But this subject will receive strength from considering the REMEDIES of civilized nations. All the products of the vegetable, fossil, and animal kingdoms, tortured by heat and mixture into an almost infinite variety of forms; bleeding, cupping, artificial drains by setons, issues, and blisters; exercise, active and passive; voyages and journies; baths, warm and cold; waters, saline, aërial, and mineral; food by weight and measure; the royal touch; enchantment; miracles; in a word, the combined discoveries of natural history and philosophy, united into a system of materia medica, all show, that although physicians are in speculation the servants, yet in practice they are the masters of nature. The whole of their remedies seem contrived on purpose to arouse, assist, restrain, and controul her operations.
There are some truths like certain liquors, which require strong heads to bear them. I feel myself protected from the prejudices of vulgar minds, when I reflect that I am delivering these sentiments in a society of philosophers.
Let us now take a COMPARATIVE VIEW of the diseases and remedies of the Indians with those of civilized nations. We shall begin with their diseases.
In our account of the diseases of the Indians, we beheld death executing his commission, it is true; but then his dart was hid in a mantle, under which he concealed his shape. But among civilized nations we behold him multiplying his weapons in proportion to the number of organs and functions in the body; and pointing each of them in such a manner, as to render his messengers more terrible than himself.
We said formerly that fevers constituted the chief diseases of the Indians. According to Doctor Sydenham's computation, above 66,000 out of 100,000 died of fevers in London, about 100 years ago; but fevers now constitute but a little more than one-tenth part of the diseases of that city. Out of 21,780 persons who died in London between December, 1770, and December, 1771, only 2273 died of simple fevers. I have more than once heard Doctor Huck complain, that he could find no marks of epidemic fevers in London, as described by Dr. Sydenham. London has undergone a revolution in its manners and customs since Doctor Sydenham's time. New diseases, the offspring of luxury, have supplanted fevers; and the few that are left are so complicated with other diseases, that their connection can no longer be discovered with an epidemic constitution of the year. The pleurisy and peripneumony, those inflammatory fevers of strong constitutions, are now lost in catarrhs, or colds, which, instead of challenging the powers of nature or art to a fair combat, insensibly undermine the constitution, and bring on an incurable consumption. Out of 22,434 who died in London between December, 1769, and the same month in 1770, 4594 perished with that British disease. Our countryman, Doctor Maclurg, has ventured to foretel that the gout will be lost in a few years, in a train of hypochondriac, hysteric, and bilious diseases. In like manner, may we not look for a season when fevers, the natural diseases of the human body, will be lost in an inundation of artificial diseases, brought on by the modish practices of civilization?
It may not be improper to compare the PROGNOSIS of the Indians, in diseases, with that of civilized nations, before we take a comparative view of their remedies.
The Indians are said to be successful in predicting the events of diseases. While diseases are simple, the marks which distinguish them, or characterize their several stages, are generally uniform and obvious to the most indifferent observer. These marks afford so much certainty, that the Indians sometimes kill their physicians for a false prognosis, charging the death of the patient to their carelessness, or ignorance. They estimate the danger of their patients by the degrees of appetite; while an Indian is able to eat, he is looked upon as free from danger. But when we consider the number and variety in the signs of diseases, among civilized nations, together with the shortness of life, the fallacy of memory, and the uncertainty of observation, where shall we find a physician willing to risk his reputation, much less his life, upon the prediction of the event of our acute diseases? We can derive no advantage from the simple sign, by which the Indians estimate the danger of their patients; for we daily see a want of appetite for food in diseases which are attended with no danger; and we sometimes observe an unusual degree of this appetite to precede the agonies of death. I honour the name of Hippocrates: but forgive me, ye votaries of antiquity, if I attempt to pluck a few grey hairs from his venerable head. I was once an idolater at his altar, nor did I turn apostate from his worship, till I was taught, that not a tenth part of his prognostics corresponded with modern experience, or observation. The pulse[14], urine, and sweats, from which the principal signs of life and death have been taken, are so variable, in most of the acute diseases of civilized nations, that the wisest physicians have in some measure excluded the prognosis from being a part of their profession.
I am here insensibly led to make an apology for the instability of the theories and practice of physic. The theory of physic is founded upon the laws of the animal economy. These (unlike the laws of the mind, or the common laws of matter) do not appear at once, but are gradually brought to light by the phænomena of diseases. The success of nature in curing the simple diseases of Saxony, laid the foundation for the ANIMA MEDICA of Doctor Stahl. The endemics of Holland[15] led Doctor Boerhaave to seek for the causes of all diseases in the FLUIDS. And the universal prevalence of diseases of the NERVES, in Great-Britain, led Doctor Cullen to discover their peculiar laws, and to found a system upon them; a system, which will probably last till some new diseases are let loose upon the human species, which shall unfold other laws of the animal economy.
It is in consequence of this fluctuation in the principles and practice of physic, being so necessarily connected with the changes in the customs of civilized nations, that old and young physicians so often disagree in their opinions and practices. And it is by attending to the constant changes in these customs of civilized nations, that those physicians have generally become the most eminent, who have soonest emancipated themselves from the tyranny of the schools of physic; and have occasionally accommodated their principles and practice to the changes in diseases[16]. This variety in diseases, which is produced by the changes in the customs of civilized nations, will enable us to account for many of the contradictions which are to be found in authors of equal candour and abilities, who have written upon the materia medica.