The good Samaritan; or, Sick man's friend... intended as a pocket companian, for Thomsonians, and all others who would wish to prevent, or cure their own diseases

Front matter

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Chapter I. On Medicine

The great, the good, the highly gifted, and much persecuted Dr. Samuel Thomson, was the first who submitted to the world, the self-evident proposition, that food and medicine must harmonize with each other — that they often grow in the same field, and may be gathered by the same hand. And indeed, common sense might teach us, that there must be a perfect correspondency and congruity between food and medicine, as both are intended alike to have a beneficial and healthy influence on the system — the one to continue a healthy action, the other to restore that action when lost.

The learned Dr. S. Robinson says of medical poisons, " It would seem a solecism in language, the bare combination of these terms, but such is the fact — poisons, the most violent and destructive, have been denominated the most valuable medicines." Indeed it is a sorrowful truth, that the most active and potent articles used by the medical faculty as medicines, and upon which they place their principal reliance, are known and acknowledged to be in an eminent degree destructive to life, and subversive of the very laws which they are intended to promote. How absurd 2 17 then it must appear to every enlightened mind, when the living power is weakened — the vital spark nearly extinguished, and all the organs in an impaired state, to administer such articles as are known to produce the same effects upon the healthy system, and which must, in disease, increase the very disorders they are intended to counteract !

A correct knowledge of proper medicinal substances can only be learned from experience and a close observation of nature. The opportunities for drawing lessons of instruction from both these sources, and the qualifications for profiting thereby, were eminently enjoyed by Dr. Thomson; and unborn millions will yet have cause to bless that providence which raised him up and sustained him in a most arduous struggle to establish his system of medical practice in the world. When his enemies and persecutors shall have been long mouldered into dust, and their names and memories eternally forgotten, the name of Samuel Thomson shall "stand as a splendid beacon on the solitudes of time, to point the traveller the road to glory."

It is not denied that the vegetable kingdom furnishes some of the most active and fatal poisons with which we are acquainted ; but this fact, instead of arguing, as some have urged, against the propriety of drawing upon that kingdom for our remedial agents, furnishes the strongest evidence in favour of it. Nothing but vegetable matter, or the product of it, can be assimilated ; that is, made to answer the purpose of nourishment. It inherently possesses an active principle by which it produces its effects, whether good or bad ; and if it furnishes the most active poisons, it should also, by analogical reasoning, yield the most active medicines. Dr. Coxe has observed in relation to Antimony, (and his remarks are applicable to all the metals,) that, " All the metallic preparations are uncertain, as it depends entirely upon the state of the stomach, whether they have no action at all, or operate with dangerous violence." But this cannot be said of vegetables, because they possess a principle in themselves, by which they are always capable of producing an effect upon the system. And no instance, perhaps, has ever been recorded, in which the application of vegetables, whether as medicines or poisons, did not produce their peculiar and specific effects, unless they were impaired by age or from other causes.

We again repeat, that the vegetable kingdom furnishes, either directly or indirectly, all our food ; and why not all our medicine] Or did a Beneficent Creator place the means of sustaining our bodies in health, upon the surface of the earth within our immediate grasp, and the means of restoring our health when sick, within its bowels 1 Impossible ! The goodness of Deity could not do this — could not suffer this ! So it follows, that whether we consult the nature of man, of disease, or of Deity, the evidence and the result are irresistible, that the vegetable kingdom alone furnishes the proper remedies for relieving our maladies.

What then becomes of the boasted discoveries and remedies of the famous Paracelsus, who first applied chymistry to develope the remedial resources of the mineral kingdom? He, to be sure, is now denounced as a miserable quack ; but it cannot be denied that he was the author of Medical Chymistry, the value and success of which is now so highly appreciated by the Medical Faculty. And what is the result of all the pretended improvements of mineral preparations which have been so perseveringly studied since the days of this famous Paracelsus] Nothing but refinements in error ; improvements of the means which have, from that day to this, inflicted innumerable woes on the human family ; and retarded and interrupted the march of true medical science. As we do not wish our readers to take our bare word for the truth of these assertions, we will refer them to the most approved standard works on medicine ; so that if they will persist in using such violent poisons, as quicksilver, opium, nitre, nightshade, hemlock, foxglove, arsenic, antimony, &c. &c, they may be apprised of the dreadful results which these deleterious articles often produce on the human system — results which no respectable physician will or dare deny. And how it ever enters the minds of benevolent physicians, that such articles as we are about turning our attention to, could be useful as medicines, is beyond conception, and affords but an additional example of the proneness of the human heart to err in despite of reason and common sense. (£j* See Appendix.

