Life of Oliver Wendell Holmes Part 9

"Yes, as I say, I look back on the long hours of the many days I spent in the wards and in the autopsy room of La Pitie, where Louis was one of the attending physicians--yes, Louis did a great work for practical medicine. Modest in the presence of nature, fearless in the face of authority, unwearying in the pursuit of truth, he was a man whom any student might be happy and proud to claim as his teacher and his friend.

And yet, as I look back on the days when I followed his teachings, I feel that I gave myself up too exclusively to his methods of thought and study. There is one part of their business that certain medical pract.i.tioners are too apt to forget; namely, that what they should most of all try to do is to ward off disease, to alleviate suffering, to preserve life, or at least to prolong it if possible. It is not of the slightest interest to the patient to know whether three or three and a quarter inches of his lungs are hepatized. His mind is not occupied with thinking of the curious problems which are to be solved by his own autopsy, whether this or that strand of the spinal marrow is the seat of this or that form of degeneration. He wants something to relieve his pain, to mitigate the anguish of dyspnaea, to bring back motion and sensibility to the dead limb, to still the tortures of neuralgia. What is it to him that you can localize and name by some uncouth term, the disease which you could not prevent and which you can not cure? an old woman who knows how to make a poultice and how to put it on, and does it _tuto_, _cito_, _jucunde_, just when and where it is wanted, is better--a thousand times better in many cases--than a staring pathologist who explores and thumps and doubts and guesses and tells his patient he will be better to-morrow, and so goes home to tumble his books over and make out a diagnosis.

"But in those days I, like most of my fellow students, was thinking much more of 'science' than of practical medicine, and I believe if we had not clung so closely to the skirts of Louis, and had followed some of the courses of men like Rousseau,--therapeutists, who gave special attention to curative methods, and not chiefly to diagnosis--it would have been better for me and others. One thing, at any rate, we did learn in the wards of Louis. We learned that a very large proportion of diseases get well of themselves, without any special medication--the great fact formulated, enforced and popularized by Doctor Jacob Bigelow."

It is well known that Doctor Holmes detests the habit of drugging practised by so many physicians of the "old school," and in his address before the Ma.s.sachusetts Medical Society, ent.i.tled Currents and Counter Currents in Medical Science, he makes a severe attack upon the inordinate use of medicines.

"What is the honest truth," he says at another time, "about the medical art? By far the largest number of diseases which physicians are called to treat will get well at any rate, even in spite of reasonably bad treatment. Of the other fraction, a certain number will inevitably die, whatever is done: there remains a small margin of cases where the life of the patient depends on the skill of the physician. Drugs now and then save life; they often shorten disease and remove symptoms; but they are second in importance to food, air, temperature, and the other hygienic influences. That was a shrewd trick of Alexander's physician on the occasion of his attack after bathing. He asked three days to prepare his medicine. Time is the great physician as well as the great consoler.

Sensible men in all ages have trusted most to nature."

Of quacks and other humbugs, Doctor Holmes had an undisguised, wholesome contempt.

"Shall we try," he says, "the medicines advertised with the certificates of justices of the peace, of clergymen, or even members of Congress?

Certainly, it may be answered, any one of them which makes a good case for itself. But the difficulty is, that the whole cla.s.s of commercial remedies are shown by long experience, with the rarest exceptions, to be very sovereign cures for empty pockets, and of no peculiar efficacy for anything else. You may be well a.s.sured that if any really convincing evidence was brought forward in behalf of the most vulgar nostrum, the chemists would go at once to work to a.n.a.lyze it, the physiologists to experiment with it, and the young doctors would all be trying it on their own bodies, if not on their patients. But we do not think it worth while, as a general rule, to send a Cheap Jack's gilt chains and lockets to be tested for gold. We know they are made to sell, and so with the pills and potions.... Think how rapidly any real discovery is appropriated and comes into universal use. Take anaesthetics, take the use of bromide of pota.s.sium, and see how easily they obtained acceptance. If you are disposed to think any of the fancy systems has brought forward any new remedy of value which the medical profession has been slow to accept, ask any fancy pract.i.tioner to name it. Let him name one,--the best his system claims,--not a hundred, but one. A single new, efficient, trustworthy remedy which the medical profession can test as they are ready to test before any scientific tribunal, opium, quinine, ether, the bromide of pota.s.sium. There is no such remedy on which any of the fancy pract.i.tioners dare stake his reputation. If there were, it would long ago have been accepted, though it had been flowers of brimstone from the borders of Styx or Cocytus."

