402 Differtation on Eccl. xii.-Roman Infcription. I can't but think it admits of a very Intemperate man! and o'er his guilty domes With many a mixture by the fun, fuffus'd, Here we have the literal fenfe; if a me- Mr URBAN, A B SI am a conftant reader of your C Mag. and never gave you any trouble in this way before. I flatter myfelf you will readily infert in your next, the following Roman infcription, (found very lately, by digging, in a treet called Micklegate, in the city of York), together with the annexed expia D nation, which is not given, as if I prefumed, it is the true one, but more with a view to come to that, by pro- LASENBIENSIS. MATAFITAGN_ CVBER KECH VL Matribus Africis, Italicis, Gallicis. Mr URBAN, Have lived a good while in the world, and have made fome obfervations on mankind. As the fmall pox has raged this year more than ordinary, not only in London, but in many parts of the kingdom; and as I fee letters in your Mag. about it from doctors and furgeons, I hope you will not think a few remarks on that fubject, from a plain man, who pretends only to common fenfe, unworthy of a place in your next; which remarks, if they are regarded by your readers, the writer is inclined to hope may have their share of usefulness, in proportion with the more elaborate performances of the gentlemen of the faculty; and at least that thofe gentlemen will excufe the attempt. It is a very prevailing notion among many people, that in this diftemper there is very little occafion for doctors and apothecaries, but a good nurse is all the affiftance that is ufually wanted. Whence this notion took its rife I cannot conceive, unless it was from the difeafe being vifible, fo that every one, when they fee it. If this is the cafe, who has been at all uted to it, knows it why fhould not nurfes be trufted in other diftempers, which are to be discovered and known by the eye fight as well as the fmall-pox? Why not in the jaundice, and in other difeales of the fkin? Why not in many cafes of furgery, (where operations are not wanted) fince these are likewife to be feen? Why not in many other diforders, as fluxes, droply, palfv, &. which are all evident to the eyes and other fenfes? Why not in other fevers as well as the fmall pox, which is a fever of a particular kind? It cannot be faid that nurfes may be F trufted with the management of the fmail pox, because it is not dangerous. Does not every body's experience, and the univerfal dread of it, more than of any other distemper, prove that it is very dangerous? We see, from the weekly and yearly bills of mortality, what numbers die of it in London. And it is generally agreed by thofe who have made calculations, that there dies one in fix of all who have the small pox in the natural way. How many other fevers do we fee very rife at different feafons, of which there does not die near this proportion, (it may be but very few) and yet nurfes are not trufted with the cafe of the fick, but only in their proper office; viz. to attend, watch with, and affift them; to give them fun tood, and drinks, and G I confefs there feems to be fome inconfiftency in two dedications to the Matribus, &c. and to the Gubernatori; H but medi ever. Against trusting to Nurfes in the Small-pox. A medicines as are ordered for them, and E F H 403 that are either peculiar to this difeafe, or common to it with others. But what can the old woman know of all these things, which are fo neceffary to be known, in order to conduct matters right in any difficult cafes? She has nurfed a few people in this diftemper,, (and a few it must be indeed in proportion to what phyficians and apothecaries of any bufinefs have attended, because fo much of her time is taken up with one) has perhaps made a few remarks herself, and heard a few from fome others, and has got a notion of three or four herbs or drugs, which the reckons famous things in the cafe, and are to ferve her upon all occafions. I fay, which of thefe two would reafon tell us are to be depended upon, for all the affiftance that is to be had in difficult cales of this diftemper as well as others? I mean this to fuch as are able to have their choice of what help they think beft, and who, in other diftempers, would be willing to be at the expence of it. For as to thofe who cannot afford it, they must do as well as they can in this, as they are forced to do in other diftempers; and must rely upon their nurfes, unless they can get the charitable affiftance of fome humane compaffionate doctor or apothecary. There are fome, indeed, who are not for trufting the whole affair to nurses at all events, but propofe to call in further help, if there thould arife fufficient danger to require it. Thele people allow that there are fome who have skill fuperior to nuries. But why do they not apply to the best help at firft, by which, perhaps, the danger might be many times forefeen and prevented? At lealt it is very often eafer to prevent than to cure. They truft too much both to the fkill and integrity of the nurfes, to difcover and advertise them of the danger. If he has not fagacity and fkill enough to fee danger early (which certainly none of them have in all its thapes) it may be paft remedy