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THE Preſent Uncertainty IN THE Knowledge of Med'cines, IN A LETTER TO THE Phyſicians in the Commiſſion for Sick and Wounded Seamen.

With a Poſtſcript to Phyſicians, ſhewing the Neceſſity of a True Theory of Diſeaſes.

By W. Corkburn, M. D. a Fellow of the Royal Society, and of the College of Phyſicians of London.

Qualitates Ignoramus in Phyſicis, & illud Vocabulum Qualitas ne quidem Nominandum eſt; quippe Res Evidentes majoribus difficultatibus involvit.

Hann. Meth. Cogn. Veget. Simp.

LONDON: Printed by R. J. for Benj. Barker, at the White-Hart in Weſtminſter-Hall; and Sold by J. Nutt, near Stationers-Hall, 1703.

THE PREFACE TO THE Phyſicians in the Commiſſion for Sick and Wounded Seamen.

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Gentlemen,

THE World, I know, will admire what Merit of yours ſhould obtain you this Addreſs; but their Curioſity will be ſatisfied when they are told, that your Pretences on this Head are very great and ſingular. You pretend to be compleat Maſters of all the Qualities that ever were found about a Med'cine; and that you never fail to determine all its poſſible Actions by this Infallible Light. If this proves not a ſufficient Apology for me, you your ſelves muſt find a better.

Indeed the former Diſappointments that Sedulous Inquirers have met with already in this Way, were enough to diſcredit my Aſſertion; but eſpecially that ſuch Abſtruſe Methods are poſſeſt by People who are as unknown as they have endeavour'd to be otherwiſe; but in that you muſt give them further Satisfaction. 'Tis enough for me to have made this part of the Diſcovery, but you muſt tell them more.

For this Trial, I do not give you the Myſtery of a Noſtrum to reſolve, neither have I put ſtranger Drugs into your Hands, nor ſome foreign Root that came but lately from the Eaſt-Indies, No, I have firſt given you a Bark that is the moſt Excellent of any Med'cine for the Diſeaſe it is to Cure; which owes its Diſcovery to wild Indians, its Ʋſe in Europe to Churchmen, and its Re-eſtabliſhment, after the Malice of Phyſicians to deſtroy it, to an Empyrick, and which now Triumphs in this next Age with the great Applauſe of Phyſicians; tho' their Predeceſſors wou'd never ſubmit to the Conqueſt; nay, its Native Strength equals at leaſt the beſt Preparations of it, on Purpoſe to ſhow how it rais'd its Reputation in ſpite of the Fathers, and will have no farther to do with the Sons than to receive their Submiſſion. And I am aſham'd to think how little Thanks Men owe us that have hinder'd them ſo long from the Benefit of ſo great a Good: But the following Story does prove how well we are ſatisfied with the Thing, and how ſtill we have neglected ſuch Diſcoveries that might aſſiſt us to give it to more Advantage. But it is this you put us in hope of being inſtructed in by you.

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The Preface.

I ſhall ſay no more of the other Two Inſtances I give, than that they are of an Older Date than to bear any Exception againſt our Opportunity of making Experiment about 'em.

Yet while I clear my Examples from Objections that may be brought againſt their Propriety of being ſuch, I am ſenſible how ready ſome People may be to object againſt my thus expoſing the Ʋncertainty of Med'cines; but one Anſwer may be, that it is in order to our arriving at a greater Certainty: But next, who but ſuch Pretenders ever wou'd have the World think that our Knowledge of them is Infallible? Don't the frequent Attempts, and as frequent Diſappointments, of worthy Phyſicians, Prove this very Ʋncertainty: Some indeed have attempted Med'cines by their Qualities, and have all miſcarried in the Enterprize; but theſe Gentlemen, who promiſe n [...]w to attempt, and I wiſh they do not fail in that. Other Phyſicians have tried to diſſect Bodies for the very Parts of their Compoſition: But a Noble Gentleman, well skill'd in all theſe Trials, has ſufficiently deſtroyed that Pretence in his Sceptical Chymiſt; and it was only this Gentleman who was the beſt able, as well as the moſt proper Perſon, to do it.

But if the Strength of this Objection is conceal'd under the fear of diſcovering ſo much of our Weakneſs to the World, the Argument is as weak as the Defence of it is unworthy of a Man. A Cheat has the worſt Grace upon a Gentleman of any thing; and I am convinc'd that both Phyſick and Phyſicians have really ſuffer'd more by the modeſt conniving at ſuch Tricks of Pretenders, than ever they can ſuffer by this Frank Declaration of mine. This is the Foundation for Quacks and Mountebanks, who know no better where to ſet up for a Character. Men of Learning go quite another Way to Work; they do not apprehend their being eſteem'd to know nothing except they pretend to know every thing: Their reaſoning is quite the Reverſe of this. They ſay that there are ſome things of which they know nothing at all, and theſe are theſe firſt Qualities, or Phyſical Cauſes, theſe Gentlemen know ſo perfectly wel'. Some things they know but Probably, and among them may be the Doctrine of Med'cines: But ſome other things they know Demonſtratively, and among them are ſome things about the Theory of Diſeaſes.

