CAUTIONS and ADVICE
TO THE 
PUBLIC, 
RESPECTING SOME
ABUSES IN MEDICINE, 
Through the Malpractices of
QUACKS OR PRETENDERS
TO THE
MEDICAL AND CHIRURGICAL ARTS. 
By WILLIAM JACKSON, 
MEMBER OF THE CORPORATION OF SURGEONS OF LONDON, &c. 
LATE SURGEON IN THE ARMY, AND NOW A PRACTITIONER 
AT ISLINGTON. 
“ Ne Sutor ultra crepidam.” 
PRINTED FOR THE AUTHOR, AND SOLD BY H.
SYMONDS, BOOKSELLER, PATERNOSTER-ROW 
Price Two SHILLINGS.
Centered at Stationers-Hall.




(vi)
PREFACE. 
HEALTH is the greatest blessing that 
we can enjoy in this transitory life; 
without it, riches, splendour, nor any 
worldly acquisitions, can produce neither 
happiness nor content. If this be admit- 
ted, it is presumed that an attempt to pre- 
serve it from those who are daily lying 
in wait for its destruction, will not be
considered as unworthy of public notice. 
The Intention of the following Sheets 
is directed to this end.—Medical Im- 
posters are numerous in this country; and
I am inclined to think, that multitudes 
fall a sacrifice to their temerity and igno- 
rance. This evil, however, appears very 
little regarded, and men, in every respect 
unqualified for what they profess, are suf- 
fered to sport with the lives and consti- 
tutions of their fellow creatures, while
they themselves acquire fortunes at the 
a2 expence

(iv)
expence of humanity. Quacks are a dis- 
grace to the practice of medicine, and the 
encouragement they experience in this 
kingdom, is obviously the encrease of 
their number. And as the desire of health 
and ease is so innate in us, it is astonishing 
that such numbers of afflicted persons will 
so inconsiderately commit themselves to 
the management of persons who are so 
badly qualified to restore them to health; 
they more frequently aggravate maladies, 
and render those difficult and complex, 
which by a judicious method, might 
easily have been remedied. 
I have often regretted, that no one has 
taken up this subject, which I consider as
of the highest importance to the Public, 
and to the welfare of Society. This omis- 
sion, perhaps, may have proceeded from a 
suspicion that a Publication of this kind, 
from a Medical Practitioner, would not 
be favourably received; and that the Au- 
thor, instead of correcting the abuse, might
incur censure and ridicule. From advo- 
cates for Quackery, I acknowledge, these 
might reasonably be expedect. But, how- 
ever


(v)
ever such a consideration may have in- 
fluenced others, I have ventured to deliver 
my thoughts upon this subject; and I 
flatter myself, that there are many in the 
world, whose sentiments are not mate- 
rially different from mine. 
I have not the vanity to suppose, that 
any thing I can say on this Subject, will 
have influence over the majority of those 
who are advocates for Quackery, sufficient 
to induce them to relinquish their faith; 
but I shall consider myself amply rewarded 
for my trouble if I shall have been instru- 
mental in preventing the destruction of a 
few individuals. 
It is not my intention to enter into a 
minute detail on the various quack medi- 
cines, and specifics, sold under pompous 
titles and fictitious names, at Booksellers, 
Perfumers, &c. nor do I mean to assert, 
that they are all composed of ingredients 
which have deleterious qualities. But 
this I can truly affirm, that most of them
are inadequate to the cure of those diseases
for which they are recommended. The di- 
versity of constitutions, and symptoms, in 
2 different

(vi)
different persons, labouring under the 
same disease, which will ever be attended
to by a judicious practitioner, must render 
the administration of any specific, at best, 
very precarious; and I am firmly per- 
suaded, that many of those certificates 
where they are represented as having per- 
formed miraculous cures, would, upon 
minute investigation, be found, if not 
false, at least very much exaggerated. It
is my intention to confine myself chiefly 
to those abuses in medicine which are most
liable to be productive of fatal conse- 
quences to mankind. 
I suspect that a publication on Quack- 
ery, coming from one of the Faculty, 
will be differently received; by some it 
may be considered as the effect of preju- 
dice and malevolence; by others, as pro- 
ceeding from vanity or interested views. 
But I hope to be believed, when I declare, 
that neither of these motives have influ- 
enced me. No person can be more ca- 
pable of judging of the fatal effects that
may often result from the injudicious 
treatment of diseases, than medical men. 
There-

(vii)
Therefore, I hope, that the more candid, 
and sensible part of my readers, will re- 
flect upon the importance of the subject;
and I flatter myself, they will expect no 
farther apology from me, for intruding 
upon the public my sentiments, with a 
view to admonish mankind to avoid such 
rash practitioners, from a full conviction
of the inaccuracy, and falsehood of their 
doctrines, and the dangerous tendency of 
their practices. 
When I first resolved to publish my 
sentiments on this subject, I intended to
annex some observations respecting the 
errors which are committed in the ma- 
nagement of children,—but as this is a 
subject which I consider equally as in- 
teresting as the present, and the little
time I can at present devote from my pro- 
fessional pursuits, does not afford me suf- 
ficient leizure, I therefore must reserve 
that object for another opportunity. Er- 
rors in the management of children, 
through the misconduct of some parents
and nurses, are certainly pernicious to so- 
ciety, and the encrease of population. 
Through

(viii)
Through the whole of this Pamphlet, 
I have endeavoured to express myself as 
clearly, and explicitly as I am able.—I 
am aware, that there is great room for 
criticism; but I hope, that the import- 
ance of the subject, and the goodness of 
my intention, will be considered as some 
compensation for any defect that may be 
found in the execution. The dread of il- 
liberal aspersions, or malevolent criticism, 
will never deter a man of integrity from
doing whatever he can to promote the 
public good; I am therefore under the 
less anxiety concerning the fate of this 
Pamphlet, which I submit to the candor 
and impartiality of those who are enemies
to Quackery and Deception.
ADVICE

ADVICE, &C.
THE numerous Empirics, or Pre- 
tenders to the Sciences of Medicine 
and Surgery, which this nation is infected 
with, usually called Quacks and Mounte- 
banks (of the former both male and fe- 
male) the ravages they must unavoidably
commit on the constitutions of many of 
its inhabitants; and the infamous impo- 
sitions and deceptions they are daily prac- 
tising on the credulous part of mankind, 
particularly on the inferior classes of people, 
who have no money to spare; and on whose 
health and recovery, the support and 
maintenance of a family frequently de- 
pends; calls loudly for redress, and for 
the interference of the magistrates: by 
whose strenuous exertions the public might 
B be

(2)
be rid of a set, whose practices are truly
dangerous, and principles highly notorious. 
I am really concerned when I reflect, 
how such caitiffs are allowed to continue 
to massacre their fellow creatures with im- 
punity; who, had they their just de- 
serts, should be taken into custody, and 
properly * punished for their base pre- 
sumptions: whose sole aim is to defraud 
the public of their money; and they often 
deprive them of what is more valuable. 
But this does not appear to be considered 
a circumstance worthy of notice. Many 
other illegal, though less important pro- 
ceedings, which have been intruded into 
society, are prohibited; but one, in which
the lives and health of mankind are so 
materially concerned, and which ought 
* When any mountebanks appeared in Montpellier, 
the magistrates had a power to mount each of them 
on a meagre miserable ass, with his head to the ass’s 
tail. In this condition they were led throughout the 
whole city, attended with the shouts and hooting of
the children, and the mob beating them, throwing 
filth and ordure at them, reviling them, and dragging
them all about. See Dr. Tissot’s Avis an Peuple, 
Vol. ii, Chap. 33, p. 276. Sect. 621.
to

(3)
to be a principal consideration, is entirely 
overlooked: therefore they are permitted 
to continue their iniquitous practices un- 
molested. 
I should imagine, it would require very 
little reflection from every enemy to im- 
positions and defrauders, (were they to 
turn their thoughts to this subject) to 
convince them, that a regulation in this 
particular, would be productive of very 
salutary effects. And by putting a stop 
to so glaring an evil, of so dangerous a 
tendency, would preserve numbers that 
fall sacrifices to ignorance and misconduct, 
Nor would it be found so difficult a task 
to effect, as some may conceive it to be. 
Many things (though apparently diffi- 
cult) are to be effected, when persons of
authority are zealously inclined to eradi- 
cate evils: and it is high time they should
receive some information on this, so es- 
sentially hurtful to society. But while 
the minds of mankind continue infected 
with prejudices and superstitious notions, 
and while such characters are considered 
qualified for what they prosess, such a re- 
B2 formation

(4)
formation, I allow, will be impracticable. 
But if mankind were to divest themselves 
of this opinion, and not so easily be pre- 
vailed upon to yield up their senses, health, 
and money to such imposters; I am in- 
clined to think, they would exert their 
efforts to prevent what so nearly concerns 
them, as the abuse of medicine; nor do 
I apprehend, they would be at a loss to 
establish a plan for abolishing Empiricism.
For those who are inspired with principles 
of humanity, and a sympathetic feeling 
for the sufferings of others, would not 
be backward in a cause so generally inte- 
resting. 
The numerous pussing advertisements, 
that daily appear in the News Papers, and
the variety of hand-bills that are offered 
to the public in all quarters of the metro- 
polis, evidently shew the encouragement 
and support of quackery; and the credu- 
lity of mankind, in reposing a confidence 
in such ignorant and unworthy characters; 
whom, void of remorse of conscience, ho- 
nour, or honesty, frequent opportunities
are afforded them to prey upon the con- 
stitutions

(5)
stitutions and properties of those whose 
lot is so unfortunate as to fall under their 
hands. 
Perhaps, most of my readers may have 
had the curiosity of perusing some of 
these boasted advertisements and hand- 
bills, therefore must have perceived that 
many of them affirm, that their nostrums 
are infallible cures in a variety of diseases, 
and in every stage of a distemper, with- 
out any regard to age, constitution, sex, 
or any particular circumstances that may 
attend individuals. Others more modestly 
confine themselves to one disease; or per- 
haps two or three only, therefore less 
liable to be so universally destructive. 
To believe that any medicine is capable 
of curing every disease indiscriminately, 
must be rationally to consider that each
disease proceeds from one and the same 
cause, and that the diversity of the symptoms
requires no variations in the mode of 
treatment. But those who suppose (which
must be obvious to every reflecting mind) 
that different diseases, and the same dis- 
ease in different persons, proceeds from
various

(6)
various causes; that different causes pro- 
duce different effects, and consequently 
require different methods of treatment, I 
think cannot hesitate in acknowledging the 
falsehood and absurdity of such preten- 
tions, and the dangerous tendency of such 
practices. And whoever advertises any 
medicine as an universal remedy for all 
diseases, is an imposter; as no such re- 
medy can exist: a little reflection on the 
opposite causes of diseases, must convince 
every rational personal of the absurdity of
such an attempt. Can any one expect to 
cure a dropsy, which proceeds from too 
great a laxity of the * fibres, and a thin
dissolved state of the blood, by the same 
remedies that are made use of to cure an 
inflammatory disease, as a † pleuresy or ‡
peripneumony, where the fibres are tense 
and rigid, and the blood too thick and 
* Fibres are simple thread-like bodies servingg to
form other parts. 
† Pleurisy is an inflammation of the membrane that 
covers the lungs. 
‡ Peripneumony is an inflammation of the substance 
of the lungs,
viscid? 

