Part 4

And here give me Leave to be serious, in examining their general Practice in all Diseases. Suppose your self to be troubled with any Distemper, it matters not which, for all is one to him you send to; upon his Arrival he feels your Pulse, and with a fix'd Eye upon your Countenance, tells you your Spirits are low, and therefore it's high time for a Cordial; the next Interogatory he puts gravely to you is, When was you at Stool, Sir? if not to Day, he promises to send you a laxative Clyster by and by; and if you complain you have a Looseness, then instead of one laxative, he will send you two healing Clysters: If besides you intimate a Pain in your Stomach, Back and Sides, then, responding to each Pain, you shall have a Stomach Plaister, another for the right Side, another for the left, and one for the Back, and so you are like to have a large Patch and well fortified round the Middle. Now before we go farther, let's compute the Charge of the first Day. There is the Cordial, composed by the Direction of some old dusty Bill on his File, out of two or three musty Waters (especially if it be towards the latter End of the Year, and that his Glasses have been stopt with Corks) _viz._ it may be a Citron, a Borrage and a Baum Water, all very full of Spirits, if River Water may be so accounted; to these is to be added one Ounce of that miraculous Treakle Water, then to be dissolved a Dram of _Confectio Alkermes_, and one Ounce of nauseous Syrup of July-Flowers; this being well shaked in the Vial, you shall spy a great Quantity of Gold swimming in Leaves up and down, for which your Conscience would be burthened should you give him less than Five Shillings; for from the meanest Tradesman he expects, without Abatement, Three and Six pence, the ordinary and general Price of all Cordials, tho' consisting only of Baum Water and half an Ounce of Syrup of July-Flowers. Your Clyster shall be prepared out of two or three Handsful of Mallow Leaves and one Ounce of common Fennil Seeds, boiled in Water to a Pint, which strained, shall be thickned with the common Electuary lenitive, Rape Oil and brown Sugar, and so seasoned with Salt; this shall be convey'd into your Guts by the young Doctor, his Man, through an Engine he commonly carries about with him, and makes him smell so wholsome; for which Piece of Service if you present your Engineer with less than Half a Crown, he will think himself worse dealt with than those who empty your necessary Closets in the Night; the Master places to Account for the Gut-Medicine (though it were no more than Water and Salt) and for the Use of his Man, which he calls Porteridge, Eight Groats. _Item_, For a Stomatick, Hepatick, Splenetick, and a Nephretick Plaister, for each Half a Crown: What the Total of this Day's Physick does amount to you may reckon. The next Afternoon or Evening the Apothecary returns himself to give you a Visit, (for should he appear in the Morning, it would argue he had little to do) and finding, upon Examination, you are rather worse than better, by Reason those Plaisters caused a melting of the gross Humours about the Bowels, and dissolved them into Winds and Vapours, which fuming to the Head, occasion a great Head-ach, Dulness and Drowsiness, and Part of 'em being dispersed through the Guts and Belly, discompose you with a Cholick, a Swelling of your Belly, and an universal Pain or Lassitude over all your Limbs. Thus you see one Day makes Work for another; however, he hath the Wit to assure you, they are Signs of the Operations of Yesterday's Means, beginning to move and dissolve the Humours; which successful Work is to be promoted by a Cordial Apozem, the Repetition of a carminative Clyster, another Cordial to take by Spoonfuls, and because your Sleep has been interrupted by the Unquietness of swelling Humours, he will endeavour to procure you for this next Night a Truce with your Disease, by an Hypnotick Potion that shall occasion Rest: Neither will he give you any other Cause than to imagine him a most careful Man, and so circumspect, that scarce a Symptom shall pass his particular Regard; and therefore to remove your Head-ach by retracting the Humours, or rather, as you are like to discern best, by attracting Humours and Vapours, he will order his young Mercury to apply a Vesicatory to the Nape of your Neck, and with a warm Hand to besmear your Belly and all your Joints with a good comfortable Ointment for to appease your Pains: The Cordial Apozem is a Decoction that shall derive its Virtue from two or three unsavoury Roots, and as many Herbs and Seeds, with a little Syrup of July-Flowers, for three or four Times taking; which because you shall not undervalue by having it brought to you all in one Glass, you shall have it sent you in so many Vials and Draughts, and for every one of them shall be placed Three Shillings to