Gatherings From Spain

“Le gambe di lui gettaron in una fossa;Il Diavol ebbe l’alma, i lupi l’ossa.”“The legs of the robber were thrown in a hole,The wolves got his bones, the devil his soul.”THE SPANISH DOCTOR

CHAPTER XVII

The Spanish Doctor: his Social Position – Medical Abuses – Hospitals – Medical Education – Lunatic Asylums – Foundling Hospital of Seville – Medical Pretensions – Dissection – Family Physician – Consultations – Medical Costume – Prescriptions – Druggists – Snake Broth – Salve for Knife-cuts.

THE transition from the Spanish ventero to the ladron was easy, nor is that from the robbers to the doctors of Spain difficult; the former at least offer a polite alternative, they demand “your money or your life,” while the latter in most cases take both; yet these able practitioners, from being less picturesque in costume, and more undramatic in operations, do not enjoy so brilliant a European reputation as the bandits. Again, while our critical monitors cry thieves on every road of the Peninsula, no friendly warning is given against the Sangrado, whose aspect is more deadly than the coup de soleil of a Castilian sun: woe waits the wayfarer who falls into his hands; the patient cannot be too quick in ordering the measure to be taken of his coffin, or, as Spaniards say, of his tombstone, which last article is shadowed out by the first feeling of the invalid’s pulse —tomar el pulso, es prognosticar al enfermo la loza. It was probably from a knowledge of this contingent remainder, that Monsieur Orfila went, or was sent, from Paris to Madrid, about the time of the Montpensier marriage with the Infanta, in the hopes of rescuing her elder and reigning sister, the “innocent” Isabel, from the fatal native lancets – a well-meant interference of the foreigner, by the way, which the Spanish faculty resented and rejected to a man; nor were the guarded suggestions of this eminent toxicologiste, or investigator of poisons, with regard to the administration of medicines and dispensaries, received so thankfully as they deserved.

THE SPANISH DOCTOR

However magnificently endowed in former times were the hospitals and almshouses of Spain, the provision now made for poor and ailing humanity is very inadequate. The revenues were first embezzled by the managers, and since have almost been swept away. Trustees for pious and charitable uses are defenceless against armed avarice and appropriation in office; and being corporate bodies, they want the sacredness of private interests, which every one is anxious to defend. Hence the greedy minion Godoy began the spoliation, by seizing the funds, and giving in lieu government securities, which of course turned out to be worthless. Then ensued the French invasion, and the confiscation of military despots. Civil war has done the rest; and now that the convents are suppressed, the deficiency is more evident, for in the remoter country districts the monks bestowed relief to the poor, and provided medicines for the sick. With few exceptions, the hospitals, the Casas de Misericordia, or houses for the destitute, are far from being well conducted in Spain, while those destined for lunatics, and for exposed children, notwithstanding recent improvements, do little credit to science and humanity.

HIS SOCIAL POSITION

The base, brutal, and bloody Sangrados of Spain have long been the butts of foreign and domestic novelists, who spoke many a true word in their jests. The common expression of the people in regard to the busy mortality of their patients, is, that they die like bugs, mueren como chinches. This recklessness of life, this inattention to human suffering, and backwardness in curative science, is very Oriental; for, however science may have set westward from the East, the arts of medicine and surgery have not. There, as in Spain, they have long been subordinate, and the professors held to be of a low caste – a fatal bar in the Peninsula, where the point of personal honour is so nice, and men will die rather than submit to conventional degradations. The surgeon of the Spanish Moors was frequently a despised and detested Jew, which would create a traditionary loathing of the calling. The physician was of somewhat a higher caste; but he, like the botanist and chemist, was rather to be met with among the Infidels than the Christians. Thus Sancho the Fat was obliged to go in person to Cordova in search of good advice. And still in Spain, as in the East, all whose profession is to put living creatures to death, are socially almost excommunicated; the butcher, bullfighter, and public executioner for example. Here the soldier who sabres, takes the highest rank, and he who cures, the lowest; here the M.D.’s, whom the infallible Pope consults and the autocrat king obeys, are admitted only into the sick rooms of good company, which, when in rude health, shuts on them the door of their saloons; but the excluded take their revenge on those who morally cut them, and all Spaniards are very dangerous with the knife, and more particularly if surgeons. Madrid is indeed the court of death, and the necrology of the Escorial furnishes the surest evidence of this fact in the premature decease of royalty, which may be expected to have the best advice and aid, both medical and theologico-therapeutical, that the capital can afford; but brief is the royal span, especially in the case of females and infantes, and the result is undeniable in these statistics of death; the cause lies between the climate and the doctor, who, as they aid the other, may fairly be left to settle the question of relative excellence between each other.

