Part 25

These errors of description amongst medical writers have of course occasioned much obscurity and perplexity in the productions of travellers and historians, who have generally confounded all these diseases with the Hebrew leprosy, or the leprosy which for so long a period desolated the fairest portions of Europe, where every country was crowded with hospitals established for the exclusive relief of the malady. The number of leper-houses, as they were denominated, has been singularly exaggerated. Paris has been made to assert that there were nineteen thousand of these hospitals, whereas he merely stated that the Knights Hospitalers, under various patron saints, but more particularly St. Lazarus, were endowed with nineteen thousand manors to support their extensive establishments; and he thus clearly expressed himself: "_Habent Hospitalarii novemdecim millia maneriorum in Christianitate_." It appears that in the reign of Louis VIII., France had no less than two thousand of these hospitals. Leprosy was well known in the eighth century, and St. Ottomar and St. Nicholas, were considered the first founders of establishments for its treatment in France and in Germany. The Crusaders, however, by their connexions with the East, materially increased its inroads in Europe, and the disgusting malady appears to have been considered as a proof of holiness. Moehser, in his work "_De medicis equestri dignitate ornatis_," informs us that the Knights of the order of St. Lazarus were not only intrusted with the care of lepers, but admitted them into their noble order: their Grand Master was himself a leper. The Crusaders, returning from their useless wars, eaten up with the disease, received the honourable distinction of being _pauperes Christi, morbi beati Lazari languentes_. The most distinguished individuals in the land attended upon them with the utmost humility; and Robert, King of France, used to wash and kiss their filthy feet to keep himself in odour of sanctity. All these attentions, however, did not always prevent the lepers from complaining of their complicated sufferings, but they were exhorted by holy men (who of course had never experienced the miseries of the malady) to be of good comfort, as their illness was a blessed favour conferred upon them as the elect of the land. St. Louis thought the Sire de Joinville an unbeliever; for having once asked him which he would prefer, being a _mezieu_ or _laide_ (a leper), or having to reproach his conscience with any mortal sin, his favourite replied to the singular question, that he would rather be guilty of thirty deadly sins; whereupon the sanctified monarch severely rebuked him by telling him in the quaint language of the times, "Nulle si laide mezeuerie n'est, comme de estre en péché mortel."

Notwithstanding the sanctity of their disease, lepers were by various laws separated from the healthy portion of the community. The ceremonies used on these occasions were curious; and we find the following description of them in the History of Bretagne: A priest in his sacerdotal robes went to the leper's dwelling, bearing a crucifix. He was then exhorted to submit with resignation to the affliction: he afterwards threw holy water upon him, and conducted him to church. There he was stripped of his ordinary vestments, and clothed in a black garment; he then knelt down to hear mass, and was again sprinkled with holy water. During these ceremonies, the office for the dead was duly sung, and the leper was finally led to his destined future residence. Here he again knelt, received salutary exhortations to be patient, while a shovelful of earth was thrown on his feet. His dwelling was most diminutive: his furniture consisted of a bed, a water-jug, a chest, a table, a chair, a lamp, and a towel. He further received a cowl, a gown, a leathern girdle, a small cag with a funnel, a knife, a spoon, a wand, and a pair of _cliquettes_, (a sort of castanets,) to announce his approach. Before leaving him, the priest added another blessing to these gifts, and departed, after commanding him under the severest penalties never to appear without his distinctive apparel, and barefooted; never to enter a church, a mill, or a baker's shop; to perform all his ablutions in streams and running waters; never to touch any article he wanted to purchase, except with his wand; never to enter drinking-houses, but to buy his liquor at their doors, having it poured into his barrel by means of the funnel graciously given him for that purpose; never to answer any question unless he was to windward of his interlocutor; never to presume to take a walk in a narrow lane; never to touch or go near children, or look at a good-looking wench; and only to eat, drink, and junket with his brother lepers; and invariably to announce his unwelcome approach by rattling his castanets.

