"The MercurialDisease,The BelladonnadoThe StramoniumdoThe TobaccodoThe CicutadoThe Butter CupdoThe ColchicumdoThe ColocynthdoThe Pork or HogdoThe VinegardoThe Fool's ParsleydoThe Fox GlovedoThe Nux VomicadoThe QuassiadoThe OpiumdoThe HelleboredoThe SaltdoThe Mineral AciddoThe AcriddoThe Putriddo"
If on examination the curious reader should find no such disease as the "Lambskin disease" in Dr. W.'s catalogue, he should remember that the list is by no means complete, and that there will be no objection to the addition of one more. And why, indeed, may I not coin terms as well as others? All names must have been given by somebody.
But I will not dwell on the subject of nosology too long. I have something else to do in this chapter than merely to amuse.I have some thoughts to present on health and sickness,—thoughts, too, which seem to me of vast importance.
A son of Mr. G., a farmer, had been at work in an adjoining town, all summer, with a man who was accustomed to employ a great number of hands in various occupations,—farming, road building, butchering, etc., etc. Of a sudden, young G., now about twenty years of age, was brought home sick, and I was sent for late at night—a very common time for calling the doctor—to come and see him.
I found him exceedingly weak and sick, with strong tendencies to putridity. What could be the cause? There was no prevailing or epidemic disease abroad at the time, either where he had been laboring, or within my own jurisdiction; nor could I, at first, find out any cause which was adequate to the production of such effects as were before me.
I prescribed for the young man, as well as I could; but it was all to no purpose. Some unknown influence, local or general, seemed to hang like an incubus about him, and to depress, in particular, his nervous system. In short, the symptoms were such as portended swift destruction, if not immediate. I could but predict the worst. And the worst soon came. He sunk, in a few days, to an untimely grave. I sayuntimelywith peculiar emphasis; for he had hitherto been regarded as particularly robust and healthy.
His remains were scarcely entombed when several members of his father's family were attacked in a similar way. Another young man in the neighborhood, who had been employed at the same place with the deceased, and who had returned at the same time, also sickened, and with nearly the same symptoms. And then, in a few days more, the father and mother of the latter began to droop, and to fall into the same train of diseased tendencies with the rest. Of these, too, I had the charge.
My hands were now fully occupied, and so was my head. Anxious as most young men are, in similar circumstances, not only to save their patients, but their reputation, and thoughthe distance at which they resided was considerable, I visited both families twice a day, and usually remained with one of them during the night. I was afraid to trust them with others.
Physically this constant charge was too much for me, and ought not to have been attempted. No physician should watch with his patients, by night or by day,—above all by night—any more than a general should place himself in the front of his army, during the heat of battle. His life is too precious to be jeoparded beyond the necessities involved in his profession.
But while my hands were occupied, my mind was racked exceedingly with constant inquiry into the cause of this terrible disease,—for such to my apprehension it was becoming. The whole neighborhood was alarmed, and the paleness of death was upon almost every countenance.
My doubts were at length removed, and the cause of trouble, as I then supposed and still believe, fully revealed. The disease so putrescent in its tendencies, had originated in animal putrefaction. The circumstances were as follows:—
The individual with whom the young men who sickened had been residing and laboring, had laid aside, in his chamber, some time before, quite a pile of lambskins, just in the condition in which they were when removed from their natural owners, and had suffered them to lie in that condition until they were actually putrescent and highly offensive. The two young men, owing to the relative position of the chambers they occupied, were particularly exposed to the poisonous effluvia.
I did not forget—I did not then forget—the oft inculcated and frequently received doctrine, that animal impurity is not apt to engender disease. It most certainly had an agency—a prominent one—in the case before us. Perhaps it has such an influence much more frequently than is generally supposed.
One of my patients, in the family which I first mentioned,—a little boy two or three years old,—died almost as soon, after being seized with disease, as his elder brother had done. The rest, though severely sick, and at times given over to die, finally recovered. Some of them were sick, however, manymonths, and none of them, so far as I now recollect,—with perhaps a single exception,—ever enjoyed as good health afterward as before.
I had in these families six or eight of the most trying cases I ever had in my life; and yet, with the exceptions before named, all recovered. How much agency my own labors as a medical man had in producing this result, I am at a loss to conjecture. As an attendant or nurse, I have no doubt my services were valuable. And it was because a good nurse is worth more than a physician that I so frequently ran the risk of watching over the sick so closely as considerably to impair my own health.
The neighbors and friends of the two sick families, as I have already intimated, looked on in silent agony during the whole campaign; expecting, first thattheirfamilies, too, would soon be called to take their turn; and secondly, that I, the commander in chief, should be a sufferer, which of course would be a great public disadvantage. They were almost as much gratified as I, when we all came forth from the fire unscathed.
On the whole, except as regards health, I was a gainer rather than a loser by the affair. I mean, of course, in the way of medical reputation. I was by this time fairly established as a powder and pill distributer, of thefirst water. In other words, I was beginning to be regarded as a good family physician, and to be sought for, not only within the narrow limits of my own native township, some four or five miles square, but also quite beyond these narrow precincts. Occasionally I had patients in three or four adjoining towns, and I was even occasionally called as counsel to other physicians. My ambition was high, perhaps higher than it ought to have been; but it had its checks and even its valleys of humiliation; so that on the whole I retained my sanity and a full measure of public confidence.
And yet, in conclusion, I have to confess that besides exposing my own health, I made many medical blunders. I would not again run the risk to health or reputation which, during this long trial of several months, I certainly ran, for any sumof money which king Croesus or the Rothschilds could command. Nor do I believe an intelligent physician can do it, without being guilty of a moral wrong. Every one has his province; let him carefully ascertain what that is, and confine himself to it. The acting commander in an important military expedition has no right to place himself in the ranks of those who are about to leap a ditch, scale a wall, or charge bayonet. Paul has no right to labor in Athens when he knows perfectly well that he can do more good in Jerusalem, and the voice of God, by his Providence or otherwise, calls him thither. And "to him that knoweth to do good and doeth it not, to him it is sin."
A certain young woman who had great general confidence in my skill, after I had stood by her many long hours in one of Nature's sorest trials, was left at length in a fair way to recover, except that she was exceedingly exhausted, and needed the most careful attendance on the part of those around her. She no longer needed any medicine, nothing but to be let alone. In other words, she needed nothing but good nursing and entire freedom from all care and responsibility.
