IA SUDDEN PLUNGE INTO WORK

Dr. Samuel R. House did not have time nor need to “hang out a shingle” upon reaching Bangkok. He had been there only a few days—not long enough to unpack his goods—when “a message came from some great man by three trusty servants that a servant whom he loved very much had got angry and had half cut his hand off with a sword.”

This wound was not accidental but self-inflicted. It was a perverted result of a Siamese custom. In those days slavery prevailed in the country. Besides the war-captives who were cast into slavery, custom made it possible for any of the common people to be sold into servitude. If a man failed to pay a debt there were two alternatives before him, to be confined in one of the horrible jails until he discharged his obligation, or to sell himself or his wife or children into slavery to remain in that state until the accumulated value of the services should cancel the debt.

Only too often these debts were the result of gambling, a vice that was universally prevalent under license of the government. If the debtor was fortunate enough, he might sell the chosen victim to some lord who was willing to accept the services in pledge for a loan with which to pay the actual creditor. Such an arrangement was not altogether without itsadvantages, for many an improvident spendthrift had a comfortable living for himself and family assured by the better management of his lord. But once in servitude the victim was likely to be held in peonage indefinitely, because usury on the loan was liable to mount up faster than the value of services rendered.

It will readily be imagined that a man so improvident as to permit himself to fall into slavery would not be the most willing worker, and many would be the tricks of the lazy man to labour as little as possible. A rather common scheme to avoid an unpleasant duty or merely to spite the over-lord was to go to the extreme of inflicting upon self a wound that would incapacitate from work. Such was the nature of this first surgical case to which Dr. House was called.

The readiness with which this great man summoned a strange foreign doctor will be easily understood when it is known that for twelve years previous there had been an American physician in Bangkok. Since 1835 Rev. Daniel B. Bradley, M.D., representing the American Board of Commissioners for Foreign Missions (A B C F M), had been practising medicine and he had established a high reputation among all classes for western medicine and surgery. On account of the recent death of his wife, Dr. Bradley, with his young children, had sailed for home only a few weeks before the arrival of the new missionary.

When Dr. House set out for Siam he knew that Dr. Bradley was there and, having had no practical experience in his profession before leaving home, he looked forward to beginning his labours in association with one who not only was a skilled practitionerbut who also knew the pathological conditions of the Siamese. When, upon arrival, Dr. House discovered that Dr. Bradley had withdrawn he felt some alarm at the absence of professional counsel, for he had a constitutional lack of self-confidence that caused him to feel a painful burden of responsibility in prescribing for patients. At the end of the first six months he wrote:

“Whatever seemed once likely to be my fate it is pretty certain now that there is more danger of my wearing out than of rusting out in this land. Have been on the run or occupied with visitors all the day and evening ... and my poor brain has, like its fellow labourer the heart, been compelled to go through with a great deal. What sights of human misery I am compelled to see. And to feel that I have not the power of skill to alleviate,—the iron enters my soul.”

Whatever may have been the first effect of being compelled to enter upon his profession alone, it is doubtful whether Dr. House ever perceived that this constraint was probably one means by which he gained the confidence of the Siamese within a very short period. For instead of being regarded either as a competitor or as an assistant to Dr. Bradley, he was accepted at the outset upon the reputation which his predecessor had so firmly established. It was this repute of western medicine which caused the great man to send so promptly for an unknown physician to treat the self-mutilated servant.

Quickly it became known among the people of Bangkok that another physician had arrived. The calls for treatment came in such numbers and withsuch importunity that in self-defense it was deemed wise to open the dispensary which had remained closed since the departure of Dr. Bradley, although there was only a limited supply of drugs on hand and the nearest base of supplies was London. The dispensary, or hospital as it was sometimes called, of which Dr. House thus suddenly found himself the proprietor and whole staff, was just one of the innumerable floating houses which lined the river banks of the Siamese capital. It is said that when this new capital was being established the common people were not allowed to build houses on land but permitted to live only in boats. At any rate, until modern times the larger portion of the population lived in floating houses.

These houses are simply constructed. A raft of bamboo forms the foundation, which is moored to the bank or to poles driven into the mud. Upon that foundation a one-story house of boards, thatched with palm leaves, is built. The house is, customarily, divided into three rooms. At either end, extending clear across the floor is a kitchen and a common bedroom. The space between is occupied by the common living-room and a porch. The living-room is fully open along the porch, from which it is separated by the rise of a step. Closely packed together in irregular rows, sometimes two or three deep, these houses are ranged along the banks of the river and of the many canals that form the Venetian highways of the city. The channel beneath the houses, kept from being stagnant by movement of the tide, served at once as the sewer and the family bath. Many of these houses are occupied as stores, with their merchandiseexposed to the full view of the customer who does his shopping in a boat.

