THE Present Uncertainty IN THE Knowledge of Med'cines, IN A LETTER TO THE Physicians in the Commission for Sick and Wounded Seamen.
With a Postscript to Physicians, shewing the Necessity of a True Theory of Diseases.
By
W. Corkburn,
M. D. a Fellow of the Royal Society, and of the College of Physicians of
London.
Qualitates Ignoramus in Physicis, & illud Vocabulum
Qualitas
ne quidem Nominandum est; quippe Res Evidentes majoribus difficultatibus involvit.
Hann. Meth.
Cogn. Veget. Simp.
LONDON:
Printed by
R. J.
for
Benj. Barker,
at the
White-Hart
in
Westminster-Hall;
and Sold by
J. Nutt,
near
Stationers-Hall,
1703.
THE PREFACE TO THE Physicians in the Commission for Sick and Wounded Seamen.
Gentlemen,
THE World, I know, will admire what Merit of yours should obtain you this Address; but their Curiosity will be satisfied when they are told, that your Pretences on this Head are very great and singular.
You pretend to be compleat Masters of all the Qualities that ever were found about a Med'cine; and that you never fail to determine all its possible Actions by this Infallible Light.
If this proves not a sufficient Apology for me, you your selves must find a better.
Indeed the former Disappointments that Sedulous Inquirers have met with already in this Way, were enough to discredit my Assertion; but especially that such Abstruse Methods are possest by People who are as unknown as they have endeavour'd to be otherwise; but in that you must give them further Satisfaction. 'Tis enough for me to have made this part of the Discovery, but you must tell them more.
For this Trial, I do not give you the Mystery of a
Nostrum
to resolve, neither have I put stranger Drugs into your Hands, nor some foreign Root that came but lately from the
East-Indies,
No, I have first given you a Bark that is the most Excellent of any Med'cine for the Disease it is to Cure; which owes its Discovery to wild Indians, its Ʋ se in
Europe
to Churchmen, and its Re-establishment, after the Malice of Physicians to destroy it, to an Empyrick, and which now Triumphs in this next Age with the great Applause of Physicians; tho' their Predecessors wou'd never submit to the Conquest; nay, its Native Strength equals at least the best Preparations of it, on Purpose to show how it rais'd its Reputation in spite of the Fathers, and will have no farther to do with the Sons than to receive their Submission. And I am asham'd to think how little Thanks Men owe us that have hinder'd them so long from the Benefit of so great a Good: But the following Story does prove how well we are satisfied with the Thing, and how still we have neglected such Discoveries that might assist us to give it to more Advantage. But it is this you put us in hope of being instructed in by you.
The Preface.
I shall say no more of the other Two Instances I give, than that they are of an Older Date than to bear any Exception against our Opportunity of making Experiment about 'em.
Yet while I clear my Examples from Objections that may be brought against their Propriety of being such, I am sensible how ready some People may be to object against my thus exposing the Ʋ ncertainty of Med'cines; but one Answer may be, that it is in order to our arriving at a greater Certainty: But next, who but such
Pretenders
ever wou'd have the World think that our Knowledge of them is Infallible? Don't the frequent Attempts, and as frequent Disappointments, of worthy Physicians, Prove this very Ʋ ncertainty: Some indeed have attempted Med'cines by their
Qualities,
and have all miscarried in the Enterprize; but these Gentlemen, who promise n
w to attempt, and I wish they do not fail in that. Other Physicians have tried to dissect Bodies for the very Parts of their Composition: But a Noble Gentleman, well skill'd in all these Trials, has sufficiently destroyed that Pretence in his Sceptical Chymist; and it was only this Gentleman who was the best able, as well as the most proper Person, to do it.
But if the Strength of this Objection is conceal'd under the fear of discovering so much of our Weakness to the World, the Argument is as weak as the Defence of it is unworthy of a Man. A Cheat has the worst Grace upon a Gentleman of any thing; and I am convinc'd that both Physick and Physicians have really suffer'd more by the modest conniving at such Tricks of Pretenders, than ever they can suffer by this Frank Declaration of mine. This is the Foundation for Quacks and Mountebanks, who know no better where to set up for a Character. Men of Learning go quite another Way to Work; they do not apprehend their being esteem'd to know nothing except they pretend to know every thing: Their reasoning is quite the Reverse of this. They say that there are some things of which they know nothing at all, and these are these first
Qualities,
or
Physical Causes,
these Gentlemen know so perfectly wel'. Some things they know but Probably, and among them may be the Doctrine of Med'cines: But some other things they know Demonstratively, and among them are some things about the Theory of Diseases.
