If the difficulty of conducting the operation of antimony, renders the general application of it, in regular practice, dangerous, it must, as a secret remedy, in the hands of those who have no medicinal skill, be still more pernicious. But as some secrets, now, universally extolled, are avowed, by their proprietors, to be preparations of antimony, let us next proceed to examine their claim to the high character which they have obtained. For this purpose the fever-powder may be selected, since if the impropriety and danger of its general use should be demonstrated, the arguments in favour of less celebrated secrets will not require a serious refutation.

Unpleasing as the task may be, and however odious, to some, it may render the man who undertakes it, yet the great importance of life and health requires, that the precepts of the most illustrious physicians should not pass without examination, nor secret and mysterious remedies be adopted with implicit faith.

The devout solemnity with which the fever-powder is ushered into the world, the exorcisms against detractors and malicious persecutors, and the invocation of God to support his own work, being in the usual stile of the mystical chymists, require no comment. As there may be some, says the Inventor, whose lucrative views may tempt them to persecute me, and the method I propose, with all the detraction and falsehood which may be expected from self-interest and unprovoked revenge, these I shall advise to save themselves a good deal of unnecessary trouble, and to let it alone; for if it be of men it will come to nought, but if it be of God ye cannot overthrow it[72]. When magical chymistry and superstition reigned over the dark ages of ignorance, this charm would have secured it from all enquiry. But as the sober light of religion and philosophy hath now illuminated the world, and displayed the absurdity of that servile bondage which obstructed all improvement, we may, notwithstanding this solemn prohibition, with candor and modesty, proceed to examine the real merit of this boasted arcanum.

The process for making it has been carefully concealed, while its being an antimonial preparation, hath, with industry and ostentation, been universally published. From the view which has already been given of the natural history of antimony, its analysis and chymical properties, its preparations and their medical effects, it has, I think, been clearly proved, that however efficacious it may have been in particular circumstances, and under judicious management, yet there is not, in unskilful hands, a medicine more dangerous and destructive.

By a judicious regulation of the doses of different preparations of antimony, by guarding against the pernicious effects which might arise from the virulent particles which it contains, by directing such food, drink, and medicines as may promote its salutary operation, and prohibiting those by which it might be rendered noxious; skilful and experienced physicians have been able, in singular instances, to render it a safe and efficacious remedy: but when it has been accidentally or imprudently given in too large doses[73], or joined with such food or medicines as excite its poisonous qualities[74], it has not only proved too violent in its operations, but has been productive of fatal consequences.

Had, therefore, the Inventor discovered a method of divesting this Proteus-like mineral of all pernicious qualities, and rendering it a medicine invariably safe and efficacious, however combined with other remedies, or mixed with a variety of humours, food, and drink in the stomach, his powder would have been more proper for common use, and might have been trusted, in unskilful hands, with less danger, than other antimonial preparations. But it does not in this respect lay any claim to superiority. Supposing, says the Inventor, physicians perfectly well skilled in the preparation and uses of it, that knowledge will inform them, that nothing can be added to it that will in any degree increase its virtues; or rather that no addition can be made to it that will not diminish them[75].

By this frank declaration we understand that the fever-powder retains the mutability of antimony, and is, from slight accidents, changed from a salutary medicine to a noxious substance; and hence proceeds the Inventor’s anxiety to prevent improper combinations. But the dread of dangerous consequences, or some other cause, has led him unwarily and inconsistently to depreciate his powder, and reduce it below all other antimonial preparations; for though by certain additions the virtues of antimony may be diminished, yet by others they may be improved; and this, it is probable, from the known properties of that mineral, will also hold with the fever-powder, although the contrary is here expressly asserted.

