medical essays-第54章

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　a　disease　from　which　the　Earl　of　Shaftesbury　was　suffering；　which　led　to　an　operation　that　saved　his　life。　　Less　felicitous　was　his　experience　with　a　certain　ancilla　culinaria　virgo；which　I　am　afraid　would　in　those　days　have　been　translated　kitchen…wench；　instead　of　lady　of　the　culinary　department；who　turned　him　off　after　she　had　got　tired　of　him；　and　called　in　another　practitioner。　＇Locke　and　Sydenham；　p。　124。　　By　John　Brown；　M。　　D。　　Edinburgh；　1866。＇　　This　helped；　perhaps；　to　spoil　a　promising　doctor；　and　make　an　immortal　metaphysician。　　At　any　rate；　Locke　laid　down　the　professional　wig　and　cane；　and　took　to　other　studies。

The　name　of　Thomas　Sydenham　is　as　distinguished　in　the　history　of　medicine　as　that　of　John　Locke　in　philosophy。　　As　Barbeyrac　was　found　in　opposition　to　the　established　religion；　as　Locke　took　the　rational　side　against　orthodox　Bishop　Stillingfleet；　so　Sydenham　went　with　Parliament　against　Charles；　and　was　never　admitted　a　Fellow　by　the　College　of　Physicians；　which；　after　he　was　dead；　placed　his　bust　in　their　hall　by　the　side　of　that　of　Harvey。

What　Sydenham　did　for　medicine　was　briefly　this　he　studied　the　course　of　diseases　carefully；　and　especially　as　affected　by　the　particular　season；　to　patients　with　fever　he　gave　air　and　cooling　drinks；　instead　of　smothering　and　heating　them；　with　the　idea　of　sweating　out　their　disease；　he　ordered　horseback　exercise　to　consumptives；　he；　like　his　teacher；　used　few　and　comparatively　simple　remedies；　he　did　not　give　any　drug　at　all；　if　he　thought　none　was　needed；　but　let　well　enough　alone。　　He　was　a　sensible　man；　in　short；　who　applied　his　common　sense　to　diseases　which　he　had　studied　with　the　best　light　of　science　that　he　could　obtain。

The　influence　of　the　reform　he　introduced　must　have　been　more　or　less　felt　in　this　country；　but　not　much　before　the　beginning　of　the　eighteenth　century；　as　his　great　work　was　not　published　until　1675；　and　then　in　Latin。　　I　very　strongly　suspect　that　there　was　not　so　much　to　reform　in　the　simple　practice　of　the　physicians　of　the　new　community；　as　there　was　in　that　of　the　learned　big…wigs　of　the　〃College；〃　who　valued　their　remedies　too　much　in　proportion　to　their　complexity；　and　the　extravagant　and　fantastic　ingredients　which　went　to　their　making。

During　the　memorable　century　which　bred　and　bore　the　Revolution；　the　medical　profession　gave　great　names　to　our　history。　　But　John　Brooks　belonged　to　the　State；　and　Joseph　Warren　belongs　to　the　country　and　mankind；　and　to　speak　of　them　would　lead　me　beyond　my　limited　subject。　　There　would　be　little　pleasure　in　dwelling　on　the　name　of　Benjamin　Church；　and　as　for　the　medical　politicians；　like　Elisha　Cooke　in　the　early　part　of　the　century；　or　Charles　Jarvis；　the　bald　eagle　of　Boston；　in　its　later　years；　whether　their　practice　was　heroic　or　not；　their　patients　were；　for　he　is　a　bold　man　who　trusts　one　that　is　making　speeches　and　coaxing　voters；　to　meddle　with　the　internal　politics　of　his　corporeal　republic。

One　great　event　stands　out　in　the　medical　history　of　this　eighteenth　century；　namely；　the　introduction　of　the　practice　of　inoculation　for　small…pox。　　Six　epidemics　of　this　complaint　had　visited　Boston　in　the　course　of　a　hundred　years。〃　　Prayers　had　been　asked　in　the　churches　for　more　than　a　hundred　sick　in　a　single　day；　and　this　many　times。　About　a　thousand　persons　had　died　in　a　twelvemonth；　we　are　told；　and；　as　we　may　infer；　chiefly　from　this　cause。

In　1721；　this　disease；　after　a　respite　of　nineteen　years；　again　appeared　as　an　epidemic。　　In　that　year　it　was　that　Cotton　Mather；　browsing；　as　was　his　wont；　on　all　the　printed　fodder　that　came　within　reach　of　his　ever…grinding　mandibles；　came　upon　an　account　of　inoculation　as　practised　in　Turkey；　contained　in　the　〃Philosophical　Transactions。〃　　He　spoke　of　it　to　several　physicians；　who　paid　little　heed　to　his　story；　for　they　knew　his　medical　whims；　and　had　probably　been　bored；　as　we　say　now…a…days；　many　of　them；　with　listening　to　his　〃Angel　of　Bethesda；〃　and　satiated　with　his　speculations　on　the　Nishmath　Chajim。

