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If you are not located in the United States, you'll have -to check the laws of the country where you are located before using this ebook. - -Title: The Æsculapian Labyrinth Explored - Medical Mystery Illustrated - -Author: Gregory Glyster - -Release Date: March 9, 2017 [EBook #54332] - -Language: English - -Character set encoding: UTF-8 - -*** START OF THIS PROJECT GUTENBERG EBOOK THE ÆSCULAPIAN LABYRINTH EXPLORED *** - - - - -Produced by deaurider, Les Galloway and the Online -Distributed Proofreading Team at http://www.pgdp.net (This -file was produced from images generously made available -by The Internet Archive) - - - - - - - - THE - ÆSCULAPIAN LABYRINTH EXPLORED; - - OR, - - MEDICAL MYSTERY ILLUSTRATED. - - IN A SERIES OF INSTRUCTIONS TO - - YOUNG PHYSICIANS, SURGEONS, ACCOUCHERS, APOTHECARIES, - DRUGGISTS, AND PRACTITIONERS OF EVERY - DENOMINATION, IN TOWN AND COUNTRY. - - INTERSPERSED WITH A VARIETY OF - - RISIBLE ANECDOTES AFFECTING THE FACULTY. - - INSCRIBED - TO THE COLLEGE OF WIGS, - BY - GREGORY GLYSTER, - AN OLD PRACTITIONER. - - “TWENTY MORE! KILL THEM TOO.”——BOBADIL. - - LONDON: - PRINTED FOR G. KEARSLEY, NO. 46, FLEET-STREET. - - MDCCLXXXIX. - - [PRICE THREE SHILLINGS AND SIX-PENCE.] - - - - -TO THE COLLEGE OF WIGS. - - - “Most potent, grave, and reverend signiors, - “My very noble and approved good” Doctors. - - -The solemnity of your somniferous aspects, no less than the -professional gravity of your external ornaments, lay claim to a bow -of obedient recollection in passing through W—— k-lane to public -inspection. As one of the most _popular_ descendants from your great -progenitor, permit me to acknowledge, I revere the _vast extent_ of -your _medical abilities_; that I feel most forcibly the _enormous -weight_ of your _accumulated learning_, and _tremble_ at the very idea -of your _experimental abilities_. - -Condescend, dread Sirs, to sanction this analization of _Æsculapian -imposition_ and _medical mystery_, with such proof of approbation, as -the dignity of a _diploma_, and the muscular rigidity of _physical -countenance_ will permit you to bestow; nor let it be the less entitled -to your favor, that a long list of _valetudinarians_ (to whom you are -daily pensioners) become partakers of the _banquet of mirth_; or the -small fry of _pharmacopolists_ (your humble dependents) _for once_ -permitted to take a seat at the _same table_ with yourselves. - -Anxiously solicitous to obtain belief, that - - “I shall nothing extenuate, - “Nor set down aught in malice,” - -you may in justice conclude me, - - _Sage Sirs!_ - - Your very candid, - - And obedient representative, - - GREGORY GLYSTER. - - - - - THE - - ÆSCULAPIAN LABYRINTH - - EXPLORED. - - -TO THE PHYSICIAN. - - -Having passed the tedious years of abstruse study and intense -application, necessary to your initiation in the mysteries of physic, -and replete with a perfect remembrance of all the requisites to this -_great art_, we suppose you recently emerged from the obscurity of -_dreary walls_ and _dull professors_, a phenomænon of universal -knowledge and _family_ admiration. The various and elaborate -examinations you have passed, with scholastic approbation, having -relieved you from the constantly accumulating load of anxiety, you are -at length launched into life under a new character, and daily pant -to display the dignity of your profession, in the happy appendage of -_M. D._ to the prescriptive initials of your name. - -You are no longer to be considered a student labouring in the heavy -trammels of _unintelligible_ lectures upon _philosophy_, _anatomy_, -_botany_, _chemistry_, and the _materia medica_, with all their -distinct and consequent advantages; or investigating the actual -properties of _electrical fire_ and MAGNETIC ENTHUSIASM, but stamped -(by royal authority) with the full force of physical agency, and have -derived from your _merit_ unlimited permission to _cure_, “_kill_ or -_destroy_,” to the best of your knowledge and abilities, “so help you -“God.” The professional path you now begin to tread, is so replete -with danger, and the probability of success so very uncertain, that -the fertile world have not omitted to make it proverbial, “A physician -never begins to get bread, till he has no “teeth to eat it.” The truth -of this may perhaps have been _lamentingly_ acknowledged by some of the -most _learned men_ that ever became dependant upon a _capricious_ world -for _precarious_ subsistance. - -This palpable fact may concisely serve to convince you, your -embarkation (with all its alluring prospects) will not only be -encumbered with difficulties, but your ultimate gratification of -success exceedingly doubtful. Great depth of learning may afford -consolation to the equity of your own feelings (if you fortunately -possess them) but it is by no means necessary to the acquisition of -_public opinion_, however it may tend to contribute to the general good. - -To avoid entering into a sentimental disquisition upon the _honesty_, -_integrity_, or _strict propriety_ of the maxims I proceed to lay -down for your future conduct to obtain professional splendour, and -_insure success_; I avail myself of the privilege I possess, to wave -every consideration of the _conscientious kind_, and once more observe -(without adverting to their consistency) they are adduced only as the -unavoidable traits of character, and modes of behaviour, by which alone -(in the present age) you can possibly hope for the least proportional -share of practice as a physician. - -At your first public entré, when the college list and court calendar -have announced your qualifications and advancement to the wondering -world (that such list should annually increase) let your friends -and relatives be doubly assiduous in propagating reports (almost -incredible) of your _great humanity_, _extensive abilities_, and -_unbounded benevolence_.—This will answer the intended purpose to a -certainty; crouds of the afflicted and necessitous will surround your -habitation, and render your place of residence constantly remarkable to -all classes, who naturally enquiring the character of the proprietor, -will eagerly extol your charity in contributing your “advice to the -poor GRATIS.” - -This method alone will gain you popularity with those that rank in the -line of mediocrity; with _their superiors_, success must be insured -more from the efforts of _interest_, than either _personal merit_, or -_sound policy_. Your attention to the wants of the poor, must soon -be regulated by the preponderation of more weighty considerations; -as you _affected_ to alleviate their distresses from the motive of -commiseration, prompting you to promote _their ease_, you have an -undoubted right to shake off such superfluous visits, to secure _your -own_. In this deceptive charity, some degree of discrimination must be -put in practice, for you will sometimes perceive one among the train, -whose apparel or behaviour must necessarily give you reason to suspect -he has assumed the cloak of necessity to save _his fee_, and avail -himself of your professional liberality in such case, call to your -aid a look of true _medical austerity_, and let him understand “advice -is seldom of any value or “effect unless it is paid for;” this will -frequently answer the purpose, and procure what you did not expect. - -On the contrary, so soon as you observe your prescriptions have -“_worked wonders_” upon two or three of the most _credulous_ and -_superstitious_, who are extolling your _great knowledge_ and -“blessing _your honour_,” strengthen the _force_ of your judgment by -_charitably obtruding_ a pecuniary corroboration into the hand of your -afflicted patient, as a confirmation of your _unbounded skill_ in -the (_miraculous_) cure of every disease to which the human frame is -incident. By such _political_ practice, you insure the recital of your -services with extacy, and your name reverberates from one end of the -metropolis to the other. - -Your person and place of residence, being by these means universally -known, and your name become in a proportional degree popular, let -your plan and mode of behaviour be instantly changed; it will be now -necessary - - “You “assume a” hurry “if you have it not,” - -Take care to be so exceedingly engaged with patients of the _first -class and eminence_, that “it is with difficulty you procure time -sufficient for the common purposes and gratifications of nature.” No -paupers _whatever_ can be admitted to your presence without a written -recommendation from _nobility_, or characters of the _first fortune_; -this will insure you no farther intrusion from a class originally -introduced for your _particular purpose_; that effected, they may now -be permitted to fall into the back ground of the picture; from whence -they were brought for no other motive than the promotion of your -personal interest and professional emolument. - -It becomes your particular care to be always in a _hurry_; let your -chariot (if you can fortunately raise one) _upon job_, be at the door -regularly by nine in the morning; to prove how very much you are -attached to the duties of your profession, and how anxiously you have -the _salubrity_ of your patients _at heart_.—Omit no one circumstance -that can contribute to a shew of being perpetually engaged. Letters -written by _yourself_, and messengers of your _own dispatching_, -cannot be seen at your doors too frequently; the chariot should be -as repeatedly ordered—remember to leave home by _one way_, and -return by _another_, and equally _in haste_; all these stratagems are -considered peculiar privileges of the _College of Wigs_, and are well -worthy your attention and constant practice. You need hardly be told, -the superficial and unthinking part of mankind are ever caught by -appearances; what proportion they bear to other distinctions, need not -in the present instance be at all ascertained. - -Having laid down rules (that should be rigidly persevered in) for the -regulation of your _public character_, I shall now advert to the strict -line of conduct it will be proper for you to adopt in your personal -transactions upon all professional emergencies. - -When called to a patient upon the recommendation of the family -apothecary, you are to consider him one of your best friends, and _pay -court to him_ accordingly; on the contrary, if you are engaged upon the -spontaneous opinion of the patient, or his relatives, you have every -reason to conclude the abilities of the apothecary are held in very -slender estimation, and you may safely venture to display as much of -your _own consequence_ and superiority, as circumstances will admit. - -After the awkward ceremony of your first appearance is over, and -matters a little adjusted, take great care to be upon your guard; -indulge in a variety of _significant gestures_, and _emphatical -hems!_—and _hahs!_ proving you possessed of _singularities_, that -may tend to excite ideas in the patient and surrounding friends, -that _a physician_ is a superior part of the creation.