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ESSAYS AND LECTURES




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MEDICAL SUBJECTS.
   BY JOHN P. HARRISON, M. D.




PROFESSOR OF MATERIA MEDICA IN THE CINCINNATI COLLEGE.
■ -5>	----------------------------------------------■ ifr *» ^--------------------- C-*' ■' ' ' ■ ' PHILADELPHIA:
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J. CRISSY, 4 MINOR STREET.




         1835. 
  w
IQ3S
  Entered, according to the Act of Congress, in the year 1835, by John
P. Harrison, M. D. in the Clerk's Office of the District Court of the
Eastern District of Pennsylvania.
Printed by J. Crissy & G. Goodman, 4 Minor St. 
PREFACE.
    The  following Essays and Lectures on subjects  of in-
  terest to Students of Medicine, are published from a con-
  viction that the suggestions contained in them  may prove of
i benefit to those, for whom they are intended.   The consci-
  entious, and  modest, and aspiring student of medicine, oc-
  cupies a trying and responsible position:  he is often sorely
  agitated by  an apprehension  that, after the most sedulous
  and assiduous devotedness to a due preparation for the prac-
  tice of medicine, he  will prove deficient in practical skill—
  that  however furnished with the acquisitions of elementary
  and  doctrinal knowledge in  his profession, he  may never-
  theless fail in that  very point, in which it is all important
  for him to acquit himself well; in the resources of a sound,
  manly,  discriminating judgment of diseases and of their re-
  medies.  This sense of afflicting  doubt is replete with per-
  plexity, and often  depresses the  sallies  of his mind after
  high attainments, and robs his faculties of that elastic tone
  and bouyancy, which  are essential to an animated prosecu-
  tion of a eomplex scheme of science. 
IV
preface.
   The Essay on Medical Experience, is intended to assist
 the  student of medicine  out  of such  embarrassment.   No
 considerations are presented in it which can, in the remotest
 degree, be construed to imply that men can become skilful
 and enlightened  practitioners  of physic, without the most
 pains-taking devotement of their best powers to the study of
 this noble and useful branch  of human  knowledge.   No.
 The working man must be found  here, if any where;  the
 science of medicine  is the product of working men; and
 without industry, the most strenuous, directed in a proper
 path of protracted intellectual effort, no man, however gifted,
 can  become   a judicious  and safe prescriber of remedial
 agents to his fellow men.   Let the  standard  of medical
 literature be elevated by the urgent demand of the public for
 cultivated physicians, and then may we confidently expect
 that the profession will no longer be infested by such a host
 of ill educated, and ill prepared practitioners of the healing
 art.

  The Lectures  were  delivered, as their  respective  title
pages denote,  in  the city  of Louisville,  where  the  author
resided, with  the exception of a few  years,  nearly forty
years.

  With lively hopes that  this little work may prove useful
to the students of that science, which the author regards as
the first of all mere human sciences in the wideness of its 
PREFACE.
V
scope of mental research, and in the high and holy claims it
urges on  the  benevolent tendencies of our nature, he dedi-
cates it to them—feeling  assured that they will receive the
fruit of his labours with  candour, and in the spirit which
prompted to the publication.

    Philadelphia,
        194 Arch St, Aug, 1835, 
 
CONTENTS.
Ky. 
 
MEDICAL  EXPERIENCE.
   The illustrious restorer of modern science, in his
 Advancement  of Learning, has given us an acute and
 just reflection  in reference  to  the slow  progress of
 medical science, which evinces his penetrating capacity
 of discrimination upon  a  subject so deeply interesting
 to the mind of every cultivated physician.
   "Medicine,"  says he,  "has been a science more
 professed than  laboured, and  yet  more laboured than
 advanced; the  labour having been, in  my judgment,
 rather in  a  circle than in progression.   For 1 find
 much iteration, but small addition."
  Whoever,  with  a  calm and  enlightened spirit of
 observation,  looks over the wide tract of medical his-
 tory, will find ample materials for the judgment Bacon
 has passed upon  our science.  With here  and there a
 light to direct the steps, we discover long.intervals of
 dark and sterile ground.
  There are  two aspects in  which  medicine  is  to be
contemplated.—One as  an art, the  other as a  science.
There are peculiar  fallacies  connected with  each of
these great leading divisions.   And the  fallacies  of
 "too much  learning" having more fascination about
them,  and being  kept  often from merited oblivion,
           2 
10
medical expedience.
by  the accompaniments  of  literary accomplishment,
deserve a more careful analysis at our hands, than the
fallacies of mere medical art, which from  its ready
liability to degenerate into empirical pretension, meets
a quick exposure in the common sagacity of mankind.
And still human nature, true to itself under all circum-
stances and in every age,  loves the luxury  of delusion,
and  most pertinaciously  clings to  exhibitions of the
wonderful, and often delights to yield itself up without
reserve, to an unlimited faith in  the wisdom and supe-
rior skill of those who assume the ground of magisterial
dictation  in matters pertaining to the  knowledge and
.cure of diseases.
   Though delusion  after delusion be exposed and pe-
rish, like images traced in sand by the sea-shore, which
the  next  wave  obliterates, yet the  spirit of delusion,
the  love  of deception, perish not,  become  not weary
 with the progress of years, with the experience of time.
 One form of error rises,  is received with  favour, eulo-
 gized  as the messenger of great good to man, endures
 for a season, till another one arises to supplant its older
 rival,  and like it, flourish in  brief existence, then fades
 away  and is forgotten.
   The science, as well as art of medicine, to the eye
 of the philosophical beholder, resembles Virgil's mys-
 tical tree at  the mouth  of  Avernus, thickly covered
 with visionary leaves, and on every leaf a dream.  But
 it is a great and useful art, a noble and elevated science,
 well  deserving of the highest appreciation, and most
  exalted esteem.  For  however obscured by error, and
  perverted by quackery,  the art of healing is the source
  of many blessings to man.   And as a science,  medi- 
MEDICAL EXPERIENCE.
11
cine is of liberal bearing, and full of intellectual great-
ness; having for its object the expansion of the human
mind on some of the most interesting topics that can
invite investigation.   Man, in  his  physical frame, in
the organic structure, and physiological laws of that
frame,—in his  capacities  of thought and emotion, and
the  inscrutable connexion of  these divine capacities
with  his physical frame,—in the diseases, so various
and  numerous, which afflict his body and mind,—the
remedies which a sound experience has authenticated
as most proper to remove those diseases,—and the col-
lateral and auxiliary sciences, which pour in their con-
tributions of aid, of light, of power, into  the storehouse
of this great and noble  science.—All these attest the
dignity,  and effectively proclaim the high and useful
bearing of medicine on the well-being of mankind.
  Medicine may be  correctly  designated a  scientific
art   For as art is  the application of knowledge to  a
practical end,  and is  empirical if acquired by expe-
rience alone,   yet if that accumulated experience  be
reasoned upon, and  reduced  to  general principles,  it
assumes a higher character, and thus constituted, be-
comes a scientific art.
  The art of medicine is exclusively grounded in empi-
rical  experience, and  is anterior  in existence to any
deductions or general principles, which go to make the
science  of medicine.   Without this experience, medi-
cine must ever remain a visionary and delusive theory,
and destitute of the inductive plan, of deducing general
principles  from the data afforded  by observation,  it
would be a degraded and abject  pursuit, lost  in  the
mysteries and  technicalities  of a mechanical  occupa- 
12
MEDICAL EXPERIENCE.
tion.  It is the inherent tendency of the art of medi-
cine, unaccompanied by the liberalizing and quicken-
ing energy of the science, to bury itself in concealed
processes, to work in  mystery, and attain its ends by
short  cuts, and often by "indirect crooked ways:" So
that a due proportion  of both  of these  elements,  or
main  constituents, are  absolutely essential toward the
formation of a sound, authentic, enlightened experience
in medicine.
  In the whole compass of our language, there is scarce
a  word of greater latitudinarian construction, and of
more  indefinite  import, than  the  word  experience.
And this  holds with peculiar emphasis, as regards the
daily  application of the  term  to  medicine.   In no
branch of human knowledge is there a more frequent
employment  of the word experience, than  in  medical
science.  To experience,  a  confident  appeal  is  ever
made  by each party in a  controversy  concerning the
curative efficacy of any particular remedy, or plan of
treatment, to be  adopted to  remove an attack  of sick-
ness.  The public in their excessive appreciation of the
value of experience in our profession, deem no opinions
wise,  or ways of managing disease safe, but  such as
have upon them  the broad impress and superscription
of experience.  Not knowing that error finds its safest
lodgment in the intrenchments of a false experience,—
that truth often has to combat on the open plain, unpro-
tected by  authority, and uncheered  by the  voice of
acclaim, so readily bestowed on experience.
  Experience, it is often averred by those who love to
dogmatize on the narrow views they have derived from
their own circumscribed opportunities  of observation, 
MEDICAL EXPERIENCE.
13
and experience alone, must be our guide in arriving at
just conclusions concerning the causes, nature and cure
of diseases.   But whilst such advocates of experience
so confidently and pertinaciously insist on its exclusive
authority in medicine, they seem unable  to point out
the boundary between experience and routine, and are
incapable of attaching any comprehensive and generous
intellectual  appreciation to  a term which appears to
convey some talismanic power to their minds.
   It has been  an unfortunate thing for the progress of
the mind in its career of  improvement, that language
has been so frequently perverted  from its high func-
tion, as the just interpreter of thought, so as to become
the shibboleth  of prejudice, or  the adopted watch-word
of hereditary error.  In its legitimate scope of agency,
language is more than the interpreter of thought; it is
embodied mind; it is tangible ideas; it is intellect made
visible.  But in order to accomplish these exalted pur-
poses  language must be employed with a  constant and
strict  reference to its precise and determinate import.
Ambiguity and imprecision  should be banished  from
the language of every cultivated  man, who wishes to
impart his  thoughts  with  force, perspicuity  and cer-
tainty.  Especially, in all  discussions on physical phe-
nomena,  and  in  the explication  of the  laws which
govern the  material world, should all  vagueness and
indefiniteness of expression be excluded.
   Medicine is  a physical science, dependent for its suc-
cessful cultivation on the same methods as other physi-
cal  sciences.   In  medicine, the inductive philosophy
has achieved  some  of its  noblest trophies.   In the
several branches of anatomy, of physiology, of phar-
                         3* 
14
MEDICAL EXPERIENCE.
macy, of therapeutics, instructed skill, patient observa-
tion, and accurate deduction have been the means by
which physicians have been enabled to read nature in
her operations, to compel her to give up  her secrets to
the expostulations of her ministers,  and to answer the
persevering interrogatories of her  worshippers.   Let
poetry in her flights to the highest heaven of invention,
deal in  words which impart no definite conceptions to
the mind, for it  is amidst the grandeur of her sketches
that she presents to the imagination  glimpses of high
objects,  in a language too  indefinite  to provoke,  and
too sublime to  allow the scrutiny of reason.   But let
the terms of medicine be well defined; let the language
of physicians be the direct interpretation of  the precise
ideas existing in their minds; and let the nomenclature
of our science be divested of all that cast of  expression
which, from  its ambiguity, has so much retarded  the
human mind  in the road of discovery.
  The science of medicine owes much to experience,
but it is an experience at once discriminative and pro-
found.  The collected light of ages  beams around her
path. To  the assiduous and enlightened cultivators of
our art from the days of Hippocrates to the present age
of the world, we are indebted for  that fund of facts and
rational deductions which go to constitute the science
of curing diseases.  No one individual,  in this  age,
should arrogate to himself an original experience, com-
pletely independent of the past experience of the medi-
cal world.  Indeed, the most skilful in our art pretend
to  nothing more than a judicious combination of the
experience of the past with  their own observations—an
application of that knowledge derived from erudition 
MEDICAL EXPERIENCE.
15
with that acquired by personal inspection, and a careful
analysis of the opinions of their predecessors, so as to
build upon  it a  manly and  self-sustained judgment
which shall enable them to disentangle the perplexities
of disease, and to send a discriminating eye over  all
those details of medical practice which  are so apt to
embarrass and confuse weak minds.
  Each physician must go through a discipline in the
school of knowledge; each  one has to advance  from
ignorance to wisdom by slow and measured steps;  no
man can,  per saltum, reach  the pinnacle  of medical
science; he  might as well attempt to construct a, dome
without foundation.  All valuable acquisition is the
fruit of toil.
  Dii laboribus omnia vendunt.  Acquisitions collected
with  labour, are  to  be  carefully preserved, and  judi-
ciously arranged.   Out  of this store, which a zeal for
improvement, and a just ambition of distinction,  have
urged the individual to accumulate,  he  produces the
treasures of mental riches.  But without a correct con-
ception of the great ends of our investigation—without
a rational view of what we  intend to accomplish, how
shall  we ever profit by the opportunities afforded for
personal experience ?
  The subjects of medical knowledge are so varied—
they lie scattered over such a vast field of inquiry, and
are of such difficult investigation, that none but a  mind
disciplined  by previous habits of  study,  and  well-
grounded in those elementary truths which prepare it
for fruitful labour, can  surmount the obstacles which
hinder its advancement  in the road of medical science.
A perception of analogy and relation lies at the founda- 
16
MEDICAL EXPERIENCE.
tion of all our intellectual attainments.  It is this which
constitutes the  mental process by  which we compare,
reason and judge.  Now, if our minds have never been
imbued with the best methods of  exercising this  per-
ceptive faculty;  if the objects upon which  it should be
exercised are not made familiar by a previous frequent
reference to the opinions entertained by others on the
points we intend to investigate, how shall we  ever be
able to make a proper discrimination of the analogies
and relations—the contrarieties and resemblances, ex-
isting in  the subjects offered to our examination.  By
learning  to measure our strength  before we rush  into
the arena we shall  be surer of success  in  the  contest
which awaits  us.  We must  regulate the action  and
measure  of our faculties by a careful training, and  thus
we prevent them  being wasted in unproductive  and
abortive  efforts.  To this end choice and unity  of  pur-
pose,  as well as perseverance and method, are required.
We must, by our choice, determine what shall  be the
subject for our investigation, and by a unity of purpose
economize our faculties, and increase their  strength by
concentrating them.
  Some physicians, feeling an incapacity for scientific
investigation, go on to amass a chaos of insulated facts
which they dignify by the term experience.  But  it  is
by cautious theory that experience can be perfected.
Between theory and experience, understood according
to their  true meaning, there is neither contrast  nor
opposition.  Who are the men that have given to medi-
cine its chief glory as an intellectual pursuit ?   They
are men  who  inferred general principles from  a saga-
cious comparison of a great variety of phenomena. And 
MEDICAL EXPERIENCE.
17
this  exercise of the reasoning faculties on the subjects
of medicine is  true  theory.   A  correct experience,
within its proper limitation, is nothing more than the
handmaid of theory.  Between an experience, enlight-
ened and guided by theory, and an experience, gross
and  undistinguishing, there is the same difference  as
there is  between the philosophy  of Newton, and the
matter-of-fact man  that labours in the  manufactory
where the instruments are prepared by which the hea-
venly bodies are seen.  To the first belong penetration,
analysis  and judgment—to the second there attaches
only a blind routine  which supersedes the exercise  of
the rational faculties.
  The science of medicine in its  legitimate spirit  of
candour, of liberality, and of the love of truth, seeks for
an open and generous field, upon which it may exercise
its powers,  and  display  the rich fruits of its acquisi-
tions.  In  accordance with the beautiful remark of the
great master of the  inductive philosophy,  "it  is an
interpretation of nature"—its elements are simple, but
its  applications  endless—and  it binds together by a
prolific principle of philosophy the scattered materials
of our otherwise rude and shapeless art.  Always par-
taking of the spirit of the age in which it may be culti-
vated, the science of medicine is  indebted to the stir-
ring genius of modern  times, for  its  richest gifts, and
most excellent  accessions.   Prompted to effort, and
guided in the effort it makes, by  the spirit of a true
interpretation of nature, which  a just  consideration  of
the faculties  of the human mind has imparted, it looks
abroad, out  from the  narrow  enclosure of personal
experience, to the wide and fertile domains of a culti 
18             MEDICAL EXPERIENCE.
vated science, as that science exists among the profes-
sion in  all parts of  the civilized world.   And whilst
each  physician  must employ,  most assiduously,  the
powers  of his own mind  to  discover what is  truth in
the science  of medicine,  still he must not neglect to
advert to other  minds,  in order to  derive from them
that light which  his own limited experience, alone, will
never confer.
  The inquiring, and conscientious, and aspiring physi-
cian, in  imitation of our  great countryman Rush, whose
whole life was one entire  consecration of his ardent and
capacious mind,  to the study of  that science he so pas-
sionately loved,  and so  eloquently enforced, will, with
persevering toil  strive, by consecutive investigation, to
attain a  higher degree of knowledge," and adjust with
greater  accuracy his attainments, each day.of  his pro-
fessional life.
  1 shall endeavour in the further discussion of the sub-
ject,  in as  brief a  manner  as  possible,  to point  out
the sources of false medical experience,  and enumerate %t
some  of the many follies  which it has engendered and
propagated; and in the  next  place notice  the best
methods of acquiring a true medical experience, and
expatiate a little on the  immense benefits to be derived
from such a source of knowledge.
   1.  False Medical  Experience.—The principal
sources  of the   many  "false facts" by which every
department  of  human   knowledge is  more  or less
vitiated are  the  following.  1.  Superstition.   2. Cre-
dulity.   3.  Fallacy  of  testimony.   4. Ambiguity  of
language.  5. False theory.
  It is difficult to bring errors into any regular classifi. 
MEDICAL EXPERIENCE.
19
cation.  Truth is one and the same, but error puts  on
infinite  and  ever-varying aspects: from  its essential
nature it appears to have no limits and no end.  But
the limits it has not in itself, it has in the nature of the
objects about which it is conversant, and from the con-
stitution of the mind.   In medicine there are a certain
number  of outlets by  which the  mind  forsakes the
straight way of truth.  These have been  indicated  by
several respectable writers, such as Zimmerman in  his
work on Experience in Physic, Paris in his Pharma-
cologia, and Sir Gilbert Blane  in  his Medical logic.  I
have selected from them the principal  sources of false
medical experience, and shall as succinctly as possible
point them out.
   1. Superstition.—Ignorance is the  foodful nurse of
that belief which reposes in security on the extraordi-
nary and supernatural  agency of remedies  in  them-
selves inert and ineffective.  In  the twilight of mind,
objects  assume  an  adventitious  appearance.  Fancy
peoples the vacuity of ignorance with endless delusions.
Instead of penetrating  the true  causes of phenomena,
and tracing out the harmony which  marks  the bene-
ficent arrangements of nature, the mind  infected with
superstition goes out in eager quest of  strange and ano-
malous fortuities, and is  ceaselessly employed in con-
juring up phantoms, which terrify and rule the soul.
   The  history of all  human  science  bears mournful
evidences  on its ample page, of the corrupting influence
of superstition.  Even among the Greeks those who
first attempted to assign the natural causes of thunder
and lightning  were condemned as the enemies of the
gods.   The fate of Galileo is familiar to all.  Medicine 
20
MEDICAL EXPERIENCE.
has been deeply tinctured with a reliance on  supersti-
tious remedies.  Among savage tribes of mankind, the
whole art of curing disease consists in the practice of
ridiculous, disgusting mummeries.  Among the Chilian
Indians the only  mode of relieving  the sick is by
blowing round their Jbeds, so that if a doctor can blow
well, he is sure to obtain a  good business.  But even
philosophers have manifested  superstition in  matters
relating to the cure of diseases.  Boyle asserts, that he
saw a sympathetic powder  effect a speedy restoration
to health,  and he places great reliance on the thigh
bone of an executed criminal for the cure of dysentery.
The  great mind  of  Lord Bacon was  darkened by a
superstitious belief in charms and amulets.  An extra-
ordinary virtue was attached by Soranus to the honey
that was produced by bees that lived near the tomb of
Hippocrates.  Among the Druids of Gaul and Britain,
who were both priests  and physicians, the misletoe,
gathered with  a gold knife, when the moon was six
days old, and consecrated by incantations, was esteemed
an infallible antidote  to poisons,  and  a preventive  of
sterility.  Galen is considered as  the author of the ano-
dyne necklace, so  long famous  among the great  and
little vulgar of England.  He asserts that if threads are
tied about the neck of a viper so as to suffocate it,  and
afterwards tied around a patient's neck, they will cure
all kinds of tumours arising on it.  The royal touch of
England, and  the  use of amulets and charms  sprang
frbm the same source.
  The three most  intense of human predilections con-
sidering man as an intellectual,  social, and  physical
being,  are the main  avenues through which tyranny 
MEDICAL EXPERIENCE.
21
has made its most successful approaches, in rude states
of society.  These are, the strong desire man feels for
 ie preservation of life, the irrepressible aspirings ol
nis nature towards religious emotion, and his earnest
want for some kind of polity.   In  ignorant and rude
conditions of society there is often a  union of the func-
tions of the physician, priest and chief,  in one indi-
vidual.   We need not, however, draw our illustrations
in the present instance from barbarous tribes, for the
celebrated Prince  Hohenlohe, perhaps still  alive,  will
furnish a most apposite example of such a species of
folly.
  Alexander Leopold Hohenlohe, a  Hungarian prince,
whose father was disqualified for government  by men-
tal derangement,  and whose mother was of an ardent
temperament, and of fervid zeal  for her religion, began
in 1815 to manifest his talents for preaching agreeably
to his fond mother's hopes and entreaties.  " After
having  received  the  papal permission to  consecrate
three thousand rosaries, crucifixes, &c. at once, he left
Rome and went to Germany, where  he was considered
by  his  colleagues  as devoted   to Jesuitism,  and an
enemy  to  knowledge."   Martin Michel, in Baden, a
worker of miraculous cures, through the power of faith,
and the efficacy of prayer, assured the Prince, that the
faith and prayers of a prince, were of much greater pre-
valence and potency  to effect miraculous  cures than
were those of a common peasant, such as Michel was.
The imagination of the fanatic prince was fired  at once,
and  he  soon proceeded to put into execution Michel's
plan of healing the halt, the blind, the impotent, and
the insane.  A princess, Matilda, of Schwartzenburg,
           3 
22
MEDICAL EXPERIENCE.
 who  had distortion of the spine, was made to walk,
 through the  agency of the princely priest and doctor,
 aided  by Michel,  his guide, encourager  and friend.
 The prince soon,  however, commenced operations on
 his own  responsibility and  prayers, and multitudes
 eagerly crowded around his path.   This spiritual phy-
.sician's fame soon diffused itself over Germany,  the
 country of the  ideal,  and reached even England  and
 America.  His  enthusiastic admirers published many,
 in their opinion at least, veritable cases of terrible  dis-
 ease,  which they solemnly averred were cured by  this
 great apostle of  delusion.   He could not succeed in his
 cases in the hospitals of Wiirtzburg and Bamberg,  and
 a prince  of  Hiedburghausen, who laboured under an
 affection of the  eyes, in consequence of discontinuing
 all  medical applications, and relying on  this spiritual
 doctor, found his eyes soon get much worse.  Still the
 confidence of Hohenlohe  was so  great, and his pre-
 sumption so overweening, that in 1821, he  solicited the
 Pope's attention to his miraculous  endowment,  but
 Pius  VII, intimated his will  to  be, that the process
 should not be designated a miracle, but priestly prayer
for healing.
  After Hohenlohe's  failure upon  the prince,  with
 diseased eyes, he declared himself exhausted, and  was
 unwilling to be  seen by the health police whilst  in  the
 act of performing  his cures.   Of late,  he works at a
 distance, and the newspapers, and some of the medical
 periodicals,  have  given us  accounts  of  the reputed
 miracles  performed by his highness, or excellency, in
 France, England,  Scotland,  Ireland and  the United
 States.  His mode  of late,  is to  direct the afflicted 
MEDICAL EXPERIENCE.
23
person, making application for cure to him, to pray at
certain times  of  the'day, cotemporaneously with him-
self.  It has been objected to these simultaneous prayers
by some caviling spirits, that a prayer at 8 o'clock, in
Hungary, has  been  ended before that of 8 o'clock, at
Marseilles  begins; but to this objection, urged  by the
sceptic, one irrefutable reply is enough,  it is  all mira-
cle, or all  superstition—from  alpha to omega—and
admits no investigation, but demands a simple, unques-
tioning faith,  too facile for doubt, and  too submissive
for reply.*
   The above furnishes a melancholy proof of the per-
verted application of that scheme of human  illumina-
tion, which Christianity furnishes, and is a signal veri-
fication of a remark already made, that mankind love
the luxury of  delusion, and seek its gratification in the
most exhorbitant exhibitions of folly.
   2. Credulity.—This vice of the mind is nearly allied
to superstition; ignorance is the mother of both.  But
though derived from the same  parent, they  differ  in
some  essential features.   Credulity  gives  credence to
propositions unsustained by  sufficient data.   The cre-
dulous man believes  extravagant accounts of the  virtues
of  medicines,  perhaps in themselves potent, but  not
possessed of all the virtues ascribed to them.   Novelty
spreads a bewildering gloss on remedies, to the eye of
him who  has  not a  sufficient maturity of judgment to
resist its fascinations.  A warm and  animated zeal for
any cause, unless that zeal is chastened  and regulated
by a severe discipline of judgment, is sure to mislead
* Encyclop. Americana: article, Hohenlohe. 
24
MEDICAL EXPERIENCE.
 the mind.   Quod volumus, facile credimus, is  as true
 in medicine as in the ordinary  pursuits of life.  Our
 science is  filled  with convincing illustrations  of this
 position.  The discoverer of every new remedy asserts
 that he finds in it  an epitome of the  whole materia
 medica.  The metallic tractors of Perkins, the animal
 magnetism of Mesmer, the elixir of life of Paracelsus,
 the alkahest of Van Helmont, and the panaceas and
 catholicons of the present day, all have derived their
 source from fraud operating on credulity. Even where
 no sordid considerations influence the propagator of a
 revived, or newly  discovered remedy, the ardent en-
 thusiasm of the experimenter urges him to great extra-
 vagance in the commendations he bestows on it.  Baron
 Storck  greatly overrated  the remedial power of the
 Narcotics upon which he  made so many experiments.
 There is  no prominent remedy in  our catalogue  of
 agents for the removal of disease, but what has been at
 one time surrounded by a mist of panegyric.  And how
 many  inert substances have been eulogized, that are
 now quietly slumbering in the tomb of forgetfulness!
 Opium, digitalis, mercury, antimony, and the bark are
 the most effective weapons of medicine.  Each of these
 have  been injured  in their  legitimate character,  as
 medicinal substances, by the indiscriminate encomiums
lavished upon them.  The most enlightened physicians
 now agree with the illustrious Sydenham, " that the
practice of physic chiefly consists in being able  to dis-
 cover the true curative indications and not medicines
to answer them; and  those that  have overlooked this
point have taught empirics to imitate physicians."
  Credulity delights in going in constant search  of an- 
MEDTCAL EXPERIENCE.
25
 omalies and novelties.  When a new remedy is sug-
 gested for some incurable malady, such as Prussic acid
 for  tubercular consumptions,  or Scutellaria for hydro-
 phobia,  the credulous minded physician does  neither
 hesitate, nor suspend his judgment, but rushes to a pre-
 cipitate  conclusion,  and upon some very inaccurately
 observed isolated  case proclaims his unlimited confi-
 dence in the article.   It is in the rank soil of credulity
 that quackery flourishes,  and sends forth its luxuriant
 branches.
   The  Eau  Medicinale d'Husson not many years
 since was implicitly  relied on for the cure of  gout, and
 the case of Sir Joseph Banks was quoted in its favour.
 What now is the just opinion attached to that nostrum
 by the most learned men  of our profession ?   Let any
 one  read what the profound Parry says about  it, and  he
 will at once be convinced of the injurious agency of the
 remedy, in preventing regular paroxysms of a constitu-
 tional disease, and thus exposing the patient to the im-
 minent peril  of apoplexy, or palsy,  or some other
 severe attack of disease.
   The doctrine of Signatures in the choice of remedies
 sprung from the same source, an excessive  credulity.
 Fox's lungs were  given  to  cure asthma, because the
 animal was capable of running long before he became
 exhausted.  Turmerick,  from  its  yellow colour, was
 administered as a sure cure for jaundice.
   Under the head of credulity most appropriately, per-
haps, are to be included  the  reveries and figments  of
Hahnemann's  subtle  but prolific brain.   Endowed to a
degree far beyond the common rate of even Germanic
ideality, and metaphysical vapouring, the author of the
                         3* 
26
MEDICAL EXPERIENCE".
system  of Homeopathy, has challenged human  cre-
dulity to the utmost, and put to test the  strength of
man's addictedness to abandon his mind to the wildest
wanderings of hypothesis: if the hypothesis is enforced
by confident appeals to  testimony, and a determined
hostility towards  all established views.   Mixing up
with the  crudest modes of explaining  the  action of
remedies, much parade of learning and professions of
philanthropy, the abettors of this system, most empha-
tically denounce and vilify all the generally established
modes of considering, and  of treating, disease.   The
captivating blandishments of infallibility and impecca-
bility are,  of course, the supreme features of homgeopa-
thism.  It is the wisest, safest, best, and most  sure
mode of treating all human maladies.   All  other plans
of conducting the treatment of disease are,  in compari-
son to the homaeopathic, but mere clumsy artifices of
medical  skill,  mere potent engines  of perpetuating
morbid  action,  and of perpetrating  death.   Hahne-
mann, like another Bacon,  has  promulgated his orga-
non, the leading doctrinal peculiarity of which is, simi-
lia,  similibus curantur, in  accordance  with which
to cure a disease, you must administer medicines  that
will excite symptoms similar to the disease—and thence
is derived the name of the system, homaeopathy, or as
it is sometimes written homoopathy—from the Greek
words, opowv alike, and *a5o$ disease.
  Experience is, with exceeding vehemence, appealed
to by the  homaiopathists as the test  and supporter of
their wise, and safe and certain plan of eradicating mor-
bid action from the system.  And their experience__it
is a distinct and  peculiar  experience—assures them 
MEDICAL EXPERIENCE.
27
that chamomile flowers excite 1480  symptoms—iron
produces  228—bark 469—platinum  402—and  elder-
flowers 116!!   A  drop of the  spirituous  tincture of
sarsaparilla is a strong dose, and a seven-millionth part
of a grain of cucumis colocynthis acts very often with
too much potency!*5
  Dr.  Rau, another metaphysical genius  of the land
of the indefinite and abstract, has given the following
among other cases to prove the verity of the homaeopa-
thic therapeutics.  A  feeble attenuated woman, sixty-
two years old, had suffered from repeated attacks of
pneumonia and difficulty of  breathing; and during an
acute attack of fever, pain in the side, frequent cough,
&c, Dr.  Rau gave her  the billionth  part of a drop of
the expressed juice of aconite, mixed  with a drachm of
water.  Very soon a thilling sensation spread over her
frame—a perspiration came on—the pain, fever, cough,
all disappeared; and after a sound night's repose, she
awoke in renovated existence, and seizing the doctor
by the hand, when he  visited her, she exclaimed with
rapture that she  was  well!  In a patient affected with
a frightful dropsy, accompanied by great prostration of
strength, coldness  of the whole  body, and inability to
discharge more than a few drops of urine, a single very
minute dose of the tincture of black hellebore, relieved
all the symptoms in a few days.t
  Reason and facts are of  no  avail in  a warfare of dis-
putation  with  such medical  mystics.  Men, whose
senses are steeped in the most  absurd credulity,  and

