G
THE ROMANCE OF MEDICINE.
JYom Iandon Koclc'y.
The Komnice of Medicine I Is It poasiblo
that there is a particle of romance iu so unro
mantlo a subject f I think there is; ami, in
deed having looked at the subject in various
ways' in reference to this paper, my gene
ral feeling if that of dismay at the abun
dance and variety of my materials, if I can only
manure to transfer to my readers the feelings
with which they have impressed myself. At
the outset of the Bubject, I may say that I am
well prepared for a general sneer against
medicW, and with the feeling that prouip s
H 1 confess I have a great sympathy. "I
don't believe in medicine," it may be urged;
and the beet do.to-i B1ve 03 ,iUle Amnn
M they c an. Voltaire "used to, say that the
doctors poured medicine of winch they know
little, into a body of which they knew nothing.
I dare cay doctors have not changed much
Rince the times of Cervantes and Moliere,
a thonjh tLeir mode, have shifted." Thus
cinch the imaginary objector; and there is a
rood deal of ground for this kind of imputa
tion. I met a ma" the other day who was
Tery indignant because his doctor had
knocked off his bitter beer. lie said he
should keep on changing his doctor until
he met with one who would strougly recom
mend bitter beer. He did not think he
Bhould have far to go. Mow this ia a fair
example of the wonderful inconsistencies
of the medical profession. Take the case of a
cold. One man will tell yon to drink a bottle
of port; another man will tell you to drink
slops; another man will tell you to drink
ne thing at all, or restrict you to three t;a
spoonstul of liquid in the course of the day.
In reference to this dry system, which has the
eminent authority of Dr. C. J. 15. Williams, the.
popular belief will be that the remedy is wor.se
than the disease. This is only taking a trivial
instance of confusion and contradiction. Then
what remarkable revolutions there have been
in medical opinion, of which the conllict
between the lowering treatment and the stimu
lating treatment is an example.
Again, did you ever know half--adozen
medical men agreed on the treatment of
cholera f In medicine, more than any other
direction, science moves slowly, "working on
from point to point." It wonderfully illus
trates the marvels of our frame, that in the
present day new discoveries relating to the
human body are now and then being made;
that medical men, as in the instance of Dr.
Bright, are immortalizing their names by giv
ing them to the new diseases they have de
tected; that medical science is avowedly full of
problems, some of which appear insoluble,
while in the case of others we are slowly and
tentatively moving towards a solution. To
speak accurately, medicine is not a science,
but an art, the art of the application of many
sciences. It is a trne saying that the surgeon
requires an eagle's eye, a lady's hand, and a
lion's heart. The greater his acquaintance
with the sciences and his own resources, and
the habit of intercommunication with his
brethren, the greater will be the ability of the
medical man to perform his healing office.
Only it is worth while, as a preliminary step,
to settle our, notions of the place of medi
cine in the' order of things. The medical
man requires to be saved from his friends
rather than from his enemies. There is
a numerous class, chiefly women, children,
and nervous people, who look on a doctor in
the light of a deity. He is their director the
mainspring of a system of lay popery who
controls their actions with irresponsible power;
andit is greatly to his credit that, in the pleni
tude of his tyranny, he does not play vagaries
to tax to their extreme limit the principles of
credulity and nndue deference to authority,
lien who see a good deal of this sort of thing
become cynical, at least until they become ill.
Let it be fairly understood that medi
cine is an art beset with limitations
and Imperfeotions; that cases can only gene
rally be referred to classes, but each
case has to be considered in its own cir
cumstances; that medical men are liable to
errors in observation and reasoning; and that
even when these errors are minimized, there
is uncertainty, and limitation, and obscurity
about the medical means employed. .
Then take the rational middle view, that in
Bpite of all the empiricism that belongs to
medicine, and all the mere theorizing, there
exist also real principles and a safe experi
ence, and mere sneers at medicine are .seen to
be Ignorant and unphilosophical. Those are
wise words in the Apocrypha: "Honor a
physician with the honor due unto him for
the uses which ye may have of him: for the
Lord bath created him. The Lord
hath created medicine out of the earth; aud
be that is wise will not abhor them. Then
give place to the physician, for the Lord hath
created him; let him not go from thee, for thou
bast need of him. There is a time when iu
their hands there is good suocess."
It is popularly said that after the age of
forty every man is either a fool or a physician.
I think, however, that there is a very nume
rous class who are a little of both. That I may
not be included in my own limb of the classiti
cation, let me hasten to say that I am merely
a layman and an outsider, and my remarks
must be taken at their worth. The only
practical advice which I shall venture to give
Is, that if you really understand your own oase,
and it is a simple one, don't be in too great a
hurry to send for the doctor; but if you really
feel yourself out of your depth, send for one.