——Let _every -action_, _every word_, _every look_, be strongly marked, denoting -doubt and ambiguity; proceed to the necessary enquiries of “what -has been done in rule and regimen, previous to your being called -in?” hear the recital with patience, and give your _nod of assent_, -lest you make Mr. Emetic, the apothecary, your formidable enemy, who -will then _most conscientiously_ omit to recommend the assistance of -such _extraordinary abilities_ on any future occasion.—Take care -to _look wisdom_ in every feature; speak but little, and let it be -impossible _that little_ should be understood; let every hint, every -_shrug_ be carefully calculated to give the hearers a wonderful -opinion of your learning and experience.—In your _half-heard_ and -mysterious conversation with your _medical inferior_, do not forget -to drop a few observations upon—“the animal œconomy”—“circulation -of the blood”—“acrimony”—“the non naturals”—“stricture upon the -parts”—“acute pain”—“inflammatory heat”—“nervous irritability,” and -all those _technical traps_ that fascinate the hearers, and render the -patient yours ad libitum. - -To the friends or relatives of the diseased, (as the case may be) -you seriously apprehend _great danger_; but such apprehension is -not without its portion of _hope_; and you doubt not, but a rigid -perseverance in the plan you shall prescribe, will reconcile all -difficulties in a few days, and restore the patient (whose recovery you -have exceedingly at heart) to his health and friends; that you will -embrace the earliest opportunity to see him again, most probably at -such an hour, (naming it) in the mean time you are in a great degree -happy to leave him in such good hands as _Mr. Emetic_, to whom you -shall give every necessary direction, and upon whose _integrity_ and -_punctuality_ you can implicitly rely. - -You then require a private apartment for your necessary consultation -and plan of _joint depredation_ upon the pecuniary property of your -unfortunate invalid, which you are now going _seriously_ to attack with -the full force of _physic_ and _finesse_. You first learn from your -informant what has been hitherto done without effect, and determine -accordingly how to proceed; but in this, great respect must be paid to -the temper, as well as the constitution and circumstances, of your -intended _prey_; if he be of a petulant and refractory disposition, -submitting to medical dictation upon absolute compulsion, as a -professed enemy to physic and the faculty, let your harvest be _short_, -and complete as possible. On the contrary, should a _hypochondriac_ be -your subject, with the long train of melancholic doubts, fears, hopes, -and despondencies, avail yourself of the faith implicitly placed in -you, and regulate your proceedings by the force of _his imagination_; -let your prescription (by its length and variety) reward your _jackall_ -for his present attention and future services.—Take care to furnish -the frame so amply with _physic_, that _food_ may be unnecessary; -let every hour (or two) have its destined appropriation—render all -possible forms of the _materia medica_ subservient to the general -good—_draughts_—_powders_—_drops_, and _pills_, may be given (at -least) every two hours; intervening _apozems_, or _decoctions_, may -have their utility; if no other advantage is to be expected, one good -will be clearly ascertained, the convenience of having the _nurse_ -kept constantly awake, and if _one medicine_ is not productive of -success, _another may_. These are surely alternatives well worthy -your attention, being admirably calculated for the promotion of your -_patient’s cure_ and your _own reputation_. - -Having written your long prescription, and learnt from Mr. Emetic -every necessary information, you return to the room of your patient, -to prove your attention, and renew your admonitions of punctuality and -submission;—then receiving your _fee_ with a consequential _air of -indifference_, you take your leave; not omitting to drop an additional -assurance, that “you shall not be _remiss_ in your attendance.” These, -Sir, are the instructions you must steadily pursue, if you possess -an ardent desire to become _eminent_ in your _profession_—_opulent_ -in your _circumstances_—_formidable_ to your _competitors_, or a -_valuable practitioner_ to the _Company_ of _Apothecaries_, from -whom you are to expect the foundation of support. A multiplicity of -additional hints might be added for your minute observance; but such -a variety will present themselves in the course of practice, that a -retrospective view of diurnal occurrences will sufficiently furnish you -with every possible information for your future progress; regulating -your behaviour, by the rank of your patients, from the _most_ pompous -_personal ostentation_, to the meanest and _most contemptible -servility_. - - - - -TO THE SURGEON. - - -I congratulate you upon your recent emancipation from incessant study, -intense application, and strict _hospital_ attendance, where I shall -willingly suppose, you was a _dresser_ of the most promising abilities; -that you excelled your cotemporaries in every _chirurgical_ opinion, -became an expert _dissecting_ pupil to one of the _court of examiners_, -and are now burst through the cloud of your original obscurity, a -perfect prodigy of _anatomical_ disquisition. - -I naturally conclude you capable of animadverting upon all the -distinct branches of your art to admiration, that you are critically -excellent in the use of an _instrument_ from the humble act of simple -_phlebotomy_, to the more important operation for a _fistula in -ano_.—You have, beyond every shadow of doubt, paid proper attention to -the fashionable precepts of the late Lord Chesterfield, and rendered -yourself (with assistance from the graces) a perfect adept in polite -address, displaying a variety of the most engaging attitudes, even in -the adjustment of a _ten tailed bandage_. The professional information -you have industriously collected, is such as will certainly afford you -the most equitable claims upon _public opinion_, being in possession of -every necessary acquisition from a _simple gonorrhœa_ to a _confirmed -lues_. - -Previous to your solicitation of favour from your friends, you have -necessarily passed the awful ceremony of examination at the _Old -Bailey_, under your former tutor (and his brethren of the court) -who would not pay his _own abilities_ so improper a compliment as -to ask you questions in _anatomy_ or _osteology_, that he knew your -qualifications inadequate to the task of technically explaining. -After passing this _fiery ordeal_, you deposit the usual _pecuniary -gratuity_, and receiving the _badge_ of your newly acquired _honor_, we -now hail you “_a Member of the Corporation of Surgeons_,” and conclude -an ornamental plate upon the door of your habitation denotes you so -accordingly. - -We suppose you embarking in a sea of spirited opposition, with your -competitors, for professional celebrity, and decorating your place -of residence in the most applicable stile to attract attention. To -effect this, let your exterior apartments be ornamented with the -_busts_ of _ancients_ you _never read_, and _portraits_ of _moderns_ -that you _never knew_. These form an excellent combination to -excite the admiration and report of those who have occasion to court -the assistance of your extensive abilities.—To gradually heighten -which surprize, your interior (or _audit room_) must be a perfect -_Golgotha_.—A proficiency in the science of _osteology_, must be -powerfully impressed upon the senses of the trembling visitors, by -a _profusion_ of _skeletons_ in different states; let the awfulness -of the scene be rendered still more striking, by a variety of -subjects suspended in spirits, interspersed with singular _anatomical -and injected preparations_, both wet and dry; giving to the whole -additional force by the introduction of a “_few ill shaped fishes_,” -as the finishing stroke to a well formed plan of _chirurgical -ostentation_. Remember to let the _certificates_ of your professional -qualifications, from your different _lecturing tutors_, be so placed -(in elegant frames) as to meet the eye in a conspicuous direction; -lest that part of your patients, who condescend to visit you in this -gloomy recess, should have reason to conclude you a _consummate dunce_ -and most _illiterate booby_, if these learned professors had not done -your friends the favour to “_certify_” to the contrary: and this they -always _chearfully_ do, rather than have it imagined they have eased -you of a part of your property, without doing you any _real service_. - -The domestic arrangement being thus formed, the reflections to which -you must now turn your mind, are the necessary modes of practice and -behaviour, that may render you not only eminent in your profession, but -respectable in your property; as great events, that contribute largely -to the gratification of such wish, do not frequently occur, inferior -cases of every kind must be rendered subservient to the purpose. In -this list, _venereals_ are entitled to pre-eminence, as the most -lucrative; the patient never hesitating to pay full as liberally for -the preservation of the _secret_ as the cure of _disease_.—But you -may be perfectly assured, this secret never rewards so well, as when -_fate_ or _fortune_ assists its introduction to _married families_; a -most striking corroboration of this fact, occurred not long since in -the neighbourhood of a _royal residence_, and afforded matter of mirth -to the first circles in its environs.—This constant friend to the -faculty was communicated to a married lady, by a _young_ and celebrated -personage of some national eminence, and immediately conveyed from her -to her _enamoured cornuto_ in the moments of true _connubial felicity_; -he, in the love of variety, unluckily conferred the favour upon the -_house maid_; and she, in the extensive liberality of her disposition, -kindly bestowed a portion upon the _footman_. The _electrical shock_ -of this _French fire_ was so rapidly communicated, that the four -sufferers, within the space of ten days, made their separate _private_ -confessions to the medical superintendant of the family, each assigning -a different cause for its introduction, and equally strangers to the -_mode_ of its being brought into so _sober a family_. Although this is -a well authenticated _fact_, it is a harvest that can be very seldom -expected to happen in so great a degree; yet you will find it a matter -often _intruding_ between husband and wife, and considered no indelible -proof of _modern inconstancy_.—To this secret, you will be frequently -admitted by one party—the other, or both; and have an undoubted -privilege to accumulate all possible pecuniary advantage from the -confidence so implicitly placed in you. - -Whatever cases are submitted to your opinion, be always prepared to -represent them _worse_ than they really _are_; making by your technical -terms, and political doubts, _bad worse_ upon every possible occasion. -Let all your proceedings have a peculiar and commanding dignity -annexed to the execution; by assuming a want of feeling, even to -_ferocity_, you will be termed a practitioner of _spirit_, and become -properly distinguished for your professional _fortitude_. No tender -sensations must be permitted to influence your feelings during any -operation, however tedious, or painful to the patient; they are an -ornament to human nature, and beneath your consideration _as one of -the faculty_.