Chapter I: Front Matter (1)

THE
ÆSCULAPIAN LABYRINTH EXPLORED;

OR,

MEDICAL MYSTERY ILLUSTRATED.

IN A SERIES OF INSTRUCTIONS TO

YOUNG PHYSICIANS, SURGEONS, ACCOUCHERS, APOTHECARIES,
DRUGGISTS, AND PRACTITIONERS OF EVERY
DENOMINATION, IN TOWN AND COUNTRY.

INTERSPERSED WITH A VARIETY OF

RISIBLE ANECDOTES AFFECTING THE FACULTY.

INSCRIBED
TO THE COLLEGE OF WIGS,
BY
GREGORY GLYSTER,
AN OLD PRACTITIONER.

“TWENTY MORE! KILL THEM TOO.”——BOBADIL.

LONDON:
PRINTED FOR G. KEARSLEY, NO. 46, FLEET-STREET.

MDCCLXXXIX.

[PRICE THREE SHILLINGS AND SIX-PENCE.]

TO THE COLLEGE OF WIGS.

“Most potent, grave, and reverend signiors,
“My very noble and approved good” Doctors.

The solemnity of your somniferous aspects, no less than the professional gravity of your external ornaments, lay claim to a bow of obedient recollection in passing through W—— k-lane to public inspection. As one of the most _popular_ descendants from your great progenitor, permit me to acknowledge, I revere the _vast extent_ of your _medical abilities_; that I feel most forcibly the _enormous weight_ of your _accumulated learning_, and _tremble_ at the very idea of your _experimental abilities_.

Condescend, dread Sirs, to sanction this analization of _Æsculapian imposition_ and _medical mystery_, with such proof of approbation, as the dignity of a _diploma_, and the muscular rigidity of _physical countenance_ will permit you to bestow; nor let it be the less entitled to your favor, that a long list of _valetudinarians_ (to whom you are daily pensioners) become partakers of the _banquet of mirth_; or the small fry of _pharmacopolists_ (your humble dependents) _for once_ permitted to take a seat at the _same table_ with yourselves.

Anxiously solicitous to obtain belief, that

“I shall nothing extenuate,
“Nor set down aught in malice,”

you may in justice conclude me,

_Sage Sirs!_

Your very candid,

And obedient representative,

GREGORY GLYSTER.

THE

ÆSCULAPIAN LABYRINTH

EXPLORED.

TO THE PHYSICIAN.

Having passed the tedious years of abstruse study and intense application, necessary to your initiation in the mysteries of physic, and replete with a perfect remembrance of all the requisites to this _great art_, we suppose you recently emerged from the obscurity of _dreary walls_ and _dull professors_, a phenomænon of universal knowledge and _family_ admiration. The various and elaborate examinations you have passed, with scholastic approbation, having relieved you from the constantly accumulating load of anxiety, you are at length launched into life under a new character, and daily pant to display the dignity of your profession, in the happy appendage of _M. D._ to the prescriptive initials of your name.

You are no longer to be considered a student labouring in the heavy trammels of _unintelligible_ lectures upon _philosophy_, _anatomy_, _botany_, _chemistry_, and the _materia medica_, with all their distinct and consequent advantages; or investigating the actual properties of _electrical fire_ and MAGNETIC ENTHUSIASM, but stamped (by royal authority) with the full force of physical agency, and have derived from your _merit_ unlimited permission to _cure_, “_kill_ or _destroy_,” to the best of your knowledge and abilities, “so help you “God.” The professional path you now begin to tread, is so replete with danger, and the probability of success so very uncertain, that the fertile world have not omitted to make it proverbial, “A physician never begins to get bread, till he has no “teeth to eat it.” The truth of this may perhaps have been _lamentingly_ acknowledged by some of the most _learned men_ that ever became dependant upon a _capricious_ world for _precarious_ subsistance.

This palpable fact may concisely serve to convince you, your embarkation (with all its alluring prospects) will not only be encumbered with difficulties, but your ultimate gratification of success exceedingly doubtful. Great depth of learning may afford consolation to the equity of your own feelings (if you fortunately possess them) but it is by no means necessary to the acquisition of _public opinion_, however it may tend to contribute to the general good.

To avoid entering into a sentimental disquisition upon the _honesty_, _integrity_, or _strict propriety_ of the maxims I proceed to lay down for your future conduct to obtain professional splendour, and _insure success_; I avail myself of the privilege I possess, to wave every consideration of the _conscientious kind_, and once more observe (without adverting to their consistency) they are adduced only as the unavoidable traits of character, and modes of behaviour, by which alone (in the present age) you can possibly hope for the least proportional share of practice as a physician.

At your first public entré, when the college list and court calendar have announced your qualifications and advancement to the wondering world (that such list should annually increase) let your friends and relatives be doubly assiduous in propagating reports (almost incredible) of your _great humanity_, _extensive abilities_, and _unbounded benevolence_.—This will answer the intended purpose to a certainty; crouds of the afflicted and necessitous will surround your habitation, and render your place of residence constantly remarkable to all classes, who naturally enquiring the character of the proprietor, will eagerly extol your charity in contributing your “advice to the poor GRATIS.”

This method alone will gain you popularity with those that rank in the line of mediocrity; with _their superiors_, success must be insured more from the efforts of _interest_, than either _personal merit_, or _sound policy_. Your attention to the wants of the poor, must soon be regulated by the preponderation of more weighty considerations; as you _affected_ to alleviate their distresses from the motive of commiseration, prompting you to promote _their ease_, you have an undoubted right to shake off such superfluous visits, to secure _your own_. In this deceptive charity, some degree of discrimination must be put in practice, for you will sometimes perceive one among the train, whose apparel or behaviour must necessarily give you reason to suspect he has assumed the cloak of necessity to save _his fee_, and avail himself of your professional liberality in such case, call to your aid a look of true _medical austerity_, and let him understand “advice is seldom of any value or “effect unless it is paid for;” this will frequently answer the purpose, and procure what you did not expect.

