Chapter XXXIII.Of Mountebanks, Quacks, and Conjurers.Sect.562.One dreadful Scourge still remains to be treated of, which occasions a greater Mortality, than all the Distempers I have hitherto described; and which, as long as it continues, will defeat our utmostPrecautions to preserve the Healths and Lives of the common People. This, or rather, these Scourges, for they are very numerous, are Quacks; of which there are two Species: The Mountebanks or travelling Quacks, and those pretended Physicians in Villages and Country-Places, both male and female, known inSwisserlandby the Name of Conjurers, and who very effectually unpeople it.The first of these, the Mountebanks, without visiting the Sick, or thinking of their Distempers, sell different Medicines, some of which are for external Use, and these often do little or no Mischief; but their internal ones are much oftener pernicious. I have been a Witness of their dreadful Effects, and we are not visited by one of these wandering Caitiffs, whose Admission into our Country is not mortally fatal to some of its Inhabitants. They are injurious also in another Respect, as they carry off great Sums of Money with them, and levy annually some thousands of Livres, amongst that Order of the People, who have the least to spare. I have seen, and with a very painful Concern, the poor Labourer and the Artisan, who have scarcely possessed the common Necessaries of Life, borrow wherewithal to purchase, and at a dear Price, the Poison that was to compleat their Misery, by increasing their Maladies; and which, where they escaped with their Lives, has left them in such a languid and inactive State, as has reduced their whole Family to Beggary.§ 563. An ignorant, knavish, lying and impudent Fellow will always seduce the gross and credulous Mass of People, incapable to judge of and estimate any thing rightly; and adapted to be the eternal Dupes of such, as are base enough to endeavour to dazzle their weak Understandings; by which Method these vile Quacks will certainly defraud them, as long as they are tolerated. But ought not the Magistrates, the Guardians, the Protectors, the political Fathers of the People interpose, and defend them from this Danger, by severely prohibiting the Entrance of such pernicious Fellows into a Country, where Mens' Lives are very estimable, and where Money is scarce; since they extinguish the first, and carry off the last, without the least Possibility of their being in anywise useful to it. Can such forcible Motives as these suffer our Magistrates to delaytheirExpulsion any longer,whomthere never was the least Reason for admitting?§ 564. It is acknowledged the Conjurers, the residing Conjurers, do not carry out the current Money of the Country, like the itinerant Quacks; but the Havock they make among their Fellow Subjects is without Intermission, whence it must be very great, as every Day in the Year is marked with many of their Victims. Without the least Knowledge or Experience, and offensively armed with three or four Medicines, whose Nature they are as thoroughly ignorant of, as of their unhappy Patients Diseases; and which Medicines, being almost all violent ones, are verycertainly so many Swords in the Hands of raging Madmen. Thus armed and qualified, I say, they aggravate the slightest Disorders, and make those that are a little more considerable, mortal; but from which the Patients would have recovered, if left solely to the Conduct of Nature; and, for a still stronger Reason, if they had confided to the Guidance of her experienced Observers and Assistants.§ 565. The Robber who assassinates on the High-way, leaves the Traveller the Resource of defending himself, and the Chance of being aided by the Arrival of other Travellers: But the Poisoner, who forces himself into the Confidence of a sick Person, is a hundred times more dangerous, and as just an Object of Punishment.The Bands of Highwaymen, and their Individuals, that enter into any Country or District, are described as particularly as possible to the Publick. It were equally to be wished, we had also a List of these physical Impostors and Ignorants male and female; and that a most exact Description of them, with the Number, and a brief Summary of their murderous Exploits, were faithfully published. By this Means the Populace might probably be inspired with such a wholesome Dread of them, that they would no longer expose their Lives to the Mercy of such Executioners.§ 566. But their Blindness, with Respect to these two Sorts of maleficent Beings, is inconceivable. That indeed in Favour of the Mountebankis somewhat less gross, because as they are not personally acquainted with him, they may the more easily credit him with some Part of the Talents and the Knowledge he arrogates. I shall therefore inform them, and it cannot be repeated too often, that whatever ostentatious Dress and Figure some of these Impostors make, they are constantly vile Wretches, who, incapable of earning a Livelyhood in any honest Way, have laid the Foundation of their Subsistence on their own amazing Stock of Impudence, and that of the weak Credulity of the People; that they have no scientific Knowledge; that their Titles and Patents are so many Impositions, and inauthentic; since by a shameful Abuse, such Patents and Titles are become Articles of Commerce, which are to be obtained at very low Prices; just like the second-hand laced Cloaks which they purchase at the Brokers. That their Certificates of Cures are so many Chimeras or Forgeries; and that in short, if among the prodigious Multitudes of People who take their Medicines, some of them should recover, which it is almost physically impossible must not sometimes be the Case, yet it would not be the less certain, that they are a pernicious destructive Set of Men. A Thrust of a Rapier into the Breast has saved a Man's Life by seasonably opening an Imposthume in it, which might otherwise have killed him: and yet internal penetrating Wounds, with a small Sword, are not the less mortal for one such extraordinary Consequence. Nor is it even surprizing thatthese Mountebanks, which is equally applicable to Conjurers, who kill thousands of People, whom Nature alone, or assisted by a Physician, would have saved, should now and then cure a Patient, who had been treated before by the ablest Physicians. Frequently Patients of that Class, who apply to these Mountebanks and Conjurers (whether it has been, that they would not submit to the Treatment proper for their Distempers; or whether the real Physician tired of the intractable Creatures has discontinued his Advice and Attendance) look out for such Doctors, as assure them of a speedy Cure, and venture to give them such Medicines as kill many, and cure one (who has had Constitution enough to overcome them) a little sooner than a justly reputable Physician would have done. It is but too easy to procure, in every Parish, such Lists of their Patients, and of their Feats, as would clearly evince the Truth of whatever has been said here relating to them.§ 567. The Credit of this Market, this Fair-hunting Doctor, surrounded by five or six hundred Peasants, staring and gaping at him, and counting themselves happy in his condescending to cheat them of their very scarce and necessary Cash, by selling them, for twenty times more than its real Worth, a Medicine whose best Quality were to be only a useless one; the Credit, I say, of this vile yet tolerated Cheat, would quickly vanish, could each of his Auditors be persuaded, of what is strictly true, that except alittle more Tenderness and Agility of Hand, he knows full as much as his Doctor; and that if he could assume as much Impudence, he would immediately have as much Ability, would equally deserve the same Reputation, and to have the same Confidence reposed in him.§ 568. Were the Populace capable of reasoning, it were easy to disabuse them in these Respects; but as it is, their Guardians and Conductors should reason for them. I have already proved the Absurdity of reposing any Confidence in Mountebanks, properly so called; and that Reliance some have on the Conjurers is still more stupid and ridiculous.The very meanest Trade requires some Instruction: A Man does not commence even a Cobler, a Botcher of old Leather, without serving an Apprenticeship to it; and yet no Time has been served, no Instruction has been attended to, by these Pretenders to the most necessary, useful and elegant Profession. We do not confide the mending, the cleaning of a Watch to any, who have not spent several Years in considering how a Watch is made; what are the Requisites and Causes of its going right; and the Defects or Impediments that make it go wrong: and yet the preserving and rectifying the Movements of the most complex, the most delicate and exquisite, and the most estimable Machine upon Earth, is entrusted to People who have not the least Notion of its Structure; of the Causesof its Motions; nor of the Instruments proper to rectify their Deviations.Let a Soldier discarded from his Regiment for his roguish Tricks, or who is a Deserter from it, a Bankrupt, a disreputable Ecclesiastic, a drunken Barber, or a Multitude of such other worthless People, advertize that they mount, set and fit up all Kinds of Jewels and Trinkets in Perfection; if any of these are not known; if no Person in the Place has ever seen any of their Work; or if they cannot produce authentic Testimonials of their Honesty, and their Ability in their Business, not a single Individual will trust them with two Pennyworth of false Stones to work upon; in short they must be famished. But if instead of professing themselves Jewellers, they post themselves up as Physicians, the Croud purchase, at a high Rate, the Pleasure of trusting them with the Care of their Lives, the remaining Part of which they rarely fail to empoison.§ 569. The most genuine and excellent Physicians, these extraordinary Men, who, born with the happiest Talents, have began to inform their Understandings from their earliest Youth; who have afterwards carefully qualified themselves by cultivating every Branch of Physic; who have sacrificed the best and most pleasurable Days of their Lives, to a regular and assiduous Investigation of the human Body; of its various Functions; of the Causes that may impair or embarrass them, and informed themselves of the Qualities and Virtues of every simple andcompound Medicine; who have surmounted the Difficulty and Loathsomness of living in Hospitals among thousands of Patients; and who have added the medical Observations of all Ages and Places to their own; these few and extraordinary Men, I say, still consider themselves as short of that perfect Ability and consummate Knowledge, which they contemplate and wish for, as necessary to guarding the preciousDepositumof human Life and Health, confided to their Charge. Nevertheless we see the same inestimable Treasures, intrusted to gross and stupid Men, born without Talents; brought up without Education or Culture; who frequently can scarcely read; who are as profoundly ignorant of every Subject that has any Relation to Physic, as the Savages ofAsia; who awake only to drink away; who often exercise their horrid Trade merely to find themselves in strong Liquor, and execute it chiefly when they are drunk: who, in short, became Physicians, only from their Incapacity to arrive at any Trade or Attainment! Certainly such a Conduct in Creatures of the human Species must appear very astonishing, and even melancholy, to every sensible thinking Man; and constitute the highest Degree of Absurdity and Extravagance.Should any Person duly qualified enter into an Examination of the Medicines they use, and compare them with the Situation and Symptoms of the Patients to whom they give them, he must be struck with Horror; and heartily deplore theFate of that unfortunate Part of the human Race, whose Lives, so important to the Community, are committed to the Charge of the most murderous Set of Beings.§ 570. Some of these Caitiffs however, apprehending the Force and Danger of that Objection, founded on their Want of Study and Education, have endeavoured to elude it, by infusing and spreading a false, and indeed, an impudent impious Prejudice among the People, which prevails too much at present; and this is, that their Talents for Physic are a supernatural Gift, and, of Course, greatly superior to all human Knowledge. It were going out of my Province to expatiate on the Indecency, the Sin, and the Irreligion of such Knavery, and incroaching upon the Rights and perhaps the Duty of the Clergy; but I intreat the Liberty of observing to this respectable Order of Men, that this Superstition, which is attended with dreadful Consequences, seems to call for their utmost Attention: and in general the Expulsion of Superstition is the more to be wished, as a Mind, imbued with false Prejudices, is less adapted to imbibe a true and valuable Doctrine. There are some very callous hardenedVillainsamong this murdering Band, who, with a View to establish their Influence and Revenue as well upon Fear as upon Hope, have horridly ventured so far as to incline the Populace to doubt, whether they received their boasted Gift and Power from Heaven or from Hell! And yet these are the Menwho are trusted with the Health and the Lives of many others.§ 571. One Fact which I have already mentioned, and which it seems impossible to account for is, that great Earnestness of the Peasant to procure the best Assistance he can for his sick Cattle. At whatever Distance the Farrier lives, or some Person who is supposed qualified to be one (for unfortunately there is not one inSwisserland) if he has considerable Reputation in this Way, the Country-man goes to consult him, or purchases his Visit at any Price. However expensive the Medicines are, which the Horse-doctor directs, if they are accounted the best, he procures them for his poor Beast. But if himself, his Wife or Children fall sick, he either calls in no Assistance nor Medicines; or contents himself with such as are next at Hand, however pernicious they may be, though nothing the cheaper on that account: for certainly the Money, extorted by some of these physical Conjurers from their Patients, but oftner from their Heirs, is a very shameful Injustice, and calls loudly for Reformation.