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CHAPTER XXXI
A SUDDEN CURE

I was called one morning very early, to see a little girl, five or six years of age, who, it was said, was extremely sick, and without immediate aid could not probably long survive.

She was one of a very numerous family, most of whom, though suffered to run almost wild, like so many rabbits, were comparatively healthy. I do not suppose they had ever called in a physician more than once or twice in a year. In truth, they had very little confidence in physicians; though in extremities, they were accustomed to call on them almost as much as other people. In any event Caroline was very sick now; and they loudly demanded aid. I was forthwith on the spot. Caroline was groaning most piteously. "Where is your distress?" I inquired. She gave no direct answer, but continued to groan and writhe, as if she were impaled. As I could obtain no reliable information from her, and could discover no special or exciting cause of her suffering, and as the case was urgent, I proceeded to do something, though, as I must honestly confess, it was to labor quite in the dark. One thing I knew, it is true; that there were spasms, and that it depended on a diseased condition of the brain and nervous system; but what the cause or causes were, I could hardly divine. Nor, in truth, had I time to ask many questions.

Though the days of Hydropathy had not yet arrived, the world, even then, had a good deal of water in it, and physicians were sometimes wise enough to use it. It was demanded, as I thought, on the present occasion. It would, at least, by whiling away the time, give opportunity for further observation and reflection, and deeper investigation. There was a good fire in the kitchen, and I ordered a warm bath immediately.

Every effort was made to hasten the process of warming the water, as well as to keep the patient quiet and within doors; for she raved like a maniac – partly indeed from a childish fear, but partly also from real bodily suffering. The family and neighborhood – for the latter were very largely collected together – were almost as much alarmed and distressed as the little patient, and this reacted on the patient to her increased disadvantage.

As there were no special preparations in those days for bathing – I mean in the region of which I am now speaking – we used a large wash-tub. The water was soon ready, and was made rather warm, quite above 100° of Fahrenheit. I had taken the precaution to have my patient already undressed, so as to lose no time. The very instant the bath was ready, she was plunged into it. It cost some trouble, for she resisted with almost superhuman strength, and uttered most terrific screams. But as the ox is dragged to the slaughter, she was dragged into the water and held in it.

The effect was like magic. She had not been in the water twenty seconds before every thing was quiet; and I do not know that she has ever had another pang to the present hour. Certain it is that she seemed to be entirely cured by this single bath, and none of her spasms ever returned.

The family were greatly delighted, and so were the neighbors. And was the physician, think you, an uninterested spectator? Had he been wholly destitute of the love of doing good, by relieving human distress, he must at least have been susceptible of receiving pleasure from general approbation.

He certainly sought respectability as a physician. And this he was by degrees now attaining.

It is hardly possible to refer the sudden quiet which followed in this instance from the application of warm water, to a mere coincidence, as if the system was ready, just at this very instant, to react or rally. The bath must have had something more than a mere imaginary or accidental effect, though its prescription may be said to have been empirical.

Had the experiment in the present instance wholly failed, it is by no means improbable the physician would still have been on a par with other men. The guess he made was his only thought. He had nothing in reserve. But he was successful; he guessed right, and it built him up. His fame now began to spread far and wide, wafted, as it were, on the wings of every breeze. If he succeeded, it was supposed to be undeniable proof of his skill; if he failed, it was not supposed to be so much his fault as the result of circumstances; or, more properly, the severity of the disease. And even in the case of failure, as I have said elsewhere, he often gained credit; for he had boldly contended, at great odds, with a mighty because intangible antagonist!

It is an old proverb, – but by no means the less true for its age, – that when a person is going down hill every one will give him a kick. But is it not equally true that when he is resolutely going up hill, they are equally ready to help him on? So at least I found it at this period of my progress.

CHAPTER XXXII
GIGANTIC DOSES OF MEDICINE

Although I was opposed to the frequent and free use of medicine, I early fell into one habit which was as diametrically opposed to my general theory as could possibly have been. I refer to the habit of giving my patients, at least occasionally, most enormous doses of those more active preparations which should seldom, if ever, be administered in this way. As nearly as I can now recollect, I fell into this habit in the following manner:

Among my standing patients, before mentioned, were several drunkards. Occasionally, however, they were more than standing or standard patients; they had attacks of mania, or as it is usually called in the case of drunkards, delirium tremens. In these circumstances, among these patients, I often had the most severe trials. Sometimes I could relieve them; but sometimes, too, I failed.

One night, while endeavoring to relieve the sufferings of one of these patients in delirium tremens, almost to no purpose, the thought struck me, "What effect would a prodigious dose of calomel have on the poor creature? Can it kill him? I doubt it. I will venture on the trial."

