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CHAPTER LXII
FEMALE HEALTH, AND INSANE HOSPITALS

A female, about thirty-five years of age, and naturally of a melancholic temperament, was very frequently at my room for the purpose of conversing with me in regard to her health. Most of her complaints – for they were numerous – were grafted upon a strongly bilious habit, and were such as required in the possessor and sufferer, more than an ordinary measure of attention to the digestive organs and the skin. And yet both these departments, especially the latter, had been in her case, hitherto, utterly neglected. To speak plainly, and with some license as a physiologist, she had no skin. It was little more than a mere wrapper, so far as the great purposes of health were concerned. A dried and even tanned hide, could it have been fitted to her person with sufficient exactness, would have subserved nearly the same purposes.

Perhaps you will excuse the tendency in the description of this case, to exaggeration, when you are informed that the treatment of themselves, in the particular here alluded to, by females especially, is one which habitually fills one with disgust, and sometimes with indignation. Persons of good sense, of both sexes, who from month to month, perhaps from year to year, never wash their skins, nor use much muscular exercise, ought to know that they must, sooner or later, experience the dreadful penalty attached to violated physical law, and from which there is, neither on earth nor in heaven, any possible escape. Can any one suppose, for a moment, that so curious and complicated an organ as the skin, and one of such considerable extent, has nothing to do?

Nearly every living person has some idea, of greater or less intensity, of pores in the skin; at least, they use language which implies such an idea. They talk, often, of the necessity of keeping these pores open. But how is it to be done? Not certainly while they use little or no muscular exercise, by washing, once a day, their hands and faces merely, or, as some say, their fingers, their noses, and the tips of their chins. They may talk, on occasions, very boldly and flippantly, about sweating away a cold, as they term it; but do they vainly suppose that the sweat vessels or sweating machinery has nothing to do, from day to day, which might prevent the necessity of resorting to these sweating processes?

Miss L. appeared to be in utter ignorance of any laws of the skin, or of the digestive or muscular systems. And yet her thoughts had been turned, often and frequently, to her own feelings and sensations. She would talk, almost incessantly, if anybody would hear her, about her aches and pains, and could describe her whole train of feelings, from morning to evening, with a faithfulness and patience and minuteness that would have furnished a genius less than Defoe with material sufficient for quite a huge volume.

Now I could have visited and counselled Miss L., at least once a week, with great profit to herself, had she been as intelligent, in general, as she was familiar with her own sensations. As things were, her confidence was rather more troublesome than agreeable; but she was, practically, a standing patient; and physicians, as you know, cannot choose. They must be, among mankind, like the Great Physician, as they who "serve;" not as those who are to be served, or accommodated. And they must serve those who come to them.

Miss L. was evidently somewhat disappointed, when she found I was not disposed to give her any medicine. A little, she thought, might sometimes be useful; a great deal she did not believe in, of course. Experience had forced upon her some of the lessons of wisdom. However, she contrived to fasten a good deal of faith on the laws of health, which I continually held forth to her. In particular, I urged on her the necessity of endeavoring to keep up what I was wont to call a centrifugal tendency in her system. A good plump, healthful, ever active, and ever vigorous skin was, as I told her, our only hope in her case. As a means to this end, and also as a means of withdrawing her attention from the slavery of a constant attendance on her own sensations, I urged her to mingle with society much more, and go about doing good to others, on the great principle, "It is more blessed to give than to receive." I warned her, however, against the danger of falling into the habit of giving an account of herself – her woes and sorrows – to every one she might meet with, who should kindly inquire about her condition, since it would greatly retard her improvement, even if it did not keep up or renew her disease.