      * See Edin. Med. and Surg. Journal, vol. 28, p. 61.
      -J* Amer. Journal of Med. Science, for Feb, 1831, 
28
MEDICAL EXPERIENCE.
whose judgments are abandoned to the wildest dreams
of folly.  We  must  deliver them  over to the same
category of imaginative  and rapt  enthusiasm, as that
which possessed the seething brains of Emmanuel Svve-
denborg, who talked familiarly with angels and devils,
and had revelations and visions as divine as the second
sight  in Scotland.  Should  the reader wish to read a
most elaborate refutation  of homaeopathy, let him, with
German patience, sit down to Dr. Leo-Wolf's  book,
entitled, Remarks on the Abracadabra of the Nineteenth
Century;  or  on Dr. Samuel Hahnemann's Homaeopa-
thic Medicine.   The following passage from this vigo-
rous assailant of the homaeopathic delusion, is evinsive
of a fond  addictness to other  reveries  about  as  well
founded as those of Hahnemann.
  "Thus animal magnetism"—the author is giving an
illustration of the discoveries of German medical men;
and seriously adduces animal  magnetism  as a proper
topic of eulogy!—" Thus" says hs, " animal magnet-
ism, first mentioned about three centuries ago by Para-
celsus, a German, and introduced as a  remedy  about
sixty years since, by Mesmer, also a German, remained
almost unnoticed  by all  other  nations,  the  French
excepted, although many professional men in Germany
still apply this  great agent as  a remedy which,  here-
after, will  be more generally appreciated,' when like-
wise divested of the mystery which fancy and credulity
have so long combined  with it."  And  when  that
divesture takes place, what will be left of animal  mag-
netism?  Take  away  the  fancy and credulity which
were at work in its creation, and are now so operative
in keeping it alive, and it will share the fate of its oreat 
MEDICAL EXPERIENCE.
29
progenitor,  Paracelsus  Theophrastus  Bombastus de
Hohenheim—the celebrated empiric and alchemist—or
that of its reviver, the great magnetizer, whose delu-
sions our illustrious Franklin aided in detecting and
exposing.  And  Paracelsus  and Mesmer were Ger-
mans! happy land to give birth to a pair of such trans-
cendental and  sublime  sons of fancy and  folly—of
visions and vanities!
  3. Fallacy of Testimony.—It was the remark of a
celebrated teacher of medicine, that there are in our
science more false facts than  false theories.  Paradoxi-
cal as this may  seem, its truth is established by the
most comprehensive and accurate  observations which
can be  made on  the wide  field  of  practical medicine.
Wherever we turn our eyes,  whatever part of the field
we may contemplate, there  rises before us a thick cloud
of false facts.   There is no department of our art so
overrun with the fruits of false experience as the mate-
ria medica.  The best and most approved authorities of
that branch  of medicine have  made  this statement.
Whence originates this lamentable state  of  things ?
Why is it that this valuable  department of our science
should abound in such uncertainties, and be oppressed
by such a load  of useless remedies? It is clear that in
order to ascertain with precision the veritable operation
of any  remedy,  three conditions  are required.  1st.
Whether the  patient is  really afflicted with the disease
for the cure of which the remedy  is to be administered.
2nd. After the remedy is  given, whether or not the
patient  is cured at  all; and  3d.  whether, if cured, it
was  the remedy which  cured him, or  he got well in.
despite of it, 
30
MEDICAL EXPERIENCE.
  The great importance of Sydenham's remark is now
more distinctly perceived.  Unless the physician under-
stands the nature of the disease and  from  that know-
ledge gathers the indications of cure, of what avail is it
that he has a long catalogue of medicines to  administer?
Here the paramount consequence of a true  theory
reveals itself.   It is upon the well established basis of a
correct pathology that the  thiumphs of our science are
achieved.  Here charlatanry stands  rebuked, by the
well  sustained  principles  of scientific investigation;
here it " loses, discountenanced, and  into folly turns."
Very frequently, reputed  cures are  discovered to  be
only  a partial suspension  of the onward  career of a
malady.   The dominant control exercised by imagina-
tion over the excitable hopes of a patient suffering under
some chronic affection  operates a very great  influence
on the body.   It is in  this way that the supposititious
cures of Mesmer and Perkins were accomplished.  It is
in this manner that charms and amulets have sometimes
suspended  the progress of a fatal disease.  In  many
instances of this kind  the  patient  has no real disease,
but is under  the dominion of a gloomy and fantastic
fancy.  The case of stone, supposed at the time to have
been cured by Mrs. Stephen's remedy, for  which Par-
liament liberally rewarded her, is  in point.  In that
instance we have a verification of the fallacy of medical
testimony.   The patient  was examined by medical
men of the highest reputation,  and  upon their declara-
tion of his being cured, the reward  was granted.   But
the  man still laboured under the stone, only  it was con-
cealed from detection by  the sound,  by  its being in-
vested in a sac of the bladder.  The reputation of other 
MEDICAL EXPERIENCE.
31
nostrums has been reared on a similar perishable foun-
dation.  The fallacy of testimony is forcibly illustrated
in the asseverations  of  some  of the older writers,
respecting  the  presence  of globular  mercury  in  the
bones.  The solemn march of the germs of the future
animal in the semen of a  ram, which drew forth such
wonderment from  Boerhaave,  stands  on  the same
grounds; and so the contagiousness of bilious remittent
and yellow fever,  is  advocated by  those  w*ho place
too much  credence in fallacious evidence.  Fordyce
attempts to prove that common remittent fever is conta-
gious, and the advocates of the contagiousness of yellow
fever are found in the highest ranks of the profession.
Coincidence is taken for causation—the post hoc occu-
pies the place of the propter hoc on such occasions.  In
consequence of that prevailing link of sympathy which
binds together  men in society, there spreads at  times a
sort of universal assent to any, however extravagant,
statement.   Thus the mind of each one seems predis-
posed to admit, without due examination, the slightest
proof as  corroborative of the remedial  efficacy of any
new article of the materia medica.   Physicians partake
of this feature of mind with other men.   They  too are
easily satisfied with the testimony afforded  in substan-
tiation of the virtues of a novel remedy.  Hence it is
that so many in our profession stand ready to
       " Catch, e'er she fall, the Cynthia of the minute."
Hence it is that medicine seems more like a magic lan-
tern, where the scene is perpetually shifting, than like
the sober light of the great orb of day.
  Perhaps a more conspicuous instance could  not be 
32             MEDICAL EXPERIENCE.
adduced  to show the utter incompetency of a limited
personal  experience  to furnish a fair attestation to the
real value of a medicine, than  the  history of digitalis
affords.   Dr. Beddoes at  one time thought that in this
remedy he had a sure and safe means of arresting pul-
monary consumption.  But the experience of the pro-
fession generally, has deprived the plant of those extra-
ordinary  powers so blindly attributed to it, as regards
the cure of phthisis.
  It were a task of immense labour to advert, by spe-
cial enumeration,  to all  the numerous  cases of  such
fallacy, as that arising from extravagant views of the
medical properties of the various agents, which from
age to age, and  from year to year, have received the
unsparing and undistinguishing eulogies  of physicians.
And not  contented to expatiate on the virtues of medi-
cines which the ingenuous dealer in  drugs kept, appro-
priately labeled, in  his shop, the most accomplished
physicians have at times departed from the employ-
ment  of  the  remedies known to  the  profession,  or
recommended by  men of scientific candour, and  too
enthusiastically attached themselves  to the use, and too
eagerly recommended remedial agents, whose compo-
sition  was a secret,   and the authors and vendors of
which, knew nothing of  the just principles of medical
science.               /
  The splendour which  at  one time surrounded  the
reputation of Swaim's Panacea, was derived  from  the
dazzling  brilliancy of that light which  several of the
luminaries of our American medicine threw around it.
With  precipitate and  onward haste, some  of  our most
enlightened physicians were  found  swelling  the loud 
              MEDICAL EXPERIENCE.             33

chorus of praise which was sounding forth  the many
virtues and transcendent  excellencies of this nostrum.
Certificates,  signed by several of the most eminent
medical men of the country, quickly found  their way
into the  newspapers,  and were by them  rapidly dis-
seminated through the Union.
  A regular  graduate of  our oldest  medical school,
became agent  for Swaim, and went on  a mission  to
England  to vend the nostrum to  our  transatlantic
brethren.  But John Bull  was not quite so  gullible
as brother Jonathan in  this matter, and the  mission
proved abortive.  That the reader may have the benefit
of higher authority than the writer of this essay, I will
copy a page or two from  the " First Report of the
Committee of the Philadelphia Medical  Society, on
Quack Medicines, read on  the 15th  December, 1827,
and ordered to be published by the Society."
  "Dr. Chapman acknowledges having 'overrated the
value  of  the  Panacea of Swaim,'  and  'for a  long
period' he has 'entirely ceased to prescribe it'—says
he has in possession not a few cases,  which, if de-
sired, are at the committee's service, and 'eminently
calculated to alarm the public on this subject.' Septem-
ber 29th,  1827.
  "Dr. Gibson says, he has found the Panacea succeed
in cases of secondary syphilis, and fail in others; and
adds, ' I have never found the remedy of any service
in scrofula.  In  several cases  which came under my
notice, ptyalism has  followed the use of it.-'  Octo-
ber 25th,  1827."
  Dr.  Dewees' experience  of this  article having been
found  useful,  is limited to "four, or, at most, five
          4 
34
MEDICAL EXPERIENCE.
 cases;" whereas his own practice, in which he has pre-
 scribed it several times, does not, he acknowledges,
 furnish a single case of any decided advantage follow-
 ing  its use.   October 26th, 1827.  Dr. Dewees does
 not state the evidence on which he gave his certificate
 to Swaim; but, it is believed, that not even half of the
 few favourable results now alluded to, had then come
 under his own personal observation."
  " Dr.  Parke's statement, in  his  letter  of Septem-
 ber 28th, 1827, is, that he witnessed the case of Trego-
 main in the Pennsylvania  Hospital; who, after being
 subjected to various methods  of treatment, was finally
 cured  by  the somewhat prolonged use  of  Swaim's
 Panacea.   The disease was  a  very obstinate malignant
 ulcer  on  her hand.  It may be well to  remark, that
 Dr.  Parke's certificate in favour  of the nostrum, was
 furnished on the strength of this single case. It would
 be a subject of curious  inquiry, to ascertain the proba-
 ble number  of certificates to which the practice in a
 large hospital would give rise, in the course of  a single
 year, if the cure of every case of a somewhat protracted
 disease were to lay claim to such  notices.   The valua-
 ble Hospital Reports, published from  time to time, in
 various cities, would then give place to hospital certifi-
 cates, with an effect on the march of medical improve-
 ment, of too painful a nature to be  contemplated." Dr.
 Parke  goes on to speak of two ladies from southern
 States, the melancholy nature and result of which so
totally different from the tenor of his letter, will be
 laid  before the Society in a subsequent part  of this
report, in which it will also  be seen that little,  if any,
 credit  can  be attached to the Panacea as  a remedial
agent in Tregomain's case." 
MEDICAL EXPERIENCE.
35
   ■■' It seems  then, from the testimony of those whose
certificates in  favour of Swaim's Panacea, have been so
much relied on by the proprietor, and his friends and
coadjutors, that nothing is adduced in them,  calculated
to inspire any confidence, whatever, in its use. On the
contrary, Dr. Chapman's having  long since ceased to
prescribe it, and his pointing out cases of its alarming
effects; Dr. Gibson's never having seen it succeed in
scrofula; the constant  failures, when  Dr.  Dewees has
prescribed it,  added to Dr. Parke's inexperience of its
use, are all circumstances, well calculated to deter from
recommending it."
  " The  committee, after  a careful examination of the
evidence, both written and verbal, submitted to them,
respecting the sensible properties, presumed composi-
tion, and curative and  deleterious  effects on the animal
economy, of Swaim's Panacea, are led to the following
conclusions and opinions.   The syrup, when  free from
any mercurial preparation, not  only  fails  to exhibit
virtues as a curative agent, superior to various com-
pound decoctions and syrups of sarsaparilla, which
have  been administered  in  the  regular practice  of
medicine for  the last  two  hundred and fifty years, in
the different stages of  syphilis, and in chronic rheuma-
tism and  cutaneous complaints, but is inferior in effi-
cacy to some of them, as well on account of  the varia-
bleness of its  composition,  as from the occasional loss
of the medical properties, and  the adulteration of cer-
tain articles entering into it."  p.  24.
  It is a matter of deep  regret to the  committee, as
they are  well  assured  it has long  been to  the Society,
that circumstances should render it necessary to enforce 
36             MEDICAL EXPERIENCE.

a position, the truth of which has always been admitted
by thinking men in every profession, and which was
received as an axiom among physicians.  A hope, may
now, however, be resonably entertained, that although
the correctness of the general  principle has not, as in
former  times, carried  with it entire  conviction,  the
direct  specification of facts  will,  in  future, produce
unanimity of sentiment among medical men, notwith-
standing the partial aberration into which some of them
may, in a moment of misplaced good nature, have beer-
betrayed.   The time  is now come, or more correctly
speaking, the necessity is as urgent as ever, for a line
of demarkation to be drawn  between the advocates of
empiricism, with all its unavoidably attendant train of
evils, and the rightful  members of  a liberal profession,
the friends of learning and of science.  What physician,
who retains the high conscientious feelings of his noble
calling, will subject himself to the imputation of con-
niving with error for the wages of imposture; or, will
be the  eulogist  of empirics and  empiricism,  console
himself with the hard alternative of escaping judgment
of corruption,  at  the  expense of his understanding;
even though an observing world should allow him the
option  of his sentence?'-*  p. 26.
  1 cannot dismiss the consideration of this particular
case—so pregnant with cogent proof of the fallacy of
testimony, and so apposite in the lesson it should  im-
part, of the  imperative necessity of great  intellectual
caution in too readily rushing to premature conclusions,
in reference to the powers of  any remedy from  a very
limited personal trial of its curative efficacy,—without
an expression of high regard for the sentiments, quoted 
Medical experience.
37
above.  And when it is remembered that such men as
Horner, Harris,  Klapp, Meigs  and Bell,  constituted
the  committee which  made  the report;—physicians
whose high reputation in the profession, and honourable
bearing, and courageous consistency in the discharge
of the responsible duties of that  profession, are known
and  recognized by the faculty  throughout our coun-
try,—when such ornaments and firm pillars of medical
science, attach their names to a publication, we have
ample warrant of the justness of the opinions, the cor-
rectness of the statements,  and the elevated  medical
morality, pervading its entire body.  And a  careful
perusal of the Report most emphatically confirms the
preconceptions,  which  a  bare  announcement  of  its
authors would  create.   May  the spirit of a vile, de-
grading, and  ruinous charlatanry be rebuked by this
Report, and may every cultivated and honest physician
through society,  maintain  an  impregnable  position
against  the encroachments  of  quackery;—refusing,
most resolutely and pertinaciously, any participation in
its spoils, and making every effort, consistent with the
purest ethics, to put down all the machinations of such
imposture!  To do this most  effectively, every physi-
cian  who regards his character and standing in  the pro-
fession, should refuse'consultation  with any nostrum-
vender, or pretender to secret remedies, and  hold  all
such in low estimation, who  do consult with such im-
postors.
  4.  Ambiguity of Language —This is an exuberant
fountainhead  of error in every species of  intellectual
inquiry.  Accurate language subserves, in  our profes-
sion, three important purposes.  First, as an  instru-
                        4* 
38
MEDICAL EXPERIENCE.
ment of intellectual analysis.  Secondly, precision  of
expression affords a medium for distinctness of thought,
like  a  clear atmosphere  gives the eye the best oppor-
tunity  of perceiving the  exact outlines  of bodies.
Thirdly;  accuracy of language is the only  sure inter-
preter of perspicuous views; for  imprecise and indefi-
nite  language is always the result of a clouded and con-
fused comprehension of a  subject.   It would be well
for every young man, who is preparing for the practice
of medicine, to read over most carefully Locke's admi-
rable chapter  on the necessity for clear  and  accurate
expression as  the  elucidation of  truth.  For  says that
great man, the want of a precise  signification  in words
is the cause of  very obscure  and uncertain  notions.
There are two words of great  currency in the profes-
sion which  will  afford an  apposite illustration of the
ambiguity of medical language.   These words are con-
gestion and sympathy.   It is apparent that the words
congestion and sympathy  are generic; that they are
similar to the word inflammation, which comprehends
several species of diseased 'action.   Whenever, there-
fore, such generic words are employed to convey ideas
relative to a species, or a variety, they are misapplied.
Thus,  without pausing now to examine the correctness
of the pathological views involved, when we read  of
congestion of the brain, or liver,  or lungs, do we
acquire from such indefinite language any  exact and
precise views  of the condition of the affected organ ?
Such fashionable words do little in conveying accurate
impressions to the reader's mind.   Like general reflec-
tions they can  never elucidate practical points in medi-
cine.  The writer  must enter into detail, and do much 
               MEDICAL EXPERIENCE.             39

by circumstances.   Nothing  can  elucidate but what is
pointed.  Every remark must particularize and specify.
The eye may take in a large range, but the mind is
affected by  inspection.   We must  descend  from  the
brow of a hill, and come down to certain spots  and
objects.  The science of medicine can never be much
benefited by such general, diffusive, and indefinite  lan-
guage as that employed by many writers.   Thus when
they have designated a fever congestive, or when they
have ascribed the origin of a disease to  sympathy, or
have traced all attacks of febrile affections to inflamma-
tion in the stomach,  they seem  to imagine  that their
task is finished, and that they have completely satisfied
the reader as  to  the pathology  of  the  disease.   But
what precise  views does he derive from such language?
The great advantage, to the writer at least, of such
language is,  that it saves  all further difficulty  in his
description of a disease.  But the reader is completely
beclouded in his apprehension of the pathological  con-
dition  of the suffering organ, when he is told that it is
congested.   What is congestion?  he is ready to inquire.
This I will endeavour to answer before this discussion
closes.
  5. False  Theory.—It is a well established fact that
some of the  most erroneous theories in medicine have
originated from men, who professed to despise theory.
And those men who are most addicted to expressions
of  contempt  against reasoning  in  medicine, are the
most disposed to  indulge in crude speculation.   And
the cause of this is obvious;  it  springs  from too ex-
clusive reliance on their  own individual experience,
apart and independent  of that accumulated wisdom of 
40
MEDICAL EXPERIENCE.
 ages to be found in books.   " To think is to theorize,"
 is a proposition not to be successfully controverted.  So
 deep in man's intellectual nature is laid that disposition
 to account for phenomena, on which all philosophy is
 built, that he cannot be induced to forego the gratifica-
 tion it affords, under any condition of his being.  The
 employment of reducing truth to its element, is one of
 the most gratifying and useful occupations of the mind.
   The luxuriant growth of our science, from the multi-
 tude of facts which have been collected by its assiduous
 cultivators,  demands  that comprehensive and accurate
 principles should  be  deduced from its many and  insu-
 lated particulars.   It is the object  of correct theory to
 reduce the  multifarious appearances of  disease  to sim-
 plicity and order.   In the present state of our science,
 there is  an  imperative necessity for the exercise of an
 inquisitive and powerful reason, to remodel and arrange
 the facts that are  already ascertained, and  to trace  up
 the analogies which run through diseases to some gene-
 ral principles.   Thus we shall  be enabled  to make a
 discriminating survey of the miscellaneous variety  of
 particulars which are placed beneath our observation.
 To frame a  correct theory we must keep in mind the
 remark of  a distinguished  medical teacher—" Medi-
 cina neque  agit in cadaver  neque  repugnante  natura
 aliquid proficit"—that  medicine will  neither act  on a
 dead body, nor will it act on a living  body, in a way
 contrary to the laws of the animal organization.  It is
 from an utter forgetfulness, or contempt, of this essen-
 tial principle that  the science has been  infested by so
 many chemical and mechanical theories.   The humoral
pathology rested on a  fallacious and shallow conception 
MEDICAL EXPERIENCE.
41
of the laws of life.   The nervous  system,  which con-
stitutes  the living being in  contradistinction to the
organized dead mass of animal matter, was overlooked,
its structure was disregarded, and its laws unobserved.
  But as the sun of medical science has ascended, the
mists which hung around the path of improvement are
disappearing.   In exact proportion to the spread of
correct views on the anatomy and physiology of the
body has been the retreat of the  humoral pathology.
Instead of physcians speaking in unintelligible language
of lentor, and alkalescenc)7, of fermentation  and concoc-
tion, and of virus floating in the blood, we  hear of cor-
rect statements of symptoms, and of the actions going
on  in the solids.   What has humoralism ever done for
medicine?   It has retarded  its march, it has shut up
the avenues to its  successful cultivation, and deterio-
rated the genuine spirit of correct investigation.
  To particularize.  Scrofula was  once attributed to a
vitiation, or depravity of the fluids, and the treatment
was empirical in accordance with  such  an erroneous
pathology.   Since  the  renunciation of this erroneous
pathology,  and the adoption  of a  correct view of the
disease as one of the solids, the treatment has been esta-
blished on scientific principles. And  so it  has  been
with gout, rheumatism, syphilis, small-pox and several
other affections.
  Dr. Armstrong's popular doctrine  of congestion is
founded on wrong views  of anatomy and physiology,
and is therefore untenable.  Indeed at  page 288 of his
work on Typhus, under the head of common continued
fever, we have an admission that congestion and inflam-
mation are  the same.  " The action  of one  artery," 
42
MEDICAL EXPERIENCE.
says he, " I have never known greater  than that of
another, and what we call increased action is, I suspect,
merely  increased accumulation; and  what we call in-
creased  determination is,  I also suspect,  merely an
increased volume of the vessels, arising from  an impe-
diment  to the return of  the blood from the quarter to
which those vessels lead."  And at page  159 of his
Essay on  Pulmonary Consumption he makes the same
admission of the oneness or identity of congestion and
inflammation.   " It  necessarily follows that when the
energy  of the heart  and arteries is  much diminished,
that they cannot maintain the natural current of arterial
blood, and of course a proportionate accumulation takes
place  in the veins; and this venous congestion appears
to load and stimulate the capillaries of the arterial sys-
tem by retarding the return  of the blood  through
them."   Four widely different  pathological states of
the system may be mistaken for congestion.
   1st. Sympathetic derangement from worms; or in-
gesta  in the alimentary canal;  or from uterine irrita-
tion giving rise to hysteria.
  2d.   Constitutional irritation  from surgical  opera-
tions,  loss of blood, or severe burns.
  3d.  Suffocated excitement, or such an intense degree
of action  as to overwhelm the powers of life.  This
often occurs in the yellow fever.
  4th. Collapse of the powers of life in the last stage of
fever.   Dr. Potter, in his edition of Armstrong, admits
that "the  symptoms so  formidable  at   the  close of
fevers are  often nervous only, and the seeming conges-
tion of as much importance as they are in hysteria."
  The Broussaian  pathology of fever is amenable to a 
MEDICAL EXPERIENCE.
43
just  objection  an account  of  its generality.  It is  a
recommendation to many minds, not disposed to scruti-
nize, that such pathological  views involve no  laborious
process of thought, and demand no extensive examina-
tion.   They are  light and portable, easily transferred
from the  author's page to the reader's comprehension.
The memory alone is exercised in their reception.  To
remember that every case of fever is nothing but con-
gestion in the liver, or a  gastro enteritis,  is quite  a
compendious mode of arriving at a  knowledge of the
pathology of a class of diseases, whose history, nature
and practice  have tasked the mightiest intellects of our
profession. And then the by-cut; the saving of thought;
and  the  fallacious facility  it  gives  to  practice!   The
allurement held out  by the simplicity of Brown's sys-
tem  enraptured, for a while, the  medical world,  espe-
cially the younger  members of it.   Dr. Rush's  unity
of disease rose with overpowering  lustre  above all
other views  of pathology, but it has long since  fallen
" like  an  exhalation in the night,  to  rise no  more,"
unless  Broussais' gastro enteritis, or Armstrong's con-
gestion, assume its guise, and  limp after it in awkward
imitation.
  Without a correct knowledge of the laws  which
govern the  animal economy,  it is at once apparent to
the discerning  mind that medicine,  as a science of just
philosophy, can never attain either stability in its doc-
trines,  or  certainty in the means which  it may suggest
for the cure of disease.
  No just and comprehensive views can be entertained
of morbid action, by the physician who is ignorant of
the physiological actions of the human structure.  We 
44              MEDICAL EXPERIENCE.

may safely  infer, therefore, that the ancient doctrines
of the four elements, and of their corresponding tempe-
raments, of the separate functions  of the vegetative,
sentient and animal spirits,  which were prevalent  in
the schools  of medicine from the time of Galen to the
middle of the seventeenth century—never could guide
to an enlightened  analysis of the symptoms, and con-
duct to a just conception of the nature of either func-
tional or structural disease.
   The  superstitious regard paid to antiquity, by some
learned, but feeble minds in our profession, is in  sad
contrast to the animating spirit of improvement so dif-
fusively abroad in the general mass of every civilized
society.  "Antiquity," says Bacon,  "deserveth that
reverence  that  men should make a stand  thereupon,
and discover what  is the best way; but  when the dis-
covery is well taken, then to make progression.  And
to speak truly,  'Antiquitas seculi, juventus mundi.'
These times are the ancient times, when the world is
ancient, and not those which we account ancient ordine
retrogrado, by a computation  backward  from  our-
selves."
  To go to  our ancient predecessors for a true patho-
logy of disease, or the most successful mode of cure,
would be, to  borrow a striking  figure  of Cabanis, to
imitate the two  sons of  Noah, who went backward to
cover their  father's nakedness;  thus manifesting their
filial piety, and  at the same time evincing that the act
involved some  degree  of humiliation on their part.
Shall we attempt to follow the eclecticism of Boerhave,
and thus, instead of one error of our own origination,
amass together in  a heterogeneous incorporation, the 
MEDICAL EXPERIENCE.
45
fallacies and follies of the most opposite sects ?  He is
designated as a very candid eclectic—and truly he well
deserves that title, if truth is to be sacrificed to autho-
rity, and antiquity is to take precedence of observation.
He borrowed from Bellini, the doctrine of obstruction,
and with that error mingled from the same most astute
genius, the fallacy of lentor, which  Bellini had taken
from  the Cartesians.  From Sylvius de le Boe, the
archchemical pathologist, Boerhave derived the ridicu-
lous figment of acid and  alkali in the blood; and from
the Galenical theory, he took the doctrine of plethora—
and  thus the  mechanicians, cartesians  and chemists,
not furnishing to this eclectic error  and folly, enough
from which to fabricate a composite structure of idle
and illusive explication of  the nature  of disease, the
venerable Galen must be called on for  aid, to help out
the scheme.   We fancy  that we  hear the grave and
most  renowned Boerhave soliloquizing, and thus ad-
dressing the manes  of Bellini, de Boe and Galen,  in
the words of Prince Hal to Hotspur:
             " All the budding honours on thy crest
         I '11 crop, to make a garland for my head.

But that garland has withered, and so may all such false
medical doctrines perish, amid the  light and glory of
advancing science!
  The theory of his medicatrix naturae,  as enforced and
relied  upon by  some authorities, partakes much  of
the mystical  jargon of Stahl's Anima  Medica.  Dr.
Cullen had  the penetration to perceive this, and the
candour  to  acknowledge it.  "1 might," says that
great man, " go further, and show  how much the atten-
           5 
46
MEDICAL EXPERIENCE.
tion to the autocrateia, allowed of in one shape or other,
by  every sect, has corrupted  the  practice  among all
physicians, from Hippocrates to  Stahl.  It must, how-
ever,  be sufficiently obvious; and I shall conclude the
subject with observing, that although the vis medica-
trix naturae must,  unavoidably,  be  received  as a fact;
yet, wherever it is admitted, it throws  an  obscurity
upon  our system;  and it is  only where the impotence
of  our art  is very manifest and considerable, that we
ought to admit of it in practice."*
  There are three very important admissions in the
above passage, which should forever banish the doc-
trine  of the vis medicatrix naturae, or autocrateia, from
medical philosophy.   First, this  doctrine has  corrupted
the practice of medicine among all  physicians.  Se-
condly,  it throws  an  obscurity upon  the  system of
medical science:  And,  thirdly, it should not  be re-
ceived, except in cases of such utter imbecility in our
resources to conduct  the treatment of disease, as to
demand the interference of such a deity.  But Horace's
rule,  nee deus intersit, nisi  dignus, &c, would apply
here  with great force, and lead  us  to  exclude all such
vain and shadowy speculations.
  The doctrine of the corruption of the blood in dis-
eased states of the economy is amenable  to  one unan-
swerable objection—this corruption  has never been
demonstrated.   It  is surely not  logical to contend for
the possibility  of a  thing which has never been proven.
We are not, as medical philosophers,  to establish any

  *  Thompson's edition of Cullen's Works—Introductory Lec-
ture—vol. 1st, p. 406. 
MEDICAL EXPERIENCE.
47
of our views of morbid action on mere possible contin-
gencies.  Cullen confesses that  " these possible changes
of the fluids  is seldom understood, and more seldom is
it known when they have taken place; that our reason-
ings  concerning  them  have been, for the most  part,
purely hypothetical,  have contributed therefore no-
thing to improve, and  have often misled the practice
of physic."
  The above concession  of this erudite teacher of medi-
cine bears Sir Gilbert Blane out in the declaration  that,
" the whole of the humoral pathology rested on a  falla-
cious and shallow, though  specious foundation."
  A  boundless  terra  incognita, as I  have stated in
another place,* is presented  by the mass of circulating
vital  fluid, contained in the arteries and veins of the
animal  machine,  which  our  fond visionaries   and
romance writers on medicine have peopled with every
variety of direful foes, to the weal of the body.  Some-
times animalcula  are  made  to  sport in cruel triumph
along the conduits of life; at other times,  the blood
is wrought into  woful chemical changes, and is thick-
ened  into a dark spissitude or lentor, or thinned into a
mere cruor,  according  as the mind of the medical
novelist  is  troubled with "thick  coming fancies," or
is  elated by etherial visions.   One will gravely write
by  the hour,  of impregnations, foreign infusions,  and
certain mysterious, but  yet  unappreciable changes in
the vital fluid.  Another will dwell with infinite com-
placency on the horrible blackness of the blood, which

  * Harrison  on Cholera—Baltimore Medical and  Surgical  Jour-
nal* July 1834. 
48
MEDICAL EXPERIENCE.
he finds dark as Cerberus, and fit only for congestions,
collapses and death.  But a still additional writer shall
entertain his readers, very little at his  own expense of
research, by expatiating over the ground of an ill-defined
and misty space, from which he imagines he descries in
clear perspective, both territories  of  humoralism and
solidism.   Such a ready scribe speaks you fair, and tells
you in grandiloquent phrase, of the possibilities, nay,
absolute probabilities, of the blood becoming corrupted,
and refers you for proof, not to the chemical  analysis of
any poisonous products found in the circulating mass, but
to the experiments of some gentle vivisectors, who veri-
tably force, by their torturing process, foreign materials
into the blood vessels.  Medicine is called by these gen-
tlemen, a demonstrative science—aye, they emblazon it
by the proud titles of an inductive and certain science,—
a department of human knowledge, requiring at each
step of its  glorious march to ultimate perfection,  a pre-
cision in the collocation of its facts, and a fixedness in
its positions, that can never be impaired by the revolu-
tions of time.   Fond conceit  ! Is not instability written
on the face of our science, and shall they who yet foster
the prejudices of the past, in favour of a doctrine that
never has  been proved, idly dream  of the ultimate
achievements of truth over error,  when they are en-
gaged in rebuilding  the crumbling fabric reared in the
dark  ages  of   human  knowledge!  We demand  the
proofs—we  require, before we give our  belief to the
undigested doctrines of  humoralism, to see something
like a rigid  and scientific  appeal made  to analysis and
demonstration.   Who  ever  appeals to  the  chemical
changes of  the  elementary constituents  of the blood, 
MEDICAL EXPERIENCE.
49
either during life, or after death, for evidences of the
state of morbid action  that may be present, or has left
its ravages behind?  It is  evident that an incalculable
amount of false experience in medicine, must have been
reared upon the conceptions of disease, and the  modus
agendi of remedial agents, adopted by the defenders of
the humoral doctrine;—such  conceptions,  in the lan-
guage of Cullen,  having  contributed  nothing to  im-
prove, and having often misled the practice of physic.
  Andral, who, to a very limited extent, is a humor-
alist, candidly avers, " that in the present state of the
science,  it is the part of a sensible man not to adopt the
doctrine of humorism too lightly, by judging from facts,
many of which require a re-examination before they
are finally admitted, and that  we ought to  be particu-
larly on our guard against being in too great a hurry to
make practical applications of it."*
  A doctrine so mysterious and impracticable,  which
must  be thus guarded,  limited and  dreaded, lest we
rashly employ it for  any useful practical  purpose, can-
not, surely, derive its  existence from correct and  en-
lightened experience; and  therefore, if we desire to see
the reign of a just philosophy extending its healthful
protection  over the science of medicine,  wre should
renounce a scheme of explanation of disease, which is
not founded  on sound observation,  and  which  exerts
such  dubious,  if not dangerous, tendencies over  the
practice of our art.
  Methods of acquiring true experience.—There are
two main sources opened to  us for the attainment of

