Soon we were able to commence admitting in-patients, being forced to limit admission to surgical cases. At first there was considerable difficulty in getting the patients to come on the actual day fixed for the operation; each one was anxious for his neighbour to be the first. Finally I was compelled to threaten to put a black mark against the name of any patient who had agreed to come in for operation and then failed to put in an appearance, adding that that patient would have to wait a long time before having a chance offered a second time. This had the desired effect, a woman needing a small eyelid operation being the first to brave the terrors of the Feringhi hospital.
In due course, instruments and dressings all having been prepared, the patient, in a condition of mortal terror, was led into the operating room, and induced to lie on the table. But alas, her fears gained the mastery, and she instantly jumped up, ran out of the room, and disappeared from the dispensary. This was not encouraging, but a few days later a little Jew boy suffering from vesical stone (a very common disease in Mosul, especially amongst children) was brought to the hospital by his father. We persuaded him to enter the hospital with his boy, and thus finally gained our first in-patient. The stone having been removed, and the boy making a good recovery, we had no further difficulty in getting in-patients. Our six wooden beds soon all had occupants, then we added six more beds; finally, obtaining a neighbouring house for our own residence, we made our old house (the inner compound) into a small hospital for women and children. Thus we were able to accommodate twenty-four patients, and as each had at least one friend, we often had over fifty people resident on the premises. It is this in-patient work that gives the most encouraging opportunities to the medical missionary. There in his little hospital he has patients of all creeds, lying side by side; many have been relieved or cured by operation, and will listen gratefully to all the teaching they can get. Each patient before the operation hears the doctor pray a short prayer, asking God to bless the operation and cause it to be successful. Day after day, week after week, he receives instruction, and gains an entirely new idea of what Christianity really is, and when he leaves the mission hospital and returns to his home, whether in the city or in a distant mountain village, all his old bitter opposition to Christianity has disappeared, and often he will send other patients for treatment to the English mission. The following statistics, for two years only, may prove interesting, as showing the far-reaching influence of even a badly equipped, undermanned medical mission:—
| Total attendance of out-patients | 24,519 | ||
| Operations performed |  | 197 Major | 569 |
| 372 Minor | |||
| Total number of in-patients | 288 | ||
| Number of villages and towns, excluding Mosul,from which patients have come to the dispensary | 348 | ||
This last item is especially interesting; excluding Mosul (from which naturally most of our patients are drawn), 348 different towns and villages (some as many as ten days’ journey) have sent us patients, and yet the work is barely started!
To illustrate the effect of a medical mission in disarming opposition, I may add that, in 1907, when it was feared that, owing to the need for retrenchment, the Society would have to close the work in Mosul, a petition, signed by most of the prominent Mohammedan residents, including the chief mullahs, was brought to me, asking that I would remit it at once to the Society. It was a request that the Medical Mission should not be withdrawn, as it had been such a boon to the inhabitants of the city. In a very wonderful manner God heard and answered our prayers, and the Mission is not to be closed, but rather it is hoped to equip it more thoroughly.
The operations most frequently called for in Mosul are those for “cataract” and vesical stone, but patients come with many other diseases, both surgical and medical. The city is full of phthisis; the insanitary conditions under which the vast majority of the inhabitants live favour its rapid dissemination. Smallpox and typhoid fever are very common, and once these diseases have been definitely diagnosed, neither the patient nor his friends will permit any further medical treatment. For the latter disease the patient is kept on fairly strict diet until he “perspires.” This to the native mind denotes the end of all possible danger, so he is then pressed to eat anything and everything, with disastrous results. Malaria, dysentery, hepatic abscesses are also rife; there have also been epidemics of cholera and plague, but not of late years. Once the projected Baghdad Railway (which will pass through Mosul) is an accomplished fact, we may expect the importation of plague from the south, unless the most stringent precautions are taken.
The Bedouin Arab can rarely be persuaded to stop in the city; after the freedom of life in the desert, he feels stifled within the four walls of a house. Ere leaving Mosul I had a curious demonstration of this fact. An old blind Arab was brought to me by his son, suffering from double cataract. I told him that by means of a simple operation he might once again be able to see, but that he would have to stay in the hospital for a few days. He indignantly refused, saying he would rather remain blind the rest of his life than sleep beneath a roof. In vain did his son plead with him, and finding that I would not operate at once and allow him to be treated as an out-patient, the old man went sorrowfully away.
Every in-patient admitted had to bring a friend to help to nurse him, as we had no proper hospital equipment and no trained nurse. Only twice in the three years did I break this rule, both times with disastrous results. The first was a poor old man from a village some days’ journey from Mosul. He was poor and friendless, also blind with “cataract”; reluctantly I allowed myself to be influenced by his pathetic pleadings, and admitted him without any one to look after him. Prior to his admission he had been bitten on the calf of one leg by a dog, and complaining of pain from this wound, we dressed it with a simple boracic fomentation. Unfortunately this dressing was forgotten and left on the leg. The eye was in due course operated upon successfully, and the patient received the usual strict injunction to lie still for twenty-four hours. At the first dressing everything seemed all right; two days later I found to my sorrow that the eye had suppurated, and that there was no hope of saving the vision. The strictest inquiry was at once instituted, but for some time we could discover no clue as to how the eye had become infected; then the truth came out. It appeared that the second night after the operation the old man commenced to feel a slight pricking pain in the eye that had been operated upon (not an uncommon symptom after “cataract” extraction, with no bad significance as a rule). The pain seemed similar to that which he had felt in his leg, which had been relieved by the application of the boracic fomentation. The patient reasoned thus with himself: “It is night time, I had better not call for the doctor; but the medicine on my eye is evidently doing no good, while that put on my leg cured a similar pain to this at once, so I had better take off this bandage from my eye and replace it with the one on my leg”! This he had proceeded to do, and consequently lost his newly acquired sight.
The other case was somewhat similar, but the patient was a fanatical Moslem priest, whom I afterwards found out was a well-known “majnoon” (madman). He also had been admitted alone, and we had but little trouble with him until after the operation (also for “cataract”) had been performed. A few hours later my assistant came running to me, and said: “Doctor, that old cataract patient declares that he must and he will say his prayers. We have done our best to prevent him, but in vain.” Now a Mohammedan, before he prays, performs certain ablutions, which include washing his hands and face; so I at once ran up to the ward, but, alas! we arrived too late. The old priest had taken off his bandage, washed his face and hands, said his prayers, and was quite unable to understand why the Hakim Sahib should be angry! We gave the poor old man some lotion and a shade for his eye, and sent him back to his home (as he lived in Mosul), refusing to accept any further responsibility. Some weeks later my assistant met the old priest in the bazaar, quite pleased with himself, for he had actually obtained sufficient sight to find his way about alone.
Fortunately the majority of the patients are more reasonable, and quickly learn to submit more or less to “hospital regulations.” Children sometimes proved troublesome, especially boys, when accompanied by a crowd of relations. I remember one morning, when making my daily round, coming across a group of people surrounding a little boy six years of age. He had been ordered a dose of castor oil, and had made up his obstinate little mind that he would not take the nasty stuff. Being a boy, and only son and heir, he had been spoilt most royally. Father, mother, aunt, grandmother, and friends each in turn tried persuasion, varied by gentle threats, all in vain. He beat and (I am sorry to say) cursed the women, his mother included, and sullenly refused to accept the medicine from his father, despite sundry promises of sweets, money, &c.