PREFACE.
Thechief purpose of the study of medicine is to acquire the knowledge of a safe and effectual method of curing diseases. The attainment of this end is intimately connected with the public good. Every endeavour to promote it, therefore, may be considered as having some claim to a candid examination. In this persuasion, I submit the following observations to public inspection.
Few diseases are at present more common thanlues venerea. For its cure, mercury is a medicine which is almost universally employed; and the efficacy with which it operates has long been confirmed by unquestionable experience. But the successful employment of mercury inthis disease requires very particular attention; and it is to be regreted, that, while many suffer from the distemper, not a few fall victims to what is used as the remedy: All therefore that has hitherto been said on this subject by no means supersedes farther attempts to improvement. To advance the practice of medicine in this particular, is the intention of the present publication.
Nothing contributes more to safe and effectual practice, than an acquaintance with those principles on which remedies operate. Hence, inquiries concerning the operation of medicines have been, and ever will be, prosecuted by those who mean to practise on a solid or rational foundation. Many practitioners, indeed, hold every thing that is in the least theoretical, in great contempt. Theyalledge, that a physician possesses all the knowledge requisite in medicine, who is acquainted with particular remedies which will infallibly cure particular diseases. Could such remedies be discovered, their reasoning would indeed hold good; and medicine, which, of all arts, is in reality the most difficult, would be the easiest. But it is incumbent on those who reason in this manner, to shew, that any such remedies actually do exist. This, however, is a point by no means determined; and, with regard to it, very great doubts may justly be entertained.
With certain limitations, some few such remedies may perhaps be allowed to exist. But no one will pretend, that these can, in every case, be employed with equal success; or that, in all circumstances, they are to be used in thesame manner. By a knowledge of the principles upon which a medicine operates in curing a disease, we can alone be enabled to accommodate its use to particular circumstances. He therefore who knows, not only that a certain remedy will cure a particular disease, but is likewise acquainted with the manner in which it acts in producing that effect, has at least a double advantage.
Errors in theory, indeed, often mislead in practice; and opinions, supported by numerous arguments, after being long believed, have at length been discovered to be without foundation. But this imperfect state of theory, in place of being any objection to its utility, is an additional inducement to continue, with unremitting ardour, a pursuit in which so much still remains to be done.It is by unwearied assiduity alone that improvement can be expected in any art. The imperfection of theory, then, can be no argument for discontinuing farther attempts to render it more perfect.
Theory in medicine is principally despised by two sets of practitioners, the ignorant and the lazy; the last are unwilling, and the first are unable, to acquire the knowledge of it; and, amidst all their boasted contempt, it will be found, that they principally differ from others in implicitly adopting whatever opinions they first receive. Theory is natural to the human mind; and those who are accustomed to think cannot be satisfied without assigning a reason for every phænomenon which falls under their observation. Theory by no means precludes observations: On the contrary, it leads toa more minute attention to facts; and in this way opinions, of themselves ill founded, have often given rise to useful discoveries in practice. For these reasons, in treating of mercury in the venereal disease, I have esteemed it necessary to begin with some observations on its operations.
There are few medicines, with regard to the operation of which all practitioners are agreed. Mercury, as well as others, has, in this respect, been a subject of dispute. It is indeed the misfortune of medicine, that many points of great consequence still remain in a very doubtful state. But it affords at least some chance of arriving at truth, that, in the present age, it is never esteemed criminal to differ even from the highest authorities: On the contrary, those whose authorityshould deservedly have the greatest weight, are unwilling that any farther deference should be paid to their opinion than arises from conviction. He therefore who imagines, that an ill-grounded opinion is generally received, has nothing to restrain him from a candid inquiry. But arguments adduced in favour of any opinion will have little weight, if another be previously received as true. To ensure therefore a fair examination, it is, in the first place, requisite to remove prepossession. These remarks will sufficiently account for the attention I have here bestowed in attempting to refute an opinion different from that which I endeavour to establish.
It is an opinion taught, and at this place very generally received, with regard to the operation of mercury, thatthe good effects it produces, in the cure oflues venerea, are to be ascribed to the evacuation which it occasions. After attentively examining this hypothesis, I cannot help thinking that it is ill founded. Notwithstanding, therefore, the authority by which it is supported, I have, with freedom, stated what to me seem strong objections against it.
After having endeavoured to overturn one hypothesis, I have attempted to establish another. The opinion I support is by no means new. The honour of invention therefore must be totally resigned to others; but the praise of broaching novelties is always to be relinquished when it comes in competition with the support of truth; and I should consider myself as having done a great deal, wereI able to give satisfactory evidence of any important but doubtful point.
After this inquiry concerning the operation of mercury in the venereal disease, I next proceed to make some observations with regard to its use.
Mercury has been employed in the cure of the venereal disease in a great variety of forms. Most of these, upon their first introduction into practice, have been extolled as the safest and most effectual method of using it in every case. Experience, however, sufficiently demonstrates, that this holds with regard to no mercurial preparation hitherto discovered. Whether such a preparation may yet be discovered, is difficult to say. In this treatise, I have not proposed any mercurial which was not formerly inuse. But if, on the one hand, I have no title to lay claim to the merit of a discovery, I cannot, on the other, be charged with being the first proposer of any dangerous practice.
In treating of the use of mercurials inlues venerea, my aim has been different from that of most authors. What I have principally had in view, is not so much to recommend any particular preparation, as to determine the comparative advantages of some of the most effectual ones at present in common use. I have likewise endeavoured to point out those circumstances to which each is best adapted. To this I have subjoined the principal cautions to be observed in the employment of mercurials; those more especially which respect thenature of the medicine, the condition of the patient, and the necessary regimen.
On these subjects, a good collection of observations would unquestionably be of the highest utility. How far I have succeeded, must be left to others to determine. To those who imagine I have not altogether failed, I need offer no excuse for having published. To those who are of a contrary opinion, it will be sufficient to observe, that every attempt to be serviceable should apologise for itself.