             * Andral's Anatomy, vol. I. p. 419. ;
                          5* 
50
MEDICAL EXPERIENCE.
true experience in medicine.  The one direct, emanating
from our own personal observation;  the other deriva-
tive, flowing from the testimony of others.   It requires
but  little reflection  to  convince the most obtuse mind
that the last is the most copious and opulent source; that
standing on that elevation we see centuries  placed be-
neath the eye, little  names are obscured,  things are ad-
justed  to  a true point of comparison, and the glaring
colours of present fashionable doctrines are effaced. To
this point nothing should ascend but the spirit and true
quality of medical truths. The science of medicine may
be divided into principles and practice.   Although for
the purpose of a more easy and perspicuous  discussion,
such a division may be adopted, yet as a useful and ne-
cessary art which is  constantly operating on  the dearest
earthly interests of society, such an arbitrary separation
between the principles and practice should not obtain.
True experience is founded on a close union of the two;
for without  principles medicine  is but a mechanical
trade,  and without practice those principles  degenerate
into idle speculations.  What  is so frequently called ex-
perience, deserves not that appellation.   The wise only
profit  by experience, is an adage that receives its most
emphatic illustration in medicine.   A  man ignorant of
the fundamental principles of the science, and incapable
of reasoning in a correct manner, may grow gray in the
practice, and remain ignorant of the most important
truths.  How often the hoary head of inveterate error
occupies the chair of authority,  which wisdom alone
should fill.  The most profoundly ignorant of medicine
are often those who have paced along the deep worn
path of routine  for  near half a century.   A thorough 
MEDICAL EXPERIENCE.
51
indoctrination of the principlesof medicine; an extensive,
accurate, and profound medical erudition, are absolutely
demanded to qualify men to acquire knowledge from
their own observations.  In vain are facts presented to
the eye of one ignorant of the principles of our science;
he is not capable of perceiving their import nor of de-
ducing  from them those corollaries which will guide
him in future cases.  There are no two cases of disease
which  bear an exact veri-similitude  to each other in
every respect.  The endless varieties observed in dif-
ferent patients suffering under the same malady, arise
from difference of constitution, diversity in  modes of
life, from the distinct nature of the exciting cause, and
from the peculiar emotions which may at the  time agi-
tate the mind. To prescribe, therefore, the same reme-
dies for the same  disease without a due inquiry into the
state of the system, merely because they were success-
ful in another patient, is rank empiricism. A perception
of analogy and contrariety must guide the practitioner
in all new cases.   Possessed of an accurate knowledge
of  the  structure  and functions of the healthy human
body, and having acquired from his  derivative  experi-
ence a  just conception of the nature,  symptoms and
treatment of the species of disease,  to which the case
under  his  observation belongs, the physician is  well
prepared to administer, not for the name of the malady,
but for the state of the system.
   There are three modes in which the  mind acts in its
acquisition of true  experience, from personal observa-
tion.   By the spirit of observation it collects the ele-
ments of judgment;  by the force of its judgment it
incorporates those elements, and by its creative energy 
52
MEDICAL EXPERIENCE.
it models and realizes new  and felicitous combinations
of thought.  The spirit of observation is the messenger
of reason,  sent out before  to explore and  prepare the
way: by it we penetrate into the phenomena of nature,
and by the judgment and creative power of the  mind
we appropriate all that is gathered by  observation, to
the  formation of a calm  and  contemplative  turn of
thought, which  is not  easily misled by the glare of
novelty, nor seduced by  the erring lights of a false ex-
perience.
  By what  preparatory steps, then,  shall  the mind be
best qualified to profit by clinical observation ? In an-
swer to this question I reply, that it is,  1st. By a care-
ful sedulity of effort in obtaining correct views of the
anatomy and physiology  of the human system.  2d. By
ascertaining from books and lectures  an  accurate know-
ledge of remedies.   3d.  By deriving experience from
the  testimony of judicious writers  and  lecturers on
medicine.
  The science of  medicine, being the result of the ac-
cumulated  knowledge of  many cultivated  reflecting
minds,  must be  digested and arranged in accordance
with a just order  and perspicuous method,  that it  may
become attainable by those, who may addict themselves
to  its study.  It has, as a physical science,  nothing di-
rectly  to do with the knowledge of reasons and  their
conclusions, which constitutes abstract  science; but is
exclusively conversant with the investigation  of causes,
and their effects, and of the laws  of nature.   Whatever
may be the value  of the abstract  sciences, the objects of
which are those primary  existences and  relations,  such
as  space, time, number, and order, and  those artificial 
MEDICAL EXPERIENCE.
53
symbols, which the intellect creates, as representatives
of its own conceptions, in disciplining thought, in de-
veloping the capacities of reason,  and  in  imparting
accuracy and  precision to the communication of our
ideas, still medicine owes little or nothing to the direct
lights of the abstract sciences.
  The foundation  of  all correct  medical and surgical
knowledge is anatomy.  Disease is the product of dis-
ordered action in the living moving powers of the body.
Disordered  action cannot  be understood without  a
knowledge of healthy function; healthy function cannot
be understood without a correct knowledge of structure;
and  structure cannot  be  understood without investi-
gating the anatomy of the system.  The disordered
movements of function can only be controlled by touch-
ing the springs of life.  From the composite mechanism
of the human body, and from  the concealment of that
mechanism from common observation,  it requires an
assiduous examination of the interior structure of each
organ, vessel, nerve and tissue, in order  to understand
the  relative situation  and connexion, the nature and
operation of the  various parts of the frame liable to dis-
ease.  In the pervading agency of the circulation, and
the dominant influence exerted by the nervous system
on  all the actions of  life,  we see  the  immeasurable
importance of a correct knowledge of these  two  great
systems,  in  order understanding^'  to  administer to
cases  in  which they  are involved in  disease.  And
what  disease is  there  in which  they are not  in-
volved? Let one  illustration suffice.  When the liver
is diseased there is often pain at the top of the shoulder.
How is this to be  accounted for by a man ignorant of 
54
MEDICAL EXPERIENCE.
anatomy?  Such a man knows nothing of the  right
phrenic nerve which sends a branch to the liver, nor of
the third cervical nerve, from which the phrenic arises,
distributing branches to the neighbourhood of the shoul-
der; thus establishing a  nervous communication  be-
tween the shoulder and liver.   Disease  of the  liver is
sometimes treated by ignorant physicians as rheumatism
of the shoulder.
  To the surgeon, anatomy is all in all.  It is what Ba-
con called knowledge in general;  it is power in every
sense of the word—power to prevent, power to allevi-
ate,  and power to save.  Without anatomical know-
ledge,  the surgeon is like a mariner on the sea without
compass, chart,  or the stars of heaven to  guide him in
a stormy night.   The great improvements in surgery
have invariably proceeded from the best informed ana-
tomists.  Surgery has risen  to  the certainty and per-
fection  of its present condition by the cultivation of
anatomy.  John Hunter, the light and glory of English
surgery, was the greatest anatomist of his  age.  Philip
Syng Physick,  the light and glory of American sur-
gery, received his elementary knowledge  in anatomy
from Hunter.
  The  diffusive lustre of French Pathological  and
minute Anatomy, has shed the rays of a better philoso-
phy on clinical experience.   Commencing with the
powerful and penetrating genius of Bichat, it has gone
on to a more  exalted  position of usefulness.   The  phy-
sician who is ignorant of the researches of Bichat, and
of the  other  authors  who  have written on minute and
pathological  anatomy, is  ill prepared  for profiting  by
his own observation.  Such a one is destitute of the 
MEDICAL EXPERIENCE.
55
true elements of a correct clinical experience.  He is
like a  man who attempts to construct an edifice with-
out a knowledge of the rules of architecture; or like
one who essays  to solve an algebraical  problem when
he has omitted one of the elements of the calculation.
  It is absolutely required as a preparation of mind for
the obtainment of a  sober experience of the remedial
power of the different  articles of the materia medica,
that the physician should  be versant in the history of
the science.  History is philosophy teaching by exam-
ple.  When we read of the numberless articles which
have been obtruded on  the medical world as rare and
effective remedies  in  many diseases—when we read of
the undistinguishing eulogies passed on inert medicines,
and learn the adventitious fallacy connected with the
reputed  experience  which gave them  birth, we are
made wise by such examples, and acquire that philoso-
phical  wariness of mind which leads us to listen with
some considerable degree  of scepticism  to the accounts
given  of any  new and  extraordinary medicine.  The
history of the materia medica  is little else than  a his-
tory of  false experience.  The stream of  time has
washed away  the  dissoluble  reputation of the   great
majority of articles once held in high estimation.  A
few are seen standing erect in the flood,  and upon them
is affixed the sure seal of an approved experience.
  Amidst the  wide spread triumphs of the art of print-
ing, it were a superfluous task to attempt any commend-
ation of the inestimable  value of that transmitted expe-
rience, which  we find recorded in books.  Medicine is
as deeply indebted to the art of printing for its present
elevation and usefulness as any other tentative and pro- 
56             MEDICAL EXPERIENCE.
 gressive branch of knowledge.   Cicero said, that the
 man who knew nothing of the past by reading, was
 always a child.  And so it is in medicine; the physi-
 cian who is uninstructed in the history of his science,
 and who expatiates on his own-narrow field of observa-
 tion, without deriving any light from his predecessors,
 or cotemporaries  in medicine,  is likely to  remain a
 child in true experience all his days.   To be sure he
 may have all the confidence which a true  experience
 should alone give, yet it is the blind assurance of igno-
 rant  arrogance,  not the  firm  dignity  of  conscious
 acquirement.
   True experience does not always grow with the pro-
 gress of years.  In many instances advancing years but
 confirm the decisions of prejudice, and add  strength to
 the presumptuousness of ignorance.  Neither does the
 multitude of patients which a physician may  be called
 to attend, necessarily enlarge his views, or  add to the
 vigour of his judgment.  It is not the number of cases
 which a physician sees, but the degree of careful analy-
 sis which he makes of those which are submitted to his
 inspection, which constitutes  true  experience.  What
 is it that distinguishes the observing traveller  from the
 undiscerning one ? They both visit the same spots, and
 yet one will only tell you of things which interest  you
 not, whilst the other, by leading you through the region
 of life and manners,  will invigorate your intellect, and
send a  refreshing  influence through  every  recess of
thought.  And what is it that made a Newton see an
apple fall with a  different eye from the millions who
had witnessed the same phenomenon before?  It  was
the power of perception, which dwelt in his inquisitive 
               MEDICAL EXPERIENCE.             57

 and penetrating mind, that separated him so far from
 the generality of mankind.  And what is it that distin-
 guishes the physician from the nurse, but the disparity
 existing in the degree of their mental cultivation ?  The
 nurse is in possession of the same senses by  which the
 phenomena of disease are  discerned as the physician;
 and yet the pure emanations of an enlightened reason
 and a true experience, are the  product of the observa-
 tions, and of the theoretic views of the one,  whilst the
 gross and vulgar apprehensions of the other seem more
 like the limited, instinctive perceptions of  the lower
 animals.
   To the  formation of a sound discriminating judgment
 in practical  medicine, there can  be no substitute for
 clinical observation.  Whatever attainments the stu-
 dent may make in anatomical, physiological, and patho-
 logical knowledge, still he must have his  faculties exer-
 cised at the  bedside, to enable him to acquire  a just and
 useful  experience in the art of curing disease.   There
 can  be  no substitute  for this most  essential mode of
 gaining a knowledge of the symptoms  and nature of
 the various  maladies  to which  the  human economy is
 subject.   All other acquisitions are only preparatory
 to the  acquirement of clinical  experience.  Without
 witnessing  the  diversified phases  of disease,  as they
 reveal  themselves substantially and truly at the suffer-
ing patient's couch, all our attainments, however valua-
 ble as a preparation, are useless as an end. As a termi-
 nating point of practical utility, it is very patent to the
most obtuse intellect, that the  most  accurate  views of
the organization of man's  composite frame,  or of the
laws of healthy action established in that organization,
          6 
58             MEDICAL EXPERIENCE.

or  even of the laws of  morbid action, could  never
impart enlightened views of the symptomatology and
therapeutics  of disease.   No one  can be  a  scientific
physician unless he is intimately acquainted  with the
anatomy and physiology of the body—but neither can
he be a judicious and safe practitioner, unless he super-
adds to all such most necessary preparatory knowledge,
the knowledge of disease as it is derivable from seeing
it—and of realizing its presence and power, and  many
changes,  by an  actual  examination of the  suffering
fellow being, whose system is prostrate under its pow-
erful  agency.   We can  not  insist  too  strenuously on
this point—it is of vital consequence to  the growth of a
legitimate  experience  in medicine—and  without it,
without clinical observation—whatever embellishments
collateral branches of knowledge may pour around, our
art—whatever  most necessary  investigations may be
had into  anatomy, physiology and pathology,  as  these
fundamental  divisions of our science  are  learned in
dissection, lectures and books, yet  at last  the  student
of medicine must acquire for himself, by an exploration
of the phenomena of disease at the bedside, the crown-
ing excellence   of all  useful experience.  Anatomy
must  be  known,  not  merely by a careful perusal of
authors,  or by  attendance on  demonstrations of the
anatomical theatre, but by dissection.   Books and lec-
tures  are well—are  needful—but dissection is better,
and more needful.   Physiology  is more dependent  on
books for its inculcation—but let the student not linger
too long  in  the enchanting  bowers of physiological
speculation.   How much is written on physiological
topics,—and  written with great plausibility and elo- 
MEDICAL EXPERIENCE.
59
quence too—that is the mere bodying forth of a vivid
imagination.  Pathology must be studied in books, lec-
tures, and  by post  mortem  examinations.  It is appa-
rent that as anatomy is dependent on a special method
of inquiry—that by dissection for its cultivation—and
as physiology and pathology, are each to be learned in
accordance with their  peculiar modes of investigation—
so must  a just  knowledge of disease be attained.  We
must see disease before we  practically can know what
are its phenomena, the  fluctuations incident to it, and
the effects wrought upon it  by our remedies.   To ap-
proach the bedside with every advantage for a skilful
exploration of  the symptoms, the student is to be well
grounded in the precognita of the science—these precog-
nita are, as already stated—anatomy,  physiology and
pathology.  Anatomy, both  special and general, as well
as pathological, must be well comprehended before the
inquirer  at the  bedside can stand on sure ground in his
interpretation of morbid phenomena.   And anterior to
a fair construction  of the intensity of the deviations
from healthy action observed in  the  system labouring
under  disordered  and  irregular  movements, the ob-
server must  know what constitutes  physiological ap-
pearances.  But there may be an excessive refinement
in anatomical researches, at war with the results  flow-
ing from the general and  pervading harmony of the
parts constituting  the organism.   Thus let us take the
brain and its  investments for an illustration.  The sub-
stance of the  brain, as an integral mass, may be looked
at in three aspects.  First, the brain; and  in this con-
sideration 1 include the spiral marrow, may be regarded
as the controlling  organ of  all  nervous influence. Se- 
60
MEDICAL EXPERIENCE.
condly, we may consider the  encephalon as the instru-
ment of  mental operations.  And  thirdly, we  may
simply view the brain as the  fountain-head of nervous
influence  to  animal life, or to the organs of relation.
Now it is very clear that either of these views of the
brain may be pronounced just, if not too isolated.   Sup-
pose we contemplate the brain in the first light, as the
controlling organ of all  nervous influence: this view
must be met and modified by the third aspect, in which
the importance of the organ is to be recognized.  For
although  man cannot live without the influence of the
brain, yet the ganglionic system subserves such an  im-
portant purpose in our economy,  as to evince that a
low degree of life can be sustained even in man, when
the functions of the brain are  greatly abridged.  Some
physiologists, more addicted to intangible speculations
than  beseems an inquiry so  dependent  on proof for
substantiation as the question under consideration, have
regarded the brain, to  use an  expression of Broussais,
as an "ontological republic,"  divided off into so many
compartments; and to each compartment, they appro-
priate the residence of a particular faculty of the mind.
We object to this scheme of explanation of diseases of
the mind, not because it does  not  explain some of the
difficulties in the  way of a correct conception of in-
sanity in  its varied  shades, but  because it pretends to
cover a field which it does not  half occupy; and because
it leaves out  of its most gratuitous hypothesis  any phi-
losophical reference  to the effects of distant organs on
the encephalon.  Mental aberration is often induced by
irritation of the  stomach, or uterus, or  any important
viscus, or  by a general derangement of the system.  If 
MEDICAL EXPERIENCE.
61
the view controverted, be true, how does one compart-
ment of the brain receive the irritation from the suffer-
ing organ, and not the other compartments ?  There  is
no particular nerve given off from such a portion of the
general mass of the cerebral substance, that could be
the special conveyancer of that irritation ?  Besides, in
conducting  the treatment of insanity, no  such wire-
drawn reflections can conduce to  our safe  guidance
along the path of a judicious practice.   And so with
regard to the other aspects,  presented briefly above, in
which the brain  is to be considered.  Too abstract a
conception of the functions of the encephalon, must not
be  taken in the treatment of disease—they are import-
ant in anatomy and physiology, to simplify the mate-
rials of study, and to  render the perquisition of these
branches of knowledge more  accessible,  but if too
rigidly carried  out  into  our practical  conceptions  of
morbid action, they will mislead.
  The brain and its membranes  are not to  be too  sys-
tematically  and rigidly separated in our investigations
of disease.  Serres has attempted this with regard  to
apoplexy, and has erected a division  of that affection,
upon a supposed disparity of the phenomena  generated
by inflammation of the membranes, contradistinguished
from structural  lesion  of the  substance of the brain.
But his division is not generally regarded as founded
upon just experience.  The immense advantages that
have accrued to practical medicine from minute patho-
logical anatomy should not render us  insensible to the
errors which may spring from a too exclusive study  of
disease through that channel of inquiry.   Symptoma-
tology must  be studied most carefully, but always  in
                        6* 
 62             MEDICAL EXPERIENCE.

 connexion with  pathological  anatomy, and, whilst the
 student of medicine assiduously  strives to  accumulate
 the stores of a scientific knowledge of his profession,
 let him ever keep in mind that at the bed side, in actual
 contact with disease, in the wards of a hospital, or the
 private chambers of the sick, must be gathered the ele-
 ments of a legitimate experience.   The effects of reme-
 dies can be learned only by  fair and repeated trials of
 their virtues in disease.  No analysis of their constitu-
 ent principles can ever assure us of their modes of ac-
 tion in the eradication of a  deranged  condition of the
 vital actions.   Neither can their potency, or impotency
 in disease be known by  experiments upon  the human
 body in health.  Nor can the agency of a remedy in
 any given malady be confidently predicted by our past
 experience of  that remedy in another  dissimilar affec-
 tion.   We should not allow any  a  priori views  to
 darken our observations at the bed side. We must come
 to the study of disease, its symptoms, and the effects of
 remedial measures on its progress, with minds unbiased
 by any preconceptions of the modus agendi of the
 means to  be employed.   Incalculable  mischief is done
 by a violation, reckless and obstinate,  of this obvious
 suggestion of true  experience.   Thus  in  Paris, the
 bright and glorious city of intellectual scepticism and
pride, the astounding anomaly, during the  prevalence
of cholera there, was witnessed, of a total exclusion of
calomel from  the  treatment  of  that  fatal epidemic.
 Leeches, tea,  lemonade, enemata, punch,  iced water,
 and weak coffee—these were relied on  by such men  as
Lisfranc,  Bouilland, Piorry  and Broussais, to  arrest
this  most  fatal  malady;  but calomel—that was  not 
MEDICAL EXPERIENCE.
63
even to be tried;—and why? because these gentlemen
had before trial, and in direct contradiction to the pub-
lished  experience  of  such  men as Johnson,  Orton,
Craigie and  others, determined that calomel was too
irritating, or perturbating for  cholera.   We fear that
popular prejudice swayed  their judgments more than
any reasoning on the subject; for the French seem to
regard calomel in  the light of  a pernicious drug, only
to be used to cure a still viler disease.
  In the examination of disordered states of the  animal
economy, three distinct and prominent points are to be
preserved in all our computations of the degree  of dan-
ger involved in the case.   First, Is the disease  we are
surveying one of functional  derangement,  unaccom-
panied by structural alteration?   Second, Has structural
lesion supervened on disordered function?  And, third,
Has  the functional ensued upon the structural disease ?
The  neuralgic affections, and some cases of fever, are
instances  of  simply disordered function.   Tetanus and
hydrophobia are so likewise, for no satisfactory local
alteration of structure has been  identified as standing in
the relation  of invariable  antecedent to either disease,
in a pathological point.   In many, not all, cases of idio-
pathic fever,  we find, after death, structural disease fol-
lowing constitutional functional derangement.   Severe
constitutional irritation will, upon reaction, induce local
changes of the interior organs.  Burns, especially in
children, will frequently  produce,  just on the  eve of
their cure, inflammation  of the  pleura, or  arachnoid
membrane.
  The phlegmasiae, as well as accidents inflicting injury
on the extremities, are followed by functional  disease. 
64
MEDICAL EXPERIENCE.
Pleurisy, or pneumonia, furnish an illustration relevant
to the above remark.  When therefore we come to the
bed side we must conduct our examination of  the case
with  special reference to the above  considerations.  Is
the patient affected with local  disease—and is  that a
functional one ? Or has he a functional malady termina-
ting in alteration of some organ ?  Or  has  the affection
been  originally a structural  one, and does it now impli-
cate the most important functions ? What is the state of
the head—of the organs of  the  chest—of those  of the
abdomen—in what condition is  the skin—what  is the
degree  of oppression and  debility under which he la-
bours, and how do the remedies administered operate^?
These general  questions must be met,  and satisfactorily
answered in the mind of the practitioner,  before he
prescribes.  Nor must the decubitus, and physiognomy
of the patient be overlooked.  The station occupied by
the medical adviser at the  side of the suffering fellow
being is full of solemn responsibility.   He is  called
upon by  the august  voice  of humanity,  and by the
stern monitions of an enlightened  conscientiousness, to
spare no pains  in the scrutiny exercised by his mind
upon the state of his patient.  Then having satisfied his
judgment as to  the condition and danger  of the case, let
his mind be pregnant with expedients for the mitigation
of pain, the extinction of disease,  and  the prolongation
of life,  thus proving that our art is the handmaid of
nature, in a wise interpretation of her laws, and a sedu-
lous guidance of the actions  of life  to a  restoration from
an irregular discharge  of its  functions  to accustomed
health.
  From what has been said it appears that true experi- 
MEDICAL EXPERIENCE.
65
ence is to be acquired by a careful avoidance of those
sources of error, fallacy, and misapprehension, whence
false  experience springs,  by a well grounded know-
ledge of the elementary branches of medical  science,
and  by  the exercise of a discriminating observation
upon the phenomena submitted to personal inspection.
  But if the physician permits his mind to be preoccu-
pied with any shadowy and airy notions of congestion,
or any   other universal all-embracing,  all-explaining,
and  at the same time vague  and indefinite,  a priori
views, of disease, in vain opportunities, the most ample
and  diversified, of acquiring a correct experience are
presented.
  Such a one sees his predominant image of mind re-
flected in every symptom—all phases of disease are but
the variegated aspects of the ruling figment of his mind,
and like  a man with a calenture on the  brain,  he  peo-
ples  vacuity itself with the creation of his prolific fancy:
or with Wirdig he runs into the extravagance of en-
deavouring to explain every thing in heaven and earth,
and under the earth, by his favourite hypothesis.  Thus
that  erring philosopher asserted of magnetism, "Uni-
versa natura  magnetica est; totus mundus  constat et
positus est in magnetismo, omnes  sublunariae vicissitu-
dines fiunt per magnetismum; vita  conservatur mag-
netismo, interitus omnium rerum fiunt per magnetis-
mum."
  Such a habit of mind converts  knowledge into pre-
judice, and limits every intellectual exercise within the
narrow boundaries of a crude and indigested hypothesis.
Our  ideas should be daily subjected to new develop-
ments, and  knowledge acquired  by past observations 
66
MEDICAL EXPERIENCE.
must be constantly quickened and made prolific of new
trains of thought by incessant  efforts of improvement.
Let us beware of a desire to subsist all our lives on the
acquisitions of a few years study and experience; let us
not exist in a state of mental petrifaction—preserving a
lifeless form of medical experience, without the anima-
ting spirit of discovery, but uniting  the acquisitions
gathered from the past with the accessions of each re-
volving  day,  we shall  rise higher and higher in the
scale of improvement, and  become more firmly fixed
on the ground of true medical experience.
  Should the student of medicine feel as deep an inter-
est in the subject discussed, in the foregoing pages, as
its  inherent merit  demands, he will seek a more en-
larged acquaintance with it.  That such a mental want
on his part may be met, and receive its  adequate supply,
I will refer him to the best sources for information on
this thesis.  The learned Zimmerman  has written two
volumes on  Medical Experience, replete  with much
that is instructive on  various medical  topics, but defi-
cient in direct and obvious bearing on the particular
theme of his inquiry.   The judicious  Cullen has many
just thoughts, in the  introductory part of his  Materia
Medica, on the intellectual wariness  and wise scepti-
cism,  which we should ever  exercise in  reference to
the reputed efficacy of remedies.   Paris has,  in part,
followed Zimmerman in the order of his reflections on
the causes which have impeded the march  of  curative
medicine; but the  train of thought pursued by him is
far superior in practical good sense,  and enlightened
 discrimination to that so tediously indulged in by his
 predecessor.  Sir Gilbert Blane, in his Medical Logic, 
MEDICAL EXPERIENCE.             67
has communicated many suggestions on the subject of
medical experience, which are pregnant with the sound-
est philosophy. Some of his illustrations are inapposite,
and badly selected; but his small work is one of great
merit, being opulent in the copious contributions of a
gifted and cultivated mind.   Dr. Abercrombie, in his
work on the Intellectual Powers, has given some excel-
lent rules  by which the medical  student should be
guided in his investigations.  There are very few wri-
ters in our profession, who possess faculties better dis-
ciplined for the discovery of truth than this distinguished
author.  All that he has written bears the clear impress
of a sound and vigorous intellect, cultivated to a skilful
action of its powers on the rich field of medical know-
ledge.  In an eminent degree he stands equally in con-
trast with an addictedness to impracticable  speculations
on the one hand, and to a blind fondness for the appli-
cation of general rules and deductions on the other. His
distinguishing qualities are patience of labour, sagacity
of observation, sound judgment, and practical tact, with
a pervading spirit of common sense discipline of mind,
binding in harmony, and inspiriting with life, his other
powers. 
ADDRESS,
DELIVERED BEFORE THE LOUISVILLE  MEDICAL
     SOCIETY, AT THEIR ANNUAL MEETING,
                JANUARY 1, 1833.
 Gentlemen of the Louisville Medical Society:
  The economy of human life seems to consist of wants,
 with their correlative supplies, and  of evils with  their
 corresponding remedies.  The  evil of sickness is in-
 separable from our mortal condition, and it becomes a
 want of pressing urgency to seek, in the art of healing,
 for methods of relief.   Among  a rude and uncivilized
 people, this art is limited to a few crude and simple pre-
 scriptions, but in proportion to  the progress of social
 refinement, medicine assumes the dignity of a distin-
 guished science, difficult of  attainment, and  character-
 ized by the diversified application of its means for the
 cure of disease.  Medicine is a  science of well ascer-
 tained  and carefully collected facts.  It is indebted for
its present elevation  among  the  other branches of hu-
man knowledge to the Baconian method of discovering
truth, so successfully pursued in all physical  investiga-
tions.  The art  of restoring  health,  took its  rise in
necessity; the first methods  adopted for relief in  pain
were, perhaps, prompted by instinct; these  were im- 
         ADDRESS TO THE MEDICAL SOCIETY.       69

proved upon as chance suggested the efficacy of other
remedies, after repeated trials of  which, observation
either confirmed, or  annulled, the propriety of  their
further employment.  Analogy aided in  the more ex-
tensive application of the remedial  plans, adopted with
success in simple and common departures from  health,
to morbid affections of rare occurrence, and of more
difficult treatment.  By analogy, likewise, plants, pos-
sessing taste,  smell and appearance similar to those
already in use as medicines, were brought into requisi-
tion, and their virtues tested by experiment.  Experi-
ence, which means nothing more than repeated observa-
tion on the curative measures instituted for the restora-
tion of  health,  is  assuredly  at the foundation of all
successful practice in medicine.  But  then it is an ex-
perience not limited to a physician's own circumscribed
sphere of observation; but an  experience enlarged and
liberalized by study, by reflection,  and  careful compari-
son.  There should be no controversy  on this  point
among  well-informed physicians.   True experience
consists in accurate and correct observation.   A previ-
ous cultivation of mind on the fundamental branches of
medical  science;  a  thorough and well grounded know-
ledge of the  structure of  man;  a comprehensive  ac-
quaintance with the laws which govern  life, with the
modes in which modifications  of vital action ensue from
the impressions, within and without the  system, con-
stantly made on these  laws, are indispensable praecognita
to the acquisition of a true, sound  and  valuable  experi-
ence. But the mental process, the  induction and analy-
sis, carried on by two different medical practitioners of
equal opportunities of experience,  may differ as much
           7 
70
ADDRESS TO THE
as wisdom differs from folly.  Here is the point upon
which, at last, rests all the acquirements of a true ex-
perience in medicine.  For if there be no sagacity,  no
power of penetrating inspection, and of correct infer-
ence, in the mind of the physician, of what avail is it
that he has trod a wide field of  practice,  in which he
has stumbled over the most ample and varied  opportu-
nities of improvement ?  But  to a man gifted with an
original capacity of inquiry, sharpened in its discern-
ment by  a liberal culture of the faculties,  of great
vigilance in the exercise of observation, and of a strong,
and strenuously exerted power of generalization on the
facts before him,  a very short  time may be sufficient  to
supply a large share of the knowledge,, derivable from
experience.  Such a physician will be rich in the bene-
fits of sound experience, and possess the judgment and
decision legitimately  founded on that accomplishment
long before he has attained old age.  Thus exemplifying
the wise  and beautiful remark,  that wisdom is gray
hair to man, and an unspotted life is old age.
   Medicine is neither a finished, nor a perfect science.
It is not finished, because it still admits of an increase
of light, certainty and power.   It is not perfect, other-
wise, no doubts  would be entertained on the nature and
treatment of any disease, which physicians are called
upon to cure. And because it is neither a finished, nor
a perfect science, we are assembled together this even-
ing as a  voluntary association, formed for our mutual
improvement in medical  knowledge.   The  world is
always better for ever}- provocative  to good  thoughts
and designs, by which its intelligence may be aug-
mented and its aims exalted.  And  the science of medi- 
MEDICAL SOCIETY.
71
cine is quickened in  its career of advancement by a
friendly interchange of facts, and an intercommunion of
thought, on medical subjects, between cultivated physi-
cians.  By the shock of fair and enlightened discussion
truth is elicited; facts seen by one  are made known to
other minds, and a deeper interest is created in the ob-
servation and generalization of the phenomena presented
at the bed side of the sick.  As members of a medical
society, we  wish  to  test our opinions and  modes of
practice by the views entertained by each other, and to
receive such accession of facts and views on the  topics
brought up for discussion as to  enlarge the boundaries
of our theoretic knowledge,  and  impart greater cer-
tainty  to  our plans of treating  diseases.  We believe
that we are neither too wise, nor too old to learn.  We
believe that our science needs many contributions from
its members in order *to give more comprehension and
precision  to  its institutes, and to  reduce to order and
system, the contradictory plans employed to restore the
disordered actions  of the  body.  Experience we  re-
cognize as valuable, but in our discussion  on  points of
practice,  there  is  not a  member of our  society who
would  have intellectual boldness enough to set aside the
experience of the profession at large, or erect his own
comparatively slender experience in opposition to that
of the most distinguished men in the profession, both at
home and abroad, who, either are  now alive, or have
belonged  to  past times.  Nor does our desire for addi-
tional light, and our deference for authority, spring
from an entire renunciation of our own opinions.  We
are deeply impressed  with  the  importance of as com-
plete an acquaintance with every medical subject as our 
72
ADDRESS TO THE
opportunities  of observation, our  perusal of authors,
and an interchange of opinion between each other, will
admit, to enable our minds to form the best judgment
at which we can arrive.  A man conscious of the inde-
pendence of his views, who can rely on the  operations
of his own faculties,  is not afraid to receive the opinions
of others.   He listens with attention to what  may  be
advanced, and uses it as counsel, but does not submit to
it as so authoritative as to  suspend the  exercise of his
judgment,  or supersede his reasoning powers.  But he
whose views stand in jeopardy every  hour of  being
confounded by objections,  and who avoids the collision
of other minds,  because his  opinions are liable  to be
driven about by every breath of opposition,  had better
never attach himself to any society in which free, fair,
and fearless controversy is  conducted.  Such a society
affords an  excellent arena on which  the  soundness  of
medical doctrines is tested.  It opens a field for the ex-
hibition of extensive professional acquirements.  Within
its consecrated enclosure there  is breathed  upon each
member a kindling influence to prompt  to  higher ac-
quisitions of medical knowledge.   Each one  belonging
to such a society, who feels the impulses of  a laudable
ambition, and who is embued with the true spirit of the
association,  has strong  desires animating  his  mind not
to appear ignorant in  such a circle.  For he is aware
that  the judgment passed by medical men on  the at-
tainments of a physician is  the only true standard of his
merit.  The motives,  thus derived, do not cease in their
exciting influence, with the discussions of the evening.
They abide in living  constancy, instinct with urgent
aspirings after additional light, during the days which 
MEDICAL SOCIETY.
73
intervene between the meeting. They urge to industry
and diligence in the study of our science, impart fresh
interest to the most common cases of sickness which we
are called to treat, and spread a softening charm over
all the difficulties experienced in our professional course.
By such a society the esprit  du corps is kept alive
among  its members;  by which zeal for the common
honour, they are preserved from a misunderstanding of
each other's character, and from those jealousies which
are such a fruitful source of professional enmities.  We
have  need of every auxiliary motive, not drawn di-
rectly from a sense of our responsibility, to sustain our
unfaltering way amidst the many  and severe  discour-
agements which impede our professional career.
  Every profession is what its  members choose to make
it.  If the  medical  profession  is  filled with ignorant,
conceited, and immoral men, it must soon become de-
graded  in the  eyes of society.  Thus degraded, the
community must  reap the bitter fruits which grow on
such a poisonous tree.  There must be physicians—and
the only question to  be settled by men of virtue and
intelligence is, whether it is best to have  an ignorant,
crafty and dishonest set of medical advisers, or men of
cultivation, of integrity, and of liberal deportment, to
administer to them when ill.   It would seem  that this
question is of easy solution; but the patronage  afforded
vile  empiricism  by men who pass for  enlightened,
throws ominous perplexity on the matter.  Ignorance
is universally conceded to be pernicious to  the welfare
of society. And yet with this general admission, ignor
ance is  every  day encouraged  by the most  extravagant
praise.  Not as ignorance, it is true, but cloaked in the
                         7* 
74
ADDRESS TO THE
bold assumptions, of superior skill,  is it patronized in
preference to knowledge, unaccompanied by that self-
commendation and self-glorification,  which are the cur-
rent language of quackery.   The atmosphere around
us appears congenial to vapours and false  fires.  The
lights of our profession shed a feeble ray on eyes blinded
by the glare of such false fires.  But let us not yield to
the disheartening considerations thus derived.   Let us
be encouraged by every motive drawn from the cause
of humanity, from  a sense of responsibility, and from
the  unbought pleasures of  a  conscientious feeling of
manly adherence to the best of causes.  Pursued in the
legitimate spirit of its high and liberal tendency, medi-
cine is a science of great dignity and importance.  It
connects itself to the best interests of man; is conversant
with the noblest piece of mechanism which God has
framed; enters  into the retirements of sickness,  and
often snatches the victim of disease from a premature
grave.  The enlightened physician is an humble imitator
of Heaven, who sends his  blessings  on the evil and the
good.   Medicine is a liberal profession.  The physician
should  be a man of letters.   Liberal learning ought to
be a constituent of his professional character. Medicine
opens to the intellect, a wide range—a range commen-
surate with man in the most extended relations of his
being.   It is the testimony of  a late most eloquent
writer,* that the medical profession has furnished more
examples of active and enlightened humanity than any
other walk or profession.   Aside from the direct min-
istrations of skill, the enlightened physician  can accom-
• Robert Hall. 
MEDICAL SOCIETY.
75
plish much for the cause of science and humanity. The
examples  of  such  men as Boerhave, Sydenham, Rush
and Wistar, illustrate and adorn the periods in  which
they lived, and send down the stream of time a pure
and refreshing influence to quicken and rejoice  future
generations.  Different departments of physical science
are under great obligations to our profession for their
cultivation.   Chemistry,  mineralogy,  natural history
and natural philosophy, have received many contribu-
tions from physicians.   And medicine can enumerate a
Goldsmith, an Aiken, an Aikenside, a Locke, a Brown
and a Mackintosh, among the constellation of great men
who have delighted and improved the world by their
literary and metaphysical writings. It behoves us there-
fore to esteem our  profession as one of dignity, of use-
fulness  and of commanding importance in society.   If
it fall into dishonour and disrepute, the fault must lie on
the heads of physicians.  Let them watch assiduously
over its character and reputation, maintain its standing
by an honourable  bearing and courageous consistency;
preserve the parallelism of their course, undeterred by
the froward petulance, and vain banter of the superficial,
and scrupulously  avoid every  art of indirection  and
supplantation in order to acquire business.  A resolute
attachment to the higher functions of the  profession is
the best safeguard against that  degrading rivalry  in
money making which inflicts such deep wounds on the
medical character.   An unalterable law of our  moral
nature—a law  of continuity,  or homogeneity, in the
human mind—binds that physician down to a perpetual
conscious  self-degradation, who has spontaneously and
deliberately violated those rules of professional ethics, 
76
ADDRESS TO THE
 which not only rest upon the rectitude and perspicacity
 of an enlightened judgment,  but come recommended
 by the past and contemporary practice among the wisest
 and  best members  of our profession.   The medical
 practitioner who connives at, or in any manner encour-
 ages, quackery to day, will ever retain his own con-
 scious dereliction. He takes his permanent professional
 character from such a humiliation, to which he has
 submitted from considerations  of the grossest self in-
 terest.   On his own spirit he has brought a stain which
 time can never efface.   His mind submissively bows to
 the humiliating terms by which he becomes a pensioner
 on the  bounty of an abused credulity—he sinks to
 the level of his lot, and even accepts and hails the scorn
 that belongs to it.
   When practised in the genuine spirit of its character,
 medicine promotes every generous sentiment of human
 nature.   It brings into play the finest feelings of sym-
 pathy, develops  the  noblest suggestions  of a tender
 concern for human happiness, and fills the mind with an
 untiring  ardour for the discovery and application of the
 most successful methods of alleviating pain,  and re-
 moving disease.
  The importance of our station in  society should be
 felt and acknowledged in the kbeneficial effects flowing
from  our profession,  rather than  in any  ostentatious
mode of  displaying it; and the  consciousness of it, in-
stead of  evaporating  in vain pretensions,  should pro-
duce a still more  assiduous devotion of our time and
concentration of our powers to its improvement.  By
an exalted appreciation of the science of medicine, we
never can promote personal vanity among physicians. 
medical society.
77
From such a high estimate of our profession, we draw
incentives to a modest opinion  of our present  attain-
ments.  The standard  of excellence  being  lifted up
above  the  ordinary rate of  professional  knowledge,
constantly reminds us of our deficiencies.   Thus a per-
vading  and influential persuasion of the contrast  felt
between our acquisitions and the standard we have set
before us,  leads the  mind  to  that philosophical  hu-
mility, which is at the foundation of all sound acquire-
ments.  The physician who does not possess this philo-
sophical modesty, can  entertain no correct conception
of abstract excellence in the line  of his profession.   He,
therefore, cannot  hold converse  with things  greater
than those presented in the limited range of his own
ideas.  His faculties never will stretch  their energies in
an eager and untiring effort  for additional illumination.
A meagre mind is apt  to be filled with the  turgid ex-
pansion of a spurious, affected  greatness.  A habit of
abstraction  liberates the mental powers from that par-
tial aspect and  contracted estimate of the worth,  and
dignity and utility of  the healing art  which so fix the
attention, enchain the  faculties, and  circumscribe the
exertions of many in our profession, that they seem to
regard  the  whole matter  of medical science,  in its
entire length and breadth, in  its fulness  of  varied
research and minuteness of practical application, as of
very easy attainment.   Where others  toil with  patient
force of investigation  to acquire a knowledge  of dis-
eases with  the best methods of curing them, their viva-
cious wits  adopt a more compendious method.   Such
practitioners look on an experience derived  from prac-
tice as constituting the sum and substance  of all medi- 
78
address to the
cal knowledge.  With them books are mere dull repo-
sitories  of theoretic  absurdities, and  all discussion of
subjects connected with the science a waste of breath,
or a shock of adverse and irreconcilable dogmas.  Rea-
soning in medicine  they renounce and hold in utter
abhorrence,  as being  inconsistent with the unerring
decisions of  their vigorous and untrammeled faculties.
From their fancied height of professional infallibility,
they look with pity, or contempt, on  those who are
toiling in the barren  region of doubt, or ascending the
rugged  path of philosophical  induction.  Such men,
perhaps, have gathered up a few crude notions of dis-
ease from such books as Buchan's  Medicine,  and
Thomas's Practice, and these are fixed and perpetuated
in their minds, without the intrusion of other ideas.
The morning sun brings no new  train  of thought to
their torpid  brains, and the evening rays depart, still
leaving them surrounded by the darkness of their
voluntary ignorance.
   The science of medicine consists  not solely  in the
administration of a few remedies for some special cases
of disease, but in a wide and comprehensive acquaint-
ance with the anatomy and physiology of man—of the
laws which govern the living organization—of the best
mode of preserving health, and of warding off attacks
of sickness,  by a correct knowledge  of the numerous
agents which are incessantly  acting  on the system.
The atmosphere,  with its chemical  constituents, and
its various impregnations of  gaseous substances—the
quality and quantity of food—climate in its heat and
coldness, dryness  and moisture—exercise and rest in
their invigorating and debilitating tendencies—sleep in 
MEDICAL society.
79
its refreshing and renovating power—the secretions and
excretions, in  their quality, quantity  or absence—the
reciprocal agency exerted by  the mind and body on
each other—and the dominant control often exercised
by the moral  emotions, either of  a depressing or ex-
citing kind—these  and many other distinct topics of
inquiry are continually presenting themselves to the
mind of the  physician, and demanding of him a careful
and protracted research. These constitute but the alpha
of the diversified points involved in the general consi-
deration of the study of our science.
   In seasons of epidemic visitations of some fatal ma-
lady, the transcendent importance of well-instructed and
humane  physicians  is felt by society.  The boastful
quack, in such a time of panic and distress, like some
bird of prey that hovers over a scene of destruction,  is
true to his  end.  He avails himself of the alarm and
confusion of  such  a season,  and  spreads  wide  the
meshes of his  net to entrap the credulous and unwary.
But the generous and enlightened physician gives up
his mind  to the most anxious thoughts, that he may
arrest  the destructive  march of the pestilence; and  if
his plans  of practice prove successful, he does not con-
ceal them in mystery, but lays them before the public
for their benefit.
   The relation sustained by the physician  towards his
patient would  seem to warrant the supposition that the
perception  of obligation  on  the  part of the sick man
would not soon fade from  his mind. Other  professional
men  advise, but the  medical man  prescribes.  His
authority over his patient  is for the time, ascendant and
complete.  There is an implicitness of acquiescence on 
80
ADDRESS TO THE
the suffering man's part which is not manifested in any
other transaction of life.   Yet how soon does the re-
membrance of services performed by the  most skilful
and humane physician, perish!  With  a waywardness,
not displayed in other things, the medical  man is often
dismissed from his attendance on the  sick, and all his
assiduity is overlooked in the eager quest after some
new physician, whose strongest claim upon public con-
fidence, often consists in the confident averments made
by himself of his superior ability in the cure of disease.
In the " corrupted  passages of this world," I am aware
that it is scarcely possible for a man of the most culti-
vated intellect, and of the most honourable deportment
to be much engaged  in  professional business  without
suffering from the  injustice, caprice,  and  inconsidera-
tion of those with whom he is concerned.  Calm reflec-
tion will teach him not to permit these evils,  so  inci-
dent to a responsible position in society, to agitate and
disturb his tranquillity, or in anydegree to turn him
aside from a persevering prosecution of a useful scheme
of life.  A magnanimous spirit will not be subdued into
a tame and  servile  compliance with wrong modes of
gaining business by the success which  accompanies the
deceptious  pretensions of those physicians, who abuse
and delude the public by the arts and blandishments of
quackery.  Conscious  rectitude,  and  an elevation of
mind which despises such paltry shifts and devices, will
sustain a man in the  even tenor of his way far better
than all the shouts of a misguided public.
  We must allow human  nature the liberty of  some
freaks and  eccentricities in medical matters, as well as
in religion  and government.   Men love the luxury of 
MEDICAL  SOCIETY.
81
delusion, and possess  a strong  appetite for  mystery.
Let them  be indulged  to  some  extent, for they  may
more  easily be exorcised of their delusion, after  they
are filled to satiety, with the diet  with which imposture
feeds  the  credulity  of  the simple.   Various  are the
schemes by  which  empirical pretenders  have  endea-
voured—too  often with  full  success  crowning their
efforts—to raise a reputation, to attract employment,
and to acquire an ascendency over their patients.*  The


