Complete Text (Part 2)

the greater the crowd the bustle and the hum of business, the more complete is the depression of spirits of a young and unfriended stranger about to take up his residence in it. More especially must this be the case in London, where there is nothing to in- vite abroad ; no seene of public sociability, as one might term it, in whieh the pleasure of the many is reflected on the solitary observer. All he sees, whether of men in high station or rolling in wealth,—whether of public institutions or personal possessions,—is repellent. There is something, moreover, in the gloom of a London sky, and the dense and murky vapours of London air, which is sedative and nareotic—stupe- fying to even the elastic spirits of boyhood. At least such are our own reminiscences. Allowances must be miade, also, for the natural susceptibilities of Dr. Armstrong; and we may add another considera- tion,—his want of a decided fondness for, and knowledge of, general literature. If there be a balm for the depressed spirits of the poor and solitary professional man, hoping for, but yet doubtful of, employment and income, and yet conscious of his having intellectual energy for the struggle and of the goodness of the cause in which he is embarked, it will be found in a communion with the master spirits of by-gone ages. Nor is a knowledge of this nature incompatible with zealous profes- sional observation and skillful practice. Within a year from the time of Dr. Armstrong’s settling in London, his prospects of practice were very much improved. He published his opinions on various practical subjects ;—on Measles, Scarlet Fever, Consumption, Chronic Diseases, Sulphureous Waters, External and Internal Inflammation, Insanity, &c.—and his plain and unpretending OF DR. ARMSTRONG. xiil manners secured him many friends. His fondness for his profession led him in his conversation, as in his writings, to dwell minutely upon common points of practice, on which, without offending the prejudices or alarming the pride of his hearers, he beeame a great authority ; and he possessed what we believe is always found to be a substantial recom- mendation to success in medicine, an almost exclusive attachment to it. There was this peculiarity about his mode of expressing himself, that his carnest dwelling even upon matters taught in every elementary book, made the hearer believe the ideas were as original as he sincerely appeared to consider them. The volume on the subjects just mentioned had less novelty than that on Typhus, but it fully maintained, Dr. Boott thinks, the reputa: tion which he had previously acquired. This author then quotes the opinion of a writer in the Edinburgh Journal, as follows: “We are at no loss to discover in it traces of the same master-hand, of the same talents for observation, the same fidelity and boldness in the delineation of discase,—the same ingenuous modesty in the reprobation of old, or the exposition of new doctrines and practices.” On the other hand, it has been alleged, that the very preface to this volume shows that the sedateness of mind maintained throughout his treatise oa Fever, had been disturbed by the praise he had received. But we must continue the thread of our narrative of the professional advance of Dr. Arm- strong, and, at the same time, notice a check from the London College of Physicians, which, by wearing the appearance of persecution, even- tually contributed to his triumph. Within the sphere of our own acquaintance or reading, we, says author of the review in the London Journal, so often quoted, can find no example of a rise so rapid as that of Dr. Armstrong, from eom- parative obscurity to a large practice. He was already a distinguished physician when he pr sented himself, as all graduates of other univer- sities than Oxford and Cambridge are under the necessity of doing, before they attempt to practice in London, to the College of Physi- cians for examination and license to prescribe. Much to his own vexa- tion, and not a little to the surprise of hiv admirers, he was rejected by Vou. 1—b xiv LIFE AND WRITINGS the College. Dr. Boott thus speaks of this remarkable incident in the life of his friend :— “He had, perhaps, undervalued the estimate which the Board of Examiners place on classical diction, and the alphabet of the profession ; for this distinguished physician, who had received a diploma from the most efficient and most celebri ed school of medicine in Great Britain, who had been in successful practice eleven years, and was the author of three of the most popular works which the medical press of this country had ever put forth, the fame of which was still sounding in the periodical journals of the day,—was rejected as incompetent to con- tinue in the practice of his profession in London, and as undeserving the honour of having his name enrolled among the members of the College. “This publie stigma, of the justice and motives of which I leave others to judge, was not without its natural and perhaps salutary effects upon the sensitive mind of Dr. Armstrong, His nature was mild, but too dignified to submit to insult and unmerited wrong, which threatened injury to his own reputation, and ruin to the welfare of his family. He did not admit the necessity of any particular attention to his pro fession to qualify him for passing the usual examination the next year, as he was aware that the first rejection was generally the only one. But he felt roused to the due assertion of his own claims to respect: and from the impressions which this act of wanton power made upon him are to be ascribed much of that indignant tone which afterwards sounded in his lectures on scholastic institutions.” ‘That his professional brethren, with a full knowledge of his valuable contributions to medical science, and of his powers of careful obsery- ation