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PROFESSIONAL
REMINISCENCES
                                       5
BENJAMIN EDDY COTTING
^
PBEPARED FOR THE NORFOLK DISTRICT MEDICAL SOCIETY
' Hortaris ut orationem amicis pluribus recitem.
  Faciam, quia hortaris;  quamvis vehementer
  addubitem."—Plin.2dus, III. ig.
        BOSTON:

PRESS  OF DAVID CLAPP &  SON.

            1888. 
loo
m 
TO
         WILLIAM PALMER BOLLES, M.D.,
             President of the Norfolk District Medical Society,

  My dear Doctor :
      You were the causa catisans of the following paper.
But  for  your aggressive persuasiveness it  never would
have been written.  It is, therefore, only right that you
should bear some  of the  responsibility of its  appearance
in print.   Besides, you know  by  experience how to
appreciate successful results through early struggles and
incessant work — labeur  ackarne as the French have it,
and your numerous followers will do  well to  imitate the
example you have set before them.
  Trusting that your earnest efforts for the welfare and
advancement of our Society  will be crowned  with fullest
success,—I remain, on retiring from its activities, firm in
the faith of the ever continuous supremacy of the regular
profession, and of its ultimate universal prevalence.
                      Your friend, THE WRITER.

  Roxbury, Boston, Feb., 1888. 
 
PROFESSIONAL  REMINISCENCES.
Mr. President, and Fellow-Members of the  Nor-
    folk District of the Massachusetts Medical
     Society:
  The  officers of our Society have directed me to
prepare a paper for this  meeting.   Having long
and earnestly maintained that every member should
attempt for the  Society any duty assigned to him,
I cannot consistently refuse to undertake the task
now imposed upon me.
  Although the subject enjoined and  the  topics
indicated are not such  as  I would have chosen —
involving, of course, much undisguised  egotism —
it is quite possible  that an unreserved  and unvar-
nished story of some of the " labors, dangers and
sufferings" of an old soldier, while groping in  the
mistiness of past times, may be not without interest
to  abler warriors, thrice armed  with  all modern
improvements  and in the light of the present, but 
6         PROFESSIONAL REMINISCENCES.

even  now in  a perpetual struggle  along the same
line of oft-perplexing service.
  At  all events, the mandate should be obeyed ;  it
is official, and " to be respected accordingly."
  Repressing,  therefore, personal  disinclinations,
and premising that I have  scarcely  any notes to
refer to, I will try to relate, as best  I may, a  few of
the way-side incidents of my professional career.

  I have now practised  medicine  for a  full half-
century.   Fifty years  ago last  August,  on  Com-
mencement Day,  three years after graduating at
Harvard University, I received at the hands  of its
President a degree of Master  of Arts ;  and, after
that, but  on the same day, a  diploma  conferring,
as it  said, "all the rights,  honors  and privileges
pertaining" to a Doctor of Medicine.
  A few weeks later I  was  admitted a Fellow of
the Massachusetts Medical  Society,  and obtained
its  "License to become a practitioner of  Medicine
and Surgery......, while a resident within the
Commonwealth " of Massachusetts.
  Armed  and  equipped  with  these  formidable
documents, a very bashful but  an undaunted youth,
I proceeded at once to  affix  to the door of my
lodgings an indication  that  thereabouts did  dwell 
PROFESSIONAL REMINISCENCES.        7
a new recruit in  the  "great army"  of those who,
in the words of its foremost leader, are ever ready
       " To do a world of good, and take a world of pay." "

  The professional  "shingle" having been  thus
duly  adjusted, a hasty retreat was effected, and the
door  bolted;  lest some  great  accident  or some
pressing emergency  should,  perchance, bring ex-
cited messengers too  suddenly before the startled
and inwardly-trembling neophyte.  But no accident
happened, no emergency arose.   Perhaps it was
the sign, it seemed indeed to say
          " The smallest fevers gratefully received; " "

but it may have been  too  inconspicuous to be read
by one who runs.  It was, in  fact, a modest affair
compared  with  many since  exhibited, — an early
effort, by the way, of  one  who long ago became a
noted landscape painter.   It is still  in service, in
humble contrast with  what fashion  or greater ac-
quirements have  since seemed to demand.

  I have been urged  to tell, especially, of my first
lodgings, the fittings-up  thereof, my manner  of
living there, the books and instruments then thought
necessary — for display, if not for study and use — 
S        PROFESSIONAL REMINISCENCES.
that these things may be compared, or  rather, con-
trasted, with the  requirements of young beginners
of the present  day.   It is a sorry story ;  but here
are some of the res angustce domi.
  In selecting lodgings the chief points were to get
as near as possible to where other and older prac-
titioners were congregated ;  and to be accessible to
Dispensary  and other equally  promising  districts,
from  which employment might at first be expected.
I tried for Winter Street, then full of  doctors, but
the best  accommodations  obtainable, within  my
limited means, were on Washington near Bedford
Street.
   As it was, I was obliged  to go up one flight, and
to take a single  room.   It was forlorn enough,
with  bare,  unpapered  walls;  and  had a hole in
one  side  for a  stove,  if I could obtain one.   I
arranged  a  cot in one corner, and concealed it, as
best  I  could, with a muslin curtain of no very ele-
gant  pattern or artistic  construction.   A  fragment
of a carpet  on the middle of the floor ;  a pine table,
with  four  attenuated  legs  supporting its corners
 and a cover of green baize, for a centre-piece ;  and
 three or four wooden chairs — one a  rocking-chair
 which subsequently had a history— completed the
 furnishings.   On the  table were a dozen or more 
         PROFESSIONAL REMINISCENCES.        9

books, chiefly medical ; and a well-worn dissecting
case of the ordinary pattern.
  What  would  a  young beginner  nowadays think
of such a " den " as this?
  Not many days after I  had taken possession of
my apartment,  while quietly settling down to the
dreary drowsiness of solitude and want of  occupa-
tion, I was aroused  from incoming torpor  by  one
of the  most gratifying surprises I ever experienced.
  A Professor  of the  Medical  School* —  waiving
the usual etiquette and  custom which required the
new-comer to make the first calls — came to my
office.   We never had been introduced;  and an
absurd custom clinging to  some of us  from under-
graduate  usages  had  prevented  my  speaking to
him, except in answers to  examination questions,
while  he  was  a  teacher  and I a  student, lest  it
should induce the accusation of " fishing," or the
seeking  of favors  and indulgences.    He brought to
me some  publications  of  recent cases, and asked
me  to assist him in a private  operation.   Thus
began an  intimate and mutually-confiding friend-
ship which terminated only with his life.
   Weeks passed,  and yet the public did not appear
to care for the patient waiter behind the door, nor
seem very much to need his services. 
 IO       PROFESSIONAL REMINISCENCES.

  Hitherto all my needs had been amply supplied ;
but now, while money could still be had for  the
asking, I had fully determined not to ask for more.
On the contrary,  I  entertained  a faint hope that
sometime I  might be able to pay back what I had
received subsequently  to  leaving college.   But,
that aside, the present was to be  provided for.   It
would  not  do  to expect  that   to-day's   expenses
might be paid by  to-morrow's earnings.    Such  a
course would soon lead to distress and discomfiture.
But, as was then  recognized and afterwards fully
realized, it would often be a hard  trial to  subsist
upon  the little actually  received,  rather than  to
venture upon  that which, though earned, had  not
been paid in.   The prospect was unpromising,  but
the will was strong ;  and the many obstacles were
at last overcome.  The first steps were  the worst—
to gain  and  reserve to-day enough for to-morrow.
  Although a  voluntary undertaking, nevertheless
to live by one's self under such, even self-imposed,
conditions, at  times  having to go days with only
bread and water, or with now and then  the addition
of an occasional dinner at  a restaurant  when bv
chance an extra fee came in, and this for  months,
was bad enough ;  but to feel obliged to '' hold  the
fort"  continuously,  day and night, that nothing 
          PROFESSIONAL  REMINISCENCES.       II

 escape through absence, depriving one's self of all
 social  or  other needed  recreation,  became much
 more unbearable.   The French have a  saying  that
 there  is no necessary  man, and.I  began  to think
 that  I  was indeed  the very individual the adage
 referred to.
   Occasionally a friend  would come  in,  and, by
 way  of consolation, suggest that a  calling which
 did not immediately pay was  not worth following
 up.
   A notable family  once  sent  for me.    They  had
 sickness in the house.   Their family physician, they
 said, had become old  and  so  infirm that they felt
 obliged to give him up.  They had long known of
 me, they said, and of my abilities and standing ;  had
 great regard  for me, and they felt, in this serious
 emergency, that they could confidently  trust in me
 — to  tell them whom  they had  better employ as
 their physician.  Keeping my self-possession as best
 I  could, I told them, without apparent hesitation,
 whom I would send for were  I ill  myself.   They
 sent for him, and he ever after attended  them.
   I had saved a trifle  from my allowance for  stu-
 dent expenses, and  only  a few coppers remained'
when a lady called me  to  her assistance.   She was
found to have a mammary scirrhus.    After proper 
12       PROFESSIONAL REMINISCENCES.
consultation with higher authorities it was decided
that the organ should be removed.   One  day she
took me aside, and, with great solemnity, asked me
to tell her, upon my honor, whether I thought that
I could do the operation well.    She did  not ask
me, she said, to say as well as the eminent gentle-
men who  had seen her,  but well.  On my answer
in the affirmative, she told me to come prepared to
to do  it on  the  following Tuesday.   Remember
that  there was no  anaesthesia  then.  It  required
several  strong persons  merely to  hold  a patient,
writhing and groaning, during such an  operation.
The operator, then, could  not loiter to  determine
uncertain tissues.   He could  not  stop even to tie
up arteries, unless  very important ones — toothed
forceps for  the  purpose were not  then  invented.
He  was obliged to  go rapidly on, and unmoved to
receive jets  of blood in  his face, or  wherever they
might fall.   Yet he did not think it advisable to
wear the  butcher-like frock now sometimes  seen,
or to embarrass  and prolong  the  proceedings by
foul-smelling vapors or  poisonous washes.
  More than one of the assistants whom  I invited
(but not  the  aforesaid  Professor of Surgery who
kindly offered to be present and aid me), suggested
the consequences of failure ; but the operation was 
         PROFESSIONAL REMINISCENCES.       13