THE SPANISH DOCTOR

The Spanish medical man is shunned, not only from ancient prejudices, and because he is dangerous like a rattle-snake, but from jealousies that churchmen entertain against a rival profession, which, if well received, might come in for some share of the legacies and power-conferring secrets, which are obtained easily at deathbeds, when mind and body are deprived of strength. Again, a Spanish surgeon and a Spanish confessor take different views of a patient; one only wishes, or ought to wish, to preserve him in this world, the other in the next, – neither probably in their hearts having much opinion of the remedies adopted by each other: the spiritual practice changes not, for novelty itself, a heresy in religion, is not favourably beheld in anything else. Thus the universities, governed by ecclesiastics, persuaded the poor bigot Philip III. to pass a law prohibiting the study of any new system of medicine, and requiring Galen, Hippocrates, and Avicenna. Dons and men for whom the sun still continued to stand still, scouted the exact sciences and experimental philosophy as dangerous innovations, which, they said, made every medical man a Tiberius, who, because he was fond of mathematics where strict demonstration is necessary, was rather negligent in his religious respect for the gods and goddesses of the Pantheon; and so, in 1830, they scared the timid Ferdinand VII. (whose resemblance to Tiberius had nothing to do with Euclid) by telling him that the schools of medicine created materialists, heretics, citizen-kings, chartists, barricadoers, and revolutionists. Thereupon the beloved monarch shut up the lecture rooms forthwith, opening, it is true, by way of compensation, a tauromachian university; – men indeed might be mangled, but bulls were to be mercifully put out of their misery, secundum artem, and with the honours of science.

MEDICAL PRACTICE

This low social position is very classical: the physicians of Rome, chiefly liberti, freed slaves, were only made citizens by Cæsar, who wished to conciliate these ministers of the fatal sisters when the capital was wanting in population after extreme emigrations – an act of favour which may cut two ways; thus Adrian VI. (tutor to the Spanish Charles V.) approved of there being 500 medical practitioners in the Eternal City, because otherwise “the multitude of living beings would eat each other up.” However, when his turn came to be diminished, the grateful people serenaded his surgeon, as the “deliverer of the country.” In our days, there was only one medical man admitted by the Seville sangre su, the best or noblest set (whose blood is held to be blue, of which more anon) when in rude and antiphlebotomical health; and every stranger was informed apologetically by the exclusive Amphitryons that the M.D. was de casa conocida, or born of a good family; thus his social introduction was owing to personal, not professional qualifications. And while adventurers of every kind are betitled, the most prodigal dispenser of Spanish honours never dreams of making his doctor even a titulado, a rank somewhat higher than a pair de France, and lower than a medical baronetage in England. This aristocratical ban has confined doctors much to each other’s society, which, as they never take each other’s physic, is neither unpleasant nor dangerous. At Seville the medical tertulia, club or meeting, was appropriately held at the apothecary’s shop of Campelos, and a sable junta or consultation it was, of birds of bad omen, who croaked over the general health with which the city was afflicted, praying, like Sangrado in ‘Gil Blas,’ that by the blessing of Providence much sickness might speedily ensue. The crowded or deserted state of this rookery was the surest evidence of the hygeian condition of the fair capital of Bætica, and one which, when we lived there, we have often anxiously inspected; for, whatever be the pleasantries of those in insolent health, when sickness brings in the doctor, all joking is at an end; then he is made much of even in Spain, from a choice of evils, and for fear of the confessor and undertaker.

