THE
ÆSCULAPIAN LABYRINTH EXPLORED;
OR ,
MEDICAL MYSTERY ILLUSTRATED .

i

TO THE COLLEGE OF WIGS.

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 ii 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

you may in justice conclude me,

Sage Sirs!

Your very candid,

And obedient representative,

GREGORY GLYSTER.

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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 2 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 3 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 4 (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 5 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,”

6

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 7 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, 8 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 9 ”—“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 cir 10 cumstances, 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 11 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 .

12

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 pro 13 fessional 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 14 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 15 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 16 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 17 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 18 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, 19 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 20 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 21 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.

22

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.

23

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 24 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 co 25 operate 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 inform 26 ation, 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 27 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 28 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 29 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 sur 30 rounding 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 31 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 32 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 33 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 .

34

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 ,

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 35 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 36 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.

37

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 38 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 39 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 40 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 41 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 jour 42 neyman (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 43 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 44 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 .

45

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 neigh 46 bours; 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 47 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 48 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 49 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 50 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 51 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 52 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 53 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

You have nobly and skilfully slipped your neck out of the collar, and left all the credit of killing (as you really ought to 54 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 55 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 56 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 57 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 58 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 59 .“——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 60 .“

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 61 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 admi 62 ration, 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, 63 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.

64

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 in 65 difference 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 66 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 67 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.

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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 69 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 70 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 71 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 72 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 73 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,

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“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 75 preventing perpetual depredation upon the other, every idea of personal ambition will be fully gratified, for

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. KEARSLEY,

At DOCTOR JOHNSON’s HEAD, No. 46, FLEET-STREET, LONDON.

Where all New Publications may be had on the shortest Notice .