Chapter V: The Malay (9)

Her unregarded locks
Matted like fury-tresses, her poor limbs
Chain'd to the ground; and stead of those delights
Which happy lovers taste, her keeper's stripes,
A bed of straw, and a coarse wooden dish
Of wretched sustenance.[18]

Now, the unfortunate persons are restored to social life as much as their sad condition allows; they enjoy every comfort that can solace them in their lucid intervals, when their hallucinations cease; in illness they are treated with kindness and liberality, and in health, their former associations with the busy world, are recalled by labour, voluntarily performed or stimulated by the incentive of some additional comfort. No coercion is resorted to, except to prevent the furious maniac from injuring himself and others, and then, such means are adopted that restrain his violence without a painful process. Even the straight waistcoat, which impedes respiration, is generally banished in all well-regulated establishments, and belts, sleeves, and muffs, which merely secure the hands, without preventing a free motion of the articulations, are usually resorted to. To such an extent is healthy occupation carried on in lunatic asylums, that at this moment at Hanwell, out of upwards of 600 inmates under my care, 421 are at work and distributed as follows:

_Males._

57 Working in the garden and grounds.
53 Handicrafts at various trades.
38 Assistants in the wards.
28 Picking coir, or the external fibre of the cocoa-nut,
for stuffing mattresses, &c.
2 Clerks in the office.
----
178
----

_Females._

120 At needlework.
2 Making brushes.
21 In the kitchen and dairy.
21 Assisting in the wards.
26 Picking coir.
30 Working in the garden.
23 In the laundry.
----
243
----

Hanwell may be said to be an asylum for incurables, since it is doomed to receive old cases that scarcely ever afford a chance of recovery; to which are added a large proportion of the idiots and epileptics of Middlesex, whose families cannot support them.

Let us hope from this gradual amelioration in the condition of this illfated class of our fellow-creatures, that every institution, both public and private, will shortly be conducted upon a similar plan, having sufficient grounds attached to it, to give occupation to such of their inmates as may still be able to enjoy some share, however trifling it may be, of the blessings of this life.

LEPROSY.

Bontius informs us that this disease was observed on the banks of the Ganges, where it was known by the name of _Cowrap_. Kaempfer noticed it in Ceylon and Japan. In Sumatra, whole generations are infected with both leprosy and elephantiasis; and those who are labouring under the latter disease, although it is not contagious, are driven into the woods. Christopher Columbus found lepers in the island of Buona Vista in 1498, and frictions of turtle blood were used to relieve them.

In our days it is a disease of rare occurrence, at least in Europe; yet it was observed at Vetrolles and Martignes, in France, in 1808, and at Pigua and Castel Franco, in Italy, in 1807. The elephantiasis still prevails in our West India colonies, more especially that species which is called "elephant leg," and which is not uncommon at Barbadoes, St. Christopher, and Nevis. Parsons, in his Travels in Asia and Africa, informs us that a similar complaint exists on the coast of Malabar, where it is called the "Cochin leg." The Hindoo physicians treat it with pills of arsenic and black pepper.

A curious species of leprosy appeared in Rome under the reign of Tiberius, which was brought thither from Asia. The eruption first broke out upon the chin, whence it was called _Mentagra_, and is thus alluded to by Martial:

Non ulcus acre, pustulaeve lucentes;
Nec triste mentum, sordidive lichenes.

From the chin it extended over the entire body, and on its disappearance left scars more unsightly, if possible, than the former disease. Its virulence and difficulty of cure induced the Romans to send to Egypt for attendance. The same disease prevailed in the second century, and Soranus, a physician of Aquitania, was sent for to heal it. Crispus, a friend of Galen, is said to have discovered the best method of cure. Pliny has given an accurate account of the mentagra in his Natural History, lib. xxvii. cap. 1. According to the same writer, elephantiasis was brought to Rome by Pompey's troops. Plutarch fixes its apparition to the time when Asclepiades of Bithynia flourished as one of his disciples. Themison wrote a treatise on the disease, which is mentioned by Caelius Aurelianus, but has not been preserved from the ravages of time. Lucilius called the affection _odiosa Vitiligo_. The _Gemursa_ of Pliny appears to have been a similar complaint; and Triller thinks that it was the _Gumretha_ of the Talmud.

Formerly, in England, the causes of lepers were committed to the ecclesiastical courts, as it was prohibited to prosecute a leper before a lay judge, as they were under the protection of the church, which separated them from the rest of the people by a ritual. At this period a law existed, called _Leproso amovendo_, for the removal of lepers who ventured to mix in society. Thus leprosy may be considered one of the most terrific maladies inflicted on mankind. Holy Writ affords us abundant proofs of its fatal character. It is probable that this disease was first observed under the scorching sun of Egypt, whence it spread its ravages to Greece and Asia; and when the East was obliged to submit to the Roman legions, the conquerors carried the scourge of the vanquished to their own country. From Italy the disorder extended to France; and in the reign of Philip I. we find some members of the church militant, called _hospitaliers_, who spent their arduous life in attending upon lepers, and waging war against the infidels.

The Hebrew tribes, on quitting Egypt, were subject to three kinds of leprosy; all of them were distinguished by the name of _Berat_ ([Hebrew]), or "bright spot." One called _Boak_ ([Hebrew]), of a dull white; and two named _Tsorat_ ([Hebrew]), or "venom or malignity:" the first variety of the latter being the _Berat Lebena_, or bright white berat; and the next the _Berat Cecha_, or the dark and dusky berat; both of which were highly contagious, and rendered those who laboured under their attack unclean, and dangerous to society.