On the contrary, so soon as you observe your prescriptions have “_worked wonders_” upon two or three of the most _credulous_ and _superstitious_, who are extolling your _great knowledge_ and “blessing _your honour_,” strengthen the _force_ of your judgment by _charitably obtruding_ a pecuniary corroboration into the hand of your afflicted patient, as a confirmation of your _unbounded skill_ in the (_miraculous_) cure of every disease to which the human frame is incident. By such _political_ practice, you insure the recital of your services with extacy, and your name reverberates from one end of the metropolis to the other.

Your person and place of residence, being by these means universally known, and your name become in a proportional degree popular, let your plan and mode of behaviour be instantly changed; it will be now necessary

“You “assume a” hurry “if you have it not,”

Take care to be so exceedingly engaged with patients of the _first class and eminence_, that “it is with difficulty you procure time sufficient for the common purposes and gratifications of nature.” No paupers _whatever_ can be admitted to your presence without a written recommendation from _nobility_, or characters of the _first fortune_; this will insure you no farther intrusion from a class originally introduced for your _particular purpose_; that effected, they may now be permitted to fall into the back ground of the picture; from whence they were brought for no other motive than the promotion of your personal interest and professional emolument.

It becomes your particular care to be always in a _hurry_; let your chariot (if you can fortunately raise one) _upon job_, be at the door regularly by nine in the morning; to prove how very much you are attached to the duties of your profession, and how anxiously you have the _salubrity_ of your patients _at heart_.—Omit no one circumstance that can contribute to a shew of being perpetually engaged. Letters written by _yourself_, and messengers of your _own dispatching_, cannot be seen at your doors too frequently; the chariot should be as repeatedly ordered—remember to leave home by _one way_, and return by _another_, and equally _in haste_; all these stratagems are considered peculiar privileges of the _College of Wigs_, and are well worthy your attention and constant practice. You need hardly be told, the superficial and unthinking part of mankind are ever caught by appearances; what proportion they bear to other distinctions, need not in the present instance be at all ascertained.

Having laid down rules (that should be rigidly persevered in) for the regulation of your _public character_, I shall now advert to the strict line of conduct it will be proper for you to adopt in your personal transactions upon all professional emergencies.

When called to a patient upon the recommendation of the family apothecary, you are to consider him one of your best friends, and _pay court to him_ accordingly; on the contrary, if you are engaged upon the spontaneous opinion of the patient, or his relatives, you have every reason to conclude the abilities of the apothecary are held in very slender estimation, and you may safely venture to display as much of your _own consequence_ and superiority, as circumstances will admit.

After the awkward ceremony of your first appearance is over, and matters a little adjusted, take great care to be upon your guard; indulge in a variety of _significant gestures_, and _emphatical hems!_—and _hahs!_ proving you possessed of _singularities_, that may tend to excite ideas in the patient and surrounding friends, that _a physician_ is a superior part of the creation.——Let _every action_, _every word_, _every look_, be strongly marked, denoting doubt and ambiguity; proceed to the necessary enquiries of “what has been done in rule and regimen, previous to your being called in?” hear the recital with patience, and give your _nod of assent_, lest you make Mr. Emetic, the apothecary, your formidable enemy, who will then _most conscientiously_ omit to recommend the assistance of such _extraordinary abilities_ on any future occasion.—Take care to _look wisdom_ in every feature; speak but little, and let it be impossible _that little_ should be understood; let every hint, every _shrug_ be carefully calculated to give the hearers a wonderful opinion of your learning and experience.—In your _half-heard_ and mysterious conversation with your _medical inferior_, do not forget to drop a few observations upon—“the animal œconomy”—“circulation of the blood”—“acrimony”—“the non naturals”—“stricture upon the parts”—“acute pain”—“inflammatory heat”—“nervous irritability,” and all those _technical traps_ that fascinate the hearers, and render the patient yours ad libitum.

To the friends or relatives of the diseased, (as the case may be) you seriously apprehend _great danger_; but such apprehension is not without its portion of _hope_; and you doubt not, but a rigid perseverance in the plan you shall prescribe, will reconcile all difficulties in a few days, and restore the patient (whose recovery you have exceedingly at heart) to his health and friends; that you will embrace the earliest opportunity to see him again, most probably at such an hour, (naming it) in the mean time you are in a great degree happy to leave him in such good hands as _Mr. Emetic_, to whom you shall give every necessary direction, and upon whose _integrity_ and _punctuality_ you can implicitly rely.

You then require a private apartment for your necessary consultation and plan of _joint depredation_ upon the pecuniary property of your unfortunate invalid, which you are now going _seriously_ to attack with the full force of _physic_ and _finesse_. You first learn from your informant what has been hitherto done without effect, and determine accordingly how to proceed; but in this, great respect must be paid to the temper, as well as the constitution and circumstances, of your intended _prey_; if he be of a petulant and refractory disposition, submitting to medical dictation upon absolute compulsion, as a professed enemy to physic and the faculty, let your harvest be _short_, and complete as possible. On the contrary, should a _hypochondriac_ be your subject, with the long train of melancholic doubts, fears, hopes, and despondencies, avail yourself of the faith implicitly placed in you, and regulate your proceedings by the force of _his imagination_; let your prescription (by its length and variety) reward your _jackall_ for his present attention and future services.—Take care to furnish the frame so amply with _physic_, that _food_ may be unnecessary; let every hour (or two) have its destined appropriation—render all possible forms of the _materia medica_ subservient to the general good—_draughts_—_powders_—_drops_, and _pills_, may be given (at least) every two hours; intervening _apozems_, or _decoctions_, may have their utility; if no other advantage is to be expected, one good will be clearly ascertained, the convenience of having the _nurse_ kept constantly awake, and if _one medicine_ is not productive of success, _another may_. These are surely alternatives well worthy your attention, being admirably calculated for the promotion of your _patient’s cure_ and your _own reputation_.

