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CHAPTER XXXV
MY FIRST CASE IN SURGERY

My first surgical case of any magnitude, was that of a wounded foot. For, though I had been required to bleed patients many times, – and bleeding is properly a surgical operation, – yet it had become so common in those days, and was performed with so little science or skill, that it was seldom recognized as belonging to the department of surgery.

One of my neighbors had struck his axe into the upper part of his foot, and cut it nearly through. Happening to be at home when the accident occurred, which was in my own immediate neighborhood, I was soon on the spot, and ready to afford assistance; and, as good luck would have it, the man was not at all weakened by loss of blood, at my arrival.

My lesson from an old surgeon⁴ was not yet forgotten. I still knew, as well as any one could have told me, that to put together the divided edges of the wound and keep them there, was half the cure. But how was this to be done? Slips of adhesion plaster would bring the divided edges of the wounded surface into their place, but would the deeper-seated and more tendinous parts unite while left without touching each other? Or should a few stitches be taken?

The wound was lengthwise of the foot, and no tendons were divided. I made up my mind to dress it without any sewing, and acted accordingly. The bleeding soon ceased. When all was secured, the patient inquired what he should put on it, to cure it. Had he not raised the question, I might, perhaps, have followed out my own ultra tendencies, and left it without any application at all; but as it was, I concluded to order something on which he might fasten his faith, – something which, though it should do no good, would do no harm.

"Nothing is better for a fresh wound," I said, "than the 'Balsam of Life.' Just send Thomas over to Mr. Ludlow's, and get a couple of ounces of his 'Balsam of Life.'" It was soon brought, and the surface of the wound and its bandages moistened with it. "Now," said I, "keep your foot as still as you can till I see you again. I will be in again before I go to bed."

I called again at nine o'clock in the evening. All appeared well, only the patient had some doubts whether the Balsam of Life was just the right thing. Several of the neighbors had been in, as he said, and, though they admitted that the Balsam might be very good, they knew, or thought they knew, of something better. However, I succeeded in quieting most of his rising fears for the present, by assuring him that nothing in the wide world was equal, for its healing virtues, to the "Balsam." My voice here was law, for I gave no reasons!

On making inquiry, afterward, with a view chiefly to gratify curiosity,⁵ I found that the first individual who came in after I had left the house, assured them there was nothing so good for a fresh wound as a peach leaf. The next, however, insisted that the best way was to bind up the part in molasses. The third said the best way was to take just three stitches to the wound, and bind it up in the blood. The fourth said the most sovereign thing in the world, for a fresh cut, was tobacco juice!

Now I could have told these various representatives of as many various public opinions, that all these things and many more which might have been named, are, in a certain sense, good, since any mere flesh wound, in the ordinary circumstances of ordinary life, will heal in a reasonable time, in spite of them. I could have told them, still further, that the Balsam of Life was probably little, if any, better than the other things proposed, any farther than as it secured more faith and confidence, and prevented the application of something which was worse. I could have assured them that all the external applications in the world are of no possible service, except to defend from cold air, and prevent external injuries, or reduce inflammation; and that the last-mentioned symptom, should it occur, would be best relieved by cold water. But what good would it have done? Just none at all, according to my own experience. Positive assurance – mere dogmatism – was much better.

The wound did well as it was, though it might have done much better, could the patient's faith have been just as firmly fixed on nothing at all but Nature, as it was on medicaments. However, the tincture I proposed, which somebody had dignified with the name of Balsam of life, had done very little harm, if any, to the parts to which it had been applied, while it had done a great deal of good to the patient's mind, and the minds of his friends. It was nothing, I believe, but a compound tincture of benzoin. I have used it a great number of times, and with the same wonderful results. The patient always gets well, either on account of it, or in spite of it! Does it make much practical difference which?

CHAPTER XXXVI
EMILIA AND THE LOVE CURE

One young family on whom I was accustomed to call from time to time, was not only accustomed to send for me in the night, as did many others, but, what made it much worse for me, they resided some four or five miles distant, among the mountains. They were of that class of people who look every man on his own things, and never, as the apostle would enjoin, on the things of others. They knew very well that a physician, though he might be half a conjuror, required sleep; still, they were willing to finish their day's work, eat their supper, perform a large number of et ceteras, even if they did not call for the doctor till he had fairly taken off his boots to retire for the night. But there was one consolation in all this, that they paid me promptly; and medical men, as you know, like other men, work for pay. They cannot live wholly on air.

