T is most certain that all Nations, even the most barbarous, have in all Ages made use of Medicines, to ease their Pains, to regain or preserve Health, the greatest among earthly Felicities; in the Absence whereof, we cannot relish any of those numerous Enjoyments, which the bountiful Creator hath plentifully bestow’d on us; so that the most sublime ancient Philosophers who excluded all other external Good from being necessary, to the well being of Man, placing Happiness only in the things whereof we cannot be depriv’d; yet out of them they excepted Health, knowing there was so near a Connexion between the Soul and Body, that the one could not be disorder’d in its Functions, but the other would be disturb’d in its Operations. Hence it is that no Part of human Knowledge can be of greater Moment than what directs to Remedies, and Means of Relief under those Infirmities to which the whole Race of Man is Heir to; so that even amongst the wisest, that Science or Art whereby those Defects we call Diseases were repair’d, was always accounted Divine; for that God is the first and chief Physician, hath been the constant Faith of all Ages, and that Physicians were accounted the Sons of Gods, was commendably asserted by Galen, and therefore it was truly spoken, that Medicines were the Hand of God, there meriting only such Names, as related to their divine Original; thus a certain Antidote was called Ισυθεο, equal to God, another Θεοδοτος, given by God, another divine; several Compositions had the Inscription Ιερα, or Sacred; and ’twas the common Belief among the Heathens, that so great a Knowledge in Physick came by Inspiration: And St. Austin is of the same Opinion in his Civi. Dei, who saith, Corporis Medicina (si altius rerum origines repetas) non invenitur unde ad homines manare potuerit, nisi à Deo. It cannot be conceived whence Physick should come to Man but from God himself.
It is well known how great a Name Hippocrates obtain’d, not only in Greece (which he deliver’d from the greatest Plague) but in remote Parts; so that the greatest Monarchs of the East, and their Vice-Roys, were Suitors to him, to free their Country from that devouring Disease, which threatned to exhaust those populous Regions of their Inhabitants, unless the same Person who freed Greece interpos’d, whom they esteem’d divine, and sent from the Gods, because successful in so great Undertakings. Very certain it is, so Noble and Useful a Study were encouraged, yea and practised by Kings, Princes, and Philosophers, by the highest, wisest, and best of Men, whereof some were honour’d by Statues erected to perpetuate their Memoirs, and by many other Instances of the publick Gratitude. So that when I consider what Reverence has been paid to this Profession, and the Professors thereof in all times whereof we have any particular Account, I am amaz’d that in this latter Age wherein it hath received greater Improvements than in Two thousand Years before, and that nevertheless it should be by many neglected, by others slighted, and by some even contemned. After a diligent Enquiry into the Causes of so strange and sudden an Alteration, I could not, in my Opinion, so justly ascribe it to Defects in the Profession, as to those of its Professors; not that I deny that Physick may be capable of greater Improvements, notwithstanding it might to this Day have been maintain’d at least in the same Degree of Honour and Esteem which all Ages have justly had for it, if the Avarice and Imprudence of the Real, the Ignorance and Baseness of the pretended Artists had not interpos’d: Under the former I comprize the Vulgar Physicians; under the latter, their Dependants the Apothecaries, who, I am confident, have caused many of the great Inconveniences under which the Practice of Physick now labours.
That the Sick are in all Cases oppressed with too many Medicines, and made to loath, and complain of the very Cordials; that the Expence is made greater, and more extravagant by the often Confederacy and Artifices visible in the new Modes of prescribing: And the Deaths of the Patient I would not say is frequently the Effect not of the Disease, but of the numerous Doses obtruded in the same Proportions in every Sickness and Age, pushing on declining, and even departing Life; which after its Exit makes Pots and Glasses observed, with the same Passions and Concern, as the bloody Sword is viewed as the Instrument of Death and Mischief. By whom, or by what Means the Purity of Physick has sunk into this Degeneracy, let us farther examine, and trace it from the first Steps of entring into this great Abuse; let us then usher in the young Physician now come from the University, and having spent a great Part of his Money (if not all) in his Education, very wisely for himself considers, which are the most obvious and practis’d Ways of making himself known, and by what Methods he may more easily insinuate himself, and that he may recover the Fortune he has lent the Publick in his Education, which he is resolved they shall now pay him with Interest. He is inform’d, or presently observes, that most, or all the Families are under the Directions of the Apothecary, who gives his Physick ’till he fears the Patient will die, and then appoints a Physician, who before is prepared to acquit him, by bearing the Reproach with the most perfect Resignation. And to support this good Temper, he is bid to cast his Eyes around the Kingdom, and consider how they flourish in the common Fame, who had the good Luck to follow those Instructions at their first Arrival.