It was such a house as this that served the missionary as a hospital. But “hospital” is scarcely the proper word to use judged from the equipment, which consisted of a chair or two, a table for operations and a few mats for the patients. But the place had one great advantage—the open side exposed the work of the foreign doctor to the gaze of the curious natives who stopped while passing in their boats, and then related to their friends the wonders they had seen.

Here in this rude native shelter, until he gave up his profession, Dr. House applied himself with deep devotion and self-abandon to relieving the physical sufferings of the people. He placed himself wholly at their service, and made no discrimination between rank of those he served. Frequently he would not reach the dinner table till the middle of the afternoon, detained by the importuning patients; and he even laments that the people would not summon him in the night time in case of serious need.

His record of patients, to one who is not familiar with a physician’s records, gives astonishment at the kind of cases which seemed to predominate. One class was the ulcers and running sores—many of them most aggravated. These usually were the result of long-neglected wounds. He writes of extracting bamboo splinters great and small that had become imbedded in the flesh and remained there to produce serious inflammation and infection. In such cases an ignorance too dense for intelligence to comprehendwas the contributory cause of untold suffering. A second class of cases frequently appearing was that of fresh wounds resulting from drunken brawls, street fights, treachery and revenge, or self-mutilation. Scarcely a week passed but a patient was brought in with head cut open, face gashed, back lashed, or some other gaping cut. But most loathsome of all were the diseases which the doctor characterised as the result of vices—diseases which found victims among all sorts and conditions of men who “working that which is unseemly” received “in themselves that recompense of their errors which was meet.”

A cursory review of one day’s succession of patients will be suggestive. Here returns a man with a tumor on his ear, having the previous day been advised to come for an operation:

“With good courage and I believe without a trembling hand, I sat down to this, my first operation not only in the Kingdom of Siam, but the first operation I think I ever undertook. It was a simple one, and oh, I cannot but catch such a glimpse of my Father’s loving-kindness in thus gently leading his poor ignorant by such simpler cases into the confidence in myself necessary to do the more serious cases which will doubtless fall to my lot.... Believing that without His blessing the simplest operation would fail and with it the most doubtful one might prosper, I lifted up my heart a moment to Him in whose name I had ventured to come among this people to try to do them good.”

While attending him, a boat came up with two women, one a loathsome object full of sores and scabs—face, hands and limbs—the scars of former ulcers. A Chinaman with a scrofulous neck—a ladwith gastric derangement—a boy whose leg was transfixed with a sharp piece of bamboo—so moves the procession. As he returns late for dinner he observes:

“This morning was fully occupied till dinner at 2 p. m., trying to do the works of mercy—how could I send any away empty! And oh, how happy I should have been in such Christ-like works had I but knowledge of the diseases, and judgment and skill. As it is now, the deciding what is to be done with each case is an act of the mind positively painful, because I am constantly fearing that I may not follow the best possible plan.”

On another day thus reads the entry:

“On going down to the floating house at 9 a. m., found several new patients. A Chinaman of fifty, with caries of the lower jaw, skin of cheek adhering, pus has discharged from a large cavity within the mouth. Another Chinaman with syphilitic destruction of the bones of the nose—a hole left in the flattened face where pus was discharging.... He seemed to be in great torment—eaten of worms literally. Now a mother brings a naked child of five, having large ulcers and a lump on the thigh, the sequel of the smallpox had two or three months ago. A Chinaman brings the child of a friend; poor lad, the smallpox had destroyed one eye and blinded the other—so no hope, no remedy.”

The hours at the hospital were daily from early morning, frequently from six or seven o’clock, till noon. During the latter part of the afternoon he answered calls in various parts of the city. By these calls he came into the homes of the people and becamebetter acquainted with them than he could have done under ordinary circumstances. He gives what he calls a fair specimen of the missionary physician’s life in Siam when his hands are full:

