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A34855 A discourse wherein the interest of the patient in reference to physick and physicians is soberly debated, many abuses of the apothecaries in the preparing their medicines are detected, and their unfitness for practice discovered : together with the reasons and advantages of physicians preparing their own medicine. Coxe, Thomas, 1615-1685.; Coxe, Daniel, d. 1730. 1669 (1669) Wing C6727; ESTC R25356 84,750 293

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as considerable as of any sort of Men whatsoever that do publickly appear in the World So that if there be any thing in Chymistry useful and noble what should hinder their bidding fair for the possession thereof Besides there are many Antient and Younger Physicians who dayly ingage in these Enquiries and the whole Colledge of Physicians is so concerned for the promoting this usefull part or appennage of Medicine that they do intend publickly to promote it by associated endeavours And notwithstanding what hath been said to the contrary I am Confident there is not a Society of men in Europe more considerable not only for that knowledge which we owe to Books for their insight into Philosophy Skill in Anatomy and all Natural History which is allowed by most but even for an intimate acquaintance with Chymistry which though some have denyed them yet how unjustly the World will be soon if it be not already convinced Now it remains that we discourse of the Fourth and last way of Practice which we said was composed of those already mentioned and indeed this is the most frequent for although I know there are some few who confine themselves to that which I call strict Method others to Cure by Specificks a Third sort who only use Chymical Medicines which they are pleased to dignifie with the glorious Title of Arcana although I fear they are far from being so and perhaps there may be some Persons in the World who have those that are really such yet I have observed that the generality of sober judicious Physicians compose out of all these a Practice which pertakes somewhat of every one yet so that Medicines which have a sensible Operation Specificks and Chymical Remedies have all a subserviency to Method that is they observe a certain order in the use of all these which is so advantageous that inverted or transposed they have not the same effect Thus perhaps first they premise some general evacuations whereby the Body being freed from impurities the Stomach after strengthned with digestives the Vital Spirits invigorated by Cordials or a Regular Diet Specificks then easily perfect the Cure which perhaps would be compleat neither without them nor with them only without the mentioned helps Now he that hath but half an Eye must necessarily discern that much of judgment much of contrivance is requisite in these Cases and indeed so much that it is well known many and I hope that it may be affirmed of most Physicians make a History of the Patients condition or Case and then after due Consideration of all circumstances determine to proceed after a certain Method from which they do not recede without great occasion given them as the intervening of some accidents which Humane Wisdom and Care could neither soresee nor prevent Now how Apothecaries or indeed any others that have not a solid Judgment quick Apprehension and fixed indefatigable Mind can sustain so much labour be capacitated for so great undertakings I cannot imagine And they that know them did never suspect they would give themselves so much trouble to obtain what they can purchase at a cheaper rate For they design not so much the doing good as that the People should entertain an opinion that they do it which is no hard matter to arrive at being in this like Machiavel's Politician though in other things silly enough who is to make a profession of Vertue and Piety but not to be really so for many things will be swallowed that are proposed under the pretence of Vertue and Piety by unwary well-meaning People who are not apt to suspect others because free from Designs themselves whereas a strict profession of Religion and Vertue will hinder the Politician from doing many things which might prove highly advantageous to him The Parallel is easie and obvious Besides as it is easie to obtain an Opinion of Vertue or Piety but to be really and truly Vertuous requires much Sweat and great diligence so it is with Learning nothing being more easie then to impose on the incautious credulous Vulgar who believes he knows most who makes the largest profession And at this the Apothecaries are excellent good success so rarely anticipating their promises that I scarcely ever heard such a thing happen'd but how devoid they are of solid Knowledge how free from Care and empty of Skill or whatsoever is requisite for the making good their pretences is so well known to them that dive into the depth of their silly intrigues and they are so numerous that it is needless to repeat what is imprinted on so many memories But we shall now proceed to enumerate and descant on the particulars wherein the Physician seems to have some advantages over the Apothecacaries and indeed all other whom Nature and a good Education have not fitted for so great an employment 1. It seems very probable that Diseases will be better cured by them that are acquainted with the Frame and Fabrick of Man in his sound