AN OLD-TIME IRISH PHYSICIAN

New Zealand Tablet, 23 January 1913, Page 45

AN OLD-TIME IRISH PHYSICIAN

(By James J. Walsh, M.D., in the Ave Maria.)

Not long since I picked up, in the Proceedings and Papers of the Kilkenny and Southeastern Ireland Archaeological Society, a reprint (Vol. V., No. 55, New Series, January, 1867), of an Irish physician's fee book of the early part of the seventeenth century. He began practice about ten years before Harvey published his description of the circulation of the blood (1628), and just three years after the death of Shakespeare (1616). In this fee book he gives brief accounts of what was the diagnosis of the cases of his patients. It would be very easy to think that three hundred years ago a physician's names for the ailments of his patients would have been very different from those employed at the present time; but this proves not to have been the case; and the people of the neighborhood of Limerick where Dr. Thomas Arthur, of the family of Fitzwilliam, though as a rule he goes under the name of Dr. Thomas Arthur, seem to have suffered from about the same sort of symptoms, grouped together under names that very much resemble those used at the present -time. His whole career has other similarities with present-day conditions in medical practice, and contrasts with what might be thought of in it because of his place in history that make it interesting to physicians and their patients in our time.

Dr. Arthur's Diary, or Fee Book, is rather different from that of the modern physician on two or three noteworthy points. In the first place, it is kept in Latin. The Latin is rather good as medical Latimty goes, and evidently Dr. Arthur could use it familiarly and without effort. This is not surprising; for, of course, all the teaching at the universities was done in Latin, also all the text-books were written in that language, even on medical subjects, until well on into the eighteenth century. This would seem to many people an unfortunate thing; for men would first have to learn Latin, and then learn to use it, and it might be argued that their expression would be stilted and incomplete as the result of using a foreign tongue. As it is, our important medicine is written in six different languages; wiiile papers are read at international medical congresses in at least four English, French, German, and Italian; and now Spanish and the Slav tongues are clamoring for recognition. A man who does not know at least four European languages is handicapped when he wants to study a medical subject thoroughly; and a man who knows but one is usually so much discouraged as to give up attempts to consult the literature. The difficulty is so great in this matter that there is serious question of taking up one of the modern invented simple languages as the universal language of science. In the old days everyone learned Latin as a portion of the preliminary education; and, having used it familiarly in the university, from six to ten years, was sufficiently conversant with it to use it almost as his native tongue, and then he was at home wherever he went. All lectures were in Latin, all the books were written in Latin, and our modern difficulties of understanding were not encountered.

'There seems to have been another reason for using Latin in this diary, and that was to preserve the professional secrecy which the physician owes to his patients. A book of clinical cases often contains rather startling confessions, and it is not proper that they should fall into the'hands of those who might use them to the disadvantage of patients. If written in the vernacular, it -is not impossible that servants or even strangers might get a glimpse into them with sad results for the professionary secrecy. -

There is 5 another way in which this professional fee book of the old-time Irish physician differs from such documents of professional life at the present time. Perhaps we should say that, at least as a rule, this difference might be noted. The first entry in the diary consists of the Holy Names written out thus with a cross between them:

Jhesus * Maria, Ano Dni 1619.

Then follows in good Irish fashion the Sign of the Cross written out fully in Latin: In nomine sanctce et individuce Trinitatis, Patris, et Filii, et Spiritus Sancti, Amen. Next comes the only English in the book. It is spelled according to the practice of the time, but that practice was so different from our custom as to be indeed notable. It is, of course, the spelling of the first folio of Shakespeare, which was printed within a few years of the date when this diary was begun. To read it is to have abundant thought for reflection on the arguments of those who insist that if we change our spelling so as to make it more rational we shall depart from the English of the classic writers, and confuse the origins, etymologies, and, as a consequence, also the significance of the words. This paragraph runs:

