FOOTNOTES:[F]Farmers, in former times, while making cider, were very slovenly. When I observed a large amount of filth adhering to their boots and shoes as they carried the pumice from the vat to the press, I thought of the worms, insects, and dust, which were ground up and incorporated with the mass, I sometimes expressed surprise. "Oh," said they, "the cider will work itself clean!" If so, I thought, and still think, it must be by the operation of some law not yet discovered. It may work itselfclear, perhaps; but to work itselfclean, is quite another matter.
[F]Farmers, in former times, while making cider, were very slovenly. When I observed a large amount of filth adhering to their boots and shoes as they carried the pumice from the vat to the press, I thought of the worms, insects, and dust, which were ground up and incorporated with the mass, I sometimes expressed surprise. "Oh," said they, "the cider will work itself clean!" If so, I thought, and still think, it must be by the operation of some law not yet discovered. It may work itselfclear, perhaps; but to work itselfclean, is quite another matter.
[F]Farmers, in former times, while making cider, were very slovenly. When I observed a large amount of filth adhering to their boots and shoes as they carried the pumice from the vat to the press, I thought of the worms, insects, and dust, which were ground up and incorporated with the mass, I sometimes expressed surprise. "Oh," said they, "the cider will work itself clean!" If so, I thought, and still think, it must be by the operation of some law not yet discovered. It may work itselfclear, perhaps; but to work itselfclean, is quite another matter.
A large family, not much more careful of their habits or cleanly about their premises than the family alluded to in the foregoing chapter, had sickened one autumn, and one of them had died. Anxious to save the rest, I again acted as physician and nurse both, and effected my object; or, at least, appeared to do so. The rest of my patients ultimately recovered.
But while thus watching these patients, by night and day, standing in the very front of the battle, I suddenly sickened. The circumstances, as nearly as I can recollect them, were the following:——
Among the sick of this afflicted family was one unmarried man of rather eccentric and very unsociable habits, and exceedingly negligent both of his person and dress. His linen, and I think also his bed-clothes, were hardly changed once a month; at least as long as he was well. And then he had, of course, extended the same neglect to his sick chamber. Added to this, moreover, was a species ofnecessityat this juncture; for so much distressed were the family, and so difficult was it to procure aid in the neighborhood, that a part of the neglect to which our old bachelor was subjected seemed unavoidable.
I took notice of the neglect, spoke of it repeatedly, and labored assiduously to correct the evil. But the case seemed an almost forlorn one. I was morally obliged, as I then felt, to do a thousand things for him that usually fall to the lot of nurses and assistants. In some instances, I passed even whole nights in the family, in attendance on him and the other sick persons.
My task was the more severe from the fact that a similar fever was prevailing in other parts of the town, and my laborsbeyond the precincts of this family were exceedingly fatiguing and severe. In truth, I was, in the end, greatly overworked and debilitated, and my system most admirably prepared for the reception of disease.
For various reasons, some of which, have already been named, I often assisted in turning my bachelor-patient in his foul bed. It is true the process was so offensive that I avoided it whenever I could; but on occasions, I yielded to the pressure of necessity.
One night, when I was greatly fatigued and exhausted, and at the bottom of my condition,—utterly unfit for exertion, even in a pure atmosphere,—I was stooping over Mr. V., to turn him in his bed, when I suddenly felt a sensation like that of receiving a blow externally on the chest and stomach. The thought struck me as quickly as the imaginary blow did—have I not taken the disease? I knew the laws of contagion; the only question was whether any contagion had been generated. My opinion was to the contrary; nevertheless, I could not wholly suppress my fears.
A sensation of oppression which followed the imaginary blow, soon gradually passed away, though I felt, each succeeding day, more and more debilitated. Many a resolution was made to leave my patients, so far as personal manual care was concerned, and be much more than I had been, in the open air, though it was only made for a time—to be broken. At length, however, principle prevailed over sympathy and inclination, and I did as I ought to have done long before. It was, however, rather late, for the die was already cast. I was taken sick, and the symptoms of my disease were precisely like those of Mr. V.
Perceiving now, most clearly, my condition, and that I was engaged in a war from which there could be no discharge, I made preparation for a long and severe sickness. First, I calmly and deliberately adjusted all my domestic concerns of a pecuniary kind, and made such arrangements as would, in case of my demise, render every thing intelligible. Then, in the second place, I made up my mind to submit, as cheerfully as Icould, to my condition. I determined to keep quiet, and not indulge for a moment in any undue anxiety. I employed a physician,—my old master—but steadfastly, and almost obstinately determined not to take much medicine;—nor was there much prescribed.
My disease proved to be much milder than was expected; but it had its regular course. I never wholly lost my muscular strength or my appetite. While I was sick, several of my nearest friends and patrons sickened in a similar way, only more severely; and one or two of them died. On my recovery, however, or about the same time, the most of them began also to recover, and the disease in general abated.
Now, when I came to reflect coolly and carefully on the whole affair, I could not help perceiving that I richly deserved all I suffered. It was the just penalty of transgression. I had been fully and repeatedly warned not to watch with my patients, as those who turn back to Chapter XXIII, and those too who remember its contents, will perceive. It was fit, therefore, that I should feel the rod, even if I could not kiss the hand that had appointed it. The only wonder with me now is, that my punishment was not more severe.
Some of these blessings have been alluded to in Chapter XXXVI. But the subject is one of too much importance to be left in an unfinished state, and I have concluded to make it the principal topic of a separate chapter.
