Public Satisfaction to See at Least One Blockhead Exposed to the Contempt We Both Agree Such Deserve

Fleam for use in Therapeutic Phlebotomy

in about Warren

Date: May 4, 1767

“Messieurs Edes & Gill, Please to insert the following.

Happy Continent, thrice happy Massachusetts, & even beyond a superlative Happy Boston, whose lot it is to be blest with so learned, so sagacious and disinterested a Physician, embellished as much as the Belles Lettres, as imbued with the art of Apollo.

Sad was my misfortune to resent the honest condemnation of so knowing a matter of art! I little tho’t what a torrent of Billingsgate awaited my devoted head! and were it not that gratitude demands my acknowledgment in more respects than one, I should scarce have troubled the Public any further with myself or my cause; but as deficiency in this article is the worst of crimes, suffer me to return to my most unfeigned thanks to the eminent Dr. M[iles]. Whitworth, for that.

He has told the world honestly, “that the patient’s first complaint was a vomiting of blood, which soon went off, but left a constant cough attended with pain at the stomach, and difficult respiration.”  Farther (as a fair state of the matter is here intended) we are informed, that “a few days before he saw her, she began to expectorate very freely a purulent matter slightly tinged with blood:” – This magazine of the descriptive part of medicine presents itself to us in a three-fold view.  First, we see the woman “a year ago vomiting blood; ever since a constant cough attended with pain at the stomach, and a difficult respiration.”  Here I think no gentleman of the faculty will accuse the Doctor of plagiary, or fitting a description to any intention: for the vomiting of blood left a cough, which would induce a common reader to suppose the very first flux of blood was from the lungs, and not from the stomach, which bowel is alone subject to the action of vomiting: what nature meant by joining pain in the stomach, with a difficult respiration, it might be reckoned a still higher aggravation of my already infinite presumption, should I attempt to penetrate.

Next, a few days before the Doctor came, “she began to expectorate very freely a purulent matter slightly tinged with blood”: this may indeed be true, and very probably is so.

Lastly, “she was at this time (we conceive the time the Doctor saw her) vastly emaciated & weak, had a low quick pulse, & great depression of spirits.”  This is all I think that the Autopsy of ille Magnus Latonius has deign’d to favour us with; and from this, the whole faculty of Physick is called upon to determine “the justice of the censure upon the Mountebank.” – I dare say but little for myself against so powerful an antagonist, but would beg leave just to enquire of any gentleman, whose views are only the disabuse and information of the Public, Whether a patient taken with an Haemoptysis or raising blood from the lungs, might not have a tumor raised, suppurated, and evacuated, and yet after all, succeeded by a second, third and fourth, or still further – And if so, whether it might not be as proper to endeavor the resolution of the last tumor by bleeding, as the first – or whether, from what the Doctor has said, it appear impossible that any inflam[m]ation or orgasm of blood should arise, that might warrant bleeding?

I have once assured the Public, and neither have had nor can expect contradiction, that the patient had inflam[m]ation, anxiety, &c. before the bleeding – that notwithstanding the bleeding, she had a farther Haemoptoe next day; and what more need be said on that head to satisfy any person of common sense in the universe?  Hence again, I thank the Doctor for his more accurate ascertainment of the quantity of blood taken, as I rather fear censure for taking too little than too much. – And thirdly, I thank the Doctor for the publick delivery of his honest and sensible prognostic on the 6th of Feb. which he found verified on the 13th of next month.  And fourthly, I thank the Doctor for his new theory of relaxation, as the bulk of authors suppose emptying the vessels gives them liberty to contract.  Fifthly, I thank the Doctor for his friendly suggestion of the plea of ignorance.  I am sensible to its use to many of the most vaporing censurers, as well as vile criminals, among whom I find myself so dispotically classed. – Sixthly, I thank the Doctor for his complaisance to the celebrated Authors bro’t to vindicate my practice; and that he has acknowleged me the capacity to read them, as his negation of either might have overturned the whole. – Seventhly, I almost adore the Doctor for his tenderness of the blood of his countrymen, and promise for the future never to take a drop from man, woman or child, in the town or province, unless I think it will do them more harm to keep than part with it. – I agree with the Doctor, that none of those gentlemen ever intended to encourage quackery, nor indeed need they, for Quacks seldom trouble their heads about them, as is evident from the figure they make, when they attempt to meddle with them. – Doctor Morgan forbids bleeding “in all deeply fixed radicated diseases.”  Huxham, “when once the phlegmon is too far advanced to be resolved, bleeding is really disadvantageous.”  Something equally shrewd are the two consistent observations. – “published his history of the case not with any regard to facts, but in order to exculpate himself.”  And then the subsequent “inconsistency of that relation,” A man who could read, might (one would think) transcribe a case from some Author in the neighbourhood, that would square pretty well. – But to pass on, He says “she took no medicine after she was let blood.”  This I should guess a fault of the press, had I not both the papers before me: But enough on Blunders.

