FOOTNOTES:[G]This error has been met and refuted in the happiest manner, by the late lamented Dr. John C. Warren, of Boston, in his little work, entitled, "Hints for the Preservation of Health." Also, by Dr. Alcott's new work, "The Laws of Health."
[G]This error has been met and refuted in the happiest manner, by the late lamented Dr. John C. Warren, of Boston, in his little work, entitled, "Hints for the Preservation of Health." Also, by Dr. Alcott's new work, "The Laws of Health."
[G]This error has been met and refuted in the happiest manner, by the late lamented Dr. John C. Warren, of Boston, in his little work, entitled, "Hints for the Preservation of Health." Also, by Dr. Alcott's new work, "The Laws of Health."
Almost at the next door from me was an opium eater. He, like the female whose case was described in the preceding chapter, was not far from three score and ten, and was of industrious and, in many respects, temperate habits. And yet he was one of the most inveterate and abandoned voluntary slaves to the drug opium I have ever seen. He had used it largely thirty years.
His case is the more singular from the fact that he became enslaved to it so very early. To use opium or laudanum at the present day, I grant is no uncommon occurrence. We may often find six, eight, or ten opium takers in a single township, if not a single village, or even a single neighborhood; and the number is rapidly increasing. Opium has not that offensive appearance to many that tobacco has, and a much larger amount of stimulus may be kept in a very small space, perhaps in the very corner of the smallest pocket.
Another circumstance which rendered the case of my opium-taking neighbor somewhat striking, was his usual good health. I say, here,usual, for there were exceptions which will appear presently. Yet though he was nearly threescore and ten, this man had, while under the influence of his accustomed stimulus, as much elasticity and nearly as much strength as most men of thirty.
How could this happen, you will naturally ask, if opium is such a deadly narcotic as some medical men proclaim it to be? How can a person, male or female, begin its use at forty and continue it to seventy years of age, and yet be, for the most part, strong and healthy?
In the first place, we must remember the force of habit.We have seen how it is with alcoholic drinks and tobacco. I might tell you how it is with arsenic, which is beginning to be taken, it is said, by men and horses, both in the old world and the new. I might even give you the story of Mithridates, king of Pontus, who is said to have so accustomed himself to hemlock,—the most deadly poison of his time,—that in any ordinary dose, it would not affect him injuriously, or, at least, would not do so immediately.
We must remember, in the second place, the active, industrious habits of this patient—of which, however, I have already spoken. He who is always or almost always in the open air, is less likely to suffer from the use of extra stimulants, and the penalty when itdoesfall on his head, is much more likely to be deferred, than in the case of the sedentary and inactive. He was so hardy and withal so bold, that in the summer season he sometimes slept in the open air, under a tree.
But, thirdly, he was descended from a very long-lived race or family. His father died at the age of ninety-seven. At the time of his decease he had been the progenitor of nineteen children, one hundred and five grandchildren, one hundred and fifty-five great grandchildren, and four of the fifth generation,—a posterity amounting in all, to two hundred and eighty-three. And what is most marvellous, nearly all of them were at that very moment living. In truth, he had several sons and daughters already between the ages of sixty-five and eighty. There was one of the brotherhood, whom I had seen, nearly eighty, and yet as active and elastic as the opium eater of seventy.
One thing more: The latter, as we have seen, was a man of excellent habits in respect to nearly every thing but opium. He drank no ardent spirits, nor much coffee and tea; he used very little tobacco, and he ate in great moderation. He was an early riser and was in general cheerful. In short, but for his opium taking, he would have enjoyed a green old age.
I have said he was usually healthy. When he was out of opium and could not obtain any, I have seen him sit and writhe in the most intense apparent anguish till the arrival ofthe accustomed stimulus, when the transformation would be as sudden as it was striking. In fifteen minutes, instead of writhing and groaning and almost dying, he might be found talking, laughing, and telling stories most merrily, to the infinite amusement of all around him.
But he had troubles more abiding than this; at least, occasionally. After taking his opium for a long time, such a degree of costiveness would sometimes supervene, as seemed almost to defy the combined powers of both nature and art. In these circumstances, of course, the aid of the physician was usually invoked. It was on one of these occasions that I first became fully acquainted with his habits and tendencies.
Once, when thus called to his bedside, I began to think he was not very far from the end of his career. The wheels of life seemed so completely obstructed, that I doubted whether they would ever start again. He himself declared, most positively and I doubt not in sincerity that he must die. But he lived on many years longer. He died at about seventy-five years of age—more than twenty years younger than his venerable and more temperate father.
From this distinguished opium eater, and from his family, I learned two things: First, that Solomon was right when he spoke of the certainty of punishment, even though long deferred. Secondly, the certainty of the visitation, so to call it, of human transgression upon subsequent generations no less than on the individual transgressor. The fourth generation from the patriarch of ninety-seven was puny and feeble—exceedingly so; the fifth and sixth not only puny and feeble, but absolutely sickly, not to say dwarfish.
Did I say I learned these important truths from this source? Not at all. I mean only, that I received from it a new confirmation of what I had fully believed long before, and concerning which, till compelled, most men—even some thinking men—appear to me not a little sceptical. They seem to think it reflects dishonor on our Maker. How this is, we shall perhaps see more fully in another place. Let it suffice, for the present, to say that the fact itself is fully established, whatever may be the deductions or its consequences.
Mr. W. was a distinguished minister of the gospel, and teacher of females. He could not at this time have been much less than seventy years of age. He was originally a man of iron constitution and of great mental activity.
Of late it had been observed by some of the members of his family, that his mind had seasons of great inactivity, and it was even suspected he had, either in his sleep or at some other time, suffered from a slight attack of paralysis. His face seemed a little distorted, and one of the angles of his mouth a little depressed. There appeared to be a slight change even of his speech. It was recollected, too, that he inherited a tendency of this kind.
