1250 TBlame QUACKERY IN THE PAST. [Y 27, 1911. dhesions which impede-free play of the tendon. The arm must now be abducted fioly, -with the: external QUACKERY IN THE PAST. condyle uppermost, whilst the operator's left hand pushes I against and resists rotation of the scapula tuntil the a.dhesions yield with their characteristic tear; the arm IN an essay on quackery there is a question that meets should then be quickly rotated outwards and carried one on the'threshold. What is a quack? Taking, like the upwards and to the front. These movements, if properly lawyers, Johnson's Dictionary as our authority for tbh carried out, are sufficient to rupture any adhesions definition of the-word, we finzd a quack there described I bat may exist in or around the joint, and provided no as " a boastful pretender to arts which he does not under- ut dae violence has been used, no inflammation will ensue. stand," or with a more direct application to the art of Pain, however, will be present to a certain extent, but healing as "a vain boastful pretender to physick; one even when severe no apprehension need be felt. Within who proclaims his own medical abilities in publick an hour or so of the operation the shoulder should be places." A further definition given by him is " An gently rubbed and moved. Tbis, if carefully done, will artful tricking practitioner in physick." From this we greatly relieve the pain,, and rarely will any local- applica- see that the great lex2icographer made a clear distinction tion be necessary. Rubbing and movement must be con- between pretenders to knowledge which they do not tinued daily, and on no account should the arm be slung possess and those who use knowledge in an artful and or kept immobile. Within a few days exercises, prefer- tricky, manner-in short, between the unqualified and the ably by means of weights and pulleys, should be com- qualified quack. Sir William Broadbent suggested that menCed, to restore the inevitably wasted and contracted this difference should be expressed by applying the muscle1.=s. word " cbarlatan" to medical men who use dishonour- In addition to the measures detailed above, considerable able methods in their, practice. This seems to us assistance- can be obtained in suitable cases by theuse of a mere artlficial distinct.ion. Randle Cotgrave in' what has been called intensive irradiation, and the wave his Dictionarie of the French and English 'Tongue, current applied from'a static machine. Intensive irradia. which is recognized by French as well As Ezglish tion is obtained by submitting the part to be treated to the scholars as authoritative, translated the- word char- rays of a 500 candle-power lamp with two reflectors, one latan as follows: "A mountebanke, a cousening drug- corrugated and the other conical, projecting lines of seller, a pratling quack salver, a tatler, babler, foolish' radiation, some of which are parallel and some crosswise. prater or comnimender of trifles." Skeat in his Etynwlogical By this means two parallel fields of great illumination are Dictionary of the Englih Language gives as the meaning' obtained, and the result of the application of this intensive of quack "to cry up pretended nostrums," and says it is irradiation is to induee a general relaxation of tissues with' only-a particular use of the original word, which he ex-' consequent relief of preesure and pain. In. acees thus plaims as " to make a noise like a duck.", He adds that tr ated istasis in the injured parts is promptly dealt with "quack-salver" is a derivative which ieans "a quack adpain is alleviated. who puffs up his salves or oin-tments 'the place of this The wave current is especially valuable in removing was later taken by " quack doctor." The waid, therefore, passive congestions by restoring the metabolic equilibrium originally meant a mountebank who ld salves, eye which is disturbed in the class of case-alludedto in this lotions, and so fortb, at fairs, like the quack depicted with article. It is interesting to note that the explanation given such realistic detail by Gerhard Douw in thb well-known of the relief of the pain in this way is that the nutrition picture which is reproduced in the plate facibg p. 1224; but of the parts affected by effusion is rectified. already in Johnson'sday ithad acquiredalargerconnotation. In dealing with painful conditions of the shoulder it is It is, unfortuhately, too true 'that many who are in a usefdtl to remember that at the point where the cir- technical sense within' the sanctuary profane their own cuomflex -ierve pesses from beneath the teres minor gained knowledge by using it for the decoy of what 'Tago mbile lthere is often' a painful hre' which requires would call " snipes." The fact that such men exist;P not special attention. Another' part of the region of the only a disgrace to the profession of' which 'they 'are shoulder where a painful area is encountered is over the members and a danger to the public, who are deluded by place where the suprascapular nerve reaches the dorsum' their pretensions, but a direct incentiive and encourage- otfthe scapula. In this connexion it must be noted that in' ment to the practice of medicine by people who have no an inflammation of a joint there must always be taken into knowledge, and equally little scrupie, in trading on the conbsideration the assobia ed condition of contraction of the ignorance of their dupes. It must be admited, further, muscular struettires round the joint. It. is this tension of. tbat there are large numbers of perfectly honest and the3muscles which eatzs the patient to complain of the honourable doctors who countenance, perhaps without feeling of heaviness of the arm in the affections' of the' full^yrealizing wha they are doing, the use of' secret and shoulder-joint under discussion. proprietary remedies. As long as such things are pre- In the cases of injuries to the shoulder-joint the deltoid scribed by orthodox practitioners it is vain to hope that muscle is especially liable to damage, and the paralysis they will be suppressed. Leaving this point for the which often results is not a difficult matter to recognize present, we will-confine ourselves-to the-practitioner who because the shoulder becomes flattened and the acromial comes within the scepe 'dJohnson's second definition-m process of the-scapula makes itself more evident.' In that is. to the " vain boastfal pretender to physick." those caEes in which the deltoid has been injured and Cause8 of Quackery. paralysis has supervened, the' practitioner must bear in Quackery has its root in the self-conceit which is one mind that the deltoid has slight recuperative power, and a of the ingredients that go to the making of " this foolish- guarded prognosis mnust be given as to the time it will take aompounded clay,' man." Hence, though every sort and for satisfactoty movement of the arm to occur. It is par. condition of men, and especially of women, is prone to pay ticularly in the case of the deltoid that the concurrent worship to the false gods of quackery, it is more common affection of joint and muscle can be demonstrated, because as a rule, in religious sects in which authority is most the circumflex nerve with others supplies both joint and ignored, and the right of private judgement is pushed to muscle in this case, and, as already described, the the furthest extreme. It is obvious that a man who adhesions which occur must' be broken down before a to satisfactory treatment of the condition can be effected. professes understand and expound the Scriptures by the In the dase of patients who are no longer young, and in light, of nature, will a fortiori think that he requires no whom wasting -of the deltoid has occurred, it is useful to guide to the perfect comprehension of the mysteries of the remember also 'that it may be a matter of months before human body. Professor Osler says: the miscle be restored to a condition of I suppose as a body olergymen are better educated than any catm activity. other, Iet they are. notorious supporters of all -the nostrums and (To be continued.) humbuggery with which the daljy and religious papers abound,i. and I find that the farther away they have wandered from the TMEE Royal Dental Hospital, Leicester Square, has decrees of the Council of Trent, the more apt' they are to be. received a donation of £500 from the trustees of Smith's steeped in thaumaturgic and Galenical superstition.* (Kensington Estate) Charity.. AMONGK those recently elected. Fellows of the Royal We have, of course, nothing to do with theologi¢al cveeis Saitary Institute are Major William Wz Clemesba, I.Ml.S., or churcese. It ie, ,therefore,i only by way, of illustraftg, Dr. Edward Sergeant, M.O,'H., Lancashire.i and D;>. R. P.. * Address on T!eachingand Thinking. Aequanimitt8.' SeCOnD3 edtl&^ Williams, Assistant M.O.E., Shefileld. LFondon. 1906. P. 131. r THI nBrrxIs r MAY 27, Ii9i , ,] QUACKERY IN THE PAST. I ZIXDICAL JOURNAL I25r =- Dr. Osler's statement that we refer to the fact that and told him of ib. Gonelle wrote his name on his tablete, quack advertisements flourish in ranker luxuriance in pretending also to make a note of the recipe. The whole religious papers which are the representatives of Noncon- length of the street he met no one who did not tell formist sects than in the Anglican or Roman Catholic him some cure or other, all different from the rest, papers. There is, indeed, what may be called a mystical but declared to have been thoroughly tried and to form of quackery, the origin of which in charms, spells, be infallible in its operation. On reaching the court- and amulets goes as far back as the beginning of human yard of the palace he found himself surrounded by people history, and which has existed in all ages down to the who were also eager in offering advice. Their names also present day in the form of belief in the healing virtues of went down on his tablets. When he entered the Duke's sacred springs, relics of holy persons, and shrines. Begin- chamber His Excellency at once called out, " What is the ning in simple faith, this form of mysticism always tends, matter, Gonelle? " The fool answered that he had tooth- wherever the shrine may be, to become a matter of ache; whereupon the Duke said, " I know something that deliberate trickery and the most odious traffic. The will stop the pain at once, even if the tooth is deoayed. quackery that trades on faith and superstition was fully Messer Antonio Massa Brassavalo, my physicia, has dealt with in the BRITISH MBDICAL JOURNAL of June 18th, never ordered anything better. Do this and that and at 1910. It is not easy to disentangle such practices from once you will be cured." Gan'elle then threw off his vulgar trade in physical remedies, for the mystic element wrappings and exclaimed, " You too, my lord, are a enters more or less into quackery of all kinde. The doctor. I have already on my way hither, although I Oriental pre ct.a3 of swallowing the prescription instead of had to pass along only one street, found more than two the medicine named therein may be regarded as a kind of hundred others. Here is the list. I am ready to bet connecting link between the credulity that frankly looks that I should find more than ten thousand if I went all for cure by a miracle in a bottle of Lourdes water and that about the town. Can you find more people practising any which expects healing from a pill or potion the vaunted profession ? " virtues of which have to be taken on faith. Quackery Then there is the boundless field of human credulity. finds the soil and atmosphere in which it can best flourish This is well illustrated by the following story: A cle7 in ignorance and superstition. brated quack was visited by a former playfellow from his Apart altogether from theological dogma there is a native village, who asked how he had got on so well, temper of mind whioh leads people to disbelieve in science adding -with the frankness of- early friendship, " Thee with its honest; cautious, and often unsuccessful gropings knowst thee never had no more brains than a pumpkin." after truth, and to accept in preference the professions of The qaack took him to the window and bade him count those -whom their very ignorance makes load and confi- the passers-by. When a hundred had passed the quack dent in statement. There is, in fact, what we have before asked his visitor, HHow many wise men do you suppose called the ansina natwraliter circulatoria (circulator, a were amonagt this hundred?" "Mayhap one," was the quack) of *hob there are conspicuous examples in reply. "Wll," returned the quack, "all the rest are journalism and in the pulpit, perhaps. even in the Mother mine." To this enormous percentage of mankind quack of Parliamentp itself, at the present time. This peouliar advettisements make their appeal. twint of mind makes a man love quackery for its own sake. 'As sho*ing ho'whe peo'ple at large are more ready to He is what the Americans, who kndwjthe breed even pin their faith on a quacli than-on a properly trained man better than we do, call a "crank "-.one who prefers a ot ebience, we miTay recaIlal story which appeared in the dim, though not necessarily. religious, light to the lamp -of French papers a few years ago. A; quack at a fair near knowledge. Hence we so often see tie eo i bf Paris was driving a roabing-tride selling nostiums, draw- belief which constitutes quackery. pervade an'awkoh ing and beguilingthe crowd in the usual ways. The mind-fai&h in cancer cures, boneetting, spiriuaism letterteeth,'olfthe F-rench- law against unqualifed practice is antivaccinztion, and,- generally, everything that is un- vey strong, though, owiDg to the indiference of the soientific, finding4there a natural home. The votaries of magistrates, it is- not strietly carried out. This, however, quackery are, to use a happy expresion recently-employed was a partdiularly flagrant case, and the polie felt com- by Mr. Butlin, "antibodis." Mincs of this tpe are pelled to intervehe. The quack was therefore accosted by natural.breeding grods -of quackery in other provinces the gudi he lw iaken to a teit at the back of thanthat of medicine; there are religious, philosophil, bd :sta'nd, and requeited to show his diploma. To the political, scientific, literary, artistic, and-coonXercial atepeflibn -'of the gendarmes, he exhibited a perfectly quacks, but these do not concern us here. autientitc degree of Doctor of Medicine of the University ,Another thing, it must be confessed, which naturally of Paris. They were profuse in their apologies, which the helps to foster quackery is the uncertainty of medicine. doctor outbshort with an urgent entreaty that they should This uncertainty appears much greater than it really is say nothing about what they had seen. "For," he said, to those who note how in the progresa of knowledge not "if the people know that I am a qualified doctor I hall only the theory but the practice of the art of healing ip have no more customers " ,cQ;stautly changing. What is called quackery at the present day often represents what was orthodox medicine Origin of Quackery. two orthree centuries ago. The superficial observer sees The history of quackery is in a sense the history of the failures of medicine, but knows nothingof its sucodsses, medicine, for before a rational art of healing existed all or wilfully shuts his eyes to them. It has been said with practitioners were necessarily pretenders to knowledge or ,sometruththatthe averageEnglishmanthinks that hecould to powers which they did not possess. We see what, was found a new religion. It is not