Forty Years in the Wilderness of Pills and Powders

My own lot for several years was to labor chiefly for the poor. In a region where it had been customary for a medical man who had the whole control of the business to charge one thousand dollars a year, my charges scarcely exceeded three hundred. A few of the wealthy employed me, it is true, but not all; while I had all the poor. Indeed, it is among the poor, as a general rule, that sickness is most frequent and prevalent, not to say fatal.

In one of these poor families, on a certain occasion, I had a long campaign and a hard one. First, I was obliged to travel a great distance to see them; secondly, I had a very severe disease to encounter; thirdly, there were several patients in the house; and the family, usually unprovided with sufficient space for a free circulation of the air, was still more incommoded when sick. Fourthly, the mistress of the house was exceedingly ignorant; and ignorance in a mother is, of itself, almost enough to insure the destruction of all patients over whom she has control.

My chief source of trouble, in the present instance, was the injudicious conduct of the mother to the family; for all else could have been borne. She was almost incessantly trying to do something over and above what I had ordered or recommended. The neighbors, almost as weak as herself, would come in and say: "Why don't your doctor give such or such a thing? Mr. Blarney was sick exactly like Samuel, and they gave him a certain powder and he got right up in a very few days." This would usually be quite sufficient to make Mrs. – very unhappy, at least till she had again seen me.

Among the sick members of her family, was a daughter of about fifteen years of age. For this daughter, in particular, more than for the son Samuel, the good matrons of the neighborhood had their thousand remedies; and they regarded them all as infallible. With these, their favorite notions and doses, they were continually filling the ears of Mrs. – .

One day, when I had been the usual round of the family, and given all needful directions for the day, Mrs. – came to me and said: "Doctor, what do you think would be the effect of a little pumpkin-seed tea on my daughter Eunice? Do you think it would hurt her?"

"Why, no; I suppose not," I said. "But for what purpose would you give her pumpkin-seed tea? Is she not doing as well as could be expected? And if so, is it not desirable to let well enough alone?"

"To be sure she is doing very well," said Mrs. – ; "and I do not know but every thing is just as it should be. We certainly have great confidence in your treatment. But she is so feeble it seems as if something might be given which would make her gain strength faster. Why, she is very weak, doctor! Mrs. Gay and several others have thought a little pumpkin-seed tea might give her strength; but I do not like to order any thing new without first consulting you."

I did not object to the pumpkin-seed tea, administered in great moderation. I did not say as I ought boldly to have said: "I shall be obliged, as your physician, at least till you choose to dismiss me, to pursue the course I have marked out for myself, since I shall have to bear the responsibility." In my modesty and even diffidence, I preferred to let the ignorant friends of the young woman dabble with this comparatively inoffensive article, rather than with something worse. Besides, I wished to have no clandestine movements, and had already rejected so many proposals to give this or that medicament, that I dared not do it longer. "Oh, yes," said I, "you may give her pumpkin-seed tea; but give it in moderation."

The pumpkin-seed tea was given for the next twenty-four hours, I believe, with great exactness. But as there was no obvious or immediate advantage from using it during that time, it shared the fate which might have been expected. Like the wad in the child's pop-gun, which some new wad soon and effectually expels, the pumpkin-seed tea was thrown aside, and some other infallible cure proposed in its stead.

Now, reader, do not suppose I deemed it at all derogatory to medical authority that pumpkin-seed tea should be proposed by a weak and silly mother for a darling daughter. Such a feeling as that would have placed me on the same level of human folly that she herself occupied. On the contrary, a medical man of any considerable experience among the sick and the friends of the sick, should think himself exceedingly fortunate when nothing worse is suggested by ignorance for his patients than pumpkin-seed tea!