From all which I shall observe,
First,
That
the Knowledge by Qualities is as Vain as it is an Ignorant Pretence.
And, 2dly,
That they who set up on this Foot, know nothing at all, not so much as where to lodge their Pretence: And they are a People who commonly Practice Physick with a Contempt of all Theories of Diseases, and you see they do it with an absolute Ignorance about Med'cines.
THE Present Uncertainty IN THE Knowledge of Med'cines.
BEfore I come to Prove the Charge of Uncertainty on our Knowledge of Med'cines, 'twill be Necessary to lay down some Rules that may be Useful in examining the Matter of Fact. And these shall be taken from the Descriptions of the Two different Sorts of Knowledge a Physician is said to have;
viz.
Experimental and Scientifical; or, a Knowledge of Experience and Science. By knowing the Virtues or Powers of Med'cines in the First Way, we know that such and such Med'cines are Recommended for, and are good or bad in, Particular Diseases, and different Circumstances of the Distemper, when either they have good Success, no Success, or an ill One. This is the lowest piece of Knowledge that can be expected from Physicians.
Or, Secondly, If by many such Experiments we should discover what Action it is in any Med'cine, whereby it produces its Proper Effects, so as to be able to deduce the good or bad Effects it will have, as so many Corollaries from the Knowledge of the Action, That wou'd be as Noble a piece of Science as Physick can be supposed to admit of, and wou'd contain all that is Necessary.
Having premised the Descriptions, which are the Rules in the ensuing Trial, I shall begin with all the Distinctness and Brevity imaginable.
But since the Bounds of a Letter will not allow me to try every single Med'cine by it self, or indeed every Class of Med'cines in general; yet 'twill be more to your Satisfaction if I Prove it by Two or Three Examples of Med'cines, that are either most in Use, or that produce most constantly the same Effects, when the least Caution is had about 'em, and are in every one's Hands; and if I can Prove our Knowledge of them to be just nothing, and that it does not so much as arrive at the First Description or Experience, I may Presume to conclude the like Imperfection to be, at least as great, in our Knowledge of Med'cines, that are not near so frequently used, nor that have not, by far, so certain and constant Effects; nay, whose Effects are most unconstant in the best Hands.
The First Instance of this Imperfection shall be of the Jesuits Pouder; a Med'cine that every one must own to be the best for Curing intermitting Feavers; and with that Certainty, that no other known Med'cine can do the like in this or any other Disease; for it generally Cures, not only in the Hands of Physicians, but e'en in those of Quacks, and Nurses, by whom it is given with no manner of Judgment or Discretion.
Yet even this Pouder has been wanting in its Success, and Agues have been known sometimes to stand their Ground against many Charges of it. This is evident sometimes here; but too often in
Virginie.
'Tis known that by the taking of it, safe intermitting Feavers have been changed into those that are continual; which are far more dangerous, and whose Event is often very doubtful.
And it is very surprising that this Turn of the Disease is not always in the same manner; for by Jesuits Pouder Agues have degenerated into unweildy Rheumatisms, or a lazy Jaundice; nay, sometimes it has terminated in a sudden Death.
These are strange and unconstant Effects of Jesuits Pouder. It Cures an Ague the best of any thing; it turns the Patient sometimes out of one Disease into another; and sometimes it kills him.
But this is not all; it will sometimes make him Costive; it Purges him; it Sweats him; yet it never has been ranked among Med'cines of these Sorts, but once to Disparage it.
And this is the Rare Med'cine which Cures us so suddenly, that it seems to Operate almost like a Charm, that yet has such strange, tho' seldom, ill Effects in the Cure of the same Disease. But since different Conditions and Circumstances make all the Variety in this Affair, as well as in every thing else, Physicians ought to be very Industrious to find out what are the Conditions in this Case, where we find such considerable Turns in Administring this Excellent Med'cine. For, perhaps if they were known, they might be avoided; at least, if a Cure is to be had by any other Med'cine, that rather is to be tried; and it is at worst better not to attempt a Cure, than certainly to Kill.