Manetho, Justin, and several historians, pretend that the Hebrews were expelled from Egypt in consequence of their being infected with this formidable disease; a reproach from which Josephus attempted to exculpate his countrymen. It appears, however, that, during their captivity of one hundred and thirty-four years, the Israelites laboured under this awful visitation; and, three thousand years after their migration we find Prosper Alpinus describing the banks of the Nile as the principal seat of the disease. Lucretius gives the same account of it:

Est Elephas morbus, qui, propter flumina Nili
Gignitur, Aegypto in media, neque praeterea usquam.

Pliny and Marcellus Empiricus refer the calamity to the same source. They state, however, that it was more general in the lower classes, although it sometimes attacked their sovereigns; an event which added to the horrors of the infliction, since it appears that royalty had the privilege of bathing in human blood as one of the most effectual curative means. Gaul and Avicenna attribute its fatal prevalence in Alexandria to the influence of the climate, and the quality of their food. The Persian writer thus expresses himself: "Et quando aggregatur caliditas aeris cum malitia cibi, et ejus essentia ex genere piscium, et carne salita, et carne grossa, et carnibus asinorum, et lentibus, procul dubio est ut eveniat lepra, sicut multiplicatur in Alexandria."

The _Boak_, or slighter berat, which is not considered to be contagious, still bears the same denomination amongst the Arabs, and is the [Greek: lepra alphos] or dull white leprosy of the Greeks. The bright white and dusky berats of the Hebrews were distinguished on account of their malignity, and with the _Tsorat_ ([Hebrew]) are still called among the Arabians by the Hebrew generic term with a very slight alteration, for the _Berat Lebena_ is their _Beras Bejas_, and the _Berat Cecha_, the _Beras Asved_.

While the Arabians borrowed the Hebrew terms, the Greeks took their denominations from the same source; and from _Tsorat_ they adopted the word _Psora_. The _Tsorat_ is restrained by the Hebrews to the contagious form of leprosy. Amongst the Greeks Lepra was a generic synonyme of _Berat_ or _Beras_.

This confusion in the adaptation of the names given to the varieties of leprosy has occasioned much perplexity in the study of the disease. Actuarius, in endeavouring to rectify these errors, has produced a greater confusion. According to him, they are different forms of a common genus. However, the most important distinction was that which defined the contagious and the non-contagious forms. The leprosy described by Moses under the name of _Boak_ or _Bohak_ was the [Greek: alphos] of Hippocrates; _Seeth_ the [Greek: phakos]; _Saphachath_ and _Misphachath_ the [Greek: leichen]; and _Bahereth_ the [Greek: leuke]; and according to Carthenser and other writers, this leprosy was the _Leuce_ of the Greeks.

The elephantiasis was long confounded with leprosy; but the former is a tubercular affection of the skin, widely different from the scaly leprosy, and certainly not contagious. Its singular name was derived from the condition of the surface of the huge misshapen limbs of those who were affected with the malady, and which bore some resemblance to the leg of an elephant. This morbid state is not uncommon in the island of Barbadoes, and in England it has been called "the Barbadoes leg." The original Arabic name for this affection was _Dal Fil_, or "the elephant's disease," which is now the common denomination; although it is frequently abridged into _Fil_ alone, literally _Elephas_. The elephantiasis is not even alluded to by Moses in his descriptions of leprosy. However, the elephant leg of the Arabians is a disease totally different from the specific elephantiasis, which is a disorder of the skin, the roughness of which led to the name, and which the Arabians called _Juzam_ or _Judam_.

These errors of description amongst medical writers have of course occasioned much obscurity and perplexity in the productions of travellers and historians, who have generally confounded all these diseases with the Hebrew leprosy, or the leprosy which for so long a period desolated the fairest portions of Europe, where every country was crowded with hospitals established for the exclusive relief of the malady. The number of leper-houses, as they were denominated, has been singularly exaggerated. Paris has been made to assert that there were nineteen thousand of these hospitals, whereas he merely stated that the Knights Hospitalers, under various patron saints, but more particularly St. Lazarus, were endowed with nineteen thousand manors to support their extensive establishments; and he thus clearly expressed himself: "_Habent Hospitalarii novemdecim millia maneriorum in Christianitate_." It appears that in the reign of Louis VIII., France had no less than two thousand of these hospitals. Leprosy was well known in the eighth century, and St. Ottomar and St. Nicholas, were considered the first founders of establishments for its treatment in France and in Germany. The Crusaders, however, by their connexions with the East, materially increased its inroads in Europe, and the disgusting malady appears to have been considered as a proof of holiness. Moehser, in his work "_De medicis equestri dignitate ornatis_," informs us that the Knights of the order of St. Lazarus were not only intrusted with the care of lepers, but admitted them into their noble order: their Grand Master was himself a leper. The Crusaders, returning from their useless wars, eaten up with the disease, received the honourable distinction of being _pauperes Christi, morbi beati Lazari languentes_. The most distinguished individuals in the land attended upon them with the utmost humility; and Robert, King of France, used to wash and kiss their filthy feet to keep himself in odour of sanctity. All these attentions, however, did not always prevent the lepers from complaining of their complicated sufferings, but they were exhorted by holy men (who of course had never experienced the miseries of the malady) to be of good comfort, as their illness was a blessed favour conferred upon them as the elect of the land. St. Louis thought the Sire de Joinville an unbeliever; for having once asked him which he would prefer, being a _mezieu_ or _laide_ (a leper), or having to reproach his conscience with any mortal sin, his favourite replied to the singular question, that he would rather be guilty of thirty deadly sins; whereupon the sanctified monarch severely rebuked him by telling him in the quaint language of the times, "Nulle si laide mezeuerie n'est, comme de estre en peche mortel."