CHAPTER XLI

BROKEN LIMBS AND INTEMPERANCE

Wrestling for amusement, in the region where I practised medicine, was a very common occurrence, and certainly had its advantages. But there was one drawback upon its excellence, except to physicians. It involved a good deal of bone-breaking. One famous wrestler with whom I was well acquainted, broke, for his neighbors, an arm and a collar-bone; and in the end almost broke his own neck. He certainly injured it to an extent from which there was never an entire recovery. I shall mention him in another place.

For more or fewer of these broken bones from wrestling, I was called on to prescribe. One case in particular may be worth a few moments' attention, especially as it brings with it certain medical confessions.

I was sent for one evening, about nine o'clock, to visit a young man who had been injured, as it was said, by wrestling. On my arrival, I found him in great distress. He had delayed sending for aid so long that there was much inflammation, and consequent heat, swelling, tenderness, and pain.

It was not easy, at first, to ascertain the exact character of the fractures; but on inquiry and examination, it appeared that while the patient was resting nearly or quite his whole weight on the fractured leg, his antagonist had struck or tripped with his foot so violently as to fracture both bones a little way above the ankle.

It was rather a trying-case to me – for as yet I was, in the art of surgery, a mere tyro. But it was a case which would not admit of much delay; for the inflammation, already sufficiently great, was rapidly increasing. Nor would it do long to hesitate from mere modesty. I was among a class of people, who would, as I well knew, construe modesty, even though it should chance to be, as sometimes it is, an accompaniment of true science, into sheer ignorance; and this would deprive me, as a physician, of my principal lever. For who can lift up the down-fallen without having their full confidence.

But I must explain. My patient with the fractured leg, though not in the usual acceptation of the term a drunkard, was, nevertheless, in the habit of drinking more or less of ardent spirit; and there were not wanting those who believed he was pretty well heated with liquor at the time his leg was broken. But, however this may have been, his frequent and excessive use of spirituous liquors had rendered his blood exceedingly impure; and I could not help shrinking, at first, from the task of having charge of him. Yet, it was a war from which there was no honorable discharge. There was no other surgeon within a reasonable distance, and why should I refuse to do my best for him? Somebody must assist him; and though the case was a troublesome one, why should I not take my share of troublesome cases among the rest?

There was another consideration. As he was poor, any thing like reluctance would have been construed into a willingness to neglect him on account of his poverty – a suspicion from which I should, at that time, have shrunk as readily as from the charge of robbery or murder.

But his associates were worse than he; and, with the exception of his own immediate relations, not an individual would be likely to call on or proffer him aid who was not half or two thirds of the time steeped in spirits. Has the surgeon or physician, in such circumstances, much reason to hope? And what is the hope of his patient? Can he reasonably expect, even with the aid of a skilful surgeon, ever to have a good leg?

However, I did my duty, according to my best knowledge. I had the man laid in a proper position, then placed the divided bones as nearly in their natural position as possible, and bound them. I confess, here, to very great ignorance. Moreover, I repeat, it was a difficult case. And yet I think I succeeded very well for a beginner.

Having properly placed the fractured bones and detained them there by suitable means, I gave due orders concerning the patient's management and treatment. I was particularly careful to interdict all stimulating or indigestible food, and all drink but water. My directions were written down with great care, and the strictest charge was given to his friends and family to see that they were faithfully regarded.

But, alas, for the best person in the world with such attendants! Whenever his wife took care of him, things went on very well; but in other instances, almost every thing went wrong. His attendants gave him rum, opium, laudanum, or almost any thing that he called for. It is true – and I mention it to his credit – that he was often rather moderate in his use of interdicted articles; but then he took just about enough of these unnatural or extra stimulants, to prevent the healing process from going forward as fast as in a man of only thirty years might have been expected.

Instead of being on his feet in a couple of months or so, he lay on his bed three months or more. And then, instead of having a good leg, it was not merely slightly crooked, but half an inch too short. And then, in addition, – and what was very hard to endure, – he charged the whole blame of its imperfection on the surgeon, and insisted that it was not "set" right!

