In the minds of the public there is a mystery about the practice of
medicine. It deals more or less with the unknown, with the occult, it
appeals to the imagination. Doubtless confidence in its practitioners is
still somewhat due to the belief that they are familiar with the secret
processes of nature, if they are not in actual alliance with the
supernatural. Investigation of the ground of the popular faith in the
doctor would lead us into metaphysics. And yet our physical condition has
much to do with this faith. It is apt to be weak when one is in perfect
health; but when one is sick it grows strong. Saint and sinner both warm
up to the doctor when the judgment Day heaves in view.
In the popular apprehension the doctor is still the Medicine Man. We
smile when we hear about his antics in barbarous tribes; he dresses
fantastically, he puts horns on his head, he draws circles on the ground,
he dances about the patient, shaking his rattle and uttering
incantations. There is nothing to laugh at. He is making an appeal to the
imagination. And sometimes he cures, and sometimes he kills; in either
case he gets his fee. What right have we to laugh? We live in an
enlightened age, and yet a great proportion of the people, perhaps not a
majority, still believe in incantations, have faith in ignorant
practitioners who advertise a “natural gift,” or a secret process or
remedy, and prefer the charlatan who is exactly on the level of the
Indian Medicine Man, to the regular practitioner, and to the scientific
student of mind and body and of the properties of the materia medica.
Why, even here in Connecticut, it is impossible to get a law to protect
the community from the imposition of knavish or ignorant quacks, and to
require of a man some evidence of capacity and training and skill, before
he is let loose to experiment upon suffering humanity. Our teachers must
pass an examination--though the examiner sometimes does not know as much
as the candidate,--for misguiding the youthful mind; the lawyer cannot
practice without study and a formal admission to the bar; and even the
clergyman is not accepted in any responsible charge until he has given
evidence of some moral and intellectual fitness. But the profession
affecting directly the health and life of every human body, which needs
to avail itself of the accumulated experience, knowledge, and science of
all the ages, is open to every ignorant and stupid practitioner on the
credulity of the public. Why cannot we get a law regulating the
profession which is of most vital interest to all of us, excluding
ignorance and quackery? Because the majority of our legislature,
representing, I suppose, the majority of the public, believe in the
“natural bone-setter,” the herb doctor, the root doctor, the old woman
who brews a decoction of swamp medicine, the “natural gift” of some
dabbler in diseases, the magnetic healer, the faith cure, the mind cure,
the Christian Science cure, the efficacy of a prescription rapped out on
a table by some hysterical medium,--in anything but sound knowledge,
education in scientific methods, steadied by a sense of public
responsibility. Not long ago, on a cross-country road, I came across a
woman in a farmhouse, where I am sure the barn-yard drained into the
well, who was sick; she had taken a shop-full of patent medicines. I
advised her to send for a doctor. She had no confidence in doctors, but
said she reckoned she would get along now, for she had sent for the
seventh son of a seventh son, and didn't I think he could certainly cure
her? I said that combination ought to fetch any disease except
agnosticism. That woman probably influenced a vote in the legislature.
The legislature believes in incantations; it ought to have in attendance
an Indian Medicine Man.
We think the world is progressing in enlightenment; I suppose it is--inch
by inch. But it is not easy to name an age that has cherished more
delusions than ours, or been more superstitious, or more credulous, more
eager to run after quackery. Especially is this true in regard to
remedies for diseases, and the faith in healers and quacks outside of the
regular, educated professors of the medical art. Is this an exaggeration?
Consider the quantity of proprietary medicines taken in this country,
some of them harmless, some of them good in some cases, some of them
injurious, but generally taken without advice and in absolute ignorance
of the nature of the disease or the specific action of the remedy. The
drug-shops are full of them, especially in country towns; and in the far
West and on the Pacific coast I have been astonished at the quantity and
variety displayed. They are found in almost every house; the country is
literally dosed to death with these manufactured nostrums and
panaceas--and that is the most popular medicine which can be used for the
greatest number of internal and external diseases and injuries. Many
newspapers are half supported by advertising them, and millions and
millions of dollars are invested in this popular industry. Needless to
say that the patented remedies most in request are those that profess a
secret and unscientific origin. Those most “purely vegetable” seem most
suitable to the wooden-heads who believe in them, but if one were
sufficiently advertised as not containing a single trace of vegetable
matter, avoiding thus all possible conflict of one organic life with
another organic life, it would be just as popular. The favorites are
those that have been secretly used by an East Indian fakir, or
accidentally discovered as the natural remedy, dug out of the ground by
an American Indian tribe, or steeped in a kettle by an ancient colored
person in a southern plantation, or washed ashore on the person of a
sailor from the South Seas, or invented by a very aged man in New Jersey,
who could not read, but had spent his life roaming in the woods, and
whose capacity for discovering a “universal panacea,” besides his
ignorance and isolation, lay in the fact that his sands of life had
nearly run. It is the supposed secrecy or low origin of the remedy that
is its attraction. The basis of the vast proprietary medicine business is
popular ignorance and credulity. And it needs to be pretty broad to
support a traffic of such enormous proportions.
