Chapter II: Front Matter (2)
It will be strictly proper for you, upon all occasions, to preserve the most inflexible serenity of countenance, even to extreme gravity; and this injunction becomes the more immediately necessary, as there are a vast variety of unexpected causes for laughter, to which you will be open, in the frequent applications of unpolished rustics, for your _great opinion_ and assistance. One class will “beg the favour of you to _subscribe_ for their complaints;” another “hopes you won’t be offended, but he is come to _insult_ you upon his case;” these instances are so exceedingly common, that you will often meet with them, where they are least expected. There now lives _an alderman_, in a very capital town and place of _royal residence_, who, a few years since, labouring under an _epidemic_ complaint, was told that symptoms were alarming, and a _glyster_ was unavoidably necessary; to which representation he expostulated, begging the apothecary “to lay aside his intention, and give him any thing to _take inwardly_, but for _God’s sake_, to have no _cutting_ and _slaying_.”—Another of the same _learned body corporate_ (for they have both kissed the K—g’s hand) said “he bore the severity of his complaint with more patience, now he was _manured_ to it.”
To prove the frequency of these accidental slips, it is impossible to resist the present temptation of introducing a few more, that occur to memory in the present recital. A lad upon the borders of Northamptonshire, being sent in the night to a medical practitioner at Banbury, and calling him out of bed, told him, “he must come immediately to his mistress, for she had got a _Vistula_!”——“Where? _In ano?_” “No, Zir, in the next parish to’t.”
In an excursion to Surrey, I was solicited in a parish near Chertsey, to give my advice to a master carpenter there, who had been a long time indisposed; but my prescription having had the desired effect, and the poor man getting abroad, he very gratefully declared to all his friends, “I was the _best musician_ that ever came into the country.”—In the county of Berks, an elderly woman came to consult me upon the bad state of her daughter’s health; and after animadverting upon symptoms, told me _in a whisper_, “that her daughter was to have been married to a young man some time since; but something happening to break it off, she really believed _’twas nature turned inward in her_.”
Paying a visit, in my earlier days, to the lady of a good old country alderman of a borough in Hertfordshire, she, after many aukward apologies for the indelicacy of the subject, tremblingly told me, “she had been very uneasy for some days, with a violent heat in her _firmament_.”—By way of suppressing those risible emotions in my disposition I have before described, I, for a moment, changed the subject, by enquiring the health of her husband; to which she replied, with thanks, “he was exceedingly well, but gone to make an _exerescence_ into the country;” plunged deeper in difficulty, and nearer the _laugh_ than before, which was now become hard to suppress, I applied myself to her snuff-box, then on the table, and passing a few encomiums on its neatness, she said, it was very much admired, being a _gypsey’s pimple_ set in _pinch-gut_.
You will, no doubt, be now prepared for such unexpected misapplication of words, such _sublimity of expression_, and regulate the rigidity of your _frontal_ muscles accordingly; when called to a patient, let your personal address and behaviour be modelled entirely by the state of his _property_; if he is _your superior_ in rank and condition, every action of yours must denote it most strikingly;—you _approach_ with _respect_—you _dictate_ with _submission_—your mildness and _affected penetration_ must be perceptible in all your enquiries, making the most scrupulous observations how far you seem to gain upon the _credulity_ and good opinion of your subject, taking leave with all those attracting expressions of tenderness and sympathy, (highly tinctured with respect) that may give your patient a favourable idea of the _integrity_, it can never be your _interest_ to possess.
On the contrary, when your advice and assistance is required to a patient, whose feelings are equally wounded by bodily affliction and the barbed arrow of adversity, you may safely reverse the whole mode of behaviour, and put into practice your personal pride, even to perfect impudence. This will be in many respects a consistency of conduct; it will be convincing them, as you have nothing to hope from their _affluence_, you have certainly nothing to fear from their _poverty_.