performed, and to the satisfaction of all. *  This was
my first case after graduation, and it required some
firmness of purpose to meet its exigences. '
  While I was attending this patient a gentleman
called for temporary advice, and insisted on paying
a fee.  It was the  first  payment  for professional
service, and  the  hesitating reluctance with  which
the amount was named  and  accepted is well re-
membered to this very hour.  The service rendered
did not seem to me worthy of any compensation —
a common experience, I believe,  with  young be-
ginners.   The bank-note thus  received (the smallest
denomination then issued), was never  parted  with.
It still hangs in  its frame by my books, a constant
reminder of the sensations it at first aroused.
  But a few patients, however prominent, do not
make a practice.  This I well knew ;  and 1 had
not taken a place among active practitioners  with
any intention of remaining permanently in the city.
The truth was that, although I had had an unusual
amount of actual practical experience for a student
in those days, especially  in obstetrics, through my
connection with the  House of Industry, I was still
in a  formative  stage.   At the  House of Industry
during my charge of it  as Interne, besides  a very
large number of patients  constantly  in  the  wards 
 14        PROFESSIONAL REMINISCENCES.

 with  all sorts  of diseases and  ailments, including
 insanity, there  were over thirty births and one hun-
 dred and  fifty  deaths.   Thus  an opportunity was
 afforded for the study of disease in all its forms and
 terminations, from earliest infancy to extremest old
 age.  There, too, were many chances for autopsies,
 dissections, and operations on the subject.
  A little knot of us students (I believe that I am
 the only survivor) had been  in the habit of meeting
 together to report cases, and to  quiz each  other's
 work, criticizing  it,  sometimes rather roughly, in
 diagnosis, prognosis and treatment.    In like man-
 ner we assembled for operations at the dead-house.
 The subject having  been  put into  position, one
 would  take the watch, for  rapid action  in those
 days  was  second only  to  thoroughly   skilful
 performance, and would call  upon one of the  others,
 at random, to do an operation then for the first time
 named.   When finished, and  the time  noted, the
operator was subjected to  the  relentless criticisms
of the lookers-on, who never failed to  find some
fault or omission, or to suggest some  improvement.
These  and  similar exercises were  the  source  of
incalculable good to each and all of us.
  It was  then  the custom also, at the college, for
students who were willing to be examined  on the 
          PROFESSIONAL REMINISCENCES.        15

previous lecture to take the front seat in the lecture
room.   Generally there would be half a dozen  or
so in this  seat, though only two or three of us took
places there throughout the whole  course.   We
thought it better to fail there than to prove ignorant
afterwards when  ignorance might be  more  disas-
trous.   Many corrections  of  unsuccessful replies
were fixed firmer in  our memories than our correct
answers.
  Notwithstanding all this, and  perhaps in conse-
quence of it as it showed our limited acquirements,
I felt  far from competent to  assume  at once  on
graduation "the responsibilities of a general  prac-
titioner"  alone and unaided, especially  in a country
town  to which I seemed destined.
  Though constantly  on the watch, the  looked-for
" opening" did not show itself to me.  Determined
to make but  one move, and that for a permanent
location, I staid on, attending additional lectures,'
"walking" the hospital, then the only  one, the
Massachusetts  General,   practising as  I  could,
" getting  up nights"  for  neighbors (always giving
up the patient in the morning to the regular attend-
ant), and  bleeding for others in  order to save them
the trouble, and to become, as  was then considered
important, adroit  in the performance  of that fre-
quent operation. 
l6       PROFESSIONAL REMINISCENCES.
  I made autopsies also,  and I  may interpolate
here that I once gave up a  lecture to make a post-
mortem  for  a  gentleman  who   left his  patient
apparently moribund the evening before.   On our
arrival the patient was  still alive, and, more than
that, subsequently recovered.   The  doctor lost the
patronage  of the  family, and   never  afterward
arranged  for an autopsy unless sure that it  would
be a ^oj/-mortem. •
  So, too, I assisted in surgical  operations  when-
ever and wherever I could  get the chance, adjusting
dressings, cleaning up, etc.  etc., in  short, seizing
(without expectation of pay)  upon  every opportu-
nity of the kind that fell in the way.  In those days
beginners were thankful enough  for  any chance to
gain experience, in order to  become qualified  to
practise  satisfactorily  when  established for them-
selves.    Things seem much  changed  nowadays.
According to some recent reports  it is not always
safe to ask a  "young doctor"  to take care of a poor
patient unless  prepared to pay  the bills.   And,
improbable as  it would  appear, not long  ago  a
lawyer's dunning letter was sent to a physician at
the instance  of another practitioner who had at-
tended  a non-paying  patient of  the former  during
his temporary absence. 
         PROFESSIONAL  REMINISCENCES.       I 7

  Some of my college classmates, fellow medical
students, went abroad.   I  saw  the  advantage of
such a course, but was not able to follow their ex-
ample— fully aware that no amount of application
at home would, at that time, give the prestige of a
short residence in a foreign capital.  Nowadays by
its frequency, and by the increased  advantages  and
the better teachings at home, this foreign  service
has become,  in  the way indicated, of  much  less
importance.
  Thus I held on,  getting little but work and expe-
rience ; enduring a real " famine," and voluntarily
accepting privations such as young men  of to-day
would hardly credit were the half only told  them.
The experiment was  indeed  a  severe trial in  its
daily demands on patience and fortitude, but it has
proved  of valuable assistance in  inducing more
appreciative  views of human exigencies ;  and its
"sufferings" now appear supremely trivial beside
the many tragical struggles for existence which the
profession daily calls one to witness.   It showed,
too, that one if so  resolved,  or  necessitated,  can
keep up appearances  and live at as little  cost in
Boston as anywhere in the world.
  After a while I could pay for  a  regular  dinner,
and obtained it of  a worthy person, who, occasion-
           2 
l8       PROFESSIONAL  REMINISCENCES.
ally  a patient, kept a boarding house in a distant
part  of the city. This also daily gave needed diver-
sion  from otherwise strictly professional pursuits.
The  distance also  answered the intrusive  question
why all  the meals were not  taken at the  same
place.
  Once  in  a while an elder practitioner would
send  a  paying patient — a  valued  recognition,
much needed and gratefully received.
  After a year or so I  obtained what I had at first
sought, a room on  the street-level in Winter Street,
becoming the twenty-fifth practitioner on that short
street.
  Just before I left Washington Street,  a singular
case  happened in the house where I had my office.
An  elderly   man,  afflicted   with  rheumatic  and
swollen  limbs, requiring, as he thought,  frequent
applications of liniments, had been bathed at night-
fall writh an  unusual quantity of alcohol and spirits
of turpentine.   On the approach of an  attendant
with  a  lighted candle  the  whole  took fire  and
enveloped his limbs and lower part of his body in
a sheet of flame.   Though  the blaze was quickly
smothered the shock was too great,  and he died in
great suffering not many hours afterwards.
  In Winter Street quarters were somewhat better, 
PROFESSIONAL  REMINISCENCES.       IO,
though  plain enough compared  with modern re-
quirements.   Here I lived in the house.   I added
to my furniture a plain book-case,  which at  an
auction cost me a couple of dollars, and I arranged
my cot to be turned up in the corner out of sight in
the day-time, as I still had but one room.   Here I
remained until I removed from the city.
  While  I  was on Winter  Street, Dr. Hayward,
taking a vacation of six weeks, asked me to remain
for the time at his house and attend to his patients.
Afterwards he  generously gave  me all the fees as
they were from time to time collected.
  President  Qiiincy  sent to  me under-graduates
who  were required to "makeup"  studies during
their vacations.   For hearing their allotted tasks,
which caused me to  review my college  studies, I
received compensation which greatly increased my
very small pecuniary income.
  A word for the rocking-chair.  When Mr., after-
wards Sir Charles, Lyell, the  geologist,  first came
to this country to lecture, I was temporarily curator
of the Lowell Institute for my friend Dr. Jeffries
Wyman, who then  held the office.   Mr. Lyell,
who was a tall and undulating person, came to my
office one morning, and,  throwing himself into the
chair, began to rock it quite violently.  As he was 
 20       PROFESSIONAL REMINISCENCES.

 uttering the words " we don't have such luxuries in
 England," over  he went,  smashing  the  chair to
 pieces.   With hearty roars of laughter he pushed
 the fragments aside, and continued his visit, sitting
 on the floor with his hands clasped about his knees.
 As long  as  he lived  he  never escaped occasional
 questionings in England  about  his experience in
 American luxuries.
   I was now getting a little  more prosperous.   I
 had also by  this time collected, mostly at auctions
 which students frequented,  a few  more  books —
 new works and monographs of the day.   Among
 these was the new  Forbes, Tweedie and Connolly
 Cyclopaedia, in four volumes, large double-columned
 8vo.,  which  was then thought to be  so complete
 that nothing further would  ever be required on the
 subjects of which it treated.   Yet who ever hears
 of the work at the present  day?   But very few be-
 ginners, I imagine, then bought many books or set
 up large libraries.
  For periodicals,  I  was  permitted to  join a
 Reading Club which  took all foreign and domestic
 medical journals.  Several physicians  having large
libraries offered the use of them.   I was appointed
librarian to  the Medical  College, which,  besides
putting  my  name  on the annual announcement, 
          PROFESSIONAL REMINISCENCES.        21,

and giving at all times free entrance to the college,
required  me  to  take care of  its rather limited
collection of oldish  works;  to be  present  every
Saturday afternoon  to  loan books to such students
as wished to  borrow;  and to keep posted  so  as
to assist searchers in their investigations.  I was
one  of  the  earliest  subscribers  to Braithwaite's
Retrospect, which began as a very  small  and thin
duodecimo.   Its first volume, which I  received in
advance, contained an abstract of a paper  on " The
Use  of Oil of Codfish  in  Scrofula," setting forth
most wonderful results.  This paper came  under
the cognizance of an apothecary's assistant, who
(having had  a difference with  his  master and  set
up for himself) determined, on the strength  of its
alleged virtues, to try " a run"  as he called it in
telling me, on the article;  little thinking,  however,
what  a  marvellous  " run"  it  would  become.
"Cod-oil" was not a new thing as a medicine.   I
had tried it, but could seldom prevail upon patients
to take  any  considerable  amount of it.   Newly
started abroad, however, it was extolled and  swal-
lowed  here ad nauseam.  So much of the  vile stuff
did doctors pour down their  patients' throats, and
the people take of their own  accord (for  any and
everv disorder, after it  had  become fashionable), 
 22       PROFESSIONAL REMINISCENCES.