Among other things, I ventured to suggest to her the importance of having something to do – something of a permanent nature. "We hear," I said, "of gentlemen at large, and you seem to be a lady at large. You have, in the usual acceptation of the phrase, nothing to do. Would it not be well for you to take charge of something or of somebody? You might, perhaps, assume the office of teacher, and take the charge of a few pupils; or even adopt a child or two as your own, where you might receive compensation. Or," as I finally added, – for I perceived she shrunk from all responsibilities of this kind, – "you might, perhaps, become the mistress of a family."

On the last mentioned topic, I was also obliged, for obvious reasons, to speak with considerable caution. She was unsocial, timid, fearful of being burdened with cares – the very stuff, though she knew it not, that human life is made of, ay, and human happiness too. But I could not hesitate to make the trial. My suggestions, however, were of little avail. She went on for some time, in the old way, and made very little progress.

I lost sight of her about this time, and never met her more. The sequel of her history I only know from report. It is painful in the extreme. It is, however, the history, in all its essential features, of thousands of selfish people, who, after all, by dint of numbers, force, and influence, contrive to rule the world.

Being fully determined to have no cares or responsibilities connected with children or household, she not only refused to hearken to my advice, but also to one or more truly kind and promising offers of marriage. She pursued her selfish course undisturbed, unless by occasional misgivings, till her brain and nervous system suffered so severely that she began to approach the confines of insanity.

It was, however, a considerable time before the silver cord was loosed, the golden bowl broken, and the wheel broken at the cistern. But the terrible result at length came. The demands of violated physical law are inexorable. She was conveyed, as a last resort, in the hope of cure, to an insane hospital. Here, after many and patient attempts to restore the crippled and broken down machinery to healthful motion, she ended her days.

My female patients were not all equally unfortunate. One I had, whose case, if minutely described, would present an array of facts painful in the extreme. She, too, approached the dark regions of insanity; but she did not enter. She still lives, and is at once a useful and happy woman, and an excellent wife and housekeeper. As a means to her recovery, however, she pursued a course diametrically opposite to that pursued by Miss L. She did not shrink from care and responsibility; on the contrary, she submitted to both. First, she sought increased activity and usefulness in her father's family; and, secondly, in a family of her own.

Concerning the last mentioned case, I have few misgivings, and equally few confessions to make. I call it a remarkable case; but it must not be revealed in its details, for other reasons besides its tediousness. In the case of Miss L., however, I have one deep and lasting regret.

In the early part of my acquaintance with her, as a medical man, she probably had more confidence in my integrity and skill than in those of any other living individual. She had been early left an orphan; and I was among the first – perhaps the very first – to take the attitude towards her of a true father. Such kindness, and especially such paternal care, never fail to make their impression.

 
"Love, and love only, is the loan for love."
 

At this early sympathizing period, had I been more faithful, I might, perhaps, have saved her. But I was remiss – disposed to delay. I waited, a thousand times, for a better opportunity. I waited till the favorable moment – ay, the only moment – had passed by.

Physicians often err here. God gives to many individuals the most unbounded confidence in medical men; and this remarkable provision of his has a deep meaning. It is not, however, to the intent that they should abuse the influence thus secured to them, by filling their patients' stomachs with pills and powders; but for such purposes, rather, as have been indicated by the general tenor of the foregoing remarks. It is that they may give them wise paternal counsel and sound physiological and pathological instruction.

Such counsel and such instruction were indeed given to Miss L., but not to that extent which the nature of the case required, and which a little more moral courage and Christian plainness would have secured. She was worth saving, and I might, perchance, have been the honored instrument of saving her, and of thus rendering to society a most valuable service. That vital energy of hers which was expended in watching over her own internal feelings, might have been rendered a much more profitable investment.

But the account is closed and sealed, to be agitated or questioned no more till the inquisitions of the last day. Let such considerations and reflections as this remark suggests to the human mind have their intended effect. Let us ever increase our zeal and watchfulness, that we may avoid such a course of conduct as makes confessions meet, or needful, or even salutary.