In the same house with the family alluded to, was a young woman, about twenty-five years of age, who had been confined to her bed ten or twelve years. She was the only daughter of very indulgent parents, who had never, from her earliest years, thought they could do too much for her. In truth, this was the source of her feebleness. Some little ailment, indeed, there might have been at the outset, induced by pie, cake, preserves, pickles, or something which no truly kind parents should permit a child to take; though nothing more than might have been got rid of in its effects, by a little patient waiting. But instead of waiting a little, the anxious mother had dosed and drugged her. And these ill turns had been more and more frequent, just in proportion to the frequency with which she had been drugged for them; till, at twelve years of age, she was almost all the while complaining. And at fourteen, she was completely bedridden – a burden to herself and to others.

"I wonder," said my principal employer, at about twelve o'clock, when I had attended to his own little family, and was about to leave, "whether you could do any thing for our Millie. She has tried almost all the doctors, to no purpose; but we have so much confidence here in your skill, that she sometimes speaks of trying you. She is hardly willing to 'give up the ship' without another trial."

This, as you must be aware, was a stirring appeal to my love of approbation; but it was too late at night to make a call on her at that moment. So, promising to come and see her shortly, I took my leave, and rode home, as usual, meditating.

Now I had never seen Emilia, but from the account which I had received from the neighbors, as well as from the nature of the case, I knew very nearly how she was; and that the great difficulty in the way of recovery was the constant habit of watching herself and attending to every internal sensation. In other words, she was so completely wrapped up in self, that I could see no reasonable prospect of getting her mind out of the maze in which it had been so long involved.

But I found time, a few days afterward, as I was employed again in the same neighborhood, to call and see her; and I ventured accordingly. She was sitting up in the bed, well bolstered, with a huge mass of clothing both on herself and on the bed. Then, at her right hand, was a stand half covered with bowls, saucers and tumblers; and near it a little closet or recess, in which were nearly an equal number of parcels of medicine, wrapped in papers ready to be used, when they were supposed to be necessary.

I had no sooner entered the room, than she began to give me an account of her medicine, rather than of herself. So rapid was her enunciation, and so eager was she to tell me what she knew – not about the symptoms of her disease, but about the treatment – that it was a full quarter of an hour before I could reach the inmost recesses of her condition. "That," said she, "is for canker in the mouth; that for sore throat; that is an eye wash I sometimes use, and that is a kind of bitters Dr. R. left for me, but which I have now nearly done taking – and they never did me any good," etc.

When I found an opportunity, I endeavored to investigate, very fully and freely, what had hitherto been supposed to be a very remarkable case. I found, indeed, that the patient had a great many little troubles, dependent mainly on the state of a mind greatly harassed by constant reflex tendencies, not easily eradicable. But I did not find it easy to prescribe for her. She was one of those very inquisitive people who wish to know what every thing you give them is, and who have a very conscientious objection to every thing. However, I at last settled down on a course of treatment, and wrote it out in a fair hand, and left it at the bedside. Not, however, I repeat, till I had foolishly fallen into my former error, and told her all the whys and wherefores.

This familarity into which she had drawn me, had already extracted one-half the virtue of my medicine; for that is no longer mysterious which the medical man openly and freely discusses. The freedom of thinking she had indulged in while I was present, had been extended to freedom of action; and the very medicine, whose virtues she had dared to discourse upon, she ventured to set aside, when her experience assured her it was not producing the effect she desired, and for which she supposed it was intended. So that what, from the first, I had feared, and more than I had feared, at length happened. She took my medicine, professedly, – that is, just when she pleased, – for about four weeks, to no manner of purpose whatever, except to deceive herself; for during the first and second weeks of its use, she imagined herself all the while getting better; while during the third week she began to doubt, and about the fourth week she came to the sage conclusion that she was just where she had been a month or two before.