 that the price of " fish-oil" in the market soon went
 up more than  five-fold.   As an example of the
 extremes to which fashion may lead even educated
 practitioners, a plump and pleasing, hectic-cheeked
 young woman was pointed out to me at  an assem-
 bly, by her physician, as an  instance of restoration
 to flesh and health by taking, he said, "  more than
 a hogshead of cod-oil."  Extravagant language this,
 but not more  extravagant than the reports  of some
 of our most prominent practitioners  at  the time.
 The young woman died a  few months after  she
 was pointed out to me, in  spite  of the  published
 cure by the " remedy."
   Little  is heard of it now, except in some mixture
 or emulsion to make  it go down with the public.

  But, if few beginners bought books, fewer still
 collected many instruments.  Surgery then  was not
 the comparatively  easy thing, without ether, that
 it now is with anaesthesia ; and not so many then
 aspired to become operators.    I had endeavored to
 qualify  myself for the surgical  emergencies of a
 country practice, where one must rely  chiefly on
 himself and  be  ready to act at once or suffer  in
reputation, if  the patient did not suffer  in life  or
limb, by delays  attendant on obtaining a bolder if
 not an  abler practitioner. 
          PROFESSIONAL  REMINISCENCES.       23

   I  had, of course,  my  common  dissecting case.
 A German,  Leitz by name, for some service I  had
 done him, had made for me, while a student, several
 delicate instruments for sub-cutaneous  tenotomy,
 and for strabismus, new Operations in which, even
 thus early, I had become quite expert.  One of my
 teachers gave me a  scalpel, an Evans, with which
 I  performed  my  first  operation after graduation,
 and my last a short time ago.  It has  been a much-
 used instrument, "my  good  English knife," as
 Dupuytren is said often to have exclaimed, holding
 up a favorite instrument.  I had free  access to  an
 instrument-maker's  armament, in  consideration of
 many suggestions I gave him.   I had  also a  present
 of tonsilotomes from the designer, and. from  the
 same source, an amputating case, all the contents
 of which, I am sorry to say,  I was  (contrary to
 prediction) obliged  subsequently  to use, even  the
 long ten-inch  double-edged catling, in an amputa-
 tion at the hip-joint.   The saw of this case was a
 common  carpenter's saw,  fine-toothed,  for hard
 wood.   It was selected by  myself, and fitted  up
 with an ivory handle, the teeth of ordinary surgical
 saws being thought  too raking for dividing bones
readily.
  Of course, as I went on, I obtained such books 
24       PROFESSIONAL REMINISCENCES.
and  instruments  as were essential to immediate
exigencies, but from the  start  I was often obliged
to follow  Baldwin's dictum * and use whatever
came to hand as best I could.   " A wooden bicker
or bowl" for a compress in a  desperate case, by a
" rough and ready lad,"  is mentioned  by Dr. John
Brown, of Edinburgh, with high approval, in his
" Locke  and  Syndenham," pp.  xi.-xii.  So,  too,
an iron spoon for a vectis, as used by a late mem-
ber of this Society in an emergency,  is worthy of
commendation.

  I  had waited  patiently in  my Winter  Street
office, but  at length the long-wished-for day came.
While  I  was  musing  on  hope deferred,  and
anxiously looking up a place, the fire was burning.
Two of  my former medical teachers, without con-
cert  or knowledge  of each other's purpose, called
upon me the same day and set forth the advantages
of Roxbury.
  I  had long  known  its woods  and  pastures in
botanical excursions, in which I collected specimens
for the wild-flower corner of the Massachusetts
Horticultural Society's weekly  shows.   From these
gatherings remain some five or six hundred varieties
dried and  preserved, in  suitable  volumes,  most of 
PROFESSIONAL  REMINISCENCES.       2$
which are now in the possession of one of our pro-
fessional neighbors.  Moreover, I was not wholly
unknown to some of its prominent citizens,  I had,
however, strange as it may seem, never thought of
it as a place of residence, but a walk thither (street
railways were not,  and  stage fares were  too  much
for the impecunious) soon determined the matter.
One look was enough to take in  the situation.   In
less than a week a  location was selected,  and a full
practice begun.
  Roxbury  then  had   six  regular  physicians in
active practice, and five or six more " doing a little
something."   There were two irregulars also, one
of big and one  of  little pills, together with several
medicine venders of no great importance.
  Among the  first-named was an old practitioner,
a thorough regular, who attended quite  a number
of the oldest families.   He took a fancy to me, and
gradually transferred  these patients to my care.
He had a pill, which he valued  much, and which
(though  a formula  of much  older  times) went by
his name.
  One day he hailed me  in  the  street, and  asked
me whether I  knew of his pills.   I replied that I
had  heard  of them.   "Oh,"  said  he, "they are
invaluable—just have  a  pocketful always;   and 
26       PROFESSIONAL REMINISCENCES.

when  people  come to  you with their long stories,
and you don't know what to do,  give them from
your pocket"  (suiting the action to the word and
bringing out a handful loose from his own),  "give
them half-a-dozen of my pills, and that will do the
work for them.   Always keep a pocketful of them
by you ! " •
  The fees then  were  very small, and, although a
more  expensive place to live in except in  house-
rents,  it is  a  few years only  since they  were  in
reality raised  to  a limited  equality with  those  in
Boston proper.
  As to getting  about town, the  main roads were
pretty good for a country place :  but the sidewalks
were  mere  earth-paths  along the travelled way.
There were no curb-stones.   The streets were not
generally lighted at night;  never when  a moon
was expected to shine.  Lights on vehicles at night
were a necessity, and lanterns had to  be carried by
pedestrians.   Rubber boots had not been invented,
and heavy, well-oiled cowskins were  a  burden  in
the mud of stormy times, and hardly kept the feet
dry.    South  of  Dover  Street there  were  a  few
houses only.  Tremont  Street was a mere road,
raised  but little above the marsh, and for most of
the way with only one house on it.  It was lighted, 
          PROFESSIONAL REMINISCENCES.       27

as other  roads were, with oil  lamps, few and  far
between : and the lighting of " the Neck " with gas,
years later, was a notable event.   There were but
few  chances by the roadside to tie a restless horse,
and  I was one of the first to adopt the weight (now
commonly used) invented by a brother physician,  *
affixing  an iron hook or snap instead of a buckle,
the original  means of its attachment  to  the  bridle.
The risks  and  fatigues of night-service  can  hardly
be imagined by later beginners.
  Roxbury then  had about nine  thousand inhabi-
tants, but was  beginning to  increase  rapidly in
population.  Now it  is  said to number more than
seventy thousand.  It was at  that time, to me,  a
beautiful  suburban  town, not much  less  distant
from Boston, in  time, and not much more accessible
than Worcester now is.  Now it  is, unfortunately,
only a "Southern District," as the law calls it, of
a large city, and  subject to all the inconveniences
of such a relation.
  Of my practice in  Roxbury, I  may  say  here as
well as anywhere, that it was very much larger
than I had ever dared, for a  moment, to anticipate
for myself there or anywhere else.  The result was
due  largely  to  the unsought  and very cordial ex-
pressions of good-will  and  confidence of the Pro- 
28       PROFESSIONAL REMINISCENCES.
fessors  in  the  Medical  School, and other eminent
medical gentlemen of the city, who had observed
my course as a student, or had witnessed my solitary
talent, if I had as much  as  that, namely, a talent
for work.
   This  practice, at times  too large for one person,
I  think I  can  truly  say I was never  unwilling  to
share with others, especially with younger men  or
new-comers, struggling  in their first efforts to get a
foothold. *   I always felt impelled to this in remem-
brance  of  my  own early  struggles, and  of similar
assistance when most needed.  For doing thus, all
I  ever  asked was  that  the recipients  should pass
similar  favors on their successors.   I never expected
nor have 1 ever received commission or personal
favor in compensation. '
   On the whole  my practice, with such increase  as
naturally follows faithfulness to employers, was  at
first derived chiefly from new-coming residents, the
patients of others voluntarily sent to me and from
practitioners relinquishing business.  Thus my suc-
cess has been  largely due to the profession's par-
tiality ;  and  I  have tried to repay in some humble
measure the great obligation.
  My actual  service has embraced all  classes from
the highest to  the  lowest; •  and  for  many years 
          PROFESSIONAL REMINISCENCES.       29

 gave no time for rest, day or night.  I never added
 up monthly or yearly charges.   Generally, once a
 year, each patient of supposed ability received an
 enclosed memorandum of his indebtedness, usually
 not made out by myself;  and he was  left to pay at
 his leisure.   A plea of poverty never failed to secure
 a withdrawal  of my  claim.  Some,  who should
 have answered,  never responded ;  and  thus  arose
 the  saying that I own  several undivided shares of
 houses, paid  for in part (if paid at all)  by fees with-
 held when they  should  have been  rendered unto
 me  for services.   Seldom,  however,  have I been
 thus overreached by any who  have not similarly
 endeavored to wrong others in  their several  occu-
 pations.  On the  other hand,  many  in  course  of
 time paid, whose indebtedness  I had entirely for-
 gotten.
   This  plan  of mine has worked well with  other
 practitioners  who adopted it at my suggestion.  One
 can  act independently if he does not know or re-
 member that the applicant  owes him  money ; and
 it is no  harm in the long run to have many debtors
 for acts of unpaid kindness thus rendered to them.
I tell young  men to make as many such debtors as
possible, thinking less of payment than of service.
  As a whole,  I do not suppose that  a half of my 
30        PROFESSIONAL REMINISCENCES.

