Read the book: «Forty Years in the Wilderness of Pills and Powders», page 3

CHAPTER X
DR. SOLOMON AND HIS PATIENT

I have said that my fellow traveller was less cautious than myself, and have intimated much more. He was in some respects cautious, and yet in others absolutely reckless. When hot and thirsty, for example, instead of just rinsing out his mouth and swallowing a very little water, he would half-fill his stomach with some of that semi-putrid stuff, ycleped water, which you often find in Virginia and the Carolinas; and when hungry, he would eat almost any thing he could lay hold of, and in almost any quantity, as well as at almost any hours, whether seasonable or unseasonable.

This course of conduct seemed to answer very well for a few months; but a day of retribution at last came. He was then in Norfolk, in Virginia. I had been absent from the place a few weeks, and on my return found him sick with a fever, and without such assistance as was absolutely and indispensably necessary. There were Yankees in the place in great numbers, and some of them were his personal acquaintances and friends; but they had hitherto refused to come near him, lest they should take the fever.

I proceeded to take care of him by night and by day. At the suggestion of an old citizen, in whom I placed great confidence, Dr. Solomon was called in as his physician. There was some bleeding and drugging, and a pretty constant attendance for many weeks; but the young man finally recovered.

If you ask what this chapter has to do with my medical confessions, I will tell you. Dr. Solomon was an old school physician, and made certain blunders, which I am about to confess for him. He prescribed – as very many of us his medical brethren formerly did, for the name of a disease rather than for the disease itself, just as it now appeared.

Thus, suppose the disease was typhus fever; in that case he seemed to give just about so many pills and powders every day, without much regard to the circumstances; believing that somehow or other, and at some time or other, good would come out of it. If his patient had sufficient force of constitution to enable him to withstand both the disease and the medicine, and ultimately to recover, Dr. S. had the credit of a cure; not, perhaps that he claimed it, – his friends awarded the honor. If the patient died, it was on account of the severity of the disease. Neither the doctor nor his medicine was supposed to be at fault. Some, indeed, regarded it as the mysterious work of Divine Providence.

Dr. S. attended my young companion in pedestrianism a long time, and sometimes brought a student into the bargain. He probably kept his patient insane with his medicine about half the time, and greatly prolonged his disease and his sufferings. But he knew no better way. He was trained to all this. The idea that half a dozen careful visits, instead of fifty formal ones, and a few shillings' worth of medicine instead of some twenty or thirty dollars' worth, would give the young man a better prospect of recovery than his own routine of fashionable book-dosing and drugging, never for once, I dare say, entered his head. And yet his head was large enough to hold such a simple idea, had it been put there very early; and the deposit would have done much to make him – what physicians will one day become – a rich blessing to the world.

Reader, are here no confessions of medical importance? If not, bear with me awhile, and you will probably find them. We have yet a long road to travel, and there are many confessions to be made in which I have a personal concern and responsibility, and, as you may perhaps conclude, no small share of downright culpability.

CHAPTER XI
PHYSICKING OFF FEVER

The eyes of my mind having just begun to be opened to the impotence of a mere routine of medication as a substitute for nature, rather than as an aid to her enfeebled efforts, I was prepared to make a wise use of other facts that came before me, especially those in which I had a personal concern and interest. Here is one of this description.

On the morning of March 12, 1821, during the very period when I was watching over my sick friend, as mentioned in the preceding chapter, I took from the post-office a letter with a black seal. It contained the distressing intelligence of the death of a much-valued sister and her husband, both of whom, but a few months before, I had left in apparently perfect health.

On a careful inquiry into the particulars, both by letter and, after my return, in other ways, I learned that the Connecticut River fever, as it was then and there called, having carried off several persons who were residing in the same house with my brother, the survivors were advised to do something to prevent the germination and development of such seeds of the disease as were supposed to be in their bodies and ready to burst forth into action. I do not know that any medical man encouraged this notion, the offspring of ignorance and superstition; but my brother and his wife had somehow or other imbibed it, and they governed themselves accordingly.

Both of them took medicine – moderate cathartics – till they thought they had physicked off the disease; and all seemed, for a time, to be well, except that they complained still of great weakness and debility. It was not long, however, before they were both taken with the disease and perished; my brother in a very short time, and my sister more slowly.

My sister, on being taken ill, had been removed to the house of her mother, in the hope that a change of air might do something for her; but all in vain. My mother and a few other friends who were with them as assistants sickened, but they all ultimately recovered. They, however, took no medicine by way of prevention.