Being obliged at this juncture to leave her for nearly the whole night, I gave the best directions to her principal nurse of which I was capable, as well as the principal reasons on which it was founded. She seemed entirely submissive, and perhaps, in theory, was so. But in my zeal to make them understand that I was acting on common-sense principles, I committed one error, a very common one, indeed, but yet an error. It was that of reasoning with them with a view to make every thing particularly intelligible. One has authority, in these matters, as long as he takes theattitudeof authority, but the moment he descends to the general level of his patients, and in true republican style puts himself on a par with them, he begins to lose their confidence as a physician. You may not be sensible of a loss of this sort, nor even the physician. You may even think the reverse were more true. But you deceive yourself. Though your patients may love you better as a friend or even as a father, yet they have lost confidence in you medically, in nearly the same proportion. Strange indeed that it should be so; but so, according to my own observation, it ever has been. That a prophet is "without honor"—and most so in his own country and among his ownpersonal friends—is as true now as it was eighteen hundred years ago.
Had I told Mrs. D.'s attendants to do so or so, and left them without saying a word more, they would probably have done it. But I had condescended to reason with them about the matter; their belief that medical men dealt with the stars, and spoke with a species of supernatural authority, had been shaken; and they were emboldened to reason on the subject, and to hearken to the reasonings as well as to what had but the slightest resemblance thereto in others, during my absence.
Having occasion to use all possible precaution against the supervention of milk fever in my patient, I left particular directions that nothing stimulating should be administered, and assigned several good, substantial reasons. No food was to be given, except a little bread and some plain chicken broth, with no condiment or dressing but a little salt; and this at intervals of about four hours. No drink—not a particle—was to be given, except frequent very small draughts of cold water.
While I was absent Mrs. D.'s mother came into their family, not only to rejoice with them in an accession to their number, but to render them a little aid. She was one of those mothers whose kindness so often defeats their best and purest intentions. She was all eyes, ears, and attention, andnearly all talk. The daughter's treatment soon underwent a special scrutiny, and was found "wanting."
"Has the doctor ordered my daughter no milk punch?" she said to the attendants. "Not a drop," they replied. She raised both hands in astonishment. "How, then," she asked, "can the ninny expect she can ever have any nourishment for thatboy?" The attendants could not inform her. "The doctor," they said, "gave reasons," but they could not fully understand them.
"He did not probably understand them himself," said she. "There are no reasons against it, I am confident. It is only a notion of his. These young doctors are always full of their book wisdom. Why, a little experience is worth a whole world full of theories. NowIknow—and so does every otherperson who has nursed children—that a little milk punch, in these cases, is necessary. Not a great deal, it is true; but a little, just enough to give the system strength. Nature is weak in these cases. I wish some of these young doctors themselves were obliged to endure the trials we have to endure, and we should see whether they could get along with no drink but cold water!"
The rebellion soon reached the daughter's ears, who, till now, had confided in the "doctor's" prescription, and was doing well. She was soon as uneasy with things as they were, as her mother and the nurse and the neighbors. The husband was not of the clique; but then he was one of those good-natured men who leave every thing to their wives; and though they may not fully approve of every thing that is attempted, will yet do and refrain from doing many things for the sake of peace. He interposed no veto on the present occasion.
The mother, in short, soon reigned "sole monarch," and proceeded to issue from her imperial throne, the sage decree that a little milk punch must be made. Judith, the nurse, was to have it prepared so and so, and she would herself administer it. Only just so many spoonfuls of rum must be added to the tumbler of milk and water, and just so much sugar. It must be weak, the decree said.
Mrs. D. drank freely of the punch, because her mother told her that it would do her good. True, she asked after the first swallow, "what will the doctor say to this?" but her mother bade her be quiet, she would see to all that. "It is made very weak," said the mother, "on purpose for you; drink of it a little and often. It will be both food and drink to you. It will be good for the babe, dear child! how can these doctors wish to starve folks? I have no notion of starving to death, or having my children or grandchildren starved."
It was now past midnight, and Mrs. D. had as yet slept but very little. Had she simply followed out my directions she might have slept an hour or two before midnight, and several hours in the aggregate afterward. This, though done by stealth and in short naps, would have given her more real rest andstrength than a whole gallon of milk punch, and instead of kindling fever, would have carried off all tendencies of the kind.
On my arrival, early the next morning, I found a good deal of headache, such as cold water and plain food and rest seldom, if ever, create. My fears were at once excited, and they were greatly strengthened when I saw her mother. But the blow had been struck, and could not be recalled. Mrs. D., in short, was already in the beginning stage of a fever which came within a hair's breadth of destroying her.
It is indeed true that she finally recovered. No thanks, however, were due to the mother's over-kindness, nor to my own over-communicativeness. Had I done my duty, had I kept my own counsel, nobody, not even the mother herself, as I now verily believe, would have ventured to disobey my positive injunctions. And had this mother done, as she would have been done by in similar circumstances, all would probably have been well still. We should have saved a little reputation, and a good deal of health.
I learned, I repeat, from this unexpected adventure, that it was wisdom to keep my own secrets. I do not say that I have always acted up to the dignity of this better knowledge, but I am justified in saying that I have sometimes profited from an acquaintance with human nature that cost me dear. It is no trifle to see an individual suffer from painful disease a couple of weeks, and jeopard the life of a child during the whole time, when a little knowledge how to refrain from speakingten wordsof a particular kind and cast, would have prevented every evil.
My first surgical case of any magnitude, was that of a wounded foot. For, though I had been required to bleed patients many times,—and bleeding is properly a surgical operation,—yet it had become so common in those days, and was performed with so little science or skill, that it was seldom recognized as belonging to the department of surgery.
One of my neighbors had struck his axe into the upper part of his foot, and cut it nearly through. Happening to be at home when the accident occurred, which was in my own immediate neighborhood, I was soon on the spot, and ready to afford assistance; and, as good luck would have it, the man was not at all weakened by loss of blood, at my arrival.
My lesson from an old surgeon[D]was not yet forgotten. I still knew, as well as any one could have told me, that to put together the divided edges of the wound and keep them there, was half the cure. But how was this to be done? Slips of adhesion plaster would bring the divided edges of the wounded surface into their place, but would the deeper-seated and more tendinous parts unite while left without touching each other? Or should a few stitches be taken?