h.o.m.oeopathy is cla.s.sed by Doctor Holmes among such "Kindred Delusions"

as the Royal Cure for the King's Evil, the Weapon Ointment, the Sympathetic Powder, the Tar-water mania of Bishop Berkeley, and the Metallic Tractors, or Perkinsism.

In making a direct attack upon the pretentions of h.o.m.oeopathy, Doctor Holmes declares at the outset that he shall treat it not by ridicule, but by argument; with great freedom, but with good temper and in peaceable language.

_Similia similibus curantur._ Like cures like, is one of the fundamental principles of h.o.m.oeopathy, and "improbable though it may seem to some," says Doctor Holmes with his usual impartial fairness, "there is no essential absurdity involved in the proposition that diseases yield to remedies capable of producing like symptoms. There are, on the other hand, some a.n.a.logies which lend a degree of plausibility to the statement. There are well-ascertained facts, known from the earliest periods of medicine, showing that under certain circ.u.mstances, the very medicine which from its known effects, one would expect to aggravate the disease, may contribute to its relief. I may be permitted to allude, in the most general way, to the case in which the spontaneous efforts of an over-tasked stomach are quieted by the agency of a drug which that organ refuses to entertain upon any terms. But that _every_ cure ever performed by medicine should have been founded upon this principle, although without the knowledge of a physician, that the h.o.m.oeopathy axiom is, as Hahnemann a.s.serts, "the _sole_ law of nature in therapeutics," a law of which nothing more than a transient glimpse ever presented itself to the innumerable host of medical observers, is a dogma of such sweeping extent and pregnant novelty, that it demands a corresponding breath and depth of unquestionable facts to cover its vast pretensions."

Among the many facts of which great use has been made by the h.o.m.oeopathists, is that found in the precept given for the treatment of parts which have been frozen, by friction with snow, etc.

"But," says Doctor Holmes, "we deceive ourselves by names, if we suppose the frozen part to be treated by cold, and not by heat. The snow may even be actually _warmer_ than the part to which it is applied. But even if it were at the same temperature when applied, it never did and never could do the least good to a frozen part, except as a mode of regulating the application of what? of _heat_. But the heat must be applied _gradually_, just as food must be given a little at a time to those peris.h.i.+ng with hunger. If the patient were brought into a warm room, heat would be applied _very rapidly_, were not something interposed to prevent this, and allow its gradual admission. Snow or iced water is exactly what is wanted; it is not cold to the part; it is very possibly warm, on the contrary, for these terms are relative, and if it does not melt and let the heat in, or is not taken away, the part will remain frozen up until doomsday. Now the treatment of a frozen limb by heat, in large or small quant.i.ties, is not h.o.m.oeopathy."

Another supposed ill.u.s.tration of the h.o.m.oeopathic law is the alleged successful management of burns, by holding them to the fire. "This is a popular mode of treating those burns which are of too little consequence to require any more efficacious remedy, and would inevitably get well of themselves, without any trouble being bestowed upon them. It produces a most acute pain in the part, which is followed by some loss of sensibility, as happens with the eye after exposure to strong light, and the ear after being subjected to very intense sounds. This is all it is capable of doing, and all further notions of its efficacy must be attributed merely to the vulgar love of paradox. If this example affords any comfort to the h.o.m.oeopathist, it seems as cruel to deprive him of it as it would be to convince the mistress of the smoke-jack or the flatiron that the fire does not literally draw the fire out, which is her hypothesis.

