PHYSIC AND PHYSICIANS.* "By an acute observer, who had looked on the transactions of the world for half a century, a very curious book might be written on the FORtune of PHYSICIANS." So said Doctor Johnson; and, acting upon the suggestion thus thrown out, we have been presented with the volumes whose title stands at the head of this paper. How far they fulfil the intention of him who originally conceived the plan of the work, it is now our business to consider. make the hearer your master. When, for a moment, we consider the number of rare and excellent gifts which should unite in the first-rate physician, we are neither astonished at the influence they wield in society, nor surprised that their number should be so limited. When we think, independently of the more im.. mediate objects of his research, of the number of tributary sciences he must study-the stock of information he must possess upon so wide a range of topics the extent of his reading-the depth of his reflection-his systematic observance of fact-his judgment-his patience-his quickness-his consideration-his promptitude-bis tact-his knowledge of the world—not that mere conventional knowledge of a sect or party which the man of fashion boasts of, but that deep and subtle insight into the springs and motives of human action which enable him to read the heart as he counts its pulsations-with the logi cal acumen of the chemist-the patient minuteness of the botanist-he must be eloquent to exhort as the divineartful to cross-examine as the lawyer —and, with all these gifts, his success were more than doubtful did he not possess advantages of manner and address, which mixing in the best society can alone confer. Whether we regard him as the man of science, cultivating, as the daily business of his life, the highest order of mental pursuits-or look upon him more nearly in his immediate relation to society, the physician has ever appeared to us a most interesting character. Denied by the wisdom, or, if you will, the prejudices, of the " rulers of the earth," those high rewards so lavishly bestowed on all other professions, his comparatively humble career would have little to compensate the arduous hours of his toil and labour, were it not that in the estimation of the world he lives in, he finds a rich harvest of grateful acknowledgment for kindness, and that hold upon the affections and sympathies of his fellow, men, which he alone can have, whose duties have so often exhibited him as the confidant, the friend, the benefactor. In that little space, bounded upon one side by health, and by death upon the other, his narrow walk is placed. Forgotten in the exciting struggle of political ascendancy-neglected in the gayer hours of pleasure-lost amid the thousand distractions of the world -we rarely think of him upon whose sympathies, at any sudden emergency, we may have to lean for support, and upon whose scientific skill we may have to trust, under God, for our lives. And yet to him-the stranger of an hour previous-we hesitate not to lay bare the cherished secret of our lives the pain-the suffering-the shame itself, that we dared not reveal to a brother-to him, without a blush, we confess the fear of death, the longing for life, to acknowledge which is to Such are some of the characteristic traits which distinguish the physician; and well and wisely did the great moralist remark, that to trace the lives of such men were a work well worth its labour. He who to-day is the confidant of his king, and to-morrow leans over the sick bed of the starving tenant of a garret, must needs see life in various aspects; and it would be to deny him powers that his very position demands, not to confess, that to him more of the romance of life is presented than to any other man. So truly is this the case, that we would fearlessly ask any great practising physician if the scenes so powerfully recorded in a late work of fiction do not fall far short in pathos and tragic result of many of those he has witnessed in the course of his professional career. *Physic and Physicians. a Medical Sketch Book, exhibiting the Public and Private Life of the most celebrated Medical Men of former days; with Memoirs of eminent living London Physicians and Surgeons. 2 vols. London: Longman, Orme, and Co. 1839. To illustrate the lives of such men were no common task; and, however thankful we may feel for the intention, we cannot fully concede our approbation to the manner of the volumes before us. After informing us in his preface that four hundred volumes have been ransacked for his facts, he proceeds to say that the preliminary chapter was written to demonstrate the antiquity of medicine, and defend its professors from certain calumnies which have been levelled against them by ignorant and unprincipled men. So far the object of our author was a good one; but as we never met any one who doubted the antiquity of medicine, much less heard of any calumnies on that score arising, we conceive that, considered in this light, the pains were superfluous. Passing from this, he proceeds to that often-repeated remark of the want of religion among medical men ; and here, indeed, he makes the singular blunder of confounding atheism with the tendency to materialism.