But, lest the assertion should give unfavourable impressions, it is immediately retracted; and we are told that, occasion may sometimes occur of employing, advantageously, a regimen, or even medicine, when judgment directs and integrity presides[76]. and again: It sometimes happens, when little or no putrid bile is contained in the stomach, bowels, &c. &c. that the powder, though given in the largest doses, will have no sensible operation of any kind whatever. In these cases half, or a whole paper should be repeated every four or six hours. But on those occasions, it will be proper to procure two stools in twenty four hours, either by a clyster, which is the most easy way, or by giving, with every dose of the powder, from five to ten grains of rhubarb[77]. But in some constitutions where a putrid bile has very much abounded, and for this reason the stimulus of the medicine, added to that of the bile, has been apt to operate more than was sufficient, it has been necessary to reduce the dose so low as two or three grains[78]: and thus, after a series of contradictions, the fever-powder, as might have been expected, is declared to require the addition of other medicines, and to be as uncertain in its operation as other antimonials.

These contradictions are suspicious, but if the efficacy of the medicine is confirmed by authentic facts, the Inventor may still be intitled to our confidence; and for this purpose some cases are related in which it was successfully used: the first is that of Mrs. Morton, on which it is remarked, that many gentlewomen were present during her whole disorder, saw her take the medicine, observed the effects, and are ready to give their testimony to the truth of what has been asserted. From what has been advanced on this subject, it clearly appears, that the operation of antimony is precarious, and its effects uncertain. Not only the most skilful physicians have given various and contradictory opinions concerning it, but the judgment of the same person has varied at different times[79]: it is not therefore to be expected, that a fact, which has not yet been agreed upon by the most intelligent and attentive practitioners, should be ascertained by these charitable gentlewomen, who, however sincere and humane their intentions might be, cannot be supposed to have any pretensions to that critical and discriminating skill which is necessary to determine a question so intricate. The Inventor therefore, in offering to the publick a proof so incompetent, must have relied on that credulity which, though generally abused, is still continued.

But though the cases had been attested by competent judges, yet the inferences in favour of the powder are not warranted by the circumstances related. Thus Mr. French of St. Albans street, late Surgeon of his Majesty’s ship the Levant, “having given tartar emetic and other medicines unsuccessfully, prescribed the powder on the fourth day of the fever: it was continued on the fifth, and on the evening of that day, the fever being entirely removed, on account of the lowness and weakness of the patient, a drachm of bark was given every hour in a glass of Madeira[80].” The misrepresentation, in this case, is evident, since the cure must be attributed, by candid and intelligent judges, not to the powder, but to the bark and Madeira; and the slovenliness of the deception is an insult to the credulity of the publick, as this is perhaps the only instance in which it has been pretended, on account of lowness and weakness, to give every hour a drachm of bark in a glass of Madeira.

These are not the only circumstances in which the evidence is deceitful; successful cases are industriously published, while those ending fatally are carefully concealed. The medicine is frequently given in slight disorders which could not, even by improper management, be rendered dangerous, and when the sick recover, its praise is loudly proclaimed.

Those who use it often become insensibly interested in advancing its reputation, and are not only incompetent judges, but partial in their testimony. Thus some who, with horror and remorse have applied for assistance, accusing themselves of murder, and vowing, for ever, to renounce quackery, have afterwards triumphed and assumed the credit of cures of which they had absolutely despaired, though the sick were, by other means, rescued from the danger incurred by the severe operation of this violent remedy; while others, shocked by the fatal consequences of their facility and misplaced confidence, wish to banish it for ever from their remembrance. The cases must therefore be dismissed as insufficient to justify the claim of infallibility to this antimonial preparation.

A proof of its salutary influence is attempted to be drawn from the bills of mortality. Fewer having, on an average, died in the space of thirteen years, from the year one thousand seven hundred and fifty, to the year one thousand seven hundred and sixty-three, than in the preceding thirteen years; this decrease in the funerals amounting to sixty-two thousand, two-hundred and sixty-six, is attributed to the fever-powder[81].

It might with some plausibility be objected, that the bills of mortality being collected from the reports of incompetent judges, cannot be admitted as proper evidence of the fact; but as no extraordinary skill seems necessary for the employment, and as the bills cannot be supposed to be made up with any partial intention, this argument must be admitted; and if the deaths, by fevers, shall be found to have decreased, in so great proportion, since the powder has been in general use, its reputation will be established by the most desirable evidence.