(7)
viscid? and yet in those hand-bills and 
advertisements you may often see diseases 
mentioned of as opposite a nature, to be 
cured by the same fovereign remedy. 
But if it is allowed, that diseases arise 
from different causes, that their characters 
are various, that alterations take place 
throughout their progress and duration; 
that they are susceptible of complications; 
that changes occur from seasons, sexes, 
different epidemics, and other causes; 
that these circumstances render it indis- 
pensably necessary to alter the medicines, 
to augment or diminish the dose of any 
particular substance in the form of the 
prescription, or wholly to remove it, and
substitute another: which evidently shews 
how hazardous it is, to have them directed
by unskilful persons. It requires great 
industry and perseverance to investigate 
the true causes of diseases, and the proper 
means of obviating them: therefore the 
skilful management in the quantity or 
dose of any medicine, adapted to the par- 
ticular circumstances of each individual, 
can only be acquired by a very extensive 
experience.

(8)
experience. Those are facts, which I 
think will be acknowledged by every 
learned unprejudiced man; and nothing 
but the most determined obstinacy and 
ignorance can contradict them. 
It is really a melancholy reflection, that 
so great a part of mankind should so rashly 
have recourse to such private executioners, 
or their boasted specifics, when afflicted
with diseases; whereby they not only ex- 
pose themselves to the most iniquitous 
frauds and impositions, but place their 
constitutions and lives into the hands of
a merciless charlatan, who has no charac- 
ter to lose, and who obtains a livelihood
at the expence of the constitutions and 
lives of those who are so unfortunately 
misled, as to be drawn into his snare. 
Being lost to every sense of honor and in- 
tegrity, he assumes the air of importance 
and wisdom, which he is ill qualified for, 
and presumes to administer remedies for 
diseases, whose real causes, nature, and
proper mode of treatment he is as igno- 
rant of as his patients. Blinded by cre- 
dulity, his employers attentively listen to
3 his

(9)
his jargon, swallow his nostrums, and 
comply with his directions; till time and 
disappointment detect the fraud, which 
few are found to be ingenuous enough to 
confess. Whether this proceeds from an 
unwillingness to acknowledge they have 
been imposed upon, or from a wish to 
see others imposed upon; or from what- 
ever motive, I will not pretend to deter- 
mine: but it is not uncommon, for per- 
sons to declare that they have received 
benefit, when it clearly appeared they 
were in the same situation (and perhaps in 
a worse) than on their first application to
them. Such conduct must certainly be 
considered disingenuous, and pernicious to
mankind. 
It is not the inferior classes of people
only that become the dupes of Empirics; 
it is not uncommon for persons of rank 
and wealth to be caught in this snare, 
and to conside in their opinions; and 
sometimes after having consulted the most 
able and judicious physicians. 
It is astonishing, that persons of edu- 
cation and good sense should suffer them- 
C selves

(10)
selves to be so greatly imposed upon, as 
to be prevailed on to suppose, that it is 
in the power of those who practise physic 
and surgery at random, without education, 
and without understanding the principles 
of the art; and to imagine that they are 
capable (however the patient may be situ- 
ated) of effecting more than the man, 
who is qualified in every particular for 
the practice of the professions alluded to. 
This is to prefer ignorance and falsehood 
to learning and veracity. Such an opinion 
I consider to be the greatest mark of dis- 
respect that can be shewn to so truly re- 
spectable, and valuable characters, as I 
consider ingenious physicians to be, men of
honor and integrity; who only ought to 
be considered the just subjects of our con- 
fidence: who will not hesitate in acknow- 
ledging, that they cannot effect what they
perceive impossibie; while the quacks, 
with unbounded assurance, promise to 
complete what they do not understand, 
without considering whether it is practi- 
cable or not. How very opposite is the 
conduct of those two characters! The 
4 encourage-

(11)
encouragement this herd meets with from 
the higher classes, will ever influence the 
lower classes of people in their favour and 
confidence. They will not desist from 
persuading them, as long as they can ex- 
tort a shilling from them, that they are 
upon the eve of being cured, although 
they have not afforded them a jot of re- 
lief; till, from length of time, and con- 
sumption of cash, those poor deluded 
people experimentally find out, that they
have been infamously cheated; if their 
diseases have not been greatly aggravated, 
through loss of time, and pernicious 
medicines. 
It is much to be regretted, that the 
Public in general are so regardless of their 
welfare, as to pay so little attention to 
the reputations and abilities of those un- 
der whose care they entrust themselves; 
as their recovery must depend upon a ju- 
dicious mode of treatment; and who fre- 
quently apply to persons, who are as un- 
acquainted with the nature of their dis- 
eases, and the right method of treating 
them, as their patients. Erroneous treat- 
C2 ment

(12)
ment most be the consequence; maladies 
are aggravated instead of remedied, na- 
ture is interrupted instead of being assist- 
ed; and far better would it be, if the 
disease were left to her efforts only: who 
will frequently readily co-operate with 
remedies calculated for the removal of 
disease, and preservation of our existence; 
and constantly endeavour to counteract the 
ill effects of those that have a tendency to
our destruction; but whose favourable in- 
terpositions are frequently overpowered 
by the rude shocks she so frequently sus- 
tains: her endeavours at length become 
languid and exhausted, and mankind falls
a sacrifice to ignorance and knavery. 
I am much concerned to be under the 
necessity of asserting this melancholy fact, 
that many of the human species perish 
by neglect, or mal-treatment; whom, if 
their distempers had been early attended 
to, or had they been placed under the 
care of a skilful and discerning practition- 
er, who would have administered proper 
medicines suitable to the nature of their 
cases, and virulence of their symptoms;
by

(13)
by which means the ravages of diseases 
being counteracted and subdued, the af- 
flicted patients might have been restored. 
But by delivering themselves into the 
hands of ignorant impostors, their diseases 
are attacked by nostrums totally unappli- 
cable to the nature of their cases, and 
probably composed of deleterious quali- 
ties; by which their maladies are greatly
aggravated, and situations rendered more 
unsupportable. But allowing that the 
medicines they administer should be in 
their nature so simple, as to be entirely 
inoffensive, so as to be incapable of aggra- 
vating the symptoms, or affording any 
benefit; allowing this to be the case, 
they then prove so far pernicious, that 
the afflicted person depending on the ef- 
ficacy of a medicine which is possessed of
none, much valuable time is lost, symp- 
toms increase, and become violent; the 
disease advances with rapid strides, and
the patient and friends are convinced of 
the fallacy, but frequently when too late. 
They then apply to the man of judgment, 
when there is nothing in his power to do,
but

(14)
but to pass the doleful sentence; that the 
favourable opportunity has passed by, and 
he can only consider himself the Under- 
taker’s harbinger. 
It is natural for mankind to have an 
anxious desire for the prolongation of 
their existence; and in many respects, they
endeavour to avoid what they conceive 
will have a tendency to impair their health, 
or destroy the vital principles. But many 
there are, who are not capable of distin- 
guishing the safest paths from the dange- 
rous ones; and in no instance does this 
appear more clear than in the present. 
The highwayman, or footpad, who ac- 
costs a man on the highway, and robs, 
and perhaps murders him, has the 
chance of defending himself, or being as- 
sisted by the arrival of other travellers. 
But the man who intrudes himself on a 
sick person, as one skilled in the practice
of physic, who is entirely ignorant of the 
science, and the disease which he under- 
takes to treat, is a more dangerous cha- 
racter than either of the former, and equally
deserving of punishment. 
That

(15)
That a lying, impudent, knavish im- 
postor, should elevate himself on a scaf- 
fold, in a public situation, surrounded by 
spectators, listening to the great encomiums
he is bestowing upon himself, or by his 
assistant, whom he has employed and tu- 
tored for that purpose; whose assertions 
are readily credited by his auditors; par- 
ticularly on seeing a few poor deluded 
persons, whom he has persuaded into his 
confidence, and the management of whose 
cases he publicly exhibits, extolling his
own fame in the treatment of them; as- 
serting a multiplicity of falsehoods con- 
cerning their situations before their appli- 
cations to him: in short, he wishes to be 
considered a wonder of the age, or a * 
supernatural being, possessed of superior 
talents to any other man: such are called 
* Many attempt, knowing the objections that may
be advanced on their never having received a medical 
education, to elude them, by prevailing on their au- 
ditors to believe, that they possess a supernatural gift, 
which is far superior to all human knowledge. In 
what light such pretensions will be considered by a 
man of sense, and void of superstition, it is hardly ne- 
cessary to insert. 
mounte-


(16)
* mountebanks. Many of those vagrants 
travel about from one county to another, 
to different villages, and country towns, 
to decoy simple rustics, who are fond of 
novelty, and easily prevailed upon to be- 
lieve every lie, and to be charmed with 
every deception, that such base fellows 
consider their interest to practise upon them. 
Others, nominated Empirics, Charla- 
tans, or Quacks, who reside in cities and 
towns; some of them (particularly in 
London) rent spacious houses, entitle 
* The credit of this market, this fair hunting doc- 
tor, surrounded by five or six hundred peasants, staring
and gaping at him, and counting themselves happy in 
his condescending to cheat them of their very scarce 
and necessary cash, by selling them, for twenty times 
more than its real worth, a medicine whose best quality 
were to be only a useless one; the credit, I say, of this
vile, yet tolerated cheat, would quickly vanish, could 
each of his auditors be persuaded, of what is strictly 
true, that, except a little more tenderness and agility
of hand, be knows full as much as his doctor; and 
that if he could assume as much impudence, he would 
immediately have as much ability, would equally de- 
serve the same reputation, and to have the same con- 
sidence reposed in him. Dr. Tissot’s Avis au Peuple, 
Chap. xxxv, p. 270, Sect. 613. 
them-