Along with other difficulties was a lame knee. This he called rheumatism; but was it so? People are very fond of having a name for every thing; and yet names very often mislead. Prof. Ives, of the Medical College in Connecticut, was wont to say to his students, "Diseases, young gentlemen, are not creatures to whom we can give particular names, or assign particular marks of distinction. They are merelymodes of action." My friend's over solicitude for a name to his complaint was therefore no new thing.
I explained the matter as well as I could, very cautiously. I told him it was of little consequence about the name of his disease, provided we could ascertain the cause and remove it. "However," I said, "we will conclude to call it rheumatism." For though possessed of a good natural constitution, and, in general, of comparatively temperate habits, he had nevertheless set at defiance some of nature's laws, and was suffering under a just penalty.
One member of his family, a favorite son, was suspicious of coffee. He himself had abandoned it long before, and had thus placed himself in a position to observe its effects on others. His father used it very strong, he said; and had used it in this way for a long time. He even ventured, at length, to express his fears to his father.
"Nonsense, my son," said the father; "do you think coffee is powerful enough to give a man a lame knee? Why, the whole world—I mean the whole civilized world—use it; and do they all have stiff knees?"
"Perhaps not," said the son; "but almost every coffee-drinker has, sooner or later, some ailment about him, that may very possibly have its origin in this source. Our troubles, as you yourself are accustomed to say, do not spring out of the ground. Coffee, as the best authorities tell us, is a slow poison; and if it is so, its effects must, at some time, be manifested."
"Ay, a very slow poison this coffee must be, my son," said the half-indignant father; "for I have used it pretty freely forty years, and am not dead yet. But to be serious for a moment, Henry, do you really believe that such a small transgression as this, even if it could be proved to be a transgression at all, would be the cause of so much suffering?"
"You admit, then, that your troubles may possibly be the result of transgression, and that they did not spring out of the ground."
"Oh yes, I suppose it must be so; but there is such a strange disproportion between the transgression and the penalty, in the case you mention, that I cannot for one moment believe any thing about it. Why, what rational man in the world will believe that a little coffee, once a day, will entail upon a person severe rheumatism?"
"To what larger transgression, my dear father, will you be more ready to refer it? You do not use tobacco, or rum, or opium; and I am happy in being able to say that you never did. You are no tea-drinker. You are no worshipper of the apothecary's shop. You have not, so far as I know, strained your knee, by over exertion, either in labor or amusementYet, here you are a sufferer; and you have suffered for months. Now, how do you account for it?"
"There is no possibility of accounting for it, my son, and why should we talk about it? If any thing can be done to cure it, I am sure I shall be glad; but though I admit that the complaint may have had a cause—and indeedmusthave had—I do not think we shall ever be able to trace it out."
The son still adhered to the opinion that the coffee was the cause of the father's sufferings; and there was reason for believing that the father was more than half convinced of it himself; only that he was too proud to confess it. He concluded by asking his father if he would like to consult me on the subject—to which he cheerfully consented.
On a careful investigation of the case, I came to a full conclusion that the son was right in his conjectures; that the coffee was the principal source of his troubles; and that troubles still more serious might befall him unless he abandoned it; and accordingly I told him so.
It was a severe trial. He was, in truth, a most inveterate coffee-drinker; and the greater his slavery to it had become, the greater his reluctance to believe it produced, on him, any injurious effects. He consented, at length, to leave off its use for two months, and see if it made any difference with him. Being, however, about half a convert to hydropathy, as was also his son, it was concluded, with my permission, to apply the colddoucheevery day to his knee, by way of an adjunct to the abstinence plan. No change was made in his diet; as, in fact, very little was needed after the coffee had been removed. "But one thing is needful," at the same meal, had long been his motto; and he was never excessive in the use of even that.
The coffee was laid aside, and resolution was put to the test. He suffered in his feelings for want of his accustomed stimulus during the first month; but during the second, very little. In about five weeks after I saw and had prescribed for him, I met him one day, by accident, and inquired about his lameness. "Very much better," said he, smiling; "but no thanks to you for it. It is thedouchewhich is curing me." I repliedthat I was not very solicitous to know the cause, provided he was cured.
On a more particular inquiry I found that his lameness had nearly disappeared already; and what is more remarkable still, it never returned. As long as he lived he could walk up and down stairs nearly as well as I. He continued to be a water-drinker about ten years, when he died, as he had lived, rejoicing in his emancipation from slavery to coffee. He believed, most fully, in its evil effects and tendencies, and did not hesitate, for many years before he died, to acknowledge that belief. Neither his son nor myself had firmer faith in the connection of law with penalty, in these matters, that he. And his only regret, in this particular, seemed to be that he had suffered himself to remain, almost all his lifetime, in what he now regarded as utter ignorance. And yet, compared with most men of his day, he was quite enlightened.
The case of Mr. W. was a pretty apt illustration of the truth of what I regard as the great or cardinal doctrine of temperance, faintly announced in Chapters XVIII., XXI., XXVIII, and elsewhere, viz., that, as a general rule, much more mischief is done to society at large by the frequent or at least habitual use of small quantities of poison, than by an equal aggregate quantity in much larger doses. I mean just this: The poisonous effects of Mr. W.'s coffee, though the amount daily taken was trifling, produced a greater aggregate of mischief, in the end, than if the same amount of poison had been applied in a very short time. A pint of rum drank in a single day will do much less mischief to the human constitution, than if divided into twentysmalldoses and two of them are taken every day for ten days. In the first case the effect will be severe, but temporary; in the second, it will seem to be trifling, but there will be an accumulation of ill effects, a heaping up, as it were, of combustible matter in the system, till by and by when an igniting spark comes to be applied to the pile, lo! we have an explosion.
Some of the hydropathists who knew the facts concerning Mr. W.,—for the case did not occur in a corner,—tried tomake it appear, perhaps in all honesty, that he was cured by the colddouche. Now I have no disposition to deny, wholly, its good effects. I have given you the facts just as they were. Yet I have not a doubt that had he returned to his coffee, the same troubles or others of equal magnitude would have fallen to his lot again, despite the influences of thedouche. In truth, I know of no sensible hydropathist who, in such a case, would rely upon thedouchealone; which is to concede, practically, all that I desire to claim.
