Dr. Young to Joseph Warren: The World Is Not So Stupid as to Take All Your Trash for Granted by Wholesale

Fleam for use in Therapeutic Phlebotomy

in about Warren

Date: June 1, 1767

“To Philo Physic

An Arbiter between contending Parties needs as least some qualifications to give either the parties or the public an evidence of his right to intermeddle – Candour should be copied from somebody if the judge is wholly destitute of it himself – Manly sense and perspicuity could not be entirely thrown away on a subject of this importance.  “The grand question” whether Doctor Young be a downright murderer or not.  Pardon me Mr. Philo Physic if I do not transcribe you at length: as I shall however aim at some degree of perspicuity – Give me leave Sir to remind you that this “grand question,” in its first appearance to the world rested on another grand question, viz. Whether any but an ignorant empiric would presume to bleed in consumptions?  As an honest sensible physician a gentleman of approved abilities boldly declared he never had heard of such practice.  To convince the people of my innocence I published the case at large, and backed the proceeding with such authority, that Dr. Whitworth nor yourself have seen cause to plead ignorance any further in that point – And one would imagine Sir, that so independent, self sufficient, and original a genius would hardly have risqued his reputation, as a judge (whatever he might as an advocate) again, on the same bottom.  Yet such Sir is the fate of human nature, that notwithstanding all the force of imagination, all the readiness of apprehension, & all the strength of judgment, of which a man may conceive himself possest; a retrospect of some of his important actions may convince him, humanum est errarei: and some times so palpably that all his industry with the largest Lion’s skin, has not been able to cover a puny Ass’s ears. – Of which, let the following serve as a specimen – “The Gentlemen seem both to agree, that the woman had been sometime unwell, that at the time when this blood was taken she was vastly weak and emaciated, that an abscess had sometime before formed upon the lungs which had suppurated, and that the patient was at this time bringing up the matter from the ulcerated lungs by expectoration.”  Had a boy at a writing school collected and delivered such a view of this case from the publications, his absolute stupidity might well have warranted his total expulsion; sed quem Jupiter vult perdere prius dementatii – This agreement Sir, flows naturally enough from your pen, whence permit me to suppose it first issued.  In the first courtly piece for which I give your honor credit is said “she was at this time vastly weak, &c.” which I took to be the time your hero “first saw her” and noted it accordingly, to set it against another paragraph a little onwards, where one finds her quite robust, to the time of that barbarous transaction the bleeding – and had not the whole agreement sprung from your own files, could madness itself have infatuated you to publish my concession, that at the time of taking blood she was bringing up matter from ulcerated lungs?

Tho’ I may have neither ability nor inclination to read authors in whole or in part, the public might expect a Judge in foro justitiaeiii at least to take a cursory view of evidence published in the prints at large; where rests as strong a refutation of that position, as words can express: Nay the original account runs thus, “A few days before I saw her she began to expectorate, &c.” and from hence who can conclude that she did not finish as well as begin purulent expectoration before Doctor Whitworth or myself ever meddled with her?  I now declare that I carefully examined her discharges, and never discovered the least particle of pus in any of them.  But mark the hurry!  “There is nothing in this account that can in the least justify blood-letting and no judicious physician would prescribe it in such circumstances.  But Doctor Young asserts further,” &c.  Pray Sir, who wrote first?

As for Doctor Whitworth’s “history of the patient” that has been sufficiently analyzed already.  Your good nature, Sir, overpowers me, in admitting for truth any one article that Doctor Whitworth does not expressly deny: An’t please your honour, what one article of my full state of the case has he either expressly or implicitly denied?  None.  And while that remains whole and entire what is it to me or the world how many fictitious circumstances you assemble, to combat?  But again, after absolute condemnation I am remanded to the bar for another trial, which thus proceeds:

