LETTER III.
The unhappy loss of our comrade, mentioned to you in my last letter, has been productive of much discussion on the subject of yellow fever. The governor is fond of reading medical books, and feels a strong interest regarding the diseases of the troops, and the maladies arising from the climate. He takes great pleasure in bringing professional men together, and in promoting medical conversations. Gladly I avail myself of the advantages to be derived from this propensity, and through the means of Mynheer Van Battenburg have frequent opportunities of hearing the remarks and opinions of the most eminent practitioners in the colony; but I find that they have established one undeviating routine of treatment. Emetics and the bark are prescribed in all cases of fever; and they insist upon the peculiar efficacy of these remedies in that species or degree commonly called “yellow fever.” This doctrine, so generally and positively asserted by the professional residents, is in direct opposition to the experience of the medical officers of our army, who, in this disease, have constantly found emetics injurious, and bark, in the early stages, useless. I have been at much pains therefore to reconcile the observations with fact; and as the opinions respecting the remedies were so directly at variance, I was anxious to satisfy myself with regard to the identity of the disease; hence, in order to ascertain, correctly, whether we were treating the same complaint, I requested several of the medical men of the colony to visit the patients in the military hospital; and begged of them to allow me to see some of the sick inhabitants of the town. This proposal being accepted, the cause of the difference of opinion, and of treatment soon became obvious; for it was ascertained that while we were contending with the continued fever of Europeans but lately arrived, they were prescribing for the remittent fever of the colonists. They candidly admitted that the disease in the hospital differed from the fever which they commonly treated; and one of the most eminent of them, who had been, during twelve years, in busy employment in the colony, acknowledged that, in the whole course of his practice, he had met with only five cases of what he now termed “genuine yellow fever.”
One of the persons whom I had the opportunity of visiting was the patient of Dr. S. who now discovered that he had seen only five cases of yellow fever within the period of a dozen years. I found that he was treating this gentleman with bark, per os atque per anum, without assisting it with opium, wine, or any of the other stimulants, or aromatics usually employed: but it was evidently a case of the remittent fever of the country. The patient, who was very dangerously ill, happily recovered, and notwithstanding my own opinion that he might have been cured with more facility, by a smaller quantity of the bark, if it had been combined with opium, wine, or the like, still I was indebted to the doctor for the opportunity which this case afforded me of witnessing the very ample and persevering adhibition of this valuable remedy by the Dutch practitioners.
One of the colonial doctors who visited our late comrade, during his short illness, termed his disease a “pituitous fever;” but still he recommended emetics and bark as the cure. If these remedies were as extensively useful, as might be inferred from the opinions of the gentlemen practising in this colony, the crowded contents of our medicine-chests might be conveniently reduced to two simple packages of bark and emetic tartar! Probably the patients who come under the care of these practitioners are, for the most part, creoles, or persons who have become creolised, in whom the disease usually assumes the remittent type, and who very seldom, if ever, have it in the aggravated form which constitutes the yellow fever.
While I am upon the subject of medicine you will forgive me if I should extend this letter by offering you a few remarks respecting a medical life. You are not unacquainted with the many inconveniences and afflictions which attach to the practice of the profession, and you will be pleased to know that these are in some measure counterbalanced by peculiar and exclusive advantages. Medical men are commonly regarded as persons of social habits and sentiments. Often they are viewed as a privileged race, and the term doctor serves as a general passport, insuring a degree of affability, and freedom of intercourse. Not unfrequently they are indebted to it for friendly civilities, to which they could have no sort of personal claim, and, on account of it, they sometimes experience a more distinguished attention than falls to the lot of others.
A medical man is made to feel himself at home in every house. He is scarcely admitted as a stranger, before he is considered as a kind of confidential acquaintance, and received, as it were, into the bosom of the family. Wheresoever fortune may place him, he is never out of the line of his profession; and it is peculiarly in his power, at all times and in all situations, to contribute to the comfort or relief of his fellow-beings. Like the word brother in masonry, the term doctor conveys an idea of universal friendship and philanthropy. Even as the brotherhood of the trowel, too, ours is a wide and ancient fraternity, and we, like them, soon become known to each other. We also seek those of our own order, and associate in cordial fellowship wherever we meet. Moreover, if general benevolence and the good of mankind be their object, so is it equally ours; and to continue the similitude, perhaps you will say that, like theirs, our signs and forms are concealed and private. But let us not pursue the parallel, lest we betray secrets, never to be revealed.