Bir Henry Holland has an essay, "On Points
where a Patient may judge for himself;" and a
little experience and common sense would
Cave medical men much trouble. At the present
day there is a great deal of general medical dis
cussion, at least among people who havu arrived
at a certain time of life. I think it is Mr. Car
lyle -who says that a man who has a perfectly
healthy stomach does not know that he has a
stomach. But there comes a time when a man
xaakes the appalling discovery that he has a
Stomach, not to mention liver and lights, and
fall bi cl na?ionable things. Then men
ui S l-helr mattering of physiology
People gregw ne vou affui
solid fiesh would melt I" Ut tUl3 too to
The other day, the Lancet sUi-ii .
a different cue The pubno a a 0D
falling into the habft of us?ng ffi&nt?
People do not become intoxicated after thl
grand gentlemanly manner of their forefather,
who took their bottles of port after dinner
but an day long they are taking sherry or
brandyin aerated drinks. Our wiue-irWoo
are much too large, and we use cylindrical
chamf agne-glanses which must be tossed off at
once. Th gonoral result is, that there is a
good deal of vague medical talk just now.
Obesity is a misfortune, although nature pro
bably gives tVe additional covering because
she sees that suli is wanting; and there may
be a good deal oHj-uth iu the present crusade
against beer and brandy aud soda. Hut
when once this becomes a popular topic there
is a great deal ot exaggeration used,
and other matters, equally or more
important, become overlooked. Nature is
not such a very bad guide after all; the
via mtdkalrix nulurve, as the doctors call it, is a
THE DAILY EVENING TELEGRAM rillLApELrniA, UllTiDAY, SEPTEMBER 19, 1SG7.
wonderful agency, devising the most curious
contrivances for remedying or modifying au
evil. Ihe excellency of a medical man lies in
the fact that he is able to interpret and sueoor
nature, and iu this lies the groundwork of the
proverb cited above which is, nevertheless, a
confession of the shortcomings of medical
science thnt the best doctors give the least
medicine. The best law of medicine is that
the intelligent man should follow nature, and
should live naturally.
The prophylactic power of medicine is one
of its most important aspects. It is far better
to keep yourself well by simple moans than
to recover health on the most elaborate sys
tem. A broken vase, though mended, is not
so good an article as the vase nnbrokon. The
truck that used to carry ten tons, alter it has
been repaired can only carry six. There is a
medical theory that if a man will only
take sufficient caro of himself, his corporal
mechanism will la.st out till the wheels volun
tarily 6top through sheer use and duration.
Nothing is clearer than that our frames are
only lent lis for a terminable period, aud that,
without the intervention of positive disease,
our life attains its kindly natural pause. How
Tithonus regrets the lot of
"Happy men who have the power to die,
And giussy barrows of tho happier Uoiul."
We remember the imagery of Lucretiu", that
he who lias feasted at the banquet of life
Bhould be contented, as a satisfied guest, to
take his departure. "Men fear death," says
Bacon, "as children fear to go into the dark,"
and to die is, after all, as natural an act as to
be born. The real horror of death is quite
independent of physical considerations. Sir
Benjamin Brodie pays, aud the observation of
most medical men coincides with his, that the
physical act of decease is rarely accompanied
with pain. We accept nature's kindly law.
We are tenants for life, or rather tenants at
will, and the usufruct, but not the absolute
possession. To quote the noble line of Lucre
tius: "Vitaque mancipio nulll datur, omnibus nsul."
Of the romance that attends the history of
medicines there can be no doubt. Many are
the strange events that have occurred before,
to use the quaint language of an old author,
they have passed "from the bowels of the
earth to the bowels of the patient." We are
able to point to positivo achievements of me
dicine, and the lair hope of achievements to
come. "Who can tell the power of the hidden
herb f" asks Spenser, in the "Faery Queen."
Much has medical science done in the way of
specifics, the discovery of remedies, whose
exact action may not, perhaps, be understood
or explained, but whose healing effects are hap
pily known. Think of the Jesuits, who, hap
pily for humanity, discovered the bark of the
chinchona tree, which is the sheet-anchor in
ague. There is reason to hope that we may
yet discover a specifio against other frightful
diseases.
Most persons know the Btory of Waterton's
wanderings in South America in search of the
secret of the wourall poison an eminent
example of the enterprise of medical dis
covery. Then take Jenner's discovery
of inoculation for small-pox. I am sorry
to hear that there are persons in this country
who violently attack inoculation. I heard
of a poor woman the other day who, per
suaded by the talk of ignorant people, re
fused to have her child vaccinated, and
shortly afterwards the poor little thing
lost its eyesight by small-pox. Our own age
has made several remarkable discoveries.
Look at the grand discovery of chloroform,
which has saved thousands of hours of help
less agony. There is no tale of daring aud
discovery more remarkable than the narrative
of the hours which Professor Simpson and his
friends in Edinburgh spent in testing various
narcotic agencies, until they become lirst ex
hilarated and then insensible while testing
chloroform, and awoke to the conviction that
they had now become acquainted with the
most powerful anaesthetic known or conceived.
