Forty Years in the Wilderness of Pills and Powders

This unnatural cookery, – this mingling medicine with viands naturally healthful, and torturing the compounds thus formed into sources of irritation, has more to do with that sensuality which has come upon us like a flood, – much of it in new forms, – than many are aware. And I am much mistaken if modern societies for moral reform, popularly so called, might not thank the over-refined cookery of a gross and highly stimulating diet, for that necessity which impels to their own field of labor.

One thing more might have been mentioned in its proper place – the tendency of high living to eruptions on the skin. These, in their various forms of pimple, carbuncle, boil, etc., are becoming quite the order of the day. Mr. Y.'s family had a full share of them, especially those of them who were scrofulous. I have already mentioned the appearance of Mr. Y.'s face, and have alluded to the change which took place after his fall. But I should have spoken of the eruptions on his face, which, at times, were such as almost made him ashamed to enter the pulpit.

You will see, from the tenor of these remarks, that I have laid the guilt, in this sad affair, just where I believe it ought to rest. I have not sought to exculpate one individual or party, at the expense of another equally guilty, but rather to do justice to all.

Only one thing remains, which is to confess my own guilt. Have I not great reason to fear that my advice was not sufficiently pointed and thorough? I might have gone to Mr. Y. and told him the truth, the whole truth. What if it had given offence? Would not the prospect of doing good, rather than of giving offence, have been worth something? In any event, I do regret most deeply my unfaithfulness, even though it arose from delicacy and diffidence, for that very delicacy and diffidence were far enough from being grounded on the love of God. They were grounded much more on the love of human approbation. No man was ever more free from it than our Saviour. Ought I not to have used the same plainness that he would have used? Had I rebuked Mrs. Y. as kindly and as faithfully as he rebuked Martha at Bethany, how much, for ought I can ever know, might have been saved, not only to the cause of health and conjugal happiness, but also to that of piety.

CHAPTER LXXVI

DR. BOLUS AND MORPHINE

A telegraphic communication was made to me one day, nearly as follows: "B. J. W. is very sick, and is not expected to live through the day. Please come on immediately."

The distance was about one hundred and fifty miles, and the mode and means of conveyance neither very direct nor rapid for these latter times. It was more than probable that Mr. B. J. W. would be dead before I could reach the place. However, as he was a particular friend, and as there was some hope, I concluded to set out.

Late in the evening, – or rather, in the night, – I arrived at the place, and found the young man still alive. He was, however, as it was easy to perceive, in a very critical condition. Glad to find him alive, but inclined to fall in with the general opinion that his case was a hopeless one, and withal greatly fatigued, I yielded to the demands of exhausted Nature, and slept a short time, when his physician arrived.

Now I had been sent for, in part, as a special friend, and in part, as a medical counsellor. And yet there were difficulties. Dr. Bolus, the family physician, was just such a man – for reasons that might be given – as I dreaded to advise with, should my advice be needed. He was one who would be likely to think any important suggestion an impeachment of his own superior wisdom. Science, true science, is always modest, and does not fear any thing; because she loves, most of all things, to be right. But Dr. Bolus had not, as I think, enough of true science to make him feel or perceive the want of it. The ignorant are always self-confident in proportion to their ignorance.

We examined the patient, as soon as possible, and retired for consultation. Dr. Bolus gave a full history of the progress of the case, with a particular account of the treatment. I saw at once, both from the existing symptoms and Dr. Bolus's statement, that the tendency to the brain – so great as to keep up an almost constant delirium – was quite as likely to be caused by the enormous quantities of morphine and quinine, and other active medicines which had been administered, as to belong properly to the disease. I therefore advised a gradual reduction and ultimate discontinuance of the extra stimulants.

Dr. Bolus was opposed to the reduction I proposed, but finally consented to it, at least in part, and the patient evidently derived almost immediate benefit from it. When I had pushed my views with regard to the stimuli as far as I could, we separated, and as the distance at which the doctor resided was considerable, and as I was on the spot to watch the patient, he proposed not to call again till early in the morning of the following day.

