Part 20 (1/2)

He was very firm, with all his kindness. He would have the truth about his patients. The nurses found it out; and the shrewder ones never ventured to tell him anything but a straight story. A clinical dialogue between Dr. Jackson and Miss Rebecca Taylor, sometime nurse in the Ma.s.sachusetts General Hospital, a mistress in her calling, was as good questioning and answering as one would be like to hear outside of the court-room.

Of his practice you can form an opinion from his book called ”Letters to a Young Physician.” Like all sensible men from the days of Hippocrates to the present, he knew that diet and regimen were more important than any drug or than all drugs put together. Witness his treatment of phthisis and of epilepsy. He retained, however, more confidence in some remedial agents than most of the younger generation would concede to them. Yet his materia medica was a simple one.

”When I first went to live with Dr. Holyoke,” he says, ”in 1797, showing me his shop, he said, 'There seems to you to be a great variety of medicines here, and that it will take you long to get acquainted with them, but most of them are unimportant. There are four which are equal to all the rest, namely, Mercury, Antimony, Bark and Opium.'” And Dr.

Jackson adds, ”I can only say of his practice, the longer I have lived, I have thought better and better of it.” When he thought it necessary to give medicine, he gave it in earnest. He hated half-practice--giving a little of this or that, so as to be able to say that one had done something, in case a consultation was held, or a still more ominous event occurred. He would give opium, for instance, as boldly as the late Dr. Fisher of Beverly, but he followed the aphorism of the Father of Medicine, and kept extreme remedies for extreme cases.

When it came to the ”non-naturals,” as he would sometimes call them, after the old physicians,--namely, air, meat and drink, sleep and watching, motion and rest, the retentions and excretions, and the affections of the mind,--he was, as I have said, of the school of sensible pract.i.tioners, in distinction from that vast community of quacks, with or without the diploma, who think the chief end of man is to support apothecaries, and are never easy until they can get every patient upon a regular course of something nasty or noxious. n.o.body was so precise in his directions about diet, air, and exercise, as Dr.

Jackson. He had the same dislike to the a peu pres, the about so much, about so often, about so long, which I afterwards found among the punctilious adherents of the numerical system at La Pitie.

He used to insist on one small point with a certain philological precision, namely, the true meaning of the word ”cure.” He would have it that to cure a patient was simply to care for him. I refer to it as showing what his idea was of the relation of the physician to the patient. It was indeed to care for him, as if his life were bound up in him, to watch his incomings and outgoings, to stand guard at every avenue that disease might enter, to leave nothing to chance; not merely to throw a few pills and powders into one pan of the scales of Fate, while Death the skeleton was seated in the other, but to lean with his whole weight on the side of life, and s.h.i.+ft the balance in its favor if it lay in human power to do it. Such devotion as this is only to be looked for in the man who gives himself wholly up to the business of healing, who considers Medicine itself a Science, or if not a science, is willing to follow it as an art,--the n.o.blest of arts, which the G.o.ds and demiG.o.ds of ancient religions did not disdain to practise and to teach.

The same zeal made him always ready to listen to any new suggestion which promised to be useful, at a period of life when many men find it hard to learn new methods and accept new doctrines. Few of his generation became so accomplished as he in the arts of direct exploration; coming straight from the Parisian experts, I have examined many patients with him, and have had frequent opportunities of observing his skill in percussion and auscultation.

One element in his success, a trivial one compared with others, but not to be despised, was his punctuality. He always carried two watches,--I doubt if he told why, any more than Dr. Johnson told what he did with the orange-peel,--but probably with reference to this virtue. He was as much to be depended upon at the appointed time as the solstice or the equinox. There was another point I have heard him speak of as an important rule with him; to come at the hour when he was expected; if he had made his visit for several days successively at ten o'clock, for instance, not to put it off, if he could possibly help it, until eleven, and so keep a nervous patient and an anxious family waiting for him through a long, weary hour.

If I should attempt to characterize his teaching, I should say that while it conveyed the best results of his sagacious and extended observation, it was singularly modest, cautious, simple, sincere.