I believe no pretender to medicine in this country ever did in so short a time send so many people prematurely to their graves”.  This at least shews the fellow has been employed.  “It is much to be regretted that a man who has nothing to recommend him but his unparallelled impudence should receive the least countenance in this place, where there are person of approved abilities.”  I agree again, that nothing is more worthy of regret, than the many scandalous impositions people have suffered from pretenders to physic; and to shew how fond I am to have such impostors detected, I hereby invite Dr. Whitworth to appoint in the public prints, time and convenient place, to state and answer (in writing) questions in all the arts, sciences and languages preparatory to a just and rational knowledge of medicine, the science of medicine itself, or any other science that becomes the gentleman, the scholar, or the physician; in which I shall, if life and health permit, attend him: and then the public will have the satisfaction to see at least one blockhead exposed to the contempt we both agree such deserve.

I have only once more to thank the Doctor for the unparallelled complaisance with which he condescends to treat my friends, “who with gaping mouths attend to my dreams.”  I know not that I exhibited on the subject of visions in other company that that of the faculty, neither of whom I presume would think it an overgrown compliment to be esteemed equal in sense or learning to Dr. Whitworth.

Some of the Doctor’s logic I confess I do not fully understand.  “I was offended at the impudence of the fellow who had thus stole in without ever consulting me.”  For my part, I always have thought that people had a right to send for whom they pleased, and chuse whether the latter must consult the former or no, without either theft or robbery in the case: But if patients be the sole property of their physicians, I rejoice in finding myself so much richer than I expected; for we are now on a footing with the watchmaker or gunsmith, who can keep the work till they have their pay.

But I much suspect this land of liberty will with abhorrence reject our claim.

The Doctor’s superb conclusion “to take no more notice of the stroller in this way,” obliges me to caution him against any other way which may further subject him to the lash of the laws of his country; to which his delicate performance has already too much exposed him.

Adieu, ’till next occasion, Tho. Young

P.S. Tho’ the above is more than sufficient for the learned, I have for the sake of the deceased’s friends, made this extract from my diary.  Feb. 13. ordered Hoffman’s sweet spirit of nitre, and a linctus of honey, parmasitty and a little balsam capivi, with honey’d barley water, cramberry sauce, &c.  20th continued with little variation.  24th. at evening bled, and order’d syrup of poppies.  Suppose I saw her on the 26th, but as I tho’t her circumstances low, did not charge the visit; neither did I the 28th, when I finally left her. – So that Dr. Whitworth found no material alteration till the 27th, tho’ she had taken my medicines from the 13th.  If she and her nurse deceived both him and me, it is not my fault – or if (which I much suspect) his visits were something rare, and his bed-side practice moderately related to his public exhibitions, it is nothing surprizing he found no remarkable alteration.  I believe his readers, both lay and learned, will struggle hard to know what he found – A man must be new in practice to think that the bulk of the faculty will slap dash come into his peremptory conclusion, that because a few days before he saw her, she expectorated purulent matter, she must therefore continue without alteration in that particular, till the 24th.  But as he has called on the gentlemen of the faculty in this or any other place for a justification of his censure – I heartily request every gentleman on the continent who may read and compare the relations, just as they stand, to publish their sentiments of justification or condemnation, as their honor and conscience may direct them.

[signed Dr.] T[homas].Y[oung].”

Source: Boston Gazette, May 4, 1767, issue 6314, p. 1 supplement

Commentary: Whig Dr. Thomas Young answers Dr. Miles Whitworth’s accusations of malpractice hastening the death of Mrs. Davis, a tuberculous consumptive. Young was the first to lay the controversy before the public as a letter to the editor of the Boston Evening-Post. Young did not name his accuser or the patient, rather focusing on a learned discussion of the clinical indications for therapeutic phlebotomy being appropriate to the controversial case. Whitworth answered the following week, identifying himself as the rival physician, hinting at the unfortunate patient’s identity, and colorfully labeling Young a dangerous quack who had stolen his patient with fatal results. The first two letters appeared in the Boston Evening-Post. This letter by Dr. Young appeared in the Whig-leaning Boston Gazette. Perhaps the Gazette’s editors and publishers Benjamin Edes and John Gill sensed a tabloid type controversy “with legs” and wanted to obtain part of an uptick in circulation for their newspaper.

The controversy so far possessed no overt political orientation, though subsequent events may have proven such a classification inaccurate. Come back to future postings as, despite Dr. Thomas Young’s best efforts, this controversy came to involve Dr. Joseph Warren and comically grotesque content.

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