SHAKESPEAEE AS A PHTSICIAK COMPRISLNG EVERY WORD WHICH IN ANY WAY RELATES TO MEDICINE, SURGERY OR OBSTETRICS, FOUND IN THE COMPLETE WORKS OF THAT WRITER, WITH CRITICISMS AND COaiPARISON OF THE SAME WITH THE MEDICAL THOUGHTS OF TO-DAY. J. PORTMAN OHESNEY, M.D., Ex-Secretary Medical Society of the State of Missouri; Corresponding Member of the Gynaecological Society of Boston ; Prof, of Gynaecology in the Northwestern Medical College, St. Joseph, Mo., etc., etc. "Sir: — I hear you are a schollar — I will be brief with you — and you have been a man long known to me, though I had never so good means, as I desire, to make myself acquainted with you. I shall discover a thing to you wherein I must vei'y much lay open mine own imperfection; but, good sir, as you have an eye upon my follies, as you hear them unfolded, turn another into the register of your own, that I may pass with a reproof the easier, sith yourself know, how easy it is to be such an offender." J. H. CHAMBERS & CO., Publisliers, CHICAGO, ILL., ST. LOUIS, MO., ATLANTA, GA. 1884. Entei-ed According to Act of Congress, in the year 1883, by JAMES H. CHAMBERS & CO., In the Office of the Librarian of Congress at Washington, D. C. TO WILLIAIM F. SCOTT, M. D., AND FRANCIS M. JASPER, M. D., OF KENTUCKY, WHO, IN THE LONG AGO, BY THEIR KINDLY WORDS AND HELPING HAND, CHEERED MY YOUTHFUL PROFESSIONAL ASPIRATIONS, THIS VOLUJIE IS RESPECTFULLY DEDICATED, BY THEIR FRIEND, THE AUTHOR. CONTENTS CHAPTER I. Obstetrics, - - - - - 17 Blue-eyed hag — Go to " Texas " — The " fly young man " — Dr. liosenweig and Madam McCarthy — Poor Alice Bowlsby and Miss Jennie Cramer — The ' horsewhip and "navy" — The poor duke's constable — Longing for stew'd prunes — Shakespeare's sagacity — The "craving" appetite in females — The blood is the life — Anorexia and delirium — "Good cheer" for pregnant women — Pompey Bum and the "social evil" — "Quick" at the second month — Puck and his girdle — Exploring the moon — Normal ovariotomj' — The nubile age — Mental emotions and abortion — Three classes of causa- tion — The fruit withers — Neoplasms — Endometritis — Syphilis and the no- bility—Juliet and lady Capulet — Lord Campbell — Forensic medicine— Child- bed privilege — The "medicine man" and his fee — Twenty money-bags — King John and his erroneous decision — Premature deliveries and the law — Two cases from Taylor — Groaned for him — The heyday of existence and the evening of age — "Hal" and Herbert Spencer — Alcohol and venery — Fish diet and sex — Abortion ; never in the prostitute — The doctor's coat — Maid of Orleans — Commission on pregnancy — Difficulties in diagnosing pregnancy— Jorisenne's method — Apprehensions in the pregnant state — The "play" as a means of education — Richard the Third at his birth — Shakespeare's intuition — Teeth generated in error— Teretology ; its va- rieties—Hunchbacks and tbeir wit — Richard's villainy — The "grunting" — The accouchement of Anne Boleyn — Graphic description — Tamora, queen of the Goths — " He is your brother by the surer side " — Early marriages and premature decay — Excuses in America — Weaning of Juliet — Stand on the floor and suck — Inanition and little gilded tombs — "Twin sisters" — Chlorosis — Scoundrels made from the mothers' milk — The mother who nurses her own offspring — Caesarian section should not be "untimely" — How fresh she looks. 9 10 SHAKESPEARE AS A PHYSICIAN. CHAPTER II. Psychology, - - - - 70 Definition — Shakespeare's profound knowledge of the subject — Bucknill's eulogium — "It is all the best"" — Shakespeare's special study of insanity an absurdity — His intuition — Scene before an Abbey — Jealousy versus sanitj' — A foul conspiracy — A psychological charlatan — Sleeplessness but a symptom — Shakespeare draws on his own domestic experience — Now not a joke, but a dark reality — Thrown into a "dankish" vault — The cell of Foscari — Public institutions need surveillance — Preliminary abuses — Probate courts and examinations in lunacy — Monkey and medical expert — A ten-dollar fee — Charles Reade — "Why hast thou put hira in such a dream?"— No darkness but ignorance — Make the trial of it in any constant question— Erroneous assumption — Bucknill on memory — What at any time have you heard her say? — "Out damned spot"— Here's the smell of blood still — Will she go now to bed? — Cure her of that — "Make thick my blood stop up the access and passage to remorse" — Cases from De Boismont — "He had a large knife in his hand and went straight to my bed" — He returned as he came — "I had so strange a dream" — His services were thereafter dispensed with — Somnambulism and insanity — The pulse as indicative of insanity — Did you nothing hear? — Hallu- cinations — The ghost — The spectre cat — The doctor's fright — Look! Amaze- ment on thy mother sits — Lesions of structure necessary to lesions of func- tion — I'm a'gwine to die!— One iinale awaits the man and all his attributes — Love and sleeplessness — Age — "No man bears sorrow better" — The final cataclysm — King Lear not insane — A dog's obeyed in office — The "Bed- lam beggar" — "How does the king?" — "You are a spirit, I know" — Lord Shaftesbury's opinion — The Emotions — Their close relationship to actual mental diseases— Jealousy — With "pin and web" — Othello, the Moor — "O! now farewell the tranquil mind" — Alas the day ! I never gave him cause— The ills we do their ill instruct as to — Ninety children the utmost limit — The rela- tive procreative capacity of the sexes — Monogamistic relations — Abortion and polygamy — Love — All lovers swear more performance than they are able — Love-marks — "Did you ever cure any so?" — The pale complexion of true love — "He took me by the wrist and held me hard" — Mine eyes were not at fault, for she was beautiful — Lust — Not from Shakespeare — One man in every five — Love powders— My daughter! my daughter! — Lucretius, the poet — A veri- table letter — Venereal excitement not love — Let not the creaking of shoes — The will and conception — "Could I find out the woman's part in me" — Paiu- ful copulation (Dyspareunia)— Anger — Envy. chaptp:r III. Neurology, - - - - -121 Epilepsy— Falling Sickness — "Rub him about the temples "—Playing "wolf "—The prototype of Othello—" What, did Caesar swoon?" — The epi- leptic zone— The trade-mark and "plug" hat — Mistaken diagnosis — This CONTENTS. 11 apoplexy will certain be his end — Gad's Hill and Sir John — I talk not of his majesty— It is a kind of deafness — Croups — Drowning as a consequence of popular delusion — The mad-stone and its votaries — Not known by medi- cal men— The treatment as good as any — "John Jones, of Albany "— Odon- tology — Set up the bloody flag against all patience — The nurse's head-ache — "Let me but bind it hard " — Varieties of the malady — Sciatica — Syphilis as a complication — Gout — Plays the rogue with my great toe — Anorexia — Pa- ralysis — " My tirm nerves shall never tremble." CHAPTER IV. PlIAKMACOLOGIA, . - - - 132 Sleepy Drinks — Foster nurse of Nature — A liberal offer — A doctor's knowl- edge appreciated — What? — The perfumed dandy — Unbearable nonsense — What's in't? — Mandragora — Drowsy syrups — Superstition — Toxicology — The trusty pistol — Fashions of suicide — Difficulty of purchase — Poisoned by a monk — This tyrant fever — Swinstead abbej' — Strange fantasies — North winds — A compound — Monks as physicians — Cardinal Beaufort — Liebreich an- ticipated — Republished — Was it chloral? — Comparison of conditions— Care, fully noted — Meagre were his looks — What, ho! — Famine is in thy cheek — Death's pale flag — Thus with a kiss — A nest of Death — A slight discrepancy — Oxalic acid — Discovei^ repeats itself — The insane root — Drugging the pos- set — "Hashish" — The unction of a mountebank — Rabies canina—Curara — From what derived?— A failure apprehended — Trap with double triggers — Fencing match — An unlooked for termination — A jealous sister — Kills and pains not — Immortal longings — Easy ways to die — Zest to a tragedy — A spe- cific — Alconcito — A royal student — Soliloquy— Most likely I did — Moreton preceded. CHAPTER V. Etiology, _ . . - - 156 Prefatory — Wine for an ague — Objects of commiseration — A promise re- deemed — Icy burning — A marshy residence — Magna charta — Allegorical — An idea of antiquity— "Would to bed " — " Falstaff, he is dead " — Congestive chill — Gad's-hill — Prince Henry and his "pals"— This man has become a god — Is Brutus sick? — Acerbity — The Appian Way — Foes to life — Malaria as a demoralizing agent — Cross gartering — The tourniquet as a remedy — Same as a cause of disease — Farewell to neuralgia — Brunonianism. CHAPTER VI. Dermatology, - - - - 164 The beginning — Serpigo — A voluminous curse — Was it small-pox? — The cursed hebenon — Acarus scabiei — The disease in Paris — Falstaff as a " wen" — Kibes — Probably vaccinated — A string of rhymes — Good fruit only 12 SHAKESrEAftE AS A PHYSICIAN. from a good tree — Transmissibility of defects — Gynaecological phenoineua— The "convulsive zone" — Spreading it on " thick" — Rouge and pearl pow- ders — 'Tis beauty truly blent — Commendable caution — Danger in the dark — A fastidious scoundrel — Supposition strengthened — We catch of you, Doll — Baths in syphilis — Ricord and Bumstead — A beautiful picture — Durability of a tanner— A curious but not creditable truth — A needed reform — Venesection in the right iliac fossa. CHAPTER VII. Organology, - - - - - 174 The stomach^Power of mind over function — Voluntary inanition — Its Pathology — What a physiologist! — Dietetic ideas of a hostess — An apt com- parison — The irritability of hunger — A plain road — An error explained — The woodman and his belt — Seat of the affections — Gin-drinker's liver — Cause for effect — Smiling at grief — Lewdness and poverty — Illustrated — Sentiment reversed — The badge of cowardice — The truth in popular ideas — Then live, Macduff — Sleep in spite of thunder — Pulmonary gangrene — Benedick, the married man — Thaw'd out — A pertinent conclusion — A blind philosopher — How are you 'fraid! — Latent senses — The green flap — Some new infection — An enquiry — An amusing incident — "Hal's" vocabulary — Renal functions — Sympathetic fibrillas — Carry bis water to the wise woman — What says the doctor to my water? — A sensible doctor, for a wonder — Changes in the kid- ney—Nose painting — A sure sign — Taste not — A cheap article — " When I was about thy years, Hal" — The lean and hungry Cassius — He smiles in such a sort— Drawing the fire out — A parody— An exploded barbarity — Mr. Strili- ling, the druggist — The blood is the life — Blasting a good resolve — Man im- proves with his condition — A plea for the lancet — Palpitation — Good air as an agent— Much effuse of blood, etc. CHAPTER VIII. Chirurgebt, ..... 192 Grows stronger for the breaking — Mistaken principle— Patching the over- coat — Bad practice — Syncope— Mistakes in prognosis — Spare the blood — Shakespeare a poor surgeon — A scar covered veteran — The money changer — The surgeon's fee — Professional failing — Doctors and the clergy — A man with a soul — The surgeon's tools— Surgeon's fort — Honors to whom honor, etc. — Trichina spiralis — Who is responsible?— Doctors and their doings — Little change — Cowardly knave— Jester for an hospital — The least merit — A precedent for doctor "she" — "Malignant fistulse " — Potent remedy — Popular ignorance — The reformed hod-carrier— Professional honor — Another comparison — A lame impostor and his lame detection — Doctor's untimely end — The English Nero — Dr. Butts, the scoundrel — A want of faith — Woful mistake — Danger of expectancy — In Macbeth — An absurd credulity— God Almighty as a visiting physician — How does your patient, doctor? — Needs a divine — No mean psychologist — Indiscreet — A self- constituted doctor. CONTENTS. 13 CHAPTER IX. Miscellaneous, - - - - 212 A vile caricature — The Huncliback — Now is the winter of my discontent — Listening to the whispers of Vanity — I'll be at charge for a looking-glass — Troublous dreams — Sleep that knits up the raveled sleeve — Our life is two- fold — Sleep hath its own world — From Byron — Neuralgia — No guaranty of truth — Kiot — Position in sea-sickness — Old quarantine regulations — The plague— From the cradle to the grave — Characteristics of senility — Take a man of honor, Kate — He brings his physic after his patient's death — An awk- ward predicament— Tests for death— Life a failure — Ay! but to die? Grim Death ! LIST OF ILLUSTRATIONS. PAGE. King Henry VIII. and the Midwife, ... 49 The Midwife to Anne Bullen, on receiving her fee, - - 50 Aaron, the Moor, and the Illegitimate Child, - - 52 An Illustration of the Benefits of Protracted Lactation, - 59 Enquiry in Lunacy — (Medical Experts to the right), - 76 Lady Macbeth murders the sleeping Duncan, - - 82 The Doctor looks for the skeleton behind him, - - 90 The Effects of gathering the May-apple root, - - 136 Romeo and the Apothecary of Mantua, ... 143 Romeo and Juliet in the " tomb of the Capulets," - - 144 Prince "Hal" manifests his friendship for Sir John Falstaff, 176 The Woodman, and his arrangement for "cheap boarding," 179 The Clown enlivening the inmates of an Hospital, - - 198 A Female Practitioner presents herself before the King, - 200 The famous "Dr. Sunrise " condescends to visit the good people of St. Joseph, ..... 203 A Gentleman who practices under the protection of a License issued by the highest authority, - - - . 211 14 PKEFACE. The thoughts of [Shakespeare enter more or less into the pro- ductions of almost every one who writes in the English language. His works abound in such a })rofuse diversity of thought and expres- sion, that they are laid under contribution to supply the gems which sparkle among the lowering effusions of the lawyer, the doctor, and the divine ; they contribute the ornamentation for the title-pages of the wit, the poet and the fictionist, — whilst in miscellaneous writings of every conceivable kind and sentiment their wisdom is pruned or distorted to suit the " mellowing of occasion." The idea even of making an entire volume based upon some single line of thought found in Shakespeare's writings is not new, — as a work embracing "Shakespeare's Legal knowledge" was written by Lord Campbell, and pul)lished in England some years ago ; and it is said, that even now, there are as many as twenty books in some way connected with the great dramatist, issued yearly from the British press. If in the vastness of this literature there has not at some time in the past appeared a work embodying "Shakespeare's Medical knowledge," it is a little strange, — though of the existence of such a work the present writer has no knowledge. The conception of presenting Shakespeare's medical knowledge in a complete and connected form is, therefore, probably original as connected with the present work. We are not unmindful, however, that his thoughts on medicine have from time to time appeared in a fragmentary form, — the latest of which is a paper a few 3'ears ago published in this country, embracing the immortal poet's ideas of Insanity ; of the scope and merit of the paper we can, however, say nothing, as it has never fallen into our hands. 15 16 SHAKESPEARE AS A PHYSICIAN. In presenting, as we have endeavored to do, truly and faithfully, every line and precept in Shakespeare's complete works which in the remotest sense bears upon the science and practice of medicine, we may say that easy as the task ma}^ seem to one who has not essayed it, — yet the satisfactory accomplishment of the work has been attended with no small amount of difficulty and labor ; and in extenuation of any faults which may be found in its pages, we will say to the ' ' critics ' ' that if in them the ' ' antique and well-noted face of plain old form is much disfigured — and, like a shifting wind into a sail, it makes the course of thought to fetch about, — startles con- sideration, — makes sound opinion sick, and truth suspected, for put- ting on so new a fashioned garb," — why, then, we shall hail with dehght a better work upon the same subject from any one of them. THE AUTHOR. St. Joseph, Mo., March 1st, 1884. Note. — Since placing tlie present work in the hands of the publishers, I have been favored by Dr. George C. Catlett, Superintendent of the Mis- souri State Lunatic Asylum, with a copy of an English work, entitled "The Mad Folk of Shakespeare," by Dr. Jno. Charles Bucknill, and from its pages I have liberally drawn in amending my chapter on Insanity. — J. P. C. CHAPTER I. OBSTETRICS. Blue-eyed liiig — Go to "Texas" — The *' fly younj? man" — Dr. Rosenweig and Madam McCarthy — Poor Alice Bowlsby and Miss Jennie Cramer — The horsewhip and "navy" — The poor duke's constable — Longing for stew'd prunes — Shakespeare's sagacity — The "craving" appetite in females — The blood is the life — Anorexia and delirium — "Good clieer" for pregnant women — Pompej' Bum and the "social evil" — "Quick" at the second month — Puck and his girdle — Exploring the moon — Normal ovariotomy — The nubile age — Mental emotions and abortion — Three classes of causa tion — The fruit withers — Neoplasms — Endometritis — Syphilis and the no" bility — Juliet and lady Capulet — Lord Campbell — Forensic medicine— Cliild- bed privilege — The "medicine man" and his fee — Twenty money-bags — King John and his erroneous decision — Premature deliveries and the law — Two cases from Taylor — Groaned for him — The heyday of existence and the evening of age — "Hal" and Herbert Spencer — Alcohol and venery — Fish diet and sex — Abortion ; never in the prostitute — The doctor's coat — Maid of Orleans — Commission on pregnancy — Difficulties in diagnosing pregnancy — Joriseune's method — Apprehensions in the pregnant state — The "play" as a means of education — Richard the Third at his birth — Shakespeare's intuition — Teeth generated in error— Teretology; its va- rieties — Hunchbacks and their wit — Richard's villainy,— The "grunting" — The accouchement of Anne Boleyn — Graphic description — Tamora, queen of the Goths — "He is your brother by the surer side" — Early marriages and premature decay — Excuses in America — Weaning of Juliet — Stand on the floor and suck — Inanition and little gilded tombs — "Twin sisters" — Chlorosis — Scoundrels made from the mothers' milk — The mother who nurses her own offspring — Ctesai-ian section should not be "untimely" — How fresh she looks. Under this caption will be considered every thing connected with parturition and the science of gynaecology. The material, though sufficiently voluminous to constitute a chapter of value, is yet so difficult of arrangement into readable order, that the task I take upon myself in essaying its accomplishment is of some solicitude. "The Tempest," A. i., S. ii., furnishes us with the first idea in this direction. 18 SHAKESPEARE AS A PHYSICIAN. " This blue-eyed hag was hither brought with child," has reference to the former mistress of Caliban, but is not of sufficient moment for comment. " 'Tis my familiar sin with maids to seem the lapwing, and to jest, tongue far from heart, play with all virgins so ; your brother and his lover have embrac'd : as those that feed grow full ; as blos- soming time, that from the seeding the bare fallow brings to teeming foison, even so her plenteous womb expresseth his full tilth and husbandry. Isabella. Some one with child by him? — My cousin Juliet? Lucio. Is she your cousin? Isabella. Adoptedly ; as schoolmaids change their names by vain though apt affection. Lucio. She it is. Isabella. O, let him marry her." The above conversation might have been overheard between a young lady and young gentleman, parties to the interesting play of "Measure for Measure," A. i., S. v., had the ear been applied to the key-hole ; and though somewhat pointed to be had between a young couple — or at least would be now so considered — it was no doubt admissible at the date in which it purports to have been used. Isabella but echoes the sentiment of a woman's heart. She would have her brother marry the girl he had wronged, and thus save her from the odium incident to the results of their improper intimacy. Not so the sentiment of masculine humanity. Tliink of it as he may, the man's acts are commonly to get away from the scenes of his villainies. Goto "Texas," get away, go any where, but leave the place of perfidy, leave his victim to the burden of both her own sorrows and his crimes is the usual mode. Some there are however essay another means of egress from the net closing around them — a means apparently less hazardous to them, but doubly so to the victim. Instead of either "marrying her" or escaping to Aus- tralia, the "fly young man" consults Dr. Rosenweig or Madam McCarthy, with one or the other of whom he perfects arrangements for boarding his "cousin" for a week or two. "My cousin, you know, has ' taken cold,' you know, and has dropsy." The result of this stay of a few days with the eminent doctor, coupled with the "treatments" he gives her to "bring her round again," is but too forcibly pictured in the fate of poor Alice Bowlsby, whose OBSTETRICS. 19 body, packed in a trunk, and shipped about the country for several days, so horrified New England a 'few years ago. Or then the victim's fate is sealed, and she hides her deep despair in the murky waters of a neighboring pond, the swift current of the river, the quiet depths of a lake — or, like the more recent case of Jennie Cramer, expiates, voluntarily, the unendurable bitterness of her folly by hiding her body and shame together in the dark waters of the sea. Those antiquated notions of "let him marry her " maj^ find an occasional response in the bosom of some of our country swains, actuated to the performance of the noble and self- sacrificing duty by the horsewhip of an indignant father, or the point of a " navy " in the hands of a big brother ; but in the city, among the refined and intelligent, where Madam M. and Dr. R. may be found almost in every block — never. In continuation of this same case, wherein the party accused of fornication was by the edict of the ruler of the country to suffer death, we have these further details: Escalus, "Well, heaven forgive us all! Some rise by sin, and some by virtue fall. Elboiv. Come, bring them away. If these be good people in a common-weal, that do nothing but use their abuses in common houses, I know the law ; bring them away. Angela. \_The duke's deputy^ trho is executing the Imv ivith the utmost rigor on others, although violating it himself ivith the most flagrant hand.^ How now, sir? what's your name? and what's the matter ? Elbotv. If it please your honor, I am the poor duke's constable, and my name is Elbow: I do not lean upon Justice, sir; and do bring in here before your good honor two notorious benefactors. Angela. Benefactors! Well, what benefactors are they! are they not malefactors ? Elboiv. If it please your honor, I know not well what they are ; but precious villains they are, that I am sure of, and void of all profanation in the world that good Christians ought to have. Escalus. This comes off well ; here's a wise oflficer. Angelo. Go to : what quality are they of? Elbow is your name : why dost thou not speak. Elbow? Clown. He cannot, sir; he's out at elbows. Angelo. What are you, sir? Elbow. He, sir? a tapster, sir; a parcel-bawd; one that serves 20 SHAKESPEARE AS A PHYSICIAN. a bad woman, whose house, sir, was, as they say, hot-house, which I think, is a very ill house too. Escalus. How know you that? Elboiu. My wife, sir, whom I detest, before heaven and your honor. Escalus. How! thy wife? Elhoio. Ay, sir ; who, I thank heaven, is an honest woman. Escalus. Dost thou detest her therefor ? Elbow. I say, sir, I will detest myself also, as well as she, that this house, if it be not a bawd's house, it is pity of her life, for it is a naughty house. Escalus. How dost thou know that, constable? Elbow. Marry, sir, by my wife ; who, if she had been a woman cardinally inclined, might have been accused in fornication, adul- tery, and all uncleanliness there. Escalus. By the woman's means? Elboio. Ay, sir, by Mrs. Overdone's means; but as she spit in his face, so she defied him. Clown. Sir, if it please your honor, this is not so. Elbotv. Prove it before these varlets here, thou honorable man ; prove it. Escalus. [^To Angela.^ Do you hear how he misplaces? Cloivn. Sir, she came in great with child, and longing (saving your honor's reverence) for stew'd prunes: sir, we had but two in the house, which at that distant time stood, as it were, in a fruit dish, a dish of some three pence : your honor have seen such dishes : they are not china dishes, but very good dishes. Escalus. Go to, go to ; no matter for the dish, sir. Cloivn. No, indeed, sir ; not of a pin ; you are therefore in the right ; but to the point. As I say, this Mistress Elbow, being, as I said, with child, and being great belly'd, and, longing as I said, for prunes, and having but two in the dish, as I said. Master Froth here, this very man, having eaten the rest, as I said, and, as I say, paying for them very honestly ; — for, as you know. Master Froth, I could not give you three pence again. Froth. No, indeed. Cloivn. Very vyell ; you being then, if you be remember'd, cracking the stones of the foresaid prunes. Froth. And so I did indeed. Clown. Why, very well ; I telling you then, if you be remem- OBSTETKICS. 21 ber'd, that such a one, and such a one, were past cure of the thing you wot of, unless they kept very good diet, as I told you." The court scene above represented is a pretty fair representation of what may be heard most any day in our inferior tribunals, — the medical matter being better however in the above instance than the legal. The idea conveyed in the last paragraph, as to the necessity of good diet in the treatment of the "diseases you wot of," was ignored by the medical world until a period so recent as to come within the memory of our junior practitioners ; and that its pro- priety, nay, necessity^ should have forced its self upon the notice of a non-medical man three centuries and a half ago, when no medical mind had grasped the idea, is only one among the thousands of evi- dences we have of Shakespeare's unequaled sagacity. The craving appetite of pregnant women is in my mind a real demand made by nature for material with which to repair some specific waste incident to conception ; and the guardians of a female in that condition, who pass lightly by the demands of their charge, are certainly dere- lict in the discharge of a sacred duty. The whole period of gesta- tion is one of severe strain upon the tissues of the mother ; every change in her structures during the nine months of the foetal existence is to her a period of retrograde metamorphosis, and this is shown by nothing better than the qualities of her blood — the changes in the composition of which, so characteristic of the pregnant state — being recognized as an indubitable evidence in this direction. "The blood is the life," and when this fails to perform its wonted functions, the whole economy follows its lead. The demands upon the system of the mother are of course to supply the materials of a new being ; and though we have no data at hand upon which to predicate an assertion that the strange and unusual articles of diet sometimes so longingly sought by the mother do contain ingredients essential to the elaboration of some of its tissues — yet it may be so. For some women to become pregnant is to become a new being — her whole aspect is changed. This metamorphosis is no where in her economy more apparent than in the digestive apparatus — the stomach more particularly participating in these perturbations in a degree often sufficient to endanger the life of the woman. Then the mental change, so noticeable a feature in some pregnant females, is doubtless due partially, if not essentiall};-, to the disturbance of the nutritive balance in the system, whereby the brain and nervous system are deprived of some ingredient which is essential to their 22 SHAKESPEARE AS A PHYSICIAN. healthy functional activity. At a later period doubtless may be added, as a factor in these manifestations, the septic influences engendered by a retention of a materies morbi in the system of the mother — the products of the waste of the growing ovum, as also of her own tissues, retained in her blood. We notice analogous symptoms connected with many wasting diseases, as, for example, in typhoid fever, where the anorexia and the delirium are only the language of the conditions before suggested. Supply, then, the woman with the " stew'd prunes," or any thing she requests — her system demands it. The champagne found to be of so much service to pregnant females by Meigs was but an ex- ample of how much " good cheer" may do for them. The appetite should not be called "morbid," and passed over carelessly; but our "great belly 'd " patients should be well fed, the fear of "plethora" to the contrary notwithstanding. Plethora, ursemic disorders, etc., are the evidences of improper elimination and impoverished organic tissues, rather than of over feeding and undue assimilation. This same Clown, Pompey Bum, entertained an idea that may yet command the notice of the physicians, clergy and law-makers of this country — namely, that to prevent some from living by the trade of bawds, it will be necessary to geld and spay all the youths of the country ; and thus would the social evil and its physical counterpart, venereal maladies, vanish together. In " Love's Labor Lost," A. v., S. ii., we find: Costard. " The party is gone : fellow Hector, she is gone ; she is two months on her way. Armado. AVhat meanest thou ? Costard. Faith, unless thou play the honest Trojan, the poor wench is cast away ; she is quick ; the child brags in her belly already." The idea of a woman being quick at the end of the second month is not borne out by the facts ; yet it is probably not due to a lack of definite knowledge on that point by Shakespeare, but is made so to place it in keeping with the general spirit of exaggera- tion which pervades tlie whole plot of the comedy. In "A Midsummer Night's Dream" we find reference to par- turient fatality in these words: " But she being mortal, of that boy did die;" which applied to the labor of Titian's companion, but there is nothing further of interest can be deduced from it. OBSTETRICS. 23 In the same play, and though somewhat irrelevant to our subject, I may mention the now somewhat notorious boast of "Puck" in regard to " putting a girdle round about the earth in forty minutes." Little did Shakespeare dream that this very thing, to him no doubt only a thought placed there to illustrate the extremist impossibility, should be an accomplished fact while yet his own great name is fresh in the minds and hearts of a majority of the civilized people of the earth. Less did he imagine that " forty minutes " should in so short a time be considered an absolute waste of the precious moments, and that the necessities of the age made it imperative that it be only forty seconds ! The speculations of the maniac who should now declare that the time will be when we shall be able to reach and explore the hidden mysteries of the moon, would seem to us as plausible as the pre- diction of "Puck;" now, we mortals behold his seemingly idle vagaries an accomplished fact. We know not what a day may bring forth. Shakespeare, with all his insight into the possibilities which reside in the human composition, did not reach, even in his wildest dreams, the ideas of the telephone, phonograph, etc., both of which have been perfected — nay, conceived, since the above paragraph was written. Wonderful as they are, are they much more so than the ability and utility found in connection with what may be accom- plished with the pen.? The pen and printing press are grandest after all. But to return to our theme: In "The Merchant of Venice" we find a coarse conversation between Lorenzo and Lancelot in regard to the pregnancy of a certain Moor, which, however, has little point, and need not be mentioned. " All's well that ends well, " act last, scene last, contains the fol- lowing: "But for this lord, who hath abus'd me, as he knows him- self, though yet he never harm'd me, here I quit him. He knows himself my bed he hath defil'd, And at that time he got his wife with child : Dead though she be, she feels her young one kick ; So there's my riddle, one that's dead is ' quick.' " The lady in this case was Doctor Helena, who worked wonders in the cure of the king's " fistula," to be spoken of in a subsequent chapter of this volume. " The Winter's Tale " supplies us with this : " The queen, 3'our mother, rounds apace: she is spread of late into a goodlj' bulk " 24 SHAKESPEARE AS A PHYSICIAN. This was the queen's ladies' -in- waiting in converse with a small boy, the " prince." Leontes, the boy's father, being wofully jealous of his wife, thought to annoy her by depriving her of the society of the child, and gave orders to his servants — "away with him; and let her sport herself with that she's big with, for 'tis Polixenes has made her swell thus." One of the king's officers, who knew that the queen was innocent of the charges that were laid at her door, avowed that if she was proven guilty that he would geld his three daughters — fourteen they should not see, to bring false generations. The more euphoneous and polite term normal ovariotomy (instead of geld) was not found in the medical vocabulary of the age in which Shakespeare lived. This idea that the age of fourteen is the beginning of the nubile age in females, is made prominent in more than one place in Shakespeare's writings, and will therefore receive a share of atten- tion as the chapter progresses. Farther on in the same "tale " is found an illustration of the wide-spread popular error that abortion is so often the result of emotional causes. " How fares our gracious lady ? As well as one so great, and so f orlorne, may hold together. On her frights and griefs (which never tender lady hath borne greater), she is somewhat before her time deliver'd." It is somewhat interesting to notice that in the above quotation Shakespeare held almost identically to the ideas widely extant to- day as to the part played by mental disturbances in the production of abortion. Strange indeed it appears, that upon this point the average medical man of this advanced age should have gone so lit- tle beyond in exact scientific positivism the inherent knowledge of the non medical mind of two hundred and fifty years ago. Many medical minds of the present can see few causes of abortion other than those of mental emotions — and even here cause and effect are not usually very clearly associated in their minds. It is here as is too often the case in other medical cases with this class of loose thinkers, a declaration merely — a vague generality meant to sub- serve, for the present, a lack of real knowledge in relation to the subject. It is not denied that great mental shock may sometimes be the proximate agency in the production of premature uterine action and expulsion of the uterine contents ; but with the experience of many years as a guide the writer is lead to think it an unusual source of such trouble. In fact, the causes of women's being " somewhat before OBSTETRICS. 25 their time deliver'd " are so numerous that to follow the subject through all its sinuosities, and into its multitudinous labyrinths, would make a volume. These causes may, for convenience, be formulated so as to cover most of the ground in this manner : 1st. Causes which reside in the general system of the mother. 2d. Those which reside alone (and are therefore local) in the re- productive system of the mother — and 3d. Those which pertain or belong exclusively to the ovum itself. In regard to the first of these divisions it may be said to be by far the less frequent source of expulsion of the uterine contents. This fact is well illustrated by the well known truth that in tuberculosis, one of the gravest of the constitutional maladies, pregnancy seems actually to exert, for the time, a retarding influence in regard to its progress — abortions, premature deliveries, etc., being almost un- known occurrences as traceable to it. But there are other constitu- tional conditions in which the reproductive organs may participate onlj^ in a general way, in which miscarriages are very common in- deed, and most noticeable among these is, perhaps, constitutional syphilis. But it is not to chronic constitutional maladies alone that we may confine our remai'ks, as it is well known that acute maladies of va- rious kinds affecting the system at large are prone to be attended with this danger when happening in the pregnant woman. Of this class may be named typhoid fever and the exanthematous fevers, — small-pox, scarlatina, etc., in particular. Defective nutrition is the essential factor in the production of these accidents when oc- curring under such circumstances quite probably. The fruit withers and falls from its parent stem from lack of the food proper for its growth and nourishment. Causes of the second variety or class are almost innumerable, and therefore preponderate largely over all others in causing abortions. It is not to conditions of the uterus singly that this fact applies ; the womb is not alone at fault always. It may be some organ or tissue entirely independent of the uterus, which by its diseased condition or by its trespass upon the womb and the space which by right belongs to it, which causes all the trouble. A distended urinary bladder or a loaded rectum may do this ; an enlarged ovary, a dropsy of the Fallopian tube, an abscess in the veseco-uterine con- nective tissue, an hsematocele in the recto-uterine cul-de-sac, tumors of the uterine walls, urinary calculi when large, exostoses when 26 SHAKESPEARE AS A PHYSICIAN. springing from any of the bony surfaces of the pelvic walls, tight corsets, and if it was said a thousand other extrinsic agencies local in their operation and outside of the womb itself operate as causes in the production of abortion, it would be no exaggeration. Besides these there are the mal-conditions belonging to the uterus proper which go to swell the list of causation. It may be set down as an axiomatic truth that an absolutely healthy womb does not expel its contents spontaneously prematurely, — that is, before the expira- tion of nine months after conception has occurred. It must be nor- mal in form, in structure, in size, in position, and in its attach- ments to insure a normal gestation. Malformations of this organ are usually congenital, and consist of a lack of development in some portion — commonly, of one horn or lateral portion of the organ, leaving it asymmetrical in outline and abridging the normal space which should constitute a proper uterine cavity, — thus rendering a progressive gestation impossible. Or the change in form may be the result of neoplasms, as in the growth of interstitial or other fibroid tumors, the effect of which upon the fer- tile function of the organ is mostly the same as in the foregoing con- genital condition. It is not always so, however, as pregnancy may and often does progress to its proper termination, a uterine tumor pres- ent notwithstanding. It must be normal in structure. The uterus, when its walls are thickened up with hyperplastic depositions, or when left in a state of sub-involution after child-birth or miscarriage, is in no condition to carry the burden of a pregnancy to the end. The muscular and mucous coats of the organ may at the 'same time be involved in this condition of turgescence and thickening, and whether one or both are involved the results are nearly the same. The vascular supply is not in healthy trim, — the distorted tissues have distorted vessels and nerves accompanying them, — the blood supply is here too small and there too great, the nerve force is unequally distributed, and neuralgia from plethora may involve one nerve fil- ament, while irritability of another may ensue from anemia. The local hemorrhage at one spot and local anemia at another, incident to change in the vascular structure of the organ, are incompatible with the growth and maturity of the fruits of conception. Changes in the size and position of the womb, when not the result of the progress of the pregnancy itself, are prejudicial to the continuation of preg- nancy from the same general facts as narrated in the preceding paragraph, though in a less degree perhaps than when accompanied OBSTETRICS. 27 by direct local lesions of the lining membrane of the organ. Endo- metritis is no doubt a fruitful source of the early discharge of the ovum. The change in the membrane being non-consonant with the nutrition and development of the conception, — if even conception occur under such a condition of the membrane. Endo-cervicitis is, however, the greater obstacle to the function of merely impreg- nation. The uterus is essentially a mobile organ when it is in its healthy condition, and anything that tends to interfere with this freedom of movement, — any event or condition which unduly encroaches upon or hampers it in its normal movements, surely have a tendency to pro- duce the unhappy event which ushers in and gave origin to this article. In iti normal state it almost floats unconstrainedly in the pelvic cavity ; while the oi'gan remains so we see few or no abortions. Let a cellulitis occur, and the organ become agglutinated by in- flammatory products and closely tied to some of the neighboring organs, even at a single point, and abortion then becomes the rule Instead of the exception. Then again as to the causes which reside in the ovum itself. These may reside alone in the sperm-cell. It may have in it vital elements sufficient to fecundate the ovule, thereby exhaust itself and then wither and die. It may go further, but to die in the near future from the effects of a morbific principle inherent in its own organization, as from the poison of syphilis for example ; and this condition may pertain to the germ-cell as well as the sperm-cell. Like other animal poisons, this also has under these circumstances the power of multiplication, as we see the terrible effects of it upon the person of the premature little being. The cause may reside or be engendered in the membranes, the umbilical cord, or in the placenta itself — inflammatory processes be- ing a large factor in such change as connected with these. Mechan- ical causes, such as detachments of the after-birth, knotting or twist- ing, or ruptures, etc., of the cord and membranes, are also among the contingencies which may cause a woman to be " before her time delivered." Enough has doubtless been said to prove that Shake- speare might have been correct in placing the miscarriage spoken of to the credit of fatigue and mental worry ; but then the chances are as one in a thousand that he might also have been mistaken. Syphilitic infection and hereditary taints are so common, doubtless among those whose marriages of consanguinity keep up the family 28 SHAKESPEARE AS A PHYSICIAN. chain for ages, that miscarriage should be the rule in place of the exception among the nobility of the old countries. As regards the age at which the menses appear, Shakespeare makes his lord commit an error in placing it absolutely at the age of fourteen years. It will be remembered that the parties of whom he is writing are located in Sicily, in latitude 36* 40' and 38'^ 20' North, which, owing to its insular climate, would have much the same tem- perature as the south of France, where statistics show that the largest number of girls menstruate for the first time at from the fifteenth to the sixteenth year ; but the error most noticeable in this regard is in the case of Juliet, a native of Verona, which is situated in latitude 45° 30' North, and in the gorges of the Tyrol, where a robust con- stitution would naturally retard the eruption for a year or two ; in this high latitude a large majority of young females do not " see " until beyond the sixteenth, and a large proportion not until the seventeenth or even the eighteenth year. We find that Juliet was fourteen at the time of her death, and the language of lady Capulet that, " younger than you, here in Verona, ladies of esteem, are made already mothers : by my count, I was your mother, much upon these years that you are now a maid" — which would certainly have placed the good lady's first period as early as her thirteenth year. I know it may be claimed by those critically inclined that the aristocratic families to which these personages are supposed to have belonged would have brought them "out" much sooner than the commonalty ; and that the excitement incident to gay life could have brought about a premature development of the sexual system, which would save the "bard of Avon " any just criticism from a com- mon pen ; bht this may be met with the fact that the luxurious ease common to the great in our day and nation was not enjoyed even among the princes and nobles of the barbarous age of which the scene and incidents in Romeo and Juliet claim to be a part. The author, no doubt, obtained his data from the time the menses usually appear among the women of England, and approximates the time or age with perhaps as much accuracy as do the doctors, notwith- standing their special enquiries. In the passage next to be quoted, there is a legal question to be discussed, and as Lord Campbell once wrote a work entitled " Shake- speare's Legal Acquirements," I certainly should, if I knew just how and where, procure a copy of his work to assist me in the mat- OBSTETRICS. 