Monthly Reviewsworn.
Monthly Reviewsworn.
Couns. for the Pris.Pray, Sir, do you know any thing of a person who calls himself officiating clergyman to the Prisoner at the bar?
M. Review.I remember one Robert Houlton, who gave himself that title.
Couns. for the Pris.Is he an author?
M. Review.Yes; he lately published a sermon, with an appendix concerning inoculation.
Couns. for the Pris.And what is his character?
M. Review.I am sorry to say, this reverend son of the church descends to the level of a merenostrum-puffer.
Couns. for the Pris.I beg, gentlemen of the jury, you will take notice;a mere nostrum-puffer. And pray, Mr. Review, is thisnostrum-pufferforgetful of the usual, the proper gravity of his profession?
M. Review.From the low wit, and familiarity with which he presumes to treat the most respectable characters, he might easily be mistaken for the Merry-Andrew of some wonder-working professor of the stage-itinerant.
Couns. for the Pris.Merry-Andrew of some wonder-working professor of the stage-itinerant! I beg, gentlemen of the jury, you will remember, that this nostrum-puffer, this Merry-Andrew, is their principal evidence, their corner stone upon which the first and most material part of the indictment depends; namely, that part which accuses the Prisoner of preserving, in an especial manner, the lives of his Majesty’s liege subjects. I say, in an especial manner; for tho’ it be not thus expressed in the indictment, it is certainly implied.
Couns. for the Crown.This is too much. I beg, Mr. President, the counsel for the Prisoner may not be suffered to mislead the jury by implications in the indictment. The fate of the Prisoner at the bar must depend solely on theletterof the indictment. We admit of no implications. My Lord Cook——
President.You must abide by the letter of the indictment. Counsel for the Prisoner, proceed.
Couns. for the Pris.Gentlemen of the jury, I was going to observe, when I was interrupted by the counsel on the other side, that unless we suppose the Prisoner peculiarly, or especially, or uncommonly guilty of preserving the lives of the King’s subjects, this will appear, at least, to be a malicious prosecution; and that it really is so, can admit of no doubt, when you recollect, from the general tenour of our evidence, how many other inoculators might, with equal justice, have been indicted for the same offence. Doctor Dimsdale, in particular, in the course of twenty years extensive practice hath lost no patients; and I will venture to affirm, that there are now in this metropolis, and in the neighbourhood, a very considerable number of inoculators, who have been equally successful with the Prisoner at the bar. Certainly, therefore, this is a malicious prosecution, and ought to be considered as such.
As to that article of the indictment, which relates to the means of perpetrating the crime of which the Prisoner is accused, namely, by secret medicines and modes of practice unknown to this College, and to all other practitioners, we have proved very clearly, by Dr. Ruston’s experiments, that the composition of the medicines is certainly known. But that they consist chiefly of a mercurial preparation, is sufficiently evident from their effects. Now that mercury hath been very commonly used as a preparative to inoculation, we have proved to you by the testimony of several witnesses of indisputable character. And with regard to the vegetable diet, enjoined by the Prisoner at the bar, it is so far from being peculiar to him, that it hath very long been the common practice. As to his manner of communicating the infection by means of the lymph taken before the eruptive fever, whether it be the invention of the Prisoner, ornot, is a matter of no importance, as it is now a very common, and therefore not a secret mode of practice.
I come now to that part of his practice, in which he hath been thought most singular, and which hath generally been imagined to be his own invention: I mean his cool regimen; that is, the practice of exposing his patients to the open air, and giving them cold water to drink. But, though this practice may not have been carried to the present extreme by regular physicians, it is nevertheless most certain, that they could not be ignorant how strenuously it was recommended, in the natural small-pox, by many writers of the first distinction.