During this generation certain branches of the life-saving and
life-prolonging art have made great advances out of empiricism onto the
solid ground of scientific knowledge. Of course I refer to surgery, and
to the discovery of the causes and improvement in the treatment of
contagious and epidemic diseases. The general practice has shared in this
scientific advance, but it is limited and always will be limited within
experimental bounds, by the infinite variations in individual
constitutions, and the almost incalculable element of the interference of
mental with physical conditions. When we get an exact science of man, we
may expect an exact science of medicine. How far we are from this, we see
when we attempt to make criminal anthropology the basis of criminal
legislation. Man is so complex that if we were to eliminate one of his
apparently worse qualities, we might develop others still worse, or throw
the whole machine into inefficiency. By taking away what the
phrenologists call combativeness, we could doubtless stop prize-fight,
but we might have a springless society. The only safe way is that taught
by horticulture, to feed a fruit-tree generously, so that it has vigor
enough to throw off its degenerate tendencies and its enemies, or, as the
doctors say in medical practice, bring up the general system. That is to
say, there is more hope for humanity in stimulating the good, than in
directly suppressing the evil. It is on something like this line that the
greatest advance has been made in medical practice; I mean in the
direction of prevention. This involves, of course, the exclusion of the
evil, that is, of suppressing the causes that produce disease, as well as
in cultivating the resistant power of the human system. In sanitation,
diet, and exercise are the great fields of medical enterprise and
advance. I need not say that the physician who, in the case of those
under his charge, or who may possibly require his aid, contents himself
with waiting for developed disease, is like the soldier in a besieged
city who opens the gates and then attempts to repel the invader who has
effected a lodgment. I hope the time will come when the chief practice of
the physician will be, first, in oversight of the sanitary condition of
his neighborhood, and, next, in preventive attendance on people who think
they are well, and are all unconscious of the insidious approach of some
concealed malady.
Another great change in modern practice is specialization. Perhaps it has
not yet reached the delicate particularity of the practice in ancient
Egypt, where every minute part of the human economy had its exclusive
doctor. This is inevitable in a scientific age, and the result has been
on the whole an advance of knowledge, and improved treatment of specific
ailments. The danger is apparent. It is that of the moral specialist, who
has only one hobby and traces every human ill to strong liquor or
tobacco, or the corset, or taxation of personal property, or denial of
universal suffrage, or the eating of meat, or the want of the
centralization of nearly all initiative and interest and property in the
state. The tendency of the accomplished specialist in medicine is to
refer all physical trouble to the ill conduct of the organ he presides
over. He can often trace every disease to want of width in the nostrils,
to a defective eye, to a sensitive throat, to shut-up pores, to an
irritated stomach, to auricular defect. I suppose he is generally right,
but I have a perhaps natural fear that if I happened to consult an
amputationist about catarrh he would want to cut off my leg. I confess to
an affection for the old-fashioned, all-round country doctor, who took a
general view of his patient, knew his family, his constitution, all the
gossip about his mental or business troubles, his affairs of the heart,
disappointments in love, incompatibilities of temper, and treated the
patient, as the phrase is, for all he was worth, and gave him visible
medicine out of good old saddle-bags--how much faith we used to have in
those saddle-bags--and not a prescription in a dead language to be put up
by a dead-head clerk who occasionally mistakes arsenic for carbonate of
soda. I do not mean, however, to say there is no sense in the retention
of the hieroglyphics which the doctors use to communicate their ideas to
a druggist, for I had a prescription made in Hartford put up in Naples,
and that could not have happened if it had been written in English. And I
am not sure but the mysterious symbols have some effect on the patient.
The mention of the intimate knowledge of family and constitutional
conditions possessed by the old-fashioned country doctor, whose main
strength lay in this and in his common-sense, reminds me of another great
advance in the modern practice, in the attempt to understand nature
better by the scientific study of psychology and the occult relations of
mind and body. It is in the study of temper, temperament, hereditary
predispositions, that we may expect the most brilliant results in
preventive medicine.