29 ter. It IS the case of the doubtful progeny of the wife of Leontes, the king of Sicily. The king had thrown his queen into prison upon a charge of adultery with his former friend, Polixenes, king of Bohemia. The queen was delivered in prison, and the good lady in attendance on her desired to carry the babe to the king to see if its presence might not soften the rigor of his " unsane lunes," but the jailor had some doubts as to his powers under the law to let the babe pass out of the prison doors without a warrant ; he was not sure but that he might gravely infringe the law in letting it pass, and thus bring down the wrath of the authorities upon his own devoted head. The lady was equal to the emergency however — as women always are when placed in trying positions of such a character, and pleaded with the prison officer in these terms : " You need not fear it, sir ; the child was prisoner to the womb, and is, by law and pro- cess of great nature, thence freed and enfranchis'd ; not a party to the anger of the king, nor guilty of, if any be, the trespass of the queen." It does not, however, come further in the scope of this work to treat of the legal aspects of this case, as forensic medicine will find a very limited place in its pages ; but it matters little what the lex scrij^ta of the case may have been, justice said "let her pass." This same woman, in her desire to save the queen from the foul charge of inconstancy to her marriage vow, presented the babe to the king, and endeavored to convince him of the legality of its paternity by the following exhibit : ^ ^ cf^ " Behold, my lords, although the print be little, the whole matter (./4j^ ^<» and copy of the father: eyes, nose, lip; the trick of his frown, a ^l^*^*^^ his forehead ; nay, the valley, the pretty dimples of his chin and ^eJU ^ cheek ; his smiles ; the very mould and frame of hand, nail, finger. — '^vj^*^ "9 And, thou, good goddess Nature, which hast made it so like him ^**^^^ * that got it, if thou hast the ordering of the mind too, 'mongst all ^'t^ ''^ colours, no yellow in't; lest she suspect, as he does, her children rV***V not her husband's." ^*^ '^*' To throw the odium of induction of premature birth on the hands ^^•'^'^ of the king, see how closely and with what tact Shakespeare keeps '-'^*^ to his points; he says, "although the print be little," etc., thus . making it correspond in size and age. The queen was brought before the husband for trial, and makes her own defence in these words : " To me can life be no commodity : the crown and comfort of my life, your favor, I do give lost, for I do feel it gone, but know not how it went. My second joy, and 30 SHAKESPEARE AS A PHYSICIAN. first-fruits of my body, from his presence I aru barr'd, like one infectious. My third comfort, starr'd most unluckily, is from my breast, — the innocent milk in its most innocent mouth, hal'd out to murder : ( The child had heen banished by order of the king) myself on every post proclaim'd a strumpet: with immodest hatred, the child- bed privilege denied, which 'longs to women of all fashion: lastly, hurried here to this place i' the open air, before I have got strength of limb." (^'■^ Limit" in Shakespeare.) It seems that the law of nature has so indelibly impressed this matter of the "child-bed privilege" upon the human race, that even the untutored savage is tamely subordinated to its sway. The deference paid even by the American Indian to his squaw, while in the parturient condition, was aptly illustrated in a story narrated to the writer once by an English lady of intelligence, who had long resided among the aborigines on our western border. The narrative interested me much at the time, but as the particulars have escaped my memory, I can only present it in substance. The wife and her lord, husband, or "buck," or whatever title is used by them to denote the head of the household, had been on inimical terms for a time, had had a domestic broil for a few days, and to rid himself of the unpleasant contiguity of a morose wife, perhaps, had gone off on a hunt. "While thus absent, the squaw took it into her head to be confined. She had, on all former occasions, been attended by an old woman, whose fee, if anything at all, was but a nominal one. This time she employed the " medicine man," who confronted the "buck" on his return with his bill, the which the luckless wight was glad to liquidate at the expense of his most valuable pony. It was an obstetric fee, and his honor was too exalted to quibble over it, be the sum small or great. Herein could many of his pale-faced brothers learn a wholesome lesson. The babe who had been banished by her father to a strange coast, and who was thought by the king to have been murdered by those to whose charge she was given, was however trusted to the tender mercies of a wilderness — found and raised by a shepherd, and when grown courted and married the prince of the country. She then returned to the land of her nativity, where she learned her own history, and was taken to see her mother's statue — who, it was supposed, had died in prison. The old king, who was yet alive, says to his son-in-law: " Yotir mother was most true to wedlock, prince, for she did print your royal father (Polixenes) off, con- OBSTETRICS. 31 ceiving you ;" whilst the bride reached forth her hand to the statue of her mother, saying: "Lady, dear queen, that ended where I began, give me that hand to kiss." {'Ticas her mother, and not a statue.) Autolicus, at the shepherd's feast, tells the gaping plebeians of a usurer's wife who was delivered of twenty money-bags at a birth, one of his fair hearers praying to be excused from marrying a usurer ! In King John, A. i., S. i., occurs another case involving an amount of scientific Inquiry, both medically and legally, to invest it with special interest. It is a case where a charge of illegitimacy was made, based upon the fact that a viable child was born fourteen weeks before "term" — counting from the period of the return of the husband, who had been from home in a distant country, in a very protracted absence. To get more fairly at the points in the case, it will be necessary to give a somewhat lengthy extract : King John. "What men are you? Philip Faulconbridge (called the Bastard). Your faithful sub- ject I, a gentleman born in Northamptonshire, and eldest son, as I suppose, to Robert Faulconbridge, a soldier, by the honor-giving hand of Coeur-de-Lion knighted in the field. King John. What art thou? (To another.) Robert. Son and heir to that same Faulconbridge. King John. Is that the elder, and thou the heir ? You came not of one mother then, it seems. Bastard. Most certain of one mother, mighty king ; that is well known, and, as I think, one father; but for the certain knowledge of that truth I put you o'er to heaven and my mother: of that I doubt, as all men's children may. (Here we have, what occurs very rarely in Shakespeare's writings, a contradiction in the same paragraph ; he first thinks he is, and then he thinks he is not, his brother's father's son — that is, old Robert Faulconbridge's son.) Elinor. Out on thee, rude man! thou dost shame thy mother, and wound her honor with this diflfldence. Bastard. I, madam? No, I have no reason for it ; that is my brother's place, and none of mine; the which if he can prove, 'a pops me out from fair five hundred pounds a year. Heaven guard my mother's honor and my land ! King John. A good blunt fellow. Why, being younger born, dost he lay claim to thy inheritance? 32 SHAKESPEARE AS A PHYSICIAN. Bastard. I know not why, except to get the land. But once he slander'd me with bastardy: but whe'r I be as true begot, or no, that still I lay upon my mother's head ; but that I am as well begot, my liege (fair fall the bones that took the pains for me!), compare our faces, and be judge yourself. If old Sir Robert did beget us both, and were our father, and this son like him, O ! old Sir Robert, father, on my knee I give heaven thanks I was not like to thee. King John. Why, what a madcap hath heaven sent us here. Elinor. He hath a trick of Coeur-de-Lion's face ; the accent of his tongue affecteth him. Do you not read some tokens of my son in the large composition of this man ? King John. Mine eye hath well examined his parts, and finds them perfect Richard. — Sirrah, speak: what doth move you to claim your brother's land? Bastard. Because he hath a half-face, like my father, with that half-face would he have all my land: a half-fac'd groat, five hundred pounds a year! Robert. My gracious liege, when that my father liv'd, your brother did employ my father much. Bastard. Well, sir, by this you cannot get my land. Your tale must be how he employ'd my mother. Robert. And once despatch' d him in an embassy to Germany, there, with the emperor, to treat of high affairs touching that time. The advantage of his absence took the king, and in the meantime sojourn'd at my father's; when how he did prevail, I shame to speak, but truth is truth : large lengths of seas and shores between my father and my mother lay, as I have heard ray father speak himself, when this same lusty gentleman was got. Upon his death- bed he by will bequeath' d his lands to me ; and took it, on his death, that this, my mother's son, was none of his ; and if he were, he came into the world full fourteen weeks before the course of time." It has been argued, that if a child born at the fifth or even the sixth month survive, this fact alone should be held as evidence of illegitimacy — that is, where concurrent circumstances point to the fact ; but according to common English law it is held that it is not essential that a child be born capable of living to any specific age, or to the full of a certain number of hours, days or mouths, to OBSTETRICS. 33 entitle it to inherit; hut it is sufheient if the child have been born alive. This construction of the law certainly would vest the rights of inheritance in the Bastard, the point of legitimacj^ alone considered ; for if it was a fact that he was born at the end of the twenty-second week of gestation, he could not only have lived, but could even have grown into the " lusty gentleman " which we now find him. Though of the legal aspect of the case, as regards rights to property, it is not our province to write, but the question as to whether a child born fourteen weeks prior to the end of the time when an ordinary gestation is completed — that is, at the end of the twenty-second week — can live and grow to adult age, is clearly one for the science of medicine to settle. Upon theoretical assumptions alone this question could not be adjusted; only facts gathered from actual observation of the witness, or those derived from records of undoubted authenticity, should be offered as testimon}^ by a medical expert in a case of this kind. From the most reliable data which we are able to gather, it does not seem improbable that a case may occasionally happen where a child even at the early period of the hoentieth week may not only be born viable, but may survive to pubert}^ or to old age. I quote two cases from Taylor : "Dr. Barker, of Dumfries, narrates a case in which a child was born at the one hundred and fifty-eighth day of pregnane}^ or at the end of twent^'-two weeks and four days after intercourse. The child weighed one pound and measured eleven inches. It did not suck properl}' till after the lapse of a month, and she didn't walk until she was nineteen months old ; was sprightly, but at the age of three and a half years only weighed twenty-nine and a half pounds." On a trial involving the legitimacy of the child of the wife of u minister, which was born on the one hundred and twenty-fourth day after marriage, one reputable medical witness testified that he had " attended a case where the child was certainly born at the end of the nineteenth week of pregnancy, and the child lived a j-ear and a half." Occurrences of this kind are so rare, however, that the judgment rendered by king John — given upon that plea alone — that is, had he based his decision upon the fact that viability is probable in a child born at the end of twenty-two pregnant weeks, would certainly hav(; been giving too great a weight to a fact which can only be admitted 34 SHAKESPEARE AS A PHYSICIAN as a possibility; and besides, the moral circumstances connected with tlie case would, if proven before an impartial jury, have cer- tainly reversed the judgment of the king. Indeed, after the decision had been rendered in favor of Pliilip, lady Faulconbridge admitted his illegitimacy. I will give the language used by the king, and the reasoning which he brought to bear in guiding him in his decision : John. \_To Robert Faulconbridge.'] " Sirrah, your brother is legitimate: j^our father's wife did after wedlock bear him ; and if she did plaj'^ false, the fault was hers, which fault lies on the hazards of all husbands that many wives." The king did not pretend to found the verdict on justice, but only adhered blindly to a rule which had clearly been shown to have in this case an exception, that wedlock is presumptive evidence of the legality of all the progeny produced within its pale. Were we called to testify in a case of the kind, we should give it as an opinion that in a case where the child had been born fourteen weeks prior to the end of the thirty-sixth week of the gestative condition, that grave doubts might be entertained of its legitimacy, if its development and other circumstances gave any room for suspicion that the wife had been " sluc'd " in the husband's absence, and his "pond fish'd by Sir Smile, his next neighbor." This proved to have been the case with the Faulconbridge familj^, the lady herself admitting the fact thus: "King Richard was thy father. By long and vehement suit I was seduc'd to make room for him in my husband's bed. — Heaven! lay not my trangression to my charge; thou art [to Philij?] the issue of my dear offence." This is sufficient to establish the error of John's decision, and ought to have established the validity of Robert's title. But enough. Elinor, widow of king Henry the Second, and her daughter-in- law Constance, were on inimical terms, and bandied foul epithets without stint or measure. The daughter thus accuses her mother: " Thy sins are visited upon this poor child ; the canon of the law is laid on him, being but the second generation removed from thy sin conceiving womb." It is natural to infer from the foregoing paragraph that history Avould give some data upon which to found the intimation which is there clearly made touching a lack of chastitj' on the part of Elinor, OBSTETUICS. 35 the widow' d queen of the second Henry ; from the history of that period now at my command, it is not apparent that such charges were reall}^ ever preferred against her. Tiiis same Constance, who seems to have been the widow of the king's eldest son, and who had died before his father, somewhere about 1185 or 6, leaving one son, Arthur, who his mother, then a scheming widow, wished to place upon the English throne ; and failing in accomplishing her purpose, even after entering into an arrangement with the king of France, who ultimately "went back on her," — her son in the meantime being taken prisoner by his uncle John, who was then king, and who was accused of murdering the boy with his own hand — she thus pours forth a tirade of bitterness against mankind in general, ending in these words: "Let wives with child pray, that their burdens may not fall this day, lest their hopes pro- digiously be cross'd." Next we have, "Have we more sons, or are we like to have? Is not my teeming date drunk up with time, and wilt thou pluck my fair son from mine age, and rob me of a happy mother's name?" This was the language of the wife of the Duke of York, in Richard the Second, when expostulating with her husband, who had determined to acquaint the king of a plot against his life, — his own son being one of the conspirators ; she then goes on: " Hadst thou groan'd for him as I have done, thou wouldst be more pitiful. But now I know thy mind ; thou dost suspect that I have been disloyal to thy bed, and that he is a bastard, not thy son." York flies to the king, and whilst he is divulging the plot his wife also hastens thither, when the old duke accosts her thus : "Thou frantic woman, what dost thou make here? Shall thy old dugs once more a traitor rear? " It would seem that each of them had a keen sense of the desola- tion attending the "sere and yellow leaf" of age, and were sad in the prospect of henceforth walking the down grade to the tomb, without even a pleasing retrospection to win them for a moment from the cheerless monotony of their journey. Asperity is not, in general, a concomitant of this period of human existence — a pensive realization of the fact that the spring-time of life has passed — the seed has been sown, the hej-daj' of existence has been reached and the harvest gathered in, and the husbandman has nothing more to do but set thoughtfully by through the autumn and winter, with his 36 SHAKESPEARE AS A PHYSICIAN. hands resting on the top of his staff, contemplating the shadows as they silently fall around him. Patriotism, or love of one's king, would hardly, in these days of self-love, bear such fruits of loyalty as was apparent in this good but mistaken old York. Prince "Hal," the riotous companion of Falstaff, and afterwards the wise and good king, Henry the Fifth, was renowned for his sound and pertinent witticisms. Upon the question of population, on one occasion, he made the remark: "The midwives say, the children are not in fault, whereupon the world increases, and kin- dreds are mightily strengthened ; " which makes it apparent that " Hal," had he lived in this age, would no doubt be a worthy mem- ber of the London Dialectical Society, and discuss " Social Science" with as much logic as Herbert Spencer and the rest of them. It is also apparent that "Sir John" himself had an idea or two in the same direction, as he places his estimate of prince John before the world in plain language ; he made the acquaintance of the prince after the close of the military campaign in which he, Sir John, won such renown, and upon the occasion when he delivered up to the prince the rebel prisoner Colevile ; here is the colloquy : Falstaff. "My lord, I beseech j'ou, give me leave to go through Glostershire ; and when you come to court, stand my good lord, pray, in your good report. Prince John. Fare you well, Falstaff; I, in my condition, sliall better speak of you than you deserve. Falstaff. (To himself.) I would, you had but the wit: 'twere better than your dukedom. — Good faith, this same young, sober- blooded boy doth not love me, nor a man cannot make him laugh; but that's no marvel, he drinks no wine. There's never any of these demure boys come to any proof, for their drink doth so over- cool their blood, and making many fish meals, that they fall into a kind of male green-sickness ; and then, when they marry, they get wenches." In these days, when the action of all alcoholic liquors upon the human economy occupies so unsettled a position in the minds of therapeutists, it is difficult to say whether the idea entertained as to its powers in influencing the sex of our offspring, as suggested in the last quotation, is true or false. Certain it is, however, that wine is a great provocative to venereal appetite, and from that fact it OBSTETRICS. 37 might be inferred that it might on occasions spur one of those cold youtlis into a condition of amorous excitement, whereby he might be- get a boy in place of a " wench." This could only have reason for a basis however, under very special restrictions, or when adminis- tered by the direction of a scientific mind, with a view to build up the weakened functions, as in the following case, treated by Dr. Wilks, an English physician, very lately : '' A little boy, aged five years and a half, was admitted to Guy's hospital in an extreme state of emaciation on Oct. 25th. No disease could be found in him, and it was thought his ailments might be due merely to starvation. In spite, however, of good living and a little wine, he did not improve, and therefore, after having been in till Dec. 15th, he was ordered one drachm of rectified spirits four times a day. In a few days he was better, was soon able to leave his l)ed, and lias been growing fatter and stronger ever since." The "sack," wine, etc., taken in excess, according to the plan of Falstaff, would not have an}^ tendenc}' to aid in the production of robust children, either of the one sex or the other, as it is a lamentable fact that a large majorit}- of the pitiful humanity that people our public charities are the offspring of drunken parents ; this is not only so where poverty is the cause of the change, but is also the case where physical and particularly mental infirmit}^ is the cause which demands the interference of charity — thus plainly telling us that though Falstaff's idea might reach consummation one time in a thousand, it will not do to build upon as a rule. Besides, sack nor any of its kindred compounds are likely to bene- fit " chlorosis " either in the male or female. The eating of fish certainly finds a misapplication in this instance, as it is now supposed that the white meats, and most noticeably among them fish, serves as the best pabulum for brain workers, thus conducing to a mental and physical state the exact antipode to both • green sickness " and the desire to the abuse of the sexual function. At least this is claimed as regards the application to more elegant society, though criticism might find vantage ground by referring to the mental, moral and physical status of the inhabitants of fishing villages — those whose diet consists almost solely of fish. The same might, perhaps, be said however of any people who are not accustomed to a diversity of alimentary substances. I do not find any statistical data to show that in fishing communities female predominates over male births. 38 SHAKKSPEARE AS A PHYSICIAN. / If drinking " sack" liad been the handmaiden of procreation in the day whereof we write, we might have reposed some confidence in the claim of pregnancy put in by the notorious bawd Mrs. Doll Tearsheet; but even with this beverage as a " partus accelerator" we doubt whether she ever conceived or brought forth anything save a bundle of notorious falsehoods, as is the wont of all her class. At the time she makes the asseveration of pregnancy she is in the hands of tlie officers of the law, and perhaps only feigned pregnancy to shield herself from the consequences of crime, as it is not at all likel}^ that one so far gone as she in the trade of licen- tiousness would become fruitful. Here is what she says in con- versation with the officer: 1st Officer. "The constables have delivered her over to me, and she shall have whipping-cheer enough I warrant her. There hath been a man or two lately killed about her. Doll. Nut-hook, nut-hook, you lie. Come on : I'll tell thee what, thou damned tripe-visaged rascal, an the child I now do go with do miscarry, thou hadst better thou hadst struck thy mother, thou paper-faced villain. Hostess. O, the lord, that Sir John were come! he would make this a bloody day to some body. But I pray God the fruit of her womb do miscarry ! " The gestation of " Mistress Doll " was evidently a hoax, because, as stated above, it is seldom indeed that a female so old in sexual license as "Mrs. Doll" preserves the power of reproduction. The oft-repeated and finally the continued engorgement of the pelvic organs incident to the frequent erotic excitement to which such women are constantly exposed, produces a change in the tissues of the reproductive organs incompatible with fruitful ovulation and germination. It is well known that these women, when some years advanced in their lamentable trade, do not become pregnant — the probable sin of abortion, added to their other excesses, thus being spared to them. In King Henry the Sixth is used, illustratively, the term " a child's bearing cloth." Obstetric literature and practice now recognize no article of the lying-in chamber by that name specifi- cally, but the presumption is that the writer has reference to the cloth on which the nui-se receives the new-born babe from the hands of the accoucheur, immediately after its separation from the secun- dines — the good nurse usually, in the hurry and excitement of the OBSTETRICS. 39 moment, seizing the first article with which her hand comes in contact, whether it be a bed comforter or a lace pocket-handkerchief. I liad a ludicrous incident in this connexion to befall myself on one occasion. As is usual, I believe, among doctors of the present (l:iy, I had "palled off my coat and rolled up my sleeves," the = better to facilitate my accoucheural duties ; and when the labor was « finished, my hands washed, etc., and I ready to take my leave, J behold I could not find my coat ! After much search and diligent ! enquiry, however, it was found deeply hidden in the recesses of > the cradle, with the new-comer snugly ensconced therein ! I con- soled myself with the remembrance of the old saw that "accidents will happen," etc. In Henry the Sixth is also an account of the trial and condem- nation of the " Maid of Orleans," wherein the Poet attaches afoul blemish to the character of that unfortunate female, unworthy of a great man — one which should have called down the stern condem- nation not only of the mighty and chivalrous nation to which Joan of Arc belonged, but also of the generous and noble of every land; this is more particularly so, since history gives us no shadow of a ground for sustaining him in an assumption, which he only put forth, doubtless, to gratify a national antagonism that has from the earliest days existed between the Celts and Anglo-Saxons. He brings her forward in a pretext to procure a stay of execution of the sentence of death by setting up a plea of pregnancy, which stay was allowable at that period, provided a commission of mid- wives, who were usually appointed to investigate the matter, re- ported that she the condemned were found actually to be in that condition. She says to her enemies: "Will nothing turn your unrelenting hearts? Then, Joan, discover thine infirmity, that warranteth by law to be thy privilege. — I am with child, ye bloody homicides : murder not, then, the fruit within my womb, although ye hale me to a violent death." It was decided not to entertain this appeal, and the unhappy "visionary" was roasted at the stake. Referring to the custom then common of appointing a commission of raidwives to determine a question in science which involved the life or death of an individual may seem to us in the highest degree farcical, but in reality a board of examiners composed of such material would know just as much with regard to the certainty of the pregnant condition as would a commission of the most enlight- 40 SHAKESPEARE AS A PHYSICIAN. ened physicians. By tliis I mean to say that there are no means yet known to the medical world by which pregnancy can be posi- tively known. Certainly there are many ways "by which the truth is approximated, and by which the intelligent pliysician may be able to satisfy his own mind as to a given case, but to say yes or no under oath would be quite another matter. We are furnished with much better and more specific data when we wish to say a woman is not pregnant. The uterus that is not increased in size above the normal (to that woman) is not pregnant. It may be increased in its dimensions and yet not be pregnant however, and this is often, very often, the case. In forming our diagnosis as to whether pregnane^'' exists, it must first be ascertained whether or not there has been a chance for con- tact between the seminal elements of tlie female and male ; this is a requirement indisi)ensable to fecundation. This union or blend- ing of the sexual elements must find a proper nidus in which to germinate. It is not essential, as would appear from the investiga- tions of Sims, that there be actual contact between the persons of the parties who furnish the spermatozoa and the ovule. The evi- dence positive that the copulative act has happened can only assure us that we have a first stepping-stone, and nowhere, in any direction, is, perhaps, to be seen a positive footing. Doubt of the pregnane}^ may yet be as prominent as ever unless there be present other phenomena characteristic of the condition. Of these, prob- ably, suspension of the menses, morning nausea, irrascibility of temper, appetite for unusual articles of diet, salivation, evident growth of the uterus — are as unfailing signs as can be observed during tlie early months. The click of the foetal heart, at a later period, is of some value. Of course it is not the province of a work like this to enumerate all that might be said upon a subject so extended, but the object sought in the foregoing is merely to call the attention of the reader to a realization of the fact of the limited amount of positive knowl- edge possessed, even at this late day, by the profession upon this seemingly simple subject. It is thought by persons outside of medicine, very generally, that any medical man ought to be com- petent to solve piositively a problem which to their seeming is very plain. The doctrine lately put forth by Jorisenne, that pregnancy may be diagnosed as early as the conclusion of the first month by a OBSTETRICS. 41 uniformity in the frequency of the pulse in the erect, reclining or horizontal position of the body of the female, is perhaps of little worth as a positive means ; it has, however, the merit of easily being put to the test of actual experimentation. If found to be true upon further investigation, it will prove all the more valuable from the fact of its simplicity. King Edward in l)attle with the forces led by the famous Warwick was defeated, and himself taken prisoner. Queen Elizabeth thus laments the catastrophe : Rivers. "The news, I must confess, are full of grief; Yet, gracious madam, bear it as you may: AVarwick may lose, that now has won the day. Elizabeth. Till then fair hope must hinder life's decay ; and I the rather wean me from despair, for love of Edward's offspring in my womb: this is it that makes me bridle passion, and bear with mildness ni}^ misfortune's cross: Ay, ay, for this I draw in many a tear, and stop the rising of blood-sucking sighs. Lest with my sighs or tears I blast or drown King Edward's fruit, true heir to th' English crown." Pregnancy exerts a very powerful influence upon the mental con- dition of many patients, elevating and enlivening the spirits of some, while it causes depression and despondency in others. It is common, I apprehend, for a large majority of women to pass through the gestative process 'mid more of apprehension and solicitude than is generally supposed. This is a necessary accom- paniment of the pains and certain amount of danger which every female instinctivelj' recognizes as inseparably connected with the parturient function ; it is under such circumstances that ho2)e — that sentiment or principle of the human soul without which all in this life would be black and comfortless despair, comes in to sustain and encourage them. If there is ever an hour in human existence when a person needs the kindly offices and sympathies of husband and friends, it is found in the life of woman during pregnancy. To carry to a successful termination a gestation which is the pro- duct of the man she loves, a woman will make the most unheard-of sacrifices ; and more particularly is this so if the partner to her condition be dead or in trouble. The whole idea of Elizabeth could be summed up in the simple sentence — "something to love and live for." 42 SHAKESPEARE AS A PHYSICIAN. It is a curious but cogent commentary upon tlie force and cliar- acter of tlie writings of Shakespeare, that although his delineations are drawn always in a merely histrionic spirit, yet they are so faith- ful a portraiture of the times, places and people to whom they appl}', that even at this day, and among the most scholarly people, they are accepted as veritable history. There is little doubt, however, but that the paucity of books at the day in which he wrote rend- ered the drama a means not only of amusement but also a source of knowledge to the play-goers ; and hence the incentive for keep- ing to the real as much as possible in the cultivation of theatric art. In the present age the morning paper is our educator, and something onl}^ to please is brought upon the stage. Fiction of the purest type is now the fashion. The good but imbecile king, Henry the Sixth, whose reign was practically ended at the battle of Tewkesbury, and who, after a rigorous confinement in the Tower at London was supposed by historians to have been murdered by the usurping Richard the " hunchback," — the same monster in partial human form who is made to commit the deed, with his own hand, by the dramatist, — had the history of his own entrance into the world given to him, by the imprisoned monarch, at the time when he went into the prison- cell to murder him. The good king knowing full well his bloody intent, and the utter hopelessness of asking mercy at his relentless hands, makes good use of his few remaining moments to paint the monster, to his own face, in all his hideousness. He says: " The owl shriek'd at thy birth, an evil sign: the night-crow cried, a boding luckless tune ; dogs howled, and hideous tempests shook down trees : the raven rook'd her on the chimney's top, and chattering pies in dismal discord sung. Thy mother felt more than a mother's pain, and yet brought forth less than a mother's hope ; to-wit, — an indigest, de- formed lump, not like the fruit of such a goodly tree. Teeth hadst thou in thy head, when thou wast born, to signify thou com'st to bite the world: and if the rest be true which I have heard, tliou com'st to — " Here Richard stabs him ; but after he has committed the bloody tragedy, he concludes the history himself : — "I have often heard my mother say, I came into the world with my legs forward. Had I not reason, think you, to make haste and seek their ruin that usurped our right? The midwife wonder'd ; and the women cried, ' Jesus, bless us! he is born with teeth ; ' and so I was." OBSTETRICS. 43 We note in the foregoing description of the parturient stage in •woman tlie same wonderful accuracy of detail in which our author is usually so fertile. Did he learn all this from his own observa- tion, or was this wonderful tact in looking into human character inherent? I have thought it must be that he kneio intuitively — that A man in an ordinar}' lifetime, no difference how profoundly ob- servant powers might be developed in him, nor how favorable his opportunities for observation, could never have learned so much of human nature as is evinced in his writings. See how he names the leading facts connected with labor. First he makes it occur in the night — making it coincide in this particular with the common time of its occurring ; then he makes the night one of the dismal kind, — thus placing it in close relation perhaps to fact. Night seems actually to be the time in which most labors happen, and bad nights are the ones most likely to be chosen b}' — what? for the occurrence of the labor. I was going to say •chosen by the mother, but then accuracy of expression forbade my doing so, because the poor mother has no choice in the matter. I was then going to say the babe chose the time at which to come into the outer world, but here again I am checked in reckless assertion, and made to acknowledge humbly that no one knows why nights — nights in which hideous tempests shake down trees — are the most seemly for such occasions, in the view of that nameless cause which man knows not of. We can see the profound superstition of the age holding place even in the mind of Shakespeare himself, in his allusions to the hooting of the owl, the boding luckless tune of the night-crow, the howling of the sleepless dog, the croak of the raven and the chat- tering of the pies. Who among us, even now, are entirely free from a small degree of the same.? Then again, the assertion that Richard came into the world with teeth would no doubt in that age have excited wonder and been grounds for forebodings of good or of evil for the possessor, just as the whim of the nurses might have dictated. This departure from the ordinary law of development is not often observed even among professional midwives and obste- tricians of large practice, altliough it has been many times noticed. Why it does not happen oftener is a matter for wonder, as of all the histological elements which go to make up the human body teeth are found to be oftener generated in error than any other tissue, and this alwavs during intra-uterine life. This curious fact 44 SHAKESPEARE AS A PHYSICIAN. is, however, oftener observed to happen in females, — the favorite situation for their development being the ovary. As many as three hundred fully developed teeth have been found in a single ovary. They are however also noticed in tumors of the male — more par- ticularly, I believe, as connected with the testes. , Deviations from normal development occurring previous to the termination of fa^tal existence are embraced under the scientific name (cyphosis) Teratology, — the signification of which is " mon- ster:" — an " indigest deformed lump" is what our author well names it in the case of Richard. The causes of these lacks of proper development are susceptible of being viewed from two stand-points — -the one pertaining to the parents, the other to the foetus itself. In regard to the first, it is believed that the germ furnished by either or by both parents may be diseased or defective in form or composition, and thus b}^ transmission we will have lack of a perfect offspring. Or, then, the impression may be made on the plastic tissues of a healthy foetus while in utero by various causes operating on it, such causes being themselves contained in the womb also in some instances, and thus acting directly upon the offspring ; w^hile another class of causes may be found to be extra uterine, but yet having their seat in the pelvic cavity, — or yet again they may reside outside of the mother's body, but produce, when brought into activity, like results. Of the first of these we can know but little. They may pertain to an undue proximity of some point in the developing tissue of the child with some point — as of a uterine tumor, for example, or a pelvic exostosis — in the mother. A nodule in the placental tissue, or a knotted umbil- ical cord may lie so in contact with the soft tissues during foetal development as by its pressure to cause a failure of organization at a given point. Of course these are but hypotheses, — because, as I said above, etiological factors belonging to this category are very obscure. These causes may operate upon one or more points of the foetus at the same time, thus producing one or more species of malforma- tion in the same person. The law whicli seems to be always fol- lowed in Teratology may be formulated somewhat intelligibly in the following manner: 1st, Dissimilar parts of the body never become united, — as a union V)etwecn an arm and afoot; nor is a hand ever found attached to a leg. It is only parts which are developed from the same OBST ETHICS. 45 isolated mass or " germinal spot," if wc may so term it, wbich become thus united. 2d. Malfornietl parts are restricted to tlieir proper place on or in the bod}'. 