(17)
themselves Physicians of Dispensaries, 
and keep their equipages. Other *, not 
quite so fortunate, and probably possessed 
of less cunning, are necessitated to live 
in a more humble way. The former 
having by stratagem devised more speedy 
and effectual methods of deceiving and 
defrauding the higher ranks of people of 
their cash; perhaps by being possessed of
a greater share of assurance, or by being 
more intriguing fellows than the latter, 
and better skilled in the art of deception: 
while the latter must be content to prey
upon the more needy and laborious part 
of mankind. 
I have heard men, whose understandings 
(by their conversation on other subjects) 
I should have imagined would have taught 
them less credulity, highly extolling some 
of those characters, relating instances of
wonderful cures performed by them; and 
even affirming, that they considered them 
more skilful and meritorious than the 
regular practitioner. 
* I am well informed, that there are at this time in
London persons of this description, who practise as 
physicians, that have been originally blacksmiths, far- 
riers, coblers, and tinkers. 
D Now


(18)
Now the numbers that apply to these 
impostors, that some of them should not 
recover is almost physically impossible, 
and I acknowledge it to be sometimes 
the case; but yet it is not less certain, 
that they are dangerous and destructive 
characters. Such cures, when they do 
happen, cannot be in consequence of the 
skill of a set of men, who are neither 
acquainted with the nature of diseases, 
the quality of the medicines they admi- 
nister, nor the circumstances necessary to
be considered. Allowing then, that their 
nostrums should accidentally succeed, I 
do not consider them in a more favourable 
view on that account, as such cures, when 
they do happen, must be merely the effect 
of chance. Their lifts, or certificates of
cures, if any person would take the trouble
of inquiring into the particulars, would 
be frequently found to be mere chimeras. 
or forgeries, calculated to delude man- 
kind. But if a catalogue of their mur- 
derous exploits could be annually obtained, 
mankind would then be inspired with 
such a wholesome dread of them, that they 
would cease any longer to be their advocates. 
and

(19)
and would be convinced of their errors, 
in countenancing and entrusting them- 
selves under the hands of such a band of 
executioners. 
It is extraordinary, that medical men 
of all others should be considered so dull 
of comprehension, as to be unable to ac- 
quire the proper knowledge of their pro- 
fession, or otherwise so base and wicked, 
as not to practise it to the best of their 
judgments: and that a man, who has 
spent the former part of his life in pur- 
suing quite a different employment, shall 
at once commence physician, or surgeon, 
without having ever received any instruc- 
tions for the practice of so important a 
science. It is considered, that in other 
arts, and in every trade, a proper length 
of time is requisite, or an apprenticeship 
must be served, before any one is sup- 
posed to have arrived at a sufficient degree 
of knowledge, so as to be qualified to act 
for himself. If a man should attempt to 
persuade another, that he could mend his
watch, when broken, or out of repair, 
or any other complex machine, who was 
not brought up to the trade, nor received
D2 proper

(20)
proper instructions, he would be ridiculed 
for his pretensions, and meet with no * 
employment. But if a man presumes 
to assert, that he is capable of rectifying 
so very wonderful, and curiously con- 
structed a machine as the human body, 
when disordered, the bait is then swallow- 
ed, confidence is reposed in him, he is 
countenanced and supported; and by many 
considered more skilful, than the man who 
has occupied the greater part of his life 
in the study of his profession. 
* Let a soldier, discarded from his regiment for his 
roguish tricks, or who is a deserter from it, a bank- 
rupt, a disreputable ecclesiastic, a drunken barber, or 
multitudes of such other worthless people, advertise 
that they mount, set and fit up all kinds of jewels and
trinkets in perfection; if any of these are not known,
if no person in the place has ever seen any of their 
work, or if they cannot produce authentic testimonials 
of their honesty, and their ability in their business, not 
a single individual will trust them with two pennyworth 
of false stones to work upon; in short, they must be 
famished. But if instead of professing themselves 
jewellers, they post themselves up as physicians, the 
crowd purchase, at a high rate, the pleasure of trusting
them with the care of their lives, the remaining part 
of which they rarely fail to empoison. Dr. Tissot’s 
Avis au Peuple, Chap, xxxv, Sect. 614, p. 271. 
I It

(21)
It is indispensably necessary, that every 
artist should be well acquainted with the 
subject matter on which he works: and 
as there is no profession, or calling what- 
ever, that requires a more regular and as- 
siduous application, than the art of me- 
dicine, before any one can arrive to that 
degree of perfection, as to be a competent 
master of the science: consequently the 
knowledge of anatomy * and physiology † is 
indisputably necessary, for either the phy- 
sician or surgeon, who would wish to 
practise with satisfaction to himself, and
benefit to the afflicted. For, how can a 
profession of such consequence to man- 
kind be thoroughly understood, unless the 
practitioner be well acquainted with the 
theoretical principles of the art? which
must pave the way to a knowledge of the 
cure of diseases. 
* Anatomy is the dissecting a human body, or sepa- 
rating its component parts, to discover their situations, 
figure, and uses; which leads to the knowledge of 
nature, and the cure of diseases. 
† Physiology is the doctrine of the animal œconomy; 
or that which teaches the constitution of the body, so
far as it is in a healthy state. 
It



(22)
It is certain, that nature does not dis- 
tribute her bounty equally to mankind. 
Some men are born with superior under- 
standings to others, who can penetrate 
into matters more deeply, and comprehend 
more quickly and accurately. Those pos- 
sessed of such shining qualities promise 
fair to excel others, in whatever profession 
or situation they may be placed; and to 
be serviceable to mankind, and an orna- 
ment to their country, (provided their 
minds are properly cultivated). Many that 
are born with such extraordinary talents, 
are not so fortunate as to have an oppor- 
tunity of improving them, but they re- 
main buried in obscurity; they often 
know not their own abilities, they are 
lost both to the world, and to themselves. 
Though Providence has furnished them 
with superior gifts, yet fortune does not 
always afford them an opportunity of dis- 
playing them. As good land cannot pro- 
duce corn if no seed is sown therein, nei- 
ther can a man of extraordinary talents 
exhibit them to the world, if the rudi- 
ments



(23)
ments of erudition is not inculcated in 
his mind. 
I shall next consider the man on whom 
nature has distributed her gifts less 
bounteously, that is possessed only of an 
ordinary share of understanding; who has 
received all those advantages resulting from 
education, which were not accessible by 
the former; he therefore becomes possessed
of that knowledge which the other does 
not arrive at, because it is not in his 
power to pursue the means; therefore the 
man of inferior genius is more perfect, 
because he has been better instructed. 
Whereas, had the other been similarly situ- 
ated, where he might have had equal op- 
portunities of acquiring knowledge, (and 
allowing both to have been equally in- 
dustrious) he would have greatly excelled 
him. 
It may be considered, that I have di- 
gressed from my subject, by thus endea- 
vouring to explain, how much inferior 
the man of superior genius without learn- 
ing, is to him of inferior genius, with 
the advantages of education. But I have 
been



(24)
been induced to make this comparison, in 
contradiction to an opinion, that I am 
convinced prevails among some people, 
which is, that these self-created Doctors 
are born with extraordinary talents, which 
enables them to attain to a knowledge su- 
perior to others, without requiring any 
earthly instructions, having obtained it by 
a supreme gift. But I wish to advise those 
who undertake the cure of * diseases by 
this gift alone, seriously to peruse the sixth 
Commandment. 
That the man, who, from his youth, 
being inspired with the desire of being 
brought up to the practice of physic, after 
having received a liberal education, previous 
* A disease is an alteration, or deviation from health
of some one function of the body. How then can 
any one be acquainted with the ailment of this func- 
tion, if he does not know all that is requisite to the 
due discharge of it? Therefore a disease must be known 
before it can be cured. For to know exactly the his- 
tory of a disease, its causes, nature, and effects; a clear 
knowledge of such medicines as prove beneficial or 
detrimental, can only be acquired by the dissection of
dead bodies, whose diseases have been carefully ob- 
served before their death. 
to

(25)
to the acquisition of what is to follow, he 
is then placed in a situation which affords 
him an opportunity of receiving every in- 
formation requisite to qualify him for such 
a practitioner; who has carefully and as-
siduously studied nature, and the different 
functions of the human body; who has 
accurately differed, and discovered the 
structure, and uses of the various parts of
which it is composed, and the causes that 
may predispose them to diseased alterati- 
ons; who has regularly and diligently 
attended able professors in the different 
branches of the profession, who has closely
visited the sick in the public hospitals, 
exposed to the effluvia of infectious dis- 
eases, and may truly be said to have been 
in jeopardy every hour; who has inquired 
into the history of cases, and traced them
from their origin to their termination in 
health or dissolution; who has industriously
examined every symptom and alteration that 
has occurred through the progress of dis- 
eases, with the effects of the medicines that
has been administered, and acquires a know- 
E ledge


(26)
ledge of those which, have proved bene- 
ficial, and of those which have been inef- 
fectual. In short, he carefully considers 
every circumstance which has attended his 
patient; or has happened to him by his 
own observations, or the information he 
has received from him, or from others;
and by comparing them with one another, 
he arrives at a knowledge of the primary 
cause of the disease, and of the best remedies
calculated to remove it. And that after 
several years labour, and a considerable 
sum of money has been expended in such 
pursuits, before he has arrived to a suffici- 
ent degree of experience, as to be deemed 
qualified for an able practitioner, he 
shall be considered inferior to an ignorant, 
illiterate knave, who is an entire stranger 
to this whole process.—Fatal absurdity!
that such numbers should suffer themselves
to be led away, without allowing them- 
selves the liberty of reasoning upon a sub- 
ject which so nearly interests them
I have

(27)
I have remarked, that * chronic diseases 
are more generally submitted to the treat- 
ment of Quacks, than those of the † 
acute kind; as if it were considered, that 
they are more peculiarly qualified for the 
treatment of this class of diseases than the 
latter, which usually fall to the lot of the 
regular practitioner. Now diseases of the 
chronic species are often so complicated 
in their nature, and variable in their 
symptoms, that they require the clearest
discernment, and the nicest accuracy in 
the proper management and treatment of
them. They are more mismanageable and 
difficult to cure than the acute; nor is it
so easy to judge of the proper method to
be pursued. 
* Chronic is a lingering disease which continues a 
considerable time, if not during the patient’s life, as 
an asthma, dropsy, scrophula, or king’s evil, &c.—
they are sometimes owing to a natural defect in the 
constitution, or acquired by irregularities in living. 
† Acute is a disease which terminates in a short 
time, or continues only a certain number of days, but 
not without imminent danger; such are fevers, small- 
pox, inflammations. &c.
E2 To