'Tis to be thought, that if all, or any, of these ill Accidents that happen by using the Bark had often been observ'd, that no Rhetorick cou'd induce the World to persist in taking it; yet since they have happen'd, they may happen again, and indeed every Day; it may therefore be thought very Expedient to know how either to give it so as to avoid Danger and Mischief, or else to know when the Proper Time is when we are not to give it at all.
It was for want of this Knowledge the Bark lost its good Name, when Sir—
Ʋ nderwood,
Mayor of
London,
died by taking of it, whose untimely Death did so terrifie his Relations, that no friezing or fryings of an Ague can ever be strong enough to force them to take it.
Now since there is so manifest Uncertainty in the Practice of this Excellent Med'cine; besides the Danger of being killed; it must be own'd that there ought to be a good deal of Discretion had when we use it. And he who is possest of this Discretionary Knowledge, must be able to know, not only that it is uncertain, but this must be warranted by my First Rule: He is obliged to know what Appearances, what Conditions, there were in the Disease; when the Bark Cured, and when it did not Cure; as also when One got a Jaundice by it, and a Third died. But if he has no Knowledge of those Times, he is under a vast Uncertainty in every Patient; neither does he know whose Cure or Death he is carrying on with the greatest Assurance, tho' he Practice with the best Med'cine.
I wou'd advise those who think they can Answer for this Sort of Knowledge, to try their Strength by the Second Rule I proposed; but it is Time enough to do that when I find my First Request answer'd. Indeed by this Rule we have the most delightful, as well as the most useful, piece of Knowledge imaginable; for by it we might know what the Uniform Action of the Bark is in it self, whereby it Cures an Ague, and we shou'd be able to deduce these Mischiefs that are already observ'd, as so many Corollaries from the Condition of the Disease; nay, by it are we made capable to suspect all the probable Dangers that can be, or perhaps have been, tho' they have escap'd the Caution of the Observer.
These related Misfortunes that have happen'd by taking the Bark, are not the Calumnies it stands charged with by its bigotted Enemies. There are many more; but these I have named have happened to many Candid Practitioners, and the most of 'em Recorded by that Excellent Physician Dr.
Sydenham.
But what can be said to the Pother had among many Authors about its under Actions of Purging, Sweating,
&c.
when they have Industriously past by so Considerable Effects of this Med'cine.
All the Use I make of this Argument for the Present, is to shew you that the Knowledge of Med'cines is as Obscure and Difficult as any thing else in Physick, notwithstanding of a common Opinion we entertain about their Certainty. And this I think is very manifest by this First Instance; because our Knowledge of the best Med'cine which answers Expectation most constantly, and is more us'd than any one Med'cine, is very obscure, and just nothing at all.
This Argument might be pursued as Successfully in every one of the Med'cines that are most Familiar to us. In all Evacuating Med'cines, as well as in those that produce no Evacuation, but are considerable for some great Effect of another kind; but so Particular an Aggravation is by no means Necessary, neither does the present Occasion require it. I shall content my self with an Instance or Two more, which will be sufficient to Prove my Argument about the real Uncertainty of Med'cines.
The next Example that I bring is of Opium; and I cannot help thinking it thus Uncertain, notwithstanding of the late Endeavours of some Ingenious Authors, being there is not full Satisfaction given about its way of producing Sleep; and far more hardly are we prest when we endeavour to account for its Action when it hinders us from Sleep, and makes us Delirous.
Moreover, Opium is observ'd to give a Check to all Sorts of Evacuations; yet great Evacuations have been known to be made by it.
'Tis noted for either relieving us of Pain, or at least giving an agreeable respite from it, though great and torturing Pains have sometimes been felt upon its Account: I mean not only those Headachs, and Pain at Stomach, it often occasions, and that are felt after its sleeping force is over; but even some that come at first taking, and that beyond all Patience, and almost to Distraction; yea, these Pains are also produced by every thing that makes Sleep, as well as by Opium, or any Preparation of it; and the more Obstinately we persist in that quieting Design, to greater Degrees we augment the Torture.
Besides all this, Opium is not like other Med'cines so easily dos'd; and an exceeding quantity has worse Consequences than any other Med'cine whatever. Nay, sometimes when we wou'd give it to good Purpose, it is Necessary to give Three or Four Grains at once, withour our coming Cautiously, and by Degrees, to that Quantity; or that it is given to People who have been long accustomed to take it, (all which Considerations alter the Case perfectly), yet there is nothing more Certain, than that Three Grains have laid People of a proper Age into an Eternal Oblivion of this World; tho' the World should not forget him that gave it.