Rhases, an Arabian physician, who wrote some hundred years ago, in his chapterDe præservatione, et de modo impediendi, &c. expresses himself, concerning the use of cold water, in order to extinguish the variolous fever, in these words:Bibendam præbeaquam in nive refrigeratam in summo frigiditatis gradu, effusim et affatim datam, et brevibus intervallis; ita ut ea prematur, et frigiditatem ejus sentiat in intestinis suis ægrotus. Quod si posthac febricitet, et in illum redierit ardor; potui illam dato secunda vice, videlicet a libris duabus ad tres, et amplius, in semihoræ spatio. Quod si adhuc calor redierit, et venter aqua repletus fuerit; fac ut illam evomat: tum denuo aquam bibendam præbe.Thus, gentlemen of the jury, you hear, that this early, this celebrated writer on the small-pox, carried the use of cold water far beyond the practice of our most adventurous inoculators. He not only ordered his patients to drink cold water till they were full, but made them spew it up, and drink again. Now, though our learned and regular physicians, who had some tenderness for their patients, and some reputation to lose, did not dare to try what appeared to them a dangerous experiment, it is, nevertheless,a practice of which they could not be ignorant; and of which the Prisoner is undoubtedly guiltless of being the inventor.
Our immortal Sydenham is so universally known to have been a strenuous advocate for the cool method of treating patients in the small-pox, that to quote him upon this occasion, were unnecessary and impertinent.
The learned Boerhaave, in aphorism 1399, advises the cool regimen in these words:In primo initio apparentis inflammationis externe, videtur requiri cautela, ne vergat in suppurationem, aut curandum ut minima fiat, procul a capite, & tarda; quod fit, victu tenuissimo putredini resistente; potu diluente, blando, subacidulo &c. regimine frigidiusculo, maxime admissu puri & frigidi aëris.So that in this aphorism we discover not only the liberal admission of pure and cold air, but also, the sub-acid liquor, and antiseptic regimen, of which the Prisonerat the bar hath so unjustly been supposed the inventor.
The celebrated Dr. Mead, though he does not advise the extreme cold regimen, nevertheless, in regard to cool air, says,In primis autem curandum est, ut purum aërem, eumque frigidulum, ubertim trahere possit.
Dr. Kirkpatrick, in his Analysis of inoculation, though he thought it not advisable to attempt an entire extinction of the ordinary process of the disease in question, says, “Notwithstanding we have little to oppose to it’s most virulent operation but powerful acids, styptics, and not only free ventilating air, but, perhaps, the strongest potential cold we can generate and apply.”
Thus, gentlemen of the jury, it appears, beyond all dispute, that the Prisoner at the bar is so far from having preserved the lives of his Majesty’s liege subjects, by secret medicines and modes of practice unknown to the faculty in general, that all his medicineshave been generally prescribed, and every article of his process either practised or recommended by a great variety of authors, whose works are universally studied.
Gentlemen of the jury, I make no doubt but you are perfectly convinced that the Prisoner is guiltless of the crimes specified in the indictment. But his accusers, not satisfied with their general charge, have, in the course of their evidence, endeavoured to convict him of dealing with the Devil; they have endeavoured to prove him guilty of witchcraft; they have endeavoured to make you believe, that, by means of a certain medicine, and a magic circle drawn with a pen round the pustules, with the addition of a prayer repeated (backwards I suppose) by his officiating clergyman; I say, they have endeavoured to persuade you, that, by the help of the black art, he is able to make the pustules retire at the word of command. But, gentlemen of thejury, I beg you will remember, that Dr. Dimsdale has clearly explained this matter; he told you, That these supposed pustules were nothing more than a rash, which frequently accompanies the small-pox, and which naturally retires of it’s own accord, without the assistance of the black art, and, consequently, that the Prisoner at the bar is no conjurer.
Couns. for the Cr.Mr. President, and you gentlemen of the jury, it is now late, and you must necessarily be fatigued by your close attention to a long tryal. I shall not, therefore, trespass on your patience, by a circumstantial reply to the elaborate speech which you have just heard; I shall only intreat you to recollect the tenor of our indictment, and the positive evidence by which it hath been proved. You have too much understanding to be improperly biassed by fine speeches, and too much integrity not to determine a cause of such importance according to the laws of justice and equity.
President.Gentlemen of the jury, Daniel Sutton, the Prisoner at the bar, is indicted for the high crime of preserving the lives of his Majesty’s liege subjects, by inoculating, or causing to be inoculated, twenty thousand persons, in the space of three years, and by secret medicines and modes of practice unknown to this College, and to all other practitioners.