So, without communicating the slightest hint to any one around me of what I was about to do, I contrived to insinuate a hundred grains or more of this substance into the man's stomach, that like a chemical receiver took what was poured into it. Having succeeded in the administration of the dose, I waited patiently the issue.

The medicine had, in due time, its full ordinary effect; but the degree of its cathartic effect was not in proportion to the largeness of the dose. Its activity hardly amounted to violence. It seemed, however, to quiet the brain and nerves as if by magic; nor am I aware that any injurious effects, either local or general, ever followed its exhibition. I had the full credit of a speedy and wonderful cure.

Another fact. I was frequently called to prescribe for children who were threatened with the croup. One night, on being called to a child of some eight or ten months, I thought of large doses of calomel. Was there any great risk in trying one? I ventured. I gave the child almost a teaspoonful of this active cathartic. It was indeed a gigantic dose, and the treatment was bold if not heroic.

For a couple of hours the patient breathed badly enough. There was evidently much oppression, not only of the lungs but of the nervous system. The parents and friends of the child grew uneasy. They were not, however, more uneasy than their physician. But I consoled myself by laboring to compose them. I preached to them long and loud, and to some extent with success.

At the end of about two hours, the latter part of which had been marked by a degree of stupor which almost discouraged me, a gentle vomiting came on, followed by moderately cathartic effects; and the child immediately recovered its mental activity, and in a few days was well.

Empirical as this practice was, I ventured on it again and again, and with similar success. At length the practice of giving giant doses in this disease became quite habitual with me, and I even extended it to other diseases. Not only calomel, but several other active medicines were used in the same bold and fearless manner. I do not know that I ever did any direct or immediate mischief in this way. On the contrary, I was regarded as eminently successful.

And yet I should not now dare to repeat the treatment, however urgent might seem to be the demand, or recommend it to others. It might, perhaps, be successful; but what if it should prove otherwise? I could make no appeal to principle or precedent in justification of my conduct. It is true, I have met with one or two practitioners whose experience has been similar; but what are a few isolated cases, of even honest practice, in comparison with the deductions of wise men for centuries? There may be after consequences, in these cases, which are not foreseen. Sentence against an evil work, as Solomon says, is not always executed speedily.

CHAPTER XXXIII
THE LAMBSKIN DISEASE

Should any medical man look through these pages, he may perchance amuse himself by asking where the writer obtained his system of classification of disease. It will not, certainly, be very easy to find such a disease as the lambskin disease in any of our modern nosologies. But he will better understand me when he has read through the chapter. He may be reminded, by its perusal and its quaint title, of the classification which is found in Whitlow's New Medical Discoveries, founded, as the doctor says, on the idea that "every disease ought to be named from the plant or other substance which is the principal exciting cause of such disease." It is as follows:

If on examination the curious reader should find no such disease as the "Lambskin disease" in Dr. W.'s catalogue, he should remember that the list is by no means complete, and that there will be no objection to the addition of one more. And why, indeed, may I not coin terms as well as others? All names must have been given by somebody.

But I will not dwell on the subject of nosology too long. I have something else to do in this chapter than merely to amuse. I have some thoughts to present on health and sickness, – thoughts, too, which seem to me of vast importance.

A son of Mr. G., a farmer, had been at work in an adjoining town, all summer, with a man who was accustomed to employ a great number of hands in various occupations, – farming, road building, butchering, etc., etc. Of a sudden, young G., now about twenty years of age, was brought home sick, and I was sent for late at night – a very common time for calling the doctor – to come and see him.

I found him exceedingly weak and sick, with strong tendencies to putridity. What could be the cause? There was no prevailing or epidemic disease abroad at the time, either where he had been laboring, or within my own jurisdiction; nor could I, at first, find out any cause which was adequate to the production of such effects as were before me.

I prescribed for the young man, as well as I could; but it was all to no purpose. Some unknown influence, local or general, seemed to hang like an incubus about him, and to depress, in particular, his nervous system. In short, the symptoms were such as portended swift destruction, if not immediate. I could but predict the worst. And the worst soon came. He sunk, in a few days, to an untimely grave. I say untimely with peculiar emphasis; for he had hitherto been regarded as particularly robust and healthy.

His remains were scarcely entombed when several members of his father's family were attacked in a similar way. Another young man in the neighborhood, who had been employed at the same place with the deceased, and who had returned at the same time, also sickened, and with nearly the same symptoms. And then, in a few days more, the father and mother of the latter began to droop, and to fall into the same train of diseased tendencies with the rest. Of these, too, I had the charge.

My hands were now fully occupied, and so was my head. Anxious as most young men are, in similar circumstances, not only to save their patients, but their reputation, and though the distance at which they resided was considerable, I visited both families twice a day, and usually remained with one of them during the night. I was afraid to trust them with others.