surprising, therefore, that doubtless the beginning of the treatment of disease in the every one should think that he understands the mysteries medicine man of savage tribes. It consisted of exorciisms, of medicine. Sydney Smith said of a celebrated statesman incantations, magic, and superstitious.observanoes, mixed that he would at any time be ready to cut for stone or take as experience grew with fumigations, mechanical applica- command of the Channel Fleet. Though all men have not tions, and the administration of preparations of herbs and lthis sublime confidence in their own powers, many folk animal substances. The earliest idea of disease seems to believe that a knowledge of melicine comes, as Dogberry have been that it was caused by an evil spirit taking said of reading and writing, bj nature. If they would possession of the patient's body. The object of medicine, hesitate to undertake a laparotomy they are always ready therefore, was to expel the demon, and this wam effected to prescribe for ordinary ailments. It is related that by making h's usurped dwelling-place as unpleasant to Altonso D'Este, Duke of Ferrara, one day in conversation him as possible. The ekall was trephined in remote wondered what trade or profession was most common. antiquity, as prehistoric remains clearly. indioae. This Hi, fool, Goselle, at once said that the art of medicine had was no doubt sometimes done as a religiou' rite, but it the largest number of professors, and wagered that he was also performed to asfford an outlet by which the evil would prove his assertion within twenty four hours. The spirits might escape. With the same object the patient next morning Gonelle came out of his dwelling, hishead was exposed to evil-smelling fumigations and had to drink swathed in wrappings,his hat crushed down upon his head, noxious draughts and submit to drastio urgation. In and his shoulders huddled up under his cloak. The first the case of women substances were introduced into the man he met iaed him what was the matter. He vagina which had the supposed property of controlling answered, "I have a frightful toothache." "Ah, my the movements of the womb. Often the patient frieud," said the other, "I know the best cure for that," was 'troddena on, rolled about an beatn, all tho BTismxmJOU3AL j IN THE PAST. 1252 RDIDAL QUACKERYQUACKERY INTHE PABTO [MAY 27, 191!.~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~igile acts of violence being therapeutic methods directed undcrake-only curable cases; it at the end of a year a *to the eviction of the baleful tenant. This belief cure has not been effected, the case is to be declared in evil spirits as the causes of disease survived till incurable. comparatively modern times, and is by no means extinct even at the present day. A curious survival of it may be Medicine and Quacikery in Greece. seen in the belief of the poorer class in the efficacy of In Greece medicine was in the earliest times taught medicines of vivid colour and evil taste. They have no by a system resembling apprenticeship. The pro- faith in medicines that are not nasty, and in their very fession was largely hereditary; the father taught his nastiness is supposed to lie their healing virtue. How far sons, and these in turn bequeathed their art to their the medioine men believed in their own magic and spells offspring. The professional fame of the descendants of it is impossible to say, and it would bs unproftable to Asklepios became so widespread that the public gratitude, discass. As man emerged into the dawn of civilization, by a prooess akin to the Chinese custom of honouring a there must have been some who recognized the futility of man by ennobling his ancestors, gave them a divine these things. Bat medical science was till the last century origin. Other practitioners doubbless found it to their a plant of very slow growtb, and it was hindered by the interest to profess to members of the family and to traditional superstitions and fettered by the shackles of know their secrets. The Asklepiads formed themselves authority in which it lay bound till the experimental into a guild. This may, perhaps, be regarded as another method got a secure footing. Bat all through the evolution form of qualification. The training of the Asklepiads was of medicine quackery has followed it like a blaok shadow, carried on by personal instruction. There were a number and will doubtless continue to do so till the diffusion of of schools, the teaching of which may be taken to be knowledge produces that mental atmosphere in which represented in the Hippowratic writings. The name of credulity and superstition cannot live. Hippocrates (460-377 B. c.) has made that of Cos celebrated for all time. He is said to have been the seventeenth in lineal and in Medicine Qaackery Egypt. succession to Asklepios. The following passages from a The quack of antiquity was not licensed-for, except letter written by Lady Mary Wortley Montagu, from possibly in India, there seems to have been no regular Lovere in Italy in 1748, gives an interesting example of licence before the thirteenth century-but an untaught the handing down of medical knowledge from father to or badly taught practitioner. Many centuries before son through several generations in comparatively modern Christ there were in Egypt, India, and Greece men times. Describing the physician who attended her in a who had received a regular professional education. The dangerous illness, she says: Egyptian physicians were held in great repute. Their He will not allow his patients to have either surgeon or position was equal to that of the priests, and they were apothecary. He performs surgical operations with great trained in schools associated with the temples. Their dexterity and whatever compounds he gives he makes in his anatomioal knowledge was very small, as they did not dis- own house which are very 'few the juic6 of herbs and these waters being commonly his sole prescription. He has very sect. They inspected the urine and professed to diagnose little learning, and professes .to draw all his knowledge from pregnancy Prayers were combined with medical thereby. experience which he possesses perhaps in a greater degree than treatment. As the doctors had a priestly character they any other mortal, being the seventh doctor in his family in a offered these prayers themselves, and attached at least as direot line. His forefathers have all left journals and registers much importance to them as to their medical directions. solely for the use of their posterity, none of them having ever published anything; and he has recourse on every There have been many for the whole people difficult must quacks, case to these manuscripts of which the veracity at 1kast is took an active interest in medicine, and at one time, as unquestionable. in Babylon, sick people were laid out in front of the In the time of Hippocrates there were no specialists, and houses, in the hope that passers-by would give advice medicine and surgery were practised alike by' all. Any as to treatment. one might practise the healing art who considered that he had the needful knowledge. The Asklepiads must not Medicine and Quackery in India. be confounded with the priests of the temples of In India, as far as can be gathered from the Vedas, the Asklepios. In these temples the sick date of which is some 600 years before Christ, diseases people slept in the hope that the god would come to them in a were looked.upon as divine punishments or as the result dream and tell them what was to be done. However of magic. Hence prayers, offerings, and charms were honest the whole thing may have been at used. But even in the Rig-V'eda mention is made of the beginning, it dietetic and medicinal remedies. The practice of medicine naturally led to deceit, the priests after a time taking upon themselves the character of the god and arranging at first was in the hands of the priest; then it extended appropriate visions for them in the watches of the to members of other castes. Thus in time a medical class night. The remedies in the more ancient times were was organized. The Ayur.Veda composed by Charaka chiefly and Susrata, which is the oldest book in Sanscrit literature, dietetic or psychical. When the dreams failed the priests had to come to the rescue with such as gives information as to the study of medicine.- The means knowledge they had derived from the experienoe gained by constant of acquiring medical knowledge were the study of medical the writings, the personal teaching of the instructor, and sight of sickness. The treatment in these temples was association with other doctors. Papils fit for the study of believed to be divine, and the priests were not, at any rate for a long time, doctors. The votive inscriptions medicine were those who came from a family of doctors or recording the cures wrought at showed that a associated with doctors. Susruta says that at the end of Epidaurus ritual which began in faith degenerated into and the course of studies the candidate had to address a superstition, petition to the King asking him to grant authority to ended in imposture. But, as we learn from Hippocrates and from Aristophanes, quackery was no means con- practise independently."* This seems to be the first trace by fined to the temples or their priests. The of resembling a legal qualification. That Hippocratic anything Oath proves that there were " " were quackery existed is shown by the testimony of Charaka, specialists to whom left on the bladder, the eye, and as who speaks contemptuously of who, making a operations the teeth, those great being beneath the dignity of the who also display in the train of a learned dootor, seek after physicians, may eagerly have felt doubt as to their capacity. These opportunities for practice. No sooner have these people early surgical quacks were in fact parasites of what corresponded to the heard of a patient than hurry off to him, fill his ears they regular profession. Their ignorance as well as their self. with their own medical ability, and are unceasing in their enumeration of the failures of the attending doctor. In interest led them to vaunt their methods and manipulations order to conceal their lack of skill they attribute their as infallible panaceas. Among the other camp followers of medicine were the gymnasts or besides want of success to the absence of the necessary means and Iatraleiptes, who, nursing and to the patient's neglect of medical injunctions. exercises, practised inunction of-the body. They were also, it would appear, and were led If they notice that things are going badly with the patient bonesetters, naturally to give aid in all and in many and they at once make off. But even the learned doctor care- first accidents diseases, to advise as to diet and regimen. Max in his fully selected his cases with a view to the safeguarding of Neuburger his reputation. Susruta recommends practitioners to History of Medicine t says: In view of the important place that these gymnasia occu- * A History of Medical Education from the Most Remote to the Most pied in the public life of it is not that the Recent Times. By Dr. Theodor Puschmann, Public Professor in Greece, surprising Ordinary at the University of Vienna. Translated and edited by Evan f English translation by Ernest Playfair. vol. i. Oxford University H. Hare. London. 1891. Press. Vol. i. 1910, p. 101. [Txu BmmnI .-IAY 27, 1911.] QUACKERY IN THE PAST. INDIaLJoDRAL I 253 - gymnasts who, in cases of injuries, fractures, or dislocations, themselves the privileges granted by the university in were called upon to render first aid before the arrival of the Mtoliere's play: physician, and who apparently possessed the greatest expe- rience of the healthy influence of the method of life and of Virtutem et puissanciam bodily exercises, soonwere looked upon as genuine physicians. Medicandi Consulted upon diet and gymnastics by sound and sick alike, Purgandi many of them overstepped the bounds of their legitimate 3eignandi sphere, and pretended, by systematic bodily exercises and Perqandi dietetic rules, to be able to cure diseases, partioularly chronic Taillandi ones. Credit must be given to the gymnasts for the fact that Coupandi they appreciated earlier than the Asclepiads and the profes-; Et occidendi sional physicians the significance of cuLres by physical exercises Impune per totam terram. and tissue c-hange. Half-educated, however, they employed dietetic means, inunctions, steam baths, massage, and body Pliny is wrong, however, in saying that the law could not movements, for all possible conditions, and with ill-judged touch a doctor whose want of skill caused the death of a exaggeration recommended cures to their patients better suited patient. The Lex Cornelia (88B a ) made him liable to arrest ,to the training of robust athletes than to the treatment of if death was brought about by his fault. Under the Empire disease. there were regular courses of instruclion, and the future In this passage the word "c ures " must be understood doctor was required to have learnt grammar, the history as meaning "treatmentt" (ctura). Treatment even by of literature, rhetoric, and mathematics before entering bonesetting or Christian Science is unfortunately by no on the study of medicine. Then they attended lectures means the same th'ing as cure. We have in the passage by the iatrosophists and received practical training from just quoted an indication of one of the causes of the success doctors in the public service, and what we should call with which quackery has resisted all attempts to put it general practitioners. By the side of what may be called down. What the patient who is hurt or taken ill requires the regular profession quackery flourished like a foul weed. is immediate relief, not a scientific analysis of his Thessalus, a physician of the Methodist sect, undertook to ,ymptoms. or a lkarned discourse on pathology. On fashion cooks, dyers, spinners, cDbblers, and weavers into Neuburger's own showing, it is somewhat difficult to see doctors in six months. Like Sangrado, he taught the what the legitimate sphere, of the regular profession in whole art at once. Papils of this stamp often could not those days could have been. The physicians were philo- write or even speak correctly; with the assurance natural sophers, but philosophy has as little skill in surgery-and to such persons they looked down on earnest students as in medicine-as honour has according to Falstaff. The fools who wasted their time on learning useless things. Greek gymnasts, like modern "'professors of physical Why, indeed, should they scorn delights and live laborious culture " and bonesetters, appealed to the results of their days in study when we learn from G&len that it was not experience, and got scribes to write paeans in their praise the most skilful doctor but the one who could most adroitly in which the number of their cures was set forth. It is flatter who gained the favour of the public ? To him, he to be presumed that the failures were left unchronicled. says,- everything is made easy; all doors stand open to The amateur doctor seems to have been almost as pre- him. He gains riches and power, and students crowd to valent. The sophists, trained to speak plausibly on any him from all quarters. Galen in one place amiably com- subject, found it profitable to deal with medical matters, pares the doctors in Rome to robbers, the only difference and by a cloud of words persuaded the public to give them between them being that, while the robbers practised solid rewards for empty verbiage. Then there were