  *  "Whenever an individual,"  says an intelligent writer,  in an
excellent  paper published  in the  North American Review, for
July, 1828, " admits and acts upon the  idea, that any other consi-
deration than that of professional knowledge  and worth is to be
the chief measure or means of his success, he becomes accessible
to motives which will almost inevitably lead  into  practices, dis-
honourable to himself and injurious to  others.  While that sound
learning which, in its veiy nature, elevates the character, is ne-
glected, those acts of winning popularity, which as certainly de-
base and disgrace it, are  cultivated in its stead.  He need not be
an old man,  who can remember when it was  the general impres-
sion, throughout a great portion  of our country, that  the  same
course  of preparatory education which was even then regarded as
a necessary preliminary to entering upon the study of either of the
other learned professions, was quite supererogatory in this.   For
our individual selves, though we lay no claim to the honours of
ages, we have heard  in our day a worthy member of a New Eng-
land legislature speak with great contempt of the folly of sending
a young man to attend a course  of lectures, and declare that his
son, who  was to be  a doctor, should go  to a dancing  master to
learn the acts of ingratiating himself with his patients."   *5What
more shameful," says a French writer,  " what more  dishonourable
to science, and yet what more common,  than to see men, who con-
sider themselves in possession of good sense, reposing confidence
            8 
82
ADDRESS TO THE
physician, who possesses true greatness of mind, whose
moral sensibility shrinks from  the defilement  con-
tracted by meanness and disingenuousness, will never
degrade his  profession by such  acts as ignorant, bold-
ness employs  to  recommend itself to the patronage of
the public.   For he is assured, that after all, competent
ability,  inflexible probity,  diligence,  humanity  and
unaffected kindness, are  the sure elements of his cer-
tain future elevation.  These qualities are the brightest
ornaments of  the physician's character, and  form the
best ground  work upon which to build  a lasting fame.
Even should a want of success now attend  his  strug-
gling steps, he will not abandon the firm foundation of
his hope of a final triumph over all the obstacles now
lying  in  his path.  He fears the check and rebukes of
a violated conscience more than  poverty.  Relying on
the goodness of his cause, he feels assured that a  final,
though long delayed, decision in favour of intelligence,
probity, and professional worth, will be made by the
public.  Filled with a   rejoicing  consciousness  that

in mere pretenders to medicine,  who are destitute of logic, and
ignorant sometimes of the first elements  of grammar, under the
ridiculous pretext that such quacks may possess excellent receipts;
and that they have seen them effect wonderful cures!  The more
ignorant and presumptuous a man is, the more he inspires confi-
dence in certain people.  A  physician who has studied  long to
acquire information has nothing marvellous about him-  but the in-
dividual who can hardly speak his native tongue, has the reputa-
tion of knowing secrets which are omnipotent against most disor-
ders; many see in him something wonderful, even supernatural; and
their  confidence is  strengthened by  that which  ought  to de-
stroy it." 
MEDICAL SOCIETY.               83
when the hour of prosperity arrives he will be pre-
pareed to enjoy it with a purer and higher satisfaction
arising from his past course, he calmly awaits a turn in
the tide of events, which will sweep away the unwor-
thy adventurer in physic  from  his present  moorings
into that ocean of hazardous enterprize for which his
spirit was framed.
  Gentlemen, we are surrounded by a cloud of wit-
nesses to  our professional eminence.  The bright con-
stellation of illustrious men, who have died, covered
with  the glory acquired  in relieving  the  sufferings of
human nature, shed on our path their radiant example—
and invite us to a participation of their fame—society,
though at times unmindful of the obligations it is under
to our profession, expects of us a faithful performance
of the duties attached to the  responsible stations we
occupy—the voice of humanity is borne by every sigh
that escapes the sick, and tells upon all the tender cha-
rities of our  nature—the monitions of conscience im-
press us with a solemn feeling of our high  calling, and
the more awful and awakening language which  bursts
from  the skies, resounds in our ears, inviting us by all
the rewards of a  bright immortality, to fulfil the task
assigned us in mitigating wo, obeying the call of dis-
tress, rekindling the lamp of life ready to  be  extin-
guished by disease, and lighting up joy in a circle of
friends, whom the  shade of death, approaching some
beloved object, had  lately covered with sorrow.  Then
will our success be signalized by the tears of gratitude,
the congratulations  of friends, and the raptures of re-
turning health, and with pure and unmingled satisfac-
tion,  we can taste of that divine  felicity which springs
from  the luxury of doing good. 
REMARKS
ON THE INFLUENCE OF THE MIND UPON THE BODY:
     AN INTRODUCTORY LECTURE, DELIVERED
                 MARCH 27, 1827.

   To a Course of Clinical Lectures in the Louisville Hospital.
  Fundamental  to  every process  of  reasoning, there
are primary truths, which being admitted,  without
debate, become  the ground work on  which the whole
superstructure is erected.  Thus in an algebraical pro-
blem, certain elements are assumed; and in our discus-
sions about the laws which regulate matter, we take it
for granted, that  matter does exist, and  that it is
known  by certain properties.   So in reference to the
theme  of inquiry now proposed, I  regard the  separate
existence of the mind  from the body, as a self-evident
truth.  For were I to contemplate the mind merely as
a modified result of the organization of the body, there
would  be a  palpable absurdity in attempting to show,
that  one portion of the  body  had  an influence and
agency upon another portion;  there being a pervading
influence of harmonious co-operation exerted upon the
entire circle of the bodily organs.
  But  the mind, although in  intimate union with the
body, is yet a  distinct  entity. Though running in 
     INFLUENCE OP THE MIND UPON THE BODY.    85

parallel lines with the  body, and deeply implicated in
all its movements, it still  manifests a superior nature,
and a far nobler destiny.
  View man with a philosophic eye from the cradle to
the grave!  See him wailing his infant cries beneath
the canopy of a mother's smiles, then behold the same
being immured within the  narrow confines of the sepul-
chre; and say, ye sage speculators!  can  you discover
any thing, either at his  birth, or in his meridian prime,
or in his mournful exit from life, which furnishes you
with  convincing  proof, that the mind is but a part of
the frail body—that the jewel  and the casket are the
same!
  It is the part of reason to draw deductions from pre-
mises made known, and infer sound conclusions from
data indisputably  established.   But  it is the part of
madness, even to deduce sound conclusions from  mis-
taken premises.
  Reason should  abstain from all presumptuous infer-
ence, where proof is not  afforded.  Now  apply   this
rule of correct philosophizing  to the subject of mind.
We have no evidence that the mind  and body are the
same, and we should, therefore, not too confidently in-
sist on a thing so uterly beyond our cognizance.   Yet
we  have  cogent  proofs furnished, that the mind is
governed  by laws essentially  distinct in nature from
those which control our material fabric: that though a
very intimate counection may exist between them, yet
there is ample evidence to  demonstrate that they are
not identical. Connection  will  not  prove  identity;
neither will the reciprocal agency of mind  and matter
on each other, establish, in the view of correct philoso-
                       8* 
86
INFLUENCE OF THE
phy, the opinion, that the mind is but a subtile, spirit-
ualized product of the brain.
  A subject is known by its predicates.  The body is
recognised by-its own properties; the mind is  recog-
nised by its own attributes.   There is no sort of just
comparison between the properties of the one, and the
attributes of the other.  The operations of mind differ
essentially from the inert properties of matter,  and the
causes which induce activity in the mind, have no kind
of agency upon the  physical organization of man.   The
mind  is governed  by  motives; the  body is actuated
into movement by extrinsic applications.
  The ancient  Greek philosophers denominated the
mind  autokinelon, self-moving;  and kinetiken,  mo-
tion-giving power.   They  designated the body as the
organon of the nous, or mind: the physical medium
through which it acted.  Phrenology, not satisfied with
the simplicity of this opinion, has boldly come forward
and  challenged our acceptance;  and in  a tone of high
demand  insisted, that it possesses the only key which
can unlock the mysteries of the human intellect.   In a
lecture of this kind, I have not room to enter the arena
of controversy  against  this  Utopian scheme,  which
sprung from the fertile region of novel doctrines, Ger-
many, and which has been fostered in the hot-bed of all
extravagant opinions, Paris; where it is now receding
a little before the returning march of a kindred idol of
the day, animal magnetism.
  The phrenologists take certain facts for granted,  and
then endeavour to erect their system on such postulata.
They are not so  modest as Archimedes, who  asked for
a place to stand on, that he might move the world; they 
MIND UPON THE BODY.
87
 assume the right to take possession of a place, though
 it be in  a land of shadows.   They  take for granted
 two things, which the most acute of them cannot prove.
 1st.  That the faculties are instruments of the mind;
 whereas the mind and its faculties are the same; what
 we  term a faculty being but a particular state, or mode
 of operation, of the mind.  For as matter, destitute of
 figure,  solidity, divisibility and extension, is a non-
 entity,  so the  mind aside from  its faculties has no real
 existence.  The second position assumed is, that there
 are divisions of the brain, called organs, which are to
 be seen on the periphery,  or surface of the brain under
 the skull, which developments, or organs, impress their
 figure on the cranium, or  skull, in such  a way as to be
 noticed  on its exterior configuration.  Now all  this
 proves to be a mere matter of conjecture.   Take off the
 skull, and the whole surface  of the  brain is alike in
 colour,   texture and  configuration;  and yet we  are
 gravely  told that  the organs are there,  but  not to be
 seen; perhaps, like the spirits in Prospero's  cell, they
 only come at the bidding of the master, and are "invi-
 sible to every  eyeball  else."
  Escaping from all such entangled and conjectural  ex-
 planations, we may adopt the  opinion  of the  Greek
 philosopher as near the truth,  as the unassisted light of
 nature can conduct us.   It was left for a far more splen-
 did  manifestation  of light, to clear away the obscuri-
ties which so long  rested on the human mind, in refer-
ence to the nature and destiny of the spiritual princi-
ple in  the bosom  of  man.  The stream of light from
heaven  which pours its  full  tide upon  the  intellect
through the clouds of our natural ignorance, has chased 
88
INFLUENCE OF THE
away the delusions which so long cheated the human
understanding under the imposing semblance of true
philosophy.
  It does not become us to dogmatize] on a question so
dark, as that involved in a  view uof the connection
existing between  the mind and the body.  That there
is a union of an intimate tie, admits of no dispute: that
the  body perishes, after a  lapse  of a few revolving
years, we  see  every day realized; and that the mind
will exist, independent of the body, beyond the narrow
circle of time,  though rationally to be inferred from
the obscure  glimpses of nature, is clearly announced to
us by revelation.
  Let us here rest satisfied, and enter directly upon the
discussion of the influence of the mind  in producing
changes of sensation and action in the body.   Coequal
with the first mental emotions which we experience, is
the agency which the mind exerts on the health of the
animal  system.   Although no very urgent or lasting
feelings actuate  the youthful heart, yet even in the very
primrose season of juvenility, the mind exerts an influ-
ence over the health of the body.   Whilst the  budding
faculties are unfolding, and the unripened moral princi-
ples are maturing, whilst the gloss ot novelty is fresh on
every object around, and the song of hope enchants the
youthful step—even in this period of our earthly exist-
ence, do the agitations of the passions induce dangerous
attacks of disease.  Thus an eminent  surgeon  in Lon-
don tells us, that he saw the life  of a fine child fall a
sacrifice to the emotion of fear, induced by her school
mistress shutting her up in a dark cellar.   Fever, with
delirium, was the consequence; during the continuance 
               MIND UPON THE BODY.             89

of which her constant cry was,  " Don't shut  me up in
the cellar."
  But as the powers of the animal economy grow more
vigorous, and  the faculties  of the mind increase in
strength and  extent of operation, the inlets are constant-
ly multiplying  through which  the  impressions which
minister food for thought and  emotion are conveyed.
As we rise higher on the scale of human existence, we
tread a  more elevated pathway of mental and sensitive
enjoyment, and at  the  same time enlarge  the  surface
upon which the impressions of pain  and sorrow are  in-
flicted.   As love and  hatred, grief and joy, hope  and
fear, by turns sway our hearts, so our bodies are affected
with the alternations of depression and increased action,
consequent to their variant agency.  Our refined mode
of life has increased in a degree  beyond present enume-
ration the amount of painful and pleasurable sensations.
Our minds are softened by the arts and accommodations
of luxury, and agitated by the incessant play of those
feelings  which the multifarious events of life  create;
whilst our bodies are rendered more susceptive and ex-
citable,  from the tenderness superinduced by the soft
indulgences to which civilized man is addicted.
  At the same time art has multiplied her resources,
and given us helps and facilities by which the evils  in-
duced by art are either prevented or repaired.  Espe-
cially, has education clothed the mind with an offensive
and  defensive armour,  by  which man is enabled to
wage a successful  warfare against many powerful ene-
mies.  Elevated as an intellectual being,  man becomes
the lord of creation,  and the  master  over the lower
principles of his nature.  The instinctive ferocity of the 
90
INFLUENCE OF THE
lion suffers no controlling principle of his nature to ex-
ercise a dominion over  this king of beasts.  But it is
the glory of man, as a moral and intellectual being,  to
say to his passions, " Here stay thy march; and hitherto
thou shalt come, but no further."
  The mind of savage man approximates to  the charac-
ter of inferior animals.  In his bosom a few  strong pas-
sions have mastery.   In obedience to the laws of self-
preservation, he pursues the chase; in  accordance with
the desire of repose, he throws his body  recumbent,
till, awakened by the calls of hunger, or the warhoop,
he rushes forwards in pursuit of his game, or dares the
prowess of his enemy.  His folded up powers of mind
never open beneath the genial ray of education.  " His
intellect is not replenished;  he is an animal, only sen-
sible in the duller parts."  Yet at  times the divinx
particulam  aurse,  (the etherial spark derived from
above,) blazes forth and enkindles the whole man.
  The object  of  the  present discussion is, not to show
the effects of the passions on  the language  or exterior
parts of the frame,  these being  within the appointed
scope  of the  rhetorician and painters; but  to indicate
the operation of the  mind, whether in its  calmer exer-
cise or more  excited moods, upon  the health of the
animal system.   Particular emotions not only have a
general influence and agency on every part of the body,
as an integral  mass animated  by  the same  vital  laws,
but a special bearing upon certain  organs.   Thus great
anxiety of mind not only impairs the appetite,  and di-
minishes the  general vigour of the  system, but often
induces jaundice.  This particular reference of action
to an organ may depend upon an  acquired or  constitu- 
MIND UPON THE BODY.
91
tional tendency to a particular disease.  But when, we
reflect that the converse obtains, that affections of the
liver  depress the mind  in a singular degree, we will
perceive that there is  a direct,  however  mysterious,
reciprocal influence existing between certain mental ope-
rations and different parts of the complex machinery of
the human frame.  Upon the fact, that the  comparative
development of different organs  modifies the character
of the individual, is built the doctrine of temperaments;
a part of physiology interesting and  admitting much
useful reflection, but carried by some authors to an ex-
tent unwarranted by evidence.
  With these general remarks, 1 will pass  on to a par-
ticular analysis of the kind and extent of action excited
by  different emotions  of the mind,  on  the physical
structure of man.
  A calm and temperate employment of the intellectual
powers  will never  impair the energy of  the system.
But a protracted and intense attention will, by inter-
fering with the demands of the animal economy, by
preventing exercise and making inroads on the nervous
system, thus keeping up excessive vigilance, mar, in a
considerable degree, the equable excitement of the sys-
tem.  Severe students are generally pale and emaciated;
they  have, as has been appositely said, borne the bur-
den of lean and wasteful learning.  The  mind, restless
by nature as the waves of  Euripus,  will  never, under
any sort of liberal  cultivation,  rest contented  with its
present images; it must have free scope in its aspirings.
Those sciences which  address themselves  to the judg-
ment and reasoning powers, such as mathematics, sel-
dom  injure the health, except by precluding the refec- 
92
INFLUENCE OF THE
 tion of the body from intensity of application.  In large
 lunatic asylums, it is very seldom seen, that a mathe-
 matician has become an object  of medical treatment.
 For where the intellect is concerned in any pursuit or
 investigation, to the  exclusion of the passions, the body
 will  not sustain  much interruption to its accustomed
 health.
   Poets, lovers, speculators, and all persons  subject to
 strong  mental  excitement from any urgent passion, are
 the usual inmates of lunatic hospitals, in all the cases
 brought on by causes, not  of  a physical, but moral
 character.  Spirituous potation, perhaps, in our country,
 is a more fruitful source of that mournful wreck of the
 human mind,  than all the  other  causes  combined.
 Though mental.occupation  does not  give rise to any
 very formidable disease of the body, yet  slight and at
 times very painful affections are meliorated, suspended,
 and  sometimes removed, by having the mind deeply
 engaged on an  amusing or interesting subject.   Pain in
 the head is often removed by agreeably engrossing  the
 attention on some topic of conversation.  Even fits of
 the gout have  been  suspended  by full occupation of
 mind,  if not unduly  protracted;  for gout in the predis-
 posed  is sometimes  brought on  by protracted mental
 application, as was the  case with the younger Pitt, and
 with the present prime minister of England.**
  When in a circle of friends, whilst the mind is pleas-
ingly entertained with a colloquial interchange  of sen-
timent, we find that  we can eat more heartily, without
inconvenience,  than when our minds are not so  agreea-
* Canning. 
               MIND UPON THE BODY.              93

bly occupied.  Strong  mental efforts  will impair, in
some degree, the digestion of food, especially if the in-
tellectual exertion be made soon after dinner; that being
the chief meal, and taxing the  digestive energies more
than any other.
  It is not, however,  the act of thought  which  inter-
feres with the body's health: but it is painful thinking,
meditation connected with anxiety, which wears down
the frail companion of the ever active spirit.
  Children who have manifested  a great  precocity of
talent, whose mind's vivacity has outrun their body's
strength,  seldom  live long; as the adage goes, "He
can't live long—he has too smart a head for such young
shoulders."  The cause  of this issue in  cases of pre-
mature expansion  of intellect, arises  from  an undue
stimulation imparted to the nervous system, and through
it, as  the channel  of sensorial power, to the animal
frame: the susceptible system  yields to the overwhelm
ing urgency of the impulse thus given by the mind to
the brain, and propagated from it  to the various parts
of the animal organization.   The  brain, though  but an
instrument of the  mind,  may have its chords kept in
too great a state of tension, so  that  the soundness of that
instrument is impaired.
  There  is a faculty of the mind of very operative and
influential power, in health  and in sickness; a faculty
whose discursive flights at times transport the soul  into
elysian joys, and  at other  times  drag it  down  to the
gloomy  Acheron.  The  capacity of  presenting ideal
scenes, of bodying the forms of things unseen, and of
gilding the distant  landscape  of life with the brightest
sunshine of bliss, is imagination. Its influence in health
            9 
94
INFLUENCE OF THE
we all experience; and its operation in disease is sig-
nally conspicuous.  It is a very prevalent opinion, that
even  previous to birth,  the influence of the mother's
imagination produces great effects on the child.   There
is nothing in the connexion existing between the mo-
ther and child, which would warrant us in any a priori
supposition, that such an event could  take  place.  Ex-
perience is appealed to as  the decisive test, by the ad-
vocates of the opinion.   But the world is full of the
experience of prejudice.   All judgment, not grounded
on the fair exposition of evidence, is but prejudice. To
draw sound deductions from phenomena, the mind must
be in  a proper condition:  it must  be free from  prepos-
sessions, not prone to precipitate  conclusions, and dis-
posed to examine the subject-matter in all  its attitudes
and varied aspects.  It is sufficient to state, that on this
point, the experience of medical men  and  popular ex-
perience are antagonists  of each other.—The  candid
mind can determine which of the  two is the best kind of
experience.
  Through the potent agency of imagination, men of a
melancholy turn of mind have  supposed themselves
affected with  every variety of disease.  Pain  is fre-
quently fixed, and  kept up in a  particular part of the
body, by a concentrated attention, first awakened by
the person's imagining himself diseased in  that spot.
By the powerful workings of imagination, miraculous
cures  are accomplished, by what are called  "faith  doc-
tors."  Quacks, and  quack remedies, flourish  in the
soil of a credulous public mind; and the effects of their
boasted catholicons and panaceas,  are mainly ascribable
to the mystery  and concealment practised; by which 
MIND UPON THE BODY.              95
the imagination is excited into extraordinary anticipa-
tions of cure.   As a proof of this remark,  it is well
known, that as soon as Ward's patent remedies were
revealed, by his direction in his will, they lost their re-
putation, which was very extensive before the compo-
sition was made  known.   Anthony  Mesmer availed
himself of this principle of human nature,  and on it
erected  his system of  animal  magnetism.  Perkins,
likewise,  established his curative metallic tractors on
the same basis. Dr. Franklin, with several other mem-
bers of the Academy  of  Sciences of Paris, were ap-
pointed to examine into the pretensions of  Mesmer's
system.  Franklin, from his acuteness of understanding
and philosophic power of mind, was well calculated  to
detect this imposition; which the committee did detect
and expose, after  a thorough examination.   Mesmer
was driven in disgrace, after some  considerable success
previous to the scrutiny of the committee, back to his
native  fens.  It  is now about fifty years since he pro-
mulgated his doctrines, and after this long quisescence
in the tomb of oblivion, animal magnetism is revived
in Paris.  In December, 1825, the French Royal Aca-
demy of Medicine in Paris, had an animated debate on
the question of taking up  this once exploded medical
superstition, and prosecuting its  investigation.  This
discussion was continued to two other sittings, in Jan-
uary and  February, 1826,  it not being decided at the
first.  It was decided at the last meeting, by a vote  of
thirty-five to twenty-five, that a commission should be
appointed to examine  animal magnetism.  In  this as-
sembly of the French faculty, it was stated by a  mem-
ber, that " he saw a woman  go  to sleep at the  simple 
96
INFLUENCE OF THE
will (as was asserted) of the magnetiser,  who, for that
purpose, was concealed in a closet of the apartment."
  In a French medical journal it is stated, that,  by the
same art, a woman was enabled to  see the time of day
on a watch dial plate, though  the watch  was placed  at
the back part of the head. But the most singular effect
is related by an English physician of eminence.  In a
visit to a female friend,  the  conversation  turned on
animal magnetism.   The doctor, to ascertain the power
of  imagination, gravely  informed her that he  could
practise the art.  She anxiously solicited a  trial  of its
efficacy on herself:  he consented,  after a little  hesita-
tion, so  as  to increase her desire.   He made solemn
gesticulations before her, passed his hand in a variety
of  motions  around her,  used some mock incantation
terms; when, all of a sudden,  the lady fainted and fell
from her chair.
  Magic, in every ignorant society of men, is the first
remedy for all sorts of disease. The dominion of magic
is founded in the sway that imagination exercises over
the uneducated and superstitious.   The father of Latin
poetry has said, felix qui potuit rerum cognoscere
causas; and the  reason  he  gives  why a man is  made
happy by understanding  the causes of natural pheno-
mena, is, that he escapes the enthralment of those vain
fears, and superstitious interpretations of  things,  which
the ignorant mind realizes in every event of life.
  Hope is the next  passion of the mind  which  1 will
notice, as having a very dominant control over the ac-
tions of animal life.
  This cordial of  the mind diffuses its sweetening in-
fluence through the  bitterest  draughts with which the 
               MIND UPON THE BODY.              97

