Act III: Compiègne and Paris (1766) [Parts I and II are available here, here, and here]
Adam Smith’s next first-hand experience with medical quackery occurs during the last part of his travels in France. By way of background, Smith had accompanied Henry Scott, the 3d Duke of Buccleuch (pictured below), who was born in 1746, along with Hew Campbell Scott, the duke’s younger brother (by one year), on their “grand tour” of Europe in the mid-1760s. Smith was travelling in his capacity as their tutor and overseas guardian, and at some point, Smith and his private pupils must have secured an invitation to visit the royal hunting park at Compiègne, France, for that is where Smith and his two pupils found themselves in August of 1766.
It was here, in Compiègne, that the young duke became violently ill. Although Smith describes this ailment as a “slight fever” in a lengthy letter (dated 26 August 1766) addressed to the duke’s stepfather, Charles Townshend:
“It is, you may believe, with the greatest concern that I find myself obliged to give you an account of a slight fever from which the Duke of Buccleugh is not yet entirely recovered, tho’ it is this day very much abated.” (Corr. 94; punctuation and spelling in the original)
Next, Adam Smith describes how the young duke had contracted what the travelling tutor describes as a “slight fever”:
“He came here to see the camp and to hunt with the King and the Court. On Thursday last he returned from hunting about seven at night very hungry, and eat heartily of a cold supper, with a vast quantity of sallad, and drank some cold punch after it. This supper, it seems, disagreed with him. He had no appetite next day, but appeared well and hearty as usual. He found himself uneasy in the field, and returned home before the rest of the company. He dined with my Lord George Lennox, and, as he tells me eat heartily. He found himself very much fatigued after dinner, and threw himself upon his servant’s bed. He slept there about an hour, awaked about eight at night in a good deal of disorder. He vomited, but not enough to relieve him. I found his pulse extremely quick; he went to bed immediately and drank some vinegar whey, quite confident that a night’s rest and a sweat, his usual remedy, would relieve him. He slept little that night but sweat profusely. The moment I saw him next day (Sunday) I was sure he had a fever, and begged of him to send for a physician. He refused a long time, but at last, upon seeing me uneasy, consented. (Corr. 94; punctuation and spelling in the original)
What Smith is describing in this passage sounds like a stomach illness, perhaps some form of food poisoning. Moreover, the duke’s ailment was severe enough that Smith ended up chasing down three different doctors to attend to and treat the duke’s malady: “Quenay” or François Quesnay (1694-1774), physician to the French royal court; “Senac” or Jean–Baptiste Senac (1693-1770), premier physician to Louis XV from 1752; and “De la Saone” or Joseph-Marie-François de Lassone (1717-1778), appointed the First Physician to the Queen of France, Marie Leszczyńska (wife of Louis XV), in 1751. In Smith’s words:
I sent for Quenay, first ordinary physician to the King. He sent me word he was ill. I then sent for Senac; he was ill likewise. I went to Quenay myself to beg that, notwithstanding his illness, which was not dangerous, he would come to see the Duke. He told me he was an old infirm man, whose attendance could not be depended on, and advised me, as his friend, to depend upon De la Saone, first physician to the Queen. I went to De la Saone, who was gone out and was not expected home till late that night. I returned to Quenay, who followed me immediately to the Duke. It was by this time seven at night. The Duke was in the same profuse sweat which he had been in all day and all the preceding night.” (Corr. 94; punctuation and spelling in the original)
Today, doctors would treat such a severe case of stomach flu with “oral rehydration solutions,” such as Pedialyte, Naturalyte, Infalyte, or CeraLyte. But in Smith’s day, bloodletting was the most likely course of action:
“In this situation Quenay declared that it was improper to do anything till the sweat should be over. He only ordered him some cooling ptisane drink. Quenay’s illness made it impossible for him to return next day (Monday) and De la Saone has waited on the Duke ever since, to my entire satisfaction. On Monday he found the Duke’s fever so moderate that he judged it unnecessary to bleed him. . . . To–day, Wednesday, upon finding some little extraordinary heat upon the Duke’s skin in the morning, he proposed ordering a small quantity of blood to be taken from him at two o’clock. But upon returning at that hour he found him so very cool and easy, that he judged it unnecessary.” (Corr. 94; punctuation, including the ellipsis, and spelling in the original)
Next, Smith acknowledges just how routine the practice of bloodletting was in his day, for in the very next sentence he makes the following offhand but revealing remark: “When a French physician judges bleeding unnecessary, you may be sure that the fever is not very violent.” (Corr. 94) Alas, the young duke was not to be spared this gruesome treatment, after all. By all accounts, bloodletting was a “cure-all,” so when Smith wrote a second letter to Duke Henry’s stepfather the very next day (27 August 1766), he describes how the duke’s doctors ended up taking “three moderate tea cupfuls of blood”:
“I resume the history of the Dukes illness from the moment in which I left it of yesterday. I had scarce sealed up my Letter when de la Saone came into the Room. He found that the fever was somewhat increased since the time that he had seen him before which was at two o’clock afternoon. Its paroxysme is always from about seven in the evening till about twelve or one in the morning. He thought that a gentle bleeding would diminish this paroxysme which had entirely broke his rest the night before. He ordered accordingly three moderate tea cupfuls of blood to be taken from him, which was accordingly done at eight at night.” (Corr. 95; punctuation and spelling in the original)
In fact, the duke’s doctors shed “a little more blood” from Duke Henry’s veins, for Smith concludes his letter by describing how “[t]he extreme good success of last night[’]s bleeding” inclined them to repeat their bloodletting procedure a second time:
“The extreme good success of last nights bleeding inclines them to take a little more blood from the Duke, provided the fever increases as usual towards seven or eight at night. Senac is more formal than la Saone who is one of the most engaging men I ever saw; In his reasonings and Judgements, however, Senac is one of the clearest, distinctest and most rational Physicians I ever saw. La Saone is not less so.
“Since I wrote the above la Saone has been to see the Duke. He finds him so easy that he imagines it will be unnecessary to bleed him to night. He is to return, however, at eight o’clock in order to decide that point along with Senac.” (Corr. 95; punctuation, spelling, and paragraph indent in the original)
Fortunately for Duke Henry–and for Adam Smith, who, after all, was responsible for the young duke’s health safety as his travelling tutor–no more of the young duke’s blood was let. But the fact that this gruesome treatment was entertained at all shows us how primitive, by modern medical standards, the practice of medicine was in Smith’s day: quackery was the rule rather than the exception in 18th-century Europe. Alas, Smith’s next direct experience with quackery, which would occur just a few weeks later in Paris, would take a deadly turn. (To be continued…)





