Overview
This letter is one of Beddoes’s first public announcements about the treatment that he would spend the next seven years campaigning for – the use of gases, especially oxygen, in cases of pulmonary consumption. Thus, it heralded the work that the Pneumatic Institution — one of the first scientific institutions dedicated to medical research — was founded to put into practice. Newly settled in Bristol, Beddoes was with this letter publicly repositioning himself — no longer a chemical lecturer at Oxford or an investigator of geology, he was now a physician aiming to radically update medicine by adapting to it the latest discoveries of chemists. That the addressee was Joseph Black (1728-99) is also significant. Black lent Beddoes’s new oxygen project credibility because he was the revered discoverer of what are now known as carbon dioxide, latent heat, and specific heat. He had been a popular and respected lecturer to many generations of students, Beddoes among them, as Professor of Medicine and Chemistry at the University of Edinburgh from 1766. He was one of the founders of the Royal Society of Edinburgh and, from 1788 to 1790, was President of the Royal College of Physicians of Edinburgh. Black’s approval of Beddoes, whom he visited in Shropshire in 1788, helped recommend Beddoes to Black’s friend James Watt, who interested him in the chemistry of pneumatic medicine, and who collaborated with Beddoes in designing breathing apparatus and testing the effects of gas inhalation from 1794. The letter also suggests the influence on Black of younger former students, Beddoes foremost among them, in Black’s shift from the phlogiston chemistry of Watt and Joseph Priestley to the oxygen-centred chemistry of Lavoisier (Beddoes and Black had debated the merits of phlogiston and caloric interpretations over several letters).
Thomas Beddoes to Joseph Black, 24 December 1793
TO
JOSEPH BLACK, M.D.
PROFESSOR of CHEMISTRY
In the University of Edinburgh
Dear Sir,
I have always, since our first acquaintance, found gratification in avowing the respect I entertain for a character so eminent as yours for genius and candour. But your late adoption of Mr. LAVOISIER’S system has greatly added to the force of this sentiment:1 And the recollection of so signal a proof, that neither years nor celebrity — the bane of vulgar minds — have had power to blunt your sensibility to truth, affords me greater pleasure than I should otherwise have felt in dedicating to you the following small collection of observations.2
These observations principally relate to a subject of unspeakable importance: and one, which in our own countrymen are more deeply interested than almost any other portion of the human race. — The invariable fatality of Pulmonary Consumption is amongst those notions which observation and reading render most familiar to the minds of medical men. Many other persons are, however, by no means fully apprized of this melancholy truth. For ‘Catarrhs’, as a great physician has observed, ‘are sometimes mistaken by the ignorant for Consumptions, or designedly called so by the crafty.’3 Hence they ‘are supposed to have been occasionally cured.’ Dr. Cullen used to mention in his lectures one instance of recovery from what he supposed to be a real consumption. But he professed himself unable to form any conjecture how this almost miraculous event was brought about; and of course he could not apply it to the benefit of other patients.4 I have heard of no other credible instance of recovery from well-ascertained consumption, except those mentioned in the following communications; yet the different practitioners whom I have questioned respecting the result of their experience must, I should imagine, have seen ten or, perhaps, twenty thousand patients. It may very safely be assumed that at least ninety-nine out of every hundred persons, ill of consumption, are cut off, notwithstanding the very earliest administration of the various compositions proclaimed by advertisements, or by the means advised in books, for their relief. Now what sort of remedies must those be, under whose operation nineteen patients die out of twenty, or even four out of five? Do they deserve the name of remedies? Credulity might, in this instance, take a lesson from the reply made to a boastful Pagan priest; who, in order to surprise a traveller into admiration of the power of his Deity, produced a list of the names of various persons whom He had preserved from shipwreck, in consequence of the vows they had offered to Him; ‘very well’, said the traveller, ‘so far, so good; now let me see the list of those who perished in spite of their vows’.
If the means in use for the cure of consumption uniformly fail, the means of prevention are also lamentably deficient. Every body knows the disease to be dangerous; the signs therefore that indicate its approach commonly excite alarm, and, on their first appearance, few except the needy neglect to call in the aid of medicine, and many, doubtless, steadily pursue the directions they receive. Nevertheless, rich houses are every day discharging into the grave victims to this dire disease.
Delusion of every kind will, I imagine, on calculating its effects, be found injurious to society. The prevailing degree of persuasion, that Pulmonary Consumption has been and may again be cured either by quack medicines or by any other of the usual means, is obviously productive of two bad consequences; 1. As it enables a most pernicious species of imposters to fatten on the produce of fraud; and 2. As it renders physicians less active in seeking, and the public less urgent in requiring, an efficacious method of treatment. Are these evils outweighed by the common-place plea in favour of deception? Of this plea, which is suggested sometimes by real, and sometimes by affected humanity, I, for my own part, question the validity: in the first place, because I have observed phthisical patients, under full assurance of their fate, suffer less than others, who have only suspected their danger (as they seldom fail to do), and who in consequence were agitated by incessant vicissitudes of hope and terror, – and, secondly, will not every sanguine patient, however firmly convinced that the true consumption is inevitably fatal, persuade himself that his own is not a case of true consumption?
