After all that has been said of the exertions of the charlatan to abuse the confidence of mankind, particularly as far as dyspepsia is concerned, it is due to the medical profession, to state what claims they may fairly advance, to entitle them to the good opinion of the public, in the cure of this much talked of affection.
A physician, who understands what he is about, knows very well, when a case of this nature comes before him, that it may proceed from a variety of causes; that it may arise in the stomach from a want of digestive power, from the small intestines by a partial failure in the process of chymification; that it may depend upon the morbid action of the large intestines, or exist merely as a symptom of an affection in other organs. Sedentary habits, or irregularities of diet, are causes which may be supposed to act locally on the digestive organs themselves; but the history of a case will generally show that the derangement of the digestive organs is secondary. When it arises from local irritation, it can only be produced through the medium of the sensorium; when it is idiopathic, it frequently originates in causes which affect the nervous system primarily; such as anxiety, too great exertion of body and mind, and impure air; in many instances, the nervous irritation which has induced the disease, being trivial, is only kept up by the reaction of its effects. Thus says Abernethy, one of the luminaries of modern medical science.
The first duty of a physician, therefore, is to ascertain from what source indigestion proceeds, and to frame his treatment accordingly. To act upon one system of cure, like our friend Mr. Halsted, in a disease arising from such a variety of circumstances, would be as reasonable as applying splints to an arm, when the thigh happens to be fractured; but enough, we would hope, has been said to disabuse the mind of the public of a predilection for these pretenders. Dyspepsia is a disease that has existed for ages, and through ages has it readily been cured. In its simple form there is no mystery about it, and when it becomes complicated, it requires more than the knowledge of a quack to master it. Confidence in a medical attendant, and an adherence to his directions, will surely suffice now, as in former times; and if the public will restrain a longing after novelty, and abandon those "who rather talk than act, and rather kill than cure," in short, who work upon their prejudices by artifice, we shall hear less of dyspepsia, simply because it exists too frequently but in their own fancies. True, there is a certain class, with such mental, as well as bodily infirmities, who, worn down by depraved habits, or suffering under weakened intellects, will permit the wildest chimeras to haunt them; hypochondriacs may be met with every day, and these may be fit patients for the charlatan, or legally subjected to the tickling, pickling, and ironing of Mr. Halsted: extraordinary maladies may justify extraordinary experiments.
The absurd and improper treatment proposed in the work we have noticed, can afford but little hope to any but the hypochondriacal dyspeptic; he may fly to any measures, however desperate or ludicrous; for "a mind diseased no medicine can cure." Let others, however, who cannot plead a malady of the mind as an excuse for resorting to such practice, be informed, that in most of the affections arising from, or confounded with dyspepsia, it is unavailing, and may prove injurious. There are many diseases which it is impossible that Mr. Halsted can distinguish from dyspepsia, and to which he would apply his irons and bottles, towels and vinegar, at the risk of his patient's safety.
His views may be sound if adapted to the animal economy of a horse, but are certainly unsuitable to the constitution of a man.
We would say, then, to the public, in conclusion; be cautious how you trust your health and lives with those who neither comprehend the nature of the one, nor the value of the other—and who would exclaim behind your backs, with Shakspeare's Autolycus, merely altering the description of his wares:—
"Ha! ha! what a fool Honesty is! and Trust, his sworn brother, a very simple gentleman! I have sold all my trumpery; not a counterfeit stone, not a riband, glass, pomander, brooch, table-book, ballad, knife, tape, glove, shoe-tie, bracelet, horn-ring, to keep my pack from fasting: they throng who should buy first, as if my trinkets had been hallowed, and brought a benediction to the buyer; by which means, I saw whose purse was best in picture, and, what I saw, to my good use I remembered."
To the gentle pretenders themselves, we have but a few words to say at parting:—
"Out you impostors,
Quack-salving cheating mountebanks—your skill
Is to make sound men sick, and sick men, kill."