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Recollections Of A Physician

Recollections Of A Physician image
Parent Issue
Day
19
Month
May
Year
1848
Copyright
Public Domain
OCR Text

One very pleasant, spring-like day, near the close of Janciary, I was requested to cali at No. - , Place, the messenger staling that, if convenient, I might make the visit at 3 o'clock in the afternoon, as the lady who desired my attendance would bo then at home. This was rather an unusual summons, as my ervices were generally required for persons confined within doors, if not to their beds. - It makes little difference to the physician, however, whether his paiients are really sick or only afflicted with imaginary ills, but that difF■crence, small as H is, somotimes induces a preference for practice with tho latter class, as the danger of loosing them in more remóte, and the bill for services rendered will fill more pages and be paid with better feeling and greatr punctuality. This view of the subject being likely to involve a consideration of the code of medical ethics, may not be duly appreciated by the public. I shall therefore waive ts further discussion at present and proceed with the narrative, Punctual to the hour, I rang the bell at the number designated in Place, and was usherod into the parlor by a servant, who promised to inform the lady that Dr. B. had arrived arcording to her request. During the few minutes tliat elapsed before my patiënt made her appearance, I was engaged in examining a drawing-book lying open on the table, which had been rolled to a position where the üght of a front window might fall upon it. The drawings were exquisitly finished, and the colors so delicately applied that at a little distance the copy of the artist absolutely rivalled some specimens of the Polygati Cordati which rested on the leaf by its de. Two unopened letters addressed to Miss E. were lying on the table. The room was luxuriously furnished, and several fino paintings, copies from the ancient masters, hung aguinst the wall. Presently a light step was hcard approaching, and a young lady entered, remarking wilh a smile - " Dr. B., I presume ; I mast introduce myelf ; Miss E. You have rather a wild patiënt to-day, Doctor; but no matter, you have ober ones enough, I suppose," and she invited me to be seated. " Doctor," resumed Miss E., " I have sent for you to consult about a matter rather novel. I have a tumor situated on the left shoulder, which, witliiti the last two months has been rapidly increasing in size, I first discovered it about four years ago ; it was then merely a mail prominence, but I have never, until lately, had any fears. Now I suppose an operation must be performed for ts removal, and he sooner it is done the less, in all probability, I shali have to suffer." " True," I answered, "and there will be no danger, as your general liealth appears to be good, and tumors located in that neighbor hood are rarely malignant in character. but an xamination will settle the question at once." " I have had Dr. V., the surgeon, to see it," he replied, " and he has given his opinión that no danger and but little pain will attend the operation ; but, Doctor, I did not send for you concerning that," and she smiled, evidently confuaed. " I am almost ashamed to teil you why I wantcd your advice, but I must, even at the risk of your considering me foolish. 7 am af raid I cannot endure the pain, notwithstanding the assurance of Dr. W., and I wanted to have your opinión whether there would be any danger in taking the Chloroform 1" " Wh3', Miss E." was my reply, astonished at the object for which I had been sent, " it is a very difficult matter for physicians to judge wliether the inlialation of this powerful agent will be safe or otherwise, as ils effecls have in numerous instances confounded aü the reasons derived a priori from an inyestigation of' temperament, habit and condition." " Then there may be danger you think, Doctor, in every case V' " Yes ; we cannot teil in advance what may be tho result, but the presumption is that you would not experience any serious evil from its use, for the rule, which some have established is, if I mistake not, that it can be used with afety, and fatal consequences are considered as exceptions." " But, Doctor, my case then might be class■ed with the exceptions ; the thought of the bare possibility makes me shudder." " You must not be alarmed so easily, Miss E," I replied ; " but my opinión candidlv is this, that Chloroform is a dangerous aent, and its use should be lirnited to cases of capital opcrations. or when the suffering is thought to be abovo human endurance, and my advice to ynu is franfcly given, not to use it. but to make up your mind to bear the pain, which will not be vcry great, as the operation will be speedily performed, and you will have your senses in that trying moment unclouded." While I was speaking, Miss E. had been walking backward and forward across the parlor. In going near the table where the book of drawings lay open, her eye caught sight of the letters, which had been left by the postman but a short time before my visit. She took lip ooe and gazed anxiously at the superscription, and then tore it open and commenced reading, apparently