§ 572. In an excellent Memoir or Tract, which will shortly be published, on the Population ofSwisserland, we shall find an important and very affecting Remark, which strictly demonstrates the Havock made by these immedical Magicians or Conjurers; and which is this: That in the common Course of Years, the Proportion between the Numbers and Deaths of the Inhabitantsof any one Place, is not extremely different in City and Country: but when the very same epidemical Disease attacks the City and the Villages, the Difference is enormous; and the Number of Deaths of the former compared with that of the Inhabitants of the Villages, where the Conjurer exercises his bloody Dominion, is infinitely more than the Deaths in the City.I find in the second Volume of the Memoirs of the oeconomical Society ofBerne, for the Year 1762, another Fact equally interesting, which is related by one of the most intelligent and sagacious Observers, concerned in that Work. “Pleurisies and Peripneumonies (hesays) prevailed atCottens a la Côte; and some Peasants died under them, who had consulted the Conjurers and taken their heating Medicines; while of those, who pursued a directly opposite Method, almost every one recovered.”§ 573. But I shall employ myself no longer on this Topic, on which the Love of my Species alone has prompted me to say thus much; though it deserves to be considered more in Detail, and is, in Reality, of the greatest Consequence. None methinks could make themselves easy with Respect to it so much as Physicians, if they were conducted only by lucrative Views; since these Conjurers diminish the Number of those poor People, who sometimes consult the real Physicians, and with some Care and Trouble, but without the least Profit, to those Gentlemen. But what good Physician is mean andvile enough to purchase a few Hours of Ease and Tranquillity at so high, so very odious a Price?§ 574. Having thus clearly shewn the Evils attending this crying Nusance, I wish I were able to prescribe an effectual Remedy against it, which I acknowledge is far from being easy to do.The first necessary Point probably was to have demonstrated the great and public Danger, and to dispose the State to employ their Attention on this fatal, this mortal Abuse; which, joined to the other Causes of Depopulation, has a manifest Tendency to renderSwisserlanda Desert.§ 575. The second, and doubtless the most effectual Means, which I had already mentioned is, not to admit any travelling Mountebank to enter this Country; and to set a Mark on all the Conjurers: It may probably also be found convenient, to inflict corporal Punishment on them; as it has been already adjudged in different Countries by sovereign Edicts. At the very least they should be marked with public Infamy, according to the following Custom practised in a great City inFrance. “When any Mountebanks appeared inMontpellier, the Magistrates had a Power to mount each of them upon a meagre miserable Ass, with his Head to the Ass's Tail. In this Condition they were led throughout the whole City, attended with the Shouts and Hooting of the Children and the Mob, beating them, throwing Filth and Ordure at them, reviling them, and dragging them all about.”§ 576. A third conducive Means would be the Instructions and Admonition of the Clergy on this Subject, to the Peasants in their several Parishes. For this Conduct of the common People amounting, in Effect, to Suicide, to Self-murder, it must be important to convince them of it. But the little Efficacy of the strongest and repeated Exhortations on so many other Articles, may cause us to entertain a very reasonable Doubt of their Success on this. Custom seems to have determined, that there is nothing in our Day, which excludes a Person from the Title and Appellation of an honest or honourable Man, except it be meer and convicted Theft; and that for this simple and obvious Reason, that we attach ourselves more strongly to our Property, than to any Thing else. Even Homicide is esteemed and reputed honourable in many Cases. Can we reasonably then expect to convince the Multitude, that it is criminal to confide the Care of their Health to these Poisoners, in Hopes of a Cure of their Disorders? A much likelier Method of succeding on this Point would certainly be, to convince the deluded People, that it will cost them less to be honestly and judiciously treated, than to suffer under the Hands of these Executioners. The Expectation of a good and cheap Health-market will be apt to influence them more, than their Dread of a Crime would.§ 577. A fourth Means of removing or restraining this Nusance would be to expunge, from the Almanacs, all the astrological Rulesrelating to Physick; as they continually conduce to preserve and increase some dangerous Prejudices and Notions in a Science, the smallest Errors in which are sometimes fatal. I had already reflected on the Multitude of Peasants that have been lost, from postponing, or mistiming a Bleeding, only because the sovereign Decision of an Almanac had directed it at some other Time. May it not also be dreaded, to mention it by the Way, that the same Cause, the Almanacs, may prove injurious to their rural Oeconomy and Management; and that by advising with the Moon, who has no Influence, and is of no Consequence in Vegetation or other Country Business, they may be wanting in a due Attention to such other Circumstances and Regulations, as are of real Importance in them?§ 578. A fifth concurring Remedy against this popular Evil would be the Establishment of Hospitals, for the Reception of poor Patients, in the different Cities and Towns ofSwisserland.There may be a great many easy and concurring Means of erecting and endowing such, with very little new Expence; and immense Advantages might result from them: besides, however considerable the Expenses might prove, is not the Object of them of the most interesting, the most important Nature? It is incontestably our serious Duty; and it would soon be manifest, that the Performance of it would be attended with more essential intrinsic Benefit to the Community, than any other Application of Moneycould produce. We must either admit, that the Multitude, the Body of the People is useless to the State, or agree, that Care should be taken to preserve and continue them. A very respectableEnglishMan, who, after a previous and thorough Consideration of this Subject, had applied himself very assiduously and usefully on the Means of increasing the Riches and the Happiness of his Country-men, complains that inEngland, the very Country in which there are the most Hospitals, the Poor who are sick are not sufficiently assisted. What a deplorable Deficience of the necessary Assistance for such must then be in a Country, that is not provided with a single Hospital? That Aid from Surgery and Physic, which abounds in Cities, is not sufficiently diffused into Country-places: and the Peasants are liable to some simple and moderate Diseases, which, for Want of proper Care, degenerate into a State of Infirmity, that sinks them into premature Death.§ 579. In fine, if it be found impossible to extinguish these Abuses (for those arising from Quacks are not the only ones, nor is that Title applied to as many as really deserve it) beyond all Doubt it would be for the Benefit and Safety of the Public, upon the whole, entirely to prohibit the Art, the Practice of Physic itself. When real and good Physicians cannot effect as much Good, as ignorant ones and Impostors can do Mischief, some real Advantage must accrue to the State, and to the whole Species, fromemploying none of either. I affirm it, after much Reflection, and from thorough Conviction, that Anarchy in Medicine is the most dangerous Anarchy. For this Profession, when loosed from every Restraint, and subjected to no Regulations, no Laws, is the more cruel Scourge and Affliction, from the incessant Exercise of it; and should its Anarchy, its Disorders prove irremediable, the Practice of an Art, become so very noxious, should be prohibited under the severest Penalties: Or, if the Constitution of any Government was inconsistent with the Application of so violent a Remedy, they should order public Prayers against the Mortality of it, to be offered up in all the Churches; as the Custom has been in other great and general Calamities.§ 580. Another Abuse, less fatal indeed than those already mentioned (but which, however, has real ill Consequences, and at the best, carries out a great deal of Money from us, though less at the Expense of the common People, than of those of easy Circumstances) is that Blindness and Facility, with which many suffer themselves to be imposed upon, by the pompous Advertisements of someCatholicon, some universal Remedy, which they purchase at a high Rate, from some foreign Pretender to a mighty Secret orNostrum. Persons of a Class or two above the Populace do not care to run after a Mountebank, from supposing they should depretiate themselves by mixing with the Herd. Yet if that very Quack, instead of coming among us, were toreside in some foreign City; if, instead of posting up his lying Puffs and Pretentions at the Corners of the Streets, he would get them inserted in the Gazettes, and News-papers; if, instead of selling his boasted Remedies in Person, he should establish Shops or Offices for that Purpose in every City; and finally, if instead of selling them twenty times above their real Value, he would still double that Price; instead of having the common People for his Customers, he would take in the wealthy Citizen, Persons of all Ranks, and from almost every Country. For strange as it seems, it is certain, that a Person of such a Condition, who is sensible in every other Respect; and who will scruple to confide his Health to the Conduct of such Physicians as would be the justest Subjects of his Confidence, will venture to take, through a very unaccountable Infatuation, the most dangerous Medicine, upon the Credit of an imposing Advertisement, published by as worthless and ignorant a Fellow as the Mountebank whom he despises, because the latter blows a Horn under his Window; and yet who differs from the former in no other Respects except those I have just pointed out.§ 581. Scarcely a Year passes, without one or another such advertized and vaunted Medicine's getting into high Credit; the Ravages of which are more or less, in Proportion to its being more or less in Vogue. Fortunately, for the human Species, but few of theseNostrumshave attained an equal Reputation withAilbaud's Powders, anInhabitant ofAixinProvence, and unworthy the Name of a Physician; who has over-runEuropefor some Years, with a violent Purge, the Remembrance of which will not be effaced before the Extinction of all its Victims. I attend now, and for a long time past, several Patients, whose Disorders I palliate without Hopes of ever curing them; and who owe their present melancholy State of Body to nothing but the manifest Consequences of these Powders; and I have actually seen, very lately, two Persons who have been cruelly poisoned by this boasted Remedy of his. A French Physician, as eminent for his Talents and his Science, as estimable from his personal Character in other Respects, has published some of the unhappy and tragical Consequences which the Use of them has occasioned; and were a Collection published of the same Events from them, in every Place where they have been introduced, the Size and the Contents of the Volume would make a very terrible one.§ 582. It is some Comfort however, that all the other Medicines thus puffed and vended have not been altogether so fashionable, nor yet quite so dangerous: but all posted and advertized Medicines should be judged of upon this Principle (and I do not know a more infallible one in Physics, nor in the Practice of Physic), that whoever advertises any Medicine, as a universal Remedy for all Diseases, is an absolute Impostor, such a Remedy being impossible and contradictory. I shall not here offer to detail such Proofsas may be given of the Verity of this Proposition: but I freely appeal for it to every sensible Man, who will reflect a little on the different Causes of Diseases; on the Opposition of these Causes; and on the Absurdity of attempting to oppose such various Diseases, and their Causes, by one and the same Remedy.As many as shall settle their Judgments properly on this Principle, will never be imposed upon by the superficial Gloss of these Sophisms contrived to prove, that all Diseases proceed from one Cause; and that this Cause is so very tractable, as to yield to one boasted Remedy. They will perceive at once, that such an Assertion must be founded in the utmost Knavery or Ignorance; and they will readily discover where the Fallacy lies. Can any one expect to cure a Dropsy, which arises from too great a Laxity of the Fibres, and too great an Attenuation or Thinness of the Blood, by the same Medicines that are used to cure an inflammatory Disease, in which the Fibres are too stiff and tense, and the Blood too thick and dense? Yet consult the News-papers and the Posts, and you will see published in and on all of them, Virtues just as contradictory; and certainly the Authors of such poisonous Contradictions ought to be legally punished for them.§ 583. I heartily wish the Publick would attend here to a very natural and obvious Reflection. I have treated in this Book, but of a small Number of Diseases, most of them acute ones;and I am positive that no competent well qualified Physician has ever employed fewer Medicines, in the Treatment of the Diseases themselves. Nevertheless I have prescribed seventy-one, and I do not see which of them I could retrench, or dispense with the Want of, if I were obliged to use one less. Can it be supposed then, that any one single Medicine, compound or simple, shall cure thirty times as many Diseases as those I have treated of?§ 584. I shall add another very important Observation, which doubtless may have occurred to many of my Readers; and it is this, that the different Causes of Diseases, their different Characters; the Differences which arise from the necessary Alterations that happen throughout their Progress and Duration; the Complications of which they are susceptible; the Varieties which result from the State of different Epidemics, of Seasons, of Sexes, and of many other Circumstances; that these Diversities, I say, oblige us very often to vary and change the Medicines; which proves how very ticklish and dangerous it is to have them directed by Persons, who have such an imperfect Knowledge of them, as those who are not Physicians must be supposed to have. And the Circumspection to be used in such Cases ought to be proportioned to the Interest the Assistant takes in the Preservation of the Patient; and that Love of his Neighbour with which he is animated.