Constitution with the Nature and Properties of the Humors and Ferments in the Body that understand which they chiefly do by Analogy from what they have observed without Man how these are depraved and perverted What was the Occasion or Instrument Whereby certainly they may neerly conjecture what is most fit to oppose the cause of these Irregularities and to remove their Effects This is no new Notion it having been the perswasion of former and later Ages That the Physician is to begin where the Philosopher ends And that the Physicians have made great advantages of Experiments and Observations is most evident from their own confession but chiefly manifested in many of those Noble productions of their Brains which will perpetuate their Names and oblige all Mankind that shall succeed them Of how great use was that admirable Invention of Harvie's concerning the Blood 's Circulation and What great advantages may we derive from the Inventions of Pecquet Glisson Ent Wharton Bartholine Willis Needham Lower and other excellent Anatomists Some have gained to themselves immortal Renown by their voluminous yet judicious Histories of Plants Animals and Minerals and indeed Natural History and Philosophy have been scarcely cultivated by any besides Physicians who were so considerable that the deservedly admired Des-Cartes not long before his death was deeply engaged in the study of Anatomy Chymistry and other appendices of Medicine designing all his Philosophical toyl only for the good and benefit of Man intending to imploy his later time in the investigation of the Nature of Diseases and their Cures Neither did a high Birth and Quality an Excellent Education a plentiful Estate and great Reputation dispose that Noble Experimental Philosopher Mr. Boyle to think himself above the Profession of Physick which cannot be questioned after he hath given so publique a testimony as the accepting a degree therein freely proffered him by one of the most Famous Universities in Europe whose expectations he hath not deceived having ever since applied himself to improve that
Diseases and that may perhaps in some measure gratifie their petulant Fancy at a cheaper rate by spoiling a part than hazarding the whole which is now their daily practice 3. It is no inconsiderable part of a Physician 's Office to know when nothing is to be done but the whole matter committed to Nature the Physician supervising and taking care to correct all Nature's aberrations and if there be occasion to give her some little assistance For Diseases seize on many in whom Nature is so strong that after some conflicts the Aggressor is expelled without any assistance from Physick according to the Aphorism of Hippocrates Naturae sunt morborum Medicatrices Whereas should a Physician in these cases administer any active Medicines or make use of other pretended helps suppose Phlebotomy unless by his great Sagacity or the obviousness of the Distempers cause he applyes a Remedy very sutable for which there is yet little occasion We cannot imagine otherwise than that Nature being weakened by evacuations or diverted from her usual Methods by Medicines which if not appropriated will rather disorder or debilitate than bring relief in the interim the distempers will proceed by insensible degrees and at length may become so powerful that Nature with the help of the most generous Remedies cannot prevail where if She had not been unseasonably weakened or diverted She would have obtained an easy Victory As for Example there is a well-known Disease wherewith Children are as frequently afflicted as by Agues or the Rickets which soone deprives the poore Infants of their colour makes them lose their appetite they sleep little and that unquietly they will be exceeding Thirsty Froward or Peevish and seem to have greivous sick or fainting fits and after they have long laboured under this distemper they have usually great swellings or hardness of the Belly and are so emaciated that they seem not much unlike to little Skeletons and yet notwithstanding all these threatning Symptoms I have seldome if ever known Children miscarry who were forbidden the use of Physick till freed from most of them for they vanish of themselves and then gently purged for a few dayes successively they not only recovered their former health but have often given me occasion to dispute with my self whether they were not rather better than worse for the distemper thus managed Whereas on the contrary others that have been disordered and weakened by evacuations Cordials or fuges appointed by the Apothecaries or other unskilfull practicioners who are very ready to prescribe and Impose Physick on these occasions although to appearance they are freed from their troublesome companion yet withall soon after many exchange this life for a better and those that survive are usually weakly more subject to Rickets Convulsions and other Distempers than those in whom the Disease was permitted quietly to take its course without interruption The same hath also been observed in elder Persons labouring under Quartain Agues Neither is it without a great deal of trouble that Physicians observe so many miscary of acute simple Feavers who committing themselves to the care of Apothecaries and rather unskilful pretenders to Medicine often receive dispatches out of this World by Food or Physick preposterously administered rather than from their Distemper