Physician and patient

by Worthington Hooker

Lobelia, it is claimed by the Thompsonians, is not a poison. I have often heard them say that there was no danger from it, taken at any time and in any quantity. Some have so said under oath. The vulgar name by which this article has always been known, Indian Tobacco, given to it from the similarity of its effects to those of common tobacco, show what its character is by general acknowledgment. Thompsonians however assert that it is not a narcotic; but every physician, who has had Thompsonian quacks in his neighborhood has occasionally witnessed effects ordinarily considered narcotic, produced by this remedy. These effects, it is proper to remark, do not commonly appear to any great amount, because vomiting occurs so soon, and the medicine is thrown off with the contents of the stomach. But when an ineffectual retching occurs instead of free vomiting, and dose after dose is given, narcosis is certain to supervene in a considerable degree, and sometimes it proves fatal. This is especially apt to take place, when the system from any cause is already in a very depressed state. Several trials have occurred of Thompsonian practitioners charged with killing their patients under such circumstances. Two cases are reported in Guy’s Forensic Medicine, in which the accused were found guilty by the jury, and the penalty of the law was inflicted.

The idea of Thompsonians and of some others in regard to poisons is this—that there are some medicines which always do harm, and these are poisons; while there are some other medicines which always do good, and these are not poisons. The medicines used by the ‘regulars’ Thompsonians consider as belonging to the first class, especially their mineral remedies; while the vegetable medicines, which they use in their practice, they claim to be of the latter class.

Let us look at the true meaning of the word poison. Webster’s definition of it is a correct one. He says it is ‘a substance, which, when taken into the stomach, mixed with the blood, or applied to the skin or flesh, proves fatal or deleterious.’

This definition has no reference to the time or the quantity required to produce the effect. There is a wide difference in both these respects between different poisons. Some are slow, and some rapid in their operation. Some, as for example opium, arsenic, and prussic acid, act as poisons in small amounts; while comparatively large quantities of such articles as lobelia, saltpetre, and salæratus, are required to produce ‘deleterious,’ and especially ‘fatal’ effects; and yet lobelia, saltpetre and salæratus are as truly poisons as are opium, arsenic and prussic acid.

It may be remarked also that this definition has reference only to the usual effects of substances; and not to any occasional effects which may be owing to circumstances. If, for example, any substance produce a bad effect simply from the influence of any constitutional peculiarity, or some temporary condition of the system, it is not to be called a poison. The term poison is used often in relation to the effects of substances in such cases, but it is only in a relative sense. Anything may be a poison in this sense. Anything which is inappropriate to any case will produce a ‘deleterious’ influence upon it, and is therefore a poison to it. Food may thus be for the time being a poison to the sick man, as really as a noxious drug. Indeed a noxious drug may be to him a cure, while in the same quantity it would be perhaps even a fatal poison to him if he were well. Thus a man sick with spasmodic colic is relieved by opium, which is a noxious drug to a well man; and perhaps, in order to produce the relief, he requires as much as would kill him if he were in a state of health.

The word poison carries terror to most minds, and it has therefore been one of the watchwords of Thompsonians and other quacks, in their warfare upon the medical profession. And yet, while they are raising this ridiculous outcry, they themselves, as I have before said, daily use poisons, even mineral poisons, as common articles of food. Salæratus, cream of tartar, and even common salt,[13] are poisons, for when taken in large quantities, they prove ‘deleterious,’ in some cases ‘fatal,’ and therefore come within the terms of the definition.

I have said thus much of the popular prejudice on the subject of poisons, and the use which Thompsonians and other quacks have made of it, because there is so general a misapprehension in regard to these points abroad in the community.

I cannot conclude this chapter without noticing the changes which have taken place in the sentiments and practice of Thompsonians within the last few years. These changes have been quite material. I have already alluded to some of them.

Thompsonians formerly denied the necessity of education in the practitioner. But now the candidates for admission to Thompsonian practice must study, and must submit to an examination before a board of Censors. And though Thompsonians have from the first denounced the medical faculty, and their institutions, they have now a medical faculty of their own, and have organized state societies.

Thompsonians are not now so bold and reckless in their practice as they once were. In the infancy of this practice every sick man, whatever might be his disease, or his state at the time, was subjected to what was called “the operation,”—that is, steaming and vomiting with lobelia. But so many died during the “operation,” or immediately after it, that Thompsonian doctors have learned to be more cautious.