From all which I ſhall obſerve, Firſt, That the Knowledge by Qualities is as Vain as it is an Ignorant Pretence.

And, 2dly, That they who ſet up on this Foot, know nothing at all, not ſo much as where to lodge their Pretence: And they are a People who commonly Practice Phyſick with a Contempt of all Theories of Diſeaſes, and you ſee they do it with an abſolute Ignorance about Med'cines.

THE Preſent Uncertainty IN THE Knowledge of Med'cines.

[1]

BEfore I come to Prove the Charge of Uncertainty on our Knowledge of Med'cines, 'twill be Neceſſary to lay down ſome Rules that may be Uſeful in examining the Matter of Fact. And theſe ſhall be taken from the Deſcriptions of the Two different Sorts of Knowledge a Phyſician is ſaid to have; viz. Experimental and Scientifical; or, a Knowledge of Experience and Science. By knowing the Virtues or Powers of Med'cines in the Firſt Way, we know that ſuch and ſuch Med'cines are Recommended [2]for, and are good or bad in, Particular Diſeaſes, and different Circumſtances of the Diſtemper, when either they have good Succeſs, no Succeſs, or an ill One. This is the loweſt piece of Knowledge that can be expected from Phyſicians.

Or, Secondly, If by many ſuch Experiments we ſhould diſcover what Action it is in any Med'cine, whereby it produces its Proper Effects, ſo as to be able to deduce the good or bad Effects it will have, as ſo many Corollaries from the Knowledge of the Action, That wou'd be as Noble a piece of Science as Phyſick can be ſuppoſed to admit of, and wou'd contain all that is Neceſſary.

Having premiſed the Deſcriptions, which are the Rules in the enſuing Trial, I ſhall begin with all the Diſtinctneſs and Brevity imaginable.

But ſince the Bounds of a Letter will not allow me to try every ſingle Med'cine by it ſelf, or indeed every Claſs of Med'cines in general; yet 'twill be more to your Satisfaction if I Prove it by Two or Three Examples of Med'cines, that are [3]either moſt in Uſe, or that produce moſt conſtantly the ſame Effects, when the leaſt Caution is had about 'em, and are in every one's Hands; and if I can Prove our Knowledge of them to be juſt nothing, and that it does not ſo much as arrive at the Firſt Deſcription or Experience, I may Preſume to conclude the like Imperfection to be, at leaſt as great, in our Knowledge of Med'cines, that are not near ſo frequently uſed, nor that have not, by far, ſo certain and conſtant Effects; nay, whoſe Effects are moſt unconſtant in the beſt Hands.

The Firſt Inſtance of this Imperfection ſhall be of the Jeſuits Pouder; a Med'cine that every one muſt own to be the beſt for Curing intermitting Feavers; and with that Certainty, that no other known Med'cine can do the like in this or any other Diſeaſe; for it generally Cures, not only in the Hands of Phyſicians, but e'en in thoſe of Quacks, and Nurſes, by whom it is given with no manner of Judgment or Diſcretion.

Yet even this Pouder has been wanting in its Succeſs, and Agues have been known [4]ſometimes to ſtand their Ground againſt many Charges of it. This is evident ſometimes here; but too often in Virginie.

'Tis known that by the taking of it, ſafe intermitting Feavers have been changed into thoſe that are continual; which are far more dangerous, and whoſe Event is often very doubtful.

And it is very ſurpriſing that this Turn of the Diſeaſe is not always in the ſame manner; for by Jeſuits Pouder Agues have degenerated into unweildy Rheumatiſms, or a lazy Jaundice; nay, ſometimes it has terminated in a ſudden Death.

Theſe are ſtrange and unconſtant Effects of Jeſuits Pouder. It Cures an Ague the beſt of any thing; it turns the Patient ſometimes out of one Diſeaſe into another; and ſometimes it kills him.

But this is not all; it will ſometimes make him Coſtive; it Purges him; it Sweats him; yet it never has been ranked among Med'cines of theſe Sorts, but once to Diſparage it.

And this is the Rare Med'cine which Cures us ſo ſuddenly, that it ſeems to Operate almoſt like a Charm, that yet has ſuch ſtrange, tho' ſeldom, ill Effects in the [5]Cure of the ſame Diſeaſe. But ſince different Conditions and Circumſtances make all the Variety in this Affair, as well as in every thing elſe, Phyſicians ought to be very Induſtrious to find out what are the Conditions in this Caſe, where we find ſuch conſiderable Turns in Adminiſtring this Excellent Med'cine. For, perhaps if they were known, they might be avoided; at leaſt, if a Cure is to be had by any other Med'cine, that rather is to be tried; and it is at worſt better not to attempt a Cure, than certainly to Kill.

