Forty Years in the Wilderness of Pills and Powders

Thus, as I began to suspect, – and the reader must pardon the suspicion, if he can, – it may be with our diversified and diverse modes of medical treatment. A proportion of our patients, – perhaps I should say a large proportion, – if well nursed and cared for and encouraged, would recover if let alone so far as regards medicine. And it is in proof of this view, that nearly as many recover under one mode of practice, provided that practice is guided by a large share of plain, unsophisticated sense, as another. And does not this fully account for a most remarkable fact?

Hence it is, too, – and perhaps hence alone, – that we can account for the strange development in Boston, not many years since, during a public medical discussion; viz., that he who had given his tens of pounds of calomel to his patients, and taken from their arms his hogsheads of blood, had been on the whole about as successful a practitioner as he who had revolted from the very thought of both, and had adopted some of the various forms of the stimulating rather than the depleting system.

"Is there, then, no choice between medication and no-medication? For if so, what necessity is there of the medical profession? Why not annihilate it at once?"

My reply is, – and it would have been about the same when these discoveries began to be made, – that there is no occasion to give up the whole thing because it has been so sadly abused. Every mode of medical practice, not to say every medical practitioner from the very beginning, has been, of necessity, more or less empirical. The whole subject has been involved in so much ignorance and uncertainty, that even our wisest practitioners have been liable to err. They have been led, unawares, to prescribe quite too much for names rather than for symptoms; and their patients were often glad to have it so. And were the whole matter to come to an end this day, it might well be questioned whether the profession, as a whole, has been productive of more good than evil to mankind. But then, every thing must have its infancy before it can come to manhood. And it is a consolation to believe that the duration of that manhood always bears some degree of proportion to the time required in advancing from infancy to maturity.

Medicine, then, as a science, is valuable in prospect. And then, too, it is worth something to have a set of men among us on whom we may fasten our faith; for, credulous as everybody is and will be in this matter of health and disease, till they can duly be taught the laws of hygiene, they will lean upon somebody; it is certainly desirable that they should rely on those whom they know, rather than upon strangers, charlatans, and conjurors, of whom they know almost nothing.

But I shall have frequent occasion to revert to this subject in other chapters, and must therefore dismiss it for the present, in order to make room for other facts, anecdotes, and reflections.

CHAPTER XVII

STRUCK WITH DEATH

Throughout the region where I was brought up, and perhaps throughout the civilized world, the notion has long prevailed that in some of the last moments of a person's life, he is or may be "struck with death;" by which, I suppose the more intelligent simply mean that such a change comes over him as renders his speedy departure to the spirit-world inevitable.

Now that we are really justified in saying of many persons who are in their last moments, that they are beyond the reach of hope, is doubtless true. When decomposition, for instance, has actually commenced, and the vital organs have already begun to falter, it would be idle to conceal the fact, were we able to do so, that life is about to be extinguished beyond the possibility of doubt.

In general, however, it is never quite impossible for the sick to recover even after recovery seems to be impossible. So many instances of this kind have been known, that we ought at least, to be exceedingly cautious about pronouncing with certainty, and to encourage rather than repel the application of the old saying, "as long as there is life, there is hope."3

I had a lesson on this subject while a medical student, which was exceedingly instructive, and which, if I were to live a thousand years, I could never forget. It was worth more to me in practical life afterward, than all my books and recitations would have been without it. The facts were these: —

My teacher of medicine used occasionally to take his students with him when he rode abroad on his professional visits. One day, it fell to my lot to bear him company. His patient was an aged farmer, a teamster rather, who had been for some time ill of a fever, and had not been expected to recover. Yet his case was not so desperate but that the physician was expected to continue his daily visits.

On our arrival at the house of the sick man, we were met by a member of the family, who said, "Come in, doctor, but you are too late to do us any good. Mr. H. is struck with death; all the world could not save him now."