The　Reverend　Mather；I　use　a　mode　of　expression　he　often　employed　when　speaking　of　his　honored　brethren；the　Reverend　Mather　was　right　this　time；　and　the　irreverent　doctors　who　laughed　at　him　were　wrong。　One　only　of　their　number　disputes　his　claim　to　giving　the　first　impulse　to　the　practice；　in　Boston。　　This　is　what　that　person　says：　〃The　Small…Pox　spread　in　Boston；　New　England；　A。1721；　and　the　Reverend　Dr。　Cotton　Mather；　having　had　the　use　of　these　Communications　from　Dr。　William　Douglass　〃　（that　is；　the　writer　of　these　words）；　surreptitiously；　without　the　knowledge　of　his　Informer；　that　he　might　have　the　honour　of　a　New　fangled　notion；　sets　an　Undaunted　Operator　to　work；　and　in　this　Country　about　290　were　inoculated。〃

All　this　has　not　deprived　Cotton　Mather　of　the　credit　of　suggesting；　and　a　bold　and　intelligent　physician　of　the　honor　of　carrying　out；　the　new　practice。　　On　the　twenty…seventh　day　of　June；　1721；　Zabdiel　Boylston　of　Boston　inoculated　his　only　son　for　smallpox；the　first　person　ever　submitted　to　the　operation　in　the　New　World。　　The　story　of　the　fierce　resistance　to　the　introduction　of　the　practice；　of　how　Boylston　was　mobbed；　and　Mather　had　a　hand…grenade　thrown　in　at　his　window；　of　how　William　Douglass；　the　Scotchman；　〃always　positive；　and　sometimes　accurate；〃　as　was　neatly　said　of　him；　at　once　depreciated　the　practice　and　tried　to　get　the　credit　of　suggesting　it；　and　how　Lawrence　Dalhonde；　the　Frenchman；　testified　to　its　destructive　consequences；　of　how　Edmund　Massey；　lecturer　at　St。　　Albans；　preached　against　sinfully　endeavoring　to　alter　the　course　of　nature　by　presumptuous　interposition；　which　he　would　leave　to　the　atheist　and　the　scoffer；　the　heathen　and　unbeliever；　while　in　the　face　of　his　sermon；　afterwards　reprinted　in　Boston；　many　of　our　New　England　clergy　stood　up　boldly　in　defence　of　the　practice；all　this　has　been　told　so　well　and　so　often　that　I　spare　you　its　details。　　Set　this　good　hint　of　Cotton　Mather　against　that　letter　of　his　to　John　Richards；　recommending　the　search　after　witch…marks；　and　the　application　of　the　water…ordeal；　which　means　throw　your　grandmother　into　the　water；　if　she　has　a　mole　on　her　arm；if　she　swims；　she　is　a　witch　and　must　be　hanged；　if　she　sinks；　the　Lord　have　mercy　on　her　soul！

Thus　did　America　receive　this　great　discovery；　destined　to　save　thousands　of　lives；　via　Boston；　from　the　hands　of　one　of　our　own　Massachusetts　physicians。

The　year　1735　was　rendered　sadly　memorable　by　the　epidemic　of　the　terrible　disease　known　as　〃throat　distemper；〃　and　regarded　by　many　as　the　same　as　our　〃diphtheria。〃　　Dr。　Holyoke　thinks　the　more　general　use　of　mercurials　in　inflammatory　complaints　dates　from　the　time　of　their　employment　in　this　disease；　in　which　they　were　thought　to　have　proved　specially　useful。

At　some　time　in　the　course　of　this　century　medical　practice　had　settled　down　on　four　remedies　as　its　chief　reliance。　　I　must　repeat　an　incident　which　I　have　related　in　another　of　these　Essays。　　When　Dr。　Holyoke；　nearly　seventy　years　ago；　received　young　Mr。　James　Jackson　as　his　student；　he　showed　him　the　formidable　array　of　bottles；　jars；　and　drawers　around　his　office；　and　then　named　the　four　remedies　referred　to　as　being　of　more　importance　than　all　the　rest　put　together。　　These　were　Mercury；　Antimony；　Opium；　and　Peruvian　Bark。〃　　I　doubt　if　either　of　them　remembered　that；　nearly　seventy　years　before；　in　1730；　Dr。　William　Douglass；　the　disputatious　Scotchman；　mentioned　those　same　four　remedies；　in　the　dedication　of　his　quarrelsome　essay　on　inoculation；　as　the　most　important　ones　in　the　hands　of　the　physicians　of　his　time。

