A View of Society and Manners in Italy, Volume 2 (of 2) / With Anecdotes Relating to some Eminent Characters

by John Moore

Salt water, and some of the mineral springs, which are unquestionably beneficial in scrophulous and other distempers, have been found hurtful, or at least inefficacious, in the consumption; there is no sufficient reason to depend on a course of these, or any medicine at present known, for preventing or dissolving tubercles in the lungs. Mercury, which has been found so powerful in disposing other ulcers to heal, has no good effect on ulcers of that organ;—though some physicians imagine it may be of service in the beginning to dissolve tubercles, before they begin to suppurate; but as there is no absolute evidence, during life, of indolent tubercles being formed, there can be none that mercury cures them.

Various kinds of gums, with the natural and artificial balsams, were long supposed to promote the healing of external wounds and ulcers, and on that account were made the basis of a vast variety of ointments and plaisters. It was afterwards imagined, that the same remedies, administered internally, would have the same effect on internal ulcers; and of course many of those gums and balsams were prescribed in various forms for the pulmonary consumption. The reasoning on which this practice was established, however, seems a little shallow, and is far from being conclusive; for although it were granted, that these balsams contributed to the cure of wounds, when applied directly to the part, it does not follow that they could carry their healing powers, unimpaired, from the stomach to the lungs, through the whole process of digestion. But more accurate surgery having made it manifest, that the granulations which spring up to supply the loss of substance in external wounds, and the healing or skinning over of all kinds of sores, proceeds from no active virtue in the plaisters or ointments with which they are dressed, but is entirely the work of nature, and best performed when the mildest substances, or even dry lint only is applied; and that heating gums, resins, and balsams, rather retard than promote their cure; the internal use of such remedies ought to be rejected now, on the same principles they were adapted formerly.

No kind of reasoning ought to have weight, when opposed by fair experience. But physicians have formed contrary and opposite conclusions, with respect to the effect of the natural and artificial balsams, even when they have laid all theory and reasoning aside, and decided on their powers from practice and experiment only. This is sufficient to prove, at least, that their efficacy is very problematical. For my own part, after the fairest trials, and the most accurate observations I have been able to make, I cannot say that I ever knew them of service in any hectic complaint proceeding from an ulcer in the lungs; and I have generally found those physicians, on whose judgment I have more reliance than on my own, of the same opinion.

It is far from being uncommon to see a cure retarded, not to say any thing stronger, by the means employed to hasten it; and physicians who found their practice on theoretical reasonings, are not the only persons to whom this misfortune may happen. Those who profess to take experience for their sole guide, if it is not directed by candour, and enlightened by natural sagacity, are liable to the same. A man may, for twenty years, order a medicine, which has in every instance done a little harm, though not always so much as to prevent nature from removing the complaint at last; and if the reputation of this medicine should ever be attacked, he may bring his twenty years experience in support of it. It ought to be remembered, that as often as the animal constitution is put out of order, by accident or distemper, nature endeavours to restore health. Happily she has many resources, and various methods of accomplishing her purpose; and very often she succeeds best without medical assistance. But medical assistance being given, she frequently succeeds notwithstanding; and it sometimes happens, that both physician and patient are convinced, that the means which did not prevent have actually performed the cure.

A peasant is seized with a shivering, followed by feverishness, and accompanied with a slight cough—he goes to bed, and excessive heat and thirst prompt him to drink plentifully of plain water; on the second or third day a copious sweat bursts from all his pores, and terminates the disorder. A person of fortune is seized with the same symptoms, arising from the same cause, and which would have been cured by the same means, in the same space of time; but the apothecary is called, who immediately sends pectoral linctuses to remove the cough, and afterwards gives a vomit, to remove the nausea which the linctuses have occasioned: the heat and fever augment; the physician is called; he orders the patient to be blooded, to abate the violence of the fever, and gives a little physic on some other account. All this prevents the natural crisis by sweat; and the patient being farther teased by draughts or powders every two or three hours, nature cannot shake off the fever so soon by six or seven days, as she would have done had she been left to herself. She generally does her business at last, however; and then the physician and apothecary glory in the happy effects of their skill, and receive the grateful thanks of their patient for having cured him of a dangerous fever.

Every body of common penetration, at all conversant in medical matters, must have seen enough to convince them that the above description is not exaggerated; but it is not to be inferred from this, that the art of medicine is of no use to mankind. There are many diseases in which nature sinks, without medical assistance. It is the part of the penetrating and experienced physician to distinguish these from others, and leave it to the knavish and weak to assume the merit of cures in cases where they know, or ought to know, that medicine can do nothing.

Some physicians, who have abandoned the other resins and gums, as useless or hurtful in hectic complaints, still adhere to myrrh as a beneficial medicine; but from what I can learn, the cases in which this gum has been thought serviceable, are hectic complaints, from debility, in consequence of excessive evacuations of various kinds, and not proceeding from ulcerated lungs. After it is fully established that myrrh is of use in such instances, it will still be worthy of investigation, whether it is of more or less than Jesuits bark. I have repeatedly mentioned blood-letting, and a spare, diluting regimen, as the most powerful means of preventing and curing all affections of the lungs that depend on inflammation. In the case of external wounds, or bruises of the lungs, this method facilitates the immediate cure by the first intention. It is the chief thing to be depended on for the cure of pleurisies; and it is often owing to a neglect, or too sparing an use of this evacuation, that the complaint terminates in an abscess. In people predisposed by the form of their bodies, or the nature of their constitutions, to a spitting of blood, it may prevent the turgid vessels from bursting; and in those who have tubercles in the lungs, it is of the greatest utility, by preventing those tumours from inflaming, and becoming ulcers; but after the ulcers are actually formed, I have great doubts with regard to the propriety of attempting a cure by repeated bleedings, even in small quantities. This method has been often tried; but I fear the success with which it has been attended, gives no encouragement to continue the practice. That symptoms may be such, in every period of this disease, as to require this evacuation, is not to be denied; but there is a great difference in the application of what is considered as an occasional palliative, and that from which we expect a radical cure. In the one case, it will only be used when some particular symptom strongly urges; in the other, it will be used at stated intervals, whether the symptoms press or not; and may tend to weaken the already debilitated patient, without our having the consolation of knowing, with certainty, that it has had any other effect.

Blisters do not weaken so much; they are of undoubted use in pleurisies; perhaps, by exciting external inflammation, they may contribute to draw off the inflammatory disposition within the breast: perhaps—But in whatever way they act, I imagine I have frequently seen blisters and setons, particularly the latter, of considerable service, even after the symptoms indicated the existence of an ulcer in the lungs.