it 
also decidedly advantageous in vertigo, '^rush of 
blood to the head'' &c., and in many cases of men- 
tal confusion. 

The influence of nitrate of silver seems to be 
exerted chiefly on the spine and spinal nerves; 
for, patients sometimes complain of lumbago, scia- 
tica and rheumatic pains while taking it. In 
such cases I abandon it for other remedies. Wri- 
ters mention blueness of skin as an occasional ef- 
fect of nitrate of silver. Having myself pre- 
scribed it, many thousand times, without ever wit* 
nessing such an effect, or the slightest appearance 
of it, I do not think any judicious physician 
would reject a valuable remedy, because its abuse 



OF DISEASE. 147 

has produced, in rare instances, a peculiar colour 
of skin — seeing that every remedy, if improperly 
applied, may occasion the far greater calamity of 
death itself ! 

Copper, — ^like silver, is now seldom used hut in 
epilepsy. Fordyce, nevertheless, thought so highly 
of it as a remedy for ague, that he ranked it with 
the Peruvian hark. Boerhaave, Brown, and others 
esteemed it for its diuretic powers ; and accord- 
ingly they prescribed it in dropsy. In the same 
disease, and in asthma I have had reason to speak 
well of it, and I can also bear testimony to its 
salutary influence in chronic dysentery — a form of 
disease so frequent in the East Indies, that I had, 
while serving there, many opportunities of testing 
Dr. Elliotson's opinion of its value. That it can 
produce all these disorders is equally true ; for 
where it has been taken in poisonous doses, ^^it 
excites (according to Parr) a pain in the stomach, 
and griping in the bowels, tenesmus, ulceration, 
bloody jstools, difficult breathing and contraction 
of the limbs.** An universal or partial shiver, will 
be found to precede or accompany all these symp- 
toms. The sulphate of copper was a favorite 
febrifuge with the older practitioners. 

Iron is a very old remedy for ague — ^perhaps 
the oldest. Stahl particularly dilates upon its 
virtues in this affection. Much of the efficacy 



148 THE rxiTY 

of a medicine depends upon the constitution of 
the season and climate — ^much upon the con- 
stitution of the patient. This metal, like every 
other remedy, has consequently had its supporters 
and detractors in every form of disease. It is, at 
present, one of the principal remedies for Chloro- 
sis and other female disorders — disorders which 
we have already shewn are mere variations of re- 
mittent fever. 

The water in which hot iron had been quenched, 
used to be prescribed by physicians as a bath for 
gout and palsy. In skin diseases and cancer, 
ricketts, epilepsy, urethral stricture, &c., iron has 
been vaunted by numerous modem practitioners. 
The ancients recommended it in diarrhcsa, dy- 
sentery, dropsy, hectic, vertigo, and head-ache. 
Now, in all these affections it has served me 
much like other powers — ameliorating or aggra^ 
vating the condition of the patient, according to 
ideosyncracy. 

Some pseudo-scientific physicians have amused 
themselves with witticisms at my expense, on the 
subject of iron. Finding it in some of my pre- 
scriptions for Phthisis, they have accused me of 
mistaking this disease for dyspepsia. How long 
will men deceive themselves with such puerile 
absurdity ? When will they learn that the human 
body, in disease, as well as in health, is a 



OF DISEASE. 149 

TOTALITY, — ^not a thing to be mapped into parts 
and portions, like a field of rice or com ! Let 
them take a lesson from St. Paul, who, in his First 
Epistle to the Corinthians, has these remarkable 
words : — " And whether one member suffer, all 
the members suffer with it ; or one member be 
honoured, all the members rejoice with it/* 

Lead. This metal is now rarely prescribed, 
except for hsemorrhages. It has, nevertheless, 
been celebrated for its beneficial agency in the 
treatment of phthisis, cancer, and other glandular 
disorcfanizations — in leucorrhcea and other dis- 
char^s-in spa^n aBd palsy. My own experi- 
ence will enable me to extend the list. I can bear 
testimony to its virtue in the treatment of vari- 
cose veins, and in many shades of cutaneous dis- 
order. In these diseases its influence would avail 
but little, did it not include^^er — the type of all 
the others. Cullen, in his Lectures on the Materia 
Medica, observes, ^^saccharum saturnii and ^mc- 
tura antuphthisica^ into which that certainly en- 
ters, have been employed in continual fevers with 
remarkable success — ^not having such, a stimulus 
as the copper — and taking off the nervous symp- 
toms, the delirium, the subsultus tendinum" — 
in other words, the twitchings or spasms. The 
workers in this metal are sufficiently acquainted 
with every one of these particular shades of disease. 



150 THE UNITY 

The Colica Pictonum is a well known instance 
of the spasmodic disorders to which it m<H*e fire- 
quently gives rise. ** One curious effect of the 
continued use of acetate of lead (says Dr Thom- 
son) is the excitement of Ptyalism — ^but notwith- 
standing this effect, it has been recommended by 
Mr. Daniels, for the purpose of allaying violent 
saUyaAion. in doses of ten grains to a scruple, in 
conjunction with ten grains of compound powder 
of ipecacuan. How," asks Dr. Thomson, " are 
these contending opinions to be reconciled ? ** My 
answer will reconcile both, — Similia similibus cu- 
rantur ; — of the truth of which the reader has al- 
ready had too many proofs to doubt. And now, 
when we are upon this subject, I shall take the 
liberty of making a passing remark upon the doc- 
trines of Hahnemann. With this gentleman, ** Dis- 
eases are the product of three evil principles only, 
qui deturpant sanguinemf namely, the psoric 
(vulgo itch) the syphilitic and the scrofulous."* 
His remedies are aconite, gold, belladonna, &c.; 
but these are only salutary, according to him, when 
prescribed in the minutest possible doses ; — the 
millionth, decillionth, and heaven knows what 
other infinitesimal proportion of a grain of aco^ 
nite or belladonna, being an infallible remedy for 
the great proportion of human diseases ! Can my 

* Quoted from a letter of Hahnemann, by Dr. Granville. 



OF DISEASE^ 151 

reader, unless absolutely mystified by metaphysics, 
require me to enter upon the serious refutation of 
such absurdities? How, even according to the 
very terms of the remaining part of the homoeo- 
patfaic doctrine — that portion, at least, which Hah- 
nemann mistakenly arrogates as his own (similia 
similibus) can this professor expect to cure grave 
disease — disease proceeding firom a grave agency 
— ^by the dissimilar agency of infinitesimal phy- 
sic ! It is only in occasional and rare instances 
that severe disorder arises from (apparently) slight 
accidents — and, where it has been cured under 
such nugatory treatment, the patient has reco- 
vered, either through the natural strength of his 
constitution, or the exvsimg faiths — a powerful in- 
fluence, as we have already shown, — ^which induced 
him to try the nostrum of the homoeopathist. 

So far from Hahnemann having developed a 
NEW TRUTH, hc has onlv driv&n over an old one ! 
The doctrine "like cures like,** may be found 
not only in the writings of some of the most an- 
cient authors, but in the actual practice of the 
vulgar, time immemorial. It is merely a fragment 
of the great abstract law in medicine — a law 
which I do not remember to have seen elsewhere 

stated ANY GIVEN POWER MAY CAUSE, CURE, 

AGGRAVATE, OR ALLEVIATE ANY GIVEN FORM OF 
DISEASE, ACCORDING TO THE DOSE, DEGREE, AND 
CONSTITUTION OF THE PATIENT. 



152 THE UNITY 

I know no agent used in physic which may not 
cause, and none which has not cured the ague ! 
If it he true then, that in the course of this uni- 
versal affection, every kind of organic change may 
he developed to which physicians have given a 
name, — are we not equally entitled to assume an 
UNITY OF ACTION in REMEDIES, as an unity of 
action in the causes of disease ? 

Arsenic. The successful employment of arse- 
nic by the natives of India, first, I believe, induced 
European practitioners to try it in ague and skin- 
disease. The happy effects of the medicine were 
found not to be confined to these disorders. Not 
only has its judicious administration been attended 
with success in epilepsy, and numerous other forms 
of convulsive disorder ; but it has been advanta- 
geously employed in the treatment of structural 
change. Dr. Parr, in his Dictionary, published 
in 1809* speaks of the beneficial result of its ex- 
hibition in open cancer. " We have seen,'* he 
says, *^ from its use, an extensive sore filled with 
the most healthy granulations, the complexion 
become clear, the appetite improved, and the ge- 
neral health increased. Unfortunately," he adds, 
"these good effects have not been permanent. By 
increasing the dose, we have gained a little more, 
but at last, every advantage was apparently lost." 
I have already stated, as a general observation. 



OF DISEASE. 153 

that few remedies will long preserve their bene- 
ficial influence over chronic disease. If this be 
true in the case of simple and uncomplicated ner- 
vous disorder, what right have we to expect a 
more favourable result, from the employment of 
any medicine, in a structural disorder of so chro- 
nic a nature as cancer ? 

