Forty Years in the Wilderness of Pills and Powders

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 to myself, 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?

CHAPTER LVI

BUTTER EATERS

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 called a 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 producing derangement 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 mean meddlesomeness, – 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.8 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 a vessel 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, that it 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 the ipse dixit of 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.

CHAPTER LVII

HOT HOUSES AND CONSUMPTION

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 as injurious 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 the sake of 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 physicians should, 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 recovery depends, 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 be postponed. 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 had ample 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, the postponement of 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 is cure, 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 in a 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 only predisposed to 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 but do as well as they know, 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.