The wound was lengthwise of the foot, and no tendons were divided. I made up my mind to dress it without any sewing, and acted accordingly. The bleeding soon ceased. When all was secured, the patient inquired what he should put on it, to cure it. Had he not raised the question, I might, perhaps, have followed out my own ultra tendencies, and left it without any application at all; but as it was, I concluded to order somethingon which he might fasten his faith,—something which, though it should do no good, would do no harm.
"Nothing is better for a fresh wound," I said, "than the 'Balsam of Life.' Just send Thomas over to Mr. Ludlow's, and get a couple of ounces of his 'Balsam of Life.'" It was soon brought, and the surface of the wound and its bandages moistened with it. "Now," said I, "keep your foot as still as you can till I see you again. I will be in again before I go to bed."
I called again at nine o'clock in the evening. All appeared well, only the patient had some doubts whether the Balsam of Life was just the right thing. Several of the neighbors had been in, as he said, and, though they admitted that the Balsam might be very good, they knew, or thought they knew, of something better. However, I succeeded in quieting most of his rising fears for the present, by assuring him that nothing in the wide world was equal, for its healing virtues, to the "Balsam." My voice here was law, forI gave no reasons!
On making inquiry, afterward, with a view chiefly to gratify curiosity,[E]I found that the first individual who came in after I had left the house, assured them there was nothing so good for a fresh wound as a peach leaf. The next, however, insisted that the best way was to bind up the part in molasses. The third said the best way was to take just three stitches to the wound, and bind it up in the blood. The fourth said the most sovereign thing in the world, for a fresh cut, was tobacco juice!
Now I could have told these various representatives of as many various public opinions, that all these things and many more which might have been named, are, in a certain sense, good, since any mere flesh wound, in the ordinary circumstances of ordinary life, will heal in a reasonable time, in spite of them. I could have told them, still further, that the Balsam of Life was probably little, if any, better than the other thingsproposed, any farther than as it secured more faith and confidence, and prevented the application of something which was worse. I could have assured them that all the external applications in the world are of no possible service, except to defend from cold air, and prevent external injuries, or reduce inflammation; and that the last-mentioned symptom, should it occur, would be best relieved by cold water. But what good would it have done? Just none at all, according to my own experience. Positive assurance—mere dogmatism—was much better.
The wound did well as it was, though it might have done much better, could the patient's faith have been just as firmly fixed on nothing at all but Nature, as it was onmedicaments. However, the tincture I proposed, which somebody had dignified with the name of Balsam of life, had done very little harm, if any, to the parts to which it had been applied, while it had done a great deal of good to the patient's mind, and the minds of his friends. It was nothing, I believe, but a compound tincture of benzoin. I have used it a great number of times, and with the same wonderful results. The patient always gets well, either on account of it, or in spite of it! Does it make much practical difference which?
FOOTNOTES:[D]See Chap. VIII.[E]Even such inquiries as these are usually of doubtful tendency. They weaken public confidence. There must be but one opinion of any value to the physician or his patients, and that must behis own!
[D]See Chap. VIII.
[D]See Chap. VIII.
[E]Even such inquiries as these are usually of doubtful tendency. They weaken public confidence. There must be but one opinion of any value to the physician or his patients, and that must behis own!
[E]Even such inquiries as these are usually of doubtful tendency. They weaken public confidence. There must be but one opinion of any value to the physician or his patients, and that must behis own!
One young family on whom I was accustomed to call from time to time, was not only accustomed to send for me in the night, as did many others, but, what made it much worse for me, they resided some four or five miles distant, among the mountains. They were of that class of people who look every man on his own things, and never, as the apostle would enjoin, on the things of others. They knew very well that a physician, though he might be half a conjuror, required sleep; still, they were willing to finish their day's work, eat their supper, perform a large number ofet ceteras, even if they did not call for the doctor till he had fairly taken off his boots to retire for the night. But there was one consolation in all this, that they paid me promptly; and medical men, as you know, like other men, work for pay. They cannot live wholly on air.
In the same house with the family alluded to, was a young woman, about twenty-five years of age, who had been confined to her bed ten or twelve years. She was the only daughter of very indulgent parents, who had never, from her earliest years, thought they could do too much for her. In truth, this was the source of her feebleness. Some little ailment, indeed, there might have been at the outset, induced by pie, cake, preserves, pickles, or something which no truly kind parents should permit a child to take; though nothing more than might have been got rid of in its effects, by a little patient waiting. But instead of waiting a little, the anxious mother had dosed and drugged her. And these ill turns had been more and more frequent, just in proportion to the frequency with which she had been drugged for them; till, at twelve years of age, shewas almost all the while complaining. And at fourteen, she was completely bedridden—a burden to herself and to others.
"I wonder," said my principal employer, at about twelve o'clock, when I had attended to his own little family, and was about to leave, "whether you could do any thing for our Millie. She has tried almost all the doctors, to no purpose; but we have so much confidence here in your skill, that she sometimes speaks of trying you. She is hardly willing to 'give up the ship' without another trial."
This, as you must be aware, was a stirring appeal to my love of approbation; but it was too late at night to make a call on her at that moment. So, promising to come and see her shortly, I took my leave, and rode home, as usual, meditating.
Now I had never seen Emilia, but from the account which I had received from the neighbors, as well as from the nature of the case, I knew very nearly how she was; and that the great difficulty in the way of recovery was the constant habit of watching herself and attending to every internal sensation. In other words, she was so completely wrapped up in self, that I could see no reasonable prospect of getting her mind out of the maze in which it had been so long involved.
But I found time, a few days afterward, as I was employed again in the same neighborhood, to call and see her; and I ventured accordingly. She was sitting up in the bed, well bolstered, with a huge mass of clothing both on herself and on the bed. Then, at her right hand, was a stand half covered with bowls, saucers and tumblers; and near it a little closet or recess, in which were nearly an equal number of parcels of medicine, wrapped in papers ready to be used, when they were supposed to be necessary.
I had no sooner entered the room, than she began to give me an account of her medicine, rather than of herself. So rapid was her enunciation, and so eager was she to tell me what she knew—not about the symptoms of her disease, but about the treatment—that it was a full quarter of an hour before I could reach the inmost recesses of her condition. "That," said she,"is for canker in the mouth; that for sore throat; that is an eye wash I sometimes use, and that is a kind of bitters Dr. R. left for me, but which I have now nearly done taking—and they never did me any good," etc.
