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A70658
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A letter concerning the present state of physick, and the regulation of the practice of it in this kingdom written to a doctor here in London.
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T. M.; Merret, Christopher, 1614-1695.
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1665
(1665)
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Wing M81C; ESTC R32085
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26,204
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65
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and little effect to serve dishonourable interests I have heard some worthy Members of your Colledge wish also that a new Pharmacopoea were agreed upon But it was quite of another Nature from that now in use For although this be better than any other extant Yet I know they well understand it has many things that need Reformation but that is a business that requires mature consideration and the present perplexity of affairs will not permit it yet I think you are not unwilling the world should know you can take notice where it is defective as well or better than any of those men who would go about to disgrace it with vain and impertinent clamors taken out of Zwelfer and some other Writers It was wisht that the Shops instead of the Medicines now commonly made were furnished with Simples only Of which such as are best and most effectually used with a little or an easie preparation as powdering infusing boiling and the like should be so kept as might longest preserve their vertue and operation and such as are most operative by a more curious way of preparing as in Tinctures Extracts Essences Elixirs Spirits Syrrups Juyces Robs Conserves c. to be likewise in such manner prepar'd as may retain their vertues most and likewise render them most durable By which means although the present expence of making them be more yet considering their long duration it will in effect be less then it is in the present Method The Physician that comes to buy will be able to make a better judgement of their goodness and may use them either either simple which was the way of ancient times or compound them as he sees occasion by which he will likewise come to observe the many and great alterations that happen from mixtures of several things together he will also be more able to make them gustful and palateable thus preserving the Tone of the Stomach which is so much destroyed by ordinary Physick that in Chronical Distempers it may be doubted whether it do not more hurt this way than it can do good another Likewise in all compositions he will be sure to have the vertues of every ingredient which will scarce be found in the compounds of the Shops as has well been observed by Zwelfer yet he himself is not without his faults in the same kinde too as my little experiments have informed me In a word Simple Medicines thus prepared and kept are not so subject to corrupt by the usual fermentations of mixt things and so will be more effectual for the use of such Physicians or Chirurgeons as have occasion to carry them abroad with them as Hippocrates has well noted or such as are employed in the Service of His Majesties Armies or Navies But not to give you too much trouble with my long Letter if we please to consider the strange and intricate variations of Diseases brought in partly by new Dyet discoveries of new places the nature of particular Soils and how these are mixt combin'd and complicated both with the old and with one another it will be the rather necessary to put something of this nature in execution I have often heard your self and several others of your ingenious Collegues discourse well and substantially on this Argument which makes me the more wonder at the late Writer of Medela Medicinae who would contrary to his own reason and conscience endeavour to perswade the world that this was a thing altogether unthought of not only by your Colledg of Physicians but all those who are commonly call'd Galenists and yet he himself hath said no one thing in that whole discourse concerning this matter that can be pretended new for which he has not cited the very Books and words of some Galenist or Methodist as he calls them And to me it seems the greatest Argument in the world on your behalf why his Majesty and the Parliament should shew you all manner of kindeness that such various and irregular changes daily appear in the Distempers of humane Body For if we allow Physick to be altogether Empirical as he pretends it must needs follow that in such things he ought to be esteem'd most able and sufficient who is furnish'd with most and best Experiments either from his own observation and these are properly his or by reading of Books which afford him the experiments of all the rest of the world and can best conclude and argue from the Analogy Correspondence and Harmony they have to one another so that a study'd Physician must in all consideration of reason have far the advantage of any other But 't is alledg'd You are too rigoroufly confin'd to the rules and methods of the Ancients who had few or no experiments of this kinde and likewise neglect that high and more potent way of Medicine which the Chymists only know how to make use of But 't is evident this is a very unkinde and unjust imputation for though in the former age when Chymistry first began to show it self in Europe It was condemned for its novelty and dreaded as full of dangers yet for any to affirm in these more illuminated times that Physicians so oblige themselves to ancient Methods as to despise or not consider the differences and alterations of several times Regions Dyets Tempers changes of Diseases caus'd by these The new and more exquisite wayes of preparing Medicines If he be a man of learning and understanding he must needs be thought to abuse his own reason for some particular interest since he brings so great a scandal not onely upon many worthy private persons but upon the freedom and ingenuity of the whole age whose happiness and honour it is to be unconfin'd and disdains the Pedantry of being enslav'd to any name or sect whatsoever and when an Inquisition of truth comes before them can as little regard the names of Hippocrates and Galen as of Paracelsus or Helmont and as freely make use of any thing it findes good in these as reject what is untrue or mistaken in the other And to measure the temper of the present time by that of the past is so great an injustice that I will desire no other instance to shew it then out of that Book For those very men who were as he sayes at first condemned by publick censure of the Colledge of Paris Sir Theod. Mayern and Quercetan came by his own confession in after times to be held and reputed among the greatest Physicians of their Age nay further to see how little you despise Rational Chymistry One of these very same men Sir Theod. Mayern a great Chymist and an excellent Physician was one of the chief men of your Colledge in his time and had a great share in making the Pharmacopoea Since then your selves look upon Rational Chymistry as an excellent way of enquiry into the natures of things and manag'd with sound Reason and Philosophy an excellent way also of preparing Medicines since you are as much conversant