(28)
To labour under a languishing, and per- 
haps incurable malady, at any period of 
life, (but particularly in youth) is cer- 
tainly a very melancholy state: and to re- 
flect, that no remedy is capable of afford- 
ing any lasting benefit, but merely to pal- 
liate the symptoms, and procure a tempo- 
rary relief, by which their miserable ex- 
istence may be prolonged, and rendered 
more supportable, is, I acknowledge, of 
all situations, the most horrid. Persons 
thus circumstanced attentively listen to, and
readily credit every fabulous report they 
hear of extraordinary cures performed upon 
persons, represented to be similarly situated
with themselves. Solicitous of obtaining
a cure at any risque, they are hurried 
about from one Quack to another; each 
promising to effect what is impracticable: 
until by their injudicious treatment causes 
often become irritated, and symptoms ag- 
gravated. Being unacquainted with the 
true nature of their diseases, their hopes
are revived by the plausible promises of 
the pretender, till time and disappointment
proves the fraud. 
I To


(29)
To attend on a patient whose disease is 
so far advanced, and inveterate, as to be 
beyond the reach of our aid, and when all 
our efforts prove ineffectual, is certainly a 
very unpleasant and melancholy part of 
practice. And to behold a fellow-creature 
languishing under the oppression of a dire- 
ful disease, and not to have it in our power 
to afford him any relief, nor sometimes even 
to mitigate his sufferings, is a reflection of
all others the most mortifying and dissatis-
factory. And as hope does not desert us 
even in the hour of death, to see him 
anxiously lifting up his eyes to his physical 
friend, whom he considers as his only 
anchor in this world, being ardently soli- 
citous (and perhaps for the sake of his 
family) to be delivered from that cruel 
tyrant Death. To see his afflicted and af- 
fectionate relations, who surround his bed- 
side, attentively looking at the countenance
of the physician, in hopes to discover by
his looks some favourable omen, and that 
a ray of hope remains; while the physician, 
who is a man of too much integrity to
assert what is contrary to his opinion,
(however 


(30)
(however his feelings may be affected by 
passing the sentence) is obliged to declare, 
that all is done which is in the power of 
human art to effect, and that the rest 
must be left to God. Such a scene 
must undoubtedly be, to every man in- 
spired with a sympathetic feeling for the 
afflictions of others, truly dismal and af- 
fecting. 
To cure diseases, and relieve those in 
pain, is a very satisfactory employment.— 
But to attend a patient through a linger- 
ing, tedious disease, without any prospect 
of curing him, but merely of affording 
him temporary ease, is a very melancholy
and disagreeable task. 
How very different is the condust of the 
prostigate Quack to the character above 
described; who, not being actuated by 
motives of rectitude, (his own interest 
being his sole consideration) conceives that
the surest way to conceal his ignorance, 
and most effectually to deceive his em- 
ployer, is to give the disease a new name, 
to disapprove of every thing that has hi- 
therto been done; and to prevail upon him
to

(31)
to believe, that he alone is acquainted 
with the true nature of his disorder, and 
the remedies suitable to remove it; which 
he boldly promises to effect without 
any regard to the state of the patient, 
or the propriety or impropriety of his 
assertions; for these are not objects of 
his consideration. He therefore pleases 
his patient, and flatters his hopes, until 
the aggravation of his misery, or a prema- 
ture death, proves his doctor a villain, (but 
not before his own purpose is obtained.) 
But if his employers would defer paying
him, until he had accomplished what he 
promised, I am disposed to think, the fal- 
lacy would soon be at an end. 
The frailty of human nature is such, 
that we most readily approve of that advice, 
which is most flattering and suitable to
our own inclinations. But a physician 
who is a man of strict veracity, and per- 
ceives the hazardous state of his patient, 
will not hesitate in affirming what he 
thinks; and because he will neither flat- 
ter, nor deceive, less confidence is reposed
in

(32)
in him, than in the man who uses both;
and who, under the cloak of wisdom and 
experience, asserts the most egregious false- 
hoods. He who intimates the necessity 
of persevering in a strict regimen, and that 
time and patience will be requisite in the 
accomplishment of a cure, will be less 
attended to, than he who consults his 
patient’s own inclinations, promises him 
a speedy cure, and permits him to indulge 
in his own taste and humour, without 
considering whether it be consistent with 
his disease or not. 
There are some of these pretenders who 
presume to judge of a patient’s disease 
merely by inspecting his urine; and who 
without seeing the person, or inquiring into
the symptoms, pretend to know what the 
disease is, and immediately administer their 
medicines. If it be admitted as a fact, 
that they possess magic powers, or super- 
natural gifts, such pretensions may be 
verified; but if this is not credited, it 
must be gross ignorance to suppose, and 
also the greatest imposition to persuade 
the public, that the mere examination of
their


(33)
their urine does afford them sufficient in- 
formation to investigate the causes and 
symptoms of a disease, and to be able 
thereby to prescribe remedies most suita- 
ble for it. The examination of a patient’s 
urine is frequently necessary, together 
with the state, and other circumstances 
relative to the patient; as in fevers, and 
other disorders, where the changes pro- 
duced in it may assist us in judging of 
the approach of a crisis * in many acute 
diseases, and the alterations that may have 
taken place in the progress of the disease, 
and in forming a prognostic. But for any 
one to assert, that he can tell a person’s 
disorder only by viewing the urine, com- 
mon sense, I should imagine, would de- 
termine the absurdity and fallacy of such 
a pretension: and whoever directs any 
medicine, without any other information 
of the state of his patient than what the 
* Crisis is a change that takes place in acute diseases, 
wherein such an alteration is produced in the state of 
the patient as to determine his fate, either for recovery 
or death. Its approach is judged of by a thick sedi- 
ment in the urine, and other symptoms. 
F inspection




(34)
inspection of his urine affords, is an in- 
famous impostor, and the person who 
confides in him a compleat dupe. 
There are none more liable to deprive 
a man of his existence, than those set of 
Quacks termed rupture doctors; who af- 
firm, that they have in their possession 
radical cures for that disease; which too 
many are inclined to believe. A rupture 
is certainly a very troublesome and bur- 
densome affliction, and most that labour 
under it are very desirous of being cured, 
(if possible) which frequently induces 
them to be misled by the false pretensions 
of these miscreants; whereby they often 
expose their lives to the most imminent 
danger, and are subjected to tedious con- 
finement, painful applications, and some- 
times dangerous and rash * operations: 
and
* I saw an instance of this in a mountebank, who 
undertook the cure of a boy of about six years of age, 
for a rupture; and not only performed the operation, 
but castrated him: when I asked him in private, why 
he used this hazardous method, without trying a truss, 
since his tender age would have easily admitted of it, 
he ingenuously confessed he did it for profit: for he 
would



(35)
and if they escape with their lives, they 
are often left in a worse situation than 
they were before. Whereas, had they 
remained contented with their former 
conditions, and been satisfied with a pro- 
per truss, they might have had no in- 
crease of their malady during their lives. 
This disease, if properly attended to, and 
judiciously treated from its commence- 
ment, will require no other application, 
nor any operation, (unless it should be a 
* strangulated rupture, which is a state
extremely 
would have been paid but a crown for the truss, whereas 
the operation brought him in ten, if not twenty. 
Heister’s Surgery, eighth edition, Introduction, p. 15. 
* A strangulated rupture is a stricture made on a 
portion of the guts, or cawl, by the borders of the 
opening formed by the separation of the fibres, of the 
tendon of a muscle of the belly, called external, oblique, 
(from its situation and direction). This is caused by 
an inflammation of the gut, its being distended with 
air, or fæces; or an additional quantity of gut or cawl, 
or both, that has descended in those that were ruptured 
before; and as long as this stricture continues, the 
parts are incapable of being returned into the cavity
of the belly. The patient, under these circumstances, 
is incapable of going to stool, the parts are painful on
F2 bein

(36)
extremely dangerous, and requires the 
immediate assistance of the most skilful 
surgeons) except the replacing of the gut, 
and the application of a well made truss. 
This is all that can be necessary; or will 
be attempted by an honest man. 
being handled, or when he is in an erect posture, or on
any exertion of the body, as in coughing or sneezing. 
If this stricture continues other symptoms succeed, as 
sicknest at the stomach, violent vomitings, accom- 
panied with more or less of a fever, and a quick and 
hard pulse. It must be attempted to be reduced by 
gentle means, and by placing the body in such a posture, 
as may favour the return of the protruded part. If this 
does not shortly succeed other means must be tried, as 
bleeding, glysters, or the fumigation of tobacco thrown 
into the bowels (by means of a proper machine in- 
vented for that purpose) cathartics, and refrigerating
applications. If these remedies do not succeed, the 
symptoms soon become aggravated; and the only re- 
source left is an operation, and no time must be lost. 
This operation consists in dilating the ring, or bor- 
der of the opening, by which that part of the gut, or 
cawl, confined by the stricture is set free, and is again
returnable into the belly. But if it be delayed too 
long, other symptoms, more fatal, ensue, such as con- 
vulsive hickups, coldness of the extremities, small, in- 
terrupted pulse, gangrene, mortification, and at last 
death. A further description of this operation is totally
unnecessary here.
Before 

(37)
Before I quit this subject, I shall endea- 
vour to give my readers some idea of the 
true nature of a rupture, that they may 
be enabled to judge for themselves. And
I hope to convince them of the incon- 
sistency and hazard of such attempts, as 
a confirmation of what I have advanced. 
A rupture is a protrusion of a greater 
or lesser portion of the * intestines, or †
omentum, or of both, the natural situations
of which are in the cavity of the belly. 
The places where they usually appear, 
are in the groin, upper and fore part of 
* The intestines, or guts, are fix in number, situ- 
ated in the cavity of the belly, inclosed in the perito- 
neum, or that membrane which surrounds the whole 
cavity, and gives an external covering to every bowel 
contained therein. They are divided into three small 
and three large intestines, the former, which are in- 
closed within the latter, are named duodenum, jegu- 
num, and ilium; the latter, cœcum, colon, and rectum, 
Those which most usually descend, and form a rup- 
ture, are the ilium, or cœcum, and colon. 
† Omentum, or cawl, is situated on the surface of 
the intestines; its upper part is connected to the bot- 
tom of the stomach, spleen, and colon: it descends 
over all the- other intestines. Its use is to lubricate
the guts for their easy motions. 
5 the

(38)
the thigh, and at the navel, producing 
an enlargement or swelling. The first is 
by surgeons named inguinal, the second 
femoral, and the third umbilical, and 
they are so called from their situations. 
They pass out from the belly through 
openings, which are natural to those who 
have not ruptures, as well as to those who
have. But whichever of these ruptures 
it may happen to be, the protruded part 
carries before it that * membrane (before 
mentioned) which lines the whole cavity 
of the belly, and forms what is called the
hernial sac, or bag in which the rupture 
is contained. It is found to be of a 
greater or lesser size, and of a different 
thickness, according to the quantity of 
its contents, and to the continuance of
the rupture. 
There are many circumstances to be 
considered, which will render this dis- 
order more or less hazardous; for the 
same kind of rupture, in different per- 
* A membrane is a white, broad, dilatable sub- 
stance, covering or lining the various cavities of the
body, the bowels, muscles, &c. 
sons,