When I found an opportunity, I endeavored to investigate, very fully and freely, what had hitherto been supposed to be a very remarkable case. I found, indeed, that the patient had a great many little troubles, dependent mainly on the state of a mind greatly harassed by constant reflex tendencies, not easily eradicable. But I did not find it easy to prescribe for her. She was one of those very inquisitive people who wish to know what every thing you give them is, and who have a very conscientious objection to every thing. However, I at last settled down on a course of treatment, and wrote it out in a fair hand, and left it at the bedside. Not, however, I repeat, till I had foolishly fallen into my former error, and told her all the whys and wherefores.
This familarity into which she had drawn me, had already extracted one-half the virtue of my medicine; for that is no longer mysterious which the medical man openly and freely discusses. The freedom of thinking she had indulged in while I was present, had been extended to freedom of action; and the very medicine, whose virtues she had dared to discourse upon, she ventured to set aside, when her experience assured her it was not producing the effect she desired, and for which she supposed it was intended. So that what, from the first, I had feared, and more than I had feared, at length happened. She took my medicine, professedly,—that is, just when she pleased,—for about four weeks, to no manner of purpose whatever, except to deceive herself; for during the first and second weeks of its use, she imagined herself all the while getting better; while during the third week she began to doubt, and about the fourth week she came to the sage conclusion that she was just where she had been a month or two before.
The great, abiding difficulties of her case—her want of simple, confiding trust in her physician, and her constant, anxious attention to her own internal sensations, were far enough frombeing overcome. She was, in short, very nearly where she was ten years before, except that she was in circumstances rather more difficult to be reached, and had become rather more sceptical about medicine.
What should now be done? Must the case be abandoned? Or was there some other way, somenewway, by means, of which it could be reached? I was not quite willing to give her up as irrecoverable, and yet I saw nothing remaining which I could do. I revolved the thing in my mind, by night and by day. At last a plan struck me which I verily believed would succeed.
A few miles distant was a young physician, just from the schools, who vainly, though naturally, supposed he knew almost every thing which was known, and who wanted business. As he had nothing to lose, even if he were to fail in a hundred trials, but every thing to gain could he effect one very remarkable cure, I proposed to the family to employ him. I knew well he would have one or two advantages over his older and more experienced brethren. He would not at once place himself on the same platform with his patient and the friends, by answering their numerous questions; and for this plain and simple reason: In the first place, that hecouldnot, and very probably knew his own weakness; secondly, he would have more of that blind faith in medicine which inspires the ignorant with confidence.
But there was another thought beyond all this, a wheel within a wheel. The young physician might succeed better than I, in drawing her thoughts, and even her affections, away from herself; for he was a single man, and the patient, though sick, not destitute of charms, especially of that more tangible charm which, toindigentyoung men, and especially youngmedicalmen, so often eclipses all others. She, on her part, as I well knew, was not wholly resigned to the world of single blessedness, though her long-continued ill health had almost unfitted her for any thing else.
It only required a littlemanagementto bring about the desired result. Dr. Juvenis was soon employed; and, though hedid not always reply to her questions, which were numerous, and often wholly irrelevant, yet according to my own secret anticipations, he gradually raised her hopes in another direction, and hence drew her attention in no small degree from herself. His reserve, too, served but to inspire her with confidence in his great wisdom. There was something deep beyond the exterior, she always thought, which did not come out to the full, vulgar gaze.
The final result was a strong attachment on her part, which, though not reciprocated by him in a direct manner, was not by any means repelled. The virtues of the medicines were no longer discussed or doubted; and it was obvious to all that she was beginning to mend.
It was now high time for me to abandon a field which was not only fully occupied, butwelloccupied. The visits of the young physician were continued, at longer or shorter intervals, for years, till the young woman's health was nearly restored; and, as I subsequently learned, they were married. The more recent history of her life, I have not been able to ascertain, except that neither party gained as much by the new connection as had been expected,—a result which, alas! is by no means any thing new, and that there was, after some time, a relapse of disease.
This artifice for restoring health to a bedridden patient, is not mentioned in a way of approbation, but of regret, or at least of confession. Yet, while it declares my weakness, it develops or at least confirms a well-known principle, which it concerns mankind, patients as well as physicians, most fully and clearly to understand. The medical efficiency of an agent is greatly enhanced when the mind can be made to go along with it.
I have wished a thousand times, both by night and by day, that I had never commended Dr. Juvenis to the favorable notice and regard of this illiterate but confiding family. True, I had the good fortune thus to get rid of a most troublesome, standingpatient. Had I a moral right thus to do? Did the end either sanction or sanctify the means? Grant that I saved,or seemed to save, the patient;—was she really saved? Was there any absolute gain in the end? These are questions which I cannot, as yet, fully settle. Most certainly she was not quite cured.
What a mighty work for this fallen world education has yet to achieve; especially Physical Education! This, reader, let me say once for all, this physical education, under the guidance of Christianity, whose handmaid all true science should be, and to whose development and application all true religion should be directed, is our chief dependence. It is the lever by which we are to raise the world.
One morning, about two o'clock, in the depth of winter, I was roused from my slumbers by a stranger's voice, requesting me to get up and go immediately along the sides of the mountain and see Hezekiah. "And who is Hezekiah?" I said, only half awake; "and where is the side of the mountain? And who are you with whom I am conversing?"
The mystery was easily cleared up, and I mounted my horse and was soon on the road through the sides of the mountain. It was wild and unfrequented; nay, it was, in places, almost impassable, especially in the night. Mr. Judkins, the father of the sick man, not only resided quite beyond my usual range of practice, but almost out of the range of everybody else, squirrels and rabbits and wild fowls excepted.
In passing along, I made many inquiries with regard to the particular condition of the young man, in order to prepare myself for a more rapid investigation of his case whenever I should arrive. But I sought in vain. The messenger's lips were almost wholly sealed. The cause, at that time, I did not at all understand; but I had, subsequently, great reason to believe he was silent and reserved by the special command of the patient's friends. All I could obtain from my guide, was that Hezekiah had an ill turn; that he was occasionally subject to ill turns, and that the family were greatly alarmed about him.