Such, if I know myself, would be my opinion, were I a disinterested spectator of those scenes of domestic misery, which Consumption is every hour producing. The desire — a reasonable desire, I hope — of seeing my own project fully and speedily carried into execution, may render me more eager to dissipate any rival delusion. But I am confident, from the temper of the present age, and from several peculiar circumstances, that it will be tried in every possible form. Patients themselves, or their friends for them, will soon learn to ask their medical attendants these two simple questions: ‘Have you had so much favourable experience of any other method as to advise me to trust my life to it? Do you know the method, newly proposed, to be inefficacious?’ — The following testimonies, must also have the greater weight both with the public and with the members of the medical profession, as they come from perfectly impartial and well-informed persons.5 Many other of the most respectable practitioners and improvers of medicine have expressed the most earnest wishes the execution of the design, as well as great anxiety for further information. And were there no other hope, those young men, to whom you communicate ardour and information, would, I am sure, prevent this chance of relieving otherwise irremediable misery from being lost to mankind. The sooner, however, its pretensions are examined, the better; in order either that the benefit may be determined, or, in case of total failure, that ingenuity may strike off in quest of other improvements. For who will deny that the art of medicine needs improvement, while so many and such frequent diseases remain incurable?
The pneumatic practice is about to be introduced into one hospital6 — another source of expectation. But an appropriated hospital, under the management of an able and impartial physician, would soonest try this practice, and improve it, if it be worthy of prosecution. Such an establishment, with rooms proper for containing modified airs, might be provided for a sum which, when set in competition with a small probability of greatly promoting the public welfare, must appear contemptible. And an individual, who from inexperience of the world, should suppose mankind in general, open to conviction and alive to their true interests, might imagine that the attention of the opulent would infallibly be arrested by considerations like the following:
Some exterminating maladies infest, almost exclusively, the habitations of the indigent. But Consumption does not confine its ravages within such narrow limits. Nor has wealth yet been able to provide materials for erecting a barrier, capable of resisting its invasion. The young, the beautiful, and ingenious are its ordinary prey and how often have you to lament that it fastens upon the objects of your fondest attachment; after whose loss this busy world will seem to you as a cheerless desert? – I am aware of the interest which a child, consuming by a slow decay, must excite in the bosom of a parent. Full allowance, however, being made for the effect of compassionate affection on the imagination, it will often appear, that the most amiable individuals of a family are really singled out by Consumption.
Self-preservation comes in to second the dictates of parental affection; for it is certain that the number of persons, who die of consumption at an advanced period of life, infinitely exceeds the common computation.
In comparison with so unceasing and diffusive a calamity, how inconsiderable are the effects of those epidemical disorders, that occasionally excite so much consternation among us? Why then hesitate to accept the aid of Science, when she offers agents endowed with great and peculiar powers, advantageous in their application, and, as there is some reason for supposing, adapted to our necessities? Is a full trial of their efficacy too expensive? At what rate then do you estimate the chance of learning how to preserve from otherwise inevitable destruction those whom their understanding and disposition may have rendered your pride or your delight? How many times a larger sum may you have to bestow without receiving in return any chance of their preservation? — But you have heard the project vilified. So would a Panacea be. So was the Peruvian bark,7 and Inoculation,8 and every great improvement of that art, from which, according to its state, all in their turn shall experience good or harm. Besides, are you sure that those who pass this sentence are uninfluenced by prejudice, pride, of thirst of gold? Recollect that to decry what we do not understand is an obvious expedient of self-love; consider therefore whether the information of these men is such as may enable them to judge from analogy, or whether they speak from actual experience: For opinion can have no solid base but in analogy or experience, since an intuitive perception of the powers of nature is not among the faculties of man. Authority, equal to any that can be opposed, is adduced in favour of the proposal. Many considerations concur to render it plausible. The few trials, hitherto made, have answered beyond expectation. There is nothing, for example in the authentic records of medicine similar to the case of florid consumption related one of the following letters. The relapses serve but to render more evident the connection between cause and effect. The same observation applies to the case of putrid fever, related in another letter. –
I flatter myself that the art of medicine will find great resources in OXYGENE or VITAL AIR. Its powers, as far as I have hitherto tried them, have exceeded my previous conceptions. But as every substance, worthy of being regarded as a medicine, must be capable of doing much mischief when misapplied, I am under some apprehension lest mismanagement should bring this species of air into disrepute. Whenever it is administered to persons whose constitutions are not much reduced, nor their strength much impaired, it should at first be diluted with three times its bulk of atmospheric air; nor should this mixture be inspired above five minutes at a sitting three or four times a-day. The subjoined case of epilepsy, in which its effects did not correspond to our wishes, will serve to enforce this caution. Within these few days another confirmation of this rule has occurred to me: An asthmatic patient, finding great relief from atmospheric air mixed with oxygene air, unadvisedly determined to attempt to subdue his disease at one attack. By largely using oxygene air little diluted, he brought on some singular symptoms, but, I hope, without doing himself permanent mischief. I do not enter into further particulars at present, as I shall probably have an opportunity of laying this case before the public in the words of the patient himself.9
In several experiments with animals that had respired diluted oxygene air, I have found them upon immersion in water much more vivacious than similar animals that had breathed atmospheric air. Of these experiments I intend soon to give an account, together with a drawing and description of a chamber-apparatus for procuring and containing elastic fluids.10 In the mean time, it were to be wished that a number of persons would engage in this promising investigation. It might perhaps be determined, whether phthisical patients vitiate the air more than persons in health? — whether asthmatic patients, during a fit, vitiate it less, as Mr. Chaptal, I think, asserts?11 — An instrument for measuring the capacity of the lungs in different people might easily be contrived; and such an instrument might possibly be useful as well as curious.12 But heads of inquiry will occur to any one who considers this copious subject.