the their profession among the hills, the doctors practised in drug vendors and so-called rhizotomists or root cutters. the cities. Thessalas, who called himself the " Conqueror As Neuburger says: of Doctors," walked along the streets escorted by a crowd like that which followed a street performer or a cele. The physicians of olden days mostly prepared their medicines brated circus rider. The eagerness to get practice induced themselves, but made use naturally of assistants whose business many to recommend themselves to the favour of influential it was to collect the plants, to separate them into their con- persons, to strut along the streets with them, to give stituent parts, and to prepare secundum artem the leaves, and to make buffoons of blossoms, roots, or juice. According to their chief occupation, banquets, themselves, while the collection of roots, such persons were called Rhizotomists. others, by the splendour of their dress, by costly ringE, Many of these, however, did not confine themselves to their own and other ornaments, sought to attract attention. We business, but made use of the scantypharmaceutical and medical fear it must be confessed that men, .even in these days, knowledge they had from time to time gleaned in a reprehen- have been known systematically to play the part of sible manner, surrounding themselves with a nimbus of mys- ticism by means of various superstitious procedures most useful Amphytrion to people of influence and to have their for their purposes. attendance on the great announced in the press. That the great Galen himself was not altogether free These would seem to have been the first herbalists. The from the faults which he condemns in others may be drug vendors did what would nowadays be called counter gathered from the fact that he was nicknamed by his practice; besides medicines they sold specialities and professional brethren " The Worker of False Miracles." nostrums, secret remedies, love philtree, beauty medicines, He was a master of what may be called "clinical and even poisons. Then there were w-hat we shou'd call diplomacy," and gulled people as cleverly as the subtlest uncertificatod midwives, who, though excluded from the practitioners of the art in later days. He bragged about practice of medicine, yet did a large trade in ministering to the purity of his drugs and of the scrupulous care with their sisters in their hour of travail, and in the sufferings which he compounded his medicines. peculiar to their sex. These also dabbled in love philtres There were specialists for nearly every part of the body, and beautymedicines. They seem to have undertakengynae- and these had generally received a very slight training, often cological and paediatric operations. They practised abor- limited to the particular operation to which they devoted tion, which was expressly forbidden to the physician by themselves. Some took fistula or rupture - for their the Oath of Hippocrates, and they seem to have added to province; others confined their operative activity to stone, their functions those of procuresses and go-betweens in love hernia, or cataract. So far was specialism pushed that we matters. hear of men confining themselves to the treatment of the buttocks I It would be interesting to learn how this very Medicine and Quackery in Rome. restricted field yielded a livelihood to any one, especially In Rome, as in Greece, the practice of medicine was as we hear little of boat races in those days. unfettered by any regulations. Those who undertook to Although, as already said, medicine was an open pro- treat diseases got their knowledge when and where they feesion or rather trade, there were, besides the Lex liked. Pliny-who, however, had a strong bias against Coraelia above alluded to, laws which must have acted the profession-says that people believed in any one who indirectly in restraint of quackery. There was a regularly gave himself out for a doctor, and seems to have looked organized public sanitary service, for admission to which upon them as chartered murderers. There was, he com- some guarantees of fitness were required. Then definite plainecd, no law by which doctors could be punished for privileges, with the right of suing for fees, were conferred ignorance, and no one took venge&nce on a doctor if a on doctors, and this must have made distinctionj in patient died through his fault. They were allowed to practice, if not in law, between the regular doctors and learn their trade at the risk of the public and to make the quacks. with impanity experiments which might cause death. During the decline of the Roman Empire and the period According to Pliny, practitioners of medicine arrogated to following, medical education also declined, and Christianity Tax B3msT I d15SI2J MUDICAL JOUBNAL J QUACKERY IN, THE PAST. [MAY 27, I9IIe QUACKERY IN THE PAST. [MAY 27, 1911. .did not favour the progress of sciene. -Pious persons, medicine. Sdnts-anwd-paiente betook themselves thither 'whn-sick; pinned their faith on prayers, which tended to from distant lands. A hospital was founded in 8s0 and become more and more of the nature of charms. The much attentioj was given to practical medicin'e. .Women schools of Greek philosophy at Athens and Alexandria taught and practised freely, and the "Malieres Salerni- were closed by the Emperor'Justinian in 529, and priests tanae" are often referred to by mediaeval writers. became the depositories of suich knowledge as survived. Quackery was taught as well as medicine. An old anthor, The laws of the Visigothbs, which were partly committed who writes as to how a doctor should conduct himself on to writing in the fifth century, doubtless contained much visiting a patient, begins with pious sentiments and goes matter of Roman origin. Regulations are there laid down on to teach the ",tricks of the trade." He says that, in for medical fees, and- for the compensation to be paid for order to impress the patient, the pulse and the urine failure to cure. The old method of apprenticeship still should always be examined. He adds the follow;ng existed; and the amount to be paid by pupils to their advice: teachers is definitely fixed. When the doctor quits the patient he should promise him that he will get quite well again, but should iniorm his friends 7Medicine and Quackery among the Arabs. that he is very ill. In this way, if a cure is effected, the fanme Among the Arabs the training of doctors was either by of the doctor will be so much the greater, but if the patient apprenticeship or in schools or hobspitals.- Medical practice dies' people will say that the doctor had foreseen the fatal was at frat free; gradually, however, it became customary event.t that doctors should obtain certificates from the teachers But Salerno must 'always be a conspicuous landmark who had- instructed them. In 931 a case of malpraxis in the history of medicine, as it was there "that -the'first which caused the death of a patient, led to the issue of an serious attempt was made to organize practitioners of order to all the practitioners of Baghdad and- the neigh. the healing art into a regular profession by the' institu- bourhood, between 800 snd 900 in nudmber, to present tion of examinations in'obedience to the order of' the civic themselves for examination before the chief physician to authorities. The first ordinan'ce to thaSt effect was pro- the Caliph. AlthQugh there.is no record of any successor mulgated by King Ruggiero (Roger) in 1140. It'' runs' as discharging the like functions, examinations were com- follows: pulsory in Baghdad in the twelfth century, and in Cordova even at an earlier period. therefore, thinks Quisquis admodo mederi voluerit, offilcialibus nostris et Puschmanri,' judicibus se presentet, eorum discutiendus judioio; quod si it certain that the beginnings of the system of -medical sau temeritate presumpserit, carceri conetringaiur bonis suis examinations are to be sought for among the Arabs. Not- omnibus publicatis. H:oc enim prospectum est, ne in regno withatanding these signs of progress, quackery prevailed nostro subjecti periclitentur ex imperitia medicorum. among the Arabs to such an extent that Rhazes, who (Whosoever from this time forth desires to practiseB medicine flourished in the tenth' century, wrote av treatise en the must present himself before our officials an&judges and, submit conditions and cireumstances cf the -medial art- which himself to their decision. Any one daring to neglect' this .shall be punished by imprisonment and confisoion of his goods. turn the hearts of the majority -away from 'the- most This decree has for its object the protection.of, the subjects of respectable doctors and, induce 'them to resort to the our kiogdom from the dangers arising fro Vihe ignorahce of Iowert class of practitioner. practitioners.) The taste of the Arabs for the marvellous naturally bred a tendency in their physicians to use every art to impose Frederick the Second confirmed this- law, and in 1240 on the people. The most important part of their kaow- gave to Salerno a curriculum for all who wished to study lesdge was astrology and uroscopy, and their ordinary medicine there. His ordinance shows that he held very medicines consisted in remedies either wholly inert or enlightened views on the subject. He says: 1i3tures made up of discordant ingredients. One, Isa. Since it is possible for a man to understand medical science Abou-Koreisch, made a great fortune by a lucky prediction only it he has prevrously learnt something of logic, we ordain founded on inspection of the urine of the Caliph's favourite, that no one shall be permitted to study medicine until he has Almodh;, that she would bring forth a'male child. There given his attention to logic for three years. After these three years he may proceed to the study of medicine. 'In this study were a great numbsr of uioscopists among the Arabian he must spend five years, during which period he must also physicians. acquire a knowledge of surgery, for this forms a part of medi- Medicine and Quackery in the Middle Ages. cine. After this, but not before, permission may be given him to practise, provided that he passes the examination prescribed In the early Middle Ages medicine in Christendom had by the authorities, and at the same time produces a certifioate fallen almost entirely into the hands of priests and illiterate showing that he has studied for the period required by the quacks. Of monastio medicine little is known, but it law.... The teachers must during this period of five years would seem to have conaisted chiefly in the caultivatio'n of expound in their lectures the genuine writings of Hippocrate`s plants and the of In and Galen on the theory and practice of medicine. . . . But medicinal concoction simples. 806 even when the prescribed five years of medical studies are past Charlemagne issued an order that boys' should be' in- the doctor should not forthwith practise on his own accounut, stracted in the heaPing art. The teaching consisted of but for a fullI year more he should habitually consult an older readino the old authors; then the pupils were taught to experienced practitioner in the exercise of his profession. recognize the medicinal plants in the imperip.l gardens; Referring to the institution of medical examinations, lastly, they worked in a hospital. This part of their train. he ing is described by Alcuin in the following lines: says: Accurent medici mox Hippocratica secta; We further the cause of the individual, while caring for the Hic venas fundit, herbas hic misoet in olla; public good. Accordingly, in view of the grievous loss and Ille coquit pultes, alter sed pocula praefert; irremediable inj'ury which may arise from the ignorance of Et tamen, medici, impedite gratis doctors, we decree that in future no one is to assume the title cunctis of doctor or to proceed to practise or to take medical charge Ut manibus vestris adait benedictio Christi. unless he has previously been found competent in the judgement Nothing is said as to the observation of disease or as to of teachers at a public meeting in Salerno, has moreover by the surgery, except in regard to bleeding. The rest of the testimony in writing of his teachers and of our officials approved himself before us or our representatives in respect wor was mixing herbs in a pot, preparing potions, and of his wortbiness and scientific maturity, and in pursuance of cooking soft food for invalids. The regular doctors this oourse has received the State licence to practise. Whoever received the scholastic education then universal as a pre- transgresses this law and ventures to practise without a licence liminary to the study of medicine. They went through is subject to pnishment by confiscation of property and the trivium, consisting of grammar, rhetorio, and imprisonment for a year. dialectics, and, the quadrivium, arithmetic, geometry, In regard to the education of surgeons it was decreed: astronomy and music. Alongside the learned leeches were many unlearned practitioners, who learnt medicine That no surgeon shall be allowed to practise until he ha. as a At some time between the seventh and submitted certificates in writing of the teachers of the Faculty handicraft. of Medicine, that he has spent at least one year in the study of th3 eighth centuries there grew up at Salerno a medical that part of medical science which gives skill in the practice of school which by the tenth century had so great a reputa- surgery, that in the colleges he has diligently and especially tion that it was known as the "Hippoaratic city." It studied the anatomy of the human body, and io also thoroughly probably originated in a number of private scBhools which experienced in the way in which operations are successfully is were gradually amalgamated into a University. There performed and healing brought about afterwards. the influence of fthe Arabs first mad itself felt on European If the doctor had pasied the examinations -and received * op. cit. X t Quoted by Puschmann. op. cit. 2 IL - THU BR.Tn I S MAYMAY 7,27,191igri.] QUACKERY IN THE PAST. 255 I PAST.