As a layman, I cannot but notice another great advance in the medical
profession. It is not alone in it. It is rather expected that the lawyers
will divide the oyster between them and leave the shell to the
contestants. I suppose that doctors, almost without exception, give more
of their time and skill in the way of charity than almost any other
profession. But somebody must pay, and fees have increased with the
general cost of living and dying. If fees continue to increase as they
have done in the past ten years in the great cities, like New York,
nobody not a millionaire can afford to be sick. The fees will soon be a
prohibitive tax. I cannot say that this will be altogether an evil, for
the cost of calling medical aid may force people to take better care of
themselves. Still, the excessive charges are rather hard on people in
moderate circumstances who are compelled to seek surgical aid. And here
we touch one of the regrettable symptoms of the times, which is not by
any means most conspicuous in the medical profession. I mean the tendency
to subordinate the old notion of professional duty to the greed for
money. The lawyers are almost universally accused of it; even the
clergymen are often suspected of being influenced by it. The young man is
apt to choose a profession on calculation of its profit. It will be a bad
day for science and for the progress of the usefulness of the medical
profession when the love of money in its practice becomes stronger than
professional enthusiasm, than the noble ambition of distinction for
advancing the science, and the devotion to human welfare.
I do not prophesy it. Rather I expect interest in humanity, love of
science for itself, sympathy with suffering, self-sacrifice for others,
to increase in the world, and be stronger in the end than sordid love of
gain and the low ambition of rivalry in materialistic display. To this
higher life the physician is called. I often wonder that there are so
many men, brilliant men, able men, with so many talents for success in
any calling, willing to devote their lives to a profession which demands
so much self-sacrifice, so much hardship, so much contact with suffering,
subject to the call of all the world at any hour of the day or night,
involving so much personal risk, carrying so much heart-breaking
responsibility, responded to by so much constant heroism, a heroism
requiring the risk of life in a service the only glory of which is a good
name and the approval of one's conscience.
To the members of such a profession, in spite of their human infirmities
and limitations and unworthy hangers-on, I bow with admiration and the
respect which we feel for that which is best in this world.
“H.H.” IN SOUTHERN CALIFORNIA
It seems somehow more nearly an irreparable loss to us than to “H. H.”
that she did not live to taste her very substantial fame in Southern
California. We should have had such delight in her unaffected pleasure in
it, and it would have been one of those satisfactions somewhat adequate
to our sense of fitness that are so seldom experienced. It was my good
fortune to see Mrs. Jackson frequently in the days in New York when she
was writing “Ramona,” which was begun and perhaps finished in the
Berkeley House. The theme had complete possession of her, and chapter
after chapter flowed from her pen as easily as one would write a letter
to a friend; and she had an ever fresh and vigorous delight in it. I have
often thought that no one enjoyed the sensation of living more than Mrs.
Jackson, or was more alive to all the influences of nature and the
contact of mind with mind, more responsive to all that was exquisite and
noble either in nature or in society, or more sensitive to the
disagreeable. This is merely saying that she was a poet; but when she
became interested in the Indians, and especially in the harsh fate of the
Mission Indians in California, all her nature was fused for the time in a
lofty enthusiasm of pity and indignation, and all her powers seemed to be
consecrated to one purpose. Enthusiasm and sympathy will not make a
novel, but all the same they are necessary to the production of a work
that has in it real vital quality, and in this case all previous
experience and artistic training became the unconscious servants of Mrs.
Jackson's heart. I know she had very little conceit about her
performance, but she had a simple consciousness that she was doing her
best work, and that if the world should care much for anything she had
done, after she was gone, it would be for “Ramona.” She had put herself
into it.
And yet I am certain that she could have had no idea what the novel would
be to the people of Southern California, or how it would identify her
name with all that region, and make so many scenes in it places of
pilgrimage and romantic interest for her sake. I do not mean to say that
the people in California knew personally Ramona and Alessandro, or
altogether believe in them, but that in their idealizations they
recognize a verity and the ultimate truth of human nature, while in the
scenery, in the fading sentiment of the old Spanish life, and the romance
and faith of the Missions, the author has done for the region very much
what Scott did for the Highlands. I hope she knows now, I presume she
does, that more than one Indian school in the Territories is called the
Ramona School; that at least two villages in California are contending
for the priority of using the name Ramona; that all the travelers and
tourists (at least in the time they can spare from real-estate
speculations) go about under her guidance, are pilgrims to the shrines
she has described, and eager searchers for the scenes she has made famous
in her novel; that more than one city and more than one town claims the
honor of connection with the story; that the tourist has pointed out to
him in more than one village the very house where Ramona lived, where she
was married--indeed, that a little crop of legends has already grown up
about the story itself. I was myself shown the house in Los Angeles where
the story was written, and so strong is the local impression that I
confess to looking at the rose-embowered cottage with a good deal of
interest, though I had seen the romance growing day by day in the
Berkeley in New York.
The undoubted scene of the loves of Ramona and Alessandro is the Comulos
rancho, on the railway from Newhall to Santa Paula, the route that one
takes now (unless he wants to have a lifelong remembrance of the ground
swells of the Pacific in an uneasy little steamer) to go from Los Angeles
to Santa Barbara. It is almost the only one remaining of the
old-fashioned Spanish haciendas, where the old administration prevails.