On my arrival, I found a group of friends large enough, almost, for a train band, gathered so closely round the bed of the young man that he could hardly breathe. There was, also, a monstrous fire in the chimney, sufficient to heat well the whole house, had the heat been properly distributed. The air was,at best, greatly confined; but it was particularly so to the poor patient, who lay panting as if in a dying condition.
Yet I soon saw, and, as it were, instinctively, that he was not likely to die immediately. Some adventitious cause was evidently operating to throw his brain and nervous system into an abnormal condition, nor was I long in determining what it was. The father was a farmer. He possessed immense orchards, and made great quantities of cider, and one of his neighbors owned a distillery. For every barrel of cider Mr. J. carried to the distillery, he received in return a certain amount of cider-brandy; and at the time when I was called to see Hezekiah, he had more than two barrels of this "precious commodity" in his cellar. At the close of autumn he had had three barrels.
Why this deposit of an article so doubtful? And what had become of the one barrel which had disappeared? Not a member of the family would touch it, but Mr. J. himself, and Hezekiah. The women and children did, indeed, sometimes taste a little molasses toddy, as it was called. Mr. J. would prepare it and pass it round in the morning just before breakfast, in the hope and expectation that all would taste it; and they usually did so. It was not, however, quite a voluntary thing on their part, but a species of moral compulsion. Left entirely to themselves, they never would have tasted it.
Now think, reader, of two persons in a family, with two or three barrels of brandy at their entire disposal, with the expectation of consuming it, or the far greater part of it, during autumn and winter. Why, three barrels are more than a quart a day, for every day of the year. Mr. J. drank freely; but not more freely than his son. The latter was treading in the steps of his father, with the almost certain prospect of going, in the end, quite beyond him.
It was not difficult to prescribe for the young man. The far greater difficulty was to induce him to follow out the prescription. I was honest enough to tell the father what ailed the son, and what ought to be done, and to plead with him to change his own habits immediately. I could not, it is true,quite prevail, when I urged him to pour his brandy, the whole of it, into the street; for that, as he said and doubtless thought, would be a waste of property. But hedidpromise tosellit; though even this promise he never kept. He even continued to drink it; though as he always insisted, with great moderation. But the greatest drinkers we have among us, are usually the first to speak of their own moderation.
The sequel of the story may easily be guessed. Hezekiah became a miserable creature, and ere he reached the age of fifty came to a most miserable end,—the drunkard's death, by the drunkard's mania. Mr. J. having inherited a strong constitution passed on to sixty-three, when, like a mighty tree with decayed trunk, a slight wind crushed him to the dust.
His family, most of them, still survive; but they are daughters, and have not inherited the vices of their father, so much as his diseases. They have, at least, inherited the disease which drinking is so apt to entail on the next generation,—I mean scrofula. Several of Mr. J.'s elder daughters are already dead; and the younger ones—for he had a very large family—are feeble, and always will be so; and their children are still more feeble. Thus "earthward," and not heavenward, "all things" in the family of the drunkard have a tendency.
How painful the reflection that I did not labor with this family, not only in season, as I certainly did, but also out of season, and try to save it! I had influence with them. My honest plainness at my first visit, above described, did not prevent them from calling on me again for counsel; though at first I had feared such a result. I was often in the family, but not so often as I might have been; nor was I so bold as I ought to have been. Shall I be able to render up my account of the intercourse I had with them, in the great day, with joy, or must it be with grief and shame?
It is easy in imagination, to be wise, especially at a distance. How many a surgical operation have I performedon paper; or still oftener, and with more assurance, in my own brain. The difficulties are much fewer than in the reality.
A fine young man came to me, one day, with a crushed thumb. He had been at work on a wool-carding machine, and through the most inexcusable carelessness had suffered his thumb to be drawn in. On a careful examination, I found the wound to be very severe, and, as I believed, requiring amputation.
But what could I do? I had no surgical instruments. Young medical men, in plain country places, are hardly expected to purchase these conveniences, except perhaps a lancet and the needful instruments for extracting teeth. I had, however, a keen penknife in my pocket, and without the smallest formality, I proceeded to separate the mangled thumb at the joint.
It was a very painful process, and as I now fully believe, quite an unnecessary one. But young men are not apt to see things in the same light with those who have had experience. They are not half as ready to rely on nature. They are inclined to think art will do every thing; nature, almost nothing. They frequently love to use the lancet, the knife, the scalpel, and the trephine. Of this fondness, however, I knew comparatively little. In the present instance, I simply saw it to be a doubtful, and as I thought, a hopeless case to attempt to save the thumb; and therefore, without much reflection, I removed it.
Now I shall never cease to feel a pang, whenever memorycalls up this hasty act, as long as I live. Were life to be protracted to a thousand years, I should always reproach myself for it. And yet I am not aware that either the young man himself or his friends ever respected me the less for it. And so far was I from suffering in the eyes of society at large, I verily believe I was a gainer by it. But I respected myself less on account of it. I respect myself less to-day. I am fully conscious I was too hasty,—that had I waited a little, I might have been a means of saving his hand without much deformity. Nature, in such cases, left to herself, will work all but miracles, especially in the young, and in those who have a sound constitution.
Early in my practice as a physician I had a patient, a little girl, who, after having been sick for many weeks with a fever, seemed at length to become stationary. She was not weak or sick enough to die, and yet she seemed not strong enough to recover. Her vitality was almost exhausted, and yet Nature was loth to give up.
On this young patient, during her long sickness, I had tried a thousand things, to see if I could not give Nature a "start;" but all to no purpose. The wheels would not move. She would either vomit up every thing I gave her, or it would pass away as into a reservoir, unchanged. There appeared to be, I repeat, no vital action in the system.
To check the vomiting or prevent it, I had tried various measures, both external and internal. I had used warm applications to her stomach, both dry and moist. I had tried frictions of the skin and fomentations of the abdomen, both simple and medicated. Electricity I believe I had not used. Cheerful conversation, music to some extent, and the society of pleasant faces had all been invoked. Still there she was, on her bed. It seemed next to impossible for her "chariot" to go either backward or forward.
One day she asked for some milk. In an instant I determined to try it. So I took a teaspoonful of this fluid, warm from the animal, and gave it to her, only requiring her to swallow it very slowly. She not only obeyed me, but appeared to relish it. Nor was there any nausea afterward, nor any evidence of evil effects or evil tendencies.
