HEART BEAT: Survival of the fittest was the only way to get by in a world lacking regulations, writes Maurice Neligan
READING LEADS you into strange byways. Recently reading some medical history led me to the realisation that our predecessors had it much harder than us soft folk of the modern era.
The life expectancy of a general practitioner in the mid- 1800s was akin to that of a subaltern in the British Army. The over-70s card was not likely to be a problem.
There were difficulties for them in prescribing, largely because very few medicines actually worked and empiricism was the guide to successful practice. In other words, what they were taught of Materia Medica and therapeutics seldom had any bearing on the illness being treated.
There were no health warnings on the packets or bottles and prescribing information was scant; teaspoons, tablespoons, minims and drops were the measurements of the day.
There were no poison centres if things went wrong. Considering the fact that they were dealing with some very dangerous substances, it is gratifying that so many patients proved the dictum of the survival of the fittest.
Many physicians of the time prepared their own medicines which did not please the apothecaries who yearned for that more modern institution, a closed shop.
Both were, however, restricted by a lack of scientific knowledge and physiological principles of the substances they were prescribing. No Health and Safety Authority then, no Medical Council; it was just tough luck if you went to the wrong doctor and wound up with the wrong result.
Or have we eaten on the insane root
That takes the reason prisoner? - Shakespeare (Macbeth)
Quite possibly it would seem, especially if you had faithfully taken what the doctor had prescribed. Quite apart from strychnine, lead, arsenic and mercury, all readily prescribed, there were countless other substances and preparations of doubtful or dangerous efficacy.
These were the days when narcotics were freely used, cannabis, morphine, codeine, etc. My namesake even had his own particular concoction - "Tincture Cannabis, Indicae; Neligan".
Its dose was repeated at intervals until the desired effect was achieved. That was presumably until the patient got a high, man! He stated that he took a full dose of his own concoction to relieve the pain of "neuritis".
It was very successful in this regard but he developed "singular hallucinations, which proved to him the duality of the brain". That must have been some trip.
He made the point that cannabis plants grown in the East were far more effective than those produced locally. Maybe that's so, but it doesn't stop some local entrepreneurial types from trying to cultivate a crop here.
And in their endeavours, the use of ultraviolet lighting greatly enlarge their carbon footprint, presumably annoying our Green brethren. This is a pity because their product should be well in keeping with Green objectives inducing a hazy, happy, tree-hugging, back-to-nature euphoria.
There were countless other preparations also and I can't resist sharing this one. It is recommended especially for organic food outlets, health stores and the credulous. It is supposed to go very well with carrot juice.
Extractum Lactucae (extract of lettuce) - "Take of the flowering herb of lettuce, 1,12lbs. Bruise in a stone mortar and press the juice; heat gradually to 130 degrees and separate the green matter by a calico filter."
To cut a long formula short, after two more heatings and stirrings, the extract is of a suitable consistency for making pills.
Well what next; you've made yourself a bunch of lettuce pills. What do you do with them?
Well, marketing wasn't up to much in those days and these damn pills, despite all the effort, didn't seem to help in any illness. Nowadays it would all be different.
Firstly you would put the words "clinically proven" into your advertisements. This bland assertion means precisely nothing. Then you target a condition that is unlikely to kill the sufferer in the near future, like the normal ageing process.
You add some fatuous comment to your ad with some anorectic looking young one saying "you need these, you deserve them".
Then, listen good here, you charge serious money. If it doesn't cost much, it can't be any good. The fact that it is no good at any price is not mentioned.
Then you add the caveat that in a small number of cases the wrinkles or whatever you are treating may not vanish overnight and the course may have to be repeated.
Next you bank the money and turn to producing dandelion elixir for some other "illness". The only problem is what to do with the money; equities and property are not doing too well right now and you are obviously too bright to put the loot in a pension fund. How about a few gold bricks?
Maybe I sound disgruntled, I'm not, but as PG Wodehouse put it, I'm not exactly gruntled either. The populace fork out happily for teeth, tummy tucks, boob jobs, face lifts, botox, etc.
Ask them to pay for brains, intestines, kidneys livers; it's a different matter. Hair transplants, sure thing; heart transplants - the State, ie the rest of us, should look after that. It's a funny old world and Jesus did I ever pick the wrong specialty. No wonder I can't keep the Highest Authority in the style to which she thinks she ought to be accustomed.
• Maurice Neligan is a cardiac surgeon