Notwithstanding the sanctity of their disease, lepers were by various laws separated from the healthy portion of the community. The ceremonies used on these occasions were curious; and we find the following description of them in the History of Bretagne: A priest in his sacerdotal robes went to the leper's dwelling, bearing a crucifix. He was then exhorted to submit with resignation to the affliction: he afterwards threw holy water upon him, and conducted him to church. There he was stripped of his ordinary vestments, and clothed in a black garment; he then knelt down to hear mass, and was again sprinkled with holy water. During these ceremonies, the office for the dead was duly sung, and the leper was finally led to his destined future residence. Here he again knelt, received salutary exhortations to be patient, while a shovelful of earth was thrown on his feet. His dwelling was most diminutive: his furniture consisted of a bed, a water-jug, a chest, a table, a chair, a lamp, and a towel. He further received a cowl, a gown, a leathern girdle, a small cag with a funnel, a knife, a spoon, a wand, and a pair of _cliquettes_, (a sort of castanets,) to announce his approach. Before leaving him, the priest added another blessing to these gifts, and departed, after commanding him under the severest penalties never to appear without his distinctive apparel, and barefooted; never to enter a church, a mill, or a baker's shop; to perform all his ablutions in streams and running waters; never to touch any article he wanted to purchase, except with his wand; never to enter drinking-houses, but to buy his liquor at their doors, having it poured into his barrel by means of the funnel graciously given him for that purpose; never to answer any question unless he was to windward of his interlocutor; never to presume to take a walk in a narrow lane; never to touch or go near children, or look at a good-looking wench; and only to eat, drink, and junket with his brother lepers; and invariably to announce his unwelcome approach by rattling his castanets.

The offsprings of these sequestrated creatures were seldom baptized; and when this rite was performed, the water was thrown away. After this oration his ghostly adviser took his final leave, and the patient's former dwelling was burnt to the ground. The sepulchre of St. Mein, in Britanny, was frequently visited by these poor creatures; and on such occasions they were obliged to have both their hands covered with woollen bags, as a distinguishing mark amongst the other pilgrims. Lepers were only allowed to intermarry with fellow-sufferers; yet we find in one of the Decretals of St. Gregory, that any woman who chose to run the chances of contagion could please her fancy. St. Gregory perhaps thought this the most effectual method of preventing the dreaded intercourse, as most probably, had it been prohibited, lepers would have been in great request, they having always been notorious for their amorous propensities. Muratori informs us that these unfortunate persons did not always submit quietly to these severe regulations, but several times joined the Jews in a revolt against the authorities.

This affliction has been observed in various countries. In Iceland it is called _Likraa_; in Norway, _Radesyge_ or _Spedalskhed_. It is to be apprehended that many of these cases of leprosy belong more particularly to the elephantiasis: such is the red disease of Cayenne, and the _Boasi_ of Surinam.

It is especially in the East, its probable original seat, that leprosy is observed. In Damascus there are two hospitals for its treatment. The waters of the Jordan are still considered efficacious in its cure, and the waters of Abraham's well are looked upon as a specific. In Candia the disease was common, and lepers were noted for their obscene profligacy. From Crimea it has also been carried to Astracan, whence it infected the Cossacks of Jaick. Pallas and Gmelin have given an accurate account of its invasion.

THE ASPIC.

Various opinions are entertained respecting the reptile that inflicted the fatal sting on Cleopatra. According to Pliny, it had hollow fangs, which distilled the venom in the same manner as the tail of the scorpion. Aelian states it to have been a snake that moves slowly, covered with scales of a reddish colour, his head crowned by callous protuberances, his neck becoming swollen and inflated when he sheds his poisonous secretion. Other naturalists affirm that the scales are shining, and the eyes of a dazzling brightness; while some authorities maintain that the reptile's hue is of a dark brown colour, and that, like the chameleon, it can assume the colour of the ground on which it drags its writhing form. However, later observers have now clearly ascertained that the aspic of the ancients is the _coluber haje_, called by the Arabs _nascher_, and classed by Lacepede as the Egyptian viper. Lucan seems to have described this serpent in the following lines:

Hic, quae prima caput movit de pulvere tabes
Aspida somniferum tumida cervice levarit.

According to Hasselquist, the aspic's head is raised in a protuberance on both sides behind the eyes; the scales which cover the back are small, of a dirty white colour, and speckled with reddish spots. The lower surface of the reptile is striated with one hundred and eighteen small parallel zones, and forty-four smaller ones are under the tail. The teeth resemble in their structure those of other vipers; and, when the animal is irritated, its neck and throat are swelled up to the size of the body. Authors vary in regard to its length. Hasselquist, from whom we have derived the above description, says that it is a short reptile; while Savary assures us that it sometimes measures six feet.

The ancients stated that the poison of the aspic did not occasion any pain, but that the person it had stung gradually sunk into a calm and languid state, which was followed by a sound sleep, the forerunner of dissolution. Modern travellers assure us, on the contrary, that this venom is most active; and Hasselquist has observed an aspic in Cyprus, the bite of which brought on a rapid mortification, which generally proved fatal in a very few hours.

In Egypt the viper is still made use of in medicinal preparations; and a great number of them are sent to Venice for the confection of the celebrated _Theriaca_. Under Nero, we are told, that these reptiles were imported into Rome for pharmaceutical purposes.