I was by no means satisfied with the compromise we had made. It had not accomplished its intended object. Dr. Bolus had, indeed, yielded a little, but not enough to satisfy me. I believed the amount of stimulus still given vastly too great, and was unwilling to continue it. In truth, I persuaded one of the attendants to omit the principal articles, whenever the hour came for administering them, assuring him that I would take all the responsibility.

Of the other attendant I would have made the same requisition, but he being exceedingly attached to Dr. Bolus, would never have tolerated the slightest concealment, or departure from the strictest letter of the law.

It was easy to see that the less stimulating treatment of each alternate two hours, during which it was entirely omitted, left behind it, on the patient's frame, a better influence than the more active treatment of the other two. And when the next medical consultation came, I pleaded for a still greater diminution of the stimulus. But, as I had unwillingly used a little duplicity, – a thing I now deeply regret, – in order to come at my conclusions against the stimulants, I was not willing to state, in full, the grounds of my opinion, and therefore could not prevail with Dr. Bolus to consent to any farther advances in the unstimulating plan.

I was now, at length, compelled to leave for home; and the results, for the rest of the time, were reported to me through the kindness of the young man's friends. It is sufficient, perhaps, to say that he finally recovered; but it was not till the lapse of several months. In the mean time, a severe ulcer broke out on the lower part of his back, which caused much suffering, and appeared to retard very greatly the progress of his recovery.

My errors in this case were numerous and great. Believing, as I did, in the outset, that Dr. Bolus and myself could never agree, I did wrong in consenting to a consultation with him. I ought to have been nothing but a visitor, or else to have entered fully into the spirit and duty of a counsellor. In the former case I might, indeed, have outraged every feeling of benevolence; in the latter I ought to have proposed my objections in full, and not to have compromised so as to submit to what I really believed to be radically and essentially wrong.

For I did most fully believe all this; and in spite of every effort at concealment, my scepticism finally came out, and I was weak enough to speak of it, and openly to find fault with Dr. Bolus. A practical quarrel followed between Dr. Bolus and myself, in which the friends joined, or, at least, strongly sympathized.

My own belief, then, was, and it still remains the same, that the violence of the young man's disease, especially the tendency to the brain, was chiefly, if not wholly, owing to the medicine administered; and that, from the very first, no active medicine – nothing but an exceedingly mild and cooling treatment – was required. It was even my belief that the ulcer was caused by the medicine.

But, while I lost confidence in human nature, and especially in the human nature of some of my brethren of the medical profession, by this experiment, I became more thoroughly convinced than ever before of the great need of honest and benevolent as well as scientific men in this department, and of the general impotency and worse than impotency of much that is dignified with the name of medical treatment. I became most fully convinced, that in acute diseases as well as chronic, Nature, unembarrassed, will generally accomplish her own work, when left to herself and to good and careful nursing and attendance.

CHAPTER LXXVII

BLEEDING AND BLISTERING OMITTED

One of my neighbors had fallen down-stairs, and injured himself internally, in the right side of the chest; and a degree, greater or less, of inflammation had followed. The pain was constant, though not severe; but the soreness was considerable, and did not give promise of speedy amendment.

My advice was to keep quiet, both in body and mind, and to avoid all kinds of exertion that could possibly affect the chest. I also advised the use of water, not only for drink, in small draughts, but, if the pain and soreness should be troublesome, as an external application to the part affected. The food was to be mild and unstimulating. A tendency to crowd around the fire was to be guarded against and prevented, by putting on, if necessary, an increased amount of clothing.

Two days passed away with no great variation of the symptoms, either for better or worse. I was now fully convinced that I had taken the true course, because, otherwise, my patient must, by this time, have become worse. Accordingly, I persevered in my general let-alone plan for about two weeks, when the patient fully recovered.