We entered the room. There lay the patient almost gone, surely. So at least, at the first view, it appeared. It was a hot summer day, and hardly a breath of air was stirring. The friends were gathered around the bed, and there was less freedom of circulation in the air of the sick-room than elsewhere. It was almost enough to kill a healthy man to be shut up in such a stagnant atmosphere; what, then, must have been the effect on one so sick and feeble?

The doctor beckoned them away from the bed, and requested them to open another window. They did it rather reluctantly; but then, they did it. The sufferer lay panting, as if the struggle was almost over. "Don't you think he is struck with death, doctor?" whispered one and another and another. Almost out of patience, the doctor at length replied: "Struck with death? What do you mean? No; he is no more struck with death than I am. He is struck much more with the heat and bad air. Raise another window."

The window was raised. "Now," said he, "set that door wide open." It was quickly done. "Now bring me a bowl of water, and a teaspoon." The bowl of water was quickly brought. "Put a little water into his mouth with the teaspoon," said he. "O doctor," they replied, "it will only distress him; he is already struck with death." – "Try it then, and see."

Tremblingly they now moistened his parched lips. "Put a little of it in his mouth, with the teaspoon," he said. They shuddered; the doctor persisted. "Why," said the attendant, "he has not been able to swallow any thing these two hours." "How do you know?" said he. "Why, he has been all the while struck with death." – "Nonsense! have you tried it?" "Tried it? oh, no; by no means." – "Why not?" – "Because we knew it would only distress him. He is too far gone to swallow, doctor; you may rely on it."

The physician's patience was now well nigh exhausted, as well it might have been, and seizing the bowl and teaspoon with his own sacrilegious hands, "I will see," said he, "whether he is struck with death or not."

He not only wetted his lips and tongue, as they had partially done before, but gradually insinuated a few drops of Nature's best and only drink, into the top of his throat. At last he swallowed! The doctor's hopes revived; while the family stood as if themselves struck, not with death, but with horror. At length, he swallowed again and again. In half an hour, he opened his eyes; before we left him, he had become quite sensible, and, had we encouraged it, might have spoken.

To make my story as short as possible, the next day he could swallow a little gruel. The third day, he could be raised upon the bed. The fourth, though still weak, he was dressed and sat up an hour. In a fortnight, he was once more driving his team; and for ought I know to the contrary, unless debarred by reason of age, he may be driving it at this very moment!

Going home together from our visit, already so fully described, the conversation turned on the silly notion which so extensively prevails about being struck with death. We talked of its origin, its influence, and its consequences. It had done no good in the world, while it had been the means, we could not doubt, of indirectly destroying thousands of valuable lives.

Of its Origin. – How came the notion abroad that a person can be struck with death, so affected that there is no possible return for him, to life and health? Struck! By whom? Is there a personage, spiritual but real, that strikes? Is it the Divine Being? Surely not. Is it an arch enemy? is it Satan himself?

"No day, no glimpse of day, to solve the knot."

The doctor and I had, however, one conjecture concerning it, which, if it should not instruct the reader, may at least, afford him a little amusement. It certainly amused us.

You have seen the old-fashioned New England Primer. It has been in vogue, I believe, a full century; perhaps nearer two centuries. It has done not a little to give shape to New England character. In its preliminary pages is a sort of alphabet of couplets, with cuts prefixed or annexed. One of the couplets reads thus: —

"Youth forward slips,

Death soonest nips."

While at its left, is the representation of a skeleton, armed with a dagger, and pursuing a youth – a child rather – with the apparent intention of striking him through. Now I cannot say how this picture may have affected others, but to my medical teacher and myself, as we mutually agreed, it always brings up the idea of striking down a youth or child prematurely, and sending him away to the great congregation of the dead.

Nor am I quite sure that this representation, innocent as may have been its intention, has not been the origin of a relentless and cruel superstition. I know certainly, that my own early notions about being struck with death, had, somehow or other, a connection with this picture; and why may it not be so with others?