In the above description, and endeavour to ascertain the nature of the aspic of the ancients, there must be some error. The _coluber aspis_ of Linnaeus is not venomous, and we may therefore conclude that the aspic was of the same species as our viper. The venom of this animal is of a yellow tinge, and small in quantity, seldom exceeding two grains in weight. In hot weather it becomes more active in its effects. Time does not seem to deprive it of its fatal properties; for instances have been known of persons having pricked their fingers with the pointed fangs of a viper preserved in spirits, when the most serious accidents have followed. The dried teeth lose this noxious power. The venom of the viper may be swallowed without any risk, provided there is not an ulcer in the mouth. Fontana has made upwards of six thousand experiments to prove the activity of this substance. A sparrow died under its influence in five minutes, a pigeon in eight or ten; a cat sometimes did not experience any inconvenience, a sheep seldom or never; and the horse appears to be proof against its action.

Some naturalists have affirmed that the female viper, in cases of sudden alarm, possesses the faculty of securing the safety of her young by swallowing them and keeping them concealed in her stomach, as the kangaroo secures her offspring in her pouch. This assertion, although fabulous, was credited by Sir Thomas Brown, and since by Dr. Shaw. Stories equally absurd have been circulated of this reptile. The Egyptians considered the viper as a typification of a bad wife, since they believed that during their union the female was in the habit of biting off her partner's head. They also looked upon it as the emblem of undutiful children, from the idle belief that the viper came into the world by piercing an opening in its mother's side.

SELDEN'S COMPARISON BETWEEN A DIVINE, A STATESMAN, AND A PHYSICIAN.

If a physician sees you eat any thing that is not good for the body, to keep you from it he cries out "It is _poison_!" If the divine sees you do any thing that is hurtful to your soul, to keep you from it he cries out "You are _damned_!"

To preach long, loud, and damnation, is the way to be cried up. We love a man who damns us, and we run after him again to save us. If a man has a sore leg, and he should go to an honest and judicious surgeon, and he should only bid him keep it warm, or anoint it with some well-known oil that would do the cure, haply he would not much regard him, because he knows the medicine beforehand to be an ordinary medicine. But if he should go to a surgeon that should tell him, "Your leg will be gangrene within three days, and it must be cut off; and you will die, unless you do something that I could tell you," what listening there would be to this man! "Oh! for the Lord's sake, tell me what this is:--I will give you any contents for your pains."

This ingenious antiquary has also made some quaint comparisons between doctors of the body and doctors of the public interests. "All might go on well," he says, "in the commonwealth, if every one in the parliament would lay down his own interest and aim at the general good. If a man was rich, and the whole college of physicians were sent to him to administer to him severally; haply, so long as they observed the rules of art, he might recover. But if one of them had a great deal of scammony by him, he must put off that; therefore will he prescribe scammony; another had a great deal of rhubarb, and he must put off that; therefore he prescribes rhubarb: and they would certainly kill the man. We destroy the commonwealth, while we preserve our own private interests and neglect the public."

Grotius called John Selden "the honour of the English nation;" and Bacon had such an implicit faith in his judgment, that he desired in his will that his advice should be taken respecting the publication or suppression of his posthumous works.

THE LETTUCE.

Various species of this plant were known to the ancients. Its type is supposed to be the _Lactuca quercina_, or the _Lactuca scariola_; both of Asiatic origin. Many powerful effects were formerly attributed to its use. It was considered as producing sleep, and recovery from intoxication; it was in consequence of this belief that this salad was served up after meals. Thus Martial tells us,

Claudere quae coenas Lactuca solebat avorum,
Die mihi cur nostras inchoat illa dapes.

Columella thus describes its properties:

Jamque salutari properet Lactuca sapore
Tristia quae relevet longi fastidia mori.

This belief in its narcotic qualities induced the ancients to esteem it as an aphrodisiac: the Pythagoreans had therefore named it [Greek: eunouchion]; and Eubulus calls it the food of the dead, _mortuorum cibum_. Venus covered the body of her beloved Adonis with lettuce-leaves to calm her amorous grief; and vases, in which they were planted, were introduced in the Adonian festivals. Galen, who had faith in its powers, called it the herb of sages, and in his sleepless nights sought its influence by eating it at supper. It was also frequently put under the pillow of the rich to lull them to repose. Its cooling qualities were so much dreaded by the Roman gallants, that its use was abandoned; but Augustus's physician, Antonius Musa, having calmed by its prescription his master's uneasiness in a hypochondriac attack, lettuce recovered its popularity: a statue was erected to the doctor, and salad once more became the fashion, although the prejudices against it could not be removed. Lobel informs us that an English nobleman, who had long wished for an heir, but in vain, was blessed with a numerous family by leaving off this Malthusian vegetable.

MEDICAL FEES.

Such is the perversity of our nature, that the remuneration given with the greatest reluctance is the reward of those who restore us, or who conscientiously endeavour to restore us to health. The daily fees, it is true, are not handed with regret, for the patient is still suffering; but if they were to be allowed to accumulate to a considerable amount, they would be parted with, with a lingering look. The lawyer's charges for a ruinous litigation, the architect's demands for an uncomfortable house, are freely disbursed, though if exorbitant they may be taxed; but the doctor's--a guinea a visit!--is sheer extortion. 'Send for the apothecary: the physician merely gives me advice; the apothecary will send me plenty of physic: at any rate I shall have something for my money.'

To what can this unjust, this illiberal feeling be attributed? Simply to vanity and pride. Illness and death level all mankind. The haughty nobleman, who conceives himself contaminated by vulgar touch, can scarcely bring himself to believe that he is placed upon the same footing as a shoe-black. All _prestiges_ of grandeur and worldly pomp vanish round the bed of sickness; and the suffering peer would kneel before the humblest peasant for relief. Then it is that money would be cheerfully lavished to mitigate his sufferings. But how soon the scene is changed! The patient is well, thrown once more in the busy vortex of business or of pleasure. He had been slightly indisposed; his natural constitution is excellent: the doctors mistook his case; thought him very ill, forsooth; but nature cured him.