‘Supposing the proportion of ingredients in the atmosphere to be that best adapted to the average state of health, is it not likely that there may be certain deviations from this state, where that fluid body contains too little vital air,13 and other deviations, where it contains too much?’14 Your encouragement of the inquiry, will, I hope, assist in furnishing the solution of a problem, which is certainly one of the most important in physiology and pathology.
I am, dear Sir.
Your affectionate Friend
Thomas Beddoes
Hope-Square, Bristol Hotwells,
Dec. 24, 1793
Published: Letters from Dr Withering, of Birmingham, Dr Ewart, of Bath, Dr Thornton, of London, Dr Biggs, late of the Isle of Santa-Cruz, Together with Some Other Papers, Supplementary to Two Publications on Asthma, Consumption, Fever and other Diseases (Bristol [1794]); CJB, II, 1227-31
Notes
1. After some debate with James Watt, Henry Cavendish and Beddoes, Black had given up the doctrine of phlogiston and adopted Lavoisier’s oxygen-based system. See his letter to Lavoisier of 24 October 1790 (CJB, II, 627) and Beddoes’s letters to him of 6 November 1787, 23 February 1788 and 21 April 1789.
2. This letter was published by Beddoes as a dedicatory epistle to Letters from Dr Withering, of Birmingham, Dr Ewart, of Bath, Dr Thornton, of London, Dr Biggs, late of the Isle of Santa-Cruz, Together with Some Other Papers, Supplementary to Two Publications on Asthma, Consumption, Fever and other Diseases (Bristol [1794]).
3. Beddoes is quoting Erasmus Darwin’s letter to him of 17 January 1793 — a letter he had published in his A Letter to Erasmus Darwin, M. D. on a New Method of Treating Pulmonary Consumption, and Some Other Diseases Hitherto Found Incurable (Bristol: printed by Bulgin and Rosse, sold by J. Murray and J. Johnson, London; also by Bulgin and Sheppard, J. Norton, J. Cottle, W. Browne and T. Mills, Bristol, 1793), pp. 61-67 (p. 61)
4. In the version of William Cullen’s lecture notes that he published as First Lines of the Practice of Physic, 4 vols (London, 1778-84), II, 260 this remark appeared, less graphically, as the statement ‘a phthisis from tubercles has, I think, been recovered; but it is, of all others, the most dangerous; and, when arising from a hereditary taint, is almost certainly fatal’.
5. Referring to the testimony following this dedicatory epistle provided by William Withering, John Ewart (d. 1800), Robert Thornton (1768-1837), Benjamin Biggs (a physician from St Croix, Virgin Islands) and others.
6. In a letter to James Watt of 7 July 1794, Beddoes says that William Saunders (1743-1817) has introduced oxygen treatment to Guy’s Hospital.
7. Peruvian bark, containing quinine, was widely used against fever, though initially viewed with suspicion when brought to Europe by missionaries to Spanish America.
8. Inoculation against smallpox was commonly practised in the Middle East and India. It was introduced to Britain in 1721 as a result of Lady Mary Wortley Montagu (1689-1762) witnessing its use in Turkey.
9. Beddoes did so in Considerations on the Medicinal Use of Factitious Airs (London: printed by Bulgin and Rosser, for J. Johnson, 1794), p. 44.
10. Again, Beddoes did so in Considerations (1794).
11. In ‘Lettre de M. Chaptal a M. Berthollet’, Annales de chimie, 4 (1789-90), 21-24.
12. Devices for measuring lung volume were designed in the nineteenth century. These included the ‘Pulmometer’ (1813) and ‘spirometer’ (1846).
13. Oxygen.
14. Henry Cavendish published in 1783 and 1784 descriptions of experiments he had made to measure the composition of the atmosphere (eudiometry): ‘An Account of a New Eudiometer’, PTRS, lxxiii (1783), 106, and ‘Experiments on Air’, PTRS, lxxiv (1784), 119–53. In October 1800 Humphry Davy (1778-1829), while in Beddoes’s employ, measured the fraction of oxygen in the air in Bristol and at Tintern with an improved eudiometer. See Davy’s letter to Davies Giddy, 20 October 1800 (CLHD, I, 65-69).