CHAPTER LXIII
A GIANT DYSPEPTIC

There have been giants in the earth, in nearly every age, if not in every clime – giants mentally, and giants physically. Of course they may have been rare exhibitions, and may thus have elicited much attention; and some of them have attained to quite a memorable place in history.

There have been and still are, on the earth, giants of other descriptions. We sometimes even meet with giant dyspeptics. Dyspepsia, at best, is formidable, many-headed, but not always gigantic. If gigantic size, in this case, were the general rule, what we now call giants would, of course, cease to be regarded as such.

It may be thought that what I shall here call dyspeptic giants, or giant dyspeptics, were better designated as monsters, than giants. Be it so, for we will not quarrel about names; though a difficulty might be found in making the required distinction between giants and monsters; for is not every giant a monster?

Not far from the year 1830, perhaps a little earlier, you might have seen, in connection with a certain private seminary of education, in New England, one of these giant dyspeptics. I do not mean, of course, that he had already attained to giant size, but only that what proved in the result to be gigantic was already a giant in miniature, and was rapidly advancing to one of magnitude.

He had early been a cabin boy; and like many other cabin boys, had been gluttonous, and in some respects intemperate. Not by any means, that he had ever been guilty of downright intoxication; for of this I have no certain knowledge. My belief is, however, that he had gone very far in this direction, though he might not have – probably had not – been justly chargeable with going quite to the last extremity.

But why should such a young man be found at a seminary of learning? Was he with "birds of a feather?" Do not these attract each other?

Mr. Gray, for that is the name I shall give to our young dyspeptic, had been recently subjected to the influences of one of those seasons of excitement well known in the religious world by the name of revivals; and what is not at all uncommon with the rude and uncultivated minds of even more hardened sailors than he, a great change had come over him. In short, he had the appearance, in every respect, of being a truly converted young man.

Why this change of character had led him to this school-house, may not at first appear. Yet such a result is by no means unusual. This waking up the mind, by awakening the soul, and causing it to hunger and thirst after knowledge, has been observed long since, by those who have had their eyes open to what was going on around them.

Young Gray was penniless, and his parents not only poor, but overburdened with the cares of a large family, so that they could give him no aid but by their prayers. He was not, however, to be discouraged by poverty. He agreed to ring the bell, sweep the hall, build fires, etc., for his board and tuition. As for clothing, he had none, or almost none. Charity, cold as her hand oftentimes is, supplied him with something. Dyspepsia had not, as yet, marred his visage or weakened his energies.

In his connection with this seminary and others of kindred character, such as he could attend and yet pay his expenses by his labor, he became, ere long, able to teach others. Here was a new means of support, of which he eagerly availed himself. In whatever he undertook, moreover, he was singularly successful. He was in earnest. An earnest mind, in connection with an indomitable will – what may it not accomplish? It is every thing but omnipotent.

"Heaven but persuades, almighty man decrees," as I have before said, assuming our old English poets as standard authority; but this saying has more in it than mere poetry. Or, if Heaven more than persuades – somewhat more – does not man still decree? But I am inclined, I see, to press this thought, perhaps in undue proportion to its magnitude. Whether or not it abates one half the guilt, I make the confession.

For several years Gray pushed his devious course, through "thick and thin," sustaining himself chiefly by his teaching. In 1835, he was the private instructor of a wealthy family in Rhode Island; but so puzzling, not to say erratic, were some of his movements, that he was not very popular. Subsequently to this, he was found in another part of New England, editing a paper, and teaching at the same time a small number of pupils.

All this while he paid great attention to physical education; but being either a charity scholar, or obliged to pay his way by his own exertions, he had not at command the needful time to render him thorough in any thing, even in his obedience, as he called it, to Nature's laws. Nearly all his studies were pursued by snatches, or, at least, with more or less irregularity.