(39)
sons, is differently situated. The consti- 
tution and age of the person, the date of 
the rupture, its being bound, or not bound 
by stricture, free, or not free from inflam- 
mation, and the general symptoms that 
attend it rendering reduction practicable, 
or impracticable, ought certainly to be 
necessary objects of consideration, and will 
require a variation in the mode of treat- 
ment. 
If a rupture is early attended to, by re- 
turning it into its natural cavity, and there 
retaining it by means of a * proper truss, 
it will be the only method by which a 
radical cure can be effected. But those 
ruptures which are of an ancient date, and
which have been neglected, and suffered 
to remain down, may have contracted 
such adhesions to their containing bag, 
as to render their return into the belly
impracticable, and very dangerous to be 
attempted. And the patient should be con- 
* I say, a proper truss, because many of them are 
very ill made, and inadequate to the purpose for which 
they were designed; hence arises the necessity of ap- 
plying to an eminent truss maker. 
tented

(40)
tented with a bag truss, unless a stricture 
in this case should take place, and ob- 
struction to the fæces, which will render 
reduction in all cases necessary. 
The cure of a rupture is distinguished 
into radical, or perfect, and palliative, or 
imperfect, and though the event is diffe- 
rent, yet the method of treatment requi- 
site in both is exactly the same; viz. re- 
turning the parts, and confining them by 
a proper truss. This in some produces 
a perfect cure, in others only a palliative 
one and this depends on particular cir- 
cumstances attendant on different ruptures, 
which it is not in our power to alter. To 
those unacquainted with the nature of a 
rupture, or the anatomical structure of 
the parts concerned in the disease, it may
appear strange, that the means to effect 
a perfect, and an imperfect cure, should 
be entirely the same. But (as I have be- 
fore said) to return the protruded part (if 
practicable) in the cavity of the belly, 
and to confine it there by a proper truss, 
is all which it is in the power of art to
effect. But nature sometimes is capable 
of

(41)
of doing more; and will accomplish a 
radical cure in some cases, which in others 
is left imperfect; and this depends on cer- 
tain circumstances, which it is not in the 
power of human art to alter. For when 
the parts forming a rupture are returned, 
an opportunity is given to the opening 
through which they passed, and which was 
consequently dilated, to contract itself, by
which means a perfect cure sometimes is 
produced. The different applications, 
embrocations, and remedies, which have 
been, and are at this time used, are not 
in the reach of the parts concerned in 
this disease, nor can they contribute in 
the least to its cure. And if it has hap- 
pened, that any have been cured while 
under such a process, it must have been 
owing to their long * resting in a supine 
posture, or to the stricture of a proper 
bandage. 
* Instances have occurred of ruptured persons, who, 
from some disease or accident which confined them to 
their beds for several weeks, have been perfectly cured
of their ruptures, and have never had any return of the 
disease. 
G To


(42)
To enter more minutely into the nature 
of a rupture, would carry me beyond my 
present design: and I hope it will be con- 
sidered, that I have so far explained the 
subject, that the reader may perceive the 
absurdity and fallacy of such insignificant 
applications, as those which are imposed 
upon the public as cures for ruptures: 
and the rashness and barbarity of others, 
who undertake to perform dangerous 
operations, which are so unlikely to prove 
successful, that on the contrary they often 
prove fatal *.
There is no disease which opens a more 
ample field for the exercise of quackery, 
or contributes more to its support, than 
the venereal, nor none that has suffered
worse treatment, and made more consi- 
* No disease has ever furnished such a constant suc- 
cession of quacks as ruptures have: they, who have 
had some smattering of anatomy, or surgery, and whose 
humanity has not been their prevailing quality, have 
adopted one of the preceding operations, or something
like them; while they who have had less knowledge, 
and more timidity, have had recourse to the more 
sneaking knavery of specific applications. Mr. Potts' 
Chirurgical Works, Vol. I, p. 170. 
2 derable

(43)
derable ravages among mankind to the 
last degree of decay. It would require 
volumes to contain the numerous instances 
of ruined constitutions, (not to say how 
many have been * poisoned by the diabo- 
lical transactions of this nest of empirics.) 
Honesty and humanity are qualities which 
they are entire strangers to; they neither 
regard the sufferings of their fellow 
creatures, nor what effects their nostrums 
may produce; nor any other considera- 
tion, but money. They swarm in all 
* I should not thus have exposed these little dabblers
in physic, nor attempted to disprove their bold and 
false assertions, published with a shameless front, to
impose upon the ignorant, and seduce the credulous 
and unwary, had not the death of a very promising 
youth, (who fell a sacrifice to the ignorance of one of
these impostors) given me this melancholy occasion. 
Besides, these men fatten upon the miseries and afflic- 
tions of other people; for they know full well that 
few persons can hurt them, because few or none will 
be willing to expose their own failings to the censure 
of their friends; nor do any care to let the world know 
they were so egregiously weak and silly, as to put 
themselves under the direction of such illiterate quacks. 
Dr. Robinson’s Treatise on the Venereal Disease, p. 
13, 14.
G2 parts

(44)
parts of London, and there is scarce a 
lamp-post, wall, or gate, but what has 
pasted on them their infamous bills; nor 
a public avenue, where some of their va- 
gabonds are not stationed, to wait for the un- 
wary, by which such numbers are ensnared 
and led to destruction. Their diseases are
made durable instead of being removed; 
and here it may very properly be said, 
that the remedy proves worse than the 
disease; for if they escape with their 
lives, the remainder of their days (by
mal-treatment or poisonous drugs) is 
embittered with miseries, and infirmities 
insurmountable. Therefore they must 
continue the residue of their lives (if such
a state can be called living) an offensive 
nuisance to themselves, and to all others 
that come within their reach. 
Happy it is for mankind, that a medi- 
cine is discovered, which is endued with
powers capable of curing this virulent, 
loathsome disease; and this medicine is
mercury *, which, by the art of che- 
mistry, 
* Mercury, or quicksilver, is a mineral fluid, and
more

(45)
mistry, may be so changed and prepared, 
by being combined with other substances, 
as to be productive of very valuable and 
beneficial effects as a medicine, and ca- 
pable of curing this malady in all its va- 
rious forms. But when entrusted to the 
management of rash pretenders, it will 
prove a curse to mankind instead of a 
blessing, and a dangerous destructive poi- 
son. It may be considered as so many 
sharp instruments in the hands of raving
madmen, who, not guided by reason or 
judgment, are incapable of calculating 
the dose suitable in different cases and 
constitutions. This only can be distin- 
guished by an able physician, or surgeon, 
more ponderous than any other. It is either extracted
by art from certain ores, or found in a fluid state in 
the earth. The greatest quantities come from the 
East Indies; but there are considerable mines of it in
Spain, Hungary, Peru, and Fruili. It is met with in 
three different forms, viz. pure, in ruddy clods, or 
glebes, which is cinnabar, and in stony glebes, or a 
mineral substance, in colour generally resembling saf- 
fron; sometimes this is blackish. This mineral is 
prepared into a variety of forms by chemical processes, 
each of which have their respective uses as a medicine. 
who-

(46)
whoever else attempts it is a cheat, and a 
dangerous pest to society. No disease re- 
quires an earlier attention, or more im- 
mediate aid, than the venereal. Its 
symptoms often advance rapidly, every 
hour becoming more virulent; and if 
through quackery, irregularities, igno- 
rance, or a false bashfulness, it be impro- 
perly treated, neglected, or suffered to 
proceed unnoticed, it may lay the foun- 
dation for future miseries, which never 
can be surmounted, and it often produces
the most direful effects. 
Various and tormenting are the symp- 
toms of this raging disorder, after it has
got into the habit, especially if no essen- 
tial means are made use of to counteract 
its virulence. The throat becomes affec- 
ted with offensive ulcers, the breath emits
a most horrid stench; scabs, blotches, or 
dark copper coloured spots, and fistulous
ulcers appear on the surface of the diffe- 
rent parts of the body; violent nocturnal 
pains torment the patient. At length the 
more folid parts (the bones) become af- 
fected with caries, or rottenness, (parti- 
cularly


(47)
culariy the bones of the palate, and roof 
of the mouth.) The shin bones are af- 
fected with * nodes, the teeth fall out 
of their sockets, and sometimes blindness 
succeeds. The venereal venom sometimes 
penetrates more deeply, laying hold of 
the vital parts, and producing a † pul- 
monary phthisis, or consumption of the 
lungs, causing a cough, purulent expecto- 
ration, hectic fever, nocturnal sweats, 
restless nights, loss of appetite, ‡ maras- 
* Node is a rising or tumor on a bone, in conse- 
quence of a confirmed lues, or pox. 
† Phthisis pulmonatis, is an affection of the lungs, 
producing a consumption, or general waste of the 
whole body. In this disease the lungs are frequently 
loaded with tubercles, or little bags of matter, which
is expectorated in coughing, and is always attendant 
on this disease, together with a hectic fever, wasting, 
night sweats, and flying pains and stitches. It proceeds 
from many causes, such as venereal and scrophulous 
virus, pleurisy or peripneumony, long continued coughs;
and is readily produced by intemperance in those who 
are constitutionally disposed to this disease, and in those
who have a particular straitness and mal-formation of
their chests. 
‡ Marasmus is lingering consumption of the whole 
body, attended with a wasting fever, and various other 
symptoms. 
mus,

(48)
mus, and a general waste of the muscular 
parts of the body; the patient becomes 
feeble, emaciated, and racked with most 
bitter pains: all the folids and fluids 
towards the last stage are a corrupted mass. 
At length, being reduced to a mereskeleton, 
he impatiently waits the arrival of death, 
as his only deliverer from his torments. 
Such horrid scenes I have frequently seen
with deep concern; and upon inquiring 
into the history of their cases, and the 
manner they had been treated, I learnt, 
that neglect and mal-treatment had been 
the sole cause of the disease terminating
so wretchedly and fatally. 
It is not uncommon for infants to re- 
ceive an hereditary taint of this nature 
from their parents; which often appears 
at the time of birth, in the form of 
crusty scabs, and pustular eruptions, ge- 
nerally on their legs, thighs, and arms, 
or ulcers about various parts of the body: 
and if they survive, they continue sickly, 
weak, diseased, and commonly useless 
members of society; and fortunate it is,
when