He was a slender boy, in the fifteenth year of his age, strongly inclined, by inheritance, to disease of the chest and brain; and this consideration, among others, led me to be extremely cautious about his treatment. The greater the danger the greater the necessity that what is done should be done right, or we shall defeat our own purposes.

But the most remarkable fact in relation to this very interesting case is, – and it is chiefly for the sake of this fact that I have related the story, – that more than forty-eight hours had passed, after the occurrence of the accident, before it came into my mind that any thing could, by possibility, be done for the chest, in the way of bleeding, blistering, etc., – so utterly irrational had this treatment, once so fashionable, come to be regarded, both by myself and a few others. How strange that I should not think of it in two whole days! Twenty years before, I should not have dared to pass through the first twenty-four hours, in such a case, without thinking, at least, of balsams and mustard poultices and the whole paraphernalia of external treatment, to say nothing of bleeding and blistering.

CHAPTER LXXVIII

MEDICAL VIRTUES OF SLEEP

My own child, a boy nine or ten years of age, and somewhat inclined to croup, was one evening wheezing considerably, and, as his mother thought, was threatened with an immediate attack, either from this or some other disease. Of course, there was not a little anxiety manifested in the family on his account, and we were deliberating what to do with him, when the late Dr. Shew, the hydropathist, chanced to come in.

After a little general conversation, we turned our thoughts again to our little patient, and asked Dr. Shew what he would do with him if he were his patient. "If it were my case," said he, "I would give him a tepid bath – say at about the temperature of 80° or 85°." "Would you do nothing more?" "Nothing at all, except to put him early to bed."

I was not committed to hydropathy, as I have before told you. I never have been, though I had a sort of general respect for Dr. Shew; and hence it was that, incidentally, I asked him the question which I did; and I was pleased with his reply. There was nothing suggested which was at all akin to violence. He did not propose a shower bath of any kind. He did not speak of hot bathing, which for that hour of the day might have induced too violent a perspiration. He did not propose vapor bathing or steaming. A tepid bath could, abstractly considered, do no harm. It would, at least, while away the time till nature could have opportunity to rally. And then, if the return to health should be attributed to the application of the tepid water, we had no special objection to it. We had no medical pride – most certainly I had none – that would lead me to fear lest I should add to the popularity of the cold-water system.

But it was rather late in the evening, – between seven and eight o'clock, – almost time for such a child to be in bed. In order to get up a tepid bath and make the application, so much time would be required that it would keep him from sleep till nine o'clock, and perhaps later; whereas, I had a very high opinion of the healing and renovating power of natural and healthy sleep. It struck me that to put the child to bed immediately, and let him have a good night's rest, would be a much wiser measure than to bathe him even in tepid water. So, after thanking Dr. Shew for his advice, I told him that, for the reasons above stated, we had concluded to omit the bath and put the child immediately to bed.

On being put in bed and suitably covered, he went to sleep immediately, and fell into a gentle perspiration, and in about two hours his breathing was much better. It continued to improve till the next morning, when he arose, at the usual time, and was nearly well. Dr. Shew himself jocosely observed that the sleep cure had proved quite as successful as the water cure.

Much, therefore, as I prize bathing of all sorts, in its proper place, it must never take the place of other and more important influences, whenever these influences can be brought to bear on the case. Indeed, no bathing of any kind can be desirable, any farther than as it serves to aid these natural processes. It has no magic or miraculous power. If we do not eat, drink, sleep, and wake, all the better for it; if the various offices of digestion, respiration, circulation, perspiration, and cerebral action are not thereby, as a whole thing, better performed, it might as well – nay, better – be omitted. Otherwise we waste time and trifle away vital energy.

If all the functions of the body and all the faculties of the mind could be kept steadily employed, and in healthful proportion, it is obvious that a person could not be sick. Or, if one of these only should be deranged, and we should fall sick, as the consequence, what else, pray tell me, is needed, but to effect a speedy return of the faltering function or part to its proper post and duty?