The great, abiding difficulties of her case – her want of simple, confiding trust in her physician, and her constant, anxious attention to her own internal sensations, were far enough from being overcome. She was, in short, very nearly where she was ten years before, except that she was in circumstances rather more difficult to be reached, and had become rather more sceptical about medicine.

What should now be done? Must the case be abandoned? Or was there some other way, some new way, by means, of which it could be reached? I was not quite willing to give her up as irrecoverable, and yet I saw nothing remaining which I could do. I revolved the thing in my mind, by night and by day. At last a plan struck me which I verily believed would succeed.

A few miles distant was a young physician, just from the schools, who vainly, though naturally, supposed he knew almost every thing which was known, and who wanted business. As he had nothing to lose, even if he were to fail in a hundred trials, but every thing to gain could he effect one very remarkable cure, I proposed to the family to employ him. I knew well he would have one or two advantages over his older and more experienced brethren. He would not at once place himself on the same platform with his patient and the friends, by answering their numerous questions; and for this plain and simple reason: In the first place, that he could not, and very probably knew his own weakness; secondly, he would have more of that blind faith in medicine which inspires the ignorant with confidence.

But there was another thought beyond all this, a wheel within a wheel. The young physician might succeed better than I, in drawing her thoughts, and even her affections, away from herself; for he was a single man, and the patient, though sick, not destitute of charms, especially of that more tangible charm which, to indigent young men, and especially young medical men, so often eclipses all others. She, on her part, as I well knew, was not wholly resigned to the world of single blessedness, though her long-continued ill health had almost unfitted her for any thing else.

It only required a little management to bring about the desired result. Dr. Juvenis was soon employed; and, though he did not always reply to her questions, which were numerous, and often wholly irrelevant, yet according to my own secret anticipations, he gradually raised her hopes in another direction, and hence drew her attention in no small degree from herself. His reserve, too, served but to inspire her with confidence in his great wisdom. There was something deep beyond the exterior, she always thought, which did not come out to the full, vulgar gaze.

The final result was a strong attachment on her part, which, though not reciprocated by him in a direct manner, was not by any means repelled. The virtues of the medicines were no longer discussed or doubted; and it was obvious to all that she was beginning to mend.

It was now high time for me to abandon a field which was not only fully occupied, but well occupied. The visits of the young physician were continued, at longer or shorter intervals, for years, till the young woman's health was nearly restored; and, as I subsequently learned, they were married. The more recent history of her life, I have not been able to ascertain, except that neither party gained as much by the new connection as had been expected, – a result which, alas! is by no means any thing new, and that there was, after some time, a relapse of disease.

This artifice for restoring health to a bedridden patient, is not mentioned in a way of approbation, but of regret, or at least of confession. Yet, while it declares my weakness, it develops or at least confirms a well-known principle, which it concerns mankind, patients as well as physicians, most fully and clearly to understand. The medical efficiency of an agent is greatly enhanced when the mind can be made to go along with it.

I have wished a thousand times, both by night and by day, that I had never commended Dr. Juvenis to the favorable notice and regard of this illiterate but confiding family. True, I had the good fortune thus to get rid of a most troublesome, standing patient. Had I a moral right thus to do? Did the end either sanction or sanctify the means? Grant that I saved, or seemed to save, the patient; – was she really saved? Was there any absolute gain in the end? These are questions which I cannot, as yet, fully settle. Most certainly she was not quite cured.

What a mighty work for this fallen world education has yet to achieve; especially Physical Education! This, reader, let me say once for all, this physical education, under the guidance of Christianity, whose handmaid all true science should be, and to whose development and application all true religion should be directed, is our chief dependence. It is the lever by which we are to raise the world.

CHAPTER XXXVII
HEZEKIAH AND DELIRIUM TREMENS

One morning, about two o'clock, in the depth of winter, I was roused from my slumbers by a stranger's voice, requesting me to get up and go immediately along the sides of the mountain and see Hezekiah. "And who is Hezekiah?" I said, only half awake; "and where is the side of the mountain? And who are you with whom I am conversing?"