"But if it were true that frost-bites were cured by cold and burns by heat, it would be subversive, so far as it went, of the great principle of h.o.m.oeopathy. For you will remember that this principle is that _Like_ cures _Like_, and not that _Same_ cures _Same_; that there is _resemblance_ and not _ident.i.ty_ between the symptoms of the disease and those produced by the drug which cures it, and none have been readier to insist upon this distinction than the h.o.m.oeopathists themselves. For if _Same_ cures _Same_, then every poison must be its own antidote,--which is neither a part of their theory nor their so-called experience. They have been asked often enough, why it was that a.r.s.enic could not cure the mischief which a.r.s.enic had caused, and why the infectious cause of small-pox did not remedy the disease it had produced, and then they were ready enough to see the distinction I have pointed out. "O no! it was not the hair of the same dog, but only of one very much like him!"

The belief in and employment of the "Infinitesimal doses," Doctor Holmes handles with the same fairness and ac.u.men; but the absurd idea affirmed by Hahnemann that Psora is the cause of the great majority of chronic diseases, he treats as it deserves, with unqualified contempt.

In conclusion, he says, "As one humble member of a profession which for more than two thousand years has devoted itself to the pursuit of the best earthly interests of mankind always a.s.sailed and insulted from without by such as are ignorant of its infinite perplexities and labors, always striving in unequal contest with the hundred armed giants who walk in the noonday and sleep not in the midnight, yet still toiling not merely for itself and the present moment, but for the race and the future, I have lifted up my voice against this lifeless delusion, rolling its shapeless bulk into the path of a n.o.ble science it is too weak to strike or to injure."

Upon the contagiousness of Puerperal Fever, Doctor Holmes wrote an able treatise some forty years ago. This was reprinted with some additions, in 1855, and in an introductory note which accompanies the still later addition (1883), Doctor Holmes says, "The subject of this Paper has the same profound interest for me at the present moment as it had when I was first collecting the terrible evidence out of which, as it seems to me, the commonest exercise of reason could not help shaping the truth it involved. It is not merely on account of the bearing of the question--if there is a question--on all that is most sacred in human life and happiness that the subject cannot lose its interest. It is because it seems evident that a fair statement of the facts must produce its proportion of well-const.i.tuted and unprejudiced minds."

The essay, a most valuable one, is republished without the change of a word or syllable, as the author upon reviewing finds that it antic.i.p.ates and eliminates those secondary questions which cannot be for a moment entertained until the one great point of fact is peremptorily settled.

There are but very few subjects, indeed, in medical science, that Doctor Holmes has not investigated, and investigated, too, most thoroughly....

In his article on "Reflex Vision," published in Volume IV. of the Proceedings of the American Academy, will be found a very interesting account of his experiments in optics. One, indeed, that will both interest and instruct.

To him, as is well known, we are indebted for numerous improvements in the stereoscope; and in microscopes also, he has done some original and important work.

Said an admirer of Doctor Holmes in referring to his career as a medical professor:

"He always makes people attentive, and I have been told that there is no professor whom the students so much like to listen to. In one of his books he says that every one of us is three persons, and I think that if the statement is true in regard to ordinary men and women, Doctor Holmes himself is at least half a dozen persons. He lectures so well on anatomy that his students never suspect him to be a poet, and he writes verses so well that most people do not suspect him of being an authority among scientific men. Though he ill.u.s.trates his medical lectures by quotations of the most appropriate and interesting sort, from a wonderful variety of authors, he has never been known to refer to his own writings in that way."

In celebrating the silver anniversary year of his wedding with the Muse of the monthlies--meaning his reappearance in the _Atlantic_--he observed that during the larger part of his absence, his time had been in a great measure occupied with other duties. "I never forgot the advice of Coleridge," he said, "that a literary man should have a regular calling. I may say, in pa.s.sing, that I have often given the advice to others, and too often wished that I could supplement it with the words, "And confine himself to it.'"