The numerous panacese which have, from time 
to time, been vaunted as cures for cancer, will be 
found, on examination, to be principally composed 
of remedies proper for intermittent fever ; — iron, 
bark, arsenic. In this, as in every other chronic 
disease, what will be beneficial one day may foil 
or aggravate the next. Let the reader try arsenic 
in cancer or consumption, not on one but many 
patients, and change it for iron, quinine, and 
prussic acid, according as he finds its action 
more or less permanently beneficial, and I feel 
assured he will not have to thank some of his 
teachers for the notions with which they have im- 
bued his mind on the subject of the absolute incu- 
rability of these diseases. 

Arsenic, like every other remedy, has its ad- 
vantages and disadvantages. Enquire of miners, 
exposed to the fumes of this metal, and you will 
find that fever, tremor, spasm, palsy, and ulcer, 
compose almost the sum total of their sufierings. 
In the Edinburgh Medical and SurgicalJournaU 



154 THE UNITY 

• 

is a relation of five cases of poisoning by arsenic. 
Among the symptoms mentioned by the narrator, 
Mr. Marshall, were vomiting, pain, and burning 
at the stomach, thirst, crural and abdominal 
spasms, purgings, head-ache, dimness of sight, 
intolerance of light, palpitation, chills emd. flushes, 
epilepsy; all of which, proceeding from other 
causes, I have successfully treated by arsenic. 
The first case of epilepsy, in which I ever found 
benefit from any remedy, was cured by this metal. 
The subject of it was a soldier of the 30th Foot, 
in whom the disease was principally brought on 
by hard drinking. The fit, in this case, came on 
at a particular hour, every alternate night. Now 
it is worthy of remark, that, after an attempt at 
suicide by arsenic, detailed by Dr. Roget, inter- 
mittent epilepsy was among the effects produced. 
The subject of it, a girl of nineteen, had also 
chills and heats, which, if the reader pleases, he 
may call Intermittenty or Remittent Fever j or any 
thing else he fancies — ^for it is not my custom to 
quarrel about names ! 

As a remedy for cutaneous disease, I have 
every reason to speak highly of arsenic, even when 
complicated with much structural change. Some 
cases in which it had very great effect, I have 
noted down. The subjects of them were native 
soldiers, who had suffered in the Rangoon War, 



QF DISEASE. 1.55 

from climate, aggravated by depraved or defective 
food^ and the usual privations of men in the field. 
These patients were under my care for a fortnight 
only; and to that period the treatment refers. All 
of them, be it remembered, had had " the fever.*' 

Case 1. — Jan Khan, havildar, had tubercu- 
lous thickening of the skin of the legs and arms, 
resembling a partial elephantiasis. His nose was 
enormously enlarged, and his whole appearance 
unhealthy. He eat and slept badly, and his 
tongue was foul and clouded. After the opera- 
tion of an emetic, the liquor arsenicalis was admi-* 
nistered in six drops thrice a day. At the end of 
a fortnight, the alteration in his general appear- 
once was wonderful. The nose had then become 
nearly of the natural size, and the disease of the 
skin had gradually lessened. He then slept and 
eat well, and expressed himself much pleased, 
with the improvement he had received from his 
medicine. 

Case 2. — Daud Khan, sepoy, had pains of the 
bones and joints, scorbutic patches aU over his 
skin, and an irritable ulcer of the scrotum, from 
which a fungus, about the size of a chesnut, sprung 
up. He complained also of a burning sensation 
in his feet. When I first saw him, he was-so 
weak, he could not rise from the floor without as- 
sistance, and his countenance indicated extreme 



156 THE UNITY 

wretchedness and debility. Having detached the 
fungus, with a pair of scissors, the lunar caustic 
was applied, and arsenic administered ut supra. 
In a week, there was great amendment of the 
ulcer. The patient since then rapidly gained 
ground ; of the pains of the bones he no longer 
complained, and the eruptions on the skin gradu- 
ally disappeared; the ulcer at the same time 
closed, and I expected he would soon be fit for 
duty. 

Case 3. — Setarrum, sepoy, had large ulcers of 
the leg, sloughy, ill-conditioned, and spreading 
in different directions. He had, also, cuticular 
eruptions, like the last-mentioned patient ; and his 
appearance and strength, though not so wretched, 
were yet sufficiently miserable. Pure nitric acid 
was applied, with a feather, to the whole surface of 
the ulcers, and a poultice ordered. The arsenic 
was given as above. On the separation of the 
sloughs, the leg was supported by Baynton's ban- 
dage. The ulcers gradually healed — ^the eruptions 
disappeared — and the patient regained complete 
health and strength. 

Case 4. — Subryah, sepoy, had his leg amputar 
ted three times, the last time in the middle of the 
thigh, but the bone had been left with only a 
covering of skin. The stump was in an ulcerous 
state when I first saw him — and the probe, upon 



OF DISEASE. 157 

being passed through one of the ulcers, found the 
bone carious and denuded as far as it could reach. 
The patient's health was altogether wrong, not 
one function being properly performed. It was 
proposed to amputate at the hip-joint, as it was 
not believed that any other treatment could do 
good. To this step, however, he would not sub- 
mit. A trial was given to arsenic, and the ulcers, 
beyond expectation, at the end of a fortnight had 
nearly healed. The patient then slept and eat 
well, and looked comparatively strong and healthy. 

Case 5— Vencatasawmy, sepoy, had ring-worm 
of the skin, and an ill-looking ulcer over the 
sternum — ^which bone was perfectly carious; — 
the probe could be passed through it to the depth 
of three inches in the direction of the mediasti- 
num. The patient was weak and irritable, and 
could neither eat nor sleep ; his pulse was rapid 
and small, and his appearance altogether mise- 
rable. Arsenic was resorted to as before. The 
TiDg-worm, under its use, disappeared — ^the ulcer 
began to look clean — the probe, when he went 
from my hands, only passed to the depth of an 
inch, and the patient's health was rapidly im- 
proving. 

These cases were intrusted to my care by Dr. 
Gibb, of the Madras Medical Staff, while he 
himself was on sick leave, and were afterwards 



158 THE UNITY 

♦ 

repcHTted by bim to tbe Medical Board of tbat 
Presidency. 

Do I now require to tell tbe reader tbe princi- 
ple upon wbicb arsenic proved efficacions in ibe 
treatment of tbese Tarioos structural cbanges? It 
acted simply by its power of controlling Remit- 
tent Fever, under a cbnxnic form of wbicb these 
unfortunate sepoys were all sufibring — ^tbe struc- 
tural lesions being mere features or developements 
of tbe general derangement 

Dr. A. T. Tbomson recomm^ids arsenic *' in 
tbreatened apoplexy after cuppings and purg* 
ings, wben tbe strengtb is diminished and tbe 
complexion pale." Upon what principle does this 
remedy prove advantageous in such cases? Simply 
by prolonging tbe remission — ^by averting the pa- 
roxysm. Long after the bark came into fashion 
for tbe cure of ague, that distemper used to be 
treated in tbe first instance by depletion, till ^*the 
complexion became pale.** Seeing tbat this treat- 
ment is not now pursued for ague, even by tbe 
most bigoted to old systems, — ^men who think for 
themselves, may possibly enquire whether it be not 
equally unnecessary in ^Hhreatened apoplexy" or 
** rush of blood to the head,'' as this affection is 
stiU ridiculously termed. The primary employ- 
ment of quinine, silver, arsenic, &c.» has enabled 
the writer of these pages to dispense entirely with 



OP DISEASE. 159 

depletion in its treatment. What did the lower- 
ing and starving system avail Sir Walter Scott ? 
In the case of that great man, might not the 
threatened apoplectic paroxysm have been averted 
by quinine or arsenic? Be this as it may, the 
^lno„«.abU.hed,*a..nygiven,^ie.- 
bark or arsenic for example, — ^has cm'ed a host of 
maladies, which the authors of nosological sys- 
terns have not only noted as separate and distinct 
disorders, but to which the profession usuaQy as- 
cribe a difference of cause and nature; — some, 
according to their views, being diseases of debi- 
Kty,— some, nervous— some, inflammatory. Now, 
connecting this with the circimistance that the 
subjects of all these, so styled, different diseases 
have remissions and exacerbations^ and have each 
a greater or less number of the symptoms or 
shades of symptom, constituting the particular type 
of disorder, so well known to the vulgar by the 
term ague ; for which, the same vulgar are aware, 
there are no remedies so generally applicable, 
as bark and arsenic; — to what other conclusion, 
can the unprejudiced reader come, than that all 
disorders are variations of this one type — that, 
abstractedly speaking, there is but one disease I 
If this, then, be true — and its truth may be 
easily tested in every hospital in Europe, am I not 
justified in believing that the notions, (for I will 

N 



160 THE UNITV 

not call them principles,) which have gnided phy- 
sicians in the application of their remedies to Dis- 
ease, have heen a mere romance of the sdiools; 
that their views of its causes have, for the most 
part, heen as erroneous as their modes of cnre have 
heen defective ; and their nomendature through- 
out, little hetter than an unmeaning jargon I 

Bloodletting. — ^While, with one class of prac- 
titioners, Medicine has heen reduced to a mere 
system of purging, from what we are daily com- 
pelled to witness in the practice of others, it might 
not unaptly he termed, the sanguinary art — every 
means heing resorted to, in the mode of ahstract- 
ing blood, from venesection, arteriotomy, and cup- 
ping, to the basest application of the leech ! 