work for  those  apparently, but  not always really
able (not including "charity"'  or "dispensary"
patients so-called), has received pecuniary compen-
sation.  The rich,  too, often  exact  more than they
are willing  to  pay for ; still, one cannot  be a very
large-hearted practitioner who does not find out at
length, in  self-satisfaction at  least, "how much
better  a  half  is  than  a whole"—especially  the
gratuitous or unpaid half!
  The practice of  medicine must  be  very disap-
pointing to  those who  follow it chiefly for the acqui-
sition of wealth.  Whoever practises it in a com-
mercial  spirit  debases the  calling and  degrades
himself.   As  a  French  writer  has  truly  said:
"Medicine  is the  noblest  of professions,  but  the
meanest of trades."
  Some  classes  have seemed to  think  they  are
entitled  to  a physician's service  as  a  matter of
course, though no reason  can  be given  for  it.
Formerly, clergymen  were considered  such beni-
ficiaries.  One year I  attended eleven clergymen's
families,  most of whom  received  larger incomes
than myself.  I felt constrained to exact  payment
of those not connected with local parishes. '  It is
customary now,  I believe, not to make even such
exceptions.   More than  this, fees  are  now some- 
          PROFESSIONAL REMINISCENCES.        31

times charged for attendance on brother-practition-
ers,  or,  if not  charged,  a liberal  honorarum is
readily accepted  for such service.   I never took a
fee from a female teacher in our public schools  nor
often from males  in the lower grades.  During the
war, I examined, gratis, the companies of recruits
assigned to me.   I also  attended, as in the other
cases alluded to without public or private announce-
ment, the  sick and the wounded officers and  men
from generals and  admirals downward, and their
families, without charge or compensation.
  The greatest  number  of professional  visits to
separate houses I ever made in one day was forty-
three (a  few of  the  houses  visited having  more
than one  patient).  It was one of  the longest days
of summer, and  there was no time  for rest, from
early dawn to late at night.  I once attended four
births in different parts of the town, within twelve
hours;  between  twelve  at night  and twelve at
noon following.   It happened to  be  a February
22cl, and  the  three  boys were each called  George
Washington, while  the girl received the name of
Martha.    The  mothers  were unknown  to each
other. •
  I had, indeed,  a full share in obstetrics.  On the
first of January following  the April of my coming 
 32       PROFESSIONAL  REMINISCENCES.

 to Roxbury, I had on my list thirty-seven obstetric
 engagements.   During the year following that date,
 I  attended  ninety-six cases ;  during the next, one
 hundred  and fifteen cases ;  and so on, until I had
 a  very large  fraction of  the whole number  in the
 town.
   This department was  never satisfactory to me,
 nor  do I deem it  pecuniarily profitable, although
 the fee is considered  large.   If all  the extra calls
 now usually demanded, and the  wasted time were
 paid for,  at average rates, without the lump-fee, the
 attendant's compensation  woidd probably be greater
 than now ;  and the patient's family would not be
 so exacting of the  physician when  he  was not
 actually needed.
   I had been early put to my trumps in this depart-
 ment.   When  I  had hardly  finished my  second
 year's  studies, and  when I had only imperfectly
 " assisted " by being present part of the time  at two
 deliveries conducted by others, I was residing with
 a  prominent Boston physician and was  sent one
 dismal  night to a distant residence  to  " keep the
 patient" until the doctor could reach the  place, he
being at the time  in  attendance  on a similar case
 afar  off in  the opposite  part of  the  city.   The
patient I was to "keep"  was a young woman in 
          PROFESSIONAL  REMINISCENCES.       33

 her first pregnancy, who  had come from the country
 to a friend's house, to make purchases for the event,
 expected some weeks later.  I had not reached the
 place too early, but on entering the reception-room
 I was plied  with  numerous  questions, rapidly put
 to me, chiefly  as  to  qualifications and experience.
 While I  was  getting " very red because  so  very
 green," I put myself on  the negative  defensive ; I
 would not force myself  upon  them ;  nor stand in
 the way of any other arrangement; I was sent to
 save them from any  mishap, and probably would
 not have been so sent if thought incompetent.  I
 added that I had no  objection  to  their sending for
 another practitioner (inwardly I wished they would
 do it), but would  remain  only  until they had  pro-
 cured one to their liking.   Meanwhile a conference
 was going on, aside.  Their  messenger had  left.
 The darkness  and storm outside were appalling.
 In their ignorance of their professional neighbors,
 a hap-hazard choice  might  be worse than taking
 the one present, who, at least, had their own doctor
 to fall back upon.   At this point, the  urgent  calls
of the nurse  interrupted their conversation ; and  I
 was hurried up into the patient's room.  Suffice it
to say that all went on happily, and I  reached my
friend's house at early dawn, before he himself had
           3 
34       PROFESSIONAL REMINISCENCES.

returned.   I had  told  the family  that the doctor
would visit them during the  day, but they  replied
that there was no need of two physicians in the
case,  and   wished  me to  continue  attendance.
Accordingly the doctor drove me  to  the  corner  of
the street, and  waited for  me  in his chaise while
I visited my patient.  This he repeated as the  case
required.  All  this happened in one of the doctor's
"first class" families.  He never saw the patient,
but he  charged and  received  a  "first-class"  fee.
I had the experience. •

   Before the idea was started that puerperal fever
may be communicated, I was once in attendance on
four cases of this disease (two, however, not until
the fever had  begun), while at the  same time I
attended eleven other patients without any injury
to them.  Once I attended a patient in the next bed
to  a  puerperal fever case, and no harm resulted,
both  patients   having  the  same  nurse.   In  an
epidemic of this  affection (there  have been such,
and probably  such will again occur)  I  have  seen
cases clearly  indicated days previous to delivery.
If ever a  consecutive  number of  cases  of  this
disease occurs in the  practice of one  physician,
while none appear in that  of others, the  same is 
PROFESSIONAL REMINISCENCES.        35
true of other diseases.   For instance, I have known
this to  happen  with scarlet fever, where "carry-
ing"  by the  attendant was out of question, as he
went  to the  patients only  after the disease  had
manifestly revealed itself.
  In fact, in spite of what non-practising theorists
allege,  I have  never known of  a  case of  this
affection to have been  unmistakably carried  by an
attendant, however much exposed  he  himself  may
have  been.    Various other theories explain  such
matters much better, if we cannot acknowledge our
ignorance.   Epidemics will prevail, and often  con-
found the wise by their strange and unusual courses.
The same may be said of all the portable diseases,
so-called.  Thus it seems to me,  and I have had
some chance to learn of these matters at home and
abroad.  At any rate, the unnecessary alarms,  so
often causelessly raised, are more damaging  to  a
community than any  such portability was  or can
be.   Witness, on a  large scale, London's ordinary
amount  of  scarlet  fever,  sensationally misnamed
"raging,"* the  recent call for  "red flags"  in our
own  neighborhood, and the present  "fright" (as
we may now add) in a country place in another
part of the  State, where with less than a score of
cases in four thousand inhabitants, according to the 
36       PROFESSIONAL  REMINISCENCES.

papers, "the town is  greatly  excited,  and  the
authorities are blamed for not being more  active in
checking the spread of the disease."   It is hard to
be reconciled to  the inevitable, the  unavoidable —
somebody must be blamed.   Are  not such proce-
dures retrograding for an " enlightened age"?

  Of the incidents and experiences befalling me
after settlement in  Roxbury, some were  certainly
peculiar, others of a somewhat serio-comic charac-
ter, of which one or two instances may be given in
illustration.
  I happened to take with me Desault's  apparatus
for fractured thigh. The reputed surgeon of the
place (Dr.  F. Brown), who was  on the point of
removing from town, often made me friendly visits.
Seeing this apparatus one day he declared it to be
perfectly superfluous ; that I had better make fire-
wood of it at once ; that there never had  been but
one case suitable  for it  in the town, and that this
case was hurried  off to a hospital  before  a local
doctor could reach the place of the accident.
  A few days only  after these remarks two cases of
fractured thigh, within  twenty-four  hours of each
other,  occurred  hardly a stone's  throw  from my
residence.   The one required my Desault, the other 
          PROFESSIONAL REMINISCENCES.       37

 all the wit I had  to construct suitable appliances
 from materials at hand.
   An amusing incident occurred in connection with
 these accidents.  As a large and full omnibus left
 its station, at the head  of it sat a consequential  in-
 dividual, a self-constituted "boss" of local matters
 and a would-be magnate of the town and vicinity.
 Overhearing  a  passenger at the other end of the
 vehicle relating the affair as  they passed the place
 of the accidents, he loudly  called out in a rough
 voice, " Who'd you say attended them?"  On be-
 ing  answered " Dr. Cotting," he again exclaimed,
 "Dr.  Cotting! who in hell is he?"
   I  took the first opportunity to render a gratuitous
 professional service to his family,  that  he might
 recognize me as a near neighbor, call the place in
 which we lived by  whatever name he chose.
   My extemporary apparatus,  somewhat improved
 upon  and used  afterwards  in preference to  any
 other, I published an  account of in the Medical
fournal,' and, as a supplement, a description (both
 with wood-cuts) of a " fracture-bench,"  so  called,
 devised for his son  by Dr. Monroe,  a member of
 the Norfolk District Society. *   Subsequently in re-
 peated instances I  found this  "bench"  easily set
 1 p and very useful. 
38       PROFESSIONAL  REMINISCENCES.