your own Account, which is five Parts more than the Whole stands him in; for the Cordial Potion as much; for the Hypnotick Potion the same Price; for your Carminative Clyster no less; and for the Epispastick Plaister a Shilling: Thus with the Increase of your Disease you may perceive the Increase of your Bill; and therefore it's no improper Observation, That the Apothecaries Practice follow the Course of the Moon. The third Day produces an Addition of new Symptoms, and an Augmentation of the old ones; the Patient stands in need of new Comfort from his Apothecary, who tells him, that Nature begins now to work more strong, and therefore all Things go well (and never ill;) but because Nature requires all possible Assistance from Cordials and small Evacuations, he must expect to have the same Cordials over again, but with the Addition of greater Ingredients, it may be Magistery of Pearl, or Oriental Bezoar in Powder, besides the Repetition of a Clyster, and the renewing of your Plaisters, for the Profit of your Physician, you must be persuaded to accept of a comfortable Electuary for the Stomach, to promote Digestion; of a Collution to wash your Gums to secure you from the Scurvy, serving at the same Time to wash the Slime and Filth from your Tongue; of a Melilot Plaister to apply to the Blister that was drawn the Night fore; of some Spirits of Salt to drop into your Beer at Meals; of three Pills of Ruffi to be swallowed down that Night, and three next Morning, which possibly may pleasure you with three Stools, but are to be computed at two Doses, each at a Shilling; the Spirit of Salt a Crown the Ounce; for the Stomach Electuary as much, for the Clysters as before; for your Cordial in relation to the Pearl and Bezoar, their Weight in Gold, which is Two-pence a Grain, the greatest Cheat of my whole Discourse; for dressing your Blister a Shilling; for the Plaister as formerly. Here I presume that Candour in you, as not to believe me so disingenuous, as to take the Advantage of Apothecaries in producing any other than the best Methods of their Practice, and that which favours the least of their Frauds, for in Comparison with others (though these are very palpable, in regard there is not a valuable Consideration regarded as a _quid pro quo_) they are such as may be judged passable; yet when you are to reflect upon the Total that shall arise on the Arithmetical Progression of Charge of a Fortnights Physick, modestly computed at about Fifteen Shillings a Day, without the Inclusion of what you please to present him for his Care, Trouble, and Attendance, I will not harbour so ill an Opinion of him, or give so rigid a Censure as your self shall upon the following Oration your Clysterpipe Doctor delivers to you with a melancholy Accent, in these Terms: Sir, I have made use of my best Skill and Endeavours, I have been an Apothecary these twenty Years, and upwards, and have seen the best Practice of our best _London_ Physicians; my Master was such a one, Mr. ------ one of the ablest Apothecaries of the City; I have given you the best Cordials that can be prescrib'd; 'tis at your Instance I did it, I can do no more, and indeed it is more properly the Work of a Physician; your Case is dangerous, and I think, if you sent for such a one, Dr. ---- he is a very pretty Man; if you please I will get him to come down. Now, Sir, how beats your Pulse? The Loss of your Monies your Bills import, give Addition to your Pain, through the Remembrance it is due to one that hath fool'd you out of it, and deserv'd it no other way, than by adding Wings to your gross Humours that before lay dormant, and now fly rampant up and down, raking, and raging; which had you not been Penny wise and Pound foolish, you would have prevented by sending for a Physician, who for the small Merit of a City-Fee (for which you might also have expected two Visits) would have struck at the Root of the Distemper, without tampering at its Symptoms, or Branches, and by Virtue of one Medicine, restor'd you to your former Condition of Health from which you are now so remote, being necessitated, considering your doubtful State, to be at the Charge of a Physician or two, to whom, upon Examination of what hath been done before, the Apothecary shall humbly declare, he hath given you nothing but Cordials; which Word Cordial, he supposes to be a sufficient Protection for his erroneous Practice; and I must tell you, that had his Cordial Method been continu'd in a Fever, or any other acute Distemper, for eight or ten Days, your Heirs would have been particularly obliged to him for giving you a Cordial Remove out of your Possession, and that through Omission of those two great Remedies, Purging and Bleeding, the exact Use whereof, in respect of Time and Quantity, and other Circumstances, can only be determined by accomplish'd Physicians.