~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~LAIDICAL JOUNAL the State licence to practise, a diploma was made out for Church. Salerno was indeed a lay university, but else. him which ran thus: where all learning was the province of the clergy. Coun- Notum facimus fidelitati vestrae, quod fidelis noster N.N. cils and Popes fulminated against the practice of medicine, ad cariam nostram accedens, examinatus, inventus fidelis et de and especially surgery, by priests and monks. In a famous genere ildelium ortus et sufficiens ad artem medicinae exer- phrase it was declared that Eccle8ia abhorret a 8anguine, cendam, extitit per nostram curiam approbatus. Propter quod de ipsius prudentia et legalitate confisi, recep to ab eo in curia but still the abuEe continued. The last decree was evaded nostra fidelitatis sacramento et de arte ipas 0ideliter exercenda by the monks, who, unwilling to lose the profits of the juxta ennsuetadinem juramento, dedimuts ei licentiam exercendi craft, instructed the lay brothers who shaved their artern rnedicinae in partibus ipsis; ut admodo artem ipsam ad heads in minor surgery. In this way they contrived to honorem et fidelitatem nostram et salutem eorum qui indigent, keep the practice of slurgery as well as medioine to a fideliter ibi debeat exercere. Qaocirca fidelitati vestrae pirae- cipiendo mandamus, qtotenus nullus sit, qui praedictum N.N. large extent in their own hands. But as the brothers fidelem nostrum super arte ipsa medicinae in terris ipsis, ut became skilful they more and morn used their knowledge dictum est, exercenda impediat de cetero vel perturbet. for their own profit. Hence, it may be conjectured, the In the oath which the young doctor had to take on this barber-Surgeons came into existence. The glory of occasion he bound himself ' to give advice to the poor, Salerno began to fade in the twelfth century, and thence. gratis, and toI inform the magistrates of apothecaries who forward it was nothing more than. magni noninis umbra. made up medicines not corresponding to prescriptions." That it was still formally alive in the eighteenth century Moreover, the fee for a visit to a patient was prescribed is shown by the fact that in 1748 the Medical Faculty by law. According to this the highest payment for a visit of Paris consulted it as to the everlasting quarrel between in the daytime within the town amounted to half a gold the physicians and the surgeons. It underwent an tareunas (a gold tarenus was a gold coin weighing 20 grains); official euthanasia on November 291h, 1811. if ths visit was outside the distriot, the fee was three or Itdoes not appear that Frederick's enlightened decreebad at most fQar tareni, excluaive of travelling expenses. The much effect in suppressing quaokery. Notwithstanding the doctor was forbidden to enter into partnership with apothe- ordiance against unqualified practice already referred to, caries, or himself to keep an apothecary's shop. The quackery continued rife under the nose of the University of apothecaries were directed to prepare the medicine accord- Paris. Jn the fourteenth century we find that august body ing to the prescription of the doctore, and to farnish it at engaged in a struggle to put it down. In the Cartulaire of a regular price. Before they were permitted to practise the University it is recorded that in 1312, .on the complaint their profession they had to bind themselves by oath to of the Dean of the Medical Faculty, Mwitr9 Jehan provide drugs according to prescribed form, and to be de Missicilir', a man and his wife were charged with guilty of no fraud in this matter. At the same time, illegal practice, and being declared contumacions -were the advapce of prioe they might allow themselves to excommunioateed. Excommunications were launched as make on medicines which perhaps had to be kept in stock freely, and light-heartedly as writs at the present day. for a long time before being used was specified, and a The full force of a major excommunication was equiva- prospect was given of a law being made regulating the lent to the most terrible form of boycott; it was not number of apothecaries' shops in the various towns of the Mr. Glidstone's euphemism " exclusive dealing," but no country. Moreover, inspectors were nominated who had de~aling' at all. The excommunicated person-was in fact to supervise the preparation of medicines, and to attest the an outcast from society, and in theory outside the pro. satisfactory character of this by their certificates in tection'-of the law. Zle was the vicinm of a carse the .Salerno itself the teachers-of medi,cine exerciied super. most awful it is possible to conceive.'-But though efeotive vision in this matter. " At the same ime we o'd," it in sometimes for political purposes, it doe,s not seem to have said in thesame passage, "that no-one sll1giieloetures. been particularly blighting to ordinary offenders of life. on medicine and surgery elsewhere than in Salerno, or 'At 'any rate, in the case in question the unqualified assume the title of teacher, unless he has been carelully ptactitioners who- 'had incurred the penalty would examined in the presence of our officials, and of the appear to have been not one penny the worse,- for we teachers of these arts." The punishment of death was fitdsthsmei man and his wite repeatedly condemned imposed on the officials who violated theirduties in giving for the -samb offence, with the same penalties, for many effept to these laws.* This remarkable document may, be years following. Another case belonging to the same called the Great Charter of the medical profession. It: .period was that of a "noble lady, Jacoba Felicia de contains the privileges and provides the.saleguards for [Almania," who in 1322 was charged with practibing which the profession has been asking ever since. medioine and surgery indebife et ilicite. Witnesses were Daring the Dark Ages there was no line between called to prove that Jacoba had given them mediciaes, qualifed practiiioners and quacks. The decree of examined their water, felt their palses, and cured their FreSlerick 11 for the first time made such a distinction. diseases. Jacoba defended herself very cleverly, pleading It was doubtless intendeda to 'remedy a state of things that the statutes and-oidinances relied on by the prosecu- which is described in the'Regimen of the School of tion applied only to persons who, knowing nothing of the Silerno in the couplet: healing art, usurped the title of practitionerf. She following argued that she, being an expert in the art, did not fall Fingit se medicum quivis idiota, profanus, within the terms of the statutes under which she was Judaeus, mo nachus, histrio, rasor, anus. prosecuted. She further urged in her defence that these It may ba pointed out that "idiota&" here and elsewhere statutes were obsolete, valid, indeed, against old people, in these mediaeval writings does not mean £4 idiot," but a but not against her, wh0se age was only 30, or even person having no special knowledge. less. Another argument she put forward was that, The evil was rampant, and before Frederick's edict for the treatment of a woman, a woman was better than attempts had been made to suppress quackery. Pre- a man; how many women, she asked, had allowed viously, in 1220, the Universiity of Paris had, with the themselves to die rather than call in doctors ? The sanction of the Church and the civil authorities, issued Facultv held that Jacoba was totally ignorant of the a statute contra illicite practicante8. Another statute, art of medioine, and could not even read. She was passed in 1271, forbade surgeons, whether men- or therefore judged unfit to administer potu8, cibo8,cly8teria, women (chirurgienne8), apothecaries, male and female etc. Hence,as she ran the risk of killing her patients, (apothicare8ee8), and herbalists of either sex, to visit she lived in a state of mortal sin; accordingly, sentence of sick people, to practise any operation or administer excommunication was passed upon her. In the same any medicine, except certain confections in common year twenty-six other quacks were sentenced to various use, unless in the presence and under the direction other punishments. The penalty did not prevent her of a physician, under pain of excommunication, imprison. carrying on her trade, for she was afterwards excom- ment, and fine. These statutes were probably pirtly municated several times for the same offence; and later intended to keep surgeons in proper subordination to the her daughter, who, obedient tothe callwhich so many .physicians. It i3 noteworthy that Frederick insisted that quacks profess to have, "kept on the business still," *the- whole axt, of healing, snarqerv as well as medicine, was excommunicated in her turn. It should be stated should be included in the curriculum of study. Surgery, that the sex of these ladies had nothing to do with their however, remaained largely in the hands of empirics owing prosecution. There were recognized women isurgeons in to the fact tha't medicinewas still in the hands of the France, as may be gathered from the, mentio'n' of-the 'Quoted fromPuschmann. op. cit. various royal edicte.Bat many women were quacks. In M Blanm I 5 6 52v6ICAL JOUBNM. QIUACKRRY IN THE PAST. [MAY 27, .

I the edict of King John dated 1352, in response to a oom- It is noteworthy that when Mondeville speaks of quacOi plaint by the Paris* Faculty, it is stated that there were he means ignorant folk who practised surgery. He was then women practising surgery with a legal title, besides' evidently not friendly to the physicians. He says that others described as mediwastres, who practised the healing unless the case is one of wound, dislocation, or fracture, art without special knowledge. Guy de Chauliac, in his if a wily doctor is called in first, a surgeon will nevrr be Grand Chirurgie (1363) speaks of the women who formed allowed to come near the patient. The physician witi the fifth and last division of the " operators " of his time, undertake the treatment himself with the professed 8ecta mulierum et multorum idiotarum, who cured dis- object of saving his patient expense, and when he eases of all kinds by the help of the saints. Their fails he declares that he is too busy to carry on the principle of practice was based on the professed belief that treatment, and tries to pass the ease on to a surge6n, the Lord had given them the gift of healing at His good. taking care to recommend the most illiterate and ignorant will, and would take it away when it pleased Him. one he knows. His choice is guided by the following "Blessed be the name of the Lord. Amen." considerations: Before Guy de Chauliac, Henri .de Mondeville, Surgeon First, that the surgeon may not know enough to recognize to Philip the Fair of France, writing at the beginning of the errors of the physician; secondly, that, he may have him the fourteenth century, had much to say of quacke. In under his thumb; thirdly, that he may' make him a scapegoat his Ohiruryie, written between 1306 and 1320, he insists on ocoasion for his own faults past and future ; fourthly- that one he may take to himself all the honour and profit-and put the that any who enters the fold of surgery- otherwise faults and disgrace if need, on the back of the Eargeon. than through the right gate is a robber and a thief. He goes on: Mondeville is honest enough to confess that the surgeons behave just in the same way with regard to the physiciane. Two ways lead us to the The first is that of theoreti- gates. He is careful to add that in eaying this he has no -wih to cal surgery, and the way to this lies in hearing the theory and appl3ing oneself to it with the greatest care and the greatest decry men of knowledge and experience; his censures interest, as he is not warranted in taking the name of master apply only to those who are ignorant and to the glib who has not first been a pupil. The second way consists in Eophists who contradict honest surgeons in all their reading this theory and' discussing it with one's companions. attempts, and at every dressing oppose everything that The second gate, which is that of practical surgery, is reached they wish to do with the deliberate intention of putting by two ways: One is to see surgeons operating; the second is to them out of temper and thus disturbing their judgemeni. operate for a long time with others and afterwards alone. Elsewhere he justly says that quackery is fostered by the He describes the of his as- quacks day wrong notions of people as to the causes of disease. VWhen Unlearned persons, such as barbers, fortune-tellers, swindlers, they see a wound inflicted by a knife or a stick or obvi- forgers, alchemists, whores, procuresses, midwives, old women, ously due to some outward and visible cause, they are oonverted Jews, Saracens, and in a word'all who have foolishly squandered their possessions. They give themselves out for willing to allow that this falls within the province of surgeons in order to gain a living and to cover with the mantle surgery. If it is something that is caused by an internal of surgery their needs and their deceits, and to be. able to or antecedent condition they ascribe it to evil chance, or penetrate under the cloak of a man of art into towns and to what the law used to call the " visitation of God." In ingdoms, spying secrets with the object of disclosing them to cases the the such vulgar believe that both God and tl-a enemy. disease would rise up against a surgeon who interfeitd; Mondeville quotes the author of De Gestis Philosoplhorum, they think that God alone strikes and cures, wounds and who, speaking of Diogenes, says that the philosopher heals. in a saw a dwelling certain town there painter who painted There are even people whose devotion is so great that they very badly, and whose woiks were the laughing-stock of do not wish to be cured by human hand. They say: "It all people. Later he met the same man in another city, pleases me to be ill because I know that it is the will of God dressed mighty fine, and regarded as a great and famous that I should be so," and that if that was not His will they physician. Diogenes said to him: would not be ill. When one says to them, Do you wish to be cured? they reply, Not by a human hand; that is not possible My friend, this is admirable. It is indeed you who in such a and would not please God, because if He wished it I should at place at such a time were a painter, and here you are all at once be cured. Therefore in the treatment of such diseases once become a doctor. It is amazing. I believe you have they thrust aside with indignity excellent and expert surgeons. grasped the truth that a bad painting remains constantly on a view on the walls, whilst the patients who die through your There is curious anticipation of Christian Science in fault and that of other fools, are at once buried underground. this attitude of mind, and the analogy holds even to tLe Thus leaving the art of painting, thou hast become a doctor. admission of the services of the surgeon in such conditions as fractures and was Mondeville further says that not only those of whom he dislocations, which Mrs. Eddy corm- pelled to admit must be considered for the time being as had just spoken praotise as quacks: outside her province. Mondeville proceeds: Kings, Princes, and Prelates, Canons, Curates, Religious, It follows then that quacks not wishing to be thus set aside Dukes, Noblemen, and Burgesses, dabble without knowledge in deny that they are surgeons for wounds whose knowledge is dangerous surgical treatments and especially in the treatment built on teaching and presence at the operations of other of diseases of the eye which is dangerous, difficult and fraudu- surgeons. They pretend that they have from the glorious God lent to that degree that one seldom finds a surgeon who is cap- an infused science whereby they know how to cure the diseases able and expert in these matters. which come by fate and which are a gift of God and the saints, Mondeville here rather gives away his case. It is not and that the grace thus given is not drawn from any man's that if his own doctrine, but from the pure providence and grace of the 8aviour surprising surgeons, following advice, whose mercy fills the earth. In this way we have the false refused difficult eases, and would have nothing to do with religious such as hermits and recluses, old whores and prc- desperate cases; unfortunate sufferers in despair tried curesses and such like of whom we have already spoken, who any treatment at the hands of any one who gave them the by.means of holy water, divine prayers, and other artificesary slightest prospect of cure or relief. Mondeville points to induce patients :to believe that they work with the help cS out how diseases at first amenable to treatment become God. completely incurable when people put their trust in Then he tells an odd story: fortune-tellers, hermits, and recluses. In this way a This grace a surgeon of my acquaintance neither had nor pre- diseased limb is often destroyed, and the patient's life is tended to have. As he was crushing in a mortar the remedkis sacrificed. Here the old French surgeon puts his finger necessary to cure a fistula which the vulgar call Saint Eloi' on the worst evil of An who disease, he chanced to break his mortar. This caused a grset quackery. ignorant person noise against him among the people. It was a divine miracie, knows nothing* of possible developments lets the disease and a judgement upon him for wishing to cure the diseases cl run on till it Vcomes the mere despair of surgery. We the saints, the treatment of which must be reserved to the have modern instances of such effects of reliance on " meta- divine surgeons alone. physical aids" in the records of Christian Science. To An edict against unqualified practice, wbich doabtless quote Mondeville again: was largely inspired by Mondeville, was promulgated The vulgar say of these religious and their like that such men by Philip the Fair in November, 1311. Its purpose was to know surgery without art, and that they have knowledge forbid any one to practise surgery in Paris without having infused into them by the pure grace of the Creator, and, it one does not completely believe in this, one is reputed a heretic and been examined by the sworn Master Surgeons of Paris an infidel or an infamous person. convoked by the first surgeon of the King, who alone is declared to have the right to grant a licence to practise * This and the following passages from Mondeville are translated runs from the French version of his Chirurgie by the late B. Nicaise. the art. We need only quote the preamble, which as Paris. 