But sleep, more than all things else, whenever the usual hour has actually arrived, has the effect to facilitate a cure. We all know how wakeful some maniacs are, and how hurried and deranged all the movements of the muscular and nervous systems are apt to become, no less than those of the brain itself. And we all know, too, how much good it does such persons to be able to obtain good, sound, substantial, quiet sleep. It acts like a charm, and does more than charms can do, or mere medicine.

Half the formality of having watchers by night in the sick room, does more harm than good. It were better, in many instances, to extinguish all the lights, except at certain set times and on particular occasions, and let the patient sleep. And yet I have as exalted an estimate of the importance of careful nursing as any other individual.

For example of my meaning, in a case of seeming contradiction, I may say that I have taken all the needful care of a young man who was very sick, for more than thirty successive nights with the exception of two, and yet maintained my health, which, as you already know, was never very firm. And I have known those who could do this for three months. But they extinguish or hide their light, and acquire a habit of waking at certain times, so as never to neglect the wants of the patient.

So true is it that sleep is the grand restorer as well as the great curer of disease, that its salutary influence in the case of various infantile complaints, has long been known and regarded. And one reason why infants should neither be nursed nor fed in the night, as many physiologists maintain, is, that it breaks in upon the soundness of the sleep, as experience has most abundantly proved. Sleep, in short, if not a "matchless" sanative, is at least a universal one.

CHAPTER LXXIX

CURE BY DEEP BREATHING

A young man, fifteen or sixteen years of age, who was in the habit of suffering from protracted colds, nearly the whole winter, till they seemed to terminate almost in consumption in the spring, came under my care about March 1st, 1854, and was treated as the nature of his case seemed to require, though with a few of what may be, by some, regarded as peculiarities.

He was directed to rise in the morning at about six o'clock, which at that season of the year is about as early as any one can see well without lamp-light. At the moment of leaving his bed, he was required to wet his body all over, as quickly as possible, either with the hand or a sponge, or if preferred, with a coarse towel, and then wipe himself hastily and partially, so as to leave on the surface a little moisture, and yet not enough to cause, by evaporation, any sensations of chilliness. The water to be used was to be cold, or at such temperature as is usual at that season, when standing all night in a room without fire. This was to be followed by a rapid rubbing with crash mittens, a coarse towel, or the hand, as long as he could keep up a good reaction and a proper degree of vital warmth.

Or, if rubbing the body increased the cough, and an assistant was required, in this case, a healthy man well charged, so to speak, with electricity, was always to be deemed preferable. In general, however, the young man found no difficulty in keeping himself warm, in this exercise, about half an hour.

Whenever his strength began to flag, or a little before, – for I did not think it desirable to go farther than the mere borders of fatigue, – he was placed in bed and well covered, so as to be immediately warm. The room itself was kept as cool as possible, even in the coldest weather, the fire having been entirely removed at bedtime the night before, and the room well aired and ventilated.

This method of placing him in a warm bed was called dry packing. In this dry pack he usually remained from half an hour to an hour. At the end of this period, he was required to get out of bed, and repeat the former course of rubbing the naked surface of the body a long time, in the cold air, though, in this case, without repeating the application of the cold water.

Thus the forenoon passed away, with a few slight but unimportant variations. At twelve o'clock, this alternation of air-bathing with friction and dry-packing, ceased, and the patient was expected to put on his clothes and come to dinner. You will, perhaps, ask when and where he had his breakfast. No breakfast was allowed him. Nothing was to be taken, except small draughts of water, till twelve o'clock.

Another operation, which had much more the appearance of peculiarity than any other part of the treatment, but which was deemed, more than all else, indispensable to his recovery, consisted in a series of deep inspirations or breathings. It may be described thus: The patient was required to draw as much air into his lungs as possible, and then immediately expel as much of it as possible. This was to be repeated and continued till a suitable degree of fatigue was induced. At first, it was only required as a species of amusement while in the dry pack; but subsequently it was demanded in other circumstances.