The first witness produced, in support of this heavy charge, was Mr. Robert Houlton, who swears positively as to the number of persons inoculated, and tells you he had his information from the Prisoner’s own books. He is no less positive on the article of secret medicines, by means of which the Prisoner has a power, unknown to the faculty, of causing the pustules to disappear at pleasure.
Dr. Baker, the second witness, gave you a clear account of the Prisoner’s general practice, but as he related nothing of his own proper knowledge,his evidence, in law, proves nothing against the Prisoner at the bar.
Mr. Chandler, the third witness against the Prisoner, relates the practice of one of his accomplices, by whose means many have been preserved; and he likewise told you, that the composition of the medicines is not known.
These are all the evidence produced in support of the indictment. We come now to those that have been examined in behalf of the Prisoner: the first of which was Dr. Ruston, who, by the result of a course of chemical experiments, has discovered the composition of these secret medicines; consequently, at the time when this indictment was laid, they were not secret medicines. This witness likewise informs you, that mercury, which appears to have been the chief ingredient, hath been long in use, especially in America, as a preparative to inoculation. He told you also, that the regimen prescribed by the Americanphysicians was very similar to that of the Prisoner at the bar, and that he himself, pursuing the same general plan, has been no less successful than the Prisoner at the bar; and he concludes with declaring, that he does not believe him possessed of any secret to which his success can be attributed.
The Counsel for the Prisoner then recalled Dr. Baker; who declared, that preparing persons for inoculation with calomel, and other purgative medicines, is a common practice; that the success, ascribed to the Prisoner, is not owing to any peculiar virtue in his medicines, but chiefly to the free use of cold air; and that this part of his practice is now very general, and not his own invention.
The next witness was Dr. Kirkpatrick; who testifies, that for many years past he hath been accustomed to prepare his patients in a manner very similar to that of the Prisoner at the bar.
Dr. Gale informed you, that he always prepared his patients with calomel.
Dr. Gatti told you, that he paid little regard to preparation, because the people in the Levant are successful without it.
Mr. Chandler, who had already been examined by the Counsel against the Prisoner, being recalled, gives it as his opinion that the success of this Suttonian practice is owing entirely to the manner of communicating the infection, which, as it is performed openly, can be no secret.
The next witness was Dr. Glass, who informed the Court that there is a certain operator in Somersetshire, who without any preparation at all hath inoculated seventeen hundred with the loss of two patients only. Being asked his opinion as to the cause of the success of this new method, as it is called, he told you, that he believed it to be principally owing to the exhibition of sudorific medicines during the eruptive fever.
Dr. Dimsdale deposed, that he hath practised inoculation in a very extensive manner for twenty years past without the loss of a patient; that his practice is very similar to that of the Prisoner at the bar; but that he has often inoculated without any preparation, and with equal success; and that he ascribes his success chiefly to the cool regimen, and to his method of communicating the infection with recent fluid matter.
The last witness called was Mr. Monthly Review, who spoke to the character of the Rev. Mr. Houlton, on the credit of whose testimony the fate of the Prisoner at the bar almost entirely depends.
Gentlemen of the jury, having thus briefly summed up the evidence on both sides, intentionally neglecting to animadvert as I went along, I shall now endeavour, as far as I am able, to state this complicated affair in such a manner, as to reduce it to a few simple questions; and if, after all,it should appear, that what hath been deposed be insufficient to explain the great mystery, I shall think it my duty, for the sake of truth, and in justice to the Prisoner at the bar, to give you as much of my own opinion as may be necessary to lead you to an equitable determination.
First, then, I must observe to you, that the part of the indictment, which accuses the Prisoner, in general, of preserving the lives of the King’s subjects, depends entirely on the deposition of Mr. Robert Houlton; for though the evidence of Dr. Baker, and Mr. Chandler, may, in some degree, corroborate his testimony, yet they are, of themselves, insufficient. Some regard is certainly due to Mr. Houlton’s sacred function; but if you believe the gentleman who spoke to his character; if you view him in the light of a merenostrum-puffer, a Merry-Andrew to the stage-itinerant; in that case, you are not only to disregard his function, but the whole of his evidence. But,in justice to the Prisoner, I must farther observe, that though you were to admit the evidence of Mr. Houlton in full force and virtue; yet, as it hath been very sufficiently proved, that there are a considerable number of operators, who are equally guilty of preserving the lives of the King’s subjects, you will doubtless consider this as a malicious prosecution, and on that account alone you will be justified in acquitting the Prisoner: for though, in general, to sin with a multitude be no excuse, yet the nature of this offence is such, that unless he be found singularly guilty, he is hardly guilty at all.