(49)
when death kindly removes them in their 
infancy from such a state of wretchedness. 
It is really a national concern, to hear 
of so many who fall victims to this horrid 
malady; and though it may not directly 
destroy the vital principle, yet it is almost 
a certainty, that it cuts short the thread of 
life. These afflicted persons are often left 
to linger under infirmities, which are 
too deeply rooted to be eradicated; per- 
haps they may live to beget a half rotten 
posterity, but the poor innocent children 
suffer severely for the fins and frailties of
their parents. Whereas had they (on the 
first appearance of their disease, or soon
after) been possessed of that prudence, 
which would have directed them to the 
man who would have attentively and judi- 
ciously considered their situations, put 
them upon a proper regimen, and attacked
their distemper with a mercurial prepara- 
tion, suited to their habit of body and 
adapted to the virulence of the disease, 
its effects on the constitution might 
have been counteracted, and all its 
terrible train of evils prevented: they
H might

(50)
might have been restored to their pristine 
health and vigor, and not have entailed 
future miseries on succeeding generations. 
It is not unusual in such cases to defer ap- 
plying to the regular practitioner, until 
the constitution is ruined, and until it is 
past the power of art to repair it. And I 
am much deceived, if what I have ad- 
vanced on this head, is not capable of 
being verified by the woeful experience of 
many. In truth, my readers, this is more 
frequently the case than you may probably 
conceive it to be, and a truly pitiable case 
it is: but it ever must remain so, unless 
such means are devised, and executed, as 
will entirely defeat the authors of such 
calamities. 
It is very common to observe, in several 
of their hand-bills and advertisements, 
that they have the effrontery to affirm, 
that they cure the various symptoms at- 
tendant on the different stages of this dis- 
temper, as well as many other diseases of 
a direct contrary nature to the former, 
with one nostrum. But that mankind can 
so far yield up their reason, as to believe
that

(51)
that this can possibly be effected (when the 
degree of the disease is so different, and 
symptoms so variable in divers persons) 
by one single panacea, is to me truly 
surprising. And yet all this is to be ac- 
complished without any regard to confine- 
ment, or restraint in diet; as if no disease, 
nor conduct whatever, could possibly with- 
stand the force and operation of their all 
powerful specifics. 
The reader will please to recollect, that
I have, in a foregoing page, endeavoured 
to point out the absurdity, and dangerous
tendency of infallible nostrums; and the 
indispensable necessity of attending to dif- 
ferent constitutions and circumstances in 
each individual case. This can only be 
acquired by an attentive reflection on causes
and effects produced in different diseases, 
and which is the only means to arrive at a 
knowledge of curing diseases. For a con- 
fined knowledge cannot qualify a man in 
any branch of the indispensable, he must 
have an extensive knowledge of the whole 
science. 
H2 Now

(52)
Now that mankind should be induced to 
believe, that the venereal disease, rheuma- 
tism, gout, itch, scrophula or king’s evil, 
scurvy, &c. are all to give way to this miracu- 
lous dose, plainly shews, how little they are 
disposed to think of a subject so serious in 
its consequences as the abuse of medicine. 
To enter into a minute detail on the na- 
ture, symptoms, and method of cure of 
these different diseases, would swell out 
this essay beyond my original design, and 
might be considered superfluous and un- 
necessary. Let it suffice to say (and I be- 
lieve by every rational person it will be 
allowed) that each of these diseases has 
its characteristic signs, by which it 
may be readily distinguished from any
other; that its nature, appearances, 
and effects, are obviously different, and 
that they vary in different subjects. If all 
this is admitted, how then can common 
sense coincide with their affirmations, 
Allowing that their compositions should 
be efficacious in the cure of the disease 
alluded to, does it also follow, that they
must be capable of curing every other? 
The


(53)
The absurdity of such a supposition will 
not admit of debate. 
Many of them, apprized of the dread- 
ful apprehensions that some persons enter- 
tain of taking mercury, consider it their 
interest to declare, that they cure this dis- 
ease, in all its various stages, without ad- 
ministering a grain of it. Now these ap- 
prehensions, which many entertain of this 
medicine, I acknowledge are not without 
foundation, when it is left to the discretion. 
of quackery: but when entrusted to the 
management of a prudent and careful phy- 
sician, or surgeon, I can from experience 
and observations venture to affirm, that 
they are entirely groundless. It may very 
safely and beneficially be administered at 
any period of life, in this distemper, with 
a strict attention to the patient’s strength
and habit, degree of virulence of the 
symptoms, and the effects which it pro- 
duces, which are extremely uncertain; as 
some constitutions can bear, and will re- 
quire a greater quantity than others to
conquer the disease; while others will 
be sensibly affected by a much smaller 
quantity,

(54)
quantity, and will not require so much: 
and this depends on particular situations 
in particular cases, and a greater or lesser 
degree of irritability in the system of dif- 
ferent persons, which demands our con- 
stant consideration. For by a proper at- 
tention to this circumstance, the success 
and safety of this medicine solely depends. 
There is no medicine that can be depended 
upon to cure this distemper but a mercu- 
rial preparation, (unless it should be a 
gonorrhœa * or a local affection) and those 
that attempt to cure it by any other method
will be baffled, and the patient will be 
disappointed. 
Great and valuable improvements of 
late years have been made in the adminis- 
tration of this medicine. Formerly pa-
* Gonorrhœa, or clap, is a local affection from an
impure coition, producing an inflammation in some 
part of the urethra, attended with a discharge of a 
purulent appearance; but which is no other than an 
increased secretion of the natural mucus, that lubri- 
cates the passage changed in its consistence and colour. 
It is to be treated as other local inflammations, with 
a low diet, mild cathartics, and refrigerating medi- 
cines; oily or mucilaginous injections: and by a strict
attention to regularity and the antiphlogistic plan, it 
will frequently require no other mode of cure. 
5 tients


(55)
tients were subjected to tedious and unne- 
cessary confinement, and severe salivations, 
who by experiments and observations, we 
are now convinced might have been cured 
by a milder method; and without expe- 
riencing the disagreeable effects resulting 
from so severe a process. For by intro- 
ducing this medicine into the habit, as 
an alterative, in a quantity suited to the 
symptoms of the case (at proper intervals) 
which may be known by the abatement of 
the symptoms, and the effects produced, 
a certain, safe, and pleasant cure generally
will be effected. I do not mean to insi- 
nuate, that every case (however malignant 
and untractable in its symptoms) will in- 
variably yield to this method, I am aware, 
that venereal complaints, in certain habits, 
and from peculiar causes, under the best 
treatment and skill of the most able of 
the profession, will sometimes require the
perseverance of months before they can 
be wholly subdued; as those situated in 
the manner I have described in a foregoing
page, and which will admit of an excep- 
tion from this last mentioned system.
There

(56)
There is a character in London, whose 
unlimited audacity and impudence exceeds 
all the rest, and whose pretensions are 
liable to produce as much mortality among
the human race, as a pestilence, famine, 
or the sword. This profligate pretender 
(with wonted assurance) informs the pub- 
lic, that he is capable of curing cancers, 
diseased bones and joints, mortifications, 
and various other diseases, indiscriminately; 
denies the necessity of the knife in any 
case whatever; challenges the corporation 
of surgeons to contradict his affirmations; 
and impertinently makes free with the 
names of some of the most eminent and 
respectable among them. 
The length of the advertisement I mean 
(almost filling the column of a news pa- 
per) cannot have failed of attracting the 
notice of many: and its repeated insertion
in different papers, evidently shews that 
numbers are disposed to credit his asser- 
tions, and entrust themselves to his ma- 
nagement, without allowing themselves the 
liberty of considering, whether what he 
advances be practicable, or consistent with
reason

(57)
or not. Alas! I unfortunate deluded people, 
I shudder to think what must have been 
the fate of many; and what will be the 
fate of others, as long as this impostor is 
permitted to continue his deceptions.— 
But while that propensity to whatever is 
new and marvellous, which predominates 
among so many of our species, and which 
has raised so many illiterate persons, and
noxious things into reputation, and while 
mankind are so ready to follow the ex- 
ample of others, whose conduct is the 
least fit to be imitated, I fear a regula- 
tion in this particular can hardly be ef- 
fected. It requires but a very small share 
of discernment to detect the falshood of 
his doctrines, and the impracticability of
what he undertakes. Such a character as 
this I consider as a most notorious cheat, 
on whom exemplary punishment should be 
inflicted, in order to deter others. For 
the professions of physic and surgery, 
when under no restraint, and subjected to
no laws, nor regulations, are a most cruel 
scourge to mankind, and a serious national 
calamity. To credit the contents of such
I an


(58)
an advertisement must be, to consider 
surgeons either ignorant, rash pretenders, 
or cruel, and inhuman savages; who, to 
satisfy their brutal inclinations, or from 
some interested motives, dismember and 
mangle their fellow creatures under the 
plea of necessity. Surely mankind are not 
so far prejudiced as to entertain so ignoble 
an idea of a body of men, who endeavour 
to do their duty in the best manner they 
are able; and to render themselves as ser- 
viceable and useful as possible. The 
plausible falshoods which are inserted in 
such advertisements are a disgrace to a 
news paper, an insult to common sense, 
and for the security of mankind, ought to
be suppressed. 
I am sensible that many persons are of
opinion, that surgeons often amputate 
limbs unnecessarily, which otherwise 
might have been cured, provided they had 
patience, and inclination to attend to them
long enough; and suspect that this is 
most generally the case in public hospitals; 
and done with a view of getting rid of such 
cases as are likely to prove tedious and
trouble-

(59)
some. But in this opinion mankind do 
them great injustice, and it is owing to 
this opinion that the character I allude to 
is principally indebted for the encourage- 
ment and support he meets with. Those 
gentlemen who fill the office of surgeons 
to public hospitals, are at the head of 
their profession, and of such eminence 
and abilities, that no other country can 
boast of a superiority in this respect. And
I am certain, that their humanity is equal 
to their skill; and justly entitles them to
the confidence of mankind. They are 
very far from meriting those illiberal asper- 
sions, with which, through misrepresen- 
tation and false prejudices, they are un- 
deservedly loaded. A long and regular 
attendance at the public hospitals in Lon- 
don, has afforded me repeated opportu- 
nities of being convinced, that the above 
opinion is groundless. I have always ob- 
served the greatest humanity and attention
shewn by these gentlemen to the afflicted
poors and every means pursued which 
were calculated for the preservation of
limbs and lives. And that in such un- 
I2 fortunate

(60)
fortunate cases as were irremediable, and 
where the sole chance of preserving the 
patient’s life depended on an operation. 
I have always found, that these operations 
were not attempted without a consultation, 
and without the acquiescence, and con- 
currence of the other surgeons of the same 
hospital. When they were, unanimous 
in opinion that no other resource was left 
the patient, they then considered it their 
duty to afford him that chance; and to 
explain to him how unhappily his case 
was circumstanced, as not to admit of any
other relief but by an operation. Such 
opinions I have seen delivered by those 
gentlemen with that tenderness and con- 
cern, which I think must have inspired 
every auditor with admiration and esteem 
for their humanity towards their afflicted
patients. 
It is a melancholy truth, that there are 
some diseases which are so circumstanced, 
that the patient has no other chance for 
his life but by submitting to the knife. 
And to determine whether the case will 
admit of any delay, or whether, if the
present