  The following season,  on a Saturday afternoon,
a master-mechanic,  a very large and heavy  six-
footer, exceedingly muscular and strong, dislocated
his shoulder.  His physician made half a dozen or
more attempts to reduce it.  The patient suffered
much, and roared lustily in the process.  The parts
became  very sore and he  very  impatient,  calling
loudly for other assistance.  I was stopped in the
street by a messenger and  taken to the place.  I
was  told by the medical  attendant of the  attempts
he had  made,  and  that I  might try my luck  if
willing.  The extension made had been  irregular
and  spasmodic,  and I noticed a failure to fix the
scapula.
  Attending to this latter point,  and putting several
strong men  on the arm that the extension  might be
slow, steady, and relentless,  in less time  than  it
takes to tell of it the reduction was effected, without
apparent pain to the patient.  Shouts went up out-
side from the crowds of workmen (it was pay day)
and  others  gathered in  the street, who,  thus and
otherwise, quickly noised the event throughout the
town.  On  my leaving the patient in his hands the
doctor  remarked  that   his  previous  efforts  had
 probably relaxed the parts and rendered the opera-
 tion easy for me.  I  accepted the explanation, but
 he never forgave me for my success. 
          PROFESSIONAL REMINISCENCES.       39

  A few weeks later I reduced, by pulleys, a dislo-
cated shoulder of several  months' standing; then,
without  ether,  a difficult not to  say  somewhat
hazardous operation.   It was deftly  done,  but I
never heard mention of it outside the house wherein
it occurred.  So  disproportionate, often,  is fame to
the merit of the service performed.
  With such a start it  is  needless to  say that for
years after I  had all  the casualty  surgery of the
neighborhood  that I was  inclined to undertake.
The building of the City Hospital brought a great
relief to  me  in  this laborious and generally ill-
requited work.
  On the union of Roxbury with Boston,  even
before its full consummation, I was officially offered
the place  of  attending surgeon  in the  hospital;
again a year or two later, and once more after that:
thrice, and thrice I declined.  I have been accused
of unwarrantable ambition.  " Was this ambition ?"
  I have, however, held the position of  consulting
surgeon to the  hospital, an honorary office, for now
nearly twenty years.
  I could tell of  a register case,  a true story ; but
strange,  in faith more  passing  strange  than  the
fiction on which Mr. Howells founded  his popular
little  drama  of that name.   It was in short,  an 
40        PROFESSIONAL REMINISCENCES.

unwarranted fabrication by a listener at a register,
who  "didn't hear  the consultants  say anything
about  the patient! "—though the case  had  been
properly considered  and for it a course of treatment
agreed upon which proved  successful.   But  for a
little  forbearance on my part  the  story and the
unavoidable defamatory inferences might have be-
come a serious  matter  to  the listener.
  For some time before and  nearly up  to my day
the art of medicine had been in a rather quiescent
state.   Diseases had been classified  and named ;
and tolerably well  defined  methods of treatment
had become  authorized.  There  was, indeed,  an
ever-recurring similarity in  these methods for the
several  diseases.   If  polypharmacy prevailed,  it
was polypharmacy  according to rule.    Given  a
disease,  "a course  to  steer by" was  pretty  well
laid out.   No sick man ever escaped it.  Nor, for
that matter, did  the well fare much better, if they
wished to have health assured to  them.  Venesec-
tion, and  other  prophylactics, were resorted to as
the several seasons came around.  But the taking of
" spring medicines" was thought obligatory  on all.
Draughts, emetics, and cathartics, were apportioned
out to adults with  a free  hand.   Sulphur,  with
cream of tartar and molasses, was periodically ad- 
      0
         PROFESSIONAL REMINISCENCES.       41

ministered to the voting ;  while  a  new-born infant
was not considered fully prepared for life's journey
until its stomach had been filled  and emptied by a
potation of molasses diluted with the vesical secre-
tion of the first youngster that could be secured  for
the purpose.
  Then, too, a doctor's call meant something.  An
emetico-cathartic inevitably followed the first visit,
no  matter what the disease might be.  No wonder
the coming of  a doctor was dreaded in those  days.
But the practitioner then had one advantage—his
course was plain.  He wras called  to do  something
at once, and he  generally did it.   If after  that he
could only be sure of his nomenclature,  his subse-
quent  action was  equally simple  and marked  out
for him.    " Tell  me the name  of my patient's
disease," said a  young doctor who had just then
pitched his tent  near mine,  " and I shall  readily
know  what to prescribe for him  ! "   In all this  the
practitioner's course was simple  and easy.   He had
to be  "heroic"  only,  with  the lancet  and heavy
doses, and his  responsibility was  cancelled.   If
successful, he had  been lucky in  hitting upon  the
right  medicine ;  if unsuccessful, it was the patient's
misfortune, the fault of the stars, perhaps,  but  not
of  the remedies, so-called, nor  of the attendant if 
42       PROFESSIONAL REMINISCENCES.

his treatment  had been  sufficiently  tumultuous.
But, alas, for the cautious or unheroic  practitioner.
His failures were accounted no  better than  homi-
cides, if not indictable.
  But medicine was not wholly at a standstill when
I  began  its  study.    New   investigations,  new
methods, and  new  doctrines  were  enlivening its
followers.   Auscultation told  a new  story of the
chest to those  who  had  ears to hear.   Peyer's
patches  had begun  to show themselves.   The
numerical  method was  in full discussion.   Louis
and his followers  were loudly  proclaiming the  re-
sults of his observations.  With some, observations
were everything;  to number their details the  chief
object and  end  of science. "
  But  the  greatest demonstration of the day, one
destined to revolutionize ideas in the  treatment of
disease  the world over,  and  for  all time, was
then promulgated to the startled profession.   That
a fever sometimes would have  its run was generally
admitted,  but  that  self-limitation is  the rule  in
most, if  not all  diseases, wa6  a doctrine the pro-
fession was not prepared for. '
  For what reason I know not, possibly  a " philo-
sophical tendency" sometimes attributed to me, I
hope truly, I inclined at once to the new doctrines, 
         PROFESSIONAL REMINISCENCES.       43

and even went a little further.  Young in medicine
as I was,  I ventured  to  ask,  if disease  be self-
limited and medicines will not arrest it, why dose
it at all,' except to make the patient more comforta-
ble, and  if possible  diminish  his risks.  I sought,
therefore, for opportunities to observe disease, un-
disturbed by medication.   Fortune favored me.
   One of  my companions was a student,*  who,
previous to taking up medicine, had resided a long
time  in  Germany  for other studies,  and was a
thorough German scholar.  Coming home, he had
brought  with  him  as  curiosities,  original publica-
tions of the author and followers of  the  " New
System," as it was called.  This was beginning to
tickle  the fancies  of  unstable heads  hereabouts,
both in and out of the  profession.   My  friend (who
had now abandoned his previous occupation and
begun the study of medicine) became interested in
" the system," and  I  shared  his interest.   By  his
aid we could study its pretensions from first sources.
Together we  tried  its efficacy.   Then we tried
parallel cases, and  we soon  found that for  every
case in  which he  could show recovery under  its
methods I  could produce one equally successful
treated without medicines. We gave "  the system "
a fair trial, but both of us soon became convinced 
44       PROFESSIONAL REMINISCENCES.
by our actual experiments that there was  literally
nothing in it—nothing in  its dogmas or its thera-
peutics.  Nature was as  fully capable, we found,
to cure diseases  without as with its assistance.  It
is unnecessary, perhaps, to add  that neither of us
became a convert.
  When afterwards the practitioners of this " sys-
tem " were asked to leave  the Massachusetts Medi-
cal Society, I advocated, for the sake of argument,
the society's allowing the practice, without com-
mittal to its doctrine,—the making a trial of  its
merits in practice as I had myself done, and as the
Society  had advocated with other new plans  or
medicines.   It would give,  I  argued, the regular
practitioner  a number of elegant placebos.  My
proposition   met  with decided,  almost  furious
opposition  from men who  declared  emphatically
that  they never used placebos;  that to  use  a
placebo  was a  detestable imposition.  Yet these
men admitted that they used doses  of a few drops
of spirits of nitre (unmitigated placebos) in  typhoid
fever!  They then  advocated expulsion,  but years
afterwards  counselled leniency lest " persecution "
should  "increase  the  popularity" of such  prac-
titioners  who, with some others  disaffected, had
now become  active and obnoxious  disorganizes in
the Society. ' 
         PROFESSIONAL REMINISCENCES.       45

  There can be no greater mistake than to attribute
modern mild medication  to  the  partial  success of
this baseless  folly.   This  last was a reduction of
the former  to absurdity.    If local tradition  and
gossip of the day  at  the  place  of  its origin were
correct, the "hayseed pellets" were suggested in
derision of the ptisans and gum-syrups of eminent
French practitioners,  and the "system" was  de-
vised  afterward  when  its  author, to   his  great
astonishment, found that his satire was  taken  for
new science by the sapient public.  The  " system "
now exists in  name only, to  attract the fanciful  and
the ill-advised.  Its theory and its treatment receive
no  support from  scientific  men.   Its  recipients
swallow its pretensions and its  pellets with won-
drous simplicity,  not knowing  the import of its
name even.   When cured  under it, nature cures
them.   Seldom, however, do such patients escape,
even at the hands of their own  special attendants,
the " regular " doses they so often denounce.   If
there  is anything in the  "system"  now it  would
appear to be  polypharmacy in form at least.  In
fact, these practitioners for years past have seemed
to be the dosers of the  day—requiring their patients
to take " something every two hours."
  It has been rather  amusing, as  time  has rolled 
46       PROFESSIONAL REMINISCENCES.

on, to hear my dissent to such  doctrines and prac-
tice attributed to prejudice due to ignorance of  the
whole  matter,  when  probably, with my friend, I
had tested the  subject by  rigid experiments more
fully than had all its boastful pretenders hereabouts
put together.