Now who wou'd not Purchase at any Rate a good Night's Rest, after watching many Nights, and a long
Vigilia?
Who wou'd not rid themselves of Troublesome Pains, and uneasie Evacuations, by taking Opium? But if the Danger that possibly may come by it was ever imagin'd, how equal might the Dispute prove about taking of it on any of the mentioned Designs; but especially if the Operation of this Med'cine shou'd fall short of it; nay, if the contrary Effects were ever suppos'd to happen. We ought to suppose at least that a very Extraordinary Pilot ought to be made Choice of, to guide us where such Hazards, and Things of so great a Value, are; and more where our Persons may be fatally concern'd.
And therefore let any One who pretends to be familiarly acquainted with this Pacifick Med'cine, examine himself throughly by the Rules I have laid down, and rest satisfied with nothing less than his being qualified by the First.
I confess it is strange enough to hear Men Boast of a Certainty in Med'cines, such as requires no Direction from Reason to Manage beyond their Skill; and yet such considerable Doubts to remain at this Day about a Med'cine of so manifest Effects, and of so great and ancient a standing. Wherefore it is manifest how proper an Example this is to Prove our Imperfection about the Knowledge of Med'cines.
But no less an Imperfection may perhaps be found in another Ancient Method of Curing, which commonly is the utmost Skill, and last Resort of a Doctor, after other Experience and Med'cines have been practis'd to no Purpose. And after so Honourable a Mention made of a Method, every Body must think it is only Proper to the
Bath,
as indeed I intend it. I must not be thought to Depretiate either the bathing or drinking of Waters at
Bath,
which I do by no Means. On the contrary, I have a valuable and just Esteem of 'em.
Only I do say, that this useful and ancient Method is far from being so sufficiently known, that we are able to reap all the Benefit of it, or to avoid all its Mischiefs, as shall be made appear immediately by Particulars.
As to its Antiquity, 'tis believed that People applied themselves to it for Relief in their Maladies before the Romans were much known in
Britain;
yet if we compare what has been said of 'em, either as to their Warmth or Medicinal Effects, by Ancient or Modern Writers, we shall find how little these have improv'd what the former asserted.
Cambden
informs us how Old
Necham
has conceived the Observations of his Time about these Waters, for their Use.
Conf
cto profunt balnea nostra seni,
Prosunt Astritis, Collisis, Invalidisque,
Et qurum Morbis Frigida causa subest.
Then he, and most Moderns after him, assign this Reason for the Heat of these Waters.
S
d quid? Sulphurcum novimus esse locum.
At present I am not bound to make all Proper Inquiries about the
Bath;
but in general, I will first observe how disproportionable the Fame of the Cures it has work'd are to its long standing, and great Character given it by some Men. And, 2dly, The extream Changes its Reputation has suffer'd in that Tract of Time: 'Thas often been esteem'd a
Panacea,
and too frequently thought good for nothing at all. And from both these Observations I conclude, that if a moderate Knowledge of this Method had been join'd with half the good Uses of these Waters, they never cou'd have had so great Ebbings in their Fame.
But to be more Particular; 'tis certain, that though Sulphur impregnating those Waters, is told us to be the Cause of their Heat; yet our Knowledge of this Method of Nature is so very obscure, that we can neither imitate her in medicating Waters after that manner; nor by any Means make other Waters Serviceable to like Purposes. Wherefore it is also manifest how Insignificant our boasted Knowledge is, and to how little Purpose our Trials of 'em have been.
I know that there are Authors that Prove, and sufficiently enough, that those Waters contain more Substances than Sulphur; but the Difficulty remains the same,
mutatis mutandis, viz.
by taking the known
Compositum,
as I took Sulphur singly in the Argument.
But further, if I should suppose that either the single Ingredient of these Waters, if there is but one, or a determin'd Quantity of Ingredients, if more were known; yet it is certain we should be still Ignorant of their Operations, if we know not the Effects of these simple Substances, which being mixed with the Waters, give 'em their Medicinal Qualities; and the Difficulty wou'd always encrease, when we were to account for their Combination. This is manifest from the Affair of Jesuits Pouder, i.e. it is manifest that if the Particular Ingredients of these Waters were in Substance and Quantity as evident to us as the Substance and Quantity of Jesuits Pouder, yet our Difficulties shall still remain unsatisfied, except we knew more of the Nature of these Substances, that are the
Composita
of the Waters, than we know of Jesuits Pouder; and I think we know less, and by Consequence less also of the Waters, even supposing we knew their Composition.