The Wits of every age and country have amused 
themselves at the expense of the physician : against 
his science, they have directed all the arrows of 
their ridicule, and in the numerous contradictions 
of its professors, they have found matter for some 
of their richest scenes. Moliere makes one of his 
dramatis persorue say to another — "Call in a phy- 
sician, and if you do not like his physic. Til soon 
find you another who will condemn it I*' Rousseau 
distrusted the entire art. The witty Marryat, in 
these days, seems equally incredulous, and Bulwer 
evidently holds the most eminent professors of it 
in dread, simply from his horror of the lancet. 



OF DISEASE. 161 

My own previous observations on the nature 
of disease, have prepared the reader to anticipate 
no very favourable view of Bloodletting, in these 
pages. He will, consequently, receive with less 
surprise, the information that in the course of 
a very extensive experience, I have not for some 
years even once ordered the abstraction of blood 
in any manner, nor have I had cause to regret 
the circumstance — ^for, since I dropped the prac- 
tice, I have met with a success in the treatment 
of disease generally, which, while my mmd con- 
tinned fettered by school-doctrines, I could not 
by any possibility have foreseen. 

"The imputation of novelty,'' says Locke, "is a 
terrible charge, amongst those who judge of men's 
heads as they do of their perukes, hy thefashion^ 
and can allow none to be right but the received 
doctrines. Truth scarce ever yet carried it by 
vote any where at its first appearance ; new opi- 
ni(ms are always suspected, and usually opposed 
without any other reason but because they are not 
already common. But truth, like gold, is not 
the less so, for being newly brought out of the mine. 
It is trial aud examination must give it price, and 
not any antique fashion; and though it be not yet 
current by the public stamp, yet it may for all that 
be as old as Nature^ and is certainly not the less 
genuine." 



162 THE UNITY 

The operation of Bloodletting is so connected 
and associated, in the minds of most men, with the 
practice of physic, that when a German physician 
some time ago, petitioned the King of Prussia to 
make the employment of the lancet penaly he was 
laughed at from one end of Europe to the other. 
The laughers never reflected that there was a pe- 
riod in the world's history, when the lancet was 
unknown as a remedy ; — and that many centuries 
necessarily elapsed hefore it was even imagined 
that loss of hlood could he required for the alle- 
viation or cure of disease. Nations, nevertheless, 
grew and prospered. To what daring innovator 
we are to attribute the introduction of the lancet, 
into the practice of physic, the annals of the art 
leave us in ignorance ; but, this we know, that it 
must have been while Medicine was yet in its in- 
fancy; when remedial means were few, and the 
action of remedies totally unknown. It was the 
invention of an unenlightened, — ^possibly, a san- 
guinary age ; and its continued use says but little 
for the after-discoveries of ages, or for the boasted 
progress of medical science I 

Of what is the body composed ? Is it not of 
blood and blood only ? What fills up the exca- 
vation of an ulcer or an abscess ? What repro- 
duces the bone of the leg or thigh, after it has 
been thrown off dead, in nearly all its length? 



OF DISEASE. 163 

What, but the blood, under the influence of the 
brain and nerves! How does the slaughtered 
animal die ? Of loss of blood solely. Is not the 
blood then, m the impressive language of scrip- 
ture, " the life of the flesh ?" What, I shall be 
asked, do we not daily see people bled to fainting 
for the simplest diseases, and the operation in- 
trusted to the merest tyros, who scruple not to 
employ it with heroic perseverance, in every dis- 
order, from infancy to age ! Does a man faU from 
his horse or a height, is he not instantly bled ? 
Has he been stunned by a blow, is not the lancet 
in requisition ? Nay, as in the case of the mur- 
dered M alibran, has an individual fainted from 
exertion or exhaustion, is it not a case of^^, and 
what so proper as venesection ? Need I say all 
this is wrong — all a superadded injury ! In every 
one of these cases, the brain and nerves are 
already in a state of debility — there is a positive 
diminution of nervous influence, evidenced by the 
cold surface, and weak or imperceptible pulse ; — 
there is an exhaustion, which the lancet, so far 
from relieving, too often converts into a state of 
utter and hopeless prostration. True, many have 
recovered who have been treated in this manner ; 
but these were not cures — they were escapes ! 

If the causes of disease, as we have already 
seen, be infinite, the reader will not be astonished 



9> 

99 



164 THE UNITY 

to find loss of blood comprised in the number. 
When I except small-pox, and a few specific con- 
tagions, I know not a disease which loss of blood 
may not produce. For proo& of this, I might 
refer to a variety of authors : Darwin says, ^* a 
paroxysm of gout is liable to recur on bleeding. 
John Hunter mentions *Mock-jaw and dropsy, 
among its injurious effects ; Travers, " blind- 
ness;" — Marshall Hall, **mania;" — Blundell, "dy- 
sentery;** — Broussais, "fever and convulsions." 
But I rather choose to refer to what I have myseK 
witnessed; and in these sanguisugal times, my 
reader will have ample opportunity of testing my 
assertions. The long shiver of the severest ague — 
the burning fever — the JiUal lock-jaw — the vomit- 
ings cramps and asphyxia of cholera — ^the spasm 
of asthma and epilepsy — the pains of rheumatism 
— ^the palpitating and tumultuous heart — the most 
settled melancholy and madness — every species of 
palsy ; — these — all these have I traced to loss of 
blood I Could arsenic — could prussic acid, in 
their deadliest and most concentrated doses, do 
more ? Yet I have heard men object to use the 
minutest portions of these agents medicinally — 
men who would open a vein, and let the life-blood 
run, until the patient fell, like a slaughtered ox, 
death-like and all but dead upon the floor I Do 
these practitioners know the nature of the power 



OF DISEASE. 165 

they thus fearlessly call to their aid ? Can they 
explain its manner of action, even in those cases 
where they have supposed it to be beneficial? 
The only information I have been able to extract 
from them upon this point, has been utterly vague 
and valueless. Their reasoning, if it could be 
called reasoning, has been based on a dread of 
inflammation or " congestion." From the manner 
in which they discuss the subject, you might be- 
lieve there was no remedy for either, but the Ian- 
cet. Ask them why they bleed in ague — in syn- 
cope, in exhaustion or collapse ? — ^they tell you, it 
is to relieve congestion. After a stun or fall? — ^it 
is to prevent inflammation. Bleeding, in all my 
experience, never, either relieved the one, nor pre- 
vented the other! Himdreds, thousands, have 
recovered under each of these circumstances, who 
never were bled — and many, too many, have died, 
for whom venesection had been most scientifically 
practised I Have I not proved that all remedial 
agents have but one mode of action — the power 
of influencing temperature ? Let the schoolman 
shew me that the lancet possesses any superiority 
in this respect ; any specific influence more ad- 
vantageous than other less questionable measures ; 
and I shall be the last to repudiate its aid in the 
practice of my profession. The beneficial influ- 
ence of Bloodletting, where it has been beneficial 



166 THE UNITY 

in duease^ relates solely to temperature. To this 
complexioB it comes at last, and nothing moie — 
the equalization and moderation aX temperature. 
In the amgestive and non-omgestiye stages of 
fever — the cold — ^the hot — the sweating — the hm- 
oet» has had its adyocates. Bloodletting, nnder 
each of these drcomstances, has changed existing 
temperature. Why, then, ohject to its use? Sim- 
ply, hecause we have remedies without numher, 
possessing each an influence equally rapid, and an 
agency equally curatiye, without being like blood- 
letting, attended with the insuperable disadyan- 
tage of abstracting the material of life. I deny 
not its power as a remedy, in certain cases; but I 
question its claim to precedence, eyen in these. 
Resorted to, under the most fayourable circum- 
stances, its success is any thing but sure, and its 
failure inyolyes consequences which the untoward 
administration of other means may not so cer- 
tainly produce. Haye we not shewn that aU dis- 
eases haye remissions, and exacerbations — ^that 
mania, asthma, rheumatism, dropsy are all remits 
tent? From the agony or intensity of each of these 
yarieties of feyer, you may obtain a temporary re^ 
lief, by the use of the lancet; but what has it 
ayailed in ayerting the recurrence of the pa- 
roxysm ? How often do you find the patient you 
have bled in the morning, ere night, with eyery 



OF DISEASE. 167 

symptom in aggravation. Again you resort to 
bleeding, but the relief is as transitory as before. 
True, you may repeat the operation, and re-repeat 
it, until you bleed away his life. Venesection, 
then, in the majority of cases, is a temporary but 
delusive relief. The general result is depression 
of vital energy, with diminution of corporeal 
force I 

Dr. Sputhwood Smith, one of the physicians to 
the London Fever Hospital, has published a book 
purposely to shew the advantages of venesection 
in fever. One of his cases is so curiously illus- 
trative of his position, that I shall take the li- 
berty of transcribing it here, with a running com. 
mentary, by the Editor of the Medical Gazette : — 
** The case of Dr. Dill, demands our most serious 
attention, and deserves that of our readers. It is 
adduced as an example of severe cerebral affection, 
in which cases. Dr. S. affirms, < the bleeding must 
be large and early as it is copious.' < I saw him,' 
says Dr. Smith, < before there was any pain in the 
hea4f or even in the back, while he was yet mdy 
feeble and chilly. The aspect of his countenance, 
the state of his pulse, which was slow and labour- 
ing, and the answer he returned to two or three 
questions, satisfied me of the inordinate, I may 
say of the ferocious attack that was at hand. — 
p. 398. 