A man came to me, one day, with sundry grievous complaints about his head and stomach. It was easy to see, at once, that they were not of mushroom growth, and that they could not be removed either in an hour or a day. However, I did the best I could with him, and charged him to follow, implicitly, my directions, which he promised faithfully to do. I told him, even, that he was in danger of a severe disease, but counselled him to do his utmost to escape it, if possible.
He was, in the first place, a New England or Yankee farmer. Not quite satisfied with the products of his farm from the labors of the day, he coupled with them the night labors of managing a saw-mill and a distillery. And not satisfied with even these, he sometimes burned charcoal, which also involved more or less of nocturnal labor. In truth, these employments and avocations kept him up a great many nights during a considerable portion of the year, and were evidently wearing him out prematurely; for, though less than forty years of age, he had the appearance of being fifty or sixty.
This severe tasking of his system, had led him greatly into temptation. Not only had he acquired the habit of chewing tobacco, as a solace in his seclusion and toil, but also of drinking very freely of cider and cider brandy; the last two of which, as might naturally be inferred from what has been said, he was accustomed to manufacture in large quantities. He was not a great eater, though I have no doubt he ate toomuch. But he did not take time to eat—he did not masticate any thing; almost every thing was swallowed in masses, and washed down with tea, coffee, or cider. Then, lastly and finally, he ate, as it were, by the job, when hedideat; for his meals were very irregular and sometimes very infrequent.
Another thing should be noticed. His cider and perhaps his tobacco, having leagued together, took away his appetite. Cider, as is well known, practically and in a gradual way, takes away the appetite, and so does coffee. Many a farmer will tell you that it is a matter of economy to give his laborers cider or coffee, since they will not eat so much. It is highly probable that brandy, and indeed all extra stimulants, have the same appetite-destroying effect.
And as the result of his various irregularities and abuses, his digestive and nervous systems had become very much deranged and disordered, and I could hardly help foreboding evil concerning him. I prescribed for him as well as I could, and requested him to call on me in two or three days, and "report progress."
On the next day but one, I was summoned to his bedside. My medicine had indeed appeared to afford him a little temporary relief, but it was only temporary. He was now much worse than ever before. I prescribed again; but it was with similar effect. Nature, somewhat relieved, as I then vainly imagined, seemed disposed to rally, but was unable. Every successive effort to rally, showed more and more clearly how much she had been crippled. At least she seemed to succumb either to the treatment or the disease, which last became in the end quite formidable.
But though Nature had yielded, apparently vanquished, she still made occasional faint efforts, every two or three days, to regain the supremacy, or, in other words, to set things right; and sometimes we were led to indulge in hope. But the remissions of disease and of suffering were only temporary, and were succeeded, in every instance, by a worse condition of things than before. I called for sage medical counsel, but allto no permanent purpose. Downward he tended, step by step, and no human power or skill seemed likely to arrest his progress.
In this downward course his constitution held out—for he was by nature exceedingly tenacious of life—till about the twenty-third day, when the vital forces began to retreat. He died on the twenty-fifth.
One practical but general error deserves to be noticed, for want of a better place, in this very connection. Notwithstanding the great difficulty of convincing a person who habitually uses extra stimulants, narcotics, or any medicinal agents, all the way from rum, opium, and tobacco, down to tea, coffee, and saleratus, that they are injuring him at all, as long as he does not feel very ill, yet it ought to be clearly and fully known that every one who is thus addicted to unnatural habits, andbeingthus addicted is seized with disease of any kind and from any cause whatever, is certain to have that disease with greater severity than if his habits had been, from the first, perfectly correct or normal. Nor is this all. Medical aid, whenever invoked under these circumstances, is more questionable as to its good tendencies. No medical man of any skill or observation but must feel, in such a case, most painfully, the terrible uncertainty of that treatment of the living machine which is quite enough so when the habits have been most favorable, by being most correct.
One caution of quite another kind may be interposed here. My patient above had neglected to call on me for several days in the beginning of his disease, under the very general impression of ignorant people, that if he called a physician he should certainly be severely sick; for if he was not already very sick, any efforts to prevent disease would only serve to make him so.
Now this is, as a general rule, a very great mistake. It would be much more safe to call a physician very early, than to wait till Nature is so much embarrassed and even crippled that we can place very little reliance on her efforts. Worse still isit for the physician, when called late, to load down the enfeebled system with medicine by way of atoning for past neglects. Thousands have made the mistake here alluded to, and have thus been a means of hastening on a fatal termination of the disease. It is not by any means improbable that such was the result in the foregoing instance.
A little child about two years of age, severely afflicted with bowel complaint, came under my care during the first year of my medical practice, and proved the source of much difficulty.
She was the child of a mother who had been trained to delicacies, in the usual fashionable way, and who had begun to carry out the same wretched course of education in her own family. In addition to a generally wrong treatment, the child had been indulged, for many weeks before I was called, with a large amount of green, or at least very unripe, fruit.
It was at a season of the year when both children and adults were suffering from bowel complaints much more than at any other; but as the hot days and nights were expected soon to give way to the cooler and longer nights of October, I fastened my hopes of the child's final recovery, very largely, on the natural recuperative effects of the autumnal season. I did not attempt to give much medicine. My reliance was almost wholly on keeping up what I was wont to call a good centrifugal force, or in keeping the skin—the great safety valve of the system—in proper and healthful activity. Much that I ordered was in the way of bathing, local and general, especially warm bathing.