The poor in no countries have much predilection for the hospital; and in Spain, in addition to pride, which everywhere keeps many silly sick out of admirably-conducted asylums, here a well-grounded fear deters the patient, who prefers to die a natural death. Again, from their being poor, the necessity of their living at all, is less evident to the managers than to the sufferers; as, say the Malthusians, there is no place vacant at Nature’s table d’hôte to those who cannot pay, so bed and board are not pressed on Spanish applicants, by the hospital committee; an admitted patient’s death saves trouble and expense, neither of which are popular in a land where cash is scarce, and a love for hard work not prevalent, where a sound man is worth little, and a sick one still less; nor is every doctor always popular for working cures, as could be exemplified in sundry cases of Spanish wives and heirs in general; therefore in the hospitals of the Peninsula, if only half die, it is thought great luck: the dead, moreover, tell no tales, and the living sing praises for their miraculous escape. El medico lleva la plata, pero Dios es que sana!– God works the cure, the doctor sacks the fee! Meanwhile the sextons are busy and merry, as those in Hamlet, and as indeed all gravediggers are, when they have a job on hand that will be paid for; deeply do they dig into the silent earth, that bourn from whence no travellers return to blab. They sing and jest, while dust is heaped on dust, and the corpus delicti covered, and with it the blunders of the medico; thus all parties, the deceased excepted, are well satisfied; the man with the lancet is content that disagreeable evidence should be put out of sight, the fellow-labourer with the spade is thankful that constant means of living should be afforded to him; and when the funeral is over, both carry out the proverbial practice of Peninsular survivors: Los muertos en la huesa, y los vivos á la mesa, the dead in their grave, the quick to their dinner.

MEDICAL ABUSES

But at no period were Spaniards careful even of their own lives, and much less of those of others, being a people of untender bowels. Familiarity with pain blunts much of the finer feelings of persons employed even in our hospitals, for those who live by the dead have only an undertaker’s sympathy for the living, and are as dull to the poetry of innocent health, as Mr. Giblet is to a sportive house-fed lamb. Matters are not improved in Spain, where the wounds, blood, and slaughterings of the pastime bull-fight, the mueran or death mob-cries, and pasele por las armas, the shoot him on the spot, the Draco and Durango decrees, and practices of all in power, educate all sexes to indifference to blood; thus the fatal knife-stab or surgeon’s cut are viewed as cosas de España and things of course. The philosophy of the general indifference to life in Spain, which almost amounts to Oriental fatalism, in the number of executions and general resignation to bloodshed, arises partly from life among the many being at best but a struggle for existence; thus in setting it in the cast, the player only stakes coppers, and when one is removed, there is somewhat less difficulty for survivors; hence every one is for himself and for to-day; après moi le déluge, el ultimo mono se ahoga, the last monkey is drowned, or as we say, the devil takes the hindmost.

MEDICAL ABUSES

The neglect of well-supported, well-regulated hospitals, has recoiled on the Spaniards. The rising profession are deprived of the advantages of walking them, and thus beholding every nice difficulty solved by experienced masters. Recently some efforts have been made in large towns, especially on the coasts, to introduce reforms and foreign ameliorations; but official jobbing and ignorant routine are still among the diseases that are not cured in Spain. In 1811, when the English army was at Cadiz, a physician, named Villarino, urged by some of our indignant surgeons, brought the disgraceful condition of Spanish hospitals before the Cortes. A commission was appointed, and their sad report, still extant, details how the funds, food, wine, &c., destined for the patients were consumed by the managers and their subalterns. The results were such as might be expected; the authorities held together, and persecuted Villarino as a revolucionario, or reformer, and succeeded in disgracing him. The superintendent of this establishment was the notorious Lozano de Torres, who starved the English army after Talavera, and was “a thief and a liar,” in the words of the Duke. The Regency, after this very exposure of his hospital, promoted him to the civil government of Old Castile; and Ferdinand VII., in 1817, made him Minister of Justice.