1893. follows: MAY QUACKERY IN THE PAST. TiE Bamsu 27,1911.] . . MDICALf JOUAL 1257 I Philip, by the grace of God King of the French. By the search and examine those whom they have before them and testimony of persons worthy of credence it has come to our shall see to it that they are worthy to practise and shall not be ears not once but divers and sundry times that a number of remiss in this particular either for love or hatred. And of those foreigners of different professions and conditions, some mur- who are not worthy they shall send us the names in writingand derers, others highway robbers, others coiners, others vaga- we will forbid them to practise according as we shall see reason bonds and libertines, cheats, alchemists, usurers, take upon tb do so. And they shall also send to us in writing the names themselves to praotise in our 'City and Viscounty of Paris the of those who are worthy to practise surgery in order that they art and mystery of surgery as if they had been sufficiently may take the oath as aforesaid. examined in the above named science and been sworn. Although they have little knowledge of the subject and are almost in- By an edict of John the First, dated April, 1352, it was experienced they dare to practise publicly, hanging their signs forbidden to any person to pratise surger in Paris with. from their windows like true-trained surgeons. Moreover, out having been examined. The edict is in the same most of them, notwithstanding our prohibition and our ordin- terms as that of A ances, go into sacred and privileged places to dress more than 1311. charter of Charles, elder brother once wounded persons, all of which things they recklessly of King John, Regent of France during the imprisonment take upon themselves to do, some that by means of their un- of his father in England, dated Jane, 1360, confirms the skilled treatment they may fraudulently extort money from the establishment of the Brotherhood of Saint Cosmas and patients, others that they may more easily hide under the cloak Saint Damian, and forbids the ,of that art the shame of their condition and the vices of their practice of surgery before a evil work. Whence, it often results that in consequence of licence has been obtained after examination by the tworn their bad practice and of the want of knowledge of the proper surgeons, etc. The King himself, it may be mentioned, treatment of these ignorant unsworn persons many wounded was a member of the brotherhood. An edict of Charles who had not been mortally hurt, whose limbs were not lost or the Fifth, dated October, 1364, is in the same terms .mutilated, have either died or h,ave lost their limbs or have as those 1311 and 1352, forbidding the practice of surgery been disabled, and of those ,who, have been with them some have been hanged, others banished unjustly, sad to relate! except after examination, and giving to the brotherhood Whilst the trickery and perversity of these reprobates and their one-half of the fines inficted for breach of the ordinance. detestable work remain and have remained unknown and A charter of the same sovereign, dated July 21st, 1370, unpunished. makes mention of experienced men who practise under The edict goes on to say that the King, wishing to the name and direction of masters. Letters patent of prevent dangers of this kind for the secarity and peace of Charles the Sixtb, dated 1381, confirms the ordinance of all his people of the City and Viscounty, decrees that no October, 1364, as to the praotice of surgery and the surgeon, man or woman, shall practise in any way what. -allocation of one-half the fines to the brotherhood. ever the art or mystery of surgery, or shall publicly or in Letters patent of the same King, dated August 3rd, 1390, secret do anything of the kind unless they have been first forbid the practice of medicine and surgery to those who carefully examined and approved in that art by the sworn are not competent in the art.* Master Surgeons dwelling in Paris convened by Master As medicine is mentioned in the ordinance, sometbing Jehan Pitart, " our beloved sworn surgeon of our Chatelet may be said about it here. Although Frederick II. had of Paris during his lifetime, or by those who succeed him united it with surgery in his edict, the two branches were in his office." The next enactment is that those who soon separated owing partly to the scholastic contempt have been so examined and approved must before prac- for handicrafts, partly to the inflaence of the clergy. tising take oath before the Provost of Paris that they will In the twelfth century the teaching of medicine at Mont. practise their profession conscientiously, that they will not pellier enjoyed the highest reputation. At this time there visit or dress any wounded person whatever in the sacred was no faculty, no monopoly; teaching was free, and was and privileged places unless it be for the first time, and given in private and rival schools. Each teacher was that immediately after that visit or dressing they shall paid by his pupils. In 1220 Cardinal Conrad gave statutes reveal the wound to the Provost of Paris or other con- to the three medical schools and placed them under the stituted authority. jurisdiction of the Bishop. By these statutes the private Farther, the " banners" or signs of all surgeons, male and schools were not abolished, but they were gathered female, not approved and sworn which shall remain hang- into a 8tuddium generale or university, and thenceforward ing from their houses after the publication of this edict shall had a common rule. This charter-was confirmed in be bunt publicly in front of these houses and retained as 1239 by a Legate of Gregory IX, and its authority was long as may be ordered. They shall be warned not to recognized for a long time. The university granted the practise without having passed an examination and taken diplomas of Bachelor, Licentiate, and Master. The two the oatb. If any of them refase to take the oath he must lower grades sufficed to give the right to practise be forbidden to practise, and if, contrary to this edict, they medicine. Each town at that time had its own special continue to practise they are to be punished prirna ratione medical organization, and granted a permission or licence by the Provost with such severity as their offence may to practise after a perfunctory examination. But the require. dootor who came from a university, even if he was only This edict long served as the basis of ordinances against Bachelor or Licentiate, enjoyed special privileges. The the illegal practice of medicine. The Ordinances and masters in medicine, the number of whom was restricted, Statates of the Brotherhood of Saints Cosmas and Damian became physicians to Popes, Kings, Princes, and digni- of the City of Paris had been enacted in 1268 at the taries of the Churcb, and had the right to practise any- instigation of Master Jehan Pitart. Apparently before where. Thus the Faculty of Medicine was founded, and that Ordinance there were no sworn surgeons. In 1301 a became one of the parts of the new university, called the further regulation was made giving the Brotherhood power School of Montpellier. Beside the university, the private to expel unworthy members. It is clear that there were schools taught, but could not give degrees. Guy de surgeons who by general repute were considered honour- Chauliac was a Master in Medicine, but he also studied able practitioners before the date of any legal recognition sUrgery, which was not officially taught, under a private of their statue. The intention of the statute would appear master. When the Popes left Avignon, the Univwrsity of to have been only partly to secure a proper qualification. Montpellier forbade its members to practise surgery. Fifty The first clause reads as follows: years before the Paris Faculty had done the same thing. The of that were much the same as As it may happen that when a murderer or thief are wounded beginnings Faculty or wounds somebody else, they come privily to the surgeons of that of Montpellier--that is to say, there were free schools Paris and have themselves treated privily, so that the murderers consisting of masters and apprentices. Besides the and the fines due to the King are lost and hidden, the Provost graduated surgeons there were barberE, a corporation of of Paris for the profit of the King and that of the City of Paris, whom, according to Guy de existed in the four. on the advice of honest men has provided and ordered that no Chauliac, surgeon qualified to practise surgery shall dress or cause to be teenth century. In 1252 this corporation had its own dressed by himself, or by anyone else any wounded person who- statutes, but these only dealt with cutting the hair and ever he may be, bloodily or otherwise, of which complaint shaving sick and wounded people. In a docament dated should be made to the authorities, more than once or twice, if March 23rd, 1268, we find doctors under the name there be danger, without making the fact known to the provost "physici" mentioned as a distinct of Paris or his subordinates, And this has been sworn and every forming corporation. one worthy to work must so swear and shall do so, And as in There was still no Faculty. About 1250 the various Paris there are some men and women who meddle with surgery schools of Paris became a university. A distinct faculty being unworthy to do so, and danger of death of men and maim- of medicine came into existence about ten or twenty years ing of many may result, the Provost of Paris on the advice of later. The faoulty was ecclesiastical in character, and good people and of the honest men of the mystery has chosen six of the best and most loyal surgeons of Paris who have sworn * Copies of these various ordinances, etc., may be found in Nicaise's on the Saints before the Provost that they fhall well and loyally edition of Mondeville above cited. Txz 1 1 BRITISH IN K25XDICAL JOURNAL -~~~~~~~~UCEYINTEPS.[AQUACKERY TIIE PAST. [MAX 27,7 I911-91 remained tinder the jurisdiction of the head of the cut for stone, operated for hernia, stone, eye diseases, Church till 1595 in the reign of Henry IV. In December, dropsy, and so forth. Some of these practised without a 1352 an edict was published by John the First, apparently licence; the others were authorized and had passed some at the instigation of the Dean and Masters, against kind of examination. Fractures and luxations were left persons practising medicine without having the titls to bonesetters. Gay de Chauliac practised all these of Master or Licentiate of Paris, or some other studiumn operations, except, perhaps, lithotomy. He speaks generale. By this decree it was forbidden to any one of with contempt of the itinerant surgeons, and does either sex or any condition to administer any alterative, not wish surgeons to abstain even from drawing or laxative medicine, syrup, electuary, or to give or cause teeth. The "regular" surgeons were afraid to operate. to be given any laxative pills, clj sters, or medicines acting Such knowledge of anatomy as they had was not suffi- on the womb, or in any way to discharge the fanction of cient to guide them; then there was the fear of bleeding the physician unless he were a Master or Licentiate of with very imperfect means of stopping it, and the medicine of Patis or any other university. When univer- great mortality after operations - a mortality be it sities came into existence in the thirteenth century, the said which continued pretty well till the time of Lister. right of granting degrees was reserved to them by the Hence we can understand the strong recommendation of Church. The titles are indicated in Papal Bull as Gay de Chauliac and so maay others to avoid bad casep. Bachelor, Licentiate, and Master. That of Doctor of To these 11periodeutics" and inci8ores we owe much. Medicine was not at first given by universities, although Thes3 men did more for surgical progress in the sixteenth the word " doctor" is used in Certain municipal docaments century than any one else. Pierre Franco, author of a as equivalent to "Master" in Medicine. This was par- Chirurgie written in 1561, was a noted operator for stone. ticularly the case in ItAly, and the expression is sometimes He expressly tells us that if the surgeons gave up these used by Guy de Chauliac, although he most frequently operations it was not that they despised either the work employs phystCus or meditus. or the workmen, but because they thought such things of Hastings Rashdall points out tbat the three titles, great importance and of a nature to ex2pose them to Master, Doctor, Professor, were in the Middle Ages abso- obloquy. He speaks with some bitterness on the subject. lately synonymous. At Paris and its derivative univer- ';Should it happen," he says, "1that a patient dies in the sities we find Magister the prevailing title in the Faculties hands of a physician the practitioner is always excused to of Theology, Medicine, and Arts; the title Profe8wor is, some extent. So it is with the apothecary. The slurgeon however, pretty frequently, that of Doctor more rarely, who practises minor surgery is also excused. But it the employed, after the rise of the university. At an earlier irregular surgeon is unlacky in his cases he is called a period it had been common. According to Daremberg, the murderer, an executioner, and is often forced to take to his title of Dootor was employed at Salerno in the twelfth cen- heele." He adds: tury at the same time as that of Master. In the fifteenth century-at least in the English universities-the practice Not that I am ignorant that the frowardness of several of our art, combined with ignorance, are the cause of tbe great gradually arose of appropriating the title Doctor to all the contempt in which this part of surgery is held. For being superior faculties. In ItaJy the term Doctor soon spread ignorant and knowing tbemselves for such, nevertbeless they from the Faculty of Law to aU the other Faculties. The dare without regard for