-"It is not very apparent that the study of medicine in its several departments has any direct or remarkable tendency to render men irreligious and immoral beyond the ordinary influence of many other studies." Without stopping to inquire whether the ordinary influence of any other studies has any such tendency, we should certainly say not. The medical man is, more than any other, confronted by facts whose tendency is directly the opposite. That recognition of the Creator in his works is to him the daily study of his life; those powerful arguments which natural theology, as it is called, possess, are to him more available, for the experience of his profession teems with them; and even where, with the unmedical world, the realm of proof ends, to him a new chapter is opened; for it is not only in the mechanism of a joint, or the handywork of a complex organ, that he seeks for evidence of divine wisdom, but in the phenomena of diseases a new, and, if possible, more convincing series of facts are developed, which defy doubt and enforce conviction. To the evidences of design alone, his belief is not limited; for while with other men he witnesses the proofs of this-the wisdom-be is also called upon by the study of his art, to recognize a still higher attribute-the providence of God. To explain our meaning more clearly there is scarcely an 'accident in our lives, however slight-scarcely a malady to which flesh is heir, so trivial, that would not, in its consequences, involve our very existence itself, was there not inherent in our bodies some antagonising power to disease and death, by which our preservation is accomplished. This sanatory process, which, under the various exigencies of disease becomes antiseptic, limiting, assuaging, alleviating, and even creative, is the great attribute by which the work of his hands is distinguished from the frail and wasting efforts of human ingenuity. Without this, the slightest ruptnre of a bloodvessel, the smallest effusion of fluid, the most trivial fracture of a bone, would be followed by the most distressing, if not fatal, consequences; and by this, not only these but the more wasting and calamitous features of disease are opposed and remedied. The stu pendous power and complex mechanism of a steam-engine might strike the uninformed observer as a more wonderful evidence of design than the simple structure of the knee or the elbow. But let a cylinder give way-let the piston break-let even a mere pinion be injured, and the proud triumph of human ingenuity becomes inert as the unwrought ore of which it is composed. But not so in the organized tissues of animal and vegetable existence. No sooner is the injury inflicted than a reparative process is set up, and where the shock of the accident ends, the first step of the cure commences. Take the case of a fractured bone: to provide for the regeneration of the lost substance, a state of perfect rest and quietude is indispensable, and this is enforced upon us by the pain and suffering connected with every chance motion of the part. Without this, the opposed surfaces of bone, continually changing their position, would offer an impos sible barrier to union; and thus, what we should otherwise regard as an infliction, is but another evidence of that wise power that "saves us from our selves." With the immobility of the part, the regeneration begins, and from the fractured extremities the gelatinous mass is effused, which assuming or ganization as it advances, fills up lost space, and cements the injured surfaces together; but even when this has taken place, and strength and stability have been once more restored, the functions of creative life do not cease; for a new process, well called by Hunter, modelling absorption, is called into play, by which any super the abundant and excessive quantity of bony matter is absorbed, and the symmetry of the part is restored with its strength. These phenomena, perhaps, after all, the most simple and least complicated which the history of disease can present us with, cannot fail to strike the thinking observer as evidences of the wisdom and goodness of him by whom we have been so 'wonderfully made." If, then, unbelief be a characteristic of that profession to which such evidences are daily and hourly presenting themselves, we must certainly seek for its causes elsewhere; for as far as regards the immediate objects of a physician's study, there is every thing to strengthen, and nothing to oppose conviction. But we think with our author, that such is not the case; and so much are we impressed with the fact, that were we called upon to enumerate from memory the most distinguished and enlightened members of that profession, we should be at the same moment recording the names of those most remarkable for the purity of their lives and the sincerity of their religious belief. To the question of how far the medical discoveries of the age have contributed to the welfare of society, the author very properly answers by a reference to the bills of mortality, which prove that "Comparing the value of life as it is now calculated, to what it was an hundred years ago, it has absolutely doubled. The most fatally malignant diseases have become comparatively mild in the hands of modern physicians. The entire half of our population, were at one time destroyed by one disease alone the small-pox; the mortality of which, at the present time, is but partial. Typhus fever was once accustomed to visit this country in annual epidemics, and to slay one out of every three whom it attacked; whereas, in the present day, it is seldom seen as an epidemic, and its average mortality does not amount to one in sixteen. Measles, scarlet-fever, hooping-cough, and consumption, are now no longer regarded with the extreme terror in which they were once viewed. From the year 1799 to 1808, the mortality of consumption amounted to about 27 per cent. of those who became ill; from 1808 to 1818, it diminished to 23 per cent.; and from 1813 to 1822, it still farther decreased to 22 per cent." While we fearlessly assert that the application of lithotrity alone has conferred a greater boon upon suffering humanity than all the other inventions of the age.