The offsprings of these sequestrated creatures were seldom baptized; and when this rite was performed, the water was thrown away. After this oration his ghostly adviser took his final leave, and the patient's former dwelling was burnt to the ground. The sepulchre of St. Mein, in Britanny, was frequently visited by these poor creatures; and on such occasions they were obliged to have both their hands covered with woollen bags, as a distinguishing mark amongst the other pilgrims. Lepers were only allowed to intermarry with fellow-sufferers; yet we find in one of the Decretals of St. Gregory, that any woman who chose to run the chances of contagion could please her fancy. St. Gregory perhaps thought this the most effectual method of preventing the dreaded intercourse, as most probably, had it been prohibited, lepers would have been in great request, they having always been notorious for their amorous propensities. Muratori informs us that these unfortunate persons did not always submit quietly to these severe regulations, but several times joined the Jews in a revolt against the authorities.

This affliction has been observed in various countries. In Iceland it is called _Likraa_; in Norway, _Radesyge_ or _Spedalskhed_. It is to be apprehended that many of these cases of leprosy belong more particularly to the elephantiasis: such is the red disease of Cayenne, and the _Boasi_ of Surinam.

It is especially in the East, its probable original seat, that leprosy is observed. In Damascus there are two hospitals for its treatment. The waters of the Jordan are still considered efficacious in its cure, and the waters of Abraham's well are looked upon as a specific. In Candia the disease was common, and lepers were noted for their obscene profligacy. From Crimea it has also been carried to Astracan, whence it infected the Cossacks of Jaïck. Pallas and Gmelin have given an accurate account of its invasion.

THE ASPIC.

Various opinions are entertained respecting the reptile that inflicted the fatal sting on Cleopatra. According to Pliny, it had hollow fangs, which distilled the venom in the same manner as the tail of the scorpion. Ælian states it to have been a snake that moves slowly, covered with scales of a reddish colour, his head crowned by callous protuberances, his neck becoming swollen and inflated when he sheds his poisonous secretion. Other naturalists affirm that the scales are shining, and the eyes of a dazzling brightness; while some authorities maintain that the reptile's hue is of a dark brown colour, and that, like the chameleon, it can assume the colour of the ground on which it drags its writhing form. However, later observers have now clearly ascertained that the aspic of the ancients is the _coluber haje_, called by the Arabs _nascher_, and classed by Lacepède as the Egyptian viper. Lucan seems to have described this serpent in the following lines:

Hic, quæ prima caput movit de pulvere tabes Aspida somniferum tumida cervice levârit.

According to Hasselquist, the aspic's head is raised in a protuberance on both sides behind the eyes; the scales which cover the back are small, of a dirty white colour, and speckled with reddish spots. The lower surface of the reptile is striated with one hundred and eighteen small parallel zones, and forty-four smaller ones are under the tail. The teeth resemble in their structure those of other vipers; and, when the animal is irritated, its neck and throat are swelled up to the size of the body. Authors vary in regard to its length. Hasselquist, from whom we have derived the above description, says that it is a short reptile; while Savary assures us that it sometimes measures six feet.

The ancients stated that the poison of the aspic did not occasion any pain, but that the person it had stung gradually sunk into a calm and languid state, which was followed by a sound sleep, the forerunner of dissolution. Modern travellers assure us, on the contrary, that this venom is most active; and Hasselquist has observed an aspic in Cyprus, the bite of which brought on a rapid mortification, which generally proved fatal in a very few hours.

In Egypt the viper is still made use of in medicinal preparations; and a great number of them are sent to Venice for the confection of the celebrated _Theriaca_. Under Nero, we are told, that these reptiles were imported into Rome for pharmaceutical purposes.