Let what will be the condition of your patient, you are not to act as some few conscientious practitioners do, explaining what you conceive to be the nature of the case, original cause of complaint, or from what operation you expect expeditious relief; this may be the best practice with those unfashionable formal old fellows, who received their medical instructions near half a century since, and pique themselves upon what they call their _integrity_; but it will be perfectly _illiberal_ in you, who have received a more modern, and polished education. Ambiguity, and true medical mystery, will be your best guide upon every occasion; by not naming the case, or _cause of complaint_, you can never be accused of having _mistaken_ it; and by letting the property of the medicine you administer remain a matter of secrecy with all but yourself, you reserve the incontrovertible power of saying, “it has had the _very effect_ you _intended_,” whether it operates by _vomit_, _stool_, _urine_, _perspiration_, or _sleep_: these are precautions a _wise_ man always takes, a _fool_ never, and may be deemed something similar to the conduct of Bayes’s troops in the Rehearsal, who, the _warlike_ messenger said, “were stealing a march in _stilts_.”
During the indisposition of your patient, ’tis your duty to think much more of the emolument that will arise from the _protraction_ of his case, than the _expedience_ of his cure. You must have it ever in mind, that he has paid you the the greatest compliment one man can possibly pay another on earth; he has placed an implicit confidence, and entrusted you with the care of his constitution and the key of his cash; in fact, he has put both his _life_ and _property_ into your hands; and the respect you owe to _self-preservation_ renders it necessary you make the most of _both_. Let your attachment to his health and interest be demonstrated by the frequency of your attendance; it will be impossible for you to give a greater proof of your _disinterested_ friendship, than by your large and constant supplies of different medicines; too great a quantity, too great a variety cannot be introduced; they all tend to a promotion of your emolument, and the sum total of your bill will be considered _a striking proof_ of your _merit_ and assiduity.
If you find the family and friends not perfectly satisfied with your conduct, that there is the least coolness and discontent perceptible, or symptoms of present or approaching danger, strongly recommend the presence of a _better opinion_ in the form of a physician; this will prove an exertion of the soundest policy—double the quantity of medicines will be thrown into _his_ prescription for the promotion of _your_ interest, an act that the present danger will amply justify, and should the unhappy victim be doomed
“To pass that bourne,
From whence no traveller returns,”
You have nobly and skilfully slipped your neck out of the collar, and left all the credit of _killing_ (as you really ought to do) to your superior, whose _diploma_ entitles him to the preference; and, _vice versa_, should you perceive the patient and family become dupes to your affected sincerity, and that you are daily raising yourself in their estimation, erect a structure of professional applause upon the basis of their _credulity_; insinuate every possible degree of self praise, and set the advice of a physician in the most contemptible point of view.—Affect unlimited attachment to the interest of your patient, and say, “you would recommend much better advice than your own, if you could do it with a conscientious consistency; but it had ever been an opinion of yours (which was still unaltered) if the apothecary could not plunder a family _sufficiently_, the better method would be to adopt _a consultation_, when it might be done to a _certainty_.”
This open manner of dealing instantly enhances you in the estimation of patient and friends, and you will consequently stand so high in opinion that you may proceed deliberately in your _spoils_ without interruption, for where there are no _daily fees_ (swallowed up in the _vortex_ of the college) your more trifling depredations will not be considered as matters of medical magnitude or imposition.
In all kinds of inferior practice render every look, every thought and action, subservient to your general intent of personal rank and pecuniary consequence; it must be your particular study to inculcate every idea in the lower class, of your great penetration and abilities; by your minute investigations, cross-examinations, and applicable nods of significance (implying the most extensive knowledge) you will discover remote symptoms, that once explained to the complaining patient, will give them reason to believe (which they very readily do) you are a supernatural agent; and one _fool_ of _this denomination_, who firmly believes you know the state of his health by the _wrinkles_ in his _forehead_, or the _cloud_ in his _urine_, will soon infect a whole county with the certainty of your infallible qualifications. This opinion once founded, the effect is absolutely incredible, an instance of which may be found in various parts of England, but more particularly in a very large and populous town, not forty miles west of the metropolis, where _fools_ from every part of the county are constantly driving (their pockets laden with _chamber-lye_) to a famous inspector of _urinals_, vulgarly denominated a _piss-pot doctor_, who, to magnify the report of his incredible skill and penetration, has adopted a certain method to impose upon the minds of the multitude, and prey upon the little pecuniary collections they can make, to become the dupes of _his villainy_ and their own _infatuation_.