3d. No malformed organ ever loses entirely its own character ; that is, Nome of its form, structure or function will remain, no difference how great the deformity. Nor will a deformed animal lose its generic distinction. The dog in the process of development may appear with an abbreviated tail, yet he is a dog all the same. 4th. Double deformities are always of the same sex. No men- tion is made by any observer worthy of credence wherein the male and female have been found united in the same or a similar manner as were the Siamese Twins. The second class of causes which produce malformations of the foetus, or arrest of its complete development, are to be found in the numerous class of external agencies which may operate through, of course, the medium of the mother's tissues. These would in- clude mainly agencies of a mechanical nature, and are, therefore, so numerous and so diversified in kind that it would be superfluous to enumerate them here. It would appear to one who gives thought to the subject, and analyzes closelj' the mental traits given to Richard by Shakespeare, that they belong more to that class of hunchbacks the deformity in whom occurs at a post natal period,- — those who are congenitally de- crepit usually lacking in their mental make-up the witticisms which render the others so companionable, and the sarcasm which is in them such a prominent characteristic. In the latter, also, what they lack in physical powers to render pugnacity successful they find supplied to them in the sting at the point of the tongue. We find two causes operating to render the labor of Richard's mother severe, and to cause the woman who brought him forth to feel " more than a mother's pains." These were the deform- ity and the presentation of the feet, either of which was sufficient doubtless to produce more pain than in a normal labor ; while both, occurring at once, would complicate the case yet more. Of course, in a case of presentation of the feet the preparatory stage of the labor is much prolonged, from the lack of the steady, even pressure of the head ; and the pain and suffering are augmented accordingly. Many women also suffer much from an impossibility to speedily deliver the head. The accuracy of the observation 46 SHAKESPEAKE AS A PHYSICIAN. then, as applied to these two points, in our author's description^ mainly defy the criticism of even the present era. But the foregoing description of the mental and physical com- ponents of Richard the Third is not by smy means given in full, and consequently all that may be written upon them cannot be deduced from a text so incomplete. The full description of his make-up, and the construction which he himself places upon the anomaly, will be found under the heading " Miscellaneous " in the last chap- ter of this volume. Apology may here also be mentioned for the apparent repetition therewith associated, but it is considered better to hazard the risk of criticism in that direction than that for ambig- uity. In the next quotation we find some seeming contradictions to declarations given above — a fault seldom observed in Shakespeare's writings. Of a piece with the description of the birth-night of Richard is that of the fearful tumult on the night of the murder of Duncan, and that of the night before the assassination of C»sar, as wit- nessed by Casca. This same distorted cut-throat, Richard, on another occasion, whilst imprecating Nature for not bestowing upon him fairer fashion, declares he came into this breathing world be- fore his time and only half "made-up;" whilst Margaret, the widow of the murdered king, tells what she knew of the miserable wretch in these words : "Thou elvish-marked, abortive, rooting hog! thou that wast seal'd in thy nativity the strain of nature, and the scorn of hell! thou slander of thy mother's womb! thou loathed issue of thy father's loins! " It is not probable that his "half make-up" was because of his having " come before his time into this breathing world," because premature children have imperfectly developed appendages, as the nails, etc., and would therefore not be likely to possess teeth, as it is asserted that this boy had, at birth ; nor is it likely that the term " abortive" used by Margaret had reference to untimely birth, but only to lack of physical development. The same Richard in an effort to enlist the populace in his favor and against his own brother, thus impeaches his mother's virtue: (To one of his adherents.) "Tell them that when my mother went with child of this insatiate Edward, Noble York, my princely father. OBSTETRICS. 47 then had wars in France; and l\y true computation of the time, lound that the issue was not his begot. " It could with some plausibility be argued that the physical de- formity of Richard was an inheritance from his parentage in the manner first discussed — namely, in the form of aljnormal germ-life as the gift of one or the other of his parents, or of both the father and the mother. It is seen in the quotation above that he openly declares the lack of virtue in his mother, and it may thus have liappened that it was some constitutional or sexual malady in her that retarded or arrested the development of the "hunch-back" while in utero. On another occasion, where he wished to marry his own niece to assist him in his designs upon the crown, he uses the following argu- ment to the girl's mother: " If I did take the kingdom from your son, to make amends, I'll give it to your daughter ; If I have killed the issue of your womb, (he had killed his two young nephews) to quicken your in- crease, I will beget mine issue of j'Our blood upon your daughter. A grandam's name is little less in love than is the doting title of a mother: They are as children, but one step below, even of your mettle, of your very blood ; of all one pain save for a night of groans endured of her for whom you did like sorrow. " Shakespeare denominated it a '• night of groans " from the mouth of " Dick the Third, " while in the tongue of our Native America it is often designated by the laconic term a " grunting. " This is one of the popular terms used for labor among the good old country women of Missouri, and is about as significant an appellation as any in use. This appellation is also applied to labor by Hamlet in his somewhat broad conversation with Ophelia as is noted in the last paragraph of this chapter. To this individual, Richard the Third, we can well apply the truism, that men's evil manners live in brass, whilst their virtues are written in water, Henry the Eighth furnishes us a few lines on the su])ject of pro- creation. A gentleman of the court in speaking of the manner in which the people did reverence to Anne Boleyn (Anne Bullen in the drama), the second wife of Henry, at the time of her marriage thus illus- trated the matter : (To a friend. J "Believe me, Sir. She is the 48 SHAKESPEARE AS A PHYSICIAN. goodliest woman that ever lay by man ; which when the people had the full view of, such a noise arose as the shrouds make at sea in a stiff tempest, as loud, and to as many tunes: hats, cloaks, (doublets, I think) flew up ; and had their faces been loose this day they had been lost, such joy I never saw before. Great-bellied women that had not half a week to go, like rams in the old time of war, would shake the press, and make them reel before them." After this marriage, in due time it is announced, "The queen's in labor; they say, in great extremity, and feared she'll with the labor end. " This was a conversation between two courtiers, and was follow'd at another place by a talk between the King and an attendant on the same subject: King. "Now, Lovell, from the queen what is the news? LoveU. I could not personally deliver to her what you com- manded me, but by her women I sent your message ; who return'd her thanks in the greatest humbleness, and desir'd your highness most heartily to pray for her. King. What say'st thou? ha! to pray for her? what! is she cry- ing out? Lovell. So said her woman ; and that her sufferance made almost each pang ar death. King. Alas, good lady ! Suffolk. God safely quit her of her burden, and with gentle travail, to the gladding of your highness with an heir! King. 'Tis midnight, Charles ; pr'y thee to bed ; and in thy prayers remember my poor queen. Leave me alone, for I must think of that which company would not be friendly to. Suffolk. I wish your highness a quiet night ; and my good mis- tress will remember in my prayers." The queen's labor progressed in the meantime, and an old lady enters the king's apartment in haste. Gentleman. (To the old lady.) " Come back ; what mean you? Old Lady. I'll not comeback ; the tidings that 1 bring will make my boldness manners. — Now, good angels, fly o'er the royal head, and shade thy person under their blessed wings ! OBSTETRICS. 49 \ : "Now, by thy looks, I guess thy message." Kinrj. Now, by the looks, I guess tliy message ; is the queen deliver'd? Saj'^, ay ; and of a bo}^ Old Lady. Ay, ay, my liege ; and of a lovely bo.y : The God of heaven now and ever bless her. 'Tis a girl, promise boys hereafter. Sir, your queen desires your visitation, and to be acquainted with the stranger : 'Tis as like you as cherry is to cherry. King. Give her an hundred marks. I'll to the queen. (Exit King.) 50 SHAKESPEARE AS A IMIYSICIAK. M J ^% # Old Lady. An hundred marks ! By this light, I'll ha' more ; an ordinary groom is for such payment : I will have more, or scold it out of him. Said 1 for this the girl was like to him? I will have more, or I will unsay 't ; and now, while it is hot, I'll put it to the issue. " In that portion of the quotation relating to the queen's labor, the description is graphic, and as true to nature as had it been drawn with the pen of a master in the science of obstetrics. How Shakespeare could have become possessed of a knowledge so accu- rate in regard to scenes and incidents in the lying-in chamber, is a problem. His domestic experiences in that particular were hardly of an order voluminous enough to have given him so correct an idea. It was another of his uitnltions. How true to the life also are his doings of the old midwife flattering the old king and then grumbling over the amount of her fee! How more than natural for the penurious old monarch to award her niggardl}^ pay- Verily, humanity i)resents itself in the same garb among the high and the low, the rich and the poor, — among all nations and in all ages. n OBSTETRIC!--. 51 A " Mark " in English money equaled about thirteen shillings and six-pence, which multiplied b}' one hundred would be considered a pretty liberal fee among modern accoucheurs in ordinary practice, but perhaps if you my reader, or I, had a royal patron we might indulge the thought that an '• hundred marks " for a case of obstetrics was nothing extra in the way of remuneration ; and the king's action in the matter of the fee was in strict keeping with the humanity which hovers along the pathway of the physician " from the college to the grave. " In Coriolanus we find the good Virgilia declining a pressing in- vitation of her mother-in-law Volumnia, who wished her to accompany lier on a visit to a good lady that " lies in ; " and in " Titus Androni- cus, " we have a goodly display of procreative knowledge in the details of the relations which existed betw^een Tamora, queen of the Goths, and Aaron, her black paramour, whose " soul was black as his face." Tamora had been prisoner to Saturninus of Rome, and through his gallantr}^ he had married her and placed her in high estate. Aaron, her black lover, had been prisoner also, and it seems that their familiarity, which existed at the time of their durance^ had continued after she became empress of Rome, thus laying the foundation for the black-a-moor child which figures in the quota- tion. Demetrius. "Come, let us go and pray to all the Gods for our beloved mother in her pains. Aaron. Pray to the devils ; the Gods have given us over. Demetrius. Why do the emperor's trumpets flourish thus? Chiron. Belike, for jo}- : the emperor hath a son. Demetrius. Soft! AVho comes there? (Enter a nvrsp., irithahlacTi- child in her arms.) 52 SHAKESPEARE AS A PHYSICIAN. " Look how the black slave smiles upon his father." Nurse. Good morrow, lords. O ! tell me, did you see Aaron the Moor? Aaron. Well, more, or less, or ne'er a whit at all, here Aaron is ; and what with Aaron now ? Nurse. O, gentle Aaron, we are all undone! Now, help, or woe betide thee ever more ! Aaron. Why, what a caterwauling dost thou keep ; what dost thou wrap and fumble in thy arms? Nurse. O, that which I would hide from heaven's eye, our empress' shame, our stately Eome's disgrace. She is deliver'd, lords ; she is deliver'd. Aaron. To whom? Nurse. I mean she's brought to bed. Aaron. Well, God give her good rest! What hath he sent her? Nurse. A devil. Aaron. Why, then, she's the devil's dam ; a joyful issue. Ncrse. A joyless, dismal, black and sorrowful issue. Here is the babe, — as loathsome as a toad amongst the fairest burdens of our clime. The empress sends it thee, thy stamp, thy seal, and bids thee christen it with thy dagger's point. Aaron. Zounds! ye whore, is black so base a hue? — Sweet j blowse fto the hahe)^ you are a beauteous blossom sure. Demetrius. Villain, what hast thou done? Aaron. That which thou canst not undo. OCSTKTIMCS. 53 Chiron. Thou hast uiuloue our mother. Aaron. Villain, I have done thy mother. Demetrius. And therein, hellish dog, thou hast undone. Woe to her chance, and danin'd her loathed choice ! Accurs'd the offspring of so foul a fiend! Chiron. It shall not live. Aaron. It shall not die. Nurse. Aaron, it must: the mother wills it so. Aaron. What! must it, nurse? then let no man but I do execu- tion on my tlesh and blood. Demetrius. I'll broach the tadpole on my rapier's point. Nurse, give it me ; my sword shall soon dispatch it. Aaron. Sooner this sword shall plow thy bowels up. (Takes the child from the nurse. J Stay, murderous villains! Will you kill your brother? Now, b^' the burning tapers of the sky, that shone so brightlj^ when this boy was got, he dies upon my scimitar's point, that touches this my first-born son and heir. What, what, 3'e sanguine, shallow-hearted boj's! Ye white-lim'd walls! ye ale- house painted signs ! coal-black is better than another hue, for all the water in the ocean can never turn the swan's black legs to white, although she lave them hourly in the flood. Tell the empress from me, I am a man to keep my own ; excuse it how she can. Demetrius. Wilt thou betray thy noble mistress thus? By this our noble mother is forever shamed. xiaron. (Speaking of the babe.) Look how the black slaA^e smiles upon the father ; he is your brother, lords, — of that self blood that first gave life to you, and from that womb where you imprisoned were, he is enfranchised and come to light : he is your brother by the surer side. Not far hence lives Muli, my country- man ; his wife was but yesternight brought to bed. His child is like to her, fair as you are ; go pack with liim, and give the mother gold, and tell them both the circumstances of all ; and how by this their child shall be advanced and be received for the emperor's heir, and substituted in the place of mine to call in this tempest whirling in the court, and let the emperor dandle him for his son." Cornelia, a midwife, olHciated on this occasion also, and according to the story of the nurse there were present at the accouchment but Cornelia, herself and the empress — the commer^dable custom being then in vogue to not be over-crowded with female assistants 54 SHAKKSI'EARE AS A PHYSICIAX. as has become somewhat the fashion in our day ; though the repre- hensible practice of employing only women — a midwife, and nurse, was then tiie invariable rule it seems, as Shakespeare no where introduces a male accoucheur in any of his obstetric scenes. We look with wonder upon the picture of depravity drawn from life at the head of a Roman court, where the empress, fair as a lily, in lewd embrace clasped to her bosom a murderous and licentious black-man. This was in the far-off past, and yet, through the gloom of twenty hundred years, its horrid details are sufficient to till us with loathing. It seems that these high digni- taries of earth, whose every walk in life should be an example from which the lowly might draw lessons of purity and goodness, are the very first to walk the highways of vice wherein the meanest plebe- ian should blush to be seen. Whilst those who lead are blind, we need not wonder that the led also stumble. We come again to speak of the nubile age, and give more fully the matter pertaining to the marriage of Juliet and Romeo. We find Capulet making plea that his daughter is too young to marry : CcqmJet. ''My child is yet a stranger in the world ; she hath not yet seen the change of fourteen years : Let two more summers wither in their pride, Ere we may think her ripe to be a bride. Paris. Younger than she are happy mothers made. Capulet. And too soon marr'd are those so early married." If all our own authorities are not at fault in observation, this remark of Capulet' s in regard to the pernicious effects of earl3' marriage is strikingly exemplified in American women. The cus- tom has obtained in this countrj'^ for persons of both sexes to enter the connubial state often at an age when their youth should pre- clude all thought of such a consummation ; and the result is seen in the wan faces and premature decrepitude of a large majority of the child-bearing women, even in the rural districts of our countrj'. The early and long continued procreative effort which results in a numerous })rogeny. together with the toil and care incident to the maintenance of a large family, have become a noticeable fact in our domestic life; and the burdens entailed upon our females as a consequence, may justly come in for their share of the censure which is no\\ .(joming inio vogue upon those who are endeavoring to adopt soini" plan for the limitation of offspring. It is not all to be OBSTKTUICS. 55 laid at Iho door of a desire for fashionable life, etc. — tiiis growing desire on the part of our females to limit the number of their children ; but it has its origin in l)urdens too grievous to be quietly borne. — Hence the growing sentiment which seeks means, — often illegitimate it may be, to rid them of an evil they know not how else to avoid. The custom of early marriage, and the rearing of a numerous progeny, as applied specially to the American people, is the result of )Hiti(nd conditions. Our country is broad and new, and possessed of resources which invite youths to an early dependence upon their own energies for an independent life, whilst the spirit of our political system, and the often crowded and frugal conditions of the parental home, all exercised a marked influence in directing the minds of our young men to early marriage. Theory prompts to this course in life— a course really the most inviting and acceptable to a large portion of American youths, whilst the practical working of the s^'^stem has shown it to l)e fraught with evils which have not been taken into the count — that of an unusual decadence of the physical, moral and social life of these young parents, and in a measure that of their offspring also. I emphasize the word moral, for it is asserted by a majority of our best men and women, that in seeking a refuge from the burdens of a large family, our females are not only deteriorating physically but also morally, in the effort. Mental degeneracy might also be added to the catalogue. "Whilst it is believed that all the evils herein named do exist to a greater or less extent among our people, I am far from conceding that they exist to an extent sufficient to cause any alarm even among that class of maudlin philosophers who make social science a specialty ; therefore, I can calmly recommend to those who feel seriously upon the subject, to possess their souls in peace, as there is little danger at present that the Yankee race will dwindle to exhaustion from excesses in the effort of procreation ; or, on the other hand, pass from the stage of living nations in an unholy con- flict with non-propagation. We have yet ample elbow-room. The practice, yet common among nursing women, of applying aloes or some other bitter or nauseous material to the nipple to pre- vent the babe from taking it at the time of weaning, finds a prece- dent in the case of the nurse who was so closely identifled with Juliet's existence : y^ 56 SHAKESPEARE AS A PHYSICIAN. Nurse. " On Lammas-eve shall she be fourteen: that shall she: I remember it well. 'Tis since the earthquake now eleven years ; and she was wean'd, — I never shall forget it, — of all the year, upon that day ; for 1 had then laid wormwood to my dug, setting in the sun under the dove-house wall : You and my lord were then at Mantua. Nay, I do bear a brain: — but, as I said, when it did taste the wormwood on the nipple of my dug, and felt it bitter, pretty fool, to see it tetch}', and fall out with the dug! Shake, quoth the dove-house ; 'twas no need, I trow, to bid me trudge." How true to the life is this picture of a garrulous nurse, and how true to the welfare of the human family is the principle herein laid down by her, as to the period during which a child should be nursed. The data goes to show that Juliet was nearly three years old at time of weaning, thus making it apparent that the murderous habit of depriving the babe of its natural aliment at an earlier age was not in vogue at that date, even among the fashionable and aristocratic. The ability to discriminate between the true and the false is no where in the writings of the dramatist more forcibly exhibited than in the few thoughts attributed to this nurse, and the bearing pos- sessed by the nursing period upon the weal or the woe of mankind. This can in no way be better here exhibited than in the quotation presented below: {Obstetric Gazette^ Vol. 1, No. 2; The Mammary Gland. By J. P. Chesney, M. D.) "To show the wisdom of a lengthened lactiferous period, it is pro- posed to speak speculatively of the female breast, and its relations to the well being of the mother and her offspring. We shall first notice it in its relations to the child. The milk of the human female in its composition fills more nearly the require- ments for tissue building than any other substance with which it is possible to supply the young child. Its tissues require for their development not the substantial elements which give firmness and solidity to its structures, but those which impart to them flexibility, plasticity and a capacity for expansion and growth. I hold it to be a fundamental proposition that no child was ever properly nursed, and I may add properly nourished, who did not draw the pabulum for its first two years sustenance from the breast of her who con- ceived and brought it into existence. Nature does not afford nor can art supply any substitute for this food. Supply the infant with the most perfect wet nurse possible, and you will find there is some incompatibility between her organization and that of the infant OBSTETRICS. 57 of another, — some incomprehensible idiosj-ncrasy which forever prev^ents a perfect reciprocity between them. She is not its mother. Jt is not her child. Children who battle with inanition from lack of the mother's milk, are of two classes. Those who starve and those who half starve. The first emanate from the abodes of luxury on the one hand and from the perlieus of wretchedness on the other; the one goes into the hands of the wet nurse for a few weeks and then to a little gilded tomb; the other is "farmed out" and in the same few weeks its emaciated little form is put silently away. This occurs in large cities where the extremes of society meet face to face. We in the country seldom see it. AVith the second of the classes, the half starved, we are somewhat more familiar. These children are the offspring of all grades of society, and are to be seen in every community. These are the vic- tims of earl}' weaning. This class is more numerous than the other, and therefore furnishes the man who carries the hour-glass and scythe his most abundant harvest. Those who die at the behest of fashion and of remorseless poverty, die a little earlier ; the others, not quite so soon, but equally as sure, from devotion to " custom." Between those mothers who do not nurse at all and those who do not nurse enough must be divided the responsibility of our great infantile mortality. Half of mankind dies before the second den- tition. Let every mother, from the humblest up to the wife of the President, nurse her own babe ; her milk is its life. Let the practice tall}^ with the theory that what we are we suck from our mother's breasts, and we shall regenerate a nation. As will appear by the foregoing, it is my firm conviction that our teachings and the practice built upon them relative to the proper time at which to wean the infant are fundamentally erroneous. The commencement of, or a reasonable progress in the first dentition is claimed by respectable authors, and agreed to by most mothers and nurses as a safe guide in weaning the babe. This takes the babe from the breast at ten or twelve months of age. The first dentition I certainly think is such a guide, but its lan- guage must not be misinterpreted. It does not necessaril}^ follow that because an infant in utero has a stomach it must therefore receive food, that because it has eyes it must then see. Nor is it essential that because a child is born with legs it must be immedi- ately placed upon them and made to walk. Infants may have teeth •58 SHAKESPEARE AS A PHYSICIAN. at the age of twelve or fifteen months, but even then they are only few and rudimentary, and wholly unfit for organs of mastication. The end of twenty-fourth or thirtieth month completes the deciduous •dentition, and not an hour before the first of these dates can a child be legitimately weaned. In reference to the influence exerted b}^ the lacteal functions upon the well-being of the mother, we may notice it in its bearings upon "her morall}'', mentally and phj^sically. There seems to be Uttle •doubt but that the peculiar mode of thought which induces a healthy mother to abandon to another the sacred duty of nursing her child, has its culmination, in many instances, in a loss of interest in her family, and a plunge headlong into idleness, extravagance, licen- tiousness, shame, disease and death. The babe at its mother's breast is the golden chain which binds happiness and virtue to the hearth-stone, and the woman who ignores its dictates is unfit for wife or mother. She who does not nurse her ■own infant, and she who is constantly in the hands of the abortion- ist, are twin sisters, and their works stand side by side as monu- ments of depravity. It is, however, more within the province of the physician to view the mental and physical ills which befall the woman from a quiescent state of the mammary glands. When we call to mind the close relations which exist between the mammary glands and tlie reproductive organs proper, — remember that it is through the impressibility of the nervous S3"stem alone that this relation is maintained, we need feel no surprise when we some- times find these cliains of communication themselves becoming the seat of morbid action ; and while any tissue or organ may perchance become the focus of disease in this way, yet it is to the brain and nervous system where we may look with most certainty of recogniz- ing its manifestations. Disturb the harmonious action of reproduc- tive life, and neuralgia, hysteria, catalepsy, chorea, epilepsj^, and the various forms of insanity arise to tax our professional acumen. The mainmaiy glands are really annexie of the female generative organs ; their sym[)athies arc therefore so closely interwoven, that a disturb- ance of the functions of the one cannot fail to leave an impression on the other. It is not my purpose, however, to speak of the path- ological conditions of the breast and the disturbances thence reflect- ed, but m}'- thought is simply to note the pathological concomitants of a forced or voluntary suppression of the lacteal function. And first as to the menstrual function. OBSTETRICS. 59 The two oliit'cs are so closel}' allied that the one may almost per- fectly supply to the woman the place of the other. Women Tv^hose maternal instincts persuade them to let their babes tug at the breast eighteen, twenty or twenty-four montlis — " lets them stand on the floor and suek," to use the saying of a wise friend of my own — are nearly always doing a wise thing iinwittingl}', both for themselves and their offspring. Wise for themselves, because the lengthened period of lactation gives to the womb and its proper annexe a peri- od of rest indispensable to the proper performance of their func- tions. Of the thirty years of procreative life in the human female, not more than ten ought to be devoted to fruitful ovulation. The life of our women is spent between hemorrhage and gestation ; their existence is but a succession of bleedings and pregnancies. Woman was fashioned by her author to produce and SMcA'Ze chil- dren. The gestative period is placed almost specificallj'^ at nine months ; to this add the nursing period, which is placed with almost the same precision l)y nature at two years, and we have a period of near-* I}' three years in which the menstrual function of most women will remain passive. This will give eight or ten normal pregnancies during the child bearing period, — a number which very closely coincides with 60 SHAKESPEARE AS A PHYSICIAN. our observations as connected with our mostliealtliy and prosperous rural families. — Families who do not know the definition of " wet nurse," "neuralgia," and "abortion." I assume in this paper what I believe to be true, namely, that if from the first the mothers nurse their babes the full length of time as pointed out by nature as necessary, they will not be likely to menstruate at seven, ten or thirteen months after labor. Work the lacteal glands normally and the womb is not forced into premature activity. Let every mother whose general health will allow her, nurse her babe twenty-two, twenty-four or thirty months, in place of the eight, ten or twelve, as is now the custom, and we shall hear much less of menorrhagia, leucorrhoBa, sub-involution, procidentia and the other ten thousand ills to which she is now a prey. And so, in like manner, we may often trace a clear connection between the uterine congestions consequent upon a repeated ovular nisus, and the many inflammatory conditions which beset the womb ; I am impressed with the belief that to this cause can be traced most of the ulcerations, erosions, endometritis, cellulitis, pelvic abscesses, etc., to which our notice is so frequently called. We must give the womb and ovaries ample rest if we will have them do their work well. I use the term "ovulation" to imply the irruption of matured "germ cells," meaning of course to exclude all of that vast crop which aborts during the periods of lactation and pregnancy. The fact is remarked by all medical authorities that it is at the close of menstrual life in married women that malignant maladies are most likely to assail them ; more particularly their generative system. Cancers of the ovaries, womb and breasts are likely to occur, while with matured females who have never given milk at all, the same maladies occur earlier, in a greater proportion of such women, and are none the less surely and speedily fata!. In this latter class particularly is it that a crop of fibroids is likely to be developed to the full. The uterus in its effort to do its office of reproduction, — never having received and been rendered satisfied by the normal stimulation of impregnation, makes a futile attempt to do its nat- ural function without assistance, and the effort results in an abor- tion — a failure — or what is infinitely worse, the production of a crop of parasites, which sap the foundations of life and hurry the woman to an earlier grave. Without a healthy parentage we cannot hope for a normal con- f)BSTKTRICS. Gl ception, a healthy gestation or a robust progeny. The early cessa- tion of the lacteal function whether froni design or accident I believe forms no small factor in the production of abortions. I think we need not invoke that ver}^ unsatisfactory explanation, the "abortive habit," to meet the difliculty. The compensatory balance which should exist between the generative and lacteal organs is disturbed by the lack of mammar}' activity; and, to fufill a law of the economy, the procreative centers are called into play, " come to the rescue," it may be — at a time when they are not recuperated sufficiently, from recent gestation, to admit of tlie nutrition proper for a normal ovum. The force is equal to the germination of the seed, but insxifficieyit to carry it to maturity. As to the effects of lactation upon rep rod act ion it is barely neces- sar}^ to speak farther. The term " reproduction " cannot properly be confined in its sig- nification to the periods of conception, gestation and parturition, but it must be made to include the period during which the new being is dependent upon the elaborative offices of its mother for its suste- nance also. Therefore the work of the whole machinery is necessary to a perfect finish. To perfect the act of propagation the mammar}^ glands are as essential as the womb and ovaries themselves. Of course it should be the desire of every individual, community and nation that none but healthy offspring be propagated. To accom- plish this successfull}^ the mother must of necessity bring to her aid all the resources with which the Creator has endowed her. Pier in- stincts, her reason, and her moral training must point out to her the most perfect application of these means to the purposes for which each was designed. Each of these resources has a law which governs it with almost specific certainty, and to learn their interpretation and act upon them in good faith is the office of the wife and mother." Capulet, as alread}' seen, opposed the marriage of his daughter whilst yet so young, while on the other hand, her mother argued thus : " Well, think of marriage now ; younger than you, here in Verona, ladies of esteem, are made already mothers." Juliet was not 3'et fourteen, and if younger than she were made already mothers, that would presuppose the menstrual function to have been established near upon the twelfth year, — an age much too early as appears in the argument put forth in the earlier pages of this chapter. f)2 SIIAKKSl'KAUK AS A PIIYSKIAX. In oui* couiitiT, where fourteen is aliont the period at which a majority of our girls take on menstrual life, out of some hundreds- of obstetric eases, tlie writer of these lines has attended but one patient under the age of fourteen, and she was a girl of more than ordinar}' physical development, and is now, though comparatively young, at least ten years in advance of her real age. The same. talkative nurse, whilst plotting and working in the inter- ests of Juliet and Romeo, thus remarks: " I am the drudge, and toil in your delight, But you shall beare the burden soon at night." It is uncertain whether we are to infer that copulation or parturi- tion is meant in this language, l)ut more probably the latter, as com- mon observation has taught mankind in general that child-birth is more common at night ; — the other, also, perhaps ; but burden would come in therewith as a misnomer as applied to the former it is thought. Capulet, in his anger against Juliet for not wishing to be married to Paris, uses the term " green sickness " in his abuse of her. How well Shakespeare kept to his physiologj^ and pathology, will be ob- served even here, where he makes his charge of chlorosis coincide exactly with the age and non-menstrual condition of little Juliet; though " beauty too rich for use, for earth too dear," as is also declared of her, would hardly have been found coupled with a pale chlorotic face. The term " green sickness " is also used in connec- tion w'ith Marina, the young girl in Pericles, whose virtue saved her, though she was quartered in a bawdy-house. In "Antony and Cleopatra," it is asserted that Jjcpidus, a companion of Caesar, had " green sickness ; " which makes it conclusive that j\ condition analogous to chlorosis in girls was recognized as sometimes afflicting males, even at that early date. When Lady Macbeth w-as informed of the purpose of Duncan, King of Scotland, to pass the night at her mansion, she, after having given her husband a curtain-lecture as to how to " catch the nearest way," thus soliloquis'd : "Come, you spirits that tend on mortal's thoughts, unsex me here, and fill me from the crown to the toe, top-full of the direst cruelty: make thick my blood stop up th' access and passage to remorse ; that no com- punctious visitiugs of nature shake my fell pur[)ose, nor keep peace between th' effect and it. Come to ray woman's breast, and take my milk for gall, you murdering ministers, wherever in-j'our sight- less substances you wait on nature's mischief." OHSTETUU'S. 63 The milk of a woman in the eoiulitioii of iiiiiid in whieh Lady IMac- beth was at the time of tliis self-communion, would not only often prove gall and wormwood to the unfortunate infant that imbibed it, l)ut might, mahap, more forcibly represent nicotine, or prussic acid^ Failing in that as respects its action on the physical well-l)eing of the reciiiient, it would doubtless prove the pabulum for a mental depravitv of the darkest and most malignant t^-pe. Most great scoundrels suck it from their mothers' breasts. Lady Macbeth whilst upbraiding her husband for his reluctance in despatching the sleeping king, enforces her arguments thus: "I have given suck, and know how tender 'tis to love the babe that milks me : I would, while it was smiling in my face, have pluck'd the nipple from his boneless gums, and dash'd the brains out had I so sworn as you liave done to do this." In this quotation we recognize the unexplainal)le truth that whether the young be the offspring of the womb of her that nurses it or not, the simple fact of its receiving its sustenance from her blood serves to engender a tie between the nurse and her charge more closely allied in sympathy, and seemingly approaching a condition of actual consanguinity nearer than does any other relations whatever. This is not so strange, after all. If the blood of the female moulds and forms the being in utero, thus impressing upon it her peculiar traits of character and mind, as also its physical contour, — thus laying the groundwork of an attachment which none but a mother may know, why may not she who afterwards supplies from her own body all the material for the development of the new-born dependant being which thenceforth becomes " flesh of her flesh " grow in love and interest as with her own— which it in reality is? We don't know really but that the nipple is a tie of affection harder to be sun- dered than are the ovaries and womb, and with reason for its foundation. The first attachment has all that endearment of close personal contact and association essential to the generation of our tenderest sj'mpathies, aided by the peculiar instinctive qualit}^ which attaches even the animal creation to that object which is their protege and dependant ; whilst the being in utero is, by most, looked upon as an inanimate nondescript with few claims for love or sympathy. However, give me first the mother who generates and nourishes her own child, and I will present j'ou with a mother who has the only proper maternal instincts ; — next to her — not she who loves the i)leasures inci 124 SHAKESPEARE AS A PHYSICIAN. Prince Humphrey and Clarence are talking to themselves in re- gard to their father's condition, when Warwick thus addresses them : " Speak lower, princes, for the king recovers. Prince Humphrey. This apoplexy will, certain, be his end. King. I pray you, take me up, and bear me hence into some other chamber : softly, pray. (His attendants do as desired.) Let there be no noise made, my gentle friends ; unless some dull and favorable hand will whisper music to my weary spirit. Warwick. Call for the music in the other room. ^ King. Set me the crown upon my pillow here. Clarence. His eye is hollow, — and he changes much. Warwick. Less noise, less noise ! Enter Prince Henry. How doth the king ? Prince Humphrey. Exceeding ill. Wartoick. Not so much noise, my lords. — Sweet princes, speak low, the king, your father, is disposed to sleep." It seems probable from a close scrutiny of the details of this case, that there was a mistake in the diagnosis ; the history of its symp- tomatology would go as near to making it one of epilepsy perhaps as of apoplexy; — the frequency of the occurrence of his "spells," his rapid recovery, the "wearied spirit," his subsequent falling into slumber, his speedy recovery of consciousness, etc., etc., all point to that fact, and all contradict the notion of apoplexy. And the idea is strengthened as to the error, at the conclusion of his life, where he is so clearly conscious as to say, " More would I, but my lungs are wasted so, that strength of speech is utterly denied me." In cases of apoplexy of such severity as to threaten speedy death the coma is too profound to admit of conscious utterances like these, and he probably had no pulmonary lesion, and was only suffering from simple prostration incident to the nervous malady. After the ludicrous robbery at Gadshill, in which Falsta:ff and "Hal" figured so noticeably, "Sir John" was brought to account for it; the following " war of words" ensued upon the occasion between the knight and Chief-Justice : Falstaff. "An't please your lordship, I hear his majesty is re- turned with some discomfort from Wales. Chief-Justice. 1 talk not of his majesty. — You would not come when I sent for you. NEUROLOGY. 125 Falstaf. And I hear, moreover, his highness is fallen into this same whoreson apoplexy. Chief- Justice. Well, heaven mend him. I pray you, let me speak with you. Falstaff. This apoplexy is, as I take it, a kind of lethargy, an't please your lordship ; a kind o' sleeping in the blood, a whoreson tingling. Chief- Justice. What tell you me of it? be it as it is. Falstaff. It had its original from much grief; from study, and perturbation of the brain ; I have read the cause of its effects in Galen: it is a kind of deafness. Chief-Justice. I think you are fallen into the disease, for you hear not what I say to yow. Falstaff. Very well, my lord, very well ; rather, an't please you, it is the disease of not listening, the malady that I am troubled withal." Shakespeare has here displayed the commendable and rare faculty of not contradicting himself — calling it in the mouth of Falstaff apoplexy, also, as the malady of which Henry the Fourth was the victim. It will be noted by the reader that Hal, the companion of Sir John Falstaff, was the successor of his father as ruler of Brit- ain and ascended the throne as Henry the Fifth. There is not more laughable material found in the writings of any writer in any lan- guage than is found in Shakespeare in the relations between Hal and Sir John. That very unsatisfactory term, "cramp," is used three times in "The Tempest" — each time, save one, as a punishment to the sour-visaged nondescript, Calaban ; in the other, Stephano com- plains of being not himself, but a " cramp," at the conclusion of his debauch, after the shipwreck. In "As You Like It," Rosalind, in discoursing on the improbabilities of a man's dying in a love-cause, relates a historic reminiscence which illustrates well an idea yet largely prevalent among mankind, namely — that " cramp " is a very fruitful source of danger to those who go into deep water ; she says, " Leander, he would have lived many a fair year, though Hero had turned nun, if it had not been for a hot midsummer night ; for, good youth, he went but forth to wash himself in the Hellespont, and being taken with the cramp, was drowned." Why the notion prevails so generally, that "cramp" is at the bottom of all these 126 SHAKESPEARE AS A PHYSICIAN. accidents, has long been a mj^'stery to me ; I have never yet seen a person who had been attacked thus whilst in water, nor have I con- versed with a person who has. Why do we not see persons who get cramp in shallow water, in a shower-bath, etc., and who come out to tell the story? If all the cases we read of in the public prints are really the result of a mishap of that nature, then "aquatic cramp" is as surely fatal as fully established rabies. It will be seen, therefore, that though danger from this source has age to lend plausibility and dignity to its pretensions, — yet it really de- serves a place side by side with the wide-spread mad-stone delusions- It is the proper province of medical men on all occasions to dis- abuse the public mind of these absurdities, because life is often sac- rificed at the shrine of these stupid errors. This is particularly so with the substance which the vulgar know as a mad-stone, — valuable time being wasted in its application which ought to be employed in calling a surgeon. It is singular in the extreme to note the hold this notion has upon the public mind ; and that too upon those whose na- tive intellect ought to be a guarantee of better things ; — read the fol- lowing from a leading New York Journal, July 3d, 18 — . "With this hot weather, and mad dogs, comes the usual complement of wonderful stories of extraordinary cures of hydrophobia by means of mad-stones. In many parts of the country, especially in the West and South, the majority of the people have implicit confidence in the efficacy of these stones in counteracting the effects of wounds inflicted by rabid animals. In some families, stones of this char- acter have been possessed for a great number of years, and have acquired a wide-spread local celebrity. Every summer numerous accounts are published of cures wrought by mad-stones, and these generally give the names of the persons cured, with other circum- stances which go to show that the persons printing the accounts have entire faith in the authenticity of the cases which they chroni- cle. One of the most celebrated of these stones is owned by a Mrs. Chastria, living near Hodgenville, Kentucky. She calls it a Chinese stone. It is said that when applied to a person bitten by a mad dog, or poisonous snake, this stone adheres so firmly that it cannot be drawn off without considerable effort, until it has ab- sorbed all the poison from the wound. This stone is reported to have performed many cures, the last being that of a Miss Prather, to whom it was applied while she was in a state of raging madness. It immediately stuck fast, where it remained four days, when it NEUROLOGY. 