'Tis to be thought, that if all, or any, of theſe ill Accidents that happen by uſing the Bark had often been obſerv'd, that no Rhetorick cou'd induce the World to perſiſt in taking it; yet ſince they have happen'd, they may happen again, and indeed every Day; it may therefore be thought very Expedient to know how either to give it ſo as to avoid Danger and Miſchief, or elſe to know when the Proper Time is when we are not to give it at all.

It was for want of this Knowledge the Bark loſt its good Name, when Sir—Ʋnderwood, [6]Mayor of London, died by taking of it, whoſe untimely Death did ſo terrifie his Relations, that no friezing or fryings of an Ague can ever be ſtrong enough to force them to take it.

Now ſince there is ſo manifeſt Uncertainty in the Practice of this Excellent Med'cine; beſides the Danger of being killed; it muſt be own'd that there ought to be a good deal of Diſcretion had when we uſe it. And he who is poſſeſt of this Diſcretionary Knowledge, muſt be able to know, not only that it is uncertain, but this muſt be warranted by my Firſt Rule: He is obliged to know what Appearances, what Conditions, there were in the Diſeaſe; when the Bark Cured, and when it did not Cure; as alſo when One got a Jaundice by it, and a Third died. But if he has no Knowledge of thoſe Times, he is under a vaſt Uncertainty in every Patient; neither does he know whoſe Cure or Death he is carrying on with the greateſt Aſſurance, tho' he Practice with the beſt Med'cine.

I wou'd adviſe thoſe who think they can Anſwer for this Sort of Knowledge, [7]to try their Strength by the Second Rule I propoſed; but it is Time enough to do that when I find my Firſt Requeſt anſwer'd. Indeed by this Rule we have the moſt delightful, as well as the moſt uſeful, piece of Knowledge imaginable; for by it we might know what the Uniform Action of the Bark is in it ſelf, whereby it Cures an Ague, and we ſhou'd be able to deduce theſe Miſchiefs that are already obſerv'd, as ſo many Corollaries from the Condition of the Diſeaſe; nay, by it are we made capable to ſuſpect all the probable Dangers that can be, or perhaps have been, tho' they have eſcap'd the Caution of the Obſerver.

Theſe related Misfortunes that have happen'd by taking the Bark, are not the Calumnies it ſtands charged with by its bigotted Enemies. There are many more; but theſe I have named have happened to many Candid Practitioners, and the moſt of 'em Recorded by that Excellent Phyſician Dr. Sydenham.

But what can be ſaid to the Pother had among many Authors about its under Actions of Purging, Sweating, &c. when [8]they have Induſtriouſly paſt by ſo Conſiderable Effects of this Med'cine.

All the Uſe I make of this Argument for the Preſent, is to ſhew you that the Knowledge of Med'cines is as Obſcure and Difficult as any thing elſe in Phyſick, notwithſtanding of a common Opinion we entertain about their Certainty. And this I think is very manifeſt by this Firſt Inſtance; becauſe our Knowledge of the beſt Med'cine which anſwers Expectation moſt conſtantly, and is more us'd than any one Med'cine, is very obſcure, and juſt nothing at all.

This Argument might be purſued as Succeſsfully in every one of the Med'cines that are moſt Familiar to us. In all Evacuating Med'cines, as well as in thoſe that produce no Evacuation, but are conſiderable for ſome great Effect of another kind; but ſo Particular an Aggravation is by no means Neceſſary, neither does the preſent Occaſion require it. I ſhall content my ſelf with an Inſtance or Two more, which will be ſufficient to Prove my Argument about the real Uncertainty of Med'cines.

[9]

The next Example that I bring is of Opium; and I cannot help thinking it thus Uncertain, notwithſtanding of the late Endeavours of ſome Ingenious Authors, being there is not full Satisfaction given about its way of producing Sleep; and far more hardly are we preſt when we endeavour to account for its Action when it hinders us from Sleep, and makes us Delirous.

Moreover, Opium is obſerv'd to give a Check to all Sorts of Evacuations; yet great Evacuations have been known to be made by it.

'Tis noted for either relieving us of Pain, or at leaſt giving an agreeable reſpite from it, though great and torturing Pains have ſometimes been felt upon its Account: I mean not only thoſe Headachs, and Pain at Stomach, it often occaſions, and that are felt after its ſleeping force is over; but even ſome that come at firſt taking, and that beyond all Patience, and almoſt to Diſtraction; yea, theſe Pains are alſo produced by every thing that makes Sleep, as well as by Opium, or any Preparation of it; and [10]the more Obſtinately we perſiſt in that quieting Deſign, to greater Degrees we augment the Torture.

Beſides all this, Opium is not like other Med'cines ſo eaſily dos'd; and an exceeding quantity has worſe Conſequences than any other Med'cine whatever. Nay, ſometimes when we wou'd give it to good Purpoſe, it is Neceſſary to give Three or Four Grains at once, withour our coming Cautiouſly, and by Degrees, to that Quantity; or that it is given to People who have been long accuſtomed to take it, (all which Conſiderations alter the Caſe perfectly), yet there is nothing more Certain, than that Three Grains have laid People of a proper Age into an Eternal Oblivion of this World; tho' the World ſhould not forget him that gave it.