Having written your long prescription, and learnt from Mr. Emetic every necessary information, you return to the room of your patient, to prove your attention, and renew your admonitions of punctuality and submission;—then receiving your _fee_ with a consequential _air of indifference_, you take your leave; not omitting to drop an additional assurance, that “you shall not be _remiss_ in your attendance.” These, Sir, are the instructions you must steadily pursue, if you possess an ardent desire to become _eminent_ in your _profession_—_opulent_ in your _circumstances_—_formidable_ to your _competitors_, or a _valuable practitioner_ to the _Company_ of _Apothecaries_, from whom you are to expect the foundation of support. A multiplicity of additional hints might be added for your minute observance; but such a variety will present themselves in the course of practice, that a retrospective view of diurnal occurrences will sufficiently furnish you with every possible information for your future progress; regulating your behaviour, by the rank of your patients, from the _most_ pompous _personal ostentation_, to the meanest and _most contemptible servility_.

TO THE SURGEON.

I congratulate you upon your recent emancipation from incessant study, intense application, and strict _hospital_ attendance, where I shall willingly suppose, you was a _dresser_ of the most promising abilities; that you excelled your cotemporaries in every _chirurgical_ opinion, became an expert _dissecting_ pupil to one of the _court of examiners_, and are now burst through the cloud of your original obscurity, a perfect prodigy of _anatomical_ disquisition.

I naturally conclude you capable of animadverting upon all the distinct branches of your art to admiration, that you are critically excellent in the use of an _instrument_ from the humble act of simple _phlebotomy_, to the more important operation for a _fistula in ano_.—You have, beyond every shadow of doubt, paid proper attention to the fashionable precepts of the late Lord Chesterfield, and rendered yourself (with assistance from the graces) a perfect adept in polite address, displaying a variety of the most engaging attitudes, even in the adjustment of a _ten tailed bandage_. The professional information you have industriously collected, is such as will certainly afford you the most equitable claims upon _public opinion_, being in possession of every necessary acquisition from a _simple gonorrhœa_ to a _confirmed lues_.

Previous to your solicitation of favour from your friends, you have necessarily passed the awful ceremony of examination at the _Old Bailey_, under your former tutor (and his brethren of the court) who would not pay his _own abilities_ so improper a compliment as to ask you questions in _anatomy_ or _osteology_, that he knew your qualifications inadequate to the task of technically explaining. After passing this _fiery ordeal_, you deposit the usual _pecuniary gratuity_, and receiving the _badge_ of your newly acquired _honor_, we now hail you “_a Member of the Corporation of Surgeons_,” and conclude an ornamental plate upon the door of your habitation denotes you so accordingly.

We suppose you embarking in a sea of spirited opposition, with your competitors, for professional celebrity, and decorating your place of residence in the most applicable stile to attract attention. To effect this, let your exterior apartments be ornamented with the _busts_ of _ancients_ you _never read_, and _portraits_ of _moderns_ that you _never knew_. These form an excellent combination to excite the admiration and report of those who have occasion to court the assistance of your extensive abilities.—To gradually heighten which surprize, your interior (or _audit room_) must be a perfect _Golgotha_.—A proficiency in the science of _osteology_, must be powerfully impressed upon the senses of the trembling visitors, by a _profusion_ of _skeletons_ in different states; let the awfulness of the scene be rendered still more striking, by a variety of subjects suspended in spirits, interspersed with singular _anatomical and injected preparations_, both wet and dry; giving to the whole additional force by the introduction of a “_few ill shaped fishes_,” as the finishing stroke to a well formed plan of _chirurgical ostentation_. Remember to let the _certificates_ of your professional qualifications, from your different _lecturing tutors_, be so placed (in elegant frames) as to meet the eye in a conspicuous direction; lest that part of your patients, who condescend to visit you in this gloomy recess, should have reason to conclude you a _consummate dunce_ and most _illiterate booby_, if these learned professors had not done your friends the favour to “_certify_” to the contrary: and this they always _chearfully_ do, rather than have it imagined they have eased you of a part of your property, without doing you any _real service_.

The domestic arrangement being thus formed, the reflections to which you must now turn your mind, are the necessary modes of practice and behaviour, that may render you not only eminent in your profession, but respectable in your property; as great events, that contribute largely to the gratification of such wish, do not frequently occur, inferior cases of every kind must be rendered subservient to the purpose. In this list, _venereals_ are entitled to pre-eminence, as the most lucrative; the patient never hesitating to pay full as liberally for the preservation of the _secret_ as the cure of _disease_.—But you may be perfectly assured, this secret never rewards so well, as when _fate_ or _fortune_ assists its introduction to _married families_; a most striking corroboration of this fact, occurred not long since in the neighbourhood of a _royal residence_, and afforded matter of mirth to the first circles in its environs.—This constant friend to the faculty was communicated to a married lady, by a _young_ and celebrated personage of some national eminence, and immediately conveyed from her to her _enamoured cornuto_ in the moments of true _connubial felicity_; he, in the love of variety, unluckily conferred the favour upon the _house maid_; and she, in the extensive liberality of her disposition, kindly bestowed a portion upon the _footman_. The _electrical shock_ of this _French fire_ was so rapidly communicated, that the four sufferers, within the space of ten days, made their separate _private_ confessions to the medical superintendant of the family, each assigning a different cause for its introduction, and equally strangers to the _mode_ of its being brought into so _sober a family_. Although this is a well authenticated _fact_, it is a harvest that can be very seldom expected to happen in so great a degree; yet you will find it a matter often _intruding_ between husband and wife, and considered no indelible proof of _modern inconstancy_.—To this secret, you will be frequently admitted by one party—the other, or both; and have an undoubted privilege to accumulate all possible pecuniary advantage from the confidence so implicitly placed in you.