168 THE UNITY 

** Whatever may be the opbiimi of our readerB, 
as to the above signs indicatiiig a fenxdons cere- 
bral attack^ they will one and all agree with us» 
that the ferocious attack was met with a ferooious 
treatment ; for an emetic was given without de- 
lay, and * blood was taken from the arm, to the 
extent of twenty ounces.* This blood was not 
inflamed* Severe pains in the limbs and loins, 
and intense pain in the head came on during die 
night — and early in the morning blood was again 
drawn to the extent of sixteen ounces 'with great 
diminution, but not entire removal of the pain.' 
Towards the afternoon, he was again bled to six- 
teen ounces. 'The pain was now quite gone — 
the blood from both these bleedings intensely in- 
flamed/ 

''During the night the pain returned, and in the 
morning, notwithstanding the eyes were dull, and 
beginning to be suffused, the fece blanched, (no 
wonder!) and the pulse slow, and intermittent 
and weak; twelve leeches were applied to the 
temples — and as these did not entirely remove the 
pain, more blood, to the extent of sixteen ounces, 
was taken by cupping. The operation afforded 
great relief — ^but the following morning, the pain 
returned, and again was blood abstracted to six* 
teen ounces. 'Immediate relief followed' this 
second operation; but, urffortunaieh/y the pain 



OF DISEASE. 169 

returned with great violence, towards evening; and 
it was now impossible to carry the bleeding any 
further.' Typhoid symptoms now began to shew 
themselves; Hhe fur on the tongue was becoming 
brown, and there was ah*eady slight tremor in the 
hands.' What was to be done? Ice, and eva- 
porating lotions, were of no avail ;— but, happily 
for Dr. Dill, the aJO^ion of cold water on the 
head, ^ the cold dash,' was thought of and em- 
ployed — and this being effectually applied, the 
relief was 'instantaneous and most complete.' So 
that this case, announced as a severe cerebral 
affection, and treated, in anticipation, by copious 
bloodletting, before there was any pain in the 
heady while the patient was yet only feeble and 
chilly y which grew worse and worse as the blood- 
letting was repeated, until after the abstraction of 
ninety ounces of blood, the patient had become 
in a 'state of intense suffering,' and 'imminent 
danger,' and was relieved at last by the cold 
dash-this case we say is brought forward as a 
Specimen of the extent to \yhich copious blood- 
letting may sometimes be required I ! I Most 
sincerely do we congratulate Dr. Dill on his 
escape, not from a dangerous disease, but from a 
dangerous remedy." — Medical Gazette. 

Could any case more forcibly exemplify the 
utter inefficiency of blood-letting, in all its forms. 



170 THE UNITY 

either as a certain remedy, or a preventive of 
fever ? Yet such is the force of custom, prejudice, 
education, that that case, — and, I have no doubt, 
thousands like it, so far from opening t^e eyes 
of the physician to the London Fever Hospital, 
only served to confirm him in his error. He 
had his methodus medendi ; and he pursued it, 
and notwithstanding the total inefficacy of his 
vaunted remedy, he gives the case at length, as a 
perfect specimen of the most perfect practice — 
mark the result of that practice I But for the 
*< cold dash," the patient must have perished. It 
is even now a question, whether he ever recovered, 
from those repeated blood-lettings, — ^for he died 
not many months after. Happy would it have beto 
for mankmd, that we had never heard of a <^ Pa- 
thological School,** — ^happier for Dr. Dill, for to 
that school, and its pervading error of imputing 
effect for cause, may we fairly attribute all this 
sanguinary practice. 

Let us now take the case of the late Lord 
Byron, as detailed by Mr. Moore; — "Of all his 
prejudices, he declared the strongest, was that 
against bleeding. His mother had obtained from 
him a promise, never to consent to being bled, 
and, whatever argument might be produced, his 
aversion, he said, was stronger than reason. 'Be- 
sides, is it not, (he asked) asserted by Dr. Reid, 



OF DISEASE. 171 

in his Essays, that less slaughter is effected hy 
the lance, than the lancet — ^that minute instro* 
ment, of mighty mischiefr On Mr. MiUingen 
observing that this remark related to tibe treat* 
ment of nervous, but not of inflammatory com* 
plaints, he rejoined, in an angry tone, *Who is 
nervous, if I am not! — and do not those other 
words of his apply to my case, where he says, that 
drawing blood from a nervous patient, is like loos« 
ening the cords of a musical instrument, whose 
tones already fail, for want of sufficient tension 1 
Even before this illness, you yourself know how 
weak and irritable I had become; and bleeding, 
by increasing this state, will inevitably kill Hie. 
Do with me what else you like, but bleed me, you 
shall not. I have had several inflammatory fevers 
in my life, and at an age when more robust and 
plethoric; yet I got through thein without bleed- 
ing. This time, also, will I take my chance.' " 
After much reasoning, and repeated entreaties, 
Mr. MiUingen at length succeeded in obtaining 
from him a promise, that should he feel his fever 
increase at night, he would allow Dr. Bruno to 
bleed him. ** On revisiting the patient early next 
morning, Mr. MiUingen learned from him, that 
having passed, as he thought, on the whole, a 
better night, he had not considered it necessary 
to ask Dr. Bruno to bleed him. What foUowed, 



172 THE UNITY 

I shall, in justice to Mr. Millingen, give in his 
own words: — ^I thought it my duty now to put 
aside all consideration of his feelings, and to de- 
clare sdemnly to him how deeply I lamented to 
see him trifle thus with his life, and shew so little 
resolution. His pertinacious refusal had aheady 
I said, caused much precious time to he lost; — 
but few hours of hope now remained, and, unless 
he submitted immediately to be bled, we could 
not answer for the consequences. It was true, he 
cared not for life, but who could assure him, that 
unless he changed his resolution, the uncontrolled 
disease miffht not operate such disorganizatian in 

of reason! I had now hit at last on the sensible 
chord; and, partly annoyed by our importunities, 
partly persuaded, he cast at us both the fiercest 
glance of vexation, and throwing out his arm, 
said, ixtthe angriest tone, "There you are, I see, 
a d — d set of butchers, — ^take away as much blood 
as you like, but have done with it!" We seized 
the moment, (adds Mr. Millingen,) and drew 
about twenty ounces. On coagulating, the blood 
presented a strong buflfy coat ; yet the relief ob- 
tained did not correspond to the hopes we had 
formed; and during the night the fever became 
stronger than it had been hitherto, the restless- 
ness and agitation increased, and the patient 



OF DISEASE. 173 

spoke several times in an incoherent manner.' " 
Surely, this was sufficient to convince the most 
school-hound of the worse than inoperative imture 
of the measure. Far from it. ^' On the follow- 
ing morning, (the 17th,) the hleeding was re- 
peated twicej and it was thought right also to 
apply hlisters on the soles of his feet 1*' Well 
might Mr. Moore exclaim : *^ It is painful to 
dwell on such details." It is enough for our pre- 
sent purpose to state, that although ^^ the rheu- 
matic symptoms had heen completely removed," it 
was at the expense of the patient's life ; his death 
took place upon the 19th (April,) that is, three 
days after he was Jirst hied. — Moore^s Life of 
Byron. Now I ask the reader, what might have 
been the termination of this case, had an emetic 
heen substituted for the lancet, and had the remis- 
sion beai prolonged by quinine or arsenic ?^ 

* Since the above was written, I am enabled to record the case of 
Moulder, aged 25, residing 32, Winchcomb- street, Chel- 



tenham. I was called to see him by his wife, who thonght him 
dying ; after he had been labomrmg for four or ^\e days, under 
severe rheumatic fever. The joints of his wrists and ancles were 
much swelled) and exquisitely painful, his heart laboured, and was 
so painful as to interfere with his breathing ; his tongue was foul, 
and furred, and he had been occasionally delirious — his pulse was 
full and hard. I ordered him an emetic, which was some time in 
operating, but when it did, the relief was great. I followed this 
up with pills, containing a combination of quinine, blue-pill and 
colchicum \ and in two days he was sitting up, with scarcely any 



17* THE UNITY 

I have preferred to give these two cases to any 
of the numerous mstances which have come under 
my own observation, as the first named gentle- 
man was well known to many of the medical pro- 
fession, while the death-scene of the noble poet, 
will arrest the attention of all who take an interest 
in his genius. In the generality of cases, it mat- 
ters little what may have been the primary cause 
of disorder. The effect, under every circumstance, 
refers to temperature, — ^with more or less inter- 
ruption to the two great vital processes Digestion 
and Respiration. In other words, there is a stop 
to SANGUIFICATION, or the necessary reproduction 
of that fluid, which, throughout all the changes of 
life is constantly maintainmg expenditure. Take 
the influence of a passion— ^ar, for example : — 
Does not the breathing immediately become diffi- 
cult, and the appetite fail? Shakespeare, who 
had no theory to support, makes Henry VIII. 
when surprising Wolsey, with the proo& of his 
treachery, exclaim : — 