§ 585. Must not the same Arguments and Reflections unavoidably suggest the Necessity of an entire Tractability on the Part of the Patient, and his Friends and Assistants? The History of Diseases which have their stated Times of Beginning, of manifesting and displaying themselves; of arriving at, and continuing in their Height, and of decreasing; do not all these demonstrate the Necessity of continuing the same Medicines, as long as the Character of the Distemper is the same; and the Danger of changing them often, only because what has been given has not afforded immediate Relief? Nothing can injure the Patient more than this Instability and Caprice. After the Indication which his Distemper suggests, appears to be well deduced, the Medicine must be chosen that is likeliest to resist the Cause of it; and it must be continued as long as no new Symptom or Circumstance supervenes, which requires an Alteration of it; except it should be evident, that an Error had been incurred in giving it. But to conclude that a Medicine is useless or insignificant, because it does not remove or abate the Distemper as speedily, as the Impatience of the Sick would naturally desire it; and to change it for another, is as unreasonable, as it would be for a Man to break his Watch, because the Hand takes twelve Hours, to make a Revolution round the Dial-plate.§ 586. Physicians have some Regard to the State of the Urine of sick Persons, especially in inflammatory Fevers; as the Alterations occurringin it help them to judge of the Changes that may have been made in the Character and Consistence of the Humours in the Mass of Blood; and thence may conduce to determine the Time, in which it will be proper to dispose them tosome Evacuation. But it is gross Ignorance to imagine, and utter Knavery and Imposture to persuade the Sick, that the meer Inspection of their Urine solely, sufficiently enables others to judge of the Symptoms andCauseof the Disease, and to direct the best Remedies for it. This Inspection of the Urine can only be of Use when it is duly inspected; when we consider at the same time the exact State and the very Looks of the Patient; when these are compared with the Degree of the Symptoms of the Malady; with the other Evacuations; and when the Physician is strictly informed of all external Circumstances, which may be considered as foreign to the Malady; which may alter or affect the Evacuations, such as particular Articles of Food, particular Drinks, different Medicines, or the very Quantity of Drink. Where a Person is not furnished with an exact Account of these Circumstances, the meer Inspection of the Urine is of no Service, it suggests no Indication, nor any Expedient; and meer common Sense sufficiently proves, and it may be boldly affirmed, that whoever orders any Medicine, without any other Knowledge of the Disease, than what an Inspection of the Urine affords, is a rank Knave, and the Patient who takes them is a Dupe.§ 587. And here now any Reader may very naturally ask, whence can such a ridiculous Credulity proceed, upon a Subject so essentially interesting to us as our own Health?In Answer to this it should be observed, that some Sources, some Causes of it seem appropriated merely to the People, the Multitude. The first of these is, the mechanical Impression of Parade and Shew upon the Senses. 2, The Prejudice they have conceived, as I said before, of the Conjurers curing by a supernatural Gift. 3, The Notion the Country People entertain, that their Distemper and Disorders are of a Character and Species peculiar to themselves, and that the Physicians, attending the Rich, know nothing concerning them. 4, The general Mistake that their employing the Conjurer is much cheaper. 5, Perhaps a sheepish shame-faced Timidity may be one Motive, at least with some of them. 6, A Kind of Fear too, that Physicians will consider their Cases with less Care and Concern, and be likely to treat them more cavalierly; a Fear which increases that Confidence which the Peasant, and which indeed every Man has in his Equal, being sounded in Equality itself. And 7, the Discourse and Conversation of such illiterate Empirics being more to their Tast, and more adapted to their Apprehension.But it is less easy to account for this blind Confidence, which Persons of a superior Class (whole Education being considered as much betterare regarded as better Reasoners) repose in these boasted Remedies; and even for some Conjurer in Vogue. Nevertheless even some of their Motives may be probably assigned.The first is that great Principle ofSeïty, orSelfness, as it may be called, innate to Man, which attaching him to the Prolongation of his own Existence more than to any other thing in the Universe, keeps his Eyes, his utmost Attention, continually fixed upon this Object; and compels him to make it the very Point, the Purpose of all his Advances and Proceedings; notwithstanding it does not permit him to distinguish the safest Paths to it from the dangerous ones. This is the surest and shortest Way says some Collector at the Turnpike, he pays, passes, and perishes from the Precipices that occur in his Route.This very Principle is the Source of another Error, which consists in reposing, involuntarily, a greater Degree of Confidence in those, who flatter and fall in the most with us in our favourite Opinions. The well apprised Physician, who foresees the Length and the Danger of a Disease; and who is a Man of too much Integrity to affirm what he does not think, must, from a necessary Construction of the human Frame and Mind, be listened to less favourably, than he who flatters us by saying what we wish. We endeavour to elongate, to absent ourselves, from the Sentiments, the Judgment of the first; we smile, from Self-complacency, at those of the last,which in a very little time are sure of obtaining our Preference.A third Cause, which results from the same Principle is, that we give ourselves up the most readily to his Conduct, whose Method seems the least disagreeable, and flatters our Inclinations the most. The Physician who enjoins a strict Regimen; who insists upon some Restraints and Self-denials; who intimates the Necessity of Time and Patience for the Accomplishment of the Cure, and who expects a thorough Regularity through the Course of it, disgusts a Patient who has been accustomed to indulge his own Tast and Humour; the Quack, who never hesitates at complying with it, charms him. The Idea of a long and somewhat distant Cure, to be obtained at the End of an unpleasant and unrelaxing Regimen, supposes a very perilous Disease; this Idea disposes the Patient to Disgust and Melancholy, he cannot submit to it without Pain; and he embraces, almost unconsciously, merely to avoid this, an opposite System which presents him only with the Idea of such a Distemper, as will give Way to a few Doses of Simples.That Propensity to the New and Marvellous, which tyrannizes over so large a Proportion of our Species, and which has advanced so many absurd Persons and Things into Reputation, is a fourth and a very powerful Motive. An irksome Satiety, and a Tiresomeness, as it were, from the same Objects, is what our Nature is apt to be very apprehensive of; though we areincessantly conducted towards it, by a Perception of some Void, some Emptiness in ourselves, and even in Society too: But new and extraordinary Sensations rousing us from this disagreeable State, more effectually than any Thing else, we unthinkingly abandon ourselves to them, without foreseeing their Consequences.A fifth Cause arises from seven Eighths of Mankind being managed by, or following, the other Eighth; and, generally speaking, the Eighth that is so very forward to manage them, are the least fit and worthy to do it; whence all must go amiss, and absurd and embarrassing Consequences ensue from the Condition of Society. A Man of excellent Sense frequently sees only through the Eyes of a Fool, of an intriguing Fellow, or of a Cheat; in this he judges wrong, and his Conduct must be so too. A man of real Merit cannot connect himself with those who are addicted to caballing; and yet such are the Persons, who frequently conduct others.Some other Causes might be annexed to these, but I shall mention only one of them, which I have already hinted, and the Truth of which I am confirmed in from several Years Experience; which is, that we generally love those who reason more absurdly than ourselves, better than those who convince us of our own weak Reasoning.I hope the Reflexions every Reader will make on these Causes of our ill Conduct on this important Head, may contribute to correct or diminishit; and to destroy those Prejudices whose fatal Effects we may continually observe.[N. B.The Multitude ofallthe Objects of this excellent Chapter in this Metropolis, and doubtless throughoutEngland,were strong Inducements to have taken a little wholesome Notice of the Impostures of a few of the most pernicious. But on a second Perusal of this Part of the Original and its Translation, I thought it impossible (without descending to personal, nominal Anecdotes about the Vermin) to add any Thing material upon a Subject, which the Author has with such Energy exhausted. He even seems, by some of his Descriptions, to have taken Cognizance of a few of our most self-dignified itinerant Empirics; as these Genius's find it necessary sometimes to treat themselves with a little Transportation. In reality Dr.Tissothas, in a very masterly Way, thoroughly dissected and displayed the wholeGenus,every Species of Quacks. And when he comes to account for that Facility, with which Persons of very different Principles from them, and of better Intellects, first listen to, and finally countenance such Caitiffs, he penetrates into some of the most latent Weaknesses of the human Mind; even such as are often Secrets to their Owners. It is difficult, throughout this Disquisition, not to admire the Writer; but impossible not to love the Man, the ardent Philanthropist. His Sentiment that—“A Man of real Merit cannot connect himself with those who are addicted to caballing,”—is exquisitely just, and so liberal, that it never entered into the Mind of any disingenuous Man, however dignified, in any Profession. Persons of the simplest Hearts and purest Reflections must shrink at every Consciousness of Artifice; and secretly reproach themselves for each Success, that has redounded to them at the Expence of Truth.] K.
Chapter XXXIII.Of Mountebanks, Quacks, and Conjurers.Sect.562.One dreadful Scourge still remains to be treated of, which occasions a greater Mortality, than all the Distempers I have hitherto described; and which, as long as it continues, will defeat our utmostPrecautions to preserve the Healths and Lives of the common People. This, or rather, these Scourges, for they are very numerous, are Quacks; of which there are two Species: The Mountebanks or travelling Quacks, and those pretended Physicians in Villages and Country-Places, both male and female, known inSwisserlandby the Name of Conjurers, and who very effectually unpeople it.The first of these, the Mountebanks, without visiting the Sick, or thinking of their Distempers, sell different Medicines, some of which are for external Use, and these often do little or no Mischief; but their internal ones are much oftener pernicious. I have been a Witness of their dreadful Effects, and we are not visited by one of these wandering Caitiffs, whose Admission into our Country is not mortally fatal to some of its Inhabitants. They are injurious also in another Respect, as they carry off great Sums of Money with them, and levy annually some thousands of Livres, amongst that Order of the People, who have the least to spare. I have seen, and with a very painful Concern, the poor Labourer and the Artisan, who have scarcely possessed the common Necessaries of Life, borrow wherewithal to purchase, and at a dear Price, the Poison that was to compleat their Misery, by increasing their Maladies; and which, where they escaped with their Lives, has left them in such a languid and inactive State, as has reduced their whole Family to Beggary.§ 563. An ignorant, knavish, lying and impudent Fellow will always seduce the gross and credulous Mass of People, incapable to judge of and estimate any thing rightly; and adapted to be the eternal Dupes of such, as are base enough to endeavour to dazzle their weak Understandings; by which Method these vile Quacks will certainly defraud them, as long as they are tolerated. But ought not the Magistrates, the Guardians, the Protectors, the political Fathers of the People interpose, and defend them from this Danger, by severely prohibiting the Entrance of such pernicious Fellows into a Country, where Mens' Lives are very estimable, and where Money is scarce; since they extinguish the first, and carry off the last, without the least Possibility of their being in anywise useful to it. Can such forcible Motives as these suffer our Magistrates to delaytheirExpulsion any longer,whomthere never was the least Reason for admitting?§ 564. It is acknowledged the Conjurers, the residing Conjurers, do not carry out the current Money of the Country, like the itinerant Quacks; but the Havock they make among their Fellow Subjects is without Intermission, whence it must be very great, as every Day in the Year is marked with many of their Victims. Without the least Knowledge or Experience, and offensively armed with three or four Medicines, whose Nature they are as thoroughly ignorant of, as of their unhappy Patients Diseases; and which Medicines, being almost all violent ones, are verycertainly so many Swords in the Hands of raging Madmen. Thus armed and qualified, I say, they aggravate the slightest Disorders, and make those that are a little more considerable, mortal; but from which the Patients would have recovered, if left solely to the Conduct of Nature; and, for a still stronger Reason, if they had confided to the Guidance of her experienced Observers and Assistants.§ 565. The Robber who assassinates on the High-way, leaves the Traveller the Resource of defending himself, and the Chance of being aided by the Arrival of other Travellers: But the Poisoner, who forces himself into the Confidence of a sick Person, is a hundred times more dangerous, and as just an Object of Punishment.The Bands of Highwaymen, and their Individuals, that enter into any Country or District, are described as particularly as possible to the Publick. It were equally to be wished, we had also a List of these physical Impostors and Ignorants male and female; and that a most exact Description of them, with the Number, and a brief Summary of their murderous Exploits, were faithfully published. By this Means the Populace might probably be inspired with such a wholesome Dread of them, that they would no longer expose their Lives to the Mercy of such Executioners.