“When I awaked in the morning found two sets of servants waiting for me—one from Prince Chao Fah Noi, who had sent his boat for me to go up to his palace just as soon as I could finish my breakfast; another from Chao Arim, the King’s brother, wishing me to come over and see some one in his palace very sick. My first duty of course was to attend to little George, whom I found still living, though much the same. This occupied the time before breakfast. After a hasty meal, stepped into the sampan sent for me (the servants still waiting to take me across the river to Chao Arim’s)—having dismissed the Prince’s servants with a note requesting to be excused. On the other shore entered gates of the city wall.... While I was waiting for the Prince to be notified of my arrival, servants gathered around; examined my clothing, one wished me to take off my hat to see if my head was shaved, another admired my watch—the ticking pleased the children mightily. Some strong ammonia I had pleased them very much. A young man with a flaming long jacket of red silk (no shirt or vest above his waist cloth) came out; all servants squatted on the ground. This young Prince conducted me up a rude ladder to the bamboo dwelling of the sick man.“Returning, invited to see the great man himself. The audience halls of these great men are after all rather well-adapted to the climate; immense rooms, lofty ceilings, furniture of matting, etc. Returning to my place, found a boatman from the Moorish Madras merchant’s awaiting me. Accompanied the Hindoo, who had been sent for me, in his open boat with umbrella over my head; the sun, however, very hot, though this is our cold season. Some distance down the river landed at the Nackodah’s commercial establishment, and found myselfin the midst of quite a number of intelligent looking and polite Mahommedan Hindoo merchants and clerks, with their picturesque costume; the turban of twisted shawl and robes of thin white muslin, and sandals. Was received very courteously, conducted to a bamboo house nearby. The patient, a fine looking man, swarthy, with aquiline nose and mustache, lay on a mat bed behind a screen.... And now the voice of Dit, a servant of Chao Fah Noi, was heard; he had followed on after me, not finding me at home—the Prince being very desirous of seeing me. So I stepped into the handsome boat he had sent, and was soon at the palace. Here received with a smile of welcome.... Wished me to shew him how to make chlorine gas. Succeeded well. Gave him a piece of fluorspar and directions for etching glass. Left several jars of chlorine. His boat in readiness to take me back.... In the evening a call from Prince Ammaruk, in his priestly yellow robes, several priests with him.”

“Returning, invited to see the great man himself. The audience halls of these great men are after all rather well-adapted to the climate; immense rooms, lofty ceilings, furniture of matting, etc. Returning to my place, found a boatman from the Moorish Madras merchant’s awaiting me. Accompanied the Hindoo, who had been sent for me, in his open boat with umbrella over my head; the sun, however, very hot, though this is our cold season. Some distance down the river landed at the Nackodah’s commercial establishment, and found myselfin the midst of quite a number of intelligent looking and polite Mahommedan Hindoo merchants and clerks, with their picturesque costume; the turban of twisted shawl and robes of thin white muslin, and sandals. Was received very courteously, conducted to a bamboo house nearby. The patient, a fine looking man, swarthy, with aquiline nose and mustache, lay on a mat bed behind a screen.... And now the voice of Dit, a servant of Chao Fah Noi, was heard; he had followed on after me, not finding me at home—the Prince being very desirous of seeing me. So I stepped into the handsome boat he had sent, and was soon at the palace. Here received with a smile of welcome.... Wished me to shew him how to make chlorine gas. Succeeded well. Gave him a piece of fluorspar and directions for etching glass. Left several jars of chlorine. His boat in readiness to take me back.... In the evening a call from Prince Ammaruk, in his priestly yellow robes, several priests with him.”

All these interesting scenes and varieties of experience, however, did not lighten the burden of the heart. When a patient suffered pain and inflammation after an operation, he cries out:

“How can I go forward in a profession where I may inflict suffering. If it was only injury to property and not to life and health and senses! Alas, how hard a destiny, how could I choose this profession!”

On a Saturday night he sighs:

“And so ends another week during which mercies have been ever changing, ever new. It has been a week of labors for Christ ... and yet, though my poor head is ready to ache with the task of deciding, judging, prescribing,I find a sweet kind of weariness that comes from serving Jesus Christ.”

Such a tender heart and sympathetic nature suffered most where it could help the least. The obstetrical customs of the country in particular caused the doctor both distress and irritation on account of the lamentable ignorance displayed and of the needless sufferings caused.

The experiences of his professional practise were not all depressing. Operations were successful in spite of his fears, and when least expected. Most cheering was the gratitude of the patients, many of whom acknowledged their lives reclaimed from death by his hands. The marks of appreciation on the part of some of these were most touching.