The parents of the child were among my most confidential, not to say influential, friends. If there was a family within the whole of my medical circuit with whom my word was law, it was this. Yet after all they were ignorant, especially of themselves; and such people always were and always will be credulous. They would open their ears, not only to the thousand and one insinuations of malice and envy, which at times are ventured against a young physician,—especially if heis going ahead, and as they say "getting rich" too fast, and thus securing more than they believe to be his share of public popularity;—but to the still larger number, if possible, of weak criticisers in his practice.
My friend's residence, moreover, was in a neighborhood contiguous to quacks and quackery, in the pretensions to which there were many believers. These dupes of ignorance and assurance were ever and anon filling the heads of my "patrons" with their stories of wonderful cures, in cases almostexactly like that of my own little patient, and urging the poor half-distracted parents to try something new—either medicine or physician. They would appeal to their feelings by asking them how they could be willing, as parents,—however great might be their confidence in me as a physician,—to let a darling child lie, day after day, and yet make no extra effort to save it.
Their appeals were not wholly ineffective; indeed, what else could have been expected? My first suspicion of any thing radically wrong, arose from a decidedly unexpected effect from a little medicine I had previously ordered. It seemed quite clear to my mind that a neutralizing agent had been at work somehow, by design or otherwise. And yet I shrunk from making an inquiry. In the end, however, I found myself morally compelled to do so. The results were very nearly what I had feared, and what might have been expected.
One of thereliabilitiesof the wise ones of the neighborhood went by the name of the "Indian" doctor. Whether in addition to a very little Indian blood he was half or three-fourths Spanish, Portuguese, or Canadian, I never knew, for I never took pains to inquire. But he had Indian habits. He was at times intemperate and vicious. No one who knew him would have trusted him with a sixpence of his own honest earnings, at least any longer than he was within his sight or reach. Yet many people would and did trust him with their own lives and the lives of their children.
There was one redeeming circumstance in connection with the history of this Indian doctor. He would never prescribe for the sick when in a state of intoxication. He knew, in thisrespect, his own weakness. But then it must be confessed he was not often free from intoxication. He was almost always steeped in cider or spirits. He was seldom, if ever, properly a sane or even a steady man.
On pressing the parents of the sick child more closely than usual, they frankly owned that though they had not of themselves called in the Indian doctor, they had permitted Mrs. A. B. to invite him in, and had permitted the child to take a little of his medicine.
The secret was now fully revealed, and it was no longer a matter of wonder with me, why poison did not work well against poison. The wonder was why, together, we had not killed the poor child. And yet it was by no means certain that the Indian's prescription was of much force, save the few drops of alcohol which it contained, for all his medicine was to be taken in alcohol.
I stated to the parents the probable issues—that unless the child possessed more than ordinary tenacity of life, it must ultimately sink under the load it was compelled to sustain. But to our great surprise—certainly my own—it survived; and, though it was suspended for weeks between life and death, it finally recovered.
The most mortifying circumstance of all was, that this miserable mongrel of a man had the credit of curing a child that only survived because it was tough and strong enough to resist the destructive tendency of two broadside fires—mine and his own. But medical men are compelled to put up with a great many things which, of course, they would not prefer. They must take the world as it is—as the world does the corps of physicians. They must calculate for deductions and drawbacks; and what they calculate on, they are pretty sure to experience. But, like other men with other severe trials, they have their reward.
Within the usual limits assigned me in the daily routine of my profession, but on its very verge, there resided an individual of much general reputation for worth of character, but of feeble constitution and cachetic or deranged habits, for whom as well as for his numerous family I had frequently prescribed.
He was at length, one autumn, unusually reduced in health and strength, and I was again sent for. There was evidently very little of real disease about him, and yet there was very great debility. All his bodily senses were greatly deranged, and all his intellectual faculties benumbed. His internal machinery—his breathing, circulation, and digestion—was all affected; but it seemed more the result of debility than any thing else. There was no violence or excess of action anywhere, except a slight increase of the circulation.
The man was about fifty-eight years of age. Had he been ninety-eight or even eighty-eight, I should have had no difficulty in understanding his case. I should have said to myself, "Nature, nearly exhausted by the wear and tear of life, is about to give way;" or in other words, "The man is about to did (?die) of mere old age." But could he have been thus worn out at the age of fifty-eight?
I gave him gentle, tonic medicine, but it did not work well. Without increasing his strength, it increased his tendencies to fever. Yet, as I well knew, depletion would not answer in a case like this, whether of bleeding, blistering, or cathartics. In these circumstances, I contrived to while away the time in a routine of that negative character which, in true medical language, means laboriously doing nothing.
He was visited about twice a week. I heard patiently all hiscomplaints, and endeavored to be patient under all my disappointments, for disappointments I had to encounter at nearly every step. No active treatment whatever would have the general effect I desired and intended. If I gave him but a single dose of elixir paregoric for his nervousness, it only added, nine times in ten, to the very woes it was intended to relieve. My policy—and I fully believe it was the only true policy—was to leave him to himself and to Nature, as much as possible.
Though I have spoken here of what I regarded as the true policy in the case then under my care, yet, after all, the truest course would have been to call for consultation some wiser head than my own. Another individual, even though he were no wiser than I, might have aided me most essentially, in compliance with, and in confirmation of, the good old adage—"Two eyes see more than one."
Why, then, did I not call on some inquiring and highly experienced physician? It was not that I was too proud to do so, nor that I was too jealous of my reputation. It was not that I feared any evil result to myself. It was rather because I did not, at first, think it really necessary; and then, subsequently, when I supposed it to be really needful, I feared my patient would grudge the expense. This fear, by the way, was grounded in something more than mere conjecture. The proposal had been practically made, and had been rejected.