As buildings, the hospitals are generally very large; but the space is as thinly tenanted as the unpeopled wastes of Spain. In England wards are wanting for patients – in Spain, patients for wards. The names of some of the greatest hospitals are happily chosen; that of Seville, for instance, is called La Sangre, the blood, or Las Cinco Llagas, the five bleeding wounds of our Saviour, which are sculptured over the portal like bunches of grapes. Blood is an ominous name for this house and home of Sangrado, where the lancet, like the Spanish knife, gives no quarter. In instruments of life and death, this establishment resembled a Spanish arsenal, being wanting in everything at the critical moment; its dispensary, as in the shop of Shakspere’s apothecary, presented a beggarly account of empty pill-boxes, while as to a visiting Brodie, the part of that Hamlet was left out. The grand hospital at Madrid is called el general, the General, and the medical assistance is akin to the military co-operation of such Spanish generals as Lapeña and Venegas, who in the moment of need left Graham at Barrosa, and the Duke at Talavera, without a shadow of aid. There is nothing new in this, if the old proverb tells truth, socorros de España, o tarde o nunca; Spanish succours arrive late or never. In cases of battle, war, and sudden death as in peace, the professional men, military or medical, are apt to assist in the meaning of the French word assister, which signifies to be present without taking any part in what is going on. And this applies, where knocks on the head are concerned, not to the medical men only, but to the universal Spanish nation; when any one is stabbed in the streets, he will infallibly bleed to death, unless the authorities arrive in time to pick him up, and to bind up his wounds: every one else – Englishmen excepted, we describe things witnessed – passes on the other side; not from any fear at the sight of blood, nor abhorrence of murder, but from the dread which every Spaniard feels at the very idea of getting entangled in the meshes of La Justicia, whose ministers lay hold of all who interfere or are near the body as principals or witnesses, and Spanish justice, if once it gets a man into its fangs, never lets him go until drained of his last farthing.

COLLEGE OF SAN CARLOS

The schools and hospitals, especially in the inland remote cities, are very deficient in all improved mechanical appliances and modern discoveries, and the few which are to be met with are mostly of French and second-rate manufacture. It is much the same with their medical treatises and technical works; all is a copy, and a bad one; it has been found to be much easier to translate and borrow, than to invent; therefore, as in modern art and literature, there is little originality in Spanish medicine. It is chiefly a veneering of other men’s ideas, or an adaptation of ancient and Moorish science. Most of their terms of medicinal art, as well as of drugs, jalea, elixir, jarave, rob, sorbete, julepe, &c., are purely Arabic, and indicate the sources from whence the knowledge was obtained, for there is no surer historical test than language of the origin from whence the knowledge of the science was derived with its phraseology; and whenever Spaniards depart from the daring ways of their ancestors, it is to adopt a timid French system. The few additions to their medical libraries are translations from their neighbours, just as the scanty materia medica in their apothecaries’ shops is rendered more dangerous and ineffective by quack nostrums from Paris. It is a serious misfortune to sanative science in the Peninsula, that all that is known of the works of thoughtful, careful Germany, of practical, decided England, is passed through the unfair, inaccurate alembic of French translation; thus the original becomes doubly deteriorated, and the sacred cosmopolitan cause of truth and fact is too often sacrificed to the Gallic mania of suppressing both, for the honour of their own country. Can it be wondered, therefore, that the acquaintance of the Spanish faculty with modern works, inventions, and operations is very limited, or that their text-books and authorities should too often be still Galen, Celsus, Hippocrates, and Boerhaave? The names of Hunter, Harvey, and Astley Cooper, are scarcely more known among their M.D.’s than the last discoveries of Herschel; the light of such distant planets has not had time to arrive.

LUNATIC ASYLUMS

To this day the Colegio de San Carlos, or the College of Surgeons at Madrid, relies much on teaching the obstetric art by means of wax preparations; but learning a trade on paper is not confined in Spain to medical students; the great naval school at Seville is dedicated to San Telmo, who, uniting in himself the attributes of the ancient Castor and Pollux, appears in storms at the mast-head in the form of lights to rescue seamen. Hence, whenever it comes on to blow, the pious crews of Spanish crafts fall on their knees, and depend on this marine Hercules, instead of taking in sail, and putting the helm up. Our tars, who love the sea propter se, for better for worse, having no San Telmo to help them in foul weather (although the somewhat irreverent gunner of the Victory did call him of Trafalgar Saint Nelson), go to work and perform the miracle themselves —aide toi, et le ciel t’aidera. In our time, the middies in this college were taught navigation in a room, from a small model of a three-decker placed on a large table; and thus at least they were not exposed to sea-sickness. The Infant Antonio, Lord High Admiral of Spain, was walking in the Retiro gardens near the pond, when it was proposed to cross in a boat; he declined, saying, “Since I sailed from Naples to Spain I have never ventured on water.” But, in this and some other matters, things are managed differently on the Thames and the Bætis. Thus, near Greenwich Hospital, a floating frigate, large as life, is the school of young chips of old blocks, who every day behold in the veterans of Cape St. Vincent and Trafalgar living examples of having “done their duty.” The evidence of former victories thus becomes a guarantee for the realization of their young hopes, and the future is assured by the past.