God or man to undertake to cure ale same was eventally the case in Germany. sorts of diseases, curable and incurable, so long as they can geL the institution- of. the towns had money from the poor simple people whom they seduce and Before, universities, bewitch by their lies and fair words to the grievous damage of taken mealsures to asaure themselves of the fitness of those the poor patients, who are often brought to death by such who wished to praotise medicine. Charles II of Anjou, pretenders, who commit infinite robberies by advertising their in a letter dated June, 1297, warned the Senesohals of superstitions and charms. Provenoe, with special reference to the town of Avignon, that no one should be allowed to practise without previous He gives a curious picture of- the way in which these examination by the council of the town and the Temporal men swindled the people who trusted them. Thus for Court of St. Peter. No barber or surgeon was allowed to dressing a hernia they get, in addition to lodgiDg, a sheet pratise in the town before taking the customary-oath for cutting for stone, a tablecloth; for operating on before the temporal; court. After the foundation of cataract, two napkins or two head coverings. ' These universities, as they did not teach surgery at first, towns things they claim as perquisites in addition to their feej, continued to constitute special juries to satisfy themselves which are sometimes 13 liards, or 13 white pieces, or of the fitness of those who wished to practise. . In short, 13 penoe or more, according to the means of the people in the Middle Ages, if Avignon is to be taken as an with whom they have to do. Franco deplores such example, the regular organization of medical practice villainies as degrading a useful and necessary art. It depended on the municipal authorities. Notwithstanding appears that the surgeons, who were themelves afraid this, irregular practitioners were numerous at Avignon. to-operate, employed the quacks. - Franoo. tells us that in An ordinance of Pope Gregory X[lI, dated November 21se, some towns the sworn surgeons have their boneeetters, 1577, informs- us as to the titles which they took in the thinking it degrading to reduce a dislocation or set a sixteenth century, and which they probably used for a long fracture, and he preaches the sound doctrine that if the time. Article 9 of this ordinance is to the following pbysicians and surgeons themselves kaew more there Effect: would be fewer quacks. The secrets of some operations "Nemo, niai doctor hujus vel alterius celebris academiae, were kept in the famil;* an example of this is rhinoplasty, intra civitatem Avenionis medicam facultatem profiteatur which was practised by the family of Brancas of Sicily. artemve exercito, et proinde pharmaczpolae, chirurgi, Then hernia was exploited by a number of quacks. They myropolae, tonsores, aliptes, renaunctores, obstetrices, always removed the testicle. This lasted up to the middle omneeque empitici a medicina facienda prohibentur." The of the seventeenth century and even later. Dionis relates myzpropolae were vendors of perfumes. The tonsores were that the hernia quacks, while pretending to leave the barbers, or shearers of animals, who carried out secret testicle, removed it and threw it under the table, where treatment. The alipfes, who rubbed bathers with oils, it was devoured by a dog trained for the purpoEe. Cutting grease, or perfames, were the attendants in public baths for stone was also long practised by itinerant inci.sores, (tuviWtes). The renunctore8 were bonesetters (renoueur8, each of whom professed to use a procedure of his owD. hlabizlleur). The operation in Paris was in the hands of a family called In the fourteenth century there was no university Collot from the time of Louis Xi to the middle of the title for surgeons. A small number, like Guy de eighteenthcentury, when a Pbilip Collot was still operator Chauliac, were clerks and masters in medioine, to the King. Henry IV gave 6,000 crowns to Pineau, who but this class of practitioner soon completely dis- was allied by marriage to the Collots, to induce him to appeared. Many phys1ici,did not come from the univer- deliver a course on the operation to the corporation of sities. The same statement holds good with regard to surgeons. And all the time there was an a&mirale all surgeons and the special corporation of surgeons description of it in Franeo's book written in 1561. of Saint C6ne in Paris anid that of barbers. Then There were quacks who pretended to operate for stone, there were a number of "specialists "-dentists, aurists making an incision through the skinl of the perineum and (redicator aurium), and the perambulant surgeons who producing a stone from their sleeve. We have spoken of did The Ufliversities of Europe in the Middle Ages. vol. i. Oxford: the"operators," who did what the surgeons noti dare Olarendon Press. 1895, p. 21. to do. This state of things continued long after the 27, [ Tm.BBm MAY gI91] QUACKERY IN THE PAST. LMRDIcL SJOQUl2r9I _25 ...l Middle Ages. At the beginning of the eighteenth century according to our commandment made sarch through all the in his camp, azadfound many of the same good fellows, which- took Heister, In8tiltutes of J8urgery, #aid@: upon them the names of surgeons, not only the names, but the Our surgeons have shamefully left the finest and most difficult wages also. We asking of them whether they were surgeons, operations of their art to the empirics and quacks- who then or no, they said they were; we demanded with whom they swarmed in Germany, usually contenting themselves with were brought up, and they, with shameless faces, would answer, knowing-how to treat a slight wound, bleed, open an abscess, or either -with one --aunningman, or another, which was dead. at most reduce a dislocated bone or set a fractured one. There Then we demanded of them what chirurgery stuff they had to were very few who dared, I do not say to undertake the opera- curt men withall; and they would show us a pot, or a box, tions which required more skill, but to whom the thought of which they had in a budget, wherein was sucfi trumpery as such a thing would never have come. they did use to grease horses' heels withall, and laid upon That which this author of German scabbed horses' backs, with nerval, and such like. And other, says surgeons that were cobblers and tinkers, they used show-maker's wax, applies generally to all others. It must be said that the with the rust of old pans, and made therewithall a noble- salve, practice of surgery in the Middle Ages was often dan- as they did term it; But in the end, this worthy rabblemeut gerous to the operator. 'Mondeville, discussing the extrac. was committed to the Marehalsea, and threatened by the duke's tion of arrows, says it i# a serious thing for.the surgeon as grace to be hanged for their worthy deeds, except theywould well as for the patient. On the one hand, Master Henry declare the trath what they were, and of what occupations, and would be said by the vulgar to be a man without pity in the end they did consent, as I have declared to you tefore. because he did not extract the arrow; had he extracted it, Yet at this time, Gale tells us, the number of regular the patient would have got well. But if he had done so bred surgeons was much greater than afterwards. When and the patient ha-d lived, people would hive said Master deploring the state of the profession he says: Henry extracted the arrow, but God cured him. (Ii a I have, myself, in the time of king Henry VIII bolpe to extrast et Dieu a gu4ri.) It, on the other hand, the furnish out of London in one year which served by sea and land, had would have said that Master threescore and twelve surgeons, which were good workmen, and patient died, people well able'to serve, and i11 Englishmen. At this present day Henry killed the man with his new treatment, and that if there are not thirty-four of all the whole' company of English- he had not extracted the arrow he would be still alive. men, and yet the most part of them be in noblemen's service, Many surgeons, if they had to intervene in serious cases, so that, if we should have need, I do not know where to find to k strict precautione. Thus Roland,' when he was twelve sufficient men. What do I sy? sufficient men: nay about to perform a serious operation on a patient whom I would there were ten amongst all the company, worthy to be the most skilful surgeons of Bologna had pronounced to be called surgeons. incurable, asked leave of the bishop to operate and took More than two centuries before Gale wrote, an attempt guarantees from the patient himself, his lord, and his had been made to separate the sheep from the goats in the friends, who were present at the operation. We see, there. matter of medical practice. There is mention of a Barbers' fore, from this that the state of public opinion naturally confraternity in the City of London as early as 1308, and produced timidity in the surgeons, and it was owing to that some kind of control was exercised may b0 gathered this that operations for hernia, stone, and so fortb,. were from the fact obronicled in the City Records that in 1354 largelyv left to quacks.- an official .izquiry was held into a charge of malpraxs We have taken France as an example showing the con- against a surgeon. The eaeewas one of dition of medical practice in the Middle Ages because of a certain enormous gnd horrible hurt on the right side of the the abundance of documentary evidence. The picture jaw of Thomas de BCbene appearing; wbether or not such injury serve for There is a carious was curable at the time when John le Spicer, of Cornhulle took may every other country. the said Thomas under his care to heal the wound aforesaid. document in the Eaglish manuscript of Guy. de Cbauliad's Who say upontheir oath that if the aforesaid John le Spicer,'at Chirurgie in the B lblotheque Nationale quoted by Nicaise, the time when 'he took the said Thomas under his care, had v."ich shows how things were in this country in the been an expert in his craft or art, or; had called in counsel aud fifteenth century. It is an ordinance of Henry V issued assistance tohis aid, he might have cured the iDjury aforesaid; in and is to and they further say that through want of skill on the part of 1420, the following effect: the said- John le Spicer the said injury under his care' became Hec est copia extracta de Rotalis domini regis, anno domini apparently incurable.* millesimo CCCC. XX. Ao. R.H.V. MXe. Itom por outer les meschieves et periles qui' longement out The' first distinct reference to surgeons as a body of contenuez dedeins le roialme entre lea gentz par my ceux qu'ot persons practising" a trade for which they required to be usez l'arts e le pratik de fisik et surgerie, pretendaints soy bien licensed by tbe authorities of 'the Citydi London- occurs et sufflaument apris de meosme les arts ou de verite n'ont par about the middle of the fourteenth Master este a grande decert a le people, si eat ordenez et assentes en century. ceat parlement que lea sires du consill du roy pue le tbmps Surgeons had to appear before the Court of Aldermen and esteants aient pooir par autorite de mesme le parlement de take oath to- faire et mettre tielle ordenancie et punisEement envers tieulx Deserve well and traly of the people in doing their cures, to personnes que desore en avant verront eutremetter et' user la take from them reasonable paytafnt, and truly to practice4their practik deadits arts et ne sont ny liables ne approvez en ycelles craft, and to-report as often as need be to the Mayor and Alder. comme appent a mesmes lea artz, c'est assavoir ceulx de Phisik men the faults of those who undertook cures. To take, charge et It s universitez et les surgeons entre les mestrez de cel art, et of. the hurt or wounded, and to give true information to the ceo coms eemblera as ditz sieurs le plus covenable et necessaire officers of the City about such persons, whether they be in en le cas selonc leur bon advis et discrecions por la sureto de le danger of death or not, etc., nd to act uprightly in all other people. thitigs belongitg to'their calling. Physical, and especially surgical, pretenders continued The Barber- Sargeons' Company made admission easy to to-flourish in spite of royal 'decrees. In the sixteenth quacks, who were chiefly cutters for stone, raptre curers, century we find John Gale complaining of the state of and couchers for cataract, in those days; but it drew the siurgery in his day. In a volume published by him in 1566 line at parish clerks' and sextons,t perhaps thinking, the there are two tracts, entitled A Brif Declaration of the association of such functionaries with the practice of Worthy Art of Medicine and The Office of a Chirurgion, in the healing art too Fuggestive. An attempt to secure which he denounced the intrusion of illiterate pretenders legal control of medical practice was made by the phy. and empirios into the practice of medicine and surgery. sicians in the early part of the fifteenth century. About Gale had served with the army in France in 1544. The 1421 they presented a petition to tho King setting forth following is his description of the state of thinDg he found that- there: Many unconnynge and unapproved in the forsayd science I remember when I was in the wars, at Muttrel (Montrenil) practiseth and Specialy in Fisyk, so that in this Roialme is in the time of that most famous prince king Henry VIII there every men be he neuer so lewed, taking upon him practyse, was a great rabblement there, that took upon them to be ysuffred to use hit, to grete harm and slaughter of many men. surgeons. Some were sow-gelders, and some horse-gelders, with Wherefore that a statute be framed- tinkers and coblers. This noble sect did such great cures that they prayed might they got themselves a perpetual name; for like as Thessalus' Perpetually to be straytly yused and kept, that no man of no sect were called Thessalions, so was this noble rabblement, manner of estate, degre or condicion practyse in Fisyk from this for their notorious cures, called dog-leaches; for in two time forward, but he have lonBg tyme yused the sooles of Fisyk dressings they did commonly make their cures whole withynne som Universitie, And be graduated in the same.. and sound for ever, so that they neither felt heat nor undur payne of long emprisonement and payinge xlili to the ,cold, nor no manner of pain after. But when the duke of King-: and that no woman use the practyse of Fisyk under the Norfolk, who was then general, understood how the people did same payne. and that of small he for die, wounds, sent me, and certainother *Quoted in femorialg of the Craft of Surgerviin England. F-rom surgeons, commanding us to make search how'these men came materials compiled by John Flint South. Edited by D'Arcy Power, to' their death, whether it were by the grievousness of their Lundon. 