Fallacies of the faculty, with the principles of the chrono-thermal system of medicine : in a series of lectures originally delivered in 1840, at the Egyptian Hall, Piccadilly / by S. Dickson.

  • Dickson, Samuel, 1802-1869.
Date:
1843
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Licence: Public Domain Mark

Credit: Fallacies of the faculty, with the principles of the chrono-thermal system of medicine : in a series of lectures originally delivered in 1840, at the Egyptian Hall, Piccadilly / by S. Dickson. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    meaning that nobody shall persuade you that it is in itself anything but a piece of hypothetical gib- berish, invented by men who knew as little of Disease and its nature as the tyros they pre- tended to illuminate. When a lady or gentle- man of a certain age complains to you of a jjainful swelling in some of the small joints of the hand or foot, you may say, if you please, that such patient has got the Gout. If the same kind of swelling should appear in the knee or Aip-joint, or take the shape of an en- larged gland or a rubicund nose, you must then change your phrase; and you may easily exhaust a volume in pointing out the dif- ferences betwixt them. But as neither this kind of disquisition, nor the baptizing your patient’s disease by one name or another, can in the very least help you to cure it, I may just as w^ell explain to you that this swelling, like every other malady incident to man, is not only a development of constitutional disease, but comes on in Jits or paroxysms. Now, Gentlemen, you will find this fit in one case perfectly periodic and regular in its recurrence; in another less determinate as to the time of its approach. The result of repeated paroxysms, as in other diseases where great heat and swel- ling take place, must be a tendency to de- composition, and in this instance, the product for the most part is a deposit of chalky or earthy matter. In that case nobody will dispute the name you have given to the dis- order; but should the result of the decompos- ing action be purulent matter or ichor, instead of chalk or earth,—which neither you nor anybody else can know beforehand,—you must not be astonished if a rival practitioner be called in to give the disease another soubriquet, —to christen it anew by some other phonic combination full as indefinite as the first, and which may thus serve you both to dispute about very ^prettily from one end of the year to the other, without either of you becoming a whit the wiser! You see, then, that the only differ- ence betwixt what is called “ Gout,” and what is called “ Inflammation,” is, that the result of the morbid action in the former case, is earthy instead of purulent deposit, a solid instead of a Jliiid product. Now, this difference may be ac- counted for, partly by hereditary predisposi- tion, and partly by the age of the respective subjects of each. Young plants contain more sap than old ones; the diseases of both must therefore in some points vary; for though in the blood of the old or middle-aged man we find the same elemental principles as that of infancy and youth,, from these being in differ- ent proportions, the results of decomposition must, mutatis mutandis, be different. What are the Causes qf Gout? One writer says one thing; another, another. Dr Holland, Phy- sician Extraordinary to the Queen, is among the latest who has written upon the subject, and he says the cause is “ a morbid ingredient in the blood;”—nay, he says, “ it cannot be de- nied.” Still, not only do I presume to dispute the dictum, but I challenge him to bring forward a tittle of proof in support of it. His whole doc- trine of Gout, I apprehend, is a fallacy; for if you enquire, the patient wdll tell you that he took too much Wme the night before his first fit; or that he had got Wet; or had been ex- posed to the East Wind; or had been Vexed by some domestic matter From which you see, the causes of Gout are any thing and every thing that may set up any other disease,—Small- pox and the other Contagious Fevers of course excepted. A paroxysm of Gout has been ac- tually brought on by Loss of Blood and also by a Purge, for which statement, if you will not be- lieve me, you may take the authority of Parr and Darwin. What, then, is the remedy? If you ask me for a Specific, I must again re- mind you there is no such thing in physic; and what is more, the man who understands his profession would never dream of seeking a spe- cific for any disorder whatever. No, the reme- dies for Gout are the same as cure other dis- eases; namely, attention to temperature during the Fit, and the exhibition of the chrono-ther- mal or ague medicines during the Reinissioiv; —for we have seen that, like the ague, it is a periodic disorder, and such is the description of it given by Sydenham, who was half his life a martyr to it,—to say nothing of Dr Samuel Johnson’s explanation in his dictionary. That it comes on like the ague with cold shiverings, the experience of almost every case will tell you; but as your minds may be too much oc- cupied with school theories to mark that fact for yourselves, I will give it to you in black and white in the words of Darwin. Speaking