Before we set out for Naples, we were refreshed, at a little inn at the bottom of the mountain, with some glasses of a very generous and palatable wine, called Lachrima Christi; and experienced the truth of what an Italian poet observed, that the effects of this wine form a strong contrast with its name. Chi fu, de contadini il più indiscreto, Che à sbigottir la gente, Diede nome dolente, Al vin, che sopra ogn' altro il cuor fà lieto ? LETTER LXIII. Naples. Your account of our friend's state of health gives me much concern; the more, as I cannot approve the change he has made of a physician. You say, the doctor, under whose care he is at present, has employed his mind so entirely in medical researches, that he scarcely displays a grain of common sense when the conversation turns on any other subject; and that, although he seems opinionative, vain, and ostentatious in his profession, and full of false and absurd ideas in the common affairs of life, yet he is a very able physician, and has performed many wonderful cures. Be assured, my dear sir, that this is impossible; for medical skill is not like the rod of an enchanter, which may be found accidentally, and which transfers its miraculous powers indiscriminately to a blockhead or a man of sense. The number of weak, gossipping men, who have made fortunes by this profession, do not prove the contrary. I do not say that men of that kind cannot make fortunes; I only assert they are not the most likely to cure diseases. An interest with apothecaries, nurses, and a few talkative old ladies, will en What inconsiderate fellow, to terrify people, could first give the mournful name of tears to that wine, which, above all others, renders the heart glad, and excites cheerfulness? able them to do the first; but a clear understanding, and a considerable share of natural sagacity, are qualities essentially necessary for the second, and for every business which requires reflection. Without these, false inferences will be drawn from experience itself; and learning will tend to confirm a man in his errors, and to render him more completely a coxcomb. The profession of physic is that, of all others, in which the generality of mankind have the fewest lights, by which they can discern the abilities of its professors; because the studies which lead to it are more out of the road of usual education, and the practice more enveloped in technical terms and hieroglyphical signs. But I imagine the safest criterion by which men, who have not been bred to that profession, can form a judgment of those who have, is, the degree of sagacity and penetration they discover on ✔subjects equally open to mankind in general, and which ought to be understood by all who live in society. You do not mention particularly what has been prescribed by either; only that the former physician seemed to rely almost entirely on exercise and regimen, whereas the present flatters our friend with a speedy cure, by the help of the pectoral and balsamic medicines which he orders in such abundance, and which he declares are so efficacious in pulmonary consumptions. Having lamented with you the mournful events which render the name of that disease peculiarly alarming to you, and knowing your friendly solicitude about Mr. I do not wonder at your earnest desire to know something of the nature of a distemper with which he is threatened, and which has proved fatal to so many of our friends. But I am surprised that you have not chosen a more enlightened instructor, when you have so many around you. Though conscious that I have no just claim to all the obliging expressions which your partiality to my opinions has prompted you to make use of, yet I am too much flattered by some of them, to refuse complying with your request. My sentiments, such as they are, will at least have the merit of being clearly understood. I shall observe your prohibition, not to refer you to any medical book and shall carefully avoid all technical terms which you so much abominate. With regard to your shewing my letter to any of the faculty; if you find yourself so inclined, I have not the smallest objection: for those who have the greatest knowledge in their profession, are best acquainted with its uncertainty, and most indulgent to the mistakes or errors of others. Alas, my friend! how is it possible that physicians should avoid mistakes? If the ablest mechanic were to attempt to remedy the irregular movements of a watch, while he remained ignorant of the structure and manner of acting of some of the principal springs, would he not be in danger of doing harm instead of good? Physicians are in the situation of such a mechanic; for, although it is evident that the nerves are the organs of motion and sensation, yet their structure is not known. Some anatomists assert they are impervious cords; others, that they are slender tubes, containing a fluid. But what the nature of this fluid is; whether it serves only to nourish the nerves themselves, or is the medium by which they convey feeling and the power of motion to other parts, is not ascertained even by those who argue for its existence; far less is it explained in what manner ideas, formed within the brain, can, by the means of solid cords, or by a fluid contained in tubes, communicate motion at pleasure to the legs and arms. We are ignorant why the will, which has no influence over the motion of an animal's heart, should find the feet obedient to her dictates; and we can no more explain how a man can move one leg over the other by volition, or the mere act of willing, than how he could, by the same means, move Ossa on the top of Olympus. The one happens every moment, the other would be considered as a miracle; but they are equally unaccountable. While parts so infinitely essential to life are not understood, instead of being surprised that so many diseases baffle the skill of the physician, we have more reason to be astonished that any can be alleviated or cured by his art. The pen of the satirist, no doubt, may be fairly aimed against the presumption and ignorance of many individu als of this, as of every other profession; but cannot with justice be directed against the art itself: since, in spite of the obscurity which still involves some parts of the animal economy, many disorders are relieved, and some of the severest and most disagreeable to which the human body is liable, are cured with certainty by the art of medicine. Unfortunately for mankind, and in a particular manner for the inhabitants of Great Britain, the pulmonary consumption is not of the number. This disease may originate from various causes. 1st, An external bruise or wound. 2d, The disease called pleurisy, including in that term an inflammation of the lungs themselves, as well as the membrane which covers them. 3d, The bursting of some of the blood-vessels of the lungs, independent of external injury, and owing to a faulty conformation of the chest, and the slenderness of the vessels. 4th, Certain small tumours, called tubercles, in the lungs. The first cause I have mentioned is an external bruise or wound. An accident of that kind happening to the lungs, is more dangerous and difficult to cure, than when the same takes place in most other parts of the body; because the lungs are vital organs, essentially necessary to life, and when their motion is impaired, other animal functions are thereby injured; because they are of an uncommonly delicate texture, in which a rupture having once taken place, will be apt to increase; because they are in constant motion and exposed to the access of external air, both of which circumstances are unfavourable to the healing of wounds, and because the mass of blood distributed to the whole body passes previously through the lungs, and consequently the blood-vessels of this organ are more numerous than those of any other part of the body. When we consider these peculiarities, it is natural to conclude, that every wound of the lungs must necessarily prove mortal; but experience has taught the contrary. Many wounds of the lungs heal of themselves, by what is called the first intention. The physician may prevent a fever, by ordering the patient to lose blood in proper quantities, and he may regulate the diet; but the cure must be left to nature, which she will perform with greater certainty, if she is not disturbed by any of those balsams which the wounded are sometimes directed to swallow on such occasions. But when the wound, either from injudicious treatment, or from its size, or from the bad habit of the patient, degenerates into an ulcer attended with hectic symptoms, the disease must be treated as if it had arisen from any of the other causes. The pleurisy, or inflammation of the lungs, is a disease more frequent in cold countries than in mild; in the spring than in the other seasons; and more apt to seize people of a sanguine constitution than others. Plentiful and repeated bleedings, fomentations, blisters near the affected part, and a cooling, diluting regimen, generally remove it, without its leaving any bad consequence. Sometimes, by the omission of bleeding in due quantity at the beginning, and sometimes in spite of all possible care, it terminates in an abscess, which, on bursting, may suffocate the patient; or, if the matter is coughed up, becomes an open ulcer, and produces the disease in question. The third cause of the pulmonary consumption above mentioned, is, a spitting of blood, from the bursting of vessels of the lungs, independent of external wound or bruise. People of a fair complexion, delicate skin, slender make, long neck, and narrow chest, are more subject to this than others. Those who have a predisposition to this complaint, by their form, are most apt to be attacked |