The mode of imposition, I shall explain in a fact as communicated by one of his most intimate friends, and leave the story itself to applaud his ingenuity:—He has (in a very respectable habitation) a small private room, to which every patient or messenger is conducted (upon a plea that the _doctor_ is not at home, or is particularly engaged) here an emissary (as if casually) asking certain questions, hears the whole story, examines the urine, and descends to particulars—the _doctor_ is in the adjoining apartment (calculated by a thin partition and certain openings, invisible to the unsuspecting visitor) where he minutely hears the entire conversation; the necessary secrets being obtained, he makes his appearance with the most commanding aspect; at this awful ceremony, the fascinated patient almost feels the effect of ANIMAL MAGNETISM; the approach of so much wisdom deprives him for a moment of speech, and the _poor devil_ undergoes a kind of temporary annihilation. An instance of this occurred not long since, when a country fellow having journeyed twelve miles to the doctor with a bottle of his wife’s _chrystal stream_, communicated the necessary particulars to the agent, when the doctor, in possession of the secret, made his appearance.—“Well, friend!”—“I have brought your honour my wife’s water, she could not _rest any longer_ without your _device_.”—“Your wife’s water—very well—let me see!—aye, I perceive she has _bruised her shoulder_.”—“Yes, Sir, she has indeed.”—“By this water (it is perfectly clear) she has _fallen down stairs_.”—“Yes, your honour!”—“She is not injured in any other part by the fall?”—“Only complains a little at the _bottom of her belly_, your honour.”—“Well, she fell from the top of the stairs to the bottom, _I see_?”—“No, your honour, she had gone down two steps before she fell.”—“Indeed! why then you have not brought me _all her water_.”—“No, your honour, there was _a little_ the bottle would not hold.”—“Why then, sirrah, the _two stairs_ are left behind.“——This circumstance, (of a thousand that might be quoted) is sufficient to demonstrate the ridiculous credulity of the multitude in all matters of quackery, and leaves us to lament, that the ignorance of one class, should become so wretched a prey to the deliberate villainy of another.
The long experience you have had, in charging and posting your accompts, under different masters of equal judgment and experience, leaves little room for instruction under that head; it may however not prove inapplicable to remind you, it is no matter how incoherent or unintelligible the _writing_ is, provided your _figures_ are _bold_ and _conspicuous_; so long as you can convince them how much they _have to pay_, it is a total matter of indifference to you, how much they have _received_.
There is one caution however exceedingly necessary to be advanced, to prevent your becoming subject to a reproof given by the celebrated Dean Swift to his apothecary, for presuming to be handsomely paid for the confidence of putting himself upon an equality with his superiors. This is the impropriety of letting the word ”_visits_“ constitute a part of your charge, instead of the more modest term of ”_journeys_,“ or ”_attendance_.“
The Dean having been afflicted with a long and severe fit of illness, requested, soon after recovery, the apothecary’s bill; which having perused, and finding a sum total very much beyond his expectation, he proceeded to _dissection_, and perceiving almost every _third article_ to announce the honour of a ”_visit_,” at five shillings each, he satirically adopted the following plan to punish _Mr. Emetic_, for what the Dean considered a piece of consummate assurance.—Having required his attendance to receive his demand, he paid down a certain sum of money, which the mortified apothecary continued to tell over, and repeatedly compare with the figures denoting the _sum total_; but still continuing _to tell and compare_, without seeming to get at all nearer the point of satisfaction, the Dean, in compassion to the confusion he visibly laboured under, observed, as he did not seem to be perfectly clear in his arrangement of the accompt, he would set him right.—If he would but deduct the amount of the “visits” from the sum total of his bill, he would find it exactly right; for being now pretty well recovered, he intended _paying_ him his “_visits_” again _one at a time_.