Or if he has found out any more effectual Medicines, or more compendious or grateful Methods of Cure, or would imitate the applauded Practice of some few of the most eminent of that Profession, whose Prescriptions were only to assist, not to overload, or suppress Nature; this is too bold a Stroke, a too dangerous Reform in Physick; he must previously consider, that the Number of Apothecaries are increas’d, and that their Dependance lieth more on the Quantities of Medicines in suitable Proportions, and notwithstanding a generous and liberal Education, by which he has learn’d to explode the malevolent and useless Practice, from a great many Prescriptions that are now in vogue; he must not dare to refute them, he must obey that great Principle of Nature, to preserve himself; he must conform to the Manners of the Age, and the general Practice; he must dispence with his not knowing whether the Medicines are made up according to his Prescription; he must wink at the Design, Ignorance, Carelessness, or Unfaithfulness of the Apothecary; whom he must not any ways disgust, tho’ he in Revenge, as well in executing his own Interest, may make his Dose up with worm-eaten superannuated Drugs, wherewith most of ’em are well stor’d, which will not work according to the Physician’s Promise, and the Patient’s Expectation: The Apothecary who here outwits the Doctor, and assumes the Character, is here ready at hand to tell his Patient that this was no ways accommodated to his Temper; nay, perhaps, he presages to him that it will not work sufficiently, (as he may without Conjuring or Astrology) by which he obtains a Reputation of a Person more judicious than the Physician making way for his own Advantage, by telling the Patient that he will prepare a Purge that shall work more effectually than the former: This you need not doubt is the same the Physician before prescrib’d, but assuredly made up of better Drugs, and so the Apothecary executes his Design, which is to exclude the Physician, and prefer himself.
The young Physician, tho’ he has learn’d the Abuse, yet he has that Regard to himself, to make use of that old Maxim, Of the two Evils, to choose the least; and finding it best suiting his Interest, which otherwise might be endanger’d by the clandestine and underhand Dealings of the other, and now finds it necessary to close in with him, and such a one as will join in a mutual Application and Advancement of each other: Now are their Engines set at work, and the Doctor not to be behind-hand, gives a new Form to his Bills, which he prescribes in Terms so obscure, that he forces all chance Patients to repair to his own Apothecary, pretending a particular Secret, which only they have a Key to unlock; whereas in effect it is no other than the commonest of Medicines disguised under an unusual Name, on design to direct you to that Apothecary, between whom and the Physician there is a private Compact of going Snips out of the most unreasonable Rates of the said Medicines; wherein if you seek a Redress, by shewing the Bill to the Doctor, he shall most religiously aver it to be the cheapest he ever read. The Consequence whereof, as to your Particular, is a double Fraud; and as the Apothecaries in general, their Numbers bearing the Proportion at least ten to one of noted Physicians; to whom allowing his Covenant Apothecary, who constituting one Part of the ten, the remaining nine Parts are compell’d either to sit still, or to quack for a Livelihood, or at least eight of them, for we’ll suppose one Part of the nine a Possibility of acquiring competent Estates, in a Way more honest than that of the Covenanters, by their wholsome Trade of fitting out Chirurgeons Chests for Sea, and supplying Country Apothecaries with Compositions: Lastly, all accomplish’d Physicians are likewise expos’d to manifest Injuries from the Covenant Apothecaries, who being sent for by Patients, after a short Essay of a Cordial, will overpower them by Perswasions to call in a Doctor, who shall be no other than his Covenant Physician; by which Means the former Physician, who by his extraordinary Care and Skill had oblig’d the Family before, shall be passed by, and lose the Practice of that Patient: And should it happen, the Sense of Gratitude of the forementioned Patient, should engage him to continue the Use of his former Physician, yet this Covenant Apothecary shall privately cavil at every Bill, and impute the Appearance of every small Pain, or Symptom (which necessarily in the Course of a Disease will happen) to his ill Address in the Art of Physick, and shall not give over before he has introduc’d his Covenanter, whose Authority in the Fraud of Physick he supposes to be most necessary.
But least you should think me overbalanc’d with a Prejudice to those that so much abuse that noble Profession, I’ll conduct you into their usual Road and Method of examining their Patients, and making Enquiry into their Diseases, wherewith being acquainted, you may, without any farther Conviction, pronounce a Verdict.
This Knack doth chiefly consist in three Notions; viz. First, That a Patient’s Grievance is either a discernible evident Disease, which his own Confession makes known to you, what it is; or, Secondly, an inward Pain; or, Thirdly, one of those two Endemic Diseases, a Scurvy, or Consumption; or, a Fourth, the Pox. This is their Theory, which is so deeply ingrafted on their Dura Mater, and may be acquired with less Industry than fourteen Years Study at one of our Universities; for so much Time is requir’d to make a Man grow up a Doctor, the Formality whereof in most Places consists in this Elogy; Accipiamus pecuniam, & dimittamus asinùm.