Chapter II

Remarks on blood-letting by Professor Terry, and Dr. Lobstein, showing the inconsistency and barbarity of such an inhuman practice.

ON BLOOD-LETTING.

BY DR. D. L. TERRY.

Can the practice of bleeding, for the cure of general and local fevers be sustained upon the testimony of correct pathology, sound physiology, careful obser-

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vation, and true experience 1 In order that a person may be qualified to give a correct decision in regard to the merits of this question, it is indispensable that he conceive just notions of fever himself; that he have a true knowledge of the nature of disease, of the general doctrine of life, and of the nature and uses of the blood ; that he mark well what he sees and feels of disease, and that he be not one of those, who are determined to be ignorant in spite of experience.

We have made some observations upon the nature and use of blood in the beginning of this essay, with which we believe every enlightened man will fully agree. Our theory or doctrine of disease, of fever, and inflammation, we have also given, with some of the evidences and authority for the same. These doctrines are in accordance with the best of our judgment and knowledge ; therefore, in forming our answer to the question at the beginning of this chapter, we shall apply the question to these doctrines as a test, and give our answer according to the result.

Any mode of practice in the treatment of fever, which harmonizes with true pathology, with physiology and experience, must be^egarded as good, according to our present state of knowledge ; if then, the practice of bleeding is not found to be so parallel with the steps of nature, in the cure of disease, as some other known and practicable means, then we must pronounce it bad.

We have said that there are many remote causes which may operate upon the human system, under certain circumstances, in such manner as to derange that regular performance of all the functions of the body ; which derangement brings on a preternatural I state of body, or, in other words, a diseased state. A I diseased state of body cannot long continue without giving rise to certain exertions of nature, which are commonly termed fever, and looked upon as real disease ; but which are called by Dr. Johnson, a salutary action, or an effort of the constitution, &c. ; by Mr. Hunter, a necessary action — a good symptom, &c. ; by Dr. Gregory, the operations of nature tending to the restoration of health, the steps of nature in curing disease, &c.

We stated that all the actions of the system (morbid or diseased actions excepted) are supported by the life'-giving stimulus of the blood. We have now arrived at the conclusion that disease is the immediate cause of fever — that fever is a necessary and salutary action, and that this action is supported by the blood. We must inquire into the immediate and subsequent effects of bleeding, to see whether they are such as may be desired in the removal of disease.

The immediate effect of the abstraction of blood, is debility or weakness. This is a fact which all experience proves; nor can it be successfully controverted. The secondary effect of bleeding, is a protracted recovery from disease ; also an increased susceptibility of the system to be affected by such causes as are calculated to produce disease.

The first of the above positions is based not only upon experience, but upon the physiological fact, that all the strength of the system is derived immediately and directly from the blood ; and hence, to pretend that a small quantity of blood may be abstracted without producing a proportionate degree of weakness, would be as good philosophy as to say that one grain of mustard-seed makes no part of the bushel ; or to say that the body contains one, two, or three pounds of blood more than is compatible or proper for its safety or health, is to say that nature performs works of supererogation, to interrupt her own laws. Such opinions would do but little honour to men of sense.

Bleeding reduces the force and frequency of the pulse ; that is, it diminishes the action of the heart and arteries, and thus reduces fever. Well, says one, if bleeding reduces the fever, it must be good. But stop, what is fever 1 Oil had forgotten that I read, in a former part of this book, that fever is a necessary and salutary effort of the constitution to relieve some oppressed organ, to restore some impeded function, to '-emove the disease. Well, then, bleeding is not good dimply because it reduces fever. But does not bleeding remove the blood which is most impure, and which is, consequently, a cause of disease 1

We are fully aware that many are honestly of this opinion, but wherever we find a physician holding out such an idea to the people, we are obliged to lay one of these things to his charge, viz : that he is unpardonably ignorant of the true knowledge of his profession, or else he is wilfully dishonest, or, in other words, is willing to sacrifice the health of his patient to his own interest. Foreign or extraneous matter is only mixed mechanically with the blood, not chymically combined with it. Where the secretory functions are suppressed, as that of the kidneys and skin, that matter or fluid which should have passed off, by these secretions, is retained, mixed with the general mass of the blood, and produces unusual irritation. The proper way to purify the blood in such case, seems to be the way which nature takes; that is, to restore the action of the skin, thus producing perspiration ; and the action of the kidneys, thereby separating more of the unhealthy particles from the blood.