cup of life is dashed.   Its  cheering radiance is spread
over the curtained gloom of sickness.  Its consolations
refresh the weary spirit in  the darkest period of bodily
languishment.  It imparts  a renovating  energy to the
actions of the system in disease, which adds increased
efficacy to the remedies  administered.   I cannot  on
this point illustrate the subject better, than by a quota-
tion from one of the most enlightened surgeons of the
present day.
  "A tranquil or cheerful state of mind,  (says  he) un-
der accident or disease, greatly contributes to the pa-
tient's recovery;  and those who  are  accustomed  to
witness a patient in the first few  hours  after  he has
received a  severe injury,  auger from his  manner, the
probability of recovery.   If he submit  himself to his
fate without repining, if he yield himself to the advice
of his friends, and  readily consents to all that  is pro-
posed for his relief, he generally  does well; but if,  on
the contrary, he bitterly laments his fate, or his mind is
actively engaged in suggesting the means of relief, im-
patient in their not being immediately obtained, being
officious in trying  to  assist, anticipating  every desire,
such a person has a degree  of constitutional irritability
highly unfavourable to his  recovery. It is the surgeon's
duty to tranquilize the temper, to  beget cheerfulness,
and to impart confidence of recovery.   Some medical
practitioners are so cold and cheerless as  to damp every
hope; whilst others inspire confidence of recovery, and
a disregard of situation,  which supports the regular
performance of all the actions necessary for restoration.
It is your duty, therefore,  to support hope, to preserve
                          9* 
9S
INFLUENCE OF THE
tranquillity, and to inspire cheerfulness, even when you
are still doubtful of the issue."
  To this advice of Sir Astley Cooper to his  pupils, I
may here remark,  that my observations at the bed-side,
fully confirm what he has thus judiciously suggested.
It is as  difficult to  restore  a patient,  who  is labouring
under a dangerous attack  of  illness, who himself de-
spairs of recovery, as it is to force the light of evidence
into a man's mind, who has barred up the avenues of
his understanding to all accession of truth, by enter-
taining  a hatred to that evidence.  To attempt the cure
of a man whose mind tinges every object around  with
the dark colours of despair, who discredits every reme-
dy  employed, and  who looks on his physician as a mere
messenger of death,  is like casting the ever-returning
stone of  Sisyphus.  You  may  gain  some  temporary
advantage over the disease, but even then, the despair
which fills the patient's mind, puts a wrong construc-
tion on  the alteration of symptoms, and those  appear-
ances which  the  physician hails as  the harbinger  of
returning health, the unhappy patient looks on as the
portent  of his approaching  fate.
  But in one particular disease,  hope itself becomes a
most inauspicious indication.  It has passed  into a medi-
cal  axiom, that hope springs eternal in the hectic breast.
Its  illusory blandishments cheat  the poor consumptive
patient  of the misery, which  might otherwise shroud
his  mind in the prospect  of a certain death from his
disease.   It may  have its  consolations,  but they are
fleeting, and whilst hope fills the mind with the visions
of returning health, the reality of death is not prevented.
In  a medical point of view,  is  has a very prejudicial 
MIND UPON THE BODY.
99
influence, in so elating the patient with an  opinion of
recovery, that the means are totally neglected, or so
negligently  employed,  at the period  when they can
avail any thing in arresting the progress of the malady,
that unless  his friends  interpose and  oblige him,  by
their  entreaties, to call in medical advice,  his life is
inevitably consigned as a victim  to the  disease.   Thus,
with the increase of hope in direct ratio to the onward
march of the disease, the mind of the unhappy individ-
ual, like the sun sinking in the western  sky, when the
clouds which gather  round his path are illumined  by
his departing rays, spreads the colouring of hope over
the latest hour of life; and only when  life has heaved
its last expiring breath, will the gay delusions of hope
cease to play their part in the hectic breast.
  Joy  is the next emotion of mind to be contemplated
in its effects on the system, in a medical point of view.
In its  most accumulated  action,  joy has extinguished
life as suddenly, as could a stroke of lightning.
  Pliny, says Dr. Cogan, informs us that  Chilo, the
Lacedemonian, died suddenly upon hearing that his son
had gained a prize in the Olympic Games.  Sophocles,
the great tragic writer, died in consequence  of a deci-
sion made in his favour, for the palm of superiority in
his  department  of  literary pursuit.   Leo  the tenth
died of  a fever,  brought  on by joyous agitation of
mind,  produced  by  his  hearing of  the capture  of
Milan.   Hume says, that many  aged  people  in Eng-
land died suddenly  of joy, upon hearing of the resto-
ration  of Charles II.   The aged  door  keeper of Con-
gress fell down dead, when told of the capture of Corn-
wall is. 
100
INFLUENCE OF THE
  Joy, when moderate,  quickens the circulation, kin-
dles  up a glow of heat over the frame, and infuses
strength into the limbs.   Dr. Rush relates  a  very in-
teresting instance of the effects of joy in contributing to
the recovery from dangerous sickness:  "  During the
time, says the Dr. 1 passed at a country school in Cecil
county, in Maryland, I  often went on a holiday  with
my school-mates to see an eagle's nest, upon  the  sum-
mit of a dead tree in the neighbourhood of  the school,
during the time of the incubation of that bird.  The
daughter of the farmer in whose field this tree stood,
and  with whom I became acquainted, married and set-
tled  in this city about forty years ago.  In our  occa-
sional interviews, we now and then spoke of  the inno-
cent haunts and rural pleasures of our youth, and among
other things of the eagle's nest in her father's field.  A
few  years ago I was called  to visit this woman, in con-
sultation with a young physician, in the lowest stage of
Typhus fever.  Upon entering her room I caught her
eye,and with a cheerful tone of  voice, said only,  "the
eagle's nest."  She seized me by the hand  without be-
ing  able to speak,  and  discovered  strong  emotions of
pleasure in her countenance, probably  from a sudden
association of  all  her early  domestic connexions and
enjoyments with the words 1 had uttered.   From that
time she began to  recover.  She is now living, and sel-
dom fails, when we meet, to salute me with the echo
of " eagle's nest."
   Both hope and joy are to be employed by the skilful
physician in bringing about a return of health.  Hope
 may be  poured in  full tide into  the patient's mind, but
joy  must be temperately employed  as a curative mea- 
MIND UPON THE BODY.
101
sure.  In other words, the cheering influence of hope
can never be injurious from excess of operation, but joy
may overpower the frail system, and hurry the patient
by a sudden stroke of mental deliquium to the  grave.
In hysteric  and  hypochondriac affections,  the employ-
ment of hope and joy  are our principal remedies.
When the mind is dejected, and the fears of the patient
much excited, although his body be but little  diseased,
it becomes the humane physician  to listen attentively
to the  sad  tale  of the patient's sufferings, and by  a
respectful deportment,  manifest a due regard to his
condition. Some unhappy individuals have been driven
to madness  and  suicide from the  unfeeling and cruel
conduct of  medical men  under these circumstances.
Whenever human misery presents itself to our notice,
and implores our aid, it is our imperative duty to assist
in its relief.  In our efforts to impart the kindly influ-
ences of hope and joy to the depressed heart, we must
consult the  peculiarities  of the individual's mind, and
external relations.—Sometimes most  astonishing re-
sults may flow from but a very trivial resource, where
the  predominant passion of the  patient is  brought into
play, as in  the following case:—Dr. Tissot relates the
case of a lady in  France, who could not be roused from
a  lethargy  by any medical application, till a person,
who knew  the   patient's  love  of money,  put some
French crowns into her hand.    She soon felt the reno-
vating  touch of  the coin, opened her eyes, and was
soon restored to  her reason, and bodily powers.
   Love is next to be regarded  by us, in  its  action on
the  health  of the animal structure.   Love  has  been
divided into  benevolence and  personal  endearment, 
102
INFLUENCE OF THE
Benevolence diffuses a sober placidness over the frame,
and is highly promotive of the healthy performances of
the system.  Personal attachments are of a varied cha-
racter; as the relation subsisting between the  persons
varies.  The feelings of personal friendship are salutary
in their operation.  Parental  love, especially  in the
mother, is one of the most powerful passions of our
nature.   The Roman  matron  who died in  her son's
arms upon his return  home from battle, after a report
of his death, is a striking specimen of the overwhelm-
ing agitation it sometimes induces.
  But the love between the sexes  is most potent in its
diversified agency  on the system,  of both  man  and
woman.   Shakspeare's Viola is a good  representative
of what is experienced by a  delicate  and cultivated
mind under  the pent-up influence of this passion:—
" She never told her love,  but  let concealment, like a
worm in the bud, feed on her damask cheek; she pined
in thought."  Man, whose mind is alternately actuated
by other interfering passions, such as love of  money,
ambition, and love of pleasure,  may escape the deterio-
rating influence exerted by love, not reciprocated, on the
health.  When moderate love  is indulged towards an
object, whose heart beats in  unison with the emotion
thus felt; where hope can  animate the  mind with the
prospect of a happy consummation, then, instead of
impairing,  it invigorates  the actions of life. But disap-
pointed  love, where the soul is  " sicklied o'er with the
pale cast of thought,"  often induces .mania, consump-
tion, and many other afflictive and dangerous diseases.
  Jealousy, which results  from ill-requited  love,  or
which arises  from  a disingenuous  disposition acting 
MIND UPON THE BODY.
103
upon the passion of love, is a depressing and corroding
feeling of the soul.  It is a  " green-ey'd monster, that
makes the food it feeds on,"  and produces jaundice,
dyspepsia, and infuriated melancholy.
  I  will  next consider the  most  destructive passion
which ever preyed upon the peace of the mind;  which,
in its diversified  workings, produces more misery to
society than all the rest, and which has more frequently
quenched, with impetuous violence, the  vital  spark,
than any other emotion.
  The sententious Horace truly says,
                     Ira furor brevis est.
          Animum rege; qui, nisi paret, imperat.
  Anger is a  short madness.   Govern your temper; for
unless you control it, it will govern you.   Anger acts
on the whole frame; the heart is roused  into violent
pulsation; the limbs are  convulsively  agitated,   and
augmented in vigour;  and the nervous system vibrates
with electric fire.   Apoplexy often precipitates the
unhappy individual  into immediate death.  The  cele-
brated surgeon and anatomist, John Hunter, died under
a paroxysm of anger.  Hemorrhage from the lungs or
stomach, from  the  bursting  of a blood-vessel,  often
comes on whilst  the patient is agitated by this vehe-
ment emotion.  Fever frequently supervenes from the
disturbance created by this passion, and gout is at times
ushered in by the onset of anger.   The healing powers
of nature are  disturbed by irritation of mind, as is  illus-
trated by a case  given by  Sir A. Cooper.  He wa3
attending a man  with an ulcer, which he could not
heal. Several times it appeared  almost well, when it 
104
INFLUENCE OF THE
would  in a little time change its healthy aspect and
grow worse.  Upon inquiry, he  found the patient was
of an irritable mind, and that being in a room where
his family was,  his temper was  often fretted  by its
arrangements.  He had him removed from such sources
of angry irritation, to a distant apartment, where the
ulcer got  well  under the same  treatment which had
failed before his removal.  The following is a melan-
choly exemplification of the strong dominion exercised
by anger  over  the mind.  A woman, says the elder
Dr.  Gregory of Edinburg,  whose husband  had been
long absent at sea, supposing him to be dead, married
another man;  but  the   first  husband returned  and
claimed his  wife.  She  went back to him,  and after
they had lived some  time happily together, she had a
child by him.  When her child was not many  weeks
old,  and the mother's  strength imperfectly restored
after her confinement, she happened to quarrel  with a
female neighbour, and a scolding match ensued; when
her  antagonist  insinuated that she had  married her
second husband, knowing the first to be alive.  The
indignation excited by this unjust charge, brought on
an attack of mania, and  sometime elapsed  before she
was restored to her mind. In the mean time, her child,
given in charge  to another,  was shamefully neglected;
and when  it was brought back to her, the shock occa-
sioned by the change,  gave rise to an immediate attack
of catalepsy.  She now  became  perfectly unconscious
of all around her, with  her  eyes  fixed, her body mo-
tionless, her pulse and breathing  scarcely perceptible.
In this state, if a limb were raised or extended, the mus-
cles  becoming rigid,  for a  short time retained  it so, 
MIND UPON THE BODY.
105
until they relaxed again, and  it gradually fell into its
former position.  The various remedies that were now
employed to restore, her, all proved fruitless, till it was
at length  deemed expedient to try what the sight of
her child might  do.  It was  brought to her, but she
remained  wholly regardless of it; until after repeated
attempts, it was placed  directly before her face, when
she appeared to become  sensible to it,  and shortly after
followed it  with her eyes, and  smiled,  and at last
stretched out her arms  to  receive it.   When given to
her, however, she pressed it to her bosom  with  a con-
vulsive force, so as to endanger its life, and its removal
became necessary.  Mania now instantly returned, and
on subsiding was succeeded by catalepsy, which alter-
nated with each other for the space of three days, until
she expired."
  Fretfulness of temper is a good symptom, especially
in children, after a severe  attack of disease—it shows
that the mind, as  an  embodied spirit, is  realizing the
union subsisting between it and the tenement of animal
life, and that it is discomposed by the  uneasiness result-
ing from  the  weakened energies of the  body.  But
often, convalescence is interrupted by a fretful irritable
state  of mind.  Especially in chronic maladies it is
injurious to the patient's restoration for him to  indulge
in a sour, splenetic and irritable temper.   Equanimity
and composure conduce to the  gradual return of health,
in an  eminent degree.
  Here I  may notice the  effects on the health of the
frame, induced by the indulgence  of  several compara-
tively minor feelings; such as malice, envy, pride and
discontent.
           10 
106
INFLUENCE OF THE
  The operation of these feelings is comparatively slow
in the results, brought about by their indulgence, to the
salutary motions of life.  Malice and envy are gnawing
vultures  which  prey  with ceaseless  voracity  on the
vitals of that man  who  harbours them.   They create
derangement of function in the stomach and liver; dis-
turb the regular repose of the organs in sleep, and  keep
up an excessive action in the brain.  The individual is
wakeful, digests his food badly, has frequent headaches,
and is generally emaciated. Pride is perhaps the father-
sin of all these base feelings—for it leads  a man to an
excessive self-appreciation, and a proportionable depre-
ciation of his fellow men.  The proud man is apt to be
malicious, envious and discontented, from  the supposi-
tion that none are so meritorious as himself; and there-
fore that none should partake of equal advantages and
blessings in human society.  But as the wrorld will not
agree in this judgment of his exalted worth, he there-
fore becomes envious—and if any way injured  or
insulted, he is infuriated with  revenge; and as heaven
will not directly interpose on his behalf with its liberal
benefactions, he is  discontented with  his  allotment in
life.   In the regulations  of our passions, there is none
of more importance, in a medical aspect, in preventing
attacks  of epidemic   diseases,  than  fortitude.  Fear
directly lowers the actions of life, lessens the ability of
the constitution to  resist disease, and sometimes of its
mere agency, brings on  the most dangerous maladies.
The benefit of smoking  tobacco, burning  tar, wearing
amulets and the other inert practices adopted by people
to ward off the attacks of epidemic and contagious dis-
eases, has its foundation  in the confidence or fortitude
which these various means inspire. 
MIND UPON THE BODY.
107
  The following cases are illustrative of the dominant
agency of fear  on the animal economy.  A man, in a
London hospital, was recovering from a serious injury
of one of his legs with  every appearance  of a speedy
cure, when an ignorant pupil said, in the patient's hear-
ing, " that leg will never  get well."  That day the poor
fellow became feverish,  his mindf oreboding a sad ter-
mination of his ease; delirium  supervened ;  the  leg
mortified, and in a few days he died.
  A lady applied to Mr.  Cline,  of London, to have a
tumour in her breast, cured.  He advised extirpation,
to which she consented with great  reluctance, saying,
" She was sure it would kill her."  That humane and
eminent  surgeon assured  her, that  such an operation
was not  at all  hazardous.  She submitted with a calm
resignation to what she said was her certain death, after
having arranged her family affairs for a fatal issue—and
as she predicted, so was it accomplished; she died  an
hour after the operation.
   Dr. Wm. P.  C.  Barton, of Philadelphia, relates  an
instructive example of  excessive alarm  producing a
state of  the body, exactly simulative of the most ter-
rific disease with which  human  nature is afflicted.   A
man  was bitten by a dog, which  he  supposed to  be
mad, but which Dr.  B.  did not consider  as affected
with canine madness—under the awful fear of the  ap-
proaching attack, the wretched  man became miserable
beyond  all description.  Symptoms of  hydrophobia
were rapidly  advancing—dread of  water—wakeful-
ness—jactitation of body; and unceasing perturbation
of mind.   Dr.  B. tried to reason with him—endeavour-
ing to show him that the animal had not the disease—r 
108
INFLUENCE OF THE
but it was fruitless.  He finally, after the poor fellow
had suffered much, told him of the reputed virtues of
the scutillaria or skull-cap plant, in curing canine mad-
ness.   The patient caught the intelligence eagerly; Dr.
B. employed the decoction of some other plant as inert
as that, and his patient soon recovered.
  Dr. Hamilton relates a curious instance of panic fever:
A girl was taken sick in the Edinburg Magdalen Asy-
lum,  after having  washed some clothes sent into the
establishment  from the city.  The  Dr.  fearing con-
tagion, had the girl's own clothes immersed in water,
and  her room  locked up.  In a  day  or two several
more of the women sickened—their clothes were buried
in water, and  the  house was fumigated with gas.  A
decided alarm now  spread through the house.  In four
days  more, twenty-two out  of  fifty individuals  were
seized with fever—some very ill, with head-ache, vom-
iting, &c.  The minds of the most stout hearted failed:
fear spread its chilling reign over the whole house.
  Dr. Hamilton emancipated his mind from  the  delu-
sion and thraldom  of the panic—went into  the sick
room and in a decided tone of voice,  told them it was
a delusion, that they were yielding to their  fears, and
authoritatively  bid  them resume  their  employments.
The tide soon changed,  some got well that night,  and
in a  short period  of time they  all  recovered  their
health.
  Anticipated attacks of periodical diseases, are pre-
vented at times  by terror.   Professor Chapman used to
mention a gentleman in Maryland, who cured his slaves
of ague and fever, with  which they were afflicted, by
digging a grave  and threatening the first  man who had 
               MIND UPON THE BODY.            109

an ague,  with an immediate inhumation.   Terror has
obliged the gouty limbed man,  at times,  to forego his
wonted indulgence of flannel and rest, and impelled him
into a  sudden locomotion.   Its countervailing  agency
has roused  the hysteric  and hypochondriac  patients
from their couch of languor and gloomy dejection, and
urged them into activity and life.  But such cases are
more  curious  than useful,  serving  to  excite astonish-
ment,  but little calculated to direct the mind to any
certain and safe practical influence.
  The shock inflicted on the system  by impassioned
grief, has frequently  snapped asunder the silken cords
of vitality.  In  its slower operation, grief arrests the
regular and  equable  flow  of  blood  through the liver;
produces jaundice, and infuses a torpor into the whole
actions of the  system.  Cancer and fungus, says the
high surgical authority already quoted, are  frequently
produced by protracted grief and anxiety.   It has pass?
ed into a proverbial saying, that such a one " died of a
broken heart."  The heart, in its real condition, with
out any figure of speech,  is deeply implicated in this
emotion.   Diseases of that organ, as palpitations, en-
largement, &c. are brought on by grief.  It  is apparent,
that afflicted with this depressing passion, it is exceed-
ingly difficult to restore a person labouring under any
serious bodily derangement.
  I have as cursorily as possible,  due improvement be-
ing considered, presented to you  the general and spe-
cial agency of some of the'most active passions on the
body.  You may be  ready, upon a retrospect  of what
has been  delivered,  to consider that the medical poet
                      no 
110
INFLUENCE OF THE
did not exaggerate the importance of the subject,  when
he asserted that
  " -Tis the great art of life, to manage well the restless mind."
  As intellectual  and  moral agents, who must sustain
various relative  duties in society, and who  must be
happy or miserable, in proportion to the discipline we
exercise over our passions,  and the resources of solid
satisfaction which we find within our own minds, it is
incumbent on us  to weigh well the importance of this
theme.  As physicians,  whose paramount duty at times
it is, to apply the soothing unction of enlivening  hope
to the weary and bruised mind, under the anguish of a
pained and disordered  body, we are called  upon to
attend to the subject-matter of this discussion.   Let us
learn from the facts disclosed above,  that  it should be
our great object to cultivate a mild and cheerful deport-
ment in our intercourse with the sick.  That we should
conciliate their good will, by manifesting our sympathy
for their sufferings, and whilst  we remain firm in the
decisions of our judgment as regards  the  best plan of
restoring health,  we may always let it be seen  that the
hand which administers the remedy is tender, even in its
severest trials of skill.   We see that the mind of a sick
person requires assiduous watchfulness, least  it be in-
vaded by any of those passions which rise  up in hostile
array against all our plans of extinguishing disease, and
defeat the best concerted measures which the physician
can devise.
  Nothing is so well calculated to excite those  depress-
ing feelings  of mind  which so judiciously act on the
sick person's mind, as the injudicious visits of ignorant
and talkative people. The officious visits of well mean-
ing but unreflecting persons, do the  sick incalculable 
MIND UPON THE BODYi
in
injury.  Tedious tales and idle gossipings,  disturb the
repose so essential to the sick.  Sometimes persons are
so forward as to interfere in the prescriptions of the
physician, or so exceedingly imprudent as to suggest
doubts as to the skill of the medical attendant,  even in
the presence of the individual oppressed with disease
and  great  mental inquietude.   Such  conduct  is repre-
hensible in the extreme; if such persons wish to sug-
gest any thing,  it should be done to the friends alone.
Discreet friends are of great  service by infusing the
cordial of social sympathy into the sick man's bosom.
Physicians are  sometimes taxed with being enemies to
religion, because they  oppose the  promiscuous inter-
course of religious persons with their  patients.  Per-
haps,  at  times, physicians are  too tenacious on this
point.  They  forget the  constitution  of  the human
mind, and overlook the importance of  the soul.  But,
let there  be here  a  fair estimate  made of  the diffi-
culty  and delicacy of accomplishing  the object  in
view, that of  soothing the harassed and dejected mind
of the patient,  without  too great a danger of sacrificing
his life. Let there be a liberal interchange of sentiment
on this point,  between physician  and  the clergyman
or religious friend.  It is of great importance at  times,
that the patient should have his mind rendered calm by
religious communication.  That physician who  refuses to
 grant his patient an opportunity of having his oppressed
heart relieved  of its burden,  by the cheering irradia-
tions of religion, is contending against even the tempo-
 ral good of the sick man.  Of how  much  greater im-
 portance are the interests of eternity, let the  man who
 has darted an anxious eye beyond the present scene  of
 things, determine. 
LECTURE
ON THE RESPONSIBILITIES  OF THE MEDICAL PRO-
    FESSION; DELIVERED IN THE LOUISVILLE
            HOSPITAL, AUG. 27, 1831.
Gentlemen:
  In bringing the series  of summer lectures, to which
you have so attentively listened,  to a  close, I  cannot
take my leave of you, in the capacity of an  humble
contributor  to  your  improvement in medical  know-
ledge,  without dwelling, for a few  moments, on  the
responsibilities involved in the practice  of the profes-
sion which  you have adopted for  your pursuit in life.
The dignity and importance of the medical profession,
are to be correctly estimated  by a  due consideration of
the great  and  responsible duties devolving on physi-
cians in the exercise of their vocation.   It is a work of
magnitude that you have  undertaken.   High and diffi-
cult are the intellectual  and  moral efforts demanded,
that you may attain  the  great ends of the profession.
In order to fill  your minds with a just appreciation of
the extent,  variety  and  greatness of the obligations
which are connected  with the  profession of medicine,
advert  with serious attention to the leading scope and
ultimate aim of all medical knowledge.  The physician
operates not on brute, unconscious matter.  His sphere 
 RESPONSIBILITIES OF THE MEDICAL PROFESSION.  113

of agency brings him in direct contact with life—the
life of  his fellow men.  He holds in his  hands the
earthly  destiny of his fellow beings; to him is commit-
ted the awful and responsible task of watching over,
with  scientific eye,  the workings of disease as they
prey on the health of fathers, mothers, children, and of
either, by his skill, restoring them to the cheerful light
of day,  or, by his ignorance, hastening them into the
darkness of a premature grave.  I am aware that medi-
cine,  in its best estate,  is an imperfect art; that  even
when its most faithful and skilful ministers have availed
themselves of  all the resources of the art of healing,
they have, in many  instances, to  lament the limitation
of their  means of cure.   Still, much good can be accom-
plished  by a  scientific application of those remedial
powers  which  a kind  Providence has placed in the
hands of man.   Disease  may be arrested in its ravages
on the human frame—pain alleviated, or subdued, and
life made  more tolerable, even under incurable mala-
dies,  by the judicious prescriptions of the skilful phy-
sician.  My object,  gentlemen, in this lecture, is not
to throw a grain of incense on the altar of professional
vanity—not to magnify the men  who practise  medi-
cine, but to magnify the office of  a physician, by indi-
cating some of the more prominent duties devolving on
medical men in the exercise of their professional  func-
tions.  I wish  you  to  feel  the great and  responsible
position you are at a future day  to occupy in society,
and to impress upon your minds the moral necessity
which is laid upon you  of making due preparation for
your contemplated sphere of life.  Let the importance
of the station be rather felt and acknowledged in its 
114           RESPONSIBILITIES OF THE
beneficial results, than ostentatiously displayed by any
course of offensive conduct.  Then the consciousness
of the magnitude of your undertaking, instead of being
suffered to evaporate  in vain airs and pompous preten-
sions, will produce a concentration of your powers in
the exertions you employ to prepare yourselves for an
honourable discharge of the duties of  the  profession.
You should apply to the work with zeal, and anticipate
important results.  The moment you  think lightly of
your profession, your resolutions abate, and imbecility
and  relaxation of effort take possession  of the  entire
man.  No man ever excelled in any profession to which
he did not feel an attachment bordering on enthusiasm.
A high and honourable  feeling of emulation  should
breathe through  all your studies.  This  feeling is the
plastic spirit  which,  penetrating  the  depth  of  your
souls, rouses every energy of your moral and intellec-
tual  being to  run with usefulness and renown the race
set before you.  Permit me to remind  you that the
chief distinction  and  crowning glory of man,  is his in-
tellectual and moral nature.   That the developments of
this intellectual and moral nature, are the  ultimate pur-
pose of all education.   That the active  faculties of the
mind, and the  best  feelings of the heart,  are  never
more powerfully  elicited than when brought to bear in
the exercise of the high functions  appertaining to that
active occupation of life which you  have chosen.   And
think not that I utter  language, on this occasion, at war
witli sober reality.  The estimate put upon the medical
profession by the brightest  intellects is in  accordance
with the above declaration.  Let me adduce the testi-
mony of one or two disinterested witnesses.  The cele- 
MEDICAL PROFESSION.
115
brated poet,  Pope, thus speaks of the members of our
profession:  "They are, in general,"  says he,  "the
most  amiable companions and the best friends, as well
as the most learned  men, I  know."  The learned Dr.
Parr, of  England,  asserts,  "That after  a long  and
attentive survey of  literary characters, I hold physi-
cians  to be the most enlightened professional persons in
the whole circle of  human arts and sciences." Black-
stone, in  the  introduction  to  his Commentaries, ad-
vises  physicians to read law, in order " to complete
the character of general and  extensive  knowledge
which  this  profession,  beyond  all  others,  has re-
markably  deserved."   I have sheltered  myself behind
the above eminent  authorities to sustain  me in  the
high  appreciation  which  I  have  put  upon our  pro-
fession.   The  demands made  on the intellectual  and
moral capacities of the physician,  are  full  of solemn
responsibility.  Diversified  and  accurate  knowledge
on  all  the branches of the science is, of  course, of
indispensable importance  in order to  qualify him to
practise the  art of curing diseases with success.   But
the physician should not only be learned in medical
science—intimately conversant with the structure of
the human body,  and possessed of a  comprehensive
acquaintance with the  principles  of  medicine—but he
must  be an  honest  man.  Not merely honest  in his
pecuniary transactions; but  honest in a  higher  and
more extensive sense.  He must possess the to  kalon
of character;  he should be a man  of honourable, liberal
and noble bearing in society.
  The science of medicine is  a  vast field  of investi-
gation;  and the practice of  it is a thorny and perilous 
116
RESPONSIBILITIES OF THE
way, in which a stern trial is made of moral integrity.
To the study of the science, you should bring faculties
disciplined by  a previous  training of classical instruc-
tion, and of the other branches of a liberal education.
Your minds should be qualified, by previous habits of
study,  to  undergo a protracted process of analysis, of
deduction, and of research.   If  your mental powers
have not been exercised in intellectual inquiries before
you commence the study  of the  science  of medicine,
you will be liable to be discouraged by the first difficul-
ties which present themselves, and  abandon the toil-
some task altogether,  or irritated into impatience, your
minds  will be driven to the more  objectionable plan of
creeping along the path thus beset with obstacles, with
discredit to yourselves and injury to society.  The great
fault of the young men of our country is an unwise and
restless desire prematurely to enter upon  the scenes of
active life—whence results a crude and superficial  pre-
paration for the  responsible duties of the respective
professions they follow. This evil does not exist to the
same  extent,  nor has it so injurious an  influence on
society, in the  mechanical  avocations  as in the profes-
sions of divinity, law  and medicine.   A young man is
generally obliged, by  the articles of his apprenticeship,
to undergo a proper novitiate that he  may be qualified
to be a good workman.  I  am  aware the different reli-
gious denominations of our country are every  day be-
coming more and more convinced of the demands of
society for an enlightened  ministry.  Legislative enact-
ments guard the bar, in some measure, from the incur-
sions of ignorant lawyers.  And, in some of the States
of our Union, there are severe laws against quackery in 
MEDICAL PROFESSION.
117
medicine.  Still, especially in Kentucky, the profes-
sion of medicine is overrun with greedy and rapacious
followers of mammon, who care neither for the honour
and dignity of the healing art, nor for the lives  of a cre-
dulous public who employ them.
  Gentlemen, truth has  its  sternness  and authority—
and it obliges me thus to  speak.
  The consequences of this eager and impatient wish to
rush, without due preparation, upon the arena of active
life, sheds a fatal blight  and withering spell upon the
future  eminence of every young man who is under its
governing authority.
  The late Judge  Tilghman,  of Pennsylvania, in his
eulogy on Dr. Caspar Wistar, who was one of the most
distinguished supports and ornaments of our profession,
very justly observes, " It has been remarked that, with
few exceptions, those who have been great in the learn-
ed professions, have  abstained from practice at  an early
age.  The cause is obvious.   The elements of science
lie  too deep to be attained without long and patient
thought.  The mind  requires  retirement  and tran-
quillity, to exert its powers of reflection to their full
extent.   But these are incompatible with  the bustle,
the anxiety,  the  agitation of active  life." When  a
young  man precipitately throws himself forward in the
ranks  of an  active  medical career, he soon feels his
inadequateness to the office he has thus most unwisely—
nay, most  iniquitously undertaken.  Finding that he
cannot sustain himself  by the internal  resources of his
own mind, and not having moral honesty enough to
resist the allurements of gain, he has  recourse to the
various shifts, crooked ways, and degrading expedients,
           11 
118
RESPONSIBILITIES OF THE
by which quackery seeks to entangle its victims.   Or,
if his remaining feelings of pride will not allow him to
practise the arts and devices of the nostrum vender, he
still is apt to slide into a sort  of vapouring, or assume
eccentricities of conduct, alike inconsistent with  real
science and the honour of a high-minded man.
  Dr. Rush, who has written  with so much ability on
the ethics of the profession, and who has reflected such
a flood of light oh practical medicine, makes the follow-
ing judicious remarks on that spirit of empiricism which
so much  disgraces  many of the professed members of
the faculty.
  "There  is," says Rush, "more  than  one way of
playing the quack.  It  is  not necessary, for this pur-
pose, that a man should advertise his skill, or his cures,
or that he should mount a phaeton, and display his dex-
terity in operating to an ignorant and gaping multitude.
A physician acts the same part in a different way, who
assumes the character of a madman or brute in his man-
ners, or who conceals his fallibility by an affected gra-
vity, or taciturnity in his intercourse with  his patients.
Both characters, like the quack, impose on the public.
It is true, they deceive different ranks of people;  but
we must recollect there are two kinds  of  vulgar, viz.
the rich and the poor, and that the rich vulgar are often
on a footing with the poor, in ignorance and credulity."
  You thus perceive, from the language just quoted
from  the greatest  medical philosopher America  has
ever  produced, that, for a  physician  " to advertise his
skill or his cures," is placing himself  side by side with
him who pretends to cure disease with a secret remedy.
The  principle  involved is the  same in  both cases. 
MEDICAL PROFESSION.
119
Both characters attempt to impose upon the public by
holding out false allurements  to confidence, and, by a
crafty appeal to ignorance and credulity, strive to win
a spurious reputation.  The true dignity and honour of
our  science, demand of every physician who regards
his profession with any elevated conceptions of its rank
and of its utility, to frown upon every man who thus
attempts to  impose  on the public.  Each enlightened
and honourable medical  man  is  bound by the highest
considerations of the duty he owes himself and of the
responsible  relations he  sustains to the profession and
to the public, to employ every moral resource in his
power to repress the spirit and exercise of quackery in
medicine.  There are men who make the profession of
medicine a base medium  through which they can prac-
tise, successfully and with impunity,  delusion and im-
posture;  and who,  governed  by sordid self-interest,
creep their reptile way along a filthy path, to the sum-
mit  of public confidence—whose  best acquirement is
that of a bold asseveration of the cures they intend to
perform, and of whom  it may be said,  that the only
benevolence they manifest, is that of giving a quietus
to the troubles of their patients, by a speedy dismissal
from  life.   The nostrum vender,  or  dealer in secret
remedies, daily and hourly  contravenes the  obvious
philanthropy of our profession, in wrapping up in im-
penetrable^mystery  and secrecy, for his personal profit,
those means of restoring  health which, in his venal dis-
simulation,  he pretends to possess.   The great orna-
ments of medicine  have been  men  of the  warmest
benevolence—whilst empirical pretenders have ever,
Cacus like,  concealed their  remedial  agents  in the 
120
RESPONSIBILITIES OF THE
gloom of a depraved  selfishness.  Jenner, the illustri-
ous benefactor of his race, was a type of the true phy-
sician.  Bombastus  Paracelsus  was the representative
of the vampyre brood  of quack doctors.
   Medicine is a liberal and intellectual pursuit.  All
mystery and  concealment are  in direct opposition to
the spirit  of  our science, both in  its intellectual and
moral bearings and tendencies.   " Come and see" is
the inscription which  blazes in living  capitals on the
front of the temple of medical  science.   This  noble
edifice stands with  its foundations built on the rock of
truth; its portals are  open day and night, for the ad-
mission of every sincere inquirer after knowledge, and
on the walls  within are hung the votive tablets of the
many thousands  who  have been cured  by the faithful
ministers that trim  its golden lamps, and burn sacred
incense on its altars.   Without its  hallowed enclosure
are seen the base tribe of greedy quacks, and venal pre-
tenders,  who  ply their lying trade about its walls, and
seek  protection under the shadow of its ample dimen-
sions.
   To every  true disciple of the healing art is com-
mitted a high  and responsible trust of keeping the de-
posit  of his profession's honour with untiring watchful-
ness.   To  such belongs the  delicate, and,  at the same
time, magnanimous  office of watching  over the best
interests of the  profession.   That physician  proves
derelict to his duty,  who  is found mingling  in the
ranks of the nostrum monger and prating mountebanks
of the profession.  What! shall the educated physician
be seen associating  on terms of professional  equality
with him who practises artifice and imposture, in order 
MEDICAL PROFESSION.             121
to circumvent  and  delude a  credulous  community?
Shall  those  who  have gathered their  inspiration  and
their  light from the high priests of our science, pollute
themselves by such disparaging intercourse?  Must we
countenance those who call themselves physicians,
       " As nimble jugglers that deceive the eye,
       Drug-working sorcerers that change the mind,
       Disguised cheaters, prating mountebanks,"

to play off their cozenage  on the people,  without any
disapprobation on the part of enlightened and virtuous
physicians?   Shall a degrading rivalry in money mak-
ing, extinguish the light of all honourable feeling in the
minds of medical  men?   Let each young man who be-
holds such  a disgraceful  exhibition, as is sometimes
seen,  of successful  charlatanry, rest assured that the
reign  of error and imposture is brief—that the founda-
tion   of the empiric is  laid on perishable  materials,
and that,  though he may  amass wealth,  no sure and
abiding honour attends his career.' Veracity is violated
by such a  man every time he administers his nostrum,
for he is practically setting his seal to a delusion which
his own false statements have engendered?  Is truth,
the tutelary  genius of science, the best friend of erring
man,  and  the only sure guide and safeguard of our  hap-
piness?  Then, the man who wilfully propaga es a lie
and practically affirms it, is, most assuredly, the enemy
of his race   The  nostrum  vender is, therefore, an
enemy of man; he  is a blot  and an anamoly on the
beauteous  face of God's moral creation, and should be
shunned as the upas tree—for he lives in an atmosphere
                        11* 
122
RESPONSIBILITIES OF THE
of deception, delusion,  imposture,  and sordid self-in-
terest.
  The responsibilities of the medical man are of a mo-
mentous kind.  He is to  understand his profession
well, before he attempts to practise it;  and he is bound,
by  every just  consideration of his responsibleness, to
improve himself every day, in order to meet the daily
demands made on his skill with augmented usefulness
to society.  Gathering, from every available quarter,
the elements  of knowledge, he must, by intellectual
analysis, convert them  into the sound deductions of a
well balanced  judgment.  But he  is called upon like-
wise to be a man of strict veracity, of exemplary so-
briety,  and of faithfulness to  his professional obliga-
tions.  Truth  should be  personified,  as  it were, and
put into  unceasing  exercise  by the  physician.   He
should reject all ostentation and paradeful exhibition of
his business, and manifest a dignified simplicity in his
intercourse with society.   A man,  filled  with a desire
to fulfil his duty, lives  for reality, and not for display.  j|
The ways of  duty  to such a man  are direct, and the
means of accomplishing them simple.   Such a one has
intellectual and moral improvement always before him,
and, regulated by  this unity  of view, he  preserves
habits  of candour and  honesty  with himself and with
those around.   Cultivate, therefore, this  true dignity
of character, and, let others debase themselves as they
may,  ever preserve this moral excellence.  Animated
by these views and considerations, your course will be
onward and upward; step by step, you  will ascend into
a freer atmosphere,  and reach a  more  expanded  pros-
pect.   Thus all your energies will  be  borne along un- 
MEDICAL PROFESSION.
123
conditionally and unreservedly towards the objects to
which  you should consecrate yourselves with absolute
devotedness.   Let every  thing be  consistent in your
plan; then there will arise no embarrassment in the ex-
ecution of the work undertaken—your minds being
fixed in a just decision, and your efforts springing from
a determination to achieve the object before you.
  Let the crafty empiric boast of his success in a course
of sordid and groveling self-interest, in which career
he has  sported with the credulity and ignorance of the
multitude.  But remember that the only stable success
attends the men whose intentions are honourable and
upright.   Such men, by  degrees, are discovered and
made known; they form  immutable and advantageous
connexions with  society, and  their  reputations   are
guarded by a  deep-founded esteem, which is increased
and  confirmed every day.  Disdain  mean, transient
and  little ends, and  seek a wide and solid foundation
for your professional standing.  Rise above the mere
motive of accumulating money, to the kindling energy
and solemn joy which are inspired by an enlarged  phi-
lanthropy.  Fear not to oppose popular delusion when
it bows down at the footstool of charlatanry;  nor  ever
hold intercourse,  or in any other way give encourage-
ment to men  who are " cheating the eye"  of the  pub-
lic " with blear illusion," in order to make that illusion
the pander to their base desire of personal aggrandize-
ment.
  In conclusion, let me press upon your consideration,
the necessity  of a calm and determined perseverance in
the pursuit of professional eminence.  Remember that
weakness of  character is restless, impatient, and full of
contrariety of purposes—that  a feverish and imagina- 
124
RESPONSIBILITIES, ETC.
 tive mind, which is ever changing its plans of  action,
 can never arrive  at  any elevation;  that fixedness of
 purpose is absolutely essential to  success in any lauda-
 ble enterprise, and that no man can excel in any walk
 of life, unless he  has power to adhere to the motives
 which first suggested his determinations.  The  world,
 it has been truly said,  is full of people who have con-
 ceived and undertaken great and noble things, but who
 failed in their accomplishment. Perhaps there are very
 few well regulated  minds, who have entered upon the
 investigation of medical science, that did not form some
 brilliant plans of professional eminence,  and hoped to
 realize them.   But how soon the efforts of many quail
 before the  difficulties of the way; how very few reach
 the bright  goal which  once glittered  before their as-
 piring wishes! How melancholy  is it to see the ocean
 of life covered with so many wrecks of lofty hopes and
 noble  aspirations!   But,  gentlemen, I  hope  better
 things of you. Your career, I trust, will  be one  of use-
 fulness in the  world.  May you have patience to  labour
 with sedulity of endeavour in the profession which you
 have adopted, and may a hallowed feeling of benevo-
 lence actuate your minds in diffusing  around your path
 in life the fruits of that charity which is " twice blessed"
 —blessed in him who gives, by irradiating his soul with
 the peaceful smiles  of an approving conscience,  and in
 him who receives, by smoothing the brow of anguish,
 and restoring  health to the pained and diseased body.
 Then your course will be luminous, with a divine radi-
 ance, and " the blessings of  them who were ready to
 perish" will descend on your heads,  fraught with the
 purest joys which man is allowed to taste  in the present
introductory stage of his immortal existence. 
         ON THE DISEASES