Could the ambitious mother admit for one moment that her daughter had been seriously ill?--a sick wife is an expensive article! If her medical attendant unfortunately hinted that the young lady had been in danger, he is considered a busy old woman, exaggerating the most trifling ailment to obtain increase of business; in fact, a dangerous man in a family where there are young persons--to be provided for. Nor can we marvel at this. No one likes to be considered morally or physically weak, excepting hypochondriacs, who live upon groans, and feel offended if you tell them that they do not look miserable. The soldier will describe the slightest wound he received in battle as most severe and dangerous; a feeling of pride is associated with the relation. The bold hunter will boast of a fractured limb; the accident showed that he was a daring horseman. Nay, the agonizing gout is a fashionable disease, which seems to proclaim good living, good fellowship, and luxury: it is, in short, a gentlemanly disease. But the slow ravages of hereditary ailments, transmitted from generation to generation with armorial bearings, the development of which may be averted by proper care, or hurried on by fashionable imprudence! how difficult even to hint to a family the presence of the scourge, when, through the transparent bloom of youth and beauty, our experienced eye reads the fierce characters of death in the prime of years. The aerial coronet floats in fond visions before the doting mother's ambitious eyes. A man would be a barbarian, nay, a very brute, to deprive the darling girl of the chances of Almacks, the delights of the pestiferous ball-room, or the galaxy of court or opera!

To attend the great is deemed the first stepping-stone to fortune, and patronage is considered as more than an equivalent of remuneration. Too frequently does the physician placed in that desirable situation forget what Hippocrates said of the profession. "The physician stands before his patient in the light of a demi-god, since life and death are in his hands."

Curious anecdotes are related of this unbecoming subserviency. A courtly doctor, when attending one of the princesses, was asked by George III. if he did not think a little ice might benefit her. "Your majesty is right," was the reply; "I shall order some forthwith." "But perhaps it might be too cold," added the kind monarch. "Perhaps your majesty is right again; therefore her royal highness had better get it warmed."

This absurd deference to rank and etiquette by a physician who at the moment is superior to all around him, reminds one of an account given by Champfort of a fashionable doctor. "D'Alembert was spending the evening at Madame Du Deffand's, where were also President Henault and M. Pont de Vesle. On this flexible physician's entering the room, he bowed to the lady with the formal salutation, '_Madame, je vous presente mes tres humbles respects_.' Then, addressing M. Henault, '_J'ai bien l'honneur de vous saluer_.' Turning round to M. de Vesle he obsequiously said, '_Monsieur, je suis votre tres humble serviteur_;' and at last, condescending to speak to D'Alembert, he nodded to him with a '_Bonjour, Monsieur_!'" On such occasions a condescending smile from power is considered a fee.

Reluctance in remunerating medical attendants was also manifested by the ancients; and Seneca has treated the subject at some length. The difficulty in obtaining remuneration has unfortunately rendered many physicians somewhat sordid, and loth to give an opinion unless paid for. In this they are unquestionably right, as gratuitous advice is seldom heeded; and one of the most distinguished practitioners used to say, that he considered a fee so necessary to give weight to an opinion, that, when he looked at his own tongue in the glass, he slipped a guinea from one pocket into another.

To consider themselves in proper hands, patients must incur expenses, and as much physic as possible be poured down. Malouin, physician to the Queen of France, was so fond of drugging, that it is told of him, that once having a most patient patient, who diligently and punctually swallowed all the stuff he ordered, he was so delighted in seeing all the phials and pill-boxes cleaned out, that he shook him cordially by the hand, exclaiming, "My dear sir, it really affords me pleasure to attend you, and you _deserve_ to be ill." Our apothecaries must surely meet with incessant delight!

The most extraordinary remuneration was that received by Levett, Dr. Johnson's friend and frequent companion. It was observed of him that he was the only man who ever became intoxicated from motives of prudence. His patients, knowing his irregular habits, used frequently to substitute a glass of spirits for a fee; and Levett reflected that if he did not accept the gin or brandy offered to him, he could have been no gainer by their cure, as they most probably had nothing else to give him. Dr. Johnson says "that this habit of taking a fee in whatever shape it was exhibited, could not be put off by advice or admonition of any kind. He would swallow what he did not like, nay, what he knew would injure him, rather than go home with an idea that his skill had been exerted without recompence; and had his patients," continues Johnson, "maliciously combined to reward him with meat and strong liquors, instead of money, he would either have burst, like the dragon in the Apocrypha, through repletion, or been scorched up, like Portia, by swallowing fire." But though this worthy was thus rapacious, he never demanded any thing from the poor, and was remarked for his charitable conduct towards them.

Various professional persons have sometimes endeavoured to remunerate their medical attendants by reciprocal services: thus an opera-dancer offered to give lessons to a physician's daughters for their father's attendance upon him; and a dentist has been known to propose to take care of the jaws of a whole family to liquidate his wine bill. One of the wealthiest merchants of Bordeaux wanted to reduce the price of a drawing-master's lessons, on the score of his taking his children's daubs with him to sell them _on account_. This arrangement, however, did not suit the indignant artist, who left the Croesus in disgust.

A singular charge for medical attendance was lately brought before the court of requests of Calcutta, by a native practitioner. He demanded 314 rupees for medicine alone, and in the items of drugs appeared pearls, gold leaf, and monkeys' navels!