In this general way things went on for some time. The friends grew uneasy, as they should have done; and one or two of them, now that it was almost too late, spoke of another physician as counsel. My own readiness and more than readiness for this seemed to have the effect to quiet the patient, though it had the contrary effect on his friends. They appeared to construe my own liberality and the admixture of modesty and conscientiousness, which were conspicuous in my general behavior, into self-distrust, and hence began themselves to distrust me.
The patient's state of mind—for he was a man whose habits of thinking and feeling approximated very closely to those of the miser—more than once reminded me of some doggerel verses I have seen, perhaps in an old almanac, which areso pertinent in illustration of the point in my patient's character which these remarks are intended to expose, that I have ventured to insert them:—
"The miser Sherdi, on his sick-bed lying,Affrighted, groaning, fainting, wheezing, dying,Expecting every hour to lose his breath,Enters a Dervise: 'Holy Father, say,As life seems parting from this sinful clay,What can preserve me from the jaws of death?'"'Sacrifice, dear son, good joints of meat,—Of lamb and mutton for the priest and poor.Nay, shouldst thou from the Koran lines repeat,Those lines might possibly thy health restore,'"'Thank you, good father, you have said enough;Your counsels have already given me ease.Now as my sheep are all a great way off,I'll quote holy our Koran, if you please.'"
"The miser Sherdi, on his sick-bed lying,Affrighted, groaning, fainting, wheezing, dying,Expecting every hour to lose his breath,Enters a Dervise: 'Holy Father, say,As life seems parting from this sinful clay,What can preserve me from the jaws of death?'
"'Sacrifice, dear son, good joints of meat,—Of lamb and mutton for the priest and poor.Nay, shouldst thou from the Koran lines repeat,Those lines might possibly thy health restore,'
"'Thank you, good father, you have said enough;Your counsels have already given me ease.Now as my sheep are all a great way off,I'll quote holy our Koran, if you please.'"
At length my patient began, most evidently, to decline. There were various marks on him and in him, of approaching dissolution. When pressed, as I frequently was, to say definitely what the disease was—that is, to give it a name—under which Mr. —— labored, I only replied that he was suffering from premature old age. This always awakened surprise, and led to much and frequent inquiry how it was that a man of fifty-eight years could be dying of mere old age. My explanations, whenever attempted,—for sometimes in my pride of profession I wholly evaded them,—were usually, in substance like the following:—
"Mr. —— was feeble by inheritance. He never had that firmness of constitution which several of his brothers now possess. Then, too, he was precocious. His body and mind, both of them, came to maturity very early; which, as you know, always betokens premature decay. Men live about four times as long, when not cut short by disease, as they are in reaching maturity. As he was apparently mature at fourteen or fifteen, he might very naturally be expected to wear out at or before sixty.
"But then, in addition to this, he has all his lifetime labored too hard, not only from necessity, but from habit and choice. His ambition, it is well known, has been unlimited, except by his want of strength to accomplish. He has only ceased to labor hard when he had strength to labor no longer, or when it was so dark or so cold or so stormy as to prevent him.
"Then of late years he has had the care and anxiety which are almost inseparable from the work of bringing up a numerous family. It is indeed true that he has not been called to that severest of all possible trials pertaining to the family, the pain of seeing that family or any of its members go materially wrong. Still he has had a world of care; of its effects none are aware who have not been called to the same forms of experience.
"There is one thing more; Mr. —— has, at times, taken a good deal of medicine: not alcohol, in any of its forms, I admit, but substances which for the time were, in their effects, almost equally bad for him. He has used tea immoderately, and even tobacco. His constant smoking has been very injurious to his nervous system, and along with other things has, doubtless, greatly hurried on the wheels of life."
Remarks like these had their intended effect on a few individuals, especially such of them as were couched in language with which they were already familiar. On most, however, they fell lifeless and hopeless. What knew they about precocity and its effects on the after life? In short, it was quite doubtful then, and is still more doubtful with me now, whether, on the whole, any thing was gained by attempts at explanation. For example, when I spoke of my patient being worn out, prematurely, by overworking, it was asked by one man, "But how is this? Other men as well as Mr. —— have worked too hard, and brought up large families, and perhaps taken a great deal of medicine, and smoked a vast amount of tobacco? Why are they not affected in this way as well as Mr. ——?"
It was not easy to make current the idea that Mr. —— was about to die of old age; although partly from conviction, butpartly, also, to conceal my ignorance, I still endeavored to promulgate it. It was the only apology I could make for suffering a man to run down and die, without appearing to those around him to be very sick.
But he died, after some time, to my infinite mortification and great regret. I was invited to his funeral, as I was usually to the funerals of my patients. In this case, however, I contrived to be absent. So great was my consciousness of ignorance and so much ashamed was I of my ill success, that I felt as if the veriest ignoramus would be disposed to point at me, and to charge me with having been, practically, the murderer of the much-beloved head of a family, and a worthy and highly respected member of society. But, whether others would deem me culpable for my ignorance or not, I could not avoid the pangs of habitual condemnation.
There were, I grant, a few extenuating circumstances in the case. One or two causes existed, of premature decline, on which, in a work like this, I cannot stop to expatiate. It was also very unfortunate for him that he was accustomed to look on the dark side of things, and to forebode ills, where, oftentimes, none existed.