INDUCED  BY MERCURY.
  My design in the following observations is,  1st, to
institute an inquiry into the mode by which mercury
acts upon the system;—in the 2d place, to point out the
causes of its morbid agency, and in the last place, to
particularize  the most common forms of disease en-
gendered by  it, and their most appropriate means of
treatment.
  There is no article in the whole compass of our re-
medial resources which can at all be compared  to  mer-
cury  in  the extent, power and  diversity of its modes
of action on the system.  Nor  is there one which, in
the hands of a  judicious practitioner, can be made to
wield such  an ascendant influence on the deranged func-
tions of life, and on the structural lesions which often
impend the organs, as the different preparations of this
mineral.   In its crude state, as quicksilver,  it  pos-
sesses no appreciable power, when employed  as a re-
medy,  except  that  resulting from  its great  specific
gravity.  Contrary to the  assertion of Pliny,  Galen,
Hippocrates and Dioscorides, and of even some of the
earlier modern  writers on  this subject, fluid mercury,
when free from alloy, exerts no deadly property at all; 
126
ON THE DISEASES
nor does  it  exert  any positive agency by its direct
contact with the living surface of the stomach  and in-
testines, as large quantities have been repeatedly swal-
lowed without injury.  Gaspard shut up large quantities
of quicksilver in the various cavities of the body with-
out observing any  other result than that arising from
the irritation of  a foreign body.  To remove obstinate
constipation, fluid  mercury was formerly a fashionable
remedy; but it is now entirely abandoned, from sev-
eral well authenticated cases of rupture of the bowels
being induced by its mechanical force.  Fluid mercury,
at the ordinary temperature  of  the atmosphere, dis-
charges copious vapours.  These  vapours will  rapidly
mercurialize the persons who inhale them.   Two well
known instances of most violent  salivation being in-
duced in the whole of  a ship's crew by the exhalations
from a large quantity of quicksilver, were witnessed in
1810, on board the British ships Triumph and Phipps.
Every person on these vessels  was more or  less affected
by the mercurial vapours, and all the cats, dogs, sheep  ^
and goats  on board were destroyed.  The bags con-
taining the mercury, which had been rescued from the
wreck of a ship near Cadiz, soon burst, after being stow-
ed in  the holds of the respective ships,  and the metal
lay in the bottom of the vessels, in  a mass.
  The accumulation of an amalgam of tin and quicksil-
ver in the cells of the colon may be the occasion of great
inconvenience, and of ultimate death. Such an instance
came under my notice in 1821, in Louisville, Ky. the
place of my former residence.  A  Mr.  Prior,  a mer-
chant  of that city, had for many years been  tormented
by the presence of a tape worm in his alimentary canal. 
INDUCED BY MERCURY.
127
 and for the expulsion of which many  remedies had
 been ineffectually employed.  In accordance with Dar-
 win's suggestion, a respectable and enlightened physician
 directed him to take the amalgam of tin filings and
 mercury.   The remedy was taken agreeably to the fol-
 lowing directions.  Twelve ounces of tin and  an equal
 quantity of mercury were mixed together, and divided
 into twenty-four parts—one of these doses—of an ounce
 each—was to be taken every  hour till the whole was
 swallowed.  Fifteen ounces were taken during the first
 day, and the day subsequent, according  to directions,
 he  took a saline purgative, which  operated well, and
 brought away near forty feet of tape worm, with a small
 quantity of the amalgam. Subsequently Mr. Prior took
 four more ounces, making in all nineteen ounces taken;
 and he felt  confident,  when I saw him  in the winter
 of 1821, that of this quantity at least sixteen ounces re-
 mained in his bowels.  Upon examination, and being a
 very thin man, the examination was very satisfactory,
 the amalgam felt as large as a  hen's egg,  and was  lying
' about mid way between the umbilicus and the superior
 anterior  spinous  process of  the ileum, being  quite
 moveable, and producing on pressure no  pain.   When-
 ever he rode on horseback priapism was quickly induced,
 and he wore a belt around his abdomen to  keep the
 mass more steady in walking.   He took this  amalgam
 in January 1820, and it remained permanently lodged
 in the colon till  his death,  which took place  in  1822.
 Being  attacked  in that summer with slight fever, in-
 flammation, ending in gangrene, soon arose in the in-
 testines.   Upon post  mortem inspection, it was found
 that the portion  of bowel in  which it was deposited, 
128               ON THE DISEASES
had sloughed before death.  The amalgam was preserved
with a portion of the intestine, by Dr. Gait the attending
physician.  Mercury, when subjected to trituration with
unctious and  other substances,  such as chalk, manna,
conserve of roses, &c.  is reduced to the condition of
an oxide,  and in that  state acts on the organic sensi-
bility.  The only preparations in ordinary medical use
are the  ointment,  the red precipitate, the blue pill, the
hydrarg. cum creta, the bichloride or  corrosive sub-
limate,  and the  protochloride or calomel.  The sul-
phurets of  mercury, like the metal, according to Chris-
tison, are not possessed of any deleterious action on the
animal  body.  Of mercurial compounds the red preci-
pitate and  turpith mineral act as irritants, and possess
the common property of all the compounds of the min-
eral, of creating mercurial  action on the system.   Cor-
rosive sublimate is a potent irritant and poison, so are
also the nitrates of mercury.   The cyanide or prussiate
of mercury is analogous to corrosive  sublimate  in its
deleterious agency on the body.  Calomel is the  most
valuable of all the forms in which mercury can be ad
ministered. It is more extensively used than any other
mercurial preparation, and from its  facility  of exhibi-
tion, has inflicted more mischief from  an  abuse  of its
powers, than all the other mercurial remedies.
  The specific irritation and corrosive effects of the
corr. sublimate are so well  known that it is not proper
to dwell on them.  The only sure antidote to the poi-
sonous agency of the  corrosive sublimate is the white
of eggs.   Thenard, the  eminent chemist, several years
ago, by  mistake,  swallowed a mouthful of the concen-
trated solution of corrosive sublimate for  water,  and 
INDUCED BY MERCURY.
129
was  saved by Orfila's discovery.   The  white of eggs
was quickly taken, and he suffered no harm.   Several
years ago I was called to a negro  man who had  taken
a considerable quantity of corrosive sublimate to destroy
his life, because his master refused to sell him  to a gen-
tleman  he was very  desirous of  living  with.  There
being a dozen of eggs in  the house, he was  made to
swallow the white of every egg—and the antidote was
entirely successful.
  In considering the agency  of mercury  on the animal
body, I shall inquire into the  local  action of the different
mercurial preparations,  and in consecutive order in-
vestigate their constitutional  effects.  Given in minute
doses, corrosive sublimate acts  as an  alterative, with
especial reference to the skin; but  in quantities over a
half a grain, it ordinarily  acts as an irritant.  Used as
an escarotic, it often effects much  good,  in  stimulating
diseased parts into recuperative efforts which terminate
in their cure.  But it should be employed  with  much
caution as an external remedy,  for death has  often re-
sulted from an incautious use of it,  either in  powder,
solution, or ointment, when  applied to ulcers  or erup-
tions  of the surface.  Intense salivation,  sometimes
accompanied with symptoms of gastric  irritation of a
violent  kind, follows its application occasionally to
wounds or eruptions. In the London Medical Repo-
sitory, vol. 16th, a case is given of death following  the
application of a solution  of  corrosive  sublimate  to an
eruption on the scalp of a child—great ptyalism ensued,
which destroyed the patient in a few days. I was taken
to  see a gentleman in 1819, when residing in Louis-
ville, who was then in a state of .great salivation from
        12 
130              ON THE DISEASES              "

the action of a nostrum, applied at least eight months
before my visit, to a fungus  cerebri.   This gentleman
had sustained an injury  on the top  of his  head, which
produced  after some months a diseased state of the
bone, as well as of the  dura  mater.   The external tu-
mour was extirpated by the knife,  but  there ensued a
rapid destruction of the  bone, and finally a fungus cere-
bri.   A Dutch quack,  who  had gained celebrity  for
curing ulcers by a secret remedy, was employed, after
the failure of repeated excisions with  the knife,  and of
pressure, to stop the growth of the fungus.  His nostrum
was a strong solution of corrosive sublimate, with the
addition of a drachm of borax to every four  ounces.
This he applied every day till a most  copious salivation
ensued—and then  the  remedy was abandoned.  The
case proved fatal, several weeks after my visit.
  The local action  of the mild mercurials,  claims our
especial consideration.   In what manner does  calomel
or blue pill influence the vital operations of the  sto-
mach and intestines ? The French physicians generally
regard calomel as an irritant, and therefore  highly im-
proper in all cases, when any degree of gastro-enterite
is suspected.  But  in what way do they arrive at this
conclusion?  First, by most dogmatically pronouncing
on  the action of the remedy, and then they resolutely
reject its employment.   And this in the open sunlight
of a counter practice, distinguished for safety and wis-
dom.  Circumscribed within the narrow enclosure of a
most abject dread of its powers, they pertinaciously and
superstitiously abhor the use  of calomel.  To the credit
of a few able French physicians, let it be  added that
calomel is not thus treated with unmerited contempt. 
INDUCED BY MERCURY.
131
Baudelocque, in his work on Puerperal Peritonitis, has
lavished much praise on mercury, as the surest remedy
in that fatal malady.  Is calomel an irritant, when ap-
plied to an ulcer  on the cornea?  To talk of irritation
being created by it in such a case, is to use words with-
out  logical accuracy.   " Those," says Sir W. Philip,
" who  are prepossessed against it and other powerful
medicines,  in their fear of the  medicine are too apt
to lose the fear  of the disease."  Mr. Annesley, in his
"Practical Observations on the Effects of Calomel
on the Mucous Surface and  Secretions  of the Ali-
mentary Canal,"  has detailed  several experiments on
dogs, to show that  calomel, even in large doses,  " has
the effect  of  diminishing vascular action, rather than
of exciting it;  which  will account, in some degree,
for the scruple-doses of calomel at once allaying irrita-
bility of stomach  and vomiting—a circumstance I have
witnessed  with astonishment,  and for which, I  never
could account till now.  These  experiments were fol-
lowed  up by the performance of  others, and the results
were always the same.  I am led, therefore," continues
he, " to the following inferences, the former of which is
confirmed  by Dr. Yelloly's interesting paper on the
vascular appearance of  the human stomach, read  to the
Medico-Chirurgical Society, July 27th, 1813—that the
natural and healthy state of the stomach and  intestinal
canal is high  vascularity; and  that the operation of
calomel in large doses is directly the reverse of inflam-
matory."   In fever, when the  stomach is so irritable as
at times to  preclude  the  use of any  other internal
remedy, calomel given in minute doses every hour, will
often, nay, generally, subdue the vomiting, and restore 
132
ON THE DISEASES
-calmness to the distressed  organ.  1 had  two  very
 alarming cases of bilious colic, several years ago, which
 occurred in my practice, close to each other, in which
 one-grain doses of calomel,  in pills, given every half
 hour, was the remedy that saved life  in  both cases.
 One patient was bled, and blistered on the abdomen, but
 still the vomiting was incessant.   The other was a deli-
 cate female, whose pulse would not admit of vascular
 depletion.  In both cases,  obstinate constipation was
 present, which enemeta did not at all relieve. Each was
 directed to take one grain of calomel every half hour.
 The man  whom I had bled, becoming impatient, took
 the medicine more rapidly,  pretending that he had lost
 the pills.  In the space of twenty-four hours, the lady
 had taken forty-eight grains, and the man in thirty-six
 hours  took  more  than one hundred.  The vomiting
 continued with little or no abatement, in each case, till
 the gums  became  sore, and then ceased with the  spas-
 modic  pain of the  bowels, which were easily acted on
 afterwards by oil.  Here every circumstance was  unfa-
 vourable to an  absorption  of the  mercury,   for the
 stomach  constantly  rejected it, and not enough was
 retained to act on the bowels, and yet ptyalism ensued;
 and in  both  patients was quite  urgent in  two  days
 after the medicine was discontinued.  Here, says the
 Broussaist, is  gastro-enterite, or  simple  gastritis; and
 will  you  give so  perturbating  a medicine as  calo-
 mel in such a case!   Is medicine a  practical art,  and
 are we to arrive at  its facts by the inductive method of
 philosophizing?  If so, try  the  remedy ere you  con-
 demn it—yes, try  it faithfully in  our bilious  fevers,
 especially  of the West and  South, and  then, and not 
INDUCED BY MERCURY.
133
 till then, are you competent to pass a judgment on the
 merits of the practice recommended above.  Calomel,
 blue-pill, and the hydrargum-cum-creta, when given as
 aperients or purgatives, in ordinary cases, do not act as
 irritants.   On the contrary,  no milder medicines can,
 in numberless instances, be given, particularly in the
 intestinal disorders incident  to deranged  hepatic func-
 tion.  No  cathartic can be selected from the  materia
 medica which operates so  kindly upon infants  as  calo-
 mel.  Not that I would carry its administration  as far as
 a practitioner in Louisville did in his own infant's case;
 but I would not be deterred by an unfounded figment of
 its perturbating quality to use it, as 1 have done during
 nearly twenty years, discriminatively,  according to the
 emergent demand.   The physician referred to above,
 gave his  child, an infant of less than a week old, within
 two days,  near one hundred grains  of calomel, and it
 recovered  of  the  attack of intestinal  irritation under
 which it was labouring.  Calomel when given in  im-
 mense quantities, will  often pass through the intestinal
 tube, unchanged.   I saw it evacuated in small  masses,
 with little or no discolouration, in the case of a gentle-
 man,  who  was taking  thirty grains  every two hours.
 There are three successive stages in  the  phenomena
 which arise in the stomach,  intestines and  collatitious
 viscera,  after calomel  is received into the  alimentary
 canal.*   The first stage is that of decomposition of the
 calomel  to an oxide,  of a dark gray  colour;  without
 which operation of the living surface and its secreted
juices on the calomel, it will exert no subsequent action
 on the alimentary tube.  The second result developed,
                      • Annesley.
                         12* 
134
ON THE DISEASES
is  the  stimulus, peculiar and unique, exerted by the
calomel upon  the  mucous  tissue of the stomach and
bowels, by which a change is wrought in the secretory
action of that tissue.  The third effect is the excitement
imparted by the remedy to the  bilious and pancreatic
secretions,  augmenting or altering them.  The unrival-
ed power of calomel in dysentery, is  abundantly con-
firmed by the valuable experience of  James Johnson,
Annesley,  Ainslie, Musgrave and others.   Dr. Ainslie
prefers small  doses, but  the weight  of authority is in
favour of the large doses  indicated by Johnson, and in
which he is followed by Annesley and Musgrave. The
increased secretory  action  created by calomel  on the
surface of the intestinal canal, and on the pancreas and
liver, is generally imparted to the kidneys and skin; so
that after the cathartic operation of calomel, or blue-
pill, these several  emunctories are in a more vigorous
discharge of their  offices  than anterior to the agency of
the remedy.
  There are two constitutional ways in which mercury
acts.   The first is a more alterant and tranquil action;
and the second is accompanied by more potent demon-
strations of the powerful agency of the mineral.  Dr.
W. Philip has written a  very good essay on the influ-
ence of minute doses of  mercury,  in which he strenu-
ously  insists  on  the beneficial  effects of giving the
remedy in  very small quantities, persisting in its use
for a  long  time.   He contends that it  possesses a two-
fold property  of stimulation and sedation, and that to
effect these ends, it must enter  the  blood.  Since the
day of Cullen, who denominated mercury a  stimulant
to  every living fibre, when  constitutionally  acting, 
INDUCED BY MERCURY.           135
almost every writer on the subject has concurred with
that great man in his views of its  action.   There are
two leading and prominent points  now to  be noticed,
which lie before our way of investigation, and must be
distinctly elucidated before any just conceptions can be
entertained on the modus  operandi  of mercury on the
body.  The  first  point is embraced in this  question,
is mercury a stimulant ? The second point is embraced
in another  question—does mercury enter  the  blood?
  If mercury is a stimulant, in what sense is it one? for
it is clear upon the most superficial consideration, that
it does not incite, or goad on the actions of life in any
manner analogous  to camphor, or volatile alkali.  Then
if really a stimulant, in  what manner  or degree does it
excite the functions of life?  If authority were of itself
sufficient to settle such a controverted matter as that
involved in  the  modus  agendi  of  mercury,  then
there would be  no room for further remark.  For the
preponderance of  medical opinion  is  greatly in favour
of the stimulant operation of mercury on the constitu-
tional energies and actions.  Thus Ainslie says,  "Mer-
cury, I conceive to be the most universal stimulant and
alterative in the whole range of the materia medica."*
And in this view he has the concurrence of Hamilton,
Alley, Eberle, and others. Dr. Chapman says, " though
undoubtedly a stimulant,  and of  the most  enduring
kind, its effects, I think, cannot be ascribed to this pro-
perty simply."  John Hunter considers it a stimulant,
and  that it  destroys the " diseased action of the living
parts, counteracting the venereal  irritation by  produ-
* Materia Indica, vol. I. p. 648. 
136
ON THE DISEASES
 cing another of a different kind," and that, therefore,
 "neither  quantity  alone,  nor evacuation,  will avail
 much; but that it will be quantity joined with sensible
 effects that will produce the quickest cure,  which from
 experience we find to be the case."*
   There are several  very  important respects in  which,
 if mercury be a stimulant, it differs from all  other arti-
 cles of that class of remedies.  First,  other stimulants
 are withheld by the enlightened  practitioner in con-
 ducting the  treatment  of diseases of acknowledged in-
 flammatory character.  Take, as examples, dysentery,
 acute hepititis,  iritis, puerperal peritonitis:—to admin-
 ister brandy, camphor, or any other stimulant for  the
 cure of these diseases, would be  a strong evidence of
 dementation.   And yet mercur}' is the sheet anchor of
 the treatment in such diseases.
   In the second place, mercury refuses to act when  the
 system is too much prostrated in its powers.  But stim-
 ulants are always given  when the vital energies  are
 sunk, for the purpose of increasing  them.  Sir  W.
 Philip, aware of these wide  points of dissimilarity in
 the  action of mercury, and  of any  stimulant article,
 properly so designated, contends that  " mercury, like
 other agents, possesses the sedative as well as the stim-
 ulant property:—and its  sedative  property appears to
 be wholly exerted on the motive powers—for when it
 appears  to lessen the sensibility,  this  effect seems to
arise from  its removing some cause of irritation." Now
such  an explanation is neither precise nor  profound.
"Like other agents,  mercury possesses  the  sedative as
well as the stimulant property;" then it, and all other
* Hunter on Venereal, p. 320. 1st Am. ed. 
INDUCED BY MERCURY.
137
remedies act in the same way—and the question is un-
resolved,  in  what does the agency of mercury differ
from  that of other remedial  articles.  There  is still
another aspect in which  the distinctive  character of
mercury is to be contemplated, as regards its action on
the animal body.   It possesses a cumulative property,
different from all  purely stimulant articles, bearing an
analogy in this respect to arsenic  and digitalis.  To
secure and perpetuate  the train of action created by
stimulants, we have to increase the quantity adminis-
tered, and often  to change the agent,  because  the im-
pression induced  by them upon the organic sensibility,
is constantly diminishing.  It is otherwise  with  mer-
curial  excitement:  to continue  the remedy in a less
dose than the one you commenced with, after the pro-
cess of mercurialism is instituted, is to  greatly enhance
the effect.  The  period which sometimes elapses be-
tween the administration of mercury and the develop-
ment  of  the  salivant  effects  of the  remedy is  often
considerable.  In  this a wide difference is seen between
its action and that of any agent belonging to the class of
stimulants.   Swediaur,  in his  work on venereal,  men-
tions a case in which the mercurial action did not break
forth till more than a month after the use of the mineral.
Dr. Hamilton,  in his work on mercury,  gives  the fol-
lowing as as instance of the cumulative property of
mercury.  "A lady, the mother of four children, in
the twenty-eight  year of her age, had a bad miscarriage
at the end of the  fourth month.   When the author was
called,  she was very much reduced from the loss  of
blood, and required the ordinary palliative remedies.
Three days after  the first visit, she complained  of a bad 
133
ON THE DISEASES
taste in her mouth, with soreness of her gums, and on
the following day salivation took place.  On inquiring
into the circumstances of her previous history, it was
learned, that four years before,  she had had for a fort-
night a course of blue pill, which had only  slightly
touched the gums,  and it was  solemnly asserted, that
she had never again taken any preparation of mercury,
and had been in general good health.  The salivation,
with  the  usual  consequences  of emaciation,  debility,
and irritability, continued  for above  twelve months.
Occasionally for a  day or  two it was  checked, but
alarming vomiting, with threatening sinking of the liv-
ing powers, supervened.   The patient, however, even-
tually recovered.  The medicines administered, during
her illness from the abortion, were  carefully analyzed,
from  a suspicion that some mercurial preparation might
have  been mixed with  them, but it turned out that they
contained no mercury."
  Dr. Ives,  in a note, gives  another case derived  from
J. M. Smith, M. D.  immediately  in  connexion with
Dr. Hamilton's, at p. 23 of Ives' Ed. of Hamilton on
Mercury.
  "In November, 1811, says Dr. Smith, I was requested
to visit a lady about 55 years of age.  Her symptoms
were  small  and frequent  pulse, tongue white with a
brownish discolouration through the middle, protracted
constipation of  bowels,  hot skin,  head ache, deliri-
um, and great prostration of strength  After premising
purgative medicines which effectually relaxed the bow-
els without mitigating the febrile symptoms, I put her
on the use of submuriate of mercury,  combined  with
pulvis antimonialis and opium.   This preparation, con- 
INDUCED BY MERCURY.           139
taining about two grains of the submuriate in a dose,
was repeated every three or four hours with the design
of exciting ptyalism.   This plan of treatment was con-
tinued three or four days, with the occasional adminis-
tration of other remedies as  the circumstances of the
case seemed to require.  At the expiration of this peri-
od, symptoms of ptyalism  not being manifested, and
the patient rapidly sinking into typhus, I was induced
to abandon  the mercurial treatment,  and to pursue a
more stimulant course; accordingly I advised the liberal
use of wine and  other cordial  remedies.  The good
effects of this plan were soon  discernible.  In a short
time she became convalescent, and in  a few weeks was
able to leave her apartment and visit abroad.
  "Three months after her first attack, I was again de-
sired to see her.   She exhibited at this time all the vio-
lence of mercurial salivation, and, with much difficulty
related the manner of its accession. Three days before,
after considerable exposure  to  humidity and cold,  she
observed her  breath  to  smell disagreeably, and  the
saliva to flow copiously.  Fcetor of breath  increased to
that degree that she avoided company, fearing her pre-
sence would be offensive.  At the same time her gums
became sore and tumid, and  at length  ulcerous; the
tongue was swoln and loaded with much white mucus,
and excessively sensible;  the salivary glands, generally,
were  also affected with  intumescence:  indeed, so se-
verely was she affected that she had scarcely the power
of utterance.  So correspondent were her  symptoms
with those which mercury is  known to occasion, that I
did not hesitate  recognising her present illness as the
effect  of that medicine.   Not suspecting at this time 
140
ON THE DISEASES
that the affection of her mouth was produced by  mer-
cury received into the system at a period so long pre-
vious as when she laboured under typhus,  I  made spe
cial inquiry whether she had recently taken any medi-
cine, and was answered in  the negative,  and informed,
that she had taken nothing of a medicinal nature, since
she was under my direction while sick with fever. Not
doubting her veracity,  and being persuaded that her
disease was a mercurial ptyalism, 1 was  led  to inquire
to what source it could be attributed.  While engaged
in this inquiry, her former illness occurred to me, and
the quantity of calomel taken at that time without pro-
ducing any sensible effects.  To account for the disease
from this source appeared  to be deviating from correct
etiological reasoning, yet so decidedly marked was her
disease, that I felt no hesitation  in assigning  this as the
cause.  For her relief I prescribed the occasional use of
flowers of sulphur and cream of tartar, with  a view to
keep the bowels  in a  soluble state; and  directed the
mouth to be frequently washed with a detergent gargle:
under this treatment she soon recovered  a state of per-
fect health."   This suspended  cumulative property of
mercury I have often witnessed, to a limited extent, in
fever.  Very frequently after the employment of calo-
mel for a number of days  in febrile diseases, without
any appreciable  manifestation  of mecurialism in the
system, a very noticeable subsidence of  the worse fea«
tures of the attack would be witnessed, and pari passu
with the patient's improvement, would be the outward
signs of the mercurial action.  The secret springs of the
disease had been touched  by the remedy before the
external phenomena, attesting its pervading  operation 
                INDUCED BY MERCURY.           141

in the system, had revealed themselves.  For a change
in the series of morbid actions going on in  the organs
is a surer evidence of the remedial  control exerted by
the mercury than foetor of the  breath, and swollen
gums.  The return of salivation after a lapse of  some
time,  I have seen in several well marked instances.  In
a boy of  six years old  who had been badly salivated
during an  attack of bilious fever there  was for several
winters a recurrence of foul breath,  swollen  gums, and
ulcerations about the mouth. The mercurial erethysm
returned, after exposure to a cold and damp air. Fever
always accompanied the recurrence of the mercurialism.
The question whether mercurial action is susceptible of
a complete intermission, formed a  material subject of
inquiry, in a  criminal prosecution some years ago, in
England.   A woman  was indicted  for  murdering her
master, by giving him  corrosive sublimate.  He had
been  salivated two months  previous to the severe sali-
vation which terminated  his life, and the question was
whether this last salivation  could be attributed to the
mercury taken before, after so long an interval.  The
medical witnesses were  in direct  opposition to each
other  in their statements.   The surgeons of Lock Hos-
pital deposed  that such a thing as an entire intermission
of salivation from mercury  was seen in the wards of
that institution—that in one case the interval was  three
months, and that in one patient there was a periodical
attack of salivation at intervals of a month or six weeks
for a whole year.*
  Dr. Gordon Smith in his Principles of Forensic Medi-

           •Christison on Poisons, 2d ed. p. 372.
        13 
142
ON THE DISEASES
cine cites from Dr. Hamilton's lectures a case in  which
the interval was four months.
  From the foregoing facts and reflections it must ap-
pear evident that mercury is not a  stimulant—if we
appropriate that  term exclusively to such  medicinal
agents as increase the vital powers and actions, without
inducing any sensible evacuation.  Stimulants impart
force and activity to the movements of life; and rouse
the whole economy into a more vigorous performance
of its  functions.  But mercury  accomplishes no such
end by any direct bearing and operation—that it quick-
ens the circulation and increases secretory effort are no
proofs of its being a stimulant, for  great depression of
the motive powers, and prostration of nervous  energy
are too often seen during its sway over the functions, to
warrant any sound inference that it is  stimulant because
it thus affects the heart and the emunctories. It is suffi-
cient for all the purposes of practical medicine,  to de-
termine what the phenomena are, and  the order of their
development,  which  we  observe in  the living  body
whilst under the dominion of mercury.   It is alien
from the spirit  of just philosophy and adverse  to the
acquisition of a true experience of the  benefits to be de-
rived  from the employment of mercury, to classify
such a remedy, acting, as it does,  with a unique and
most  exclusive agency, with any other remedial sub-
stances.  It stands alone, insulated in its own wonder-
ful and extensive capabilities of  good or evil,  and in
solitary strength bids defiance at all our weak attempts
to compare its properties with any other article in the
materia medica.
  Have we any well authenticated, incontestible proofs 
INDUCED BY MERCURY.
143
that mercury  ever  enters the  blood?  A hundred
tongues and pens are ready to enter the arena  of con-
troversy at once, and with precipitate zeal, put down
all doubt or dispute on the point.   And the  attenuated
form of the antiquarian and bibliomaniac, covered with
the dust and cobwebs of his closet, is seen gliding with
rapid -strides  across  the arena, ready to throw at  our
heads the large tomes of Brasavolus, Rudius,  Schen-
kius, Poterius,  Hochstetter and other  most illustrious
cultivators of hypothetical illusions.  But let us hear
what they say  for themselves in this matter. "Bone-
tus,"  says a late writer,  " gives us  several instances,
collected from  Renodoeus, who states  from Trajanus,
hydrargyrus copiosus repertus est, in  cranio nempe,
scapularum at  brachiorum juncturis."
  Cardanus took two ounces of crude mercury out of a
patient of his own—which he no doubt had put there
after death.  Schenkius saw a patient vomit a spoonful
of quicksilver,  during a mereurial  course.  Rhodius
saw two patients piss crude mercury; and  in the Ger-
man Ephemeres, says Christison, it is said, that no  less
than a  pound  of it was found in the brain, and two
ounces in the skull-cap of one who had been long sali-
vated!!   Buchner avers, that Pickel of Wiirszburg ob-
tained  mercury  by the destructive distillation of the
brain of a venereal patient, who had long taken corro-
sive  sublimate.  This same  Buchner  detected  abun-
dance of quicksilver  in the  blood, in the  saliva,  and
urine of mercurialized patients. Now, says the humor-
alist, with the pride of certain victory sparkling in his
eye, what can you say to these stubborn facts.   If the
facts are not stubborn, they are  at least amazing and 
144
ON THE DISEASES
miraculous. For as the moderns, with the best improve-
ments in chemistry,  can make no such discoveries, or
rather inventions, we must rather presume, with some
of the former very erudite disciples  of Galen, that the
human body has undergone a change in  its anatomical
structure, than that Pickel or Schenkius could misinter-
pret or misrepresent facts in an age of wonderment and
superstition.  All that I shall pointedly urge in answer
to the above is by way of illustration. " Dr. Cooke men-
tions a case, says Professor Christison, in which the fluid
in the ventricles of the brain had the smell and taste
of gin,  the liquor which had been taken.*   It is added
that the liquid was  inflammable.   It would have been
desirable that Dr. Cooke, or rather his informer, Sir A.
Carlisle, had  mentioned how  the inflammability was
proved;  for some fallacy may  be strongly suspected;
because gin of sufficient strength to take fire, could  not
enter the blood-vessels without coagulating the blood,
and  so  preventing its further progress."  In addition
to the above, the same author states, that in animals
poisoned with alcohol introduced into the  stomach, he
never could perceive even the smell of the spirits jn
any  other part of the body.t
   John Hunter, Philip Syng Physick, Bostock, Chris-
tison, with many  of the other acute  and herculean
minds  of the  profession in modern days, have never
been able to  detect  mercury  in the blood, saliva and
bones,  in the  manner,  it  is said, the wonder-loving
explorers in this dark mine of inquiry, in former ages,
found so readily and  in such abundance.