—Custom has rendered you ineligible to a place in the -_jury box_, as an evident proof of your professional _brutality_; by -therefore turning “their pains to laughter and contempt,” you only -justify the character you are already in possession of. - -In the most trifling operations (even phlebotomy) descend to the very -minutiæ of medical consequence, not only making the ceremony _long_, -but _serious_, that you may be the better entitled to personal respect -and pecuniary compensation. In all those dreadful accidents that alarm -friends and distress families, take care to throw out (during your -apparent care and attention) a variety of observations that convey -_large sounds_ with _little meaning_; by such ambiguous expressions you -render the cure more extraordinary, whenever it happens, and is no bad -preparative for the procrastination of it to your own emolument. In all -cases requiring the interposition of instruments, take great care that -you produce them with mysterious solemnity, impressing the spectators -and assistants, with equal _awe_ and _fear_ of your abilities; if -_incisions_, or _separation_ of the _soft parts_, become necessary, be -sure, like “old Renault,” to “shed blood enough;” it will be attended -with a double advantage; first in the appearance of business, and the -more _pleasing consideration_, that the _larger_ and _deeper_ the -wound, the longer time will be necessary for _incarnation_; during the -course of which, your personal attendance and daily _epithemas_ cannot -be dispensed with. - -The _greater operations_ do not occur every day, therefore tedious -_cicatrizations_, in addition to _simple_ and _compound fractures_, are -comfortable aids to fill up the spaces of intervention. Fractures of -the _lower extremities_ are exceedingly favourable, for you may then -exert proper authority; it becomes your duty to keep _them down_ when -they _are so_, for surely you may take upon you to know (with propriety -and professional privilege) when they are capable of _standing_ and -_walking_, better than they can _themselves_.—Tho’ one exception to -this rule has fallen within my knowledge, and nearly set aside the -privilege of the practice in the neighbourhood where it happened. - -An honest hearty _miller_, in a small parish in the county of -H—-—-, having, on the market day, made some lucky purchases, and -congratulating himself upon his good fortune with a few friends over -the bottle, got himself insensibly intoxicated; but obstinately -persisting in his determination (and ability) to ride home, he was -suffered to depart, and was found afterwards upon the road by one of -his own servants almost lifeless; he was conveyed to his habitation, -and one of the most _eminent surgeons_ from a certain large and -populous town was called in, who finding the trunk nearly inanimate, -proceeded to _venesection_, then to an accurate examination of the -body, in which he presently discovered “a _fracture of the tibia_, -and two of the ribs; he had every reason to apprehend (from present -symptoms) a _concussion of the brain_; but situated as things were, he -should now administer proper _palliatives_, and pursue the necessary -steps upon his arrival in the morning.”—He then left the patient, -after strict injunctions “that he should not be suffered to move from -the position he had placed him in, till his return.”—At the hour -before appointed, the _Doctor_ returned, and not finding the wife -below stairs, explored the region he had left his patient in the night -before, surrounded by his sorrowful friends; when, strange to relate! -(_stranger to believe!_) the bird was flown, the bed made, and the very -room exhibited a striking proof of rustic neatness. Recovering in some -degree from his surprise, and feeling _very forcibly_ the aukwardness -of his situation, he descended to the kitchen, and there finding the -wife (who had just returned from some business in a back yard) he -eagerly enquired “How, or which way, his patient had been conveyed, and -where to?”—When the poor woman very simply and civilly replied, that -“her husband was gone into the fields among his folks; that she had -repeatedly urged the doctor’s orders of his _not getting out of bed_; -but he was a very obstinate man, and said he’d be d—’d if he’d ever -lay in bed with a _broken leg_ for any doctor in England, so long as -he could walk upon it.”—It may be better conceived than described how -severe a stroke this proved upon the reputation of the surgeon; certain -it is, his practice continued in a declining state for some years, and -it was not till the circumstance was nearly buried in oblivion (with -the body of the miller) that he recovered his former celebrity, being -at this moment one of the oldest and most eminent practitioners in the -neighbourhood where he resides. - -This instance sufficiently demonstrates the impropriety of -overstraining the professional prerogative, especially with those -obstinate uncivilized beings, who have so little pliability of -disposition, as not to lay in bed when required; particularly in cases -of emergency, where it is so evidently for the promotion of their own -health and safety. - -Remember in all cases of difficulty and danger to be mindful of the -_emplastrum adhæsivum_ of connexion, by which every branch of the -faculty should be united for the preservation of the whole; advise -(without the least reference to the enormity of expence) a consultation -of the most eminent; this renders the case of your patient more serious -and alarming, and you oblige your brethren by the recommendation; first -of a physician, whose _prescription_ introduces the _apothecary_; -and you then proceed _physically_ and _systematically_ in the joint -depredation and cure; your two friends, by the law of retribution, -gratefully recommending your inspection of every simple _laceration_ -upon all similar occasions. - -These are maxims that may at first sight seem beneath the attention -of a young and _brilliant_ practitioner, who erroneously conceiving -_merit_ a sufficient recommendation, requires no other conductor; but -they are so evidently an absolute part of his necessary study, that -unless such _mutual arts_ are occasionally put in practice, he can -never (in the present multiplied state of practitioners) expect to -derive the common necessaries of life from a fair and generous practice -of his profession. - -Men of understanding, experience, and observation, know, that the -benignant hand of providence continues to anticipate in a variety -of instances the interpositions of _art_; and _nature_ would, upon -many occasions, entirely effect her own work, if not so frequently -interrupted and retarded by the officious hands and interested -experiments of professional jugglers. - - - - -TO THE ACCOUCHER, - -OR, - -MAN-MIDWIFE. - - -You fortunately make your appearance upon the boards of public -patronage, under the most striking advantages; the prevalence -of _fashion_ has exceeded every consideration of _decency_ and -_discretion_, and you are become (by the influence of pride and -imitation) as necessary to the comfort of a cottage, as the happiness -of a court. From the nature of your professional destination, a -pleasing exterior, and an accomplished person, are invariably expected; -necessarily blending (from your intended intercourse with the _purer_ -part of the creation) the precision of taste, with the perfection of -the scholar. - -The certificate granted you by that elaborate lecturer, the _obstetric -professor_, proclaims you qualified in the very minutiæ of this -mysterious art. The parts, externally and internally, necessary to -generation, are so perfectly familiar to your “mind’s eye,” that -you can extemporaneously delineate the _ovariæ_, the “_fallopian_ -tubes,” the _fimbriæ_, and the very act of _conception_, from -the “_animalculæ_” in “_semen masculino_,” to the last stage of -_gestation_; the gradual expansion of the _uterus_, the dilatation -of the _os uteri_, the progress of _labour_, and all the methods of -extraction. - -You can clearly define the classes as _natural_, _laborious_, and -_preternatural_; the use of the _forceps_, _scissars_, _crotchet_, and -_blunt hook_; the introduction of the _catheter_, the extraction of the -_placenta_, and the separation of the _funis_; in fact, all the _et -ceteras_ are so perfectly clear to you in _theory_, that it is almost -treason to suppose you can _err_ in the practice. - -But, Sir, ripe as you are in these advantages, the harvest of universal -applause, and the sweets of emolument, are scarcely to be acquired -even by time, labour, and the most indefatigable industry. You have -in the practice of _midwifery_, all the ills of _Pandora’s box_ to -encounter, and after twenty years practice may be left to exclaim most -emphatically, - - “Vain his attempt who strives to please you all.” - -The only consolation you have, is, that you are destined to cooperate -with subjects, whose smiles render some degree of compensation for -the incessant fatigue dependant upon the practice. Under these -considerations, in the full career of your expectations, it can never -prove inapplicable to prepare your mind for some of the rebuffs and -disappointments that inevitably ensue. I conclude you are possessed of -youth, health, diligence, and constitutional _stamina_; but there are -other requisites, equally necessary for the performance of professional -duties, to which by election you dedicate the store of knowledge you -have so industriously acquired. The indispensible qualifications, for -the successful execution of the arduous task you are undertaking, -may be comprised in very few words, and those few exceedingly -expressive and readily understood; without _sobriety_, _fortitude_, -_judgment_, and _patience_, you never can expect to attain the summit -of excellence, or obtain admission to those families whose patronage -will contribute most to both credit and emolument. But admitting you -possessed of all the requisites for mere manual operation, the process -of delivery, and consistency of conduct, yet there are a multiplicity -of embellishments, that nothing but previous information, private -instruction, or experimental practice, can sufficiently recommend to -your attention. - -In the awful minute of your introduction to a scene of excruciating -agony and eager expectation, where the hope of a mother, and the -anxiety of friends, all center in you, as the messenger of peace, -throw off the ostentatious air of self-importance, exerted over -those _patient paupers_ upon whom you practised in the days of your -initiation, and recollecting yourself the humble solicitant of public -opinion and private favour, display your tenderness and civility, as no -bad harbinger of your better qualifications. Strengthen such favourable -impression by every degree of delicacy and attention to the suffering -expectant, who imploring assistance from the interposition of your art, -hails you as “the god of her idolatry,” by whom she is to receive an -early acquittal from all her sufferings. - -As this is not often to be instantly expected, and many tedious hours -frequently intervene between the _hope_ and _execution_, it will be -necessary (exclusive of your periodical consolations to the patient’s -inspiring resignation) you address yourself to the passions and -foibles of the gossips, with whom you will in general be too numerously -attended, and whose clamours upon many occasions are not easily to be -subdued.