Now who wou'd not Purchaſe at any Rate a good Night's Reſt, after watching many Nights, and a long Vigilia? Who wou'd not rid themſelves of Troubleſome Pains, and uneaſie Evacuations, by taking Opium? But if the Danger that poſſibly may come by it was ever imagin'd, how equal might the Diſpute prove about [11]taking of it on any of the mentioned Deſigns; but eſpecially if the Operation of this Med'cine ſhou'd fall ſhort of it; nay, if the contrary Effects were ever ſuppos'd to happen. We ought to ſuppoſe at leaſt that a very Extraordinary Pilot ought to be made Choice of, to guide us where ſuch Hazards, and Things of ſo great a Value, are; and more where our Perſons may be fatally concern'd.

And therefore let any One who pretends to be familiarly acquainted with this Pacifick Med'cine, examine himſelf throughly by the Rules I have laid down, and reſt ſatisfied with nothing leſs than his being qualified by the Firſt.

I confeſs it is ſtrange enough to hear Men Boaſt of a Certainty in Med'cines, ſuch as requires no Direction from Reaſon to Manage beyond their Skill; and yet ſuch conſiderable Doubts to remain at this Day about a Med'cine of ſo manifeſt Effects, and of ſo great and ancient a ſtanding. Wherefore it is manifeſt how proper an Example this is to Prove our Imperfection about the Knowledge of Med'cines.

[12]

But no leſs an Imperfection may perhaps be found in another Ancient Method of Curing, which commonly is the utmoſt Skill, and laſt Reſort of a Doctor, after other Experience and Med'cines have been practis'd to no Purpoſe. And after ſo Honourable a Mention made of a Method, every Body muſt think it is only Proper to the Bath, as indeed I intend it. I muſt not be thought to Depretiate either the bathing or drinking of Waters at Bath, which I do by no Means. On the contrary, I have a valuable and juſt Eſteem of 'em.

Only I do ſay, that this uſeful and ancient Method is far from being ſo ſufficiently known, that we are able to reap all the Benefit of it, or to avoid all its Miſchiefs, as ſhall be made appear immediately by Particulars.

As to its Antiquity, 'tis believed that People applied themſelves to it for Relief in their Maladies before the Romans were much known in Britain; yet if we compare what has been ſaid of 'em, either as to their Warmth or Medicinal Effects, by Ancient or Modern Writers, we ſhall [13]find how little theſe have improv'd what the former aſſerted. Cambden informs us how Old Necham has conceived the Obſervations of his Time about theſe Waters, for their Uſe.

Conf [...]cto profunt balnea noſtra ſeni,
Proſunt Aſtritis, Colliſis, Invalidiſque,
Et qurum Morbis Frigida cauſa ſubeſt.

Then he, and moſt Moderns after him, aſſign this Reaſon for the Heat of theſe Waters.

S [...]d quid? Sulphurcum novimus eſſe locum.

At preſent I am not bound to make all Proper Inquiries about the Bath; but in general, I will firſt obſerve how diſproportionable the Fame of the Cures it has work'd are to its long ſtanding, and great Character given it by ſome Men. And, 2dly, The extream Changes its Reputation has ſuffer'd in that Tract of Time: 'Thas often been eſteem'd a Panacea, and too frequently thought good for nothing at all. And from both theſe Obſervations I conclude, [14]that if a moderate Knowledge of this Method had been join'd with half the good Uſes of theſe Waters, they never cou'd have had ſo great Ebbings in their Fame.

But to be more Particular; 'tis certain, that though Sulphur impregnating thoſe Waters, is told us to be the Cauſe of their Heat; yet our Knowledge of this Method of Nature is ſo very obſcure, that we can neither imitate her in medicating Waters after that manner; nor by any Means make other Waters Serviceable to like Purpoſes. Wherefore it is alſo manifeſt how Inſignificant our boaſted Knowledge is, and to how little Purpoſe our Trials of 'em have been.

I know that there are Authors that Prove, and ſufficiently enough, that thoſe Waters contain more Subſtances than Sulphur; but the Difficulty remains the ſame, mutatis mutandis, viz. by taking the known Compoſitum, as I took Sulphur ſingly in the Argument.

But further, if I ſhould ſuppoſe that either the ſingle Ingredient of theſe Waters, if there is but one, or a determin'd [15]Quantity of Ingredients, if more were known; yet it is certain we ſhould be ſtill Ignorant of their Operations, if we know not the Effects of theſe ſimple Subſtances, which being mixed with the Waters, give 'em their Medicinal Qualities; and the Difficulty wou'd always encreaſe, when we were to account for their Combination. This is manifeſt from the Affair of Jeſuits Pouder, i.e. it is manifeſt that if the Particular Ingredients of theſe Waters were in Subſtance and Quantity as evident to us as the Subſtance and Quantity of Jeſuits Pouder, yet our Difficulties ſhall ſtill remain unſatisfied, except we knew more of the Nature of theſe Subſtances, that are the Compoſita of the Waters, than we know of Jeſuits Pouder; and I think we know leſs, and by Conſequence leſs alſo of the Waters, even ſuppoſing we knew their Compoſition.

