medical essays-第55章

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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　surgery　in　New　England；　by　his　labors　as　teacher　and　author；　greater；　it　is　claimed　by　some；　than　was　ever　done　by　any　other　man。　　The　two　Warrens；　of　our　time；　each　left　a　large　and　permanent　record　of　a　most　extended　surgical　practice。　　James　Jackson　not　only　educated　a　whole　generation　by　his　lessons　of　wisdom；　but　bequeathed　some　of　the　most　valuable　results　of　his　experience　to　those　who　came　after　him；　in　a　series　of　letters　singularly　pleasant　and　kindly　as　well　as　instructive。　　John　Ware；　keen　and　cautious；　earnest　and　deliberate；　wrote　the　two　remarkable　essays　which　have　identified　his　name；　for　all　time；　with　two　important　diseases；　on　which　he　has　shed　new　light　by　his　original　observations。

I　must　do　violence　to　the　modesty　of　the　living　by　referring　to　the　many　important　contributions　to　medical　science　by　Dr。　Jacob　Bigelow；　and　especially　to　his　discourse　on　〃Self…limited　Diseases；〃　an　address　which　can　be　read　in　a　single　hour；　but　the　influence　of　which　will　be　felt　for　a　century。

Nor　would　the　profession　forgive　me　if　I　forgot　to　mention　the　admirable　museum　of　pathological　anatomy；　created　almost　entirely　by　the　hands　of　Dr。　John　Barnard　Swett　Jackson；　and　illustrated　by　his　own　printed　descriptive　catalogue；　justly　spoken　of　by　a　distinguished　professor　in　the　University　of　Pennsylvania　as　the　most　important　contribution　which　had　ever　been　made　in　this　country　to　the　branch　to　which　it　relates。

When　we　look　at　the　literature　of　mental　disease；　as　seen　in　hospital　reports　and　special　treatises；　we　can　mention　the　names　of　Wyman；　Woodward；　Brigham；　Bell；　and　Ray；　all　either　natives　of　Massachusetts　or　placed　at　the　head　of　her　institutions　for　the　treatment　of　the　insane。

We　have　a　right　to　claim　also　one　who　is　known　all　over　the　civilized　world　as　a　philanthropist；　to　us　as　a　townsman　and　a　graduate　of　our　own　Medical　School；　Dr。　Samuel　Gridley　Howe；　the　guide　and　benefactor　of　a　great　multitude　who　were　born　to　a　world　of　inward　or　of　outward　darkness。

I　cannot　pass　over　in　silence　the　part　taken　by　our　own　physicians　in　those　sanitary　movements　which　are　assuming　every　year　greater　importance。　　Two　diseases　especially　have　attracted　attention；　above　all　others；　with　reference　to　their　causes　and　prevention；　cholera；　the　〃black　death〃　of　the　nineteenth　century；　and　consumption；　the　white　plague　of　the　North；　both　of　which　have　been　faithfully　studied　and　reported　on　by　physicians　of　our　own　State　and　city。　　The　cultivation　of　medical　and　surgical　specialties；　which　is　fast　becoming　prevalent；　is　beginning　to　show　its　effects　in　the　literature　of　the　profession；　which　is　every　year　growing　richer　in　original　observations　and　investigations。

To　these　benefactors　who　have　labored　for　us　in　their　peaceful　vocation；　we　must　add　the　noble　army　of　surgeons；　who　went　with　the　soldiers　who　fought　the　battles　of　their　country；　sharing　many　of　their　dangers；　not　rarely　falling　victims　to　fatigue；　disease；　or　the　deadly　volleys　to　which　they　often　exposed　themselves　in　the　discharge　of　their　duties。

The　pleasant　biographies　of　the　venerable　Dr。　Thacher；　and　the　worthy　and　kind…hearted　gleaner；　Dr。　Stephen　W。　　Williams；　who　came　after　him；　are　filled　with　the　names　of　men　who　served　their　generation　well；　and　rest　from　their　labors；　followed　by　the　blessing　of　those　for　whom　they　endured　the　toils　and　fatigues　inseparable　from　their　calling。　　The　hardworking；　intelligent　country　physician　more　especially　deserves　the　gratitude　of　his　own　generation；　for　he　rarely　leaves　any　permanent　record　in　the　literature　of　his　profession。　　Books　are　hard　to　obtain；　hospitals；　which　are　always　centres　of　intelligence；　are　remote；　thoroughly　educated　and　superior　men　are　separated　by　wide　intervals；　and　long　rides；　though　favorable　to　reflection；　take　up　much　of　the　time　which　might　otherwise　be　given　to　the　labors　of　the　study。　　So　it　is　that　men　of　ability　and　vast　experience；　like　the　late　Dr。　Twitchell；　for　instance；　make　a　great　and　deserved　reputation；　become　the　oracles　of　large　districts；　and　yet　leave　nothing；　or　next　to　nothing；　by　which　their　names　shall　be　preserved　from　blank　oblivion。