In the above description, and endeavour to ascertain the nature of the aspic of the ancients, there must be some error. The _coluber aspis_ of Linnæus is not venomous, and we may therefore conclude that the aspic was of the same species as our viper. The venom of this animal is of a yellow tinge, and small in quantity, seldom exceeding two grains in weight. In hot weather it becomes more active in its effects. Time does not seem to deprive it of its fatal properties; for instances have been known of persons having pricked their fingers with the pointed fangs of a viper preserved in spirits, when the most serious accidents have followed. The dried teeth lose this noxious power. The venom of the viper may be swallowed without any risk, provided there is not an ulcer in the mouth. Fontana has made upwards of six thousand experiments to prove the activity of this substance. A sparrow died under its influence in five minutes, a pigeon in eight or ten; a cat sometimes did not experience any inconvenience, a sheep seldom or never; and the horse appears to be proof against its action.

Some naturalists have affirmed that the female viper, in cases of sudden alarm, possesses the faculty of securing the safety of her young by swallowing them and keeping them concealed in her stomach, as the kangaroo secures her offspring in her pouch. This assertion, although fabulous, was credited by Sir Thomas Brown, and since by Dr. Shaw. Stories equally absurd have been circulated of this reptile. The Egyptians considered the viper as a typification of a bad wife, since they believed that during their union the female was in the habit of biting off her partner's head. They also looked upon it as the emblem of undutiful children, from the idle belief that the viper came into the world by piercing an opening in its mother's side.

SELDEN'S COMPARISON BETWEEN A DIVINE, A STATESMAN, AND A PHYSICIAN.

If a physician sees you eat any thing that is not good for the body, to keep you from it he cries out "It is _poison_!" If the divine sees you do any thing that is hurtful to your soul, to keep you from it he cries out "You are _damned_!"

To preach long, loud, and damnation, is the way to be cried up. We love a man who damns us, and we run after him again to save us. If a man has a sore leg, and he should go to an honest and judicious surgeon, and he should only bid him keep it warm, or anoint it with some well-known oil that would do the cure, haply he would not much regard him, because he knows the medicine beforehand to be an ordinary medicine. But if he should go to a surgeon that should tell him, "Your leg will be gangrene within three days, and it must be cut off; and you will die, unless you do something that I could tell you," what listening there would be to this man! "Oh! for the Lord's sake, tell me what this is:--I will give you any contents for your pains."

This ingenious antiquary has also made some quaint comparisons between doctors of the body and doctors of the public interests. "All might go on well," he says, "in the commonwealth, if every one in the parliament would lay down his own interest and aim at the general good. If a man was rich, and the whole college of physicians were sent to him to administer to him severally; haply, so long as they observed the rules of art, he might recover. But if one of them had a great deal of scammony by him, he must put off that; therefore will he prescribe scammony; another had a great deal of rhubarb, and he must put off that; therefore he prescribes rhubarb: and they would certainly kill the man. We destroy the commonwealth, while we preserve our own private interests and neglect the public."

Grotius called John Selden "the honour of the English nation;" and Bacon had such an implicit faith in his judgment, that he desired in his will that his advice should be taken respecting the publication or suppression of his posthumous works.

THE LETTUCE.

Various species of this plant were known to the ancients. Its type is supposed to be the _Lactuca quercina_, or the _Lactuca scariola_; both of Asiatic origin. Many powerful effects were formerly attributed to its use. It was considered as producing sleep, and recovery from intoxication; it was in consequence of this belief that this salad was served up after meals. Thus Martial tells us,

Claudere quæ coenas Lactuca solebat avorum, Die mihi cur nostras inchoat illa dapes.

Columella thus describes its properties:

Jamque salutari properet Lactuca sapore Tristia quæ relevet longi fastidia mori.