Whatever cases are submitted to your opinion, be always prepared to represent them _worse_ than they really _are_; making by your technical terms, and political doubts, _bad worse_ upon every possible occasion. Let all your proceedings have a peculiar and commanding dignity annexed to the execution; by assuming a want of feeling, even to _ferocity_, you will be termed a practitioner of _spirit_, and become properly distinguished for your professional _fortitude_. No tender sensations must be permitted to influence your feelings during any operation, however tedious, or painful to the patient; they are an ornament to human nature, and beneath your consideration _as one of the faculty_.—Custom has rendered you ineligible to a place in the _jury box_, as an evident proof of your professional _brutality_; by therefore turning “their pains to laughter and contempt,” you only justify the character you are already in possession of.

In the most trifling operations (even phlebotomy) descend to the very minutiæ of medical consequence, not only making the ceremony _long_, but _serious_, that you may be the better entitled to personal respect and pecuniary compensation. In all those dreadful accidents that alarm friends and distress families, take care to throw out (during your apparent care and attention) a variety of observations that convey _large sounds_ with _little meaning_; by such ambiguous expressions you render the cure more extraordinary, whenever it happens, and is no bad preparative for the procrastination of it to your own emolument. In all cases requiring the interposition of instruments, take great care that you produce them with mysterious solemnity, impressing the spectators and assistants, with equal _awe_ and _fear_ of your abilities; if _incisions_, or _separation_ of the _soft parts_, become necessary, be sure, like “old Renault,” to “shed blood enough;” it will be attended with a double advantage; first in the appearance of business, and the more _pleasing consideration_, that the _larger_ and _deeper_ the wound, the longer time will be necessary for _incarnation_; during the course of which, your personal attendance and daily _epithemas_ cannot be dispensed with.

The _greater operations_ do not occur every day, therefore tedious _cicatrizations_, in addition to _simple_ and _compound fractures_, are comfortable aids to fill up the spaces of intervention. Fractures of the _lower extremities_ are exceedingly favourable, for you may then exert proper authority; it becomes your duty to keep _them down_ when they _are so_, for surely you may take upon you to know (with propriety and professional privilege) when they are capable of _standing_ and _walking_, better than they can _themselves_.—Tho’ one exception to this rule has fallen within my knowledge, and nearly set aside the privilege of the practice in the neighbourhood where it happened.

An honest hearty _miller_, in a small parish in the county of H—-—-, having, on the market day, made some lucky purchases, and congratulating himself upon his good fortune with a few friends over the bottle, got himself insensibly intoxicated; but obstinately persisting in his determination (and ability) to ride home, he was suffered to depart, and was found afterwards upon the road by one of his own servants almost lifeless; he was conveyed to his habitation, and one of the most _eminent surgeons_ from a certain large and populous town was called in, who finding the trunk nearly inanimate, proceeded to _venesection_, then to an accurate examination of the body, in which he presently discovered “a _fracture of the tibia_, and two of the ribs; he had every reason to apprehend (from present symptoms) a _concussion of the brain_; but situated as things were, he should now administer proper _palliatives_, and pursue the necessary steps upon his arrival in the morning.”—He then left the patient, after strict injunctions “that he should not be suffered to move from the position he had placed him in, till his return.”—At the hour before appointed, the _Doctor_ returned, and not finding the wife below stairs, explored the region he had left his patient in the night before, surrounded by his sorrowful friends; when, strange to relate! (_stranger to believe!_) the bird was flown, the bed made, and the very room exhibited a striking proof of rustic neatness. Recovering in some degree from his surprise, and feeling _very forcibly_ the aukwardness of his situation, he descended to the kitchen, and there finding the wife (who had just returned from some business in a back yard) he eagerly enquired “How, or which way, his patient had been conveyed, and where to?”—When the poor woman very simply and civilly replied, that “her husband was gone into the fields among his folks; that she had repeatedly urged the doctor’s orders of his _not getting out of bed_; but he was a very obstinate man, and said he’d be d—’d if he’d ever lay in bed with a _broken leg_ for any doctor in England, so long as he could walk upon it.”—It may be better conceived than described how severe a stroke this proved upon the reputation of the surgeon; certain it is, his practice continued in a declining state for some years, and it was not till the circumstance was nearly buried in oblivion (with the body of the miller) that he recovered his former celebrity, being at this moment one of the oldest and most eminent practitioners in the neighbourhood where he resides.

This instance sufficiently demonstrates the impropriety of overstraining the professional prerogative, especially with those obstinate uncivilized beings, who have so little pliability of disposition, as not to lay in bed when required; particularly in cases of emergency, where it is so evidently for the promotion of their own health and safety.