127 dropped off, and the patient recovered. Stories of a like nature are told of mad-stones in various parts of the country." Now, though the foregoing quotation is from one of the leading New York weeklies, not one word is said hy the writer to tell us that he too is not a believer in this mad-stone delusion. If there really existed a remedy so potent for good in this terrible malady, why should not a portion of it, at least, be found in the hands of the medical profession? How happens it that articles of such incal- culable value should always happen to be the property of some dilapidated old crone in some immensely obscure corner of the earth? Who ever met a regular physician who possessed a mad- stone, or had beheld wonders performed by them? It is time intel- ligent people, at least, should realize the fact that there is no such a thing in existence as the thing reputed a mad-stone. No doubt but there are many things called such, as for instance a bit of brick-bat, a lump of hardened clay, chalk, or a bit of calcined bone, etc., — one as good as the other so long as tjie delusion is maintained. After all, however, as disgusting as the popular ignorance is in the minds of reflecting persons, — especially so to professional men, it may have a share of bliss in it, — because when we reflect that the mind of him who may be bitten by a dog, — mad, or one supposed to be mad, may by the application of one of these substances be rendered satisfied as to his future security — that certainly is a boon to the nineteen that may be bitten by real rabid animals but who never have symptoms of rabies, whilst the twentieth one, who has it applied, dies ; — just the termination of these cases as when left entirely to nature. Viewing it then in this way, we may not consider it such bad treatment after all, as neither med- icine nor surgery could make a better exhibit in a malady so dreadful. To be sure surgical attention, timely applied, might have saved the one fatal case ; but considering the uncertainties of whether even the most scientific assistance has ever obviated death in rabies, it is questionable whether intense expectancy and place- bos (as the mad-stone) in the conduct of these cases is not, in the present state of our knowledge, about as good a course as any ; though one can hardly forbear wishing to be rid of the ignorance which persists in the belief in their reality — more so when it is of that presumptuous kind which prompted the fellow to leave this inscription on my office slate, a short time ago: "Doctor, don't you want to buy a mad-stone? John Jones, Albany, Mo." 128 SHAKESPEARE AS A PHYSICIAN. I beg the reader's pardon for this long irrelevancy, but the sub- ject forced itself upon me in this connection, and it was thought the space might not be filled with more useful matter. Odontalgia is spoken of under the common term "toothache" twice or more in "Much Ado About Nothing," — once as a "raging tooth," in A. iii., S. iii., Othello, — and in "Cymbeline" is repeated the old adage that " he that sleeps feels not the toothache." And that popular complaint, palpitation, which often causes so great an alarm and so little harm, among the uninform'd, is noticed as a coincidence of jealousy in the case of Leontes. He is so particular in regard to the friendship between his queen and friend, that he thinks that to "mingle friendships far is to mingle bloods," and he gets tremor cordis accordingly; his heart danced, but "not for joy — not joy." He is not the only man, poor soul, whose heart has been made to "palpitate" by the actions of a flirt. Of colic, we find the following in Coriolanus ; it is a conversation between Menenius and Brutus, — the latter being one of the " tribunes of the people:" Brutus. "Come, sir, come; we know you well enough. Menenius. You know neither me, yourselves, nor anything. "When you are hearing a matter between party and party, if you chance to be pinched with the colic, you make faces like mummers, set up the bloody flag against all patience, and in roaring for a chamber-pot dismiss the controversy." : / ) This was said to illustrate the want of stability in a Roman noble- man, — if such a character as a nobleman could exist in a republic, which I believe Eome was at that time ; and shows the contempt with which they view'd physical sufferings. In regard to cephalalgia, the good old nurse of Juliet gives us this: "What a head have I; lord, how it aches: it beats as it would fall in twenty pieces. My back ! o' t' other side. — O, my back, my back ! Beshrew your heart for sending me about to catch my death." Othello tells Desderaona, " I have a pain upon my forehead here. Desdemona. Faith, that's with watching; 'twill away again: let me but bind it hard, within this hour it will be well." Desdemona was domestic. The fashion of compressing the head to relieve pain in the different regions of it has perhaps always been practiced. This is not to be wondered at when we remember how few remedies NEUROLOGY. 1 29 there are in the way of medicine even in our advanced age, tliat will afford it relief — some of its forms at least. Indeed the true pathology of headaches is difficult to make out in most cases ; therefore our therapeutics have had little basis except empiricism until lately, when the ophthalmoscope has done something to elu- cidate the uncertainty. Headaches commonly depend upon some internal cause — some inter-cranial cause, though not always. The pain may be continual, or it may be occasional or periodic ; it may be aggravated or ameli- orated according to the position of the body. This pertains only to the complaint in some of its forms. Headache may occupy one particular region, or it may include the whole of the head. The latter is rare. The pain may have any one of the characteristics, as acute, throbbing, dull, etc., and may have particular hours or days for its recurrence. These varied characteristics of the pain have certain significance attached to them, from the fact of their being indices to the causation of the malady. Thus, the periodic variety pointing nearly always to a sympathetic or constitutional origin, while the continuous or persistent form more commonly has as its etiological factor some morbid process connected directlj'- with the head^ — (brain, membranes, etc.) Some constitutional diseases manifest themselves particularly in the way of localizing their ravages upon the organs of mentation, and thus producing pain in the part. Of these, tubercle and syphilis are examples. The pain in these, particularly the last, may have something of a periodicity attached to it, but not the regularity which marks those cases of brow ague, etc., which have a malarial origin. It would commonly be as well in our divisions as to the patho- logical status of headaches to say that they are always accompanied by, and depend largely for their characteristic symptoms upon, one of only two pathological conditions — anemia or hyperemia. Of course, in determining to which of these varieties a given case be- longs we have to weigh well the accompanying conditions, — and here the ophthalmoscope will always be found a valuable aid in making the diagnosis. Unfortunately, its use is now restricted to the hands almost exclusively of the specialist ; but it will in time find a broader field in general practice. Of the medicines which do most for headaches, morphine is cer- tainly most indispensable in the more usual forms. Arsenic, in the 130 SHAKESPEARE AS A PHYSICIAN. form of Fowler's solution, as a remedy in the yet more persistent cases, while iodide of potassium is indispensable to the treatment of many forms, — of course more so in the specific varieties, as above named. Othello's headache was, it seems, of a transitory character, and would have yielded to a dose of morphine. In " Measure for Measure," and also in " Timon of Athens," sciatica is spoken of ; — in the latter the language is as follows : " Plagues, incident to men, your potent and infectious fevers heap on Athens ! thou cold sciatica, cripple our senators, that their limbs may halt as lamely as their manners." Sciatica, in the drama first referred to, was located in the " hip " of course, and was in the person of a character said to be also syphilitic, — a complexity in these cases quite common now, and common enough then it seems to fall under the non- medical notice of Shakespeare. Titania, in " A Midsummer Night's Dream," thus muses: " The moon, the governess of floods, pale in her anger, washes all the air, that rheumatic diseases do abound," whilst the term "rheumatic" is used twice to illustrate the little querulous bouts between Fal- staff and his " Doll." Venus even allows that she is neither " rheu- matic " nor " cold " in her efforts to arouse her bashful boy Adonis to the " sticking point." Now for the gout : " A Midsummer Night's Dream." " Friend has thou none ; for thine own bowels, which do call thee sire, the mere effusion of thy proper loins, do curse the gout," whilst the little vixen, Rosalind, who had a very old head on a very pretty body doubtless, talks thus: Orlando. " Who ambles time withal? Rosalind. With a priest that lacks Latin, and a rich man that hath not the gout: for the one sleeps easily because he cannot study, and the other lives merrily because he feels no pain." Falstaff even knows a " thing or two" about it also: Falstaff. " I can get no remedy against this consumption of the purse : borrowing only lingers and lingers it out, but the desire is incurable; go bear this letter to my lord of Lancaster; this to the prince ; this to the earl of Westmoreland ; and this to old Mistress Ursula, whom I have weekly sworn to marry since I perceived the first white hair on my chin. About it: you know where to find me. (Exit Page.) A pox of this gout! or, a gout of this pox! for the NEUROLOGY. 131 one or the other, plays the rogue with my great toe ! 'Tis no mat- ter, if I do halt ; I have the wars for my color, and my pension shall seem the more reasonable." It seems probable that a "gout of this pock" was much the more reasonable exclamation for Sir John to make, as the easy virtue of Mrs. Tear-sheet, and others perhaps of the knight's female friends, rendered its acquirement much easier than that of the other. It certainly is not a common point — the " great toe,'' in which to locate a local syphilitic lesion ; but yet, it presents itself under such varied forms, that we need not be at a loss to find it cropping out at any place in the person of such an old sinner as he. The term "gouty " is used incidentally in " Timon of Athens," and in " Cymbeline," thus: Scene: a Prison. Jailer. " You shall not now be stolen; you have locks upon you, so graze as you find pasture. 2d Jailer. Ay, or stomachs. Posthumus. fin Jail.) Most welcome, bondage, for thou art a way, I think, to libertj'. Yet am I better than one that's sick o' the gout ; since he had rather groan so in perpetuity, than be cured by the sure physician, death, who is the key t' unbar these locks." This extract shadows the obstinate nature of gout, — points to the trouble of both physician and patient, and is altogether a good simile. v_ Anorexia, which, like thirst, may be classed among the nervous phenomena, is mentioned definitely but once in Shakspeare : " To her, my lord, was I betroth' d ere I saw Hermia! but, like in sickness, I did loath this food ; but as in health, came to my natural taste." — "A Midsummer Night's Dream," A. iv., S. i. Paralysis is spoken of three times ; once by the duke of York in "Richard the Second," who would have chastis'd Bolingbrokc had his arm not been " prisoner to the palsy ; " and again Lord Say, when brought before Jack Cade, when accused of trembling, denied it, saying " the palsy and not fear provoketh me." It is also noted in " Troilus and Cressida," where Ulysses describes the jests of Patroclus — the latter personifying old Nestor, for the merriment of Achilles. In the "Tempest" we find, "the nerves are in their infancy again, and have no vigor in them," having reference merely to a state of debility; and in "Macbeth" we have, "Take any shape but that, and my firm nerves shall never tremble." CHAPTER IV. PHARMACOLOGIA. Sleepy Drinks — Foster nurse of Nature — A liberal offer — A doctor's knowl- edge appreciated — What? — The perfumed dandy — Unbearable nonsense — What's ia't? — Mandragora — Drowsy syrups — Superstition — Toxicology — The trusty pistol — Fashions of suicide — Difficulty of purchase — Poisoned by a monk — This tyrant fever — Swinstead abbey — Strange fantasies — North winds — A compound — Monks as physicians — Cardinal Beaufort — Liebreich an- ticipated — Republished — Was it chloral? — Comparison of conditions — Care- fully noted — Meagre were his looks — What, ho! — Famine is in thy cheek — Death's pale flag — Thus with a kiss — A nest of Death — A slight discrepancy — Oxalic acid — Discovery repeats itself — The insane root — Drugging the pos- set — "Hashish" — The unction of a mountebank — Rabies canina — Curara — From what derived?— A failure apprehended — Trap with double triggers — Fencing match — An unlooked for termination — A jealous sister — Kills and pains not — Immortal longings — Easy ways to die — Zest to a tragedy — A spe- cific — Alconcito — A royal student — Soliloquy— Most likely I did — Moreton preceded. In arranging a chapter on pharmacology, it is the design to divide it into two portions: — the first to include all articles of the materia medica proper, — the other to be devoted to toxicology. The first is brief, for the simple reason that the material for its elaboration is limited ; the material for the latter, being more voluminous, will extend the chapter to some length. Narcotic remedies seem to have had an extended use in past ages, as we have them mentioned frequently in older writers, and pretty frequently in Shakespeare. Archidamus in the "Winter's Tale " says : "I don't know what to say. — We will give you sleepy drinks, that your senses, unintelligent of our insufficience, may though they cannot praise us, as little accuse us." This " sleepy drink " probably referred to some form of alcoholic intoxicant, as the parties to the conversation belong to the revelers of a royal court. 132 PHARMACOLOGIA. 133 The "sleeping potion" of Friar Laurence will be noticed more fully hereafter. In regard to treating Lear for his disordered intellect, we find the following in A. iv. of that play : Cordelia. "Alack! 'tis he: why, he was met even now, as mad as the vex'd sea: singing aloud; crown'd with rank fumiter and furrow weeds, with hoar-docks, hemlock, nettles, cuckoo-flowers, darnel, and all the idle weeds that grow. A century send forth ; search every acre in the high-grown field, and bring him to our eye. (Exit an officer.) What can man's wisdom (do) in the restoring his bereaved sense? He that helps him, take all my outerward worth. Doctor. There is medicines, madam : Our foster-nurse of na- ture is repose, the which he lacks ; that to provoke in him are many simples operative, whose power will close the eye of anguish. Cordelia. All bless'd secrets, all you unpublish'd virtues of the larth, spring with my tears! be aidant and remediate, in the good man's distress." Then occurs a time when they are all absorbed in business, but Cordelia has not forgotten old Lear, who, it appears, she had left in the care of the doctor, for she makes inquiry, "how does the king? doctor. Doctor. Madam, (he) sleeps still. Cordelia. O, you kind gods, cure this great breach in his abused nature ! Doctor. So please your majesty that we may wake the king? he hath slept long. Cordelia. Be govern'd by your knowledge, and proceed i' the sway of your own will. Is he array'd? Doctor. Ay, madam ; in the heaviness of his sleep, we put fresh garments on him. Kent. Good madam, be by when we do awake him ; I doubt not of his temperance. Cordelia. Very well. (Music.) Doctor. Please you, draw near. — Louder the music there. Cordelia. He wakes, speak to him. Doctor. Madam, do you, 'tis fittest. Cordelia. How does my royal lord? How fares your majesty? Sir, do you know me? Lear. You are a spirit, I know. Where did you die? 134 SHAKESPEARE AS A PHYSICIAN. Cordelia. Still, still, far wide. Doctor. He's scarce awake. Let him alone awhile. Lear. Where have I been? Where am I? I am a verj foolish, fond old man, four-score and upwards, not one hour more nor less, and to deal plainly, I fear I am not in my perfect mind." Cordelia becomes pathetic, as we may very well imagine, and the kind physician requests her to "be comfortable, madam; the great rage, you see, is cur'd in him ; and yet it is dangerous to make him even o'er the time he has lost. Desire him to go in ; trouble him no more till further settling." Now, good my prof essional reader, what "simple" used the doc- tor wherewith he "closed the eye of anguish" in the foregoing case? Was it opium, chloral hydrate, bromide of potassium? — What? Most likely some vegetable narcotic, as such remedies as "hemlock" and other powerful agents of that class were much in vogue at that day. The doctor clearlj'' presented the very best plan of treatment — enunciating the principle upon which the successful conduct of all such cases depends, namely, the "foster-nurse of nature — repose.''^ I doubt much, however, whether the gentle Cor- delia did not forget the very fair promise in regard to the bestowal of her "outward worth," as my personal experience teaches me to regard with mistrust those who make loud pretensions of how hand- somely we are to be paid — it usually culminating in the doctor fail- ing of any fee at all, and with very little gratitude for his services. Regarding the pleasant effects of music on the weary mind and spirits, notice is taken of it in " The Tempest," thus: — "A solemn air, and the best comforter to an unsettled fancy, cure thy brains ;" and in the death-bed scene of Henry the Fourth, where he saj^s — "let there be no noise made, my friends; unless some dull and favorable hand will whisper music to my weary spirit." In Buck- nill's "Mad Folk of Shakespeare " is to be found a long chapter on the beneficial effects of music in the treatment of the insane, in both ancient and modern times. Hotspur's contempt for the perfumed dandy who asserted that "parmaceti for an inward bruise" was "the sovereign' st thing on earth," was commcndal)le ; though it is exceedingly^ distasteful, we often are compelled to sit by in silence, and hear some vulgar igno- ramus expatiate upon the value of this or that or the other pro- cedure in medicine or surgery — ignoring our presence, and talking PHARMACOLOGIA, 135 with the face as of one with authority. What doctor is there who has not had to learn, over, many times, from the lips of some foolish old woman, matters in his profession which, if not absurd or ridicu- lous, are at most puerile ; — swallowing them with the gravity of one who is listening to his sentence to the gallows? What unbearable nonsense do we tolerate and sometimes tacitly assent to for the privilege of being physicians? I set it down in print — in bold and unmistakable language, that the doctor occupies the most unenvi- able position of any member of modern society. "My noble mistress, here's a box; I had it from the queen: what's in 't is precious ; if you are sick at sea, or stomach-qualm' d at land, a dram of this will drive away distemper." " Cymbeline," A. iii., S. V. The " what's in't " must have been bromide of potassium, good wine, or else " effervescing nitrate of cereum," as these are said to be the best remedial measures other than " position," if it is remem- bered aright. Sea-sickness will likely always remain, in defiance of the combat waged with it by therapeutics. The soliloquy of Juliet, as to how she should feel in the event of her waking too soon and finding herself among the dead of "all the Capulets," evokes this language: " Alack, alack! is it not like that I, so early waking, — what with loathsome smells, and shrieks like mandrakes torn out of the earth, that living mortals hearing them, run mad?" In " Antony and Cleopatra," we find, "give me to drink man- dragora, that I might sleep out this great gap of time," in the lan- guage of Egypt's voluptuous queen. The first only needs notice from the fact of the superstition concerning it by the people of the middle ages, — the latter only for that of its early employment as a remedy, — especially for its soporific qualities, which were some- what analagous to the poppy it is supposed. " Not poppy, nor mandragora, nor all the dreamy syrups of the world, shall ever medicine thee to that sweet sleep, which thou ow'dst j^esterday," sa3^s the villain lago, when he noted the tor- tured Othello approaching him. Mandragora is not used as a medicine to any considerable extent at the present day. It is indigenous to European countries, and not officinal in the United States. In illustration of the su])er- stitious notions connected with the may-apple, the duke of Suffolk, in execrating the king for banishing him, uses this term, — " would 136 SHAKESPEARE AS A PHYSICIAN. curses kill as cloth the mandrake's groan" — an idea derived from a mythological source, and founded on the notion that the may-apple sprang from the remains of a dead criminal, and that when it was drawn from the earth for the use of man, something must die. To accomplish the extraction of the root with the least detriment to animal existence, it was customary to loosen the soil about its roots, tie a worthless dog to it and then run away, stopping the ears to avoid hearing the shriek. The dog surely died. " The dog surely died." The "poultice" as a remedy for " aching bones " is suggested by "Nurse" in " Romeo and Juliet." We come now to the more voluminous, and we hope the more in- teresting, portion of this chapter — Part Second — or that which treats more especially of the toxic materials used in the writings of Shakespeare. It may well be imagined that in a work abounding in tragedies, and one in which women and sentiment played so conspicuous a part, that poisons would occupy a conspicuous place in the cata- logue of means whereby to put a quietus to a weary existence, — and such is the fact. It is more common now, for those who reach a point from which they view life as a failure, to resort to means more in keeping with the spirit of the age ; therefore they usually resort to that ever handy and speedy agent, a trusty pistol ; this however is more strikingly true of suicide in America, whilst the poisons are yet often resorted to in Europe, and among other civilized nations. Under the heading " The Fashions of Suicide," PHARMACOLOGIA. 137 Dr. Lankester, in his report of inquests for 1868-69 (noted in Med. Press and Circular), gives some interesting facts in regard to the subject. He says considerable change has taken place in the selection of poisons for suicidal purposes. That most fre- quently used during late years being cyanide of potassium ; it is purchased without difficulty, and its action is most deadly. The next agent in most frequent use is oxalic acid, whilst the use of opium, hj'^drocyanic acid, etc., is on the decline, owing perhaps to the greater difficulty encountered in procuring them by purchase. The reason the other substances are more easily procured is that they are largely used in the arts, and are in the hands of number- less persons everywhere. Although reference is made to poison in "The Tempest," A. iii., S. ii., and in one place again reference made to giving it so that it might " work a great time after," and spoken of also in "The Winter's Tale," A. i., S. i., and "rats'-bane" as a poison two or three times, there is nothing worthy of note said of it until in "King John," A. v., S. vi., where the following language occurs : Herbert. (The king's cliamberlain). "The king, I fear, is poi- soned by a monk : I left him almost speechless, and brake out to acquaint you with this evil, that you might the better arm you to this sudden time, than if you had at leisure known of this. Bastard. How did he take it? who did taste to him? Herbert. A monk, I tell you ; a resolved villain, whose bowels suddenly burst out: the king yet speaks, and, peradventure, may recover." In this quotation Shakespeare does not appear to have kept close to the symptomatology, for the king had been sick a time before this poisoning should have happened. In Scene iii., whilst on the field of battle, the king was made to exclaim, — "Ah, me! this tyrant fever burns me up, and will not let me welcome this good news. Set on towards Swinstead ; to my litter straight ; weakness possesseth me, and I am faint." If the monk had been using treachery toward the king, then he certainly had been using " poison to work a great time after," because even prior to the facts last stated as to the condition of King John on the battle-field, the com- plaint is made by him, — "this fever that hath troubled me so long, lies heavy on me : O! my heart is sick." 138 SHAKESPEARE AS A PHYSICIAN. The Bastard seemed fully persuaded of the truth of the report that the king was poisoned, as he hastilj'^ ordered the messenger, — "Away, before: conduct me to the king; I doubt, he will be dead ere I come." After reaching Swinstead Abbey the oft quoted soliloquy of Prince Henry occurred : "It is too late: the life of all his blood is touch'd corruptibly ; and his pure brain (which some suppose the soul's frail dwelling-house), doth by the idle comment that it makes, foretell the ending of mortality." Pembroke. " His highness yet doth speak ; and holds belief that being brought into the open air it would allay the burning quality of that fell poison which assaileth him. Prince Henry. Let him be brought into the orchard here. — Doth he still rage? Pembroke. He is more patient than when you left him: even now he sung. Prince Henry. O ! vanity of sickness ! fierce extremes in their continuance will not feel themselves. Death, having prey'd upon the outward parts, leaves them unvisited ; and his siege is now against the mind, the which, he pricks and wounds with many legions of strange fantasies, which, in their throng and press to that last hold, confound themselves. 'Tis strange that death should sing." The king is then brought to the open air, and thus rejoices : "Ah, marry, now my soul hath elbow-room, it would not out at windows, nor at doors. There is so hot a summer in my bosom, that all my bowels crumble up to dust: I am a scribbled form, drawn with a pen upon a parchment, — and against this fire I shrink up. Prince Henry. How fares your majesty? King John. Poison'd, — ill fare; — dead, forsook, cast-off; and none of you will bid the winter come, nor let (my kingdom's) rivers take their course through my burn'd bosom ; nor entreat the north winds kiss my parched lips, and comfort me with cold. The poison is as a fiend, confin'd to tyrannize on unreprievable condemned blood." The question for solution, when we analyze the foregoing extract, presents two points of interest: first, was the king poisoned at all? and, second, if he was poisoned, what substance had been used for that purpose ? PHARMACOLOGIA. • 139 In regard to the first of these propositions, it is pretiy clearly- apparent, to our mind, that he was not poisoned at all by the hand of a monk, or any one else — in fact was not poisoned at all in the light in which himself and attendants viewed the matter. This we shall attempt to establish clearly in a subsequent portion of this work. As to the second proposition, there is more difficulty ; he had not sj'mptoms confined alone to the action of one virulent poison, but some common to several ; therefore if he was poisoned, he had cer- tainly been dosed with a compound. These too had been of both vegetable and mineral origin, if we may judge from the symptoma- tology. In the quotations, — "Doth he still rage?" and "the idle comment that it makes," with "many legions of strong fan- tasies," etc., all show a mind disordered, either from disease or poison. If from the latter, then it was from a narcotic or cerebro- spinal poison, the class of which are usually of vegetable origin — acting secondarily if at all, upon the visceral structures ; whilst those "fell poisons" which have " bnrning qualities" about them and produce "burn'd bosoms" and "parched lips," necessitating entreaties for flowing rivers of water and north winds, are usually of the corrosive mineral kinds — producing intense inflammatory action in the tissues with which they come in contact, but seldom acting upon the brain sufficiently to disturb the intellectual facul- ties. If in this case "poison" had contained " physic," it was an unfortunate circumstance ; the monks often practiced the healing art, I believe, in those days — hence the king may have possessed an idiosyncrasy which was antagonistic to the prescription em- ployed. It is not very clear what is meant by the term used in connection with the monk who tasted to the king when it is said his bowels suddenly burst out. He was, no doubt, the subject of a hernial protusion and had the misfortune to have the intestine escape at the particular juncture named, and some movement or word of his betrayed the condition to those present at the king's attendance. They were anxious to find a pretext for his accusation and hence magnified even this accident to the poor monk's condemnation. As to the singing of the king when thought to be dying, this is not very uncommon during the recovery from the influence of chlo- roform or in the intoxication of alcohol and some other poisons,- though in the very jaws of death from a congestive chill I have 140 SHAKESPEARE AS A PHYSICIAN. heard the sufferer siag and pray as if in a toxic or inebriated condi- tion. " Give me some drink ; and bid the apothecary bring the strong poison I bought of him " are words from the lips of the dying Cardinal Beaufort, Bishop of Winchester. As suggested before, the consideration of the soporific or "sleep- ing potion" of Friar Laurence is placed under the division of toxi- cology because of the characteristic effects of the remedy upon the animal economy — no remedy having such power, being free from toxicological properties when given in quantities, or to the susceptible or in peculiar conditions of the system ; it therefore takes quantity as well as gitaZ^ to constitute a poison, — its poisonous properties only being judged by its effects. It has been suggested by an ingenious writer, that the good Friar had certainly anticipated Liebreich in the discovery and use of the hydrate of chloral ; and a cursory view of the symptoms attending the action of the real and the mythical remedies upon the human system, might very easily cause any one to commit a like error : but there is a great dissimilarity in their action, as we shall see. I will quote from an article of my own, written upon this subject, and published in the Leavenworth Medical Herald^ some years ago : "I am of the opinion that if the correspondent of the '■Michigan University Medical Journal^' who seems to have made the important discovery of the identity of these drugs, had read the whole of the Friar's instructions, and not have mutilated them by making ex- tracts, he could not have seen so striking an analogy in the action of the remedies. The full conversation ran thus : Friar. ' Take now this phial, being then in bed, and this dis- tilled liquor drink thou off ; when, presently, through all thy veins shall run a cold and drowsy humor ; for no 2)ulse shall keep his na- tive progress, but surcease: no toarmth, no breath shall testify that thou livest; the roses in thy lips and cheeks shall fade to paly ashes; thy eyes' windows fall, like death when he shuts up the day of life ; each part deprived of suple-government, shall stark and stiff and cold apipear like death: and in the borrow'd likeness of shrank death thou shall continue two and forty hours, and then awake as from a pleasant sleep. Now, when the bridegroom in the morning comes to rouse thee from thy bed, there art thou dead: then, as the manner of our country is, in thy best robes uncover'd on the bier, be borne PHARMACOLOGIA. 141 to burial in thy kindred's grave.' Wlien discovered by her nurse and Lady Capulet, tremendous exertions were made to awaken her, but without avail ; then comes Capulet himself, who thus exclaims : 'Ha! let me see her. Out, alas! she's cold! Her blood is settled, and her joints are stiff; life and those lips have long been separated.' After a careful survey of the literature of the subject, I find the salient points of the action of the hydrate of chloral, on the bodily functions, to be the following: Little or no impairment of the function of respiration ; no abnormal condition of the j^ulse — the heart being the last of the vital orc/aris to become affected by the agent. The face becomes flushed, and the eyes suffused and congested; unusual renal activity. There is an especial relaxation of all the soft tissues of the body, with an exalted cutaneous sensibility. Sixteen hours the longest time recorded, during ivhich a patient has been kept under its influence by a single dose, and that in the case of a person suffering from stupor and melancholia, — hardly a fair test. The hypnotic action of the drug, though very rapid, not morbidly profound like that of opium and some other narcotics ; — a hand on the door, a gentle icord, or slight puncture being sufficient to arouse the sleeper to immediate and complete consciousness. Now I am per- suaded that a careful collation of the two leading paragraphs of this article, — especially the italicised lines, will disclose the fact that hydrate of chloral produces few of the symptoms attributed by Shakespeare to his mythical drug ; and that if Friar Laurence supplied the fair Juliet with a ' sweet oblivious antidote,' to rid her of an odious and troublesome suitor, it was not chloral hydrate." As stated before, the foregoing quotation was written a few months after the discovery of the "hydrate," but the action of the agent was so carefully noted by those who had administered it up to that time that there have been no observations from its more extended use, which change the notions of the profession from the therapeutic facts as above related of it. It must be admitted, however, that we have no remedy in our voluminous materia medica of which we are aware, that would come as near producing the genercd effects of the Friar's remedy as the hydrate of chloral ; and it would really seem that to regard it in a general way, Liebriech has only reproduced a long lost article — known and used hundreds of years in the past — medicine as well as 142 SHAKESPEARE AS A PHYSICIAN. history repeating itself. If the powerful remedy used by Juliet was a mystery, we yet have another in the drug employed by Romeo in his tragic end. " AYell, Juliet, I will lie with thee to-night. Let's see for means : O, mischief ! thou art swift to enter in the thoughts of desperate men. I do remember an apothecary, and hereabouts he dwells, which late I noted in tatter' d weeds, with overwhelming brows, culling of simples : meagre were his looks, sharp misery had worn him to the bones ; and in his needy shop a tortoise hung, an alli- gator stuff'd, and other skins of ill-shap'd fishes; and about his shelves a beggarly account of empty boxes, green earthen pots, bladders, and musty seeds, were thinly scatter'd to make up a show. Noting his penury, to myself I said — and if a man did need a poison now, whose sale is present death in Mantua, here lives a caitiff wretch would sell it him. O ! this same thought did but forerun my need; being holiday, the beggar's house is shut. — What, ho! apothecary ! Apothecary. Who calls so loud? Romeo. Come hither, man. — I see that thou art poor ; hold, there is forty ducats : let me have a dram of poison ; such soon-speeding gear as will disperse itself through all the veins, that the life- weary taker may fall dead ; and the trunk may be discharged of breath as violently, as hasty powder fir'd doth hurry from the fatal cannon's womb. Apothecary. Such mortal drugs I have ; but Mantua's law is death to any he that utters them. Romeo. Art thou so base, and full of wretchedness, and fear'st to die? famine is in thy cheeks, need and oppression starveth in thine eye, contempt and beggary hang on thy back, the world is not thy friend, nor the^world's law ; the world affords no law to make thee rich ; then be not poor, but break it, and take this. ( Giving money. ) Apothecary. My poverty, but not my will, consents. Romeo. I pay thy poverty, not thy will. PHAEMACOLOGIA, 143 Apothecary. Put this in any liquid tiling you will, and drink it off; and if you had the strength of twenty men, it would despatch you straight." Supplied with the death-dealing agent furnished him in violation of the penal statutes of the government of Mantua, the grief-stricken representative of all the Montagues hastened from his exile to the ' tomb of all the Capulets,' where, upon dis- covering the still form of his bride, he thus soliloquized: "Death, that has suck'd the honey of thy breath, hath no power yet upon thy beauty: thou art not conquer'd ; beauty's ensign yet is crim- son in thy lips, and in thy cheeks, and death's pale flag is not advanced there. Ah! dear Juliet, why art thou yet so fair? I will believe that unsubstantial death is amorous ; and that the lean abhorred monster keeps thee here in dark to be his paramour. For fear of that I still will stay with thee, and never from this place of dim night depart again : here, here will I remain with worms that are thy chambermaids ; O ! here will I sit up my everlasting 144 SHAKESPEARE AS A PHYSICIAN. rest, and shake the yoke of inauspicious stars from this world- wearied flesh. Eyes, look your last ; arms, take your last embrace ; and lips, O! you, the doors of breath, seal with a righteous kiss a dateless bargain to engrossing death. — Come, bitter conduct, come unsavory guide! thou desperate pilot, now at once run on the dash- ing rocks thy sea-sick weary bark. Here's to my love. — (^Drinks his poison. ) O, true apothecary ! thy drugs are quick. — Thus with a kiss I die." (^Friar Laurence visits the tomb, and the lady wakes.) Juliet. "O, comfortable Friar! where is my love? I do remem- ber well where I should be, and there I am. — Where is my Romeo? i^riar.— "Lady, come from that nest of death." Friar. Lady, comejfrom that nest of death, contagion, and un- natural sleep. Come, come away ; thy husband in thy bosom there lies dead ; come, I will dispose of thee among a sisterhood of holy nuns. Stay not to question ; come, go, good Juliet. — I dare no longer stay. PHARMACOLOGIA. 145 Juliet. Go, get thee hence, for I will not away. — What's here? a cup, clos'd in my true love's hand? poison, I see, hath been his timeless end. — O churl! drink all, and leave no friendly drop to help me after? — I will kiss thy lips; haply, some poison doth yet hang on them, to make me die with a restorative. Thy lips are warm ! ' ' Juliet then falls dead with Romeo's dagger buried deep in her heart. The old Friar explained the whole matter to the relatives of the two lovers in the following words : " I will be brief, for my short date of breath is not so long as a tedious tale. Romeo there dead, was husband to that Juliet; and she there dead, that Romeo's faithful wife: I married them; and their stolen marriage-day was Tybalt's dooms-day, whose untimely death, banished the new-made bridegroom from this city, — for whom, and not Tybalt, Juliet pin'd. Then comes she to me, and with wild looks bade me devise some means, or in my cell there would she kill herself. Then gave I her, (so tutor'd by my art) a 'sleep- ing potion, which so took effect as I intended, for it wrought on her the form of death. Prince. This letter doth make good the Friar's words, their course of love, the tidings of her death, and here he writes, that he did buy a poison of a 'poor apothecary.' " It will be noticed that the condition of Juliet at the time of Romeo's contemplation of her, and a description of her condition at the time of her first taking the remedy, are quite discrepant; in the first she is in the " likeness of shrank death," the " roses in her lips and cheeks are faded to paly ashes," whilst in the other it is said that " beauty's ensign yet is crimson in her lips and in her cheeks, and death's pale flag is not advanced there." The latter con- dition coincides more nearly with the conditions of one under the influence of chloral. It is a remai'kable fact, that neither in lan- guage nor sentiment is there scarcely to be found a contradiction in all of Shakespeare's writings ; the contradiction in the case of Juliet's condition being not of his making, as the five lines begin- ning, "Death that hath sucked the honey of thy breath," and containing the error or contradiction in idea is, in the copy from which I quote, the work of an " emendator ;"— not to be found in older copies of the work, and notably absent from the quarto of 146 SHAKESPEARE AS A PHYSICIAN. 1597. This shows conclusively, that few men can correct errors for, or improve upon the works of Shakespeare. In regard to the poison used by Romeo, it seems that oxalic acid comes nearer filling the physical and toxical conditions of the material than any other we possess at this day. " Put this in anj^ liquid thing you will, and drink it off, and it will despatch you straight ;" showing that it acted with celerity, and that it was neces- sary to dissolve or dilute it ; nicotina or prussic acid might have been used in the event of the last suggestion, but the other is most plausible. Oxalic acid is a colorless, crystallized solid, possessing a strong, sour taste ; it dissolves in nine times its weight of cold, and in its own weight of boiling water ; it dissolves in alcohol. It is a viru- lent poison in large doses, producing death with great rapidity and certainty in from ten to sixty minutes ; it was not noticed as a poi- son until 1814, by Royston ; since then by Percy, Thompson, and others ; it is much used in the arts — particularly in calico printing, for discharging colors, — and therefore is quite a common agent in the hands of the suicide, even now. Cyanide of hydrogen, or prussic acid was first discovered by Scheele, in 1782, whilst nicotina was not known until quite recently ; so that, if either of these ar- ticles were among the contraband in the stock of the poor apothe- cary of Mantua, we have only another instance of the fact that scientists are now discovering many things as new, which have been in use so long ago as to have fallen into disuse and have been for- gotten. Banquo, in a conversation with Macbeth soon after encountering the witches upon the heath of Fores, speculates in this way: "Were such things here, as we do speak about, or have we eaten on the insane root, that takes the reason prisoner?" It is probable that the substance here referred to as the " insane root," was the modern cicuta or conium maculatum — the "hemlock" of the ancients, which was so popular as a weapon for the purpose of suicide and criminal poisoning ; it is a most energetic poison, three drops of conia, the active principle of the plant, having killed a stout cat in a minute and a half ; it acts upon the spinal cord, prostrating the nervous powers, paralyzing the voluntary muscular system, and destroys life by arresting the function of respiration. The brain does not seem to be influenced in any marked degree, even by a poisonous dose of the medicine ; therefore the idea that PHARMACOLOGIA. 