Читать книгу The Æsculapian Labyrinth Explored; Or, Medical Mystery Illustrated - William Taplin - Страница 5

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Having passed the tedious years of abstruse study and intense application, necessary to your initiation in the mysteries of physic, and replete with a perfect remembrance of all the requisites to this great art, we suppose you recently emerged from the obscurity of dreary walls and dull professors, a phenomænon of universal knowledge and family admiration. The various and elaborate examinations you have passed, with scholastic approbation, having relieved you from the constantly accumulating load of anxiety, you are at length launched into life under a new character, and daily pant to display the dignity of your profession, in the happy appendage of M. D. to the prescriptive initials of your name.

You are no longer to be considered a student labouring in the heavy trammels of unintelligible lectures upon philosophy, anatomy, botany, chemistry, and the materia medica, with all their distinct and consequent advantages; or investigating the actual properties of electrical fire and MAGNETIC ENTHUSIASM, but stamped (by royal authority) with the full force of physical agency, and have derived from your merit unlimited permission to cure, “kill or destroy,” to the best of your knowledge and abilities, “so help you “God.” The professional path you now begin to tread, is so replete with danger, and the probability of success so very uncertain, that the fertile world have not omitted to make it proverbial, “A physician never begins to get bread, till he has no “teeth to eat it.” The truth of this may perhaps have been lamentingly acknowledged by some of the most learned men that ever became dependant upon a capricious world for precarious subsistance.

This palpable fact may concisely serve to convince you, your embarkation (with all its alluring prospects) will not only be encumbered with difficulties, but your ultimate gratification of success exceedingly doubtful. Great depth of learning may afford consolation to the equity of your own feelings (if you fortunately possess them) but it is by no means necessary to the acquisition of public opinion, however it may tend to contribute to the general good.

To avoid entering into a sentimental disquisition upon the honesty, integrity, or strict propriety of the maxims I proceed to lay down for your future conduct to obtain professional splendour, and insure success; I avail myself of the privilege I possess, to wave every consideration of the conscientious kind, and once more observe (without adverting to their consistency) they are adduced only as the unavoidable traits of character, and modes of behaviour, by which alone (in the present age) you can possibly hope for the least proportional share of practice as a physician.

At your first public entré, when the college list and court calendar have announced your qualifications and advancement to the wondering world (that such list should annually increase) let your friends and relatives be doubly assiduous in propagating reports (almost incredible) of your great humanity, extensive abilities, and unbounded benevolence.—This will answer the intended purpose to a certainty; crouds of the afflicted and necessitous will surround your habitation, and render your place of residence constantly remarkable to all classes, who naturally enquiring the character of the proprietor, will eagerly extol your charity in contributing your “advice to the poor GRATIS.”

This method alone will gain you popularity with those that rank in the line of mediocrity; with their superiors, success must be insured more from the efforts of interest, than either personal merit, or sound policy. Your attention to the wants of the poor, must soon be regulated by the preponderation of more weighty considerations; as you affected to alleviate their distresses from the motive of commiseration, prompting you to promote their ease, you have an undoubted right to shake off such superfluous visits, to secure your own. In this deceptive charity, some degree of discrimination must be put in practice, for you will sometimes perceive one among the train, whose apparel or behaviour must necessarily give you reason to suspect he has assumed the cloak of necessity to save his fee, and avail himself of your professional liberality in such case, call to your aid a look of true medical austerity, and let him understand “advice is seldom of any value or “effect unless it is paid for;” this will frequently answer the purpose, and procure what you did not expect.

On the contrary, so soon as you observe your prescriptions have “worked wonders” upon two or three of the most credulous and superstitious, who are extolling your great knowledge and “blessing your honour,” strengthen the force of your judgment by charitably obtruding a pecuniary corroboration into the hand of your afflicted patient, as a confirmation of your unbounded skill in the (miraculous) cure of every disease to which the human frame is incident. By such political practice, you insure the recital of your services with extacy, and your name reverberates from one end of the metropolis to the other.

Your person and place of residence, being by these means universally known, and your name become in a proportional degree popular, let your plan and mode of behaviour be instantly changed; it will be now necessary

“You “assume a” hurry “if you have it not,”

Take care to be so exceedingly engaged with patients of the first class and eminence, that “it is with difficulty you procure time sufficient for the common purposes and gratifications of nature.” No paupers whatever can be admitted to your presence without a written recommendation from nobility, or characters of the first fortune; this will insure you no farther intrusion from a class originally introduced for your particular purpose; that effected, they may now be permitted to fall into the back ground of the picture; from whence they were brought for no other motive than the promotion of your personal interest and professional emolument.