The whole history of anesthetics, from the
days of Sir Humphrey Davy, or rather from
Cavendish and Priestley, form one of the most
remarkable chapters in the history of human
progress. It is possible, according to Dr.
Antsey's "Narcotics and Stimulants," that
the wonderful properties of the Peruvian coco
may be made extensively useful in this coun
try. The discovery of cod-liver oil has been a
boon of the most inestimable kind. Dr. Wil
liams states that iu a certain he prescribed it
in eleven thousand cases, and in ninety-live
per cent, with beneficial results. It is now
known that consumption is curable in its
earlier stages. It was stated in the re
cent Hunter trial, in the Court of
Queen's Bench, th.t the average length of
consumptive cases, which used to be two years,
i3 now prolonged to five years. Even where
medicine cannot heal, it obtains one of its
greatest triumphs in palliating a disorder.
There never was a time in the history of me
dicine when its soothing and alleviating side
was so assiduously and successfully culti
vated as at the present time.
Then the knowledge of the human frame
daily grows more extensive and exact. Look
at Laennec's wonderful discovery of the stetho
scope. It is now known that of the three
orgars which make the tripod of life brain,
lungs, and heart (according to Biohat's theory,
now generally received, death always issues
from one of these three avenues) diseases of
the heart, which were once considered ex
ceedingly rare, are the most common, and
probably the least hurtful. It is half the
battle with disease to know accurately what
is really the matter with the patient. There
appears to be no reason to doubt that the
average length of human life is more extended
than it used to bo, aud some share in this is
to be set down to medicine, especially in its
sanitary and prophylactic side. The progress
of knowledge, the scientific insight into disease,
form the basis and pledge of subsequent pre
vention, cure, or alleviation. I take from Mr.
Bowman's "Address in Surgery" (18UU), state
ments of the facts of medical progress so mar
vellous that they belong to "the fairy tales of
science"or the romance of medicine. "Harvey
bad heard the healthy sounds of the heart; but
its morbid sounds inform us now of the nature
of its structural defects. The sounds of
breathing must, countless times ere this, have
met the ear ; but it was reserved for our owu
days to study them so often as to enable
every tyro to nay what is the state of those
great organs hidden from our view, but so
indispensable to life. Aud so with percussion.
Nay, with our eyes we can now beholl, for
the first tinit, in its living acts, that marvol
Ioub mechanism in its most exquisite and joy
inspiring movcm.i.is, as well as when it
s oppress bv .Ksense, which stands as
a seiani.d at the orifice of the air passages,
der.?? ull U' v,,i(" au'1 primarily
ffi't, V . liy that modern
which t ! .TV compound microscope,
elements of r ' 'A Wt,rol amo,,S the very
Structure-, w,,Vi.i . niuimeuti ot organiu
gard, though U l a, Lu rt to lightly re
has inUnitl UauuiK1?" A"""'
practitioner, even , Zt11 " ,t',u"lte'
only cons. iei.Uouhly alert ,7h K' u,a
say with coMid.n, ot e a0u;lc "urrva'!t. fu
wasting fmuM lio.- him l1, 1 ?' iu lM
out of h: UsLt, wKteL
and is the seat of no pain, 'This glanl
has been certainly pawing through this or
that d"stniclive change; it is now so and
so; I can accomplish this, or probably only
this, for its relief; and this, or this, will be tlu
end.' " The reproach which Bacon iu his
timo threw upon medicine, that those who pro
fessed It did not seek lor specific remedies, U
bow taken away, for this is the era of inces
sant experiment, and medicine now rests on a
found basis, Mid no limits can be placed to its
expansion in far-of ages.
Many of the phenomena presented by dis
ease are exceedingly curious, and even roman
tic. Take, for instauce, bronchitis. Some
times it happens that a bronchial tube be-,
comes cainil'u d at one end, or is filled by some
substance. The result is that the tube is
converted into a musical instrument. It gives
a flute-like pound. It coos like a wood-dove.
Sometimes the bronchial tube acts differently.
The sound resembles the noise made by a loud
snorer. Then it mimics the noise of an infu
riated tom-cat. Cullen's celebrated account
of the phenomena of a fever might well de
serve a place in the romance of medicine,
deeply and painfully interesting as it is.
From the many thousand cases that are on
record in medical journals, many might be
cited involving matters very curious in a
scientific point of view, and narratives of per
sonal history of the most dramatic kind.