—Notwithstanding this, the good opinions and recommendations -of these motley visitors (of all ages and constitutions) are the -very materials to form the foundation of _report_, upon which the -superstructure of your reputation and future practice is to be -raised.—Although _gravity_, even to a certain degree of _solemnity_, -is a characteristic of your professional practice, yet there are -times when you must unavoidably come forward to enliven the _good -ladies_ with a specimen of your volubility, and variegate the natural -extremities of pain with the applicable insinuations of mirth. Jocular -inuendoes and double entendres are not only expected, but courted in -the intervals of ease, or, as the good women generally term it, “when -the business stands still.” - -The introduction of the tea-table and the joke are always considered -equally promoters of mirth and the delivery; the practitioner is -expected to be well stocked with the most fashionable recitals of -_seduction_, _rapes_, _fornication_, and _adultery_, which, if well -told, and applicably introduced, insures him to a certainty the future -interests of his company. It will be absolutely necessary for you to -fall into all the opinions of the table, except the glass of brandy -repeatedly pressed upon you by the _nurse_ (as a specific, or grand -arcana, for every ill) with the very expressive plea of its not doing -you _any harm_; and “besides, Sir, what’s good for the goose is good -for the gander.” - -After such casual respites (which frequently happen) when the progress -of labour calls you again to your _chair of office_, resume the -language of commiseration, giving your patient every alleviation of -hope for a speedy deliverance, at the very time you are impressing -(by significant looks and emphatic gestures) the attendants and -friends with an idea of great difficulty and impending danger. In the -alternate moments of respiration, evade every retrospective allusion -to the length of the labour, by frequent insinuations that it advances -rapidly, that you have great reason to hope every obstacle will be -soon surmounted; but you are afraid the consolation you administer, -and the pain she suffers, will take but little hold of the memory, if -you may be permitted to judge from the declaration of a very pretty -woman you delivered during your attendance at the Lying-in Hospital, -who, in reply to your tender admonitions of fortitude and patience, -said, “She was very much obliged to you for your kindness, but -she was very certain it would be just the same again by _that time -twelvemonth_.”—This will make way for any thing applicable of your own -collection, but they must be all bordering upon the original cause of -the scene before you; for although the patient is in extreme pain, it -is not so with the attendants; they consider it a _matter of course_, -and feel no disgust but from fatigue, which they very justly conceive -they have a right to alleviate with occasional mirth—tea, and a -_little good brandy_. - -To the _nurse_, great part of your attention must be directed; for she, -like a bellows blower to the organist at a cathedral, will expect to be -included and constitute _WE_ in all the merit of your execution.—The -rapidity, or gradual progress of labour, at length closes your -complicated scene of mirth and anxiety; you deliver your patient, -and proceed to the subsequencies (_secundem artem_) all which having -concluded to general admiration, and received ten thousand thanks and -blessings from your subject, you convey a pecuniary _hope_ for future -services into the hand of the _nurse_, take a tender leave of your -patient, with a promise of seeing her again in proper time, drop an -attracting _nod_ of obedience to the surrounding females, and meeting -the husband at the bottom of the stairs, congratulate him upon his son -or his daughter; slightly hint the difficulty of the case, the danger -you apprehended, the fatigue you had undergone, all which is not worthy -a thought, _perfectly happy_ in an event that contributes so largely to -the happiness of him and his family. - -That part of the work being completed, that most depended upon -the efforts of _Nature_, it becomes your duty to promote your own -interest by every exertion of _art_. Should, after your departure, any -_hemorrage_ ensue, inevitable danger will be apprehended, the patient -will be reduced, the friends alarmed, and you, in the moments of -dreadful anxiety, be immediately sent for; this _lucky circumstance_ -will operate to your earnest wish; it will afford ample scope for -your most fertile invention, and happily introduce a long list of -_styptics_, _anodynes_, and all those necessary concomitants that give -a profitable complexion to the business, by enlarging your hopes, -protracting the case, and encreasing the danger. - -However, should this favourable circumstance not occur, your privilege -is by no means curtailed; you immediately commence your previous -intentional operation of dispatching a _sufficiency_ of _balsamic -anodyne_ draughts, “to promote and mitigate the severity of _after -pains_, that very much distress the patient.” These draughts should be -continued every _four hours at least_, and as a sufficient quantity -of that excellent (and cheap) medicine, _spermacæti_, cannot be -well dissolved in each draught, without rendering it too viscid in -consistence, it will be peculiarly advantageous to you (as well as the -patient) to let them be accompanied with _boluses_ to be taken at the -_same time_, composed of _pulv. sperma_—_confect. alkermes_, &c.—Let -the administration of these medicines be entirely regulated by the -temper, docility, and recovery of your subject; having it ever in mind, -that it is neither your duty or interest to make the least observation -upon their being no longer necessary, till their frequent use is -complained of by the patient sufferer; and even then you are favoured -by fortune in a plea, that you “are now under the absolute necessity -of making unavoidable alterations for the prevention of the _milk, or -puerperal_ fever, which you very much apprehend may ensue.” That it is -an invariable rule with you, never to recommend the use of medicines, -but where they are highly necessary; in the present instance, it is -your duty, from the motive of _gratitude_, to be equally circumspect, -for the promotion of _her health_ and your _own reputation_. - -To effect every desirable purpose, a gentle _diaphoresis_ must -be supported, to prevent obstructions and promote the necessary -excretions; to procure which, you must entreat most earnestly an -implicit obedience to your directions, which from a variety of -_unpleasant symptoms_ becomes indispensible. To carry which point in -a still greater degree, renew, at every visit, your attentions to -the _nurse_ (who in your absence is a vortex of knowledge, in your -presence all obedience) her approbation of your conduct, and good -opinion of your practice must be obtained _at any price_; it becomes -with you a consideration of greater magnitude than your patient’s -recovery; for should _death_ no longer permit _her_ presence in the -scene of sublunary events, you lose _one patient only_; but with the -good opinion and recommendation of the _nurse_, vanishes hundreds of -patients _in embryo_, to be brought forth by the influence of her -exaggerated reports of your incredible abilities. - -The nurse once secured and attached to your interest, becomes an -admirable instrument for the promotion of all your designs, she -embraces every opportunity to strengthen your directions, and urges -(as you have done) the continuation of medicine, “till, with the -blessing of God, her mistress is quite set up and upon her legs again.” -A proper reflection upon these subjects will convince you (even in the -infancy of your embarkation) that a _midwifery case_ in a _good_ family -is no _bad_ thing, and made the most of, with the occasional aid of -perpetual _cardiacs_,—_balsamics_,—_carminatives_, and _anodynes_, -to ease and “quiet the child,” every time it _coughs, or belches_, -constitutes a harvest of industry and political necessity, that the -world in general is very little acquainted with. - -Previous to the closing of the curtain, you have still an additional -chance for more depredations upon the unfortunate husband; should -_stagnant_ milk occasion a _coagulum_ in the _lacteals_, constituting -a _turgency_ of the breasts, threatening a formation of matter, -_suppuration_ becomes almost unavoidable, and you promote it -accordingly; this leads to _certain operation_, daily dressings, &c. -all tend to encrease your interest, and give you the enjoyment of a -temporary monopoly in the joint practice of _midwifery_, _surgery_, and -_physic_. - - - - -TO THE APOTHECARY. - - -The varieties of your past, as well as the personal requisites for -your future destination, are of such a pantomimic and party-coloured -complexion, that I cannot proceed to a recital so truly risible, -without first offering you, in the lines of Woty, a predominant trait -in my _own character_, - - “I love to laugh, though Care stand frowning bye, - And pale Misfortune rolls her meagre eye.” - -Thus happily disposed to those brilliant sallies of mirth, that almost -renovate life, and set melancholy at defiance, you will be the less -liable to surprise, that I shall descend to the very minutiæ of your -necessary qualifications, for the support of so arduous and complicated -a character as you are now going to perform upon the theatre of life. - -It is very natural to conclude you have, during the tedious years -of initiation as an apprentice, and your more mature services as a -journeyman, (politely ycleped assistant) whether in the metropolis, -or the country, gone through every degree of drudgery, and feelingly -experienced every indignity, that _insolent pride_ could bestow, or -_patient merit_ receive. Not an inferior trust (of the inferior part of -the faculty) but you have carried into execution, from the injection -of an _enema_ in a garret, to the separation of an _emplastrum -vesicatorium_ in a workhouse. These are offices of humanity and service -to your fellow creatures, that do you immortal honour; they are -retrospectives that form an epoch in the mind of every practitioner, -and afford him the powerful consolation of _sacred truth_, “He that -humbleth himself,” &c. by which rule, and the force of a fertile -imagination, any _apothecary_ may _conceive_ himself a _physician_, -even in the administration of a _glyster_. In this hospitable execution -(taken metaphorically) there cannot be supposed the least indignity; -for it is universally known the _greatest_ and most _prudent_ generals -are in the _rear_ during the heat of battle; and we are again taught -seriously to believe “the last shall be first,” &c. so that you have -every way, (by both _faith_ and _services_) insured a religious and -prophetic _hope_ of preferment. - -Having for many years encountered the _worst_, you are now prepared -for the _best_; and bidding adieu to the rigid rules of austere -masters, embark upon your own foundation, qualified for every -medical consultation, from the bedchamber of a _duchess dowager_ to -the subterraneous residence of her _chairman_. You have, at this -period, not only shaken off the shackles of servitude, but the very -recollection of your long standing culinary connections. In your -various changes of residence, tedious peregrinations, and medical -observations, it is natural to conclude, you have acquired by care, -study, and attention, a competent knowledge of almost every tint in the -picture of life; which, with embellishments, derived from a few courses -under some of the _metropolitan lecturers_, and _hospital attendance_, -to qualify you for the complication of _country_ practice, there is no -doubt but you come from the forge properly formed, to make wrong appear -right, and right wrong, in the face of every _old woman_ in the county -where you are going to reside. - -Exclusive of these qualifications, and the many instructions already -introduced under the two preceding heads (to which you may occasionally -refer) there are a great variety that must be advanced for _your -particular use_, and to those you will, no doubt, pay every proper -attention, if you indulge the least desire to become a popular member -of the faculty. In respect to personal appearance, former distinctions -and peculiarities are in some degree levelled, the world is very much -relaxed in its severities, and the apothecary mixes with the general -herd of mankind, without those distinguishing exteriors that _were_ -his professional characteristics. The gilt-headed cane and enormous -tassel are no longer in use; the _full-bottom wig_, that so universally -ornamented the _os frontis_ of the faculty in general, is now almost -laid aside with inferior classes, and engrossed by the _college_. The -apothecary (particularly in the country) is in every respect free from -the illiberal censure of former times, and treading close upon the -heels of the _parson_ and the _lawyer_, enjoys, without restraint, the -_chace_, the _gun_, the _bottle_, and _bona-roba_. These, if you are of -a volatile disposition and amorous constitution, afford (at seasonable -opportunities) a happy and high relished relaxation from the many -severities of medical practice. - -Having fixed upon your intended spot for embarkation, let every thought -be employed to display an attracting uniformity in the disposition of -your apparatus, for the _claptrap_ of public approbation; and though -that great investigator of human nature has beautifully portrayed -“_a beggarly account of empty boxes_,” yet they become immediately -necessary to your present purpose; it not being his business to explain -the folly and extravagance of your placing any thing of consequence -there, before you was experimentally convinced you should have occasion -for its use. Let there be a _profusion of appearance_; the _shell_ -of a shop is not very expensive, and druggists are so numerous, that -you may be expeditiously supplied whenever circumstances require -it.—The bottles (being transparent) become more immediately in need -of _something_ in each, particularly a few of those articles (as -hartshorn, lavender, &c.) that are in common request. The lower drawers -(within reach) may be labelled with _obsolete titles_, and in each -placed various paper parcels of _bran_ or _saw-dust_, to avoid a chance -of the sarcasm upon the faculty by a countryman, who happened to be -left alone some time in the shop of an apothecary, and whose curiosity -being excited by the great _number of drawers_, was powerfully prompted -to open one labelled “_Thus_,” which finding _empty_, he was induced -to try a second, _still the same_; a third, _the same also_.—Oh! oh! -says he, “I see plain enough how it is, they are all _Thus_.” Your -shop being at length finished in a stile modern and striking, let a -green silk curtain (with brass rods and rings) be affixed to your -window; it is an excellent method of conveying an idea of internal -mystery, and inspiring proportionate external curiosity. Let no paltry -diffidence appear in the board over your door, announcing your name and -qualifications; there are great numbers that can’t distinguish _small -letters_ at a distance, to avoid which inconvenience, let the capitals -be as conspicuous as the canvas figures at a country puppet-shew. - -“Thus far before the wind;” and being (as it is natural to conclude) -not greatly engaged, it becomes your immediate attention to wait -personally upon the different overseers of the surrounding parishes, -and give them most forcibly to understand, they have been for many -years the subjects of imposition; but you having more _honesty_ than -the whole body of the faculty, will undertake to _farm_ the medical -superintendance of the _poor_, at half the annual sum it has ever cost -the inhabitants before. This political stroke will excellently answer -both your purposes, for overseers in general care not how little they -pay; and you being professionally callous to the tears of poverty and -distress, care not how little you give for their money. - -_Tartar emetic_—_Pulv. contray._ c.—_Pulv. nitri_, and _Pulv. -jalapii_—are medicines admirably calculated for the constitutions of -the poor; and thirty or forty shillings a year in those articles, will -be sufficient for the consumption of _five_ or _six_ parishes; with the -additional advantage of rendering _vials_ unnecessary, a consideration -of some consequence, when it is remembered they are now double their -former price. These parochial connections will be productive of -advantage in more ways than one, for as the unhappy paupers will be -constantly seen at your door, it will afford all the appearance of -sudden popularity. - -Ostentatious parade, and personal consequence, must be your leading -traits, and never lost sight of; _a couple of horses_ will contribute -largely to these objects; not that you are expected to degrade the -dignity of your profession, by riding, like Hughes or Astley, _two at -a time_, but their appearance will constitute an admirable shew of -business in being rode _alternately_; and as most young men who have -not been long their own masters, are fond of displaying their persons -on the _outside of a horse_, you may exultingly not only “feed fat” -the propensity, but the general run of your mechanical neighbours (who -see no farther than the tips of their noses, and are ever caught by -appearances) will erroneously suppose you are visiting some of the -first characters in the county. As it will be now highly derogatory for -you to stain your hands with any menial services, procure speedily a -_journeyman_ (alias assistant) to enhance your own weight; if there is -at present nothing for him to do, the curtain, before recommended, will -obscure his indolence from the prying eye of public curiosity. - -No part of the faculty having ever been remarkable for the regularity -or fervency of their _devotions_, your presence at church will -consequently not be expected (particularly after the impressions you -have made of being perpetually engaged) unless you politically appear -there at two or three different times, merely for the convenience -of being called out _by your own direction_, at the still and most -awful part of the service; a circumstance that will tell much to your -advantage with every superannuated _old woman_ in the parish. Take -particular care that your horse is constantly brought to your door on -the sabbath day, just as the neighbours are passing to church, and -there paraded some time previous to your appearance, which to every -weak mind will have its effects; and be equally careful to measure the -steps of your _horse_, by the hands of your _watch_, so that whether -your journey is accidentally long, or intentionally short, you return -just at the moment of their dismission from the religious conventicle. -In passing the whole body of inhabitants, be strictly careful of your -self consequence—a bow of _significant respect_ to two or three of -the _superiors_, may be applicable and consistent—but no familiarity -with, or knowledge of, the multitude; the greater your _ostentation_ -and _indifference_, the more _servile_ will be their _admiration_ and -_respect_. - -By no means form any hasty or inconsiderate matrimonial connection; -you will derive many advantages at first from a life of _celibacy_; -there are always a variety of juvenile females in the country (as well -as the metropolis) who considering themselves _every way qualified_ -to constitute _doctor’s ladies_, will most industriously _throw_ -themselves in your way upon every occasion, that their personal -attractions may not escape your observation. To families where there -are daughters, nieces, or cousins, who _conceive_ themselves ripe for -the _gordian knot_, you may assure yourself of being called in a short -time; for as you are such “a charming man” in your appearance, (and so -admirably _fitting_ for a husband) there can’t be the least reason to -doubt your professional qualifications. - -You may perhaps start some doubts, (or conscientious qualms may arise) -how these appearances are to be supported in the infancy of business, -without any great personal property to sanction or justify the attempt; -in such diffidence you perfectly display, not only your pusillanimity, -but want of knowledge and experience; for certainly out of the -above description of females, who will constantly pay court to your -consequence, and by a _thousand modes_ solicit your attention, surely -some one of the _best possessions_ may be obtained, whose _fortune_, -and advantage of family connection, may answer your most sanguine -expectations: but should _fate_ conspire against you in both _business -and marriage_, you will have the consolation of having made _a bold -push_, and failing in the attempt, you only become a fashionable -adventurer, and gratefully pay your creditors _nothing in the pound_. - -Having gone through a chain of circumstances and instructions, -necessary for the support of your _public_ appearance, it will be -naturally expected I shall revert to the modes of behaviour that are to -constitute your _private_ character, in the professional transactions -that you conclude will daily occur. First, let it be your constant -observance to be equally reserved and difficult of access—whenever -your opinion is required, even in your own shop, appear there with -tedious reluctance, as if privacies of the utmost consequence prevented -your earlier attendance; this will not only add to your medical weight, -but raise your reputation for _good breeding_ and intercourse with the -polite world; for it is universally known, none but the inferior orders -are introduced to each other without ceremony; it would be therefore -highly ridiculous in you