Berbische, July.
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!