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The Fitzpatrick Lectures
delivered in ig$o & igji at the
Royal College of Physicians
WILLIAM BROCKBANK MA MD (Camb) FRCP
William Heinemann Medical Books Ltd, London, 1954
FOR MY FATHER
First published .... 1954
Reprinted 7,955
This book is copyright. It may not be
reproduced in whole or in part, nor may
illustrations be copied for any purpose,
without permission. Application with
regard to copyright should be addressed
to the publishers.
Printed in Great Britain by W. S. Cowell Ltd
at the Butter Market, Ipswich
By the same Author
PORTRAIT OF A HOSPITAL The bicentenary h istory of the Manchester Royal
Infirmary
AN HISTORIC ADDRESS Delivered at the bicentenary celebrations
The Author is grateful for permission to reproduce illustrations and quote from
recently published books as follows:
The Director of the Wellcome Historical Medical Museum and Library (illustrations on
pages 16, 17, 18, 19, 28, 29, 47, 56, 68, 75, 77, 85, 91, 92, 145, 150, 151).
The Editor oî La Presse Médicale (illustrations on pages 17, 44, 48, 49, 57).
Ferdinand Enke of Stuttgart (illustrations on pages 24, 42, 43, 45).
The Directeur of Aesculape (illustrations on pages 44, 47, 71).
The Editor of the British Medical Journal (illustrations on pages 59, 60).
The Director of the British Museum (illustrations on pages 26, 74).
The Editor of the Lancet (illustration on page 57).
The Editor of the Proceedings of the Royal Society of Medicine (illustration on
page 59)·
The Editor of the Journal of the Royal Anthropological Institute (illustration on
page 53).
The Director of the Gruuthuse Museum, Bruges (illustration on page 27).
Messrs. Victor Gollancz and Messrs. A. M. Heath & Co. for a quotation and
reproduction on pages 98 and 99 from Evelyn Eaton's Every Month was May.
Messrs. Seeker & Warberg for a quotation from George Orwell's essay 'How the
poor die' from his book Shooting an Elephant.
Messrs. Watts & Co. for a quotation from Sir Arthur Keith's Autobiography.
A few of the remaining illustrations are from books in the Library of the
ROYAL SOCIETY OF MEDICINE. The remainder are reproduced from books
and prints in the possession of MANCHESTER UNIVERSITY MEDICAL
LIBRARY.
rets*ce
IT WAS A GREAT HONOUR to be invited to give the four Fitz-
patrick Lectures at the Royal College of Physicians during the years
1950 and 1951. After a good deal of thought I decided to tell the
story of a number of the older therapeutic procedures that had
dominated medicine for centuries and played their part even at the
sick-beds of reigning monarchs. This subject has interested me for
a long time. Cupping and leeching and the various methods of
counter-irritation have never been effectively dealt with in the his-
tories of medicine; nor has the enema. It is true there are excellent
papers on this latter subject in the journals, notably that by Frieden-
wald and Morrison, which has been a great help to me. But there
was interesting material that had not been included by these authors
and the pictorial side of the story has never been reproduced ade-
quately. The choice of the subject for the fourth lecture was difficult.
I was anxious to find one that was interesting and historically obscure.
Eventually I decided to recount the history of the intravenous
injection of drugs. I can only hope that the lectures now recorded
in print will provide the reader with as much interest and delight
as they rewarded the writer.
References
A major difficulty was presented by the large number of illustra-
tions and bibliographic details included in the book. The reference
numbers to these threatened to obstruct the smooth reading of the
text. It was eventually decided to deal with the problem in a some-
what unusual way. The bibliographic details will be found at the
end of each lecture arranged in sections. If the quotation from an
author's work in any section refers to one or two books only, no
figure or date has been inserted in the text, but the reference will be
found at the end of the chapter. Wherever possible the anachronistic
method 'Hippocrates (1936)' has been avoided. It is hoped and
believed that scholars and students will have little or no difficulty
in turning up the source of a statement or quotation. It is also hoped
that the reader will not be infuriated at the reference numbers that
have forced their way into the text. Wherever possible these have
been inserted at the end of a paragraph.
Acknowledgements
I am much indebted to many of my friends for help and advice.
Dr. Harvey Flack has used his editorial experience on my text and
illustrations to their great advantage. Dr. E. Ashworth Underwood
has put at my disposal the vast collection of apparatus, pictures and
books in the Wellcome Historical Medical Museum and Library.
Mr. O. R. Corbett, B.A., and Mr. John Lingard, B.A., of the Man-
chester Grammar School, have helped me with Latin and French
translations, and Mr. H. J. Pearson, M.A., of Manchester University,
has also given me the benefit of his knowledge of Latin. Mrs. Frida
Bier has covered my deficiencies in the German language. Professor
H. W. Fairman, of Liverpool University, and Mr. Burton-Brown,
B.A., of Manchester University, have helped me on matters con-
nected with Egyptian papyri and the exact meaning of heiro-
glyphics. Their work has been invaluable and has enabled me to
check original sources.
Mr. George Wilson, the Librarian of the Manchester University
Medical Library, and his staff have produced innumerable old and
new books for me with astonishing willingness and speed. On the
rare occasions where they have failed me, my wants have been
supplied by the Librarians of the unrivalled Wellcome Historical
Medical Library and of the Royal Society of Medicine. Without
their help these lectures could never have been prepared. I was
particularly fortunate in having a library so rich in old medical
books in my home town.
The photography has been done with great skill by Mr. J.
Killshaw, Mr. R. Schofield and the staff of the Department of
Medical Photography at the Manchester Royal Infirmary, working
under the direction of Dr. Robert Ollerenshaw. Their work is a
vital feature of my book and has been displayed to full advantage by
Mr. David Gwynn. The distinguished lay-out is entirely his work.
Finally I must thank my publishers Dr. Johnston Abraham and Mr.
Owen R. Evans of William Heinemann Medical Books Ltd. It is
a real pleasure to work with them.
W. B.
Manchester,
February 1954
Che (jrr^cieyyt (ytrt
^ J V I C V ^ I^ ^ T ^ V ^ | | V | Î 5 f r t * ^ t ' Î ^ V|
JOHN HEYWOOD'S Play called the Four P's is first known in print in
1545 and is a familiar document in the history of English drama. In
it a Palmer, a Pardoner and a Potycary argue about their merits.
The Palmer boasts of the shrines he has visited and of the spiritual
merit he has won. The Pardoner asserts that his relics and pardons
are a much easier and safer way of saving souls. The Potycary
claims that he alone is the true soul-saver, since it is by virtue of his
medicines that people get their start towards Heaven. The fourth P,
the Pedlar, walks on, and it is suggested that he should decide which
of the three was the best soul-saver. He declined so responsible a
duty but readily agreed to judge which could tell the best lie. In
due course the Potycary described the case of an incurable epileptic
girl:
And though for life I did not doubt her
Yet did I take more pain about her
Than I would take with my own sister
So at the last I gave her a clyster.
I thrust a tampion in her tewel.
By this he meant an enema of gunpowder, 'Tampion' being a
gunnery term and £tewel' meaning a tail and, hence, the anus. This
when fired threw her ten miles through the air to a castle strongly
built of stone, which she wrecked so completely that no stone was
left standing on another.
As a result she was
Delivered with such violence
Of all her inconvenience
I left her in good health and lust
And so she doth continue I trust.
After so valiant an effort it is a matter for regret to have to record
that the Potycary did not win the contest. 35· 72 jo