The statements of the following chapter will include a confession of one of the principal faults of my life,—a fault, moreover, which, as a physician, I ought to have guarded against with the most assiduous and unwearied care. For no man more than the medical man, is bound to let his light shine—especially in the matter of general temperance, in such a manner that others may be benefited by it.
When, in the beginning of my medical career, I attempted to establish a temperance society, though I was exceedingly free from the charge of using distilled liquors, according to the tenor and spirit of the pledge, yet exposed, as I was, to colds, and delicate in constitution, and above all, particularly liable, in the daily routine of business, to temptation, I was yet one of those who lay aside one stimulus and retain or resort to another. I did not, indeed, use my substitute with much freedom, at first. The example daily before me, which was alluded to in Chapter LII, was sufficient, one would think, to deter me from excess; and so it proved. All I did for some time, whenever I had been peculiarly exposed and feared I had taken cold, was to go and swallow a small pill—say about a grain—of opium.
But as usually happens in such cases, though the pill seemed to remove all tendency to cold, or in other words to cure me for the time, the necessity for recurring to it became more and more frequent and imperious, till I was, at length, a confirmed opium taker. And yet—strange to say it—all the while I regarded myself as a rigid temperance man; nay, I was a violent opposer of the use even of opium as a daily stimulus, in the case of everybody but myself. My apology was—andhere was the ground of self-deception—that I only used it as a medicine, or rather as a medical means of prevention.
It is, however, quite obvious to my own apprehension now, that a substance is hardly entitled to the name of medicine, in any ordinary sense of the term, which is used nearly or quite every day. Yet to this stage of opium taking I soon arrived. Nay, I went even much farther than this, and was, at length, pretty well established in the wretched habit of using this poisonous drug three times a day.
In the summer of 1830, while under the full habitual influence of opium, I had a slight attack of dysentery. It even went so far as to derange all my habits, and to break in, among the rest, upon my opium taking. Opium or laudanum was, indeed, included in the prescription of my physician,—for I did not wholly rely on my own judgment in the case,—but as a habitual daily stimulus, at certain fixed hours, it was, of course, omitted. As I began to recover, however, my old desire for the opium pill began to recur, at the accustomed former hours, and with all its wonted imperiousness.
In a moment of reflection, reason resumed her throne, and the inquiry came up, whether I should ever again wear the chain which had been temporarily loosened. After a short debate, it was decided in the negative. But a second question soon came up, whether I could keep my resolution. This was a matter of serious inquiry, and it caused a somewhat lengthy mental discussion.
During the discussion a new thought struck me. It was a child's thought, perhaps; and yet it was interesting, and not to be despised for its simplicity and childishness. It was that I would take my opium, what I had in the house, and after carefully enclosing it in my pill box, would make use of the box as a nucleus for the twine I was daily using. "When I am inclined to break my resolution," thought I, "nothing shall be done till I have unwound the ball of twine. I shall thus gain a little time for reflection; and perhaps before I come to the opium, I may permit reason to return and to mount the throne. The trial shall, at all events, be made."
My resolution was carried into effect, and steadily adhered to. The opium was fairly entombed in the twine, where, for aught I know, it still remains. Most certainly I never saw it more; nor have I ever tasted any of the opium or laudanum family, from that day to the present, whether in sickness or in health.
Having occasion to go to the metropolis, one day, I took the most expeditious public conveyance which the times and the season afforded. It was January, 1832. Railroad cars were not so much in vogue that I could step into one of them, and, unless in case of accident, be there in four or five hours, as I now could. It required something like twenty-four hours to perform the journey I proposed, especially in the winter.
We started at three o'clock in the morning. It had recently snowed, the snow was deep, and the path was not well broken. Of course it was not daylight when we set out, and as it was cloudy, it proved, as is not unfrequent in such cases, to be the darkest time in the whole twenty-four hours. However, we did as well as we could—driver, horses, passengers, and all.
Our company consisted of seven males and two females. The coach was small, and we filled it to the brim. The weather was by no means very cold for the season; at least, it was not extreme. There was a sound of rain,—the January thaw, perhaps, as we are wont to call it,—but as yet, fortunately for us, the storm had not begun.
We had proceeded about ten miles, and the day had not yet dawned, when, in passing around the point of a hill and winding our way among the deep drifts, our driver and his charge missed the path, and we were precipitated down a steep bank. The horses stopped immediately. Every effort was made to rescue us from the stage-coach, which was lying on its side, deeply embedded in the snow. I was so situated at the first moment after the overturn, that most of the affrighted passengers made use of me as a stepping-stone in their endeavors to reach the door above, which was either opened or broken. Atlast we were all fairly outside of the coach; no one appeared to be seriously injured.
As we were at a considerable distance from any dwelling-house, and as the stage-coach was somewhat broken, and the harnesses torn, it required a full hour to put things to rights, so as to enable us to proceed. Meanwhile, though the weather was not very cold, it was quite chilly. Some of the passengers stood still or sat still; others walked about. The day had broken when we renewed our journey.
The sleighing here was better than at the place where we started. At the next stage-office we exchanged our coach for a huge sleigh, which was not only more commodious than the coach, but more easily drawn over the ground, especially for a short time.
About noon it began to rain. Soon the travelling became worse again, and our progress was slow and tedious. To me, the tediousness of the journey was increased by a lame shoulder—the effect either of the overturn, or of being used as a stair when the passengers made their sudden exit, or of both. No bones were broken, nor joints dislocated; though there were several considerable bruises.
Our other troubles were not yet over. In the midst of a violent rain, and at a considerable distance from any public house, our sleigh broke down, and we were obliged to send for a wagon. In making the exchange, moreover, we were more or less exposed to the storm. I for one became considerably wet, and did not get perfectly dry till we reached the metropolis.