Now we will suppose that there are twenty-eight pounds of blood in the body, and with this is mixed four pounds of impure fluid from retention. Now we take one pound of blood, and we remove but one twenty-eighth part of the morbid matter, at the same time taking away one twenty-eighth part of that strength, of which the patient may stand in the greatest need. But, says one, the doctor says, " it is the bad blood which he draws," and I think he is correct ; for, on watching the operation of bleeding, I have frequently noticed that when the blood first begins to flow, it is quite thick, and looks dark and clotted. All this may be true, and frequently is, as respects the appearance of the blood ; but let us look into the cause. It is customary, previous to opening a vein, to apply a ligature around the limb, between the point to be punctured and the heart, for the purpose of retarding the blood in the veins, and thus rendering the vein to be opened more conspicuous and prominent. — The blood contained in the veins on the side of the ligature more distant from the heart, by being obstructed, loses its colouring matter, by uniting with a larger quantity of the carbon of the animal substance; hence, it becomes darker, and, by its quiescence, partially coagulates, forming the. small clots before mentioned.

Therefore, when the blood begins to flow, upon the opening of the vein, it looks dark, &c. ; but after it has flowed sufficiently long to remove that portion which had been retarded by the ligature, it appears of a brighter red, no clots are discovered, and all conclude that the bad blood is all drawn off, and, consequently, it is time to stop. Yes ! we agree with them ; it is time to stop — to stop such absurdities, such imposition, and such sacrifice of life ! If the blood abstracted by venesection differs at all from the general mass of blood, we would be led, from certain circumstances, to believe that it is the better portion of the blood.

It is well known to physicians that, in many dis-

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eases, there are very frequent determinations and congestions of blood in different organs, as the brain, the lungs, the liver. &c. ; of course, the congested or stagnated blood ceases to give that stimulus and strength to the system which is usually imparted by this fluid. Then the only dependence which the constitution has for strength to support life and to make the necessary efforts to remove disease, must be solely derived from the circulating and vivifying blood ; it is the blood which is in active circulation (except the obstruction caused by the ligature) that is drawn by venesection ; hence, according to the reasoning above, it must be a portion of the blood of the better quality, that is drawn off by the lancet.

Though bleeding, when it is performed during increased action of the heart and arteries, invariably reduces this action for the time ; yet it is known to have a different effect if performed at the time when the action of the heart is below par, from the oppression of the general disease, concussion of the brain, suffocation from gases, Sec. In these cases, bleeding increases the action of the heart and arteries by accelerating the febrile action, or forwarding the process of a reaction. Well, then, says the believer in bleeding, you have established the propriety of blood-letting in this state of the system, upon your own principles ; for you say here, that bleeding increases the action of the heart and arteries, when performed under the above described circumstances; you say, also, that it accelerates the accession of febrile action, or forwards the process of reaction ; you have said that this febrile action or reaction is a necessary and salutary action or effort of the constitution, tending to the restoration of health ! Now, agreeably to all this, it seems to me that bleeding must be good ; for, if the fever is a salutary action, tending to remove disease, it cannot come on too soon ; when there is disease existing 4n the system, the sooner it commences, the sooner the restoration of health will be accomplished. Now we look upon this kind of reasoning, as arising from a very superficial examination of the subject ; and, under no other examination of it, could such a series of reasoning appear even in the slightest degree plausible.

In order to form a correct decision as to the merits of any question, it is not enough that we examine and bring forward all the evidences which can be found to favour one side of the question, which we might, from a superficial view, think best supported; but we should also examine and weigh well the arguments against this side.

We have already observed that all diseases consist in either functional or organic lesion, and that their immediate consequence upon the system, is oppression of its organs, and depression of its general strength. We have also remarked that a natural fever or re-action, on account of the existence of disease, does not take place, until the disease is so extended as to endanger the immediate safety of the individual affected ; that is, fever does not take place so long as there is sufficient strength and vital stamina in the constitution, to hear up under the oppressive influence of disease. Hence, the interval between the primary application of an efficient morbid cause to the body, and the commencement of the redaction of fever, designed to remove the effects produced in the body, by the operation of the external morbid cause, will be longer or shorter in proportion to the extent or intensity of the cause itself, and the strength of the system at the time. Nature, suffered to take her own course, always*starts at the best time and under the most favourable circumstances.

To illustrate our idea, we will suppose an individual to receive a fall from some considerable eminence, in which he strikes upon the feet in such a manner as to produce no external wound, but, as soon as he comes to the ground, he falls apparently dead.