forgetful of the subject of our conversation. A rich glow mantled her ■cheek as her eye ran over its contents, " Forgive me, Doctor," she exclaimed, cloeing the letter; " my conduct must appear ■extremely rude, but this letter is from a f'riend in England who is about returning home and I was anxious to know the time. 1 must have the operation performed very soon, and then if 1 should not have courage to submit - why, Doctor, the very thought of the knife almost maddens me. I know I shall never muster fortitude to endure it ;" and she showed signs of great agitation. The conference here ended, and having rer.eived a generous fee I returned home. Miss E. was about nineteen, tall, but of slight figure, with drk eyes and hair, fine expression of countenance, manners highly polished, and mind richly cultivated. There was a charm in her conversation unusually attractive, arising from the union of' a brilliant intellect with great beauty of person. I afterwards learned tbat she was engaged to a Mr. R., a young gentleman of fortune, who was now abroad compleling his education by making the tour of Europe. The wedding was to be solemnized as 6oon as bo returned, and the letter she had just read contained the welcome news that he might be expected by the next stcamer from Liverpool. Four days after my visit to Miss E. I was summoned in great haste to her residence. - When I arrived I found the house in the utmost confusión; the front door was open and servants were running in every direction. " Is this the doctor V' exclaimed the servant girl, meeting me as I ontered the door; "ifso, then go up stairs, for God.s sake, for my young mistress is dead ;" and she sobbed as if her heart would break. T ran up stairs, and seeing a crowd around a door near at hand, made an opening and gained access to a room without much ceremony. The fiïst person 1 saw on entering was Dr. W He appeared to be much aiarmed, a thing unusual with him, as the profession are well a ware. "Dr. B.," said he, "we have singular work here. Miss E. took the Chloroform - only twenty five drops. I am afraid she is gone past recovery." I took Miss E. 's hand, but found no pulsation. I placed my finger on her temple, where a slight wound had been made by Dr. W. in opening the temporal artery - no pulsation I there. A looking-glass was procured and held before her mouth, but no vapor disturbed its surface. Miss E. had determined on having the op eration performed before Mr. R. arrived, and not having nerve sufficiont to undergo the pain, she had concluded to run the hazard of inhaling the Chloroform. Dr. W., an eminent surgeon, was selected to opérate, and he also advised Miss E. not to use any agent to produce insensibihty, but his objections were overruled. The Chloroform was administered, the tumor removed and the dressings applied but Miss E. gave no signs of returning consciousness. Dr. W. became aiarmed and requested counsel, and 1 was sent for, as she had informed her father, in making arrangements I for the operation, that if any unpleasant cir■ cumstances transpired she wanted my attendance. A number of females having been drawn to the spot by the news of this strange calamity, ve placed the unfbrtunate patiënt in their charge, directing first the immediate use of a warm bath, then frictions witli the Tictura Capsici. In the mean time tlie house was cleared of all the rest but the physicians and those connected with the family. A crowd remained in the Btreet opposite, which was finally despersed by the pohce. The operation was performed at one o'clock, P. M., and the treatment above discnbed was continued with bat little intcrruptiun until six. We then ordered her to be placed in a warm bed, which being done, we again entered the chamber. Miss E. did not wear the look of death, but of repose. There was pallidity, but not the bleachcd appearance attending exsanguination. Theeyes were closed as in slurnber. She appeared as if the powers of life had been sudden'.y arrested - so suddenly that no time was permitted to elapse betwcen the excitement of heallh and the quietudo of perfect insensibility - not time even for the least change of expression - as thougli the Iightning's stroke had stilled but not defaced this rare specimen of earth's loveliness. The body was warm and the joints flexible, and if the breathing had not been suspended, the observer would have pronounced her in a state of quiet sleep. To us, vvho knew something about the laws of organic life, the illusions of appearance had no iriflueuce. We had but fewdoubts about the fatal ity of the issue ; sttll wc had doubls, and were determined not to suspend ourefforts at resusciiation until palpable signs of decomposition become manifest. Dr. W. had to make some visits which could not be postponed, and I remained the night, watching with the keenest avidity for the first sign of returning animation. The parents of Miss. E. ivere prostrated with grief and unable to renderany assistance. I have often observed tliat parents are unsafe counsellors wlien their children are subjects of disease, and it is a well known fact lhat physicians cannot prescribe for their own families. The reason is obvious. Deep solicitude unfits ihe mind for calm inquiry and