But let us suppose that the
Bath
is good for decay'd Old Age; for People that are Lame, and those who labour under a Disease from a Cold Cause; yet our Knowledge about the
Bath
must remain Uncertain, if we are not able to justifie our sending People thither on other Accounts, for Reasons not yet assign'd; and if we cannot show that Effects quite contrary to those it is noted for have not happen'd, with the Particular Circumstances of the Case.
Instances of the last Sort are adduced in a good Number by
Bath
Doctors; and though possibly the Crutches that hang there may not be the Martyrology of the
Bath,
as Doctor
Willis
wou'd have it; yet they are confess'd not to be the Trophies of its constant Success. But it is most certain that we have not conveyed to us the Failings and cross Successes which are absolutely Necessary for the smallest Degree of Certainty in this Affair.
Perhaps the sending People for all Diseases may be alledg'd for its great Use: And I do Concur with them who say so, though I think very meanly of the Judgment of the Physicians who do so; and am Positive, that how soever excellent the
Bath
may be, that it neither is Infallible, nor a
Panacea;
but that it will always want a suitable Direction, which will be the more Infallible the greater our Knowledge is.
But the Weakness of our Understandings in this Particular is but too manifest by some Facts I shall Adduce.
For we know that many People who have been forsaken in the Jaundice by their Physicians, have yet found their Health at
Bath,
though the
Bath
is accused for bringing the Jaundice upon a great many.
It has been the common Complaint, especially for these Two or Three last Years, that a vast Number of People have got Rheumatisms at
Bath;
it is notwithstanding most incontestably True, that great Numbers have got rid of Rheumatisms there.
Many more Examples of other Diseases might be brought to Prove this Thing, besides the sudden Deaths that have happen'd there; and yet I am apt to believe that it is very hard to account for these Accidents, even by my Rule of Experience, which but too sufficiently Proves the great Imperfection our Knowledge lyes under in this very Matter, of the most ancient and useful Method of the
Bath.
But I am asham'd to think that this ancient and useful manner of Bathing shou'd begin to be so much neglected, as if it neither wanted, or did not deserve our improving. No manner of Consideration is had about making it have its best Use, which is so little known, that some great Physicians are scandalously Nice by giving the Waters by Spoonfuls: As if Old Experience was to be laid aside to make way for such as they wou'd call New.
What Considerations are rais'd about
Bathing?
What Inquiries are made about our being
Immerg'd
in Water? What Questions are ask'd about its
entering
or
not
entering our
Vessels?
And what
Effects
it may produce by
mixing
with the Liquors in 'em? And, Lastly, what may the
Difference
be in being Immerged in
Hot
and
Cold
Water?
These Considerations are not only Fine, but Useful, and wou'd soon make us Masters of all that Affair. 'Tis sure a Masterpiece of Impudence to pretend to a Knowledge very Particular of any Bath, and to remain Ignorant of these Particulars I have just mention'd; nothing can be more strange, except the setting no Value upon such Inquiries, as those Pretenders are very ready to do.
But not to press this Argument any farther, I may be apt to think that there can be no manner of Doubt about the great Imperfection of our Knowledge in respect of Med'cines; and how Inestimable a good it wou'd be to be brought out of this Infirmity.
But,
Gentlemen,
to put an End to this Matter, I have not only given you Med'cines of most ancient and common Use, but I have but just nam'd such of their Effects as are recorded by the best Authors; and which consequently cannot probably be false. 'Tis therefore your Business to give Satisfaction to these Examples I have Adduc'd, and that by your Quality-Method of
Hot
and
Cold, Red
and
Yellow, Acid
and
Alkaly,
by
Taste
and
Smell, &c.
or because you love high Flights by the
Causes
of these Qualities; yet if you have any Regard to my condescending to give you a lower Method, I Challenge you to give such Proofs in Point of Experience that may assist our administring them in Practice.
