Overview
This letter is significant because it illustrates Beddoes’s determination to reform medicine by using the post and the press to collect and publicise information about new treatments. Rather than advertise the virtues of nitrous acid in curing venereal disease on the basis of favourable results reported by friends or obtained by himself, he publishes a call to ‘any Physician, Surgeon or Apothecary’, asking the medical profession to conduct trials and to communicate their outcomes to him. He will then collate their communications and publish a comprehensive, statistically-based, survey of the treatment’s effects. In this way, he hoped, reliance on anecdotal, partial and limited evidence prone to confirmation-bias could be avoided. He would adopt a similar statistical approach in the flu epidemic of 1803, sending doctors all over the kingdom a standardised questionnaire about the disease’s transmission and spread, and publishing the results in a medical journal. In this methodology, Beddoes was a pioneer, even if, in the case of nitrous acid, he subsequently became so convinced of its powers that he tried to downgrade the importance of results that did not support his own high estimation of it.

 

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Thomas Beddoes, circular letter, 5 September 1797

Sir

You probably know that Mr Scot of Bombay,¹ was led by considerations, that need not be stated here, to try the nitrous acid in the venereal disease, that the experiment answered, and that it has been successfully imitated in England. In above fifty cases, many of them picked for the worst, the Surgeons of the Royal Hospital in Plymouth have found this acid certain, expeditious, and infinitely milder than mercury. Their mode of administration is extremely commodious. To a pint of wine they add a drachm of strong nitrous acid, together with 4 or 6 ounces of simple syrup. This mixture is sucked through a glass tube. 1½ or 2 drachms of the strong acid, so diluted, have proved an adequate dose for the day.²

Mr Cruikshank of Woolwich ingeniously substituted bodies of analogous constitution. He represents the oxygenated muriate of potash,³ as more powerful than nitrous acid. It produced an inflammatory state of the system.⁴

What is here recapitulated, together with some suggestions, may be read at large in Considerations on factitious airs part IV and V Johnson; in Two cases of Diabetes, Dilly⁵ ; and in Reports concerning the effects of nitrous acid, &c Johnson. Above 100 bad cases stand attested as cured beyond all reasonable doubt. Some unsuccessful trials are noticed in the last pamphlet.

The mild action and general power of the acid, with the proportion of failures, render a fuller induction of facts and testimonies highly desirable. — It cannot have escaped you, that the pretentions of many quack medicines are rested on the occasional inefficacy of mercury, and on an overcharged representation of its baneful effects. It is therefore certain, that to establish the anti-venereal virtue of substances, not injurious to the constitution, would be giving a deadly blow to empirical imposture.

By the co-operation of practitioners, a thousand cases might soon be collected. And it is hoped that you will not refuse your assistance to such an undertaking. The share I have had in conveying information to the public, very naturally led me to reflect on the speediest method of solving this problem; how far the cure of lues can be justifiably entrusted to the nitrous acid in the first instance. In consequence, I have taken the liberty of making the present application. I do not think that it can yet be deemed superfluous to collect more evidence, nor will the advantage of bringing the evidence together be disputed. There are persons, to whom every large design appears, by reason of its comprehensiveness, absurd. Others, I trust, will not condemn the idea of attempting to induce a large part of the medical profession, to unite in an enquiry of the highest interest.

Where the case prospers, the report should concisely state the symptoms, with the date and permanence of the cure. Appearances leading to a knowledge of the cause of failure should be noted. The nitrous acid (and the oxygenated muriate) will be found useful in various diseases.

But as the collection here proposed, will be confined to syphilis, information on other subjects should be written separately.

If any profits accrue, they shall be divided among charitable establishments for venereal patients. On this account it will not, I hope, be thought improper to request that communications be transmitted, free of expence, to Mr. JOHNSON, Bookseller, 72, St. Paul’s Church-Yard, London.⁶

I do not wish that any reports should be forwarded before Jan, 1798. If by the end of February, the number shall suffice for publication, they shall be immediately printed; or else returned.

To render the task of editor as little disagreeable as possible, it is desired that all technical terms and quantities may be written at length, and the whole in a fair hand.

Sept. 5 1797

Thomas Beddoes

Be pleased to communicate this letter to any Physician, Surgeon or Apothecary of your acquaintance.

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Notes

1. Helenus Scott, an East India Company surgeon who became an MD of Aberdeen University in July 1797. Scott’s communications about the treatment of venereal cases with nitric acid were included in Considerations on the Medicinal Use of Factitious Airs, 3rd edn (Bristol: printed by Bulgin and Rosser for J. Johnson, 1796), Parts IV and V.

2. The Plymouth treatments are detailed by Beddoes in Reports Principally Concerning the Effects of the Nitrous Acid in the Venereal Disease, by the Surgeons of the Royal Hospital at Plymouth and by Other Practitioners (Bristol: printed by N. Biggs for J. Johnson, London, 1797). This circular letter aims to follow up Reports, promoting the treatment across the nation and initiating the gathering of information from which its efficacy could be reliably gauged.

3. Potassium chlorate.

4. This treatment, developed by William Cruikshank, a chemist and physician at the Royal Military Academy, Woolwich, was reported in in the work of his colleague: John Rollo, An Account of Two Cases of the Diabetes Mellitus: with Remarks, as They Arose during the Progress of the Cure. To Which Are Added, A General View of the Nature of the Disease and its Appropriate Treatment, Including Observations on Some Diseases Depending on Stomach Affection; and a Detail of the Communications Received on the Subject since the Dispersion of the Notes on the First Case. ... With the Results of the Trials of Various Acids and other Substances in the Treatment of the Lues Venerea; and Some Observations on the Nature of Sugar, & c. (London, 1797). Beddoes had enquired about Cruikshank’s work when writing to Rollo on 10 January 1797.

5. Rollo, An Account of Two Cases of the Diabetes Mellitus.

6. Beddoes edited and Joseph Johnson published the reports that this letter precipitated as A Collection of Testimonies Respecting the Treatment of the Venereal Disease by Nitrous Acid (London: Joseph Johnson, 1799).