Cases of insanity especially possess horribly
grotesque character. In the work of M. E.-s-quiros
alone there is a remarkable collection of
very singular cases. It is to be noted that in
sanity is a physical disease of which several
hundred people die annually. The curious
disease commonly known as St. Vitus' dance
(chorea), presents some remarkable phe
nomena. It is generally painless, aud most
frequently attacks boys and girls, and very
rarely has a fatal termination. The patient be
comes a merry Andrew, and twists the face
into all kinds of ridiculous forms. It is im
possible for the lookers-on not to be amused,
but any such unworthy feeling would certainly
cease when they become acquainted with the
horrible and most distressing forms which the
disease can assume. The name of chorea,
which signifies a dance Hunter calls it rotatio
is derived from the dancing phenomena
which are not uncommonly found with it
the insanity of the muscles, as it has been called.
St. Vitus is supposed to have been a worthy
saint, who was much alllicted this way, to
whom a chapel is dedicated at Ulm in Swabia.
A case is mentioned in which a young woman
would dance on one leg and hold the other in
her hand. When a drum sounded a kind of
air she would dance up to the drum and con
tinue dancing till the drummer was out of
breath. Another would leap, exactly as a fish
might do, from the top of a wardrobe five feet
high. Another patient, a little girl, would
twirl round on her feet like a top. She would
spin for six or seven hours at a time, the
evolutions being sixty a minute. Another
patient was continually walking backwards,
receiving many falls and bruises. "Such
histories," says Sir Thomas Watson, "would
sound very like romances, if they were met
with in the old authors alone, or if they were
not attested by unimpeachable authority."
Such diseases are morbid affections ot the
nerves, and are well called "the dark corners
of pathology." The whole subject of the in
fluence of the nervous system on the organic
functions is replete with curious memorabilia.
Here is a curious case, mentioned by Mr.
Paget: "A lady who is subject to attacks of
what are called nervous headaches always
finds next morning that some patches of her
hair are white as if powdered with stasch.
The change is effected in a night; and, in a
few days alter, the hairs gradually regain their
dark-brownish color."
Dr. Carpenter explains the famous mirnnl
or the thorn, which is such a leading event in
the history of Port Royal, where. an advanced
fistula lacrymalis was undoubtedly healed
through the influence of the nervous system.
He says that there is scarcely a malady to
which, according to well-grounded medical
opinion, amendment has not been produced
"by practices which can have had no other
effect than to direct the attention of the suf
ferer to the part, and to keep alive his con
fident expectation of the cure." Among such
curious instances may be recalled the servant
maid, whom Coleridge quotes, who, in the
ravings of fever and the ravings of fever are
always more or less remarkable repeated
long passages from the Hebrew, which she did
not understand, aud could not repeat when
well, but which, when living with a clergyman,
she had heard him read aloud. Dr. . Forbes
Winslow's work on the "Obscurer Diseases of
the Brain," gives many highly curious cases,
and Dr. Maudsley's philosophical work, re
cently published, is an extremely thoughtful
work, enriched with notes of great literary in
terest. Dr. Maudsley's collection of fifty cases
of insanity, which he has had under his own
care, is both striking and instructive, and
many similar cases might almost be entitled
"Studies for Stories." I have just noted a
curious case reported by Dr. Fitzpatrick, of
London, for the Pathological Society of Dub
lin. A man wasted away in hospital as if for
consumption. On post-mortem examination
it was found that a small fishbone of a plaice
had passed into the left lung, and the pre
sence of this foreign body had made a cavity.
A surgeon was performing a simple operation
in the neck, when suddenly a slight hissing
sound was heard. The air had forced Its way
into a vein, and death was the result. But
such curious cases might be multiplied ad
libitum; a collection might easily be formed by
any reader of current medical literature. Tho
human interest is even greater than the scien
tific interest, and it must be noted, to the
credit of practitioners, that they exemplify
Bishop Butler's law, that their sympathies,
being accompanied with active goodness, in
stead of being dulled by the multiplicity of the
phenomena of suffering, constantly become
more tender and acute.
Something might be said in contradiction to
the theory mentioned just now, that an organi
zation will act regularly till worn out by long
use. At the same time there can be no doubt
that carelessness is the origin of most diseases.
Medical men also hold that foolish people who
follow their own whims have hardly a chance
of recovery when visited by serious disease.
Nine-tenths of the doctors' work would be done
if people were only consistently prudent and
cautious. Only it is so hard to be habitually
cautious. On abundant occasions a man may
be most elaborately prudent, and then, to his
utter astonishment, he dangerously imperils
his health by some startling impropriety.
When he has used every imaginable pains lie
Is always amenable to the force of nooident.
There is another plausible theory, strongly
antagonistic to the one we have named, to the
effect that every man has the seeds of some
particular disease In his constitution, au4
some tilllli'g accident will come, sooner or
later, which will have for him the same elleot
as a match falling upon gunpowder. Moilical
men explain this en theories of constitutional
tendencies, or of some poison latent in the
system. The fatal accident, to one
man is the merest accident for
another. Two men while walk
ing get well soaked by the raiu. One man
shakes off the water pretty much as a dog or a
duck might do, aud rather enjoy his shower
bath than not. Another man is tak"U ill of
inflammation ol th ' lun-. and prol.al.lv die.
