Forty Years in the Wilderness of Pills and Powders Cogitations and Confessions of an Aged Physician
CHAPTER XLI.
BROKEN LIMBS AND INTEMPERANCE.
Wrestling for amusement, in the region where I practised medicine, was a very common occurrence, and certainly had its advantages. But there was one drawback upon its excellence, except to physicians. It involved a good deal of bone-breaking. One famous wrestler with whom I was well acquainted, broke, for his neighbors, an arm and a collar-bone; and in the end almost broke his own neck. He certainly injured it to an extent from which there was never an entire recovery. I shall mention him in another place.
For more or fewer of these broken bones from wrestling, I was called on to prescribe. One case in particular may be worth a few moments' attention, especially as it brings with it certain medical confessions.
I was sent for one evening, about nine o'clock, to visit a young man who had been injured, as it was said, by wrestling. On my arrival, I found him in great distress. He had delayed sending for aid so long that there was much inflammation, and consequent heat, swelling, tenderness, and pain.
It was not easy, at first, to ascertain the exact character of the fractures; but on inquiry and examination, it appeared that while the patient was resting nearly or quite his whole weight on the fractured leg, his antagonist had struck or tripped with his foot so violently as to fracture both bones a little way above the ankle.
It was rather a trying-case to me--for as yet I was, in the art of surgery, a mere tyro. But it was a case which would not admit of much delay; for the inflammation, already sufficiently great, was rapidly increasing. Nor would it do long to hesitate from mere modesty. I was among a class of people, who would, as I well knew, construe modesty, even though it should chance to be, as sometimes it is, an accompaniment of true science, into sheer ignorance; and this would deprive me, as a physician, of my principal lever. For who can lift up the down-fallen without having their full confidence.
But I must explain. My patient with the fractured leg, though not in the usual acceptation of the term a drunkard, was, nevertheless, in the habit of drinking more or less of ardent spirit; and there were not wanting those who believed he was pretty well heated with liquor at the time his leg was broken. But, however this may have been, his frequent and excessive use of spirituous liquors had rendered his blood exceedingly impure; and I could not help shrinking, at first, from the task of having charge of him. Yet, it was a war from which there was no honorable discharge. There was no other surgeon within a reasonable distance, and why should I refuse to do my best for him? Somebody must assist him; and though the case was a troublesome one, why should I not take my share of troublesome cases among the rest?
There was another consideration. As he was poor, any thing like reluctance would have been construed into a willingness to neglect him on account of his poverty--a suspicion from which I should, at that time, have shrunk as readily as from the charge of robbery or murder.
But his associates were worse than he; and, with the exception of his own immediate relations, not an individual would be likely to call on or proffer him aid who was not half or two thirds of the time steeped in spirits. Has the surgeon or physician, in such circumstances, much reason to hope? And what is the hope of his patient? Can he reasonably expect, even with the aid of a skilful surgeon, ever to have a good leg?
However, I did my duty, according to my best knowledge. I had the man laid in a proper position, then placed the divided bones as nearly in their natural position as possible, and bound them. I confess, here, to very great ignorance. Moreover, I repeat, it was a difficult case. And yet I think I succeeded very well for a beginner.
Having properly placed the fractured bones and detained them there by suitable means, I gave due orders concerning the patient's management and treatment. I was particularly careful to interdict all stimulating or indigestible food, and all drink but water. My directions were written down with great care, and the strictest charge was given to his friends and family to see that they were faithfully regarded.
But, alas, for the best person in the world with such attendants! Whenever his wife took care of him, things went on very well; but in other instances, almost every thing went wrong. His attendants gave him rum, opium, laudanum, or almost any thing that he called for. It is true--and I mention it to his credit--that he was often rather moderate in his use of interdicted articles; but then he took just about enough of these unnatural or extra stimulants, to prevent the healing process from going forward as fast as in a man of only thirty years might have been expected.
Instead of being on his feet in a couple of months or so, he lay on his bed three months or more. And then, instead of having a good leg, it was not merely slightly crooked, but half an inch too short. And then, in addition,--and what was very hard to endure,--he charged the whole blame of its imperfection on the surgeon, and insisted that it was not "set" right!
Now, while I confess to much awkwardness, and to the possibility that the limb was not managed as well as it might have been, I must maintain, notwithstanding, that such a charge was wholly misplaced and even gratuitous. Had he employed the best surgeon in the world, and had the leg received the best possible attention, it could not have been kept in its proper place with so much distilled spirits in the house, and so many slaves of the bottle! One might almost as well expect a leg to heal in the nether pit. Though I have never said, either by way of retaliating the abuse or otherwise, that his punishment was richly merited, I _might_ have said so. A man is hardly entitled to good health and a good frame who keeps such company as he did, whether in sickness or in health. God has so connected law and penalty, that he who should complain of the penalty would but insult the law given.
Many cases of petty surgery as well as of severe and complicated disease, fell to my lot, which embarrassed me in a manner not unlike the foregoing; though in no one did I suffer quite so much from misrepresentation as in this. For at least twenty years, to my certain knowledge, my patient took pains to speak of me in terms of reproach, and to say that his leg was set badly; and all without the slightest evidence. I do not positively aver, I again say, that the surgery in the case was faultless; but whether it was so or not, neither he nor any living individual could know, unless it were a more skilful surgeon than myself; and no such surgeon, I am sure, ever saw him during the time I was in attendance.