medical essays-第61章
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n； and possibly an occasional dose of Antimony。 He would perhaps have had a rheumatic patient wrapped in the skin of a wolf or a wild cat； and in case of a malignant fever with 〃purples〃 or petechiae； or of an obstinate king's evil； he might have prescribed a certain black powder； which had been made by calcining toads in an earthen pot； a choice remedy； taken internally； or applied to any outward grief。
Except for the toad…powder and the peremptory drastics； one might have borne up against this herb doctoring as well as against some more modern styles of medication。 Barbeyrac and his scholar Sydenham had not yet cleansed the Pharmacopoeia of its perilous stuff； but there is no doubt that the more sensible physicians of that day knew well enough that a good honest herb…tea which amused the patient and his nurses was all that was required to carry him through all common disorders。
The student soon learned the physiognomy of disease by going about with his master； fevers； pleurisies； asthmas； dropsies； fluxes； small…pox； sore…throats； measles； consumptions。 He saw what was done for them。 He put up the medicines； gathered the herbs； and so learned something of materia medico and botany。 He learned these few things easily and well； for he could give his whole attention to them。 Chirurgery was a separate specialty。 Women in child…birth were cared for by midwives。 There was no chemistry deserving the name to require his study。 He did not learn a great deal； perhaps； but what he did learn was his business； namely； how to take care of sick people。
Let me give you a picture of the old=fashioned way of instruction； by carrying you with me in imagination in the company of worthy Master Giles Firmin as he makes his round of visits among the good folk of Ipswich； followed by his one student； who shall answer to the scriptural name of Luke。 It will not be for entertainment chiefly； but to illustrate the one mode of teaching which can never be superseded； and which； I venture to say； is more important than all the rest put together。 The student is a green hand； as you will perceive。
In the first dwelling they come to； a stout fellow is bellowing with colic。
〃He will die； Master； of a surety； methinks；〃 says the timid youth in a whisper。
〃Nay； Luke；〃 the Master answers； 〃't is but a dry belly…ache。 Didst thou not mark that he stayed his roaring when I did press hard over the lesser bowels？ Note that he hath not the pulse of them with fevers； and by what Dorcas telleth me there hath been no long shutting up of the vice naturales。 We will steep certain comforting herbs which I will shew thee； and put them in a bag and lay them on his belly。 Likewise he shall have my cordial julep with a portion of this confection which we do call Theriaca Andromachi； which hath juice of poppy in it； and is a great stayer of anguish。 This fellow is at his prayers to…day； but I warrant thee he shall be swearing with the best of them to…morrow。〃
They jog along the bridle…path on their horses until they come to another lowly dwelling。 They sit a while with a delicate looking girl in whom the ingenuous youth naturally takes a special interest。 The good physician talks cheerfully with her； asks her a few questions。 Then to her mother： 〃Good…wife； Margaret hath somewhat profited； as she telleth； by the goat's milk she hath taken night and morning。 Do thou pluck a maniplethat is an handfulof the plant called Maidenhair； and make a syrup therewith as I have shewed thee。 Let her take a cup full of the same； fasting； before she sleepeth； also before she riseth from her bed。〃 And so they leave the house。
〃What thinkest thou； Luke； of the maid we have been visiting？〃 〃She seemeth not much ailing； Master； according to my poor judgment。 For she did say she was better。 And she had a red cheek and a bright eye； and she spake of being soon able to walk unto the meeting； and did seem greatly hopeful； but spare of flesh； methought； and her voice something hoarse； as of one that hath a defluxion； with some small coughing from a cold； as she did say。 Speak I not truly； Master； that she will be well speedily？〃
〃Yea； Luke； I do think she shall be well； and mayhap speedily。 But it is not here with us she shall be well。 For that redness of the cheek is but the sign of the fever which； after the Grecians； we do call the hectical； and that shining of the eyes is but a sickly glazing； and they which do every day get better and likewise thinner and weaker shall find that way leadeth to the church…yard gate。 This is the malady which the ancients did call tubes； or the wasting disease； and some do name the consumption。 A disease whereof most that fall ailing do perish。 This Margaret is not long for earthbut she knoweth it not； and still hopeth。〃
〃Why； then； Master； didst thou give her of thy medicine； seeing that her ail is unto death？〃
〃Thou shalt learn； boy； that they which are sick must have somewhat wherewith to busy their thoughts。 There be some who do give these tabid or consumptives a certain posset made with lime…water and anise and liquorice and raisins of the sun； and there be other some who do give the juice of craw…fishes boiled in barley…water with chicken… broth； but these be toys； as I do think； and ye shall find as good virtue； nay better； in this syrup of the simple called Maidenhair。〃
Something after this manner might Master Giles Firmin have delivered his clinical instructions。 Somewhat in this way； a century and a half later； another New England physician； Dr。 Edward Augustus Holyoke； taught a young man who came to study with him； a very diligent and intelligent youth； James Jackson by name； the same whose portrait in his advanced years hangs upon this wall； long the honored Professor of Theory and Practice in this Institution； of whom I shall say something in this Lecture。 Our venerated Teacher studied assiduously afterwards in the great London Hospitals； but I think he used to quote his 〃old Master〃 ten times where he quoted Mr。 Cline or Dr。 Woodville once。
When I compare this direct transfer of the practical experience of a wise man into the mind of a student；every fact one that he can use in the battle of life and death；with the far off； unserviceable 〃scientific〃 truths that I and some others are in the habit of teaching； I cannot help asking myself whether； if we concede that our forefathers taught too little； there is nota possibility that we may sometimes attempt to teach too much。 I almost blush when I think of myself as describing the eight several facets on two slender processes of the palate bone； or the seven little twigs that branch off from the minute tympanic nerve； and I wonder whether my excellent colleague feels in the same way when he pictures himself as giving the constitution of neurin； which as he and I know very well is that of the hydrate of trimethyle…oxethyle…ammonium； or the formula for the production of alloxan； which； though none but the Professors and older students can be expected to remember it； is C10 H4 N4 O6＋ 2HO； NO5｝=C8 H4 N2 O10＋2CO2＋N2＋NH4 O； NO5。
I can bear the voice of some rough iconoclast addressing the Anatomist and the Chemist in tones of contemptuous indignation： 〃What is this stuff with which you are cramming the brains of young men who are to hold the lives of the community in their hands？ Here is a man fallen in a fit； you can tell me all about the eight surfaces of the two processes of the palate bone； but you have not had the sense to loosen that man's neck…cloth； and the old women are all calling you a fool？ Here is a fellow that has just swallowed poison。 I want something to turn his stomach inside out at the shortest notice。 Oh； you have forgotten the dose of the sulphate of zinc； but you remember the formula for the production of alloxan！〃
〃Look you； Master Doctor；if I go to a carpenter to come and stop a leak in my roof that is flooding the house； do you suppose I care whether he is a botanist or not？ Cannot a man work in wood without knowing all about endogens and exogens； or must he attend Professor Gray's Lectures before he can be trusted to make a box…trap？ If my horse casts a shoe； do you think I will not trust a blacksmith to shoe him u