  As for personal experience, during pupilage I
took care  of unnumbered cases of measles,  and
scores  of patients in scarlet fever without medica-
tion ; banishing,  no easy  matter, hot  saffron  and
similar teas, the then  usual  resort in such cases
" to bring  out  the  eruption,"  and allowing abun-
dance of light, air, and water, then  so often denied
the sufferers.  Many cases of typhoid fever were
also entrusted to my management, and  many were
the undeserved compliments I  received for skill iu
medication which had been successful by omission.
   Not many years ago there was a severe epidemic
of typhoid among the  gentry  at the  west end of
London, with numerous cases and many deaths.
As the  dwellings  were  faultless in  construction,
drainage, and water-supply, and, as theorizers must
have second causes,  the  milk-supply  was  charged
with the introduction of the fever.   The  milk was
of the best character,  and  from  faultless farms 
          PROFESSIONAL REMINISCENCES.       47

especially selected for these people.  A man  had
died on one of these farms a short time  before, but
his disease had not been even suspected to be of a
typhoid character.   The story fabricated out of his
death, ill-founded as it seemed to us, was sufficient
to satisfy the demands ; but the assumption is  said
to  have  cost the companies over sixty  thousand
dollars, without utility.  Nevertheless, milk is  still
taken by everybody, in England as well as in other
countries,  and  epidemics  continue to  break  out
where the)' cannot  be attributed  to it,  or to  any
other  discoverable  cause.  Thus epidemics  will
occur when and where least expected. *  They have
always done so, and probably  ever will  continue,
in spite of the " authorities called  upon  to suppress
them," to the end of time, or until the limit assigned
to them in the course of nature.
  A most eminent zoologist once gave in detail to
an  equally  eminent mathematician  the  conditions
of existence of a parasite, its manner of reproduc-
tion, its rise, its residence  in different " hosts," the
dangers  that beset it throughout existence,  etc.
etc.,—and the mathematician calculated  that, by
the doctrine of chances, the creature could not be
reduced  to extinction.    From this there  would
seem to be but little probability of our being  able 
40       PROFESSIONAL REMINISCENCES.

to " stamp  out" disease by destroying its  micro-
scopic or invisible  causal or attendant  organisms,
by means of " germicides,"  or  by a proclamation
of the sheriff, while we fail in ability to exterminate
a tape-worm or an  acarus,  or  any similar  visible
monster.  Is it not more than probable that disease,
like other created  things, will leave the world, if
ever, as  the ancient saurians did  or  the  dodo  in
historical times, only in the course of events. *
  I early had  experience in  two severe epidemics
of typhoid :  one during pupilage, and one just after
graduation,  the latter  when  acting locum  tenens
while the resident physician  of a large village took
a vacation.   The outbreak began just as my friend
was leaving, and  continued  until sometime after
his  return.   By his  books it  appeared  that  the
disease had  occurred in over seventy houses  in our
circuit.  No cause for it could be assigned.  Other
neighboring physicians were equally  occupied, in
their villages, and I was fully acquainted with their
treatment.  My own  methods  were generally  ac-
knowledged to be at least as good as theirs ; and I
had  not used  active  or perturbating  medicines.
Their  measures were generally  of  the  more
"heroic" kind.  I saw one of their patients taken
out of a  wet sheet, " a cold pack"  as it was called,
—dead !   The fever had been broken up. 
          PROFESSIONAL REMINISCENCES.       49

  In an epidemic of typhus fever, some years later,
and among immigrants chiefly, I took care of three
hundred and seven  cases  without  administering
drugs.  Thirty-one died, or about  one  in  ten.  In
the same epidemic and in the same class of people,
at Ward's Island (where the commissioners declared
in their report that the  "practice had been among
the most successful,")  there were two thousand and
nine  cases,  with four  hundred  and twenty-seven
deaths, or more than one in five.   This  was noticed
by officials nearer home,  who  publicly reported,
in print, of my cases that  " it  was  apparent  that
the mode of treatment must have been judicious
and skilful from the small number of deaths  which
occurred." '
  Moreover, in this  epidemic,  another point  was
noticed;  some  of  the attendants were attacked.
Of these,  where  the onset was  of the  severest
character, even to delirium, there were instances
of rapid abatement and of convalescence in a few
days,  the disease having  been  "broken up" by
non-interference.
  Before  I  came to  Roxbury  I  had  practised
venesection  so often  for  other  physicians that its
performance was to me an insignificant matter, yet
so thoroughly had I become convinced of its  use-
          4 
50       PROFESSIONAL REMINISCENCES.

lessness, or harm, that I did not bleed in the first
case of pneumonia, here  coming under  my  care.
The patient was a man  of standing  and influence.
I suffered much  anxiety  during his illness,  for  I
well knew that if he died I should be unsparingly
denounced by practitioners and laity, and perhaps
be obliged to leave the place.   Still I resolutely did
as I would be done by.   The man recovered, with
less damage apparently than is usual in such cases.
I have never bled in that disease since.  Moreover,
the influence of this case, with other similar cases,
was surprisingly marked on the general  practice of
the  neighborhood.   Practitioners hereabouts soon
began to learn  that  milder  measures  and  less
disagreeable  doses, matters which I often advocated
at our Medical Meetings, are quite  as effective for
good, and deprive  the sick-room of much  of its
discomfort and dread. *
   The matter of dietary for  the sick has always
had  a  conspicuous  place in  medical teachings.
To order this aright is more than  half the physi-
cian's beneficial task.   Hippocrates  says that the
Art of Medicine would not have  been  invented
if  the  food  and  drink  of those in health were
proper for  the  sick. *   Rules  without  number
abound, but  most practitioners are fully  aware how 
         PROFESSIONAL REMINISCENCES.       51

inadequate such rules often become.  Patients will
frequently reject all offered things, yet (as it were
instinctively)  demand  articles  of food or  drink
of,  seemingly, the most  ?'/«proper character,  but
which,  when allowed, unexpectedly  prove bene-
ficial.   Every one has seen or heard of such cases.
I have  had my share of them.   Not to speak of
adults  who, with the  sorest mouths and almost
moribund,  have  taken  down  raw  brandy  with
relish and restoration, or the gulping down goblets
of milk with benefit when the rebellious state of
the stomach  and looseness  of bowels (inflamed
and probably ulcerated) seemed  to consultants to
contra-indicate any such allowances—not to allude
to these,
  I was once  in  attendance upon a three-quarters
weaned infant, in the beginning of its second sum-
mer.   It  was wasted  to a  shadow  by  cholera-
infantum and inability to retain any kind of prepared
food or even  breast-milk.    Its death was hourly
expected.   Sandwiched between  two  small  down
pillows, it would not allow removal from its favorite
position on its mother's shoulder.  Famished herself,
the mother was prevailed upon to go to  luncheon
thus encumbered.  On  the table there happened to
be a hot, steaming, and fragrant boiled ham.  The 
52
PROFESSIONAL  REMINISCENCES.
 wretched little patient made evident signs  for the
 ham.  In their perplexity the parents sent for  me.
 On  witnessing  the child's unmistakable  efforts, I
 cut off a piece of the ham and put it to the  infant's
 mouth.  All its  energies seemed at once aroused ;
 it tried to clutch the  morsel; its  eyes glowed in
 their sunken sockets, and  its whole frame seemed
 to be  agitated with extraordinary  delight.   In  a
 word,  it was life to the dying.   For days it lived
 and  thrived on the juices of ham.  Gradually leav-
 ing this for breast-milk and other food, it ultimately
 recovered, to full flesh and health.
   It is often worth while to try the sick with seem-
 ingly irrational articles of diet.   I have frequently
 done this with  apparent advantage; sometimes
 adding—to impress my purpose, and in self-defence
—better is a pine shaving taken with avidity than a
 fragment of stalled ox aversion therewith.

  About the  time of my pupilage,  surgery  was
 thought to have reached  a pretty high degree of
perfection.  Some of its ablest men had gone,  but
many remained.  I do not call to mind any startling
innovation or radical  change.  The subcutaneous
division of tendons was for a while much talked of,
but a "run"  in that direction  did not promise  a 
          PROFESSIONAL REMINISCENCES.       53

 great deal, for as one  of its  principal performers,
 who really seemed to  have foundation for his  re-
 mark, said  in my hearing, that  he did  " not  see
 why,  in  God's  name,  all  deformities  occurred
 among poor people."
   The  great  revolution in surgery came not long
 after, on  the accidental discovery of anaesthesia.
 I call this an  accidental discovery, though in fact it
 was rather the accident of an accident.  An adven-
 turous dentist happened to have a  nervous patient,
 who wished a tooth extracted but failed in  courage
 at the critical moment.  The dentist, out of patience,
 sought for something to engage her attention  while
 he could seize the tooth.   He  applied to  a well-
 known  chemist for a gas-apparatus to serve as a
 ruse.  The latter, as the dentist was leaving, called
 out in a nonchalant manner, " why not  try ether,
 that'll put her to sleep."  This was more  than the
 dentist asked for, but it did not suggest anaesthesia,
 and there is  no evidence  that at  the  time either
of them was  contemplating a painless operation.
That point was not in  question.  Control of the
patient was the only object then sought for.   With
his forceps  on the  tooth  the dentist would finish
the operation, no matter how painful it might be.
  Now  sulphuric  ether was  then well known  to 
54       PROFESSIONAL REMINISCENCES.