We arrived at evening at a large thoroughfare, forty miles or more from our point of destination, when, after procuring a comfortable supper and a good sleigh, with a new relay of horses, we set out to perform the remainder of our journey. This was fortunate and very expeditious. We reached our place of destination just before midnight, having travelled the last forty-two miles in little more than four hours. This was almost equal to railroad speed; but it was good sleighing, and we had with us, in the sleigh, the United States mail, whichimposed on the driver a necessity of being as expeditious as the nature of the case would admit. For even then, we had been twenty-one hours in making our passage.
I soon discovered that I had taken a severe cold during the journey; nor do I believe my opium itself would have saved me. My only medicine was a warm bed, into which I threw myself as soon as possible. In the morning I repaired as early as I could to a boarding-house, in which a friend to whom I had previously written, had made ready a place for me.
I was at first quite ill; but in the hope that a few days of rest would restore me, I was not particularly anxious about myself, though some of my friends were so. Several individuals called to inquire after my health—nearly every one of whom pressed me to take medicine.
The second day after my arrival I began to expectorate a little blood. Those who were familiarly acquainted with my consumptive tendencies became greatly alarmed. They thought me not only presumptuous, because I took nothing, but absolutely and carelessly ungrateful. And as I refused to dose myself, they pressed me to send for a physician.
Yielding, at length, to their importunity, they called one of the oldest and best physicians in the metropolis. He was an eccentric man, but he had the full confidence of the better sort of people, and richly deserved it; and I knew I should not be advised by him hastily. He was acquainted with my peculiar views, at least in part. Besides, I should not be obliged to follow his counsel implicitly. I should still be my own physician. My disease had not, at least thus far, impaired my intellect or taken out of my hands my free agency.
The doctor remained with me half an hour or so, during which time I made him acquainted, as perfectly as I could, with my whole case. My good friends, many of them, sat around waiting almost with impatience, to hear him bid them or me to do some great thing—for great men though some of them were, they were not great in matters pertaining to health and disease. They were born, several of them, in the eighteenth century.
At length the time for prescription and departure had arrived, and my good brother and father of the lancet rose very deliberately, and said with great gravity, "You will be obliged to stay in your room a few days, and keep both your body and mind as quiet as possible. For the most part, it will be well to maintain a recumbent position. For food, use a little water gruel. In following this course, I think you will very soon find yourself convalescent." Then, with a sort of stiff bow, that every one who knew him could pardon in so excellent a man, he said, "Good-morning, sir,—Good-morning, gentlemen;" and was making the best of his way to the door of the chamber. "Will it not be needful for you to call again?" I said to him. "I shall be most happy to call," said he, "should it be necessary; but I doubt very much whether my advice will be any farther required."
My friends were very much astonished that he did not prescribe active medicine. "What can it mean?" they asked again and again. For myself, too, I must confess that I was not a little disappointed. Not that I had any considerable attachment to pills and pill boxes,—such a confidence had gone by long before, as you know,—but I verily thought my particular tendencies to pulmonary consumption demanded a little tincture of digitalis, or something in the shape of strong medicine.
But the physician knew my theories, better than he knew the power of that habit whose chains, in this respect, he had long ago escaped. For I learned afterwards, much better than I then knew, that so feeble was his faith in medicine, at least in all ordinary cases, that whenever the intelligence of his patients would at all warrant it, he prescribed, as he had for me, just nothing at all, but left every thing to be done by Nature and good common-sense attendants. This was, in fact, just what he attempted to do here. He doubtless supposed my friends were nearly as well informed in the matter as I was; and that I was as fully emancipated in practice as I was in theory.
"How much drugging and dosing might be saved," I said tomyself, when I came to reflect properly on the subject, "if mankind were duly trained to place a proper reliance on Nature and Nature's laws, instead of fastening all their faith on the mere exhibition of some mystic powder or pill or tincture—or, at best, a few drops of some irritant or poison. It is their ignorance that makes their physicians' and apothecaries' bills so heavy, and the grave-digger's calling so good and so certain."
It is hardly necessary for me to say that I followed the advice which had been so wisely given, and which, after all, was but the echo of my own judgment, when that judgment was freely exercised. My friends were not satisfied at first; but when they saw that I was slowly recovering, they submitted with as good a grace as they could. The fact was that they had no court of appeal. They had selected a man who was at the head of his profession, and whose voice, in the medical world, and as a medical man, wherever he was known, was law. Had some young man given such "old woman's" advice, as they would most certainly have regarded it, they would have appealed to a higher court.
No man ever did better, when placed in similar circumstances, with the aid of medicine, than I did without it. In two weeks, at farthest, I was as well as I had been at any time in ten years or even twenty. What more or greater could I have asked? What more could my friends have expected? What more could have been possible? Could Hippocrates or Galen have done more?
About the year 1833, I became somewhat intimately acquainted with the dietetic and general physical habits of a young woman in a family where I was a boarder, whose case will be instructive.
She was about twenty-five years of age, and resided in a family that had adopted her as their own, her parents being unknown. She possessed a good natural constitution; and was, for the most part, of good habits. If there was any considerable defect of constitution, it consisted in a predominance of the biliary and lymphatic over the nervous and sanguine temperaments. Yet she was not wholly wanting in that susceptibility, not to say activity, which the sanguine temperament is wont to impart. But the same necessity which is so often the mother of invention, is also sometimes the progenitor of a good share of activity; and this was, in a remarkable degree, the lot of Miss Powell.
Although her skin was not by any means fair, it was not a bad skin. It was firm in its structure, and very little susceptible of those slight but ever recurring diseased conditions in which persons of a sanguine temperament so often find themselves involved. Such I mean to say was her natural physical condition, when uninfluenced by any considerable practical errors.
And yet I had not been many months one of her more intimate acquaintances, ere her face—hitherto so smooth and transparent—became as rough and congested as any drunkard's face ever was, only the eruption was more minute. It was what the common opinion of that region would have calleda rash. It came on suddenly, was visible for a short time, and then gradually disappeared, leaving, in some instances, a branny substance, consisting of a desquamation of the cuticle.