(61)
present opportunity should be neglected, 
another equally favourable may not offer, 
is a point, which requires the nicest, and 
most accurate discernment.—This is not 
unfrequently the case in compound * frac- 
tures, where the surrounding skin, muscles, 
tendons, (and ligaments when the injury 
is received at the joints) are so crushed 
and lacerated, and the bones so shattered, 
as in cases where broad-wheeled waggons, 
or other ponderous bodies fall upon, or 
pass over the limbs;) and when the parts 
are so bruised and impaired, that the cir- 
culation through them is so much impe- 
ded, that without immediate amputation 
a gangrene, and mortification must take 
place, and death inevitably follow. For 
inflammation soon takes possession of the
limbs, and an encreased irritation, and 
action of the vessels of the whole system, 
would frustrate our endeavours in an ope- 
ration, subject the patient to unnecessary
pain, and hasten his dissolution. Whereas 
* Compound fracture, is a fracture accompanied with 
a wound; and sometimes with a protrusion, or thrusting
forth of the bone through the integuments, or skin.
4 had

(62)
had the operation been performed imme- 
diately after the accident, and before these 
symptoms had appeared, the patient might 
have been preserved. 
There are other cases which will allow 
of longer deliberation, but where the 
knife becomes at last indispensibly neces- 
sary, to afford the patient a fair chance for 
his life; as in joints, where the heads of 
the bones are enlarged, and rotten, and in 
putrid corrosive ulcers, where the texture 
of the bone underneath is greatly dis- 
eased; and where, by the profuse dis- 
charge attending it, the patient’s strength
is greatly exhausted, and he is become 
emaciated; or by the re-absorption of a 
virulent pus, causing a hectic fever and 
night sweats; if an operation is delayed, 
and these symptoms suffered to advance 
too far, until the patient’s strength is too 
much exhausted, it will be then too late 
to propose an operation. These are mat- 
ters which require the greatest judgment 
in a surgeon to determine, that he may 
not unnecessarily and rashly deprive his
patient of a limb, or through ignorance, 
or


(63)
or timidity desist from affording him the 
only probable chance of his preservation. 
Many other cases I could mention, in 
vindication of the operative part of sur-
gery; but what I have already advanced 
on the subject, by a moment’s reflection 
from every reasonable man, I hope will be 
considered sufficient, to convince him of
the necessity of the knife in many de- 
sperate accidents, and deplorable cases. 
Great, and frequently fatal errors are 
committed in the use of the lancet. This 
operation is daily performed by barbers, 
farriers, and such like uninformed persons; 
who, however expert they may be as ope- 
rators, are badly qualified to judge whe- 
ther the patient be likely to derive benefit
or detriment from this evacuation. Al- 
lowing it to be necessary, how can they 
rightly determine the quantity proper to
be taken away? To ascertain this, the 
state of the pulse, and the other symp- 
toms, are proper guides, which are cir- 
cumstances that they are totally unac- 
quainted with. And it is their interest to
bleed

(64)
bleed every person who applies to them 
for that purpose. 
A very pernicious custom prevails among
many persons, but particularly the more 
laborious part of mankind, which is, on 
the first attack of any disease, they have 
recourse to those kind of people to be 
bled; as if they considered bleeding as a 
sovereign remedy, and capable of check- 
ing the progress of every disease indiscri- 
minately. There are certain diseases where 
the use of the lancet is primarily and in- 
disputably necessary, and productive of 
the most salutary effects; and where the
patient by the neglect of it, must fre- 
quently inevitably perish; and on the 
contrary, there are many other diseases, 
where it is not only unnecessary and im- 
proper, but often productive of the most
malignant and fatal consequences:—of the 
former are diseases originating from ple- 
thora, where there is a superabundant 
quantity of blood, of too dense a consist- 
ence causing an encreased force in circu- 
culation, which impedes the regular 
action of the vessels; such a state of the
blood


(65)
blood predisposes the person to inflam- 
matory fevers, pleurisies, peripneumony, 
phrenitis, and various other inflammatory 
diseases. Of the latter are those diseases, 
where the blood is in too impoverished a 
state, with a dimished action of the heart, 
and vascular system; or those originating 
from a fault in the solids and fluids, as in 
dropsies, agues, intermittent, nervous, 
putrid, and malignant fevers; in various 
chronic diseases, or those from a vicious 
constitution of the humours, as in scro- 
phula, scurvy, &c. and where bleeding 
cannot remove the whole of the virus 
from the habit, but only a proportionable
quantity as the blood drawn away con- 
tains. 
It is the usual custom of many persons, 
(though fortunately of late years it has 
been less in vogue,) to be bled twice a 
year, and they generally prefer the spring and
autumn, which they consider as the most 
favourable seasons for this operation. This 
custom, they imagine, protects them from 
diseases, which otherwise they would be 
more liable to receive. This is a very
K egregious

(66)
egregious mistake, and is liable to entail 
on them the very mischief, which they 
suppose it prevents. Those who have ac- 
customed themselves to this habit for some 
years, will require it at the usual season of
the year, at which this evacuation has been 
made; they will thereby materially injure 
their constitutions, and become obnoxious 
to various diseases. 
If the vascular system is not over dis- 
tended, and the circulating fluids not too 
rapid, the pulse will be neither too full, 
strong, nor oppressed. If so, how can it be 
necessary to weaken the powers of nature, and
lessen the action of the heart and arteries, 
which was not too much encreased. The 
pulse is the certain diagnostic of the state 
of the circulating fluids; and when 
the pulse is too full and hard, it evidently
proves that a plethora prevails, and that 
bleeding may be advantageously performed. 
But when the pulse is neither too frequent, 
nor hard, nor the circulation too rapid, 
this evacuation is in general extremely 
injudicious, and often productive of fatal 
consequences.
Nothing

(67)
Nothing will so quickly weaken the 
powers of nature, and produce so general 
a relaxation, as phlebotomy. It diminishes 
the action of the vessels, and the motion 
of the blood through them; and if car- 
ried too far, may produce a general langour; 
for by this evacuation the pulse may, to 
any degree, be weakened. 
If it is admitted that there are certain 
diseases where blood letting is not only 
injudicious, but extremely dangerous; 
and, on the contrary, that there are other 
diseases, where bleeding is not only judi- 
cious, but indispensably necessary, and 
productive of the most salutary effects; if 
this practice is considered as warrantable, 
I think it must also be admitted, that, 
to distinguish those diseases where bleeding
may be beneficial from those where it may 
prove prejudicial, must require a thorough 
knowledge of the characteristic marks by 
which one disease may be readily distin- 
guished from another.—This requires 
great experience, and attentive examina- 
tion into causes, symptoms, and effects. 
And in those diseases requiring the use of
K2 the

(68)
the lancet, it is a material consideration 
to endeavour to ascertain the quantity ne- 
cessary to be taken away; which can only 
be judged of by the state of the patient, 
in respect to strength, constitution, date 
of the disease, and the degree of virulence 
of the symptoms. To investigate this 
necessary quantity, the pulse is the best 
and surest guide. 
As phlebotomy is an evacuation of 
greater importance than is generally ima- 
gined, I hope it will not be considered that 
I am too prolix on this part of my sub- 
ject. Being aware that the imprudent use 
of it has been the bane of many, is a con- 
sideration sufficient to influence one that
is anxious for the welfare of mankind, to 
declaim with the utmost energy, against 
the pernicious custom of want only lavish- 
ing away the vital fluid. And this is 
daily done without taking any advice about
the propriety of such an evacuation. The 
most able and discerning practitioner is 
not capable of rightly judging of his own 
case, and to prescribe for himself under 
disease; of which we have had some re- 
cent instances, where from too great a 
self-


(69)
self-confidence, society have probably been 
deprived of some valuable members, and 
the profession of some of its brightest 
ornaments, and this has happened through 
an ill-timed bleeding.—I hope these facts 
will inspire the reader with a wholesome 
dread of this pernicious custom, so as to 
avoid falling into this error himself, and
induce him to caution others from ex- 
posing themselves to the like danger. 
The greater number of persons that 
have recourse to these phlebotomists, are 
the laborious, and poorest classes of peo- 
ple, who depend upon their manual labour 
for their own and families subsistence: and
it seems as if divine providence interposes 
that so many escape, without some fatal 
accident; or at best without being de- 
prived of the use of an arm. They do not
consider that they commit a valuable limb 
into the hands of a man, who, is unac- 
quainted with the situation of the arteries, 
nerves, and tendons of that limb. Either 
of these being punctured in the operation, 
may be productive of very serious conse- 
quences, as the loss of a limb, and in 
some

(70)
some cases life, or at bed leave the person 
a cripple the remainder of his days. These 
operators being unacquainted, or regard- 
less of the consequences that would result
from wounding an artery *, nerve †, or ten- 
don; and without feeling for the pulsation 
of an artery to distinguish its situation, and 
without endeavouring to avoid it, rashly 
plunge in the lancet without regarding 
the possibility of laming the patient, or 
doing him more fatal mischief. 
* An artery may be punctured instead of, or toge- 
ther with a vein, which may be followed with a dan- 
gerous hæmorrhage, aneurism, and even death. 
† The puncturing a tendon, or nerve, is generally 
attended with excruciating pain.—The limb becomes 
inflamed, swoln, convulsed, and stiff; and if proper 
assistance is not timely procured, it threatens general 
convulsions, a gangrene of the part, and may terminate 
fatally. 
If a vein be cut asunder there will be an extravasa- 
tion of blood. The arm becomes of a livid colour, 
swelled, sometimes greatly inflamed, and very painful. 
This is sometimes followed by suppuration, at other 
times by mortification. The above symptoms may 
proceed from a person using his arm too soon after 
bleeding; the action of the muscles causing the vein to 
swell, and the blood is forced into the interstices be- 
tween the skin and flesh. 
Perhaps 



(71)
Perhaps it may be said, that as these ac-
cidents rarely occur through the opera- 
tion of blood-letting, I am too severe 
upon a class of men, who get a livelihood 
by performing it. They may censure me 
as being of an uncharitable and severe 
disposition, and that I aim at depriving 
these men of a subsistence. I should be 
sorry, if I knew that any person enter- 
tained so ignoble an opinion of me. It 
is true, there are many who make a trade 
of this operation, but most of them in 
conjunction with some other branch; and 
this is the case with midwives, barbers, 
and such like.—Were such persons to con- 
fine themselves to their own respective cal- 
lings, they might meet with sufficient em- 
ployment to maintain themselves and fami- 
lies, without presuming to perform a chi- 
rurgical operation, and perhaps depriving 
a fellow creature of a valuable limb. Al- 
lowing that these accidents do not fre- 
quently happen, yet it is a hazard that 
every man is exposed to, who entrusts 
himself under the hands of ignorant, il- 
literate practitioners: and there are many 
3 of