147 it '' takes the reason prisoner," is scarcely correct. In the fearful tragedy of "Macbeth," again, A. ii., S. ii., it is stated that Lady Macbeth " drugged the possets " of the king's attendants, "that death and nature did contend about them, whether they lived or died." The half clear, half disturbed slumbers of these men, whilst Macbeth with bloody hands bent over their prostrated bodies, shows that they perhaps were laboring under the effects of some powerful toxical agent ; — the "hashish," cannabis indica, or Indian hemp comes nearest meeting the characteristics in action upon the brain, of any of our modern substances ; it is a powerful narcotic when given in sutBcient quantity, but in a less dose it produces an in- toxicated mind with delirious hallucinations — with, finally, drow- siness, stupor, etc., but has little effect upon the action of the heart. When taken into the stomach, it acts with much greater rapidity than opium, and most other vegetable toxicants ; nor does it produce nausea as does opium occasionally. There is in "Hamlet," A. iv,, S. vii., recorded a conference be- tween Laertes and the king, in regard to the assassination of Ham- let, as he seemed to stand directly in the path of their villainies. The former uses this language : "I will do 't ; and for that purpose I'll anoint my sword. I bought an unction of a mountebank, so mortal that but dip a knife into it, where it draws blood no cata- plasm so rare, collected from all simples that have virtue under the moon, can save the thing from death, that is but scratch'd withal. I'll touch my point with this contagion, that if I gall him slightly, it may be death." We have the analogue of this " unction " in the virulent organic poisons, — those I mean of animal origin, and also a few cases in which they are probably of vegetable origin. In regard to those originating from the animal kingdom, it is a singular fact that they are not in any instance capable of being elaborated by the manipu- lations of the chemist, or by combinations brought about external to the living animal economy, but are, on the contrary, always, perhaps, generated by the animal organism in a state of vitality — most commonly during a state of normal vitality. As an illustra- tion of the latter we have the poisons of the reptile and insect creations, one of which perhaps furnished the vindictive Laertes with his " contagion," whilst of the other, we may name the viru- lent products of rabies canina, glanders, etc., omitting entirely the 148 SHAKESPEARE AS A PHYSICIAN. products of animal decomposition, the specific poisons of small- pox, etc. All savage nations of the earth are in the habit of using these animal poisons for the purpose of tipping their arrows and spears, — but one vegetable poison being in use for this purpose within my knowledge, namely, the " curare " or " arrow poison " of British Guiana^ — used by the natives for the purpose indicated by the name. This poison is as deadly as that of the rattlesnake, and, like it, exerts its most noticeable action upon the subcutaneous tissues ; though the least abrasion of the mucous or cutaneous surfaces is sufficient to admit it into the body. It is claimed by most authorities that this wonderfully active production is derived from the bark of a ground-like plant, by aqueous extract ; though there are others who claim that it is derived from the animal king- dom ; and these are the most likely correct, from the simple fact that it has many analogues in that direction and none in the other. The action of these three forms of poisons upon the animal economy is quite unlike in the main^ — those of vegetable origin acting for the most part upon and through the nervous system — producing little or no observable change in the structures of the body, while of mineral poisons, as before remarked, inflammatory and destructive metamorphosis is the common accompaniment of their action. Of the animal poisons, those generated in the living animal, as in rabies and the poison of serpents, etc., they multiply in the system when taken into the blood, and have thus always offered ample soil in which to propagate. As to the poisons gener- ated in the putrefactive process in animal products, and which generate the low fevers for example, these should no longer be re- garded as poisons proper, as they are now commonly recognized as belonging to and identical with parasitic, living, organisms — are real animals, as much so as are the lions and tigers found in the jungles of Central Africa. Immediately succeeding the conversation in which Laertes boasts of having purchased the poison, he and the king continued, — King. "Let's farther think of this; weigh, what convenience, both of time and means, may fit us to our shape. If this should fail, and that our drift looked through our bad performance, 'twere better not assay'd: therefore, this project should have a back, or second, that might hold, if this should blast in proof. Soft! — let me see: — we'll make a solemn wager on your cunnings, I ha 'C: when in your motions you are hot and dry (as PHARMACOLOGIA. 149 make your bouts more violent to that end), and that he calls for drink, I'll have prepar'd him a chalice for the nonce, whereon but sipping, if he by chance escape your venom' d stuck, our purpose may hold there." (This will be remembered as the plan for the termination of the fencing match, which had been arranged to take place between Laertes and Hamlet. They supposed that Hamlet knew nothing of the malice they bore him, but in that they were mistaken ; he was better posted than his eccentricities would suffer them to acknowledge.) " Set me the stoop of wine upon that table there. If Hamlet give the first or second hit, or quit in answer of the third exchange, the king shall drink to Hamlet's better breath. Give me the cups ; now the king drinks to Hamlet ; come, begin ; Hamlet. Come on, sir. LaeHes. Come, my lord. Hamlet. One. Laertes. No. Hamlet. Judgment. Osric. (A courtier.) A hit, a very palpable hit. King. Stay : give drink. Hamlet, the pearl is thine (the pearl was placed in the poisoned glass) ; here's to thy health. — Give him the cup. Hamlet. I'll play this bout first ; set it by awhile. King. Our son shall win. Queen. (Hamlet's mother. J He's fat, and scant of breath. — Here's a napkin; rub thy brows, mj'^ son: the queen carouses to thy fortune, Hamlet. Hamlet. Good madam, — King. Gertrude (thf- queen J, don't drink. Queen. I will, my lord: I pray you pardon me. f Drinks. J King. It is the poisoned cup ! it is too late. (Aside.) Hamlet. I dare not drink yet madam ; by and by. Queen. Come, let me wipe thy face." Laertes and Hamlet then play their third bout, when Hamlet is wounded, and by chance changes daggers with his antagonist and wounds him also; the queen falls — crying, the drink 1 the drink! I'm poisoned! {Dies.) Laertes then falls also, and as he docs so he exclaims — "It is here Hamlet. Hamlet, thou art slain; no medicine in the world can do thee good: in thee there is not half 150 SHAKESPEARE AS A PHYSICIAN. an hour of life : the treacherous instrument is in thy hand, unbated and envenom'd. The foul practice hath turn'd itself on me ; lo, here I lie, never to rise again. Thy mother's poison'd; I can no more. The king, the king's to blame. Hamlet. The point envenom'd too! Then, venom, do thy work! (^Stahs the king.) It is probable that the poison in the wine was the conium macu- latiim. It usually commences to operate in half an hour, when taken in poisonous doses. It seems that the toxic agents of Shakes- peare's imagination were of a potent quality whether those in the drug shops of his cotemporaries were so or not, and certain it is, he lacked no skill in using them with tragic effect. In " King Lear," A. v., S. ii., we find another character disposed of by poison ; this is Regan, who was, through jealousy, poisoned by her sister Goneril — she then committing suicide with a poniard. The circumstances attending this tragedy are not drawn with the minuteness and skill which characterize most other scenes of this nature in Shakespeare's writings ; therefore we have fewer grounds for speculation. Othello spoke of poisons as an agent with which to rid himself of the torments of jealousy, but he relinquished this purpose in favor of the more trusty dagger. The defeat of Mark Antony determined Cleopatra to take her departure to that bourne from whence no pilgrim has ever returned, and she thus declares, " Not the imperious show of the full-fortuned Csesar ever shall be broach' d with me; if knife, drugs, serpents, have edge, sting or operation, I am safe." She finally decides upon the decisive act, and thus addresses her attendant: — "Hast thou not the pretty worm of Nilus there, that kills and pains not? Attendant. Truly, I have him ; but I would not be the party that should desire you to touch him, for his biting is mortal: those that do die of it, do seldom or never recover. ClcojMtra. Remember'st thou any that have died on 't? Attendant. (^A down.) Very many, men and women too. I heard of one of them no longer than yesterday : a very honest woman, but something given to lie, as a woman should not do but in the way of honesty how she died of the biting of it, what pain she felt. — Truly, she makes a very good report of the worm ; but he that will believe all they say, shall never be saved by half what they do. But this is most fallible, the worm 's an adder-worm. Cleojmtra. Get thee hence ; farewell. PH ARM AC OLOGIA. 151 Attendant. I wish you all joy of the worm. Cleopatra. Farewell. Attendant. Look you, the worm will do his kind, remember. Cleo2Jatra. Ay, ay ; farewell. Attendant. Look you, the worm is not to be trusted but in the keeping of wise people ; for, indeed, there is no goodness in the worm. Cleopatra. Take thou no care, it shall be heeded. Attendant. Very good. Give it nothing, I pray you, for it is not worth the feeding. Cleopatra. Will it eat me ? Attendant. You must not think I am so simple, but I know the devil himself will not eat a woman: I know, that a woman is a dish for the gods, if the devil dress her not ; but, truly these same whoreson devils do the gods great harm in their women, for in every ten that they make, the devils mar nine. Cleopatra. Well, get thee gone ; farewell. Attendant. Yes, forsooth ; I wish you joy of the worm. (^Ex. doion.) (^Enter female attendant.) Cleopatra. Give me my robe, put on my crown ; I have immortal longings in me. Now, no more the juice of Egypt's grape shall moist this lip. — So, have you done? Come, then, and take the last warmth of my lips." {They kiss, and the maid falls dead, token Cleopatra asks :) — "Dost fall.? have I the aspick in my lips? If thou and nature can so gently part, the stroke of death is as a lover's pinch, which hurts and is desir'd. Dost thou lie still? If thus thou vanishest, thou tell'st the world it's not worth leave- taking. (To the adder.) Come, thou mortal wretch, with thy sharp teeth, this knot intrinsicate of life at once untie : poor ven- omous fool, be angry, and despatch. {To her maid.) Dost thou not see my baby at my breast, that sucks the nurse asleep? {She had applied the serpent to her breast. ) As sweet as balm, as soft as air, as gentle. — Nay, I will take thee too. {Applies one to her arm.) Why should I stay." — {Falls dovm dead.) CiBsar, whose prisoner she was, then enters the room and enquires — " the manner of their deaths? I do not see them bleed. Poisoned, then. O noble weakness ! — If they had swallow'd poison, 'twould appear by external swelling ; but she looks like sleep. Here, on her breast, there is a vent of blood, and something blown the like is on her arm. 152 SHAKESPEARE AS A PHYSICIAN. Attendant. This is an aspick's trail. Ccesar. Most probable, that so she died, for her physician tells me, she hath pursu'd conclusions infinite of easy ways to die." In the modern science of ophiology the adder is placed as a rela- tive of the viper family, a species of serpent which usually inhabits dry, rocky and barren districts, and is not found in the vicinity of rivers and marshy grounds. The poisonous animal to which refer- ence is made under the name of the " worm of Nilus," most prob- ably belonged to the trigonocephalies piscivorus of naturalists, which inhabits rivers and marshes in many southern latitudes, and the bite of which is speedily fatal. The absence of external swelling would be no proof that poison had not been swallow'd, as Caesar seems to have conjectured ; but its absence might have been taken as some evidence that the parties had not died from the poison of a venomous reptile, as " external " swelling is an almost universal accompaniment of this virus when in contact with subcutaneous tissue. There are no logical grounds for the idea of the maid's dying merely from the contact of her mistress' lips ; — the matter gives zest to a tragedy, but will scarcely bear rigid scientific enquiry. It is well known that the poison of most if not all herpetologic nature, is innoxious when in contact with unabraded cutaneous and mucous surfaces. Cleopatra cer- tainly learned originality, whether she succeeded in hitting upon an " easy way to die " or not ; but that the poison of any of the snake tribe "kills and pains not" is hardly consonant with the expe- riences upon that point, — the most of them being extremely painful in their action ; the bite of the tarantula, rattlesnake, etc., being attended with vomiting, cramps, suffocating spasms, coldness and great prostration of the nervous powers, and death. Notwithstand- ing the fact that some of these poisons blast human life with the celerity of the lightning's stroke, yet it is probable that had an en- lightened physician of the present day been present, he might have I saved the life of Cleopatra, as, aside from the whiskej^and ammonia treatment now so common and usually so successful, there has been , recently discovered a specific for the evil ; this is nothing else than / the gall of the serpent so causing the wound, — one of the same species, or else the gall of some other species whose poison is more virulent than the one that did the biting. The manner of using is , to take ten parts of ninety-five per cent alcohol, or an equal quan- \ tity of the best whiskey, to one part of the gall, then dilute five PHARMACOLOGIA. 153 drops of this mixture with half a tumbler (rather indefinite) of pure water, and give a teaspoonf ul everj'^ three or five minutes until all is taken. If the pain and swelling are not much benefited, re- peat the process as before. The author of this treatment is a medical gentleman who has long resided in India, and says that of fifty cases treated, he had to re- peat the first quantity but twice, and every patient recovered. The native Indians are said to use a tincture made from a plant called alconcito, or solobasta, for the bites of the most poisonous va- rieties, and with good success. They also inoculate with it as a pro- phylactic against the venom of all noxious animals. Our American aborigines are in the habit of using the aristoloqiiia virginiaria, or serpentaria, for the same purpose, but with what success I don't know. In Cjnnbeline, A. i., S. iii., we have the following: Queen. "Now, master doctor, have you brought those drugs? Physician. Pleaseth your highness, ay : here they are, madam : but I beseech your grace, without offence (my conscience bids me ask), wherefore you have commanded of me these most poisonous compounds, which are the movers of a most languishing death ; but though slow, deadly. Queen. I wonder, doetor, thou ask'st me such a question: have I not been thy pupil long? Has thou not learn'd me how to make perfumes? distill? preserve? yea, so that our great king himself doth woo me oft for mj'^ confections? Having thus far proceeded (unless thou think' st me devilish), is 't not meet that I did amplify my judgment in other conclusions? I will try the forces of these thy compounds on such creatures as we count not worth the hang- ing (but none human), to try the vigor of them, and apply allay- ments to their act, and by them gather their several virtues and effects. Physician. Your highness shall from this practice but make hard your heart: besides, the seeing these effects will be both noisome and infectious." It appears from this paragraph that Shakespeare held the notions of most laymen even of to-day in regard to vivisections and physi- ological experiments in general upon the lower animals. He puts his words in the mouth of a physician however, — a place from which would emanate very little of that teaching at this time— ex- 154 SHAKESPEARE AS A PHYSICIAN. cept, perhaps, it might so happen under exactly the same or anal- ogous circumstances wherein the doctor was using onlj'^ subterfuge — evading the unpleasant duty of directly offending a royal patron. The custom of such physiological experimentation of course then obtained, or had obtained, or Shakespeare would have had no data upon which to found an idea of it — unless it was another of his intuitions. In another place, and when alone, the good Doctor Cornelius talks thus with himself: " I do not like her; she doth think she has strange lingering poisons : I do know her spirit, and will not trust one of her malice with a drug of such damn'd nature. Those she has will stupefy and dull the senses awhile ; which first, per- chance, she'll prove on cats, and dogs, then afterward up higher; but there is no danger in what show of death it makes more than the locking up the spirits a time to be more fresh reviving. She is fooled with a most false effect ; and I the truer, so to be false with her." It is made evident that the queen had a homicidal mania; and in a passage in A. v., S. v., same play, it is said by Cornelius that the flight of Cymbeline's daughter was all that saved her from being " taken off by poison." The doctor then divulges the fact to the king, that he had very often been importuned by the queen to "temper" poisons for her, pretending that she only wanted to eradicate such vile things as cats and dogs, and things of no esteem ; but he divining that her purpose was of danger to the life of some- thing more important, did compound for her a certain stuff, which being taken, would cease the present powers of life ; but, in short time, all offices of nature should again do their due functions. — "Have you taken of it? Daughter. Most likely I did, for I was dead." The action of this "stuff" of Shakespeare is most beautifully typical of chloroform ; and had we the slightest evidence that a drug of that character had ever existed as such, save in the fertile brain of the greatest writer of the world, we well might doubt the priority of discovery of anaesthesia by both Morton and Wells. " It will stupefy and dull the sense awhile, hut there is no danger in what show oj death it makes more than the locking up the spirits a time.'" It seems that Shakespeare's wonderful mind not only compre- hended matters of the past, — imbibed the ideas of his present, but with prophetic grasp anticipated the most important events which PIIARMACOLOGIA. 155 were to transpire ages after he ceased to be. In reference to the action of the drug of Cornelius on the human body, it will be remembered that when Imogen set out on her trip to Milford Haven, Pisanio presented her with a box, saying that it was from the queen, and extolling its virtues — a dram of it being sufficient to drive away distempers. She arrived at the cave of Belarius in an ex- hausted condition, where she says to herself, " I should be sick, but that my resolution helps me ; I am not very sick, since I can reason of it;" — whilst again directly, after being left alone, she continues: "I am sick still; heart sick. — Pisanio, I'll now taste of thy drug." The scene then occurs in which after the return from the hunt and the encounter with Cloten, they find Imogen in her stupor, and suppose her dead — her face being like the "pale prim- rose." Belarius. "How found you him? (her.) Arviragus. Stark, as you see." (^He had brought the body in in his arms.') She then awaked as if from slumber, and anathematizes the good old Pisanio for giving her the box, in these words : " The drug he gave me, which, he said, was precious and cordial to me, have I not found it murderous to the senses?" There is one assertion in the last quotation which would make the identity of the article used to be chloroform, and distinguish it from chloral, and that is, that the body was stark. It was^ja^e also, another proof of chloroform. CHAPTER V. ETIOLOGY. Prefatory — Wine for an ague — Objects of commiseration — A promise re- deemed — Icy burning — A marsliy residence — Magna charta — Allegorical — An idea of antiquity— "Would to bed " — " Falstaff, he is dead" — Congestive chill — Gad's-hill — Prince Henry and his "pals"— This man has become a god — Is Brutus sick? — Acerbity — The Appian Way — Foes to life — Malaria as a demoralizing agent — Cross gartering — The tourniquet as a remedy — Same as a cause of disease — Farewell to neuralgia — Brunonianism. In summing up the material which Shakespeare furnishes us as a causation of disease we do not find much that is explicit or definite, and perhaps the matter could as well have been arranged under some other title as appropriately as that under which we have ar- ranged it. There is one element connected with the matter which goes to make the chapter, however, that presents itself so promi- nently that it cannot well be placed under any other heading than the one given, — and that is malaria, If I chance, however, to introduce ideas in this connection which the reader may find irrele- vant, I beg that he will remember the diflSculty one must necessarily encounter in arranging the ideas of a non-medical person to make them strictly conform to scientific order. Hoping that my apology may be clearly comprehended and appreciated, I shall at once enter upon the subject matter proper to the text. We find allusion to malaria first in " The Tempest, "A. ii., S. ii., thus: Caliban. " All the infections that the sun sucks up from bogs, fens, flats, on Prosper fall, and make him by inch-meal a disease!" whilst in the latter portion of the same scene, there is faithfully portrayed an occurrence which may be witnessed any August day in the malarial districts of our own south and west. It is the place where the malingering Caliban was thought by the drunken butler, 156 ETIOLOGY. 157 Stephano, to have, " as I take it, an ague ; he's in his fit now, and does not talk after the wisest. He shall taste of my bottle : if he have never drank wine afore, it will go near to remove his fit; if all the wine in my bottle will recover him, I will help his ague." This is but in accord with the popular notion of to-day, i. e. — that alcoholic stimulation or alcoholic sedation rather is a sine qua non in the treatment of some conditions dependent upon miasmatic poison- ing; — not only that its good effects are manifested in some ex- treme conditions arising from that cause, but that "whisky" is a prophylactic for malaria. The medical profession in this part of the country, I presume, is also fully persuaded of its value in these cases, as during a dis- cussion upon typho-malarial fever, in the St. Joseph Medical So- ciety, a few evenings since, it was claimed by members of large experience in managing such cases, that alcoholics are indispensable to the best treatment of the most dangerous of malarial poisoning cases — is good at all times and in all forms of Autumnal fevers which have marsh poisons as their cause. Not only is it good in malarial diseases of all grades and at all times, but that in typhoid fevers it is claimed by an eminent medical friend of my own to be antidotal to the etiological agent, and counteracts its influence just as, or in a similar manner as does it in the poison of the rattlesnake. " My wind, cooling my broth, would blow me to an ague fit," — " Merchant of Venice," A. i., S. i., is of no special import, but, " he will look as hollow as a ghost, as dim and meagre as an ague fit," in "King John," A. iii., S. iii., has grounds for reflection in it as conveying a good portrait of one laboring under ague. They are always objects of commiseration. In Richard the Second, A. ii., S. i., we see the words, " a lunatic lean-witted fool, presum- ing on an ague's privilege." These words were those of Richard himself in criticism of some plain words used by the former king, John of Gaunt, when he "breathed his last in wholesome counsel to his unstaid youth." In this quotation we have it plainly asserted that John had an ague even at the hour of his dissolution, — the truth of which I fully acquiesce in after making a diagnosis from his symptoms and the previous history of the case. We stated in the chapter preceding this, whilst noting this case under the heading of toxicology, that although it was claimed by the persons about the king at the time of his last illness, and also by the king himself, that he had been 158 SHAKESPEARE AS A PHYSICIAN. poisoned by a monk, yet we did not coincide in that view regarding the king's malady ; and that in a future portion of the book we would endeavor to present logical grounds for our opinion : in the following pages we propose to make good that promise. The case of King John, bears a much closer analogy to a case wherein the hand of nature has been instrumental in saturating the system with poison, than does it to one in which a "villainous monk" had been the instrument.' Miasmatic exhalations had no doubt wrought the evil in this case. "None of you will bid the winter come, to thrust his icy fingers in my maw; nor let my king- dom's rivers take their course through my burn'd bosom; nor entreat the north to make his bleak winds kiss my parched lips, and comfort me with cold. There is so hot a summer in my bosom, that all my boiv- els C7'umbleup to dust; against this fire, 1 shrink wp." To this must be added the fact that he had been sick before, as will be remembered by his language on the battle-field, " Ah me ! this tyrant fever burns me tip," and '■^ this fever that hath troubled me so long, lies heavy on me; weakness possesseth me and I am faint." In the most deadly forms of pernicious fever there is no symptom so horrible to the patient as this sense of burning heat ; this is his agonizing torment when he is pulseless and his skin is icy cold — nay his breath is even cold, and his surface as blue and lifeless as the body of him who already tenants the grave, — the thermo- meter showing at the same time a great reduction in the normal temperature of the patient's body, whilst the oppressive internal congestions make him clamor for air, air ; — bring him to the win- dow, door, — into the yard, orchard, anywhere so that he may have air! and the exclamation often is, ' O! that I had a river of cold water running through me ! lam burning up.' In all these ma- larial cases an unbearable burniyig sensation or pain in the stomach is one of the most distressing concomitants. Hence the exclama- tion, " Bid the winter come to thrust his icy fingers in my maw." Quinine is the only prompt and infallible agent for this symptom: opium, water, ice, etc., are good, but quinine is the cure. He had been sick a time before his last severe illness, and withal inhabited a marshy district, between the discharge of two considerable rivers — the Wash and the Humber, where the surface is so low that the ocean has in many places to be kept at bay by dikes, and where, to this day, thousands upon thousands of acres of the country are kept only for the support of the vast flocks of geese, both domestic and ETIOLOGY. 159 wild, which feed upon thorn. Moors and fen-hinds cliaracterise Lincolnshire to-day, after all the efforts with money and labor to re- claim it from the sea ; and when we go back to the twelfth century, we ought surely to find it as malarial as the Pontine marsh of Italy, or the sloughs of our own Mississippi. In this district it is that lie buried the bones of Catharine Swinford, the wife of John of Gaunt ; and in this district, at Newark on the Trent, died John, in the year 1216, at the age of forty-nine years. He signed the Great Charter the year before — 1215. The probable cause of the great dramatist's placing the death of John to the account of a monk, and that with poison, originates in the fact of there having been a great antagonism existing between John and the Eoman church, — an antagonism which finally resulted in the complete and humble — nay servile submission of John. This perhaps is construed into a simile of real physical death — the poison represented by Shakespeare's own disdain for the Romish faith — that is if matters in religion ever gave him any concern at all. Shakespeare, however, has managed the symptomatology of the case with such a masterly skill, that it might puzzle the most astute diagnostician of our time, — even his countryman, the great Watson himself, to say whether, from the symptoms, the king died with poison or malarial fever ; — because they are sometimes very much alike. The term "ague-fit of fear" is used by Richard the Second illustratively, whilst in the first part of Henry the Fourth, A. iii., S. i.. Hotspur uses the term ague in the same sense — that is, to illustrate an idea; also in A. iv., S. i., of same play, he uses the words, "worse than the sun in March, this praise doth nourish agues;" thus pointing to the fact, that the notion yet prevalent among the mass of mankind that to bask in the sun at spring-time is to propagate agues, certainly can boast of antiquity as a basis, whether the idea itself be false or true. Sunlight alone never "nourished agues," whether in March or August, directly; the proximate principle in its causation, — malaria, however, doubtless is generated by the action of solar heat in conjunction with other agents, and, thus, if at all responsible, being so in a very round- about way. In King Henry the Fifth, we have a most artistic description of the influence of marsh poison in the case of the demise of Sir John Falstaff. He is first announced as " very sick, and would to bed," 160 SHAKESPEARE AS A PHYSICIAN. by the boy at the house of Mrs. Quickly, who requests Nym, one of Falstaff's followers, to " come in quickly to Sir John; ah! poor heart, he is so shaked of a burning quotidian tertian, that it is most lamentable to behold;" and further on, in concluding the career of this — one of the most marked characters that has ever figured in dramatic composition, Pistol urges the boy to " bristle his courage up, for Falstaff he is dead, and we must yearn therefore." Bardolph. "Would I were with him, wheresome'er he is, either in heaven or in hell. Mrs. Quickly. Nay, sure, he's not in hell: he's in Arthur's bosom. 'A made a fine end and went away, and it had been any Christian child ; 'a parted ev'n just between twelve and one, ev'n at the turning o' the tide: for after I saw him fumble with the sheets, and play with flowers, and smile upon his finger's end, I knew there was but one way ; for his nose was as sharp as a pen on a table of green freize. How now. Sir John ? quoth I : what, man ! be of good cheer. So 'a cried out — 'God, God, God!' three or four times ; now I, to comfort him, bid him, 'a should not think of God ; I hoped, there was no need to trouble himself with such thoughts yet. So 'a bade me lay more clothes on his feet: I put my hand into the bed, and felt them, and they were as cold as any stone ; then I felt to his knees, and so upward, and all was as cold as any stone." There are certainly many of the details which go to form the symptomatology of congestive chill omitted in this history ; but enough are present to show us that it is a fair picture of that malady — just as the practiced eye can tell the malady at the first glance, without asking previous history, in a case to which he may be called, in the miasmatic regions of our own and other countries. "We regard miasm as the cause of the symptoms and death in the case above related as evidenced not only by the history and symp- toms, but also by the habits, circumstances and age of the patient, — typhoid fever, with the which it would more likely be confounded, happening very seldom in a person of Falstaff's age, whilst it will also be rememberod that the haunts of Prince Henry and his noto- rious "pals" were in the county of Kent, about Rochester and Gad's-hill, — the surface of the country being low and covered in many places with swamps and forests. Of the million and forty- one thousand acres composing this county, nine hundred thousand are meadows and arable land, — even the Kentish and Surrey por- ETIOLOGY. 161 tion of the city of London lying in many places several feet below the highest tides. I think it is somewhere said that in former years this portion of London was often subject to malarial fevers of a severe type, though it is against the rule for this to be so in cities generally. "Ague" stayed the Duke of Buckingham "a prisoner in his chamber" on an important occasion; and Patroclus allows (in Troilus and Cressida) that " those wounds heal ill which men do give themselves" — an assertion acknowledged by the whole medical world, and which has, perhaps, a better foundation for its truth than has the next — which says that " danger, like an ague, subtly taints." Coriolanus likens fear to an ague also, whilst we find an animated discussion of CiBsar's merits between Cassius and Brutus in this language : Cassius. " And this man is now become a god ; and Cassius is a wretched creature, and must bend his body, if Caesar carelessly but nod to him. He had a fever when he was in Spain, and when the fit was on him, I did mark how he did shake: 'tis true, this god did shake: his coward lips did from their color fly ; and that same eye, whose bend doth awe the world, did lose his lustre. I did hear him groan ; ay, and that tongue of his, that bade the Romans mark him, and write his speeches in their books, alas ! it cried, ' Give me some drink, Titinius,' as a sick girl. Ye gods, it doth amaze me, a man of such a feeble temper doth get the start of the majestic world, and bear the palm alone." Now when the matter is considered in all its relations, we have in this extract another case arising from marsh poison — palpable, plain, unmistakable. We find a case something on the same order in that of Brutus himself, when his wife Portia uses this language: " Is Brutus sick, and is it physical, to walk unbrac'd, and suck up the humors of the dank morning? What! is Brutus sick, and will he steal out of his wholesome bed to dare the vile contagion of the night, and tempt the rheum and unpurged air to add unto his sickness?" and when met in the senate chamber on the day of the assassination, Caesar jocularly assures Brutus that he is not so much his enemy as " that same ague which hath made him lean," and he then invites Brutus and the others to drink some wine, with the view perhaps to neutralize the acerbity which he knew to be present in their bosoms. The neighborhood of Rome, where this scene transpired, is note- 162 SHAKESPEARE AS A PHYSICIAN. riously the most malarial district in Europe. The poison of the Pontine marsh, before referred to, is so pestilential in its concen- tration, that an unacclimated person passing the great " Appian Way" from Rome to Naples at night time, and in the hot season of the year, may imbibe enough to dangerously compromise his existence. Macbeth, in his extremity, while shut up in his castle at Dunsi- nane, thought to resort to the very common expedient of exter- minating his enemies by drawing them into pestilential districts, there to be prey'd upon silentlj'' by " pale distemperatures and foes to life," as 'twas said by many would be the fate of the Union soldiers on our southern coasts during our civil war. In the stead of the yellow fever, which was relied upon to do its share in per- petuating the reign of " King Cotton," Macbeth placed his reliance on the same unreliable alliance, and depended upon "ague" to " eat them up," — A. iv., S. v. Lear prays thus to be avenged upon his undutiful daughter, Goneril: "You nimble lightnings, dart your blinding flames into her scornful eyes; infect her beauty, you fen-suck' d fogs, drawn by the powerful sun, to fall and blast her pride." I do not know of an agent more potent to ravish beauty of its charms, than a residence in a malarial locality. Marsh poison blights — "subtly taints" the whole vital economy, and renders those reared mid its foul pollutions dull and the victims to hebetude, mentally, physically and morally. The latter assertion may seem queer to those who know nothing of malarial districts and their people; but I know from experience that what I assert is true; — they are as a general proposition lacking in the moral principles, so much so that physicians are commonly loth to attend the best of them, as he expects to realize little or nothing for his services ; and I have never seen a sprightly physical or mental organization reared from infancy to adult age in such an atmosphere. "This does make some obstruction in the blood, this cross-gar- tering " — so says Malvolio in "Twelfth Night," — A. iii., S. iv. The custom among the women of civilized countries, of ligating or constricting the legs in keeping their hose in place, is no doubt pro- ductive of serious evils. It has been suggested as an expedient worthy of trial in cases of retarded or suppressed menstruation — and also in puerperal eclampsia, to resort to ligation of the thighs (arms also, in the latter), in the first to throw the force of the sys ETIOLOGfT. 163 temic circulation upon the pelvic organs more directly, and in the latter to cut off transiently a supply of blood to the brain, but not to lose it to the system at large, as would be done in direct ab- straction. Now, if there is any just ground for such a theory as the above, it follows as a necessity that there would be conditions in which this practice would be inadmissible, and where its adoption would be hurtful. These cases might be enumerated somewhat in the following order: menorrhagia, cases prone to abortion, pla- centa previa, all cases of hemorrhagic diathesis, in rectitis, hemor- rhoids, cystitis, metritis, nephritis, cellulitis, etc., etc., as connected with the pelvis, whilst varix, phlebitis, etc., might result to the extremities themselves. These are not all, but convulsive con- ditions themselves may be engendered from this cause as effectually as from a loaded rectum and gravid womb, provided the condition is forcibly persisted in ; and, again, the blood so impeded in a free circulation through its normal channels becomes itself a toxic ma- terial. These considerations should be held sufficient for placing the system of "gartering" among our women in the same category with tight-lacing, low-neck dresses and high-heeled shoes. Let them all go down to oblivion together, and the days of hysteria, "palpitations" and neuralgias will in a great measure take their departure. In "Twelfth Night" also, we find the term " Brownist " used in a sense of derision. A foot-note in the edition from which we quote says that the Brownists were a sect (whether in medicine, or what, is not stated), afterwards called the "Independents," who were much ridiculed by the writers of the time. This perhaps had reference to the followers of John Brown, an Englishman (not, how- ever, the lately departed "friend" of Queen Victoria), who held to the opinion that the proximate cause of all fevers was nothing more than a general depression of the vital powers of the whole body, and that treatment based upon that supposition was the only rational method. These ideas were vehemently assailed by Brous- sais and his followers, who declared that fevers were all sympto- matic — that they had their origin in a preceding local lesion, and that therefore the treatment must be shaped to suit the altered pathology. The term "devouring pestilence hangs in the air " is found in Richard the Second, but is of no significance in its application to Shakespeare's medical knowledge. CHAPTER VI. DEBMATOLOGY. The beginning — Serpigo — A voluminous curse — Was it small-pox? — The cursed hebenon — Acarus scabiei — The disease in Paris — Falstaff as a " wen" — Kibes — Probably vaccinated — A string of rhymes — Good fruit only from a good tree — Transmissibility of defects — Gynaecological phenomena — The "• convulsive zone" — Spreading it on " thick" — Rouge and pearl pow- ders — 'Tis beauty truly blent — Commendable caution — Danger in the dark — A fastidious scoundrel — Supposition strengthened — We catch of you, Doll — Baths in syphilis — Ricord and Bumstead — A beautiful picture — Durability of a tanner— A curious but not creditable truth — A needed reform — Venesection in the right iliac fossa. For the sake of convenience, and to avoid a multiplication of short but separate classifications, all diseases affecting the super- fices of the body noticeably, will be considered under the above caption. This will necessarily bring into close proximity affections of a very diverse pathology — some which might be very properly classed under other heads perhaps had we more material of the same kind — but many of the subjects touched upon are in them- selves very brief, and though demanding their share of attention, yet are too short for any purpose save condensation or incorporation into an article general in its character ; for this reason, and also because syphilis almost always involves the cutaneous structures to a greater or less extent, it will likewise be noticed in connection with dermatologic medicine. " Serpigo" is an affection of the skin of the " tetter" family, — sometimes seemingly related more closely to the " herpetic" group ; it is mentioned in "Measure for Measure" and also in "Troilus and Cressida," where Therestes uses it in his maledictions upon the managers of the siege of Troy ; and the same character, whose tongue was caustic as a red-hot scalpel, in his wrangle with Patro- clus, talks thus : 164 DERMATOLOGY. 