1801

Thomas Beddoes to the Editors of The Medical and Physical Journal, 18 July 1801

GENTLEMEN,

I have been silently preparing to bring the too long depending question concerning acids in Syphilis to a decision, according to the terms of my challenge to Mr. Pearson. I am impatient that it should be known to the whole public, whether careless management, with foul play and an insufficient range of powers, occasioned the loss of many lives, and the deduction of many constitutions, which acids would have saved.

I request you to insert the enclosed paper, or a sufficient abstract of it, in your valuable Journal. I have only to add, that I am ready to communicate with any members of the medical profession, on the regulations to be adopted with regard to patients, and their reception at the Pneumatic Institution.

I am, &c.

T. Beddoes

July 18, 1801.

The idea of a public trial of acids in the venereal disease seems to have been generally approved; and I have now the satisfaction of making it known, that the means of setting the scheme on foot are in my possession.

I. A greater benefit could scarcely be conferred on human society than the discovery of a new remedy for the venereal disease. This is acknowledged by all parties. But however strongly men, experienced in medicine may feel the urgency of the existing necessity, no general terms can convey an idea of it to others. The relation of particular facts would far exceed the bounds of a prospectus, or do the subject the greatest injustice. Where the constitution, from early mismanagement, becomes thoroughly impregnated with the venereal poison, mercury not unfrequently fails, or, by the use of this severe medicine, the patient dearly earns a short respite from his daily and nightly tortures. This is more commonly the lot of the ignorant and the poor, of whom, after they have in vain tried hospital practice and advertised medicines, it remains untold in what corner they hide themselves to be preyed upon by their unrelenting disorder. But mercury (which must still be allowed a station in the foremost rank among the articles of the Materia Medica) proves also the occasional scourge of the wealthy and the knowing. In particular instances, however skilfully managed, it is ineffectual, or it aggravates the complaint. When it answers the immediate end, it gives rise to disorders that either soon arrive at a fatal termination, or blast the spring of life, induce premature decay, and afflict advancing years with evils not their own. The transmission of the proper venereal disease is disputed. But what concerns society full as much is indisputable; namely, the transmission of morbid tendencies, engendered by its reputed sole specific. Hence the spectacle of parents, condemned to witness their youthful imprudencies, visited upon their children, too often occurs to those to whom the interior condition of human beings is laid open without disguise.

In corroboration of this statement I may appeal to our cities, our universities, the army and the navy. Wherever youth feels and indulges its ordinary propensities, there mercury lays the foundation of evils, the contemplation of which ought surely to produce something beyond barren horror or commiseration.

II. Could the mass of testimony either for or against the acids be annihilated, that on the other side must, from its multiplicity and strength, decide the public opinion. What therefore can be expected from fresh accessions of private testimony? If success is announced, how easy to suppose a mistake in regard to the disease, or to find some other method of explaining away the fact! Failure may be equally imputed to mismanagement. For nothing is so easy as to administer acids with safety to the patient, but without effect on the disease. The dispute therefore will be left as it stands. Nor will the negligent, the luke-warm, the biassed, and the envious be at a loss for unsuccessful reports, till they shall feel the controul of general opinion, established upon experiments beyond the reach of cavil.

III. It has been surmised that the mass of attestations, lately collected, and the accumulated proofs of a proper salivating power in acids, would set innumerable enquirers at work. A considerable time has however elapsed, and there are tokens enough of a communicative disposition among the Faculty; yet no single symptom of the predicted ardour of investigation has transpired.

Further reasons will hardly be required. Otherwise I might go on to explain what a blow empirical imposture would receive from the ascertainment of antivenereal power in new substances; and how much our medical logic would be improved. For it is hardly conceivable to what a degree the exclusive opinion, commonly entertained, narrows our views of organic susceptibility. As if it were possible that any considerable proportion of the medicinal treasures of Nature could be known when, in the course of ages, no enterprise of discovery worth mentioning has been undertaken.

It remains that the Inquiry be unexceptionably conducted; so that Europe may be no longer defrauded of that benefit from acids which India is unanimously attested to enjoy. All doubt as to the nature of the cases must be obviated. Hence it should be a rule, to receive no patient without a statement signed by at least three physicians or surgeons. And every patient must be inspected, on his reception and during the treatment, by practitioners on the spot.

But the public must be satisfied that the medicines alleged are administered, and no others. A person, worthy of confidence, must therefore be engaged to superintend the treatment. And although this person, in common with others, may exercise his judgment upon the cases, nothing will rest on his single opinion.

The author of this paper having actually tried many varieties of acid medicines, and formed other combinations in his mind, proposes to direct the treatment. But he will hold no communication with any patient but in the presence of the superintendant. – To him, in his situation, celebrity in any other common disorder would be far more lucrative. But as the consignment to his care of the papers, relative to a practice that was originally promoted by his crude speculations, first engaged him in the question, so a sense of its importance now induces him to submit to exertions in bringing it to an issue. He is convinced that many more difficult investigations may be proposed in medicine, but not one more immediately useful.

He still abides by the opinion expressed in his letter to Mr. Pearson, ‘that the patients must be persons of regular conduct, and concerning whom we may be able to procure information at a considerable distance of time.’ (Communications, p. lxi.)

It will be necessary perhaps to take some pledge for the perseverance of the patient, to whom it should be previously explained that he is to be treated on a plan supposed on such and such grounds efficacious, and less trying to the constitution than the mercurial. As soon as it should be deemed improper to continue the new plan, the one will be adopted.

Patients with the proper certificate would be admitted to the number of twelve; and though little stress would be laid on out-patients, yet any number of these would be treated.

One day in the week, at certain hours the house would be open to all visitors whatsoever. The practitioners who choose to observe and attest these experiments must have the necessary access to the patients.

The first object in view is to satisfy the public if certain substance not mercurial, are or are not remedies for the confirmed venereal disease. But I could also wish to continue the trials till some judgment can be formed whether, if they be anti venereals, they equal mercurial preparations in virtue.

With the necessary co-operation on the part of the profession to supply patients and observe the treatment, I trust that with what I may afford from my own purse, added to the remainder of the subscriptions to the Pneumatic Institution (which the committee is willing to have expended in this manner ) and to some contributions for this express purpose, I shall be able to solve the first question.

Whether I shall have ability or funds to solve the second, will depend upon the opulent part of the public. That they will feel how deeply they are interested in the subject, I cannot foresee. But, for helping to render this enquiry more lull and satisfactory, those among their sons, who are liable to have their constitutions impaired or destroyed by the operation of mercury, would owe them greater obligations than for a large patrimony. And (if on such a subject one may speak the truth in defiance of false delicacy) they will not less essentially serve their daughters by saving their future husbands from the ravages of the fame remedy.

Those who may incline to support this scheme, are desired to forward their subscriptions to Messrs. Couts and Co. Bankers, Strand, London; or to Messrs. Savery and Pugh, Bankers, Bristol.

Published: The Medical and Physical Journal, 6 (July 1801), 164–68