However magnificently endowed in former times were the hospitals and almshouses of Spain, the provision now made for poor and ailing humanity is very inadequate. The revenues were first embezzled by the managers, and since have almost been swept away. Trustees for pious and charitable uses are defenceless against armed avarice and appropriation in office; and being corporate bodies, they want the sacredness of private interests, which every one is anxious to defend. Hence the greedy minion Godoy began the spoliation, by seizing the funds, and giving in lieu government securities, which of course turned out to be worthless. Then ensued the French invasion, and the confiscation of military despots. Civil war has done the rest; and now that the convents are suppressed, the deficiency is more evident, for in the remoter country districts the monks bestowed relief to the poor, and provided medicines for the sick. With few exceptions, the hospitals, the Casas de Misericordia, or houses for the destitute, are far from being well conducted in Spain, while those destined for lunatics, and for exposed children, notwithstanding recent improvements, do little credit to science and humanity.
HIS SOCIAL POSITION.
The base, brutal, and bloody Sangrados of Spain have long been the butts of foreign and domestic novelists, who spoke many a true word in their jests. The common expression of the people in regard to the busy mortality of their patients, is, that they die like bugs, mueren como chinches. This recklessness of life, this inattention to human suffering, and backwardness in curative science, is very Oriental; for, however science may have set westward from the East, the arts of medicine and surgery have not. There, as in Spain, they have long been subordinate, and the professors held to be of a low caste—a fatal bar in the Peninsula, where the point of personal honour is so nice, and men will die rather than submit to conventional degradations. The surgeon of the Spanish Moors was frequently a despised and detested Jew, which would create a traditionary loathing of the calling. The physician was of somewhat a higher caste; but he, like the botanist and chemist, was rather to be met with among the Infidels than the Christians. Thus Sancho the Fat was obliged to go in person to Cordova in search of good advice. And still in Spain, as in the East, all whose profession is to put living creatures to death, are socially almost excommunicated; the butcher, bullfighter, and public executioner for example. Here the soldier who sabres, takes the highest rank, and he who cures, the lowest; here the M.D.’s, whom the infallible Pope consults and the autocrat king obeys, are admitted only into the sick rooms of good company, which, when in rude health, shuts on them the door of their saloons; but the excluded take their revenge on those who morally cut them, and all Spaniards are very dangerous with the knife, and more particularly if surgeons. Madrid is indeed the court of death, and the necrology of the Escorial furnishes the surest evidence of this fact in the premature decease of royalty, which may be expected to have the best advice and aid, both medical and theologico-therapeutical, that the capital can afford; but brief is the royal span, especially in the case of females and infantes, and the result is undeniable in these statistics of death; the cause lies between the climate and the doctor, who, as they aid the other, may fairly be left to settle the question of relative excellence between each other.
THE SPANISH DOCTOR.
The Spanish medical man is shunned, not only from ancient prejudices, and because he is dangerous like a rattle-snake, but from jealousies that churchmen entertain against a rival profession, which, if well received, might come in for some share of the legacies and power-conferring secrets, which are obtained easily at deathbeds, when mind and body are deprived of strength. Again, a Spanish surgeon and a Spanish confessor take different views of a patient; one only wishes, or ought to wish, to preserve him in this world, the other in the next,—neither probably in their hearts having much opinion of the remedies adopted by each other: the spiritual practice changes not, for novelty itself, a heresy in religion, is not favourably beheld in anything else. Thus the universities, governed by ecclesiastics, persuaded the poor bigot Philip III. to pass a law prohibiting the study of any new system of medicine, and requiring Galen, Hippocrates, and Avicenna. Dons and men for whom the sun still continued to stand still, scouted the exact sciences and experimental philosophy as dangerous innovations, which, they said, made every medical man a Tiberius, who, because he was fond of mathematics where strict demonstration is necessary, was rather negligent in his religious respect for the gods and goddesses of the Pantheon; and so, in 1830, they scared the timid Ferdinand VII. (whose resemblance to Tiberius had nothing to do with Euclid) by telling him that the schools of medicine created materialists, heretics, citizen-kings, chartists, barricadoers, and revolutionists. Thereupon the beloved monarch shut up the lecture rooms forthwith, opening, it is true, by way of compensation, a tauromachian university;—men indeed might be mangled, but bulls were to be mercifully put out of their misery, secundum artem, and with the honours of science.
MEDICAL PRACTICE.