Tb doctors cannot explain the diligent 'issue,
uuu ui-y wouiu niso iq very much puzzled to
puftiacury account ot the pneumonia
itself. They will, indeed. PeiiHrallv e villain
diseases by theories more or less plausible,
and practice has been built upon theory, and
theory has, no doubt, sacrificed a nunib-r of
nnman lives. Xet medicine must have its
dogmatic system, And without it medicine be
comes little better than empiricism.
Some time ago it was the theory that the
type of disease had changed; and, indeed,
it ia difficult to believe that there
are not substantial grounds for
such an opinion. Dr. Watson once held this
opinion very strongly, but of late years he
seems entirely to have withdrawn his adhe
rence; and the simple fact is that the charac
ter of diseases Is better understood now than
was the case once. We have seen, even of
late years, works where the tendency of cer
tain diseases to death, and the tendency of
certain diseases to convalescence, is much In
sisted on; but I imagine that such a classifica
tion would now be exposed to rigorous criti
cism. The history of medicine reveals to us
a succession of so-called "systems," some of
them mixed up with theories of the universe
and visionary mysticism, like the gases of
van iieimont or the Vortices of Descartes.
and often issuing in rules and practices as
simple and as sanguinary as that of San-
graao. tuperstition and mysticism and
mere notions are now discarded for the
results of exact science and patient ex
periment. It is now understood that patho
logy and physiology fade into each other,
and that the processes of disease are in
accordance with those which belong to the
structure and functions ot Healthy organs
The study of such a work as Dr. Williams on
the "Principles of Medicine," to which the
late Mr. Buckle was so largely indebted, will
indicate the present state of medical science
and supply a line of reasoning susceptible of
being followed by every thoughtful and edu
cated mind.
The recollection of by gone systems of medi
cine might supply us with abundant curiosi
ties of prescriptions. They are curious enough
In modern medicine, as, for instanoe, air
Charles Hastings' brochure on the use of the
serpent in phthisis. Ihe following regimen
of Brown's for the treatment of a hypochon
driac ratient is rrobablv uniaue amone Dm
scriptions. Its absurdity should not blind us
to the fact that there are real merits in the
Brunonian system, as it is called. With many
people such regimen as the following would
be popular enough:
"For breakfast, toast and rich soup made
on a slow fire, a walk before breakfast and a
good deal after it; a glass of wine in the fore
noon from time to time; broth or soup to dinner,
with meat of any kind he likes, but always
the most nourishing; several glasses of port
or punch to be taken after dinner, till some
enlivening effect is perceived from them, and
a dram after everything heavy; one hour and
a half after dinner another walk; between tea
time and supper a game with a cheerful com
pany at cards, or any other play, never too
prolonged; a little light reading; jocose, hu
morous company, avoiding that of popular
Presbyterian ministers and their admirers,
and all hypocrites and thieves of every de
scription. Lastly, the company of
amiable, handsome, and delightful young
women, and an enlivening glass."
Dr. Russell, to whom we are indebted for
the quotation, might well say that "John
Brown's prescriptions seem a caricature of his
system." Dr. Russell also mentions the great
Sydenham's plan, "Ue Methodo tnedr-ndi niot bos
;xr Accubitum Junioris." Sydenham, though
a theorist, was a great man, and his name is
justly regarded with a high degree of vene
ration, lie mentions several cases in which
he cured the diseases of elderly people by
making young people sleep with them. The
practice has Biblioal authority, and we believe
is even now pursued in foreign countries.
Another Dr. Brown of Edinburgh, the author
of the "Iorw Subseciva," shall supply us with
a further anecdote of prescriptions: "Many
years ago a countryman called on a physician
in York. He was in the depth of dyspeptio
despair, as often happens with the chaw
bacons. The doctor gave him some plain
advice as to his food, and ended by writing a
prescription for some tonic, saying, "Take
that and come back in a fortnight." In ten
days Oiles came In, blooming and happy,
quite well. The doctor was delighted, and
not a little proud of his skill. He asked to
see what he had given him. Giles said he
hadn't got it. "Where was it ?" "I took it,
sir," "Took it 1 What have you done with
the prescription !" "I ate It, sir. You told
me to take it."
Dr. Brown's view of the human constitution
we mean the Dr. Brown whose "system"
almost made a medical revolution half a cen
tury ago is thus ingeniously set forth by his
disciples, and in its main illustrations may be
accepted: "Suppose a fire to be made in a
grate, filled with a kind of fuel, not very com
bustible, and which could only be kept burn
ing by means of a machine containing several
tubes placed before it, aud constantly pouring
streams of air into it. Suppose, also, a
pipe to be placed in the back of the chimney,
through which a constant supply of fresh
fuel was gradually let down into the grate to
repair the waste occasioned by the flame kept
up by the air machine. The grate will
represent the human trame; the iuei in it tne
matter of life, the excitability of Dr. Brown,
and the sensorial power of Dr. Darwin. The
tube behind supplying fresh fuel, will denote
the power of all living systems constantly to
regenerate or reproduce excitability; while
the air-machine of several tubes denotes the
various stimuli applied to the excitability of
the body, and the name drawn forth in conse
quence of that application represents life, the
product of the exciting powers acting upon
the excitability." This illustration has a
shadowy resemblance to the famous cave
image iu Plato.
