Forty Years in the Wilderness of Pills and Powders / Cogitations and Confessions of an Aged Physician

by William A. Alcott

THE GREEN MOUNTAIN PATIENT.

Not many years since, I received a letter from a family in a retired village of the Green Mountains, begging me to visit one of their number, a young woman about twenty-seven years of age. She was a farmer's daughter, and had been, in early life, employed as is customary in such families in that region; but, for a few years past had been employed, a considerable portion of the time, in teaching in the district or public schools. It is probable she exchanged the employments of home for the labors of the pedagogue, on account of increasing ill health (though of this I am not quite certain), since nothing is more common or more hazardous. The daughters of our agriculturalists, who inherit, as she did, a scrofulous constitution, and who appear to be tolerably healthy while they remain at home, almost always break down within a few years after leaving the broom and duster.

But whatever may have been the first cause or causes of her diseased condition, it is probable there had been both action and reaction. She was now, at the time I received her most piteous petition, quite ill, and had been so for a considerable time. However, in order to come at the case and the results, it may be as well to make a few extracts from the letters of her friends and herself. For, though they were not accustomed to such descriptions of a case as a medical man would be apt to give, yet, for popular perusal, they are, after all, the more useful.

My first extract will be made from a long letter written by her brother.

"The first attack of what we suppose to be her present disease, was a year ago last spring, and was believed to be the result of taking severe colds repeatedly, while teaching school among the mountains of New Hampshire, and which ended in what Dr. K. (their family physician) called inflammation of the lungs, and was treated accordingly. There was much cough and expectoration of mucus. Though she partially recovered, so as to be able to teach again the ensuing summer, yet her cough was somewhat troublesome till autumn, when health seemed again to smile upon her.

"Late in the fall, however, she had a very severe attack of diarrhœa,—caused, perhaps, by imprudence in diet, and sundry other deviations from a straight line,—which has been her constant companion ever since. (This was a period of eight months.) During all this time her food has passed almost without being dissolved. There is much pain in the stomach and bowels, unless mitigated by opiates, morphine or something analogous. But very little cough has attended her since the last attack of diarrhœa. There has been some pain and soreness in the right side; an eruption over the region of her stomach, swelling of the feet and ankles, whenever fatigued by walking, with pain and soreness in the left ankle.

"I will now give you, briefly, her physician's views. He was called soon after the disease had taken hold of her, and made an examination of her case, which he then called dyspepsia, attended with a little inflammation of the right lung, or perhaps, said he, a slight filling up of the air passages, and he thought the lower part of her right lung might be somewhat indurated. 'Still,' said he, 'the case is not a serious one.' These were his very words. He said he could cure her; and, till very lately, he has always held out to her the language of hope. But now he speaks very differently; he says the case is a hopeless one—that of tubercular consumption; and he says he has always known it to be such!—and adds that there is, even now, a small cavity in her right lung, and that her lungs are passing off in her diarrhœa, without any inconvenience in breathing, or any disagreeable sensation in filling the lungs to fulness."

It is difficult to believe that a medical man who has any regard for his own reputation, would tell such a downright falsehood, as that above represented; and still more difficult to believe he would make the strange mistake of representing her lungs as passing off through the bowels! Why, they might almost as well pass though the moon! Probably my correspondent did not exactly and truly apprehend his meaning; at least, I would charitably hope so.

The appeal for relief was so very urgent, and withal so humble, I visited and examined her, the family physician being present. I found the latter to be a timid invalid, for whom, before I left, I was requested to prescribe; which may account, in part, for his very inefficient practice. I also found him ignorant, in many particulars, of the first principles of his profession; and it was with extreme difficulty—like that of mingling oil with water—that we could unite on any thing reasonable or desirable. He still clung to medicine, as his sheet-anchor in the case, while I was for depending, mainly, on a strict conformity to the laws of health, and the restorative efforts of Nature.

There were other difficulties. A part of the family still inclined to a reliance on him and his old system, while the rest were in favor of my general views, as far as they understood them. The patient herself sometimes inclined to one, and sometimes to the other. While in health, she had been a woman of much decision of character; but, in her present condition, she was weak and vacillating.