But while I speak to your Method of Qualities, I must inform you how Ignorant your Pretence is in this Particular. You pretend to determine the Power any Med'cine has to Cure a Disease only by knowing some of Its Notable Qualities, which is manifestly false; because there is scarcely one Disease that has not Med'cines of opposite Qualities found useful in its Cure, and recommended to us by our Forefathers as such.
This is a Digression, but not an improper one; yet to proceed; is the previous Knowledge of a Med
cine, or of Med'cines, by its or their Qualities, necessary before we Administer them? And have you this kind of Knowledge? If you have, show it us, for it is much wanting. If you have not, then require no more of others than you your selves are Masters of; and order as few Med'cines for the Publick as you do to Patients; and none to either of 'em till you have satisfied us that you can do it in the mentioned Way.
But if you have any tolerating Method whereby you wou'd justifie your administring Med'cines in your Probation Time, do as you wou'd be done by; share your Freedom to others of your Brethren, who are at least in no lower a form of knowing than you be.
And if you have a special Rule whereby you can prefer the Use of one Med'cine to that of another, for the Cure of the same Disease: If you have,
viz.
any Method for which you wou'd rather give Jesuits Pouder for the Cure of an Ague, than any of the other Med'cines recommended for the same: Let us have this your Method of reasoning; for it may be so extensive as to comprehend more Med'cines in this and other Distempers.
I know the Trite and Common Methods among Philosophers, and all Mankind, is first to know if a thing is so, and then how it is so if we are able to compass it; but if they should not get this length, you must reckon those little better than Mad-men that deny the actual Existence of a Thing, because we do not know the Way of its Being. And but justly, because it wou'd have us disbelieve our Senses, and the Senses of all Mankind; because we cannot answer some Questions that are, or that happen not, to be the Objects of our Senses, and are too fine for our Understanding. So that in the Trial, if a Man, or a Thing, is, or does, such an Action, or produces such an Effect, we must judge of these Changes by our Eyes and other Senses, or take them upon the Testimony of Honest Capable People that relate them, if we were not there our selves. This is the Way of the World, and I shall not enlarge upon it, to avoid Scandal: Tho' so much I must say, because you and your Friend have so boldly unhing'd all these common Ways of judging of past Actions, that I am not able to go further with you, till you have inform'd us more in those new Methods; yet whether you will do it or not, depend upon it, a Time may come wherein the World shall be informed how you use their old ones in Matters of the greatest Importance.
Thus I bid you Farewel, knowing to how little Purpose it wou'd be to invite you to the following Discourse. For you never once dreamt of any such thing; and your proper Talent is to Snarl in a Corner at so Generous Attempts.
A Postscript to Physicians about the Necessity of a true Theory of Diseases.
I Continue the Discourse to you on this Subject; not but that I am sensible how seriously
many
of you think of this Matter. And that even they who Calumniate you on this Score, do themselves pretend sometimes to reason about this Affair; tho' at the same time they endeavour to perswade the World, that all Reasonings of this Nature are Vain, and but so much Time lost to the improving of Practice. You are sensible how they assume the quantity of Blood in a Man's Body given, and then do determine the Numbers of its Circulations in a certain Time: So you find, that howsoever they depreciate reasoning in your Case about things of Physick, they are very fond of the Character of Men of Reason for themselves; nay, you find they apply
Arithmetick
too, and therefore it is not reasoning they are angry with, but that your Reason and Arithmetick is better than theirs.
After the same manner they being told how Barbarous Indians Cure Yaws with
Guaiacum,
do immediately extend its Use to the European
Pox,
and from that to
Leprosies,
&c. This is in the Nature of Man to do; but it is the highest Ingratitude to Calumniate People that offer them more of such Med'cines, or that wou'd teach them more natural and righter Methods, whereby this extending of their Knowledge may be more usefully brought on.
And therefore it is that I wou'd perswade you to bear up against the Calumnies of these ill Men, and continue to do good to Mankind, by improving your Profession. Be Diligent in your Enquiries about a true Theory of Diseases; for it is even by that you shall be greatly assisted in ascertaining your Knowledge of Med'cines; and by that you shall be brought beyond what Chance has put into your Hands.
Besides, if Med'cines were as certain in their Effects as our Hearts could wish, they can do but little good without a true Theory of Diseases; but especially in respect of the good they do, when assisted with it. And therefore I shall take Leave to press this Argument a little farther to you than it is commonly done.
The first of these is very manifest to those who have thought the least on that Subject; and I believe some time or other I may be able to give some Light into this Abstruse Affair.