The mystery was easily cleared up, and I mounted my horse and was soon on the road through the sides of the mountain. It was wild and unfrequented; nay, it was, in places, almost impassable, especially in the night. Mr. Judkins, the father of the sick man, not only resided quite beyond my usual range of practice, but almost out of the range of everybody else, squirrels and rabbits and wild fowls excepted.

In passing along, I made many inquiries with regard to the particular condition of the young man, in order to prepare myself for a more rapid investigation of his case whenever I should arrive. But I sought in vain. The messenger's lips were almost wholly sealed. The cause, at that time, I did not at all understand; but I had, subsequently, great reason to believe he was silent and reserved by the special command of the patient's friends. All I could obtain from my guide, was that Hezekiah had an ill turn; that he was occasionally subject to ill turns, and that the family were greatly alarmed about him.

On my arrival, I found a group of friends large enough, almost, for a train band, gathered so closely round the bed of the young man that he could hardly breathe. There was, also, a monstrous fire in the chimney, sufficient to heat well the whole house, had the heat been properly distributed. The air was, at best, greatly confined; but it was particularly so to the poor patient, who lay panting as if in a dying condition.

Yet I soon saw, and, as it were, instinctively, that he was not likely to die immediately. Some adventitious cause was evidently operating to throw his brain and nervous system into an abnormal condition, nor was I long in determining what it was. The father was a farmer. He possessed immense orchards, and made great quantities of cider, and one of his neighbors owned a distillery. For every barrel of cider Mr. J. carried to the distillery, he received in return a certain amount of cider-brandy; and at the time when I was called to see Hezekiah, he had more than two barrels of this "precious commodity" in his cellar. At the close of autumn he had had three barrels.

Why this deposit of an article so doubtful? And what had become of the one barrel which had disappeared? Not a member of the family would touch it, but Mr. J. himself, and Hezekiah. The women and children did, indeed, sometimes taste a little molasses toddy, as it was called. Mr. J. would prepare it and pass it round in the morning just before breakfast, in the hope and expectation that all would taste it; and they usually did so. It was not, however, quite a voluntary thing on their part, but a species of moral compulsion. Left entirely to themselves, they never would have tasted it.

Now think, reader, of two persons in a family, with two or three barrels of brandy at their entire disposal, with the expectation of consuming it, or the far greater part of it, during autumn and winter. Why, three barrels are more than a quart a day, for every day of the year. Mr. J. drank freely; but not more freely than his son. The latter was treading in the steps of his father, with the almost certain prospect of going, in the end, quite beyond him.

It was not difficult to prescribe for the young man. The far greater difficulty was to induce him to follow out the prescription. I was honest enough to tell the father what ailed the son, and what ought to be done, and to plead with him to change his own habits immediately. I could not, it is true, quite prevail, when I urged him to pour his brandy, the whole of it, into the street; for that, as he said and doubtless thought, would be a waste of property. But he did promise to sell it; though even this promise he never kept. He even continued to drink it; though as he always insisted, with great moderation. But the greatest drinkers we have among us, are usually the first to speak of their own moderation.

The sequel of the story may easily be guessed. Hezekiah became a miserable creature, and ere he reached the age of fifty came to a most miserable end, – the drunkard's death, by the drunkard's mania. Mr. J. having inherited a strong constitution passed on to sixty-three, when, like a mighty tree with decayed trunk, a slight wind crushed him to the dust.

His family, most of them, still survive; but they are daughters, and have not inherited the vices of their father, so much as his diseases. They have, at least, inherited the disease which drinking is so apt to entail on the next generation, – I mean scrofula. Several of Mr. J.'s elder daughters are already dead; and the younger ones – for he had a very large family – are feeble, and always will be so; and their children are still more feeble. Thus "earthward," and not heavenward, "all things" in the family of the drunkard have a tendency.

How painful the reflection that I did not labor with this family, not only in season, as I certainly did, but also out of season, and try to save it! I had influence with them. My honest plainness at my first visit, above described, did not prevent them from calling on me again for counsel; though at first I had feared such a result. I was often in the family, but not so often as I might have been; nor was I so bold as I ought to have been. Shall I be able to render up my account of the intercourse I had with them, in the great day, with joy, or must it be with grief and shame?