Note: When Dalrymple’s long-running BMJ column ended in 2012, he had a backlog of about 60 unpublished pieces, and he kindly gave them to us to post here at Skeptical Doctor. We are posting them on Wednesdays to coincide with the schedule of his old BMJ column. We hope you enjoy them.
Time was, not so very long ago, when medical students were expected to know Latin: indeed it was, if I may coin a phrase, a sine qua non (or what a doctor friend’s doctor father used to call a without-which-not) of becoming one.
I discovered just how much Latin medical students were once expected to know when I looked into The Latin Grammar of Pharmacy, 8th edition (and 10th thousand), 1903, by Joseph Ince, Lecturer in Pharmacy to the Pharmaceutical Society of Great Britain. The preface, written from the author’s home, Number 13, Alfred Road, Acton, takes the need for such knowledge for granted, since it does not explain it; and the author later points out that “a classical education alone will not prove sufficient to master the purely technical details involved in deciphering medical formulae.”
Here, for example, is a directive that a doctor is supposed to make to a pharmacist for a charcoal poultice:
Panem prope ignum macera in aqua horae sextam partem dein misce, lini farina gradatim addens inter agitationem ut fiat ctaplasma molle. Cataplasmate carbonis dimidium imsisce et reliquum supra consperge.
Macerate the bread in the water for ten minutes near the fire, then mix and add the linseed meal gradually, stirring the ingredients, that a soft poultice may be formed. Mix this with half the charcoal, and sprinkle the remainder on the surface of the poultice.
Ne nimis amarum sit dentifricium.
Let not the tooth powder be too bitter.
Panni linnei solutione madefacti applicanda.
Let woollen cloths moistened in the solution be laid on.
There are exercises in the book for translation into Latin, which unintentionally give us an insight into the medicine that was practised in 1903:
A blister of Spanish Fly to be placed on the region of the stomach (epigastric) for ten minutes, unless there is too much pain.
Mix, and make an ointment, of which let a piece the size of a nutmeg be rubbed on the painful forehead night and morning until pustule break forth.
(The ointment, incidentally, was to be made of tartrate of antimony and spermaceti from sperm whales).
Mix, and make a solution to be applied to the painful part by means of a camel’s-hair pencil.
Oddly enough, the few Latin abbreviations that we still use in prescribing do not appear in the list that the book supplies. Which among us knows what V.O.S. or Donec alv. bene. respond. once meant (vitello ovi solutus, dissolved in yolk of egg, donec alvus bene responderit, until the bowels have been well opened)?
One may wonder why the use of Latin persisted so long. Perhaps in the absence of a real ability to make a difference to outcomes, impressiveness was the most important medicine of all. Certainly Sit emplastrum fuscum; vetustum recenti praeferendum is more impressive than Let the plaster be brownish-yellow; the old is to be preferred to the fresh-made.
The use of arcane language, such that all who hear may not understand, is a permanent temptation of those whose claims to special knowledge or skill are ill-founded, doubtful or insecure. Who, reading a circular emanating from management, has not wondered why the matter contained in it is not put more simply? The fact is that we must always take what management says cum grano salis.