As to the 2d Particular, we find the whole World on our side in the main; for to what Purpose should an Infallible Med'cine serve, if we knew not the Disease it Cures, when it appears upon us or our Neighbour? Supposing,
viz.
it were as great a Difficulty to know an Ague in
general,
as it is to know it in
all
its Circumstances, 'tis certain that this Excellent Med'cine, the Jesuits Pouder, should be of very little Use to us.
So far I may be thought in the right; but next, no general Description that is almost possible to be made of a Disease, can be of sufficient Use to us in administring our Infallible Med'cines, because we are not always improperly Sick; but as a Distemper at one Time may Kill us, yet it may Cure us of some other Disease at another: And if this is possible, it is evident to every Common Understanding, that the more surely any Med'cine did promise the overthrow of a Disease, with the same certainty it brought along the impending Fate of the Sick Person. If Diseases thus sometimes Cure others that afflict us; and if we only want to have them describ'd in order to apply our trusty Remedy, as it is suppos'd: It is most manifest that we do really hinder and obstruct a perfect Cure of a Disease that should be dismist by some other, if we did not endeavour to remove this curing Disease by a faithful Med'cine; and yet, perhaps, we rid our Patients of neither of them: Nay, the more Powerful and Infallible the Med'cine is that we Employ, the more do we put it out of the Power of Nature, or the Strength of Constitution, to conquer the afflicting Distemper, and the more
Noxious
Remedy. So that here appears a mighty Paradox, that one Disease should prove a Cure for another, and yet we never shall be able to know when one Disease will be the Cure of another, but by a true Theory of Diseases, which by most is ridicul'd, and neglected by too many.
Hippocrates,
and all ancient Physicians, especially, have fully prov'd this Paradox by their repeated
Observations;
and neither have
they
failed in their Truth among more Modern Physicians, who have thought observing of any Use. It will not be amiss, I presume, to give some Examples of this Matter: and those shall be of that Nature, that the Diseases I shall name do most especially require the quickest Aid, and the most certain Ways of Curing; yet if even they are the Cures of other Diseases, this whole Matter must be true without Exception.
Feavers, Dysenteries, Dropsies,
&c. are of this kind; and who wou'd not wish for an unerring Specifick for their Cure? Yet
Hipp.
says, That
if a Feaver comes upon one afflicted with Convulsions, it Cures him of that Distemper;
and therefore whosoever does attempt to banish this Feaver with his Trusty Med'cine, must, according to his Success, either entail this Disease on his Patient, or destroy him altogether, if Nature is not able to baffle both the Curer and the Disease.
The same
Hippocrates
exhorts us not to despair of a
Maniacal Mad
Person when he
begins
to have a
Dysentery,
or a
Dropsie,
but to
hope
the better of his
Recovery;
and therefore if any one observing the approach of any such Disease, should turn to his Receipt book for a Cure, and should be happy enough to have an Excellent Med'cine for either of 'em, must be the more mistaken in the Success by the Sinistrous Application; for he does with great Certainty confirm the Madness on his Patient.
Moreover, great Vomitings, which are not only of fatal Consequence, but at once cut off all Hopes of succouring languishing Nature, do require the speediest Care of the best Physician, and the most Infallible Methods; yet these are sometimes of great Benefit when they come in the latter end of a
Lcoseness
of a long continuance, as the same
Hippocrates
assures us, and constant Experience does vouch. And therefore, tho'
Dysenteries, Feavers, Dropsies, Vomiting,
&c. be Diseases that can of themselves bring Life to its final Period, and do justly require our utmost Study to discover their Nature, and to find out the best Methods and Med'cines for Curing 'em; yet they come sometimes as the best and most speedy Remedies for some other Distempers, which perhaps have already baffled all other Methods already, besides these Diseases that thus Cure: And there being no other Means left to shake off the Distemper, it must still continue to be dangerous, if the unhappy Curer has Success enough to baffle that Healing Disease; and thereis no Possibility of knowing a fatal Distemper from the
same,
when it is to prove a Cure, but by knowing the necessary Productions of Diseases, and the particular Conditions of Human Bodies, in which they are produc'd,
i.e.
by having a true Theory of Diseases. Wherefore a true and an accurate Theory of Diseases is the most necessary Thing for advancing a Physician's Knowledge for Curing Diseases.