and successful practice, should not attach any importanee to the proceedings of the college, is quite natural, But the strongest proof of ‘is conduct in this measure being unpopular, aud inno way impeding Dr. Armstrong’s advancement, was that furnished by the conduct of the trustees of the Fever Hospital of St.’Paneras. ‘These gentlemen not only elected him physician, but suspended the by-law which made it necessary for a person holding such office to be a member of the college. OF DR. ARMSTRONG, xv We learn from Dr. Boott, that the introduction of Dr. Armstrong into general practice was through the instrumentality of his professional brethren ; to a few members of whom or to their families he acted the part of medical adviser. ‘This eonfidence became more and more general, and it has been said, and it is believed truly, that during the eleven years he resided in London, he was ealled upon to attend more medical men than any other member of the profession. If to this ei eumstance we add another, that those families who had had once an opportunity of feeling the effects of the gentleness and delicacy of his manner could think of no other adviser, and we have the two causes of his suecess in London. “ He had the faculty of communicating his ideas to other: in the most easy and intelligible manner, and, from the fertile resources of his own mind, of throwing light upon the most obscure and involved cases. Those difficulties which embarrassed common minds seemed at once charmed away by the magic influence of his own; and his opinions were delivered with so much eandour and: perspieuity, that while others bowed before the superiority of his intelligence, they were instinctively impelled to place the fullest con- fidence in his skill and integrity, and to feel an irresistible affection for his character as the man, blending with their admiration of his talents as the physician. His manners were simple almost to a fault, and were at first forbidding, from the absence of every thing like an attempt at effect: but no sooner did he enter upon the consideration of a case, than it was apparent he was completely absorbed by it. His seeming reser at once gave way to a visible feeling of deep and tender interest in the welfare of his patient, who felt satisfied that he was in the hands of an amiable and a sagacious man, to whom he might confidently intrust himself’? One of the first instances of his introduction to practice, soon after he settled in London, was in the family of the late Mr. C. T. Haden, himself a distinguished practitioner. ‘The patient was Mrs. Haden, who had been se’ d with puerperal fever. ‘The husband from the first despaired of her recovery; but having heard that Dr. Armstrong had settled in London, he instantly determined to go in search of him: and in a state of the most distressing anxiety he hurried from home, xvi LIFE AND WRITINGS and inquired at every druggist’s shop that he passed in Piccadilly, but in vain, At last he fortunately met with a gentleman who had resided in the north of England, and who directed him to the residence of the Armstrong instantly ordered a large deple- object of his search, “ Dr. tion, which was repeated a second and a third time, and within eight or ten hours from the time of Mr. ITaden’s leaving home in a state of despair at the condition of his wife, he saw her, in his own opinion, out of danger; and her rapid recovery impressed him with feelings of profound gratitude towards the stranger whose assistance he had so urgently sought.” A case of the same kind occurred in the family of the late Mr. Hor- er-in-law nidge, surgeon, of Great Ormond Street. ‘The patient was ed with the decision and success to this gentleman, who was so impr of Dr. Armstrong’s practice that he drew up an account of the ease for publication, In the years 1820 and 1821, Dr. Boott attended his practice in the Fever Hospital, and he bears strong, and we doubt not just, testimony to Dr. Armstrong’s conscientious discharge of his duty in that adm! able establishment ; in fact, to his humanity, urbanity, and punctuality. situation could be more interesting to a physician whose attention fover, and the daily experience had already been so much occupied w of such an institution would at once show him the limits of his former experience, and the many yet undescribed varictics of continued fever. In 1821, Dr. Armstrong first became a lecturer in the school esta- inger ; and his fluency, bli animation, and the general kindness of his manners, soon ensured him ion of shed by the late distinguished Mr. G a high degree of popularity among the students. Of his po the higher qualities of a lecturer his biographer speaks ia language approaching to enthusiasm. His tirst was the only one he ever gave from an entire manuscript; for his habit was to lecture from notes, Dr. Boott says: “I have in my possession all his note books, which are generally wholly unintelligible to me, as they consist of words without any immediate connexion. Many of his lectures are com- prised in a few pages, written in a neat hand, the lines beginning with * a capital letter, and placed wide apart, for the facility of catching the OF DR. ARMSTRONG. xvii thread of his discourse; and the names of persons frequently occur, whose eases he detailed in illustration of his views and treatment of disease.” The biographer refers to a valuable manuscript copy taken in the lecture room by a very intelligent pupil, Mr. Rix of St. Neotts, and adds, what miust apply to all oral instruction delivered by an author himself: we have lost much of that elegant style, and that d Of the estimation in which Dr, Armstrong copious reference to particular facts, which made them so attractive instructive to his hearers. himself held the copy taken by Mr. Rix, proof is furnished in the lithographed