theexercise of soind discretion. Mrs. E. was naturally of a feeble constitution, and this sudden calamity was more than she could well support; she was accordingly consigned to her own apartment, where she remained a close prisoner for many weary days and nights. Mr. E. made great efforts at composure, but his suffering was most intense ; during the whole of this night I could hear his restless tread in the adjoining room as he paced the floor, occasionally intermitting to inquire if any change had taken place. Josephine, the only remaining raember of this afflicted family, near fourteen yearsofage, appeared to have been struck speechlees when she was informed that Miss E. did not revive. Although naturally of a lively, talkative disposition, not a whisper now passed her lips ; her eye, when in the chamber, was constantly resting on the placid features of her sister, and not a tear feil or sigh escaped togive relief to her feelings, wrought up to the highest pitch of anxiety. Like Miss E., Josephinc was eminently beautiful, and her look, so wildly. feverishly anxious, illustrated most forcibly the strength of that unselfish affection existing betwcen sisters before seperation and change weaken its power. My watch was in vain. In the morning, at eight o'clock, wben Dr. W. returned, the body was in the same condition as when lie left the evening previous. I now retired to take a few hours' rest leaving instructions to be called instantly if any change occurred. - I had my sleep and The curtains had been withdrawn, to admit as much light as possible, and ür. W. was examining the counLenance of Miss. E. " It may be all fancy," he remarked, as I carne in, " but I thought I perceived a slight Tush on her left cheek. It may be owino-, lowever, to the direction in which the light 'alls on her countenance." Upon a close examination, I too fancied that [ could distinguish ]ke the faint üenciling of nature occasionallv observable on the peach, so delicate as to be almast transparent. Here there was a slight cause for hope, slight enough to be sure, but under the circumstances not'to be disregarded ; and Dr. W. and myself were accordingly soon engagèd in i comparing opinions as to the future medical I discipline. On a careful consideration of all the remedies indicated ín cases of suspended animation, we agreed for tlie presenV to renew the treatment adopted on the preceding evening, and directed that every attention should be given to have the body kept in a warm state. Sevoral competent mirses had been procured, and everything that afFection prompted and wealth could furnish was almost anticipated, so great was the anxiety to have e very tneans adopted that could furnish a hope, however slight, of ultimate success. During tlie course of this day three physicians, celebraled for their skill and expenence, we re called in to give Dr, W. and myself the benefit of their opinions. But with regard to all who sat around this board of consultation, expenence, the great teacher in relation to cases hke the one befo re us, was wanting, and I presume the same remark vvould apply to every member of the Medical Faculty in this city. Accounts of extremely protracted cases of suspended vitality are often paraded in the public journals, but when the evidence on which j such strange occurrences are made to rest, is sifted, hule reliance can be placed upon their aecuracy. Therefore, vvhen a case like the present arises, the treatment must be in a great measure empirical. So thought this highly intelligent board, and for the additional reason that the action of Chloroform is not welt understood. With respect to the modus operandi of most of the preparations used in medicine the profession is presumed to be acquamted, and when evil effects follott' their use, remedies founded upon this knowledge are pointed out. Here is a new anassthetic agent, &udden and powerful in its operation, lessening or prostrating the sensibility of the nervous system, but not always affecting the mind, staying the wheels of life but leaving the intellect free. - Whether these phenomena are always dependent upon chemical changes wrought in the blood, or whether, occasionally, upon simple exhaustion of the vital principie, are questions to be answered hereafter, when medical knowledge becomes enriched trom the details of a sufficiency of post mortem examinations. The board oí consultation adjourned to meet again on the ensuing day, without recommending anything material in addition to the treatment then in practice. i he scconcl day aftor the operation had now come. No change had taken place, with the exception of the disappearance of the slight blush we had noticed on the check. The body retained its warmth, and the countenance exhibited the same happy expression of quiet rest. At the of the medical advisers it was suggested by Dr. W., and the suggestion promptly acceded to, to try the use of galvanism. A machine was procured and ïmmediate preparations vvere made to use it. Ar, matic wine, spirits of' ammonia and other stimulants were placed near at hand, to be used if' the battery had any influence in restoring vitality. When the instrument had been adjusted and Dr. W. was about to apply the wires, Josephine, who had been Iingering about the room, came to the bedside and took hold of her sister's hand. All eyes vvere directed to the countenance of the patiënt, to see if there remained irritability of the muscular system sufficient to be affected by the electnc current. The wires were applied, and almost instantaneously Josephine uttered a piercing cry and feil fainting to the floor. - The confusión attending this unforseen event , interrupted the experiment, and perhaps was tt!