No. 76.] Quackery. 113 agreed to be united to that of Paris; and to act in conjunction with it, in promoting practical medicine, for the honour of the profession, and the good of mankind. At the last meeting of the society, a paper was read on a branch of medicine which has been much neglected, both by the ancient and modern physicians, viz. extemporaneous prescriptions, in which the writer satisfactorily proved the absurdity of forming an opinion of the value of a prescription by its chemical character; for, although it may appear to the philosophical or analytical chemist to be unchemical, the new combinations that form, may, on being taken into the stomach, produce beneficial effects, which the articles were incapable of doing, had they not been decomposed. He contended, that the value of a medicinal composition could only be ascertained by repeated experience. He pointed out the absurdity of the chemical observations which are dispersed through Dr. Paris's Pharmacologia, to guide young practitioners in writing prescriptions, which he very justly termed pedantry. Messrs. Price & Griffiths communicated a case of tape worm, in which the spirit of turpentine had been administered, to the extent of eleven ounces, at different intervals, (in the dose of an ounce and a half,) in the course of twenty hours, without effect. They also communicated the particulars of a case of fungus hematodes, which they successfully removed by ligature. The society is desirous to establish a correspondence with a leading medical gentleman in every county, and to receive communications from them. Dr. Dods, of Worcester, presented a copy of his physician's society, and was elected a corresponding member. Their quarterly work will not appear till the first of August. We are happy to understand, that the price is not to exceed 2s. 6d. a number. Communications are addressed to the secretary, Mr. Sheppard, 31, Duke-street, Piccadilly. QUACKERY, (continued.)-Another cause of the prevalence of this traffic is found in the great expence attendant upon advice and medicine in regular practice; a consideration which has driven tradesmen of good understanding to the nostrum shops; for there lies no alternative between the mischief of quackery and the inconvenient expence of the Physician and Apothecary so that the public, if they do not lay down and die, without resistance to their diseases, must fall either into Scylla or Charybdis. The Legislature does not allow the apothecary to charge for his attendance, and as he, consequently, possesses no other claim to recommendation for his trouble than he is legally allowed to charge for his medicines, he necessarily sends a daily number of nauseous draughts to make up a bill that shall in some measure pay for his time and attendance. This evil does not rest alone upon the patient, but the apothecary shares it also; the former is obliged to be constantly swallowing a nauseous potion which injures his appetite, and thus probably removes the best agent towards his recovery; whilst the latter, for the sake of the recompense, adds greatly to his annual expense, by increasing the bills of his glassman, his druggist, &c. We have this day received the copy of an apothecary's bill, in which eight draughts, three boluses, and six powders, are charged daily, for many weeks, VOL. VII. in a simple disease; and what converts the farce into a serious drama is, that this was a case of charity, undertaken by the apothecary at the instance of a person who was desirous of extending medical assistance to his friend, whose finances did not allow him the means of obtaining it. If apothecaries were allowed to charge five shillings for each visit, without any demand for medicines, this disgraceful practice would be renounced, and the guinea trade would soon languish, and a regular practice would soon be established to the general benefit of both apothecaries and patients. It has been objected that were such a measure as we have proposed carried into effect, the apothecary, out of parsimoniousness, would not supply his patients with the proper quantity of medicines. This is answered by observing, that the apothecary would stand in the same relative situation as he now does, as regards responsibility. We conceive that every man's aim is reputation, and the sooner the patient recovers, the more likely he is to obtain it; and besides, he risques the danger of incurring the dissatisfaction of the patient or of his friends, if the case appears unnecessarily tedious, and he may be discharged. Upon the whole, we think there would be no grounds for such a charge; it accords with the popular joke, that "doctors give their patients a draught to-day to do them good, and another to-morrow to make them worse again. When Henry the Eighth instituted the College of Physicians, it was presumed, as is clear from the duty he imposed upon them, that they were acquainted with surgery and pharmacy; for the members are not only authorised to exercise the chirurgical art, but to examine the drugs, &c. of the shops of the apothecaries: now if the king had known that they were ignorant of surgery, he would not have granted them authority to exercise it; for Henry, except for his own private gratification, was not very ready to countenance imposition. As to an acquaintance with the characters of drugs, it is notorious that the graduates of Cambridge and Oxford (and but too many of Edinburgh even) have not the ability to distinguish one from another: their own charter, therefore, from the particular licences expressed in it, would lead to the conclusion that Linacre, whose influence