before the finds it out. And if he is full of herfelt, and notfo honeft as the fhould be, fhe may conceal after he knows it, in hopes that the patient may flruggle thro' it, under her care, (as fometimes happens by meer ftrength of nature, or by fome lucky incident and that then the fhall have the credit of the recovery. It is certain that many do, and wil die under the direction of the belt ware and kill, but then fich have had the be chance for their lives that could be gi en them And if not that be a fot fath Small-pox too nice a Point to be trufted to Women. C 404 faction to the furviving relations? Why then will they run fo much hazard of being deprived of it, by delaying to fend for further help, till they expect that within a few hours they fhall want to fend for the undertaker, unless the A doctor or apothecary can work a miracle and raife the dead? Would they delay or truft to a nurfe, in cafe of a broken limb,or any other misfortune, by which a child or a friend would be in danger of becoming a criple? Would they not rather leffen the fortune (if that was neceffary) which was intended for a child, for the chance of faving a limb? And will they run the hazard to the last extremity, where life's at stake? Should they not rather have that help which they think beft, as early as they can, in order to prevent danger as much as poffible? Nay even for fuch who either can afford, or are refolved to be at but little expence, is it not better to bestow it in the beginning, than towards the end of the cafe, when it is too late to do any thing with any profpect of adadvantage? There is an old proverb, Well begun is balf done, or in other words, A good beginning is the way to a good end. D And by all I could ever learn of the cafe before us, a great deal is reckoned to depend upon a right fetting out. The beft advice fhould therefore direct at first how the patient is to be managed, and whether any, or what evacuations are neceflary. Whether bleeding be needful (which is reckoned by fome of the best judges to be of the utmost im portance in fome patients, and in others to be quite improper)or a vomit or purge is neceflary or not: what fort of diet and liquors are proper, as also what degree of temperature of air is to be kept in the room, according to the different conftitutions and conditions of the pa tients, and the feafons of the year or weather; how the patient's body is to be kept with regard to ftools; how and when to procure fleep by art, &c. bleeding is more commonly practifed by fome of the belt phyficians now a days, than it was formerly, even after the small pox is come out, and in fome conftitutions and cafes is found to be very beneficial. I have alfo learned, that keeping the body more open during the courfe of the diftemper, than was formerly used, is found to be right. Can nurses be judges when and how far these things are to be done? Do they underftand the difference of conftitutions, or know that fuch a kind of management B as will be very proper and useful in one, may be very wrong, or even deftructive in another? Do they know the nature of the pulfe, urine, &. or how to judge of the state of the fever? What tho' they can fee how the pock goes on, may not the fever run high, and other very dangerous and even fatal fymptoms come on while the pock looks well? What do they know of the nature of the medicines, or when and how to apply it? If indeed no medicines were ever wanting, but that all which is neceflary, were care and proper drinks,&c. then there would be more reafon for leaving the affair to the conduct of nurfes, and especially if they were directed in the first fetting out. And whenever nurses are to have the fole management, I think they fhould be abfolutely forbid by the relations, and effectually watch'd and reftrain'd from giving any fort of medicines. This would be leaving the affair to nature, which is much better than to truft to falfe pretenfions to art and skill. But when they are trufted to give medicines, I am afraid they either trifle with things of little or no virtue, which they falfely call medicines, and, by depending upon them, lofe the opportunity of having help from proper advice, or elfe are too bufy with things of efficacy, giving them at a wrong time, or too freely. A fkain of purple filk boiled in drinks, as a remedy againit the purples; a little cochineal juft to colour a liquor, a few tares boiled in drink, or fome herbs of no efficacy, are I believe examples of the firft; and I am afraid that fack and faffron, poffets and fweats, are too common inftances of the latter. And it may be fufpected that fome of them, by giving hot things to drive out, as they call it, by too much heat from fires and bed-cloaths, too of ten occafion fo much mischief at first setting out, as all the college cannot afterwards remedy. For if, when the fever runs high, either at the beginning, or the fecond fever (I think it is called) E F I remember to have read Sydenham, when I was a young man, who was G reckoned to have been a very skillful and a very honeft phyfician. He fays it is too nice and difficult a point, to be trufted to the capacity and judgment of old women, even to determine the degree