But let us ſuppoſe that the Bath is good for decay'd Old Age; for People that are Lame, and thoſe who labour under a Diſeaſe from a Cold Cauſe; yet our Knowledge about the Bath muſt remain Uncertain, if we are not able to juſtifie our ſending People thither on other Accounts, [16]for Reaſons not yet aſſign'd; and if we cannot ſhow that Effects quite contrary to thoſe it is noted for have not happen'd, with the Particular Circumſtances of the Caſe.

Inſtances of the laſt Sort are adduced in a good Number by Bath Doctors; and though poſſibly the Crutches that hang there may not be the Martyrology of the Bath, as Doctor Willis wou'd have it; yet they are confeſs'd not to be the Trophies of its conſtant Succeſs. But it is moſt certain that we have not conveyed to us the Failings and croſs Succeſſes which are abſolutely Neceſſary for the ſmalleſt Degree of Certainty in this Affair.

Perhaps the ſending People for all Diſeaſes may be alledg'd for its great Uſe: And I do Concur with them who ſay ſo, though I think very meanly of the Judgment of the Phyſicians who do ſo; and am Poſitive, that how ſoever excellent the Bath may be, that it neither is Infallible, nor a Panacea; but that it will always want a ſuitable Direction, which will be the more Infallible the greater our Knowledge is.

[17]

But the Weakneſs of our Underſtandings in this Particular is but too manifeſt by ſome Facts I ſhall Adduce.

For we know that many People who have been forſaken in the Jaundice by their Phyſicians, have yet found their Health at Bath, though the Bath is accuſed for bringing the Jaundice upon a great many.

It has been the common Complaint, eſpecially for theſe Two or Three laſt Years, that a vaſt Number of People have got Rheumatiſms at Bath; it is notwithſtanding moſt inconteſtably True, that great Numbers have got rid of Rheumatiſms there.

Many more Examples of other Diſeaſes might be brought to Prove this Thing, beſides the ſudden Deaths that have happen'd there; and yet I am apt to believe that it is very hard to account for theſe Accidents, even by my Rule of Experience, which but too ſufficiently Proves the great Imperfection our Knowledge lyes under in this very Matter, of the moſt ancient and uſeful Method of the Bath.

But I am aſham'd to think that this ancient and uſeful manner of Bathing ſhou'd [18]begin to be ſo much neglected, as if it neither wanted, or did not deſerve our improving. No manner of Conſideration is had about making it have its beſt Uſe, which is ſo little known, that ſome great Phyſicians are ſcandalouſly Nice by giving the Waters by Spoonfuls: As if Old Experience was to be laid aſide to make way for ſuch as they wou'd call New.

What Conſiderations are rais'd about Bathing? What Inquiries are made about our being Immerg'd in Water? What Queſtions are ask'd about its entering or not entering our Veſſels? And what Effects it may produce by mixing with the Liquors in 'em? And, Laſtly, what may the Difference be in being Immerged in Hot and Cold Water?

Theſe Conſiderations are not only Fine, but Uſeful, and wou'd ſoon make us Maſters of all that Affair. 'Tis ſure a Maſterpiece of Impudence to pretend to a Knowledge very Particular of any Bath, and to remain Ignorant of theſe Particulars I have juſt mention'd; nothing can be more ſtrange, except the ſetting no Value upon ſuch Inquiries, as thoſe Pretenders are very ready to do.

[19]

But not to preſs this Argument any farther, I may be apt to think that there can be no manner of Doubt about the great Imperfection of our Knowledge in reſpect of Med'cines; and how Ineſtimable a good it wou'd be to be brought out of this Infirmity.

But, Gentlemen, to put an End to this Matter, I have not only given you Med'cines of moſt ancient and common Uſe, but I have but juſt nam'd ſuch of their Effects as are recorded by the beſt Authors; and which conſequently cannot probably be falſe. 'Tis therefore your Buſineſs to give Satisfaction to theſe Examples I have Adduc'd, and that by your Quality-Method of Hot and Cold, Red and Yellow, Acid and Alkaly, by Taſte and Smell, &c. or becauſe you love high Flights by the Cauſes of theſe Qualities; yet if you have any Regard to my condeſcending to give you a lower Method, I Challenge you to give ſuch Proofs in Point of Experience that may aſſiſt our adminiſtring them in Practice.

But while I ſpeak to your Method of Qualities, I muſt inform you how Ignorant your Pretence is in this Particular. [20]You pretend to determine the Power any Med'cine has to Cure a Diſeaſe only by knowing ſome of Its Notable Qualities, which is manifeſtly falſe; becauſe there is ſcarcely one Diſeaſe that has not Med'cines of oppoſite Qualities found uſeful in its Cure, and recommended to us by our Forefathers as ſuch.