This low social position is very classical: the physicians of Rome, chiefly liberti, freed slaves, were only made citizens by Cæsar, who wished to conciliate these ministers of the fatal sisters when the capital was wanting in population after extreme emigrations—an act of favour which may cut two ways; thus Adrian VI. (tutor to the Spanish Charles V.) approved of there being 500 medical practitioners in the Eternal City, because otherwise “the multitude of living beings would eat each other up.” However, when his turn came to be diminished, the grateful people serenaded his surgeon, as the “deliverer of the country.” In our days, there was only one medical man admitted by the Seville sangre su, the best or noblest set (whose blood is held to be blue, of which more anon) when in rude and antiphlebotomical health; and every stranger was informed apologetically by the exclusive Amphitryons that the M.D. was de casa conocida, or born of a good family; thus his social introduction was owing to personal, not professional qualifications. And while adventurers of every kind are betitled, the most prodigal dispenser of Spanish honours never dreams of making his doctor even a titulado, a rank somewhat higher than a pair de France, and lower than a medical baronetage in England. This aristocratical ban has confined doctors much to each other’s society, which, as they never take each other’s physic, is neither unpleasant nor dangerous. At Seville the medical tertulia, club or meeting, was appropriately held at the apothecary’s shop of Campelos, and a sable junta or consultation it was, of birds of bad omen, who croaked over the general health with which the city was afflicted, praying, like Sangrado in ‘Gil Blas,’ that by the blessing of Providence much sickness might speedily ensue. The crowded or deserted state of this rookery was the surest evidence of the hygeian condition of the fair capital of Bætica, and one which, when we lived there, we have often anxiously inspected; for, whatever be the pleasantries of those in insolent health, when sickness brings in the doctor, all joking is at an end; then he is made much of even in Spain, from a choice of evils, and for fear of the confessor and undertaker.
The poor in no countries have much predilection for the hospital; and in Spain, in addition to pride, which everywhere keeps many silly sick out of admirably-conducted asylums, here a well-grounded fear deters the patient, who prefers to die a natural death. Again, from their being poor, the necessity of their living at all, is less evident to the managers than to the sufferers; as, say the Malthusians, there is no place vacant at Nature’s table d’hôte to those who cannot pay, so bed and board are not pressed on Spanish applicants, by the hospital committee; an admitted patient’s death saves trouble and expense, neither of which are popular in a land where cash is scarce, and a love for hard work not prevalent, where a sound man is worth little, and a sick one still less; nor is every doctor always popular for working cures, as could be exemplified in sundry cases of Spanish wives and heirs in general; therefore in the hospitals of the Peninsula, if only half die, it is thought great luck: the dead, moreover, tell no tales, and the living sing praises for their miraculous escape. El medico lleva la plata, pero Dios es que sana!—God works the cure, the doctor sacks the fee! Meanwhile the sextons are busy and merry, as those in Hamlet, and as indeed all gravediggers are, when they have a job on hand that will be paid for; deeply do they dig into the silent earth, that bourn from whence no travellers return to blab. They sing and jest, while dust is heaped on dust, and the corpus delicti covered, and with it the blunders of the medico; thus all parties, the deceased excepted, are well satisfied; the man with the lancet is content that disagreeable evidence should be put out of sight, the fellow-labourer with the spade is thankful that constant means of living should be afforded to him; and when the funeral is over, both carry out the proverbial practice of Peninsular survivors: Los muertos en la huesa, y los vivos á la mesa, the dead in their grave, the quick to their dinner.
MEDICAL ABUSES.
But at no period were Spaniards careful even of their own lives, and much less of those of others, being a people of untender bowels. Familiarity with pain blunts much of the finer feelings of persons employed even in our hospitals, for those who live by the dead have only an undertaker’s sympathy for the living, and are as dull to the poetry of innocent health, as Mr. Giblet is to a sportive house-fed lamb. Matters are not improved in Spain, where the wounds, blood, and slaughterings of the pastime bull-fight, the mueran or death mob-cries, and pasele por las armas, the shoot him on the spot, the Draco and Durango decrees, and practices of all in power, educate all sexes to indifference to blood; thus the fatal knife-stab or surgeon’s cut are viewed as cosas de España and things of course. The philosophy of the general indifference to life in Spain, which almost amounts to Oriental fatalism, in the number of executions and general resignation to bloodshed, arises partly from life among the many being at best but a struggle for existence; thus in setting it in the cast, the player only stakes coppers, and when one is removed, there is somewhat less difficulty for survivors; hence every one is for himself and for to-day; après moi le déluge, el ultimo mono se ahoga, the last monkey is drowned, or as we say, the devil takes the hindmost.