In the West Indies, and particularly on service with the army, the medical officers are found to have many advantages; for, in every ship, with every regiment, and almost at every plantation, they find a professional brother who in the most friendly way promotes their comfort, and kindly seeks to procure them accommodation. On this head I speak with much satisfaction, being able, from personal experience, to bear testimony to a general spirit of amity, and an uniform practice of good offices, on the part of my brethren.
At most of the West India plantations some member of our fraternity is either resident, or in occasional attendance, as the physician, surgeon, and intimate friend of the household. He is usually a person of influence, and whenever a medical officer of the army visits the estate, the doctor, interesting himself for his professional brother, quickly makes him acquainted with the family, and procures him all the facilities of social intercourse. This I have many times experienced; and, by means of the medical attendant, have not unfrequently been regarded as the friend of the house, before my military comrades had ceased to be considered as strangers!
These may appear only as trifles to you, who daily indulge amidst the luxuries of England, and can hourly command the supplies and conveniences of all-prolific London; but they, who have known the hard lot of privation, will tell you that these little circumstances are often very important on service, particularly to those who are employed on distant and foreign stations.
Many other privileges might be enumerated as peculiar to medical men, or attaching to their professional occupation, some even amidst the bloody strife of war; for although balls and bullets show no distinction in the field, still, not his friends only, but the enemy likewise inclines to protect, rather than to injure the doctor, for his is a kind and tender duty, and extends alike to all. It belongs not to him to discriminate. The effect of the battle alone concerns him: he has nothing to do with the cause! If a suffering object appear, it is no question whether he be a friend or a foe: he languishes, and is therefore entitled to his care; for it is his to stop the gushing streams of life, and to pour a healing balm into the wounds of afflicted humanity, in whatever breast she bleed.
In his command a medical man is absolute, and without control. Indeed nothing can be more arbitrary than medical government. The doctor is even more despotic than the mightiest chief. Passive obedience is his first law: he dictates in positive terms, and exacts the most rigid submission. Nor will this seem unreasonable, when it is recollected that the general’s authority regards only life, while the doctor’s concerns both life, and, ... still more important, health!
Perhaps you will pardon my pen in proceeding one step further, to notice the very highest gratification and best reward of a medical life: in comparison of which all the honors, privileges, and advantages above alluded to, are light as the dying breeze. It may be remarked that the duties of a medical man are arduous and important beyond all other occupations. Constant fatigue and anxiety are his lot. The health of others is his care; and he is often intrusted with the lives and happiness of those united by the nearest and dearest ties. Unbounded confidence is reposed in him, and if his anxious exertions are crowned with success, he is hailed as saviour, father, and friend! His time is at the public command. Not a moment is securely his own: daily and hourly he is called upon to witness the most heart-rending scenes of affliction, and it is his peculiar lot to be sought only in the hour of danger; whence his whole life is spent in the house of woe. But, happily for the humane and zealous mind, even these duties have their reward. On service, if a soldier or a sailor be relieved, gratitude attaches him to his doctor’s interest, and he is ever afterwards secure of his aid and protection. He will fight in his defence, and expose himself to every danger for his safety. But it is in private life, and in the more retired paths of the profession, that the feeling heart meets its genuine return: for to relieve a suffering object from distress—to check the sad ravages of disease—to restore an affectionate and beloved parent, or a duteous child from the bed of sickness, and thereby to dispel the cloud of sorrow, or wipe away the tear of affliction; and then to receive the heart-felt thanks and blessings of a grateful family, is a consolation which none but medical men can know! This it is that reconciles the anxious toils of the profession:—that forms the high compensation of our labours; and the happiest reward of our cares!