But, 2dly, This Argument holds very strong in respect of Idiopathical and Sympathical Diseases; for most frequently the Distemper that makes the greatest Figure is most taken notice of, and frightens us the most, is very dependent, and is supported by a very small Cause, and yet it will continue frightful and threatning so long as all our Applications are for this fearful Part; and its inconsiderable Cause remains unregarded, except in midst of this Bustle the Mi
ute Occasion passes off of it self, very much to the Reputation of the Malignant Curer, tho' little is added to the Stock of Physick. There be Thousands of Instances to prove this Thing; but I shall be satisfied to adduce One, because it is Evident, and of great Use, when extended to all its Length, and that it fully proves all I have said on this Head. The Example is this Case of One, who having a Wound, there may be a very moderate Pain, and a Generation of
Pus,
and with this there will be a Feaver more or less to the Causes. This Feaver may be improv'd by a Feaver-Doctor, that the Suppuration shall miscarry, and the fatal Feaver get a mighty Strength: Whereas if he is less frightned with this Common Feaver, and has Patience or Art to suffer the Suppuration to proceed, or to promote it by various Methods, his Fears will vanish with the Feaver, which assuredly goes off in that order that the
Pus
does take place.
This Argument holds evidently in every thing that relates to the Cure of Diseases: For Diseases are not only the Cures of Diseases; and not only great Discretion is to be used in discovering an Idiopathical One; neither do we only administer Infallible Remedies in undue and unseasonable Times, having no better Guides than a general Description of Diseases. But also, for not having a true Theory of Diseases, we do not know when it is time to put a stop to our Successful Method; and but too frequently carry on a needless Practice, to the great Detriment and Hazard of the sick Person. There may be sundry Examples brought for proving of this; but I shall again content my self with One: In the
Jaundice, viz.
whose Pathognomonical Sign is most commonly the
Yellowness,
as its very Name imports; yet this Yellowness is not
always
attending the Indisposition, but does sometimes continue when the sick Person is free of the Distemper, and past all Danger from the ill Accidents that succeed it; nay, frequently the Yellowness is augmented by some Methods that Cure the Disease: By which means the Cure is still manag'd to the Charge, Abhorrence and Danger of the Patient, and still with the good Intention of an Ignorant Curer.
Whereas by a true Theory of Diseases, it is not only easie to determine when one is Yellow, and has the Jaundice, and when one is Yellow, and cur'd of the Jaundice. But understanding the Reason of both, he can destroy the Yellowness, when no Consideration is hald to the first Disease.
I think this does very manifestly convince us that there is something else Necessary, besides Infallible Med'cines, for the Cure of Distempers; though at the same time the best Theories will Cure no Disease without Proper Remedies; and the more Excellent they are of their Kind, the more Valuable they are.
Lastly,
This Matter will appear manifestly, and at once to our View, if we do but reflect on the various and opposite Sorts of Med'cines, that the faithful Observations of all former Ages have sent us for the Cure of the same Disease. For the Variety shows the Defect, as well as the Necessity of trying about for more, and more certain, Med'cines: And the opposite Sorts point out to us the Variety of Circumstances of the Distemper: So that my former Gentleman,
A—s,
is scarcely initiated in these Matters, when he talks of a Med'cine of one Quality to Cure the same Disease. This in passing. An Example of this is every Disease. But I shall Instance in the Case of a Consumption, for which Experience has recommended a very notable Variety of Med'cines, and these very opposite. Are we not told of
Milk
and
Brimstone, Balsams,
and
Attenuating
Med'cines, and a great Abundance of more jarring Things? But to give a fuller Example in this Particular, I refer you to what I have said on this Subject in my
Alvi Profluvia:
By all which it is very plain how insufficient the greatest Stock of the best Med'cines is, without a true Theory of Diseases, even for the Cure of Diseases.
Let me therefore perswade Candid and Honest Physicians to set about a sedulous Inquiry for a true Theory of Diseases, and a more exact Method for discovering the directest and most advantageous Uses of good Med'cines, that we may do the most good to Mankind, and show that the Med'cines chance have put into our Hands, may even have some Improvement from us: Neither let us in this Inquiry be discourag'd with the Impudence of Pretenders nor by the small Advances we can hope to make; for they only hate you for your doing better than themselves; and no Body can tell what attempting in this Matter does produce, but they that have once tried it.
FINIS.