This belief in its narcotic qualities induced the ancients to esteem it as an aphrodisiac: the Pythagoreans had therefore named it [Greek: eunouchion]; and Eubulus calls it the food of the dead, _mortuorum cibum_. Venus covered the body of her beloved Adonis with lettuce-leaves to calm her amorous grief; and vases, in which they were planted, were introduced in the Adonian festivals. Galen, who had faith in its powers, called it the herb of sages, and in his sleepless nights sought its influence by eating it at supper. It was also frequently put under the pillow of the rich to lull them to repose. Its cooling qualities were so much dreaded by the Roman gallants, that its use was abandoned; but Augustus's physician, Antonius Musa, having calmed by its prescription his master's uneasiness in a hypochondriac attack, lettuce recovered its popularity: a statue was erected to the doctor, and salad once more became the fashion, although the prejudices against it could not be removed. Lobel informs us that an English nobleman, who had long wished for an heir, but in vain, was blessed with a numerous family by leaving off this Malthusian vegetable.

MEDICAL FEES.

Such is the perversity of our nature, that the remuneration given with the greatest reluctance is the reward of those who restore us, or who conscientiously endeavour to restore us to health. The daily fees, it is true, are not handed with regret, for the patient is still suffering; but if they were to be allowed to accumulate to a considerable amount, they would be parted with, with a lingering look. The lawyer's charges for a ruinous litigation, the architect's demands for an uncomfortable house, are freely disbursed, though if exorbitant they may be taxed; but the doctor's--a guinea a visit!--is sheer extortion. 'Send for the apothecary: the physician merely gives me advice; the apothecary will send me plenty of physic: at any rate I shall have something for my money.'

To what can this unjust, this illiberal feeling be attributed? Simply to vanity and pride. Illness and death level all mankind. The haughty nobleman, who conceives himself contaminated by vulgar touch, can scarcely bring himself to believe that he is placed upon the same footing as a shoe-black. All _prestiges_ of grandeur and worldly pomp vanish round the bed of sickness; and the suffering peer would kneel before the humblest peasant for relief. Then it is that money would be cheerfully lavished to mitigate his sufferings. But how soon the scene is changed! The patient is well, thrown once more in the busy vortex of business or of pleasure. He had been slightly indisposed; his natural constitution is excellent: the doctors mistook his case; thought him very ill, forsooth; but nature cured him.

Could the ambitious mother admit for one moment that her daughter had been seriously ill?--a sick wife is an expensive article! If her medical attendant unfortunately hinted that the young lady had been in danger, he is considered a busy old woman, exaggerating the most trifling ailment to obtain increase of business; in fact, a dangerous man in a family where there are young persons--to be provided for. Nor can we marvel at this. No one likes to be considered morally or physically weak, excepting hypochondriacs, who live upon groans, and feel offended if you tell them that they do not look miserable. The soldier will describe the slightest wound he received in battle as most severe and dangerous; a feeling of pride is associated with the relation. The bold hunter will boast of a fractured limb; the accident showed that he was a daring horseman. Nay, the agonizing gout is a fashionable disease, which seems to proclaim good living, good fellowship, and luxury: it is, in short, a gentlemanly disease. But the slow ravages of hereditary ailments, transmitted from generation to generation with armorial bearings, the development of which may be averted by proper care, or hurried on by fashionable imprudence! how difficult even to hint to a family the presence of the scourge, when, through the transparent bloom of youth and beauty, our experienced eye reads the fierce characters of death in the prime of years. The aerial coronet floats in fond visions before the doting mother's ambitious eyes. A man would be a barbarian, nay, a very brute, to deprive the darling girl of the chances of Almacks, the delights of the pestiferous ball-room, or the galaxy of court or opera!

To attend the great is deemed the first stepping-stone to fortune, and patronage is considered as more than an equivalent of remuneration. Too frequently does the physician placed in that desirable situation forget what Hippocrates said of the profession. "The physician stands before his patient in the light of a demi-god, since life and death are in his hands."

Curious anecdotes are related of this unbecoming subserviency. A courtly doctor, when attending one of the princesses, was asked by George III. if he did not think a little ice might benefit her. "Your majesty is right," was the reply; "I shall order some forthwith." "But perhaps it might be too cold," added the kind monarch. "Perhaps your majesty is right again; therefore her royal highness had better get it warmed."