§ 566. But their Blindness, with Respect to these two Sorts of maleficent Beings, is inconceivable. That indeed in Favour of the Mountebankis somewhat less gross, because as they are not personally acquainted with him, they may the more easily credit him with some Part of the Talents and the Knowledge he arrogates. I shall therefore inform them, and it cannot be repeated too often, that whatever ostentatious Dress and Figure some of these Impostors make, they are constantly vile Wretches, who, incapable of earning a Livelyhood in any honest Way, have laid the Foundation of their Subsistence on their own amazing Stock of Impudence, and that of the weak Credulity of the People; that they have no scientific Knowledge; that their Titles and Patents are so many Impositions, and inauthentic; since by a shameful Abuse, such Patents and Titles are become Articles of Commerce, which are to be obtained at very low Prices; just like the second-hand laced Cloaks which they purchase at the Brokers. That their Certificates of Cures are so many Chimeras or Forgeries; and that in short, if among the prodigious Multitudes of People who take their Medicines, some of them should recover, which it is almost physically impossible must not sometimes be the Case, yet it would not be the less certain, that they are a pernicious destructive Set of Men. A Thrust of a Rapier into the Breast has saved a Man's Life by seasonably opening an Imposthume in it, which might otherwise have killed him: and yet internal penetrating Wounds, with a small Sword, are not the less mortal for one such extraordinary Consequence. Nor is it even surprizing thatthese Mountebanks, which is equally applicable to Conjurers, who kill thousands of People, whom Nature alone, or assisted by a Physician, would have saved, should now and then cure a Patient, who had been treated before by the ablest Physicians. Frequently Patients of that Class, who apply to these Mountebanks and Conjurers (whether it has been, that they would not submit to the Treatment proper for their Distempers; or whether the real Physician tired of the intractable Creatures has discontinued his Advice and Attendance) look out for such Doctors, as assure them of a speedy Cure, and venture to give them such Medicines as kill many, and cure one (who has had Constitution enough to overcome them) a little sooner than a justly reputable Physician would have done. It is but too easy to procure, in every Parish, such Lists of their Patients, and of their Feats, as would clearly evince the Truth of whatever has been said here relating to them.§ 567. The Credit of this Market, this Fair-hunting Doctor, surrounded by five or six hundred Peasants, staring and gaping at him, and counting themselves happy in his condescending to cheat them of their very scarce and necessary Cash, by selling them, for twenty times more than its real Worth, a Medicine whose best Quality were to be only a useless one; the Credit, I say, of this vile yet tolerated Cheat, would quickly vanish, could each of his Auditors be persuaded, of what is strictly true, that except alittle more Tenderness and Agility of Hand, he knows full as much as his Doctor; and that if he could assume as much Impudence, he would immediately have as much Ability, would equally deserve the same Reputation, and to have the same Confidence reposed in him.§ 568. Were the Populace capable of reasoning, it were easy to disabuse them in these Respects; but as it is, their Guardians and Conductors should reason for them. I have already proved the Absurdity of reposing any Confidence in Mountebanks, properly so called; and that Reliance some have on the Conjurers is still more stupid and ridiculous.The very meanest Trade requires some Instruction: A Man does not commence even a Cobler, a Botcher of old Leather, without serving an Apprenticeship to it; and yet no Time has been served, no Instruction has been attended to, by these Pretenders to the most necessary, useful and elegant Profession. We do not confide the mending, the cleaning of a Watch to any, who have not spent several Years in considering how a Watch is made; what are the Requisites and Causes of its going right; and the Defects or Impediments that make it go wrong: and yet the preserving and rectifying the Movements of the most complex, the most delicate and exquisite, and the most estimable Machine upon Earth, is entrusted to People who have not the least Notion of its Structure; of the Causesof its Motions; nor of the Instruments proper to rectify their Deviations.Let a Soldier discarded from his Regiment for his roguish Tricks, or who is a Deserter from it, a Bankrupt, a disreputable Ecclesiastic, a drunken Barber, or a Multitude of such other worthless People, advertize that they mount, set and fit up all Kinds of Jewels and Trinkets in Perfection; if any of these are not known; if no Person in the Place has ever seen any of their Work; or if they cannot produce authentic Testimonials of their Honesty, and their Ability in their Business, not a single Individual will trust them with two Pennyworth of false Stones to work upon; in short they must be famished. But if instead of professing themselves Jewellers, they post themselves up as Physicians, the Croud purchase, at a high Rate, the Pleasure of trusting them with the Care of their Lives, the remaining Part of which they rarely fail to empoison.§ 569. The most genuine and excellent Physicians, these extraordinary Men, who, born with the happiest Talents, have began to inform their Understandings from their earliest Youth; who have afterwards carefully qualified themselves by cultivating every Branch of Physic; who have sacrificed the best and most pleasurable Days of their Lives, to a regular and assiduous Investigation of the human Body; of its various Functions; of the Causes that may impair or embarrass them, and informed themselves of the Qualities and Virtues of every simple andcompound Medicine; who have surmounted the Difficulty and Loathsomness of living in Hospitals among thousands of Patients; and who have added the medical Observations of all Ages and Places to their own; these few and extraordinary Men, I say, still consider themselves as short of that perfect Ability and consummate Knowledge, which they contemplate and wish for, as necessary to guarding the preciousDepositumof human Life and Health, confided to their Charge. Nevertheless we see the same inestimable Treasures, intrusted to gross and stupid Men, born without Talents; brought up without Education or Culture; who frequently can scarcely read; who are as profoundly ignorant of every Subject that has any Relation to Physic, as the Savages ofAsia; who awake only to drink away; who often exercise their horrid Trade merely to find themselves in strong Liquor, and execute it chiefly when they are drunk: who, in short, became Physicians, only from their Incapacity to arrive at any Trade or Attainment! Certainly such a Conduct in Creatures of the human Species must appear very astonishing, and even melancholy, to every sensible thinking Man; and constitute the highest Degree of Absurdity and Extravagance.Should any Person duly qualified enter into an Examination of the Medicines they use, and compare them with the Situation and Symptoms of the Patients to whom they give them, he must be struck with Horror; and heartily deplore theFate of that unfortunate Part of the human Race, whose Lives, so important to the Community, are committed to the Charge of the most murderous Set of Beings.§ 570. Some of these Caitiffs however, apprehending the Force and Danger of that Objection, founded on their Want of Study and Education, have endeavoured to elude it, by infusing and spreading a false, and indeed, an impudent impious Prejudice among the People, which prevails too much at present; and this is, that their Talents for Physic are a supernatural Gift, and, of Course, greatly superior to all human Knowledge. It were going out of my Province to expatiate on the Indecency, the Sin, and the Irreligion of such Knavery, and incroaching upon the Rights and perhaps the Duty of the Clergy; but I intreat the Liberty of observing to this respectable Order of Men, that this Superstition, which is attended with dreadful Consequences, seems to call for their utmost Attention: and in general the Expulsion of Superstition is the more to be wished, as a Mind, imbued with false Prejudices, is less adapted to imbibe a true and valuable Doctrine. There are some very callous hardenedVillainsamong this murdering Band, who, with a View to establish their Influence and Revenue as well upon Fear as upon Hope, have horridly ventured so far as to incline the Populace to doubt, whether they received their boasted Gift and Power from Heaven or from Hell! And yet these are the Menwho are trusted with the Health and the Lives of many others.§ 571. One Fact which I have already mentioned, and which it seems impossible to account for is, that great Earnestness of the Peasant to procure the best Assistance he can for his sick Cattle. At whatever Distance the Farrier lives, or some Person who is supposed qualified to be one (for unfortunately there is not one inSwisserland) if he has considerable Reputation in this Way, the Country-man goes to consult him, or purchases his Visit at any Price. However expensive the Medicines are, which the Horse-doctor directs, if they are accounted the best, he procures them for his poor Beast. But if himself, his Wife or Children fall sick, he either calls in no Assistance nor Medicines; or contents himself with such as are next at Hand, however pernicious they may be, though nothing the cheaper on that account: for certainly the Money, extorted by some of these physical Conjurers from their Patients, but oftner from their Heirs, is a very shameful Injustice, and calls loudly for Reformation.§ 572. In an excellent Memoir or Tract, which will shortly be published, on the Population ofSwisserland, we shall find an important and very affecting Remark, which strictly demonstrates the Havock made by these immedical Magicians or Conjurers; and which is this: That in the common Course of Years, the Proportion between the Numbers and Deaths of the Inhabitantsof any one Place, is not extremely different in City and Country: but when the very same epidemical Disease attacks the City and the Villages, the Difference is enormous; and the Number of Deaths of the former compared with that of the Inhabitants of the Villages, where the Conjurer exercises his bloody Dominion, is infinitely more than the Deaths in the City.I find in the second Volume of the Memoirs of the oeconomical Society ofBerne, for the Year 1762, another Fact equally interesting, which is related by one of the most intelligent and sagacious Observers, concerned in that Work. “Pleurisies and Peripneumonies (hesays) prevailed atCottens a la Côte; and some Peasants died under them, who had consulted the Conjurers and taken their heating Medicines; while of those, who pursued a directly opposite Method, almost every one recovered.”§ 573. But I shall employ myself no longer on this Topic, on which the Love of my Species alone has prompted me to say thus much; though it deserves to be considered more in Detail, and is, in Reality, of the greatest Consequence. None methinks could make themselves easy with Respect to it so much as Physicians, if they were conducted only by lucrative Views; since these Conjurers diminish the Number of those poor People, who sometimes consult the real Physicians, and with some Care and Trouble, but without the least Profit, to those Gentlemen. But what good Physician is mean andvile enough to purchase a few Hours of Ease and Tranquillity at so high, so very odious a Price?§ 574. Having thus clearly shewn the Evils attending this crying Nusance, I wish I were able to prescribe an effectual Remedy against it, which I acknowledge is far from being easy to do.The first necessary Point probably was to have demonstrated the great and public Danger, and to dispose the State to employ their Attention on this fatal, this mortal Abuse; which, joined to the other Causes of Depopulation, has a manifest Tendency to renderSwisserlanda Desert.§ 575. The second, and doubtless the most effectual Means, which I had already mentioned is, not to admit any travelling Mountebank to enter this Country; and to set a Mark on all the Conjurers: It may probably also be found convenient, to inflict corporal Punishment on them; as it has been already adjudged in different Countries by sovereign Edicts. At the very least they should be marked with public Infamy, according to the following Custom practised in a great City inFrance. “When any Mountebanks appeared inMontpellier, the Magistrates had a Power to mount each of them upon a meagre miserable Ass, with his Head to the Ass's Tail. In this Condition they were led throughout the whole City, attended with the Shouts and Hooting of the Children and the Mob, beating them, throwing Filth and Ordure at them, reviling them, and dragging them all about.”§ 576. A third conducive Means would be the Instructions and Admonition of the Clergy on this Subject, to the Peasants in their several Parishes. For this Conduct of the common People amounting, in Effect, to Suicide, to Self-murder, it must be important to convince them of it. But the little Efficacy of the strongest and repeated Exhortations on so many other Articles, may cause us to entertain a very reasonable Doubt of their Success on this. Custom seems to have determined, that there is nothing in our Day, which excludes a Person from the Title and Appellation of an honest or honourable Man, except it be meer and convicted Theft; and that for this simple and obvious Reason, that we attach ourselves more strongly to our Property, than to any Thing else. Even Homicide is esteemed and reputed honourable in many Cases. Can we reasonably then expect to convince the Multitude, that it is criminal to confide the Care of their Health to these Poisoners, in Hopes of a Cure of their Disorders? A much likelier Method of succeding on this Point would certainly be, to convince the deluded People, that it will cost them less to be honestly and judiciously treated, than to suffer under the Hands of these Executioners. The Expectation of a good and cheap Health-market will be apt to influence them more, than their Dread of a Crime would.§ 577. A fourth Means of removing or restraining this Nusance would be to expunge, from the Almanacs, all the astrological Rulesrelating to Physick; as they continually conduce to preserve and increase some dangerous Prejudices and Notions in a Science, the smallest Errors in which are sometimes fatal. I had already reflected on the Multitude of Peasants that have been lost, from postponing, or mistiming a Bleeding, only because the sovereign Decision of an Almanac had directed it at some other Time. May it not also be dreaded, to mention it by the Way, that the same Cause, the Almanacs, may prove injurious to their rural Oeconomy and Management; and that by advising with the Moon, who has no Influence, and is of no Consequence in Vegetation or other Country Business, they may be wanting in a due Attention to such other Circumstances and Regulations, as are of real Importance in them?