At the end of four hours, I gave her another teaspoonful of milk, in the same way and with similar effects. At the end offour hours more, another was given; and thus onward. In twenty-four hours I was able to increase, slightly, the dose. All this while there was no stomach sickness, in the smallest degree. In three or four days, she could bear a table-spoonful of the "new medicine," every four hours, or a quantity equal to two or three ounces a day. In a week or ten days, she could take nearly half a gill at once, and had gained considerable strength. She recovered in the end, though her recovery was very slow.
But I had hardly used the milk three days, before I began to be denounced as an almost insane man, especially by those who were wont to set themselves up as the arbiters of public opinion, and who lived too remotely to witness the good effects of the course I was pursuing. The family, of course, though they disapproved of what I did, could say nothing against it, especially as it afforded the only ground of hope of recovery. The whole public mind, in that region, was affected by the belief that milk, in a fever, is heating and dangerous. "What a strange thing it is," said many an old woman, and not a few young ones, "that the doctor should give milk to a person sick with a fever! He will certainly kill the girl before he is through with her. If these young doctors are determined to make experiments, they ought surely to make them on themselves, and not on their patients."
The public complaint involved one serious mistake, else it would have had the semblance of reason to justify it. As a general fact, milk is heating in a fever, and is consequently inadmissible. The mistake to which I allude consisted in the belief that the fever still existed, when it had wholly passed away and left nothing behind it but debility, or the consequences of the fever.
But the evidence that milk did not hurt her, lay, after all, in the indisputable fact that she improved as soon as she began to use it, and under its moderate and judicious exhibition entirely recovered her health. Observe, however, that I do not say it cured her; although I might make this affirmation with as much confidence as can justly exist with regard to any thing belonging to themateria medica. All I say is, that after havinghung in suspense for some time, neither growing better nor appearing likely to do so, she commenced the use of the milk as aforesaid; and almost as soon as she began to use it she began to be convalescent, and her improvement went on steadily, till it terminated in sound health.
And yet our good friends, up and down the country, who uttered so many jeremiades about the folly of giving milk to a little girl in a fever, lived to witness her complete recovery, notwithstanding. She is now a mother in our New England Israel, and I believe a very healthy one.
Whether I would venture to pursue exactly the same course in the same circumstances, were I to live my life over again, is not quite certain. And yet I certainly think it not only safe, but desirable in such cases, to do something. Why, I have occasionally, in circumstances of convalescence from fever, given things which, in themselves considered, are much more objectionable than a little milk, and with the most perfect success. I have even given pork, cabbage, cheese, and beans. It is true, I have been compelled to exercise a good deal of care in these cases, with regard to quantity. That which in the quantity of half a pound might destroy life, might in the quantity of half an ounce, be the one thing needful to the salvation, physically, of a valuable member of society.
A man in New Haven County, in Connecticut, some fifty years ago, was for a long time suspended, as it were, between this world and the next, in consequence of being left in great debility after a long and dangerous fever. For several weeks, in fact, it was scarcely guessed, except in the softest whisper, whether the slightest movement or change in his system might not precipitate him at once into the eternal world. In this perilous condition, he one day asked for sweet cider, just from the press. His attendants very properly and naturally hesitated; but the physician, when he arrived and was made acquainted with his request, immediately said, "Yes; give him a teaspoonful of good, clean, sweet cider, every two hours." The cider was given, according to the commandment, and appeared to have a restorative effect. The man recovered in a reasonable time, and is, I believe, alive to this day.
Physicians are sometimes compelled by the force of circumstances, to visit the poor as well as the rich; albeit, they expect, so far as mere pecuniary compensation is concerned, that they are to have "their labor for their pains." They know well that honesty here, if nowhere else, is the best policy. Dr. Cullen, who became, as is well known, a giant in the profession, first attracted public attention from the act that he was often seen coming out of the hovels of the poor.
My own lot for several years was to laborchieflyfor the poor. In a region where it had been customary for a medical man who had the whole control of the business to charge one thousand dollars a year, my charges scarcely exceeded three hundred. A few of the wealthy employed me, it is true, but not all; while I had all the poor. Indeed, it is among the poor, as a general rule, that sickness is most frequent and prevalent, not to say fatal.
In one of these poor families, on a certain occasion, I had a long campaign and a hard one. First, I was obliged to travel a great distance to see them; secondly, I had a very severe disease to encounter; thirdly, there were several patients in the house; and the family, usually unprovided with sufficient space for a free circulation of the air, was still more incommoded when sick. Fourthly, the mistress of the house was exceedingly ignorant; and ignorance in a mother is, of itself, almost enough to insure the destruction of all patients over whom she has control.
My chief source of trouble, in the present instance, was the injudicious conduct of the mother to the family; for all else could have been borne. She was almost incessantly trying todo something over and above what I had ordered or recommended. The neighbors, almost as weak as herself, would come in and say: "Why don't your doctor give such or such a thing? Mr. Blarney was sick exactly like Samuel, and they gave him a certain powder and he got right up in a very few days." This would usually be quite sufficient to make Mrs. ——very unhappy, at least till she had again seen me.
Among the sick members of her family, was a daughter of about fifteen years of age. For this daughter, in particular, more than for the son Samuel, the good matrons of the neighborhood had their thousand remedies; and they regarded them all as infallible. With these, their favorite notions and doses, they were continually filling the ears of Mrs. ——.
One day, when I had been the usual round of the family, and given all needful directions for the day, Mrs. —— came to me and said: "Doctor, what do you think would be the effect of a little pumpkin-seed tea on my daughter Eunice? Do you think it would hurt her?"
"Why, no; I suppose not," I said. "But for what purpose would you give her pumpkin-seed tea? Is she not doing as well as could be expected? And if so, is it not desirable to let well enough alone?"
"To be sure she is doing very well," said Mrs. ——; "and I do not know but every thing is just as it should be. We certainly have great confidence in your treatment. But she is so feeble it seems as if something might be given which would make her gain strength faster. Why, she is very weak, doctor! Mrs. Gay and several others have thought a little pumpkin-seed tea might give her strength; but I do not like to order any thing new without first consulting you."