to practise a mode of behaviour in use only -with the lowest classes of mankind. - -Never leave home without letting your horse be held long enough at the -door to be observed by the surrounding neighbours; the most trifling -indication of business is a point in your favour, and ought by no -means to be omitted. By the invariable good effect of which rule, no -messenger whatever should arrive from the country for medicines, but he -must be detained _as long as possible_; his preparations should never -be ready when called for; on the contrary, his horse should be hung -or held at the door for half an hour at least; a double advantage is -derived from this necessary caution—the horse at the door will prove a -striking object to the public, and the messenger will assure the family -you attend, that, nothing but your great hurry occasioned the delay in -his return. - -It will be strictly proper for you, upon all occasions, to preserve -the most inflexible serenity of countenance, even to extreme gravity; -and this injunction becomes the more immediately necessary, as there -are a vast variety of unexpected causes for laughter, to which you -will be open, in the frequent applications of unpolished rustics, for -your _great opinion_ and assistance. One class will “beg the favour -of you to _subscribe_ for their complaints;” another “hopes you won’t -be offended, but he is come to _insult_ you upon his case;” these -instances are so exceedingly common, that you will often meet with -them, where they are least expected. There now lives _an alderman_, in -a very capital town and place of _royal residence_, who, a few years -since, labouring under an _epidemic_ complaint, was told that symptoms -were alarming, and a _glyster_ was unavoidably necessary; to which -representation he expostulated, begging the apothecary “to lay aside -his intention, and give him any thing to _take inwardly_, but for -_God’s sake_, to have no _cutting_ and _slaying_.”—Another of the same -_learned body corporate_ (for they have both kissed the K—g’s hand) -said “he bore the severity of his complaint with more patience, now he -was _manured_ to it.” - -To prove the frequency of these accidental slips, it is impossible -to resist the present temptation of introducing a few more, that -occur to memory in the present recital. A lad upon the borders of -Northamptonshire, being sent in the night to a medical practitioner -at Banbury, and calling him out of bed, told him, “he must come -immediately to his mistress, for she had got a _Vistula_!”——“Where? -_In ano?_” “No, Zir, in the next parish to’t.” - -In an excursion to Surrey, I was solicited in a parish near Chertsey, -to give my advice to a master carpenter there, who had been a long -time indisposed; but my prescription having had the desired effect, -and the poor man getting abroad, he very gratefully declared to all -his friends, “I was the _best musician_ that ever came into the -country.”—In the county of Berks, an elderly woman came to consult me -upon the bad state of her daughter’s health; and after animadverting -upon symptoms, told me _in a whisper_, “that her daughter was to have -been married to a young man some time since; but something happening to -break it off, she really believed _’twas nature turned inward in her_.” - -Paying a visit, in my earlier days, to the lady of a good old country -alderman of a borough in Hertfordshire, she, after many aukward -apologies for the indelicacy of the subject, tremblingly told me, -“she had been very uneasy for some days, with a violent heat in -her _firmament_.”—By way of suppressing those risible emotions in -my disposition I have before described, I, for a moment, changed -the subject, by enquiring the health of her husband; to which she -replied, with thanks, “he was exceedingly well, but gone to make an -_exerescence_ into the country;” plunged deeper in difficulty, and -nearer the _laugh_ than before, which was now become hard to suppress, -I applied myself to her snuff-box, then on the table, and passing a few -encomiums on its neatness, she said, it was very much admired, being a -_gypsey’s pimple_ set in _pinch-gut_. - -You will, no doubt, be now prepared for such unexpected misapplication -of words, such _sublimity of expression_, and regulate the rigidity -of your _frontal_ muscles accordingly; when called to a patient, let -your personal address and behaviour be modelled entirely by the state -of his _property_; if he is _your superior_ in rank and condition, -every action of yours must denote it most strikingly;—you _approach_ -with _respect_—you _dictate_ with _submission_—your mildness and -_affected penetration_ must be perceptible in all your enquiries, -making the most scrupulous observations how far you seem to gain upon -the _credulity_ and good opinion of your subject, taking leave with -all those attracting expressions of tenderness and sympathy, (highly -tinctured with respect) that may give your patient a favourable idea of -the _integrity_, it can never be your _interest_ to possess. - -On the contrary, when your advice and assistance is required to a -patient, whose feelings are equally wounded by bodily affliction and -the barbed arrow of adversity, you may safely reverse the whole mode of -behaviour, and put into practice your personal pride, even to perfect -impudence. This will be in many respects a consistency of conduct; -it will be convincing them, as you have nothing to hope from their -_affluence_, you have certainly nothing to fear from their _poverty_. - -Let what will be the condition of your patient, you are not to act as -some few conscientious practitioners do, explaining what you conceive -to be the nature of the case, original cause of complaint, or from what -operation you expect expeditious relief; this may be the best practice -with those unfashionable formal old fellows, who received their medical -instructions near half a century since, and pique themselves upon what -they call their _integrity_; but it will be perfectly _illiberal_ -in you, who have received a more modern, and polished education. -Ambiguity, and true medical mystery, will be your best guide upon every -occasion; by not naming the case, or _cause of complaint_, you can -never be accused of having _mistaken_ it; and by letting the property -of the medicine you administer remain a matter of secrecy with all but -yourself, you reserve the incontrovertible power of saying, “it has had -the _very effect_ you _intended_,” whether it operates by _vomit_, -_stool_, _urine_, _perspiration_, or _sleep_: these are precautions a -_wise_ man always takes, a _fool_ never, and may be deemed something -similar to the conduct of Bayes’s troops in the Rehearsal, who, the -_warlike_ messenger said, “were stealing a march in _stilts_.” - -During the indisposition of your patient, ’tis your duty to think -much more of the emolument that will arise from the _protraction_ of -his case, than the _expedience_ of his cure. You must have it ever in -mind, that he has paid you the the greatest compliment one man can -possibly pay another on earth; he has placed an implicit confidence, -and entrusted you with the care of his constitution and the key of -his cash; in fact, he has put both his _life_ and _property_ into -your hands; and the respect you owe to _self-preservation_ renders -it necessary you make the most of _both_. Let your attachment to -his health and interest be demonstrated by the frequency of your -attendance; it will be impossible for you to give a greater proof of -your _disinterested_ friendship, than by your large and constant -supplies of different medicines; too great a quantity, too great a -variety cannot be introduced; they all tend to a promotion of your -emolument, and the sum total of your bill will be considered _a -striking proof_ of your _merit_ and assiduity. - -If you find the family and friends not perfectly satisfied with your -conduct, that there is the least coolness and discontent perceptible, -or symptoms of present or approaching danger, strongly recommend the -presence of a _better opinion_ in the form of a physician; this will -prove an exertion of the soundest policy—double the quantity of -medicines will be thrown into _his_ prescription for the promotion of -_your_ interest, an act that the present danger will amply justify, and -should the unhappy victim be doomed - - “To pass that bourne, - From whence no traveller returns,” - -You have nobly and skilfully slipped your neck out of the collar, and -left all the credit of _killing_ (as you really ought to do) to your -superior, whose _diploma_ entitles him to the preference; and, _vice -versa_, should you perceive the patient and family become dupes to your -affected sincerity, and that you are daily raising yourself in their -estimation, erect a structure of professional applause upon the basis -of their _credulity_; insinuate every possible degree of self praise, -and set the advice of a physician in the most contemptible point of -view.—Affect unlimited attachment to the interest of your patient, -and say, “you would recommend much better advice than your own, if you -could do it with a conscientious consistency; but it had ever been an -opinion of yours (which was still unaltered) if the apothecary could -not plunder a family _sufficiently_, the better method would be to -adopt _a consultation_, when it might be done to a _certainty_.” - -This open manner of dealing instantly enhances you in the estimation -of patient and friends, and you will consequently stand so high in -opinion that you may proceed deliberately in your _spoils_ without -interruption, for where there are no _daily fees_ (swallowed up in the -_vortex_ of the college) your more trifling depredations will not be -considered as matters of medical magnitude or imposition. - -In all kinds of inferior practice render every look, every thought -and action, subservient to your general intent of personal rank and -pecuniary consequence; it must be your particular study to inculcate -every idea in the lower class, of your great penetration and abilities; -by your minute investigations, cross-examinations, and applicable -nods of significance (implying the most extensive knowledge) you will -discover remote symptoms, that once explained to the complaining -patient, will give them reason to believe (which they very readily do) -you are a supernatural agent; and one _fool_ of _this denomination_, -who firmly believes you know the state of his health by the _wrinkles_ -in his _forehead_, or the _cloud_ in his _urine_, will soon infect a -whole county with the certainty of your infallible qualifications. -This opinion once founded, the effect is absolutely incredible, an -instance of which may be found in various parts of England, but more -particularly in a very large and populous town, not forty miles west -of the metropolis, where _fools_ from every part of the county are -constantly driving (their pockets laden with _chamber-lye_) to a famous -inspector of _urinals_, vulgarly denominated a _piss-pot doctor_, who, -to magnify the report of his incredible skill and penetration, has -adopted a certain method to impose upon the minds of the multitude, and -prey upon the little pecuniary collections they can make, to become the -dupes of _his villainy_ and their own _infatuation_. - -The mode of imposition, I shall explain in a fact as communicated by -one of his most intimate friends, and leave the story itself to applaud -his ingenuity:—He has (in a very respectable habitation) a small -private room, to which every patient or messenger is conducted (upon -a plea that the _doctor_ is not at home, or is particularly engaged) -here an emissary (as if casually) asking certain questions, hears the -whole story, examines the urine, and descends to particulars—the -_doctor_ is in the adjoining apartment (calculated by a thin partition -and certain openings, invisible to the unsuspecting visitor) where he -minutely hears the entire conversation; the necessary secrets being -obtained, he makes his appearance with the most commanding aspect; -at this awful ceremony, the fascinated patient almost feels the -effect of ANIMAL MAGNETISM; the approach of so much wisdom deprives -him for a moment of speech, and the _poor devil_ undergoes a kind of -temporary annihilation. An instance of this occurred not long since, -when a country fellow having journeyed twelve miles to the doctor -with a bottle of his wife’s _chrystal stream_, communicated the -necessary particulars to the agent, when the doctor, in possession of -the secret, made his appearance.