But the influence and consequences of this superstition must be adverted to for a moment. I said they affect and have affected thousands; perhaps I ought to have said millions. Under the confused and preposterously silly idea that Death, the personification of Satan or some other demon, has laid hold of the sick or distressed, and that it would be a sort of useless, not to say sacrilegious, work to oppose, or attempt to oppose, the grim messenger, we sometimes leave our sick friends in the greatest extremity, to suffer and perhaps die, when the gentle touch of a kind hand, a mere drop of water, or a breath of fresh air, might often bring them back again to life and health and happiness and usefulness.

If this chapter should not be deemed a confession of medical impotence, it is at least a practical confession of medical selfishness or ignorance. If duly enlightened themselves, medical men ought long ago, to have rid society of this abominable superstition; and if not sufficiently enlightened to perceive its existence and evil tendency, they ought to have abandoned their profession.

CHAPTER XVIII

EFFICACY OF COLD SPRING WATER

An aged man not far from where I was studying, had an attack of dysentery which was long and severe. Whether the fault of its long continuance lay in his own bad habits, or the injudicious use of medicine, or in both, we can inquire to better advantage by and by. I was not, however, very much acquainted with his physician, so as to be able in the premises to form a very correct opinion concerning him.

The greatest puzzle with me, at that time, was why he should live so long after the disease appeared to have spent itself, without making any advances. The physician used to call on him day after day, and order tonic medicine of various kinds, all of which was given with great care and exactness. Every thing in fact, seemed to be put in requisition, except what were most needful of all, pure air and water. The former of these was, as is usual in such cases, neglected; the latter was absolutely interdicted.

For this last, as not unfrequently happens at this stage of acute diseases, the poor man sighed from day to day as though his heart would break. But, no; he must not have it. The effect on his bowels, he was told, would be unfavorable. And such at that day was the general theory. It was not considered that a very small quantity at first, a few drops merely, would be a great relief, and might be borne, till by degrees a larger quantity would be admissible.

After repeated efforts, and much begging and crying for a little water to cool his parched tongue, the old gentleman, one night dreamed that he drank from a certain cold spring, which really flowed at a remote corner of his farm and was a great favorite both with him and his whole family, and that it almost immediately restored him. Delighted with his dream, he no sooner fairly awaked than he called up his eldest son and sent him with a bottle, to the spring. He did not now plead, he commanded. The son returned in due time, with a bottle of water. He returned, it is true, with great fear and trembling, but he could do no less than obey. The demands and commands were peremptory, and the father was almost impatient.

"Now, my son," said the father, "bring me a tumbler." It was brought, and the father took it. "Now," said he, "pour some of that water into it." Samuel could do no other way than submit to the lawfully constituted authority, though it was not without the most painful apprehensions with regard to the consequences, and he kindly warned his father of the danger. Nor were his sufferings at all diminished when the father, in a decided tone of voice, ordered him to fill the tumbler about half full.

Whether he had at first intended to drink so large a draught and afterwards repented, is not known; but instead of swallowing it all at a draught, the son's distress was greatly mitigated when he saw that he only just tasted it, and then set down the tumbler. In a few minutes he drank a little more, and then after a short time a little more still. He was about half an hour drinking a gill of water. When that was gone, he ordered more; and persisted in this moderate way till morning. By ten o'clock, when his physician arrived, he had drunk nearly a quart of it, and was evidently better. There was a soft, breathy perspiration, as well as more strength.

The physician no sooner saw him than he pronounced him better. "What have you been doing?" he said, rather jocosely. The sick man told him the simple story of his rebellion from beginning to end. The doctor at first shook his head, but when he came to reflect on the apparent good consequences which had followed, he only said: "Well, I suppose we must remember the old adage, 'Speak well of a bridge that carries you safe over,'" and then joined in the general cheerfulness.