Notwithstanding my former ignorance and doubt, and numerous misgivings, in cases like the foregoing, I have of late years, on a maturer review, been obliged very frequently to confirm my earlier decisions. In the case which has been detailed in this chapter, I have, on the whole, come to a belief that my first judgment was nearly correct; and that the patient actually perished, as much as men ever do, of premature old age. It is, indeed, very possible that had I pursued a different course in several important particulars, his life might have been prolonged for a year or two. Men have a tendency to become what they are taken to be; and many a person has died much sooner for being taken to be near his end, and treated accordingly. If we would have our patients recover, we must take for granted that recovery is at least possible.
In the case above, I believe I lost reputation, in large measure. Several shrewd people insisted, at the time and longafterward, that I ought to have had medical counsel. Mr. ——, they said, was too good a man to lose without a more persevering effort to raise him. They charged me with having got my name up, and having at the same time grown careless. Had he been properly doctored, they said, from the very first, they believed he might still have been alive to ornament and bless society.
There are, of course, many ways of destroying or killing people. To kill, with malice aforethought, though sometimes done, is a much less frequent occurrence than killing in the heat of passion, or by carelessness; by leading into bad habits, or by the injudicious use of medicine.
Then, again, there is such a thing as killing by omitting to keep alive. Thus we have sins of omission as well as of commission. If I leave a man in a mill-pond and suffer him to drown, or if I suffer him to take a dose of arsenic or Prussic acid, when I might, with the utmost ease, or even with considerable difficulty, prevent it,—is it not, in a practical sense, to destroy or kill him?
It is certainly within the wide range of human possibility, that a daughter may, without bludgeon or pistol, and even without poison, kill her mother. And it is quite notorious and a plain matter of fact that many a mother kills her own children. It could be demonstrated that thousands, if not tens of thousands of children are destroyed every year by their own mothers; as truly so as if they had received at their hands a quantity of arsenic. Why, then, may not children sometimes kill their parents?
I have known people, in very many instances, kill, in trying to save. I have even known the medical man do this, as may be seen by turning back to Chapter XXX. Then, too, I have known the attendants of the sick, though among their dearest friends, sometimes kill in this very way. In truth, such killing is not uncommon.
One of the most painful instances of this last kind of killingcame under my own immediate observation, and was in the range of my own practice.
I was visiting a sick woman, whose only property lay in three or four lovely and loving children. Two of these, who were full-grown daughters, resided in her house and took care of her. She was severely afflicted with typhoid dysentery. Her daughters in turn watched over her, both by day and night, and would not suffer her to be left in the care of anybody else for a single minute. And, in general, their faithfulness was above all praise.
One day, however, disliking the appearances of a part of my medicine, they mutually agreed to throw it into the fire; and the deed was done. They had supposed it to be calomel, as it had the color and general appearance of that drug, and to calomel they had a most inveterate and irreconcilable hatred. It was a hatred, however, which whether well or ill founded, very extensively prevails.
At first, I could not help wondering at the results of my supposed doses of medicine; and indeed it was a long time before I began to suspect the true cause. For, while I verily believed I was employing the only thing which could help her,—one which I then thoughtoughtto help her,—I had the unspeakable mortification of finding her every day growing worse. What could be the possible cause, I often asked myself, of this downward tendency?
While thus perplexed and pained, I accidentally learned that the main ingredient in my plan of treatment—the main pillar in my fabric—had been habitually withdrawn by her anxious but injudicious attendants. I no longer wondered at the threatening symptoms. My only wonder was, that things had not gone wrong with her at a much more rapid rate.
The patient continued to sink from day to day, and to become more and more insensible. The daughters themselves saw her downward tendency, for it could not be concealed. I did not tell the young women of their error at first, although I did so afterwards. It was a most painful duty, but it was one from which I dared not shrink. I hoped and trusted it would be a means of saving some among the coming generations.
I have never met with either of these daughters since that day—for one of them, at least, is still living—without blushing for their sake. They, on their part, appear to be equally affected and agitated. They almost adored their mother, and yet they inadvertently destroyed her. She might have perished, it is true, without their aid; but I rather think she would have slowly recovered.
Let him that readeth understand: It is extremely hazardous for a second or third person to change the doses of a physician's medicine, either by the omission or addition of an ingredient. It would be safer—very much safer—to omit every thing, and leave the disease wholly to nature. The true course, however, in all cases, is to follow the prescription of the physician, to the best of our abilities, or else dismiss him.
I might pause here a moment to animadvert on the unreasonableness of the vulgar prejudice which almost everywhere prevails against calomel. That this drug does great harm, in many instances, is most certain; but that it does more mischief to the human constitution when in the hands of judicious practitioners, than some half a dozen articles of themateria medicaI could name, about which complaint is seldom made, remains to be proved. Let us, if possible, prevent the necessity of using any of these two-edged weapons, by so living that disease cannot assail us, and then we shall not, of necessity, be exposed to the danger of medicinal agents, whether calomel or any thing else.
My own principal error in relation to this interesting case, consisted in not telling the attendants of the sick woman, in the plainest language, what my medicines were and how much, in my own estimation, depended on their careful and proper exhibition; that if they should take away or suffer to be taken away, one faggot from the bundle, they would not only spoil their effect, but might, very probably, turn the edge of the sword against the very citadel of life itself. But from the extreme of explaining every thing, in sick families where I was called, I had passed over to that of explaining nothing. Truth here, as elsewhere, usually lies midway between extremes.
One of my patients was subject to repeated attacks of rheumatism. He was by no means a man of good and temperate habits, and never had been so. And even his rheumatic attacks, though they were now frequently excited by taking cold, or by a sudden strain, as well as by many other causes of no considerable magnitude, often had both a foundation or predisposition in his former and later intemperance.