This is a Digreſſion, but not an improper one; yet to proceed; is the previous Knowledge of a Med [...]cine, or of Med'cines, by its or their Qualities, neceſſary before we Adminiſter them? And have you this kind of Knowledge? If you have, ſhow it us, for it is much wanting. If you have not, then require no more of others than you your ſelves are Maſters of; and order as few Med'cines for the Publick as you do to Patients; and none to either of 'em till you have ſatisfied us that you can do it in the mentioned Way.

But if you have any tolerating Method whereby you wou'd juſtifie your adminiſtring Med'cines in your Probation Time, do as you wou'd be done by; ſhare your Freedom to others of your Brethren, who are at leaſt in no lower a form of knowing than you be.

[21]

And if you have a ſpecial Rule whereby you can prefer the Uſe of one Med'cine to that of another, for the Cure of the ſame Diſeaſe: If you have, viz. any Method for which you wou'd rather give Jeſuits Pouder for the Cure of an Ague, than any of the other Med'cines recommended for the ſame: Let us have this your Method of reaſoning; for it may be ſo extenſive as to comprehend more Med'cines in this and other Diſtempers.

I know the Trite and Common Methods among Philoſophers, and all Mankind, is firſt to know if a thing is ſo, and then how it is ſo if we are able to compaſs it; but if they ſhould not get this length, you muſt reckon thoſe little better than Mad-men that deny the actual Exiſtence of a Thing, becauſe we do not know the Way of its Being. And but juſtly, becauſe it wou'd have us disbelieve our Senſes, and the Senſes of all Mankind; becauſe we cannot anſwer ſome Queſtions that are, or that happen not, to be the Objects of our Senſes, and are too fine for our Underſtanding. So that in the Trial, if a Man, or a Thing, is, or [22]does, ſuch an Action, or produces ſuch an Effect, we muſt judge of theſe Changes by our Eyes and other Senſes, or take them upon the Teſtimony of Honeſt Capable People that relate them, if we were not there our ſelves. This is the Way of the World, and I ſhall not enlarge upon it, to avoid Scandal: Tho' ſo much I muſt ſay, becauſe you and your Friend have ſo boldly unhing'd all theſe common Ways of judging of paſt Actions, that I am not able to go further with you, till you have inform'd us more in thoſe new Methods; yet whether you will do it or not, depend upon it, a Time may come wherein the World ſhall be informed how you uſe their old ones in Matters of the greateſt Importance.

Thus I bid you Farewel, knowing to how little Purpoſe it wou'd be to invite you to the following Diſcourſe. For you never once dreamt of any ſuch thing; and your proper Talent is to Snarl in a Corner at ſo Generous Attempts.

A Poſtſcript to Phyſicians about the Neceſſity of a true Theory of Diſeaſes.

[23]

I Continue the Diſcourſe to you on this Subject; not but that I am ſenſible how ſeriouſly many of you think of this Matter. And that even they who Calumniate you on this Score, do themſelves pretend ſometimes to reaſon about this Affair; tho' at the ſame time they endeavour to perſwade the World, that all Reaſonings of this Nature are Vain, and but ſo much Time loſt to the improving of Practice. You are ſenſible how they aſſume the quantity of Blood in a Man's Body given, and then do determine the Numbers of its Circulations in a certain Time: So you find, that howſoever they depreciate reaſoning in your Caſe about things of Phyſick, they are very fond of the Character of Men of Reaſon for themſelves; nay, you find they apply Arithmetick too, and therefore it is not reaſoning they are angry with, but that your Reaſon and Arithmetick is better than theirs.

[24]

After the ſame manner they being told how Barbarous Indians Cure Yaws with Guaiacum, do immediately extend its Uſe to the European Pox, and from that to Leproſies, &c. This is in the Nature of Man to do; but it is the higheſt Ingratitude to Calumniate People that offer them more of ſuch Med'cines, or that wou'd teach them more natural and righter Methods, whereby this extending of their Knowledge may be more uſefully brought on.

And therefore it is that I wou'd perſwade you to bear up againſt the Calumnies of theſe ill Men, and continue to do good to Mankind, by improving your Profeſſion. Be Diligent in your Enquiries about a true Theory of Diſeaſes; for it is even by that you ſhall be greatly aſſiſted in aſcertaining your Knowledge of Med'cines; and by that you ſhall be brought beyond what Chance has put into your Hands.

Beſides, if Med'cines were as certain in their Effects as our Hearts could wiſh, they can do but little good without a true Theory of Diſeaſes; but eſpecially in reſpect of the good they do, when aſſiſted [25]with it. And therefore I ſhall take Leave to preſs this Argument a little farther to you than it is commonly done.

The firſt of theſe is very manifeſt to thoſe who have thought the leaſt on that Subject; and I believe ſome time or other I may be able to give ſome Light into this Abſtruſe Affair.

As to the 2d Particular, we find the whole World on our ſide in the main; for to what Purpoſe ſhould an Infallible Med'cine ſerve, if we knew not the Diſeaſe it Cures, when it appears upon us or our Neighbour? Suppoſing, viz. it were as great a Difficulty to know an Ague in general, as it is to know it in all its Circumſtances, 'tis certain that this Excellent Med'cine, the Jeſuits Pouder, ſhould be of very little Uſe to us.