Remember in all cases of difficulty and danger to be mindful of the _emplastrum adhæsivum_ of connexion, by which every branch of the faculty should be united for the preservation of the whole; advise (without the least reference to the enormity of expence) a consultation of the most eminent; this renders the case of your patient more serious and alarming, and you oblige your brethren by the recommendation; first of a physician, whose _prescription_ introduces the _apothecary_; and you then proceed _physically_ and _systematically_ in the joint depredation and cure; your two friends, by the law of retribution, gratefully recommending your inspection of every simple _laceration_ upon all similar occasions.

These are maxims that may at first sight seem beneath the attention of a young and _brilliant_ practitioner, who erroneously conceiving _merit_ a sufficient recommendation, requires no other conductor; but they are so evidently an absolute part of his necessary study, that unless such _mutual arts_ are occasionally put in practice, he can never (in the present multiplied state of practitioners) expect to derive the common necessaries of life from a fair and generous practice of his profession.

Men of understanding, experience, and observation, know, that the benignant hand of providence continues to anticipate in a variety of instances the interpositions of _art_; and _nature_ would, upon many occasions, entirely effect her own work, if not so frequently interrupted and retarded by the officious hands and interested experiments of professional jugglers.

TO THE ACCOUCHER,

OR,

MAN-MIDWIFE.

You fortunately make your appearance upon the boards of public patronage, under the most striking advantages; the prevalence of _fashion_ has exceeded every consideration of _decency_ and _discretion_, and you are become (by the influence of pride and imitation) as necessary to the comfort of a cottage, as the happiness of a court. From the nature of your professional destination, a pleasing exterior, and an accomplished person, are invariably expected; necessarily blending (from your intended intercourse with the _purer_ part of the creation) the precision of taste, with the perfection of the scholar.

The certificate granted you by that elaborate lecturer, the _obstetric professor_, proclaims you qualified in the very minutiæ of this mysterious art. The parts, externally and internally, necessary to generation, are so perfectly familiar to your “mind’s eye,” that you can extemporaneously delineate the _ovariæ_, the “_fallopian_ tubes,” the _fimbriæ_, and the very act of _conception_, from the “_animalculæ_” in “_semen masculino_,” to the last stage of _gestation_; the gradual expansion of the _uterus_, the dilatation of the _os uteri_, the progress of _labour_, and all the methods of extraction.

You can clearly define the classes as _natural_, _laborious_, and _preternatural_; the use of the _forceps_, _scissars_, _crotchet_, and _blunt hook_; the introduction of the _catheter_, the extraction of the _placenta_, and the separation of the _funis_; in fact, all the _et ceteras_ are so perfectly clear to you in _theory_, that it is almost treason to suppose you can _err_ in the practice.

But, Sir, ripe as you are in these advantages, the harvest of universal applause, and the sweets of emolument, are scarcely to be acquired even by time, labour, and the most indefatigable industry. You have in the practice of _midwifery_, all the ills of _Pandora’s box_ to encounter, and after twenty years practice may be left to exclaim most emphatically,

“Vain his attempt who strives to please you all.”

The only consolation you have, is, that you are destined to cooperate with subjects, whose smiles render some degree of compensation for the incessant fatigue dependant upon the practice. Under these considerations, in the full career of your expectations, it can never prove inapplicable to prepare your mind for some of the rebuffs and disappointments that inevitably ensue. I conclude you are possessed of youth, health, diligence, and constitutional _stamina_; but there are other requisites, equally necessary for the performance of professional duties, to which by election you dedicate the store of knowledge you have so industriously acquired. The indispensible qualifications, for the successful execution of the arduous task you are undertaking, may be comprised in very few words, and those few exceedingly expressive and readily understood; without _sobriety_, _fortitude_, _judgment_, and _patience_, you never can expect to attain the summit of excellence, or obtain admission to those families whose patronage will contribute most to both credit and emolument. But admitting you possessed of all the requisites for mere manual operation, the process of delivery, and consistency of conduct, yet there are a multiplicity of embellishments, that nothing but previous information, private instruction, or experimental practice, can sufficiently recommend to your attention.

In the awful minute of your introduction to a scene of excruciating agony and eager expectation, where the hope of a mother, and the anxiety of friends, all center in you, as the messenger of peace, throw off the ostentatious air of self-importance, exerted over those _patient paupers_ upon whom you practised in the days of your initiation, and recollecting yourself the humble solicitant of public opinion and private favour, display your tenderness and civility, as no bad harbinger of your better qualifications. Strengthen such favourable impression by every degree of delicacy and attention to the suffering expectant, who imploring assistance from the interposition of your art, hails you as “the god of her idolatry,” by whom she is to receive an early acquittal from all her sufferings.

As this is not often to be instantly expected, and many tedious hours frequently intervene between the _hope_ and _execution_, it will be necessary (exclusive of your periodical consolations to the patient’s inspiring resignation) you address yourself to the passions and foibles of the gossips, with whom you will in general be too numerously attended, and whose clamours upon many occasions are not easily to be subdued.—Notwithstanding this, the good opinions and recommendations of these motley visitors (of all ages and constitutions) are the very materials to form the foundation of _report_, upon which the superstructure of your reputation and future practice is to be raised.—Although _gravity_, even to a certain degree of _solemnity_, is a characteristic of your professional practice, yet there are times when you must unavoidably come forward to enliven the _good ladies_ with a specimen of your volubility, and variegate the natural extremities of pain with the applicable insinuations of mirth. Jocular inuendoes and double entendres are not only expected, but courted in the intervals of ease, or, as the good women generally term it, “when the business stands still.”

The introduction of the tea-table and the joke are always considered equally promoters of mirth and the delivery; the practitioner is expected to be well stocked with the most fashionable recitals of _seduction_, _rapes_, _fornication_, and _adultery_, which, if well told, and applicably introduced, insures him to a certainty the future interests of his company. It will be absolutely necessary for you to fall into all the opinions of the table, except the glass of brandy repeatedly pressed upon you by the _nurse_ (as a specific, or grand arcana, for every ill) with the very expressive plea of its not doing you _any harm_; and “besides, Sir, what’s good for the goose is good for the gander.”