“It is very well known to every practical physician, that violent pain in the side and difficult respiration are often brought on by the lodgment of the sharp acrid matter proceeding from the ulcers in the lungs,” &c. and it’s great pity, Sir, that a gentleman of your assumed importance should not know, that, be the cause of that violent pain and difficult respiration what it will, bleeding is the alone remedy.  We hear again that bleeding checks expectoration, without discrimination in what circumstances.  Can you be so stupid as to think the world will take all your trash for granted by wholesale?  I know as well as you do, that when a tumor in the lungs, or any where else, is too far advanced to be resolved, bleeding is then improper: But so far is bleeding from generally having a direct tendency to check expectoration, that judiciously administred, it beyond all other methods promotes the freeing of the vitals. – You say it confines the acrimonious matter upon the lungs: Yourself or hero said it absorbed the purulent matter into the blood; but what is there to do will all this parade till something is offered to evince there being pus there?  Here again we have the event appealed to for proof of the latter theory, and what will it not prove in such expert hands, whose arithmetic finds that taking away a seventh part of the blood diminishes at least one quarter of the vital force?  The whole of the matter is, that fas aut nefasiv  something must prove that Dr. Young murdered the patient; nay, rather than fail, he must be persuaded that “after such an impartial view of the case” he would act wisely in generously acknowledging his mistake.  But hold, Rhadamanthus!  tho’ very complaisant in return of thanks, not altogether so free in confessions.  To preserve the appearance of justice in any measure, you should have arranged some number of facts against me, for which there was at least color of evidence – You might specei gratiav have mentioned some one thing in my defence, or censured Dr. Whitworth’s conduct in as gentle a manner as you pleased in plumply pronouncing sentence of death on the sinking patient, whose spirits no historian of her case gives us reason to suspect needed depression.  To hint I did not expect questions on the animal aeconomy from him, was only to suggest that I tho’t myself safe in his incapacity, but might fear greater things from you, which is really fact; for in such lengthy pieces, and so pregnant with matter, I know not what respondent would not find his match – In fine, you should have had positive evidence that the absolute reverse of my representation was true; which I confide the addition of all Dr. Whitworth’s ghosts to the present appellees, will scarce be able to maintain. –

In your trailing discourse on rel[ax]ation, you own “in a sanguinary plethora, taking away blood will, by restoring the equilibrium between the solids and fluids, give the vessels liberty to contract;” include a plethora ad vasa,vi   and what more need be said on the subject?  Is not the equilibrium between the solids and fluids the very scope and design of all medical application? on this certainly depends all the digestions, secretions and discharges; and without keeping this constantly in view, all your subtle reveries on the subject may for me pass to the next generation unanswered.  And not to insist too largely or push you too far into essay writing, left peradventure the world itself might not be able to contain the books, nor the angels to collect and dispose the matter. – In return for your “good nature,” “impartiality,” signal lenity, and deluge of admonition; would barely hint to you to study some kind of order in your future publications; that being at least ornamental to a Judge, to say no more of it. –

[- Dr.] Tho[mas]. Young.

i [Editor’s Latin translation]: to err is human.

iibut the one whom Jupiter wishes to destroy, he first drives mad.

iiiin a court of justice…

ivright or wrong…

v for the sake of appearance…

vi …an abundance with respect to the vessels…

Source: Boston Evening-Post, June 1, 1767, issue 1654, p. 3

Commentary: Thomas Young answers Philo Physic, the pseudonymous Joseph Warren, by questioning Warren’s reasoning in criticizing Young’s treatment and fatal outcome concerning Mrs. Davis. Young takes the tact of pointing out inconsistencies in the detail of Philo Physic’s analysis. Additionally, Young shows off his knowledge of Latin, questions Philo Physic’s impartiality, and calls out particular words like ‘perspicuity.’ He colorfully challenges his detractor: “Can you be so stupid as to think the world will take all your trash for granted by wholesale?”

We imagine the wags gleefully taking sides, in conversations over flip and rum, in Massachusetts taverns. Meanwhile the publishers of the Boston News-Letter and Boston Gazette had a story ‘with legs,’ as they published salvos from opposing medical voices week by week. The first appearance on April 16th of this story had been in a letter to the editor written by Thomas Young six weeks prior. And the worst, or best depending on how ones views such tabloid fireworks, is yet to come.

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