Whatever one thinks about modern medicine and modern medical practices, it’s hard to mourn the “good old days” in that particular area.
In NATURE’S GOD, Matthew Stewart tells us of an 18th century American physician by the name of Thomas Young. Young, while a political and philosophical radical, was no quack when it came to his medical practice; as Stewart says, “Young was serious about his medicine. A substantial part of his surviving writings consists in medical tracts published in various Boston and Philadelphia periodicals. Though the writings were undoubtedly intended in part as advertisements for his own services, they also show that he was a staunch advocate of what one could call health care reform. His ambitious agenda was to make a science out of the theory of medicine and to make a profession out of its practices.”
Young was a contemporary of Thomas Jefferson, John Adams, and George Washington. Like them, he was a product of the Enlightenment, the empiricism and physicalism of which informed his practice:
“In the theoretical part of his medical oeuvre, Young presents a bracingly physico-mechanical vision of the human body. The human being, he says, is a ‘pneumatico-hydraulic engine,’ ‘a material system…subject to the laws of nature.’ It is a complex of ‘hard, soft, and liquid elements,’ and its chief business is to engage in a constant flux and reflux of ‘particles of matter’. Fever is a great ‘foe to human happiness,’ and its conquest involves gaining control over the ingestion and expurgation of these particle flows. In agreement with many of the medical authorities of the time, Young seems to have supposed that the cure to what ails us has to do mostly with the exit strategy. So, in his practice, he relied heavily on the prescription of emetics, diuretics, laxatives, and anything else that might return particles from within the body to the outside.”
And so let us follow Dr. Thomas Young on his rounds, circa 1770 or so:
“On a typical working day, he would lug his bag of leeches and lancets from bedside to aching bedside. He would douse his fevered people with crushed millipedes served in wine to flush their kidneys, sal ammoniac (ammonium chloride) mixed in gruel to flush out everything else, and, as the circumstances demanded, horseradish. In properly indicated situations, he might drain his patients of a few ounces of their blood. Some of the cures he favored—such as calomel, that is, mercurous chloride, a neurotoxin now used as an insecticide—may today be judged unhelpful. Others—such as chamomile tea—are now thought to be mildly beneficial. What is certain is that in keeping with the cruelty of statistics and the realities about the medical practices of this time, Young watched a lot of people die.”
To be sure, doctors today still watch a lot of people die; but at least those people (the patients) are spared the final indignity of being treated to death with leeches, crushed millipedes, insecticides, and horseradish.
If nothing else, let this be a reminder that in the olden days, “death panels” just meant any random assemblage of doctors.