§ 578. A fifth concurring Remedy against this popular Evil would be the Establishment of Hospitals, for the Reception of poor Patients, in the different Cities and Towns ofSwisserland.There may be a great many easy and concurring Means of erecting and endowing such, with very little new Expence; and immense Advantages might result from them: besides, however considerable the Expenses might prove, is not the Object of them of the most interesting, the most important Nature? It is incontestably our serious Duty; and it would soon be manifest, that the Performance of it would be attended with more essential intrinsic Benefit to the Community, than any other Application of Moneycould produce. We must either admit, that the Multitude, the Body of the People is useless to the State, or agree, that Care should be taken to preserve and continue them. A very respectableEnglishMan, who, after a previous and thorough Consideration of this Subject, had applied himself very assiduously and usefully on the Means of increasing the Riches and the Happiness of his Country-men, complains that inEngland, the very Country in which there are the most Hospitals, the Poor who are sick are not sufficiently assisted. What a deplorable Deficience of the necessary Assistance for such must then be in a Country, that is not provided with a single Hospital? That Aid from Surgery and Physic, which abounds in Cities, is not sufficiently diffused into Country-places: and the Peasants are liable to some simple and moderate Diseases, which, for Want of proper Care, degenerate into a State of Infirmity, that sinks them into premature Death.§ 579. In fine, if it be found impossible to extinguish these Abuses (for those arising from Quacks are not the only ones, nor is that Title applied to as many as really deserve it) beyond all Doubt it would be for the Benefit and Safety of the Public, upon the whole, entirely to prohibit the Art, the Practice of Physic itself. When real and good Physicians cannot effect as much Good, as ignorant ones and Impostors can do Mischief, some real Advantage must accrue to the State, and to the whole Species, fromemploying none of either. I affirm it, after much Reflection, and from thorough Conviction, that Anarchy in Medicine is the most dangerous Anarchy. For this Profession, when loosed from every Restraint, and subjected to no Regulations, no Laws, is the more cruel Scourge and Affliction, from the incessant Exercise of it; and should its Anarchy, its Disorders prove irremediable, the Practice of an Art, become so very noxious, should be prohibited under the severest Penalties: Or, if the Constitution of any Government was inconsistent with the Application of so violent a Remedy, they should order public Prayers against the Mortality of it, to be offered up in all the Churches; as the Custom has been in other great and general Calamities.§ 580. Another Abuse, less fatal indeed than those already mentioned (but which, however, has real ill Consequences, and at the best, carries out a great deal of Money from us, though less at the Expense of the common People, than of those of easy Circumstances) is that Blindness and Facility, with which many suffer themselves to be imposed upon, by the pompous Advertisements of someCatholicon, some universal Remedy, which they purchase at a high Rate, from some foreign Pretender to a mighty Secret orNostrum. Persons of a Class or two above the Populace do not care to run after a Mountebank, from supposing they should depretiate themselves by mixing with the Herd. Yet if that very Quack, instead of coming among us, were toreside in some foreign City; if, instead of posting up his lying Puffs and Pretentions at the Corners of the Streets, he would get them inserted in the Gazettes, and News-papers; if, instead of selling his boasted Remedies in Person, he should establish Shops or Offices for that Purpose in every City; and finally, if instead of selling them twenty times above their real Value, he would still double that Price; instead of having the common People for his Customers, he would take in the wealthy Citizen, Persons of all Ranks, and from almost every Country. For strange as it seems, it is certain, that a Person of such a Condition, who is sensible in every other Respect; and who will scruple to confide his Health to the Conduct of such Physicians as would be the justest Subjects of his Confidence, will venture to take, through a very unaccountable Infatuation, the most dangerous Medicine, upon the Credit of an imposing Advertisement, published by as worthless and ignorant a Fellow as the Mountebank whom he despises, because the latter blows a Horn under his Window; and yet who differs from the former in no other Respects except those I have just pointed out.§ 581. Scarcely a Year passes, without one or another such advertized and vaunted Medicine's getting into high Credit; the Ravages of which are more or less, in Proportion to its being more or less in Vogue. Fortunately, for the human Species, but few of theseNostrumshave attained an equal Reputation withAilbaud's Powders, anInhabitant ofAixinProvence, and unworthy the Name of a Physician; who has over-runEuropefor some Years, with a violent Purge, the Remembrance of which will not be effaced before the Extinction of all its Victims. I attend now, and for a long time past, several Patients, whose Disorders I palliate without Hopes of ever curing them; and who owe their present melancholy State of Body to nothing but the manifest Consequences of these Powders; and I have actually seen, very lately, two Persons who have been cruelly poisoned by this boasted Remedy of his. A French Physician, as eminent for his Talents and his Science, as estimable from his personal Character in other Respects, has published some of the unhappy and tragical Consequences which the Use of them has occasioned; and were a Collection published of the same Events from them, in every Place where they have been introduced, the Size and the Contents of the Volume would make a very terrible one.§ 582. It is some Comfort however, that all the other Medicines thus puffed and vended have not been altogether so fashionable, nor yet quite so dangerous: but all posted and advertized Medicines should be judged of upon this Principle (and I do not know a more infallible one in Physics, nor in the Practice of Physic), that whoever advertises any Medicine, as a universal Remedy for all Diseases, is an absolute Impostor, such a Remedy being impossible and contradictory. I shall not here offer to detail such Proofsas may be given of the Verity of this Proposition: but I freely appeal for it to every sensible Man, who will reflect a little on the different Causes of Diseases; on the Opposition of these Causes; and on the Absurdity of attempting to oppose such various Diseases, and their Causes, by one and the same Remedy.As many as shall settle their Judgments properly on this Principle, will never be imposed upon by the superficial Gloss of these Sophisms contrived to prove, that all Diseases proceed from one Cause; and that this Cause is so very tractable, as to yield to one boasted Remedy. They will perceive at once, that such an Assertion must be founded in the utmost Knavery or Ignorance; and they will readily discover where the Fallacy lies. Can any one expect to cure a Dropsy, which arises from too great a Laxity of the Fibres, and too great an Attenuation or Thinness of the Blood, by the same Medicines that are used to cure an inflammatory Disease, in which the Fibres are too stiff and tense, and the Blood too thick and dense? Yet consult the News-papers and the Posts, and you will see published in and on all of them, Virtues just as contradictory; and certainly the Authors of such poisonous Contradictions ought to be legally punished for them.§ 583. I heartily wish the Publick would attend here to a very natural and obvious Reflection. I have treated in this Book, but of a small Number of Diseases, most of them acute ones;and I am positive that no competent well qualified Physician has ever employed fewer Medicines, in the Treatment of the Diseases themselves. Nevertheless I have prescribed seventy-one, and I do not see which of them I could retrench, or dispense with the Want of, if I were obliged to use one less. Can it be supposed then, that any one single Medicine, compound or simple, shall cure thirty times as many Diseases as those I have treated of?§ 584. I shall add another very important Observation, which doubtless may have occurred to many of my Readers; and it is this, that the different Causes of Diseases, their different Characters; the Differences which arise from the necessary Alterations that happen throughout their Progress and Duration; the Complications of which they are susceptible; the Varieties which result from the State of different Epidemics, of Seasons, of Sexes, and of many other Circumstances; that these Diversities, I say, oblige us very often to vary and change the Medicines; which proves how very ticklish and dangerous it is to have them directed by Persons, who have such an imperfect Knowledge of them, as those who are not Physicians must be supposed to have. And the Circumspection to be used in such Cases ought to be proportioned to the Interest the Assistant takes in the Preservation of the Patient; and that Love of his Neighbour with which he is animated.§ 585. Must not the same Arguments and Reflections unavoidably suggest the Necessity of an entire Tractability on the Part of the Patient, and his Friends and Assistants? The History of Diseases which have their stated Times of Beginning, of manifesting and displaying themselves; of arriving at, and continuing in their Height, and of decreasing; do not all these demonstrate the Necessity of continuing the same Medicines, as long as the Character of the Distemper is the same; and the Danger of changing them often, only because what has been given has not afforded immediate Relief? Nothing can injure the Patient more than this Instability and Caprice. After the Indication which his Distemper suggests, appears to be well deduced, the Medicine must be chosen that is likeliest to resist the Cause of it; and it must be continued as long as no new Symptom or Circumstance supervenes, which requires an Alteration of it; except it should be evident, that an Error had been incurred in giving it. But to conclude that a Medicine is useless or insignificant, because it does not remove or abate the Distemper as speedily, as the Impatience of the Sick would naturally desire it; and to change it for another, is as unreasonable, as it would be for a Man to break his Watch, because the Hand takes twelve Hours, to make a Revolution round the Dial-plate.§ 586. Physicians have some Regard to the State of the Urine of sick Persons, especially in inflammatory Fevers; as the Alterations occurringin it help them to judge of the Changes that may have been made in the Character and Consistence of the Humours in the Mass of Blood; and thence may conduce to determine the Time, in which it will be proper to dispose them tosome Evacuation. But it is gross Ignorance to imagine, and utter Knavery and Imposture to persuade the Sick, that the meer Inspection of their Urine solely, sufficiently enables others to judge of the Symptoms andCauseof the Disease, and to direct the best Remedies for it. This Inspection of the Urine can only be of Use when it is duly inspected; when we consider at the same time the exact State and the very Looks of the Patient; when these are compared with the Degree of the Symptoms of the Malady; with the other Evacuations; and when the Physician is strictly informed of all external Circumstances, which may be considered as foreign to the Malady; which may alter or affect the Evacuations, such as particular Articles of Food, particular Drinks, different Medicines, or the very Quantity of Drink. Where a Person is not furnished with an exact Account of these Circumstances, the meer Inspection of the Urine is of no Service, it suggests no Indication, nor any Expedient; and meer common Sense sufficiently proves, and it may be boldly affirmed, that whoever orders any Medicine, without any other Knowledge of the Disease, than what an Inspection of the Urine affords, is a rank Knave, and the Patient who takes them is a Dupe.§ 587. And here now any Reader may very naturally ask, whence can such a ridiculous Credulity proceed, upon a Subject so essentially interesting to us as our own Health?In Answer to this it should be observed, that some Sources, some Causes of it seem appropriated merely to the People, the Multitude. The first of these is, the mechanical Impression of Parade and Shew upon the Senses. 2, The Prejudice they have conceived, as I said before, of the Conjurers curing by a supernatural Gift. 3, The Notion the Country People entertain, that their Distemper and Disorders are of a Character and Species peculiar to themselves, and that the Physicians, attending the Rich, know nothing concerning them. 4, The general Mistake that their employing the Conjurer is much cheaper. 