Physically this constant charge was too much for me, and ought not to have been attempted. No physician should watch with his patients, by night or by day, – above all by night – any more than a general should place himself in the front of his army, during the heat of battle. His life is too precious to be jeoparded beyond the necessities involved in his profession.

But while my hands were occupied, my mind was racked exceedingly with constant inquiry into the cause of this terrible disease, – for such to my apprehension it was becoming. The whole neighborhood was alarmed, and the paleness of death was upon almost every countenance.

My doubts were at length removed, and the cause of trouble, as I then supposed and still believe, fully revealed. The disease so putrescent in its tendencies, had originated in animal putrefaction. The circumstances were as follows: —

The individual with whom the young men who sickened had been residing and laboring, had laid aside, in his chamber, some time before, quite a pile of lambskins, just in the condition in which they were when removed from their natural owners, and had suffered them to lie in that condition until they were actually putrescent and highly offensive. The two young men, owing to the relative position of the chambers they occupied, were particularly exposed to the poisonous effluvia.

I did not forget – I did not then forget – the oft inculcated and frequently received doctrine, that animal impurity is not apt to engender disease. It most certainly had an agency – a prominent one – in the case before us. Perhaps it has such an influence much more frequently than is generally supposed.

One of my patients, in the family which I first mentioned, – a little boy two or three years old, – died almost as soon, after being seized with disease, as his elder brother had done. The rest, though severely sick, and at times given over to die, finally recovered. Some of them were sick, however, many months, and none of them, so far as I now recollect, – with perhaps a single exception, – ever enjoyed as good health afterward as before.

I had in these families six or eight of the most trying cases I ever had in my life; and yet, with the exceptions before named, all recovered. How much agency my own labors as a medical man had in producing this result, I am at a loss to conjecture. As an attendant or nurse, I have no doubt my services were valuable. And it was because a good nurse is worth more than a physician that I so frequently ran the risk of watching over the sick so closely as considerably to impair my own health.

The neighbors and friends of the two sick families, as I have already intimated, looked on in silent agony during the whole campaign; expecting, first that their families, too, would soon be called to take their turn; and secondly, that I, the commander in chief, should be a sufferer, which of course would be a great public disadvantage. They were almost as much gratified as I, when we all came forth from the fire unscathed.

On the whole, except as regards health, I was a gainer rather than a loser by the affair. I mean, of course, in the way of medical reputation. I was by this time fairly established as a powder and pill distributer, of the first water. In other words, I was beginning to be regarded as a good family physician, and to be sought for, not only within the narrow limits of my own native township, some four or five miles square, but also quite beyond these narrow precincts. Occasionally I had patients in three or four adjoining towns, and I was even occasionally called as counsel to other physicians. My ambition was high, perhaps higher than it ought to have been; but it had its checks and even its valleys of humiliation; so that on the whole I retained my sanity and a full measure of public confidence.

And yet, in conclusion, I have to confess that besides exposing my own health, I made many medical blunders. I would not again run the risk to health or reputation which, during this long trial of several months, I certainly ran, for any sum of money which king Croesus or the Rothschilds could command. Nor do I believe an intelligent physician can do it, without being guilty of a moral wrong. Every one has his province; let him carefully ascertain what that is, and confine himself to it. The acting commander in an important military expedition has no right to place himself in the ranks of those who are about to leap a ditch, scale a wall, or charge bayonet. Paul has no right to labor in Athens when he knows perfectly well that he can do more good in Jerusalem, and the voice of God, by his Providence or otherwise, calls him thither. And "to him that knoweth to do good and doeth it not, to him it is sin."

CHAPTER XXXIV
MILK PUNCH FEVER

A certain young woman who had great general confidence in my skill, after I had stood by her many long hours in one of Nature's sorest trials, was left at length in a fair way to recover, except that she was exceedingly exhausted, and needed the most careful attendance on the part of those around her. She no longer needed any medicine, nothing but to be let alone. In other words, she needed nothing but good nursing and entire freedom from all care and responsibility.

Being obliged at this juncture to leave her for nearly the whole night, I gave the best directions to her principal nurse of which I was capable, as well as the principal reasons on which it was founded. She seemed entirely submissive, and perhaps, in theory, was so. But in my zeal to make them understand that I was acting on common-sense principles, I committed one error, a very common one, indeed, but yet an error. It was that of reasoning with them with a view to make every thing particularly intelligible. One has authority, in these matters, as long as he takes the attitude of authority, but the moment he descends to the general level of his patients, and in true republican style puts himself on a par with them, he begins to lose their confidence as a physician. You may not be sensible of a loss of this sort, nor even the physician. You may even think the reverse were more true. But you deceive yourself. Though your patients may love you better as a friend or even as a father, yet they have lost confidence in you medically, in nearly the same proportion. Strange indeed that it should be so; but so, according to my own observation, it ever has been. That a prophet is "without honor" – and most so in his own country and among his own personal friends – is as true now as it was eighteen hundred years ago.