Now I do not presume to say, that my young friends were destroyed solely by medicine, for the assertion would be unwarranted. I only state the facts, and tell you what my convictions then were, and what they are still. My belief is, that though they might have sickened had they taken no medicine or preventive, yet their chance of recovery after they sickened was very much diminished by the unnecessary and uncalled-for dosing and drugging.

The notion that we can physick off the seeds of disease, or by our dosing prevent their germination, is as erroneous as can possibly be, and is a prolific source of much suffering and frequent death. The best preventive of disease is good health. Now, physicking off generally weakens us, instead of giving strength. It takes away from our good health instead of adding to or increasing it. As a general rule, to which there are very few exceptions, all medicine, when disease is unusually common or fatal, is hazardous without sound medical advice, and not generally safe even then. It is fit only for extreme cases.

You may be at a loss to understand how such facts and reflections as these could allure me to the study and practice of medicine as a profession. Yet they most certainly had influence. Not that I felt a very strong desire to deal out medicine, for to this I felt a repugnance which strengthened with increase of years and experience. What I most ardently desired was to know the causes of disease, and how far they were or were not within human control. Such a science as that of hygiene– nay, even the word itself, and the phrase laws of health– was at that time wholly unknown in the world in which I moved. There was, in truth, no way then to this species of knowledge, except through the avenues opened by a course of medical study. Hence it was that I blundered on, in partial though not entire ignorance, for some time longer, groping and searching for that light which I hardly knew how or whence to seek, except in pills and powders and blisters and tinctures.

CHAPTER XII
MANUFACTURING CHILBLAINS

At the period of my life to which we have at length arrived, I was for four or five months of every year a school teacher. This was, in no trifling degree, an educational process; for is it not well known that,

 
"Teaching we learn, and giving we retain?"
 

It was at least an education in the great school of human nature.

Every morning of one of these winter sessions of school keeping, Lydia Maynard, eight years of age, after walking about a mile, frequently in deep snow, and combating the cold northwest winds of one of the southern Green Mountain ranges, would come into the schoolroom with her feet almost frozen, and take her seat close to the stove, so as to warm them and be ready for school as quickly as possible. Here she would sit, if permitted to do so, till the bell rang for school.

It was not long before I learned that she was a great sufferer from chilblains. Whether she inherited a tendency to this troublesome and painful disease, which was awakened and aggravated by sudden changes of temperature, or whether the latter were the original cause of the disease, I never knew with certainty. But I was struck with the fact that sudden warming was followed by such lasting and terrible consequences.

And herein is one reason why I have opposed, from that day to this, the custom or habit, so exceedingly prevalent, of rushing to the fire when we are very cold, and warming ourselves as quickly as possible. I have reasoned; I have commanded; and in some few instances I have ridiculed. Every one knows it is hazardous to bring the ears or fingers or toes, or any other parts of the body, suddenly to the fire when really frozen, – that is, when the temperature is lowered down in the part to 32°; and yet, if it is only down to 33°, and the part not quite frozen, almost every one, young and old, will venture to the fire. Can there be such a difference in the effects when there is only a difference of one degree in temperature? No reflecting person will for one moment believe it. The trouble is we do not think about it.

Sudden changes from heat to cold are little more favorable than when the change is in the other direction. Indeed, it often happens that children at school are subjected to both these causes. Thus, in the case of Lydia, suppose that after roasting herself a long time at the stove, she had gone to her seat and placed her feet directly over crevices in the floor, through which the cold wind found its way at almost freezing temperature. Would not this have greatly added to the severity of the disease?

There are, it is true, other reasons against sudden changes of temperature, particularly the change from cold to heat, besides the fact that they tend to produce chilblains; but I cannot do more just now than barely advert to them. The eyes are apt to be injured; it renders us more liable than otherwise we should be to take cold. Occasionally it brings on faintness and convulsions, and still more rarely, sudden death. I will only add now, that sudden warming after suffering from extreme cold, whether we perceive it or not at the time, is very apt to produce deep and lasting injury to the brain and nervous system.

But my main object in relating the story is answered if I have succeeded in clearly pointing out to the reader one of the avenues through which light found its way to my benighted intellect, and led me to reflection on the whole subject of health and disease. Here was obviously one cause of a frequent but most painful complaint. It was natural, perfectly natural, that by this time I should begin to inquire. Have all diseases, then, their exciting causes? Many certainly have; and if many, perhaps all. At least, how do we know but it may be so? And then again, if the causes of chilblains are within our control, and this troublesome disease might be prevented, or its severity mitigated if no more, why may it not be so with all other diseases?