After such casual respites (which frequently happen) when the progress of labour calls you again to your _chair of office_, resume the language of commiseration, giving your patient every alleviation of hope for a speedy deliverance, at the very time you are impressing (by significant looks and emphatic gestures) the attendants and friends with an idea of great difficulty and impending danger. In the alternate moments of respiration, evade every retrospective allusion to the length of the labour, by frequent insinuations that it advances rapidly, that you have great reason to hope every obstacle will be soon surmounted; but you are afraid the consolation you administer, and the pain she suffers, will take but little hold of the memory, if you may be permitted to judge from the declaration of a very pretty woman you delivered during your attendance at the Lying-in Hospital, who, in reply to your tender admonitions of fortitude and patience, said, “She was very much obliged to you for your kindness, but she was very certain it would be just the same again by _that time twelvemonth_.”—This will make way for any thing applicable of your own collection, but they must be all bordering upon the original cause of the scene before you; for although the patient is in extreme pain, it is not so with the attendants; they consider it a _matter of course_, and feel no disgust but from fatigue, which they very justly conceive they have a right to alleviate with occasional mirth—tea, and a _little good brandy_.

To the _nurse_, great part of your attention must be directed; for she, like a bellows blower to the organist at a cathedral, will expect to be included and constitute _WE_ in all the merit of your execution.—The rapidity, or gradual progress of labour, at length closes your complicated scene of mirth and anxiety; you deliver your patient, and proceed to the subsequencies (_secundem artem_) all which having concluded to general admiration, and received ten thousand thanks and blessings from your subject, you convey a pecuniary _hope_ for future services into the hand of the _nurse_, take a tender leave of your patient, with a promise of seeing her again in proper time, drop an attracting _nod_ of obedience to the surrounding females, and meeting the husband at the bottom of the stairs, congratulate him upon his son or his daughter; slightly hint the difficulty of the case, the danger you apprehended, the fatigue you had undergone, all which is not worthy a thought, _perfectly happy_ in an event that contributes so largely to the happiness of him and his family.

That part of the work being completed, that most depended upon the efforts of _Nature_, it becomes your duty to promote your own interest by every exertion of _art_. Should, after your departure, any _hemorrage_ ensue, inevitable danger will be apprehended, the patient will be reduced, the friends alarmed, and you, in the moments of dreadful anxiety, be immediately sent for; this _lucky circumstance_ will operate to your earnest wish; it will afford ample scope for your most fertile invention, and happily introduce a long list of _styptics_, _anodynes_, and all those necessary concomitants that give a profitable complexion to the business, by enlarging your hopes, protracting the case, and encreasing the danger.

However, should this favourable circumstance not occur, your privilege is by no means curtailed; you immediately commence your previous intentional operation of dispatching a _sufficiency_ of _balsamic anodyne_ draughts, “to promote and mitigate the severity of _after pains_, that very much distress the patient.” These draughts should be continued every _four hours at least_, and as a sufficient quantity of that excellent (and cheap) medicine, _spermacæti_, cannot be well dissolved in each draught, without rendering it too viscid in consistence, it will be peculiarly advantageous to you (as well as the patient) to let them be accompanied with _boluses_ to be taken at the _same time_, composed of _pulv. sperma_—_confect. alkermes_, &c.—Let the administration of these medicines be entirely regulated by the temper, docility, and recovery of your subject; having it ever in mind, that it is neither your duty or interest to make the least observation upon their being no longer necessary, till their frequent use is complained of by the patient sufferer; and even then you are favoured by fortune in a plea, that you “are now under the absolute necessity of making unavoidable alterations for the prevention of the _milk, or puerperal_ fever, which you very much apprehend may ensue.” That it is an invariable rule with you, never to recommend the use of medicines, but where they are highly necessary; in the present instance, it is your duty, from the motive of _gratitude_, to be equally circumspect, for the promotion of _her health_ and your _own reputation_.

To effect every desirable purpose, a gentle _diaphoresis_ must be supported, to prevent obstructions and promote the necessary excretions; to procure which, you must entreat most earnestly an implicit obedience to your directions, which from a variety of _unpleasant symptoms_ becomes indispensible. To carry which point in a still greater degree, renew, at every visit, your attentions to the _nurse_ (who in your absence is a vortex of knowledge, in your presence all obedience) her approbation of your conduct, and good opinion of your practice must be obtained _at any price_; it becomes with you a consideration of greater magnitude than your patient’s recovery; for should _death_ no longer permit _her_ presence in the scene of sublunary events, you lose _one patient only_; but with the good opinion and recommendation of the _nurse_, vanishes hundreds of patients _in embryo_, to be brought forth by the influence of her exaggerated reports of your incredible abilities.

The nurse once secured and attached to your interest, becomes an admirable instrument for the promotion of all your designs, she embraces every opportunity to strengthen your directions, and urges (as you have done) the continuation of medicine, “till, with the blessing of God, her mistress is quite set up and upon her legs again.” A proper reflection upon these subjects will convince you (even in the infancy of your embarkation) that a _midwifery case_ in a _good_ family is no _bad_ thing, and made the most of, with the occasional aid of perpetual _cardiacs_,—_balsamics_,—_carminatives_, and _anodynes_, to ease and “quiet the child,” every time it _coughs, or belches_, constitutes a harvest of industry and political necessity, that the world in general is very little acquainted with.