chemists, and taught by them, to be capable of pro-
ducing " a degree of intoxication when its vapor
is  inhaled  by  the  nostrils," but  taught always
with the caution that " this may prove dangerous
or even fatal."   Our chemical teachers, this  very
chemist among  the  rest,  had annually told us all
this, for I quote their very words.  How much the
dentist knew of ether is uncertain, nor is it  material,
but heedless of consequences, he at  once  obtained
some, tried it upon himself, and  slept a while, un-
harmed.   Thus far a  chance-word had  had its
effect.   Had the dentist  known as  much as the
chemist was  supposed  to know, perhaps  he  also
would have thought  such experiments, as  his  own
upon himself, too " reckless," as the chemist called
them, and the discovery would not have then  been
made by him.
  Again, a fortuitous occurrence, the turning point
in the  whole matter.  By good luck the  dentist's
next patient happened to be one  (and we have since
known  not  a few such) to  "go off" without  a
struggle on the very first inhalation.  This was  a
lucky chance indeed, for had it been otherwise, the
whole thing would have failed.   The  agent was
administered.   In a  moment the patient, to the un-
trained eyes of the  operators, seemed to be expir- 
         PROFESSIONAL REMINISCENCES.       55

ing, apparently in articulo mortis.   The  dentist,
startled but not demoralized, immediately extracted
the tooth, to have something to show for  his  ven-
ture.   The patient, reviving as quickly as he had
succumbed, declared that he "knew nothing of the
operation and had not suffered pain."  The aston-
ished  dentist,  controlling  his emotions,  at once
obtained an attested written document to that effect;
and immediately sought to have his discovery  con-
firmed  by others  whose authority would not be
questioned.  Thus a succession of chances produced
a glorious  result.
  These facts, and they  are the facts, should  not
detract from the honor  due him  who so  quickly
seized upon the offered  boon, had  it thoroughly
tested, and made it available to the  world.  Therein
was the merit,  and the whole  of this was his and
his only ; and he should have the credit of it.
  All these things I was personally cognizant of at
the time.  Most of the  parties except the dentist,
who was previously unknown to me, were  among
my intimate friends or relatives ; and while I dwelt
near enough to know all the facts  in the matter, I
was fortunately far  enough away  to escape being
involved in the controversies.  I knew the  chemist
long and well, and, I am as sure of it as of my own 
56       PROFESSIONAL REMINISCENCES.

existence, that without the dentist, or one like him,
this  discovery  would  not  then have  been  made.
When asserting his claims before a body of scien-
tists, the chemist was asked by an  eminent savant
(who had just come among us,  and happened to be
present)  " doctor, did you make one leetel exper-i-
tnent?"  The chemist hesitated ; but on a repetition
of the question was obliged to  confess that he did
not.   "I think it would have  been better, doctor,
had  you made  one leetel expei-\-ment."  Therein
was  the gist of  the whole matter !
  That one who had never made an experiment in
that  direction, and who at  first had,  with an  em-
phasis and rightly,  disclaimed  all connection with
it, and  had  denounced it  as  " a  ---- humbug,"
should have,  so soon after its success  was known,
claimed the merit of the whole  thing, is sufficiently
surprising;  but that a  foreign practitioner, who
had  subsequently  merely made  use of a kindred
agent, a  deadly one  at  that,  brought to him by
another  person,  should  have  the  effrontery to
appropriate to himself the whole credit of obtaining
true  anaesthesia,  and  to accept civic  and other
honors in return for such meritorious achievement,
is  almost passing  belief.   A well-deserved  and
withering castigation  at the  hands  of the ablest of 
         PROFESSIONAL REMINISCENCES.       57

Boston physicians almost took  the  life  out of the
victim, and made the friends of the trickster writhe. *
They should now cease  to  worry his manes with
undeserved laudation.
  Of the great changes in surgical practice effected
by anaesthesia there is no need of recital  here.   It
has not only  enabled the performance of many and
formerly  impossible   operations, with   ease  and
safety, but has wholly altered the manner of opera-
ting.  Sometimes an old operator becomes impatient
at the slowness of the procedure, and longs to take
the knife and finish it with  a stroke.
  The first experiments in this country with chloro-
form were made  at my house, by the chemist above
spoken of, who had received the article from Edin-
burgh, only a few hours before.  He, himself,  ad-
ministered it to several then present, one of whom
experienced  alarming symptoms.   In the  present
knowledge of its deadly  character, the wonder now
is that a fatal result was averted.
  There has  been another,  milder, and more recent
sensation which has not wholly subsided.   I refer
to Listerism.  That there was need enough in some
foreign hospitals, possibly  in our  own,  though I
cannot think it,  for  a  cleanlier management of
wounds and wounded persons, and  for less objec- 
58       PROFESSIONAL  REMINISCENCES.

tionable dressings, no one  need be  told who  had
visited them in days gone by.   But the opposite ex-
treme does not seem  to  have been  called for; ac-
cordingly, much of the original trumpery and com-
plicated processes of the  new scheme  have been
abated.   Less cumbersome dressings  have been
adopted.  The foul smelling agents  that were first
considered essential have, it is said, been  abandoned
by their originator, as harmful  or even dangerous,
while it is sought to sustain the "principle" by
other more agreeable and less pernicious substitutes.
The London Lancet of December  31,  1887,  in a
review of the past year,  rather gently says,  " Both
the spray and the gauze  of the Listerian  method
are now rarely seen.  That this is a gain who can
doubt?"
  If, as of old, simplicity of dressings, cleanliness,
proper chance for exit  of secretions or  accumu-
lations (and it is difficult to understand  even now,
why the thread of a "long suture" so much in-
veighed against, soft and  flexible  as  it is in the
moisture around it, is not as good a conductor for
drainage as a tube many times larger, and liable to
become rough by erosion,  etc.,  and, where there
are no long sutures, a dependent point left uncom-
pressed will ordinarily answer all needed purposes) 
          PROFESSIONAL REMINISCENCES.       59

— if these things, with rest and support of the parts
involved,  are thoroughly attended to, there will be
less need of the harmful measures and  agents even
now  advocated,  whatever  may be  the accepted
theory of  absorption or infection.  A  few  years
ago the true principles and  methods in the care of
wounds were well set forth by one of our members *
before the  Massachusetts  Medical  Society,  in  a
paper which  the late  Surgeon  George A.  Otis,
United States  Army, compiler  of  the "Medical
Memoirs  of the  Civil  War,"  highly  approved of
and supplemented. *
  It has been said that every surgical aspirant must
invent a splint.   Without ever having been such an
aspirant, but having "a mechanical  turn of mind,"
I have used half a  dozen or more constructed by
myself, or adapted  for  simplicity or availability.
Accounts  of some of these  I published ;  mention,
however,  should  be made  of the great value of
splints constructed of pasteboard, or  thick  paper
strengthened by thin strips  of iron,  * a suggestion
of the late Dr. Ira Allen, a much lamented member
of this  Society.  They are  easily made, are very
firm, and exceedingly light, so light that the patient
hardly recognizes their application.   I have made
and used dozens of them.  They are susceptible of 
60       PROFESSIONAL REMINISCENCES.

any kind of shape or twist, being admirably adapt-
ed, for instance, to  fractures Of the elbow, of the
patella, Colles's, and even to fractures of the neck
of the thigh  bone—enabling the patient to sit up,
to be moved  about  easily, with freedom  from most
of the usual restraints enjoined in such injuries.
   When I began,  bandaging was  a  complicated
and  cumbrous matter,  difficult  for the attendant
and  a burden  to the patient.    For example, the
regulation  bandage for  fractured clavicle required
three rollers of nine yards each and a large axilla
pad, the application of which was a severe test of a
student's adroitness  and  proficiency in  the  art  of
bandaging.   I  tried many  schemes to  get  rid  of
some of this, and to find simpler and equally effec-
tive  methods.  Naturally, I was pleased with the
handkerchief bandages of Dr. Mayor, of Lausanne,
of which he had  published an account; *  and I
obtained many useful hints from his very practical
suggestions on extemporaneous  treatment of acci-*
dental and other injuries.  His two-handkerchief
arrangement for fractured clavicle was an immense
improvement over the cumbersome affair mentioned
above.
   I  have also altered if not improved a few minor
operations, and  originated one which seems  at 
           PROFESSIONAL REMINISCENCES.       6l

 length to be finding favor in the profession. *  It is
 founded on a new principle, and promises uniform
 relief from a very troublesome and disabling  affec-
 tion.
    In  a pecuniary  point  of view surgery has  not
 much to recommend it to the general practitioner.
 Occasionally  a large  fee is  heard  of,  but  the
 average is small.    Surgical  cases  occur mostly
 among laborers and the poor, from the nature of
 their  employments.  Personally it helped me in a
 marked degree in a somewhat peculiar manner.
 He who  dosed largely was  considered the bold
 man, the  " heroic "  practitioner.  No matter how
 small  the dose, I  have never been accused of fear
 to give a larger, or of want of heroism.   My surgi-
* cal boldness,  such as it was, effectually precluded
 such a  charge! .  . .