* Upon the eccentricities of medical men, the author has given a rather amusing chapter of those medical Joe Millers, so widely "repandu” in society. We have failed in our search for an extract from this portion of the work, by discovering that the only anecdotes worth recording were already well known and oft-repeated ones. Those of Abernethy unite both evils, for they are as common as they are pointless. Indeed, whether we have been ourselves dosed "ad nauseam" by the mock wit brutalities of this person or not, we honestly confess that we have ever held him as cheap as a physician, as insipid as a sayer of good things. Abernethy's character as a wit, however, was for the most part acquired in the lecture-room; and very little experience of such an arena enables us to predict, that the smallest offering of the jocose is ever most gratefully acknowledged there. The proverb of "little Latin for a priest" might well be coupled with little wit for a medical lecturer. Our very heart sinks at the remembrance of the scholastic jests in anatomy and surgery, to which we were doomed to listen each winter for five years of our student's existence. Of one little professor of Opthalmic surgery we have a mournful memory to this day. Though happily removed from ear-shot of his the scenes of his trite witticisms, yet piercing and shrill voice, and far from less jests, and stingless severity, that so clear is our recollection of his point we shudder at it even to this hour. In the chapter upon the "early struggles" of eminent medical men, there is much to commend. No better examples for imitation can be held out to the younger members of the pro While upon this subject, we cannot pass without remarking the perfection to which a Dublin Surgeon, Mr. L'Estrange, has brought the instrument for this operation. By his apparatus every possible objection to the lithotrite, as at first used, is completely got over; and while a greater degree of safety is secured to the patient, such a facility is afforded to the operator, that any commonly dexterous surgeon can now accomplish what before was a work requiring great practice and manual precision. fession, than those selected by our author. "Dr. Baillie was one of those whose success was greatly to be attributed to professional knowledge adorned with every private virtue. Minute anatomical knowledge had been too much disregarded by physicians of his day, and conceived necessary for those only who practised surgery. Dr. Baillie's comprehensive knowledge of anatomy, therefore, gave him immense superiority over those who were competing with him. Whenever more than the ordinary scientific precision was wanted, his opinion was resorted to; and the advantages which his anatomical skill afforded him, soon established his reputation among the better informed in his profession, as well as secured to him the confidence of the public. However unaccountable it may appear, yet it is not less true, that many physicians then in London were of opinion that his pre-eminence in anatomical knowledge, instead of establishing his fame as a practitioner, would be the means not only of impeding, but absolutely of frustrating his prosperity; and he was in consequence repeatedly advised to relinquish his anatomical pursuits. "The celebrated Monro's success in life has been attributed to his habit of noting down cases; and we owe the works of the celebrated Dr. Parry, which exhibit a pure science seldom found in modern medical writings, to a similar practice. He says The great book of nature, which is alike open to all, and is incapable of deceiving, I have hourly read, and I trust not wholly in vain. During the first twelve or fourteen years of my professional life, I recorded almost every case which occurred to me, either in private practice or in the chief conduct of an extensive charity. When afterwards the multiplication of common examples seemed to me an unnecessary waste of inestimable time, which might be much more profitably employed, I contented myself with the more useful task of recording chiefly such cases, or, on occasions, such particular circumstances only of cases, as led to the establishment of principles. This I have done generally on the spot, or rarely deferred beyond the day of observation, always rejecting what, on repeated varied inquiry, I have not been able to verify.' We should be glad that our approval could extend farther; but, unfortunately, the spirit of the latter portion of this chapter is very different indeed. "To succeed in the medical profession requires, on the part of the practitioner, in far the great majority of cases, a degree of chicanery and trickery, from which men of honourable and gentlemanly feelings naturally recoil. "The tricks of the trade' are as numerous in medicine as in law; and he who has recourse to them the most, is the most successful man.' Here we are at complete issue with our author. There are doubtless cases where trick and charlatanism have succeeded in preference to true knowledge and scientific acquirements, but these cases, so far from being as he asserts, the great majority, are, on the contrary, the mere exceptions. We can readily conceive, in a profession whose followers are tested by individual successes, that a very inferior man may, from a happy casualty, obtain great momentary repute; but that unsupported by stronger claims upon the views of his subject, he can for any world, and unassisted by really sound length of time maintain an eminent position among medical men, we can not believe. As to the prejudices of the world regarding the habitudes of physicians, we go to the full extent with the work before us. Too much cannot be said upon the illiberality and unfairness of this feeling, and to such, and not, as he supposes, to