This absurd deference to rank and etiquette by a physician who at the moment is superior to all around him, reminds one of an account given by Champfort of a fashionable doctor. "D'Alembert was spending the evening at Madame Du Deffand's, where were also President Hénault and M. Pont de Vesle. On this flexible physician's entering the room, he bowed to the lady with the formal salutation, '_Madame, je vous présente mes très humbles respects_.' Then, addressing M. Hénault, '_J'ai bien l'honneur de vous saluer_.' Turning round to M. de Vesle he obsequiously said, '_Monsieur, je suis votre très humble serviteur_;' and at last, condescending to speak to D'Alembert, he nodded to him with a '_Bonjour, Monsieur_!'" On such occasions a condescending smile from power is considered a fee.

Reluctance in remunerating medical attendants was also manifested by the ancients; and Seneca has treated the subject at some length. The difficulty in obtaining remuneration has unfortunately rendered many physicians somewhat sordid, and loth to give an opinion unless paid for. In this they are unquestionably right, as gratuitous advice is seldom heeded; and one of the most distinguished practitioners used to say, that he considered a fee so necessary to give weight to an opinion, that, when he looked at his own tongue in the glass, he slipped a guinea from one pocket into another.

To consider themselves in proper hands, patients must incur expenses, and as much physic as possible be poured down. Malouin, physician to the Queen of France, was so fond of drugging, that it is told of him, that once having a most patient patient, who diligently and punctually swallowed all the stuff he ordered, he was so delighted in seeing all the phials and pill-boxes cleaned out, that he shook him cordially by the hand, exclaiming, "My dear sir, it really affords me pleasure to attend you, and you _deserve_ to be ill." Our apothecaries must surely meet with incessant delight!

The most extraordinary remuneration was that received by Levett, Dr. Johnson's friend and frequent companion. It was observed of him that he was the only man who ever became intoxicated from motives of prudence. His patients, knowing his irregular habits, used frequently to substitute a glass of spirits for a fee; and Levett reflected that if he did not accept the gin or brandy offered to him, he could have been no gainer by their cure, as they most probably had nothing else to give him. Dr. Johnson says "that this habit of taking a fee in whatever shape it was exhibited, could not be put off by advice or admonition of any kind. He would swallow what he did not like, nay, what he knew would injure him, rather than go home with an idea that his skill had been exerted without recompence; and had his patients," continues Johnson, "maliciously combined to reward him with meat and strong liquors, instead of money, he would either have burst, like the dragon in the Apocrypha, through repletion, or been scorched up, like Portia, by swallowing fire." But though this worthy was thus rapacious, he never demanded any thing from the poor, and was remarked for his charitable conduct towards them.

Various professional persons have sometimes endeavoured to remunerate their medical attendants by reciprocal services: thus an opera-dancer offered to give lessons to a physician's daughters for their father's attendance upon him; and a dentist has been known to propose to take care of the jaws of a whole family to liquidate his wine bill. One of the wealthiest merchants of Bordeaux wanted to reduce the price of a drawing-master's lessons, on the score of his taking his children's daubs with him to sell them _on account_. This arrangement, however, did not suit the indignant artist, who left the Croesus in disgust.

A singular charge for medical attendance was lately brought before the court of requests of Calcutta, by a native practitioner. He demanded 314 rupees for medicine alone, and in the items of drugs appeared pearls, gold leaf, and monkeys' navels!

In one of the old French farces there is an absurd scene between Harlequin and his physician. The motley hero had been cured, but refused to remunerate his Esculapius, who brought an action for his fees, when Harlequin declares to the judge that he would rather be sick again; and he therefore offers to return his health to the doctor, provided he would give him back his ailments, that each party might thus recover their own property. This incident was perhaps founded on an ancient opinion of Hippocrates, who frequently mentioned salutary diseases. In 1729, a Dr. Villars supported a thesis on this subject, entitled "_Dantur-ne morbi salutares?_" and Theodore Van Ween has also written a learned dissertation on the same subject.