165 Therestes. " Why, thy masculine whore. Now, the rotten dis- eases of the south, the guts-griping, ruptures, catarrh, loads o' gravel i' the back, lethargies, cold palsies, raw eyes, dirt-rotten livers, wheezing lungs, bladders full of imposthume, sciaticas, lime- kilns 1' the palm, incurable bone-ache, and the riveled fee-simple of the tetter, take and take again such preposterous discolourers. Patrodiis. Why, thou damnable box of envy, thou, what meanest thou to curse thus?" This quotation, although containing a little of everything, could not be separately stated, and we therefore give it for what it is worth. The ghost of Hamlet's father in his story of how he was most foully murdered by his brother and his own queen, speaks of a " loathsome crust:" Ghost. "But, soft; methinks, I scent the morning air : brief let me be. — Sleeping within my orchard, my custom alway in the after- noon, upon my secure hour thy uncle stole, with juice of cursed hebenon in a phial, and in the porches of mine ears, did pour the leprous distillment ; whose effects holds such an enmity with the blood of man that swift as quicksilver, it courses through the natural gates and alleys of the body ; and with a sudden vigor it doth posset, and curd, like sour droppings into milk, the thin and wholesome blood : so did it mine: and a most instant tetter bark'd about, most lazar-like, with vile and loathsome crust all my smooth body." There are few morbific agents which will strictly answer in every particular the characteristics of the contents of the phial, in this case. It must have been some powerful animal toxic, similar to, or identical with the virus of small-pox ; the only plea which could be deducted against this hypothesis, from the quotation itself, being the " sudden vigor " with which it acted. This, however, is an indefinite assertion, and " sudden " might be a week or ten days in one case, whilst it might be only a few moments or hours in another. It is possible that the word " hebenon " may have had a meaning similar to our "narcotism" or "narcotic," and that it was used this time in relation to the supposed effects upon the system, — the term likely having its origin in the word " hebes " — dull, obtuse, heavy, sluggish. Hebenon is not found in any lexicon to which I have access. The " itch mite " intrudes itself u^dou our notice in 166 SHAKESPEARE AS A PHYSICIAN. "Romeo and Juliet." — " Her wagoner, a small gray-coated gnat, not half so big as a round, little worm piek'd from the finger of a milk-maid." The arachnoid insect, known among naturalists as the acarus scabiei or common itch insect, is here certainly referred to. It was formerly supposed that this parasite found its way into the human skin from many of the animal species, as the dog, and others of our domestic animals. Several persons in Paris were said to have contracted the disease whilst attending upon a diseased camel. We see in the extract that milk-maids were thought to suffer from it, which would give us to think it communicable from the cow, if we agree with the text. There is an insect somewhat akin to the one under notice, which infests cheese, but it never affects the human or animal system. The true acarus scabiei is now universally believed to be propagated through raw or brown cane sugar; hence the term "finger of a grocer's maid" would in truth have been more appropriate in the case in question than was that of milk-maid. The vaccine disease, afterwards so thoroughly studied by Jenner, may have fallen under the notice of Shakespeare, and it may be that to this he refers in the quotation. This would get the itch and cow-pox only a little mixed. "Hal," afterwards Henry the Fifth, likens Falstaff to a " wen." Prince Henry. (To Poins.J "I do allow this wen to be as familiar with me as my dog;" and again in "Merry Wives of Windsor:" Falstaff. " Well, sir, I am almost out at heels. Pistol. Why then let kibes ensue." We recognize no such a malady as "kibes" in our modern nosology ; but in former times it was in use, and meant to " chap" or crack open from cold, as in chilblains. The term is said to be of Persian origin, — the affection being, as intimated by Pistol, most common about the heels. "You rub the sore, when you should bring the plaster — and, most chirurgeously." — " The Tempest." "To strange sores, strangely they strain the cure." — "Much Ado About Nothing." Was the elastic bandage here presaged? Thersites tells us what he knew about boils, as does also Coriola- nus in his anathemas upon his ungrateful countrymen. Timon of Athens speaks of " ulcerous sores," whilst Charmian, in " Antony and Cleopatra," excuses herself from a game of billiards on the score of a sore arm. (Wonder if she hadn't been vaccinated.) DERMATOLOGY. 167 The following extract is from " A Midsummer Night's Dream :" " So shall all the couples three, Ever true in loving be ; And the blots of Nature's hand Shall not in their issue stand : Never mole, hare-lip, nor scar, Nor mark prodigious, such as are Despised in nativity. Upon their children be." And in "Cymbeline:" " On her left breast a mark cinque-spotted, like the crimson drops i' the bottom of a cowslip," and " upon his neck a mole, a sanguine star: it was a mark of wonder." In speculating upon the first of these extracts, it may be re- marked that the "fates" probably understood few of the "tricks that are 7iot vane" in the hands of nature, — if they had, it is hardly probable that so rash a promise as that their children should possess neither " mole, blot nor scar," would have been made, — as it is an unalterable fact that to have sound fruit we must have perfect parentage ; [parents who are either morally, mentally or phj^sically imperfect may transmit their characteristics to their progeny, and it seems to be an established fact as regards acquired imperfections as well as those that are inherent in individuals : thus crop your dog's tail, and his offspring may ajDpear minus the caudal appendage, — if not in the first or second — may be in the third gen- eration — atavism. This will happen the more surely if both the male and female parents be so treated. Blumenbach remembered a man whose little finger of the right hand was left crooked after an injury; several of his sons at birth had the identical deformity in their right hand. Two brothers at Brussels were micropthalmic in the left eye ; their father had lost the left eye fifteen years be- fore his marriage. A lady at Dover, England, was frightened by a ferret whilst enciente; every child born after that had eyes like the animal, and they all became blind, or nearly so, at the age of pu- berty. Brown-Sequard noted a case where a man became epileptic after a fall in which the dorsal vertebrae were shattered ; he mar- ried and his son became epileptic, though there had not before been epilepsy in the family previous to the father's injury, I myself know a circumstance where the mother, and daughters in three gen- erations following, — that is to say, from child to great grandmother, 168 SHAKESPEARE AS A PHYSICIAN. each had a small encysted tumor of the scalp exactly in the same situation, and all of the same nature. But the most beautiful and satisfactory results of this power of transmission are seen in the inferior animals, where many of the traits may be directly propa- gated from one living and mature being to another mature being, — of the same species or not, and afterwards these characteristics may be transmitted to the progeny. This is illustrated by the stripes on the shoulders and legs of the horse colt when the mother has previously borne mules ; and is sometimes also seen in the hu- man family when the children of a second husband resemble in physical, mental or moral traits the mother's former husband. Through the relation of parentage the husband and wife may also impress upon each other their peculiarities — as in becoming to re- semble each other in personal appearance, tastes, habits, mental traits, etc. Association, in young married people, together with the identity of conditions of physical and mental growth, may con- tribute to this end, but for its most complete attainment they must have "mingled bloods" in the great office of propagation. But as I started out to say before, these strange powers of transmission are best seen in the lower orders of animal creation, — as for in- stance in the guinea-pig. Experiments upon nervous phenomena by Dr. Brown-Sequard show that in the guinea-pig exposure of the spinal cord, or severe injury to a large nerve trunk, will be followed by convulsions by irritating what he calls the " epileptic zone," — a small spot of skin near the ear. In animals before mentioned as having received a nervous injury, convulsions may be produced at the pleasure of the experimenter by touching this special point of the cutaneous sur- face. When recovery of the injured nerve takes place, the hair always falls from the "convulsive zone;" — but what I more par- ticularly wished to notice is the fact that the young of these epi- leptic animals, brought forth after recovery, have the same epileptic seizures, and recovery is preceded by falling off of the hair in pre- cisely the same place ! And further, — he remarked that the ani- mals under experiment often eat off the toes of a paralyzed limb, and that in the young of the toeless father or mother the progeny would also appear with the same member missing! This is a cu- rious and interesting subject, and merits the close attention of the physiologist and gynaecologist. It appears that aesthetics received a proper share of attention in DERMATOLOGY. 169 past ages, as well as in this present "fast" age of the world. " Timon of Athens " in his misanthropic rage talks thus : " Whore still : paint till a horse may mire upon your face," and in " Cymbeline " he speaks of " some jay of Italy, who smothers her with painting, hath betrayed him," thus giving us information to the effect that the "rouge" and "pearl powders" found their votaries in old times as they do to-day, mainly among the demi monde. That sensible people then looked upon the custom of "painting" as they now do, we may infer from a passage in " Twelfth Night : " Olivia. "Have you any commission from your lord to negotiate with my face? We will draw the curtain and show you the picture. Look, you, sir ; such a one I am at this present : is't not well done? Viola. {In the garb of a youth.) Excellently done, if God did all. Olivia. 'Tis ingrain, sir; 'twill indure wind and weather. Viola. 'Tis beauty truly blent, whose red and white nature's own sweet cunning hand laid on. Lady, you are the cruelest she alive, if you will lead those graces to the grave, and leave the world no copy." The term " let her paint an inch thick," is also used, which tells us that the habit of "spreading it on heavy" was perhaps not a strange proceeding to the " ancient fair," whilst the same is hinted at by " Clown" in " Measure for Measure." The second portion of this chapter, as previously intimated, will be devoted to the consideration of syphilography. In " Measure for Measure " Lucio, the fantastic, in conversation with two gentlemen : 1st Gentleman. "Do I speak feelingly? Lucio. I think thou dost ; and, indeed, with most powerful feel- ing of speech: I will, out of mine own confession, learn to begin thy health ; but, whilst I live, forget to drink after thee. 1st Gentleman. I think I have done myself wrong, have I not? 2d Gentleman. Yes, thou hast, whether thou art tainted or free. Lucio. Behold, behold, where Madam Mitigation comes ! 1st Gentleman. I have purchased as many diseases under her roof, as comes to 2d Gentleman. To what, I pray ? 170 SHAKESPEARE AS A PHYSICIAN. Lucio. Judge. 2d Gentleman. To three thousand dollars a-year. 1st Gentleman. Ay, and more. Lucio. A French crown more. 2d Gentleman. Thou art always figuring diseases in me ; but thou art full of error : I am sound. Lucio. Nay, not as one would say healthy ; but so sound as things that are hollow : thy bones are hollow ; impiety hath made a feast of thee." In the first paragraph of the foregoing it will be perceived that direct reference is made to the throat lesion of secondary syphilis, the lesion of articulation, and the danger incident to drinking after (from the same vessel) a person so contaminated is almost directly stated. Lucio proved his own wisdom in that matter, if he knew nothing else of value ; and his determination to always forget to drink after the gentleman is worthy to be imitated by every think- ing person. Indeed J have long practiced the habit of avoiding all places of public resort for the purpose of taking a drink of water, because syphilitio and other loathsome affections often cling to the lips and fingers of those resorting to them ; particularly is the syphilitic poison wide-spread among the transient portion of man- kind ; and one does not know what moment he might innocently place this the most loathsome contagion to his lips, by the use of a public dipper, or by the hand-towel in the wash-room of an hotel. The ravages made by pock upon the osseous system seems to have been clearly comprehended by Shakespeare, from the language used at the conclusion of the extract ; and though the disease had then been of comparatively recent introduction into Europe (it is claimed from America), yet it had been pretty thoroughly studied we may suppose from this apparent familiarity with it by the un- professional. This same pedantic fellow, Lucio, in a conversation with the Duke thus demeans himself. (Duke in disguise.) Lucio. " I was once before him (the duke) for getting a wench with child. Duke. Did you such a thing? Lucio. Yes, marry did I; but I was fain to forswear it: they would else have married me to the rotten medlar." ('Twould have been too good for him. ) DERMATOLOGY. 171 Falstaff' s quandary as to whether he was afflicted with gout or syphilis has been touched upon in the chapter on neurology ; in the remarks there made, it is stated that notwithstanding the fact of the pain which gave rise to the thought, being situated in the great toe in place of the " shin," yet knowing the lascivious habits of "Sir John," and the exceedingly diverse phases which syphilitic lesions assume, we were inclined to believe " a gout o' this pox " true in this case of the " knight." We are strengthened in the position there taken, by the following conversation : Falstajff. " How now. Mistress Doll? Hostess. Sick of a calm : yea, good sooth. Falstaff. So is all her sex; an they be once in a calm, they are sick. Doll. You mauddy rascal, is that all the comfort you give me? Falstaff. You make fat rascals. Mistress Doll. Doll. I make them? Gluttony and diseases make them : I make them not. Falstaff. If the cook helps to make the glutton, you help to make the diseases, Doll: we catch of you, Doll, we catch of you ; grant that, my virtue, grant that." As to the treatment of syphilis it is apparent that local treatment in the form of baths must have been common in Shakespeare's time if we look to the following in " Timon of Athens: " Timon. "Art thou Timandra? Timandra. Yes. Timon. Be a whore still ! they love thee not that use thee : give them diseases, leaving with thee their lust. Make use of thy salt hours ; season the slaves for tubs and baths ; bring down rose- cheeked youth to the tub fast, and the diet." Perhaps it is the worse for our patients that we do not adopt a rigid course of bathing and personal purification in syphilis ; espe- cially might it benefit those in whom the cutaneous system is deeply involved ; cleanliness is a most God-like virtue, and as a prophylac- tic measure — nay often a curative means, its worth is beyond esti- mate. Ricord, Videlle nor Bumstead could hardly paint a better pen- picture of the ravages of syphilis than did this same cynical old Timon on another occasion when in conversation with one whom he accuses of harlotry. 172 SHAKESPEARE AS A PHYSICIAN. Timon. "Consumption sow in hollow bones of men; strike their sharp shins, and mar men's spurring. Crack the lawyer's voice, that he may never more false title plead, nor sound his quil- lets shrilly ; down with the nose, down with it flat ; take the bridge away from him, make curl'd pate ruffians bald; and let the un- scarr'd braggarts of the war derive some pain from you." There cannot be found in the writings of the ablest medical au- thority of this age, a more terse and truthful picture of syphilis than is seen in these words of the sour old Timon. His description is indeed a marvel of accuracy. Witness the allusion to the throat, nasal and other osseous lesions — the fauces, vomer, tibia, etc., being special points of involvement in the tertiary state of the malady. Hamlet. " How long will a man lie i' the earth ere he rot? Clown. 'Faith, if he be not rotten before he die (as we have many pocky cases now-a-days, that will scarce hold the lying in), he will last you some eight year, or nine year : a tanner will last you nine year." Thus it is seen that the " owner of a foul disease " (Hamlet, iv., i.) is punished even in the solitudes of the grave, by returning to dust much more rapidly, than do virtuous men. Lysimachus, in "Pericles," enquires of the bawd: "How now, wholesome iniquity! have you that a man may deal withal, and defy the surgeon? " And the same gentleman in his interview with the virtuous Marina whose ill-luck had placed her in this den where " no heretics were burn'd but wenches' suitors" (Lear, iii.,ii.), she assured him that " since I came (here), diseases have been sold dearer than physic," — a truth which holds good even now whilst I write. It is known to every doctor that the degraded scoundrel who gives his last five dollars for the privilege of getting the malady will spend thirty in trying to evade the payment of the twenty he owes his surgeon for curing him. "When the medical profession makes it four times as costly for this class of patients to get rid of the malady as it is to catch it, there will be less need of " contagious disease acts" and "bawdy- house inspectors," and all that, — and the service will then only be awarded pay according to its worth. There is no class of practice in which the fees are so loosely and foolishly conducted as this ; DERMATOLOGY. 173 and it is to be hoped that medical organizations everywhere will sometime make it incumbent upon members always to " bleed" this class of patients — not in the " bend of the arm" but in the purse. The idea that syphilis may be propagated through the blood of a person so affected, and that by microscopic observation we may detect in it certain syphilitic characteristics, finds some old footing in an assertion made by Andreas Csesalpinus to the effect that when the Spaniards abandoned the town of Somma, near Mount Vesu- vius, they mixed blood from the patients in the hospital of St. Lazarus with all the wine in the place, and thereby infected with syphilis all who drank it. This happened early after its alleged American origin. The bacterial theory might account for this. CHAPTER VII, ORGANOLOGY. The stomach — Power of mind over function — Voluntary inanition — Its Pathology — What a physiologist! — Dietetic ideas of a hostess — An apt com- parison — The irritability of hunger — A plain road — An error explained — The woodman and his belt — Seat of the affections — Gin-drinker's liver — Cause for effect — Smiling at grief — Lewdness and poverty — Illustrated — Sentiment reversed — The badge of cowardice— The truth in popular ideas — Then live, Macduff — Sleep in spite of thunder— Pulmonary gangrene — Benedick, the married man — Thaw'd out — A pertinent conclusion — A blind philosopher — How are you 'fraid! — Latent senses — The green flap — Some new infection — An enquiry — An amusing incident— " Hal's " vocabulary — Renal functions — Sympathetic flbrillae- Carry his water to the wise woman — What says the doctor to my water? — A sensible doctor, for a wonder — Changes in the kid- ney — Nose painting — A sure sign — Taste not — A cheap article — " When I was about thy years, Hal" — The lean and hungry Cassius — He smiles in such a sort— Drawing the fire out — A parody— An exploded barbarity — Mr. Strib- ling, the druggist — The blood is the life — Blasting a good resolve — Man im- proves with his condition — A plea for the lancet— Palpitation — Good air as an agent — Much effuse of blood, etc. Though not of the most rigidly appropriate character, it is pro- posed to include under the title " organology" all subjects pertain- ing to the different organs and structures of the body that have not before been noticed, and whilst we are aware that the arrangement may not escape criticism, we can only ask that he who may find fault with it may find the inclination, at some future time, to accom- plish the very same task better. The first organ to claim our notice is that fundamentally import- ant one — the stomach. It has been said in a former page, that unquiet meals make ill digestions, — the truth of which has forced itself upon the notice of most persons, no doubt. It seems that the function of alimentation is more closely allied to the proper working condition of the brain and nervous system than most other functions of the body. Strong emo- 174 ORGANOLOGY. 175 tional conditions of the mind may not only suspend the normal functions of this viscus, — impair them for a time, but may in rare instances totally destroy them, Within the last week, a man ar- rested and confined in our county jail, on a clear charge of murder, refused food from the time of his arrest, until his death took place from inanition, — in perfect health, otherwise, seemingly. In these cases there is actually no demand for food, from the simple fact that the nerves, — the gastric distribution of the parvagum, lose, through the powerful mental shock, their proper function, — and no hunger is felt. In cases of voluntary abstinence, like that of Tanner and others, the freedom from mental perturbation is the main factor in their power of indurance, though after a time, this same "abstinence" may and does "engender maladies" as its sequence, as we have it asserted in "Love's Labor Lost." In "Richard the Second," John of Gaunt is made to say — "things sweet to taste prove in digestion sour," which would lead us to believe that the chemistry of the assimilative process was understood by Shakespeare as well as most of our modern phy- sicians, — whilst we may exclaim, what a physiologist he might have become! This remark may, however, be applied to other appetites besides that of the stomach ; and doubtless John only used it as a metaphor. It appears that in the day of Mrs. Quickly it was not thought meet that one tax their digestive powers too far, — and Mrs. Quickly, who was an innkeeper, seems to have been one to entertain thoughts of so wholesome a kind. We hear her arguments upon this subject 176 SHAKESPEARE AS A PHYSICIAN. " Hal came down on Sir John's pate with a bottle." upon an occasion when " Hal" came down on " Sir John's" pate with a bottle for likening the king to a singing-man of Windsor. Mrs. Quickly. " Thou didst swear to me then, as I was washing thy wounds, to marry me, to make me "my lady" thy wife. Canst thou deny it? Did not good-wife Keech, the butcher's wife, come in then, and call me gossip Quickly? coming in to borrow a mess of vinegar? telling us she had a good dish of prawns, whereby thou didst desire to eat some, whereby I told thee they were ill for a green wound." The term "green wound" is also used in "Henry the Fifth," an idea erroneous enough certainly, but part and parcel of the notions of that day it appears. Henry the Fourth likens the stomach to fortune that gives single- handed ; — " she either gives a stomach and no food — such are the poor (in purse) ; or else a feast and no appetite, — such are the rich that have abundance and enjoy it not : but the illustration of ORGANOLOGY. 177 Menenius, who compares with the digestive system the governor of a province, is very good. Menenius. "There was a time when all the body's members rebell'd against the belly; thus accus'd it: That only like a gulf did it remain i' the midst of the body, idle and inactive, still cupboarding the viands, never bearing like labour with the rest ; where the other instruments did see and hear, devise, instruct, walk, feel, and mutually participate, did minister unto the appetite, and affection common to the whole bod3^ The belly answered. — Citizen. Well, sir, what answer made the belly? Menenius. I will tell you, if you will bestow a small (of what you have a little) patience awhile, you'll hear the belly's answer. Citizen. Y' are long about it. Menenius. Note me this, good friend ; your most grave belly was deliberate, not rash like his accusers, and answered: 'True is it, my incorporate friends,' quoth he, 'that I receive the general food at first, which you do live upon ; and fit it is, because I am the storehouse, and the shop of the whole body: but if you do remember, I send it through the rivers of your blood, even to the heart, the brain, the strongest nerves, and small inferior veins ; they all receive from me that natural competency whereby they live ;' " and the irritable humor of a hungry man, is given by this same Menenius, in good style, in a conversation with Sicinius, one of the " tribunes of the people:" Menenius. "He was not taken well (meaning that he was not approach'd at the proper time) ; he had not dined : the veins unfill'd, our blood is cold, and then we pout upon the morning, are unapt to give or to forgive ; but when we have stuffed these pipes, and these conveyances of blood with wine and feeding, we have suppler souls than in our priest-like fasts: therefore, I'll watch him till he be dieted to my request, and then I'll set upon him. Brutus. You know the very road into his kindness, and cannot lose your way." It is quoted by Darwin, as the saying of a certain physician, that this irritability of temper so conspicuously noticeable in a hungry man, is often converted by him, unconsciously, into actual anger — in or by which state he is stimulated into a more bearable condition, both mentally and physically. V 178 SHAKESPEARE AS A PHYSICIAN. This same authority tells us a truth but partially when he says that "good digestion waits on appetite, and health on both," because it is well known that there is often an abundance of appe- tite with no digestion at all ; — yet we admit the truth of the latter portion of the paragraph, as healthy appetite attended by good digestion are the almost certain concomitants of good health. It seems that the great author was in error as to the modus operandi of a dinner in producing a placid mind ; it cannot be the " filling of the vein" — neither the "stuffing of the pipes and conveyances," as a result of drinking and feasting, which bring about this praiseworthy result, for in that event it would only be manifested some hours perhaps after meals, whereas it usually supervenes very speedily after a sumptuous dinner. I suspect that it is this gastric division of the " eighth pair " that here again raises the quarrel, and that the savory viands yexy soon apply their pacifying antidote to the millions of its fibrillse which ramify upon the inner or mucous coating of the stomach ; these same victuals perhaps also acting mechanically in some degree in producing the same effect, — and thus for once transforms a cross and oft-times unreasonable nondescript into a benign and pleasant husband and gentleman. Speaking of the mechanical action of food upon the stomach — it will be recollected by the reader that this "pressure" upon the nerves and tissues of the organ need not always be made from the interior of its cavity ; but that pressure from without will in some degree produce the same effect. Remember the woodman who prepared himself to be absent at his camp a fortnight, and who in the place of food supplied himself with a broad leathern belt supplied with buckles and twelve holes ; he took up his belt one " hole " each day, and at the end of two weeks was as sprightly as the " buck" of his native woods. The liver was, by the ancients, supposed to be the seat of the affections, and in this fact we have an explanation of Btron's (not B^/ron's) talking of — "this is the liver vein," after having read some lines of erotic poetry; the line is found in "Love's Labor Lost." Gratiano, in "The Merchant of Venice," puts matters in a sen- sible shape, thus: " With mirth and laughter let old wrinkles come, and let my liver rather heat with wine, than my heart cool with mortifying groans. Why should a man whose blood is warm within, ORGANOLOGY. 179 sit like his grand-sire cut in alabaster? sleep when he wakes, and creep into the jaundice by being peevish? " Here we have an honorable and ancient precedent for " hobnail liver," and he who chooses to follow the example can do so without the fear of being charged with a design to innovate upon the old and well established customs. The woodman who prepared himself with a leathern belt. In regard to a man's "creeping into jaundice through peevish- ness " — the effect is mistaken for the cause ; old "Shake" got his cart before the horse that once. He had doubtless " let his liver heat with wine " on that occasion. This same idea as to the effects of excessive alcoholic stimulation upon the liver is seen also in "Antony and Cleopatra," A. i., S. ii. ; and the confounding of cause and effect named above is corrected in a line in " Troilus and Cressida," when he says " what grief hath set the jaundice on your cheeks? " The idea — erroneous as it is, and though antiquated as the ever- 180 SHAKESPEARE AS A PHYSICIAN. lasting hills, — which makes the liver the seat of love and pusil- lanimity, finds many places to crop out in the writings of Shake- speare ; of the former, Rosalind gives a negative attest when she wishes to "wash the liver of Orlando as clean as a sound sheep's heart, that there shall not be one spot of love left in 't," whilst in "Twelfth Night" " The Duke " and Viola speculate on the con- nexion between the liver and the tender passion in this style : Duke. "Alas! their love maybe called appetite, no motion of the liver, but the palate, that suffers surfeit, cloyment, and revolt; but mine is hungry as the sea, and can digest as much ;" when Viola, detailing the depths of her own affections, — she " pin'd in thought, and with a green and yellow melancholy, she sat like Patience on a monument, smiling at grief." In this we see the notion of a close relationship between melancholia and a deranged hepatic function. "This wins him, liver and all," says Fabian, whilst listening to the reading of the letter by his dupe Malvolio. "Put fire in your heart and brimstone in your liver," was another of the shrewd suggestions of the same fellow. In an allusion to the supposition that lewdness and poverty go hand in hand. Prince Henry speaks of "hot livers" and "cold purses," and Falstaff, in his wrangle with the Chief Justice, assures him that " you, that are old, consider not the capacities of us that are young: you measure the heat of our livers with the bitterness of your gall." Pistol, one of the riotous companions of Sir John, gives us an idea as to the causation of hepatitis, in the instance when he informs "Knight Falstaff" of the news pertaining to his "Doll," and " Hellen of his noble thoughts," — the which thought would "in- flame his noble liver." It would be extremely difficult to say what, in a constitution like that of Falstaff, might serve to produce an inflamed liver ; if cowardice, love or wine should be considered etiologic of liver complaint, we should expect such an unmitigated old lout as he to be a continued series of afflictions. Leontes in his jealous obliquity remarked that if his " wife's liver were infected as her life, she would not live the running of one glass." In this quotation we again find sentiment reversed: — "Were my wife's life affected as her liver, she would not live the running of one glass, "^would do very well, and would be in har- mony with the general tenor of the sentiment on this subject, for it will be remembered that he claimed his wife to be in love with Polixenes. ORGANOLOGY. 181 Falstaff comes in again as an authority upon the liver question as affecting the principles of heroism. He says: "The second property of your excellent sherries is, the warming of the blood, which, before cold and settled, left the liver white and pale, which is the badge of pusillanimity and cowardice." The "boy" spoken of before in connection with the demise of Sir John Falstaff, speaks of the courage of Bardolph in this light vein: "He is white liver'd and red faced, by the means whereof 'a faces it out, but fights not," whilst Sir Toby Belch declares of one of the characters in " Twelfth Night," that the blood in his liver would not clog the foot of a fl^a. The same notion as to the color of the liver under similar circumstances is found in "Richard the Third," whilst the term " lily liver'd " in connection with a lack of personal courage, is used in both "Macbeth" and "King Lear." The notion that anger is productive of an increased physi- ological condition of the liver, finds expression in " Henry the Eighth," and also in "Troilus and Cressida," A. i., S. iii. It is said that most all notions which find credence among the public at large, no difference how improbable they may seem to those who are better informed, yet have some truth in them ; this, no doubt, is the fact in regard to the wide-spread belief that the hepatic function is such that it leaves the liver white in all cowards ; though here, as in a former instance or two, [the confounding of effect and cause is apparent. The influence which excited states of the mind exert upon the various organs and their functions is well known to persons conversant with the science of physiology, — and that the liver should bear a prominent share in these derange- ments of function we need not be at a loss to suppose when noting the important place it holds in the vital economy. That the mental emotion denominated fear makes pale also the heart we have evi- dence in "Macbeth," who uses tbe memorable words — "Then, live, Macduff: what need I fear of thee? But yet I'll make assurance doubly sure, and take a bond of fate : thou shalt not live ; that I may tell pale-hearted fear it lies, and sleep in spite of thun- der." It is not only fear that exercises a depleting influence over the liver in Shakespeare's estimation, but he says, in "Troilus and Cressida," that " reason and respect make livers pale, and lusti- hood deject." "Spotted livers" are noted there also, but seem to have no special significance. The lungs are spoken of in "The Tempest," where lord Adrian 182 SHAKESPEARE AS A PHYSICIAN. allows " the air breathes upon us here most sweetly," to which Sebastian replies — "As if it had lungs, and rotten ones," whilst Antonio concludes the fancy by suggesting, "or as 'twere perfumed by a fen," — having reference to the very offensive eminations which escape from low and marshy grounds during hot weather. We find here a connection of the two conditions of the lungs which go to constitute a case of that exceedingly rare malady — pulmonary gangrene. Whether Shakespeare was reasoning from analagous conditions as observed in other decomposing animal material, or had been the accidental observer of a case of real putrefaction of the lung tissue (progressive, of course), we of course have no means of knowing ; but sure it is, he came very near the facts for a person who was merely guessing. Benedick, "the married man," does not seem to have been so fastidious upon the health conditions of the woman he designed to make his wife, as would be one of our youths in 1884 ; for whilst Beatrice asserted that she only consented to wed him through pity, he avers he only took lier because he had been told she was in a consumption! This would go near to be the truth perhaps, if Beatrice was old and wealthy, and lived in the United States at this era (I mean not the consumption, but the motive). But Beatrice had no tuberculosis — only a "whoreson cold, sir; a cough, sir," which soon left her when her frigid nature was thaw'd out by the workings of her nuptial pleasures. The extract relative to the demise of Henry the Fourth, noticed in this work in the chapter on neurology, and reading thus : " More would I, but my lungs are wasted so, that strength of speech is utterly denied me," appears to have been merely predi- cated upon a generally exhausted condition of the vital powers rather than to have depended upon an actual local pulmonary lesion. This conclusion is reached from the fact that no antecedent symptoms connected with the case are sufficient to warrant a different one. Old Pandarus, who figures quite conspicuously in the courting affairs of Troilus and Cressida, "had it bad" if we are to place much credence in the old fellow's accuracy of judgment after hav- ing our faith so badly shaken in him upon remembering his failures on the woman question. He says: "A whorseson phthisic, a whore- son rascally phthisic so troubles me, and the foolish fortune of this girl ; and what one thing, and what another, that I shall leave you one o' these day ; ORGANOLOGY. 183 I'll sweat and seek about for eases, And at that time (death?) will bequeath you ray diseases." It seems probable that if this person had a whoreson phthisic at all, that it was likely of a syphilitic origin, as in the two last lines quoted he gives us some hint in that direction ; and the language of Troilus, whose confidence he had shamefully abused in the matter of his representations respecting the virtues of Miss Cressida, goes far toward substantiating the conclusion : Troihis. "Hence, brothel-lackey! ignominy and shame pursue thy life, and live aye with thy name. Pandarus. A goodi}' medicine for mine aching bones ! O world ! world! world! thus is the poor agent despised." The mere asser- tion, however, that he would bequeath his disease does not make it positive that he had not a whoreson phthisic, for the reason simply that it is now proven beyond a doubt that tuberculosis is directly transmissible from one person who is suffering from it to another who is in good health. The germs, — bacteria — may be carried into the system of a sound person through several avenues, or by more than one means, viz. : by inoculating, either with the blood, or di- rectly with tubercular matter ; or by inhaling the detritus from the expiration of a tubercular patient ; and also, perhaps, by ab- sorption — cutaneous and mucous, as in occupying the same couch with a tubercular patient. The matter pertaining to the pathology of the respiratory system having been noticed, we come next to its physiology. In this direc- tion we have such phrases as "so shall my lungs coin words till they decay," " thou but offend'st thy lungs to speak so loud," and "the heaving of my lungs to ridiculous smiling," etc., etc., are some of them. An extract from "A Midsummer Night's Dream," which is inter- esting to the physiologist, is found in the following: "Dark night, that from the eye his function takes, The ear more quick of apprehension makes ; Wherein it doth impair the seeing sense, It pays the hearing double recompense." Under ordinary circumstances the above is not true — as for exam- ple in the case of a physician who is necessarily out much of nights; but I do believe a person learns to, or acquires the power to see better by being trained in the school of night perambulations ; the 184 SHAKESPEARE AS A PHYSICIAK. transient suspension of any one of the special senses will not be compensated for by any one of the others assuming its duties in part or in whole, but it is certainly true that the total obliteration of one or more of them, and a long schooling of those which remain perfect, render them much more acutely sensitive to their wonted stimulus, and may thus often in some degree fill the principle of compensation. I had Shakespeare's idea, as above expressed, very fairly illus- trated some years ago in my own family. There was sojourning in the village where we then resided, a gentleman of fine intelligence who was congenitally blind. My wife chanced to be calling at the house of a lady where he was stopping, and he heard her name called, and also had some conversation with her ; from that time forward he could always recognize her in name and in person by the voice alone ; I was much from home about this time, and my wife was considerably exercised as to the probability of the "blind man's" wanting to stay a time at our house, as he had been com- plimenting most of the neighbors with his company for a few days each. One day she had been down the street on an errrand, and whilst on her return she discovered on the other side of the street, but considerably in advance of her, the "blind man," Mr. Flem- ming, making his way in the same direction ; she instantly said in a low tone to a companion who was with her — " Yonder goes the blind man ; I don't want him to go to our house, for I am afraid of him." — " How are you afraid ! " suddenly rang out sharp and clear from the poor man's lips. She was much surprised, as she supposed that at that distance no ordinary ear was able to distinguish the sound of an ordinary conversation, little less the exact words. Here this power of compensation had doubtless been educated to the point of the nicest acuteness as a necessity to the welfare of the individual, as otherwise he no doubt would have encountered many dangers in his perambulations about the country entirely alone. Apropos of this subject, a strange story comes to us from Europe, in the work of Mr. W. H. Levy, entitled "Blindness and the Blind," in which he tells of himself that although he is totally blind yet he has the power to distinguish one object from another — to tell perfectly well when near to an object, etc., almost as well as though he was possessed of vision ; he can distinguish a house from a shop, or a board fence from a stone wall, — tell how high an ORGANOLOGY. 