with the king obtained it, imposed upon his majesty with respect to their qualifications. It is indeed laughable to witness the assumed gravity, the shake of the head, or the expressive smack of the lips, of some of our courtier physicians, and other sticklers for the fee trade, when examining a medicine, at the bed-side, although they are profoundly ignorant of the means of judging of it: but they have two motives in this pretended scrutiny; the one is, to appear to know something of it; and the other is to be afforded an opportunity of reprobating "the carelessness with which it has been prepared," or the "bad quality of the drugs of which it is composed;" and then they give hint that prescriptions prepared at Mr. are com pounded with the very best medicines, and with the greatest accuracy." A little discrimination tells you that the druggist and the physician are partners in the proceeds of such recommendation. This practice is really very common in the metropolis, and often No. 76.] Quackery. 115 forms part of the chamber scence, in which the doctor is the chief "dramatis persona." One of the celebrated physicians of the day, a man basking in the sun-shine of royalty, lately ordered for his patient a mixture containing a solution of Epsom salt and salt of tartar. At his next visit he beheld part of the medicine in the phial with a white powder settled at the bottom. "Hey day!" says the astonished philosopher, "I ordered a mixture of two salts extremely soluble, and here is an insoluble powder settling in the menstruum ; there is a gross ignorance somewhere." And in truth the doctor was right in all he advanced, for the mixture was unchemical, and the powder which he observed was magnesia derived from the decomposition of the Epsom salts by the kali. The charter of this "Royal College of Physicians" is found to contain a singular licence, which is, a permission to any one and every one to practise the healing art by the use of herbs only. Now we really do consider this as ample a permission as any man would require, for poor must be the resources of that physician's mind, and very narrow his knowledge of medical botany, who could not from the vegetable kingdom alone cure most of the diseases of the human frame: even the specific of mercury, if we were driven to the necessity of a substitute, might probably be rivalled in some of these productions of nature. We know not whether we have most reason to hail the discovery of mercury as a blessing, or regard it as a curse, since the diseases it entails are as numerous as those which it cures. Our best informed dentists declare that they can clearly witness the progress of the use of mercury in the increasing diseases and decay of the teeth. There are serious objections also to other articles of the metallic world: antimony, iron, and arsenic are dangerous remedies in the hands of the ignorant; and mankind, perhaps, in the aggregate, would be benefitted by their expulsion from medical practice. A medical man, really concerned for the proper dignity and respect of his profession, cannot, without emotions of regret, witness the practice which has of late years prevailed amongst apothecaries of encouraging the nostrum trade. It has been defended by this argument, that this class of practitioners has lately increased so exceedingly by the reduction of the army and navy, that the regular practice of the country does not afford them the means of subsistence, and they are obliged to resort to the sale of nostrums to make up the deficiency; for it appears, from some recent calculations, that in this metropolis there is a medical man to every seven hundred persons; a proportion certainly inadequate to support the medical practitioner by respectable means, when we consider the large number of those who are unable to receive medicines except through the means of charitable institutions. There is scarcely a chemist also, however respectable, that has not some nostrum or pretended superior preparation, as a leading article to keep up his trade; deprived of which, his business would soon dwindle to nothing. Here we may notice the "smelling salts," the "yellow essence," and "cordial lavender," of Godfrey;-the "Seidlitz powder" and the "Cheltenham salts" of Paytherus, &c. &c. &c. Is not this, we would ask, a sanction of quacking in a quarter from which we ought not to receive it? The use of the Latin language in all matters of medical science is too often the cloak of ignorance. This custom is now the reproach of this country only; for in America, Portugal, Spain, and France, the examination of candidates for diplomas is conducted in the vernacular tongue; whilst in London, a licence to practise physic cannot be obtained until the applicant has gone through a Latin examination; and should his classical attainments be insufficient to enable him to support a controversy in that language, he is not allowed to enter upon the practice of his profession within the jurisdiction of the college, however splendid may be his medical talents; in fact, instances have been known of the rejection of men of acknowledged abilities, in consequence of their not sufficiently understanding the questions put to them in a language with which they were not familiar enough to be able to enter into a colloquial conversation. An American physician, even were his knowledge of diseases superior to that of the members of the profession in England, could not practise in this town unless he were master of the Latin language; the college laws, instead of promoting, injure" the interests of his majesty's liege subjects and his good city of