I cannot better describe their Unaptness for so great a Work, nor express the great Difficulties that must be conquer'd to deserve the first Character of a compleat Physician, than in the Words of that eminent and learned Physician Dr. _Fuller_; 'It requires (says he) to understand the learned Languages, Natural Philosophy, all the Parts of the Body, and the Animal Oeconomy, the Nature, Causes, Times, Tendencies, Symptoms, Diognosticks, and Prognosticks of Diseases, the Indications of Cure, and contra Indications, the Rules of Errors of living as to the Six Non-naturals; we must have the Skill to judge to whom, for what, when, how much, how often to prescribe Bleeding, Vomiting, Purging, Sweating, and other Evacuations; as also to Opiates, Calybiates, Cortex, and the numberless other Alteratives: We must be very well acquainted with the Virtues, Faults, Preparations, Compositions, and Doses of Vegetables, Animals, Minerals, and all Shop Medicines; and lastly, to compleat all, must be able, upon every emergent Occasion, to write a Bill for a Patient, readily, pertinently, and in Form according to Art. Now to accomplish all this, a Man had need be rightly born, and set out by Nature, with a peculiar Genius, and particular Fitness, and with a strong prevailing Inclination to this Study and Practice above all others.

'He must endeavour with Diligence, Sagacity and Gravity, Integrity, and such a convenient Briskness and Courage as will bear him up, and carry him through Difficulties, without presumptuous Rashness or barbarous Hard-heartedness; and then 'tis necessary he should be a Man of a competent Estate, to answer the great Expence of Education and Expectation; for he must be brought up directly in it from the Beginning of his Studies in the University; he must lay out all his Time and Talents upon Reading, Advising, Observing, Experimenting, Reasoning, Remembering, with an unwearied Labour of Body and Application of Mind; he must run through Courses of Anatomy, Botany, Chymistry and _Galenick_ Pharmacy: And when he hath done all this, cannot handsomely compleat himself, except he see good Variety of others practise, which (by the by) it's probable he will have more Time for than he could wish, before he can get any of his own.'

Now each of those singly will require a great deal of Pains, Expence and Time to be attained; and yet all these and much more that can be in short summed up, ought to be done and in some measure accomplished, before a Man can be rightly and duly qualified even to begin Practice.

And as to Matter of Fact, few (very few, God knows) there have been, or now are, who tho' they spared not for Education or Diligence, ever work themselves up to a tolerable Sufficiency: Nay, _Hippocrates_ himself, that great Genius, is not ashamed to confess, in an Epistle to _Democritus_, That though he was now got to Old Age and to the End of Life, yet he was not got to the End of Physick; no, nor was _AEsculapius_ neither, the Inventor of it.

By all which, it's undeniably evident, that the Science and Practice of Physick is one of the largest Studies, and most difficult Undertakings in the World; and consequently, not any the best Collection of Prescripts that ever was, will, or can be writ or printed, can alone make a compleat Physician, any more than good Colours and Pencils alone can make a fine Painter. And yet every illiterate Fellow and paltry Gossip that can make shift to patch up a Parcel of pitiful Receipts, have the Impudence and Villainy to venture at it; and in hopes of a good Pig, Goose or Basket of Chickens, shall boldly stake their Skill (forsooth) against Mens Lives, and lose them; and at the same Time scandalize and keep out true Physicians, that might probably save them.

And this leads me to the third Consideration, The great Danger and Damage occasioned by the rash tampering of such as are not educated rightly and qualified for it.