To revert for a moment to the case of Lydia Maynard. Though I was the cause, in a certain sense, of her suffering, yet it was a sin of ignorance. But it taught me much wisdom. It made me cautious ever afterward. I do not doubt but I have been a means of preventing a very considerable amount of suffering in this form, since that time, by pointing out the road that leads to it.

Prevention is better than cure, was early my motto, and is so still. And from the day in which I began to open my eyes on the world around me, and to reason from effects up to their causes, I have been more and more confirmed in the belief that mankind as a race are to be the artificers of their own happiness or misery. All facts point in this direction, some of them with great certainty. And facts, everywhere and always, are stubborn things.

CHAPTER XIII
HOW TO MAKE ERYSIPELAS

My periodical tendency to a species of eruptive disease closely resembling measles, was mentioned in Chapter IV. During the summer of 1823 this affection became unusually severe, and seemed almost beyond endurance. The circumstances were as follows: —

I had in charge a large and difficult school. The weather was very hot, and I was not accustomed to labor in summer within doors. Besides, my task was so difficult as to call forth all the energies of body and mind both; and the "wear and tear" of my system was unusually great. It was in the very midst of these severe labors, in hot and not well-ventilated air, that the eruption appeared. Perhaps it was aggravated by my diet, which, in "boarding around," was of course not the best.

The eruption not only affected my body and reached to the extremities, but was accompanied by an itching so severe that I was occasionally compelled to lie awake all night. My general strength at last began to give way under it, and I sought the advice of our family physician.

He advised me to use, as a wash to the irritated and irritable surface, a weak solution of corrosive sublimate. I hesitated; especially as I believed it to be, with him, an experiment. But on his repeated assurance, that if I would take special care of myself and avoid taking cold, there was no danger, I waived my objections, and proceeded to carry out his plan.

The solution was applied, accordingly, to the letter of the doctor's directions. For many days no change appeared, either favorable or adverse. At length a most distressing headache came on and remained. My sufferings became so severe that I was obliged to postpone my school and return to my father's house.

On the road, I observed that an eruption of a peculiar kind had appeared, particularly about the forehead, accompanied with small blisters. It was not here that I had applied the solution, but on the arms, chest, and lower limbs. Of course the corrosive sublimate, if at all operative, had affected me through the medium of the circulation and not by direct contact.

Our physician came, pronounced the disease erysipelas, and without saying a word about the cause, prescribed; and I followed out carefully his prescription. But the disease had its course in spite of us both, and was very severe. It took away my sleep entirely for a day or two. It proved a means of removing the hair from one side of my head, and of so injuring the skin that it never grew again. Indeed, gangrene or mortification had actually commenced at several points. Suddenly, however, the pain and inflammation subsided, and I recovered.

Now my physician never said that I was poisoned by the corrosive sublimate, probably for the two following reasons: 1, I never made the inquiry. 2, He would probably have ascribed the disease to taking cold rather than to the mercury, had I inquired. I do not believe I took cold, however. How it came to affect me so unfavorably I never knew with certainty; but that it was the medicine that did the mischief I never for one moment doubted. I suppose it was absorbed; but of the manner of its introduction to the system I am less certain than of the fact itself.

But besides the absorption of the corrosive sublimate into the system, and its consequences – a terrible caution to those who are wont to apply salves, ointments, washes, etc., to the surface of the body unauthorized – I learned another highly important lesson from this circumstance. Active medicines, as I saw more plainly than ever before, are as a sword with two edges. If they do not cut in the right direction, they are almost sure to cut in the wrong.

I must not close, however, without telling you a little more about the treatment of my disease. After I had left my school and had arrived at home, a solution of sugar of lead was ordered in the very coldest water. With this, through the intervention of layers of linen cloth, I was directed to keep my head constantly moistened. Its object, doubtless, was to check the inflammation, which had become exceedingly violent. Why the sugar of lead itself was not absorbed, thus adding poison to poison, is to me inconceivable. Perhaps it was so; and yet, such was the force of my constitution, feeble though it was, that I recovered in spite of both poisons. Or, what is more probable, perhaps the lead, if absorbed at all, did not produce its effects till the effects of the corrosive sublimate were on the wane; so that the living system was only necessitated to war with one poison at a time. Mankind are made to live, at least till they are worn out; and it is not always easy to poison a person to death, if we would. In other words, human nature is tough.

Now I do not know, by the way, that any one but myself ever suspected, even for one moment, that this attack of erysipelas was caused by the corrosive sublimate. But could I avoid such a conclusion? Was it a hasty or forced one? Judge, then, whether it was not perfectly natural that I should be led by such an unfortunate adventure to turn my attention more than ever to the subject of preserving and promoting health.

