When the local disease cannot be cured, and has induced the scrophulous hectic; when this cannot be removed by the means commonly employed, and which have been mentioned in the dissertation on simple inflammation, then the diseased part must be removed, if its situation permit. This must not, however, be rashly done, but must be delayed until we ascertain, that our remedies, general and local, (which must be used with assiduity and care), are of no avail. It is not sufficient that the hectic continues, and that other appearances are almost stationary; they ought to be augmenting, in order to justify amputation of a useful and important part; because every practitioner must have observed the recoveries which take place, even after the hectic fever has made considerable progress. On the other hand, we must not allow the constitution to suffer too much, but must interfere, whenever we perceive that our labours are fruitless, and that the hectic is regularly and progressively increasing, and the strength sinking. When this is observed, the only chance for life is an operation; and every day this is delayed adds to the risk attending it; for there is a degree of injury, more than which the constitution cannot sustain, and which will prove fatal, even although the exciting cause be removed. To fix the proper period requires judgment in the surgeon; but he may be enabled to do so, by attending carefully to the state of all the symptoms; for whenever these continue progressively to become worse, and have reduced the patient already to a state of weakness, which cannot be much increased without danger, he may consider it as impossible to delay amputation longer with any hopes of success.
Having made these observations on this species of scrophula, I shall now conclude, by shortly mentioning the mode of treatment adopted by the older practitioners.
Bleeding, which at first was made use of according to the custom of the day, was soon laid aside, on observing, that, in many cases, it was manifestly hurtful, and in every instance useless. But although the plan of general depletion was given up, yet local evacuations were much insisted on; for they held it as absolutely requisite, that the brain should be purged of its pituita, (the redundancy of which produced the disease), by errhines, fomentations to the ears, and the application of issues and sinapisms to the head. The stomach was cleared of viscosities, by emetics of mustard or broom-seed; the bowels, by aloes; and the skin and kidneys, by sudorifics and diaphoretics.
Having thus procured a sufficient evacuation, the patient was desired to smell a pomum odoratum, composed of styrax, amber, myrrh, aloes, and many other ingredients; the vapours of which were supposed to get up to the anterior ventricles of the brain, and dry them. Hunger and thirst, by drying the juices, were decreed to be salutary. Every thing was rendered nauseous with medicine. The bread was seasoned with anise and fœnugrek seeds, and the drink consisted of decoctions of guaiac and mastic wood, which last was “a friend to the brain and viscera[105].” As a condiment to these medicated meals, Arnoldus de Villa Nova treated his patients to the burnt sponge, mixed with salt and pepper.
But these, and indeed all the medicines yielded by the materia medica, were considered as trifling, and of no avail, when compared to the miraculous power possessed by the king, who, with one touch of his hand, could banish this dreadful disorder, and dry up all the sores. So valuable did this royal prerogative appear in the eyes of many, that it became a national controversy, whether it belonged to the French or English; whilst the Romish and Protestant churches reciprocally urged this prerogative of the king of the country where they were established, as a manifestation from heaven of the justice of their cause.
In France, the king touched publicly, at four dated feasts in the year, preparing himself the day before by prayer and fasting; then entering the apartment where the sick were arranged, the patients were individually presented by the chief physician to his majesty, who placed his hand upon their head, pronouncing these words, “Le Roy te touch, et Dieu te guarit.” The sick then retire, and soon find a manifest amendment. “In some the ulcers dry up; in others the swellings diminish; and, wonderful to relate, in a few days, more than 500 out of 1000 are perfectly cured!”—“Hic hœrant philosophi, cœcutiunt medici, stupet prophanum vulgus.”
Upon reading these accounts, we smile at the credulity of mankind; but we pity them, when we learn, that near a thousand every year made weary and expensive pilgrimages, from very distant countries, to purchase this imaginary benefit.