You will now naturally conclude every instruction that can be possibly necessary, has been submitted to your consideration, for the promotion of your prosperous and profitable career through the medical journey of life; it is not so; for although we have gone through the usual forms of sickness, to either recovery or death, there is still one remark necessary, to the completion of consistency, in your professional character. It is a few observations, in derision of that truly contemptible burlesque upon propriety, in following the corps of your patient to the grave; a folly originating in _ignorance_, and established by _custom_; a circumstance so truly ridiculous and farcical, that it did not escape the penetration and sarcastic wit of our Aristophanes of the present century, who attacked it with the full force of his satire, in the description given by a taylor, in one of his celebrated comedies, who says, “as he was going home to a customer with a pair of breeches under his arm, he perceived his neighbour _Gargle_, the apothecary, following a _corps_ to the grave,—so says he, Master Gargle, I see you are going home with your _work too_.” The justice of this remark renders the circumstance so truly ridiculous, that it is a matter of admiration, how any man of the most common understanding can ever submit to an indignity so truly laughable. It certainly bears the appearance of your not being content with preying upon the property of the deceased, during their last hours of sublunary affliction, but you meanly pursue their very remains to the grave, and obtain a paltry hatband and gloves, at the expence of decency and discretion. Exclusive of this very striking obstacle, there is one of equal weight in the scale of your professional reputation—it certainly can add none to the eminence of your character, that the contents of the coffin was publickly known to be a subject of your skill and experimental practice.
You will certainly experience some difficulty in evading a compliance with many requests, made to you for this purpose; but I would recommend it to you to encounter displeasure, rather than become the dupe of so great an absurdity. To inculcate by example, what I have strongly recommended in precept, you may be assured, that I have, during my long practice, retained so great an aversion to this inconsistency of character, that I rendered myself totally incapable of compliance, by never having in possession _a suit of mourning_; this resource has always proved my never failing friend, when no other apology would be accepted; and by never seeming to recollect _the want_ till a few hours before the _funeral_, a written apology has always proved a respectable substitute, to which there was no alternative.
Having descended to the very minutiæ of a long, extensive, and successful practice, to form your mind, and regulate your manners in every professional transaction of your life, I cannot doubt, but rules so directly consonant to your personal interest and reputation, will receive every assistance from your unerring consistency and perseverance, conveying a perfect corroboration of the _gratitude_ you feel, for the intrinsic worth of so liberal and friendly a communication.
TO
THE CHYMISTS AND DRUGGISTS.
It will create no surprise that you bring up the rear of this medical exhibition, when it is remembered that the most opulent, eminent, or respectable, generally close every public procession.—You are to the faculty, what the _hammerman_ is to the _forge_; you are in fact the _arterial reservoir_, from whose source flow the rich streams, that feed the _venal divisions_ in every branch of the profession, whether in town or country. To the fertility of your genius, to the extent of your commerce, to the enterprising spirit of your pecuniary embarkations, the faculty are indebted for the great variety and striking novelties, that render them so much the subjects of admiration.
You happily derive your affluence from dealing innocently around you the various _instruments_ of _death_, with an indifference that sufficiently exculpates you from the suspicion of _murder_, even as accessaries before the fact.—Your constant, and extensive inventions (for the promotion of private emolument and public good) rank you high in general estimation, and you prudently recommend yourselves to the attention of the most learned, by your very _frequent_ and _extraordinary_ discoveries.—Your advertisements (with which almost every literary vehicle teems) are alike calculated to excite wonder and approbation; they seem to indicate proofs, that _you alone_ exceed the limits of human penetration, and display a hope of perpetual existence, by setting mortality at defiance; like a groupe of _desperate hazard players_, you are “at all in the ring,” and with a degree of emulative opposition to each other, produce from your _alembics_—_bolt heads_, and _balneum arenæs_, antidotes to every ill: the only ray of consolation to the less learned is, that _death_ (often an unexpected visitor) opens the eyes of the world to the arts of your deception, and you slide into the grave with the calm and unobserved obscurity of your neighbours. The wonderful extent of your fertile abilities are constantly conveyed to public attention, through the pompous medium of “Letters Patent” and “Royal Authority,” that are at length become (from the higher arts) the fashionable introduction to a _breeches ball_; a _tincture for the tooth ach_; a _blacking cake_, or a _gamboge horse ball_.
While I lament this degradation, this prostitution of patronage, to such _trifling_, such _contemptible_ efforts of _sterility_, I cannot but consider how gratefully, how extensively, you are bound to a credulous and indulgent public, who implicitly sanction with their patronage, every production of _genius or dullness_, whether in a _philosophic taper_, a concentrated _acid of vinegar_, or a _salt of lemons_; they are undoubtedly discoveries of _immense magnitude_ to the public at large; and experience has sufficiently proved, that so much _patriotic virtue_ should meet its _own reward_.