It becomes your particular care to be always in a hurry; let your chariot (if you can fortunately raise one) upon job, be at the door regularly by nine in the morning; to prove how very much you are attached to the duties of your profession, and how anxiously you have the salubrity of your patients at heart.—Omit no one circumstance that can contribute to a shew of being perpetually engaged. Letters written by yourself, and messengers of your own dispatching, cannot be seen at your doors too frequently; the chariot should be as repeatedly ordered—remember to leave home by one way, and return by another, and equally in haste; all these stratagems are considered peculiar privileges of the College of Wigs, and are well worthy your attention and constant practice. You need hardly be told, the superficial and unthinking part of mankind are ever caught by appearances; what proportion they bear to other distinctions, need not in the present instance be at all ascertained.

Having laid down rules (that should be rigidly persevered in) for the regulation of your public character, I shall now advert to the strict line of conduct it will be proper for you to adopt in your personal transactions upon all professional emergencies.

When called to a patient upon the recommendation of the family apothecary, you are to consider him one of your best friends, and pay court to him accordingly; on the contrary, if you are engaged upon the spontaneous opinion of the patient, or his relatives, you have every reason to conclude the abilities of the apothecary are held in very slender estimation, and you may safely venture to display as much of your own consequence and superiority, as circumstances will admit.

After the awkward ceremony of your first appearance is over, and matters a little adjusted, take great care to be upon your guard; indulge in a variety of significant gestures, and emphatical hems!—and hahs! proving you possessed of singularities, that may tend to excite ideas in the patient and surrounding friends, that a physician is a superior part of the creation.——Let every action, every word, every look, be strongly marked, denoting doubt and ambiguity; proceed to the necessary enquiries of “what has been done in rule and regimen, previous to your being called in?” hear the recital with patience, and give your nod of assent, lest you make Mr. Emetic, the apothecary, your formidable enemy, who will then most conscientiously omit to recommend the assistance of such extraordinary abilities on any future occasion.—Take care to look wisdom in every feature; speak but little, and let it be impossible that little should be understood; let every hint, every shrug be carefully calculated to give the hearers a wonderful opinion of your learning and experience.—In your half-heard and mysterious conversation with your medical inferior, do not forget to drop a few observations upon—“the animal œconomy”—“circulation of the blood”—“acrimony”—“the non naturals”—“stricture upon the parts”—“acute pain”—“inflammatory heat”—“nervous irritability,” and all those technical traps that fascinate the hearers, and render the patient yours ad libitum.

To the friends or relatives of the diseased, (as the case may be) you seriously apprehend great danger; but such apprehension is not without its portion of hope; and you doubt not, but a rigid perseverance in the plan you shall prescribe, will reconcile all difficulties in a few days, and restore the patient (whose recovery you have exceedingly at heart) to his health and friends; that you will embrace the earliest opportunity to see him again, most probably at such an hour, (naming it) in the mean time you are in a great degree happy to leave him in such good hands as Mr. Emetic, to whom you shall give every necessary direction, and upon whose integrity and punctuality you can implicitly rely.

You then require a private apartment for your necessary consultation and plan of joint depredation upon the pecuniary property of your unfortunate invalid, which you are now going seriously to attack with the full force of physic and finesse. You first learn from your informant what has been hitherto done without effect, and determine accordingly how to proceed; but in this, great respect must be paid to the temper, as well as the constitution and circumstances, of your intended prey; if he be of a petulant and refractory disposition, submitting to medical dictation upon absolute compulsion, as a professed enemy to physic and the faculty, let your harvest be short, and complete as possible. On the contrary, should a hypochondriac be your subject, with the long train of melancholic doubts, fears, hopes, and despondencies, avail yourself of the faith implicitly placed in you, and regulate your proceedings by the force of his imagination; let your prescription (by its length and variety) reward your jackall for his present attention and future services.—Take care to furnish the frame so amply with physic, that food may be unnecessary; let every hour (or two) have its destined appropriation—render all possible forms of the materia medica subservient to the general good—draughts—powders—drops, and pills, may be given (at least) every two hours; intervening apozems, or decoctions, may have their utility; if no other advantage is to be expected, one good will be clearly ascertained, the convenience of having the nurse kept constantly awake, and if one medicine is not productive of success, another may. These are surely alternatives well worthy your attention, being admirably calculated for the promotion of your patient’s cure and your own reputation.

Having written your long prescription, and learnt from Mr. Emetic every necessary information, you return to the room of your patient, to prove your attention, and renew your admonitions of punctuality and submission;—then receiving your fee with a consequential air of indifference, you take your leave; not omitting to drop an additional assurance, that “you shall not be remiss in your attendance.” These, Sir, are the instructions you must steadily pursue, if you possess an ardent desire to become eminent in your profession—opulent in your circumstances—formidable to your competitors, or a valuable practitioner to the Company of Apothecaries, from whom you are to expect the foundation of support. A multiplicity of additional hints might be added for your minute observance; but such a variety will present themselves in the course of practice, that a retrospective view of diurnal occurrences will sufficiently furnish you with every possible information for your future progress; regulating your behaviour, by the rank of your patients, from the most pompous personal ostentation, to the meanest and most contemptible servility.