In nothing, however, was he more irregular than in his diet. This, to a person already inclined, as he certainly was, to dyspepsia, was very unfortunate. Perhaps, as generally happens in such cases, there was action and reaction. Perhaps, I mean, his dyspeptic tendencies led to more or less of dietetic irregularity; while the latter, whenever yielded to, had a tendency, in its turn, to increase his load of dyspepsia.

There was, indeed, one apology to be found for his irregularity with regard to diet, in his extreme poverty. There were times when he was actually compelled to subsist on the most scanty fare; while his principles, too, restricted him to very great plainness. In one instance, for example, after he had finished his preparatory, course of study and entered college, he subsisted wholly on a certain quantity of bread daily; and as if not quite satisfied with even this restriction, while he needed his money so much more for clothing and books, he purchased stale bread – sometimes that which was imperfect – at a cheaper rate. Now a diet, exclusively of fine flour bread, and withal more or less sour or mouldy, is not very suitable for a dyspeptic, nor yet, indeed, for anybody whatever. However, he learned, at length, to improve a little upon this, by purchasing coarse, or Graham bread.

Subsequently to this period, not being able, either alone or with the aid of friends, most of whom were poor, to pursue a regular academic course of instruction, he accepted the proposition that he should become an assistant teacher in the English department of a school in Europe. This, he feared, might postpone the completion of his studies, but would enable him, as he believed, to improve his mind, establish his health, and add greatly to his experience and to his knowledge of the world. It would also perfect him in teaching, so far at least as the mere inculcation of English grammar was concerned.

His health was by no means improved by a residence of three or four years in Europe, but rather impaired. He returned to America, in the autumn of 1839, and as soon as he had partially recovered from the effects of a tedious and dangerous voyage, went to reside in the family of a near relative who was a farmer, with a view to learn, for the first time, what the labors of the farm would do for him.

Here he often resorted to the same rigid economy which he had before practised, both at academy and college, and in Europe. The very best living he would allow himself was a diet exclusively of small potatoes – those, I mean, from which the larger ones had been separated for the use of others.

This, his dyspeptic stomach would not long endure. His digestive and nervous systems both became considerably deranged; and even his skin, sympathizing with the diseased lining membrane of his stomach and intestines, became the seat of very painful boils and troublesome sores. These, while they indicated still deeper if not more troublesome disease, gave one encouraging indication – that the recuperative powers of the system were not as yet irrecoverably prostrated.

He now came to me and begged to become my patient, and to reside permanently under my roof, so that he might not only receive such daily attention and counsel as the circumstances required, but also such food, air, exercise, and ablutions as were needful. He was accordingly admitted to the rights, privileges, and self-denials of the family.

Here he spent a considerable time. While under my care, I made every reasonable exertion for his recovery which I would have made for a favorite child. Indeed, few children were ever more obedient or docile. He would sometimes say to me: "Doctor, I have no more power over myself than a child, and you must treat me as you would a child." Nor was he satisfied till I restricted his every step, both with regard to the quantity and quality of his food, and the hours and seasons of bathing, exercise, reading, etc. It was to me a painful task, and I sometimes shrunk from it, for the moment. There was, however, no escape. I had embarked in the enterprise, and must take the consequences.

At first, his improvement was scarcely perceptible, and I was almost discouraged. But at length, after much patience and perseverance, the suffering digestive organs began, in some measure, to resume their healthful condition, and the whole face of things to wear a different aspect. He left us to take charge of a public school.

For some time after the opening of this school, his health seemed to be steadily improving, and the world around him began to have its charms again. He was in his own chosen, and, I might say, native element, which was to him a far more healthful stimulus than any other which could have been devised, whether by the physician or the physiologist.

Nothing in this world is so well calculated to preserve and promote human health, as full and constant employment, of a kind which is perfectly congenial and healthful, and which we are fully assured is useful. In other words, the first great law of health is benevolence. It keeps up in the system that centrifugal tendency of the circulation of which I have already spoken, and which is so favorable for the rejection of all effete and irritating matters. It would have been next to impossible for our Saviour, with head, heart, and hands engaged as his were, to have sickened; nor was it till the most flagrant physiological transgressions had been long repeated, that even Howard the philanthropist sickened and died. Not the whole combined force of malaria and contagion could overcome him, till continual over-fatigue, persistent cold, and strong tea, – an almost matchless trio, – lent their aid to give the finishing stroke.