For if our family physician – cautious and judicious as in general he was – had been the unintentional cause of a severe attack from a violent and dangerous disease, which had come very near destroying my life, what blunders might not be expected from the less careful and cautious man, especially the beginner in medicine? And if medical men, old and young, scientific as well as unscientific, make occasional blunders, how much more frequently the mass of mankind, who, in their supposed knowledge of their own constitutions and those of their families, are frequently found dosing and drugging themselves and others?

I do not mean to say that in the incipiency of my observations and inquiries my mind was mature enough – well educated enough, I mean – to pursue exactly the foregoing train of thought; but there was certainly a tendency that way, as will be seen more fully in the next chapter. The spell at least was broken, and I saw plainly that if "died by the visitation of God" never means any thing, it generally does not. And as it turned out that the further I pushed my inquiries the more I found that diseases were caused by transgression of physical and moral law, and hence not uncontrollable, why should it not be so, still farther on, in the great world of facts which I had not yet penetrated?

CHAPTER XIV
STUDYING MEDICINE

My thoughts were now directed with considerable earnestness and seriousness, to the study of medicine. It is true that I was already in the twenty-fourth year of my age, and that the statute law of the State in which I was a resident required three years of study before receiving a license to practise medicine and surgery, and I should hence be in my twenty-seventh or twenty-eighth year before I could enter actively and responsibly upon the duties of my profession, which would be rather late in life. Besides, I had become quite enamored of another profession, much better adapted to my slender pecuniary means than the study of a new one.

However, I revolved the subject in my mind, till at length, as I thought, I saw my path clearly. It was my undoubted duty to pursue the study of medicine. Still, there were difficulties which to any but men of decision of character were not easily got removed. Shall I tell you how they were gradually and successfully overcome?

Our family physician had an old skeleton, and a small volume of anatomy by Cheselden, as well as a somewhat more extended British work on anatomy and physiology; all these he kindly offered to lend me. Then he would permit me to study with him, or at least occasionally recite to him, which would answer the letter of the law. Then, again, I could, during the winter of each year of study except the last, teach school, and thus add to my pecuniary means of support. And lastly, my father would board me whenever I was not teaching, and on as long a credit as I desired. Were not, then, all my difficulties practically overcome, at least prospectively?

It was early in the spring of the year 1822 that I carried to my father's house an old dirty skeleton and some musty books, and commenced the study of medicine and surgery, or at least of those studies which are deemed a necessary preparation. It was rather dry business at first, but I soon became very much interested in the study of physiology, and made considerable progress. My connection with our physician proved to be merely nominal, as I seldom found him ready to hear a recitation. Besides, my course of study was rather desultory, not to say irregular.

In the autumn of 1824, having occasion to teach school at such a distance as rendered it almost impracticable for me to continue my former connection as a student, I made arrangements for studying with another physician on terms not unlike those in the former case. My new teacher, however, occasionally heard me recite, especially in what is properly called the practice of medicine and in surgery. His instructions, though very infrequent, were of service to me.

In 1825 I became a boarder in his family, where I remained about a year. Here I had an opportunity to consult and even study the various standard authors in the several departments which are usually regarded as belonging to a course of medical study. So that if I was not in due time properly qualified to "practise medicine and surgery in this or any other country," the fault was chiefly my own.

However, in the spring of 1825, after I had attended a five months' course of lectures in one of the most famous medical colleges of the Northern States, I was regularly examined and duly licensed. How well qualified I was supposed to be, did not exactly appear. It was marvellous that I succeeded at all, for I had labored much on the farm during the three years, taught school every winter and two summers, had two or three seasons of sickness, besides a severe attack of influenza (this, you know, is not regarded as a disease by many) while attending lectures, which confined me a week or more. And yet one of my fellow students, who was present at the examination, laughed at my studied accuracy!

One word about my thesis, or dissertation. It was customary at the college where I heard lectures – as it probably is at all others of the kind – to require each candidate for medical license to read before the board, prior to his examination, an original dissertation on some topic connected with his professional studies. The topic I selected was pulmonary consumption; especially, the means of preventing it. It was, as may be conjectured, a slight departure from the ordinary routine, but was characteristic of the writer's mind, prevention being then, as it still is, and probably always will be, with him a favorite idea. I go so far, even, as to insist that it should be the favorite idea of every medical man, from the beginning to the end of his career. "The best part of the medical art is the art of avoiding pain," was the motto for many years of the Boston Medical Intelligencer; and it embraced a most important truth. When will it be fully and practically received?

But I must recapitulate a little; or rather, I must go back and give the reader a few chapters of incidents which occurred while I was a student under Dr. W., my second and principal teacher. I will however study brevity as much as possible.