But he is likewise accused of administering medicines, the composition of which is unknown to the faculty in general. In answer to this charge, Dr. Ruston hath demonstrated, that calomel is the principal ingredient, and several other witnesses have deposed, that calomel hath long been an universal medicine on these occasions.Of this part of the indictment therefore the Prisoner stands fairly acquitted.
As to what relates to the other part of his practice, after the evidence you have heard, you can have no doubt, that he cannot with the least appearance of justice be accused of singularity, as his cold regimen, his mode of preparation, and method of communicating the disease, are at this time exactly similar to the practice of almost every other inoculator in this kingdom.
But admitting that you are satisfied of the reality of his great success in the practice of inoculation, a natural question will arise, namely, to what particular circumstance is that success to be attributed? Before we attempt to solve this problem, let us first recollect the several opinions of those who have been examined relative to this matter.
Mr. Houlton’s opinion was, that it is owing to certain secrets in theart; but it hath plainly appeared in the course of our proceedings that no such secrets exist.
Dr. Baker was of opinion, that the success is principally to be ascribed to the free use of cold air; but in answer to this, I must observe, that there have been cases, particularly one related by Dr. Glass, in his late pamphlet, in which this was found insufficient.
Mr. Chandler attributes it to the practice of communicating the disorder with crude lymph; but Dr. Dimsdale informed you, from long experience, that the mode of communication is a matter of indifference.
Dr. Glass ascribes it to the effect of sudorifics, administered at the period of eruption; but Mr. Chandler told you, that the Suttonian practice requires no such effect from the medicines; and Dr. Dimsdale pursues a contrary method.
As to preparation, it evidently appears from the Levant practice, from that of the Somersetshire operator,and from Dr. Dimsdale’s confession, that it is a matter of much less importance than hath generally been supposed; or rather, it appears to be of no importance at all. Nevertheless, we are obliged to acknowledge, that fewer patients have died under inoculation within those few years, than formerly, when the practice was in its infancy. It should therefore seem natural to conclude, that some considerable improvement has been made; but the nature of this improvement appears, from the proceedings of this day, to be yetin nubibus. That this new method of inoculation hath been amazingly successful, is beyond all contradiction; but that this success is not confined to the Prisoner at the bar, is equally indisputable. None of our patients die. The success is universal. Whether we prepare our patients or not; whether we give them mercury, or no mercury; whether we inoculate with crude lymph, or with matter ultimately variolated;whether we sweat them in the eruptive fever, or send them into the cold air; in short, let us proceed as we will, to kill a patient by inoculation, seems to be out of our power.
From thesedata, I think, you may rationally conclude, that the Prisoner himself is totally ignorant of the real cause of his successful practice; and if you are of that opinion, this being a Court of equity, you must necessarily acquit him of the crimes laid to his charge. But as judge of this Court, for the sake of truth, and the more effectually to exculpate the Prisoner at the bar, I shall now endeavour to explain this mysterious affair.
The small-pox hath been generally ranked among inflammatory diseases, and certainly with propriety, if we consider it only in it’s first stage; but that, in it’s natural progress, it becomes a putrid disorder, is indisputably true. Let us now suppose a number of patients ill of a malignant putriddisease, the jail fever for instance. Let us suppose these unhappy beings pent up in the close ward of an hospital, swallowing hot medicines, and denied the use of fresh air. In such a state the disease would certainly exert it’s utmost virulence, and very few of the patients would recover. Let us farther suppose a number of patients, in a contiguous ward, receiving the infection from the others; but let us imagine their medicines less inflammatory, and the air less confined: is there a physician here present, who has the least doubt that the disorder, in this case, would be less malignant and less fatal? Let us yet farther suppose a third ward, contiguous to the second, and the patients, infected from the second ward, treated more on the anti-phlogistic and antiseptic plan, and particularly indulged with fresh air: such patients, I say, having caught a milder disease, and being more rationally treated, would more generally escape. But if wecarry our supposition still farther, as we gradually recede from the first ward, we shall find, by a parity of reasoning, that the disease will at last retain no more of it’s original malignity, than is barely sufficient to communicate the infection. The disorder will now assume so mild an aspect as hardly to appear of the samegenuswith that from which it originally sprung.