1886. wound,, or by thelack of knowledge of the surgeons; and we f Bouth, OD. Cit. 1 IN THE PAST. I260 QUA.CKERYQUACKERY N the [MAYr27,g27, 19134 T2NBEIOUSA I PAcree. [BfAY A. gracious reply was returnee to the petition and the in particiular, the, decree, after alludin'g t'o the. m'alice of Lords of the Council were directed to see, that effect was Sgatan, goes on: given to the demands of the physicians.Nothing, how- Namely thence it is, that transformig ,himselfe after his this. The then wonted manner into an Angell of light, under pretence of con- ever, seems to have come of physicians for the feeble bodies of their brethren, and of managing; united themselves with the surgeons for the formation of a theirsuItingChurch businesse more faithfully, he perswades smein college, with powers to prevent unauthorized practice. To regular persons to read the Lawes,vand to weighP out ?h.ysica Henry VIII belongs the credit of having beeh the pioneer confections, and so draws them out of their Cloysters. TThere- of medical reform in this country.In 1 511, the third year foreQlest. by ocaaion of their knowledge therein, spirituall men of his an Act for the of medical and stir- be agane involved in mundane affaires, Wee make .adeclee that. reign, regulation idea of the. no man after a Vow of Religion, and religious profession taade gical Practice was passed. As the Act gives an i pla'e, a to go forth to rheadPhs'k o th state of the healing art in London at the beginning of the humaffepsome Lawes:bebbutpermittedif they shall goefooth,and' returbe"no, 'te sixteenth century, the most important passages may be their.cloyster within the space of.two moneths, that they be quoted: avoyded of all men as excommunicate persons, eto, Forasmuch as the science and cunning of physikand y surgery Primrose also cites the Council of Tours to the same (to the perfect knowledgewhereof be requisite both great" earn- effect': a ingandrripe'expeience) is daily Within this fealm dzexrised by religious persons going out of their cloystersheasreto a great multijude of ignorant persons, of whom the greater part Law'Againttor Physick Lectures; Alexander ourPredeceb sour made as haveo o aiunaerin'sightof in' the same, nor in any otherkiidoof Decree formerly in the Councell -of Tours; that except; 1eatniuig:o ome also can see no letters on the book, so far forth, theyv return to their Cloyster within the, space of two that common artificers, as smiths, weavers, and women,- boldly they should be avoyded of all men as excommunicate and paccustorably take upon them great cures and things of monuethid,andita no cafe be if theyplead: And being great'difficulty:the'in which they partly use sorcery and witch- persons, heaerd,be the lowest wouldof all the brethrenih' the As- craft, partly applymesuch dicines unto the disease' as be very. returned, atthat'theyth-e Table,and in the Convocationhouse, and unlesse noioua, and nothing meet therefore, to the high displeasure of semblies,the mercy of the ApostQlicall chairs, to loeo all hope'of pre- 'grea'rtabGod, infamiy' to the' faculty,andtheh grievous hurt, by ome.of throughi. thedifferent ai5ddestruo¢tion of ma'm'aof the King's liege people, ferment. Butt.becausesomeemen, were excused;these,and found indig' gTe danmage, cially those that- canot discern the uncunning opinions of factoincu'r re the mofromstespetthe .of Be it (to the surety and com- We willing that for the future they' doe ipso allounnii?g: therefore of this present Osentence of Excommunication,btraitlydo chargandd oom'm'd,i fort of manner people), by the authority to the end, that aslZwell the Diocesant, , and in their Con- Parliamen't,n'ented thatno' peron within the City of London fistories, as by the Bishops in whose Diocesses they study, such nor within sevenmlese of the same, take upon him to exer- excommunicate persons be publiquely pronounced lyable to the, cise arld ocupy as a physiioitioo surgeon, except he be first enalties. And because we desire that the study of examined, approvel and admitted by the Bishop of London, or aforesaidDivinitiep mayAbe enlarged, that the place of its Pavilion being' by the Dean of Paul's for the time being, calling to him or dilated, it be further propagated, that the Catholick Faith' them four'doctors of physik,a ad' for suargery other expert, be eivironedmay with an impregnable wall of warriours, that fadtlty. 9nd the firstexamination such as may tho e that We will and persrnsin'shall'fthin cOnveniienfoirtand alwaIafour of them which may be able to resist oppose it, they afterward forfeiture for 'command, that this be exftended to all Archdeacons Deacons, thatbasrebeen so approved,uponi the paino si men, and othersthathave Ecciesiasticall every month that do,they ocupyas physician's or surgeons, ,Provosts,moreoveriging Parish-priests (unlesse they desist' within not' r fter the tenour of this Act of five ,livings, subscribed it be firmly pound,adxififttdetc.o Andexaminedoverfthis, That no person out 'of the said the time limited) and that in the name and prdciuotol seven miles of the'same, except hvvehe observed. City,been' (as is aforesaid) approved in-same,the take upon him to There are parts at least of this fulmination that might, exercise and occupy as a physician orsurgeon, in' ay diocese find application at the present day. within thisrealm, butif he befirst examinedand approved by of mountebanks" he shrewdly remarks: the Bishop of thesam e diocese, or, he being out of the diocese, Speaking" by Vicar-general; either of them calling to them such And itis wonderfull thing that manyshould be so wary in his in the said faculties, as their discretion shall thechoice of Physicians, that if a Physician settle in some thinkexpertconvenient,perEons and giving their letters, testimonials under place, they dare not of a long time commit themselves unto their seal to him that they shall so approve, upon like pain to him, and yet they presently trustthemselves to a Mountibank, them that to this Act,etc. that comes to stay but a few weeks, and (as I have often ocupy contrary observed) men of the meanest rank, that plead poverty to In a memoradum appended to the Actit is provided Physicians, can finde money enough to give to these Mounti- "that surgeons be comprised in this Act as physicians, for banks. like mischief of ignorant persons presuming to exercise He says that not any one of them in Italy, France, and surgery." England have more than three sorts of remedies. These ThisAct excited much indignation against the surgeons, are the antidote against poisons, the balsam for wounds, who in a petition presented to Parliament were accused of and the ointment for burnings, to which sometimesthey "minding only their own lucres and nothivg theprofit or add a perfamed ball. They have also the common ease of the diseased." The quacks who were disturbed in purging remedies, which they bay at home from apothe. their practice were described as" honest persons, as weU caries and sell at a veryhigh rate. It is remaikable men as women, whom God hath endued with that know- that Primrose expressly exempts from the ranks of the ledge of the nature, kindand operation of certain herbs, quack roots and waters, and the using and ministering of them those manuall Operatists, thatcut for the Stone, whom to such as be pained withcustomable diseases, etc." It Hippocrates callsepViTar as also such as coucl the Cataract, be a petition of irregular practitioners at the present those that cut for the Rupture, for they are lawfull mightdayI It was successful, for and although also some oftheMountibanks that wander aboutArtificers, dare likewise to attempt the same. it was ordained, established, and enacted of this present Parlia- England, ment that at all times from henceforth it is lawful to anyper- Water Doctors. son. the King's subject, having knowledge or experience and of thebeingnature of etc., to minister in and to any outward Uroscopy was very common among the Arabians sore or woundaccordingberbs, to their cunning.* also in France in the Middle Ages. Primrose has a good deal to say about peoplo who, as he says,"peepe into In 1518 the College of Physicians was founded, its urines." charter giving it large powers for the suppression of Plantius in the life of Fernel, relates, that that most excellent unqualified practice. Nevertheless quacks continued to was wont to look into urines that were brought from thrive. In the seventeenth century we learn from James physicianabroad unto which abuse notwithstanding he approves Primrose,f that servants," Ministers, Mounti- not, but reprehendshim, them, which like Boxuthsayersdoe prophesie physicians' and women who are said of the absent sick party, by only lookingupon the banks, Runnagate Quacksalvers manyurine.thingsThat there was very great fraud therein, the bookes which to meddle in surgery," practised the art of healing. As so Gordonius, and others have set forth concerning the cautions of much is heard at present of the co-operation of ministers urines doe plainly shew, wherein a Physician is taught how he of religion with doctors in' the treatment of the sick, it may deceive the people, as also takeheed to himself of their may not be out of place to quote a decree of the Church in subtilties. Yea to this day among the Germanes thiscustome which reference is made to this matter. It is pointed out is in force, even whether the Physicians will or no, of whom to the doe speak sharply against it, Heurnius, Foresius, Senner- that " they in the Church of God be preferred order manyand but most excellently Fuchsius in the beginning of Clerkes, let them in no case be diverted from diviune tus,of his chapterothers, of urines, he calls Physicians that peep into administration, nor let them be distracted with cares and urines, asses, cheaters, pisse-drinkers, unworthy with whom Secular affairs." With to the practice of medicine goodl men sho-uld contend, seeinig that they more esteemne of the regard of it selfe. But now a daves * Quoted by South, op. cit. gain they get by urine, then troith Popular Errours, or Errours of the Peovle in P7iusick. in France and Italy, the Physicians have quite abandoned ehis8 London.t 1651. the foolish custome of divining by urine. Th MA& 27, 1911.] QUACKERY IN THE PAST. E MEDICALBamaJouWMAr. 1261I

THE WATER DOCTOR. (fter David Teniers the Younger.) Since the days of Hippocrates physioians have rightly The Datch painters have left many pictures of water attached the greatest importance to the inspection of the doctors, one of which is reproduced above. Sir Lauder urine. Sir William Gtull said that the famous maxim Branton, in an address, entitled " The Method of Zadig 1nowK thyself " was to be interpreted as meaning- know in Medicine," which was published in the BRITISH MEDICAL the characters of your urine. Of course, in the days before JOuINAL of January 2nd, 1892, says that these water doctors chemical tests were heard of, all sorts of fantastic notions doubtless learnt a good deal about the patients owing to prevailed as to the significance of different appearances of their trained powers of observation. Thus, although he the urine, and a class of quacks grew up wvho made this knew nothing about albumen, he probably "recognized that their speciality. We find it mentioned in the Roman du the persistence of froth on the utine after shaking it was Renart, in the twelfth century. Again in the Cent of somewhat ominous import, and that would lea him to siouvelles noUvellea, assigned to the time of Louis XI, and give a guarded prognosis." He may even have learnt, he by some to that King as author, we find the following adds, to associate this frothiness with nervous symptoms, narrative: such as restlessness, irritability of temper, and sudden out- Quand elle eust ceste urine, fist taut qu'elle eust ung urinal bursts of passion, quite out of proportion to the amount of et dedans la bouta, et dit A son beau filz qu'il Ia portast monstrer offence. He goes on: " The water dootor would be sure A un tel m6decin pour savoir qu'on pourra faire A sa fille, et se to divide his frothy urine into pale and dark, and he would on luy peut ayder.... Notre homme part don avec son urinal to chez le m6decin. C'est ici la consultation A. distance chez know that these two corresponded quite different types. l'uromancien qui volt tout dans le prcieuux liquide, les maux et The dark urine was probably passed by an individual who le rem6de. Vecy nostre gueux qui arrive devers le m6decin A was short of breath, disposed to rest, and frequently tout l'urine de sa femme. Et quand il y eust fait In r6v6rence, drowsy. The pale urine would be passed either by an il luy va compter comment sa femme estait deshaiti6e et individual who rose in the morning with his eyelids merveilleusement malade: et vecy son urine que vous aporte afin que mieulx vous informes de son oas et que plus seurement swollen and puffy, and who was protably drooping and ne puissies conseiller. Le m decin prent l'urinal et contremont languid during the day, or by a person of quite a different le lhive, et tourne et retourne l'uribie et puisva dire: Vostre stamp-energetic, irritable, restless, sleepless, always on femme est fort aggrav6e de chaulde-maladie et en dangier de the move, and driving on like a high-pressure engine. mort, s'elle n'est prestement secourue, vdoy son urine qui le Further than that, perhaps, the water doctor might not monstre. go." But this is enough to show that if the uroscopist was Uroscopy has formed the subject of innumerable pi¢c a man of any power of observation, he must have learnt a tures, particularly by Dutch artists. An illustrated good deal from his inspection. Sir Lauder Brunton, in the article on the subject by Dr. Paul Richer was published same address, relates a story told him by Milner Fother- in the NouveZUe Iconograpphie cd la Salpglriire, Mars-Avril, gill, whioh well illustrates the keenness of observation 1902. It forms a chapter of the same physician's mag- developed by practice in some of these men: nificent work, L'Art et la m6decine. " In the town of Leeds there once lived a quack who had The practice of " divining by waters continued, how- received no professional instruction whatever, but was known ever, to be used in medicine well in the nineteenth far and wide for his wonderful cures, and espeoially for his century. One of Gavarni's caricatures is entitled "His power of diagnosing the diseases of patients whom he had First Diagnosis." It represents a medical student never seen by simply examining their urine. A celebrated a of urine with an interested surgeon, Mr. X., wishing to see his method of working, desired anxiously scanning bottIe to be present one day, and the quack readily acceded to his girl looking on. But it is true that the method was request, feeling much flattered that so great a man should generally left to quacks, who were called uroscopists. patronize him. Shortly after Mr. X. had ta,ken his oeat a, Tux ERmen I 262 1 IN THE 126 KZDICALMAJUNLJOURNAL F OUACKERYQUc CEY I H PAST.AT [MAYMY2,II27, Igl-l", woman came in with a bottle of urine, which she handed to DDaniel Ddfoe, in his Journal of th-, Plague Year, gives the quack. He looked at her, then at the bottle, held it up a between him and the light, shook it, and said, " Your vivid description of how people ran to conjurers and husband's? " "Yes, sir."1 "He is a good deal older than witches and all sorts of deceivers to know what should you? " " Yes, air." " He is a tailor?" " Yes, sir." "Here," become of them. '; So that they were as mad upon their he said, handing her a box of pills, " tell him to tske running after quacks and mountebanks and every practis- one of these pills every night for a week and a big drink of ing old woman for medicines and remedies; storing them- cold water every morning and he will soon be all right." No sooner had the woman gone out than Mr. X. turned to the selves with such multitudes of pills, potions, and preserva- quack, curious to know how he had made out all this. " Well, tives, as they were called, that they not only spent their you see," said the quack, " she was a young woman, and looked money but even poisoned themselves beforeband for fear well and strong, and I guessed the water was not hers. I saw of the poison of the infection, and prepared their bodies for she had a wedding ring on her finger so I knew she was the plague instead of preserving them married, and I thought the chances were it was her husband's against it. On the water. If he had been about the same age as she it was hardly other hand it is incredible and scarce to be imagined how likely that he was going to be ill either, so I guessed he was the posts of houses and corners of streets were plastered older. I knew he was a tailor becau3e the bottle was stopped over with doctors bills [prescriptions] and papers of not with a cork, but with a bit of paper rolled up and tied ignorant fellows, quacking and tampering in physic, and round with a thread in a way no one but a tailor could have inviting the people to done it. Tailors get no exercise, and consequently they are all come to them for remedies, which very apt to be constipated. I was qaite sure that he would be were generally set off with such flourishes as these,'namely, no exception to the rule and so I gave him openiDg pills." 