" Bead o'er thb 

And after, this— and then to breakfast 
With what appetite you have 1 **-— 

The first effect of disorder, then, being a ces- 
sation of sanguification — ^let us beware how we 

swelling remaining in the affected joints. In two days more he had 
no complaint. Would such have been the result, had he been 
treated according to the depleting &shion f 



OF DISEASE. 175 

employ a remedy, which if it succeed not in resto- 
ring healthy temperature, inevitably hastens the 
fatal catastrophe — ^or, in default of that, produces 
those low chronic fevers, which, under the names 
of dyspepsia, hypochondria, hysteria, &c., the best 
devised means too often fail to alleviate, far less 
to cure. While I freely admit, then, that the lan- 
cet is capable of giving temporary relief to local 
fulness of blood, and the attendant symptoms, I 
reject it generally, upon this simple and rational 
ground, that we can do the same thing by other 
and better agency. For, I care not whether you 
take inflammation of any considerable internal 
organ, such as the brain, liver, or heart — or of any 
external part, such as the knee or ancle joint,— 
with the lancet, you can seldom ever do more 
than give a delusive relief, at the expense of the 
powers of the constitution. The man of routine,— 
givmg up fever, perhaps, and a few other disor- 
ders, which the occasional obstinacy of a re- 
fractory patient has, contrary to " received doc- 
trine,*' taught him may yield to other means than 
bloodletting — ^will ask me what I should do with- 
out the lancet in apoplexy? Here the patient 
having no will of his own, and the prejudices of 
his Mends being all in favour of blood-letting, the 
school-bound member of the profession has seldom 
an opportunity of opening his eyes. Mine were 

o 



17^ I'HE LVITY 

opened by observing the want of success attend- 
ing the sanguinaiy treatment; in oChor words, 
the number of deaths that took place, ^ther in 
consequence, or in spite of it ! Was not that a 
reason for change of practice ? HaTing in my 
Military Hospital no prejudices to combat ; and 
observing the flushed and hot state of the patients 
forehead and face, I determined to try the cold 
affusion. The result was beyond my most san- 
guine expectations. The first patient was laid out 
all his length, and cold water poured on his head, 
from a height. After a few ablutions, he stag- 
gered to his feet, stared wildly round him, and 
then walked to the hospital, where a smart pur- 
gative completed his cure. In the army, I had a 
sufficiently extensive field for my experiments; 
and I seldom afterwards lost on apoplectic patient. 
Shall I be told there are cases of apoplexy, 
where the face is pale, and the temperature oc^ ? 
My answer is — these cases are not apoplexy, but 
Jaint /—cases which the cold dash, or a stimulant 
might recover, but which the lancet in too many 
instances has perpetuated to fatality I If the prac- 
titioner tells me that the cold dash will not cure an 
apoplexy, where a vessel is ruptured with san- 
guineous effusion, my reply is, that in such a 
case he may bleed all the blood from the body, 
with the same unsuccessful result! In the case of 



OF DISKASE. 177 

effusion of blood in an external part, from a bruise 
for instaace, would aay repetition of venesection 
make the effused blood re-enter the vessel from 
which it bad escaped ? No more would it do so 
in tl^ brain, or any other part. When cm the 
c^Diitrary, there is no ruptured vessel, the cold 
dash will not only contract the vessels more effec- 
tually than blood-letting, but it will, moreover, 
rouse the patient from his stupor, by the simple 
shock of its application. From theory and hypo- 
thesis, I appeal to indubitable and demonstrative 
£act 

Let the older members of the profession, seri- 
ously reflect upon the ultimate injury which may 
accrue to their own interests, by opposing their 
schooUfollies and prejudices to palpable and de- 
monstrative truth. So long as colleges and schools 
could mystify Disease and its nature, any treat- 
ment that these proposed — ^no matter how cruel or 
atrocious — ^would be submitted to in silence ; but, 
when men find out that every kind of disorder, 
inflammation included, may be conquered^ not 
only by external but by internal means, they will 
pause before they allow themselves to be depleted 
to death, or all but death, by the lancets of either 
surgeon or physician. 

Will any practitioner be so bold as to tell me 
that inflammation of any organ in the body is 



178 THE UNITY 

beyond the control of internal remedies. For what, 
then, I ask, do we prescribe mercury for inflam- 
mation of the liver and bowels? Why do we give 
eolchicum for the inflamed joints termed gout and 
rheumatism ? Do not these remedies, in numer- 
ous mstances, lessen the temperature, pain, and 
morbid volume of these inflanmiations, as surely 
as the application of leech or lancet ? If, for 
such inflammations we have internal remedies, 
why may we not have medicines equally available 
for diseases of the lungs? Have I not the authority 
of Magendie, Elliotson, Granville, &c., for the 
value of prussic acid in such cases ! But I shall 
be told of the danger of such a remedy in any but 
skilful hands. In the hands of the ignorant and 
injudicious, what remedial means, let me ask, have 
not proved not only dangerous but deadly ? Has 
not mercury done so ? Are purgatives guiltless ? 
How many have fallen victims to the lancet ! 
Properly diluted and combined, with prussic acid I 
have saved the infant at the breast from the threat* 
ened suffocation of croup* I have known it in the 
briefest space of time relieve inflammation of the 
lungs, where the previous pain and difficulty of 
breathing were hourly expected to terminate in 
death. True, like every other remedy, it may fail 
— ^but have we no other means or combination of 
means for such cases? With emetics and quinine 



OF DISEASE. 179 

I have seldom been at a loss ; and with mercury 
and turpentine I have cured pneumonia. 

But will the inflamed heart yield to anything 
but bloodletting ? Fearlessly I answer yes 1 and 
with much more certainty. With emetics, prussic 
acid, mercury, colchicum, silver, &c., I have con- 
quered inflammations of the heart, which the ab- 
straction of half the blood in the body could not 
have cured. Dr. Fosbroke, physician to the Ross 
Dispensary, a gentleman at one time associated 
with Jenner in his labours,* and one to whose 
talents, learning, and varied acquirements, even 
his enemies bear testimony, has given cases of this 
kind in the Lancet ; and with a rare candour he has 
admitted that a lecture of mine on the heart and 
circulation, had no small influence in leading him 
to dismiss bloodletting in the treatment of heart- 
disease. The same physician, in a subsequent com- 
munication to the Lancety gives the following sum- 
mary of his views upon this point: — "Finally, I do 
not deny that bleeding is the best practice ; huty it 
certainly appears to me that a man may be bled, all 
but to death, to save his life, and die notwithstand- 
ing — that bleeding may be the best means to pre- 
vent what is called metastasis — ^but, that it may 
ensue after a patient has been bled so often as 
six times — that getting worse is no uncommon 

* See Baron's life of Jenner. 



180 I'HE IS'lTY 

thing, and that getting better is a veiy bad sign, 
for nothing is so frequent as relapse and death 
after it — that it does not very plainly appear that 
the bleeding cures the few who get well raider 
such treatment — and that where it has appeared 
to cure them, enough is left behind sooner or later 
to cause death. To use M. Andral's exclamation, 
•how fruitless are these sanguine emissions to pre- 
vent the one or cure the other!' " "I can clearly 
foresee (continues the Doctor,) that the general 
application of bloodletting is destined to undergo 
a great change, and to be brought within more 
rational limits. M . Louis, an authority of weight, 
has assailed it with much force of fact in pneu- 
monia, a disease for which Professor Gregory 
went so far as to abstract three hundred ounces of 
blood. Only one case in ten thousand, says Profes- 
sor Allison, could bear such a loss ! 'Bleeding (says 
Mr. Liston,) is too often resorted to by thoughtless 
or ill-educated prax^titioners to the detriment of 
the patient. It is had recourse to, by those who 
have no correct ideas of the actions of the aiiinial 
economy, who have not within their heads a pe^ 
to hang an idea upon — or if they have, they are 
too lazy to think and combine their ideas, do as to 
come to a proper conclusion regarding what i§ tte 
judicious course to be pursued in any cas0» They 
follow a routine, and bleeding is too generally th« 



OF DISEASE. 181 

commencement of it.*" Dr, Fosbroke, after a com- 
plimentary notice of my own labours, which it 
would ill become me to quote, sums up the subject 
of bloodletting thus : — "Let not petulant ignorance 
assume that bloodletting has been an immutable 
and unassailable practice. The Egyptian and Py- 
thagorean schools rejected it, because the ' life is 
in the blood,' — the latter, after Hippocrates had 
revived it. It has alternately fallen and prevailed 
through thirty-six centuries, and its more or less 
use will be subject to the discovery of agents ade- 
quate to supersede it." 

I have been occasionally asked, how I would treat 
ENTERITIS — inflammation of the bowels — without 
the lancet. Before I have given my answer, I 
have generally asked this question — Can gentle- 
men boast of any particular success from deple- 
tion in this disease ? If so, why have they been 
so solicitous to get the system under the influence 
of mercury? Was it not that the nature of the 
relief afforded by bloodletting, was either tempo- 
rary and delusive, or altogether nugatory in the 
majority of cases? "The symptoms of enteritis'^ 
says Dr. Parr, " are a shivering with an uneasi- 
ness in the bowels, soon increasing to a violent 
pain, occasionally at first remitting^ but soon be- 
coming continual. Generally the whole abdomen 
is aflFected at the same time with spasmodic pains. 