LUNATIC ASYLUMS

Next to the barracks, prisons, arsenals, and fortresses of Spain, the establishments for suffering mortality are the least worth seeing, and are the most to be avoided by wise travellers, who can indulge in much better specimens at home. This assertion will be better understood by a sketch or two taken on the spot a few years ago. The so-called asylums for lunatics are termed in Spanish hospitales de locos, a word derived from the Arabic, locao, mad; they, like the cognate Morostans (μωρος) of Cairo, were generally so mismanaged, that the directors appeared to be only desirous of obtaining admission themselves. Insanity seemed to derange both the intellects of the patients and to harden the bowels of their attendants, while the usual misappropriation of the scanty funds produced a truly reckless, makeshift, wretched result. There was no attempt at classification, which indeed is no thing of Spain. The inmates were crowded together, – the monomaniac, the insane, the raving mad, – in one confusion of dirt and misery, where they howled at each other, chained like wild beasts, and were treated even worse than criminals, for the passions of the most outrageous were infuriated by the savage lash. There was not even a curtain to conceal the sad necessities of these human beings, then reduced to animals: everything was public even unto death, whose last groan was mingled with the frantic laugh of the surviving spectators. In some rare cases the bodies of those whose minds are a void, were confined in solitary cells, with no other companions save affliction. Of these, many, when first sent there by friends and relations to be put out of the way, were not mad, soon indeed to become so, as solitude, sorrow, and the iron entered their brain. These establishments, which the natives ought to hide in shame, were usually among the first lions which they forced on the stranger, and especially on the Englishman, since, holding our worthy countrymen to be all locos, they naturally imagined that they would be quite at home among the inmates.

They, in common with many others on the Continent, entertain a notion that all Britons bold have a bee in their bonnet; they think so on many, and perhaps not always unreasonable, grounds. They see them preferring English ways, sayings, and doings, to their own, which of itself appears to a Spaniard, as to a Frenchman, to be downright insanity. Then our countrymen tell the truth in bulletins, use towels, and remove superfluous hairs daily. And letting alone other minor exhibitions of eccentricity, are not the natives of England, Scotland, and Ireland guilty of three actions, any one of which would qualify for Bedlam if the Lord Chancellor were to issue a writ de lunatico inquiriendo? – have they not bled for Spain, in purse and person, on the battlefield, on the railroad, in the Stock Exchange? —

“Oh tribus Antyceris caput insanabile!”

FOUNDLING HOSPITALS

To return, however, to Spanish madmen and their hospitals, the sight was a sad one, and alike disgraceful to the sane, and degrading to the insane native. The wild maniacs implored a “loan” from the foreigner, for from their own countrymen they had received a stone. A sort of madness is indeed seldom wanting to the frantic energy and intense eagerness of all Spanish mendicants; and here, albeit the reasoning faculties were gone, the national propensity to beg and borrow survived the wreck of intellect, and in fact it was and is the indestructible “common sense” of the country.

There was generally some particular patient whose aggravated misery made him or her the especial object of cruel curiosity. Thus, at Toledo, in 1843, the keepers (fit wild beast term) always conducted strangers to the cage or den of the wife of a celebrated Captain-General and first-rate fusilier of Catalonia, an officer superior in power to our Lord-Lieutenant of Ireland. She was permitted to wallow in naked filth, and be made a public show. The Moors, at least, do not confine their harmless female maniacs, who wander naked through the streets, while the men are honoured as saints, whose minds are supposed to be wandering in heaven. The old Iberian doctors, according to Pliny, professed to cure madness with the herb vettonica, and hydrophobia with decoction of the cynorrhodon or dog-rose-water, as being doubly unpalateable to the rabid canine species. The modern Spaniards seemed only to desire, by ignorance and ill-usage, to darken any lucid interval into one raving uniformity.