185 object near him may be, — distinguish a stump from a horse, etc., with much precision. This power he terms "facial perception," or the power of seeing with the face, as he loses the faculty when the face is covered, and cannot perform the function with any other portion of the surface, though it be uncovered. Writers call this power the " latent sense," but at best it is not very clearly under- stood. "Sand-blind," "high gravel blind," are terms used in the "Merchant of Venice," and seem to be of the same signifi- cance as our term "stone blind." "I do see the cruel pangs of death, bright in thine eye," is found in "King John," whilst Thersites, in " Troilus and Cressida," tells us what he knows about ophthalmia and its therapeutics when he likens Patroclus to a " green sarcinet flap for a sore eye ; " and the man Benvolio, in " Romeo and Juliet," gives us his in the oft- quoted couplet : — "Take now some new infection to thine eye. And the rank poison of the old will die." I have often wondered why the "green flap " is universally worn in these cases ; I can think of no optical law which makes it either desirable or necessary. In the couplet is embodied the whole prin- ciple of the treatment of ophthalmic affections, namely: the pro- duction of a new or of another condition in the structures of the eye. " Come on my right hand," for this ear is deaf," says Caesar to Antony. This infirmity is one of grave annoyance, as the writer can attest from a past experience ; and, like Caesar (in one particu- lar at least), he always wants his companion on his right hand ; indeed it is unpleasant for one to ride or walk to his left, though it be in silence, so confirmed is the habit. An incid( nt occurred in this connection a year or so ago, when on a horseback ride into the country with a strange gentleman. He, upon starting, got to my left hand, — as I supposed by chance ; it was no great while until an opportunity offered, which I made the most of, by riding in a care- less manner on his left ; this process was repeated several times during tlie trip, until at last it was evident that on his part as on my own, the change was not by accident but by design ; and upon enquiry it was found that the worthy gentleman was in the same unpleasant predicament as Csesar and myself, — he always wanted his Antony on his right hand, as his left ear was deaf. Epistaxis is noticed in "The Merchant of Venice," and pleuritis 186 SHAKESPEARE AS A PHYSICIAN. or pleurodinia, "side stitches that shall pen the breath up," in " The Tempest," while " the dropsy drown this fool," and "that swollen parcel of dropsies," are terms in the vocabularies of Cala- ban and Prince "Hal." If we take the latter as veritable fact, it gives us another argument in the chain of evidence that old " Sir John" was miasmatic, as it is a well known fact that abdominal dropsies are a very frequent concomitant of malarial poisonings, and the term was applied by the prince to his old friend — "Jack Falstaff, gentleman." The renal function is noticed first in the " Merchant of Venice," in this way: "Some are mad if they behold a cat; and others, when the bagpipe sings i' the nose, cannot contain their urine for affection." In this quotation we see again the power of emotional conditions of the mind over the organic functions ; in cases of the character just alluded to we find the analogue of the peristaltic action of the intestinal mucous membrane through the excitation of the sympathetic fibrillse which supplies it, in cases of fear; or in the lachrymal apparatus through the patheticus. The tormentors of poor Malvolio, in "Twelfth Night," concocted a plan by which they attempted to make him believe they were in earnest as to his lunacy ; they proposed to " carry his water to the wise woman" — a proceeding very popular in a certain class of our profession only a few years ago. The "urine doctors" do not flourish to the same extent in this country as in days gone by. Falstaff does not escape in this matter either; "what says the doctor to my water? Page. He said, sir, the water itself was a good water ; but for the party that owned it, he might have more diseases than he knew of." A sensible and conscientious doctor, for a wonder. In " Macbeth " it is given out as a fact that " drink" is a great provoker of three things, viz. : •' Nose-painting, sleep and urine." Lager beer for the latter always. ^ ' ■ As in the case of the liver, so with the kidneys, — the alcoholic stimulants exercise a very marked influence over their functions ; what may at first constitute only an augmented functional activity through the stimulating effects upon the renal organs, will, in the end, if long continued, lead to structural change in the kidney in the form of granular degeneration, or atrophy, or some other ab- normal condition which is a sure precursor of toxaemia, dropsical effusions, and other perversions of the healthy life which ultimate ORGANOLOGY. 187 in death; even the sleep itself which "drink" promotes is one morbid in its action ; whilst the nose-painting which seems only a matter for sport, to those who observe superficially, is a sure sign to others that the alcohol has commenced its destructive processes in the system in earnest. It is claimed of late that some skilled artizan has discovered a process by which the illuminated proboscis may be bleached, and rendered as good as new. The only remedy, however, known to physicians is to " leave sack." Falstaff even had to bear the odium of being fat attached to his other sins. Prince Henry. " Here comes lean Jack, here comes bare bones. How long is't ago, Jack, since thou sawest thy own knee? Falstaff. My own knee? when I was about thy years, Hal, I was not an eagle's talon in the waist ; I could have crept into any alder- man's thumb-ring: a plague of sighing and grief! it blows a man up like a bladder." Then after a wrangle, in which much laugh- able matter occurs between them, they conclude in this way: Falstaff. " The king himself is to be feared as the lion. Dost thou think I'll fear thee as I fear thy father? Nay, an I do, I pray God, my girdle break! Prince Henry. O, if it should, how would thy guts fall about thy knees! But, sirrah, there's no room for faith, truth, nor honesty, in that bosom of thine ; it is filled up with guts and midriff." The dissimilarity in the mental organization is on a par with that of the physical when we compare another of Shakespeare's char- acters with his inimitable Falstaff. Reference is made to Cassius, whose physique and mental make up are thus placed in contrast with that of Sir John. Ccesar. " Let me have men about me that are fat ; sleek-headed men, and such as sleep o' nights. Yond' Cassius has a lean and hungry look ; he thinks too much : such men are dangerous. Would he were fatter ; but I fear him not ; yet if my name were liable to fear, I don't know the man that I should avoid as soon as that spare Cassius. He reads much ; he loves no plays, he hears no music, seldom smiles, and when he does, he smiles in such a sort as if he mock'd himself, and scorn'd his spirit that could be moved to smile at anything." Falstaff would have been a man after Caesar's own heart. 188 SHAKESPEARE AS A PHYSICIAN. It is very clearly perceived and forcibly illustrated in the fore- going selection that Shakespeare had observed the fact that ali- mentive and intellectual capacity are not likely to be twins — or, in other words, to reside in the same person. Stomach work and brain work are not generally compatible, from physiological reasons as given in a former chapter. "And make each petty artery in his body, as hardy as the Numean lion's nerve." — Hamlet. " My veins are chill, and have no more of life, than may suffice to give my tongue that heat to ask your help." A case of extreme debility in the person of Pericles. Veins and their contents are noticed in "A Winter's Tale," and "As fire cools fire within the scorched veins of one new burn'd " in "King John ; " whilst another passage in the same reads " or if that surly spirit, melancholy, had bak'd thy blood, and made it heavy, thick, which else runs trickling up and down the veins." In the first of these quotations from "John," it is evident that it had a deep hold upon the popular mind ; as we see ninety nine out of a hundred common people, even now, hold to and act upon the notion that exposing a fresh burn to the fire afterward will "draw the fire out." The process of roasting the victim of a coal oil explosion slowly before a red-hot stove as a healing process has no good grounds in the philosophy of therapeutics ; we might well C(^mmit a parody and exclaim O Science, O Medicine, what barbari- ties are enacted in thy name ! In "King John" we also find a line which reads thus: "That whiles warm life plays in that infant's veins " — only an idea in veri- fication of the old scripture — " the blood is the life thereof." Falstaff, after marching up and throwing down the body of the dead Percy, claiming that he had slain him, whilst pleasantly con- templating his chances of growing renowned over his feat, talks thus to himself : " He that rewards me, God reward him ; if I do grow great, I'll grow less ; for I'll purge and leave sack, and live cleanly, as a nobleman should." Poor Sir John, the grounds upon which he built his good resolves proved as fallacious as the mirage of the desert ; but the resolve alone teaches us to remember the fact that man always rises with his condition ; place a boor on a seat of rosewood and he will think twice before cutting it, or place him in a room with Brussels carpets, and he will scarcely eject his saliva. ORGANOLOGY. 189 As to curtailing his obesity by purging, it was of doubtful pro- priety, but the resolve to leave off sack and live cleanly were the very essence of philosophy. The fat in his system represented the hydro-carbon that should have been consumed in the respiratory process ; but the system being always supplied with an abundance of that material in the sack, the respiratory fires were kept burning with that fuel, and the fat was laid by for a rainy day, or for a period of hybernation as it were. So of the cleanliness : remove the dirt from the surface, and oxydation of the superfluous tissues will be hastened. The subject of fever is a little too general to come appropriately under the present head ; but as there seems no more convenient place for the little that is named of the subject, I shall introduce it here nevertheless. I quote two or three lines from " Love's Labor Lost:" Dumaine. "I would forget her, but a fever she reigns in my blood, and will remember'd be. Biron. (Aside.) A fever in your blood? why, then, incision would let her out in saucers," (evidently refering to the custom of venesection), — whilst we find in " King John " some lines reading thus: "This fever that hath troubled me so long, lies heavy on me," and " ah me! this tyrant fever burns me up ;" " entreat the north to make his bleak winds kiss my parched lips, and comfort me with cold." These words were quoted before in the chapter on etiology, and their causation and pathological significance placed to the action of malaria, instead of "poison tasted to him by a monk." We also find the idea, as expressed in the words of Biron, embodied in a conversation between the Archbishop of York and the Earl of "Westmoreland, in " Henry the Fourth;" and, though only used in an allegorical sense, yet it conveys a good notion of the practice of the times. Arclibisliop. " We are all diseas'd ; and with our surfeiting, and wanton hours, have brought ourselves into a burning fever, and we must bleed for it; of which disease, our late king, Richard, being infected, died," The condition of the circulation in fever is noted in " Troilus and Cressida," as appears in the following: Pandarus. (Speaking of Cressida.) "She's making her ready. She'll come straight: you must be witty now. She does so blush, 190 SHAKESPEARE AS A PHYSICIAN. and fetches her wind so short, as if she was frayed with a sprite : I'll fetch her. It is the prettiest villain: she fetches her breath so short as a new-tak'n sparrow. (Ex. Pandarus.) Troilus. Even such a passion doth embrace my bosom : my heart beats thicker than a feverous pulse, and all my powers do their bestowing lose." The foregoing is a very fair pen-picture of the excitement inci- dent to venereal anticipation in the modest young man. This from old Timon, is after his usual style: " Go, suck the subtle blood of the grape, till the high fever seethe your blood to froth, and so 'scape hanging: trust not the physician; his antidotes are poison, and he slays more than you rob," whilst may be mentioned again the charge against Caesar: " He had a fever when he was in Spain, and, when the fit was on him, I did mark how he did shake." "Hectic," is used in "Hamlet," In "Love's Labor Lost" we have a precedent for " open air " exercises held now as so essential for health. "So it is, besieged with sable-coloured melancholy, I did commend the black-oppressing hour to the most wholesome physic of the health giving air ; and, as I am a gentleman, betook myself to walk. The time when? About the sixth hour; when beasts "most graze, birds best peck, and men sit down to that nourishment called supper. So much for the time when. Now for the ground which ; which, I mean, I walk'd upon; it is ycleped the park. Then for the place where ; where, I mean, I did encounter that obscene and most preposterous event, that draweth from my snow-white pen the ebon-coloured ink, which here thou viewest, beholdest, survey est or seest," So much for the exhilaration of an evening's walk. In "The Winter's Tale," Leontes says: "The blessed gods purge all infection from our air, whilst you do climate here," whilst we see in "King John" the faith in good air: "His high- ness yet doth speak ; and holds belief, that being brought into the open air, it would allay the burning quality of that fell poison," etc. The horrors of pestilential vapors are thus presented : "A many of your bodies shall, no doubt, find native graves, upon the which, I trust, shall witness live in brass of this day's work ; and those that leave their valiant bones in France, dying like men, though buried in yon dunghills, they shall be fam'd ; for there the sun shall greet them, and draw their horrors up to heaven. ORGANOLOGY. 191 leaving their earthly parts to choke your clime, the smell whereof shall breed a pestilence in France," whilst the hurtful influence of air to an early wound is thus stated: " The air hath got into my deadly wounds, and much effuse of blood doth make me faint." — "Henry the Sixth," A. ii., S. vi. The deleterious effects of the local action of even pure air upon open wounds is clearly recognized even now. Filter it — removing all germs and mechanical irritants, and yet the oxygen or some other constituent admitted with it will cause the wound to progress in a manner different from one hermetically closed. CHAPTER VIII CHIRURGERY. Grows stronger for the breaking — Mistaken principle — Patching the over- coat — Bad practice — Syncope— Mistakes in prognosis — Spare the blood — Shakespeare a poor surgeon — A scar covered veteran — The money changer — The surgeon's fee — Professional failing — Doctors and the clergy — A man with a soul — The surgeon's tools— Surgeon's fort — Honors to whom honor, etc. — Trichina spiralis — Who is responsible?— Doctors and their doings — Little change — Cowardly knave — Jester for an hospital — The least merit — A precedent for doctor "she" — "Malignant fistulse " — Potent remedy — Popular ignoranse — The reformed hod-carrier— Professional honor — Another comparison — A lame impostor and his lame detection — Doctor's untimely end — The English Nero — Dr. Butts, the scoundrel — A want of faith — Woful mistake — Danger of expectancy— In Macbeth — An absurd credulity — God Almighty as a visiting physician— How does your patient, doctor? — Needs a divine — No mean psychologist — Indiscreet — A self- constituted doctor. There will be united in the present chapter all the matter pertain- ing to the specialty of Surgery, — the surgeon, therapeutics, and the physician ; at the same time taking care to keep the specific material of each as distinct from the other as possible. It is asserted in the second part of "Henry the Fourth" that a "broken limb united, grows stronger for the breaking;" and in the same " thou hast drawn my shoulder out of joint." Now the first of these propositions is perhaps predicated upon the assumption that because the deposition of bony material at the site of fracture is usually more voluminous than the original nor- mal bone, the strength of the new structure will be greater also. This conclusion is opposed to the principles of repair not only in histogenetic operations, but also in the ordinary physical and me- chanical appliances. This principle, in its application to living tissues, used to be fairly illustrated by the late Prof. Linton, of St. Louis, in this way: " The neoplasms are all formed of materials of a less perfect vitality than the normal original tissue of the part 192 CHIRURGERY. 193 where they may chance to be located ; — that in cicatricial tissue in particular is this so marked, that he could illustrate the difference in no better way than to liken it to patching your over-coat with a bit of your cotton shirt." This principle holds good with the osseous as well as all other tissues, and demonstrates conclusively that we have caught Shakespeare in one error at least. When once we have a broken femur, we may, under the most favorable circum- stances, never hope to have it " just as good as new ;" or, "just as good as old ' ' rather. In " As You Like It" we find the following: "And here, upon his arm, the lioness had torn some flesh away, which all this while had bled ; and now he fainted, and cried in fainting upon Rosalind. Brief, I recover' d him, bound up his wound," etc. Shakespeare here observed the caution to not make a patient dangerous as to hemorrhage from a lacerated wound ; though he lets him bleed enough to make him fall into a syncope ; the damage, however, was not lasting, as we are assured that Orlando was again soon " strong of heart." In "Henry the Fourth" occurs another passage in regard to a swoon into which the king had fallen. Somerset. " Rear up his body ; wring him by the nose." TMl teaching as to changing a person to an upright or semi-upright position in a common syncope is averse to the very law and re- source of nature, — the falling into a horizontal position being the, very means adopted by unassisted nature to restore such cases. As to the " wringing by the nose" to revivify a fainting patient, that method was never any part of nature's plan, but is doubtless the offspring of some miserable botch. The loss of blood is also re- cognized as a source of syncope in the case of Clifford where he tells us that " much effuse of blood doth make me faint." We have another failure in Shakespeare to sufficiently weigh surgical princi- ples, in the fact that he did not discriminate between lesions of a serious nature and those which are comparatively unimportant : — thus, he makes the loss of an eye and part of the cheek as very early fatal in the case of Salisbury in " Henry the Fourth ;" he makes the case as speedily fatal as would be a wound of a vital organ — as the lung, liver, kidney, etc., whilst another error is in the words — "the blood I drop, is rather physical than dangerous to me" — found in Coriolanus. It is axiomatic in all surgical practice that the less blood we have from a traumatism or following the use of the sur- geon's knife, the better for the patient. The same rule holds true 194 SHAKESPEARE AS A PHYSICIAN. in obstetric practice, as it is a truisra that the most dangerous cases of metritis and other complications arising to post parturient pa- tients in my hands have followed usually in cases preceded by pro- fuse hemorrhage. The grave apprehensions entertained for the safety of a patient with fractured ribs, as seen in " As You Like It," would also add weight to the conclusion that tho' Shakespeare was good at most all things else, he was sadly deficient as a writer upon surgical sci- ence. There is a notice of a character having had his " shoulder blade" "torn out" in "Winter's Tale," and in "King Lear" we find " flax and whites of eggs " recommended as a hemostatic. The wound in "Portia's thigh " has nothing significant in it, whilst only a military surgeon would be interested in the scar-covered veteran Marcius who had one wound i' the shoulder, one i' the left arm, seven hurts i' the body, one i' the neck and two i' the thigh, etc., making in all twenty-seven. "The Winter's Tale" also has "I fear my shoulder blade is out," as a conclusion to "Shakespeare as a Surgeon." The term " surgeon" is used quite frequently. In "Midsummer- Night's Dream " is a witticism that "with the help of a surgeon he (one of the number of fops) might yet recover, and yet prove an ass" — an assertion that is too true of many, many of the surgeon's clients. In the case of Shylock, the Jewish money-changer, the court en- joined the necessity of having " some surgeon" at hand when he cut his " pound of flesh," "to stop his wounds, lest he do bleed to death." Shylock failed to cut, therefore the surgeon's skill was not brought into service; wonder if he got his fee? I suspect he did not, as it is the amount of physical labor, and the quantity of medi- cine administered in a given case, which entitles the practitioner to 2Jay in the estimation of a majority of mankind. We find a very good illustration of the character of the cases which surgeons are often called to treat in the case of a riot between Sir Toby Belch, Sir Andrew Ague-cheek, and Sebastian in " Twelfth Night," and also a stab at the morals of some of our "Surgeon Dicks" who get " tight," and get their " eyes set at eight i' the morning." Unfor- tunately for themselves and for their patrons, it was the custom, not long in the past, for many of the best minds in the surgical and medical professions to drink immoderately ; but I am of the opin- ion from an extended observation, that the "whisky habit" has CHraURGERT. 195 grown much less common among medical men during the last twenty years. The morals of medical men as a class, seems to me not inferior to that of an equal number of persons chosen from any class in soci- ety — not even omitting the clergy. It has been said: "Show me three physicians, and I will show you two sceptics," as an illustra- tion of the religious status of, the profession. This happens, no doubt, from the fact that physicians are usually men who do not swallow blindly the teachings of others ; they think and reason for themselves, and the consequence is that they find much that is put forth by the theoretical propagators of Christianity as too futile for a moment's serious consideration; they are men who look up from nature to nature's God, and worship accordingly. If you want a man with a soul go to the ranks of the true physician, and you will be sure to find him. "Surgeon's box" is mentioned in " Troilus and Cressida," and " fetch a surgeon " in " Romeo and Juliet " in the case of Mer- cutio. Borneo. " Courage, man, the hurt cannot be much. ^ Mercutio. No, 'tis not so deep as a well, nor so wide as a church door, but 'tis enough ; 'twill serve : ask for me to-morrow, and you will find me a grave man." Now in reference to the "surgeon's box," we suppose that the case in which surgeons keep their "tools" — (to use the unmistaka- ble language of a young medical gentleman of our acquaintance) is meant ; whilst " go get him surgeon," is the language of Duncan in behalf of a wounded soldier. "Let me have a surgeon, I am cut to the brain," was the request of old King Lear in one of his fantasies ; and lago, that impersona- tion of the sum of all villainies, proffered to " fetch a surgeon" for Rodrigo, who had been set upon by his own hired assassins. It is apparent that the practice of surgery was even at that early day looked upon with much more respect than the practice of med- icine ; thus it is to-day, and thus it will ever be. There is one very obvious cause for this, and one which all may and do more or less observe — and that is the surgeon's work is al- ways tangible to the naked eye of the populace, no comprehensive thinking or philosophizing being brought into requisition for the recognition of the surgeon's power; whilst the intricacies which ■— 1 196 SHAKESPEARE AS A PHYSICIAN. the doctor proper has to meet and overcome are far beyond the scru- tiny of the ordinary observer. Whilst, really, the surgeon is only an ordinary mechanic in many instances, and the physician a deep and genuine philosopher, the one carries the palm amongst a thoughtless community, whilst the other is set down as an old fogy. It seems, too, that the profession is half inclined to honor the sur- geon more than the physician, and it may be that it is from the fact that the peculiarities of the science and art of surgery proper are not cursed with the multitudes of parasites to which the practice of medicine is exposed — the practice of medicine, owing to the advan- tages which may be taken of it, having to bear the odium of a million professional (?) leeches sucking at its integrity. The great profession legitimate medicine, reminds me of a strong man who partakes of an underdone pork steak, and in process of time becomes afflicted, heart, brain and all, with trichina spiralis. Quackery is every- where ; it pervades the high places as well as the low, flourishes in the palace of the rich as well as in the hovel of the poor, and is so fastened upon and rooted into the profession and society that there is no feasible way in which to get rid of the evil. The profession it- self is in some degree responsible for this ; but in the mean it is due to the willful ignorance of the populace. Our American people will be humbugged, and the pretenders in medicine make them pay dearly for their willing pliability. As Part II. of Chapter VIII., we design adding what we have upon the subject of "Doctors and their doings ;" and, though con- stituting the bulk of the chapter, we hope it may not prove less interesting on that ground. Of materials we have an assortment : we have the "regular" and the "mountebank," — doctor "she" and the " tooth-slinger," each in his sphere; little observable change in the quantity or quality of the "goods" in three hun- dred years. The renowned "French physician" — Doctor Caius, whose mis- understanding with Sir Hugh Evans is so well described in the " Merry Wives of Windsor," is a true representative of the adver- tising fraternity of this day ; and when Sir Hugh avowed that his antagonist had "no more knowledge of Hibbocrates and Galen, — and he is a knave besides; — a cowardly knave," he no doubt hit upon the exact truth. CHIRUKGERY. 197 We find a strange bargain as to service in an hospital in " Love's Labor Lost," in the matter of the courtship between Rosaline and Biron : Rosaline. "If you my favor mean to get, a twelvemonth shall you spend, and never rest, but seek the weary beds of people sick. Biron. Studies, my lady? Mistress, look on me: behold the window of my heart, mine eye, what humble suit attends the answer there ; impose some service on me for thy love. Rosaline. Oft have I heard of you, my lord Biron, before I saw you, and the world proclaims you replete with mocks^ comparisons, and wounding flouts, which you on all estates will exercise, that lie within the mercy of your wit : to weed this wormwood from your fruitful brain, and, therewithal, to win me, if you please, without the which I am not to be won, you shall this twelvemonth term, from day to day, visit the speechless sick, and still converse with groaning wretches ; and your task shall be, with all the fierce en- deavor of your wit, to force the pained impotent to smile. Biron. To move wild laughter in the throat of death? it cannot be ; it is impossible : mirth cannot move a soul in agony. Rosaline. Why, that's the way to choke a gibing spirit, whose influence is begot of that loose grace, which shallow laughing hearers give to fools. A jest's prosperity lies in the ears of him that hears it, never in the tongue of him that makes it: then if sickly ears, deaf'd with the clamours of their own dire groans, will hear your idle scorns, continue there, and I will have you, and that fault withal ; but, if they will not, throw away that spirit, and I shall find you empty of that fault, right joyfully of your re- formation. 198 SHAKESPEARE AS A PHYSICIAN. " I'll jest a twelvemonth In an hospital." Biron. A twelvemonth ? well, befall what will befall, I'll jest a twelvemonth in an hospital." It appears to me that there is less merit — less applicability, less pretext for the above quoted matter, and that the occasion was less appropriate for the exercise of such a train of thought, than is to be found in connection with almost any single passage or reflection in the entire writings of Shakespeare. The only merit I am able to discover in it is the originality of the idea of employing a " jester " to an hospital ; the idea being new, whether its application would be of value or not. It is not every day that we stumble on original thought even of doubtful merit, and we will prize this accordingly. The champions of female physicians may find a precedent for their doctrines in "All's Well That Ends Well," in the case of Lady Helena, who ministered to the king successfully. The old lord, Lafeu, in a conversation with the Countess of Rousillon, in answer to the"enquiries as to the health of the king, remarked — "He hath abandoned his physicians, madam; under whose practice he hath persecuted time with hope, and finds no other advantage in the process, but only the losing of hope by time. CHIRURGERY. 199 Countess. "This young gentlewoman (meaning Helena, her ward) had a father, — O, that had ! how sad a passage 'tis, — whose skill, almost as great as his honesty, had it stretch' d so far, would have made nature immortal, and death should have played for lack of work. Would, for the king's sake, he were living! I think it would be the death of the king's disease. He was famous, sir, in his profession. Lafeu. He was excellent, indeed, madam : the king very lately spake of him, admiringl}^ and mourningly ; he was skilled enough to have lived still, if knowledge could be set up against mortality. Bertram. What is it my good lord, the king, languisheth of? Lafeu. A fistula, my lord." King. (Another Scene.) " How long is it, count, since the physician at your father's died? He was much fam'd. Bertram. Some six months since, my lord. King. If he were living, I would try him yet: — lend me an arm ; — the rest have worn me out with several applications : nature and sickness debate at their leisure." Then follows a lengthy conversation on other matters, and then the king's malady is again brought up : Lafeu. "I have seen a medicine that is able to breathe life into a stone, quicken a rock, and make you dance canary with spritely fire and motion ; whose simple touch is powerful to upraise King Pepin, nay, to give great Charlemain a pen in's hand, to write to her a love line. King. What her is this ? Lafeu. Why, doctor she. My lord, there's one arriv'd, if you will see her: — now, by my faith and honor, if seriously I may con- vey my thoughts in this my light deliverance, I have spoke with one, that in her sex, her years, profession, wisdom, and constancy, hath amaz'd me more than I dare blame my weakness. Will you see her (for that is her demand), and know her business? That done, laugh well at me. King. Now, good Lafeu, bring in the admiration, that we with thee may spend our wonder too, or take off thine by wond'ring how thou took'st Id." Lafeu then brings in Helena, and remarks — " This is his majesty ; say your mind to him : a traitor you do look like ; but such traitors 200 SHAKESPEARE AS A PHYSICIAN. his majesty seldom fears. I am Cressida's uncle, that dare leave two together. Fare you well. King. Now, fair one, does your business follow us } Helena. Ay, my good lord. Gerard de Narbon was my father ; in what he did profess well found. King. I knew him. Helena. The rather will I spare my praises towards him ; know- ing him is enough. On 's bed of death many receipts he gave me ; chiefly one which, as the dearest issue of his practice, and of his old experience the only darling, he bade me store up as a triple eye, safer than mine own two, more dear. I have so : and hearing your high majesty is touch'd with that malignant cause, wherein the honor of my dear father's gift stands chief in power, I came to ten- der it, and my appliance, with all bound humbleness. " Helena and the King.* CHIRURGERT. 201 King. AVe thank you, maiden, but may not be so credulous of cure: when our most learned doctors leave us, and the congregated college have concluded that labouring art can never ransom nature from her inaidable estate, I say, we must not so stain our judgment, or corrupt our hope, to prostitute our past-cure malady to empirics ; or to dissever Our great self and our credit, to esteem A senseless help, when help past sense we deem. Helena. My duty then shall pay me for my pains : I will no more enfore my office on you ; humbly entreating from your royal thoughts a modest one, to bear me back again. King. I cannot give thee less to be called grateful. Thou thought'st to help me, and such thanks I give As one near death to those that wish him live ; But what at full I know, thou knowest no part, I know all my peril, thou no art. Helena. What I can do can do no hurt to try, Since you set up your rest 'gainst remedy. He that of greatest works is finisher Oft does them by the weakest minister. King. I must not hear thee ; fare thee well, kind maid. Thy pains not used, must by thy self be paid : Proffers, not took, reap thanks for their reward. Helena. Dear sir, to my endeavors give consent ; Of heaven, not me, make an experiment. I am not an impostor, that proclaim Myself against the level of mine aim ; But know I think, and think I know most sure. My art is not past power, nor you past cure. King. Art thou so confident? Within what space hop'st thou my cure? Helena. The greatest grace lending grace. Ere twice the horses of the sun shall bring Their fiery torcher his diurnal ring ; Ere twice in murk and occidental damp Moist Hesperus hath quench' d his sleepy lamp ; 202 SHAKESPEARE AS A PHYSICIAN. Ere four and twenty times the pilot's glass Hath told the thievish minutes how they pass, What is infirm from your sound parts shall fly, Health shall live free, and sickness freely die. King. Upon thy certainty and confidence, what dar'st thou ven- ture? Helena. Tax of impudence, a strumpet's boldness, a divulged shame, traduced by odious ballads ; my maiden's name Seared otherwise ; the worst of worst extended, With vilest torture let my life be ended. King. Methinks, in thee some blessed spirit doth speak, His powerful sound in this, an organ weak ; Sweet practiser, thy physic I will try. That ministers thine own death, if I die." We see in the above quotation but a reflection of the ideas of the ignorant masses from that day to the present ; the matter is only the nations of to-day presented in their most feeble aspect. Ninety-nine hundredths of the people of this March, 1884, would quit the "most learned doctors, and congregated college," and run wild after some " Indian doctor," the which is only another name for some reformed hod-carrier. Even " kings and potentates," and others whose com- mon sense ought to be a guarantee of better actions, trust the lives of their children — sometimes themselves, to the medical care of some creature having less skill than a boot-black. Our lady friends who are ambitious to become specialists in the department of " malignant fistulae " may in the foregoing case find an ancient and honorable precedent. Apropos of the cure of fistulas, it was the fortune — good or bad — of this city, a few years ago, to be visited by an old and impudent negro, who called himself Dr. Sunrise. He made a specialty of treating "fistulae." He '■'■pulled them out!" and never failed of a cure. He took quarters in a hovel in the purlieus of the city, before the door of which might be seen any day the carriages of the wealthy, \ CHIKURGERY. 203 " Dr. Sunrise " in St. Joseph. while the common people thronged the streets, all seeking to be healed. He would not receive his pay in a check on a city bank — he had no time to spare in running to the bank for his fee ! It must be jjaid, cash in hand, or no treatment did he mete out! $3,000, it was said, rewarded his three weeks' scattering of handbills and flippant arrogance. The profession of this era is certainly cursed to the very full with this kind of stuff, but medical men may console them- selves (when reading the foregoing) by remembering that this is not the only age and generation that has been cursed with the incubus. In " Richard the Second " we find an appeal to God to put it into a physician's mind to help his patient to his grave immediately. It is somewhat singular that among the multitude of villainies we constantly see or read of, it is one of the rarest to hear of a physician abusing the confidence of his patients. A physician's purposely murdering his patient is one of the rarest of crimes. There have been two cases in the United States within my recollection where this crime has been charged upon physicians, but fortunately for the honor of the profession, and the ends of justice it is to be hoped, both parties were acquitted of the charge ; I allude to the case of Dr. Schoeppe in Pennsylvania, and that of Dr. ^Madlicott in Kansas ; the one for the murder of Miss Stenick through motives of avarice, the other of Mr. Ruth for the purpose of inheriting his widow. These were the charges. 204 SHAKESPEARE AS A PHYSICIAN. The most debased wretch who has the hardihood to enter the medical profession, seems to regard fully the duty of holding sacred the trusts of his patrons as tenaciously as he does his own private secrets. I have hardly known this trust betrayed in more than a sin- gle instance. I have known but a single case where the morals of the family of any one have been directly polluted by the family doctor.' Can we say as much of any other calling? How stands even the immaculate clergy upon this point? This merit alone in the physician should entitle him to the confidence and esteem of all the world, and make him revered as a patron of virtue, if for nothing else. It is not the man, but the calling, however, that makes him what he is in this regard. "Physician" is mentioned in "Henry the Fourth," "Richard the Third," and in "Henry the Sixth." In the latter we find detailed the doings of an impostor, which is worth transcribing : (Enter one, crying a miracle! a miracle!) Glocester. "What means this noise? Fellow, what miracle dost thou proclaim? One. A miracle ! a miracle ! Suffolk. Come to the king : tell him what miracle. One. Forsooth, a blind man at St. Alban's shrine, within this half hour hath recover' d his sight ; a man that ne'er saw in his life before. King Henry. Now, God be prais'd, that to believing souls gives light in darkness, comfort in despair. (Enter SimjJcox and his kinsfolk.) Cardinal. Here come the townsmen in procession, to present your highness with the man. King. Great is his comfort in this earthly vale, though by his sight his sin be multiplied. Glocester. Bring him near; his highness' pleasure is to talk with him. King. Good fellow, tell us here the circumstance ; has thou been long blind, and now restor'd? Simpcox. Born blind, an't please your grace. Wife. Ay, indeed was he. Suffolk. What woman is this ? Wife. His wife, an't like your worship. Glocester. Hadst thou been his mother thou could' st have better told. CHIRURGERY. 205 King. Wliere wert thou born ? Simpcox. At Berwick in the North, an't like your grace. King. Poor soul! God's goodness hath been great to thee. Queen. Tell me, good fellow, earnest thou here by chance? Cardinal. What! art thou lame? Simpcox. Ay, God Almighty help me ! Svffolk. How cam'st thou so? Simpcox. A fall off a tree. Wife. A plum-tree, master. Glocester. How long hast thou been blind ? Simpcox. O, born so, master. Glocester. What ! and wouldst climb a tree ? Simpcox. But that in all my life, when I was a youth. Wife. Too true ; and bought his climbing very dear. Glocester. 'Mass, thou lovest plums well, that would venture so. Simpcox. Alas, good master, my wife desir'd some damsons, and made me climb with danger of my life. Glocester. A subtle knave ; but yet it shall not serve ; — let me see thine eyes: — wink now; — now open them. — In my opinion yet thou seest not well. Simpcox. Yes, master, clear as day ; I thank God. Glocester. Say 'st thou me so? What colour is this cloak of ? Simpcox. Red, master ; red as blood. Glocester. Why, that's well said. What colour is my gown of? Simpcox. Black, forsooth ; coal black as jet. King. Why, then, thou know'st what colour jet is of? Suffolk. And yet, I think, jet did he never see. Glocester. But cloaks and gowns before this day, a many. Wife. Never before this day, in all his life. Glocester. Tell me, sirrah, what's my name? Simpcox. Alas, master, J know not. Glocester. What's thine own name? Simpcox. Saunder Simpcox, an't please you, master. Glocester. Then, Saunder, sit thou there, thou lyingest knave in Christendom. If thou hadst been born blind, thou might' st as well have known all our names as thus to name the several colours we do wear. Sight may distinguish of colours ; ])ut suddenly to nominate them all, it is impossible. My lords, would ye not think his cunning to be great, that could restore this cripple to his legs ? Simpcox. O, master, that you could! " 206 SHAKESPEARE AS A PHYSICIAN, Glocester then sends for a whip and stool, gives Mr. Simpcox a good thrashing, — he leaps from the stool and runs away, the people following and shouting — a miracle ! a miracle ! There was little show of erudition or even good sound sense in the effort to expose the malingering of this fellow Simpcox ; no person, however expert, can distinguish, in many cases, by a mere examina- tion of the physical appearance of the eye, whether or not its optical powers are perfect ; and the plea that the inability of Simpcox to individualize the parties present by their several names was sufficient to brand him as an impostor is simply ridiculous. If he had been afflicted with congenital cataract, and had that day been operated upon successfully, why then he would not have been able to say of colours which was red or which black ; he might have acquired the power very soon from a process of education, but not in a few hours. The readiness with which he recognized colours rendered it certain that he either had not been blind at all, or else had been operated upon at sometime prior to that present day. He had not been blind from birth if he could immediately distinguish colors — that is certain. Doctor Shaw, a notorious political intriguer, is named in "Richard the Third," but not in connection with medical matters ; and Doctor Peace had held a place of trust and honor in the government, until displaced through the jealousies of Cardinal Wolsey. It is said that through grief at this misfortune, he ran mad and died. In "Henry the Eighth" we find mention of one Doctor Butts, the king's physician; — a man who seems to have been as heartless and unprincipled as his bloody master. It happened that this self-import- ant doctor did not like Cranmer, the Archbishop of Canterbury, and when this august functionary was humbled to the dust by the cold- blooded English Nero, — Henry the Eighth, — this same Butts, contrary to the instincts of the true physician, triumphed in his degradation, and took delight in making the fallen prej^te feel it to the utmost. He acted a contemptible part. Menenius, in " Coriolanus," says: "It gives me an estate of seven years' health ; in which time I will make a lip at the physician : the most sovereign prescription in Galen is but empiric physic, and to this preservative, no better than a horse- drench," thus giving little credit to the powers of medicine. The notion prevails among a large portion of mankind, that the doctor has really little power over disease, and from this belief springs the patronage which in most instances falls into the hands of CHIBURGERY. 