This is a case of concussion of the brain ; that is, the brain is so much jarred by the fall, as to cease in a measure to perform its usual function. The equilibrium of the circulation is disturbed ; a congestion of blood takes place in the brain, and perhaps in some other of the internal organs. Now, though this is very oppressive to the system, yet, from the vigour of the constitution, the system is enabled to bear it, and still perform the vital functions sufficiently to support life, till nature shall have prepared her means, so as to make her efforts of restoration under the most favourable circumstances.

But if bleeding be resorted to, a degree of debility is thereby produced, which incapacitates the system for the endurance of the derangement, till all would (except for bleeding) have been in readiness for the work of reaction.

Thus we find, that by bleeding we give rise to the necessity of a premature accession of fever ; we also diminish the strength of the constitutional efforts of fever, and, at the same time, add to the strength of the disease. If it is not the vital energy of the system which stays the ravages of disease, we know of no property in animal matter from which disease can meet with any resistance.

Mr. Hunter says, "that bleeding increases irritability, and causes an increased disposition to act, without the power to act with." The way in which bleeding increases irritability, is this : that it produces direct debility. When it is said that a part of the whole body is irritable, it is meant, that such part, or the body is much affected by slight causes ; there is so much weakness, as to disqualify the part for resisting slight attacks. In this state, the body corresponds with the mind of those persons, who get angry from slight and trivial causes ; such are said to have irritable tempers of mind, and everybody knows that this irritability of temper arises from weakness of mind.

Bleeding causes an increased disposition to act, since it increases the weight of the disease by diminishing the strength of the one who bears it. The same load that would be regarded as light, by the strong man, would be declared by the weak man to be insupportably heavy ; and if the burden were to be carried to a little distance by the weak man, he could not stand and hold it, till the obstructions could be moved out of his path, but he sees that his only alternative is to make onwards ; and, from his being weak, the burden heavy, and his path rough, he probably falls before he gets halfway ; he is no more able to raise the load, no, not even to raise himself. Not so with the strong man; he stands with his load on his shoulder till some one (the physician) goes and moves the obstructions out of his way ; he then advances with firm and sure steps, arrives at the destined spot, throws down his burden, and is free and ready to attend to his business. In speaking of the weak man, it should have been observed, that, should he get through, and throw off his burden, still he is so much exhausted as to require much tonic medicine and a convalescent stage of several weeks.

" Bleeding increases the disposition to act, without the power to act with." Suppose a hungry person just to sit down to a table furnished with food agreeable to his taste, but there is only enough for his present necessity ; now suppose one to come and carry off the food from his table ; would not his disposition to act be increased, without the means to act upon 1 He would see that his only chance would be, to make sure of all he could while it is going:.

So, when the human system is labouring under disease, and some wise son of Esculapius comes and begins to abstract the blood, the disposition to act is increased, because the system seems sensible that a certain effort must be made, and that her power of making it is going. Nature, therefore, makes the attempt ; but too often finds her resources deficient, from loss of blood. But, say our brethren of the bleeding faith, we know that we can reduce fever and inflammation by bleeding, sooner than by any other means. We admit that this assertion is correct ; but it is one of the strongest arguments which can be used against the very mode of practice, for the vindication of which it is urged. For every person who has a correct view of fever and inflammation, (which we call local fever,) must see, that they should not be reduced, till the disease, for the removal of which they were excited, shall be subdued. So, bleeding does not effect the desired object, it only does it apparently. Though the removal of disease is invariably attended with a subsidence of fever, yet the reverse of this, in no case, can happen.

If an individual discovers that his health is somewhat deranged, the natural desire to live, together with the recollection of the enjoyment of health, prompts him to make an attempt to restore health. He sends for a physician of the regular order, (because he desires regular treatment;) his physician comes, and, after feeling his pulse, viewing his tongue, and making some inquiry of the state of the bowels, pronounces his patient to be sick of a fever ; if the fever be high, the physician recommends his patient to be bled ; upon being bled, the pulse sinks, the strength fails, the fever is diminished or weakened, and the disease strengthened.

But what is the modus operandi, or manner in which bleeding acts, in the removal of the disease 1 Who is able to tell us 1 We must say, that we have never seen even a plausible explanation given concerning its curative powers, in our reading ; and we believe we have carefully studied and read those authors oil practical medicine and surgery, who most boldly and strenuously advocate the practice of bleeding for the removal of febrile and inflammatory diseases.

The fact is obvious, that bleeding is a mode of practice, which, when used for the cure of disease, admits not of a rational explanation, nor will physicians attempt to explain its effects to men of enlightened and experienced minds.