When the eruption had once fairly disappeared, her skin was as smooth as ever. Then again, however, in a little time, its roughness would return, to an extent which, to young ladies, is usually quite annoying. Young men, in general, are not so much disturbed by a little roughness of the skin, as the young of the other sex.
My particular acquaintance with her habits and annoyances continued as many as four or five years. During this period there were several ebbings and flowings of this tide of eruptive disease. My curiosity, towards the end of this period, was so much excited that I sought and obtained of her an opportunity for conversation on the subject. The result was as curious as it was, to me, unexpected. It appeared, in the sequel, that she understood, perfectly well, the whole matter, and held the control of her cutaneous system in her own hands, nearly as much as if she had been a mere piece of mechanism. She had not sought for medical advice, because she knew the true method of cure for her complaints as well as anybody could have told her.
In truth, she cured it about once a year, simply by omitting the cause which produced it. This she had found out was butter, salted butter, of course, eaten with her meals. She had somehow discovered that this article of food was the real cause of her disease, and that entire abstemiousness in this particular, would, in a reasonable time, remove it.
I inquired why, after a long period of abstinence from butter, she ever returned to its use. Her reply was that she was too fond of it to omit it entirely and forever. She preferred to use it till the eruption began to be quite troublesome, which was sometimes many weeks; then abstain from it till she recovered, and then return to it. This gave her an opportunity to use it from one-third to one-half of the time; and this she thought greatly preferable to entire abstinence.
At this time I did not press her to abandon wholly an article of food, which, though partially rejected, was yet slowly producingderangement of her digestive system, and might, in time, result in internal disease, which would be serious and irremediable. I did not do it; first, because I knew my advice would not be very acceptable; secondly, for want of that full measure of gospel benevolence which leads us to try to do good, even in places where we have no right to expect it will be received; and, lastly, no doubt for want of moral courage.
Were I to live my life over again, particularly my medical life, I would pray and labor for a little more of what I am accustomed to call holy boldness. By this term I do not meanmeddlesomeness,—for this is by no means to be commended,—but true Christian or apostolic boldness.
Of late years the young woman above referred to has been in circumstances which, I have reason to believe, practically precluded the use of the offending article. I meet her occasionally, but always with a smooth face, which greatly confirms my prepossessions.[H]Happy would it be for a multitude of our race if their circumstances were such as to exclude this and many other articles of food and drink which are well known to injure them.
One instance occurred in the very neighborhood of the foregoing, which, though I received it at second hand, is not a little striking, and is wholly reliable. A certain young mother—the wife of a merchant in easy circumstances, was so excessively fond of butter, that, though she was a dyspeptic, and knew it increased her dyspepsia, she used to eat it in a manner the most objectionable which could possibly have been devised.
For example: she would take a ball of this article,—say half or three-quarters of a pound,—pierce it with the point of a firm stick, and having heated it, on all sides, over the fire, till the whole surface was softened, would then plunge it into avessel of flour, in such a manner that the latter would adhere to it on all sides, till a great deal was absorbed by the butter. Having done this, she would again heat the surface of the ball and again dip or roll it in the flour. This alternate melting the surface of the ball and rolling it in flour, was continued till the whole became a mass of heated or scorched flour, entirely full of the melted butter, and as completely indigestible as it possibly could be, when she would leisurely sit down at a table and eat the whole of it.
Did it make her sick?—you will ask. It did, indeed, and she expected it would. She would go immediately to bed, as soon as the huge bolus was swallowed, and lie there a day or two, perhaps two or three days. Occasionally such a surfeit cost her the confinement of a whole week.
It is truly surprising that any Christian woman should thus make a beast of herself, for the sake of the momentary indulgence of the appetite; but so it is. I have met with a few such. Happily, however, conduct so low and bestial is not so frequent among females as males, though quite too frequent among the former so long as a single case is found, which could be prevented by reasoning or even by authority.
There is one thing concerning butter which deserves notice, and which it may not be amiss to mention in this place. What we call butter, in this country,—what is used, I mean, at our tables,—is properly pickled or salted butter. Now, I suppose it is pretty well understood, that in some of the countries of Europe no such thing as salted or pickled butter is used or known. They make use of milk, cream, and a little fresh butter; but that is all. In the kingdom of Brazil, among the native population, at least, no such thing as butter, in any shape, has ever yet been known.
Fresh butter is sufficiently difficult of digestion; but salted butter is much more so; and this is the main point to which I wish to call your attention. Why, what is our object in salting down butter? Is it not to prevent change? Would it not otherwise soon become acid and disagreeable? And does not salting it so harden or toughen it, or, as it were, fix it, thatit will resist the natural tendency to decomposition or putrefaction?
But will not this same "fixation," so to call it, prepare it to resist changes within the stomach as well as outside of it; or, in other words, prevent, in a measure, the work of digestion? Most unquestionably it will. And herein is the stronghold of objection to this article. Hence, too, the reason why it causes eruptions on the skin. The irritation begins on the lining membrane of the stomach. The latter is first coated with eruption; and, after a time, by what is called sympathy, the same tendency is manifested in the face.
These things ought to be well understood. There is great ignorance on this subject, and what is known is generally theipse dixitof somebody. Reasons there are none for using salted butter. Or, if any, they are few, and frequently very flimsy and weak. Let us have hygiene taught us, were it only that we may know for ourselves the right and wrong of these matters.
FOOTNOTES:[H]Since this was penned, the young woman has died of erysipelas. Can it be that she has been compelled, in this form, to pay a fearful penalty for her former abuses? One might think that twenty years of reformation would have worn out the diseased tendencies. Perhaps she recurred, in later years, unknown to the writer, to her former favorite article.
[H]Since this was penned, the young woman has died of erysipelas. Can it be that she has been compelled, in this form, to pay a fearful penalty for her former abuses? One might think that twenty years of reformation would have worn out the diseased tendencies. Perhaps she recurred, in later years, unknown to the writer, to her former favorite article.