Had I told Mrs. D.'s attendants to do so or so, and left them without saying a word more, they would probably have done it. But I had condescended to reason with them about the matter; their belief that medical men dealt with the stars, and spoke with a species of supernatural authority, had been shaken; and they were emboldened to reason on the subject, and to hearken to the reasonings as well as to what had but the slightest resemblance thereto in others, during my absence.

Having occasion to use all possible precaution against the supervention of milk fever in my patient, I left particular directions that nothing stimulating should be administered, and assigned several good, substantial reasons. No food was to be given, except a little bread and some plain chicken broth, with no condiment or dressing but a little salt; and this at intervals of about four hours. No drink – not a particle – was to be given, except frequent very small draughts of cold water.

While I was absent Mrs. D.'s mother came into their family, not only to rejoice with them in an accession to their number, but to render them a little aid. She was one of those mothers whose kindness so often defeats their best and purest intentions. She was all eyes, ears, and attention, and nearly all talk. The daughter's treatment soon underwent a special scrutiny, and was found "wanting."

"Has the doctor ordered my daughter no milk punch?" she said to the attendants. "Not a drop," they replied. She raised both hands in astonishment. "How, then," she asked, "can the ninny expect she can ever have any nourishment for that boy?" The attendants could not inform her. "The doctor," they said, "gave reasons," but they could not fully understand them.

"He did not probably understand them himself," said she. "There are no reasons against it, I am confident. It is only a notion of his. These young doctors are always full of their book wisdom. Why, a little experience is worth a whole world full of theories. Now I know – and so does every other person who has nursed children – that a little milk punch, in these cases, is necessary. Not a great deal, it is true; but a little, just enough to give the system strength. Nature is weak in these cases. I wish some of these young doctors themselves were obliged to endure the trials we have to endure, and we should see whether they could get along with no drink but cold water!"

The rebellion soon reached the daughter's ears, who, till now, had confided in the "doctor's" prescription, and was doing well. She was soon as uneasy with things as they were, as her mother and the nurse and the neighbors. The husband was not of the clique; but then he was one of those good-natured men who leave every thing to their wives; and though they may not fully approve of every thing that is attempted, will yet do and refrain from doing many things for the sake of peace. He interposed no veto on the present occasion.

The mother, in short, soon reigned "sole monarch," and proceeded to issue from her imperial throne, the sage decree that a little milk punch must be made. Judith, the nurse, was to have it prepared so and so, and she would herself administer it. Only just so many spoonfuls of rum must be added to the tumbler of milk and water, and just so much sugar. It must be weak, the decree said.

Mrs. D. drank freely of the punch, because her mother told her that it would do her good. True, she asked after the first swallow, "what will the doctor say to this?" but her mother bade her be quiet, she would see to all that. "It is made very weak," said the mother, "on purpose for you; drink of it a little and often. It will be both food and drink to you. It will be good for the babe, dear child! how can these doctors wish to starve folks? I have no notion of starving to death, or having my children or grandchildren starved."

It was now past midnight, and Mrs. D. had as yet slept but very little. Had she simply followed out my directions she might have slept an hour or two before midnight, and several hours in the aggregate afterward. This, though done by stealth and in short naps, would have given her more real rest and strength than a whole gallon of milk punch, and instead of kindling fever, would have carried off all tendencies of the kind.

On my arrival, early the next morning, I found a good deal of headache, such as cold water and plain food and rest seldom, if ever, create. My fears were at once excited, and they were greatly strengthened when I saw her mother. But the blow had been struck, and could not be recalled. Mrs. D., in short, was already in the beginning stage of a fever which came within a hair's breadth of destroying her.

It is indeed true that she finally recovered. No thanks, however, were due to the mother's over-kindness, nor to my own over-communicativeness. Had I done my duty, had I kept my own counsel, nobody, not even the mother herself, as I now verily believe, would have ventured to disobey my positive injunctions. And had this mother done, as she would have been done by in similar circumstances, all would probably have been well still. We should have saved a little reputation, and a good deal of health.

I learned, I repeat, from this unexpected adventure, that it was wisdom to keep my own secrets. I do not say that I have always acted up to the dignity of this better knowledge, but I am justified in saying that I have sometimes profited from an acquaintance with human nature that cost me dear. It is no trifle to see an individual suffer from painful disease a couple of weeks, and jeopard the life of a child during the whole time, when a little knowledge how to refrain from speaking ten words of a particular kind and cast, would have prevented every evil.