Notwithstanding the superiority and extent of your knowledge, so visibly displayed in the _sublimity_ of your frequent experiments, that have raised you to such a great degree of professional eminence, there may yet be some profitable principles of practice, inculcated by a long and studious observer, that will evidently add to your emoluments, if not to the encrease of your reputations.
Your _peculiar modesty_ may have prevented your attaining the utmost perfection of your art, and left you strangers to the very great and undiscovered advantages, that the privileges of your profession so singularly entitle you to; for though you may hitherto have reconciled yourselves to a paltry _mechanical_ profit of thirty-five or forty per cent. what law forbids you making the “most of your market,” and enhancing those profits to such state, as may best accord with your idea and gratification of _city eminence_—_rural ease_—_external appearance_, and _domestic hospitality_? To insure these comforts to a certainty, accept such instructions, (as closely adhered to) will inevitably produce the purposes for which they are introduced.
Hitherto, a stranger to the happy effects of necessary _adulteration_, it may not be inapplicable to say a few words upon its numerous advantages; first, at your embarkation, you should adopt it as the _ultimatum_ of all your professional views, and render it as subservient to your wishes, as the lover’s invariable observance of “_persevere_ and _conquer_,” is to his. _Adulteration_ has many pleasing advantages annexed to its practice; by the applicable introduction of an _harmless_ ingredient, you may reduce the dangerous property of a _drastic_ purgative, and render a powerful _poison_ less destructive; by such acts you will enjoy the inexpressible consolation of hourly contributing to the safety of your fellow-creatures, in exertions of _humanity_, that will do you the greatest honour.
The prelude to the _Pharmacopœia_, sufficiently informs you, the _College of Wigs_ are empowered by royal sanction to invent, or constitute forms, and the _cabinet_ to enforce them; but your superior knowledge sets such arbitrary dictation at defiance, and your _practical arts_ will ever supersede their _theoretical_ penetration. Let them happily enjoy the power to alter names, and improve forms of all the compositions in that _laughable farrago_, their _new dispensatory_; they have the province to direct, and you have the pleasure to evade; obeying their injunctions no farther than is strictly consistent with your own interest and convenience. To assist the aptitude of your fertility, let me introduce to your attention (as specimens of what may be done) some few of the advantageous alterations that may be made in medicinal composition, to promote your certain emolument, without arraigning your _integrity_.
In that expensive preparation _confectio cardiaca_ (newly named by college sagacity _confectio aromatica_) opportunity offers to display a part of your privilege in substituting the use of _saffron paper_, which will impart to the composition the rich colour of the original _crocus_; for those other high priced articles _cardamoms_, _cinnamon_, _nutmegs_, and _cloves_, applicable and proportional quantities of those cheaper (and equally efficacious) _cordials_ and _carminatives_, _ginger_, _grains of paradise_, or any of the inferior spices may be added. In large preparations of the _electarium lenitivum_, an introduction of the _pulp of prunes_ for the _pulp of cassia_, will save much additional expence and trouble.—In the _syrupus e spina cervina_, treacle is certainly preferable to the finest lump sugar, with this advantage, that the predominant nausea will prevent the discovery.
Experience will convince you that _spiritus c. c._ (_per se_) obtained by distillation from the accumulated stale urine of a parish workhouse, or the bones of animals, will be by far preferable to that drawn from the purest _cornu cervi_; as are the rasura c. c. from the shank bones of horses, or cows, preferable to all other.—_Sp. terebinthinæ_ (carefully and proportionally incorporated) becomes an admirable associate with the _ol. juniperi_.—_Ol. amygdalinum_ (and many other articles blended _secundum artem_) form an excellent combination with, and increase the stock of _ol. anisi verum_.—_Genuine gum guaiacum_—_galbanum_—_storax_, and _bals. tolutanum_, may undergo the process of _purification_ much better, if impregnated with the occasional assistance of either the _resina nigra_, or _flava_.—The various unguents will derive advantage from the salutary introduction of _auxungiæ porcincæ_, as a substitute for those more _expensive and unnecessary_ articles _cera flava_ and _ol. olivarum_.