18ti THE UNITY 

which extend to the loins, apparently owing to flatu- 
lency. The pulse is small, frequent, generally soft, 
but sometunes hard, and at last irregular and inter- 
mittent — ^the extremities are cold, — the strength 
sinks rapidly." ** Perhaps, (he adds,) bleeding is 
more seldom necessary in this disease than in any 
other inflammation ; — ^for it rapidly tends to morti- 
fication, — and should it not at once relieye, it soon 
proves £^taL" Such is the view of bloodletting in 
enteritis, taken by a man as remarkable for his 
opportunities of seeing disease of every kind, as 
for his great regard to truth. My own practice is 
this : — I give an emetic combined with a purga- 
tive, and apply the cold affusion to the hot and 
agonised abdomen, and whether the emetic act or 
not I follow it up with calomel, quinine, or tur- 
pentine, or one or two of them in combination. 
That these measures will cure iritis — ^inflamma- 
tion of an analogous membrane, supposing the 
case to partake of peritonite — every medical man 
knows. Let the practitioner try these means in 
abdominal inflammation, and he will not at all 
events find himself less successful than by his pre- 
sent ahnost universally fatal practice of blood- 
letting. 

The human mind does not easily turn from 
errors with which, by early education, it has been 
long imbued: and men, gray with years and prac- 



OF DISEASE. 183 

tioe» seldom question a custom that, fortunately 
for them, at least, has fallen in with the prejudices 
of their times. For myself, it was only step by 
step, and that slowly, that I came to abandon the 
lancet altogether in the treatment of disease. My 
principal substitutes have been the remedies upon 
which I have already entered. That none of them 
are without danger in the hands of the unskilful, 
I admit ; — ^nay, that some of them, mercury and 
purgatives for example, have, from their abuse, 
sent many more to the grave than they have ever 
saved from it. is allowed by every candid and sen- 
sible practitioner. But that was not the fault of 
the medicines, but of the men, who, having pre- 
scribed them, without properly understanding the 
principles of their action, have, in the language 
of Dr. Johnson, " put bodies, of which they knew 
little, into bodies of which they knew lessl'* 

Enter the crowded hospital, you will see the 
marks of blood on nearly every bed ; and from 
whom drawn ? From the ill-fed artizan, and the 
starved labourer, whose diseases, in an immense 
majority of instances, have been the result of de- 
fective nutrition and vitiated air ; — ^nay, as if this 
were not enough, a wretched ptisan supplies, even 
here, the place of wholesome food; and only when 
life reaches its last flutter, is the then useless wine 
administered with hesitating hand. 



184 THB v^nr 

This is no picture of the imagination j^^he at- 
tentive observer may witness it daily» in abaaost 
every hospital* No longer, it is true, do physicians 
shut up^ as they once did, the doors and win* 
dows of their fever-wards; — ^no longer do they 
destroy the health of their patients with reiterated 
ooorses of mercury, for diseases which they now 
know yield to the simplest remedies. But, so deeply 
rooted are even the popular prejudices in favor of 
Bloodletting, it will be long before such a re- 
action take place in medical practice as to render 
any reasoning of mine against it of material avail 
to suffering man. This much, however, I may 
be allowed to hope, that my medical readers will 
not, on every trifling occasion, order their pa- 
tienfs arm to be bared to the lancet ; and even in 
more serious disorder, turn over in their minds 
the possibility of, at least, a safer, and less debili- 
tating cure. 

I have already confessed that I have not always 
had this horror of bloodletting. In many in- 
stances have I formerly used the lancet, where a 
cure, in my present state of knowledge, oould 
have been effected without; but this was in my 
noviciate, influenced by others; and without suf- 
fient or correct data to think for myself. In the 
Army Hospitals, I had an opportunity of studying 
disease, both at home and abroad* There I saw 



OF DISEASE. i^ 

th* fine tall soldier, on his first admission, bled» to 
relief of a symptom, or to fainting* And what is 
Jbmtifigf A palsy of ev^ organic peareeption, 
which oirly diflfers from deaths in being remittent. 
Prolong it to permanency and it is death ! Pri- 
mary sj^mptoms were, of course, got over by such 
meaisures — but once having entered the hospital 
walls, you found that soldier's face become tami'* 
liar to you. Seldom did his pale countenance 
recover its former healthy character. He became 
the victim of consumption, dysentery, or dropsy; 
his constitution was broken by the first depletory 
measures to which he had been subjected. 

Such instances, too numerous to escape my ob- 
servation, naturally led me to ask — Can this be 
the proper practice ? It was assuredly the prac- 
tice of others, — of all. Could all be wrong? Rei- 
flecition taught me that men seldom act for them- 
selves ; but take, for the most part, a tone or bias 
frbni some individual master. 

By edacation, most have been misled, 

80 they believe, because they were so bred. 

'. I had the resolution to think for myself— aye-^ 
and to act, — and my conviction, gained from mudi 
and extensive experience is, that all diseases may 
be B^ocessfuUy treated, without loss of blood ; and 
that bloodletting, however put in practice, though 
it give a temporary relief, almost invariably in* 



186 THE UNITY 

jures the general health of the patient. English- 
men I you have trayersed seas, and dared the most 
dangerons climes, to put down the traffic in blood; 
—are you sure that in your own homes there is no 
such traffic carried on ? — no Guinea trade f * 

Abstinence — ^has been a favourite remedy with 
philosophers, as well as physicians. That it is 
proper in the commencement of acute disease^ 
nobody will doubt. The &ct is proved by the 
inability of the patient to take his accustomed 
meal : his stomach is then as little fit to digest 
nutriment, as his limbs are inadequate to loco- 
motion; both require rest 

In chronic disease, the patient should take food 
only in small quantities at a time, in the same way 
as the limbs should be gently but equally exer- 
cised. In this country, abstinence is generally 
carried too far by medical men. I must again 
repeat. Est modus in rebus. 

A modem Russian physician, has detailed many 
cases of intermittent fever, which he has cured, 
solely, by exacting a rigid abstinence on the part 
of his patients. We can understand this: the 
brain may be influenced, both beneficially and 

* A copper asked me one day to patronbe him. I tM him I 
iie¥er ordered Cupping. "Ah Sir! It 7?a^# very well.'*-^TboM 
nurses who obtain their livelihood by applying leeches, yery luUu- 
rally abuse me on all occasions. 



OF DISEASE. 187 

the reverse, by abstinence, much in the same 
way as by loss of blood. Abstinence may produce 
almost every form of disease, which has Altered 
into the consideration of the physician; another 
proof of the unity of morbid action, whatever be 
its cause. The prisoners of the Penitentiary "were 
suddenly put upon a diet, from which animal 
food was almost entirely excluded. An ox's head» 
which weighed eight pounds, was made into soup 
for one himdred people ; which allows one ounce 
and a quarter of meat to each person. After 
they had been living on this food for some time, 
they lost their colour, flesh, and strength, and 
could not do as much work as formerly. At 
length, this simple debility of constitution was 
succeeded by various forms of disease. They had 
scurvy, dysentery, diarrhoea, low fever j and lastly, 
affections of the brain and nervous system. 

"The affections which came on during this 
faded, wasted, weakened state of body, were head- 
ache, vertigo, delirium, convulsions, apoplexy, 
and even mania. When bloodletting was tried, 
the patients fainted, after losing five, four, or even 
fewer ounces of blood. On examination, after 
death, there was found increased vascularity of 
the brain, and sometimes fluid between its mem- 
branes, and in its ventricles.'' — Dr. Latham^ and 
CyclapcBdia of Medicine. Article Abstinence. 



IBS THK UNITY 

Sir Walter Scott, in his autolui^raphys has 
giTen U8 the' effects of abstinenoe, or, what b& •de- 
scribes, as a '^ sevei^ ve^taUe diet" upon jbtiaob- 
8d£ ^' I waa alTected," h^ says, '* while ^OM^ier 
its iniucaioe» with a nervousnetfs^ which I aev^r 
felt before nor since ; a disposition to start npoji 
cdaght alarms ; a want of decision in feeHng itnd 
acting, which has not usually been my failing^^*-r 
an aeate sensibility to trifling inconveiiienciefi!^ 
«nd an unnecessary apprehension of contiig^^ 
misfortunes rise to my memory, as connected with 
vegetable diet." Lockharfs Life of SaM. 

Is not this a lesson to some of our mod^n dec- 
torsi who are so fond of recommending starva4;ien 
to their patients ? 



CONCLUSION. 

We have proved, we hope, to the satisfaction 
of all but the prejudiced and the interested : — 

1. That, the phenomena of perfect health 
consist in a regular series of alternate actions — 
each embracing a special portion of time. 