Let me here say, most distinctly and unequivocally, even at the risk of being charged with repetition, that a large proportion of even these casual or apparently accidental attacks of rheumatism, neuralgia, sick headache, etc., etc., with which our world—the fashionable part of it, at least—is half filled, instead of springing out of the ground, or coming upon us by the special appointment of high Heaven, have their origin in the intemperance, excess, or licentiousness of somebody. The cause may lie many years back, and may be almost forgotten; nay, it may be found in a preceding generation rather than the present. But it lies somewhere in the range of human agency. "Almighty man," as the poet has well said, "decrees it." Solomon never uttered a more palpable truth than when he said: "Because sentence against an evil work is not executed speedily, therefore the heart of the sons of men is fully set in them to do evil."
My rheumatic friend sent for me one day, to come and see him in great haste, for, as the messenger said, he could not long continue in such suffering. I found him in the greatest distress, and after making the usual temporary applications, I gave him what I had never given him before—a pretty fulldose of tincture of stramonium. It had, in due time, its accustomed effect, and I left him, rather prematurely, to visit another patient in a somewhat distant part of the town, intending, however, to see him again in the evening.
But I had not been absent more than an hour, before I was sent for in post-haste. As soon as possible I hastened to the spot. I found my patient in a state somewhat peculiar and not easily described. He was evidently affected by the stramonium; but how, I said to myself, can this be? I certainly did not give him an overdose. Besides, as I well knew, the effects, so long as I remained with him, had been decidedly favorable.
The mystery was soon revealed. On finding himself much better, soon after my departure, he had resorted again to the stramonium bottle, which in my haste and contrary to my usual practice, I had left within his reach. The result was a degree of delirium that had alarmed his friends and induced them to send for me.
By means of careful and persevering management, a partial recovery soon took place, though a train of incidental evils followed which it is not necessary here to enumerate. The patient was one of those ignorant and selfish individuals on whom a permanent cure can rarely be effected.
This circumstance taught me one important lesson which ought to have been impressed on my mind long before. It was, not to leave medicine of any kind within reach of my patients or their friends. In many an instance, medicine thus left has been taken by others, under the belief that since it operated favorably in the case for which it had been prescribed by the physician, it would do so in another case which was vainly supposed to be just like it, when, in truth, it was not at all similar.
To the custom of keeping medicine in the house, of any sort, I am equally opposed, and for similar reasons. There will generally be time enough to send for it when its presence is really needed. Such at least is the fact, ninety-nine times in ahundred. And as a set-off against the fact of its being thus useful once in a hundred times, we have to acknowledge the multiplied dangers to which we are exposed, of using it without prescription, and to which we are otherwise exposed by having it constantly before us in our houses.
Theodore, a laborious young man, came to me one day, saying, "I am afraid I have a cancer on one side of my nose, and I wish you would look at it." Accordingly I made a careful examination of the sore, taking care to give him a little pain, and, at the same time, as a most indispensable ingredient, to look "wondrous wise;" after which the following conversation, in its essentials, took place between us:—
"What makes you suspect this sore to be a cancer?"
"There are various reasons. Many of the neighbors think it to be so. Then, too, it has a very strong resemblance to the cancer on Mrs. Miller's lip. And then, again, it burns and itches and smarts, just as people say cancers always do."
"How long have you been troubled with it?"
"It is three months or more since I first observed it; but it has given me very little uneasiness or trouble till within a few weeks."
"What have you done for it?"
"It would take a long time to tell you of all I have done for it. Every thing I could hear of, far or near, has been applied; from plasters of clay and chalk, to plasters of vitriol and other poisonous things. But I have used most a plaster made of chalk and the white of an egg. I do not know that any thing I have done has benefited it."
"Perhaps you have not persevered in the use of any thing long enough. How long is it, pray, since you began to use the chalk and egg plaster?"
"Oh, it is three weeks, or more."
"And how long is it usual to wear it? do you know?"
"Mrs. Lovejoy, who advised it, only said, 'Use it as long as it appears to do good.'"
"Is it a favorite remedy with her?"
"Very much so."
"Has any one been really cured by it?"
"Oh, yes. Mr. Browning, the gardener, was entirely cured by it; so, at least, people say."
"Any one else?"
"Yes, half a hundred or more have tried it."
"But how many have been cured by it? That is my main inquiry."
"That I cannot tell you. I have heard of no positive cure but that of Mr. Browning."
"It is almost incredible, my dear sir, that any thing like fifty cases can have come within such a small range of population as the village or even the town in which Mrs. Lovejoy resides. Do you mean as you say?"
"Well, then, a great many. I know of a dozen, most certainly; and I have heard of a great many more. I venture, at least, to say twenty."
"And you have no positive knowledge of but one permanent cure among them all?"
"Only one, I meant to say, that I can call by name. There must be many more, I am sure, but I have not their names."
"Have you much confidence in a method of treatment that succeeds once in fifty times, or even once in twenty?"
"Not much, I confess; but if it now and then succeed, that is something. You know that they who run in a raceallrun, though but one receives the prize."
"Are you quite sure thereisany gain or prize, after all?"
"Do you mean to ask if I believe Mr. Browning was really cured?"
"Yes."
"How could I doubt what I have seen and known?"