The new railway passes it now, and the hospitable owners have been
obliged to yield to the public curiosity and provide entertainment for a
continual stream of visitors. The place is so perfectly described in
“Ramona” that I do not need to draw it over again, and I violate no
confidence and only certify to the extraordinary powers of delineation of
the novelist, when I say that she only spent a few hours there,--not a
quarter of the time we spent in identifying her picture. We knew the
situation before the train stopped by the crosses erected on the
conspicuous peaks of the serrated ashy--or shall I say purple--hills that
enfold the fertile valley. It is a great domain, watered by a swift
river, and sheltered by wonderfully picturesque mountains. The house is
strictly in the old Spanish style, of one story about a large court, with
flowers and a fountain, in which are the most noisy if not musical frogs
in the world, and all the interior rooms opening upon a gallery. The real
front is towards the garden, and here at the end of the gallery is the
elevated room where Father Salvierderra slept when he passed a night at
the hacienda,--a pretty room which has a case of Spanish books, mostly
religious and legal, and some quaint and cheap holy pictures. We had a
letter to Signora Del Valle, the mistress, and were welcomed with a sort
of formal extension of hospitality that put us back into the courtly
manners of a hundred years ago. The Signora, who is in no sense the
original of the mistress whom “H. H.” describes, is a widow now for seven
years, and is the vigilant administrator of all her large domain, of the
stock, the grazing lands, the vineyard, the sheep ranch, and all the
people. Rising very early in the morning, she visits every department,
and no detail is too minute to escape her inspection, and no one in the
great household but feels her authority.
It was a very lovely day on the 17th of March (indeed, I suppose it had
been preceded by 364 days exactly like it) as we sat upon the gallery
looking on the garden, a garden of oranges, roses, citrons, lemons,
peaches--what fruit and flower was not growing there?--acres and acres of
vineyard beyond, with the tall cane and willows by the stream, and the
purple mountains against the sapphire sky. Was there ever anything more
exquisite than the peach-blossoms against that blue sky! Such a place of
peace. A soft south wind was blowing, and all the air was drowsy with the
hum of bees. In the garden is a vine-covered arbor, with seats and
tables, and at the end of it is the opening into a little chapel, a
domestic chapel, carpeted like a parlor, and bearing all the emblems of a
loving devotion. By the garden gate hang three small bells, from some old
mission, all cracked, but serving (each has its office) to summon the
workmen or to call to prayer.
Perfect system reigns in Signora Del Valle's establishment, and even the
least child in it has its duty. At sundown a little slip of a girl went
out to the gate and struck one of the bells. “What is that for?” I asked
as she returned. “It is the Angelus,” she said simply. I do not know what
would happen to her if she should neglect to strike it at the hour. At
eight o'clock the largest bell was struck, and the Signora and all her
household, including the house servants, went out to the little chapel in
the garden, which was suddenly lighted with candles, gleaming brilliantly
through the orange groves. The Signora read the service, the household
responding--a twenty minutes' service, which is as much a part of the
administration of the establishment as visiting the granaries and
presses, and the bringing home of the goats. The Signora's apartments,
which she permitted us to see, were quite in the nature of an oratory,
with shrines and sacred pictures and relics of the faith. By the shrine
at the head of her bed hung the rosary carried by Father Junipero,--a
priceless possession. From her presses and armoires, the Signora, seeing
we had a taste for such things, brought out the feminine treasures of
three generations, the silk and embroidered dresses of last century, the
ribosas, the jewelry, the brilliant stuffs of China and Mexico, each
article with a memory and a flavor.
But I must not be betrayed into writing about Ramona's house. How
charming indeed it was the next morning,--though the birds in the garden
were astir a little too early,--with the thermometer set to the exact
degree of warmth without languor, the sky blue, the wind soft, the air
scented with orange and jessamine. The Signora had already visited all
her premises before we were up. We had seen the evening before an
enclosure near the house full of cashmere goats and kids, whose antics
were sufficiently amusing--most of them had now gone afield; workmen were
coming for their orders, plowing was going on in the barley fields,
traders were driving to the plantation store, the fierce eagle in a big
cage by the olive press was raging at his detention. Within the house
enclosure are an olive mill and press, a wine-press and a great
storehouse of wine, containing now little but empty casks,--a dusky,
interesting place, with pomegranates and dried bunches of grapes and
oranges and pieces of jerked meat hanging from the rafters. Near by is a
cornhouse and a small distillery, and the corrals for sheep shearing are
not far off. The ranches for cattle and sheep are on the other side of
the mountain.
Peace be with Comulos. It must please the author of “Ramona” to know that
it continues in the old ways; and I trust she is undisturbed by the
knowledge that the rage for change will not long let it be what it now
is.