Now, while I confess to much awkwardness, and to the possibility that the limb was not managed as well as it might have been, I must maintain, notwithstanding, that such a charge was wholly misplaced and even gratuitous. Had he employed the best surgeon in the world, and had the leg received the best possible attention, it could not have been kept in its proper place with so much distilled spirits in the house, and so many slaves of the bottle! One might almost as well expect a leg to heal in the nether pit. Though I have never said, either by way of retaliating the abuse or otherwise, that his punishment was richly merited, I might have said so. A man is hardly entitled to good health and a good frame who keeps such company as he did, whether in sickness or in health. God has so connected law and penalty, that he who should complain of the penalty would but insult the law given.

Many cases of petty surgery as well as of severe and complicated disease, fell to my lot, which embarrassed me in a manner not unlike the foregoing; though in no one did I suffer quite so much from misrepresentation as in this. For at least twenty years, to my certain knowledge, my patient took pains to speak of me in terms of reproach, and to say that his leg was set badly; and all without the slightest evidence. I do not positively aver, I again say, that the surgery in the case was faultless; but whether it was so or not, neither he nor any living individual could know, unless it were a more skilful surgeon than myself; and no such surgeon, I am sure, ever saw him during the time I was in attendance.

CHAPTER XLII

DYING FROM MERE FILTHINESS

The family of a wealthy farmer came under my hands, as physician, one autumn, in circumstances peculiarly painful and trying. Several of them had been taken suddenly and severely sick, and one or two were almost dead before they were fairly aroused to a sense of danger. They lived, however, quite remote from any village, and were strongly prejudiced against both physicians and medicine. But a fearful foe, in the shape of typhoid dysentery, now assailed them, and handled them so roughly that they laid aside their prejudices for the moment, and cried aloud for help.

I was soon on the spot, but, oh, what a scene presented itself! As I have more than intimated, two of the family were already beyond hope. Others seemed likely to die. What was to be done for them, as I saw plainly, must be done quickly. On nearly every countenance I met with, both within the family and beyond its precincts, were the marks of consternation, and on some, of despair.

In these circumstances – for desperate cases require a desperate remedy – I sought the counsels of an older physician. He came immediately and took a survey of the dreadful field of slaughter. On retiring with him for consultation, he immediately said; "There must be some local cause or causes for all this. Have you," he added, "been into the cellar?" When I replied in the negative, he said, "Then we must go there immediately."

On speaking to the lady of the house, who was among the sick, by the way of asking permission, she objected, and with a good deal of promptitude and spirit. However, she at length yielded, and we made a thorough examination. The results of this examination were such as to confirm our suspicions. "We need not search further for the causes of a deadly disease," said Dr. B., and I thought so too.

I have said already that the family was wealthy; but wealth need not include negligence, and still more filth. It was now September; and I am quite of opinion that the cellar had not been cleaned in one year, perhaps not in two. I had seen many farmers' cellars before, but I had never seen such an one as this. Nor do I believe my consulting physician ever had, though he was some twenty years older in medical practice than myself. Nor am I certain that what I may state will appear to you wholly reliable.

In the first place there were, in abundance, cabbage leaves and stumps in a semi-putrid state. Next there were decayed potatoes, turnips, beets, and apples. Then there were in various parts of the cellar remnants of cider and vinegar, and cider lees – the latter in a most offensive condition. Finally, there were remnants of barrels of beef and pork, in a bad state – to say nothing of other casual filth – the whole contributing to such a stench as I had never before perceived in a cellar.

The old physician who accompanied me had said, "We need not go farther;" but our determination was, on full and mature reflection, to know the worst and the whole, and we governed ourselves accordingly.