"I do not expect you will doubt the existence of what you have seen and known. But the question before us is, whatyouhaveseen and known. Mr. Browning had something on his face, and it got well; but do we know it was a cancer? Only a very small proportion of twenty sores suspected to be cancers ever prove to be such, and many of them get well after a little time, if they are let entirely alone; or, if not let entirely alone, they would probably still get well, in spite of the treatment. It is quite a marvel with me, not that one person, Mr. Browning, recovered in spite of the treatment, but that more did not."
"This is to me a new way of reasoning on this subject, and yet I do not know but you are correct. I confess, that on reflection, I do not find positive evidence that any good has been done to Mr. Browning. It may be so, or it may not. And yet the story of his cure is told all over the neighborhood and for many miles around, and Mrs. Lovejoy gets great credit by it."
"No doubt she does; and thousands obtain both credit and cash in a similar way. Much of the reputation of our wonderful cure-alls, advertised in the newspapers, comes in a similar way."
"Do you really think so?"
"It can be demonstrated."
"Why, then, is it not oftener done?"
"It has been done, again and again."
"Are the public, then, fully determined to act against their own interest? Do they choose to be humbugged?"
"It seems so."
"But can you do nothing with my face?"
"I can try. I will do what I can. But I must first tell you what Icannotdo. I cannot pronounce your disease to be cancer. I cannot say positively that my method of treatment will cure it. I cannot say, moreover, that somebody else cannot cure you, even if I cannot. If, however, I prescribe for you, you must consent to follow me for the time most implicitly, and let everybody else alone."
"That I shall be both willing and glad to do."
"You need not begin till you are fully satisfied in regard to the efficacy of Mrs. Lovejoy's plaster."
"I am pretty well satisfied already. I see that science is modest but honest, and I prefer it to humbuggery."
My prescription was an application of the common blistering ointment of the apothecary's shop. The part to which it was to be applied was quite denuded and tender; but I told the patient to stick a small piece of the plaster over it and wear it, and keep it as sore as he could for a month or more. He was, however, to call on me once a week,—or, perhaps, at first, twice,—that I might watch the effects. There was some danger of an absorption of the cantharides into the system, which might do more of general harm than would justify an attempt at local good.
No man ever followed the prescription of his physician with more pertinacity and faithfulness than young Theodore. He adhered, without wavering, to plain and unstimulating food, and to water for drink. At the end of twenty-one days, all the fiery redness of the ulcer had passed away, and it had begun to wear a healthy appearance. "Now," said I, "you may take away your plasters, and let the sore get well, if it will."
In about ten, or at most fourteen days more, the young man's nose was as well as any other part of his system. Whether the Spanish flies contained in the plaster had any thing to do with it, or whether it recovered its healthful condition in spite of them,—having just then got ready to heal,—I cannot, of course, positively determine. In any event, the case was a strong one, though not stronger, I confess, than that of dosing largely with calomel, as detailed in Chapter XXXII. And yet, as I have already told you, I should not dare to repeat that heroic treatment. Success is not always competent proof that a given course is correct;—at least, this is true with regard to the success of a particular formulary of medicine. There are very many things on earth to be known and thought of, as well as in heaven.
Not far from this period I was called to visit Mr. O. B., sixty-one years of age, a farmer by occupation. He had been for twenty or thirty years addicted to cider drinking very freely, according to the custom of the country; which habit, conjoined with full feeding, a diminished amount of exercise, and a lymphatic tendency by inheritance, had rendered him exceedingly corpulent. His legs had even fallen into a habit of swelling, especially at night, sometimes to a very alarming extent.
His story concerning himself was essentially as follows: In getting into a wagon, some time before, he had detached a small portion of skin from one of his legs. Although the wound was slight, and was duly attended to, according to the usual method of the family, with cabbage leaves, and with considerable care and neatness, yet, instead of healing kindly, it had put on a very unhealthy appearance, and had, at length, even become extensively ulcerated. He was also habitually a sufferer from chronic rheumatism in his back and hips, partly constitutional and partly as the result of overstraining the parts, especially in wrestling.
When I was called in to see him, it was about the last of June. His wounded leg was now evidently growing worse; and as the heat of the weather was increasing, and was for some time to come likely to increase, I could hardly help apprehending the most serious consequences. He had been in the habit of making greasy applications to it for a short time, but these at my special request were set aside immediately.
He was also encouraged to keep his leg cool; to exercise his whole system moderately; to avoid exciting, above all, stimulating,food and drink; and to keep his mind quiet. In regard to drinks, particularly, he was directed to use none but water. He was also required to abstain wholly from pork, and all long-salted meats. He had also been, for almost half a century, a chewer of tobacco—a circumstance rather unfavorable to a rapid return of healthy action; but I did not think it expedient to interdict its use entirely at the very first; for I feared the change, at his advanced age, would be more than his system could well endure.
In fact, I found it extremely difficult to persuade him to pursue the straight and narrow path which, letting alone his tobacco, I had deemed indispensably necessary. To encourage him to do so, I availed myself of a circumstance which, though in itself trifling, was nevertheless likely to have its influence. The thirteenth day of July was at hand, and would be the fortieth anniversary of his marriage. My proposal was that he should commence the change of habits that very day, and continue it precisely eighteen months.
Although the danger to which he would be exposed by neglecting my prescription was neither immediate nor imminent; yet it was so considerable in prospect that I pressed him very hard to comply with my requirements, notwithstanding their seeming rigidity. And as a further inducement,—for he was not above the influence of pecuniary considerations,—I offered him a certain sum of money.