è cause of complete failure. When Josephine had recovered and was sufficiently cemposed to give an account of the cause of her alarm, she stated that at the moment the wires were applied she feit a strong grasp from her sister's hand. The electric apparatus was again put in motion and continued for a long time. I held Miss E's hand carefullv all the while, to distinguish, if possible, the least muscular movement, but all susceptibility to be affected by the electric current appeared to have been lost, and we were reluctantly corapelled to abandon any further use of the instrument. Disappointec! and almost disheartened, yet with another feeble ray of hope, suddenly lit up, we separated with the understanding that we should assemble at twelve o'clock preoisely the next diy. Dr. W. remained with the patiënt, and I returned home, to recruit my wasted energies with a quiet. night's rest. Ateight o'clock the next morning, as I was about making a few visits to some patients whose cases had been neglected, my attention was arrested by some newsboys crying - " The Extra Sun - news by the Hibernia - more failures in London," etc. Having purchased a copy, I made my morning calis, and then proceeded to the residence of E. This was the third day, and I found on arriving that the condition of Miss E. was unchanged in the least particular. Further treatment was interrnitted until twelve o'clock, when my associates were to assemble. 1 had been reading the extra paper, and had Iaid it on atable in the hall, where it appears Mr. E. found it, for 1 heard him remark to his daughter in the next room, " Alas ! Josephine, what a meeting we shall have ! The name of Mr. R. is Ín the list of passengere by the Hibcrnia, and he will be here in the course of the day." Who was Mr. R. 1 Was he engaged to Miss E. ? - were questions that arose in my mind, as 1 recollected the affair of the letter, on the occasion of my firstvisit. lfthere have been love passages between these parties, the one living and full of hope, the other stricken nigli if not bcyond the possibility of recovery, what fearful scènes await ! But to the consul ation. Oneofour number recited the case of a persun, who, for some capital offence, had been executed by hanging, and whose body was handed over to the surgeons, and placed upon the dissecting table. An incisión made on the breast with the scalpel was followed by a slight flow ofblood; the circulation wasthus renewed, and life restored for a brief season. Also, of acatiileptic girl, related by the Abbe Menon, who was doomed to dissection ; the first stroke of the scalpel awoke her, and she lived. He followed by suggesting the propriety of trying the knife in the case before us, as the condition of the body was favorable, and no harm could result. The majority of the board, without deciding on the proposition, concluded to delay the experiment for a day or tvvo. No e6sential variation in tho management was [ recornmended, and the board broke up to moet again on the following day, unless sooner called together by circumstances that might intervene. Anotlier cause of excilment had arisen before ihe close of this day, by the appearance, of Mr. R. 1 was not present when he arrived but 1 was informed that he came to the door in al! the ammation natural to a warm affection, expecting to meet his betrothed in the full possession of health and happiness. His impatient ring was answered by a servant, stationed for the purpose of preventing the alarming intelligence which was in reserve from reaching him, from any other source than through Mr. E. He was admitted and conducted in silence to the parlor, where, after a few moments, Mr. E. joined him. Mr. R. was somewhat disturbed at the blank and mvsterious looks of the servant, and when Mr. E. enlered, with a countenance betokening the deepest sorrow, he became thoroughly alarrned, and anticipated in his mind the recital of some terrible calamity. But he was not prepared for the intelligence, communicated in a slow and faltering manner by Mr. E., of the living death of her he loved most on earth. lf he had heard that her regard for him had cooled, and that she had transfered her love to another, or of her sudden death and burial, the shock, severe as it might be, could have been borne, and hope crushed might live again ; but to learn that, in all probability, her mind, active and intelligent as ever, was imprisoned in its earthly temple, from which the pulsations of existence had departed forever - his senses for the time reeled, and it was with great difficulty that he was prevented from rushing into her room, where his uncontrolled excitement might have terminated in confirmed madness. (CONCLUDED NEXTWEEK.)

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Michigan Liberty Press
Old News