In one of the old French farces there is an absurd scene between Harlequin and his physician. The motley hero had been cured, but refused to remunerate his Esculapius, who brought an action for his fees, when Harlequin declares to the judge that he would rather be sick again; and he therefore offers to return his health to the doctor, provided he would give him back his ailments, that each party might thus recover their own property. This incident was perhaps founded on an ancient opinion of Hippocrates, who frequently mentioned salutary diseases. In 1729, a Dr. Villars supported a thesis on this subject, entitled "_Dantur-ne morbi salutares?_" and Theodore Van Ween has also written a learned dissertation on the same subject.

A celebrated Dublin surgeon was once known to give a lesson of economy to a wealthy and fashionable young man remarkably fond of his handsome face and person. He was sent for, and found the patient seated by a table, resting his cheek upon his hand, whilst before him was displayed a five-pound note. After some little hesitation he removed his hand, and displayed a small mole on the cheek. "Do you observe this mark, doctor?"--"Yes, sir, I do."--"I wish to have it removed."--"Does it inconvenience you?"--"Not in the least."--"Then why wish for its extirpation?"--"I do not like the look of it."--"Sir," replied the surgeon, "I am not in the habit of being disturbed for such trifles; moreover, I think that that little excrescence had better remain untouched, since it gives you no uneasiness; and I make it a rule only to take from my patients what is troublesome to them." So saying, he took the five-pound note, slipped it into his pocket, and walked out of the room, leaving the patient in a state of perfect astonishment.

It is related of a physician who received his daily fee from a rich old miser, who had it clenched in his fist when he arrived, and turned his head away when he opened his hand for the doctor to take it, that, on being informed his patient had died in the morning, not in the least disconcerted he walked up to the dead man's chamber, and found his clenched fist stretched out as usual; presuming that it still grasped the accustomed remuneration, with some difficulty he opened the fingers, took out the guinea, and departed.

The Egyptian physicians of old were paid by the state, but they were not prevented from accepting remuneration from individuals, and they were allowed to make demands for their attendance except on a foreign journey, and during military services.

When we compare the value of money it appears probable that the fees of olden practitioners were more considerable than the remuneration of the present day. Attendance upon royalty and the court seems also to have been more profitable. Dr. Radcliffe says, that he received from King William 200_l._ a year more than any other physician in ordinary--this monarch upon his appointment, gave him moreover, 500 guineas out of the privy purse for his attendance on the Earl of Portland, and the Earl of Rochford. When the same physician went to Hanau to attend Lord Albemarle, he received 1200_l._ from the king, with 400 guineas from his patient, besides a valuable diamond ring.

Dr. Radcliffe's fortune must have been considerable, as appears from his legacies, bequeathing 5000_l._ for the improvements of University College--4000_l._ for the building of a library at Oxford--and 500_l._ yearly for the amelioration of the diet of St. Bartholomew's hospital. Radcliffe had not been a year in London when he received 20 guineas daily, and he mentions that his fee for a visit from Bloomsbury Square to Bow, was five guineas.

We do not exactly know what was the exact honorarium of Doctors in former days, yet Baldwin Hammey informs us that in 1644, Dr. Robert Wright who had only been settled three years in London, was in the habit of receiving a thousand broad pieces (22 shillings) in the course of the year.

The following is a curious account of a puritan's consultation with Dr. Hammey.

"It was in the time of the civil wars when it pleased God to visit him with a severe fit of sickness, or peripneumonia, which confined him a great while to his chamber, and to the more than ordinary care of his tender spouse. During this time he was disabled from practice; but the very first time he dined in his parlour afterwards, a certain great man in high station came to consult him on an indisposition--(_ratione vagi sui amoris_,) and he was one of the godly ones too of those times. After the doctor had received him in his study, and modestly attended to his long religious preface, with which he introduced his ignominious circumstances, and Dr. Hammey had assured him of his fidelity, and gave him hopes of success in his affair, the generous soldier (for such he was) drew out of his pocket a bag of gold and offered it all at a lump to his physician. Dr. Hammey, surprised at so extraordinary a fee, modestly declined the acceptance of it; upon which the great man, dipping his hand into the bag himself, grasped up as much of his coin as his fist could hold, and generously put it into the doctor's coat-pocket, and so took his leave. Dr. Hammey, returned into his parlour to dinner, which had waited for him all that time, and smiling (whilst his lady was discomposed at his being absent so long), emptied his pocket into her lap. This soon altered the features of her countenance, who telling the money over, found it to be thirty-six broad pieces of gold: at which she being greatly surprised, confessed to the doctor that surely this was the most providential fee he ever received; and declared to him that during the height of his severe illness, she had paid away (unknown to him) on a state levy towards a public supply, the like sum in number and value of pieces of gold; lest under the lowness of his spirits, it should have proved a matter of vexation, unequal to his strength at that time to bear; which being thus so remarkably reimbursed to him by Providence, it was the properest juncture she could lay hold on to let him into the truth of it." It has been supposed, that the sanctimonious sufferer was no other than Ireton, Cromwell's son-in-law.

During the imprisonment of Dr. Friend in the tower, Dr. Head attended his patients, and on his liberation he presented him with 5000_l._ the amount of the fees received on his account. Dr. Meade's practice averaged from 5000_l._ to 6000_l._ per annum. It is somewhat strange, that this celebrated physician whose evenings were generally spent in convivial meetings at Batson's Coffee-house, used in the forenoon to receive consulting apothecaries at a tavern near Covent-garden, prescribing for the patients without seeing them at half-a-crown fee.

ENTHUSIASM.

Enthusiasm, from its derivation, might in strictness be called a _fixity of idea in divinity_; but Locke has given a better definition of this morbid state of our intellectual faculties in considering it as a heated state of the imagination, "_founded neither on reason nor divine revelation, but arising from the conceits of a warmed or overweening brain_." I shall not venture to take the field of controversy to support this doctrine against that of some metaphysicians, who most probably would consider this mental aberration as an original and natural judgment inspired by the Almighty, founded not on reason or reflection, but an instinctive impulse of the powers of the mind.