You that enter not by the Door into the Profession, but climb up some other Way, ought to take it into your most serious Thoughts, that Mistakes and Mismanagement in so difficult a Business easily happen; often the Mischiefs occasioned thereby are impossible to be retrieved; and being upon the Body, perhaps Mind of Man, sometimes produce such undoing Misery, such deplorable Ruin, as would make even an Heart of Stone break and bleed, and Death to think of it. Suppose one should lose his Limbs or Health, and live unhappily in Pain, Sick or Bedrid all his Days through your improper Applications or ignorant Omissions; Would it not turn your very Bowels within you, and make you wish a thousand times you had never been that unadvis'd Busie-body to act thus foolishly and unfortunately?

But put the Case again: You behold a dead Man (which to me is the most lamentable of all lamentable Spectacles Upon Earth) I say, put Case a poor dead Man were laid before your Eyes, that your Heart tells you might probably have lived many a fair Year, had it not been for your physicking of him: Such a Sight, such a Thought, (if you have the least Humanity left) cannot fail to pierce your very Soul; and ever after the Remembrance, yea, the evil Conscience of it must haunt you and give you Horror and Terror, and a sort of Hell to your dying Hour.

Perhaps it may be an only and hopeful Son, in whose Life his aged Parents Lives were bound up; and they die too, or linger out a miserable Life in Sorrow and Anguish worse than Death.

Perhaps the good Father of a many little Orphans, who being poor and now helpless, must pitiously perish, or being fallen into bad Hands, and cheated of what was left them, may suffer Poverty, Contempt, Injury and Misery all their Life long.

Perhaps a Wife, who might have brought forth an useful eminent Man, a Hero of his Generation, and the Head of splendid Families; and so the Mischief you do may fall upon not only the present but future Ages.

But Possibilities and putting of Cases are endless, the Upshot of all this, if you take upon you to cure the Sick, and be not licensed and otherwise qualified for it, if you presumptuously thrust in your self, and bar out another that is authorized and able, though no ill Event chance thereupon, yet well it might, and was likely to do so for all you; and therefore good Providence that protected your Patient, and fenced off the Evils, is alone to be thanked, and you nevertheless to be blamed.

But if Death ensue your arrogant Intermeddling and pernicious Quackery, be assured of it, 'tis a sort of Murder in the Court of Conscience, and probably will be adjudged so in the last Great Court.

This is not my private Opinion only, but the Judgment and Decision of the Legislature of our Land; for the _Present State of_ England tells us, That by the Law of _England_, if one who is no Physician or Surgeon, and not expresly allow'd to practise, shall take upon him a Cure, and his Patient die under his Hands, this is Felony in the Person presuming so to do.

'Tis not enough for you to say, If I can do no Good, I'll do no Hurt, (which you may as well invert, and say, If I do no Hurt I'll do no Good) no, you interlope, you injure the Faculty, you discourage Education, you keep out better Advice, you trifle with Mens Lives, you lose the golden Opportunity, you prolong the Case 'till it gets head, and grows incurable and mortal, or else extremely hazardous and almost helpless; and this is doing Hurt with a Vengeance.

To bring this home to you, and make it more plain. If an House be on Fire, and you come and pretend to put it out your self, and absolutely keep off others, and then fling in Dust instead of Water, and so the Flame gets Mastery; in this Case, though you did not directly intend any positive Hurt, though you did not actually pour in Oil, nor stir and blow up the Coals; yet forasmuch as you would needs be an Undertaker, and could not extinguish it your self, and suffered not others, used to and skill'd in the Business, who coming with Water and proper Engines, might have done it, you are really and truly the Cause of it being burnt.

Think not to excuse your self by pretending you did it out of Charity, and meant well, though it fell out ill; no, no, be it known to you, such a Charity as did not appertain to you, and proved murderous, was unpardonable Presumption, and therefore will not cover the multitude of Sins.

If you are not sufficient for those Things, you'll do well and wisely to desist from this difficult and dangerous Practice, and fall into such a Trade of Life as you well understand and rightly can manage. And then like the Men who used curious Arts (_Acts_ xix. 19.) you may burn all your Receipt-Books; so shall you keep your Innocence, save your Conscience, secure your Quiet, and yet reserve Room enough to exercise your Charity.