London." Another circumstance which excludes the physicians of the continent from the practice of London, is the extent of the demand made by the College of Physicians for a licence, which amounts to seventy pounds. A charge for a licence or diploma is peculiar to this country, and is disgraceful to the state, that fosters a body, whose avarice and cupidity deprives the community of the services and talents of many a valuable character. In France and the United States of America, medical education is obtained at a very trifling expense, compared with that of this country; for here, the professor and heads of classes stretch their cord of exorbitancy to its utmost limit; and the student, if he does not come well prepared with the means of satiating this extortion, must limit the extent of his information to that of his purse. No one, to be satisfied of this truth, need look farther than to the annual prospectus of lectures, &c. at the different medical schools in this metropolis, which are industriously circulated, like so many bills of fare at a tavern, and the student may, if he can pay for it, gorge himself upon a share of the whole, or take a snack only of such parts as suit best with his pocket. (To be continued.) BLOOD.---SIRS-Most of your readers, though not of the medical profession, are most probably familiar with a certain peculiar appearance of the blood which is observed often in fevers, more especially in cases of inflammation, particularly of an important organ; or in any state of the body attented with increased velocity of the circulation. When blood has been drawn from a vein under such circumstances, and has remained at rest a sufficient time to allow of the complete coagulation of the solid or red part, and of the separation of the fluid or serum from it, the coagulum, or crassamentum as it is called, is seen firmly contracted into a small, almost spherical body, considerably scooped out at the upper part, so as to resemble a cup, (it is called the cupped blood,) with the edges thin and wide, projecting inwards, and hanging over the hollowed surface, somewhat like the mouth of a bag slightly contracted by a drawing string. The upper (or as it might almost be called the inner) surface of this blood is No. 76.] Cutting Instruments. 117 observed to be of a very different colour to the rest of the coagulum, and instead of presenting the natural red appearance of the blood, it exhibits a bright buff or yellow covering, which if divided, by passing an instrument through it, is found to be of various thickness, density, and tenacity, in different cases. The following case furnishes an instance not often met with. Mr. Thornick, of Douglas Street, Westminster, some time previous to the beginning of the year, received a cold from getting wet, which induced a slight cough; this he neglected for a month or six weeks, when he became alarmed in consequence of a vessel in the lungs giving way during coughing, and he instantly sought advice. Twelve ounces of blood were taken from the arm, and digitales administered; the loss of this quantity of blood but little retarded the velocity of the pulse, which was beating 110 strokes in a minute. The next day, the blood was found "cupped and buffy," and sixteen ounces more were extracted. This bleeding considerably reduced the frequency and hardness of the pulse, and in fact produced such a decided effect in taking off the determination of blood to the lungs, and of the irritation of the whole system, as to snatch the patient from impending comsumption, towards which he was rapidly verging. This second quantity of blood, being carefully examined the next day, presented the following phenomena: the crussamentum globular, and in size less than a cricket-ball; deeply cupped; thin inverted edges; surface covered with the buffy coat. A pin thrust through it suspended the mass, whose weight was supported by the extreme toughness of this membrane-like covering, which on being divided, and a rule applied to its edges, was found to be of the astonishing thickness of three-eighths of an inch; it was readily peeled off entire, and is now in my possession, resembling a dense strong fibrous membrane. It may not be amiss perhaps to state that this substance is one of the constituent portions of the blood called "fibrine, (or, from its quality of becoming solid, "coagulable lymph,") it is quite distinct from the red particles or colouring matter of the blood, but yet it is intimately mixed with it, and under ordinary circumstances, does not, after bleeding, separate from it, and attach itself to the surface, as it is found to do in the instances before enumerated. I am, Sirs, your humble servant, London, Feb. 27, 1822. MEDICUS. CUTTING INSTRUMENTS.-The thanks of the Society for the encouragement of Arts, Manufactures, and Commerce, were last session voted to George Reveley, Esq. of Queen Square, for a communication on the use of soap instead of oil, in setting cutting instruments on a hone. It sets quicker, gives a good edge, removes notches with great facility, and is a much more cleanly material than oil; the operation is performed as follows: Having first cleaned the hone with sponge, soap, and water, wipe it dry; then dip the soap lightly over it until the surface is thinly covered all over; then proceed to set in the usual way, keeping the soap sufficiently moist, and adding from time to time a little more soap and water, if it should be necessary. Observe that the soap is clean and free from dust before you rub it on the hone; if it should not be so it is easily washed clean. Strop the razor after set 1 |