Mr. Gray was a boarder with a gentleman who kept a grocery store, and who was glad to employ him on certain days and hours of vacation or recess, in taking care of the shop and waiting on his customers. Here the tempter again assailed him, in the form of foreign fruits, raisins, figs, prunes, oranges, dried fish, cordials, candy, etc. For some time past he had been wholly unaccustomed to these things; they had even been forbidden him, especially between his meals. As a consequence of his indulgences, and his neglect of exercise, his health again declined, and he came a second time under my care.

He was partially restored the second time, but not entirely. His labors, which were teaching still, became more exhausting than formerly. Cheerfulness, hope, sympathy, conscious usefulness, and the force of many good habits, sustained him for a time, but not always. His great labors of body and mind, with a deep sense of responsibility, and the indulgences to which I have alluded, preyed upon him, and dyspepsia began once more her reign of tyranny.

Doubtless he attempted too much here, for he was an enthusiast on the subject of common schools and common school instruction. And yet, under almost any circumstances of school-keeping, dyspepsia, nurtured as it was by every physical habit, would most certainly have assailed him. With regard to his food and drink he was very unwise. It contributed largely to an extreme of irritability, which was unfavorable, and which at the end of a single term compelled him to resign his place and seek some other employment.

This was a grievous disappointment to Mr. Gray, and, as some of his friends believe, was the mountain weight that crushed him. The horrors of the abyss into which he believed he had plunged himself, were the more intolerable from the fact that he now, for the first time, began to despair of being able to consummate a plan by means of which both his sorrows and joys, especially the latter, would have been shared by another.

Yet, even here, he did not absolutely despair. Hope revived when he found himself, a third time, my patient. I did all in my power to encourage him till I had at length, to my own surprise as well as his, the unspeakable pleasure of finding him again returning to the path of health and happiness. It is indeed true, that a capricious appetite still retained its sway, in greater or less degree, and whenever he was not awed by my presence, he would indulge himself in the use of things which he knew were injurious to him, as well as in the excessive, not to say gluttonous, use of such good things as were tolerated. He occasionally confessed his impotence, and begged us to keep every thing out of his way, even those remnants which were designed for the domestic animals!

And yet, after all, strange to say, he absented himself very frequently, as if to seek places of retirement, where he could indulge his tyrannical appetite. I saw most clearly his danger, and spoke to him concerning it. I appealed to his fears, to his hopes, to his conscience. I reminded him of the love he bore to humanity, and the regard he had for Divinity.

Once more, being partly recruited, he resumed his labors as a teacher. This was doubtless a wrong measure, and yet I was not aware of the error at the time, or I should not have encouraged the movement, or assisted him as I did in procuring a situation. But I then thought he had been punished so effectually for his transgressions, that he would at length be wise. Besides he was exceedingly anxious to be at work, and to avoid dependence, a desire in which his friends participated, and in regard to which they were so unwise as to express their over anxiety in his hearing.

Three months in the school-house found him worse than ever before. He had attempted to board himself, to subsist on a very few ounces of "Graham wafers" at each meal, and to be an hour in masticating it. As an occasional compensation for this, however, a sort of treating resolution, he allowed himself to pick up the crusts and other fragments left about the school-house by his pupils, and when he had collected quite a pile of these, to indulge his appetite with them, ad libitum. Nor was this all. He erred in other particulars, perhaps in many.