I did not object to the pumpkin-seed tea,administered in great moderation. I did not say as I ought boldly to have said: "I shall be obliged, as your physician, at least till you choose to dismiss me, to pursue the course I have marked out for myself, since I shall have to bear the responsibility." In my modesty and even diffidence, I preferred to let the ignorant friends of the young woman dabble with this comparatively inoffensive article,rather than with something worse. Besides, I wished to have no clandestine movements, and had already rejected so many proposals to give this or that medicament, that I dared not do it longer. "Oh, yes," said I, "you may give her pumpkin-seed tea; but give it in moderation."
The pumpkin-seed tea was given for the next twenty-four hours, I believe, with great exactness. But as there was no obvious or immediate advantage from using it during that time, it shared the fate which might have been expected. Like the wad in the child's pop-gun, which some new wad soon and effectually expels, the pumpkin-seed tea was thrown aside, and some other infallible cure proposed in its stead.
Now, reader, do not suppose I deemed it at all derogatory to medical authority that pumpkin-seed tea should be proposed by a weak and silly mother for a darling daughter. Such a feeling as that would have placed me on the same level of human folly that she herself occupied. On the contrary, a medical man of any considerable experience among the sick and the friends of the sick, should think himself exceedingly fortunate when nothing worse is suggested by ignorance for his patients thanpumpkin-seed tea!
Wrestling for amusement, in the region where I practised medicine, was a very common occurrence, and certainly had its advantages. But there was one drawback upon its excellence, except to physicians. It involved a good deal of bone-breaking. One famous wrestler with whom I was well acquainted, broke, for his neighbors, an arm and a collar-bone; and in the end almost broke his own neck. He certainly injured it to an extent from which there was never an entire recovery. I shall mention him in another place.
For more or fewer of these broken bones from wrestling, I was called on to prescribe. One case in particular may be worth a few moments' attention, especially as it brings with it certain medical confessions.
I was sent for one evening, about nine o'clock, to visit a young man who had been injured, as it was said, by wrestling. On my arrival, I found him in great distress. He had delayed sending for aid so long that there was much inflammation, and consequent heat, swelling, tenderness, and pain.
It was not easy, at first, to ascertain the exact character of the fractures; but on inquiry and examination, it appeared that while the patient was resting nearly or quite his whole weight on the fractured leg, his antagonist had struck or tripped with his foot so violently as to fracture both bones a little way above the ankle.
It was rather a trying-case to me—for as yet I was, in the art of surgery, a mere tyro. But it was a case which would not admit of much delay; for the inflammation, already sufficiently great, was rapidly increasing. Nor would it do long to hesitate from mere modesty. I was among a class of people,who would, as I well knew, construe modesty, even though it should chance to be, as sometimes it is, an accompaniment of true science, into sheer ignorance; and this would deprive me, as a physician, of my principal lever. For who can lift up the down-fallen without having their full confidence.
But I must explain. My patient with the fractured leg, though not in the usual acceptation of the term a drunkard, was, nevertheless, in the habit of drinking more or less of ardent spirit; and there were not wanting those who believed he was pretty well heated with liquor at the time his leg was broken. But, however this may have been, his frequent and excessive use of spirituous liquors had rendered his blood exceedingly impure; and I could not help shrinking, at first, from the task of having charge of him. Yet, it was a war from which there was no honorable discharge. There was no other surgeon within a reasonable distance, and why should I refuse to do my best for him? Somebody must assist him; and though the case was a troublesome one, why should I not take my share of troublesome cases among the rest?
There was another consideration. As he was poor, any thing like reluctance would have been construed into a willingness to neglect him on account of his poverty—a suspicion from which I should, at that time, have shrunk as readily as from the charge of robbery or murder.
But his associates were worse than he; and, with the exception of his own immediate relations, not an individual would be likely to call on or proffer him aid who was not half or two thirds of the time steeped in spirits. Has the surgeon or physician, in such circumstances, much reason to hope? And what is the hope of his patient? Can he reasonably expect, even with the aid of a skilful surgeon, ever to have a good leg?
However, I did my duty, according to my best knowledge. I had the man laid in a proper position, then placed the divided bones as nearly in their natural position as possible, and bound them. I confess, here, to very great ignorance. Moreover, I repeat, it was a difficult case. And yet I think I succeeded very well for a beginner.
Having properly placed the fractured bones and detained them there by suitable means, I gave due orders concerning the patient's management and treatment. I was particularly careful to interdict all stimulating or indigestible food, and all drink but water. My directions were written down with great care, and the strictest charge was given to his friends and family to see that they were faithfully regarded.
But, alas, for the best person in the world with such attendants! Whenever his wife took care of him, things went on very well; but in other instances, almost every thing went wrong. His attendants gave him rum, opium, laudanum, or almost any thing that he called for. It is true—and I mention it to his credit—that he was often rather moderate in his use of interdicted articles; but then he took just about enough of these unnatural or extra stimulants, to prevent the healing process from going forward as fast as in a man of only thirty years might have been expected.
Instead of being on his feet in a couple of months or so, he lay on his bed three months or more. And then, instead of having a good leg, it was not merely slightly crooked, but half an inch too short. And then, in addition,—and what was very hard to endure,—he charged the whole blame of its imperfection on the surgeon, and insisted that it was not "set" right!
Now, while I confess to much awkwardness, and to the possibility that the limb was not managed as well as it might have been, I must maintain, notwithstanding, that such a charge was wholly misplaced and even gratuitous. Had he employed the best surgeon in the world, and had the leg received the best possible attention, it could not have been kept in its proper place with so much distilled spirits in the house, and so many slaves of the bottle! One might almost as well expect a leg to heal in the nether pit. Though I have never said, either by way of retaliating the abuse or otherwise, that his punishment was richly merited, Imighthave said so. A man is hardly entitled to good health and a good frame who keeps such company as he did, whether in sickness or in health. God has so connectedlaw and penalty, that he who should complain of the penalty would but insult the law given.
Many cases of petty surgery as well as of severe and complicated disease, fell to my lot, which embarrassed me in a manner not unlike the foregoing; though in no one did I suffer quite so much from misrepresentation as in this. For at least twenty years, to my certain knowledge, my patient took pains to speak of me in terms of reproach, and to say that his leg was set badly; and all without the slightest evidence. I do not positively aver, I again say, that the surgery in the case was faultless; but whether it was so or not, neither he nor any living individual could know, unless it were a more skilful surgeon than myself; and no such surgeon, I am sure, ever saw him during the time I was in attendance.