which will appear evident to them who consider that a Feaver is usually Natures Instrument or an Ebullition of the Blood caused by the Vital Principle in order to the expelling of some substance mixt with the Blood or other Humors in the Body whose presence perverts Natures regular actions and thereupon is opposed by those active parts through whose mediation She performes her operations Now in most of those conflicts Nature would be victorious subdue or expel her intestine Enemy if She were recruited sparingly with the liquid part of Her ordinary and daily supply and be not diverted by gross Food whose digestion while the Spirits attend the Morbous matter exceeding the remainder in quantity or energy may gain great advantages either by vitiating the Organs or by reducing the Humors to their own Nature by a depraved Ferment and the Stomach wanting Spirits copious enough to assist it in digesting the Food dismisses it crude or being it self disaffected imparts thereto some noxious qualities which are again communicated to the Blood whose impurities it thereby encreases extreamly hazarding and sometimes over-powring the Principle of Life The same happens by Medicines unsutable to the Distemper or unseasonably exhibited as if in the height of a Feaver one should advise to hot Medicines whereby more Fuel is added to the Fire and the Disease rendered more formidable and difficult of cure than ever or if in the declination of the same Distemper when the Patient should be supported by Cordials and relieved by Opiates whereby the Crisis or separation of the peccant matter is most certainly and easily affected if instead of these refrigerating Medicines Juleps Clysters or other Coolers which weaken the Blood depress the Spirits and disable Nature for her intended separation whereby the Distemper runs into a Diuturnity and if Life chance to be secured for the present howsoever the Patient continues weak and without great regularity or exact observation of Diet Exercise and the other Non-Naturals will become subiect to some Chronical Distempers whether Consumption Scorbute Dropsie Jaundice Scyrrhus Tumors or Ulcers which frequently succeed acute diseases ill managed and are seldome perfectly removed at least not by the Apothecaries who were the occasion of these and are daily of many other Miscarriages when they are consulted about Persons who would recover without the use of any or with the help of little Physick But as it is above their skill to know what Persons are thus affected so it is contrary to their Interest to manage them aright and therefore they neither can nor will do it That they cannot the faithful Character or Description we have given of them will render sufficiently probable That they will not may be easily believed if we consider that this way of proceeding would diminish their Profit which they do by no means approve but will rather charitably obtrude store of Physick on all their Patients and that sometimes so much to their prejudice that they had better hire them at a dearer rate to be less officious 4. Oftentimes persons seem to labour under several Diseases when as really the whole Tragedy is acted by the same peccant matter which is either translated from one part to another and affecting them after different manners the Symptoms are various and their Denominations different or from differences in Age Sex previous habit of body Complexion or Constitution Strength of the Patient Season of the year and other circumstances Matter which hath the same Nature and Properties may diversly affect the Persons thus discriminated also according to Quantity and Degrees in the same Qualities it may diversly affect the body and thereby occasion different Symptoms which to the Unwary or Unskilful seem distinct Diseases when
as it is but one and the same matter variously displaying it self and which may be removed or otherwise disposed of by one and the same Method or Medicine Thus for instance a great number of Diseases are caused by the redundance of Acidities which acid noxious juyce being mortified all those troublesome effects of its presence cease Many Diseases there are which proceed from the obstruction of some part such are Apoplexy's Lethargy's Carus Catalepsia Gutta Serena Palsy's c. Now those Methods and Medicines which will cure the most obstinate and dangerous of these will seldom fail to remove the rest The same happens in Convulsions Epilepsy Madness Hysterical and Hypochondriacal Passions Vertiginous Affections and Melancholy c. We also daily observe that many violent Fluxes wherein the blood or other humours have the same cause and cure all which proceed mostly from sharpness thinness or heat of the blood are removed by Medicines answering the Indications of cooling dulcifying or incrassating Some of the Diseases thus cured are immoderate Fluxes in Women spitting and vomiting of blood Periodical or other copious Evacuations thereof at the Nose Haemorrhoids with the Urine or by Stool in the Flux commonly called Hepaticas and Dysenteries to which we may add several sorts of Diarrhea's fluor albus incontinentia Urinae much Spitting Weeping Coryza and Rheumes of divers kinds Further most simple continued and intermittent Feavours have very nearly the same way of Cure although the Body seems diversly affected by them an evident Argument that their causes are little different We might instance in Colical