copy of his letter addressed to this gentleman, and inserted in the preface to the first volume of this edition of his Lectures. Though it be somewhat long, we shall insert here Dr. Boott’s account of the impression produced by him when lecturing, and of his qualifi- cations for the task. Asa lecturer Dr. Armstrong was preéminently successful : he always spoke from the fulness of a mind rich in a store of facts, which he had collected from his sagacious observations of disease. He was not so deeply read in the learning of his profession as many teachers have been, and scldom quoted the opinions of others, He had attentively perused the modern medical literature of his country; but did not often allude to it, exeept in the case of the illustrious Sy- denham, whom he considered the first of physicians, equal to Hippo- crates in powers of observation, and superior to him in practical skill. His mind had originally imbibed its impressions of disease from others, and traces of these engratted opinions are visible in his earlier publica- tions. But when he entered on the praetice of his profession, he soon saw the discrepaney hetween scholastic axioms and the phenomena of uature; and endowed with admirable powers of discerament he soon abandoned the beaten track; and with that instinetive confidence which genius bestows upon its possessors, he opened to himself a new path to usefulness and distinction, whieh he triumphantly followed to the close of his short and brilliant eareer. “ One of the most striking characteristies of his mind was a power of generalization, which enabled him to grasp at once a complicated subjeet, and to view it from an intellectual elevation unattainable by men of ordinary powers. He had at the same time an extreme simpli- be sili LIFE AND WRITINGS city, and as it were modesty of judgment, combined with a keenness of mental vision, which made him sensible of things too familiar to arrest the observation of others; so that while they were often lost in the misty atmosphere of their minds, which obscured some points and distorted others, his calm and clear intellect in the equable light it dif- fused around, perceived and noted al! existing phenomena, without undervaluing what was minute, or exaggerating what might be of more prominent proportions. « These were the sources of his superior sagacity, and they eminently characterise the man of genius.” Such praise, says the reviewer, from whom we freely borrow on this oceasion, without however fully coinciding with him in all his views of the subject of this memoir, convinces us more strongly of Dr. Boott’s admiration for Dr. Armstrong than of Dr. Armstrong's possessing exactly the qualities desirable in a teacher of practical medi- cine. It impresses us with a belief of the irrelevancy of the topics. and the unrestrained declamation which we have often been told were- occasionally touched upon and indulged in. Testimony is borne out by the same authority to the value of the Lectures which we introduce now for the first time, in book form, to the notice of American medical readers. We should be doing injustice to the work were we not to transcribe the language of the reviewer on the subject. “Tt is not that we are insensible to the peculiar merits of Dr. Arm- strong’s Lectures, as exemplified in the spirited transcript of them edited by Mr, Rix, and the fidelity of which is unquestionable. We admire, in almost every page, the precise and cautious practical directions ; the striking allusions to instructive cases; the urgent recommendations of the pupils to be careful, to be diligent in observation, to avoid hurry and heedlessness, to be attentive to the poor. Nothing can be more ex- cellent than the rules laid down for all the parts of the delicate manage- ment of fever patients; nothing more judicious than the general in- structions arising out of the lecturer’s perfect knowledge of mankind, and his perfect descrimination of the relative characteristics of the upper, the middle, and the poorer classes, lis prudent admonitions respecting the employment of some of the heroic remedies, as mercury, OF DR. ARMSTRONG. xix arsenic, and colchicum, attest his powers of observation and his practi- cal merits. We do not quarrel even with a few eccentricities, such as a depreciation of what are called saline medicines, which are so univer- sally refreshing to patients in febrile disorders ; and an unaccountable prejudice against the term constitutional, to which Dr. Armstrong was unable or unwilling to attach any definite meaning. But there is stil] much, very much, in the lectures, of which we cannot but most strongly disapprove. There is a frequent affectation of simplicity, or of what Dr. Boott has indulgently called dressing medicine in artless guise ; of which the rejection of the term pericardium, and the subst tution of the inelegance of ¢ bag of the heart’ may be taken as an ex- ample. This was done, no doubt, to avoid a word derived from two Greek words, taught ‘in schools and colleges.’ Yet to avoid this learning, some inaccuracy was incurred.’” Some strictures follow on the author’s depreciation of Cullen Though, in justice to Dr. Armstrong, we ought to mention, that his eri- ticisms are more specially directed against the nosological system of the Scotch professor: nor do we deem it necessary, at this day, to attemp! to defend the errors in pathology and practice of this celebrated man. Besides his Lectures on the Praetice of Physic, Dr. Armstrong de- livered a course of lectures on the Materia Medica. He had not paid any particular attention to the practical details of pharmacy, and his lectures were very general on the subject. Ile fitted up an extensive cabinet of drugs, to which he added the best works on materia medica and pharmaceutical ehemistry, and he directed his pupils to make