They may say that bleeding is an ancient practice, and that it has been sanctioned by men of much learning and experience, and that this is sufficient authority. But the march of science and truth have condemned many of those practices which were thought proper in ancient times. As well might we say that it is right to worship idols because it was customary in ancient ages ; and, we might add, even too common in our-own day and country ; for whether is it better to worship the sun, moon and stars, or to worship wealth, fashion, fame, and worldly applause !

Well, says my friendly and well-disposed reader, from what you have said on the subject of blood-letting, I am disposed to regard it as a bad practice in general, yet I think you must admit that bleeding is good in some few cases ; such for instance as pleurisy and cases of violent bruises from falls and blows. No, kind reader, we cannot admit that the abstraction of blood is a good practice, in even these cases. To agree with onr fellow-men in sentiment feeling, and mode of thinking, when such sentiment, feeling, and thinking are agreeable and consistent with reason, and productive of general good and" happiness, is a source of much gratification to an improved and virtuously directed mind. But whenever we discover that our fellow-men are labouring under unreasonable and erroneous impressions or sentiments, to agree with them in such sentiments, would be hypocrisy, not wisdom ; would be vicious, not virtuous ; and would excite the sensation of an admonishing and condemning conscience, not the peaceful delights of conscious goodness. Pleurisy is an inflammatory disease, that is, a diseased state of that delicate and finely organized membrane (the pleura) which lines the internal parietes of the thorax or chest, and forms a complete envelope for the lungs. This diseased condition of the pleura necessarily demands and gives rise to inflammation, which, through the medium of universal sympathy, affects the whole arterial system, and therefore comes under the head of general fever. It is well known by all who have been the subjects of this disease, that it is one of excruciating pain and almost insupportable suffering. The acute pain arises from distention of the pleuratic arteries and veins, increased and morbid sensibility, and the unavoidable dilatation and contraction of the lungs in performing the function of respiration. But this pain is only a secondary and, necessarily, consequent symptom ; that is the inflammation. Nature's efforts to remove the disease could not be performed, but at the expense of this severe pain. We must recollect that the part affected is highly sensible and constantly agitated by the motion of the lungs ; the causes (we mean the immediate causes) which produce the pain, are absolutely requisite for the adjustment of the derangement; hence the pain must be regarded as a partial and necessary evil, which is more than counterbalanced by the good which grows out of the direct causes that excite the pain.

From what has just been said, we come to the conclusion, that means may be used in the treatment of disease, which relieve pain, but strengthen disease. So in pleurisy, bleeding generally gives speedy relief, since it produces a vacuum in the vessels of the bleeding vicinity ; thus making room for some of that blood which should and would have gone to the affected part ; but how long would this relief from pain continue'? The answer is obvious, viz: just long enough for the vacuum to be filled, and the blood to be again (and necessarily too) injected into the arteries and veins of the pleura. Then, when nature commences her efforts to relieve the oppressed organ, the pain, as an unavoidable consequence, returns. If the doctor is present, he bleeds again, and gives relief for the moment in the way before explained. Should nature once more be able to make an effort, sure as the doctor finds it out, he bleeds. Now, if any one wishes to know the result of such practice, let him call to mind the cases of pleurisy which he knows to have been treated in this manner, and then tell me, if such patients have not been doomed to a speedy dissolution, a long convalescence, or to a slow, sluggish and ineffectual fever, (termed by the books typhoid pneumonia,) or in simple language, disease of the lungs, accompanied with the ineffectual and puny efforts which nature makes after being deprived of her strength.

The result of what we have said upon bleeding, in cases of pleurisy, is, that pain, in all diseases, is a consequent and unavoidable symptom ; that the degree of pain will be proportioned to the degree of sensibility in the affected part, and the extent of the disease ; that pain may be relieved, without removing disease, and that in all these cases there is danger that the relief is purchased at too dear a rate ; that bleeding, though it may, and frequently does give temporary relief, never fails to add strength to the disease by weakening the vital powers of the system ; that there is no more propriety for bleeding, in cases of pleurisy, than in any other inflammatory affection of the internal organs. In cases of severe falls and bruises, it is customary for physicians to bleed immediately ; and the custom is sanctioned by the common consent of thousands ; but we appeal to those physicians of modern education, for a refutation of this practice; they know it is condemned by the greatest and best authors on modern surgery. When a blow or fall is first received, it produces general oppression, which can only be obviated by a reaction ; bleeding protracts the interval between the reception of the injury and the commencement of the reaction or fever, and necessarily renders the reactive effort less effectual when it does come on.