       * Cooke on Nervous Diseases, p, 104, Am. Ed.
       f Christison on Poisons, 2d Ed. p. 802. 
               INDUCED BY MERCURY.           145

  "Mercury," says the great and original  man, who
stands as the father of modern English surgery, " often
produces  pains like those of rheumatism,  and also
nodes which are of  a scrofulous nature; from thence it
has been  accused of affecting  the bones, 'lurking  in
them,' as authors have expressed it.   It may be sup-
posed to be unnecessary to mention in  the present state
of our knowledge, that it never gets into the bones  in
the form of a metal, although this has  been asserted by
men of eminence and  authority in the profession; and
even the dissections of  dead bodies have been brought
in proof  of it; but my  experience in anatomy has con-
vinced me that such appearances never occur.   Those
authors have been  quoted  by others;  imaginary cases
of disease have been increased; the credulous and igno-
rant  practitioner  misled, and patients rendered  mise-
rable."*
  Dr. Physick, in the  fifth volume of the New York
Medical Repository, has given the result of his experi-
mental investigation on this subject.   " So confident,"
says  he,  " were they formerly of mercury entering the
system, that it was even believed, in some instances, to
have been deposited in  the  bones in the form of quick-
silver.   The  latter  opinion has been sufficiently dis-
proved by accurate anatomical investigations; though
the former continues  still  in  vogue, and is generally
believed."  In that communication, the Doctor relates
some experiments performed by himself and Dr. Sey-
bert, upon the blood and saliva of patients, affected with
mercurial salivation, and then adds, "The introduction

             * Hunter on Venereal, p. 316.
                        13* 
146
ON THE DISEASES
of mercury into the blood-vessels through the absorbents,
(an hypothesis which appears to have been admitted
by  physicians  without much examination) is  at least
rendered very improbable  by the above experiments.
It may,  indeed, be  said,  that the  mercury is  com-
bined with the blood in such a peculiar way,  that the
above  means have  not been  adapted  to detect it;  but
such an  objection must be granted  to be a very lame
one, because it is hypothetical."
  Mayer, not long ago, subjected to accurate chemical
analysis, the chief solids and fluids of a person who died
while taking mercury,  and Devergie,  so late as 1828,
by a very delicate process, so delicate as to enable him
to detect a  122.680th part of corrosive  sublimate in
blood, endeavoured  to detect mercury in the blood,
saliva  and  urine of persons under a mercurial course:
and Christison  tried  to find mercury in the solids and
fluids of two rabbits killed  by  inunction, but the result
in all their hands was, that no mercury could be found.
  Dr.  Bostock states,  in  his " Observations  on  the
Saliva, during the action of Mercury on the  System,"
that he could not detect the  minutest portion  of mer-
cury in the saliva of a patient deeply affected, both
locally and constitutionally,  with that agent.   "We
learn," says he, " from the experiments, in the  first
place that no portion of the mercury  is actually present
in  the fluid, from which it follows that the effects of
this medicine, although so remarkably manifested on
the  salivary glands,  must be produced through  the
medium of the system generally, and hence we may
presume that  all the  organs destined for the secretion
of mucus will undergo the same change.  This change 
INDUCED BY MERCURY.
147
would appear to consist essentially in the conversion of
the animal matter, from the state of  mucus to that of a
serous, or rather of an albuminous fluid.*
  Mercury  sometimes  produces fatal effects in very
small quantities.  Dr. Ramsbotham, in the first volume
of the London  Medical Gazette, gives a  case of fatal
salivation from  fifteen grains of blue pill, taken in three
doses, one every night.   Dr. Crampton, in  the  fourth
volume of the Transactions of the Dublin  College  of
Physicians, relates an instance in which two grains  of
calomel,  caused ptyalism,  extensive ulceration  of the
throat, exfoliation of the lower jaw, and death.   Three
drachms of mercurial ointment employed in  the way  of
inunction have induced violent salivation and death  in
eight days.t
  Dr. Hamilton gives a case in which five grains of blue
pill, given within three nights, created such  an  intense
degree of sialagogue effect,  that for a month the lady's
life was in the utmost jeopardy.
  Dr. Alley, in his work on Hydrargyria,  relates the
case of Francis Milroy, aged ten  years, to whom only
three grains of calomel as a purgative were given,  in
whom it produced a severe eruption  over the entire
surface of the body.
  In persons who have been severely ptyalized,  I have
seen a single grain of calomel, or a few grains of blue
pill renew, after a lapse of months, a painful degree  of
salivation.
  How can these facts, and those before cited in refer-
ference to the suspended cumulative  action of mercury,

  • London Medico-Chirurgical Transactions, vol. 13th, p. 79.
  f Christison. 
148
ON THE DISEASES
and the intermissions  often observed  in  mercurialism
of the system, with the crude and absurd notion of the
introduction of mercury  into the blood?  During the
days of medical superstition,  when every sort  of idle
tale concerning the effects of medicines was credited, it
might answer very well, as a substitute for knowledge,
to talk about venereal poison floating in the blood, and
tell the credulous that mercury had  a  specific elective
affinity upon such virus to neutralize and expel it.  But
now when  the phenomena of disease are studied, as
they are seen,  in the living solids, and when with  such
a mass of contradictions and errors darkly rising before
our view on the whole field of humoral pathology, it
behoves every one who desires to talk sense, and adhere
to things open  to examination, no longer to indulge in
the fond vagaries of a wandering and excursive  fancy.
If mercury enters the blood in one patient it should do
so in every  one, to whom it is given to an  extent suffi-
cient to salivate.  If it does so  in every  case why did
not Physick,  Seybert,  Bostock, Christison, Mayer,
Devergie, and many other acute experimental inquirers
detect it, assisted, as they  were, by the lights of modern
chemistry ?  Besides, mercury will not act  as a salivant
on  many constitutions.  In one case  I gave it in large
quantities for a number of days without witnessing the
smallest manifestation of ptyalism. The gentleman had
venereal, and was  otherwise in good health.  If it en-
ters the blood,  why did  it not affect  the  system  as a
sialagogue in this case ? It did not purge my patient, or
to any great extent, act on any of the emunctories.  Let
us recur to the question, how does mercury act ?  First,
it acts as a purgative locally on the stomach and intes- 
INDUCED BY MERCURY.
149
tinal canal.  Secondly, its action is radiated to the pan-
creatic  and hepatic functions.  Thirdly, its circle of
operation is more widely diffused in its agency  on the
kidneys and skin, and still more expansively directed
to the glandular apparatus of the mouth.  Not that the
action of mercury is invariably,  in all states  of the sys-
tem, precisely in this consecutive order of influence.
But  when it is judiciously administered, its range of
action is as indicated.  There is  an additional capability
of impression upon the constitution which seems almost
peculiar to this sovereign remedy.  That capability re-
sides in its governing influence over the diseased move-
ments of the capillary system  in many cases of disor-
dered health.   Dr.   Farre, in view of this power of
arresting  the inflammatory process in iritis, contends
that mercury has the power of preventing or arresting
the deposition  of coagulable lymph. " I have uniformly
regarded," he writes to his friend Mr.  Travers, " the
mercurial action as the most effective means of arrest-
ing the  disorganizing process of adhesive inflammation,
whether of  the iris,  or  of any other  texture  of the
body."*
  Arsenic acts on the capillary system, particularly of
the skin, in a most effective manner in many diseases.
But mercury has a more penetrating and dominant con-
trol  over the  capillary  system  than  arsenic.  This is
strikingly evinced in fevers of a low grade,  termed by
Armstrong congestive, where  the skin is cold   and
bloodless—directly  the mercurial impression is created
on the constitution,  the surface becomes warm,  and as-

        * Cooper and Travers* Surgical Essays, art. Iritis. 
150
ON THE DISEASES
sumes its functional action.   The increased  action of
the heart, consequent on mercurialism, results from this
development of energy in the capillary system.  In this
sense is mercury a stimulant, but if regarded in other
lights, it is the very opposite of a stimulus. Its agency
is a peculiar, mixed, characteristic one—totally unlike
that of any mere stimulant, or sedative, or evacuant, or
of all combined.   By the union  of no  other  remedies
can you imitate,  with  any success, the widely diffused
operation of mercury on the constitution.   When given
in very small doses it  produces a slow and permanent
change in the deranged condition  of the functions.  And
yet with all its capability of restoring health to the or-
gans, and of preventing or arresting morbid depositions
of lymph, mercury is often  a  most potent engine of
mischief.  My next object is to point out the  causes of
its evil effects upon the living animal body.   The  first
cause which  produces the morbid affections springing
from the agency of mercury on the system is idiosyn-
crasy. An inscrutable peculiarity of constitution renders
it a matter of great peril for some persons to take mer-
cury in any shape.  The smallest dose of  blue pill, or
calomel, will in such individuals create the most alarm-
ing symptoms,  and death will  sometimes result from
the taking of a  few grains  of either.  Sir W.  Philip
mentions the case of a lady in whom salivation was caused
by one fourth of a grain of blue pill; and in another
lady's case, one grain of calomel equally distributed in
eighty pills of extract of liquorice was prescribed—one
pill to be taken  at a time—but that the 80th part of
the grain of calomel so affected her with depression  and
irritation, as to compel the abandonment  of the reme- 
INDUCED BY MERCURY.
151
dy.  In the summer of 1822, I attended a lady with
violent dysentery, in whose case a few grains of calomel
produced the most intense degree of erethismus—death
seemed to impend each time she took the remedy. And
yet in consultation it was determined to persevere in
the use of the remedy,  as it appeared the only resource
left us for her restoration.   The  dose was increased
from a few to ten grains every four hours, and  under
this treatment she recovered. This idiosyncrasy obtains
in certain persons in relation to the agency of other ar-
ticles,  both  dietetic and  medicinal.   Opium is  like
poison to  some constitutions, even in  the  smallest
quantity.
  The second cause operating in the production  of the
morbid  consequences arising from the administration
of mercury is the inapposite condition of the system at
the period of its being given.  Thus a  broken  down
constitution cannot  bear the mercurial action.   If the
vital forces are  either in a very exalted, or depressed
state, the administration of the remedy to produce a
constitutional effect, is injurious.   The  strumous dia-
thesis, is well known to be  unfavourable to the benefi-
cial agency of mercury.  Neither young  children, nor
aged  people,  can withstand  a powerful  mercurial im-
pression.  Another cause which is frequently the origin
of the mischiefs inflicted by the action of mercury on
the body, is  the excessive quantity administered. That
there is a point  of limitation as regards the quantity of
calomel to be given, is quite apparent, not only because
the practice of medicine requires judgment to discrimi-
nate  in  reference  to  each  case of  disease, how far a
remedy may itself  become  an evil, but  on account of 
152
ON THE DISEASES
the subaction, that calomel must undergo in the sto-
mach, before it will influence the organic sensibility of
the mucous tissue of  the bowels.  It is not desirable,
by any means to throw into the stomach, a substance
which will lie there as a mechanical weight.  To give
therefore an ounce, or half an ounce  of  calomel, in one
dose, as has been done, is a practice unwarranted by
sound therapeutical considerations.   Fifteen, twenty,
or thirty grains of calomel are as large a dose  as any
exigency would seem to  demand.  Ten  or twenty
grains of the remedy repeated twice,  thrice,  or four
times a day, is  as far as the practitioner should  pro-
ceed in  cases requiring the medicine,  unless the sto-
mach rejects it soon after being administered.  Where
the  physician desires to induce, rapidly, the constitu-
tional result of mercury, in addition to the use of calo-
mel, he should sedulously employ inunction,  or the
dressing of blistered surfaces with the ointment.   That
the reader may judge of the extent to which the practice
of giving large doses of calomel has been carried in this
country, the following is copied from Dr. Cooke's Re-
marks on Cholera, as it appeared in Lexington, in June,
1823.   In  " case 6th," of " A. Walker, a man of 40,
perhaps," who called  at the professor's  house,  "and
complained of uneasiness in his bowels, but there was
neither  vomiting nor looseness.  His complexion was
very bilious."  Sixty grains of calomel were ordered,
at 12 o'clock in the day time, he took the dose, and at
night it was repeated; second day an ounce  of calomel
was given, and tincture of aloes; third day, " he took
more calomel, in similar doses"—We infer of an ounce
each, and died on the fourth day. 
INDUCED BY MERCURY.
153
  "Case 7."  A black woman took two ounces, in two
successive days, and recovered.
  "Case 9." A coloured girl often years of age, "took
half an ounce of calomel, and repeated it several times
in the course of a few days." She got well.
  "Even a table-spoonful," says Dr. Cooke, "did  not
always effect the object"—that of  producing  bilious
discharges from the bowels.  " A  black  girl at Mr.
Benjamin Theiser's, took several such does before the
watery discharges were stopped.  Bilious discharges
then followed, and tincture of aloes, about  a wine-glass
full at a time, kept them up, and she recovered."
  " Case 26.  William Douglass," rested satisfied with
f taking twenty grains of calomel  early in the day," of
his illness.  Dr. C. gave him a table-spoonful of calomel
in the evening of the same day.   Next morning early,
another table-spoonful of calomel was given," and con-
tinuing to live, contrary to all expectation, and the  dis-
charges continuing  the  same, he took the same quan-
tity (a table-spoonful)  every six hours on that day, and
the next, and the third."*  The young  man died, the
Doctor thinks in consequence of bad nursing, and a
change in the form of the aloetic medicine.   In con-
sultation  with a physician  who  held views similar to
the author just quoted,  it was proposed by him to
administer to a man very ill with cholera, announce of
calomel—half immediately and the balance in half an
hour,  or  an hour, " in  order," says  he, with great
apparent consciousness of the perspicacity of his supe-

  * Transylvania Journal of Medicine, for July, August and Sep-
tember, 1834.
           14 
154
ON THE DISEASES
rior judgment, "to tap  the  liver, and make the bile
run freely."   He declared that he would have nothing
further to do with the case, unless his prescription was
followed; and as the other medical men, with myself,
took another view of the propriety of thus tapping the
liver, the heroic doctor  retired from the field, in per-
fect disgust at the  timidity of  the other less knowing
ones.
  A still  additional cause, which often operates in pro-
ducing disease and suffering of  a most protracted kind,
thus inflicting on the patient  an  existence which  is
loathsome and torturing  in  the extreme, is improper
regimen,  or a  reckless  exposure to the  vicissitudes
of atmospheric temperature, during a mercurial course.
  In warm climates, in which a uniform temperature is
maintained, the  ill effects arising from a sudden arrest
given the functions of the skin, whilst  the system  is
under mercurialism, are seldom experienced. But even
in India, according to Ainslie, pernicious effects flow
from  the  use, or rather abuse of the remedy.   "The
Hindoos," he remarks,  " reckon mercury one of their
most  powerful medicines, but are very apt,  not always
intentionally, to induce,  by its use, the most frightful
salivations; I say  frightful,  for however desirable  it
may  be  that the mouth  should  be touched before we
can be certain of much lasting  good having  been done,
few things are more distressing than severe ptyalism."*
Musgrave, who practised in Antigua, observes, in his
essay " On  the unmixed Effects of Mercury on the
System," that he never saw or  heard " of a  case where
• Materia Indica, vol. II. p. 349. 
INDUCED BY MERCURY.
155
symptoms bearing the stamp  of secondary syphilis, in
the common acceptation of these words, were ever sus-
pected to be the offspring of mercury administered for
the cure of any other disease"—that the only bones he
ever  saw immediately  or ultimately affected  by the
most  aggravated  cases  of  mercurial mismanagement,
were those of the upper and lower jaw, whose vitality
might have been partially  destroyed by  a process of
denudation, caused by the  extensive sloughing within
the mouth, which involved their periosteum."*   It is a
well known truth among practical physicians, that to
conduct with skill, a mercurial course, strict attention
should be paid to the condition of the patient's system.
If he lives on  in  the indulgence  of stimulating  food,
partaking perhaps of wine or spirits every day, he in-
curs great hazard of injury to his constitution, from the
exorbitant or  perverted actions created in the organs
by the mercury.   And when we reflect upon the great
powers of the  remedy, as evinced by the processes of
functional  activity which it arouses  in the system, no
surprise should be excited at the great evils resulting
from the reckless manner with  which patients often
conduct themselves during its administration.   Subse-
quent reflections will be offered  on this  point, as the
discussion is proceeded  in.
   But in verity,  and without  misconception, is there
any such thing as mercurial disease at all,  or is it a mere
nonentity, the "the shadow of a dream," infesting the
brains of the ultra anti-mercurialists? It would have been
 well for many an unfortunate patient had  mercury been

    *  Edinburgh Med. and Surg. Journal, vol. XXVIIL p. 54. 
156               ON THE DISEASES

fraught with no properties but those which are saluti-
ferous—were it never the dire messenger of evil to the
suffering human being who has been tormented by its
potent sway.  And although Carmichael of Dublin,
very  high  surgical authority  it is readily conceded,
avers that  he  had not,  " nor  did  he  believe that any
other  person  had witnessed  ulcers on  the skin and
throat, and nodes on the bones, from the exhibition of
the most extensive courses of mercury  in any  other
than the venereal disease, nor even an eruption, except
the well known  mercurial eczema,"*  yet Mathias,
'and other medical writers,  most positively pronounce
the contrary to be the fact.   And my own limited ex-
perience in this matter has most  impressively taught
me, how much easier it is to dogmatize than to prove,
in reference to the position  taken by Carmichael.  Mer-
cury may produce disease by  its  direct immediate ac-
tion on the stomach, or surface—or it may induce its
morbid effects by a slower  operation through the gen-
eral system.  By its rapid irritating impression on the
gastric mucous tissue,  or upon the skin, it may act as a
poison, either from idiosyncrasy of the constitution, or
from  some peculiar condition  of  the nervous system.
The instances  already cited show  that mercury some-
times acts as a  violent irritant, and  Pearson in his "Ob-
servations  on  the Effects  of various Articles of the
Materia Medica in the cure of Lues Venerea," in speak-
ing of the  erethismus  mercuriale which  affected  some
of his patients, observes that, by abandoning the mer-
cury for a few days or weeks in the cases of patients
* Ed. Med. and Sug. Journal, Vol. XI. p. 436. 
INDUCED BY MERCURY.
157
thus affected by it, he always found that he  afterwards
could with safety return to  its use, without the indi-
viduals  experiencing any  bad consequences from its
administration.  In its quick action on the first  pas-
sages the mildest preparation  of the mineral  may bring
on, 1st, Emesis and  vomiting.  In the second place the
genuine erethismus mercuriale may result;—or, in the
third place, a vesicular eruption may be developed;—or,
in the fourth place, the patient  may be affected with a
very severe,  perhaps dangerous, inflammation of the
throat and mouth.   When the constitutional influence
of mercury is exercised, disease may result either  from
the excess of  the action instituted by the remedy, or
from  that influence being checked, thwarted or inter-
fered with, by exposure to a cold and humid atmos-
phere, or by improprieties of living.   In the constitu-
tional class of cases we have ulcerations of the skin and
throat,  pains  simulative of  rheumatism, nodes,  and
sometimes  destructive inflammation in the nasal car
tilages.
   The severe emetic quality sometimes evinced by calo-
mel is  generally owing  to a peculiar susceptibility of
the individual, whom it thus affects.  1 have never
known any bad result arise from the emetic or cathartic
operation of calomel, though Hoffman tells  us of cases
of death from the violent operation of the medicine on
the first passages.   Trotter,  in his Nervous Tempera-
ment, has related some cases to show the dangers incur-
red by the free use of calomel; but he seems to labour
under a nervousness himself on this point,  and practi-
cally  illustrates,  in his horror of mercurial remedies,
the doctrines of  his book on  such  nervous maladies.
                         14* 
158
ON THE DISEASES
Erethismus mercuriale was first accurately described by
Pearson in his  Observations on the Effects of various
articles of the  Materia Medica in  the  cure of Lues
Venerea.  He thus describes it:—"Erethismus mercu-
riale is characterized by great depression of strength, a
sense of anxiety about the pcecordia, irregular action of
the heart, frequent  sighing, trembling, partial or uni-
versal, a small, quick, and sometimes an  intermitting
pulse, occasional vomiting, a pale contracted counte-
nance, a sense  of coldness; but the tongue  is seldom
furred, nor are  the vital or natural functions much dis-
ordered.*
  The vesicular eruption, termed  by Pearson, eczema
mercuriale, or rash from the use of mercury,  denomi-
nated by Alley  hydrargyria, and by Spens and M'Mul-
len erythema mercuriale, and by Moriarty mercurial
lepra, is sometimes occasioned by a single dose of calo-
mel,  or a small quantity of mercurial ointment rubbed
on  the thighs.
  The  Tremblement Mercuriel,  or  Shaking  Palsy,
may likewise be induced by the sudden impression of
mercury on the system—it is rarely the result of the
medicinal use of the  mineral;  but  most always arises
from the inhalation of mercurial  vapours, by miners,
gilders, barometer makers, and glass platers.   Dr. Dar-
wall says that he once " saw the tremour established in
a child,  to whom  a  considerable quantity of calomel
had been given for incipient symptoms of hydrocepha-
lus, "t

  • P. 15&.
  f London Cyclopedia of Practical Medicine, Vol. 1, p. 152. 
INDUCED BY MERCURY.
159
  "On the whole," says  Christison,  "those who are
liable to the shaking palsy  do not appear liable to sali-
vation.  Even those who  undergo mercurial frictions
may have it, according to Merat: and M. Colson,  who
confirms  this  statement,  quotes Swediaur as  another
authority for it.  It is not  merely long-continued expo-
sure to mercurial preparations that causes  the shaking
palsy; a single strong exposure may be sufficient; and
the same exposure may cause tremours in one and sali-
vation  in  another.   My  friend Mr. Haidinger,  the
mineralogist, has mentioned to me an accident a baro-
meter maker of his acquaintance met with, which illus-
trates both of these statements.  This man and  one of
his workmen were exposed one night, during sleep, to
the vapours of mercury  from  a  pot on  a stove,  in
which a fire had been accidentally kindled. They were
both most severely affected,  the latter with salivation,
which caused the loss of all his teeth, the former with
shaking palsy, which lasted his whole life."
  The attack of mercurial  palsy is sometimes, though
not often, sudden, but  most commonly  it comes on
gradually; at first with defective control over the mus-
cles of the arms, followed by  slight convulsive snatches,
and agitations which terminate at length in a tremulous
stale, increasing in intensity, and extending to the legs,
and whole body, if the patient continue his exposure to
the cause.  The accompanying symptoms  of the trem-
bling are arid and unhealthy  brown  skin,  distended
belly, and generally a slow pulse; the appetite and di-
gestion are generally good, and sleep sound.   A single
dose of calomel will sometimes occasion severe and long
continued salivation.  In the summer of 1814, whilst a 
160
ON THE DISEASES
6tudent of medicine, I saw a coloured woman severely
ptyalized by five grains of calomel given at  night; the
salivation  came on before morning, and continued dis-
tressing for a week.
  Dr. Christison mentions the case of a chimney sweep-
er, who died in consequence of gangrene of  the mouth
produced by cleaning a gilder's chimney, during which
operation he felt a disagreeable sense of tightness in the
throat.
  In the summer of 1821, I attended with Dr.  G. W.
Smith,  the  patients of a temporary small hospital in
Louisville, Ky. which had  been opened by the citizens
for the poor of the town: the present commodious edi-
fice, erected by the state  for a marine hospital, was not
then built; neither was there an alms house, which now
exists. There were carried  to this  house a woman and
child, both very ill.  The child was six years old, and
had been sick with fever  before admission.  Whilst at
home, five days previously, it had taken six grains of
calomel, agreeably to a physician's order.  The physi-
cian directed the mother, for she  was at that time able
to attend to her child, to  give it as much cold water as
it wanted.  Soon after taking the calomel, and subse-
quently, it drank copiously of cold water just from the
well.   In a few days, no  other medicine being given,
its mouth  became sore, the  mother  being too sick to
attend to it, the poor thing was neglected.  On the fifth
day  a small   black spot appeared externally  on the
cheek, and the internal surface of the cheeks was dis-
coloured,  the  lips were swoln and  puffy, and a  most
unpleasant odour affected  the breath.  On this day the
child and mother were admitted into the hospital.  The 
INDUCED BY MERCURY.
161
mortification of the cheeks was  unchecked by any re-
medy,  and complete sphacelus of the whole left cheek
taking  place in two days after its admission; it  soon
died. The cold water in this case  unquestionably caused
the mischief which arose.
  I have  seen  another case, which  happened  in the
practice of a respectable  physician of Louisville,  in
which the child took several doses of calomel,  before
the mouth became inflamed, and the patient was saved
with the loss of nearly all the teeth in both jaws, and a
portion of one cheek—about  half an inch from the left
corner of the mouth having sloughed off. A blister was
applied to the cheek, in which the red  spot,  the fore-
runner of the gangrene, made its appearance: charcoal
powder was freely  used to correct the foetor,  the  tem-
perature  of the skin was kept up by warm  clothing,
and the bowels were kept open with sulphur and  char-
coal; the child being sustained by small quantities, fre-
quently given, of well-made chicken soup.
  In the spring of  1815, whilst a student of medicine,
a case of great interest came  frequently under my no-
tice.  It was the case of a young man who, having con-
tracted the venereal disease,  applied to a learned, but
very negligent, practitioner for the cure of it.  He was
put under a course  of mercury without any preparation,
or discipline.   He  ate,  drank, and exercised as he was
accustomed to; and during the course he slept in a cold
room,  in  the winter season,  drank iced water in the
night when thirsty,  and sleeping near a window  with
a pane  of glass out, he  was exposed to a current of the
cold  air on his head.  In a short  time his throat became
sore, and severe pains affected his joints.   All this was 
162
ON THE DISEASES
nothing, but the poison of Venus traversing his veins-—
as he thought, and as, perhaps, his physician  learnedly
communicated  to  him.   The calomel, and inunction,
were now plied with more assiduity and  earnestness to
overtake the  virus, with which his  blood was so re-
plete.   But he had became worse—severe  pains seized
his head, nodes made their  appearance  on his  bones,
and ulcers  commenced  on his scrotum and dorsum
penis.  Thus beset  and distressed, he abandoned his phy-
sician and applied  to the medical  man,  with  whom I
was studying.  His case proved a  most intractable one,
and often did he declare that were it not for the dark
mystery of the future, to him one of peril and  dread,
that he would abandon life by an act of self violence, so
full of bitter suffering and wretchedness were his days.
Cicuta, Lisbon diet drink, and  similar remedies were
tried with little advantage.  Neither arsenic, nor pow-
dered sarsaparilla were employed in his case.  After a
few months  he went to New Orleans,  and  there his
health improved gradually; but he has since informed
me that he  was finally cured by boiling down two gal-
lons of water, into which half a pound of  gum guiacum,
broken into small  pieces,  had been put, into a gallon,
and taking  a quart of this every day.
  About twenty years  ago there practised a physician
in a part of Kentucky, who as familiarly  dealt out calo-
mel by the spoonful, as Broussais  does his ice water. The
result of this practice was mournful in the extreme, ac-
cording to the  declaration  made to me by persons in
whom reliance could be placed.  In one family several
children were deformed  about the face, in consequence
of the sloughing induced in the lips and cheeks,  by the 
INDUCED BY MERCURY.
163
enormous  doses  of  calomel given, for even  ordinary
attacks of fever.
  The following  cases are given as examples of mercu-
curial disease, as  springing from the excessive or per-
verted action of the medicine.
  In the summer of 1826, I attended a stout  young
man with  slight  fever,  accompanied, however, with
great  cerebral  disturbance.  He was bled repeatedly,
and actively purged by mercurial,  and other cathartics.
Contrary to directions, he used cold water,  both exter-
nally to his head, and as a drink. His mouth becoming
slightly sore from the frequent doses of calomel which he
had taken, the cautionary precepts respecting the use of
cold water  were reiterated.   Whilst his mouth was sore
from the mercurial influence, he would persist in wash-
ing his head all  over with the cold water.   He reco-
vered and went  home to his farm, a few  miles from
Louisville.  Before his system had entirely recovered
from the mercurialism, he exposed himself on the farm,
going through the fields, whilst the grass was wet with
dew,  and  lying on  the green sward in front of his
house, during the early part of the night.  In about five
or  six weeks, subsequent to his departure from town,
he  called  on me with rheumatism, or an  affection in
his knees and ancles, very similar to the chronic form
of rheumatism.   I gave him some medicines, which he
did not take very faithfully.  In the course of a week
or ten days, eruptions came out on his skin, in different
parts of the surface.  They were of a copper-colour,
not painful to any considerable degree, and which had
simultaneously  appeared with tumours on the shin-
bones, and on the radius of the right arm.  He grew 
164
ON THE DISEASES
worse,  his throat became inflamed and suppurated,
and he was unable to walk, from several ulcers on the
thighs and legs.   I prescribed arsenic internally, and
directed him to wash his ulcers with diluted nitric acid,
holding opium in solution. But this lotion irritated his
sores, and  aggravated his sufferings.  He quit me, and
applied to a country practitioner, who discontinued my
remedies,  although he concurred in my opinion of the
nature of the disease.  He now took small portions of
sulphur  to neutralize  the mercury in  the blood  and
bones, and washed the ulcerations with the solution of
sugar of lead.  The patient grew worse under this plan
of treatment, and again sent for me.  I found him, after
a lapse of  several weeks from my last visit, with very
bad  ulcers,  superficial  and spreading,  on the thighs,
arms and back.   A dense scab, in the process of the
sore, was first formed,  and the ulceration commenced
under it.   In this  way,  originated the  phagedenic
ulcers, which were rapidly forming in different parts of
the body.   He was now ordered  to resume Fowler's
solution  of arsenic, fifteen drops, three times a day, to
be gradually increased to thirty drops, in a tea-spoonful
of tinct. guaiac. amnion.,  to be taken in a cup of milk.
His  ulcers  were  dressed  with the  common saturnine
ointment of the Dispensatory.  After persevering in this
treatment six or seven weeks,  his ulcers healed up,  and
the nodes  disappeared;  but  there remained a slight
efflorescence on the forehead. His strength was so well
repaired, that in  the end  of November, he went fox-
hunting, and afterwards on the same day, being Sunday,
sat  in a  country  church  without  fire;—the day  was
damp, windy and cold for the season.  In a day or two 
INDUCED BY MERCURY.
165
after this  last exposure he was seized with an excru-
ciating affection of the scalp,  and pain and swelling
denotive of periostitis in the lower end of the radius of
the right arm.   There was no reappearance of the erup-
tion.  By my advice he was bled several times, and
took Dover's  powder, at night, to enable him to sleep.
The  bleedings rather aggravated his sufferings, but the
anodyne produced  alleviation of the pain and procured
repose.  Subsequent to this, he took an emetic of ipeca-
cuanha  every other day,  which produced pretty full
vomiting.  His diet was milk and mush, or bread.  The
repeated emetics conjoined with Lisbon diet drink, and
small doses of antimonial wine, on the intermediate
days, restored him to tolerable state of health, but there
remained  some lameness of the left knee, which was
swoln and stiff.  This young man afterwards  visited
the southern  part of Kentucky, and remained in  suffi-
cient health to travel  to  St. Louis, in Missouri.  In
going to the  latter place, he was exposed to the  rain,
and by the time he reached his place of destination, he
was again  affected with pains and stiffness of the joints,
sore  throat and  cutaneous  eruptions.   He called in a
physician  at St. Louis, who upon hearing a history of
his case, promptly and unhesitatingly pronounced it to
be syphilitic.  In vain the young man protested that he
never had any  sore on the penis, nor had he  ever
exposed himself to the infection.   That made no sort
of difference, was  the  doctor's reply,  he might  have
caught the disease on the seat of a privy, or by sleep-
ing in sheets in which a man with the venereal had lain
all night,  and the matter  might so secretly insinuate
itself into  his blood,  as that he might be utterly uncon-
           15 
166
ON THE DISEASES
scious of the time and mode of its ingress.   So positive
was the medical man on  this head, and so confident in
his averment of rapidly and  permanently curing him,
that he persuaded him to  submit  to a severe mercurial
course at once.  This was in the  month of May, 1827.
Large doses  of calomel were administered to him,
which rapidly  and most severely salivated  him, with
an  aggravation  of all the symptoms.  With difficulty
he reached Louisville in a steamboat. Upon his arrival,
he commenced  taking Swaim's nostrum, but finding no
benefit from its use, again sent for me.  By the arsenic
and tinct. guiac.  he regained, during the summer, his
health.  In 1828 he had, apparently, entirely recovered
from  the effects of the mercurial disease; and he got
married and settled  in town. But upon getting very
wet, when heated at a fire, he relapsed.  After several
months he again was restored to some degree of health,
until winter, when he grew worse.   I lost sight of the
case till  January, 1830,  when I was requested by a
respectable physician to  see  him in  consultation with
him;—he had salivated him for lues venerea, but with
most evident injury.   1 saw him but once, for we could
not agree in our views of the treatment.   The mercu-
rial plan was persisted in for weeks, that  the poison of
Venus might without failure  be now most thoroughly
driven from its strong holds in the bones and mem-
branes.  Soon  after  this, he fell into the  hands of a
notorious nostrum-vender, who pretended that he never
employed mercury for the cure of any disease.   This
medical adventurer and  impostor lured  many into his
snares by a vapouring and  imposing air and manner.
He not only did not employ  mercury to cure diseases, 
INDUCED BY MERCURY.
167
but he possessed a secret remedy, he averred, by which
he could extract  all  the mercury deposited by  other
doctors in the  bones  of his  patients.   In a short time
he salivated this  poor  man most violently, and this he
accomplished by giving him  every night, as I under-
stood, forty-one  grains  of  calomel, twelve grains of
rhubarb, and two grains of opium.*
  This unfortunate  victim of  mercury lost a part of his
nose, which  sunk  in,  and most  of the  palate  of his
mouth—and continuing under the quack,  heat last died
of phthisis pulmonalis,  as I was informed  by  a brother
of his.
  In the summer of  1822, I  was called to see a gentle-
man affected with a violent  attack of  the terrific epi-
demic, which then  desolated  the town and neighbour-

  * The secret composition of this empirical adventurer, which he
prescribed, indiscriminately, to cure  scrofula, mercurial  disease,
convulsions, rheumatism, dysentery &c, was made known to me
by a former student of his, now a very correct and respectable phy-
sician.  This young  gentleman, allured by the surreptitious repu-
tation of the ready and crafty charlatan, who was then regarded by
some of our  wiseacres as JEsculapius  returned to bless the earth
with his profound skill in the treatment of human maladies, com-
menced the study of medicine with him; or, rather remained in his
shop to be a witness of his miracles in the art of healing all diseases
with one remedy.  He became  disgusted with the ignorant  crea-
ture's presumption and blustering  charlatanry, and abandoned him,
though some of the enlightened people still adhered to his nostrum-
working  power.  Pearson  well  remarks, "although there are
many who pretend to exclude mercury from their nostrums, yet
their perfidious declarations are betrayed by the salivating quality
of that mineral, which in defiance  of every disguise and combina-
tion, will appear to the detection of the impostor." 
168
ON THE DISEASES
 hood of Louisville.* His constitution was very vigorous;
 he was  a native of  the northern part of the United
 States, and was habitually temperate.   He was bled to
 a  large  extent  a few hours after the accession of the
 fever, and took a dose of calomel and jalap,  which
 operated slightly.  The day after the seizure another
 physician was called in to attend  with me, and  it was
 agreed on in conference to push for mercurialism in the
 case.  He accordingly took ten grains of calomel every
 four  hours, and as his pulse was reduced  by the  bleed-
 ing,  no further detraction of blood was practiced.  Hav-
 ing been seized with fever the  subsequent day myself,
 the care of the patient was surrendered to the other
 physician.  He continued the calomel, and added in-
 unction.  Whilst under this treatment, convulsions came
 on, the pulse still reduced, the warm bath was employ-
 ed, and small portions  of opium.   After  my recovery
 I visited the patient at the request of  the third physi-
 cian, the second one having been  attacked with  fever.
 The patient was at this time,  fourteen days from the
 period of the discontinuance of my attendance, affected
 with  mercurial ulcers in the mouth and throat, his  dis-
 charges were  of a  tenacious consistence  and dark co-
 loured, and he lay in a state of  coma.  The remedy had
 not excited ptyalism  at all—there being  no increased
 secretion of saliva.   The pulse was weak  and quick,
 and the thirst great.   The ulcerations  came on several
 days after all remedies were abandoned, and daily grew
 worse till, apparently, they were extended through the

  * For an account of this epidemic fever,  see  Chapman's Journal,
Vol. 8. 
INDUCED BY MERCURY.
169
intestinal tube, for his anus became ulcerated, and san-
guineous evacuations closed his life.
  In the year 1825,  a man named  Hamilton, was ad-
mitted  into the Louisville Marine Hospital, affected
with a very extensive cutaneous disease.   Not being in
attendance at the time, I was invited  by the attending
physician and surgeon to see the case.   It appeared a
matter of much uncertainty with the attending physi-
cian and surgeon which  of them should conduct  the
treatment of the man's case;—they therefore determined
to prescribe for him in consultation.  He was a boat-
man, and formerly a British seaman, and in good health
previous to the appearance of the eruption.  His general
health  was  still good. The whole surface of the  body
was covered,  almost  literally, with a furfuracious erup-
tion, which was most crowded on the trunk, before and
behind.  When he  pulled off his shirt, at our request,
the branny scales fell around him like snow flakes. On his
scrotum, and  the inner part of each thigh, in contact
with the scrotum, there  were  superficial ulcers.   The
glans penis was sound, but the inguinal glands were in-
durated and enlarged to a small degree. He told several
different tales,  concerning his previous  situation, and
thus increased the perplexity of the medical gentlemen,
who sought to ascertain  the precise nature of his  mala-
dy.  Some of the physicians and surgeons of the house
who saw the case, considered it lepro vulgaris; while
others  regarded it as  a good specimen of general herpes.
Several, with  myself,  in reflecting  on the  patient's
mode of life,  general health,  and the character  of the
eruption, were convinced that  it was syphilitic.   To
strengthen  the position, which we took, 1 referred  the
                         15* 
170               ON THE DISEASES

gentlemen to the positive  declaration of Carmichael,
who says, " the true syphilitic eruption is scaly, a cir-
cumstance by which it may be distinguished from the
eruptions of the other forms of the  venereal  disease,
which we have seen are either papular, pustular, or tu-
bercular.* Candour compels me to state, however, that
upon further investigation,  I found that this distinguish-
ing criterion, so confidently announced by the eminent
surgeon just quoted,  is not confided in by very high
authority. S. Cooper, in his Surgical Dictionary, makes
the following remarks:  " There is as little  certainty,
about the essential characters of a syphilitic eruption,
as about the test of every other symptom  of the vene-
real disease, or rather diseases." " It must be allowed,"
he further observes, " that it is frequently very  difficult
to say,  whether an eruption is syphilitic or not, and an
opinion should rather  be formed  from the history of
the  case, than from any particular appearance of the
eruption itself. Dr.  Hennen, in his valuable book, does
not pretend to  be able to discriminate the true syphilitic
eruptions from others, and indeed by what criterion
they are to  be known, I am myself entirely puzzled to
comprehend, after the  numerous  facts, so fully estab-
lished by recent experimental inquiries.t
  In lepra there is an impairment of general health; and
this not being the case with this man, we felt warranted
in pronouncing the disease  not to be leprous.   Herpes
is a vesicular affection, and therefore altogether  dissimi-
lar to this eruption.   Besides, the fellow acknowledged