[H]Since this was penned, the young woman has died of erysipelas. Can it be that she has been compelled, in this form, to pay a fearful penalty for her former abuses? One might think that twenty years of reformation would have worn out the diseased tendencies. Perhaps she recurred, in later years, unknown to the writer, to her former favorite article.
If any individual in the wide world needs to breathe the pure atmospheric mixture of the Most High,—I mean a compound of gases, consisting, essentially, of about twenty parts of oxygen and eighty of nitrogen,—it is the consumptive person. Mr. Thackrah, a foreign writer on health, says, "That though we are eating animals, we are breathing animals much more; for we subsist more on air than we do on food and drink."
And yet I know of no class of people, who, as a class, breathe other mixtures, and all sorts of impurities, more than our consumptive people. First, their employments are very apt to be sedentary. Under the impression that their constitutions are not equal to the servitude of out-of-door work, agricultural or mechanical, they are employed, more generally, within doors. They are very often students; for they usually have active, not to say brilliant minds. And persons who stay in the house, whether for the sake of study or anything else, are exceedingly apt to breathe more or less of impure air.
Secondly, it is thought by many that since consumptive people are feeble, they ought to be kept very warm. Now I have no disposition to defend the custom of going permanently chilly, in the case of any individual, however strong and healthy he may be; for it is most certainly, in the end, greatly debilitating. It would be worse than idle—it would be wicked—for consumptive people to go about shivering, day after day, since it would most rapidly and unequivocally accelerate their destruction.
And yet, every degree of atmospheric heat, whether it is applied to the internal surface of the lungs through the medium of atmospheric air, or externally to the skin, is quite asinjurious as habitual cold; and this in two ways: First, it weakens the internal power to generate heat, which, no doubt, resides very largely in the lungs. Secondly, it takes from them a part of that oxygen or vital air which they would otherwise inhale, and gives them in return a proportional quantity of carbonic acid gas, which, except in the very small proportion in which the Author of nature has commingled it with the oxygen and nitrogen of the atmosphere, is, to every individual, in effect, a rank poison.
Hence it is that those who have feeble lungs, or whose ancestors had, should pay much attention to the quality of the air they breathe, especially its temperature. And this they should do, not only for thesakeof its temperature, but also for the sake of its purity. Such a caution is always needful; but its necessity is increased in proportion to the feebleness of the lungs and their tendency to suppuration, bleeding, etc.
I was once called to see a young woman (in the absence of her regular physician) who was bleeding at the lungs. She had bled occasionally before, and was under the general care of two physicians; but a sudden and more severe hemorrhage than usual had alarmed her friends, and,in the absence of better counsel, they sought, temporarily, the advice of a stranger.
It was a cold, spring day, and in order to keep up a proper temperature in her room, I had no doubt that a little fire was needful. But instead of a heat of 65° in the morning and something more in the afternoon, I found her sitting in a temperature, at ten o'clock in the forenoon, of not less than 75° or 80°. On inquiry, I was surprised to find that the temperature of her room was seldom much lower than this, and that sometimes it was much higher. I was still more surprised when I ascertained that she slept at night in a small room adjoining her sitting-room, and that a fire was kept all night in the latter, for her special benefit.
No wonder her cough was habitually severe! No wonder she was subject to hemorrhage, from the irritated vessels of the lungs! The wonder was that she was not worse. The greatest wonder of all was, however, that two sensible physiciansshould, for weeks if not for months, have overlooked this circumstance. For I could not learn, on inquiry, that a single word had been said by either of them on the subject.
If you should be inclined to ask whether she had no exercise in the more open and pure air, either on horseback or in a carriage, the reply would be, none at all. Horseback exercise was even regarded as hazardous, and other forms of exertion had not been urged, or, that I could learn, so much as recommended.
I was anxious to meet her physicians, that I might communicate my views and feelings directly to them; but as this was not convenient I gave such directions as the nature of the case seemed to require, requesting them to follow my advice till the arrival of her physicians, and then to lay the whole case before them. My advice was, to reduce the temperature of the sitting-room as low as possible, and yet not produce a sensation of chilliness, and to have her sleeping-room absolutely cold, taking care to protect her body, however, by proper covering. I also recommended exercise in the open air, such as she could best endure; and withal, a plain, unstimulating diet.
What was done, I never knew for many months. At last, however, I met with a neighbor of the family, one day, who told me that the young woman's physicians entirely approved of my suggestions, and that by following them out for some time, she partially recovered her wonted measure of health.
Whether she recovered entirely, I never knew. The far greater probability is, that she remained more comfortable through the summer and autumn, but that the injudicious management of the next winter and spring reduced her to her former condition, or to a condition much worse. People are exceedingly forgetful even of their dearest rights and interests. They may, perhaps, exert themselves in the moment of great and pressing danger; but as soon as the danger appears to be somewhat over they relapse into their former stupidity.
There is, however, much reason for believing that consumptive people might often live on many years beyond their present scanty limit, could they be made to feel that their recoverydepends, almost wholly, on a strict obedience to the laws of health, and not on taking medicine. If Miss H., by strict obedience, could recover from a dangerous condition, and enjoy six or eight months of tolerable health, is it not highly probable, to say the least, that a rigid pursuance of the same course would have kept her from a relapse into her former low and dangerous condition?
It is in this way, as I suppose, that consumption is to be cured, if cured at all. It is to bepostponed. In some cases it can be postponed one year; in some, five years; in some, ten, fifteen, or twenty; in a few, forty or fifty. It is in this respect with consumption, however, as it is with other diseases. In a strictly pathological sense, no disease is ever entirely cured. In one way or another its effects are apt to be permanent. The only important difference, in this particular, between consumption and other diseases, is, that since the lungs are vital organs, more essential to life and health than some other organs or parts, the injury inflicted on them is apt to be deeper, and more likely to shorten, with certainty, the whole period of our existence.