and Iliack pains and many other torments in the Stomach and Bowels which seem to have their rise from the same Causes and have almost the same Cure Nay to proceed still higher What Analogy doth there seem to be between the Palsie and the Colick yet this often degenerates into that which also many other Diseases do whereof I could give a large account but shall refer it to a more convenient Opportunity We might proceed to shew how great an affinity there is between many outward affections in their Causes and Cures But because the care of such Diseases is denied by some to belong to Physicians and because the Apothecaries do scarcely ever intermeddle with the Chyrurgeons imployment which yet it is much less intricate then the Physicians I shall pass over this Ponsideration Thus we have given a superficial account of those opportunities judicious Physicians have to discriminate themselves from ignorant pretenders by their discerning with great Celerity and Sagacity how to act where all these are allwayes grievously perplexed and often perfectly confounded as is manifest in their wayes of proceeding which are usually so ridiculous and Irrational that they would give intelligent Physicians a full and pleasant Divertisement if they could Indulge themselves therein which they can by no means do where their Errours and Miscarriages are so far from Innocent that they do often exceedingly hazard and sometimes occasion the Misery or Destruction of the unhappy credulous Patient Which sad accidents dispose those generous Physicians they neglected rather to Pitty and Compassion than to disport themselves or look with Malicious Smiles on misfortunes which they in some measure deserved for being guilty of so egregious a piece of folly as committing themselves to Ignorant and Unskilful Practiciooners altogether unfit for so great a trust And indeed it will excite Admiration in any judicious Person to observe what a Wild-Goose-Chase they go in most of the Cases we lately mentioned sometimes applying a Remedy they have learned is proper for the Head-ach then another for the Tooth Stomach or Heart-ach Gripes Flux heats in the Head and burning in the habit of the Body Vartigo Asthma and other semblances of Distempers which one and the same matter will often occasion Now the Sagacious Physician soon detests this Cheat and immediately by a stroke or two at the root intercepts the depraved Nourishment so that all the other ill effects cease with the removal of their cause whereas should he only attend to every particular symptome as the less discerning do there would be no end either of Physick or the Disease which 't is very probable will receive a great aggravation by so many improper Remedies For Physick is or ought to be active and if not appropriated to the distemper it must necessarily work an effect contrary to that for which it was designed so that if it do not abate of the Disease 't is more than likely to exasperate it if it do not strengthen Nature actually or consequentially I mean by removing Impediments it will certainly weaken Her V. It seems most evident That many Diseases may be Cured by a convenient Diet. AND if this be so great a truth as Physitians have hitherto generally esteemed it to be then he that is acquainted with the Nature of Aliments and the Process of Nutrition will probably cure Diseases with greater certainty and less trouble to the Patient than him that is utterly ignorant of both these And who is more like to be a Possessor of this knowledge than a judicious learned Physitian For 1. He understands the Nature of Aliments whether Animal or Vegetable he knows that such among them as are most temperate and have no sensible Operation are more agreeable to the body and nourish more than others which abound with active parts whose Purging Vomitive Sweating Diuretick or other Qualities render them unfit for Nutrition As also that most if not all things that are used for food although they be not active in so high a degree as others which come commonly in use for Medicine that yet they often cause great alterations in the body according to the quantity quality right or unsutable application thereof and find that the Cause and Cure of many if not most Diseases have their dependance on a good and regular or a bad inordinate Diet. But this will be made more evident by descending to particulars I think nothing can be more plain and evident than that Onions Shalutes Horse-radish Capers Olives Broom-buds Pepper Cinnamon Nutmegs Salt Sugar Butter Vinegar Wine and Oyl are active alterative substances and yet they are often taken alone or variously compounded to make savory picquant Sauces which are supposed to promote digestion by rendring the food more grateful and by strengthning the ferment of the stomach But besides these there are many Vegetables which come frequently in use among all people and in some Countres with Bread Cheese and Milk are almost their only food such are Melons Pompions Cucumbers as also Turneps Carrots Parsnips Skirrets Radishes Pease Beans Artichocks and other Thistles Asparagus Hop-tops Cabbages Coleworts Cauleflowers Comfry Lettuce Purslain Parsly Sage Leeks c. not to mention various kinds of fruits These are either boyled or eaten crude alone or variously compounded according to pleasure being rendred more grateful or as is thought wholesome by the addition of Butter Vineger Pepper or other of