I left him without much hope, after all, that he would follow out my suggestions and advice, so difficult is it, at the age of sixty, to make substantial and radical changes. But I was most happily disappointed. He began the work of reform on the very day appointed, and began it well; and though he did not adhere to the letter of my prescription entirely, he did quite as much as I had dared, even in my most sanguine moments, to expect. And though his leg did not at first improve much, it was something to find that during the very hottest weather of the season it did not grow worse.
For three months he did not use, as he said, so much as fifty cents worth of pork, nor much salted food of any kind. Heabandoned entirely all drinks but water, and all condiments with his food except a little salt. He subsisted almost wholly on bread, fruits, and vegetables, with a very little flesh or fish.
At the end of three months he ventured abroad more than before; and as it was now near the middle of October, he consented to put on woollen stockings. But he made one change at this time which I had not intended. He returned to the use of one of his former greasy and worse than useless ointments. In the course of the month, however, in spite of the foul external application, his leg was entirely healed; and the swelling considerably abated. In short, at the close of the year he had entirely recovered.
The friends and neighbors attributed the cure to the ointment. How very unreasonable! The ointment had been used during the spring, up to the time when he came under my direction, without any apparent benefit. What evidence then was there that it had been useful now? Why should not the change for the better be attributed to his increased exercise, the change of air and food, and the stimulus and warmth of woollen stockings? Had water, moreover, as his only drink, nothing to do with the cure?
But while standing in the position I did, it was useless to decry the ointment or exalt my own treatment, since it would have been regarded as merely special pleading. Still, I did not shrink wholly from the statement of my honest convictions, whenever I was inquired of, even though I did not manifest a disposition to carry the war into Africa.
Mrs. N. was about seventy years of age. In her early years she had possessed a sort of masculine constitution; and though embarrassed by poverty, had reared a large family of children, who were all well settled in the world. She resided with the youngest but one of them, where she did just as she pleased. In short, she had a good home, and, had she enjoyed health, might have been happy.
But a change had come over her in point of health, which it was not so easy to account for at its outset as in its progress. For her first derelictions, at least, I know of no cause. But she had, at length, become reconciled to the use of tea, and as her spirits began to flag, she added to it strong coffee. From these she proceeded to the pipe.
The more she increased her extra stimulants, the more she added to her troubles, and the greater was her necessity for additional stimulus. Laudanum was very soon on her list; at first, it is true, in very small quantities. Yet, as she grew older, she found a necessity, as she verily believed, for increasing the size of her dose from year to year, till, at the age of seventy, I found her in the full and free use of tea, coffee, tobacco, and laudanum,—the latter to the enormous extent of half an ounce a day,—and yet her complaints were more numerous than ever.
She was a reasonable woman, and therefore I attempted to set forth, in their true colors, the realities of her condition. However, as I was not acting as her physician, but only as a friend, I had little hope of making any very permanent impressions. She knew the whole story as well as I or any one else could know it. The great difficulty under which she laboredwas a want of resolution to change her habits. Her irresolution was sustained by the belief—a very general one—that old people cannot make sudden changes in their physical habits with safety.[G]But she was unhappy in the condition she then was. She had no peace with conscience, nor, as I might almost venture to say,—for she was a religious woman by profession,—with God.
I assured her that the real danger of sudden changes, at her age, had been greatly overrated; though danger there certainly was, in greater or less degree. But I pointed out to her the means of obviating what danger there was, and urged her, as a Christian, to make up her mind to meet it. Of course, I did not presume to urge her to cast every thing aside, and return to Nature's path at once; but to drop first one thing and then another. I counselled her to be thorough and determined, as far as she went; and when she abandoned a thing to make no reserve, but to be sure of not going too fast and too far at once.
When I left her one day, after a somewhat protracted conversation, it was with many feelings of discouragement. I doubted very seriously whether, on the whole, she would move at all. The power of half an ounce of laudanum and a paper of tobacco daily, in paralyzing the human will, is very great. But she was one of those persons who cannot, or think they cannot, leave off a habit gradually, in the way I proposed. She must "go the whole figure," as it is said vulgarly, or do nothing at all.
Judge then, if you can, of my surprise, when about two months afterward I learned, from a source which was perfectly reliable, that the very next day after I saw her, she abandoned the whole herd of extra stimulants, both solid and liquid, and betook herself to water. Nor had it, so far as I could learn, at all injured her.
No sooner did I hear the news of her reformation, than I took my horse and made her a visit. There she was, nearly as well as ever she had been in her life, though perhaps a little paler and thinner. And oh, what rejoicing she had in her freedom! It would have done you good to see her. She had now no fears for the result. "True," she said, "I suffered for a few days, but the agony was soon over."
One thing should be mentioned, since it doubtless added to the dangers, real and imaginary, of her condition and trial. It took place during the middle of a very cold winter—one of the coldest which we of the North ever experienced; scarcely, if at all, behind those of 1855-6 and 1856-7.
But all persons have not Mrs. N.'s faith, nor her deep-abiding religious principles. These, it is presumed, greatly aided her in the terrible conflict. No one ought to attempt such changes, at least in life's decline, unless most fully convinced of their importance and necessity. Yet,withthis conviction, and strong faith in addition, all becomes comparatively easy.
Mrs. N. died a few years after her reform; but she died a free woman, and not a slave to her appetite. Some few there were of her acquaintance who appeared to think that the sudden changes to which she had subjected herself several years before, hastened her dissolution. But I do not believe there was a particle of evidence to be found that such was the fact. Reader, remember Mrs. N., and if you are in the road of error, and not more than seventy years of age, go and do likewise. If you have notlivedfree, resolve at least to have the pleasure of dying so.