' Thomas Arthur Fitzwilliam, doctor of physick, came from Paris to Lymerick, on the 14th day of May, in ano Dili 1619. Since then God blessed him in his practice, by which he gott what feese hereafter enseweth, for which, with the rest of God's bountiefull benefitts conferred uppon him, he alwayes rendereth most humble and hartie thanckes to the euernoweing Offspring of all goodness, God.' A little sketch of : c The Education of this Old-time Physician

has many points of historical interest, political as well as religious and academic. Dr. Thomas Arthur was born on the eve of St. Catherine Martyr, A.D. 1593. It is he himself who notes the date thus. At that time the Penal Laws against Roman Catholics-, were in force, and it would have been impossible for young Arthur to enter at Trinity College, Dublin, or at either of the English Universities* Not only would there have been danger to his faith, but he would have had to take the oath of the King’s supremacy as head of the Church as well as the State, and of that no member of his family would think for a moment. The Fitzwilliam family to which he belonged had come into Ireland late in the twelfth century, just before King Henry 11. acquired control ; and royalty conferred upon it many favors. In the next century the Fitzwilliams filled the office' of Mayor under Edward 1., and for five or six hundred years after that they occasionally held the highest positions in the Church and in the ' corporation of Limerick. A biographer says of them : ‘To the Church they were munificent' benefactors; and to the corporation they gave in eclat, by the splendor of their riches and the admirable manner in which the deeds of some of the family were recognised and awarded by the Kings of England.’

It was to such people that the Penal Laws now forbade university education. Besides, these same laws made it impossible for them to enter the army or navy or the civil service, or to become members of the Bar. All these professions required the taking of the oath of supremacy. It was because of this that, in the seventeenth and eighteenth centuries, so many Irishmen who wanted to take up the military profession entered the armies of foreign States. We know what a good account they gave of themselves. -It was they who tempted Marlborough to say, ‘ Cursed be the laws that deprived me of such soldiers This fact, however, of being unable to take up any profession except that of medicine (for in the medical profession no oaths were required), did much to turn the attention of many brainy Irishmen to medicine, and they made a magnificent success of it. We have the records of

A Number of Distinguished Contributors to medicine in the seventeenth and eighteenth centuries ; and the tradition of good medical work continued into the nineteenth. If the contributions of Irish physicians to medicine as written in English were to be erased it would make as great a lacuna as if the contributions of Irish writers to English literature were to be obliterated. Without Moore, Goldsmith, Sheridan, Burke, Swift, Steele, Grattail rtnrrn.n "Dpm'a TTlm-onno A/T^Po•»•+V.-r» r\>n 11 _ , „„_-.„„, Jw r„—.„ JU.UVIH "■"J' , \-T WUUOU, Davis, Mangan, there would indeed be sad gaps in our English literature,— greater, however, than would be made if the achievements of the great Irish School of Medicine of the nineteenth century— Stokes, and

Graves, and Corrigan, to whom we owe so much important medical progress, : were. to be omitted. Not being able to receive their education at home, young Irishmen like Dr. Thomas Arthur went abroad. Even when they became physicians many of them stayed abroad to practise. Noe a few of these achieved distinction in practical medicine. O’Higgins was King’s physician in Spain, at the time of the Emperor Charles V. Dr. Quinlan, a Carick-on-Suir man, was physician to the Emperor of Russia, under whom he realised a fortune. In the eighteenth century, Dr. Thomas Hearn, of Waterford, was physician to Duke Godoi of Spain, who was known as the Prince of Peace.

Dr. Arthur, then unable to obtain an education in Ireland, went to the Continent, where he spent about five or six years, perhaps more, in the University of Bordeaux. After this he was admitted to the role of the Masters of the Medical Faculty of Paris, where he was assigned’ to the ‘ Society 'of the Most Constant German Nation.’ The students of the University of Paris at this time were divided into Nations, according to the part of Europe from which they came. Those from North France were grouped together as one nation those from South France and Spain, as another; those from Germany and England, including those who came from Ireland, as a third; and those from Italy and countries to the east of Europe, as the fourth. How the Irish were satisfied to be classed as of the German nation we have no record. The nations were combinations of students for protective purposes, and for the facilitation of the students’ material affairs at the University. The officials of the different nations secured quarters for the students, intervened in any disputes between students and landlords or merchants, represented them when there was trouble with the faculty, and in general acted as intermediaries to secure justice from the townspeople and proper respect from the gownsmen for their members. They represented in a certain way the students’ arbitration or advisory committee, that has been reconstituted in many American Universities in modern times to represent students before the faculty. We are likely to think such institutions new, but they are only restorations of old customs and privileges that had been worked out in the medieval university days. These customs, good and wholesome as they were, were largely supported by the churchmen and carefully respected by ecclesiastical officials. When the Church no longer represented' a co-ordinate authority to the State in University matters, these customs gradually fell into abeyance. Government had no sympathy with them, and the rights and liberties of university students went the same way as the rights and liberties of the peoples and the nations at the time of the socalled Reformation.