(72)
of them, who perform this operation in 
a state of inebriation. These two circum- 
stances, viz. the ill effects that may ensue 
from blood-letting injudiciously, and un- 
necessarily performed—together with the 
dangerous and sometimes fatal conse- 
quences that may attend injuring the parts 
herein mentioned, I am inclined to think 
will, by persons who are rational, and ca- 
pable of judging rightly, be considered 
of such importance, as to require the ne- 
cessity of warning mankind of the direful 
consequences that may attend on such in- 
cautious proceedings. 
Perhaps some of my readers may be 
disposed to start the following question. 
Has either of the aforesaid accidents 
never happened to the regular practitioner? 
It is not my intend on to advance that they 
never have: all the mean to say is, that to 
a cautious and well informed man, ac- 
quainted with the situation of the parts he 
ought to avoid injuring in the operation, I 
think, I may safely venture to affirm they 
never can happen. When such blunders 
have been committed they must have pro- 
ceeded



(73)
ceeded from gross ignorance, or careless- 
ness; therefore cannot reasonably be con- 
sidered as a sufficient vindication for the 
support of uninstructed men, who are so 
liable to commit them frequently. 
I am inclined to think, that the term 
empiric, or quack, is not applied to so 
many as deserve it. There are persons 
who, though they may be qualified to 
compound and prepare medicines, yet are 
far from being qualified to take upon 
themselves the province of the physician: 
and who, under the denomination of apo- 
thecaries, visit the sick, and prescribe me- 
dicines *. Such a qualification is not to 
be acquired in the laboratory, or in an 
apothecary’s shop; yet there are many 
who, without any other information than 
what such a situation has given them, un- 
dertake the treatment of diseases; and 
who after a certain term of years devoted 
to an apprenticeship, where probably few 
* I am informed from good authority, that there 
are persons who practice physic in the character of 
apothecaries, who have originally been porters in 
apothecaries and chymist’s shops. 
L (if



(74)
(if any) opportunities have occurred of 
attending patients, or examining into the 
nature of diseases; and whose time has 
been principally spent in preparing medi- 
cines; and without any further medical 
pursuits, have set themselves up for prac- 
titioners. But how they can be qualified 
for such an undertaking, I shall leave to 
the reader’s good sense to determine. 
The original design of an apothecary 
was to prepare the prescriptions of the 
physician. Later ages have enlarged this 
branch, and it is now customary among 
persons, in almost every station of life, 
on the first attack of a disease, to send for 
an apothecary, in full confidence that he 
is capable of judging of their case, and of 
prescribing a medicine and regimen suit- 
able to counteract its effects on the con- 
stitution; and it seldom happens that a 
physician is consulted until a disease is 
considerably advanced, or until it becomes 
untoward or refractory, or when some 
alarming symptoms threaten the patient. 
Let not the reader mistake my meaning,
4 and




(75)
and think that I presume to insinuate, that 
apothecaries in general are not qualified
for what they undertake; this is far from
being my meaning, and far from the 
truth: nor is it likely that I should thus 
vilify a profession which I myself follow. I 
am perfectly sensible that the greater num- 
ber of the gentlemen who practise this 
branch of medicine, are well informed, 
truly ingenious, and perfectly equal to what
they profess. But on the other hand, I am 
confident that these gentlemen will agree
with me in opinion, that there are some 
exceptionable characters, who are not suf- 
ficiently informed, and who are ill quali- 
fied for so important an undertaking. But
this is a circumstance, which, among 
many other national evils, is overlooked. 
Mankind in general are incapable of dis- 
criminating, whether or not the practi- 
tioner they employ, is a man of real judg- 
ment in his profession; and this is more 
frequently the case in the practice of phy- 
sic, than in surgery; as in the latter, cer- 
tain cases occur, in which ignorance must
be soon detected, such as luxations, 
L2 frac-

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fractures, and accidents, which require 
an operation. When, in the former cases, 
patients are often disposed to receive, as 
gospel, the directions, and swallow with 
confidence the medicines that are admi- 
nistered to them, without a supposition 
that those who prescribe them are 
equally ignorant and illiterate. Those 
who are disposed to pursue the means, 
will find no difficulty in acquiring that 
information which is necessary to qualify
a man for a well-informed practitioner. 
In London, there are as able professors in
the different branches of medicine, anato- 
my, and surgery, as in any country what- 
ever. There are many public hospitals, si- 
tuated in different quarters of the metro- 
polis, in which every practical informa- 
tion, both physical and surgical, may be
received. 
Those who have neglected to pursue
these essential parts of medical erudition, 
however regularly they may have served 
an apprenticeship, can have no clear idea
of the true nature of diseases; they will 
be liable to commit egregious blunders in
the

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the treatmet of them; and the smallest 
errors are sometimes productive of fatal 
consequences. There are many practi- 
tioners of this description who experience 
the confidence of mankind; because man- 
kind, in general, are not competent judges, 
whether the practitioner they employ, is 
a man of real abilities. And it sometimes
happens, that they get into an extensive 
practice; while others, who have spared 
neither pains, nor expence, to acquire 
every requisite kind of knowledge, and 
are truly ingenious, do not meet with the
same encouragement, which from their 
merit and abilities, they are entitled to
expect. This is an incontrovertible fact, 
and serves to prove how little inquisitive 
people are in general, respecting the edu- 
cation of those with whom they entrust
their health and lives. 
Having advanced so far on the subject 
of Quackery, it will probably be expected 
that I should propose some plan for re- 
moving this evil. But I fear it is an evil, 
too deeply rooted, to be easily eradicated; 
nor can it be effected, unless a regulation

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is established among the regular practi- 
tioners. 
If a law was enacted, that no person 
whatever, should be permitted to prac- 
tice physic and surgery, but those who 
have been examined by proper persons 
appointed for that purpose, from whom 
they should receive certificates of their 
qualifications;—that severe fines, and 
penalties, should be inflicted on every
person who should presume to practice 
without such a privilege;—that persons 
should be employed, from time to time, 
to inspect each respective parish, who 
should make regular reports, and lodge 
an information against every one who 
should attempt to practice without having
received a certificate of their qualifica- 
tions; it might perhaps be attended with 
the best of consequences, and save the 
lives of many of his Majesty’s subjects. 
The College of Physicians of London,
are the guardians of medicine in this 
kingdom, and are the best judges who 
are, or are not, qualified for practising
this

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this science, of so much importance to so- 
ciety. If a certain number of this learned 
and respectable body, were to examine 
every person (in the English language *) 
who was to practice in the capacity of an 
apothecary, before they were permitted to 
prescribe remedies for diseases; and, were 
the Company of Surgeons to suffer no per- 
son to practise any branch of surgery, as 
well without †, as within the bills of mor- 
tality
* I mention the English language, because those 
who are admitted as fellows and licentiates of the col- 
lege, are examined in Latin. And though a person 
may be qualified to answer any practical question in 
his own native language, yet be may not be sufficiently
conversant with Latin to answer such questions pro- 
posed to him in that language. 
† Those without the Bills of Mortality, are per- 
mitted to practice surgery, and are not summoned to
be examined before the Court of Examiners of the 
Corporation of Surgeons. This, if I may take the 
liberty to say, I think requires some regulation, which, 
if put in force, might be productive of salutary ef- 
fects. Doubtless there are, in the country, as well 
as London, some practitioners who are not sufficiently
informed, and who may be sent for in many cases and 
accidents, which require immediate assistance, and 
where the fate of the patient depends on the skill of
the

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tality, except those who have been exa- 
mined, and received a testimony of their 
being qualified, from the Court of Exa- 
miners, very salutary benefits would be 
derived to mankind from such a regulation: 
errors, and abuses in medicine, of so 
pernicious a tendency, would be removed; 
the institution of medical practice would 
be secured on an equitable foundation, 
and many lives would be preserved from 
falling sacrifices, through ignorant and
rash pretenders. 
As public utility is my sole view in 
writing these sheets, I should therefore
be concerned, if I thought that my in- 
tention should be misconstrued, so as 
to be supposed an advocate for cruelty and
oppression.—This is so far from being the 
case; that, on the contrary, compassion, 
and a fellow-feeling for the sufferings of
others, have influenced me to endeavour 
the surgeon. For, in some parts of the country, a 
consultation cannot be so readily procured as in Lon- 
don, and the patient may perish; who, if proper 
assistance had been afforded him, might have been
preserved. 
to

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to warn mankind of the risk they are ex-
posed to, by having their diseases treated 
by unskilful persons. 
I have not the vanity to expert, that 
my sentiments, on this subject, will meet 
with the concurrence of every one that 
may be disposed to peruse this pamphlet. 
I am aware that advocates for quackery, 
in this country, are numerous; from these 
I do not expect the most liberal senti- 
ments. There are many credulous per- 
sons who will readily resign up their un- 
derstanding, and become dupes to the 
most illiterate knaves. And there is not 
an instance in which the truth of this re- 
mark appears more plausible than in quac- 
kery.—Such persons will readily condemn 
and ridicule the sentiments of a man that
does not coincide with their own favou- 
rite system, without considering, if what 
he has advanced, is consistent with reason
and truth, or not. I flatter myself, how- 
ever, that these sheets will fall into the 
hands of some who will judge of their 
contents more candidly, and conclude 
more rationally, and whose friendly ad- 
M moni-

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monitions may induce many to avoid this 
snare. 
Perhaps the reader will consider me too 
prolix on this subject; but before I con- 
clude, shall only add, that though I have 
presumed to publish my thoughts on a sub- 
ject which I consider of so interesting a na- 
ture, I have no self-interested views; all 
I aim at, is to endeavour to induce man- 
kind to avoid a nest of profligate cheats, 
who are void of every principle of honour, 
honesty, and remorse of conscience; who 
are actually ignorant of the profession they 
presume to practice, who not only de- 
fraud people of their money, but ruin 
their constitutions, and shorten the lives 
of many; who often receive large pre- 
miums, when they deserve to be hanged. 
In short, the numbers they massacre in a 
year, are truly a national evil; and I will 
venture to affirm, that if empiricism was 
abolished, many lives would be yearly 
preserved, who fall victims to their rash
and erroneous practice. 
As this pamphlet is designed for the 
perusal of the public at large, I have en- 
deavoured



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deavoured, through the whole of it, to 
express myself in a clear intelligible man- 
ner. Where I have added a technical 
term, I have attempted to explain it; 
whether or not I have effected this, I 
will leave the reader to determine. 
FINIS.
ERRATA. Page 6, line 18, for Pleurisy, read Pleurisy.