I have usually required a person to begin the process by ten, twenty, or thirty deep inspirations, according to his strength of lungs and their irritability; for, at first, it often makes him cough. In the present case, I began with fifty, and gradually increased the number to one hundred. Sometimes, by way of experiment, and to pass away the time while in the dry pack, he went much farther; once to six hundred. In this case, however, the face became slightly flushed, the eyes reddened, and the whole arterial action became hastened. It was evidently like "too much of a good thing," and was never repeated.

The afternoon was spent in physical exercise, active amusement, reading, conversation, etc. The first consisted chiefly in sawing and splitting wood, and in walking abroad. The amusements were of various kinds. The reading was chiefly of the lighter sort, such as newspapers and magazines. The conversation – not always controllable – was the best we could furnish him. Some of the walks were long, extending to five or six miles.

Music, both vocal and instrumental, was regarded as a most valuable amusement, and was not wholly overlooked. It had its difficulties, but most of them could be surmounted. As a devotional exercise, its soothing influence was almost always evoked.

I have said that no breakfast was taken by this young man, and no drink used but cold water. The dinner was also without drink, and so was the supper. The first consisted of a very few kinds of coarse food, – generally not more than two or three at once, – such as coarse whole-meal bread, rice, potatoes, apples, etc., and was the principal meal. The supper was a lighter meal, both as respected quantity and quality, and was taken at about six o'clock. No condiments were allowed except salt, and very little of this; and no animal food, or the products of animals, except, occasionally, a little milk. Fruits, either raw or cooked, were frequently among the staples at dinner, but never at supper.

This treatment, with slight variations, would be applicable to most persons suffering with lingering complaints, and to persons in health, as a means of invigorating their systems; but my present purpose is, chiefly, to speak of it as a remedial agency in the particular case of this young man.

I had hoped to be able to effect a cure on him in about a month. But I was happily disappointed in finding him recover so fast that he was dismissed and sent home on the twenty-fifth day. Nor has his consumptive tendency ever again appeared with much severity. Since the spring of 1856 – now between two and three years – it has not appeared at all.

This method of cure, by deep breathing, consists simply in using the lungs freely, without overworking them. They may be overworked as well as used too little; though the danger is generally in the latter direction. They are made, most undoubtedly, for a great amount of action, in breathing, conversation, singing, reading, etc.; and yet, in all these respects, they are sadly neglected.

Our ordinary conversation is such as hardly to exercise the lungs at all. We talk with the mouth and throat rather than the lungs. So is it, for the most part, with our singing. And, as for breathing, we only breathe a little way down, even when our dress is such as to form no impediment. Full breathing, except in making violent efforts, is hardly known.

CHAPTER LXXX

SPIRIT-DOCTORING

One of the most amusing incidents of my "Forty Years among Pills and Powders," is found at full length of detail in the following chapter. The amusement it affords has, however, a tinge of sadness.

A young man came under my care in the early part of the year 1854, who, for the sake of convenience, I will call Thomas. He was about eighteen years of age, but as delicate, sensitive, and effeminate as a female directly from Broadway would have been, or as a plant reared in a hothouse. In truth, he had been reared very much like many females of the present day, in a manner entirely sedentary – the creature of over-tenderness and over-kindness.

His disease was scrofula; but, with his scrofulous tendencies were conjoined some other difficulties, more obscure and still more unmanageable. His joints were enlarged; and in particular portions of his body were various watery swellings or sacs.

As it was a scrofulous tendency that lay at the bottom or basis of his complaints, I proceeded to treat him accordingly. I was to have him under my care three months, during which time, it was believed, something might be done, if ever. At least, it was believed that a beginning might be made, if indeed the disease should prove to be at all curable.