The patient continued to drink his spring water from day to day, and with increasing good effects. It acted almost like a charm; it was not only food and drink to him, but also medicine. Doubtless his great faith in it was not without its efficacy; still it was not to be denied that the water did him great and positive good.

He soon found his newly discovered medicine not only more agreeable to his taste, but cheaper also than Huxham's tincture and quassia. He also found that his son's daily visits to the spring cost him less than Dr. Physic's daily rides of three or four miles. So that though he was greatly delighted to see the smiling face, and hear the stories and jolly laugh of the latter, he was glad when he proposed to call less frequently than he had done and to lay aside all medicine.

He recovered in a reasonable time, and lived to a very advanced age. A friend of his and mine, found him in his eighty-sixth year, mowing thistles barefooted. Two or three years still later, I found him – it was during the cold month of January, 1852 – in the woods with his hired man far from his house, assisting in cutting and loading wood; in which employment he seemed to act with much of the energy and not a little of the activity of his earlier years.

I do not of course undertake to say that he owed his recovery from his long sickness, above described solely to drinking cold water, there are so many other circumstances to be taken into the account, in settling all questions like this, that such an assertion would be hazardous, not to say foolish. His fever at the time of making his experiment, had already passed away; and having great tenacity of life, it was but reasonable to expect nature would ere long, rally, if she could rally at all. It is also worthy of remark, that though his physician was one of those men who place their chief reliance on the medicine they give, rather than on the recuperative powers of the system, yet to his credit be it said, he had in this instance departed from his usual routine, and given comparatively little.

Perhaps we may explain the phenomenon of his recovery, as follows: nature long oppressed, yet by rest partially restored to her wonted energy, was now ready to rally as soon as she could get the opportunity; this the moderate draughts of water by their effects on the circulation enabled her to do; then, too, one consideration which I forgot to mention in its place, deserves to be noticed. When the sick man began the use of water, he laid aside (without the knowledge of his physician) most of what pills and powders and tinctures were prescribed him. And finally he had great faith in the water, as you have already seen; whereas he had lost all faith in drugging and dosing. And the efficacy of faith is almost sufficient in such cases, to work a cure, were this our only reliance. Of this we shall have an illustration in Chapter LXXVI.

But though the water, as I now fully believe – and as I more than half believed when I heard of the facts at the time, – was fairly indicated, there is great hazard, in such circumstances in its use. Had this gentleman taken a large draught at first, or had he swallowed more moderate draughts with great eagerness, and a quick succession, it might have produced an ill effect; it might, even, have provoked a relapse of his dysentery and fever. Many a sick patient in the same circumstances, would have poured the cooling liquid into an enfeebled throat and stomach without the least restraint. And why did not he?

I will give you one reason. He was early taught to govern himself. He told me, when eighty-eight years of age, he had made it a rule, all his life long, never to eat enough, but always to leave off his meals with a good appetite. He did not indeed, follow out with exactness the rule of the late Amos Lawrence: "Begin hungry and leave off hungrier," but he came very near it. He managed so as always to have a good appetite, and never in the progress of more than fourscore years, whether by night or day, to lose it. Such a man, if his mind is not too much reduced by long disease, can be safely trusted with cold spring water, even during the more painful and trying circumstances of convalescence from acute disease.

Another thing deserves to be mentioned in this connection. He had not kept his bowels and nervous system, all his life long, under the influence of rum, tobacco, opium, coffee, tea, or highly seasoned food. He did not it is true, wholly deny himself any one of these, except opium and tobacco; but he only used them occasionally, and even then in great moderation. Nor was it from mere indigence, or culpable stinginess that he ate and drank, for the most part in a healthful manner. It seemed to be from a conviction of the necessity of being "temperate in all things;" and that such a course as he pursued tended to hardihood. As one evidence of a conviction of this kind, I have known his children and their school teacher to carry to the schoolroom for their dinner, a quantity of cold Indian cake – ycleped Johnny cake – and nothing else; nor was there an attempt at the slightest apology. Such a man would not be very likely to have an ulcerated alimentary canal, or bad blood; or to be injured by swallowing every five minutes a table-spoonful of cold water; no, nor to sink as quickly as other people under the depressing tendency of irritating or poisonous medicine.