they inhabited Seplasiarii Vnguentarii that I shall not give you any further trouble about it 2. The second reason for this Method is this The Physician is hereby oblig'd to make himself throughly acquainted with the Nature Goodness and exact Preparations of Medicines now sold by the Apothecary whether Simple or Compound Otherwise he will not know how to lay out his money and may easily be impos'd upon by the dishonesty of another to the ruine of his Patient of his Reputation and consequently of his Livelihood and Subsistence For what ever accident may happen from the ill preparation of the Physick it will now become the fault of the Physician whose ignorance or neglect it was that he did not provide what was good for his occasion 3. For the reason before alledg'd The Physician will be also engag'd to frequent visits of the Apothecaries Shop to view his Simples and consider his manner of preparation from which he will likewise gain many opportunities of Improving Medicines already in use both as to their Essicacy and Operation and also as to their Taste and Scent which ought to be one great part of a Physicians care and is now too much neglected although nothing can be more his interest then this He will be also more able to invent new Medicines and bring in the use of Simples yet undiscover'd Lastly he will have frequent occasions of observing many excellent Phaenomena which now pass unregarded through the hands of Apothecaries and their Servants for the use and service of Philosophy 4. This renders the Physician much more acceptable to every Patient and affords him many real opportunities of gaining his hearty kindeness and affection which others now enjoy and also takes away the Scandal and Reflexion which is cast upon the Physician by some Apothecaries and upon both the Physician and Apothecary by Mountebanks and those that call themselves Chymists For the first Although the writing of a Bill and directing proper Remedies for every Distemper be the result of the pains and careful Study of many Years and the Physician that prescribes well may justly be said under God Almighty to be principal in the cure of the Disease yet an ordinary Patient is not sensible of this but thinks it very hard to part with ten shillings for a few words in Paper especially when he must go from thence to the Apothecary and there be at another extraordinary charge for what was prescribed and also use some means beside to oblige the Apothecary to prepare it well Whereas if the same Physician should instead of that give the Physick it self that is to be taken at a reasonable and moderate price assuring the Patient of his care to prepare it as it ought to be and also his counsel and advice for nothing unless sent for out of his own house he must needs infinitely gain the heart and good will of every man Besides many occasions would be offer'd of giving to the Poor for nothing which is Christian Charity and sometimes also to the Rich themselves of which a wise man will know how to make an honourable and discreet advantage and put frequent obligations upon them For the second I remember well the Apothecaries counsel laid a great and unhandsome scandal upon all your Colledge and that in publick before a Committee of our House affirming you incompetent to visit their Shops or to make a judgement of their Medicines and though it was then said with much rashness and passion there being so great a number of your Learned Members excellently knowing this way yet I wish there had been no cause to think it in some part true But this will for ever prevent all calumny of that nature for now you will understand them better then the Apothecaries themselves On the other side the Mountebanks Chymists c. have nothing to boast of so much as the making their own Physick recommending their great industry and care to finde out and prepare exactly the best of Medicines and accusing the Shops of dull enactive and slight preparations and your selves of too much delicacy pride sloth and ignorance for not providing better and taking pains as they pretend to do in searching into the Rich and large Stock of Remedies which the wisdom and bounty of Nature has created in so great plenty for the benefit of men 5. This will restore the ancient true and only fit way of breeding up young Students in this Faculty That is to say in exercises of Anatomy knowledge of Herbs mixing and compounding Medicines visiting the Sick under the direction of a grave Physician not as they are now for the most part in speculative discourses only and reading of Books Thus was the late famous Dr. Wright the younger educated under Dr. Fox and was the first Physician that dissected at the Colledge which till his time had ever made use of Chirurgeons in their publick Theatre And while the young Physician employes his industry in such services as these for the elder he gains besides what is learn't from Books and Authors the long experience of the other sees his Patients hears him discourse of their several cases considers the Medicines provided for them and observes their several effects All which advantages you now in vain give away to Apothecaries to whom the Practice of Physick does not belong And if this has been the course that all mankinde has ever taken to raise and propagate Practical Arts and Trades of daily use in humane life why should it not be us'd in Physick which is a Practical Art of so much greater consequence especially if we consider how dangerous the errors of this Profession are and how necessary a Practical Education is for any man that intends the exercise of it as Galen and more particularly Hippocrates often inculcates and the nature of the thing makes it evident I need not tell you how it was confin'd till the time of Hippocrates to one single Family under a curse not to communicate it to any other nor reckon up the many famous men who were Galen's Masters from whom he learn't this Art and whom he mentions with so much honour Yet give me the favour to recall an excellent Passage of Hippocrates to this effect He advises a Physician when he carries his Disciples with him to 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 a Patient to appoint in his absence such a one of them to observe the Patient as is well advanc'd and studied in this Art and knows what is fit to be done and how to give him an account of the case that so he may be ignorant of nothing that is material though he could not be there himself These things consider'd if a person of three or four years standing in either of our Vniversities for none else should be entertained by any should agree with a Physician for a reasonable consideration and acknowledgement to be made which was held very honourable in Hippocrates age as appears in his Oath and