What hath been said of the jail fever, will evidently apply to the small-pox. We Europeans received it a malignant, a fatal disease; the fatality and malignancy of which, by the general practice of nurses, and, indeed, of most physicians, hath, perhaps, been rather increased than diminished: for, if an infectious disease may be rendered more mild by judicious treatment, it is no less certain, that a mild disorder may, by a series of improprieties, be gradually raised to such a height of virulence, as to assume a new aspect, and exhibitphenomena so different from those of it’s parent disease, that, in the end, it will constitute a new genus. If this be admitted as a possibility, perhaps it might be no difficult matter to trace many of our disorders to their origin, and to prove, that a considerable number are of our own creation; they are the offspring of medicine, the children of dulness or chimera, begotten upon old women.
The small-pox, by a treatment diametrically opposite to that which reason, and a perfect knowledge of the nature of the disease, would have dictated, hath, through a series of many ages, preserved all the virulence with which it first burst into Europe. But experience hath taught us, that, when produced by inoculation, it is much less fatal. Why? Is it because those that are inoculated are previously prepared? No: that is a very insufficient reason; for you have heard, that, in the Levant, preparationis disregarded; and also, that some of the most successful operators in this nation think it of little importance. We must therefore search for another cause; to the discovery of which let us consider, in what respect the communication by inoculation differs from that in the natural way. In the latter case the variolousmiasmataare conveyed into the body either with the air into the lungs, or with the saliva into the stomach: in the former, it is received into the system by means of the lymphatic vessels which are distributed over the surface of the body. There is yet another difference, perhaps a very essential one, namely, that in the natural infection, it is communicated by volatile particles, which probably may be in their nature more virulent than those which are fixed. For my own part, I am of opinion that the small-pox is a disease of the lymphatic system only, and my opinion seems to be confirmed by the impossibility of communicatingthe infection by inoculating with the blood. Be this as it may, it is indisputably true, that the crude lymph is sufficient to give the infection, and that there is no necessity to draw blood at the time of incision. Add to this, the frequent tumour of the lymphatic glands in the axilla soon after the operation.
From these premises, it seems rational to conclude, that the general success of inoculation is chiefly to be attributed to our mixing the fixed variolous ferment with the lymph on the surface of the body, by which means the viscera, most essential to our existence, are less affected, and the poison rendered less virulent by dilution. But the wonderful success of the present practice of inoculation remains yet to be accounted for.
I have told you, that the most malignant diseases may be rendered less malignant by proper treatment. The malignancy of the small-pox hath been considerably abated by inoculation,and that malignancy hath been still farther diminished by the gradual introduction of the anti-phlogistic and antiseptic plan. So that in all places where inoculation hath been long practised, and the patients thus treated, the small-pox will naturally become a mild disorder, and the ignorant operators themselves will be surprised at their unexpected success.
This, gentlemen of the jury, I conceive to be a true picture of the present state of inoculation in these kingdoms. You will now lay your heads together, and weigh well the evidence you have heard. If you are of opinion that the articles of the indictment have been sufficiently proved; that the Prisoner hath in an especial manner preserved the lives of his Majesty’s liege subjects, by secret medicines and modes of practice unknown to all other practitioners, you will then find him guilty. If on the contrary, you think that these thingsare not true, and that this is a malicious prosecution, you will in that case acquit him.
The jury having laid their heads together, without going out of Court, were called over, and answered to their names.
Cl. of the Cr.Gentlemen of the jury, are you agreed in your verdict?
Jury.Yes.
Cl. of the Cr.Who shall say for you?
Jury.Our foreman.
Cl. of the Cr.Daniel Sutton, hold up your hand. You of the jury, look upon the Prisoner. How say you? Is Daniel Sutton guilty of the high crimes and misdemeanors of which he stands indicted, or not guilty?
Jury.Not guilty.
The Prisoner was acquitted, and discharged accordingly.
FINIS.