The whole subject of medical jurisprudence
Is an exemplification of the Romance of Medi
cine. ' The great authority on this subject is,
of course, Dr. Alfred Swayne Taylor, whose
work on medical jurisprudence Is much more
fascinating reading than most novels are. 1 he
English public are unfortunately only too
familiar with medico-legal cases. We have
cenerally some great Oyer and Terminer oase
KOing on, where poison had been the agency
employed, and medical men are exhaustively
discussing the scientific aspect of tue case.
Such trials as those of Palmer, Madeline
Smith, Smethurst, Pritchard, and others, have
made the publio nnwholesomely familiar with
toxicology. In cases of circumstantial evi
dence medical men are freq ueutly 'the leading
witnesses.
It was long a disputed scientific question
Whether a person can die of poison, and yet no
trace be found in the body. When a very
celebrated physician declared that he was ac
quainted with several vegetable poisons which
absolutely left no trace at all, we are credibly
informed that he was inundated with letters
from persons entreating him to say what those
poisons were. We may be sure that a thirst
for scientific knowledge, or a mere curiosity,
I dictated the 'great wans of those letters; but at
the same time thoro may be donMful sprcu- i
lations as to the motives which actuated some
of these inquiries.. Some very curious cases,
tinning ou minute points, occasionally arise
in medical juiispruden e. Such Is the case
of the M.tack ou the Duke of Cumberland by
his valet, Scllis, who afterwards committed
suicide; some vnguc popular suspicion at
tached to the duke, aud Sir Edward Home
made a joint in the case in the duke's
,favor on the distinction between venous
and arterial blood. We notice that,
in his Index, Dr. Taylor gives no less than
three allusions to the case of the Due de
Praslin. Dr. Taylor alao discusses ti e oase of
General I'ichegru, who was found strangled
in prison through the ligature of his neck
being tightened by a twisted s'.ick. A strong
suspicion of murder was excited, and it was
thought that death had been caused through
an order of the Emperor Napoleon. Dr.
Taylor states that the evidence of this having
been au act of homicide is very weak, and
that, so far as the medical circumstances ex
tend, there is no reason to doubt that it was
an act of suicide.
There was a remarkable case of strangula
tion which happened in London mauy years
ago, and which many may recollect. There
was an unfortunate man who used to ex
hibit himself publicly In the act of hanging,
and at a certain point released himself
without having sustained any injury.
One day the poor fellow continued the ex
periment a little too far, and was hanged in
real earnest. The curious fact is, that a gap
ing mob surrounded him all the time, and
allowed him to hang for thirteen minutes
before the suspicion was entertained that some
thing might be wrong. Every medical man
is constantly liable to be called into the witness-box
in cases of violence, poisoning, and
that numerous and most melancholy class
concealment of birth. Dr. Taylor advises him
to make his antecedent examinations most
carefully, and to be very careful as to the kind
of figure which he cuts in the witness-box.
Dr. Taylor speaks rather severely of counsel.
and at times counsel have spoken rather
severely of Dr. Taylor; he inclines towards a
contemptuous feeling in reference to juries,
with which it is impossible not to feel some
measure of sympathy. I he most remarkable
cases which occur in medicaid urisprudence are
unquestionably those of chromo poisoning.