Connected with this subject, viz., the treatment of consumption, there is probably much more of quackery than in any other department of disease which could possibly be mentioned. One individual who makes pretensions to cure, in this formidable disease, and who has written and spoken very largely on the subject, heralds his own practice with the following proclamation: "Five thousand persons cured of consumption in one year, by following the directions of this work." Another declares he has cured some sixty or seventy out of about one hundred and twenty patients of this description, for whom he has been called to prescribe.
Now, if by curing this disease is meant the production of such changes in the system, that it is no more likely to recur than to attack any other person who has not yet been afflicted with it, then such statements or insinuations as the foregoing are not merely groundless, but absolutely and unqualifiedly false, and their authors ought to know it. For I have hadample opportunity of watching their practice, and following it up to the end, and hence speak what I know, and testify what I have seen. But if they only mean by cure, thepostponementof disease for a period of greater or less duration, then the case is altered; though, in that case, what becomes of their skill? No book worthy of the name can be consulted by a consumptive person without his deriving from it many valuable hints, which if duly attended to may assist him in greatly prolonging his days; and the same may be said of the prescriptions of the physician. Yet, I repeat, it is a misnomer, in either case, to call the improvement a cure.
Consumptive people continue to live, whenever their lives are prolonged, as the consequence of what they do to promote their general health. One is roused to a little exercise, which somewhat improves his condition, and prolongs his days. Another is induced to pay an increased regard to temperature, and he lives on. Another abandons all medicine, and throws himself into the open arms of Nature, and thus prolongs, for a few months or a few years, his existence. If this iscure, then we may have all or nearly all of our consumptives cured, some of them a great many times over. Some few aged practitioners may be found to have cured, during the long years of their medical practice, more than five thousand persons of this description.
There is no higher or larger sense than this in which any individual has cured five thousand, or five hundred, or even fifty persons a year, of consumption. On this, a misguided, misinformed public may reply: Many, indeed, revive a little, as the lamp sometimes brightens up in its last moments; but this very revival or flickering only betokens a more speedy and certain dissolution.
On the other hand, predisposition to consumption no more renders it necessary that we should die of this disease in early life, at an average longevity of less than thirty years, than the loading and priming of a musket or piece of artillery renders it necessary that there should be an immediate or early explosion. Without an igniting spark there will be no discharge ina thousand years. In like manner, a person may be "loaded and primed" for consumption fifty years, if not even a hundred, without the least necessity of "going off," provided that the igniting spark can be kept away. Our power to protect life, both in the case of consumption and many more diseases, is in proportion to our power to withhold the igniting spark.
And herein it is that medical skill is needful in this dreadful disease, and ought to be frequently and largely invoked. If the estimate which has been made by Prof. Hooker, of Yale College, that one in five of the population of the northern United States die of consumption, is correct, then not less than two millions of the present inhabitants of New England, New York, Pennsylvania, and Ohio, are destined, as things now are, to die of this disease. What a thought! Can it be so?
Can it be that two millions of the ten millions now on the stage of action in the northern United States, are not onlypredisposedto droop and die, but are laid under a constitutional necessity of so doing? Must the igniting spark be applied? Must the disease be "touched off" with hot or impure air, by hard colds, by excitements of body and mind, and in a thousand and one other ways? People are not wholly ignorant on this great subject. Would they butdoas well as theyknow, the fatal igniting spark would be much oftener and longer withheld; and, indeed, in many instances, would never prove the immediate cause of dissolution. The lamp of life would burn on—sometimes, it may be, rather feebly—till its oil was wholly exhausted, as it always ought. Man has no more occasion, as a matter of necessity, to die of consumption, than the lamp or the candle.
This, if true,—and is it not?—should be most welcome intelligence in a country where, at some seasons and in particular localities, one-fourth of all who die, perish of this disease. In March, 1856, twenty-one persons out of eighty who died in Boston in a single week, were reported as having died of consumption; and in June of the same year, the proportion was nearly as great. In Newton, a few miles from Boston, the proportion for the last ten years has been also about one in four.
But place the proportion for the whole northern United States, at one in five only, or even one in six. Yet even at this rate, the annual mortality for New York or New England, must be about twelve or fourteen thousand. Yet it seems to excite little if any surprise. But when or where has the cholera, the yellow fever, or the plague depopulated a country of three millions of people, for each succeeding year, at the rate of twelve thousand annually, or one hundred and twenty thousand every ten years?
One reason why the statements I have made, of the possible postponement of consumptive disease, should be most welcome intelligence, is found in the fact that they inspire with the hope ofliving. The ordinary expectation that those who inherit a consumptive tendency must die prematurely, has been fatal to thousands. Mankind, in more respects than one, tend to become what they are taken to be. If we take them to be early destined to the tomb, they go there almost inevitably. There is, I grant, one most fortunate drawback upon this tendency. Most people who have the truly consumptive character, are disposed to disbelieve it. They are generally "buoyant and hopeful," which, in some degree, neutralizes the effect of sombre faces, and grave and prognosticating jeremiades.
It will not be out of place to present the patient reader with an anecdote, which may or may not be true, but which I received as truth from the people of the neighborhood where the facts which it discloses are said to have occurred.
In the eastern part of Connecticut, not many years since, a young man lay on his bed, very feeble and greatly emaciated, almost gone, as everybody supposed but himself, with pulmonary consumption. And yet, up to that very hour, the thought that his disease was consumption, had never obtained a lodgment in his own mind for a moment. On the contrary, he was still fondly hoping that sooner or later he should recover.
It was fortunately about the middle of the forenoon one day,—an hour when his body and mind were in the best condition to endure it,—that his listening ear first caught from those around him the wordconsumption. Starting up, he said, "Doyou think my disease is consumption?" They frankly told him their fears. "And do you think," he added, "that I must die?" They did not conceal longer their real sentiments.
He was for a few moments greatly distressed, and seemed almost overpowered. At length, however, a reaction came, when, raising his head a little, he deliberately but firmly exclaimed, "I can't die, and I won't die." After a few moments' pause and reflection, he said, "I must be got up." His attendants protested against the effort, but it was to no purpose. Nothing would satisfy him but the attempt. He was bolstered up in his bed, but the effort brought on a severe fit of coughing, and he was obliged to lie down again.