In collecting this proof, the whole circle of disorders, accidents and casualties has been calculated, though the powder was then only recommended for fevers. It has, indeed, been since extended to other diseases, but our examination shall be restricted to fevers, during the period to which the Inventor refers.

Though some of the cases which he relates happened in the year one thousand seven hundred and forty-one, yet the medicine was not much known till one thousand seven hundred and fifty, the Æra from which its auspicious influence on the bills of mortality is dated. But antimonial medicines were more in fashion before the powder came into general use, than at any future time. Dr. Huxham having, in the year one thousand seven hundred and thirty-seven, recommended, in the highest strain of panegyric, the vinum benedictum, it was universally adopted, though expressly condemned by the Inventor of the fever-powder. Great numbers, says he, of those whose employment it is to attend the sick, cunningly exhibited to their patients something, which they asserted was like the fever-powder, and would do as well. I leave it to the relations of those who took the something, to judge the consequence, for I suppose few or none of them who were thus treated survive[82].

The something, it is well known, was essence of antimony or tartar emetic, medicines under the direction of prudent practitioners, similar in their operation and in their effects, not only to each other, but also to the fever-powder; and though the Inventor has perhaps too much indulged his indignation against his competitors in the antimonial trade, yet his general position, concerning the fatal consequences of the universal administration of antimonial medicines, is well supported by the evidence to which he has appealed, the bills of mortality having greatly increased during the prevalence of that practice.

The numbers of those who died of fevers from the year one thousand seven hundred and thirty-eight, to one thousand seven hundred and fifty, including a series of thirteen years, is fifty-five thousand four hundred and ninety, and those in a like series of years, immediately succeeding, is thirty-six thousand three hundred and seventy-two; consequently nineteen thousand one hundred and eighteen fewer have died in the latter than in the former period, and this has, with some appearance of justice, been urged as a proof of the efficacy of the fever-powder.

But if this decrease in the funerals were actually owing to that medicine, it should have been still more observable in the last ten years, when the powder has been more universally used. But, in that period, thirty-five thousand four hundred and ninety-four have died, and consequently, the number of deaths, by fevers, have increased eight thousand seven hundred and eighty; and if inflammation, rash, and sore-throat, which were included in the former calculations, are added, the number will amount, nearly, to ten thousand, and therefore, on an average, one thousand, or near one-third more have died, of fevers, every year, in the last ten years, while the medicine has been universally used, than in the thirteen immediately preceding. The proof, therefore, from the bills of mortality is fatal to the fame of the fever-powder, and the decrease in the funerals during the thirteen years to which the Inventor appeals for the success of his antimonial powder, must be attributed to the desertion of the antimonial practice, and not to its prevalence.

But an appeal to the sum-total of the funerals, to prove the efficacy of the fever-powder, is unfair and inconclusive, since a great number of deaths happen from disorders, accidents and casualties with which it cannot possibly have any connection. That it might have a fair trial, our calculation has been restricted to fevers; and if the other diseases, in which it is recommended, had been included, the evidence would have been still more unfavourable.

Another argument in favour of the powder is, if it had not been attended with general success, it could not, amidst the opposition of Physicians, have grown into reputation. But transitions, from the highest approbation of antimony, to the absolute condemnation of it, have been so frequent, and are so familiar to those acquainted with its history, that no conclusion can be drawn from its casual reputation, or transitory condemnation; and since, in the course of our enquiry, no advantage has been taken of the penal laws enacted against its use, nor of the public edicts by which it has been prohibited, neither can any concession be made on account of the transient applause, artfully, obtained to some of its preparations.

As to the opposition of physicians, the Inventor, indeed, that the prophecy with which he set out might be fulfilled[83], complains, that all laws human and divine, have been trampled upon in opposing him; that he has been persecuted with malice, rancour, virulence, detraction and unprovoked revenge, and that his enemies have not only sacrificed candour, honour, truth and reputation, but even the lives committed to their care, in order to discredit his boasted arcanum[84].