The family of a wealthy farmer came under my hands, as physician, one autumn, in circumstances peculiarly painful and trying. Several of them had been taken suddenly and severely sick, and one or two were almost dead before they were fairly aroused to a sense of danger. They lived, however, quite remote from any village, and were strongly prejudiced against both physicians and medicine. But a fearful foe, in the shape of typhoid dysentery, now assailed them, and handled them so roughly that they laid aside their prejudices for the moment, and cried aloud for help.
I was soon on the spot, but, oh, what a scene presented itself! As I have more than intimated, two of the family were already beyond hope. Others seemed likely to die. What was to be done for them, as I saw plainly, must be done quickly. On nearly every countenance I met with, both within the family and beyond its precincts, were the marks of consternation, and on some, of despair.
In these circumstances—for desperate cases require a desperate remedy—I sought the counsels of an older physician. He came immediately and took a survey of the dreadful field of slaughter. On retiring with him for consultation, he immediately said; "There must be some local cause or causes for all this. Have you," he added, "been into the cellar?" When I replied in the negative, he said, "Then we must go there immediately."
On speaking to the lady of the house, who was among the sick, by the way of asking permission, she objected, and with a good deal of promptitude and spirit. However, she at length yielded, and we made a thorough examination. The results ofthis examination were such as to confirm our suspicions. "We need not search further for the causes of a deadly disease," said Dr. B., and I thought so too.
I have said already that the family was wealthy; but wealth need not include negligence, and still more filth. It was now September; and I am quite of opinion that the cellar had not been cleaned in one year, perhaps not in two. I had seen many farmers' cellars before, but I had never seen such an one as this. Nor do I believe my consulting physician ever had, though he was some twenty years older in medical practice than myself. Nor am I certain that what I may state will appear to you wholly reliable.
In the first place there were, in abundance, cabbage leaves and stumps in a semi-putrid state. Next there were decayed potatoes, turnips, beets, and apples. Then there were in various parts of the cellar remnants of cider and vinegar, and cider lees—the latter in a most offensive condition. Finally, there were remnants of barrels of beef and pork, in a bad state—to say nothing of other casual filth—the whole contributing to such a stench as I had never before perceived in a cellar.
The old physician who accompanied me had said, "We need not go farther;" but our determination was, on full and mature reflection, to know the worst and the whole, and we governed ourselves accordingly.
Close to one corner of the kitchen was the well, the water in which was very low, and near to that the sink. And if the contents of the sink did not find their way, from day to day, into the well, thus adding impurity to putridity, it must have been in virtue of some unknown law which stood opposed to the great law of specific gravity and attraction. It is true that many speak of the earth as having acleansingpower in such cases; but I know of no power which it possesses of cleaning sink water, while the latter is passing only five or six feet through it. The coarser parts may be strained out, but the essence must remain.[F]
But our work was not yet finished. The vault, greatly neglected, was not far from the well; and so of the pigsty. Nor was it easy to resist the conviction that there was an underground communication between them. Then, finally, the house instead of standing on an elevation, greater or less,—a very common mode of building in New England,—stood in a sort of concavity, which contained also the barn and barnyard and woodpile;—connected with both of which was a large amount of decayed and decaying animal and vegetable matter.
Now after such a review as this, he who could remain in doubt with regard to the cause of existing disease, especially on its assuming the form of bowel complaint with typhoid tendencies, must be much more ignorant of the laws of health and disease than I was. In fact the signs were unmistakable.
We immediately made our report to the heads of the family, and recommended a most thorough cleansing, at once. It was easy to see that we gave great offence; indeed we had anticipated such a result. But we were not at all intimidated. We insisted on a work of immediate expurgation, which was finally effected, only we could not put pure water into the well. But we could and did require that the well water should not be used for any thing except washing clothes.
The result was a decided and almost immediate improvement in the condition of the family, except the two already spoken of, and a very young child. These three died. Some of the rest lingered for weeks, and one or two for months; but they finally recovered.
It is worthy of remark, moreover, that of the people of the neighborhood, though they had been excessively frightened and had not at first dared to come near the house, at least without holding their breath, not a person among them sickened.The disease began and ended over the foul cellar I have mentioned; nor has a similar disease ever since broken out there. The fair presumption is, that they have never since suffered such foul accumulations to remain through the hot season, on their premises.
My honest and truly honorable course of conduct, in this instance, cost me something. Though I was a means of saving their lives, the survivors never thanked me for the exposure I made of their slovenliness. Perhaps I was wrong in reporting it abroad; but it was next to impossible to conceal the facts; and I, for once, did not attempt it. Physicians sometimes thus stand between the living and the dead, and must expect to give offence. They are, however, in duty bound to keep the secrets of their patients' faults as long as they can, unless the greater good of the public demands an exposition.
But while I lost reputation in this particular family, I have not a doubt that I gained a strong hold, by this adventure, on the public mind and feelings. In truth, despite of even some trifling errors, I deserved it. I had, moreover, during the adventure, acquired a good deal of practical knowledge, of which, in the progress of my course as a medical man, I was glad to avail myself.
This was doubtless an extreme case of disease from filthiness; but cases of the same general character are quite numerous. I have sometimes wished the public could have a history of these cases. There is an immense amount of neglect in the departments of cleanliness and ventilation; and the consequent suffering in the various forms of disease, is in similar degree and proportion.
I will conclude this chapter with a single anecdote, which, were it necessary, could be substantiated by a very great number of living witnesses.
Some fifteen or twenty years ago, a severe disease was accustomed to visit one of our New England factory villages, and to carry off more or fewer of its inhabitants. So regular and certain were its yearly visits and ravages, that not a few were disposed to regard it as a sort of necessary evil, or, perhaps, asa divine infliction. At length a very shrewd old gentleman told the people that the troublesome visitor was of human and not of divine origin; and that if they would attend properly to their cellars, sleeping-rooms, wells, etc., it would no more be heard of. At first, they were disposed to laugh at him; but the matter was talked of and agitated, till a work of general purgation was actually attempted and finally accomplished. The disease has never re-appeared. Was all this the result of mere accident? Do our diseases spring out of the ground? Are they the result of chance or hap-hazard? or, are they not the heaven-appointed penalties of transgression?