He came to my house a fourth time, but my situation was such that I could not well receive him. He staid only a day or two, but his residence with us was long enough to enable me to mark the progress of his case, and to deplore what I feared must be the final issue. From me he went to a friend in an adjoining State; not, however, till he had alluded to certain errors of his recent life that he had not yet devulged, even to his best friend. "Doctor," said he, "there are some things that I have not yet told you about."

To me, also, it belongs, at this point of Gray's lamentable history, to make confession of great and glaring error. To have received the young man to my house, and to have devoted myself to the work of endeavoring again to raise him, would, most undoubtedly, have been a sacrifice to which few people in my circumstances would have thought themselves called. Yet, difficult as it was, the sacrifice might have been made. Had he been my only brother, I should, doubtless, have received him. The Saviour of mankind, in my circumstances, would probably have taken him in. Was I not his follower? And was I not bound to do what I believed he would do, in similar circumstances?

His more distant friend, but more consistent Christian brother, opened wide his doors for his reception, and did the best he could for him. It was his intention, at first, to employ him, as I now think he ought to have been employed long before; viz., on a small farm. In this point of view this friend's house was particularly favorable. Yet there were offsets to this advantage. One thing in particular, cast a shade upon our efforts in his behalf. It was about April 1st, and the house and farm had an eastern aspect, and the easterly winds, which at that season so much prevailed, were very strong and surcharged with vapor at a low temperature. For a few days after his arrival he was worse than ever.

This was discouragement heaped upon discouragement, and he began soon to sink under it. For a short time he was the subject of medical treatment. What was the character of the medicine he took, I never knew. At length there were signs of convalescence; but no sooner did his bodily health and strength begin to improve, than his mental troubles began to press upon him, till he was driven to the very borders of insanity. Indeed, so strong was the tendency to mental derangement that his relatives actually carried him, per force, to an insane hospital.

But his residence at the hospital was very short. Provision having in the mean time been made for his reception in a private family, among his acquaintance, and the superintendent of the hospital having advised to such a course, he was remanded to the country, to familiar faces, and to a farm.

On reaching the place assigned him, he became extremely ill, – worse, by far, than ever before, – so that, for several weeks, his life was despaired of. But by means of careful medical treatment, and a judicious and very simple diet, which at the hospital had been exchanged for a stimulating one, nature once more rallied, and in three or four weeks he appeared to be in a fair way for recovery. His strength increased, his mind became clear; his digestive function, though still erratic, appeared about to resume its natural condition, and to perform once more its wonted office; and the other troublesome symptoms were all gradually disappearing, except one; – he had still a very frequent pulse.

But even this rapid arterial action was at length abating. From a frequency of the pulse equal to 100, 110, and sometimes 120 in a minute, it fell in two weeks to from 70 to 75; and this, too, under the influence of very mild and gentle treatment. There was no reduction of activity or power, by bleeding, or by blistering, or in any other way; on the contrary, as I have intimated, there was a general increase of strength and vigor, both of body, and mind. He did not even take digitalis or morphine. The prospect, therefore, was, on the whole, truly encouraging.

And yet he had a set of friends – relatives, I should say, rather – who were not satisfied. It was strongly written on their minds that he was about to die; and they sternly insisted on removing him to his native home, that if he should die, he might die in the bosom of his own kindred. I was consulted; but I entered my most solemn protest against the measure, as both uncalled for and hazardous. It was to no purpose, however. In their over-kindness they determined to remove him; and the removal was effected. I ought also to say that though Mr. Gray highly appreciated their kindness, he was himself opposed to the measure, as one attended with much hazard.

On the road to his paternal home, influenced in no small degree by mental excitement, his delirium returned, and with an intensity that never afterwards abated. He was, for about three weeks, a most inveterate and raving maniac, when, worn out prematurely with disease, he sunk to rise no more till the general resurrection.

There was no post-mortem examination of this young man, though there should have been. Not that there was any lurking suspicion of peculiarity of disease, but because such examinations may always be made serviceable to the cause of medical science, while they cannot possibly injure either the dead or the living.