5, Perhaps a sheepish shame-faced Timidity may be one Motive, at least with some of them. 6, A Kind of Fear too, that Physicians will consider their Cases with less Care and Concern, and be likely to treat them more cavalierly; a Fear which increases that Confidence which the Peasant, and which indeed every Man has in his Equal, being sounded in Equality itself. And 7, the Discourse and Conversation of such illiterate Empirics being more to their Tast, and more adapted to their Apprehension.But it is less easy to account for this blind Confidence, which Persons of a superior Class (whole Education being considered as much betterare regarded as better Reasoners) repose in these boasted Remedies; and even for some Conjurer in Vogue. Nevertheless even some of their Motives may be probably assigned.The first is that great Principle ofSeïty, orSelfness, as it may be called, innate to Man, which attaching him to the Prolongation of his own Existence more than to any other thing in the Universe, keeps his Eyes, his utmost Attention, continually fixed upon this Object; and compels him to make it the very Point, the Purpose of all his Advances and Proceedings; notwithstanding it does not permit him to distinguish the safest Paths to it from the dangerous ones. This is the surest and shortest Way says some Collector at the Turnpike, he pays, passes, and perishes from the Precipices that occur in his Route.This very Principle is the Source of another Error, which consists in reposing, involuntarily, a greater Degree of Confidence in those, who flatter and fall in the most with us in our favourite Opinions. The well apprised Physician, who foresees the Length and the Danger of a Disease; and who is a Man of too much Integrity to affirm what he does not think, must, from a necessary Construction of the human Frame and Mind, be listened to less favourably, than he who flatters us by saying what we wish. We endeavour to elongate, to absent ourselves, from the Sentiments, the Judgment of the first; we smile, from Self-complacency, at those of the last,which in a very little time are sure of obtaining our Preference.A third Cause, which results from the same Principle is, that we give ourselves up the most readily to his Conduct, whose Method seems the least disagreeable, and flatters our Inclinations the most. The Physician who enjoins a strict Regimen; who insists upon some Restraints and Self-denials; who intimates the Necessity of Time and Patience for the Accomplishment of the Cure, and who expects a thorough Regularity through the Course of it, disgusts a Patient who has been accustomed to indulge his own Tast and Humour; the Quack, who never hesitates at complying with it, charms him. The Idea of a long and somewhat distant Cure, to be obtained at the End of an unpleasant and unrelaxing Regimen, supposes a very perilous Disease; this Idea disposes the Patient to Disgust and Melancholy, he cannot submit to it without Pain; and he embraces, almost unconsciously, merely to avoid this, an opposite System which presents him only with the Idea of such a Distemper, as will give Way to a few Doses of Simples.That Propensity to the New and Marvellous, which tyrannizes over so large a Proportion of our Species, and which has advanced so many absurd Persons and Things into Reputation, is a fourth and a very powerful Motive. An irksome Satiety, and a Tiresomeness, as it were, from the same Objects, is what our Nature is apt to be very apprehensive of; though we areincessantly conducted towards it, by a Perception of some Void, some Emptiness in ourselves, and even in Society too: But new and extraordinary Sensations rousing us from this disagreeable State, more effectually than any Thing else, we unthinkingly abandon ourselves to them, without foreseeing their Consequences.A fifth Cause arises from seven Eighths of Mankind being managed by, or following, the other Eighth; and, generally speaking, the Eighth that is so very forward to manage them, are the least fit and worthy to do it; whence all must go amiss, and absurd and embarrassing Consequences ensue from the Condition of Society. A Man of excellent Sense frequently sees only through the Eyes of a Fool, of an intriguing Fellow, or of a Cheat; in this he judges wrong, and his Conduct must be so too. A man of real Merit cannot connect himself with those who are addicted to caballing; and yet such are the Persons, who frequently conduct others.Some other Causes might be annexed to these, but I shall mention only one of them, which I have already hinted, and the Truth of which I am confirmed in from several Years Experience; which is, that we generally love those who reason more absurdly than ourselves, better than those who convince us of our own weak Reasoning.I hope the Reflexions every Reader will make on these Causes of our ill Conduct on this important Head, may contribute to correct or diminishit; and to destroy those Prejudices whose fatal Effects we may continually observe.[N. B.The Multitude ofallthe Objects of this excellent Chapter in this Metropolis, and doubtless throughoutEngland,were strong Inducements to have taken a little wholesome Notice of the Impostures of a few of the most pernicious. But on a second Perusal of this Part of the Original and its Translation, I thought it impossible (without descending to personal, nominal Anecdotes about the Vermin) to add any Thing material upon a Subject, which the Author has with such Energy exhausted. He even seems, by some of his Descriptions, to have taken Cognizance of a few of our most self-dignified itinerant Empirics; as these Genius's find it necessary sometimes to treat themselves with a little Transportation. In reality Dr.Tissothas, in a very masterly Way, thoroughly dissected and displayed the wholeGenus,every Species of Quacks. And when he comes to account for that Facility, with which Persons of very different Principles from them, and of better Intellects, first listen to, and finally countenance such Caitiffs, he penetrates into some of the most latent Weaknesses of the human Mind; even such as are often Secrets to their Owners. It is difficult, throughout this Disquisition, not to admire the Writer; but impossible not to love the Man, the ardent Philanthropist. His Sentiment that—“A Man of real Merit cannot connect himself with those who are addicted to caballing,”—is exquisitely just, and so liberal, that it never entered into the Mind of any disingenuous Man, however dignified, in any Profession. Persons of the simplest Hearts and purest Reflections must shrink at every Consciousness of Artifice; and secretly reproach themselves for each Success, that has redounded to them at the Expence of Truth.] K.
Of Mountebanks, Quacks, and Conjurers.
Sect.562.
Sect.562.
One dreadful Scourge still remains to be treated of, which occasions a greater Mortality, than all the Distempers I have hitherto described; and which, as long as it continues, will defeat our utmostPrecautions to preserve the Healths and Lives of the common People. This, or rather, these Scourges, for they are very numerous, are Quacks; of which there are two Species: The Mountebanks or travelling Quacks, and those pretended Physicians in Villages and Country-Places, both male and female, known inSwisserlandby the Name of Conjurers, and who very effectually unpeople it.
The first of these, the Mountebanks, without visiting the Sick, or thinking of their Distempers, sell different Medicines, some of which are for external Use, and these often do little or no Mischief; but their internal ones are much oftener pernicious. I have been a Witness of their dreadful Effects, and we are not visited by one of these wandering Caitiffs, whose Admission into our Country is not mortally fatal to some of its Inhabitants. They are injurious also in another Respect, as they carry off great Sums of Money with them, and levy annually some thousands of Livres, amongst that Order of the People, who have the least to spare. I have seen, and with a very painful Concern, the poor Labourer and the Artisan, who have scarcely possessed the common Necessaries of Life, borrow wherewithal to purchase, and at a dear Price, the Poison that was to compleat their Misery, by increasing their Maladies; and which, where they escaped with their Lives, has left them in such a languid and inactive State, as has reduced their whole Family to Beggary.
§ 563. An ignorant, knavish, lying and impudent Fellow will always seduce the gross and credulous Mass of People, incapable to judge of and estimate any thing rightly; and adapted to be the eternal Dupes of such, as are base enough to endeavour to dazzle their weak Understandings; by which Method these vile Quacks will certainly defraud them, as long as they are tolerated. But ought not the Magistrates, the Guardians, the Protectors, the political Fathers of the People interpose, and defend them from this Danger, by severely prohibiting the Entrance of such pernicious Fellows into a Country, where Mens' Lives are very estimable, and where Money is scarce; since they extinguish the first, and carry off the last, without the least Possibility of their being in anywise useful to it. Can such forcible Motives as these suffer our Magistrates to delaytheirExpulsion any longer,whomthere never was the least Reason for admitting?
§ 564. It is acknowledged the Conjurers, the residing Conjurers, do not carry out the current Money of the Country, like the itinerant Quacks; but the Havock they make among their Fellow Subjects is without Intermission, whence it must be very great, as every Day in the Year is marked with many of their Victims. Without the least Knowledge or Experience, and offensively armed with three or four Medicines, whose Nature they are as thoroughly ignorant of, as of their unhappy Patients Diseases; and which Medicines, being almost all violent ones, are verycertainly so many Swords in the Hands of raging Madmen. Thus armed and qualified, I say, they aggravate the slightest Disorders, and make those that are a little more considerable, mortal; but from which the Patients would have recovered, if left solely to the Conduct of Nature; and, for a still stronger Reason, if they had confided to the Guidance of her experienced Observers and Assistants.
§ 565. The Robber who assassinates on the High-way, leaves the Traveller the Resource of defending himself, and the Chance of being aided by the Arrival of other Travellers: But the Poisoner, who forces himself into the Confidence of a sick Person, is a hundred times more dangerous, and as just an Object of Punishment.
The Bands of Highwaymen, and their Individuals, that enter into any Country or District, are described as particularly as possible to the Publick. It were equally to be wished, we had also a List of these physical Impostors and Ignorants male and female; and that a most exact Description of them, with the Number, and a brief Summary of their murderous Exploits, were faithfully published. By this Means the Populace might probably be inspired with such a wholesome Dread of them, that they would no longer expose their Lives to the Mercy of such Executioners.
§ 566. But their Blindness, with Respect to these two Sorts of maleficent Beings, is inconceivable. That indeed in Favour of the Mountebankis somewhat less gross, because as they are not personally acquainted with him, they may the more easily credit him with some Part of the Talents and the Knowledge he arrogates. I shall therefore inform them, and it cannot be repeated too often, that whatever ostentatious Dress and Figure some of these Impostors make, they are constantly vile Wretches, who, incapable of earning a Livelyhood in any honest Way, have laid the Foundation of their Subsistence on their own amazing Stock of Impudence, and that of the weak Credulity of the People; that they have no scientific Knowledge; that their Titles and Patents are so many Impositions, and inauthentic; since by a shameful Abuse, such Patents and Titles are become Articles of Commerce, which are to be obtained at very low Prices; just like the second-hand laced Cloaks which they purchase at the Brokers. That their Certificates of Cures are so many Chimeras or Forgeries; and that in short, if among the prodigious Multitudes of People who take their Medicines, some of them should recover, which it is almost physically impossible must not sometimes be the Case, yet it would not be the less certain, that they are a pernicious destructive Set of Men. A Thrust of a Rapier into the Breast has saved a Man's Life by seasonably opening an Imposthume in it, which might otherwise have killed him: and yet internal penetrating Wounds, with a small Sword, are not the less mortal for one such extraordinary Consequence. Nor is it even surprizing thatthese Mountebanks, which is equally applicable to Conjurers, who kill thousands of People, whom Nature alone, or assisted by a Physician, would have saved, should now and then cure a Patient, who had been treated before by the ablest Physicians. Frequently Patients of that Class, who apply to these Mountebanks and Conjurers (whether it has been, that they would not submit to the Treatment proper for their Distempers; or whether the real Physician tired of the intractable Creatures has discontinued his Advice and Attendance) look out for such Doctors, as assure them of a speedy Cure, and venture to give them such Medicines as kill many, and cure one (who has had Constitution enough to overcome them) a little sooner than a justly reputable Physician would have done. It is but too easy to procure, in every Parish, such Lists of their Patients, and of their Feats, as would clearly evince the Truth of whatever has been said here relating to them.
§ 567. The Credit of this Market, this Fair-hunting Doctor, surrounded by five or six hundred Peasants, staring and gaping at him, and counting themselves happy in his condescending to cheat them of their very scarce and necessary Cash, by selling them, for twenty times more than its real Worth, a Medicine whose best Quality were to be only a useless one; the Credit, I say, of this vile yet tolerated Cheat, would quickly vanish, could each of his Auditors be persuaded, of what is strictly true, that except alittle more Tenderness and Agility of Hand, he knows full as much as his Doctor; and that if he could assume as much Impudence, he would immediately have as much Ability, would equally deserve the same Reputation, and to have the same Confidence reposed in him.
§ 568. Were the Populace capable of reasoning, it were easy to disabuse them in these Respects; but as it is, their Guardians and Conductors should reason for them. I have already proved the Absurdity of reposing any Confidence in Mountebanks, properly so called; and that Reliance some have on the Conjurers is still more stupid and ridiculous.
The very meanest Trade requires some Instruction: A Man does not commence even a Cobler, a Botcher of old Leather, without serving an Apprenticeship to it; and yet no Time has been served, no Instruction has been attended to, by these Pretenders to the most necessary, useful and elegant Profession. We do not confide the mending, the cleaning of a Watch to any, who have not spent several Years in considering how a Watch is made; what are the Requisites and Causes of its going right; and the Defects or Impediments that make it go wrong: and yet the preserving and rectifying the Movements of the most complex, the most delicate and exquisite, and the most estimable Machine upon Earth, is entrusted to People who have not the least Notion of its Structure; of the Causesof its Motions; nor of the Instruments proper to rectify their Deviations.
Let a Soldier discarded from his Regiment for his roguish Tricks, or who is a Deserter from it, a Bankrupt, a disreputable Ecclesiastic, a drunken Barber, or a Multitude of such other worthless People, advertize that they mount, set and fit up all Kinds of Jewels and Trinkets in Perfection; if any of these are not known; if no Person in the Place has ever seen any of their Work; or if they cannot produce authentic Testimonials of their Honesty, and their Ability in their Business, not a single Individual will trust them with two Pennyworth of false Stones to work upon; in short they must be famished. But if instead of professing themselves Jewellers, they post themselves up as Physicians, the Croud purchase, at a high Rate, the Pleasure of trusting them with the Care of their Lives, the remaining Part of which they rarely fail to empoison.