Close to one corner of the kitchen was the well, the water in which was very low, and near to that the sink. And if the contents of the sink did not find their way, from day to day, into the well, thus adding impurity to putridity, it must have been in virtue of some unknown law which stood opposed to the great law of specific gravity and attraction. It is true that many speak of the earth as having a cleansing power in such cases; but I know of no power which it possesses of cleaning sink water, while the latter is passing only five or six feet through it. The coarser parts may be strained out, but the essence must remain.6

But our work was not yet finished. The vault, greatly neglected, was not far from the well; and so of the pigsty. Nor was it easy to resist the conviction that there was an underground communication between them. Then, finally, the house instead of standing on an elevation, greater or less, – a very common mode of building in New England, – stood in a sort of concavity, which contained also the barn and barnyard and woodpile; – connected with both of which was a large amount of decayed and decaying animal and vegetable matter.

Now after such a review as this, he who could remain in doubt with regard to the cause of existing disease, especially on its assuming the form of bowel complaint with typhoid tendencies, must be much more ignorant of the laws of health and disease than I was. In fact the signs were unmistakable.

We immediately made our report to the heads of the family, and recommended a most thorough cleansing, at once. It was easy to see that we gave great offence; indeed we had anticipated such a result. But we were not at all intimidated. We insisted on a work of immediate expurgation, which was finally effected, only we could not put pure water into the well. But we could and did require that the well water should not be used for any thing except washing clothes.

The result was a decided and almost immediate improvement in the condition of the family, except the two already spoken of, and a very young child. These three died. Some of the rest lingered for weeks, and one or two for months; but they finally recovered.

It is worthy of remark, moreover, that of the people of the neighborhood, though they had been excessively frightened and had not at first dared to come near the house, at least without holding their breath, not a person among them sickened. The disease began and ended over the foul cellar I have mentioned; nor has a similar disease ever since broken out there. The fair presumption is, that they have never since suffered such foul accumulations to remain through the hot season, on their premises.

My honest and truly honorable course of conduct, in this instance, cost me something. Though I was a means of saving their lives, the survivors never thanked me for the exposure I made of their slovenliness. Perhaps I was wrong in reporting it abroad; but it was next to impossible to conceal the facts; and I, for once, did not attempt it. Physicians sometimes thus stand between the living and the dead, and must expect to give offence. They are, however, in duty bound to keep the secrets of their patients' faults as long as they can, unless the greater good of the public demands an exposition.

But while I lost reputation in this particular family, I have not a doubt that I gained a strong hold, by this adventure, on the public mind and feelings. In truth, despite of even some trifling errors, I deserved it. I had, moreover, during the adventure, acquired a good deal of practical knowledge, of which, in the progress of my course as a medical man, I was glad to avail myself.

This was doubtless an extreme case of disease from filthiness; but cases of the same general character are quite numerous. I have sometimes wished the public could have a history of these cases. There is an immense amount of neglect in the departments of cleanliness and ventilation; and the consequent suffering in the various forms of disease, is in similar degree and proportion.

I will conclude this chapter with a single anecdote, which, were it necessary, could be substantiated by a very great number of living witnesses.

Some fifteen or twenty years ago, a severe disease was accustomed to visit one of our New England factory villages, and to carry off more or fewer of its inhabitants. So regular and certain were its yearly visits and ravages, that not a few were disposed to regard it as a sort of necessary evil, or, perhaps, as a divine infliction. At length a very shrewd old gentleman told the people that the troublesome visitor was of human and not of divine origin; and that if they would attend properly to their cellars, sleeping-rooms, wells, etc., it would no more be heard of. At first, they were disposed to laugh at him; but the matter was talked of and agitated, till a work of general purgation was actually attempted and finally accomplished. The disease has never re-appeared. Was all this the result of mere accident? Do our diseases spring out of the ground? Are they the result of chance or hap-hazard? or, are they not the heaven-appointed penalties of transgression?

CHAPTER XLIII

TAKING THE FEVER

A large family, not much more careful of their habits or cleanly about their premises than the family alluded to in the foregoing chapter, had sickened one autumn, and one of them had died. Anxious to save the rest, I again acted as physician and nurse both, and effected my object; or, at least, appeared to do so. The rest of my patients ultimately recovered.