CHAPTER XIV.

THE HOLMES BREAKFAST.

As the seventieth birthday of Doctor Holmes drew near, the publishers of the _Atlantic Monthly_ resolved to give a "Breakfast" in his honor. The twenty-ninth of August, 1879, was, of course, the true anniversary, but knowing it would be difficult to bring together at that season of the year the friends and literary a.s.sociates of Doctor Holmes, Mr. Houghton decided to postpone the invitations until the thirteenth of November.

Upon that day a brilliant company a.s.sembled at noon in the s.p.a.cious parlors of the Hotel Brunswick, in Boston.

Doctor Holmes and his daughter, Mrs. Sargent, received the guests, who numbered in all about one hundred. Mrs. Harriet Beecher Stowe, Mrs.

Julia Ward Howe, Ralph Waldo Emerson and John G. Whittier a.s.sisted in this ceremony, and after a couple of hours spent in sparkling converse, the company adjourned to the dining-room, where a sumptuous "Breakfast"

was served to the "Autocrat" and his friends.

At the six tables were seated writers of eminence in every department of literature. Grace was said by the Rev. Phillips Brooks, D.D., and after the cloth was removed, Mr. H.O. Houghton introduced the guest of the day in a few happily-chosen words.

The company then rose and drank the health of the poet, after which Doctor Holmes read the following beautiful poem:

THE IRON GATE.

Where is the patriarch you are kindly greeting?

Not unfamiliar to my ear his name, Not yet unknown to many a joyous meeting In days long vanished,--is he still the same,

Or changed by years forgotten and forgetting, Dull-eared, dim-sighted, slow of speech and thought, Still o'er the sad, degenerate present fretting, Where all goes wrong and nothing as it ought?

Old age, the gray-beard! Well, indeed, I know him,-- Shrunk, tottering, bent, of aches and ills the prey; In sermon, story, fable, picture, poem, Oft have I met him from my earliest day.

In my old aesop, toiling with his bundle,-- His load of sticks,--politely asking Death, Who comes when called for,--would he lug or trundle His f.a.got for him?--he was scant of breath.

And sad "Ecclesiastes, or the Preacher,"

Has he not stamped the image on my soul, In that last chapter, where the worn-out Teacher Sighs o'er the loosened cord, the broken bowl?

Yes, long, indeed, I've known him at a distance, And now my lifted door-latch shows him here; I take his shrivelled hand without resistance, And find him smiling as his step draws near.

What though of gilded baubles he bereaves us, Dear to the heart of youth, to manhood's prime, Think of the calm he brings, the wealth he leaves us, The h.o.a.rded spoils, the legacies of time!

Altars once flaming, still with incense fragrant, Pa.s.sion's uneasy nurslings rocked asleep, Hope's anchor faster, wild desire less vagrant, Life's flow less noisy, but the stream how deep!

Still as the silver cord gets worn and slender, Its lightened task-work tugs with lessening strain, Hands get more helpful, voices grown more tender, Soothe with their softened tones the slumberous brain.

Youth longs and manhood strives, but age remembers, Sits by the raked-up ashes of the past, Spreads its thin hands above the whitening embers That warm its creeping life-blood till the last.

Dear to its heart is every loving token That comes unbidden ere its pulse grows cold, Ere the last lingering ties of life are broken, Its labors ended, and its story told.

Ah, while around us rosy youth rejoices, For us the sorrow-laden breezes sigh, And through the chorus of its jocund voices Throbs the sharp note of misery's hopeless cry.

As on the gauzy wings of fancy flying From some far orb I track our watery sphere, Home of the struggling, suffering, doubting, dying, The silvered globule seems a glistening tear.

But Nature lends her mirror of illusion To win from saddening scenes our age-dimmed eyes, And misty day-dreams blend in sweet confusion The wintery landscape and the summer skies.