Previous to the closing of the curtain, you have still an additional chance for more depredations upon the unfortunate husband; should _stagnant_ milk occasion a _coagulum_ in the _lacteals_, constituting a _turgency_ of the breasts, threatening a formation of matter, _suppuration_ becomes almost unavoidable, and you promote it accordingly; this leads to _certain operation_, daily dressings, &c. all tend to encrease your interest, and give you the enjoyment of a temporary monopoly in the joint practice of _midwifery_, _surgery_, and _physic_.

TO THE APOTHECARY.

The varieties of your past, as well as the personal requisites for your future destination, are of such a pantomimic and party-coloured complexion, that I cannot proceed to a recital so truly risible, without first offering you, in the lines of Woty, a predominant trait in my _own character_,

“I love to laugh, though Care stand frowning bye,
And pale Misfortune rolls her meagre eye.”

Thus happily disposed to those brilliant sallies of mirth, that almost renovate life, and set melancholy at defiance, you will be the less liable to surprise, that I shall descend to the very minutiæ of your necessary qualifications, for the support of so arduous and complicated a character as you are now going to perform upon the theatre of life.

It is very natural to conclude you have, during the tedious years of initiation as an apprentice, and your more mature services as a journeyman, (politely ycleped assistant) whether in the metropolis, or the country, gone through every degree of drudgery, and feelingly experienced every indignity, that _insolent pride_ could bestow, or _patient merit_ receive. Not an inferior trust (of the inferior part of the faculty) but you have carried into execution, from the injection of an _enema_ in a garret, to the separation of an _emplastrum vesicatorium_ in a workhouse. These are offices of humanity and service to your fellow creatures, that do you immortal honour; they are retrospectives that form an epoch in the mind of every practitioner, and afford him the powerful consolation of _sacred truth_, “He that humbleth himself,” &c. by which rule, and the force of a fertile imagination, any _apothecary_ may _conceive_ himself a _physician_, even in the administration of a _glyster_. In this hospitable execution (taken metaphorically) there cannot be supposed the least indignity; for it is universally known the _greatest_ and most _prudent_ generals are in the _rear_ during the heat of battle; and we are again taught seriously to believe “the last shall be first,” &c. so that you have every way, (by both _faith_ and _services_) insured a religious and prophetic _hope_ of preferment.

Having for many years encountered the _worst_, you are now prepared for the _best_; and bidding adieu to the rigid rules of austere masters, embark upon your own foundation, qualified for every medical consultation, from the bedchamber of a _duchess dowager_ to the subterraneous residence of her _chairman_. You have, at this period, not only shaken off the shackles of servitude, but the very recollection of your long standing culinary connections. In your various changes of residence, tedious peregrinations, and medical observations, it is natural to conclude, you have acquired by care, study, and attention, a competent knowledge of almost every tint in the picture of life; which, with embellishments, derived from a few courses under some of the _metropolitan lecturers_, and _hospital attendance_, to qualify you for the complication of _country_ practice, there is no doubt but you come from the forge properly formed, to make wrong appear right, and right wrong, in the face of every _old woman_ in the county where you are going to reside.

Exclusive of these qualifications, and the many instructions already introduced under the two preceding heads (to which you may occasionally refer) there are a great variety that must be advanced for _your particular use_, and to those you will, no doubt, pay every proper attention, if you indulge the least desire to become a popular member of the faculty. In respect to personal appearance, former distinctions and peculiarities are in some degree levelled, the world is very much relaxed in its severities, and the apothecary mixes with the general herd of mankind, without those distinguishing exteriors that _were_ his professional characteristics. The gilt-headed cane and enormous tassel are no longer in use; the _full-bottom wig_, that so universally ornamented the _os frontis_ of the faculty in general, is now almost laid aside with inferior classes, and engrossed by the _college_. The apothecary (particularly in the country) is in every respect free from the illiberal censure of former times, and treading close upon the heels of the _parson_ and the _lawyer_, enjoys, without restraint, the _chace_, the _gun_, the _bottle_, and _bona-roba_. These, if you are of a volatile disposition and amorous constitution, afford (at seasonable opportunities) a happy and high relished relaxation from the many severities of medical practice.

Having fixed upon your intended spot for embarkation, let every thought be employed to display an attracting uniformity in the disposition of your apparatus, for the _claptrap_ of public approbation; and though that great investigator of human nature has beautifully portrayed “_a beggarly account of empty boxes_,” yet they become immediately necessary to your present purpose; it not being his business to explain the folly and extravagance of your placing any thing of consequence there, before you was experimentally convinced you should have occasion for its use. Let there be a _profusion of appearance_; the _shell_ of a shop is not very expensive, and druggists are so numerous, that you may be expeditiously supplied whenever circumstances require it.—The bottles (being transparent) become more immediately in need of _something_ in each, particularly a few of those articles (as hartshorn, lavender, &c.) that are in common request. The lower drawers (within reach) may be labelled with _obsolete titles_, and in each placed various paper parcels of _bran_ or _saw-dust_, to avoid a chance of the sarcasm upon the faculty by a countryman, who happened to be left alone some time in the shop of an apothecary, and whose curiosity being excited by the great _number of drawers_, was powerfully prompted to open one labelled “_Thus_,” which finding _empty_, he was induced to try a second, _still the same_; a third, _the same also_.—Oh! oh! says he, “I see plain enough how it is, they are all _Thus_.” Your shop being at length finished in a stile modern and striking, let a green silk curtain (with brass rods and rings) be affixed to your window; it is an excellent method of conveying an idea of internal mystery, and inspiring proportionate external curiosity. Let no paltry diffidence appear in the board over your door, announcing your name and qualifications; there are great numbers that can’t distinguish _small letters_ at a distance, to avoid which inconvenience, let the capitals be as conspicuous as the canvas figures at a country puppet-shew.