One　or　two　other　facts　deserve　mention；　as　showing　the　readiness　of　our　medical　community　to　receive　and　adopt　any　important　idea　or　discovery。　　The　new　science　of　Histology；　as　it　is　now　called；　was　first　brought　fully　before　the　profession　of　this　country　by　the　translation　of　Bichat's　great　work；　〃Anatomie　Generale；〃　by　the　late　Dr。　George　Hayward。

The　first　work　printed　in　this　country　on　Auscultation；that　wonderful　art　of　discovering　disease；　which；　as　it　were；　puts　a　window　in　the　breast；　through　which　the　vital　organs　can　be　seen；　to　all　intents　and　purposes；　was　the　manual　published　anonymously　by　〃A　Member　of　the　Massachusetts　Medical　Society。〃


We　are　now　in　some　slight　measure　prepared　to　weigh　the　record　of　the　medical　profession　in　Massachusetts；　and　pass　our　judgment　upon　it。　But　in…order　to　do　justice　to　the　first　generation　of　practitioners；　we　must　compare　what　we　know　of　their　treatment　of　disease　with　the　state　of　the　art　in　England；　and　the　superstitions　which　they　saw　all　around　them　in　other　departments　of　knowledge　or　belief。

English　medical　literature　must　have　been　at　a　pretty　low　ebb　when　Sydenham　recommended　Don　Quixote　to　Sir　Richard　Blackmore　for　professional　reading。　　The　College　Pharmacopoeia　was　loaded　with　the　most　absurd　compound　mixtures；　one　of　the　most　complex　of　which　（the　same　which　the　Reverend　Mr。　Harward；　〃Lecturer　at　the　Royal　Chappel　in　Boston；〃　tried　to　simplify；　was　not　dropped　until　the　year　1801。　Sir　Kenelm　Digby　was　playing　his　fantastic　tricks　with　the　Sympathetic　powder；　and　teaching　Governor　Winthrop；　the　second；　how　to　cure　fever　and　ague；　which　some　may　like　to　know。　　〃Pare　the　patient's　nails；　put　the　parings　in　a　little　bag；　and　hang　the　bag　round　the　neck　of　a　live　eel；　and　put　him　in　a　tub　of　water。　　The　eel　will　die；　and　the　patient　will　recover。〃

Wiseman；　the　great　surgeon；　was　discoursing　eloquently　on　the　efficacy　of　the　royal　touch　in　scrofula。　　The　founder　of　the　Ashmolean　Museum　at　Oxford；　consorting　with　alchemists　and　astrologers；　was　treasuring　the　manuscripts　of　the　late　pious　Dr。　Richard　Napier；　in　which　certain　letters　（Rx　Ris）　were　understood　to　mean　Responsum　Raphaelis；the　answer　of　the　angel　Raphael　to　the　good　man's　medical　questions。　　The　illustrious　Robert　Boyle　was　making　his　collection　of　choice　and　safe　remedies；　including　the　sole　of　an　old　shoe；　　the　thigh　bone　of　a　hanged　man；　and　things　far　worse　than　these；　as　articles　of　his　materia　medica。　　Dr。　Stafford；　whose　paper　of　directions　to　his　〃friend；　Mr。　Wintrop；〃　I　cited；　was　probably　a　man　of　standing　in　London；　yet　toad…powder　was　his　sovereign　remedy。

See　what　was　the　state　of　belief　in　other　matters　among　the　most　intelligent　persons　of　the　colonies；　magistrates　and　clergymen。　Jonathan　Brewster；　son　of　the　church…elder；　writes　the　wildest　letters　to　John　Winthrop　about　alchemy；mad　for　making　gold　as　the　Lynn　rock…borers　are　for　finding　it。〃

Remember　the　theology　and　the　diabology　of　the　time。　　Mr。　Cotton's　Theocracy　was　a　royal　government；　with　the　King　of　kings　as　its　nominal　head；　but　with　an　upper　chamber　of　saints；　and　a　tremendous　opposition　in　the　lower　house；　the　leader　of　which　may　have　been　equalled；　but　cannot　have　been　surpassed　by　any　of　our　earth…born　politicians。　　The　demons　were　prowling　round　the　houses　every　night；　as　the　foxes　were　sneaking　about　the　hen…roosts。　　The　men　of　Gloucester　fired　whole　flasks　of　gunpowder　at　devils　disguised　as　Indians　and　Frenchmen。