2. That, DISEASE, under all its modifications, is 
a simple exaggeration or diminution of the same 
actions ; — and being universally alternative with 
<a comparative state of health, strictly speakii^, 
resolves itself into fever, remittent or inters 



OF DISEASE. ISO 

MiTTENT, chronic or acute: — every kind of strue* 
tural lesion or disorganization, from the caries 
of a tooth, to the puhnonary decomposition of 
phthisitf Bud that state of knee which is termed 
whi^ kwellingy being merely developements in its 
course.* 

S. That the tendency to disorganization, uEuai% 
demmiinated acute or inflammatory, differs &^om 
the chronic or scrofulous in the mere amounst 
of temperature and action : — ^the former bebag 
more remarkably characterised by excess of both, 
and consequently exhibiting a more rapid pro- 
cess to decomposition or cure ; while the latter 
Z^^y^ ^ -peod™ tenntoadon,. by «.« 
subdued, and consequently slower and less ob- 
vious alternations of the same action and tempera- 
ture. The slow and rapid caries of a tooth vary, 
in nothing, from the chronic and " galloppmg*' 
consumptions, except in the difference of tissue 
involved, and the degree of danger to life, arising 
out of the nature of the respective offices of each. 

Disease, thus simplified, will be found to be 
amenable to a principle of treatment equally sim- 
ple. Partaking of the nature of ague, throughout 
all its modifications, it will be best met by a prac- 
tice in accordance with the proper treatment of 
tbis. When the doctrine of the Concoction qf 

♦ Tooth-cotisiitBptioOy— Lnng-con9URiption,— Knce-^coD&uraption. 



190 THE UNITY 

Humours, held its baneful sway over the mind of 
the physician, it was considered the greatest of 
medical errors to repel the paroxysm — each fit 
hdng supposed to be a firiendly effort of nature, 
for the expulsion of a peccant or morbid humor 
from the body. Like the popular error of our 
own day, so prevalent in r^ard to '^ the Gout," 
it was deemed to be a salutary trial of the consti- 
tution. An ague in spring, was, said to be, good 
for a king ! That monarchs occasionally became 
its victims at this season, had no particular share 
in the revolution which has since taken place in 
medical opinion. So late as the time of Boer- 
haave, a physician asserted, that if he could pro- 
duce a fever as easily as he could cure it, he should 
be well satisfied with his own skill ! The conse- 
quence of such notions was, that the practitioner 
exerted his utmost to increase the heat of the body 
during the paroxysm, — but the Jittality attending 
the practice had no otiier effect upon the mass of 
the profession, than to make them redouble their 
exertions in the discovery of means of increasing 
this heat, that they might thereby assist the un- 
known process which morbid matter was supposed 
to undergo! One hundred years have scarcely 
elapsed since the fever-patient was wrapped in 
blankets — since door, window, and bed curtains 
were closed, and the apartment heated by a large 



OF DISEASE. 191 

fire! Like the treatment of Syphilis in more re- 
cent times, the practice proved infinitely more 
destructive to life than the disease itself — ^but, so 
far from opening men's eyes, the seniors of the 
profession, when the invaluable bark was first in- 
troduced into practice, opposed it with a violence 
and a virulence which has, only since, been paral- 
lelled by the resistance they successively offered 
to the introduction of the variolous and vaccine 
innoculations. To bring forward any sweeping 
or useful measure in Medicine, requires a moral 
courage and perseverance that fall to the lot of 
few. The man, who wishes to gain a ready noto- 
riety, has only to puff off some inert or mystical 
mode of treatment, and his success is certain. 
He must beware of coming before the public with 
a remedy to which the stigma of poison can be 
attached. Does not the quack constantly boast 
of the absolute safety of his remedy I 

As now practised. Medicine is little better 
than a copy of the exploded navigation of the 
ancients. Taking his bearings, less by the ob- 
servation of the fixed stars, than by every little 
eminence and prominent locality, the ancient ma- 
riner, cautiously, if not timidly, crept along shore. 
With the unerring compass for his guide, the sea- 
man now steers his bark boldly upon the bound- 
less ocean. Despising the localisms that formerly 

p 



192 THE UNITY 

guided his sail, he now completes his voyage to 
the distant port, in as many days, as it formerly 
occupied him weeks or months. Keeping in view 
the principU, here Wd do™, th^lh^cUa 
may, in like manner, with a few rare exceptions^ 
entirely dispense with the common anatomical 
land-marks of his art,* — ^if he he not startled with 
the novelty of the light hy which we have endea- 
voured to dispel the darkness that has hitherto 
clouded the field of Medicine. Taking constitu- 
tional unity and totality for his rudder and com- 
pass — the hrain and nerves for the ocean and seas 
on which he is to act — ^temperature and remit- 
tency for his tide and season — ^idiosyncrasy or 
habit for the rule by which he must occasionally 
change his tack— he may now rapidly accomplish 
ends which, by groping among the intricaciL of 
nomenclature, or by a vulgar attention to mere 
localities, he can only imperfectly attain by the 
reiteration of long and painful processes; — ^he 
may thus, with ease, obviate difficulties which he 
previously believed to be insurmountable. Let 
him not question whether or not the adoption of this 
will best serve his own interest. As physic is for 
the public, not the public for physic, he may rely 
with certainty, that notwithstanding the present 

* Sydenham shewed how little the anatomists had done for Me« 
dlcine when he said *' Anatomy is a fit study for a painter !" 



OF DISEASE. 193 

over-crowded state of the profession, the supply of 
medical aid will, sooner or later, adjust itself to 
his own, as well as to the general weal. 

It was one of the hoasts of the eccentric 
Radcliffe, that he could write the practice of 
physic on half a sheet of paper : the whole might 
be comprised in half a line — attention to 
TEMPERATURE I The judicious treatment of all 
disease comes to this, and to no more. What is 
the proper practice in ague? To apply warmth, 
or administer cordials in the cold stage ; in the 
hot to reduce the amount of temperature, by cold 
affusion and jfresh air; or, for the same purpose, 
to exhibit, according to circumstances, an emetic, 
a purgative, or sudorific medicine. With quinine, 
arsenic, opium, &c., the period of remission, or 
medium-temperature, may be prolonged to an in- 
definite period. In this manner may health 
become established in all diseases — ^whether from 
some special local developementj the disorder be 
denominated mania, epilepsy, croup, cynanche, 
the gout, the influenzal 

In the early stages of disease, to arrest the fever 
is, in most instances, sufEicient for the reduction 
of every kind of local developement. Except in a 
few rare cases, it is only when the disorder has 
been of long standing and habitual, that the phy- 
sician lyill be compelled to call to his aid the 



194 THE UNITY 

various local measures which have a relation to the 
greater or less amount of the temperature of parti- 
cular parts. 

In obstinate cases, it is my custom, as I have 
aJready said, to pre^be two or more powers, 
ha™g'» general Luenee, with two or JL W- 
ing a special local bearing. I have, necessarily, 
on certain occasions, combined remedies which 
may partially decompose each other. In continu- 
ing still to do so, / am justified by successful 
RESULTS — the only test of medical truth — the ulti- 
mate end and aim of all medical treatment ! The 
charge of want of chemical knowledge, which has 
been occasionally, urged against me, by drug com- 
pounders — those to whom "a little learning is a 
dangerous thing."-is one which I am willing to 
share with numerous medical men, whom the 
world has already recognised as eminent in their 
art.* To such a charge the answer has been often 
given — that the human stomach is not a chemist's 
alembic, but a living organ capable of modifying 
the action of every substance submitted to it. 

* Sir Astley Cooper, for example, prescribes Oxymuriate of 
Mercury in tincture of Bark. This is unchemical— but its value as 
a remedial means is unquestionable. ''Were it my business to un- 
derstand physic/* says Locke, ''would not the surer way be to 
consult Nature herself, in the history of diseases and their cures, 
than to espouse the principles of the dog^matists, methodists, or 
eliemists ?** 



OF DISEASE. 195 

To the Army Surgeons belongs the honor of 
many improvements in particular forms of disease. 
The opportunities afforded to them by the nature 
of their duties and the singularly effective hos- 
pital-administration of their present chief, Su: 
James M^ Grigor, have not been lost to the Service 
or the public. These officers have tried and suc^ 
ceeded with the cold affusion in fever ; they have 
proved the curability of syphilis by milder means 
than mercurial salivation ; and to them I confi- 
dently look for the slow but progressive expulsion 
of the lancet and the leech from the therapeutic 
branch of Medicine. Instead of the physician 
being looked upon with fear and trembling by the 
majority of patients, I hope to live to see him re- 
spected and honoured by all ranks — not accord- 
ing to the number of letters or vain distinctions 
he attaches to his name; but, according to the 
number of lives he shall have contributed to pro- 
long. Medicine will then be a salutary, not a 
sanguinary art — a blessiag, not a bane to hu- 
manity I 



196 THE XJKITT 

APPENDIX. 