any deficiency in manner, and want of worldly tact, may be attributed, in a great measure, the little of success which John Hunter experienced as a practising physician. Any taste for the fine arts, any leanings to literature, any knowledge of the more graceful accomplishments which render man's social hours lighter to himself, and more agreeable to his friends, are forbidden to the physician, under the heavy penalty of the world's displeasure. The sick man, or what is the same, "the Malade imaginaire," pays for the sympathy of his doctor, with pretty much the same notion of a bargain as he buys his sugar from his grocer. In the miserable guinea, often tendered with reluctance, he barters the egotism of self complaining tediousness, for the encouraging smiles and bland assurances of his luckless physician. This, after all were fair enough, did it end here; but, alas, such is only the first step of his bondage, and nothing is too severe, nothing too illiberal to be said of the doctor, when the 11 13 hours of a painful and laborious day passed, should he either unbend in the lighter amusements of the world, or avail himself of the recreations which, to over-worked minds are almost a necessity of existence. No, no-we never can forgive the man who has listened to our narrative of gouty suffering or dyspeptic ill-temper, if he be seen the same evening enjoying himself at the opera, or the next morning breathing the free air of the hunting field. In this respect the world nearly resembles the celebrated Mr. Pickwick, who cannot conceal his disgust at the duplicity of his lawyer, who actually saluted Sergeant Busfuz, and "asked him how he did." The sick man thinks I have bought him with a price; he is mine. It is not his skill, though he should have spent years in acquiring it-it is not his talent, though it should be pre-eminent-it is not his quickness and manual dexterity, though both be conspicuous. No-these I must have -but also I claim his sympathy for my suffering his patience for my tediousness his interest in my egotism. In a word, he is mine, hand and foot, to weep over my woes, to lament over my misfortunes, to comfort my weariness; and, worse than all, to enter into the ten thousand absurd and foolish suggestions which sickness and credulity fabricate, till the happy hour arrives for both, and the patient is pronounced cured, and the medical slave is manumitted. If this be supposed a strong view of the case, ask of any medical friends if it be not a true one. We do not deny that the picture has a reverse. The warmest friendship, the most enduring gratitude, are in many cases the result of a medical man's intimacies; and we should say, no physician has ever gone through life, without feeling that to the exercise of his calling, he is indebted for the strongest and most lasting attachments he has found in the world. your The chapter on medical poets is of necessity a short one. Goldsmith's name alone stands_conspicuous; for though Garth and Darwin have their beauties, yet we should never think of associating their names with those whose memories are linked to immortal verse. "The man who can bring to the study of medicine a mind, patient and unwearied in the search after phenomena, and a disposition not to generalize too hastily, is likely to prove himself a suc cessful practitioner; but he, whose poetic and active imagination compels him to arrive at premature conclusions, after an insufficient consideration of data, is likely to be the very reverse of successful, when summoned to the bed-side of a patient. "The poet is engaged in tracing resemblances between objects; and he who is engaged in the exercise of his judgment, in the search after truth, is mainly employed in discovering differences, in separating error from truth, and what is false from what is meretricious. "Considered, then, as a question of organization, the man with a highly poetic temperament is not the best calculated to shine as a medical philosopher. On the same principle Locke maintains that a person with highly developed powers of wit, must necessarily be defective in judgment. The physiological explanation of the fact is this one mental faculty is exercised to excess, and that energy which ought to be more generally distributed through the brain, the material instrument of mind, is concentrated to one portion of the sentient organ." However the absorbing duties of a severe profession may accord with the distractions of lighter literature, they certainly but ill admit of any devotion to the muses who accept no divided Hence it is that the allegiance. medical men who have written poetry are much less remembered as physicians than poets, even though in the latter walk their success may not have been pre-eminent. The observations upon quackery we shall not discuss. The chapter on a similar subject by Millingen, in his "Curiosities of Medical Experience," is much more full, and contains an interesting account of that arch-humbug, homeopathy, of which our present author knows actually nothing. In the same way we should pass over the chapter which follows, entitled "How to get a Practice," were it not that our attention was particularly directed to it by an observation in the preface-"This chapter must be read in the spirit in which it is written. It is a satire," &c. Acting upon the injunction, we read the chapter through ; but not feeling that the spirit moved us, we re-read it, hoping at length that some light might break upon our benighted imagination, and enable us to see where all around was dark as Erebus;" but still we could perceive nothing, save that the author, following up the early error of his volume, persists in asserting that true knowledge and accurate information on the |