207 the class of empirics known under various names, and outside of tlie pale of regular medicine — the idea being prevalent among the common people that they will do no harm if they do no good. If such reasoners would carry their arguments a little further, they would surely see that they had better employ no person at all, as one that is neither competent for good nor for evil is simply a nonentity, save in the matter of fees. But they who take up the idea that even the common disease of rheumatism is not dangerous, and will get along quite as well when not treated at all, are wofully mistaken. The plan was tried in the Massachusetts General Hospital, during the past summer, of leaving cases of rheu- matism without active treatment, and the progress of the cases noted. Ten ordinary cases, eight with first attacks, and two with a second attack — all young or middle-aged adults. Two died, three of seven examined got heart disease, and the average duration of the disease was about six weeks ! This was an appalling record for nature as a doctor, and shows us, as definitely as so few cases can, the dangers of trifling with life. The idea of Macbeth, — "throw physic to the dogs, I'll none of it," is doctrine of the same worthless sort. Whilst I know full well the many abuses cloaked under the guise of the healing art, — and certain as I am of the murderous work it performs in the hands of the igno- rant, yet it is a God-like calling, in its purity ; and separated from the evils which beset it in the shape of unworthy pretenders, and there is nothing in the way of human ministrations productive of more good to the human race. In ' ' Macbeth ' ' we find the doctor occupying a conspicuous place, notwithstanding his low estimate of physic. We find the old notion in regard to the power of a touch of the royal hand in curing scrofula : Malcolm. " Well ; more anon. — Comes the king forth, I pray you ? Doctor. Ay, sir ; there are a crew of wretched souls, that stay his cure : their malady convinces the great assay of heart ; but at his touch, such sanctity hath heaven given his hand, they presently amend. Malcolm. I thank you, doctor. Macduff. What's the disease he means? Malcolm. ' Tis called the evil : a most miraculous work in this good king, which often since my here remain in England, I have seen him do. How he solicits heaven, himself best knows ; but strangely- visited people, all swollen and ulcerous, pitiful to the eye, the mere 208 SHAKESPEAKE AS A PHYSICIAN. despair of surgery, he cures ; hanging a golden stamp about their necks, put on with holy prayers ; and, 'tis spoken, to the succeeding royalty he leaves the benediction. With this strange virtue he hath a heavenly gift of prophecy, and sundry blessings hang about his throne, that speak him full of grace." The absurdity of the idea that a "swollen and ulcerous" person affected with king's evil can be cured by " charms and incantations" has not entirely passed from the minds of living generations. I was reading in a medical periodi- cal no longer ago than yesterday where a medical gentleman gravely proposed the setting apart of a certain ward in an hospital into which patients of exactly the same class as those in the other wards should be admitted, and who, in addition to the identical treatment given to the others, should receive special and persistent prayers for their recovery, and that the success of the plan be carefully noted. It seems to me that this plan would imply the ridiculous idea that the patients in the wards of our hospitals as now conducted are removed entirely from the recognition of a benignant Providence, and that the salvation of their inmates is left entirely to the care of the nurses and physicians. It is certainly said that "the prayers of the righteous availeth much," but I am persuaded that they are not of sufficient power in these latter days to amputate a thigh, or supersede the anti- periodic powers of quinine. If the plan proposed by the good doctor should prove a success, I presume the practice of the healing art would go back into the hands of the monks and barbers. The same doctor who had such faith in the king's virtues as a "healer" was called to see Lady Macbeth for her sleep-walking, and with commendable con- scientiousness announced the disease as "beyond his practice," — " yet," says he, " I have known those who walked in their sleep, who have died holily in their beds." During the course of the treatment it was asked by Macbeth. " How does your patient, doctor? Doctor. Not so sick, my lord, as she is troubled with thick-coming fancies that keep her from her rest. Macbeth. Cure her of that. Canst thou not minister to a mind diseas'd, pluck from the memory a rooted sorrow, raze out the written troubles of the brain, and with some sweet oblivious antidote cleanse the stuff' d bosom of that perilous grief, which weighs upon the heart ? Doctor. Therein the patient must minister unto himself." CHIRURGERY. 209 It is apparent that Macbeth had entertained the hope that the pow- ers of the physician might avail something in the restoration of his wife's mental faculties, which had been so perturbed since the murder of Duncan ; and that it was only after the doctor declared his inability to do her good that he passionately exclaimed — ' ' throw physic to the dogs, I'll none of it" — a loss of confidence which seems to have had some grounds for it, as in his extremities he had hoped much, and received no help. It is probable that the case of Lady Macbeth would have been benefitted in the hands of many of our modern psychological experts ; and there is little doubt but that if the power of persistent prayer is necessary for the restoration of the sick. Lady Mac. would have been a fit subject upon which to have made experiment ; she was sick morally as well as mentally, and if a white neck-cloth and lugubrious physiognomy ever do good in the restoration of suffering humanity it is in maladies like hers. We find a metaphoric expression in Hamlet to this effect: " Your wisdom should show itself more richer, to signify this to his doc- tor ; for, for me to put him to his further purgation, would per- haps plunge him into more choler. " In " Lear ' ' we find a doctor mixed up in the matters considerably, and in association with the treatment of old Lear's mental alienation proves himself to be no mean psychologist ; his treatment of the case, as fully detailed in the chapter on pharmacologia, testifies to his ability in his professional ac- quirements, and to the matter as it is there stated we may refer the reader again. True to his mission of justice and mercy, we find the physician, Cornelius, in " Cymbeline," thwarting the evil designs of the heart- less queen. ' ' She doth think she has strange lingering poisons : I do know her spirit, and will not trust one of her malice with a drug of such damned nature," whilst he comes in for a charge of a lack of discretion by Cymbeline, for simply announcing that the queen was dead : Cornelius. "Hail, great king! To sour your happiness, I must report the queen is dead. Cymbeline. Whom worse than a physician would this report be- come? But I consider, by medicine life may be prolong'd, yet death will seize the doctor too." 210 SHAKESPEARE AS A PHYSICIAN, We find one of that numerous and detestable class — self-constituted doctors, making himself prominent in attending the shipwrecked per- sons in " Pericles :" "Get fire and meat for these poor men ; it has been a turbulent and stormy night. (To a servant.) Your master will be dead ere you return: there's nothing can be minister'd to nature, that can recover him. Give this to the 'pothecary, and tell me how it works. 'Tis known, I ever have studied phj^sic, through which secret art, by turning over authorities, I have (together with my practice) made familiar to me and to my aid, the blest infusions that dwell in vegetables, in metals, stones ; and can speak of the disturbances that nature works, and of her cures. Make fire within : fetch hither all the boxes in my closet. Death may usurp on nature many hours, and yet the fire of life kindle again the over-pressed spirits. I heard of an Egyptian that had nine hours lain dead, who was by good appliance recovered." How like the boastful lies of this class — the mountebanks of this day ! And the benighted public swallow the stories as gospel truths. Verily humanity is composed of the selfsame ingredients among all people and in all ages. The recent law passed by the legislature of Missouri and other states, lodging in the hands of Boards of Health the power to grant this class of men exclusive privileges, in the practice of their nefa- rious traffic — traflEic in human life — is a shame to the age, and is the extreme realization of the idea called the Black Arts in Medicine. One Hundred Dollars to the ' ' State Board ' ' and any man may have issued to him a certificate authorizing him to practice medicine in the great and enlightened States of Missouri, Illinois, West Virginia, and some others perhaps ; and the would-be reformers in the profession — those who are loud mouthed and boisterous in their clamor for a "higher standard of medical education," are the willing agents of these mountebanks in endangering the lives of helpless and unsus- pecting women and children. The people should see to it that such laws are removed from the statute books of the state. This recent medical legislation in the various states is in the interest of designing cliques, and the hands of those with whom the power for the execution of the laws has been placed have never been raised a single time against quackery, — but, on the contrary, have smote none but legiti- mate practitioners. [^ The licence law mentioned above is, to the practice of medicine, what the ' ' high licence law " is to the dram shops — places a mo- CHIRURGERT. 211 nopoly of the itinerant medicine business in the hands of him who has money, but summarily stops the " wheels of progress" of the impecunious and less fortunate quack. I am not aware of any case " I have my licence from the State Board of Health, and here is your medicine." yet where any one has taken out the hundred dollar licence, but if any do not avail themselves of the opportunity to revel in the bene- fits of a rich monopoly, it is certainly no fault of the law. CHAPTER IX MISCELLANEOUS . A vile caricature — The Huncliback — Now is the winter of my discontent — Listening to the whispers of Vanity — 111 be at charge for a looking-glass — Troublous dreams — Sleep that knits up the raveled sleeve — Our life is two- old — Sleep hath its own world — From Byron — Neuralgia — No guaranty of truth — Kiot — Position in sea-sickness — Old quarantine regulations — The plague — From the cradle to the grave — Characteristics of senility — Take a man of honor, Kate — He brings his physic after his patient's death — An awk- ward predicament— Tests for death— Life a failure — Ay! but to die? Grim Death ! Under the above title will be included various subjects which could not be well arranged under a different heading, and which did not embrace material sufficient in volume to entitle it to a place in the work as a whole chapter. The principal subjects noticed here will be Cyphosis (hunchback), Sleep, Senility, Necrology, etc., to- gether with other minor matters of little importance, with which the volume will close. In commenting upon the physical deformities of Richard the Third in a preceding chapter, it was mentioned that a quotation at more length depicting also his mental and moral traits in connection with other physical defects (those not mentioned there), might be found in the present place. This work, claiming to be an embodi- ment of Shakespeare's medical knowledge, would, it is thought, be incomplete without his complete description of that hideous carica- ture of humanity; and, although it may seem that a large portion of the matter is irrelevant to actual medicine, yet it is hardly possible to comprehend the medical point found in it unless we take them in their full connection. Richard the Third, King of England, occupied the throne from 1 183 to 1485, and the foul crimes enacted during his brief lease 212 >nSCELLANEOUS. 213 of authority made his history a blot upon the human character. He was killed at the battle of Bosworth Fields, where his army of twelve thousand men was completely defeated by one of half the number under the command of the Earl of Richmond, who then became King Henry the Seventh. Nowhere in Shakespeare's whole productions is his power of delin- eating human character more manifest than in his pen-picture of this individual ; it is perfect, both as to his physical, moral, and mental de- velopments. The description shows Richard to have been a fit repre- sentative of his class, both as to physical and mental characteristics ; it being a noticeable fact that in their mental organization they (hunch- backs) almost invariably possess a piquancy and subtility unequaled by most persons of a better physique, and whilst their mental traits do not give them just claims to profundity, yet they are commonly shrewd in the management of the business affairs of life, and their witticisms are often hurled with blighting effect at any they may not chance to like ; and their moral distortions are commonly of so pro- nounced a type as to have originated among the Germans an old adage, that " he upon whom God has set a mark, watch him, for he has surely come to bite the world." Richard thus descants upon his own deformity: " Love forswore me in my mother's womb ; and, for I should not deal in her soft laws, she did corrupt frail nature with some bribe to shrink my arm up like a withered shrub ; to make an envious mountain on my back, where sits deformity to mock my body ; to shape my legs of an un- equal size ; to disproportion me in every part, like to a chaos, or an unlick'd bear-whelp, that carried no impressions like the dam." Then after he had murdered the king, Henry the Sixth, with his own hand, on his blooody march to power, he thus cogitates: " Now is the winter of my discontent made glorious summer by the sun of York ; and all the clouds that lowered upon our house, in the deep bosom of the ocean buried. Now are our brows bound with victo- rious wreathes ; our bruised arms hung up for monuments ; our stern alarums chang'd to merry meeting, our dreadful marches to delight- ful measures. Grim visaged war hath smoothed his wrinkl'd front; and now, instead of mounting barbed steeds, to fright the souls of fearful adversaries, he capers nimbly, in a lady's chamber, to the lascivious pleasing of a lute. But I that am not shaped for sportive tricks, nor made to court an amorous looking-glass ; I, that am rudely stamp' d, and want love's majesty, to strut before a wanton 214 SHAKESPEARE AS A PHYSICIAN. ambling nymph ; I, that am curtail' d of these fair proportions, cheated of features by dissembling nature, deformed, unfinish'd, sent before my time into this breathing world, scarce half made up, and that so lamely and unfashionable, that dogs do bark at me as I halt by them ; why I, in this weak, piping time of peace, have no delight to pass away the time unless to see my shadow in the sun, and descant on mine own deformity ; since heaven hath shaped my body, so let hell make crook'd my mind to answer it ; and therefore, since I cannot prove a lover to entertain these fair well spoken days, I am determined to prove a villain, and hate the idle pleasures of these days." Notwithstanding these vows, the foul toad found a time when he could listen to the whisperings of vanity and be influenced thereby ; he even got so that he thought well of his own good looks ; hear him after he had been paying court to Annie, the widow of the murdered Edward : " And will she yet abase her eyes on me that cropp'd the golden prime of this sweet prince, and made her widow to a wof ul bed? On me that halt and am misshapen thus ? My dukedom to a beggar- ly dinner, I do mistake my person all this while ; upon my life she finds, although I cannot, myself to be a marvelous proper man, I'll be at charge for a looking-glass, and entertain a score or more of tailors, to study fashions to adorn my body ; since I am crept into favor with myself, I will maintain it with some little cost." The most complete bibliography of malformations resulting from incomplete (intra uterine) development of parts does not claim that the foetal extremities — the arm or leg — are abridged in development. They may fail of development utterly and the child be born either armless or legless, but not with an arm " shrank up like a withered shrub," nor " legs of an unequal size," as was the case with Rich- ard, according to his own account. Constrictions, as of the looping around an extremity by the umbilical cord, migJithsiye retarded their growth, but the fault is placed to the credit, seemingly, of the same agencies which placed the " envious mountain on his back." The action of a constricting funis could not be properly accused of this. As was shown in a former chapter, when speaking of teratologic con- dition of the foetus, that the departures from the normal almost al- ways consist of lack of development and not in an excess of develop- ment; hence the conclusion may be fairly entertained that the moun- tain which sat mockingly upon the back of Richard^was not of intra IVnSCELLANEOUS. 215 uterine growth, but perhaps occurred during his early childhood. He also testifies to the fact that he was lame, as the dogs barked at him as he " halted " by. This was much more likely to have been of post natal origin than to have been part of a congenital deformity. It is not uncommon to see the lower extremities become of unequal length in spinal affections which occur subsequent to birth, as in rickets for example. Growths of such a character as the one situated upon his back if of intra uterine origin are known usually to consist of an extra foetus more or less perfect, constituting a tumor covered by integument. It is not impossible but that the tumor we write of was of this na- ture, though his mother, not being free from a suspicion of some constitutional sexual vice, would be less likely to make an effort in the way of over-production than she would to transmit a constitu- tional taint which should in childhood manifest itself in curvature of the spine. This latter seems to have been the real deformity in the case under consideration, although Shakespeare puts forward the tes- timony of more than one witness to the fact that it was congenital. It will be remembered that he had murdered the husband of Annie with his own hand at Tewkesbury, and he meets her on the way to the grave with her husband's body and proposes marriage to her, which she, to his utter amazement, accepts. Queen Margaret thus gives us his portrait: " Thou elvish marked, abortive rooting hog! thou that was sealed in thy nativity the strain of nature and the scorn of hell! Thou slander of thy mother's womb! thou loathed issue of thy father's loins!" Constance speaks thus of one she could not love. kShe was speak- ing to her fair boy, Arthur : " If thou, that bidd'st me be content, wert grim, ugly, and slander- ous to thy mother's womb, — full of unpleasing blots, unsightly stains, lame, foolish, crooked, swart, prodigious, patch' d with foul moles, and eye-offending marks, I would not care, I then would be content; for then I should not love thee ; but thou art fair, and at thy birth, dear boy, nature and fortune joined to make thee great." The physiological process called sleep is spoken of in "Macbeth," "Julius Caesar," and "Henry the Sixth." In the latter the " troublous dreams this night doth make me sad " says the " hunch- back," on one occasion during the time he was scheming for the crown; whilst the first (Macbeth) says "the innocent sleep; — sleep. 216 SHAKESPEARE AS A PHYSICIAN. that knits up the ravell'd sleave of care, the death of each day's Ufa, sore labour's bath, balm of hurt minds, great nature's second course, chief nourisher in life's feast." The innocent sleep thinks Caesar when he says : "let me have men about me that are fat ; sleek- headed men, and such as sleep o' nights ; yond' Cassius hath a lean and hungry look; — he thinks too much." "Our life is two-fold: sleep hath its own world, a boundary be- tween the things misnam'd death and existence ; sleep hath its own world, and a wide realm of wild reality. And dreams in their de- velopment have breath and tears and tortures, and the touch of joy ; they leave a weight upon our waking thoughts, they take weight from off our waking toils, they do divide our being ; they become a portion of ourselves as of our time, and look like heralds of eternity ; they pass like spirits of the past, — they speak like sybils of the future ; they have power, — the tyranny of pleasure and of pain; they make us what we were not — what they will, and shake us with the vision that's gone by, the dread of vanish' d shadows — Are they so? Is not the past all shadow? What are they? Creations of the mind? — The mind can make substance, and people planets of its own with beings brighter than have been, and give a breath to forms which can out- live all flesh." I introduce the above quotation from Byron, that readers may find diversity of sentiment, and in this instance have the chance to see side by side the ideas of two of the most profound minds that ever looked into the human heart. "Before the curing of a strong disease, even in the instant of repair and health, the fit is strongest." — King John. "The same diseases heal by the same means." — The Merchant of Venice. The first of these assertions is certainly correct, as the disease must reach its acme before the decline commences ; in that instant repair must gain the ascendancy over waste, though the instant of absolute health is not yet reached the moment repair is begun. There is neither anything shrewd nor illogical in the second assertion. " Indeed, we feared his sickness was past cure," in "King John, " had reference not to physical infirmity, but to the political danger of Prince Arthur. "John" also contains the proposition to " heal the inveterate canker of one wound, by making many" — an idea only MISCELLANEOUS. 217 used illustratively, but one which finds application very often in prac- tical medicine and surgery. A quotation from " Richard the Second" to the effect that "they breathe truth that breathe their words in pain " is recognized as a basis of action in admitting certain testimony in our courts of justice. If a person make a statement whilst under the impression that he cannot long survive, we, as a rule, give great regard to its probable truthfulness ; but whether such credence could be placed in the veracity of one who was simply laboring under an attack of neuralgia without any apprehension of danger to life, we are not so well satisfied. Under these considerations of the fact a party would have to be laboring under pain, to his or her mind evidently speedily mortal, before much special significance could be given to their utterances. In " Henry the Fourth " there is a laughable incident where Fal- staff takes up the quarrel of Mrs. Tearsheet, and thereby precipi- tated a riot with Pistol, who, with his sword, made thrusts at Fal- staff's belly and stabbed him in the groin, Sir John at the same time hurting Pistol in the shoulder ; the reader must turn to the original, and get the matter in its full connection, to enjoy a good laugh. A very early, and also a very tardy case of dentition is noticed in "Richard the Third," and "it is time to give them physic, their diseases are grown so catching " is seen in "Henry the Eighth." " Then recovered him again with aqua vitae, or some other hot infu- sion " is found in the " Winter's Tale ; " the term " aqua vitse" be- ing used in one other place in Shakespeare, also. " Hot infusions" are the popular domestic resort even to this hour, and when after scalding, steaming and roasting a patient his friends or parents can- not " recover " him, the physician perhaps is invited to undertake the then no easy task. " Sea-sick " is also noticed in the " Winter's Tale," but no ideas as to its true pathology or best treatment are advanced. Observations as to position being the cause, and the change of that position into a (philosophically) more proper one as a prophylactic, and also a curative measure, appear to be the most logical ideas ever enter- tained and promulgated upon this distressing condition, Dr. Beard to the contrary notwithstanding. It is to be hoped that experience may prove the value of the suggestions. The phrase "with a mind that doth renew swifter than blood decays" is found in " Troilus and Cressida," and probably has reference to the mere coagulation 218 SHAKESPEARE AS A PHYSICIAN. of the blood ; as blood does not really undergo the change of putre- faction sooner than many other organic compounds. Upon the subject of sanitary science, we find the following in " Romeo and Juliet " in regard to quarantine : " Going to find a bare-foot brother out, one of our order, to asso- ciate me, here in this city visiting the sick, and finding him, the searchers of the tower, suspecting that we both were in a house where the infectious pestilence did reign, seal'd up the doors, and would not let us forth." This was the story of Friar John after his return from Mantua, whither he had been on the mission to Romeo to acquaint him with the condition of Juliet as she lay bound by the Friar Lawrence's " sleeping potion " in the " tomb of the Capulets." It seems that quarantine regulations were more rigidly enforced at that early day than at present; and it is likely that the " infectious pestilence" referred to was either small-pox or plague, as barring doors would have little effect in warding off the subtle germs that propagate cholera. The " plague " is named by " Timon ; " though it is probable that this scourge had not lately visited the British islands, as this is the only instance in which Shakespeare speaks of it in his entire writings ; had he, however, lived half a century later, at the time when London was almost depopulated from this dreadful malady, he would doubtless have given the world a graphic descrip- tion of its horrors ; it was his strong point to seize upon every salient feature of an age, and present it in a light, and with a force of thought, never attained by any other individual. It will be remem- bered that the plague visited London in 1665, and the great fire in 1666, just fifty years after the death of Shakespeare. The oft-quoted " all the world's a stage " is a truism ; "they have their exits and their entrances, and one man in his time plays many parts, — his acts being seven ages. At first the infant, mewling and puking in his mother's arms ; then, the whining school-boy, with his satchel, and shining morning face, creeping like snail unwillingly to school. And then the lover, sighing like furnace, with woful ballad made to his mistress' eye-brows. Then a soldier, full of strange oaths, and bearded like the pard, jealous in honor, sudden and quick in quarrel, seeking the bubble reputation even in the cannon's mouth. And then the justice in fair round belly, with good capon lin'd, with eye severe and beard of formal cut, full of wise saws and modern instances ; and so he plays his part. The sixth age shifts into the lean and slipper' d pantaloon, with MISCELLANEOUS. 219 spectacles on nose and pouch at side ; his youthful hose, well sav'd, a world too wide for his shrunken shanks, and his big manly voice, turning again towards the childish treble, pipes and whistles in his sound. Last scene of all, that ends this strange eventful history, is second childishness, and mere oblivion ; sans teeth, sans eyes, sans taste, sans everything " — the listless old man sits in his quiet corner, his hands resting on the top of his cane, waiting patiently for the final summons. The Chief Justice and Falstaff get the matter in this shape : Falstaff. "You that are old, consider not the capacities of us that are young. Chief Justice. Do you set down your name in the scroll of youth, that are written down old with all the characters of age? Have you not a moist eye, a dry hand, a yellow cheek, a white beard, a de- Qreasing leg, and increasing belly? Is not your voice broken, your wind short, your chin double, your wit single, and every part about you blasted with antiquity, and will you yet call yourself young? Fie, fie, fie, Sir John. Falstaff. My lord, I was born about three of the clock in the afternoon, with a white head, and something of a round belly ; for my voice — I have lost it with hollaing and singing of anthems. To ajjprove my youth farther, I will not : the truth is, I am only old in judgment and understanding ; and he that will caper with me for a thousand marks, let him lend me the money and have at him." " Hal " gets off a pretty good thing in the same direction during his courtship with his Kate: "While thou livest, dear Kate, take a fellow of plain and uncoin'd constancy, for he perforce must do thee right, because he hath not the gift to woo in other places ; for these fellows of infinite tongue that can rhyme themselves into ladies' favors, they do always reason themselves out again. A good leg will fail, a straight back will stoop, a black beard will turn white, a curled pate will grow bald, a fine face will wither, a full ej^e will wax hollow — but a good heart, Kate — " while Hamlet finishes it in this wise : " This satirical rogue here, says that old men have grey beards ; that their faces are wrinkled ; their eyes purging thick am- ber and plum-tree gum ; and that they have a plentiful lack of wit, together with most weak hams." Though after all these pictures of decay, it is claimed by the cynical philosophy of the blind Glos- 220 SHAKESPEARE AS A PHTSICIAN. ter, in " King Lear," that but for the hatred we have for the world — engendered by its strange mutations, life would never yield to the inroads of time, and our existence on earth would become perpet- ual. It no doubt occurs to every one who has had experience in the vicissitudes of earthly existence, at some time in their career, to ask themselves the question — " To be or not to be? or whether 'tis nobler in the mind, to suffer the stings and arrows of outrageous fortune ; or to take arms against a sea of troubles, and by opposing end them?" Or, like Constance, in "King John," who in the " extremity of her griefs " says of the " grim monster " — "No, I defy all coun. sel, all redress, but that which ends all counsel, true redress, death, death, O, amiable, lovely death! thou odoriferous stench! sound rottenness ! arise from forth the couch of lasting night, thou hate and terror to prosperity, and I will kiss thy detestable bones." In " Henry the Eighth " we find a simile in regard to his marriage, in these words: " He brings his physic after his patient's death " — an occurrence by the way not unfrequent in the career of many doc- tors of medicine. Experience teaches us that this fact is often more embarrassing than the matter would seem to warrant ; but really, one who has practiced medicine in the rural districts and has many times called to see his patient and finds him twenty-four hours dead, can fully ap- preciate my meaning. The writer of these lines not long in the past practiced in the country, and when approaching the house of a pa- tient whom he had left in a critical condition at the last visit, it was customary to scan closely the premises, and if he found a number of horses tied along the fence — many of them with side saddles on, he at once felt crestfallen, and without further information concluded that "he brings his physic after the patient's death. "_2J..^ "<' The language of Capulet, once before noted in these pages — "Out, alas! she's cold! her blood is settled and her joints are stiff; life and these lips have long been separated ; death lies on her like an untimely frost," is a fair picture of the ending of mortality; though if one swallowed all the ideas and speculations he reads of, he might reach the conclusion that after all, it is a difficult matter to say posi- tively when a person is dead. For the more satisfactory demonstra- tion of its certainty, numerous tests are given, one of the most re- cent being to ligate the finger of the party suspected, and if it swells beyond or on the distal side of the constriction, then the circulation goes on and of course the person lives. Another is to apply the MISCELLANEOUS. 221 flame of a candle to the point of the finger, and if the burn is fol- lowed by vesication the person lives, — if it remain parched and brown then he is dead ; whilst again if the fingers of the suspected party be held between the eye of the observer and a strong light, as the sun at noonday, if they are transparent then life remains, if opaque or dark, then death has done his work ; whilst yet another test is to drop a solution of atropine in the eye, and if it dilates, all right, — if not, then we may begin to suspect something wrong. I suspect however that the test of old Lear — that of placing a looking-glass be- fore the lips of the party suspected, and if the " shine is moistened" by the condensed expired vapors, then he lives — otherwise he is caput mortuum. The wafting of a feather by the breath is also sug- gested as a test in "King Lear." Of easy ways to die I know of no one who has given the subject more special attention than the voluptuous Cleopatra, who studied the matter well with a view to its practical application in her own person. The assertion that one recovered after having nine hours lain dead, is only a marvelous story from the lips of a quack — the analogue of cases with which we meet every day. Apropos of the dying and the dead, we find a case in medical ju- risprudence in " Henry the Sixth " — a case which if " not positively proven" is very well argued upon a basis of hypothecation. The case referred to is the death of the duke of Gloster, who it was claimed had been murdered at the instance of the queen and her paramour, the earl of Suffolk. Warwick. "I do believe violent hands were laid upon the life of this thrice-famed duke. Suffolk. A dreadful oath, sworn with a solemn tongue! What in- stance gives Lord Warwick for his view ? Warwick. See how the blood has settled in his face. Oft have I seen a timely parted ghost, of ashy semblance, meagre, pale, and bloodless, being all descended to the laboring heart ; who in the con- flict that it holds with death attracts the same for aidance 'gainst the enemy; which with the heart there cools, and ne'er returneth to blush and beautify the cheek again. But see, his face is black, and full of blood; his eye-balls farther out than when he liv'd, staring full ghastly like a strangled man: his hair upraised, his nostrils stretch'd with straining. His hands abroad display' d like one that grasp 'd and tugg'd for life, and was by strength subdued. Look, on the 222 SHAKESPEARE AS A PHYSICIAN. sheets, his hair you see, is sticking ; his well proportioned beard made rough, rugged, like to the summer's corn by tempest lodged. It cannot be but he was murdered here ; the least of all these signs were probable." The annals of forensic medicine do not furnish a more consistent and graphic picture of death by hanging or by strangulation than is here presented. The endeavor, however, to point out negative signs as evidence of the duke's murder is rather lame and inconclusive. Shakespeare falls into such an error but seldom indeed. It was said a few paragraphs back, that no doubt was entertained, that most persons who had encountered for a time the vicissitudes of life, had often concluded that after all, life is an unsatisfactory state of existence, that life is a failure, and that there are few things here below worth living for; but then "to die, and go we know not where ; to lie in cold obstruction and to rot ; this sensible warm mo- tion to become a kneaded clod ; and the delighted spirit to bathe in fiery floods, or to reside in thrilling regions of thick-ribbed ice: to be imprison' d in the viewless winds, and blown with restless violence round about the pendent world ; or to be worse than worst of these — 'tis too horrible! The weariest loathed worldly life, that age, ache, penury and imprisonment can lay on nature, is a paradise to what we fear of death." In regard to the terror manifested by Shakespeare at the bare idea of the uncertainties of a future existence, it appears a little puerile to myself. To the philosophic mind the thought of a future oblivion in which we maybe should possess no more of dread than the oblivion in which we were. Indeed, as I was one hundred years ago is, to my mind, the condition in which I loill he one hundred years hence. To my thinking the analogue is complete. If I am hereafter im- prisoned in the viewless winds or lie in cold obstruction, what is it more than I have been? We have this life certainly which we may present as an analogical conclusion for another ; but on the other hand ive know, from observation, of two states of non-existence for these forms of ours — the remove from the beginning, and from the ending of the present one — and so " I take my leave." THE END. Ij^DEX. PAGE I Abortion... 24, 25, 58, Ol, 64 A boon to nineteen 127 Acumen, Professional 58 Age, Nubile 24 Alcohol and venery 36 All the world's a stage 218 Anaesthesia 154 Anger 120 Anorexia 22 Antidote 84 Appetite, Craving 21 " Sexual 107 Arrow-poison 148 Asperity 35 Atavism 167 A very old head „ 130 Avon, Bard of 28 Balance, Nutritive 21 Banquo 80 Barker, Dr., of Dumfries 33 Baths in syphilis 171 Bearing-cloth... 38 Beau Nash 89 Biron 197 Blasted 219 Blood, Smell of 80 Blue-eyed hag 18 Blumenbach 167 Boards of Health 210 Bowlsby, Alice 18 Brownist 163 Brown-Sequard 167 Bryant, W. C 96 Bucknill, Dr 71, 78, 85, 101 Bullen, Anne 47 Byron, Lord 216 223 PAGE CcBsarian section 64 Campbell, Lord 28 Cataclysm, Final 95 Carry his water 186 Cataract 206 Cave of Belarius _ 155 Cephalalgia 128 Chastria, Mrs 120 Chemistry of digestion 175 Child, A thankless 65 Chlorosis 37 Chosen, by what? 43 Coma and speech 124 Come back 48 Come on my right 185 Conclusions ...117 Consanguinity 27 Conspiracy 74 Convulsions, Puerperal 68 Cornelia 53 Country swain 19 Cramer, Jennie 19 Cramp in drowning „ 125 Cut-throat 46 C>T)hoses - 44, 212 Dankish vaults 74 Death of Falstaff 160 DeBoismont 82, 87, 91 Deformities, Double 45 Degeneracy, Mental 55 Delineation, Farcical 73 Dentition, a guide 57 Dialectical society 36 Digestion and sleep 94 Diseases dearer than physic. 172 Disturbances, Mental 73 224 SHAKESPEARE AS A PHYSICIAN. PAGE Down grade of life 35 Do you nothing hear? 86 Drama and education 42 Dreams, alwaj^s involuntary... 83 Drinks, Sleepy 132 Duhaget, Dom 82 Dyspareunia 70, 119 Early marriages 54, 55 Earth and its girdle 23 Eclampsia _ 68 Elimination 22 Emendator, Error of 145 English common law 32 Envy 120 Epilepsy 121 Epistaxis 185 Etiology 156 Existence, A future 222 Expert, Medical 33 Expression and bromides 123 Facial perception _ 185 Fact, the only evidence 33 Falling sickness 121, 123 Families, Aristocratic 28 " Rural 60 Farmed out 57 Female physicians 198 Fencing match 149 Fever, Typhoid 22, 92 Few can correct errors 146 Fibroids, Uterine 60 Fleming, the phrenologist 184 Fools not mad folks 97 Foscari, Cell of 74 Garrulous nurse 56, 62 Garters, an evil 162 Gentleman, Lusty 32, 33 Germ-life 47 Give her an hundred marks .... 49 Give me some drink 161 Gland, The mammary 56 Gout 131 Green sickness 37, 62 Groans, Night of 47 Grocer's maid 166 Gynaecology 17 PAGE Halitus, Pulmonary 102 Hallucinations 90, 91, 147 Handkerchief 42 Hatred, Immoderate 30 Harangue 121 Headache 129, 130 Head, Compression of 128 Hebenon 165 He reads much 187 Hernia 113 He upon whom God sets a mark 213 Histo - genetic operations 192 Hobnail liver 179 Hope 41 Horse, with side-saddle 220 Hospital, Guy's 37 How stand the clergy? 204 Hunchback, The 42 Hypnotics 141 Idea, A paramount 100 Idiosyncrasy 139 Ignorance of the populace.... 196 Illegitimacy .... ...31, 32, 34, 55 Imagination, Scientific 92 Immortality 93 Inanition 57 Incident, Ludicrous 39 Indian, American 30 " doctor 202 Inebriate "Homes" 75 Infanticide 64 Infantile vitality 68 Influences, Septic 22 Insane hospitals 74 Irritability of hunger 177 Jealousy 101, 103, 104, 105 Jones, John, of Albany 127 Jorisenne, Dr, 40 Knowledge, Intuitive 72 Knowing him is enough 200 Lactiferous period 56 Lady, English 30 Language, Irrelevant 98 INDEX. 225 PAGE Lankaster, Dr lo7 Lebreicht 140 Le Sage 88 Lex scripta 29 Letter, A veritable 116 Licence, Sexual 107 Liquidating a bill 84 London, Tower of 42 Love powders 115 " marks 109 Lugubrious physiognomy 209 Lunacy, courts of enquiry.... 76 Lust 112 Lying-in chamber 50 Macbeth, Lady 79 Madness and emotion 101 Mad-folk of Shakespeare 134 Maid, A fun-loving 77 Malaria and mortality 162 Male accoucheurs, none 54 Malformations 26 Malignancy and milk 60 Mammary glands 56, 58, 61 Mandragora 135 Mantua, Apothecary of 142 Man's procreative capacity 107 Marriage in 1884 182 " Early, and morals.. 55 Marshall, Minnie.... 116 Massachusetts gen. hospital ... 207 Mastication, Organs of 58 Medical Soc'y.of St. Joseph ... 157 Medicine, Forensic 29 Medlicott, Dr 203 Menses 28 Mental phenomena. Aberrant. 71 Metamorphosis _ 21 Milk ...30, 56, 57, 60, 62, 63, 82 Midwives, Commission of 39 Mind, the offspring of matter 91 Moliere 78 Money-bags 31 Monkey as an expert _ 76 Monogamistic relations 108 Montagues, The 142 Mormon society 108 Morbi materies 22 Motion 91, 93 Murder, Picture of 221 Music as a remedy 133 Narcotics 132 Night, Dismal 42 Nipple, The 55, 56, 63 Non medical men 21, 24 Not from Shakespeare 112 Not pregnant. When 40 Normal pregnancies. Ten 59 Notions, Antiquated 19 Nubility and fourteen 24 Nursing, Attachments of 63 " her own child sacred 58 Odontalgia 128 Offspring, Limitation of 54 Olivares, Duke of 88 On death 222 Opium 84 Organology 174 Orleans, Maid of 39 Ovariotomy, Normal 24 Ovulation 60 Ovid 115 Pabulum of thought 96 Painting, Face 196 Paramour, A black 51 Pen, The 22 Pen of a master 50 Perfumes of Arabia 80 Phonograph 23 Physiology of sleep 215 Pierre Chatel 82 Poisoned by a monk 137 Pontine marsh 159 Prather,Miss 126 Prayer vs. quinine 208 Pregnancy, Diagnoses of 40 " Signs of 40 Pretty worm of Nilus 150 Printing press. The 23 Private retreats 75 Privilege, Child-bed 30 Procreative life of women 59 Prunes, Stew'd _ 22 " Longing for 20 226 SHAKESPEARE AS A PHYSICIAN. PAGE Psychology 70, 72 Puck 23 Pulse as a guide 85 Pure air deleterious 191 Pythagoras 78 Quack, A 67 Quack, The impecunious 221 Quick at second month 22 Race, Yankee 55 Rape, but no conception 118 Reade, Charles 76 Red-hot stove, curative 188 Reproduction, when complete 61 Resuscitation, Writer's mode 69 "Retreats," Private 75 Revolver, The trusty Ill Rosenweig, Dr. 18 Royston 146 Sack 38 Sagacity of Shakespeare 21 Scheele 146 Schoeppe, Dr 203 Scientific use of the imagina- tion 92 Sea-sickness, Position in. 135, 217 Section, Caesarian 64 Sexual relations, Equality in. 106 Shaftesbury, Lord . 107 Shakespeare, a contradiction 31 Shylock, the Jew 194 Sims, Dr. J. Marion 40 Singing man of Windsor 176 Skeleton 90 Sleeplessness 73 Sleep, Physiology of 93 Smile, sir 34, 102 Snake bite 152 Social science 36 Solobasta 153 Somnambulism 81, 82 Soul, The 93 Specifics, Love ^ 114 Spectres, etc. 87 Spencer, Herbert 36 Squaw, Labor of 30 PAGE Sterile condition 110 Storm, Relentless 90 Study of Shakespeare 71 Suicide, Fashions of 136 Sunrise, Dr 203 Surgery 192 Swinstead Abbey 138 Syphilis, Baths in 164 Tanner, resists decay 172 Tanner, the faster 175 Tearsheet, Mrs. Doll 38, 130 Telephone 23 Temptation, A terrible 76 Teratology 44, 214 Tewkesbury and Gov. Butler 75 Then live, Macduff 181 The public dipper 170 The Wash and the Humber ... 158 Thorn, A jealous 105 Tissue, Plastic 44 Trust not the physician 190 Truth and popular idea 180 Tubercular bacteria 183 Tubercle and syphilis 129 Twins, Siamese 45 Utah 108 Uterus a mobile organ 27 Vaccine disease 166 Varden, Dolly 109 Villain, what hast thou? 52 Vision, Obliquity of 103 Vivisection 153 Von Helmont 115 Vulgarian 134 Waggish old man 122 Wedlock no evidence 34 Whistle, The seaman's 66 Wilkes, Dr 37 Wine and blood 173 Witticisms 45 Woman, a dish for the gods ... 151 Woodman, The 178 Young fiirt, The 110 Zone, Epileptic 168 UNIVERSITY OF CALIFORNIA LIBRARY Los Angeles This book is DUE on the last date stamped below. --m£0 UB. 6I0MED UB. mm JAM 2 Z '86 Jan 10 1986 biomdm 1 9 78 BIOMED, ^ftir!M978 B.o«tf^A^2l^^3 Form L9-40m-5,'67(H2161s8)4939 RECD BRfcSEkii^SO FEB 1 5 i9S0 REC'D