So far I may be thought in the right; but next, no general Deſcription that is almoſt poſſible to be made of a Diſeaſe, can be of ſufficient Uſe to us in adminiſtring our Infallible Med'cines, becauſe we are not always improperly Sick; but as a Diſtemper at one Time may Kill us, yet it may Cure us of ſome other Diſeaſe at another: And if this is poſſible, it is evident to every Common Underſtanding, that the more ſurely any Med'cine did promiſe the overthrow of a Diſeaſe, with the ſame certainty it brought along the impending Fate of the Sick Perſon. If Diſeaſes thus ſometimes Cure others that afflict us; and if we only want to have them deſcrib'd in order to apply our truſty Remedy, as it is ſuppos'd: It is moſt manifeſt that we do really hinder and obſtruct a perfect Cure of a Diſeaſe that ſhould be diſmiſt by ſome other, if we did not endeavour to remove this curing Diſeaſe by a faithful Med'cine; and yet, perhaps, we rid our Patients of neither of them: Nay, the more Powerful and Infallible the Med'cine is that we Employ, the more do we put it out of the Power of Nature, or the Strength of Conſtitution, to conquer the afflicting Diſtemper, and the more Noxious Remedy. So that here appears a mighty Paradox, that one Diſeaſe ſhould prove a Cure for another, and yet we never ſhall be able to know when one Diſeaſe will be the Cure of another, but by a true Theory of Diſeaſes, which by moſt is ridicul'd, and neglected by too many.

Hippocrates, and all ancient Phyſicians, eſpecially, have fully prov'd this Paradox by their repeated Obſervations; and neither have they failed in their Truth among more Modern Phyſicians, who have thought obſerving of any Uſe. It will not be amiſs, I preſume, to give ſome Examples of this Matter: [26]and thoſe ſhall be of that Nature, that the Diſeaſes I ſhall name do moſt eſpecially require the quickeſt Aid, and the moſt certain Ways of Curing; yet if even they are the Cures of other Diſeaſes, this whole Matter muſt be true without Exception. Feavers, Dyſenteries, Dropſies, &c. are of this kind; and who wou'd not wiſh for an unerring Specifick for their Cure? Yet Hipp. ſays, That if a Feaver comes upon one afflicted with Convulſions, it Cures him of that Diſtemper; and therefore whoſoever does attempt to baniſh this Feaver with his Truſty Med'cine, muſt, according to his Succeſs, either entail this Diſeaſe on his Patient, or deſtroy him altogether, if Nature is not able to baffle both the Curer and the Diſeaſe.

The ſame Hippocrates exhorts us not to deſpair of a Maniacal Mad Perſon when he begins to have a Dyſentery, or a Dropſie, but to hope the better of his Recovery; and therefore if any one obſerving the approach of any ſuch Diſeaſe, ſhould turn to his Receipt book for a Cure, and ſhould be happy enough to have an Excellent Med'cine for either of 'em, muſt be the more miſtaken in the Succeſs by the Siniſtrous Application; for he does with great Certainty confirm the Madneſs on his Patient.

Moreover, great Vomitings, which are not only of fatal Conſequence, but at once cut off all Hopes of ſuccouring languiſhing Nature, do require the ſpeedieſt Care of the beſt Phyſician, and the moſt Infallible Methods; yet theſe are ſometimes of great Benefit when they come in the latter end of a Lcoſeneſs of a long continuance, as the ſame Hippocrates aſſures us, and conſtant Experience does vouch. And therefore, tho' Dyſenteries, Feavers, Dropſies, Vomiting, &c. be Diſeaſes that can of themſelves bring Life to its final Period, and do juſtly require our utmoſt Study to diſcover their Nature, and to find out the beſt Methods and Med'cines for Curing 'em; yet they come ſometimes as the beſt and moſt ſpeedy Remedies for ſome other Diſtempers, which perhaps have already baffled all other Methods already, beſides theſe Diſeaſes that thus Cure: And there being no other Means left to ſhake off the Diſtemper, it muſt ſtill continue to be dangerous, if the unhappy Curer has Succeſs enough to baffle that Healing Diſeaſe; and thereis no Poſſibility of knowing a fatal Diſtemper from the ſame, when it is to prove a Cure, but by knowing the neceſſary Productions of Diſeaſes, and the particular Conditions of Human Bodies, in which they are produc'd, i.e. by having a true Theory of Diſeaſes. [27]Wherefore a true and an accurate Theory of Diſeaſes is the moſt neceſſary Thing for advancing a Phyſician's Knowledge for Curing Diſeaſes.