At the present time there appears to be a
fearful race between the art of the poisoner
and the art of detecting poison. Ihe history
of the processes employed to test for poisons
Is highly curious, and ot much scientific in
terest. Dr. Taylor says that persons have
died from the effects of poison eleven months
after the poison had been swallowed, and that
there is no reason to doubt that instances may
occur of a still more protracted nature. "The
occurrence of such cases as these suggests
grave reflections on the insecurity of life,
when poison is used with skill and cunning,
and on the inefficiency of the present system
of registering causes of death. The editor
of the Law Magazine has truly said, in
commenting upon the Smethurst case, "All
that is requisite for future murderers by
poison to do is to use small doses, combine
the use of various destructive drugs, and
subpoena the proper witnesses. If the judge
and jury should, nevertheless, be convinced
that the skilful poisoner was guilty, it is then
open to him to work the papers and 'public
opinion,' get other doctors' evidence, and
apply to the Home Office. That this will be
the course pursued by future poisoners i3
highly probable; hence the characters of
chronic poisoning have acquired a special
interest for the medical jurist." The single
subject of frauds upon insurance offices opens
up a wide field of medical jurisprudence. The
publio obtained glimpses of this in the case of
Palnier, but the cases were not fully gone into,
as a conviction was obtained in the indictment
respecting Cook. It may, however, be said
that the insurance cases of which the publio
obtain glimpses are few when oompared with
the insurance cases of which the publio know
nothing. A collection of such cases would
form one of the most curious and fearful books
of the age. It sometimes happens that an
office has no moral doubt, though it has little
legal proof; and if they venture to resist a
claim, it will probably happen that the claim
will not be insisted upon. We give the fol
lowing anecdote on the authority of a medical
friend. A woman insured one or two lives in
an office, and the lives rapidly fell In. When
this happened with a third life, the office
having seen some reasons for suspicion, de
murred as to the payment of the policy. The
woman called at the office, and said angrily to
the manager, "Do you think I poisoned my
own relation ?" A sudden thought struck
the manager. He walked up to the' woman,
put his hand on her shoulder, and looking
fixedly at her, sald,"We knoie you did." The
woman, in great agitation, left the office, and
was never seen there again.
Very much that is very remarkable belongs
to the diagnosis and prognosis of a case. No
two medical cases exactly resemble one an
other any more than two human faces are ex
actly alike, or any two blades of grass even.
A man can no more be a physician by reading
book than a man can be an artist by reading
all extant publications on form and color.
Each case is a separate study ia itself. Now
this diagnosis is 'exceedingly troublesome
work. Patients often cause a a good deal of
this trouble. They send for a medical man,
and at once expect him to explain what is the
matter, and to write them a prescription. If
a medical men will not do this off-hand,
they lose confidence in him, and will
apply to some other practitioner. It is per
fectly wonderful now a London physician m
extensive praotiee will examine and prescribe
in a very few minutes. But, as a rule, alman
ought to have an opportunity of studying
achronlo case minutely before he adopts any
decided treatment. Invalids have also another
way of proceeding, whioh Is a sore trouble to
some medical men. They make a round of
the London physicians, and taKe a morwa aia
light in discovering conflict of medical opi
nion. They go to some doctor, and when they
have extracted an opinion from him, they
suddenly turn round and say that his views
are totally at variance with those of the re
nowned Sir Kappa Chi, and derive little coun
tenance from the views of Dr. Lambda. Some
doctors become reticent in their opinions, and
are afraid to deliver a judgment until they
know what may be the opinion of the great
authorities. But, for the most part,
the general practitioner will give his own
views; and if they are at variance with those
of the great authorities he will declare that
the great authorities are in the wroug. I
do not think, however, that the patient has
been in the w rong. In the multitude of coun
sellors there is wisdom, and an obscure case
has the fullest chance of being properly under
stood w hen it has been submitted to different
medical lights. The diagnosis Is the making
out of what Is exactly the matter with the
patient; the prognosis is the judgment made,
with more or less certainty, of the issue of the
dipnse.
Some doctors attain a wonderful skill in both
respects. They can almost complete both
diugnosli and prognosis by locking at a
jntieut'H luce. 'It' is aver' c'.'ifbnlt c.:-e."
uid a civ.iwi me Uy W ft eat, ' hul I 111
tell you ove thing for your consolation, which
is tnni you will well." Tins proved to be
the case, but, singularly enough, the ivat
inSn himself died suddenly before he the
patient ugain. .As a man for the first t f mo was
entering a physician's consulting-room, the
i;:uer -inspired io a ii lend, "Case of great
p:iin, I am sure muscle adhering to bone
chronic and hopeless" as it proved. The same
man was walking downs street, and at tho
door of an hotel was a smiling landlord,
portly, fresh-colored, and apparently robust'.
'J he friend made some casual remark, to the
effect that there was a typical Briton, er some
thing of that kind. "You think so," said the
doctor. "That man is safe to die within a
twelvemonth." The diagnosis, sometimes
tasy enough, is occasionally perplexing iu the
extieme. The great majority of cases are
patent enough; au experienced physician will .
see it all in live minutes; but others are ex
ceedingly obscure, and the medical man is
tever quite al.le to clear up the obscurity.
Sometimes there is some little circumstance,
unexpected and out of harmony with other
circumstances, which baflles all the calcula
tions. "In every respect the patient is going
on extremely well," said a doctor to an
anxious member of a family; "but I confess
there is a little twiching over the eye which I
do not at all like." The case terminated
fatclly. It sometimes happens that when a
patient, by all the rules ot art, ought to be
getting better or worso, he persists in getting
worse or better. 'It 13 a question of the pa
tient's previous history and constitution; a
slight attack in one case beiug more dangerous
even than a dangerous attack in another. I
remember being very much amused with the
case of a young doctor and his first patient.
It was a child afflicted with hydrocephalus.