Nothing was for show, for self-love; there was no rhetoric, no declamation, no triumphant ”I told you so,” but the plain statement of a clear-headed honest man, who knows that he is handling one of the gravest subjects that interest humanity. His positive instructions were full of value, but the spirit in which he taught inspired that loyal love of truth which lies at the bottom of all real excellence.

I will not say that, during his long career, Dr. Jackson never made an enemy. I have heard him tell how, in his very early days, old Dr.

Danforth got into a towering pa.s.sion with him about some professional consultation, and exploded a monosyllable or two of the more energetic kind on the occasion. I remember that that somewhat peculiar personage, Dr. Waterhouse, took it hardly when Dr. Jackson succeeded to his place as Professor of Theory and Practice. A young man of Dr. Jackson's talent and energy could hardly take the position that belonged to him without crowding somebody in a profession where three in a bed is the common rule of the household. But he was a peaceful man and a peace-maker all his days. No man ever did more, if so much, to produce and maintain the spirit of harmony for which we consider our medical community as somewhat exceptionally distinguished.

If this harmony should ever be threatened, I could wish that every impatient and irritable member of the profession would read that beautiful, that n.o.ble Preface to the ”Letters,” addressed to John Collins Warren. I know nothing finer in the medical literature of all time than this Prefatory Introduction. It is a golden prelude, fit to go with the three great Prefaces which challenge the admiration of scholars,--Calvin's to his Inst.i.tutes, De Thou's to his History, and Casaubon's to his Polybius,--not because of any learning or rhetoric, though it is charmingly written, but for a spirit flowing through it to which learning and rhetoric are but as the breath that is wasted on the air to the Mood that warms the heart.

Of a similar character is this short extract which I am permitted to make from a private letter of his to a dear young friend. He was eighty-three years old at the time of writing it.

”I have not loved everybody whom I have known, but I have striven to see the good points in the characters of all men and women. At first I must have done this from something in my own nature, for I was not aware of it, and yet was doing it without any plan, when one day, sixty years ago, a friend whom I loved and respected said this to me, 'Ah, James, I see that you are destined to succeed in the world, and to make friends, because you are so ready to see the good point in the characters of those you meet.'”

I close this imperfect notice of some features in the character of this most honored and beloved of physicians by applying to him the words which were written of William Heberden, whose career was not unlike his own, and who lived to the same patriarchal age.

”From his early youth he had always entertained a deep sense of religion, a consummate love of virtue, an ardent thirst after knowledge, and an earnest desire to promote the welfare and happiness of all mankind. By these qualities, accompanied with great sweetness of manners, he acquired the love and esteem of all good men, in a degree which perhaps very few have experienced; and after pa.s.sing an active life with the uniform testimony of a good conscience, he became an eminent example of its influence, in the cheerfulness and serenity of his latest age.”

Such was the man whom I offer to you as a model, young gentlemen, at the outset of your medical career. I hope that many of you will recognize some traits of your own special teachers scattered through various parts of the land in the picture I have drawn. Let me a.s.sure you that whatever you may learn in this or any other course of public lectures,--and I trust you will learn a great deal,--the daily guidance, counsel, example, of your medical father, for such the Oath of Hippocrates tells you to consider your preceptor, will, if he is in any degree like him of whom I have spoken, be the foundation on which all that we teach is reared, and perhaps outlive most of our teachings, as in Dr. Jackson's memory the last lessons that remained with him were those of his Old Master.

THE MEDICAL PROFESSION IN Ma.s.sACHUSETTS.

A Lecture of a Course by members of the Ma.s.sachusetts Historical Society, delivered before the Lowell Inst.i.tute, January 29, 1869.

The medical history of eight generations, told in an hour, must be in many parts a mere outline. The details I shall give will relate chiefly to the first century. I shall only indicate the leading occurrences, with the more prominent names of the two centuries which follow, and add some considerations suggested by the facts which have been pa.s.sed in review.