For if at any Time your Heart move you to pity and succour a poor sick Neighbour that can't pay for Advice, there will be no Necessity that you should try your Skill upon him, 'till you mischief or murder him by way of Charity. Do but you send him a Physician, Medicines and Necessaries without Hope of Requital; and trust me, that will be an handsome Assistance, most nobly becoming a generous Mind and a charitable Man.

Now that not one of our Apothecaries, or indeed very few of our modern Traders in Physick, have these requisite Endowments, I shall leave it to any considerate Person to judge of; and how far they stretch beyond their Knowledge, we have a many miserable Objects in our daily View, woful Instances of their great Rashness, Folly and Ignorance.

That the Profession has sunk into the Craft of deceiving, and amusing, and making Profit by new Medicines, or useless Preparations brought into fashion, and highly esteem'd, as long as the Mode of crying them up shall last, and the Fallacy which imposes them can support it, the unhappy People suffer themselves to be deluded, and cheated of their Lives, and their Money. The Rich please themselves that they can purchase the Alexipharmic, which has Power to controul the Disease, and have not any Doubt within themselves, that by the often Use, their Lives become almost immortal; they look down with some small Pity on the Vulgar, who they think must die before them, being not able to pay the Ransom. They please themselves, because Health and Life are of the highest Demands for these Rarities peculiar to them. The Gentlemen of both the higher and lower Faculty have not been wanting to make use of the Credulity and Weakness of the richer Patients; and I shall now lay open to your great Surprize, that the most despicable and useless Stuff have been brought into the highest Esteem to be rely'd on in the most difficult and dangerous Distempers.

And _First_, of the _Bezoar_-Stone, an obvious Instance of our _English_ Practice, from whence you may concur with the Physicians abroad, with what Skill, and Art, and Integrity the Profession continues to be practised here.

_Bezoar_ (which has neither Smell nor Taste, and upon taking into the Stomach gives no Sensation perceivable) has held its Name and Reputation almost sacred with us, though exploded long since in almost all Parts of _Europe_. The _French_ are well convinced that they have been impos'd upon by the trading Physicians returning from the _Indies_, to take off the pretty Trifle at a very great Price; they had made it to be admired, by asserting that it was able to encounter Poisons, that no malignant Distempers were able to resist its soveraign Virtues; but their overdoing, spoilt their Market, the more curious and wiser Part of the Nation discerning the Abuse, had the Opportunity of promoting the Experiment, which they procured by the King's Command, two Criminals who had Poison given them, with Promise of Life, if _Bezoar_ could procure their Pardon. They lost their Lives, and the Physicians and the Stone their Reputations. The greatest and most learned abroad have freely own'd that they have been deceiv'd by it, but their Patients much more, who had used it without Success, and any observable Effect.

Doctor _Pauli_ tells you, he has left the Use of it many Years, and had given to better Purpose, the more powerful and certain Cordials taken from Plants; and supports his Opinion with the Suffrages of _Casper_, _Bauhinus_, _Casp. Hofmanus_, _Rectius_, _Fabricius_; The learned and judicious _Deemoebreck_ in his Treatise of the Pestilence, declares he had no Regard to it, that he gave it often _absque ullo fructu, movebat aliquo modo exiguum duntaxit sudorem_. It did, says he, no good to those who used it; scarcely mov'd so much as a little Sweat: It was of the best Parcel chosen of any coming from the _Indies_, or ever was sent to _Europe_, but gave them not the least Relief, though they had promised themselves the greatest from it: To confirm his Opinion that it is worth nothing, he produces the Opinion of _Hercules Saxonias_, and _Crato_ Physician to three Emperors, and refers you to many others. Doctor _Patin_, late Royal Professor of Physick in _Paris_, decides the Pretences to its being of any kind of Use: He says it neither stirs the Blood, nor puts the Spirits in any Motion; besides, some of the above-nam'd Physicians, he appeals to the Judgment of many others, and his own Experience of more than thirty Years. The lately corrected _Leewarden_'s Dispensatory leaves it out of their _Gascoins Powder_, condemning it as a useless and frivolous Ingredient.