“Thus far before the wind;” and being (as it is natural to conclude) not greatly engaged, it becomes your immediate attention to wait personally upon the different overseers of the surrounding parishes, and give them most forcibly to understand, they have been for many years the subjects of imposition; but you having more _honesty_ than the whole body of the faculty, will undertake to _farm_ the medical superintendance of the _poor_, at half the annual sum it has ever cost the inhabitants before. This political stroke will excellently answer both your purposes, for overseers in general care not how little they pay; and you being professionally callous to the tears of poverty and distress, care not how little you give for their money.

_Tartar emetic_—_Pulv. contray._ c.—_Pulv. nitri_, and _Pulv. jalapii_—are medicines admirably calculated for the constitutions of the poor; and thirty or forty shillings a year in those articles, will be sufficient for the consumption of _five_ or _six_ parishes; with the additional advantage of rendering _vials_ unnecessary, a consideration of some consequence, when it is remembered they are now double their former price. These parochial connections will be productive of advantage in more ways than one, for as the unhappy paupers will be constantly seen at your door, it will afford all the appearance of sudden popularity.

Ostentatious parade, and personal consequence, must be your leading traits, and never lost sight of; _a couple of horses_ will contribute largely to these objects; not that you are expected to degrade the dignity of your profession, by riding, like Hughes or Astley, _two at a time_, but their appearance will constitute an admirable shew of business in being rode _alternately_; and as most young men who have not been long their own masters, are fond of displaying their persons on the _outside of a horse_, you may exultingly not only “feed fat” the propensity, but the general run of your mechanical neighbours (who see no farther than the tips of their noses, and are ever caught by appearances) will erroneously suppose you are visiting some of the first characters in the county. As it will be now highly derogatory for you to stain your hands with any menial services, procure speedily a _journeyman_ (alias assistant) to enhance your own weight; if there is at present nothing for him to do, the curtain, before recommended, will obscure his indolence from the prying eye of public curiosity.

No part of the faculty having ever been remarkable for the regularity or fervency of their _devotions_, your presence at church will consequently not be expected (particularly after the impressions you have made of being perpetually engaged) unless you politically appear there at two or three different times, merely for the convenience of being called out _by your own direction_, at the still and most awful part of the service; a circumstance that will tell much to your advantage with every superannuated _old woman_ in the parish. Take particular care that your horse is constantly brought to your door on the sabbath day, just as the neighbours are passing to church, and there paraded some time previous to your appearance, which to every weak mind will have its effects; and be equally careful to measure the steps of your _horse_, by the hands of your _watch_, so that whether your journey is accidentally long, or intentionally short, you return just at the moment of their dismission from the religious conventicle. In passing the whole body of inhabitants, be strictly careful of your self consequence—a bow of _significant respect_ to two or three of the _superiors_, may be applicable and consistent—but no familiarity with, or knowledge of, the multitude; the greater your _ostentation_ and _indifference_, the more _servile_ will be their _admiration_ and _respect_.

By no means form any hasty or inconsiderate matrimonial connection; you will derive many advantages at first from a life of _celibacy_; there are always a variety of juvenile females in the country (as well as the metropolis) who considering themselves _every way qualified_ to constitute _doctor’s ladies_, will most industriously _throw_ themselves in your way upon every occasion, that their personal attractions may not escape your observation. To families where there are daughters, nieces, or cousins, who _conceive_ themselves ripe for the _gordian knot_, you may assure yourself of being called in a short time; for as you are such “a charming man” in your appearance, (and so admirably _fitting_ for a husband) there can’t be the least reason to doubt your professional qualifications.

You may perhaps start some doubts, (or conscientious qualms may arise) how these appearances are to be supported in the infancy of business, without any great personal property to sanction or justify the attempt; in such diffidence you perfectly display, not only your pusillanimity, but want of knowledge and experience; for certainly out of the above description of females, who will constantly pay court to your consequence, and by a _thousand modes_ solicit your attention, surely some one of the _best possessions_ may be obtained, whose _fortune_, and advantage of family connection, may answer your most sanguine expectations: but should _fate_ conspire against you in both _business and marriage_, you will have the consolation of having made _a bold push_, and failing in the attempt, you only become a fashionable adventurer, and gratefully pay your creditors _nothing in the pound_.

Having gone through a chain of circumstances and instructions, necessary for the support of your _public_ appearance, it will be naturally expected I shall revert to the modes of behaviour that are to constitute your _private_ character, in the professional transactions that you conclude will daily occur. First, let it be your constant observance to be equally reserved and difficult of access—whenever your opinion is required, even in your own shop, appear there with tedious reluctance, as if privacies of the utmost consequence prevented your earlier attendance; this will not only add to your medical weight, but raise your reputation for _good breeding_ and intercourse with the polite world; for it is universally known, none but the inferior orders are introduced to each other without ceremony; it would be therefore highly ridiculous in you to practise a mode of behaviour in use only with the lowest classes of mankind.

Never leave home without letting your horse be held long enough at the door to be observed by the surrounding neighbours; the most trifling indication of business is a point in your favour, and ought by no means to be omitted. By the invariable good effect of which rule, no messenger whatever should arrive from the country for medicines, but he must be detained _as long as possible_; his preparations should never be ready when called for; on the contrary, his horse should be hung or held at the door for half an hour at least; a double advantage is derived from this necessary caution—the horse at the door will prove a striking object to the public, and the messenger will assure the family you attend, that, nothing but your great hurry occasioned the delay in his return.