The Hebrews named this impulse _Nabi_ [Hebrew], (plural _Nebiim_,) "to approach or enter," on the surmise that the spirit pervaded the prophets, who were called _Roeh_ [Hebrew], or _Seeing_, hence _Seers_.

Plato divided enthusiasm into four classes. I. _The Poetical_, inspired by the Muses. II. _The Mystic_, under the influence of Bacchus. III. _The Prophetic_, a gift of Apollo; and IV. _The Enthusiasm of love_, a blessing from Venus Urania. This immortal philosopher was not the visionary speculatist which some writers have represented him; his logic did not consist of frivolous investigations, but embraced the more useful subject of correct definition and division, as he sought to reconcile practical doctrines of morality with the mysticism of theology by the study of Divine attributes. Whatever some of the Eclectic philosophers might have asserted, Plato considered that our ideas were derived from external objects, and never contemplated the extravagant doctrine of imbodying metaphysical abstractions, or personifying intellectual ideas.

To this day, the attentive observer will find Plato's classification of enthusiasm to be correct. The ecstatic exaltation of religion and of love are not dissimilar; only the latter can be cured, the former seldom or never admits of mitigation: the fantastic visions of the lover may be dispelled by infidelity in the object of his misplaced affection; the phantasies of fanaticism can only yield to an improbable state of infidelity. Shaftesbury has justly observed, "There is a melancholy which accompanies all enthusiasm, be it of love or religion; nothing can put a stop to the growing mischief of either, till the melancholy be removed, and the mind be at liberty to hear what can be said against the ridiculousness of an extreme in either way."

Our poet Rowe has beautifully pointed out the facility with which a noble and martial soul can free itself from love's ignoble trammels.

Rouse to the combat,
And thou art sure to conquer; war shall restore thee:
The sound of arms shall wake thy martial ardour,
And cure this amorous sickness of thy soul,
Begot by sloth, and nurs'd by too much ease.
The idle God of Love supinely dreams
Amidst inglorious shades and purling streams;
In rosy fetters and fantastic chains
He binds deluded maids and simple swains;
With soft enjoyment woos them to forget
The hardy toils and labours of the great:
But if the warlike trumpet's loud alarms
To virtuous acts excite, and manly arms,
The coward Boy avows his abject fear,
On silken wings sublime he cuts the air,
Scar'd at the noble horse and thunder of the war.

The only trumpet that can arouse the religious enthusiast from his ascetic meditations is the war-whoop that calls him to destroy all those who impugn his doctrines in a battle-field, where each champion seeks pre-eminence in cruelty, and rancorous persecution.

When we contemplate the miseries that have arisen from fanaticism, or fervid enthusiasm, although it is but a sad consolation, yet it affords some gratification in our charitable view of mankind, to think, nay to know, that this fearful state of mind is a disease, a variety of madness, which may in many instances be referred to a primary physical predisposition, and a natural idiosyncrasy. It is as much a malady as melancholy and hypochondriacism. In peculiar constitutions it grows imperceptibly. Lord Shaftesbury has made the following true observation: "Men are wonderfully happy in a faculty of deceiving themselves whenever they set heartily about it. A very small foundation of any passion will serve us not only to act it well, but even to work ourselves in it beyond our own reach; a man of tolerable goodnature, who happens to be a little piqued, may, by improving his resentment, become a very fury for revenge."

Thus it is with enthusiasm, a malady which in its dreadful progress has been known to become contagious, one might even say epidemic. Vain terrors have seized whole populations in cities and in provinces; when every accident that happened to a neighbour was deemed a just punishment of his sins, and every calamity that befel the fanatic was considered the hostile act of others. Jealousy and dark revenge were the natural results of such a state of mind, when the furious fire of bigotry was fanned by ambition until monomania became daemonomania of the most hideous nature, and every maniac bore in his pale and emaciated visage the characteristic of that temperament which predisposes to the disease. Seldom do we observe it in the _sanguineous temperament_, remarkable for mental tranquillity, yet determined courage when roused to action. The _choleric_ and _bilious_, impetuous, violent, ambitious, ever ready to carry their point by great virtues or great crimes, may no doubt rush into a destructive career; but then they lead to the onset the atrabilious, men saturated with black bile, and constituting the _melancholy temperament_. Here we behold the countenance sallow and sad; the visage pale and emaciated, of an unearthly hue; gloom, suspicion, hate, depicted in every lineament; the mirror of a soul unfitted for any kind sentiment of affection, pity, or forgiveness. Detesting mankind, and detested, they seek solitude, to brood upon their wretchedness, or to derive from it the means to make others as miserable as themselves. Such do we usually find the enthusiastic monomaniac. His ideas are concentrated into a burning focus, which consumes him like an ardent mirror. His life of relation is nearly extinguished. His external senses are rendered so obtuse and callous that he becomes insensible to hunger and thirst, to heat and cold however intense; and bodily injuries, which would occasion excruciating agonies in others, he bears without any apparent feeling. On this subject of religious enthusiasm the remarks of Evagrius are worthy of notice. "Contrarieties," he says, "are in themselves so tempered, and the grace of God maketh in them such an union of discordant things, that life and death, which are in essence so opposite to each other, seem to join hands and dwell together in them. Happy are they while they live, and happier still when they depart." It has been known amongst these rigid ascetics that when a stranger visited them, they mortified themselves by entertaining him and partaking of the good cheer. Thus inventing a novel kind of fasting--eating and drinking against their will.