  * Carmichael on Venereal Disease, Emerson's Edition, p. 292*
  f 4th London Edition, Art. Venereal Disease* 
INDUCED BY MERCURY.
171
to the steward of the institution, that he had  venereal
congress with  a courtezan at  St. Louis,  about three
weeks before he perceived the eruption.  The surgeon
and physician in attendance treated it not as syphilitic,
but as a disease "stat nominis umbra."  They purged
their patient with saline cathartics,  and  ordered the
black wash  to  be applied  to the ulcers.   Under this
treatment he did not improve, but under a reduced diet
and the purgation, grew weak.   This method  was per-
severed *in for four weeks, at the end of  which time,
there were several ulcers on the breasts, and the axil-
lary glands were enlarged.   In this  condition  he fell
into the hands  of  the next   attending  surgeon in
course,  who being positive of the venereal origin of the
affection, determined at once  to  assail it most heroically.
So poured in the  mercury with the  utmost precipita-
tion, and soon salivated the patient quite to his satis-
faction.  But instead of improving under this rash mode
of giving mercury, Hamilton grew worse—phagadenic
ulcers appeared in different parts of his body,  his nose
ulcerated, and an afflorescence covered his forehead and
face.  At times  a tensive  membranous pain  was felt
over his brows.   He was finally cured,-after remaining
in  the  hospital  nine  months,  with  arsenic,  given  in
conjunction with cicuta,  and  by dressing his ulcers with
weak citron ointment.  He left the house in the spring
of 1826, but returned in consequence of exposure to  a
wet, cool atmosphere, which brought back the disease.
One of the surgeons employed Swaim's panacea on him,
much to the dissatisfaction of  the other surgeons and
physicians: for to the  honour of the most  eminent of
the faculty in Louisville, they never  connive at quack- 
172
ON THE DISEASES
ery in any shape, or under any guise. The man finally
quit the house without being perfectly cured, and went
to New  Orleans, where a dry hot summer  effected a
complete cure of his case.  1 saw him afterwards per-
fectly well.  In the above case, small doses of corrosive
sublimate, with a decoction of sarsaparilla, should have
been given for the eradication  of the eruption  in  the
first instance; and the mercury  should never have been
so lavishly employed.
   Dr. Chapman has very  judiciously remarked that,
" no  diseases are so  unmanageable by constitutional
remedies as those of the surface, and particularly of the
cuticle.   As one cause of  failure, in these cases, much
may be ascribed to  the manner in  which mercury is
ordinarily prescribed.   Eager to attain  its effects, it is
too much our habit to pour into the system, and hastily
to induce salivation,  by which the end in view is
usually defeated.   "My friend," continues the doctor,
in a note, " Dr. Holcombe, of New Jerse}', has justly
acquired much celebrity for his uncommon success in
the management of chronic  eruptions  and  obstinate
ulcers.  He lately assured me, that his practice consists
in giving the tenth  of a  grain  of corrosive mercury
twice a day for months, and the decoction of dulcamara.
By this course, he recently cured a case of prurigo for-
micans, which had  baffled  the  efforts of some  of  the
best practitioners of this city."*
   A man,   named Memmer,  died from excessive  in-
flammation, terminating in  gangrene, of the mouth and
throat, several years ago in the  Louisville Marine Hos-
* Chapman's Mat. Med. 6th Ed. vol. II. p. 224. 
INDUCED BY MERCURY.
173
pital.   Upon inquiry into  the  history of the case, it
appeared that a drunken doctor at Shippingport, had
given  him  large quantities of calomel for the cure of
ague and fever.   Memmer had been a patient of mine
in the  hospital the  year before for dyspepsia, of the
most aggravated  character  I  ever witnessed; which
resulted from his taking, by a physician's directions, in
Mississippi, some where, a powerful dose of almost un-
diluted nitric acid,  " to eat  off an ulcer he had in his
liver," as the sage doctor elegantly described it.  From
the symptoms present, I fully thought that there exist-
ed an ulcer in his stomach.  After a tedious confinement,
he got well of the dyspepsia.  After his death from the
excessive mercurial irritation, we  carefully  examined
his stomach, as well  as the  other organs.   No trace of
organic lesion could be seen in the stomach, and no
globules of mercury  could be detected in  the salivary
glands, or any other  part, although some of the physi-
cians present, were firm believers in that dogma.
  On the  13th  November,  1832,  I was requested  to
meet a very intelligent country practitioner, in a case
of some considerable  delicacy and interest.  The patient
was a young married man, a lawyer by profession, who
had been confined to  his room for several months. The
history of the case, as gathered from the attending phy-
sician, and the gentleman himself, was the following:—
Before  marriage,  he had contracted a chancre, which
was treated with  caustic, and a quick and severe mer-
curialism.  The chancre disappeared, and a few months
afterwards  he entered the  matrimonial state.  Several
months after marriage, upon some exposure, he became
affected with sore throat, and ulcerations of the surface 
174
ON THE DISEASES
of the body.   A  medical man being consulted, looked
upon the symptoms as essentially syphilitic,  and put
the patient under the  use of blue-pill.  But he grew
worse.  Another physician being sent for, actively de-
pleted him, holding, as  he told me in our conference
on the case, the doctrine of Broussais, that there was no
peculiar difference between one inflammation  and an-
other, only in the degree of action of the affected parts.
Under the guidance of this very erroneous position, he
had  bled  his patient several times, and  kept him on a
very reduced diet, occasionally exhibiting blue-pill to
act on the liver.  The state of the young gentleman,
when  I saw him, was hazardous.   There  were ulcers
on his back, breast, arms and legs; his throat was quite
sore, and the glans penis  had become ulcerated.  His
wife suffered from no infection.  There  was an injunc-
tion to refrain from his marital rights, but it was a mat-
ter of doubt whether he obeyed.   In our conversation
on the case, no agreement of opinion, as regarded the
treatment, took  place, though the disease was consi-
dered  by both of us  as  mercurial.   The medical at-
tendant persisted in his Broussian views,  and  seemed
resolutely bent on fulfilling the legitimate indications of
treatment, founded on such wrong conceptions of the
nature of inflammation.   The  patient died during that
winter.
  The following  corollaries are fairly deducible from
the reflections and facts presented in the foregoing dis-
cussion.
  1. That mercury  has two  modes of  action, a local
and general. 
INDUCED BY MERCURY.
175
  2.  That mercury operates on the living  solids, and
does not enter the blood.
  3.  That there is nothing so specific in the mercurial
disease, as should  deter us from pursuing a line of prac-
tice, built upon  our knowledge  of inflammation,  as
modified  by texture, the state  of the constitution, and
the effects of remedies.
  4. That to restore the secretions generally, and espe-
cially that of the  skin, should be our polar star in such
cases.
  When  mercury acts strongly as a local irritant,  its
agency on the  glandular apparatus and capillary system
is defeated.  Paris,  in his  excellent work has some
judicious  suggestions on this point, and he  pertinently
puts the question, " would it not appear that powerful
doses rather produce  a local than general effect."
He  illustrates the  operation of medicines given in a
large or small dose, by the  result of impressions made
on the skin—if the impression be violent local pain is
induced; but  if gentle, a general sensation  is excited.
But a mercurial  medicine, such as calomel, may not
only act  locally on the stomach, and thus bring on
immediate  vomiting and  purging, in  consequence  of
 which local effect, its general alterant  impression will
 be defeated;  it  may likewise create  another kind of
 local circumscribed  irritation, a little farther diffused,
 which will be entirely subversive of its best constitu-
 tional agency—and  this  irritation may  be properly
 viewed essentially a  disease created  by  the remedy.
 Alley has seen the hydrargyria, or eczema mercuriale,
 follow the administration of a few grains of the mildest
 preparation of  mercury, before  the mercurial action 
176
ON THE DISEASES
 could have been excited.  But this irritation instead of
 being expended on the skin,  may be  directed to the
 mouth, especially in children.   It appears  to me, that
 much confusion has existed in the minds  of medical
 men, as regards the efficacy of the mercurial action in
 fever. Inflammation, and even ulceration, of the mouth
 may take place  without the fever  giving away.   Here
 the remedy acts as a local irritant,  and will not suppress
 the febrile movements.  But whenever the proper con-
 stitutional agency of mercury  can be secured in fever,
 the secretions of bile, urine and sweat,  are restored by
 that alterant or modifying influence, and whether you
 rouse  the  salivary  glands into very exalted action or
 not, you cure the fever.
   Fordyce, in his work on Fever, has made some pro-
 found reflections in reference to the twofold effects of
 tartar emetic.  When it  nauseates in fever, it simply
 depresses the powers of the system; but given in doses,
 not to nauseate,  it exerts  a more favourable impression
 on the functions, and gently conducts the  organs back
 to their original  type of health.  Digitalis has a similar
 mode  of operation.   Given in such quantity as to sen-
 sibly affect the stomach, it lowers  the heart's action in
 a powerful manner, but  when administered in  small
 doses,  it influences the secretory office of the kidneys.
 The physiological action of mercury, antimony, arsenic
 and  other potent instruments of medical art,  may be
 considered as local  and remote.  If the local action be
very powerful, then we have a case of poisoning—such
as may be  produced  by corrosive sublimate,  tartar
emetic, &c.   If not sufficiently powerful to destroy life
in a short time,  then other organs  are affected.  Some 
INDUCED BY MERCURY.            177
poisons affect with a peculiar transference of irritation,
one organ or circle of tissues, and leave certain other
organs free, comparatively, from their influence.  Thus
infusion of tobacco, and  upas antiar, act, with  certain
relevancy,  on  the heart.   Mr. Brodie's  experiments
prove this,  for he found  that  when the infusion of
either of these poisons was injected into any part of the
body, it speedily caused  a cessation of  the  heart's
action, and after death the  heart was not irritable to
galvanism.   Majendie  found that in  poisoning  with
tartar emetic, the lungs were inflamed, and sometimes
even hapatized.
  Nux vomica  acts on the spine, and narcotics on the
brain.  Arsenic, applied  to  the  skin, will  inflame the
alimentary mucous tissue—cantharides the urinary or-
gans—spurred  rye, when used  as  an article of diet,
causes gangrene of the limbs.  The effects  of a power-
ful agent, such  as  mercury, well managed, are exceed-
ingly multifarious.  By  a variety of causes  its action
may be, almost in an endless manner, modified.   The
most important to notice, in a  brief way,  1  are quan-
tity__2  chemical  preparation—3  combination   with
other remedies—4 points of the body  to which ap-
plied—5  age  and idiosyncrasy—6 certain  states  of
disease.
  I pretend not to penetrate further  into the action
of mercury on  the body, than a careful observation of
the phenomena upon  its exhibition.   No doubt it acts
in accordance with the laws of  the system—but to en-
deavour to cover the whole field of the controversy by
any cant medical phrase—such as sympathy, or purifi-
cation of the blood, is in violation of sound philosophy.
           16 
178
ON THE DISEASES
As " interpreters and ministers of nature,"  we must
watch her modes of working, and  not force her into
any narrow circumscriptions of action.  Nor are we to
substitute our  fancies for her  facts—"imposing gay
deliriums for truths."  We must believe what we can
prove, and  leave the rest in doubt and mystery.
   The cases given in this essay, exemplify the position
taken.  In the child's case, the operation of the calomel
on the bowels and bilious secretion, was interfered with
by the cold water drank.  It is  a well known fact, that
salivation is peculiarly  hazardous  in children under
eight years of age.   It  is impossible to produce it  in
very  young children,  and when mercury makes the
mouth sore in  children of a tender age,  the salivary
glands are  not excited  into an increase of secretory
action,  but ulceration  of the  gums and cheeks, and
sometimes the entire destruction  of the alveolar pro-
cess takes place  The gums turn white and recede from
the teeth, which drop out, and mortification, if the dis-
ease is severe, soon destroys the cheeks.   Cold drinks
freely indulged in, when the febrile action is  not very
high,  1 consider detrimental, when calomel is  taken.
They act injuriously in  two ways—first,  by exciting
a  disturbing action  in  the stomach,  inimical to the
kindly cathartic effect of the medicine; and the second
place,  by reducing the functional activity of the der-
moid  tissue.  Whatever  affects  the vital properties and
susceptibilities of the stomach and skin, most interferes
with the regular due exertion of mercury on  the sys-
tem.  To give opium with calomel in fever, is injudi-
cious, unless the powers of life are sunk. Opium arrests
secretory  action in most of the organs, and augments 
INDUCED BY MERCURY.
179
the local inflammations.   Where a stimulus is needed,
camphor or Virginia  snake-root, in decoction,  is pre-
ferable to opium.   Where pain  exists, and it is desira-
ble to tranquilize the patient,  then  opium  must  be
united with the calomel.
  There is nothing peculiar or specific  in the inflamma-
tion produced by the irritating agency of mercury on the
animal economy.  Sulphur has been consecrated by the
darkened views of humorilism to the cure of mercurial
diseases, from the idle  and ridiculous supposition that it
acted chemically on the mercury floating  at large in the
blood,  and committing sundry depredations.  By  its
effects upon the skin  and bowels, sulphur may be  of
some service in such cases.
  Physicians formerly  seemed afraid to approach mer-
curial affection with the ordinary remedies for inflam-
mation, but of late a better practice has obtained.   The
condition of the system should  never  be lost sight  of
in conducting the cure  of mercurial affections.  In treat-
ing severe  ptyalism it is  sometimes proper to purge
with the neutral salts,  in  order that a  revulsive action
should be set up.   But where the pulse is weak, and
the skin below the natural temperature, the warm bath,
and Dover's powder are the most eligible remedies.
The best local remedy is the sulphate  of copper,  with
bark and charcoal, where  ulcers exist  in the mouth.
The sugar of lead is a most excellent remedy, where
the inflammation is intense.  It is to be  used as a wash
for the mouth. Blisters over the enlarged parotid glands
are at times  demanded.   Gentle emetics are often of
much advantage, and  tart,  emetic  given in small por-
tions  acts very favourably, where there exists much 
180   ON THE DISEASES INDUCED BY MERCURY.

iorce in the heart and arteries.  The state of the skin
must be watched,  most sedulously watched: a proper
degree of functional energy must be maintained in it.
  Arsenic  exerts a strong action on the skin and sub-
cutaneous cellular tissue,  as  is evinced in  its curing
elephantiasis, and in producing effusions about  the up-
per parts of the face.  Powdered sarsaparilla, given as
Brodie directs, I have used within a year or two with
much  satisfaction.   Upon  it and  Fowler's  solution I
mainly  rely in mercurial ulcerations of the  surface.
Sometimes by  stimulating these ulcers of the skin and
sub-cutaneous  cellular  tissue,  by the following lotion
they have been aroused into healthy action,  after other
dressings had failed.
         rjL Sulphas Cupri           9 j
           Balsam Copaivae         ^ ss
           Pulv. Gum  Arabic       3 ij
             Water                §vj
             M.
Or a strong solution of white vitriol, twenty or thirty
grains  to the ounce  of water,  will often be of signal
efficacy.
   In irritable  weakened constitutions a mild generous
diet must be allowed—even a little wine,  or  malt li-
quors, should the  patient's strength require either, or
his  previous habits have  rendered such drinks neces-
sary. 
A  STATEMENT
OF THE CIRCUMSTANCES CONNECTED WITH THE SUDDEN DEATH OP

     EIGHT PERSONS WHO PARTOOK OF COLD CUSTARD IN

                  LOUISVILLE, KT.
  Early in June, 1834, a very great sensation was pro-
duced in the city of Louisville by the sudden death of
eight individuals belonging to a  respectable family of
relations and dependents.  And as every person who
died  had partaken of a cold custard,  a suspicion was
hastily  created that they had been poisoned.  This sus-
picion received  confirmation from  the  fact that some
negroes belonging to the family, in which the custard
was prepared, had been suspected of a robbery commit-
ted on  the premises several weeks  previous to this sad
period, and were much exasperated in  consequence of
the suspicion, and attempts at a discovery of the stolen
goods.   Arsenic had  been inquired for at one of the
drug stores of the city by a negro man  in the name of
the family, in which the deaths occurred.  It  was re-
fused, and  no subsequent  call at that drug  store  was
made for it.
  Three  or four negroes were put in  jail  upon these
grounds of suspicion, and one of the bodies disinterred
for examination.  I was invited  with  other physicians
to attend the  post mortem examination of the disinter-
red body.  Upon my arrival at the house in which the
examination  of  the  body was to  take  place,  I found
several of our most respectable physicians present.  At
this  meeting, and subsequent to the post mortem inves-
                        16* 
182
DEATH OP EIGHT PERSONS
tigation, a committee of four physicians, then present,
was appointed to collect all the facts pertaining to the
subject  of  these  sudden deaths, and submit a report of
the result of their inquiry at as early a date as  possible
to a meeting of the faculty,  to be called  whenever they
were ready to communicate that result.   On June 13th
nineteen physicians  met agreeably  to  the  request of
the committee, at which meeting Dr.  T. S. Bell, chair-
man of the committee, read the following report.
   " At a meeting of the ph)*sicians of Louisville on the
10th  inst..  it was resolved that ' Drs.  Bell,  Pender-
grast, Salbot, and Wantyn, be appointed a committee to
investigate all the circumstances attending the onset,
progress and termination of the late cases in  the Buck-
ner family, and report the result of their  deliberations
to the faculty.'"
   " The committee appointed under the foregoing reso-
lution,  respectfully report, that they have  examined
with much care,  the  various statements which have
come to them in a tangible  form, from sources  entitled
to  attention.  In submitting these facts to your con-
sideration, the committee feel, in the faithful  discharge
of their duty, bound to abstain from the expression of
individual  opinion on  the facts;  their exclusive bu-
siness  is to collect,  arrange,  and present them,  and
any argument which they may enter into, will  be more
for the  elucidation of truth, than for the purpose of influ-
encing  a particular bias.  Divesting ourselves, as much
as possible  from the  deep  and pervading excitement,
which  is sweeping through this  community  on  the
subject, we have endeavoured to guard against the
approach of every thing that would prevent  a  faithful
narrative of all  the circumstances, placed within our 
          WHO PARTOOK OP COLD CUSTARD.        183

reach.   If the anxieties of  the public mind could have
slumbered, we might with more time,  have presented
a more satisfactory report; but so far from diminishing,
they are on the increase—rumour, on its busy wings, is
afloat, magnifying the slightest incident, into a  great
one, and giving to its crude fancies,  the  force, dignity,
and  solemnity of  truth.   The public  look up to the
medical faculty for information, and is  anxiously sus-
pended upon the combined result of our inquiries: and
animated with a sense of respect for its feelings, we pro-
ceed to a statement of all the facts,  we have been able
to receive.  It appears that the first cases of  disease oc-
curred in  the families of Mr.  Fontaine  and  Col.  R.
Buckner,  in the persons of a young  lady,  connected
with the family of Buckner, and a servant boy of Col.
Buckner's.   They were  attacked  in the morning of
Sunday, the 7th inst. (8th.) about the same time of day.
 Miss Vanasdel, the young lady, complained of  slight
indisposition immediately after  breakfast and vomited
some coffee which she drank at breakfast. She said but
little about  her sickness, until towards about eleven
 o'clock, when, the symptoms becoming somewhat more
 urgent, such  as increased sickness of the stomach and
 bilious diarrhaea, she consented to permit a physician to
 be sent for.   It was accordingly done and he found her
 on his arrival, about half past  11 o'clock, but slightly
 indisposed, with what he considered a very  mild  attaek
 of cholera morbus, for such was the appearance of the
 disease.   Making a prescription for her, he was sum-
 moned to the negro boy of Col.  Buckner, and  found
 his system nearly collapsed, and the boy vomiting pro-
 fusely and purging  rice  water evacuations.  After a
 vigorous  effort on the  part of the physician, all  endea- 
184
DEATH OP EIGHT PERSONS
vours at his relief were given up—his case was utterly
hopeless.   While engaged  with the boy,  his  partner
was called upon to see Miss Vanasdel—reached her at
half past two, and found her collapsed.  A  livid circle
surrounded the eye lids, the extremities perfectly cold,
with occasional spasms, though very slight  ones, pulse
imperceptible, the  face  extremely cold and covered
with a profuse  clammy sweat.  Medicines were ad-
ministered and other measures ordered for her relief—
another physician was summoned in consultation,  and
before his arrival the pulse had resumed a  thread-like
expression.  In  consultation it was agreed that it was a
case of cholera, and  such was the general appearance of
the case.   She had but  three rice water discharges be-
fore her collapse, and her and the boy died before  12
o'clock at night.
  " A black man, belonging to Col.Buckner,  and having
a wife at  Mr. Fontaine's, was also attacked very vio-
lently with a vomiting and purging of water about the
time  Miss Vanasdel was  so violently affected.  His
spasms were not  violent and soon ceased under the same
treatment that had failed in her case,  and  which had
been found frequently successful in attacks  of cholera;
he recovered without the  appearance of any of those
effects, seen in the convalescence of  cholera  cases.  At
half past 4 o'clock, P. M. on Sunday the 8th inst. Dr.
Talbot informs the committee, he was called to see Mrs.
Foster; he found her with  anxious  countenance, eyes
sunken, features contracted, slight lividness of the skin,
particularly immediately below  the eyes; learned that
her bowels had been  actively operated on for the last
half hour—that she had eaten some dinner,  and felt as
well as usual up to the commencement of purging, and 
WHO PARTOOK OF COLD CUSTARD.        185
then not sick, as expressed by herself.  While in the
room she took cramp in one foot, shortly after in the
other, and in a very short time vomiting supervened
and general cramp of the extremities came on,  with
great anxiety and tossing, and insatiate thirst.  In two
and a half hours from the commencement of  the attack
she was pulseless  at the wrist,  extremities cold and
clammy, lived  nine hours after, occasionally conversing
rationally with her friends, and calmly expired.   On
Monday morning (9th inst.) about  sunrise, was called
to Mr.  Foster's little  daughter,  found her  restless,
tongue clean, pulse regular, round and rather full,  skin
in good condition, with frequent rice water evacuations
from the bowels; vomiting came on, restlessness and
anxiety increased, the  skin  became pale, assumed a
light bluish appearance—throughout great thirst, which
increased in intensity, the skin remained warm, though
declining in temperature, and the pulse regular  until
about 4 o'clock,  P. M., at which time she  took  light
general spasms, and shortly after expired.
   "Monday morning, Mrs.Buckner, the mother of the
family,  was attacked with vomiting, and bilious dis-
charges.  Her family  physician reached her immedi-
ately after she was taken, but notwithstanding strong
and repeated efforts for her relief were made,  she died
in the course of the evening  (afternoon) of Monday.
She had rice water discharges towards the termination
of the case.  Up  to within  a very few  hours of  her
death,  with corrugated hands, she had a full, but  pow-
erless pulse, whilst her skin was livid, and cramps were
present in the hands and feet.
  "At 2 o'clock, Monday morning (9th) the son of Mr.
Milton Buckner, was  attacked  with vomiting  and 
186
DEATH OP EIGHT PERSONS
purging, and died during the same morning—which
attack was a renewal of one which had  taken place on
the Saturday previous, but which was then arrested by
medicine.
  " A black boy of Mrs.Pope's, living with Mr. Fon-
taine, was taken Sunday night (8th)  between 10 and 11
o'clock, with violent vomiting—collapsed at 11,  with-
out the rice water purging.  It came  on after he was
collapsed.  He complained immediately he  was taken,
that he was burning up  all  over.   He died Monday
morning (9th) after breakfast time.
   " This is a full, and it is believed, a faithful sketch of
the cases up to the time of death. Examinations of tw
of the bodies were made.  One on Monday,  by an  in-
dividual member of the committee, who was  forced by
great press of business to make the  examination at  the
only moment of leisure he  obtained, and who in that
short interval, endeavoured ineffectually to get the  aid
of the  only physicians he could see.  Their  engage-
ments prevented them from attending the examination.
The other examination was  made Tuesday  afternoon,
(the 10th) in presence of seven of  the  faculty, on  the
body of Mrs. Pope's boy, who was  buried on Monday
morning,  and disinterred on  that afternoon,  just before
the post mortem inspection.
  " The committee have now discharged their duty by
bringing forward the facts of the case.   The common
rumours afloat have not been noticed, because it did not
belong to the committee to say any  thing about them.
Their province  was to investigate, and bring forward
the facts of the case,  independent  of their  individual
opinions." 
          WHO PARTOOK OP COLD CUSTARD.       187

  After the reading of the above report, it was resolved
by the meeting, " that  from the facts laid before us by
Drs. Bell, Talbot, Pendergrast  and Wantyn, that the
persons referred to,  died of cholera asphyxia;  but there
is  some just grounds for  an opinion that, stale or sour
custard, did  act as an exciting cause in producing de-
rangement of the stomach."   The  facts in reference to
the custard, as stated by several of the physicians, who
obtained their information from the family,  were these.
On Thursday,  the 5th of June, a custard had been pre-
pared for a wedding, that  night to be celebrated in the
house of Mrs. Buckner, one of the persons who died.
It was discovered,  subsequent to its preparation  and
cooking,  that  the custard had been  made of milk not
entirely  fresh, as it had undergone  some change; the
whey in the  composition having separated  from the
curd in a slight degree.   Whereupon it was  put aside
and not used at the  supper table  of the nuptials.  The
next day (Friday the  6th,)  it was  distributed among
the immediate relatives of the family.   All those who
died,  ate of this custard on Friday, and some kept it
till Saturday, before entirely using all  that was sent
them.  On Friday, several other persons, besides those
who died, had partaken of it; some of these were made
sick by it, but a few were not.
   In addition to the above enumerated  seven individu-
als, Mrs. Fontaine also  was seized with  symptoms
analogous to those  detailed  as  occurring in  the  other
cases, and died (I think) on the day  of the meeting of
the physicians to receive the above report.  Her illness
was, like the others, short and characterized by cramps
and collapse of the vital energies.  So  agitated  was she 
 188           DEATH OF EIGHT PERSONS

 with the awful apprehension of being poisoned,  that
 she told a lady of my acquaintance that were it not for
 this terrible impression haunting her mind, she would
 soon be well—"but," says she, "see here how much
 arsenic  there  is in  me"—pulling  some tartar,  at the
 same time, from off her teeth—"how can I live when
 this is so."
   Mrs.  Foster, Mrs. Fontaine, and the two Buckners
 mentioned above, were children of old Mrs. Buckner,
 at whose house the wedding took place.  There was a
 large quantity of the custard made, and it was  sent to
 the families designated above through a hot sun, in
 different parts of a small  city.   It  had  been kept in a
 cool cellar, in a tin vessel, previous to its  distribution.
 The post mortem examinations of the two cases noticed,
 conducted to nothing conclusive, as regards poisoning
 being the cause of the  attacks.  The boy's stomach
 contained a large quantity of calomel, in a state of semi-
 oxide, but was not at all inflamed; and his  bowels were
 filled with a thick rice water secretion,  there being no
 trace of bile within the intestines.   Dr. Bell stated that
 in the other case there was perforation of the stomach,
 with strong evidences of vascular fullness, and a spot of
 gangrene on the villous coat.
  The report as first read, was  much  longer than as
 given above, and  it was  curtailed  by the  meeting, by
 the exclusion  of what was considered irrelevant, or
 superfluous matter. The following sentences are  copied
from those parts of it which were rejected.
  " On  the one hand it is  argued, that the cases in their
general  features, bore the certain and characteristic im-
press of cholera. The vomiting, purging of rice-water,
spasms and length of asphyxiated stage, so universally 
WHO PARTOOK OF COLD CUSTARD.       189
found in cholera, were in these cases."  "Upon inves-
tigation  of all the circumstances of the question, there
is at least a probable ground for the belief, that a delete-
rious agent has had much  to do in the cases.  We say
only a probable ground for belief,  because there is no
positive  testimony on  the subject."   And again—
  "On the supposition  that poison was administered,
arsenic was not the poison used."
  On a  careful analysis of the contents of the two sto-
machs, obtained by opening of the two negroes, nothing
but calomel could be detected. The conclusion to which
the meeting came, as regards the origin of these melan-
choly cases, was by no means satisfactory to  the  public
mind.  The impression was  general,  that  the negro
slaves had poisoned the family, and whatever absence
of proof there was, that  any poison was given;  and
however pointed and cogent the facts were in favour of
the opinion at which a majority of the faculty arrived,
yet a judicial  process must be gone into.  Whilst the
slaves, suspected of the commission of the act of poison-
ing, were in jail, Dr. T.  S. Bell, over his own signature,
published  in one of the  daily newspapers, his opinion,
that  these people  did not  die of cholera, but of some
kind of poison. His language in the Louisville Journal,
of June  23d, is, in part, as follows, whilst animadvert-
ing on the resolution  passed  by the meeting of physi-
cians.
  "It is evident" says the Doctor,  "now,  that what-
ever analogy there might  have  been between  cholera
and  some of the  cases,  no power on earth  can weave
these into  cases  of asphyxia.  Speak to a physician
of a case of asphyxia with a pulse, and he would laugh
           17 
190           DEATH OF EIGHT PERSONS
 at it.  A living dead tree, would  be a  phrase synony-
 mous with it.  What confidence  then  is to be put in
 such a decision, under such circumstances ?  A commit-
 tee reports, among their facts, two cases with  pulse and
 warm extremities, and the majority of the faculty, on
 this testimony of the committee, resolve that they were
 cold and pulseless.   It speaks broadly  of the  benefit of
 a resolution, but is not very creditable to the power of
 testimony   Any dogma, no  matter how obnoxious to
 truth, may be thrown into the form of a resolution; but
 it is quite another thing to prove it."   " That the cases
 were not cholera, 1 am firmly convinced—that they
 were the effects of poison, I am just as certain."  Here
 is downright positive, bold assumption and dogmatism,
 with a vengeance.
   Dr. Bell heads his article in the  newspaper,  " Health
 of Louisville;" and labours through the whole of it to
 prove that no choleric predisposition  existed  in  the
 atmosphere,  and  that therefore  the custard  must have
 played a more important  part than a mere excitant to
 cholera.   The truth  was, that  cases of cholera asphyxia
 were occurring nearly every day in the city at  this very
 time; and as a proof, I will merely state, that on  the
 12th of June, I was called in  consultation with  Dr.
 Rogers to see Mr. Raymond and mother, who both
 died that  day of the  disease,  after but a few  hours
 illness.
  In this newspaper article, Dr. Bell says,  " I do  not
 feel at liberty to say any more about the circumstantial
 evidence—though this is the weakest link in the chain.
 A wish for justice compels me not to intrude into  the
 precincts of a judicial examination." By a wish for jus-
tice, the Dr.  means that inasmuch as the  slaves  were 
WHO PARTOOK OF COLD CUSTARD.
191
then in prison, waiting their trial before a court of jus-
tice, he did not wish to say any more about it.  A love
of justice, as  well as humanity,  if  not professional
courtesy, should have kept him from such a publica-
tion.  And did the Doctor detect any poisonous sub-
stance in the custard, or in the matter  ejected from the
stomachs of the patients he attended ?  Not a particle.
And when called before  the grand jury, who sat soon
after his publication, to make solemn inquest upon the
guilt of the slaves,  " the weakest link in the chain" of
the evidence which the Doctor  could adduce, was not
corroborated by any stronger links.  In  other  words,
no true  bill  was found, and the  slaves were liberated.
The palpable violation of consistency in opinion on the
part of Dr. Bell, is seen by comparing what he  says as
chairman of the committee, and what he, without due
caution, so boldly and peremptorily decides to be true,
in his newspaper article.   In the first he admits that the
"length of  the asphyxiated  stage," among the other
symptoms,  "so universally found  in  cholera, were in
these cases;" in the latter, he avers the contrary, as re-
spects the very same cases.  In the one instance, to be
sure, he addressed  those  competent to decide  on the
question; in the other, the appeal was  made to the pre-
judice and ignorance  of persons incompetent to arrive
at a just conclusion on such a subject.  To  the great
injury of medical science,  and the degradation of the
profession in the eyes of the  public, are newspaper dis-
cussions and controversies on medical topics.   Avoid-
ing  such a mode of agitating the point, I have  written
the above statement, with a hope that it may prove use-
ful in putting medical men  on  their  guard against the
formation of rash  and premature  opinions on nice and 
 192       DEATn OF EIGHT PERSONS, ETC.

 perplexed questions of toxicolog)r,  and to persuade
them to weigh well, all the bearings of a  controverted 1
 point,  before they too  dogmatically  declare  their
 thoughts—especially when such a declaration is calcu-   ■
 lated only to alarm and distress those personally inte-   ,
rested, and to hinder the beneficent  operation of public   *
sympathy in  favour of those accused of such a  vile   .1
 crime as that of poisoning.                              t
  Whatever difficulties may embarrass the solution of a .
 litigated topic, we are never to reject the most  rational  j
 inference, because we cannot free  it of  all  obscurity,  J
 nor are we to pronounce upon a question as if we were J
 gifted, by a special revelation of light, to decide  accord- I
ing to the rapid glance of our limited intellectual vision.
 Let the candid and intelligent reader reflect carefully ^
 on  the above detailed cases, and  compare  what Orfila,
 Paris and Fonblanque, Beck or Christison, has written ]
 on  the symptoms of poisoning, the rapid access  of such J
 symptoms,  subsequent to  the  administration  of  the
 noxious substance, with the symptoms in the  above 1
cases, and the period after eating the custard in which |
they arose; and can they do otherwise than acknow- |
ledge, Dr. Bell's opinion to the contrary notwithstand-
ing, that these persons did not die of poison.  By what- J
ever name he may choose to designate their disease,  it
is apparent that to  live one, two and three days, with-
out any symptoms of poisoning making their appear- <
ance, is ample proof,  besides the total absence of all
positive testimony  to prove that poison  was adminis-
tered, that it is a most irrational suspicion  that could be
grafted on such an airy basis—a basis that melts away
at the first touch of calm and sober scrutiny. 
 
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