of heat, which is neceffary for patients to be kept in, before and during the eruption, according to the feafon of the year, the age and manner of life of the patient, and other circumftances, but that it requires the fkill of a judicious physician. And I have heard that H alter Beft Nurfes least conceited. after the pocks are turned, they ufe too hot a method; it feems eafy to imagine, that by adding fuel to the fire, they may raife fuch a flame as all the power of art cannot extinguish. B 405 therefore they are not willing that either doctor or apothecary fhould be called in upon them. But if they cannot prevent this, there is one way ftill in their power, (if they are not well watched and which they have too often done; viz. to throw away the medicines ordered by the doctor or apothecary, and give the patient what they please of their own. If the patient dies they are fure to conceal what they have done, and to aver that they followed directions moit punctually; but if he recovers, fuch is their pride and thirft of praise, that they cannot fometimes forbear difcovering the treacherous fecret. What an inftance is this of pride, of affurance, of folly, of unfaithfulness to their truft! Is it not a robbery of the patient of fo much money as the fees and medicines come to? Is it not a crime that nearly approaches towards murder, for them to be fo arrogant as to prefume to judge in cafes committed to the judgment and direction of others, and to deprive the patient, in a clandestine and treacherous manner, of fuch means, as, for what they know, might be the faving of their lives Would not all the world agree (even thofe nurfes themselves againit other mures) that this was the cafe in any other diftemper? Why then not in this Or if murder be too hard a word, (especially for the first fact) muft it not at leaft be reckoned manflaughter? There is indeed one remedy against this great evil, which ought always to be made ufe of in this cafe, and that is, for fome relation or friend to fee all the medicines, which they are to pay fo dearly for, faithfully adminiftered. But is it, not better to have a nurfe, if fuch can be found, who may be confided in to F do it? It may be obferved of nurses, (which A indeed is true of mankind in general) that those of the beft understanding are leaft conceited and confident; fo that those who are fitteft to be trufted, are leaft defirous of it: while the ignorant, being in poffeffion of two or three remedies, as they reckon them, and having nurled a few who have had the good luck to efcape, grow felf-fufficient, and think their kill in this diftemper fuperior to that of any other, not only of the fifterhood, but even of apothecaries and doctors; and therefore they endeavour to inculcate a notion, that any advice of the faculty is altogether needlefs, to fuch as commit themfelves to their care; and with people of equal understanding with themfelves they too often prevail. Such is the ambition of mankind to be upper. moft! Too many love to have a province of their own to govern in, how little foever they are qualified to come mand; when they might be fure not only to avoid blame, but even to acquire credit and applaufe, if they could but know their proper place, and be contented to do the duty of their station. A nurse who will be modeft and governable in other difcafes, will think her felf as knowing in this as any phyfici- E an, and therefore will not obey but while in fight. In this fhe loves to have the fole direction to herself. It might feem ftrange that people fhould be fond of being the dernier refort in cafes of life and death, and especially when their pay is not greater than it would be, if they acted only in their own proper fphere. A nurfe is as neceffary in her place in this distemper, as a phyfician or apothecary, and therefore muit be employed. If fhe could fubmit to obey orders, no doctor would want to turn away a good nurfe, but a conceited nurfe would be glad to be rid of the beft doctor in the kingdom. If I was a nurfe, I think I fhould like to have fome fuperior to receive crders from. If I was an apothecary 1 fhould like to receive directions from a phyfician. If I was a phyfician, I fhould be glad of a confultation in all cafes of difficulty. But with fome of these nurfes, the more danger the more honour; and they had rather run the rifque of lofing the patient, than that any one fhould fhare with them in the credit of the recovery; (Gent. Mag. SEPT. 1753) G Some, indeed, have efcaped, who have been thus bafely and cruelly treated. And fo fome who have been at fea, without pilot, or fails, or rudder, have, by the favour of the winds and waves, been driven lafely on fhoar. But if I was to go to fea, I fhould like to be under the care of an able commander, and good failors, with a good fhip, and the tackling all in order. If I wanted advice about my eftate, I fhould not apply to the petty-foggers, but employ the men who I thought were bett killed in the law, and had the most inteHgrity. If I or my family were to be fick of this, or any other distemper, I fhould choose to have the beft advice, fo far as I was able, and the beft medicines 1 could procure. Yours, &c. J. J. Eee Ke |