But, 2dly, This Argument holds very ſtrong in reſpect of Idiopathical and Sympathical Diſeaſes; for moſt frequently the Diſtemper that makes the greateſt Figure is moſt taken notice of, and frightens us the moſt, is very dependent, and is ſupported by a very ſmall Cauſe, and yet it will continue frightful and threatning ſo long as all our Applications are for this fearful Part; and its inconſiderable Cauſe remains unregarded, except in midſt of this Buſtle the Mi [...]ute Occaſion paſſes off of it ſelf, very much to the Reputation of the Malignant Curer, tho' little is added to the Stock of Phyſick. There be Thouſands of Inſtances to prove this Thing; but I ſhall be ſatisfied to adduce One, becauſe it is Evident, and of great Uſe, when extended to all its Length, and that it fully proves all I have ſaid on this Head. The Example is this Caſe of One, who having a Wound, there may be a very moderate Pain, and a Generation of Pus, and with this there will be a Feaver more or leſs to the Cauſes. This Feaver may be improv'd by a Feaver-Doctor, that the Suppuration ſhall miſcarry, and the fatal Feaver get a mighty Strength: Whereas if he is leſs frightned with this Common Feaver, and has Patience or Art to ſuffer the Suppuration to proceed, or to promote it by various Methods, his Fears will vaniſh with the Feaver, which aſſuredly goes off in that order that the Pus does take place.

This Argument holds evidently in every thing that relates to the Cure of Diſeaſes: For Diſeaſes are not only the Cures of Diſeaſes; and not only great Diſcretion is to be uſed in diſcovering an Idiopathical One; neither do we only adminiſter Infallible Remedies in undue and unſeaſonable Times, having no better Guides than a general Deſcription of Diſeaſes. But alſo, for not having a true Theory of Diſeaſes, we do not know when it is time to put a ſtop to our Succeſsful Method; and but too frequently carry on a needleſs Practice, to the great Detriment and Hazard of the ſick Perſon. There may be ſundry Examples brought for proving of this; but I ſhall again content my ſelf with One: In the Jaundice, viz. whoſe Pathognomonical Sign is moſt commonly the Yellowneſs, as its very Name imports; yet this Yellowneſs is not always attending the Indiſpoſition, but does ſometimes continue when the ſick Perſon is free of the Diſtemper, and paſt all Danger from the ill Accidents that ſucceed it; nay, frequently the Yellowneſs is augmented by ſome Methods that Cure the Diſeaſe: By which means the Cure is ſtill manag'd to the [28]Charge, Abhorrence and Danger of the Patient, and ſtill with the good Intention of an Ignorant Curer.

Whereas by a true Theory of Diſeaſes, it is not only eaſie to determine when one is Yellow, and has the Jaundice, and when one is Yellow, and cur'd of the Jaundice. But underſtanding the Reaſon of both, he can deſtroy the Yellowneſs, when no Conſideration is hald to the firſt Diſeaſe.

I think this does very manifeſtly convince us that there is ſomething elſe Neceſſary, beſides Infallible Med'cines, for the Cure of Diſtempers; though at the ſame time the beſt Theories will Cure no Diſeaſe without Proper Remedies; and the more Excellent they are of their Kind, the more Valuable they are.

Laſtly, This Matter will appear manifeſtly, and at once to our View, if we do but reflect on the various and oppoſite Sorts of Med'cines, that the faithful Obſervations of all former Ages have ſent us for the Cure of the ſame Diſeaſe. For the Variety ſhows the Defect, as well as the Neceſſity of trying about for more, and more certain, Med'cines: And the oppoſite Sorts point out to us the Variety of Circumſtances of the Diſtemper: So that my former Gentleman, A—s, is ſcarcely initiated in theſe Matters, when he talks of a Med'cine of one Quality to Cure the ſame Diſeaſe. This in paſſing. An Example of this is every Diſeaſe. But I ſhall Inſtance in the Caſe of a Conſumption, for which Experience has recommended a very notable Variety of Med'cines, and theſe very oppoſite. Are we not told of Milk and Brimſtone, Balſams, and Attenuating Med'cines, and a great Abundance of more jarring Things? But to give a fuller Example in this Particular, I refer you to what I have ſaid on this Subject in my Alvi Profluvia: By all which it is very plain how inſufficient the greateſt Stock of the beſt Med'cines is, without a true Theory of Diſeaſes, even for the Cure of Diſeaſes.

Let me therefore perſwade Candid and Honeſt Phyſicians to ſet about a ſedulous Inquiry for a true Theory of Diſeaſes, and a more exact Method for diſcovering the directeſt and moſt advantageous Uſes of good Med'cines, that we may do the moſt good to Mankind, and ſhow that the Med'cines chance have put into our Hands, may even have ſome Improvement from us: Neither let us in this Inquiry be diſcourag'd with the Impudence of Pretenders nor by the ſmall Advances we can hope to make; for they only hate you for your doing better than themſelves; and no Body can tell what attempting in this Matter does produce, but they that have once tried it.

FINIS.
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Zitationsvorschlag für dieses Objekt
TextGrid Repository (2020). TEI. 5607 The present uncertainty in the knowledge of med cines in a letter to the physicians in the Commission for sick and wounded seamen With a postscript to physicians shewing the necessity of a true the. University of Oxford Text Archive. . https://hdl.handle.net/21.T11991/0000-001A-57D2-5