things for being clear and plain; besides which, I am fully prepared to serve my kind at the price of a little discredit. I say this, because if it were not for the prejudices of the vulgar, there are other diseases which this treatment would suit." Pleurisy perhaps ! "The usual pomp of medicine, exhibited over dying patients, is like the garlands of a beast at the sacrifice." "2 In speaking of the treatment proper for epidemic coughs, after condemning the practice of those "who would force a sweat, and so think to terminate the cause of the disease," Sydenham makes the following observations :-"Nevertheless, it must be owned that spontaneous sweats often did good-more, indeed, than anything else. These, however, are very different things from forced ones. What is the difference between spontaneous and enforced perspiration? The former is or may be a symptom that a certain diseased action has terminated; that the good forces have vanquished the bad, this victory being demonstrated by what is called a critical discharge. The recovery and the perspiration were simultaneous; but the sweat was the consequence, not the cause of the recovery. If that were the case, then, indeed, to induce sweating with the purpose of cure, would be as sensible as to light bon-. fires and ring bells to secure, not to announce, a victory. This little sentence, which drops parenthetically, shows that Sydenham was questioning the whole theory of the evacuant or Hippocratic system of medicine. These evacuations, although they attended the recovery, he had seen to be unsafe and not conducive to cure. That disease must be got rid of in some way or other, and that the most obvious way, and the oldest―the evacuation of the mischief-making humours-was attended with great danger and difficulty,—to these conclusions Sydenham had arrived. Here follows the next step. Speaking of 1 Vol. II., p. 26. 2 Vol. I., p. 228. intermittent fevers, he says, "We must do one of two things; we must, by careful and anxious observation of the processes by which Nature relieves herself of this disease, draw indications as to the manner by which the incipient fermentation may be promoted, and the patient restored to health; or else, we must discover a specific. By the latter method we attack the malady directly.' Here is the alternative either, with Hippocrates, to observe and follow Nature, imitate her methods of cure, assist her to open gates, and build bridges for the enemy to retreat with as little loss to the country it has ravaged as may be; or, to march against the foe, and destroy it with a direct specific! Discover specifics! How? Bacon well observes that such discoveries are made, "not in years, but in ages." Sydenham has won immortal renown by his bold and intelligent use of one specific, discovered by accident from the tradition of savages, and introduced by Jesuit priests: how much honour would be due to a man who should not only discover specifics, but discover and disclose a method of their discovery? By Sydenham, at least, such a man would have been held in highest honour; for he observes, "I have ever held that any accession whatever to the art of healing, even if it went no farther than the cutting of corns, or the curing of toothaches, was of far higher value than all the knowledge of fine points, and all the pomp of subtle speculations,-matters which are as useful to physicians in driving away disease, as music is to masons in laying bricks." There is a society called by the name of Sydenham: let us hope it appreciates and imitates his independence and candour, and welcomes every improvement in the healing art, come from what quarter it may. As this old parliamentary soldier accepted a gift even from the hands of the Jesuits, let us hope that those who reign in its councils 1 Vol. I., p. 81. may never, by any exhibition of bigotry or intolerance, expose themselves to the bitter taunt of building up sepulchres to the memory of the prophets long dead, while they cast stones at their living descendants. ... In the following passage we have a broad intimation of what medicine stands in need of to improve its usefulness. It bears a striking resemblance to the words of Lord Bacon on the same subject. "Just as Hippocrates blamed those who, in their exceeding curiosity and officiousness, busied themselves more in speculations on the human frame than in practical observations upon the intentions of Nature, so may a prudent physician of the present time blame those who believe that medicine is to be promoted by the new chemical inventions of our day, more than by any other process whatsoever. To hesitate in our acknowledgments to chemistry for more than one valuable medicine, and for more than one method of satisfying the indications of treatment would be ungrateful.” . . . “The art is a useful one, but most useful when confined to the pharmacopaia. Blame, or if not blame, error lies at the doors of those who have so tortured and overheated their brains as to believe, that the chief weakness of medicine is its want of great and efficacious remedies, which nothing but chemical preparation will supply. Viewing the matter closely, we shall find it otherwise. The chief weakness of medicine is, not our ignorance as to the ways and means by which certain indications may be satisfied, but our ignorance of the particular indications that thus want satisfying. How I can make a patient vomit, and how I can purge and sweat him, are matters which a druggist's shopboy can tell me off-hand." ... "When, however, I must use one sort of medicine in preference to another, requires an informant of a different kind—a man who has no little practice in the arena of his profession.' 1 Vol. II., p. 172. Sydenham leaves his meaning a little obscure in the phrase, "when I must use one sort of medicine in preference to another; " but it is very probable that if he did not mean to limit its application to specifics, yet these medicines were pointedly alluded to in the passage. In reference to the meaning he applied to the word Specific, there is an interesting sentence in his observations upon the alleged specific action of mercury in the cure of lues. He maintains that in this mercury is specific only by producing salivation, and adds these significant words: “An indirect (mediate) specific it may be, but only in a loose sense of the term; just as I have hinted elsewhere, that a lancet is a specific to a pleurisy. The bleeding cures the one disease, the ptyalism the other." The knife, according to Paracelsus, was the specific for the stone, blood-letting for mania. Sydenham had advanced from Paracelsus to Bacon and Boyle. He no longer used the term specific to signify a medicine which cured a disease with more or less of certainty, but wished the name to be restricted to a medicine which cured a disease directly, without the intervention of any evacuant or revulsive process. Specific medicine is, in his eyes, something wholly different from either Hippocratic or chemical medicine. In the following passage, Sydenham expresses the hope, not only of finding accidental specifics, but of inaugurating a specific method of treatment. "Before I come to a close of this discussion, I must notice that whatever has been said concerning the duration of autumnal intermittents, and whatever has been said concerning the time required for the despumation of the blood, apply only to the recorded operations of nature, under the influence, and with the support of the common-place and usual medicines" (what we should now call the allopathic). "By no means do I wish to express myself as if wise and learned physicians were to despair, as if they were to think out no better modes of treatment, and as if they were to throw away the hope of discovering nobler and more potent medicines for accelerating the cure of disease. So far am I from this, that I do not despair of finding out, even myself, some such medicine and some such methodus medendi." This method of cure-the expression is important is by specifics. Of these, the only one Sydenham knew was the Peruvian bark, and this one he employed with greater skill and success than any of his contemporaries, with the exception, always, of the quackish Dr. Talbot. - The reason of his superior success is given in the following passage: "It seems to me better to imbue the blood with the aforesaid drug (Peruvian bark) moderately, gradually, and at long intervals before the fits, than to attempt, by a single blow, to cut short the paroxysm." To find out specifics, and to give them "moderately, gradually, and at long intervals!"-Surely we are entitled to claim the English Hippocrates as the herald of the new system of medicine which is now developing itself, two hundred years after this was written. Nay, he even seems to have anticipated the objection most commonly made to the homœopathic method; for he observes: "As to the man who accuses my remedies of being simple and inartificial, I may accuse his manners and honesty in disliking that others should be so, when, for his own part, he would be glad that himself, his wife, or his children, might in case of sickness be cured by even the most contemptible means. Such a trifler de ceives himself. "Equitans in arundine longo." The pomp and dignity of the medical art is less seen in neat and elegant formula, than in the cure of diseases."" There is one passage, and but one, where Sydenham stumbles over the homoeopathic formula in an inverted 2 Vol. II., p. 181. 1 Vol. I., p. 88. |