This last-mentioned fact concerning the use of water, – for it is a fact on which we can rely, and not one of those statements which Dr. Cullen was accustomed to call "false facts," – was to me exceedingly instructive. It taught me more concerning the human constitution and the laws of health and disease than I had ever before learned from a single case of mere disease, in my whole life; and I endeavored to make a wise use of it – of which as I trust, I shall give some evidence in the very next chapter.

CHAPTER XIX

CHEATING THE PHYSICIAN

It was by no means an uncommon thing with me, while studying medicine, to take long walks. One day, in the progress of one of these rambles, I came so near the family mansion of a young man with whom I had formerly been acquainted, that I thought I would, for once, go a little out of my way and make a call on him. And judge, reader, if you can, of my surprise, when I found him exceedingly sick. For residing, as we did, only a few miles apart, why had I not heard of it? Most people, in truth, would have called on some of the young doctors – for there were three or four of us together, – to take care of the sick man, especially by night. Young doctors, I grant – and this for various reasons which might be named, were it needful – are usually the very worst of watchers and nurses of the sick; but the public often appear to think otherwise, and even to prefer them.

I found him under the care of an old school physician; – one who, though he otherwise prescribed very well, gave quite too much medicine; and like the old physician mentioned in the preceding chapter, mortally detested cold water; at least he detested its use in bowel complaints. The young man's case, however, was as yet wholly unlike that of the elderly gentleman of the foregoing chapter; and cold water at first, was not particularly needed; nor perhaps quite safe.

Some few days afterward, I called again. Found my young friend rather less feverish, but no better; in fact, he was much worse, and was most obviously running down. I continued after this to call on him daily, till he too, like the old man before mentioned, began to beg for cold water. But his physician said, "No, not a drop," and with a good deal of emphasis.

One day, while I was at his bedside, he turned to me, and with a most imploring look begged to know whether I believed a very little cold water would really hurt him. I told him no; but that a good deal doubtless would, and might even prove the means of his destruction. "Simple a thing as water is," I said, "it is to you, in circumstances like yours, a sword with two edges. If it should not cut away the disease, it would probably cut in the other direction, to the destruction of your health, if not of your life."

My remarks had both awakened his curiosity and increased his desires for the interdicted beverage. I found I had gone too far, and I frankly told him so. I told him it was not in accordance with medical etiquette, nor even with the rules of good breeding, for one medical man to prescribe for another's patient without his knowledge. But this explanation did not satisfy him. Water was what he wanted; and as I had opened the budget and removed some of his fears, water he must have. He was willing, he said, to bear the responsibility.

Water, then, in exceedingly small quantity at a time, was permitted; but it was to be given by stealth. The physician was not allowed to know it, or, at all events, he was not to know under whose encouragement he acted. His friends were very careful in regard to the quantity, and I had the happiness of finding him, in a few days, very much better. But, as I said in reflecting on the recovery of my aged friend before mentioned, it is not quite certain, after all, how much was effected by the water, and how much by the recuperative efforts of Nature herself. She might have been long waiting for that opportunity to rally, which the judicious introduction of the water, and the partial or entire discontinuance of other medicine, greatly facilitated.

CHAPTER XX

THE MEDICINAL EFFECTS OF STORY TELLING

My aged father sickened about this time, and remained in a low condition many months. I was at a distance so great, and in circumstances so peculiar, that I could not see him often enough to become his medical adviser. Besides, in my then unfledged condition as a disciple of Galen, I should not have regarded myself competent to the discharge of so weighty a responsibility, had I even been at home with him. The result was that he employed his family physician as usual, and went through, as might have been expected, with the whole paraphernalia of a dosing and drugging campaign.