But while thus watching these patients, by night and day, standing in the very front of the battle, I suddenly sickened. The circumstances, as nearly as I can recollect them, were the following: —

Among the sick of this afflicted family was one unmarried man of rather eccentric and very unsociable habits, and exceedingly negligent both of his person and dress. His linen, and I think also his bed-clothes, were hardly changed once a month; at least as long as he was well. And then he had, of course, extended the same neglect to his sick chamber. Added to this, moreover, was a species of necessity at this juncture; for so much distressed were the family, and so difficult was it to procure aid in the neighborhood, that a part of the neglect to which our old bachelor was subjected seemed unavoidable.

I took notice of the neglect, spoke of it repeatedly, and labored assiduously to correct the evil. But the case seemed an almost forlorn one. I was morally obliged, as I then felt, to do a thousand things for him that usually fall to the lot of nurses and assistants. In some instances, I passed even whole nights in the family, in attendance on him and the other sick persons.

My task was the more severe from the fact that a similar fever was prevailing in other parts of the town, and my labors beyond the precincts of this family were exceedingly fatiguing and severe. In truth, I was, in the end, greatly overworked and debilitated, and my system most admirably prepared for the reception of disease.

For various reasons, some of which, have already been named, I often assisted in turning my bachelor-patient in his foul bed. It is true the process was so offensive that I avoided it whenever I could; but on occasions, I yielded to the pressure of necessity.

One night, when I was greatly fatigued and exhausted, and at the bottom of my condition, – utterly unfit for exertion, even in a pure atmosphere, – I was stooping over Mr. V., to turn him in his bed, when I suddenly felt a sensation like that of receiving a blow externally on the chest and stomach. The thought struck me as quickly as the imaginary blow did – have I not taken the disease? I knew the laws of contagion; the only question was whether any contagion had been generated. My opinion was to the contrary; nevertheless, I could not wholly suppress my fears.

A sensation of oppression which followed the imaginary blow, soon gradually passed away, though I felt, each succeeding day, more and more debilitated. Many a resolution was made to leave my patients, so far as personal manual care was concerned, and be much more than I had been, in the open air, though it was only made for a time – to be broken. At length, however, principle prevailed over sympathy and inclination, and I did as I ought to have done long before. It was, however, rather late, for the die was already cast. I was taken sick, and the symptoms of my disease were precisely like those of Mr. V.

Perceiving now, most clearly, my condition, and that I was engaged in a war from which there could be no discharge, I made preparation for a long and severe sickness. First, I calmly and deliberately adjusted all my domestic concerns of a pecuniary kind, and made such arrangements as would, in case of my demise, render every thing intelligible. Then, in the second place, I made up my mind to submit, as cheerfully as I could, to my condition. I determined to keep quiet, and not indulge for a moment in any undue anxiety. I employed a physician, – my old master – but steadfastly, and almost obstinately determined not to take much medicine; – nor was there much prescribed.

My disease proved to be much milder than was expected; but it had its regular course. I never wholly lost my muscular strength or my appetite. While I was sick, several of my nearest friends and patrons sickened in a similar way, only more severely; and one or two of them died. On my recovery, however, or about the same time, the most of them began also to recover, and the disease in general abated.

Now, when I came to reflect coolly and carefully on the whole affair, I could not help perceiving that I richly deserved all I suffered. It was the just penalty of transgression. I had been fully and repeatedly warned not to watch with my patients, as those who turn back to Chapter XXIII, and those too who remember its contents, will perceive. It was fit, therefore, that I should feel the rod, even if I could not kiss the hand that had appointed it. The only wonder with me now is, that my punishment was not more severe.

CHAPTER XLIV

BLESSINGS OF CIDER AND CIDER BRANDY