—“Well, friend!”—“I have brought -your honour my wife’s water, she could not _rest any longer_ without -your _device_.”—“Your wife’s water—very well—let me see!—aye, -I perceive she has _bruised her shoulder_.”—“Yes, Sir, she has -indeed.”—“By this water (it is perfectly clear) she has _fallen -down stairs_.”—“Yes, your honour!”—“She is not injured in any other -part by the fall?”—“Only complains a little at the _bottom of her -belly_, your honour.”—“Well, she fell from the top of the stairs to -the bottom, _I see_?”—“No, your honour, she had gone down two steps -before she fell.”—“Indeed! why then you have not brought me _all her -water_.”—“No, your honour, there was _a little_ the bottle would not -hold.”—“Why then, sirrah, the _two stairs_ are left behind.“——This -circumstance, (of a thousand that might be quoted) is sufficient to -demonstrate the ridiculous credulity of the multitude in all matters -of quackery, and leaves us to lament, that the ignorance of one class, -should become so wretched a prey to the deliberate villainy of another. - -The long experience you have had, in charging and posting your -accompts, under different masters of equal judgment and experience, -leaves little room for instruction under that head; it may however not -prove inapplicable to remind you, it is no matter how incoherent or -unintelligible the _writing_ is, provided your _figures_ are _bold_ and -_conspicuous_; so long as you can convince them how much they _have to -pay_, it is a total matter of indifference to you, how much they have -_received_. - -There is one caution however exceedingly necessary to be advanced, to -prevent your becoming subject to a reproof given by the celebrated Dean -Swift to his apothecary, for presuming to be handsomely paid for the -confidence of putting himself upon an equality with his superiors. This -is the impropriety of letting the word ”_visits_“ constitute a part -of your charge, instead of the more modest term of ”_journeys_,“ or -”_attendance_.“ - -The Dean having been afflicted with a long and severe fit of illness, -requested, soon after recovery, the apothecary’s bill; which having -perused, and finding a sum total very much beyond his expectation, he -proceeded to _dissection_, and perceiving almost every _third article_ -to announce the honour of a ”_visit_,” at five shillings each, he -satirically adopted the following plan to punish _Mr. Emetic_, for what -the Dean considered a piece of consummate assurance.—Having required -his attendance to receive his demand, he paid down a certain sum of -money, which the mortified apothecary continued to tell over, and -repeatedly compare with the figures denoting the _sum total_; but still -continuing _to tell and compare_, without seeming to get at all nearer -the point of satisfaction, the Dean, in compassion to the confusion he -visibly laboured under, observed, as he did not seem to be perfectly -clear in his arrangement of the accompt, he would set him right.—If -he would but deduct the amount of the “visits” from the sum total of -his bill, he would find it exactly right; for being now pretty well -recovered, he intended _paying_ him his “_visits_” again _one at a -time_. - -You will now naturally conclude every instruction that can be possibly -necessary, has been submitted to your consideration, for the promotion -of your prosperous and profitable career through the medical journey -of life; it is not so; for although we have gone through the usual -forms of sickness, to either recovery or death, there is still -one remark necessary, to the completion of consistency, in your -professional character. It is a few observations, in derision of that -truly contemptible burlesque upon propriety, in following the corps -of your patient to the grave; a folly originating in _ignorance_, -and established by _custom_; a circumstance so truly ridiculous and -farcical, that it did not escape the penetration and sarcastic wit of -our Aristophanes of the present century, who attacked it with the full -force of his satire, in the description given by a taylor, in one of -his celebrated comedies, who says, “as he was going home to a customer -with a pair of breeches under his arm, he perceived his neighbour -_Gargle_, the apothecary, following a _corps_ to the grave,—so says -he, Master Gargle, I see you are going home with your _work too_.” The -justice of this remark renders the circumstance so truly ridiculous, -that it is a matter of admiration, how any man of the most common -understanding can ever submit to an indignity so truly laughable. It -certainly bears the appearance of your not being content with preying -upon the property of the deceased, during their last hours of sublunary -affliction, but you meanly pursue their very remains to the grave, -and obtain a paltry hatband and gloves, at the expence of decency and -discretion. Exclusive of this very striking obstacle, there is one of -equal weight in the scale of your professional reputation—it certainly -can add none to the eminence of your character, that the contents -of the coffin was publickly known to be a subject of your skill and -experimental practice. - -You will certainly experience some difficulty in evading a compliance -with many requests, made to you for this purpose; but I would recommend -it to you to encounter displeasure, rather than become the dupe of -so great an absurdity. To inculcate by example, what I have strongly -recommended in precept, you may be assured, that I have, during my -long practice, retained so great an aversion to this inconsistency of -character, that I rendered myself totally incapable of compliance, by -never having in possession _a suit of mourning_; this resource has -always proved my never failing friend, when no other apology would be -accepted; and by never seeming to recollect _the want_ till a few hours -before the _funeral_, a written apology has always proved a respectable -substitute, to which there was no alternative. - -Having descended to the very minutiæ of a long, extensive, and -successful practice, to form your mind, and regulate your manners -in every professional transaction of your life, I cannot doubt, but -rules so directly consonant to your personal interest and reputation, -will receive every assistance from your unerring consistency and -perseverance, conveying a perfect corroboration of the _gratitude_ -you feel, for the intrinsic worth of so liberal and friendly a -communication. - - - - -TO - -THE CHYMISTS AND DRUGGISTS. - - -It will create no surprise that you bring up the rear of this medical -exhibition, when it is remembered that the most opulent, eminent, or -respectable, generally close every public procession.—You are to -the faculty, what the _hammerman_ is to the _forge_; you are in fact -the _arterial reservoir_, from whose source flow the rich streams, -that feed the _venal divisions_ in every branch of the profession, -whether in town or country. To the fertility of your genius, to the -extent of your commerce, to the enterprising spirit of your pecuniary -embarkations, the faculty are indebted for the great variety and -striking novelties, that render them so much the subjects of admiration. - -You happily derive your affluence from dealing innocently around you -the various _instruments_ of _death_, with an indifference that -sufficiently exculpates you from the suspicion of _murder_, even as -accessaries before the fact.—Your constant, and extensive inventions -(for the promotion of private emolument and public good) rank you -high in general estimation, and you prudently recommend yourselves -to the attention of the most learned, by your very _frequent_ and -_extraordinary_ discoveries.—Your advertisements (with which almost -every literary vehicle teems) are alike calculated to excite wonder and -approbation; they seem to indicate proofs, that _you alone_ exceed the -limits of human penetration, and display a hope of perpetual existence, -by setting mortality at defiance; like a groupe of _desperate hazard -players_, you are “at all in the ring,” and with a degree of emulative -opposition to each other, produce from your _alembics_—_bolt heads_, -and _balneum arenæs_, antidotes to every ill: the only ray of -consolation to the less learned is, that _death_ (often an unexpected -visitor) opens the eyes of the world to the arts of your deception, -and you slide into the grave with the calm and unobserved obscurity -of your neighbours. The wonderful extent of your fertile abilities are -constantly conveyed to public attention, through the pompous medium of -“Letters Patent” and “Royal Authority,” that are at length become (from -the higher arts) the fashionable introduction to a _breeches ball_; a -_tincture for the tooth ach_; a _blacking cake_, or a _gamboge horse -ball_. - -While I lament this degradation, this prostitution of patronage, to -such _trifling_, such _contemptible_ efforts of _sterility_, I cannot -but consider how gratefully, how extensively, you are bound to a -credulous and indulgent public, who implicitly sanction with their -patronage, every production of _genius or dullness_, whether in a -_philosophic taper_, a concentrated _acid of vinegar_, or a _salt of -lemons_; they are undoubtedly discoveries of _immense magnitude_ to the -public at large; and experience has sufficiently proved, that so much -_patriotic virtue_ should meet its _own reward_. - -Notwithstanding the superiority and extent of your knowledge, so -visibly displayed in the _sublimity_ of your frequent experiments, -that have raised you to such a great degree of professional eminence, -there may yet be some profitable principles of practice, inculcated -by a long and studious observer, that will evidently add to your -emoluments, if not to the encrease of your reputations. - -Your _peculiar modesty_ may have prevented your