It is related of St. Macarius, that one day having killed a gnat that had stung him, he was struck with such compunction at the sight of blood, that by way of atonement, he threw off his clothes, and remained in a state of nudity for six months in a marsh exposed to the bites of every noxious insect. Sozomen in praising this mortification, assures us that this exposure to the inclemency of the weather, did so harden and tan him that his beard could not make its way through the skin.

It has been erroneously supposed that such individuals, being hostile to mankind, are prone to do evil,--this is not generally the case; they seem satisfied with their own sufferings, and only seek to inflict them upon others when roused from their concentration by fanaticism.

A late ingenious writer, in his work entitled "The Natural History of Enthusiasm," has somewhat overdrawn the portrait of these unfortunate but dangerous beings when labouring under the disease, which he thus defines: "It will be found that the elementary idea attached to the term in its manifold applications, is that of fictitious fervour in religion, rendered turbulent, morose, or rancorous by junction with some one or more of the unsocial emotions; or, if a definition as brief as possible were demanded, we should say that fanaticism is enthusiasm inflamed by hatred. Fanaticism supposes three elements of belief: the supposition of malignity on the part of the object of our worship; a consequent detestation of mankind at large, as the subjects of malignant power; and then, a credulous conceit of the favour of Heaven shown to the few, in contempt of the rules of virtue."

Shaftesbury had already said, that "nothing besides ill-humour, either natural or forced, can bring a man to think seriously that the world is governed by any devilish or malicious power." Such a fearful conviction constitutes a clear case of daemonomania. Patients labouring under that malady are ever prone to injure themselves and others, prompted, as they constantly avow, by an evil spirit; but enthusiasts, who live in solitary mortification until a paroxysm of fanaticism draws them from their retreat, seldom or never meditate mischief to others, or indeed that hatred to mankind which our author considers a feature of their condition. Society may become irksome, and may be shunned for ever, without a sentiment of hate. The gayest of the gay may be impelled by feelings more or less morbid to seek a voluntary endurance, to expiate real or imaginary offences, without experiencing a desire of a uselessly vindictive sentiment towards the former companions of their vices or follies. Extremes of depravity and contrition do not infrequently meet; and it has been remarked in Eastern countries, where asceticism arose, that the gates of the most splendid and luxurious cities open upon desert wilds or mountainous solitudes, to which the penitent may flee from his former scenes of ambition and enjoyment.

Such enthusiasts, excepting when enjoying the beatitude of ecstatic exaltation, are more to be pitied than feared. Persecution would most probably drive them to a dangerous state of fanatic rage; and the noble philosopher whom I have already quoted, very justly observes, "They are certainly ill physicians in the body politic who would needs be tampering with these mental eruptions, and, under the specious pretence of healing the itch of superstition, and saving souls from the contagion of enthusiasm, should set all nature in an uproar, and turn a few innocent carbuncles into an inflammation and a mortal gangrene."

Enthusiasts are supposed by their followers to be gifted with the faculty of prophecy; and it is somewhat strange that the ancients considered certain temperaments as best fitted for this inspiration. The atrabilious temperament took the lead; and this melancholy state was to be increased by abstinence, mortification, and more especially rigid continence. The latter privation, indeed, was deemed indispensable for prophets; and the Jewish Rabbins inform us that Moses abandoned his wife Zipporah the very moment that he was prophetically inspired. A physical reason has been adduced to prove the necessity of a chaste life, which I here must be allowed to pass over; but upon the same principle, emasculation was considered as rendering man totally unfit for prophetic revelation, or indeed any holy inspiration; and we find in the first of Deuteronomy that such subjects were not admissible to the service of the Temple.

Jesaias, and some other Jewish writers, have affirmed that Daniel belonged to that class of beings; but it has been shown that the name of _Spado_, which he bore, merely gave him the high rank that eunuchs held at the Assyrian court. Potiphar bore the same title among the Pharaohs. Baruch Spinosa maintained that temperaments should vary according to the nature of the prophecy; thus, a gay prophet would predict victory and happiness, a gloomy one misery and wars; peace and concord, if he is human; destruction and merciless events, if he were sanguinary: and, in support of his doctrine, he quotes the passage in Kings, where Elisha, when brought before Jehosophat, called for a minstrel ere he predicted that victory should crown the arms of Judah.

Various artificial means have been resorted to at all periods to prepare the intellects for inspirations, by creating a heated imagination. Pliny informs us that, in his days, the root of the _Halicacabum_, supposed to be a species of hyoscyamus, was chewed by soothsayers. Christopher D'Acosta relates that the Indians employ a kind of hemp called _Bangue_ for the same purpose: and in St. Domingo their supposed prophets masticate a plant called _Cohaba_. The priestesses of Delphi were also in the habit of chewing laurel-leaves before they ascended the tripod, which it is stated was originally formed of a laurel-tree root with three branches. Sophocles calls the Sibyls [Greek: daphnephagos], laurel-eaters; and thus Tibullus,

Vera cano, sic usque sacras innoxia lauros
Vescar, et aeternum sit mihi virginitas.

Auguries were drawn from the burning of the laurel-leaf. If it crackled and sparkled during combustion, the inference was favourable; the reverse, if it was consumed in silence. Propertius alludes to this belief:

Et tacet extincto laurus adusta foco.

Yet so far from possessing exhilarating qualities, laurel-leaves were supposed to diminish the excitement produced by wine; and Martial affirms that the Roman ladies made use of them to drink large potations with impunity:

Foetere multo Myrtale solet vino;
Sed fallat ut nos, folia devorat lauri,
Merumque, cauta fronde, non aqua miscet.