'Infallible preventive pills against the plague,' 'Never "But how did you know she came from S.?" " Oh, Mr. X., failing preservatives against the infection,' ' Sovereign bave y-ou lived so long in Leeds and don't know the colour of cordials against the corruption of the air,' ' Exact regula- S. clay ? It was the first thing I saw on her boots the moment tions for the conduct of the body in case of an infection,' she came in." 'Anti-pestilential pills,' 'Incomparable drink against the Removal of Stones from Head. plague, never found out before,' ' An universal remedy for A curious form of quackery prevailed in the seventeenth the plague,' 'The only true plague water,' 'The royal century which was taken as a subject for painting by antidote against all kinds of infection,' etc." There were several Dutch artists; Jan Steen was particularly fond of also the usual offers on the part of "An eminent high treating this subject. It consisted in treating headache or Dutch physician," who had cured multitudes of people;, supposed brain disease by extracting a stone from the "'an Italian gentlewoman" who had a choice secret to head. An incision was made in the scalp and the quack prevent infection; " an ancient gentlewoman " who having tock out a stone which he had ready for the purpose, praotised with great success in the late plague in this city, when hey presto! the patient was cured. An illustration Anno 1636, gives her advice only to the female sex. "An of this is given at p. 1263. experienced physician who has long studied the doctrine Tar Water. of antidotes against all sorts of poison and infection, has A striking proof that even the most enlightened men after forty years' practice arrived at such skill as may with with no special knowledge of medicine is to be found in God's blessing direct persons how to prevent their being Bishop Berkeley's belief in the virtues of tar water. In touched by any contagious distemper whatsoever. He a letter dated July, 1748, Lady Mary Wortley Montagu directs the poor gratis." This offer of gratuitous advice, writes: which we know so well at the present day, is illustrated by Tar-water has succeeded t3 Ward's drops, and it is possible the advertisement of another quack quoted by Defoe, who that some other form of quackery has by this time taken place announoed that he gave advice to the poor for nothing. of that. The English are more than any other nation infatuated Abundance of poor people came to him accordingly, to whom by the prospect of universal medicine. he made a great many fine speeches, examined them of the Berkeley expressed the belief that the drinking of tar state of their health, and of the constitution of their bodies, water and-told them many good things for them to do which were of no great moment. . But the issue and conclusion.of all was that would mitigate and even prevent the small-pox and 'erysipelas; he had a preparation whi-ch if they took such a quantity of that nothing isso useful as this in cases of painful uleer'd bf the every-morning he.would&pawn his life they. should never have .bowels; in consumptive coughs and ulcers of- the- lungs with the plague,-rno, though,they lived in the house with people who .expectoration of pus; that it cures asthma, dropsy, and were infected. .This,made, the people all resolve to have it; indigestion, the King's Evil, all kinds of -sores and the foulest but then the price'of that was 0o much-I think it was h'alf- disorders. a-crown. -"But, sir," ay on,e poor woman, "I am' a poor Time confirmed him in these almsw'oman and -I am 'kept by the parish, and your bills say and experience only opinions. you give the poor youir lhelp for nothing." " Ay,good woman,. In a subsequent publication he says: says the doctor, "Iso I,do, as I publish there. I give my advice I freely own that I suspect tar water} to be a panacea. .. and ,to the poor for nothing, but not my physic." "Alas! sir," says as the old philosopher cried aloud from the the- housetop to his she, "that'is a snare lIid for'the poor, then, for you give them fellow citizens, "Educate your children," so if I had a situa- your advice for 'nothing; that is to say, you advise them gratis tion high enough and a voice loud enough, I would say to all the to bus your physic for their toney. So does every shopkeeper valetudinarians upon earth, "Drink tar water."' with is wares." He{re the woman began to give him iU words, and stood at his door all that day telling her tale to all the The reputation of tar water was short-lived. people that came, till the doctor finding she turned away his customers was obliged to call her upstairs again and give her Quack Advertisemfents. his box of physic for nothing, which perhaps too was good for The quack has always been skilful in advertising him- nothing when she had it. self. He used to be an inevitable figure at iillage faire, standing on a platform, glibly repeatinig his patter and This instructive story shows, as AEsop says, that human selling his infallible remedies. Facing p. 1224 will be found nature does not change. Qaacks practise the same arts a reproduction of the famous picture" The Quack Doctor" by which their congeners have done for centuries, and gulls Gerhard Douw. Moliere, who satirized the doctors, did not allow themselves to be caught by the silly bait. The spare the quack. In L'Amnour Medectn an " operator" is moral is that people who are deceived by them should introduced selJing orvietan, an electuary, introduced into imitate the pertinacity of the almewoman and expmse the France (compounded, as Jaques would say, of many simples) cheat of which they have been victims. But this is just in 1647, by a quack from Orvieto; hence the name. In what, partly from shame, partly from want of resolution, Moliere's play the "operator" sings: they do not do. On this the quacks trade and flourish L'or de tous les climats qu'entoure l'Ocan, as they did at the time of the Great Plague, when Defoe Peut-il jamais payer ce secret d'importance? tells us1 that the crowds that ran after them were infinitely Mon rem6de gu6rit, par sa rare excellence, greater and their, doors were more thronged than those Pins de maux qa'on n'en peut nombrer dane tout un an; of the most famous physician of the time. La gale, An article in the Spectator of La rogne, July 26tb, 1714, is devoted La teigne, to quacks. It is there pointed out that " those who have La Uevre, little or no faith in the abilities of a quack will apply ILapeste, themselves to him, either because he is willing to sel La gortte, health at a reasonable profit, or because the a Verole, patieit, like Deseente, drownilg man, catches at every twig and hopes for relief Rougeole, from the most ignorant when the most able physiciaam O grande puissance give him none. Though impudence and many words are *~~~~~~~eIel'oryietan I as necessy to these itinerary Galens as a laced hat to a MAt 27, 19II.] [ Thu Bamus I263 QUACKERY IN THE PAST. I JDIOAJouM.. 2 merry Andrew, yet they would turn very little to the nostrums. In a reErint of the first number of that higbly advantage of the owner if there were not some inward respectable newspaper,.the Observer, dated December 4th, disposition in the sick man in. favour of the mountebank." 1791, it is seen that its pages swarm with quack adver- In this disposition lies the secret' of the prosperity of all tisements. The virtues of " Dr. Howell's Celebrated quacks. The writer goes on to mention another set of Powders, the only effectual Remedy ever yet discovered pretenders who send forth notice to the world of their for curing 'all kinds of Fits, particularly Epileptic or extraordinary parts and abilities by printed bills and Falling Fits," are attested by grateful patients who had advertisements. "I have heard," he says, " of a porter who suffered many things from many physicians without serves as a knight of the post under one of these operators, benefit. Mr. Charleo Angbaud, surgeon, described as and, though he was never sick in his life, has been cured ".Grandson to the inventor, who was an eminent Apothe- of all the diseases in the dispensary. These are the men cary to King William and Qaeen Anne," offers for sale '; at whose sagacity has invented elixirs of all sorts, pills, and his house, No. 78, the Angel and Trumpet, the upper end of lozenges, and take it as an affront if you come to them St. Martin's Lane, Westminster," the Pectoral Lozenges before you are given over by everybody else. Their of Blois, " so universally and satisfactosily known for medicines are infallible and never fail of success-that is," their excellent properties in curing the Usual Diseases it is slyly added, " of enriching the doctor and setting the of the Lungs, as Colds, Tickling Coughs, Shortness of patient effectually at reat.' Breath (which they also contribute to sweeten), Asthmatic, 'Goldsmith devotes two papers in the Citizen of the Phthisicky and Consumptive Complaints." Mr. Smith, lVorld to quacks. He says the- advertising4professors No. 5 (the corner of Golden Square), Lower John Street, delight in eases of difficulty. Be the disorder never so gives the names of a few of his, patients who have .been desperate or radical, there will be found numbers in every cured by his medicine of gout, rheumatism, and scurvy. street wh6 by levelling a pill at the part affected promise Mr. S wainson, the sole proprietor of the genuine syrup of a certain cure without lons of time, knowledge of a bed. De Velnos, warns,the public against counterfeits, adding: fellow, or hindrance of, business. The benevolence of the " If, after repeatedly publishing the affidavits of Mr. and quackh is amazing. They not only in general give their Madame Da Velnos, and exhibiting the deeds which secure medicines 'for half value, the secret of Mr. Swainson, but use the most persuasive weak and silly persons rmmonstranecs to induce -U,I will believe the-bare aster- the' sick to come and' be tions of unprincipled im- cured. He goes on to may: postors, they must suffer Few, physicians here go for their oedulity."u through the ordinary courses This is the merest outline of e`duntion, but receive all of a vast subject, for the their'kao'wledge' of medicine of quackery is illimit- b ";immediate inspiration .feld froiEHeaven. Some are thus able. It will be sufficient, inspired, even, in the -womb, however, to show that and, htiq very remarkable, quackery m the past is un erstandtheirprofesision as - . 2 the same as wel'at three years'old as at essentially. threescore. Others have spent quackery in the present. a great part of their lives un- The law is, indeed, much consoious of any latent excel- l N )a 3 ,istricter than 'in the good lence, until a bankruptcy or a old daysv, whe'n it was resid5uce in gaol have called it ~~~difficult, often impessibWe, their miraculous powers into exertion. to know an impostor from And others still there are ..f, ;'I 1 -1' 3 a qualified doctor. But indebted to their superlative quackery,, so far from ignorance alone for success. 1 having been suppressed, The more ignorant the prac- has enlarged the scope of titioner, the less capable he is -|l X thought of deceiving. The its pretensions and assumed people here judge as they do - new forms. It hasi thisO in -the East, where it is enormous advantage over thought absolutely requisite science that the ove of that a man should be an idiot is before he pretend to be either myster deeply im a conjurer or a doctor.- plante in the human 5w:,_3R4 @ breast. As Pliny himself This flattering estimate ______-__>£? e w; -no. friend to doctors- of the amount of intelli- for the REMOVAL OF STONE to EADBY A QUACK. acknowledged, pwple have gence required prac- FRI seventeenthcenBAur). t less belief in things relating tice of the healing art is AfterH. evdmaiis *eve centurto their health if they largely entertained by people who are in the ordinary understand (minus credunt quae ad suam saluten perti- sense educated and who are experienced in matters of the nent, ui intelligunt). The author ef Hudibras has expressed world. We have ourselves known a practitioner who the same view in the following lines: has long since gone to a place where there is neither The world is generally averse physic nor fees, and who had a very large practice among To all the truths it sees and hears; leading politicians and journalists. One of the latter But swallows nonsense and a lie expressed what was the general feeling among these With greediness and gluttony. superior persons when he said to us on one occasion: THE medical notes in the report of the Kashmir Mission " Oh, yes, I know; he is a d-d fool, but he is a devilish Hospital for 1910 state that in dealing with septic cases good dootor I " Of the prevalenoe of advertisement in the iodine skin disinfection has proved a great reinforcement eighteenth century we find proof in another essay by to other precautions. By its means and by using sterilized Goldsmith, where he says: towels to exclude infected areas, primary aseptic union The learned are not here retired with vicious modesty from was obtained in several cases of gangrene in which ampu- public view; for every dead wall is covered with their names, tation had been performed within a few inches of the line their abilities, the amazing cares and places of abode. Few of demarcation. In dealing with the webbed arms re- patients can escape falling into their hands unless blasted by sulting from extensive burns, it has been found better not lightning or struok dead with some sudden disorder: it may to apply any stitches after division of the cicatrices, but to so etimes happen that a stranger who does not understand fill the gaps with Thiersch grafts, and that if there be no En lish, or a countryman who cannot read, dies without ever oozing of blood these do best when exposed to air under hearing of the vivifying drops or restorative electuary. - But for the protection of a wire cage. The experience of the hos- my part before I was a week in town I had learnt to bid the pital in regard to the value of saline mfusion in cases of whole catalogue of disorders defiance and was perfectly collapse from cholera is regarded as disappointing. At the acquainted with the names and medicines of every great man and woman of them all. leper asylum, whieh is under tke medical care of the' gret mission, nastin was employed last year on 10 patients; -The Genteman's Magazine for 1748 gives a list of the; 4 of them were much improved, 4 somewhat benefted, and quacks then preying on the people of London and their In 2 there was no obvious result.