A geographer who was asked to describe the tides of Ma.s.sachusetts Bay, would have to recognize the circ.u.mstance that they are a limited manifestation of a great oceanic movement. To consider them apart from this, would be to localize a planetary phenomenon, and to provincialize a law of the universe. The art of healing in Ma.s.sachusetts has shared more or less fully and readily the movement which, with its periods of ebb and flow, has been raising its level from age to age throughout the better part of Christendom. Its pract.i.tioners brought with them much of the knowledge and many of the errors of the Old World; they have always been in communication with its wisdom and its folly; it is not without interest to see how far the new conditions in which they found themselves have been favorable or unfavorable to the growth of sound medical knowledge and practice.

The state of medicine is an index of the civilization of an age and country,--one of the best, perhaps, by which it can be judged. Surgery invokes the aid of all the mechanical arts. From the rude violences of the age of stone,--a relic of which we may find in the practice of Zipporah, the wife of Moses,--to the delicate operations of to-day upon patients lulled into temporary insensibility, is a progress which presupposes a skill in metallurgy and in the labors of the workshop and the laboratory it has taken uncounted generations to acc.u.mulate. Before the morphia which deadens the pain of neuralgia, or the quinine which arrests the fit of an ague, can find their place in our pharmacies, commerce must have perfected its machinery, and science must have refined its processes, through periods only to be counted by the life of nations. Before the means which nature and art have put in the hands of the medical pract.i.tioner can be fairly brought into use, the prejudices of the vulgar must be overcome, the intrusions of false philosophy must be fenced out, and the partners.h.i.+p with the priesthood dissolved. All this implies that freedom and activity of thought which belong only to the most advanced conditions of society; and the progress towards this is by gradations as significant of wide-spread changes, as are the varying states of the barometer of far-extended conditions of the atmosphere.

Apart, then, from its special and technical interest, my subject has a meaning which gives a certain importance, and even dignity, to details in themselves trivial and almost unworthy of record. A medical entry in Governor Winthrop's journal may seem at first sight a mere curiosity; but, rightly interpreted, it is a key to his whole system of belief as to the order of the universe and the relations between man and his Maker. Nothing sheds such light on the superst.i.tions of an age as the prevailing interpretation and treatment of disease. When the touch of a profligate monarch was a cure for one of the most inveterate of maladies, when the common symptoms of hysteria were prayed over as marks of demoniacal possession, we might well expect the spiritual realms of thought to be peopled with still stranger delusions.

Let us go before the Pilgrims of the Mayflower, and look at the sh.o.r.es on which they were soon to land. A wasting pestilence had so thinned the savage tribes that it was sometimes piously interpreted as having providentially prepared the way for the feeble band of exiles. Cotton Mather, who, next to the witches, hated the ”tawnies,” ”wild beasts,”

”blood-hounds,” ”rattlesnakes,” ”infidels,” as in different places he calls the unhappy Aborigines, describes the condition of things in his lively way, thus: ”The Indians in these Parts had newly, even about a Year or Two before, been visited with such a prodigious Pestilence; as carried away not a Tenth, but Nine Parts of Ten (yea't is said Nineteen of Twenty) among them so that the Woods were almost cleared of those pernicious Creatures to make Room for a better Growth.”

What this pestilence was has been much discussed. It is variously mentioned by different early writers as ”the plague,” ”a great and grievous plague,” ”a sore consumption,” as attended with spots which left unhealed places on those who recovered, as making the ”whole surface yellow as with a garment.” Perhaps no disease answers all these conditions so well as smallpox. We know from different sources what frightful havoc it made among the Indians in after years,--in 1631, for instance, when it swept away the aboriginal inhabitants of ”whole towns,” and in 1633. We have seen a whole tribe, the Mandans, extirpated by it in our own day. The word ”plague” was used very vaguely, as in the description of the ”great sickness” found among the Indians by the expedition of 1622. This same great sickness could hardly have been yellow fever, as it occurred in the month of November. I cannot think, therefore, that either the scourge of the East or our Southern malarial pestilence was the disease that wasted the Indians. As for the yellowness like a garment, that is too familiar to the eyes of all who have ever looked on the hideous mask of confluent variola.