_Pulv. anisi verum_ will be much more easily reduced from the cakes, after the seed has been expressed, the oil obtained, and their medical virtue entirely extracted; it is an article only in use for horses and cows; whether they are _killed or cured_, is an object not worthy your consideration. _Liquorice_, _fenugreek_, _diapente_, _turmeric_, and _elecampane_, are to receive their basis from _horse beans_ ground (at the medical mills) exceedingly fine, and to be impregnated properly with the different articles from which they derive their names, so as to retain each their predominant effluvia; and as these are articles in use for cattle only, you will give proof of your humanity, by drenching them with _food_ instead of _physic_. The species _hiera_ will be much more certain in its effects, if prepared with the _Barbadoes_, instead of the _Succotrine_ aloes; and the true Dutch biscuit powder, will form no unprofitable union with the powder of _Salop_. In fact, innumerable instances of professional skill and œconomy might be introduced, extending instructions to a much greater length than originally intended; protracting the explanatory parts beyond the limits of utility, an accusation it has been my principal care to avoid.
It may perhaps be almost unnecessary to remind you, how absolutely needful it will be, to reduce to impalpable pulverization and complicated forms, all inferior and damaged _drugs_ of every denomination; in _powders_, _tinctures_, _electuaries_, and other preparations, their defects will not be perceptible, and it will prove matter of no small gratification to you, that many practitioners are very _inferior judges_ of the compositions they constantly prescribe; to these may be added the still greater number, that never condescend to undergo the task of inspection, forming together a major part of the very numerous and respectable body I have undertaken to instruct.—If you are a dispenser of _chemicals_ and _galenicals_ by retail, one additional observation will prove worthy your attention—never let your shop, or dispensary, get into disrepute by too much modesty, in saying you are without the most obsolete or ridiculous article that can be enquired for; if _oil of swallows_, _oil of bricks_, _lobsters’ blood_, or _milk of lilies_, should be the objects in request, let the fertility of your invention _instantly_ furnish a substitute for either; of these, such a great variety are always to be found, the least enumeration becomes unnecessary.
The series of instructions advanced for the promotion of professional interest, have been promulgated without a fear of offence, or hope of reward; amidst the very great number of different practitioners, into whose hands these admonitions must inevitably fall, happy he who can exultingly exclaim,
“Let the gall’d jade wince, our withers are unwrung.”
From the physician, who lingers out a life of _studious suspense_, and derives a scanty subsistence from the alternate labour of morning visits and evening lectures—from that _dignified_ “member of the corporation,” whole _mercurial_ abilities are thrust into the hand of every dirty passenger, in the more dirty avenues of the metropolis—from that industrious _accoucher_, whose incessant nocturnal labour renders him, in common life, little superior to the _nightman_, and that equal drudge the metropolitan _pharmacopolist_, I can have little to expect but universal denunciation of vengeance, and threats of malevolence: to the effect of these, I oppose the stability of _truth_, that will render me _invulnerable_ to all their attacks.
A steady observance of the iniquity of medical practice has long since powerfully convinced me of the absolute necessity of professional reformation, and should I (by arming the public with a weapon of self-defence) succeed in producing a change in the systematic imposition of one, and preventing perpetual depredation upon the other, every idea of personal ambition will be fully gratified, for
“So little slave to what the world calls fame;
As dies my body—so I wish my name.”
But this obscurity in the present instance is much more anxiously to be _hoped_ than _expected_, for there cannot be the least doubt entertained but _some one_ of his Majesty’s ministers (who are ever anxious for the public good and increase of revenue) will, through the medium of the publisher, discover the joint secret of _name_ and _residence_, that by placing the author in the TREASURY, CUSTOMS, or some office equally lucrative, they may avail themselves of his INTEGRITY, not hesitating a moment to believe, that so just an investigator of professional impositions upon individuals, must unavoidably render the STATE adequate service, in the discovery of official depredations upon the PUBLIC.
FINIS.
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Price Three Shillings and Sixpence sewed.
Illustrated by a great Number of Plates, which include
above One Thousand Examples,
The Sixth Edition, including a Variety of Additions and
Improvements, both in the Plates and Letter-press,
A Short and Easy INTRODUCTION to HERALDRY, in Two Parts.
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The Æsculapian Labyrinth Explored; Or, Medical Mystery IllustratedChapter II: Front Matter (2)
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