How　deeply　the　notion　of　miraculous　interference　with　the　course　of　nature　was　rooted；　is　shown　by　the　tenacity　of　the　superstition　about　earthquakes。　　We　can　hardly　believe　that　our　Professor　Winthrop；　father　of　the　old　judge　and　the　〃squire；〃　whom　many　of　us　Cambridge　people　remember　so　well；　had　to　defend　himself　against　the　learned　and　excellent　Dr。　Prince；　of　the　Old　South　Church；　for　discussing　their　phenomena　as　if　they　belonged　to　the　province　of　natural　science：

Not　for　the　sake　of　degrading　the　aspect　of　the　noble　men　who　founded　our　State；　do　I　refer　to　their　idle　beliefs　and　painful　delusions；　but　to　show　against　what　influences　the　common　sense　of　the　medical　profession　had　to　assert　itself。

Think；　then；　of　the　blazing　stars；　that　shook　their　horrid　hair　in　the　sky；　the　phantom　ship；　that　brought　its　message　direct　from　the　other　world；　the　story　of　the　mouse　and　the　snake　at　Watertown；　　of　the　mice　and　the　prayer…book；　　of　the　snake　in　church；　of　the　calf　with　two　heads；　and　of　the　cabbage　in　the　perfect　form　of　a　cutlash；　all　which　innocent　occurrences　were　accepted　or　feared　as　alarming　portents。

We　can　smile　at　these：　but　we　cannot　smile　at　the　account　of　unhappy　Mary　Dyer's　malformed　offspring；　　or　of　Mrs。　　Hutchinson's　domestic　misfortune　of　similar　character；　in　the　story　of　which　the　physician；　Dr。　John　Clark　of　Rhode　Island；　alone　appears　to　advantage；　or　as　we　read　the　Rev。　Samuel　Willard's　fifteen　alarming　pages　about　an　unfortunate　young　woman　suffering　with　hysteria。　　Or　go　a　little　deeper　into　tragedy；　and　see　poor　Dorothy　Talby；　mad　as　Ophelia；　first　admonished；　then　whipped；　at　last；　taking　her　own　little　daughter's　life；　put　on　trial；　and　standing　mute；　threatened　to　be　pressed　to　death；　confessing；　sentenced；　praying　to　be　beheaded；　and　none　the　less　pitilessly　swung　from　the　fatal　ladder。

The　cooper's　crazy　wifecrazy　in　the　belief　that　she　has　committed　the　unpardonable　sintries　to　drown　her　child；　to　save　it　from　misery；　and　the　poor　lunatic；　who　would　be　tenderly　cared　for　to…day　in　a　quiet　asylum；　is　judged　to　be　acting　under　the　instigation　of　Satan　himself。〃　　Yet；　after　all；　what　can　we　say；　who　put　Bunyan's　〃Pilgrim's　Progress；〃　full　of　nightmare　dreams　of　horror；　into　all　our　children's　hands；　a　story　in　which　the　awful　image　of　the　man　in　the　cage　might　well　turn　the　nursery　where　it　is　read　into　a　madhouse？

The　miserable　delusion　of　witchcraft　illustrates；　in　a　still　more　impressive　way；　the　false　ideas　which　governed　the　supposed　relation　of　men　with　the　spiritual　world。　　I　have　no　doubt　many　physicians　shared　in　these　superstitions。　　Mr。　Upham　says　theythat　is；　some　of　themwere　in　the　habit　of　attributing　their　want　of　success　to　the　fact；　that　an　〃evil　hand〃　was　on　their　patient。　　The　temptation　was　strong；　no　doubt；　when　magistrates　and　ministers　and　all　that　followed　their　lead　were　contented　with　such　an　explanation。　　But　how　was　it　in　Salem；　according　to　Mr。　Upham's　own　statement？　　Dr。　John　Swinnerton　was；　he　says；　for　many　years　the　principal　physician　of　Salem。　　And　he　says；　also；　〃The　Swinnerton　family　were　all　along　opposed　to　Mr。　Parris；　and　kept　remarkably　clear　from　the　witchcraft　delusion。〃　　　Dr。　John　Swinnertonthe　same；　by　the　way；　whose　memory　is　illuminated　by　a　ray　from　the　genius　of　Hawthornedied　the　very　year　before　the　great　witchcraft　explosion　took　place。　　But　who　can　doubt　that　it　was　from　him　that　the　family　had　learned　to　despise　and　to　resist　the　base　superstition；　or　that　Bri