According to all the rules the child ought to
die. Nevertheless, the untoward infant per
sisted in not dying. The doctor went from
his books to the bedside, and from the bedside
to his books. He confidentially asseverated to
me that the infant ought to die, and mani
fested a not altogether friendly feeling towards
the infant because it did not die. His treat
ment was altogether better than his prognosis:
at the time w hen my knowledge of the case
teiminated, it was going on well.
It is very hazardous lor a doctor to give a
prognosis; if he openly gives an unfavorable
prognosis, and the case terminates favorably,
his reputation is wellnigh gone. But you will
not often find a medical man doing this sort of
thing. As a rule, the doctor always takes
the most cheerful view possible of a case, and
even hopes against hope. In the last illness
of George IV, the physicians were also pro
nouncing him better, and in the midst of tha
"betternesa" he died. Other doctors, how
ever, there are, morbidly disposed, from whom
you may take every grain of comfort they
give, and something more. It is curious that
a doctor cannot always be trussed with tha
diagnosis and prognosis of his own case. The
great Dr. Baillie is said to have been a case of
this. He is said to have died of consumption,
and' yet to have denied that he was con
sumptive. He did not experience any diffi
culty in breathing, and argued that, while
his breathing was good, his lungs could not
be bad. But no medical man now takes this
as decisive. Nature, in her bounty, provides
a larger space of lung than is necessary, and
will long go on with a very small amount of
lung, and with very little difficulty in breath
ing. . Another noteworthy case of lung
disease is a very different person, the noto
rious empiric, St. John Long. He professed
to cure consumption, but in reality, like other
similar quacks, he only cured cases of cough
and bronchitis with symptoms imitative of
those in phthisis. He unquestionably caused
death in several instances by a treat
ment which would be perfectly harmless
in most cases, but which was fatal to many
delicate women. He was himself struck
down by consumption, and died at the early
age of thirty-seven. One of our most pro
mising doctors In chest complaints, Dr. Hope,
who at an early age had reached almost the
summit of his profession, was prematurely
cut off by consumption. There are few volumes
more affecting than the narrative of his life;
and it is impossible to resist the impression
that his fatal illness was in great measure due
to extreme and unmitigated devotion to intel
lectual labor. .
Medicine has often very startling surprises
in store, which are frequently gloomy enough,
though sometimes of a pleasant nature. We
will, in' the first place, select some of the
former. A clergyman in the neighborhood of
Mount Edgecumbe was one day walking very
fast, when he was met by his doctor. He ex
plained, in conversation, that he was suffer
ing from pains of indigestion, and was in the
habit of taking long walks in order to get rid
of them. The medical man insisted on exa
mining him, and then explained to him that
he was in fact suffering from aneurism of the
heart, and that these long walks were the
worst things possible for him, and was
obliged to add that the disease would some
day prove suddenly fatal. The statement was
sadly verified. In the midst of a sermon; at
a very emphatio passage, the preacher fell
down from his pulpit, and life was found to be
quite extinct. The congregation broke up ia
the utmost consternation and terror. A man
was in company with another, and from some
casual circumstance he took off his stockings.
His friend took the liberty of observing
that one of his feet was really very black. It
was discovered that from some cause the foot
was mortified. In former times it would have
been theught necessary to amputate it, but
medical art has contrivances whereby this is
avoided. A very remarkable case is men
tioned by the pious Bishop Newton, In the
valuable fragment, of the "Antobigraphy"
which has come down to us. A young noble
man in the country was dangerously ill with
a fever. Physicians were bummoned from
difi'erent quarters, and the bishop relates that
no Jess a sum than seven hundred guineas
was paid to them as fees. All the means used
were unavailing, and the patient sank raoidlv.
When he was quite given over, and left alone
to die, he w as heard to muimur a request for
beer. A larpe goblet, containing nearly a
quart of small beer was handed to him which
he drained at a draught, and then' drank
again. He recovered.
I think I recollect also a similar case Iu one
of the London hospitals. A mau was talking
one day at a dinner-table with a physician!
and he mentioned a particular circumstanoe
occurring in his own iustance. "I do not
mind mentioning to a man like you " said th
doctor "that that Is a sign of the existence of
a cavity In the lung." A man who had been
adiLg tor a long time was persuaded by a friend
to consult an tmiuent physician. He X.norTl
inglywept to t he conning ro0ni and
an animation he was significantly ask.d by
as pestilence () the other hand the utmost
happiness had been caused when men had made
up their minds for the worst and had then been
dit,ibuKed of some mistaken notion. Suoh an
ncui.ciice is not uutiequMnt. One of the
latest fees ever known iu the profession was
iun to W, Astley Cooper, wh UUht
...... - i'"ujto mas, no only liveii a fiirt
wKh f ?T'in,'f n1 L7e U -aot a c Jein
wluh he died of the doctor rather than of
disease; tor the panic destroy nlmnaf i.