The next forenoon, at about the same hour, he renewed the request to be got up. The result was nearly as before. The process, however, was repeated from day to day, till at length, to the great joy and surprise of his friends, he could sit in his bed fifteen or twenty minutes. It is true that it always slightly increased the severity of his cough; but the paroxysm was no worse at the twentieth trial than at the first, while he evidently gained, during the effort, a little muscular strength. It was not many weeks before he could sit up in bed for an hour or more, with a good degree of comfort.
"Now," said he, "I must be taken out of bed and placed in a chair." At first his friends remonstrated, but they at length yielded and made the attempt. It was too much for him; but he persevered, and after a few repeated daily efforts, as before, at length succeeded. Continuing to do what he could, from day to day, he was, ere long, able to sit up a considerable time twice a day.
He now made a third advance. He begged to be placed in an open carriage. As I must be brief, I will only say that, after many efforts and some failures, he at length succeeded, and was able to ride abroad several miles a day, whenever the weather was at all favorable. Nor was his cough at all aggravated by it. On the contrary, as his strength increased, it became rather less harassing and exhausting.
One more advance was made. He must be helped, as hesaid, upon a horse. It was doubtful, even to himself, whether he had strength enough to endure exercise in this form; but he was determined to try it. The attempt was completely successful, and it was scarcely a week before he could ride a mile or two without very much fatigue.
The final result was such a degree of recovery as enabled him to ride about on horseback several miles a day for six years. He was never quite well, it is true, but he was comfortable, and, to some extent, useful. He could do errands. He could perform many little services at home and abroad. He could, at least, take care of himself. At the end of this period, however, his strength gave way, and he sank peacefully to the tomb. He was completely worn out.
Now the principal lesson to be learned from this story is obvious.Determinationto live is almost equivalent topowerto live. A strong will, in other words, is almost omnipotent. Of the good effects of this strong determination, in case of protracted and dangerous disease of this sort, I have had no small share of experience, as the reader has already seen in Chapter XXIII.
Another fact may be stated under this head. A young man in southern Massachusetts, a teacher, was bleeding at the lungs, and was yielding at length to the conviction—for he had studied the subjects of health and disease—that he must ere long perish from consumption. I told him there was no necessity of such a result, and directed him to the appropriate means of escape. He followed my directions, and after some time regained his health. Ten or twelve years have now passed away, and few young men have done more hard work during that time than he; and, indeed, few are able, at the present moment, to do more. It is to be observed, however, that he made an entire change in his dietetic habits, to which he still adheres. He avoids all stimulating food—particularly all animal food—and uses no drink but water.
I did not advise him, while bleeding, to mount a hard-trotting horse, and trot away as hard as he could, and let the blood gush forth as it pleased. It is a prescription which I have not yethazarded. I might do so in some circumstances, when I was sure of being aided by that almost omnipotent determination of which I have elsewhere spoken. I might do it occasionally; but it would be a rare combination of circumstances that would compel me. I might do it in the case of a resolute sea captain, who insisted on it, would not takenofor an answer, and would assume the whole responsibility. I might and would do it for such a man as Dr. Kane.
I have, myself, bled slightly at the lungs; but while I did not, on the one hand, allow myself to be half frightened to death, I did not, on the other hand, dare to meet the hemorrhagic tendency by any violent measures; not even by the motion of a trotting horse. I preferred the alternative of moderate exercise in the open air, with a recumbent position in a cool room, having my body well protected by needful additional clothing, with deep breathing to expand gently my chest, and general cheerfulness. But I have treated on this subject—my own general experience—at sufficient length elsewhere.
A child about a week old, but naturally very sensitive and irritable, became, one night, unusually restless and rather feverish, with derangement of the bowels. The condition of the latter was somewhat peculiar, and I was not a little puzzled to account for it. There was nothing in the condition of the mother which seemed to me adequate to the production of such effects. She was as healthy as delicate females usually are in similar circumstances.
The derangement of the child's bowels continued and increased, and I was more and more puzzled. Was it any thing, I said to myself, which was imbibed or received from the mother? Just at the time, I happened to be reading what Dr. Whitlaw, a foreign medical writer, says of the effects which sometimes follow when cows that are suckling calves feed on buttercup. The poison of the latter, as he says, instead of injuring the cow herself, affects, most seriously, the calf, and, in some few instances, destroys it. This led me to search more perseveringly than I had before done, for a cause of so much bowel-disturbance in my young patient.
At length I found that a wooden pail, in which water was kept for family use, had been but recently painted inside; and that the paint used was prepared in part, from the oxyde of lead, usually called white lead. On this I immediately fastened the charge of poisoning.
My suspicions were confirmed by the fact that the mother had been more thirsty and feverish than usual, during a few hours previous to the child's first manifestation of disease, and had allowed herself to drink very freely of water, which was taken from the very pail on which our suspicions now rested.Another fact of kindred aspect was, that the child recovered just in proportion as the mother left off drinking from the painted pail, and used water which was procured in vessels of whose integrity we had no doubt.
Most people who had any knowledge of the facts in the case, said that the cause I assigned could not have been the true one, since it was inadequate to the production of such an effect. But the truth is, we know very little about poisons, in their action on the living body, whether immediate or remote. Till this time, although I had read on it as much as most medical men, yet I knew—practically knew—almost as little as the most illiterate. Yet the subject was one with which professional physicians should be familiarly acquainted, if nobody else is. Many an individual, as we have the most abundant reason for believing, loses his health, if not his life, from causes which appear to be equally slight. A Mr. Earle, of Massachusetts, cannot swallow a tumbler of water containing a few particles of lead, without being made quite sick by it. Nor is he alone in this particular. Such sensitiveness to the presence of a poisonous agency is by no means uncommon. It may be found to exist in some few individuals in every country, and almost every neighborhood.