In　the　〃Proceedings〃　of　this　Society　for　the　year　1863　is　a　very　pleasant　paper　by　the　late　Dr。　Ephraim　Eliot；　giving　an　account　of　the　leading　physicians　of　Boston　during　the　last　quarter　of　the　last　century。　　The　names　of　Lloyd；　Gardiner；　Welsh；　Rand；　Bulfinch；　Danforth；　John　Warren；　Jeffries；　are　all　famous　in　local　history；　and　are　commemorated　in　our　medical　biographies。　　One　of　them；　at　least；　appears　to　have　been　more　widely　known；　not　only　as　one　of　the　first　aerial　voyagers；　but　as　an　explorer　in　the　almost　equally　hazardous　realm　of　medical　theory。　　Dr。　John　Jeffries；　the　first　of　that　name；　is　considered　by　Broussais　as　a　leader　of　medical　opinion　in　America；　and　so　referred　to　in　his　famous　〃Examen　des　Doctrines　Medicales。〃

Two　great　movements　took　place　in　this　eighteenth　century；　the　effect　of　which　has　been　chiefly　felt　in　our　own　time；　namely；　the　establishment　of　the　Massachusetts　Medical　Society；　and　the　founding　of　the　Medical　School　of　Harvard　University。


The　third　century　of　our　medical　history　began　with　the　introduction　of　the　second　great　medical　discovery　of　modern　times；of　all　time　up　to　that　date；　I　may　say；once　more　via　Boston；　if　we　count　the　University　village　as　its　suburb；　and　once　more　by　one　of　our　Massachusetts　physicians。　　In　the　month　of　July；　1800；　Dr。　Benjamin　Waterhouse　of　Cambridge　submitted　four　of　his　own　children　to　the　new　process　of　vaccination；the　first　persons　vaccinated；　as　Dr。　Zabdiel　Boylston's　son　had　been　the　first　person　inoculated　in　the　New　World。

A　little　before　the　first　half　of　this　century　was　completed；　in　the　autumn　of　1846；　the　great　discovery　went　forth　from　the　Massachusetts　General　Hospital；　which　repaid　the　debt　of　America　to　the　science　of　the　Old　World；　and　gave　immortality　to　the　place　of　its　origin　in　the　memory　and　the　heart　of　mankind。　　The　production　of　temporary　insensibility　at　willtuto；　cito；　jucunde；　safely；　quickly；　pleasantlyis　one　of　those　triumphs　over　the　infirmities　of　our　mortal　condition　which　change　the　aspect　of　life　ever　afterwards。　Rhetoric　can　add　nothing　to　its　glory；　gratitude；　and　the　pride　permitted　to　human　weakness；　that　our　Bethlehem　should　have　been　chosen　as　the　birthplace　of　this　new　embodiment　of　the　divine　mercy；　are　all　we　can　yet　find　room　for。

The　present　century　has　seen　the　establishment　of　all　those　great　charitable　institutions　for　the　cure　of　diseases　of　the　body　and　of　the　mind；　which　our　State　and　our　city　have　a　right　to　consider　as　among　the　chief　ornaments　of　their　civilization。

The　last　century　had　very　little　to　show；　in　our　State；　in　the　way　of　medical　literature。　　The　worthies　who　took　care　of　our　grandfathers　and　great…grandfathers；　like　the　Revolutionary　heroes；　fought　（with　disease）　and　bled　（their　patients）　and　died　（in　spite　of　their　own　remedies）；　but　their　names；　once　familiar；　are　heard　only　at　rare　intervals。　　Honored　in　their　day；　not　unremembered　by　a　few　solitary　students　of　the　past；　their　memories　are　going　sweetly　to　sleep　in　the　arms　of　the　patient　old　dry…nurse；　whose　〃blackdrop〃　is　the　never…failing　anodyne　of　the　restless　generations　of　men。　　Except　the　lively　controversy　on　inoculation；　and　floating　papers　in　journals；　we　have　not　much　of　value　for　that　long　period；　in　the　shape　of　medical　records。

But　while　the　trouble　with　the　last　century　is　to　find　authors　to　mention；　the　trouble　of　this　would　be　to　name　all　that　we　find。　　Of　these；　a　very　few　claim　unquestioned　preeminence。

Nathan　Smith；　born　in　Rehoboth；　Mass。；　a　graduate　of　the　Medical　School　of　our　University；　did　a　great　work　for　the　advancement　of　medicine　and　s