Were we not witnesses of his triumph, we should naturally conclude that he had suffered as a martyr in the cause of truth and humanity. Yet we find, in his Dissertation, many cases in which the powder was given under the sanction of eminent physicians, and these, too, produced by the author, in proof of its efficacy; though by his own account of the medicine, it is of all others the most improper to be used without an accurate knowledge of its composition, and cannot therefore be prescribed by physicians on any justifiable principles; although they may, from facility or complaisance, yield to the importunity and prejudice of the sick or their relations, and assent, even against their better judgement, to its administration.

When the fever-powder is given, says the Inventor, no other medicine should be taken either with it, or during the course of it. For want of this caution many have perished. For it may be depended upon, that in the state of credit in which it has at present the honour of standing amongst many of the medicinal worthies, nothing is meant by any addition, but to counteract or discredit the powder at the expence of the patient’s life. It is usual for them to say, that they are acquainted with the preparation of the medicine, or that they cannot use a medicine that they do not know, just as either favours the present intention and purpose. Now let us suppose they do not know it, which is very true; by what conjuration, magic, or inspiration are they taught a method of improving, by adding something to a medicine, of which they are so totally ignorant, that they choose to suffer their friends to perish rather than employ it[85].

It may be left to the Author to explain how those physicians, who do not use the powder, kill their friends, by adding something to counteract or discredit it, while from his own declaration, we may fairly conclude that those who do use it, must, in his opinion, be destitute either of judgment or integrity. For supposing them, says he, perfectly well skilled in the preparation and uses of it, their behaviour is, for this very reason, abundantly more infamous. For the same knowledge would inform them, that no addition can be made to it that will not diminish its virtues[86].

But so far is this heinous charge of committing murder to discredit the powder from being supported by any shadow of proof, that physicians, on the contrary, have been complaisant to excess, or culpably indolent, in suffering the many misrepresentations concerning this medicine to pass uncensured and unexposed; and those who, from the most laudable principles, have refused to adopt it, are wanting to themselves, to their profession, and to the public, in neglecting to explain the honourable principles on which they have acted; while others from different motives, which they can best justify to themselves, have acquired fame and fortune by a studied compliance with the popular prejudices in favour of this fashionable remedy.

In the course of more than twenty years practice, though I have never prescribed this medicine, yet, I have not, after fairly declaring my opinion, opposed its being given, when desired by the sick or their relations; and as the cure, where I have been concerned, has been wholly committed to it, without the addition of any medicine, or even regimen, excepting what is prescribed in the printed directions, or what the Inventor himself has ordered, some fair opportunities have occurred of observing its effects, to which, and to every other information that could be obtained, with a mind open to conviction, I have carefully attended. But in this, as in all our former researches, the evidence has been unfavourable to the fame of the powder.

In some instances it has occasioned fainting, convulsions, and other violent symptoms, which terrified those who gave it. In all which I have seen, it has proved unsuccessful, though, in some cases the cure has afterwards been accomplished by safer methods; and in those where it was too late to use other remedies, the sick have died, although it was probable they might have recovered by a different management, which has succeeded in similar instances, but from an abused and misplaced confidence, has too often been set aside to make way for this favourite medicine.

An argument still remains in favour of the powder drawn from the credit due to its Inventor. If that is impeached by what has already been advanced, it is only by the force of the evidence, since all personal application has been avoided. But as the reputation of the medicine is chiefly supported by an implicit confidence in the Inventor, it is necessary, however unpleasing, that this should also be considered.

When our assent is demanded, on the credibility of the relator, to any fact which we are not permitted to examine, we can only judge of its probability from his known accuracy and ability. Several specimens of these have occurred in the course of our enquiry. Quotations have been misrepresented[87]. Authorities misapplied[88]. Evidence produced which establishes facts, directly opposite to those in support of which it is perverted[89]. Palpable contradictions have been pointed out[90]; and an air of mystery and devotion detected, the tendency of which, when joined to a train of suspicious circumstances, cannot be mistaken[91].