attaining the utmost -perfection of your art, and left you strangers to the very great and -undiscovered advantages, that the privileges of your profession so -singularly entitle you to; for though you may hitherto have reconciled -yourselves to a paltry _mechanical_ profit of thirty-five or forty -per cent. what law forbids you making the “most of your market,” and -enhancing those profits to such state, as may best accord with your -idea and gratification of _city eminence_—_rural ease_—_external -appearance_, and _domestic hospitality_? To insure these comforts to -a certainty, accept such instructions, (as closely adhered to) will -inevitably produce the purposes for which they are introduced. - -Hitherto, a stranger to the happy effects of necessary _adulteration_, -it may not be inapplicable to say a few words upon its numerous -advantages; first, at your embarkation, you should adopt it as -the _ultimatum_ of all your professional views, and render it as -subservient to your wishes, as the lover’s invariable observance -of “_persevere_ and _conquer_,” is to his. _Adulteration_ has many -pleasing advantages annexed to its practice; by the applicable -introduction of an _harmless_ ingredient, you may reduce the dangerous -property of a _drastic_ purgative, and render a powerful _poison_ less -destructive; by such acts you will enjoy the inexpressible consolation -of hourly contributing to the safety of your fellow-creatures, in -exertions of _humanity_, that will do you the greatest honour. - -The prelude to the _Pharmacopœia_, sufficiently informs you, the -_College of Wigs_ are empowered by royal sanction to invent, or -constitute forms, and the _cabinet_ to enforce them; but your superior -knowledge sets such arbitrary dictation at defiance, and your -_practical arts_ will ever supersede their _theoretical_ penetration. -Let them happily enjoy the power to alter names, and improve forms -of all the compositions in that _laughable farrago_, their _new -dispensatory_; they have the province to direct, and you have the -pleasure to evade; obeying their injunctions no farther than is -strictly consistent with your own interest and convenience. To assist -the aptitude of your fertility, let me introduce to your attention (as -specimens of what may be done) some few of the advantageous alterations -that may be made in medicinal composition, to promote your certain -emolument, without arraigning your _integrity_. - -In that expensive preparation _confectio cardiaca_ (newly named by -college sagacity _confectio aromatica_) opportunity offers to display -a part of your privilege in substituting the use of _saffron paper_, -which will impart to the composition the rich colour of the original -_crocus_; for those other high priced articles _cardamoms_, _cinnamon_, -_nutmegs_, and _cloves_, applicable and proportional quantities of -those cheaper (and equally efficacious) _cordials_ and _carminatives_, -_ginger_, _grains of paradise_, or any of the inferior spices may -be added. In large preparations of the _electarium lenitivum_, an -introduction of the _pulp of prunes_ for the _pulp of cassia_, will -save much additional expence and trouble.—In the _syrupus e spina -cervina_, treacle is certainly preferable to the finest lump sugar, -with this advantage, that the predominant nausea will prevent the -discovery. - -Experience will convince you that _spiritus c. c._ (_per se_) obtained -by distillation from the accumulated stale urine of a parish workhouse, -or the bones of animals, will be by far preferable to that drawn from -the purest _cornu cervi_; as are the rasura c. c. from the shank bones -of horses, or cows, preferable to all other.—_Sp. terebinthinæ_ -(carefully and proportionally incorporated) becomes an admirable -associate with the _ol. juniperi_.—_Ol. amygdalinum_ (and many other -articles blended _secundum artem_) form an excellent combination -with, and increase the stock of _ol. anisi verum_.—_Genuine gum -guaiacum_—_galbanum_—_storax_, and _bals. tolutanum_, may undergo -the process of _purification_ much better, if impregnated with the -occasional assistance of either the _resina nigra_, or _flava_.—The -various unguents will derive advantage from the salutary introduction -of _auxungiæ porcincæ_, as a substitute for those more _expensive and -unnecessary_ articles _cera flava_ and _ol. olivarum_. - -_Pulv. anisi verum_ will be much more easily reduced from the cakes, -after the seed has been expressed, the oil obtained, and their medical -virtue entirely extracted; it is an article only in use for horses -and cows; whether they are _killed or cured_, is an object not worthy -your consideration. _Liquorice_, _fenugreek_, _diapente_, _turmeric_, -and _elecampane_, are to receive their basis from _horse beans_ -ground (at the medical mills) exceedingly fine, and to be impregnated -properly with the different articles from which they derive their -names, so as to retain each their predominant effluvia; and as these -are articles in use for cattle only, you will give proof of your -humanity, by drenching them with _food_ instead of _physic_. The -species _hiera_ will be much more certain in its effects, if prepared -with the _Barbadoes_, instead of the _Succotrine_ aloes; and the true -Dutch biscuit powder, will form no unprofitable union with the powder -of _Salop_. In fact, innumerable instances of professional skill and -œconomy might be introduced, extending instructions to a much greater -length than originally intended; protracting the explanatory parts -beyond the limits of utility, an accusation it has been my principal -care to avoid. - -It may perhaps be almost unnecessary to remind you, how absolutely -needful it will be, to reduce to impalpable pulverization and -complicated forms, all inferior and damaged _drugs_ of every -denomination; in _powders_, _tinctures_, _electuaries_, and other -preparations, their defects will not be perceptible, and it will prove -matter of no small gratification to you, that many practitioners are -very _inferior judges_ of the compositions they constantly prescribe; -to these may be added the still greater number, that never condescend -to undergo the task of inspection, forming together a major part of the -very numerous and respectable body I have undertaken to instruct.—If -you are a dispenser of _chemicals_ and _galenicals_ by retail, one -additional observation will prove worthy your attention—never let -your shop, or dispensary, get into disrepute by too much modesty, in -saying you are without the most obsolete or ridiculous article that -can be enquired for; if _oil of swallows_, _oil of bricks_, _lobsters’ -blood_, or _milk of lilies_, should be the objects in request, let -the fertility of your invention _instantly_ furnish a substitute for -either; of these, such a great variety are always to be found, the -least enumeration becomes unnecessary. - -The series of instructions advanced for the promotion of professional -interest, have been promulgated without a fear of offence, or hope of -reward; amidst the very great number of different practitioners, into -whose hands these admonitions must inevitably fall, happy he who can -exultingly exclaim, - - “Let the gall’d jade wince, our withers are unwrung.” - -From the physician, who lingers out a life of _studious suspense_, -and derives a scanty subsistence from the alternate labour of -morning visits and evening lectures—from that _dignified_ “member -of the corporation,” whole _mercurial_ abilities are thrust into -the hand of every dirty passenger, in the more dirty avenues of -the metropolis—from that industrious _accoucher_, whose incessant -nocturnal labour renders him, in common life, little superior to the -_nightman_, and that equal drudge the metropolitan _pharmacopolist_, I -can have little to expect but universal denunciation of vengeance, and -threats of malevolence: to the effect of these, I oppose the stability -of _truth_, that will render me _invulnerable_ to all their attacks. - -A steady observance of the iniquity of medical practice has long since -powerfully convinced me of the absolute necessity of professional -reformation, and should I (by arming the public with a weapon of -self-defence) succeed in producing a change in the systematic -imposition of one, and preventing perpetual depredation upon the -other, every idea of personal ambition will be fully gratified, for - - “So little slave to what the world calls fame; - As dies my body—so I wish my name.” - -But this obscurity in the present instance is much more anxiously -to be _hoped_ than _expected_, for there cannot be the least doubt -entertained but _some one_ of his Majesty’s ministers (who are ever -anxious for the public good and increase of revenue) will, through -the medium of the publisher, discover the joint secret of _name_ and -_residence_, that by placing the author in the TREASURY, CUSTOMS, -or some office equally lucrative, they may avail themselves of his -INTEGRITY, not hesitating a moment to believe, that so just an -investigator of professional impositions upon individuals, must -unavoidably render the STATE adequate service, in the discovery of -official depredations upon the PUBLIC. - - -FINIS. - - - - - BOOKS lately published by G. 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This Work will be comprized in Four Volumes Octavo. - -II. It will be published in Weekly Numbers till compleated, price One -Shilling each. - -III. The whole will not exceed Twenty-four Numbers. - -IV. The first Number will be published on Saturday November the 8th, -being the first Week in Michaelmas Term. - -V. The money will be received for each Number when delivered. - - * * * * * - -Transcriber’s Notes - -Obvious typographical errors have been silently corrected. All other -spelling and punctuation remains unchanged with the exception of the -following substitutions: - lest for least - lest you make Mr. Emetic, the apothecary, your formidable enemy - lest that part of your patients, who condescend to visit you - emerged for immerged - you recently emerged from the obscurity - Surrey for Surry - In an excursion to Surrey, - duchess for dutchess - from the bedchamber of a duchess dowager - -Italics are represented thus _italic_. - - - - - -End of the Project Gutenberg EBook of The Æsculapian Labyrinth Explored, by -Gregory Glyster - -*** END OF THIS PROJECT GUTENBERG EBOOK THE ÆSCULAPIAN LABYRINTH EXPLORED *** - -***** This file should be named 54332-0.txt or 54332-0.zip ***** -This and all associated files of various formats will be found in: - http://www.gutenberg.org/5/4/3/3/54332/ - -Produced by deaurider, Les Galloway and the Online -Distributed Proofreading Team at http://www.pgdp.net (This -file was produced from images generously made available -by The Internet Archive) - -Updated editions will replace the previous one--the old editions will -be renamed. - -Creating the works from print editions not protected by U.S. copyright -law means that no one owns a United States copyright in these works, -so the Foundation (and you!) can copy and distribute it in the United -States without permission and without paying copyright -royalties. 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