''Masked Intermittents. — ^These macy be 
sttccincdy described to be certain diseases ^miliar 
in a continued (?) form to medical men and our 
nosologies.-recurring at intervals in paroxysms 
of greater or less duration, apparently owing their 
origin to the influence of Malaria (?) and remedi- 
able by the means employed to cure intermittent 
fever.'* 

^< These diseases are either inflammatory or 
nervous. Of the first class there have been men- 
tioned examples of pneumonia (Pallas) — ^pleuritis 
tertian (SauvageSy Arloing) — carditis (Ibid et 
Juncker) — otitis (Mongellaz and others) — ^perito- 
nitis (JeU under the writer^ s own observation) — 
ophthalmia frequent, — coryza frequent, — ^tertian 
swelling of the head (Mongellas) — quotidian and 
tertian urticaria (Ibid) — quotidian scarlatina, — 
livid spots, probably of purpura, quotidian, 
(Storck) — tertian erysipelas (Mongellas) — ^rheu- 
matism quotidian, tertian and quartan, (Ibid and 
others) — ^gout first quotidian, then double quar- 
tan ; epistaxis quotidian ; intermittent odontalgia 
and cephalalgia very frequent ; quotidian inflam- 
mation of leech bites (Elliotson*s Lectures^ pub- 
lished in the Medical Gazette) — encephalitis and 
menengitis quotidian, tertian and quartan (Leu- 
caire Parent du Chatelet, Martinet, Sfc.) gastro- 



OF DISEASE. 107 

enteritis (Havard) diarrhcea tertian (Picque 
Journal de Medecine, 1774^ a^d quotidian fre- 
quent (from the writer^ s observcUion;) and dysen- 
tery has not been found unfrequently complicating 
the paroxysms of an intermittent." 

"Of the nervou. aftedo^s. the foUo^g .» 
the most remarkable — asthma frequent; but many 
cases, which have occurred in the practice of 
the writer, lead him to suspect that the periodic 
exacerbation of permanent bronchitis has been, 
occasionally, confounded with mtermitting dysp. 
no^periidicd h,.teria and epilepsy 4-^- 
intemuttmg deafaess, type tertian (JSphemendes 
Curios. Natwr. 1704^ — ^tertian convulsions and 
blindness (^/&«d! 1694 J — quotidian dumbness (Ibid 
1684;— periodical sneezmg— three paroxysms oc- 
curring every evening, and each paroxysm com- 
prising three hundred sneezes (Ibid 1672) — 
tertian eructations at the rate of three hundred 
eructations per hour (Ibid I762) — ^periodical flow 
of leucorrhoea with lypothymia, convulsions and 
mutism, intennittentH^r-neodonedbym^ay. 
and an excellent example of intemuttmg hemiple- 
gia of the left side is related in Dr. Elliotson's 
Lectures, published in the Medical Gazette. It 
was generally tertian or quartan, but once occurred 
at the interval of sixteen days/' — SeeArticlewEVER 
in the Cyclopedia of Medicine. The writer. 



198 THE UNITY 

(Dr. Joseph Brown) gives other forms of disease of 
an intermittent character,— aU which he presumes 
to he dependent on malaria I Now, the singula- 
rity of the thing is this : — that since my attention 
first hecame directed to the suhject, I have met 
«th no fonn of di^ase whatever! or b, wh..«er 
caused, which has not proved intermittent or re- 
mittent in its course I The philosophical physi- 
cian, on reflection, will wonder how he ever could 
have douhted the remittency of any form of dis- 
ease. When the mind of any individual, however 
intelligent, is upon a false scent and intensely 
occupied, he will pass hy the most natural and 
ohvious facts, — in the same way as a soldier, in 
the eagerness of the comhat, will lose an arm for 
minutes without knowing it. — ^When any truth 
has heen discovered, we have wondered that it 
did not sooner strike us. 

Dr. Irving, formerly of the Madras Medical 
Estahlishment, has, in two instances of tooth-ache, 
succeeded with quinine internally administered — 
he was led to try the quinine from observing the 
remissions. 

Apoplexy. — "It is evident that the remedy 
[bloodletting] can have no direct effect in remov- 
ving the extravasated blood, nor can it lessen the 
quantity of blood altogether within the skull, so 
as to give additional space, and thereby diminish 



OF DISEASE. 199 

the pressure the effused blood is making on the 
brain; — ^and yet it is employed in these cases as 
if it were capable of accomplishing with certainty 
one or other of these purposes : it is used too with 
such fi^dom, a« if it needed only to be carried to 
a certain extent in order to insure success. But, 
blood once extravasated, can be removed only by 
absorptioTiy which is a natural and slow process — 
requiring for its completion at least a moderate 
share of general strength." "As mere matter 
of experiencey there is reason to believe that 
bloodletting in these cases does much less good, 
and the omission of it less injury ^ than is gene- 
rally supposed.'' — ClutterhiLck. All this reason- 
ing equally applies to the treatment of every kind 
of palsy. 

Grey hair. — A child of nine years of age, was 
lately brought to my notice, whose hair was per- 
fectly grey. She had patches on her skin of a 
brownish colour, like freckles, but of the size of 
the pahn and larger, on diflferent parts of the body. 

While serving in India, I was astonished to find 
many of the natives with large white patches on 
various parts of their skin ; which patches resem- 
bled the European cutis. The subjects of this 
disease were generally aged. I take it to be 
analogous to grey hairs. 

Temperature. — The influence of temperature 

Q 



200 THE UNITY 

upon Pregnancy must be powerful: — according 
to Dr. J. R. Johnson, the aphis, and also the 
wood-louse, may be made to bring forth either eggs 
or live young at pleasure, by keeping them in a 
particular temperaturey and treating them in a 
particular manner. What produces the chick 
in ot;o?— change of temperature solely! 



THE END. 



HARPKRi PRINTERi CHELTENHAM. 



:hia. 



Mil 



Qty 

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ed 



scant 



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tural 

Tensive 
inty of- 
ensive 

fensive 
mly of- 



itural 

itural 

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(tural 

ne 

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me 
itural 



natui 



scant 

natu) 
none 



natu 

nont 

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natu 

natu 

nat 

nal 



nat> 
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nat 
nor 
nat 



cop 
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MILK. 


182 
Janug 

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Datural 


Fel 


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1 


copious 
copious 
natural 




none 


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copious 


A]^ 


none 
natural 

• 


183 


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none 


Man 


m 


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Not 

Aptf 

■ 


m 

m 
m 


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m 


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183 


m 


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^^■ii^* 



DATE. 



1833 
May 




^ILK. 



HJ . 



PU 



June 

Sept. 
Dec. 
1834 
April 

Nov, 



110 f 



quicli 

144 1 
1201 

1201 



mious 



Po 



June 



140 
120 
130 



Oct. 



tpious 



120 
120 
120 



1836 
Jan. 



139 



) 



120 
100 



130 



U- . 



iiyi"! 



4. 




March 



April 



May 
June 

Dec. 



1837 
Jan. 

April 



May 

Sept. 

1838 

January 



March 



April 



43 
44 
45 

46 
47 
48 
49 
50 
51 

52 
53 
54 
55 
56 

57 
58 
59 
60 
61 
62 
63 
64 
65 
66 
67 
68 
69 
70 
71 
72 
73 
74 
75 
76 
77 
78 
79 
80 
81 
82 
83 
84 
85 
86 
87 
88 
89 
90 
91 
92 

93 

94 

95 

96 

97 

98 

99 

200 

201 

202 

203 

204 

205 



Carey! 
Barloi 
Waldi 

Pratt 

White 

Hands 

Farrai 

Grove 

Miller 

Boone 

Davied 

Earle 

Brown 

HillerT 



BuckU 

Coopei 

Herve] 

Ford 1 

Ingles L 

Dunk]/ 

Lewis 

Brown 

Planfo 

Robert 

Nichol 

Hoare 

Wiles 

Story 

Hanc04 

Cell J 

Chandl 

Connoi 

Dragai 

Frankli 

Connoi 

More I 

Burton- 

Poole I 

Mann ': 

Grady 

Whiteh 

Wainw 

Hely 

Noonai 

Collins 

Greenh 

Lane 

Barron 

O'Brieil 

Hatton 



Cox 

Jourdai 

Foster 

Wiles 1 

J. Whi 

Connor 

Roper 

Levick 

Aldrett 

Knight 

Wynne 

Elliot 

Harwdo 



quid 

very 

130 5 

very- 
very^ 

1- 

130' 
very 

i 

\ 

quid 

130 

130 

t 

1 



1 

1 

very, 
quid 
quid 
flutf 
quid 
quif 



14 




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T.. 




eness 
"epeat 



■hiver 



1 ski) 
'ostra 



tion 



trv. Tune of death from four to fl j • . .u • , 

>h, in ten cases. In three, c'* ^°^ "*' both conjoined. 
108. 1 and 3^ no affection of r}»«>°<»<^<>»™on to the 33 cases 



■■■ift. 



h 



rs : cold sweats 



lirreg. shiveriDg 



■ 

I 
I 

■ 

;vhen roused : 
iipils 



hard: fre- 
quent 

120 small 



Dts on its convex surface ; two of 
91e lobe of right lung. 
>f dura mater red. Brain healthy, 
lira mater. Considerable abscess 



nium inBamed ; also dura mater. 
tie joints. The cartilages of the 



ichnoid thick ; subjacent effusion, 
imeath. Peritonitis with eflusion ; 



the sinus vascular. Longitudinal 
kne in the other sinuses. Abscess 
^y. Ulcerations of the intestines. 

\ under the pia mater. Liver and 
Bses of different sizes. 



5 only lymph. In one case neit 
t the sole cause of secondary afiec 
ry. Time of death from four to f( 

I}B, in ten cases. In three» c 



f 



nstances of opacity of arach- 

t : and six, both conjoined, 
ance common to the 33 cases 



f: 



■ 



i