§ 569. The most genuine and excellent Physicians, these extraordinary Men, who, born with the happiest Talents, have began to inform their Understandings from their earliest Youth; who have afterwards carefully qualified themselves by cultivating every Branch of Physic; who have sacrificed the best and most pleasurable Days of their Lives, to a regular and assiduous Investigation of the human Body; of its various Functions; of the Causes that may impair or embarrass them, and informed themselves of the Qualities and Virtues of every simple andcompound Medicine; who have surmounted the Difficulty and Loathsomness of living in Hospitals among thousands of Patients; and who have added the medical Observations of all Ages and Places to their own; these few and extraordinary Men, I say, still consider themselves as short of that perfect Ability and consummate Knowledge, which they contemplate and wish for, as necessary to guarding the preciousDepositumof human Life and Health, confided to their Charge. Nevertheless we see the same inestimable Treasures, intrusted to gross and stupid Men, born without Talents; brought up without Education or Culture; who frequently can scarcely read; who are as profoundly ignorant of every Subject that has any Relation to Physic, as the Savages ofAsia; who awake only to drink away; who often exercise their horrid Trade merely to find themselves in strong Liquor, and execute it chiefly when they are drunk: who, in short, became Physicians, only from their Incapacity to arrive at any Trade or Attainment! Certainly such a Conduct in Creatures of the human Species must appear very astonishing, and even melancholy, to every sensible thinking Man; and constitute the highest Degree of Absurdity and Extravagance.
Should any Person duly qualified enter into an Examination of the Medicines they use, and compare them with the Situation and Symptoms of the Patients to whom they give them, he must be struck with Horror; and heartily deplore theFate of that unfortunate Part of the human Race, whose Lives, so important to the Community, are committed to the Charge of the most murderous Set of Beings.
§ 570. Some of these Caitiffs however, apprehending the Force and Danger of that Objection, founded on their Want of Study and Education, have endeavoured to elude it, by infusing and spreading a false, and indeed, an impudent impious Prejudice among the People, which prevails too much at present; and this is, that their Talents for Physic are a supernatural Gift, and, of Course, greatly superior to all human Knowledge. It were going out of my Province to expatiate on the Indecency, the Sin, and the Irreligion of such Knavery, and incroaching upon the Rights and perhaps the Duty of the Clergy; but I intreat the Liberty of observing to this respectable Order of Men, that this Superstition, which is attended with dreadful Consequences, seems to call for their utmost Attention: and in general the Expulsion of Superstition is the more to be wished, as a Mind, imbued with false Prejudices, is less adapted to imbibe a true and valuable Doctrine. There are some very callous hardenedVillainsamong this murdering Band, who, with a View to establish their Influence and Revenue as well upon Fear as upon Hope, have horridly ventured so far as to incline the Populace to doubt, whether they received their boasted Gift and Power from Heaven or from Hell! And yet these are the Menwho are trusted with the Health and the Lives of many others.
§ 571. One Fact which I have already mentioned, and which it seems impossible to account for is, that great Earnestness of the Peasant to procure the best Assistance he can for his sick Cattle. At whatever Distance the Farrier lives, or some Person who is supposed qualified to be one (for unfortunately there is not one inSwisserland) if he has considerable Reputation in this Way, the Country-man goes to consult him, or purchases his Visit at any Price. However expensive the Medicines are, which the Horse-doctor directs, if they are accounted the best, he procures them for his poor Beast. But if himself, his Wife or Children fall sick, he either calls in no Assistance nor Medicines; or contents himself with such as are next at Hand, however pernicious they may be, though nothing the cheaper on that account: for certainly the Money, extorted by some of these physical Conjurers from their Patients, but oftner from their Heirs, is a very shameful Injustice, and calls loudly for Reformation.
§ 572. In an excellent Memoir or Tract, which will shortly be published, on the Population ofSwisserland, we shall find an important and very affecting Remark, which strictly demonstrates the Havock made by these immedical Magicians or Conjurers; and which is this: That in the common Course of Years, the Proportion between the Numbers and Deaths of the Inhabitantsof any one Place, is not extremely different in City and Country: but when the very same epidemical Disease attacks the City and the Villages, the Difference is enormous; and the Number of Deaths of the former compared with that of the Inhabitants of the Villages, where the Conjurer exercises his bloody Dominion, is infinitely more than the Deaths in the City.
I find in the second Volume of the Memoirs of the oeconomical Society ofBerne, for the Year 1762, another Fact equally interesting, which is related by one of the most intelligent and sagacious Observers, concerned in that Work. “Pleurisies and Peripneumonies (hesays) prevailed atCottens a la Côte; and some Peasants died under them, who had consulted the Conjurers and taken their heating Medicines; while of those, who pursued a directly opposite Method, almost every one recovered.”
§ 573. But I shall employ myself no longer on this Topic, on which the Love of my Species alone has prompted me to say thus much; though it deserves to be considered more in Detail, and is, in Reality, of the greatest Consequence. None methinks could make themselves easy with Respect to it so much as Physicians, if they were conducted only by lucrative Views; since these Conjurers diminish the Number of those poor People, who sometimes consult the real Physicians, and with some Care and Trouble, but without the least Profit, to those Gentlemen. But what good Physician is mean andvile enough to purchase a few Hours of Ease and Tranquillity at so high, so very odious a Price?
§ 574. Having thus clearly shewn the Evils attending this crying Nusance, I wish I were able to prescribe an effectual Remedy against it, which I acknowledge is far from being easy to do.
The first necessary Point probably was to have demonstrated the great and public Danger, and to dispose the State to employ their Attention on this fatal, this mortal Abuse; which, joined to the other Causes of Depopulation, has a manifest Tendency to renderSwisserlanda Desert.
§ 575. The second, and doubtless the most effectual Means, which I had already mentioned is, not to admit any travelling Mountebank to enter this Country; and to set a Mark on all the Conjurers: It may probably also be found convenient, to inflict corporal Punishment on them; as it has been already adjudged in different Countries by sovereign Edicts. At the very least they should be marked with public Infamy, according to the following Custom practised in a great City inFrance. “When any Mountebanks appeared inMontpellier, the Magistrates had a Power to mount each of them upon a meagre miserable Ass, with his Head to the Ass's Tail. In this Condition they were led throughout the whole City, attended with the Shouts and Hooting of the Children and the Mob, beating them, throwing Filth and Ordure at them, reviling them, and dragging them all about.”
§ 576. A third conducive Means would be the Instructions and Admonition of the Clergy on this Subject, to the Peasants in their several Parishes. For this Conduct of the common People amounting, in Effect, to Suicide, to Self-murder, it must be important to convince them of it. But the little Efficacy of the strongest and repeated Exhortations on so many other Articles, may cause us to entertain a very reasonable Doubt of their Success on this. Custom seems to have determined, that there is nothing in our Day, which excludes a Person from the Title and Appellation of an honest or honourable Man, except it be meer and convicted Theft; and that for this simple and obvious Reason, that we attach ourselves more strongly to our Property, than to any Thing else. Even Homicide is esteemed and reputed honourable in many Cases. Can we reasonably then expect to convince the Multitude, that it is criminal to confide the Care of their Health to these Poisoners, in Hopes of a Cure of their Disorders? A much likelier Method of succeding on this Point would certainly be, to convince the deluded People, that it will cost them less to be honestly and judiciously treated, than to suffer under the Hands of these Executioners. The Expectation of a good and cheap Health-market will be apt to influence them more, than their Dread of a Crime would.
§ 577. A fourth Means of removing or restraining this Nusance would be to expunge, from the Almanacs, all the astrological Rulesrelating to Physick; as they continually conduce to preserve and increase some dangerous Prejudices and Notions in a Science, the smallest Errors in which are sometimes fatal. I had already reflected on the Multitude of Peasants that have been lost, from postponing, or mistiming a Bleeding, only because the sovereign Decision of an Almanac had directed it at some other Time. May it not also be dreaded, to mention it by the Way, that the same Cause, the Almanacs, may prove injurious to their rural Oeconomy and Management; and that by advising with the Moon, who has no Influence, and is of no Consequence in Vegetation or other Country Business, they may be wanting in a due Attention to such other Circumstances and Regulations, as are of real Importance in them?
§ 578. A fifth concurring Remedy against this popular Evil would be the Establishment of Hospitals, for the Reception of poor Patients, in the different Cities and Towns ofSwisserland.
There may be a great many easy and concurring Means of erecting and endowing such, with very little new Expence; and immense Advantages might result from them: besides, however considerable the Expenses might prove, is not the Object of them of the most interesting, the most important Nature? It is incontestably our serious Duty; and it would soon be manifest, that the Performance of it would be attended with more essential intrinsic Benefit to the Community, than any other Application of Moneycould produce. We must either admit, that the Multitude, the Body of the People is useless to the State, or agree, that Care should be taken to preserve and continue them. A very respectableEnglishMan, who, after a previous and thorough Consideration of this Subject, had applied himself very assiduously and usefully on the Means of increasing the Riches and the Happiness of his Country-men, complains that inEngland, the very Country in which there are the most Hospitals, the Poor who are sick are not sufficiently assisted. What a deplorable Deficience of the necessary Assistance for such must then be in a Country, that is not provided with a single Hospital? That Aid from Surgery and Physic, which abounds in Cities, is not sufficiently diffused into Country-places: and the Peasants are liable to some simple and moderate Diseases, which, for Want of proper Care, degenerate into a State of Infirmity, that sinks them into premature Death.
§ 579. In fine, if it be found impossible to extinguish these Abuses (for those arising from Quacks are not the only ones, nor is that Title applied to as many as really deserve it) beyond all Doubt it would be for the Benefit and Safety of the Public, upon the whole, entirely to prohibit the Art, the Practice of Physic itself. When real and good Physicians cannot effect as much Good, as ignorant ones and Impostors can do Mischief, some real Advantage must accrue to the State, and to the whole Species, fromemploying none of either. I affirm it, after much Reflection, and from thorough Conviction, that Anarchy in Medicine is the most dangerous Anarchy. For this Profession, when loosed from every Restraint, and subjected to no Regulations, no Laws, is the more cruel Scourge and Affliction, from the incessant Exercise of it; and should its Anarchy, its Disorders prove irremediable, the Practice of an Art, become so very noxious, should be prohibited under the severest Penalties: Or, if the Constitution of any Government was inconsistent with the Application of so violent a Remedy, they should order public Prayers against the Mortality of it, to be offered up in all the Churches; as the Custom has been in other great and general Calamities.
§ 580. Another Abuse, less fatal indeed than those already mentioned (but which, however, has real ill Consequences, and at the best, carries out a great deal of Money from us, though less at the Expense of the common People, than of those of easy Circumstances) is that Blindness and Facility, with which many suffer themselves to be imposed upon, by the pompous Advertisements of someCatholicon, some universal Remedy, which they purchase at a high Rate, from some foreign Pretender to a mighty Secret orNostrum. Persons of a Class or two above the Populace do not care to run after a Mountebank, from supposing they should depretiate themselves by mixing with the Herd. Yet if that very Quack, instead of coming among us, were toreside in some foreign City; if, instead of posting up his lying Puffs and Pretentions at the Corners of the Streets, he would get them inserted in the Gazettes, and News-papers; if, instead of selling his boasted Remedies in Person, he should establish Shops or Offices for that Purpose in every City; and finally, if instead of selling them twenty times above their real Value, he would still double that Price; instead of having the common People for his Customers, he would take in the wealthy Citizen, Persons of all Ranks, and from almost every Country. For strange as it seems, it is certain, that a Person of such a Condition, who is sensible in every other Respect; and who will scruple to confide his Health to the Conduct of such Physicians as would be the justest Subjects of his Confidence, will venture to take, through a very unaccountable Infatuation, the most dangerous Medicine, upon the Credit of an imposing Advertisement, published by as worthless and ignorant a Fellow as the Mountebank whom he despises, because the latter blows a Horn under his Window; and yet who differs from the former in no other Respects except those I have just pointed out.