“Have been permitted by a gracious providence this week to have the happiness of saving the life of a fellow-creature, which the venom of a poisonous snake was appearing fast to be destroying. Poor fellow, he was thankful enough. The first symptom of returning consciousness before he regained his lost power of speech was his attempt to put his feeble hands together and raise them to his forehead in token of his gratitude to his doctor. When three days after, sound in health and limb, he came to see me. ‘Doctor, you are very, very good,’ was his very emphatic expression of what filled his heart. And then he grasped my hand—a liberty men of his condition in life seldom take—in both his and repeated, ‘You are very, very good.’”

Dr. House had adopted the policy of gratuitousservice. His motive was to exemplify the Christian spirit by rendering these inestimable benefits without charge. Perhaps at the time he did not know the philosophy of the Siamese in the matter of good deeds.

The theory of the Buddhist religion is that a good deed gains merit for the doer. As a sequence, to be the recipient of a favour is to assist the other person to earn merit; and since the merit is ample reward for the good deed it is not necessary to make any personal return for the favour received. When Dr. House later came to understand this philosophy he perceived why it was that “of ten healed only one returned to give thanks.” Yet there were not a few whose natural sense of gladness was not wholly suppressed by their religious theories. One day, three or four years after he had been in Siam, he went out along one of the canals into the country to a limekiln to get some lime for the new house under construction at the mission. An old woman came out to wait upon him, and to his surprise she refused to take pay; and explained that some time previously the doctor had healed her little girl.

The set policy not to accept fees was not so easily understood by the Chinese to whom he ministered. Frequently, to avoid offense, the Doctor found it necessary to compromise by accepting gifts in lieu of money; and then he would be the recipient of generous presents of fruit, quantities of rice, numerous cakes of sugar and small chests of fine tea—gifts in such abundance that he had to share them with his friends to dispose of all.

But not least of the rewards for professional servicedid he esteem the acquaintance and friendships among the patients. These people came from many parts of the country and there were numerous representatives from other countries. Sailors from European ports sought him out for medical treatment, Chinese tradesmen and junk captains, Malays, Burmese, Peguans, Cambodians, Lao, and the foreign merchants from India. Then, too, Bangkok the capital of Siam was visited periodically by officials from the distant provinces, many of whom came for professional advice to the foreign physician. The contact established with these various peoples, and especially with the provincial governors, served to excellent advantage in after years when the doctor made tours into the far regions. In particular, the under-Governor of Petchaburi who came for professional advice, invited the doctor to visit his provincial capital, and in later years when he had been promoted in office and rank in Bangkok he remained the steadfast friend of Doctor House.

There were bits of humour now and then amidst the procession of human tragedies.

“While feeling the pulse of the patient and holding my watch to count its beat, another man sitting by begged me to feel his, and after I had counted it he gravely asked me ‘in just how many years after this he would die.’”

Some of the humour was grim humour indeed; for one day he was hastily summoned only to find that the supposed patient was a corpse. Humourous fromone point of view but quite perturbing for a physician was the innocent disregard for the directions left with medicines; indeed the doctor could never tell whether the failure of a prescription was due to the ineffectiveness of the drugs or to the failure of the patient to take the medicine as prescribed, for he found that the patient was liable to take the whole potion at once or just as liable to have another member of the family take the remedy vicariously.

Quite frequently, when the callers from a distance came to see him, they made the parting request for medicine to take home with them, and thought it altogether needless for the doctor to know what disease they expected to use it for. Pathetic was the case of the cholera patient consumed with fever who begged the doctor to give “medicine to cure the desire for drinking water.” Even more simple-minded was the old man who came to inquire if he could be healed if he “wyed” to Jesus,—that is to make the reverential bow of worship customarily accorded to the image of Buddha. Then there was the deaf man who came back to report that he had read “the Christian book of magic” and that it had failed to cure him.

Not the least perplexing of these absurd situations was the difficulty of securing necessary permission to administer the medicines even after the doctor had been especially summoned:

“The poor woman who lay on a mattress bolstered up was in great distress evidently—and I soon found that no time was to be lost. I shall never forget how piteously she turned her anxious eyes towards me as she faintly said, ‘Can you heal me?’ I recommend certain treatment. Nothing could be done, however, till thematter had been submitted to the Praklang. So a messenger was despatched,His Excellency againaroused from his nap;—and what a message brought back: The application of hot cloths would be permitted, but the more effective treatment proposed was something new—he did not know—he could not consent to it. Thinking then of another mode of treating the case and not dreaming but that this I might venture to give—but no; this prescription must be reported to headquarters before it could be administered. Again a messenger was despatched. The answer came back: we must wait to see what a hot fomentation would do; if this did any good then the prescription might be tried.”

Back to Index Next