In Paris, however, the old customs were maintained until Napoleon’s time; and it is rather interesting to find some of the entries in Dr. Arthur’s common-place book as a student. There were certain fees ( solaria ) that students contributed for church purposes and other celebrations. There is a note of ten shillings paid as an honorarium for Masses to be said for deceased . students; and a like sum when he was in attendance at the Mass for the soul of Mary Stuart, whom -we know as Mary Queen of Scots, and who, it will be recalled, was put to death some fifteen years before Dr. Arthur left the University of Paris. There were faithful hearts thinking of her still in Paris, where she had been a happy, beautiful, lively dauphiness, with no premonition of the fate in store for her. Then there is sixteen shillings paid for his share of the expenses of a huntius to the Bishop of Tuam. Evidently, students contributed rather generously, considering the value of money in those days.

The Diseases from which Dr. Arthur's patients suffered have strangely familiar names, even as they come to us through the Latin. On the second day of his practice he saw a patient suffering from putrid sore throat, very probably a diphtheria. The next day there was a young man suffering from a feverish condition due to obstruction of the liver. Then came a pleurisy; then a bradypepsia (a nice long name from the Greek, mean-

ing slowness of digestion). ; George Eliot once said, ‘We map out our ignorance in long Greek names’; and the physicians had the habit even in the early part of the seventeenth century. Then there- was a patient suffering from dysentery; then one with a warm dyscrasia of the liver, whatever that may mean; though it expresses as much as our modern biliousness, which covers a multitude of symptoms and affections. Then there was a maxillary abscess and a stomachic cardialgia —that is, a disturbance of sensation of the heart, perhaps even of pain due to the stomach. There was a palpitation of the heart and an hysterical dropsy; and a lady suffering from hysteria, and another from headache, though Dr. Arthur calls this by the nice long name cephalalgia, surely as satisfying a word as our modern neurasthenia. Occasionally there were children suffering from worms; and then, as the winter comes on, there are many pleurisies, some of which we might strongly suspeefi as tuberculous in origin; then eye troubles of various kinds, and an occasional mental disease.

These names of the diseases so like our own for. which Dr. Arthur treated his patients, and for the treatment of which he got such good fees, considering the value of money, bring home to us a vivid picture of his practice. His usual fee was five shillings. We commonly., say that -in Shakespeare's day- money was worth seven or eight times what it is at present, so that five shillings would indeed be a large '■ sum of money. This seems to have been for the full treatment of the various diseases of the patients, and %e have no record of how much he charged ■ a visit. '; During his first year in practice he made ; ; £74 Is Bd. That would be 350 dollars in our money, and probably, over 2000 dollars in the values of our time; for the purchasing power of money was ever so much greater. - Our high prices have played / sad havoc with the value of wages. I showed ."in the second edition of my Thirteenth Centwry, in response to objections about the misery of the working classes of the old time, since they got such low wages that, though the workman of the Middle Ages, got only eight cents a day (that was the minimum wage as determined by act of Parliament), he could buy much more for the eight cents than the ordinary workman can now with the two dollars or two dollars and a-half ho receives per day. For instance, the maximum price of a pairof hand-made shoes, as established by the same law that made the minimum wage eight cents, was in English money fourpence or eight cents. No workman can now buy a pair of hand-made shoes, or any sort of shoes, for his daily wage. People who talk much about the improvement of the workman's condition as a consequence of high wages in modern times, should consider such facts, and realise how foolish are many modern contentions with regard to better conditions in the modern time. High prices for necessaries more than counterbalance high wages. Facts are not truths unless you have all the facts. . - ;? ■ , . f-f Professional Fees

have always been maintained at a high standard whenever medical education . has been taken seriously. The professional fees as set down in the Code of Hammurabi, more than 2200 years before Christ, show that professional men have always received good rewards. The ordinary fee in Babylonia 4000 years ago for a serious operation on a wealthy man was equivalent to the wages of a workman for a year. The middle class had to pay ■ only half this fee, and the . working class less than one-fifth, but the standard is strangely like that of our own time. Dr. Arthur seems to have, been able to maintain an excellent standard of fees; and, though we would be likely to think of Limerick in the early part of the seventeenth century as not containing many well-to-do people, it was really a city of great importance commercially; . and /there _ must have been many people able J and. willing;'to pay a good doctor good fees. ' v * . '" - :.':, : " : L : _ - (To be concluded next week.)"