§ 581. Scarcely a Year passes, without one or another such advertized and vaunted Medicine's getting into high Credit; the Ravages of which are more or less, in Proportion to its being more or less in Vogue. Fortunately, for the human Species, but few of theseNostrumshave attained an equal Reputation withAilbaud's Powders, anInhabitant ofAixinProvence, and unworthy the Name of a Physician; who has over-runEuropefor some Years, with a violent Purge, the Remembrance of which will not be effaced before the Extinction of all its Victims. I attend now, and for a long time past, several Patients, whose Disorders I palliate without Hopes of ever curing them; and who owe their present melancholy State of Body to nothing but the manifest Consequences of these Powders; and I have actually seen, very lately, two Persons who have been cruelly poisoned by this boasted Remedy of his. A French Physician, as eminent for his Talents and his Science, as estimable from his personal Character in other Respects, has published some of the unhappy and tragical Consequences which the Use of them has occasioned; and were a Collection published of the same Events from them, in every Place where they have been introduced, the Size and the Contents of the Volume would make a very terrible one.
§ 582. It is some Comfort however, that all the other Medicines thus puffed and vended have not been altogether so fashionable, nor yet quite so dangerous: but all posted and advertized Medicines should be judged of upon this Principle (and I do not know a more infallible one in Physics, nor in the Practice of Physic), that whoever advertises any Medicine, as a universal Remedy for all Diseases, is an absolute Impostor, such a Remedy being impossible and contradictory. I shall not here offer to detail such Proofsas may be given of the Verity of this Proposition: but I freely appeal for it to every sensible Man, who will reflect a little on the different Causes of Diseases; on the Opposition of these Causes; and on the Absurdity of attempting to oppose such various Diseases, and their Causes, by one and the same Remedy.
As many as shall settle their Judgments properly on this Principle, will never be imposed upon by the superficial Gloss of these Sophisms contrived to prove, that all Diseases proceed from one Cause; and that this Cause is so very tractable, as to yield to one boasted Remedy. They will perceive at once, that such an Assertion must be founded in the utmost Knavery or Ignorance; and they will readily discover where the Fallacy lies. Can any one expect to cure a Dropsy, which arises from too great a Laxity of the Fibres, and too great an Attenuation or Thinness of the Blood, by the same Medicines that are used to cure an inflammatory Disease, in which the Fibres are too stiff and tense, and the Blood too thick and dense? Yet consult the News-papers and the Posts, and you will see published in and on all of them, Virtues just as contradictory; and certainly the Authors of such poisonous Contradictions ought to be legally punished for them.
§ 583. I heartily wish the Publick would attend here to a very natural and obvious Reflection. I have treated in this Book, but of a small Number of Diseases, most of them acute ones;and I am positive that no competent well qualified Physician has ever employed fewer Medicines, in the Treatment of the Diseases themselves. Nevertheless I have prescribed seventy-one, and I do not see which of them I could retrench, or dispense with the Want of, if I were obliged to use one less. Can it be supposed then, that any one single Medicine, compound or simple, shall cure thirty times as many Diseases as those I have treated of?
§ 584. I shall add another very important Observation, which doubtless may have occurred to many of my Readers; and it is this, that the different Causes of Diseases, their different Characters; the Differences which arise from the necessary Alterations that happen throughout their Progress and Duration; the Complications of which they are susceptible; the Varieties which result from the State of different Epidemics, of Seasons, of Sexes, and of many other Circumstances; that these Diversities, I say, oblige us very often to vary and change the Medicines; which proves how very ticklish and dangerous it is to have them directed by Persons, who have such an imperfect Knowledge of them, as those who are not Physicians must be supposed to have. And the Circumspection to be used in such Cases ought to be proportioned to the Interest the Assistant takes in the Preservation of the Patient; and that Love of his Neighbour with which he is animated.
§ 585. Must not the same Arguments and Reflections unavoidably suggest the Necessity of an entire Tractability on the Part of the Patient, and his Friends and Assistants? The History of Diseases which have their stated Times of Beginning, of manifesting and displaying themselves; of arriving at, and continuing in their Height, and of decreasing; do not all these demonstrate the Necessity of continuing the same Medicines, as long as the Character of the Distemper is the same; and the Danger of changing them often, only because what has been given has not afforded immediate Relief? Nothing can injure the Patient more than this Instability and Caprice. After the Indication which his Distemper suggests, appears to be well deduced, the Medicine must be chosen that is likeliest to resist the Cause of it; and it must be continued as long as no new Symptom or Circumstance supervenes, which requires an Alteration of it; except it should be evident, that an Error had been incurred in giving it. But to conclude that a Medicine is useless or insignificant, because it does not remove or abate the Distemper as speedily, as the Impatience of the Sick would naturally desire it; and to change it for another, is as unreasonable, as it would be for a Man to break his Watch, because the Hand takes twelve Hours, to make a Revolution round the Dial-plate.
§ 586. Physicians have some Regard to the State of the Urine of sick Persons, especially in inflammatory Fevers; as the Alterations occurringin it help them to judge of the Changes that may have been made in the Character and Consistence of the Humours in the Mass of Blood; and thence may conduce to determine the Time, in which it will be proper to dispose them tosome Evacuation. But it is gross Ignorance to imagine, and utter Knavery and Imposture to persuade the Sick, that the meer Inspection of their Urine solely, sufficiently enables others to judge of the Symptoms andCauseof the Disease, and to direct the best Remedies for it. This Inspection of the Urine can only be of Use when it is duly inspected; when we consider at the same time the exact State and the very Looks of the Patient; when these are compared with the Degree of the Symptoms of the Malady; with the other Evacuations; and when the Physician is strictly informed of all external Circumstances, which may be considered as foreign to the Malady; which may alter or affect the Evacuations, such as particular Articles of Food, particular Drinks, different Medicines, or the very Quantity of Drink. Where a Person is not furnished with an exact Account of these Circumstances, the meer Inspection of the Urine is of no Service, it suggests no Indication, nor any Expedient; and meer common Sense sufficiently proves, and it may be boldly affirmed, that whoever orders any Medicine, without any other Knowledge of the Disease, than what an Inspection of the Urine affords, is a rank Knave, and the Patient who takes them is a Dupe.
§ 587. And here now any Reader may very naturally ask, whence can such a ridiculous Credulity proceed, upon a Subject so essentially interesting to us as our own Health?
In Answer to this it should be observed, that some Sources, some Causes of it seem appropriated merely to the People, the Multitude. The first of these is, the mechanical Impression of Parade and Shew upon the Senses. 2, The Prejudice they have conceived, as I said before, of the Conjurers curing by a supernatural Gift. 3, The Notion the Country People entertain, that their Distemper and Disorders are of a Character and Species peculiar to themselves, and that the Physicians, attending the Rich, know nothing concerning them. 4, The general Mistake that their employing the Conjurer is much cheaper. 5, Perhaps a sheepish shame-faced Timidity may be one Motive, at least with some of them. 6, A Kind of Fear too, that Physicians will consider their Cases with less Care and Concern, and be likely to treat them more cavalierly; a Fear which increases that Confidence which the Peasant, and which indeed every Man has in his Equal, being sounded in Equality itself. And 7, the Discourse and Conversation of such illiterate Empirics being more to their Tast, and more adapted to their Apprehension.
But it is less easy to account for this blind Confidence, which Persons of a superior Class (whole Education being considered as much betterare regarded as better Reasoners) repose in these boasted Remedies; and even for some Conjurer in Vogue. Nevertheless even some of their Motives may be probably assigned.
The first is that great Principle ofSeïty, orSelfness, as it may be called, innate to Man, which attaching him to the Prolongation of his own Existence more than to any other thing in the Universe, keeps his Eyes, his utmost Attention, continually fixed upon this Object; and compels him to make it the very Point, the Purpose of all his Advances and Proceedings; notwithstanding it does not permit him to distinguish the safest Paths to it from the dangerous ones. This is the surest and shortest Way says some Collector at the Turnpike, he pays, passes, and perishes from the Precipices that occur in his Route.
This very Principle is the Source of another Error, which consists in reposing, involuntarily, a greater Degree of Confidence in those, who flatter and fall in the most with us in our favourite Opinions. The well apprised Physician, who foresees the Length and the Danger of a Disease; and who is a Man of too much Integrity to affirm what he does not think, must, from a necessary Construction of the human Frame and Mind, be listened to less favourably, than he who flatters us by saying what we wish. We endeavour to elongate, to absent ourselves, from the Sentiments, the Judgment of the first; we smile, from Self-complacency, at those of the last,which in a very little time are sure of obtaining our Preference.
A third Cause, which results from the same Principle is, that we give ourselves up the most readily to his Conduct, whose Method seems the least disagreeable, and flatters our Inclinations the most. The Physician who enjoins a strict Regimen; who insists upon some Restraints and Self-denials; who intimates the Necessity of Time and Patience for the Accomplishment of the Cure, and who expects a thorough Regularity through the Course of it, disgusts a Patient who has been accustomed to indulge his own Tast and Humour; the Quack, who never hesitates at complying with it, charms him. The Idea of a long and somewhat distant Cure, to be obtained at the End of an unpleasant and unrelaxing Regimen, supposes a very perilous Disease; this Idea disposes the Patient to Disgust and Melancholy, he cannot submit to it without Pain; and he embraces, almost unconsciously, merely to avoid this, an opposite System which presents him only with the Idea of such a Distemper, as will give Way to a few Doses of Simples.
That Propensity to the New and Marvellous, which tyrannizes over so large a Proportion of our Species, and which has advanced so many absurd Persons and Things into Reputation, is a fourth and a very powerful Motive. An irksome Satiety, and a Tiresomeness, as it were, from the same Objects, is what our Nature is apt to be very apprehensive of; though we areincessantly conducted towards it, by a Perception of some Void, some Emptiness in ourselves, and even in Society too: But new and extraordinary Sensations rousing us from this disagreeable State, more effectually than any Thing else, we unthinkingly abandon ourselves to them, without foreseeing their Consequences.
A fifth Cause arises from seven Eighths of Mankind being managed by, or following, the other Eighth; and, generally speaking, the Eighth that is so very forward to manage them, are the least fit and worthy to do it; whence all must go amiss, and absurd and embarrassing Consequences ensue from the Condition of Society. A Man of excellent Sense frequently sees only through the Eyes of a Fool, of an intriguing Fellow, or of a Cheat; in this he judges wrong, and his Conduct must be so too. A man of real Merit cannot connect himself with those who are addicted to caballing; and yet such are the Persons, who frequently conduct others.
Some other Causes might be annexed to these, but I shall mention only one of them, which I have already hinted, and the Truth of which I am confirmed in from several Years Experience; which is, that we generally love those who reason more absurdly than ourselves, better than those who convince us of our own weak Reasoning.
I hope the Reflexions every Reader will make on these Causes of our ill Conduct on this important Head, may contribute to correct or diminishit; and to destroy those Prejudices whose fatal Effects we may continually observe.
[N. B.The Multitude ofallthe Objects of this excellent Chapter in this Metropolis, and doubtless throughoutEngland,were strong Inducements to have taken a little wholesome Notice of the Impostures of a few of the most pernicious. But on a second Perusal of this Part of the Original and its Translation, I thought it impossible (without descending to personal, nominal Anecdotes about the Vermin) to add any Thing material upon a Subject, which the Author has with such Energy exhausted. He even seems, by some of his Descriptions, to have taken Cognizance of a few of our most self-dignified itinerant Empirics; as these Genius's find it necessary sometimes to treat themselves with a little Transportation. In reality Dr.Tissothas, in a very masterly Way, thoroughly dissected and displayed the wholeGenus,every Species of Quacks. And when he comes to account for that Facility, with which Persons of very different Principles from them, and of better Intellects, first listen to, and finally countenance such Caitiffs, he penetrates into some of the most latent Weaknesses of the human Mind; even such as are often Secrets to their Owners. It is difficult, throughout this Disquisition, not to admire the Writer; but impossible not to love the Man, the ardent Philanthropist. His Sentiment that—“A Man of real Merit cannot connect himself with those who are addicted to caballing,”—is exquisitely just, and so liberal, that it never entered into the Mind of any disingenuous Man, however dignified, in any Profession. Persons of the simplest Hearts and purest Reflections must shrink at every Consciousness of Artifice; and secretly reproach themselves for each Success, that has redounded to them at the Expence of Truth.] K.