But the inaccuracy betrayed in the directions given with the powder, is sufficient to put us on our guard. The best general and plain direction, we are told, is to repeat half a paper, or ten grains and a half of the powder once in six hours[92], but in South America they seldom give less than twenty, which the Inventor thinks right[93], yet when it fell under the direction of the navy-surgeons, the general rule which was avowedly intended, and is still continued, for the common people, was found to be fraught with danger, and the Inventor admits that it has been necessary to reduce the dose so low as two or three grains[94], thereby acknowledging the best plain general direction, to be a very improper one for the common people, since no good reason can be assigned, why ten or twenty-one grains should be given by those who have no medical skill, though it is judged necessary to warn others, who may be supposed capable of conducting its operation, and detecting and counteracting its pernicious effects, of the necessity of reducing it, in some cases, to two or three grains. The only solution of this parodox, is, there is one faith for the learned, and another for the unlearned.

But not to insist on the contradictions abounding in this dissertation, one more only shall be mentioned. No addition, it has been said, can be made to this medicine, by which its virtues will not be diminished, and that assertion has again been retracted; but as one affirmation is as good as another, that there may be no doubt which is to be credited, the Inventor being extremely cautious of leading any one into error in an affair of so much importance as is that of life, thinks it imprudent to neglect repeated bleeding, purges, clysters, and all other assistances which the art of medicine can afford[95], and is obliged to own, that, as he esteemed life too sacred to be hazarded for the sake of an experiment, he had never neglected to call in all other medical aids to his assistance when he thought the case required them, and believed they would of service[96]. But though he is extremely cautious, and though life is too sacred to be hazarded, yet the experiment of using the powder without any addition or aid, is still to be tried throughout the whole British dominions, and in other parts of the world, where our commerce has conveyed it[97], excepting by the Inventor and the Navy Surgeons, who being persons versed in practice will readily distinguish when the rules laid down are punctually to be followed and when not[98].

The real motives assigned for these contradictions and this mysterious conduct, waving whatever artifices might be employed by way of palliation or disguise, are represented without reserve, and with that sincerity which will stand the strictest scrutiny. The Inventor was very cautious of divulging a medicine of such vast importance, because if it failed of success, it would subject him to infinite reproach. He was so ignorant as to expect assistance and applause from every one concerned in any branch of physic, not considering that a miliary or nervous fever of twenty days continuance, was attended with greater emoluments than one that terminated in two or three. But he had soon an opportunity of discovering his error, for some became his avowed enemies, without the least pretence to any provocation; whilst others, with the countenance of friendship, pointed a dagger to his breast[99], and therefore, after a contest between simplicity and caution, ignorance and shrewdness, the unsuspecting Inventor thought it time prudently to consult his own interest, and the advancement of his private fortune, by securing to himself the exclusive privilege, and putting it out of the power of others to disguise, misrepresent, deny, or forge facts[100].

Thus, from the parade, ostentation, and mysterious secrecy, with which this medicine has been published, from its resemblance to the Berlin specific febrifuge, from its being prepared from an arsenical mineral, and easily converted into a noxious substance; from the difficulty of ascertaining the dose, and conducting its operation, and from the necessity of calling in other medical aids to its assistance; from the incompetency of the generality of the witnesses in its favour; from the unfair conclusions drawn from their testimony; from the dangerous symptoms and fatal consequences, which have followed its administration; from the inaccuracy and inconsistency of its Inventor; and from the increase of the bills of mortality during its general use, it appears, not only, that no proof of its salutary efficacy has been produced, but that many circumstances and facts, which have been perverted to that purpose, concur to demonstrate its general and indiscriminate application to be highly dangerous to mankind, to whom, to borrow the language of the Inventor, it is not material, whether they lose their lives by ignorance, mistake, or design.