If a sick Man makes his Address to a vulgar Physician, he demands his Complaint; t’other replies, he is troubled either with a Vomiting, Looseness, want of Stomach, Cough, bad Digesture, difficulty of Breathing, a Phtisick, Faintness, Jaundice, Green-Sickness, Dropsy, Gout, Convulsion-Fits, Palsy, Diziness, or Swimming in the Brain, Spitting of Blood, an Ague, a continual great Heat or Fever, &c. These are all evident Diseases the Party himself expresses he is troubled with; but his Sickness not being an evident Disease, which he himself can explain, the Vulgar Doctor concludes, it must be either an inward Pain, or an Endemick Disease: The Patient then making complaint of an inward Pain, to his old way of guessing t’other goes, enquiring first in what Part? If he answers, he feels a Pain in the right Side, or under the short Ribs, he tells him it is an Obstruction, or Stoppage in the Liver; if in the left Side, in the opposite Part, then ’tis a Stoppage of the Spleen; if in the Belly, he it may be calls it a Cholick, or Wind in the Guts; if in the Back, or Loins, he perswades him it’s Gravel, Stone, or some other Obstruction in the Kidneys; if a Stitch in the Breast, he terms it Wind, or other times a Pleurisy: Lastly, if the Party be reduc’d to a very lean Carcass, by reason of a long tedious Cough, Spitting of Blood, or want of Stomach, or Feebleness, or almost any other Disease, or Pain, then besure he tells him he’s in a Consumption, or at least falling into one: But being troubled with several Diseases and Pains at once, as running Pains, Faintness, want of Stomach, change of Complexion, so as to look a little yellowish, duskish, or greenish; then t’other whispers him, he is troubled with the Scurvy. If diseased with Ulcers or running Sores, red, yellow, blue, or dark Spots, Pimples, or Blotches in the Face, Arms, Legs, or any other Part of the Body, that’s determin’d to be the Scurvy likewise, supposing the Party to be a sober discreet Person: But if appearing inclined to Wantonness by reason of his Youth, or sly Countenance, then the fore-mention’d Disease is to be call’d the Pox. In most Diseases of Women, they accuse the Mother. In Children, their Guess seems far more fallible; for a Child within the six Months being taken ill, restless, and froward, if there appear no evident Disease, he ever affirms it’s troubled with Gripes; upon which he prognosticates, that if not speedily remedied, the Child will fall into Convulsion-Fits; but this not happening according to his Prediction, to prevent the Forfeiture of his Skill and Repute, endeavours to possess the Mother, and rest of the Gossips, it had inward Fits. The Child being past six Months, and falling indispos’d, then instead of Gripes, it is discompos’d by breeding of Teeth; but having bred all his Teeth, and being surpriz’d with any kind of Illness, the Doctor then avouches it is troubled with Worms: In short, take away these three Words, Obstruction, Consumption, and Scurvy, and there will remain three dumb Doctors, the Hackney Physician, the Prescribing Surgeon, and the Practicing Apothecary.
Hitherto we have only discovered to you the Ordinary Physicians conjecturing Compass, whereby he steers his Course, to arrive to the Knowledge of his Patients Diseases: There yet remains we should unlock the other Ventricle of his Brain, to behold the Subtilty of his Fancy in groaping at the Causes of Diseases, which, tho’ the Poet declares (Felix qui potuit rerum cognoscere causas) to be cloathed with the darkest Clouds, yet by the Virtue of this following Principle, aims at this Mark immediately, viz. That most Diseases are caus’d by Choler, Phlegm, Melancholy, or abundance of Blood: Of these, two are suppos’d to be hot, namely, Choler, and abundance of Blood, and the other two cold, to wit, Phlegm, and Melancholy, and consequently Causes of hot and cold Diseases: These four Universals being reduced to two general Categories; under the Notion of hot and cold, any one having but the Sense of distinguishing Winter from Summer, may, in the Time of an Hixius Doxius, instantly appoint a Cause for almost every Disease: So that a Patient discovering his Trouble, it may be a want of Stomach, bad Digesture, Fainting, Cough, Difficulty of breathing, Giddiness, Palsy, &c. his Vulgar Physician has no more to do, but take him by the Fist, to feel whether he be hot or cold; if he finds him cold, then summons in his old Causes, Phlegm, and Melancholy; which ready, and quick pronouncing of the Cause upon a meer Touch, doth almost stupify your Patient, thro’ Admiration of Æsculapian Oracle, hitting him in the right Vein to a hair’s breadth: For, quoth he, indeed, Mr. Doctor, I think you understand my Distemper exceedingly well, and have infallibly found out the Cause; for every Morning as soon as I awake, I spit such a deal of Phlegm, and moreover, I must confess my self extreamly given to Melancholy. This jumping in Opinions between them, makes Mr. Doctor swell with Expectation of a large Fee, which the Patient most freely forces on him, and so the Fool and his Monies are soon parted. Now it’s two to one but both are disappointed, the one in his unexperienced Judgment, t’other in his fond Belief; for, state the Case, the Disease takes its Growth from Choler, or abundance of Blood, or any other internal Cause; there is scarce one in a hundred that are indispos’d, who is not subject to hauk and spit in the Morning, and being reduc’d to Weakness, by reason of his Trouble, must necessarily be heavy in the Passions of the Mind, and incident to melancholy Thoughts, through the Memory of his Mortality, occasion’d by this Infirmity: So that, seldom Mirth and Cheerfulness are housed in indispos’d Bodies, because they are deficient of that abundance of Light, and clear Spirits, required to produce them. No Wonder the Vulgar is so opinionated in the Affair of their Temperament, when belabour’d with a Disease; since in their healthful State, it’s impossible for a Physician to engage their Opinion otherwise, than to believe themselves phlegmatick and melancholy.