    In 1S48, I went abroad  to see  how much better
 they order these  matters  in  foreign lands.    My
 famine was over.   I had repaid to my over-gener-
 ous parents the cost of my professional education,
 principal and interest;  and had laid up enough to
 authorize the proposed outlay. . . .
    It was a year of revolutions.  We were in Paris
 during many  sanguinary  emeutes,  and  the  four 
62       PROFESSIONAL REMINISCENCES.
days battles of the great insurrection, seeing enough
of fighting and  military surgery.   I passed several
months in attendance on the services of the noted
men of the time, in  the  hospitals and  elsewhere,
and  then visited  some  of the principal medical
centres, on the  continent and in England. . .  .
  In  i860, I made a more  extended tour, through
Spain, *  and  eastward as  far as Constantinople and
the Black Sea. .  .  . Desirous  of  acquiring  some
little knowledge of people in the ordinary exigencies
of life, in their homes as well  as in public institu-
tions, in most of the places  I visited I  sought op-
portunities to see private patients with some medical
resident, and this of course in addition  to the ordi-
nary  sight-seeing and routine  of  most  travellers.
Thus  in  Rome, after having done the city even to
a fearful descent into the catacombs, I  became the
guest of Dr. Valerj,  medical professor in the Uni-
versity.   Through him a door was opened to  things
not usually accorded to strangers.   He  showed me
hospital and private patients, and the medical col-
lection of the College.  One of the latter was  rather
unique,  representing the fingers  of  the operator
passing  into the abdomen through the walls of the
gravid organ at term, in  an attempt to dislodge its
contents!  Through him,  too, I  was made  a cor- 
         PROFESSIONAL REMINISCENCES.       63

responding member of "/' Accademia de' £hiiriti"
a then prominent Societ}' of all sciences.
  When in Rome we had an opportunity to witness
a "real miracle."  Some thousands had assembled
in St. Petei"'s,  to  assist in  the  canonization of a
saint.  Many hundreds of candles had been lighted
and  the  illumination was at the  point of comple-
tion,  when  a very long ladder  slipped  from the
hands of the workmen  and fell  diagonally  across
the multitude.   The  impending  fall had been no-
ticed  in season  for the crowd to divide, and to let
the ladder come crashing  down  without striking
any one.  As soon as the appalling murmur of the
terror-striken  mass  had somewhat  subsided,  an
official jumped  upon a seat and loudly proclaimed
that  no one had been  injured.   To the Pope, who
came in at this moment, the  circumstances were
explained and  the story of the wonderful escape
told, to his apparent great satisfaction.  The cere-
monies proceeded  without  further  delay.   The
next evening, as we  had predicted, an illuminated
broadside appeared attributing the complete safety
of the people to a miracle  of the new-made saint.
Dr. Valerj, however, whispered in my ear that he
himself  had that day  attended  three  premature
deliveries directly attributed  to  fright and  shock 
 64       PROFESSIONAL REMINISCENCES.

 from the accident!—but that how many more there
 were he had not heard.
   At Naples I was  present at the daily evening
 deposit in one of the three hundred and sixty-six pits
 in the Campo  Santo, the all-gathering  receptacle
 of the city's dead poor.  After a look into Hercu-
 laneum, a walk about Pompeii, and an  ascent of
 Vesuvius,  then  active on  its sides and  not very
 indolent on top, we went on, stopping a few hours
 at Messina and Malta, to the Piraens ; and thence
 to Athens by the Skele makra, or  at least where
 they should be.
  At Athens I was under the special charge of Dr.
 Roeser, the Queen's personal and household physi-
 cian, who was ever  at hand and constant in his
 attentions.   He took me  to the  Royal  Medical
 Society, where I was called  upon to talk of ether
 and  chloroform, and other  subjects of interest at
 the time.  A few days later the venerable  Rev. Dr.
 Hill  told  me that my  "assistance" and  remarks
 had been very kindly received by  the Society, which
 proposed to make me a corresponding member, and
that  the diploma would probably reach  America
before we did. *
  One day there was  a sham-fight, and the taking
of a  fortified place  just out of town, in which all 
           PROFESSIONAL REMINISCENCES.       65

  the available  troops were engaged  for the sake of
  practice.  This was led by the King and Queen,
  the Queen riding at the head of the attacking party.
  An officer  of  high rank, injured  by his horse's fall
  into a pit, was brought to a tent adjoining the King's
  pavilion.  Having been taken there  by Dr. Roeser
  to the injured  man, surrounded by their Majesties
  and high army surgeons, I  was requested, at the
  Queen's intimation, to make an examination of the
  case.   I did this and  made a  report,  which, corres-
  ponding to  the diagnosis already made, seemed to
  give general satisfaction.   I then went  with Dr.
  Roeser  to  the  officer's  home to  announce to his
 wife and family his condition, and  to prepare for
 his reception.
   At  Athens  I saw several  Greek  patients,  also
 through  Dr. Roeser.  One of these, a peculiarly
 sad-looking girl in typhoid fever, seemed very much
 pleased with my attendance.  As, at my suggestion,
 Dr. Roeser omitted medicine  for a day or two, the
 family were subsequently inclined to attribute to
 me her restoration  to safety and health.....

  At Vienna I went through the usual  rounds,
wondering, as 1 went, how careful  and painstaking
for science, "how careless of a single life."   I once
          5 
66       PROFESSIONAL REMINISCENCES.
saw there an eminent diagnostician literally almost
turn a man inside out for a slight external ailment
—examining every organ, cavity, and function, ad
absurdum;  till I could not help saying, as an old
neighbor  said  to me of  another's  practice:  " I
would rather trust old dame Natur  unaided, and
let disease have its own way," than undergo such  a
diagnostic preliminary investigation.....
  Omitting  many things—I must not  forget the
supremely cordial attentions from Dr. John Brown,
of Edinburgh.   Never was a kindlier reception af-
forded aliy one.  " Auld Reekie" and New Town,
and all in and about them, he would  have us see
and know ;  and  his delightful talks made the visit
most charming.  He  has recorded my call on him,
in his old quaint way, in " Spare Hours; Second
Series," page 328 :
  " I  was greatly  pleased when Dr. Cotting,  of
Roxbury, came in  yesterday and introduced him-
self to me by asking,  k Where is Dick? '  To  think
of our Dick being known in Massachusetts ! "
  Nor must  I  omit mention of my  very pleasant
call on the veteran, Dr. Stokes, at Dublin, and  my
visit to Meath Hospital.   If the full allowance to
the forlorn mortals there could be called " feeding,"
the wonder was what low diet would be.  Meagre 
         PROFESSIONAL REMINISCENCES.       67

soups or broths  may possibly be high  living  for
poor wretches  who naturally, as a  professor once
said to me, " never see a bit of meat from one year's
end to another." *

  In 1865, when in Brazil for other purposes, * I
visited hospitals in various places.   The principal,
Casa  Misericordia, at Rio  de Janeiro, especially
in  its  newer portions, was  a model.   Its  wards
were   arranged   around   pleasant  and  shaded
court-yards,  delightful to those in bed, as well as
to  the  convalescents resorting  to  them.  It was
notable, also,  for  its high ceilings, with windows
from  the floor upwards ; for absolute cleanliness ;
for the pleasing arrangement of its white-covered
beds, with their red blankets rolled into cylinders
at the foot-boards.   The medical attendants seemed
fully posted in all  the latest science  of the day,  and
were very considerate to the sick in  their charge.
   The  Dora Pedro II.  Hospital for the Insane, at
Botafoga,  is worthy of all  praise.   Our first visit
there is fully  described  by Mrs.  Agassiz in  her
"Journey in  Brazil,"  pp. 80-81,  where  also  a
picture-page gives a very good  idea of its situation
and the surrounding scenery.
   The Brazilians were then at war  with Paraguay, 
68       PROFESSIONAL REMINISCENCES.
 and the Emperor, ever on the lookout  for medical,
 as well as other scientific matters, called me to his
 palace to discuss with him  anaesthetics  and other
 methods of  care for sick and wounded soldiers in
 the field, naturally supposing  that  our long Civil
 War had taught something  in such  matters.  Re-
 collections of these discussions undoubtedly led His
 Majesty, when in  Boston, eleven years afterwards,
 to name  me one of the seven he asked  to breakfast
 with him.   With this in  mind, also, he was induced
 to wait over a day in order to attend the  annual
 meeting  of the Massachusetts Medical Society, and,
 contrary  to   his usual wont, to accept  honorary
 membership in the Society.
  And here 1 would  introduce an anecdote of  my
friend, the late Dr. Wucherer, of Bahia,—an extra-
ordinary linguistic scholar and learned physician :
  When  the yellow fever raged in  Bahia  (a few
years before I was there), to aid helpless sufferers
and to quiet the people, Dr. Wucherer took yellow-
fever patients into  his house,  and filled  his grounds
with booths and tents for those who could not find
other shelter.  For all this  nobody thanked him ;
while some  called  him foolish for so doing.
  A few seasons afterwards, an Austrian ship-of-
 war anchored in the harbor.  A sailor, on shore by 
          PROFESSIONAL REMINISCENCES.       69

permit, became ill, and the ship's  surgeon having
named the disease yellow fever, Dr. Wucherer was
called in consultation as an expert.  He found  the
surgeon  in  error, but, to save him from disgrace,
allowed  the name to stand, and kept  the patient
under treatment and isolated until after the  ship
sailed.  The surgeon was commended  for his pru-
dence, and Wucherer for his skilful services.
  Months afterwards, when the affair had entirely
passed from his mind, Dr. Wucherer was  sum-
moned from a social  medical meeting by an official,
to receive into  his  own hands  the heavily-sealed
credentials of Knighthood from the Austrian  Gov-
ernment!  The ship's captain had reported him as
having probably  saved the ship's  crew  from  the
dreadful  disease.
  He was  accustomed, facetiously, to  say of  the
whole affair,  that  " for serving  the  sick  and  the
public at the supposed risk of  his family and  him-
self he got nothing but reproaches, but, for acting
out a fractional white lie, he was knighted ! "
  Returning to America from Brazil  by way of
Europe,  then the only  direct way, I  visited  the
great  hospital of San Jose  in Lisbon,  where  the
ship made a stop  for supplies, etc.  I  saw there,
among other curiosities, an  apparatus for  the  pre- 
70       PROFESSIONAL  REMINISCENCES.

vention of ante-mortem  burials—a series  of rings
for the fingers and other  attachments, operating, on
the least motion, upon bells in a guard-room near
by.  Only once had an alarm been given, and then
in a  doubtful case, wherein death was indubitable
on the following day.

  On the evening of December 31, 1839, *  attended
the opening of the Lowell Institute of Boston, " as-
sisting" Dr. Jeffries Wyman, its curator.   In like
manner, and for like  purpose, I often went to the
lectures.  One season, I  had the full charge during
my friend's absence abroad.  On his resignation in
1843, I received  an  appointment to  the  position
which he  had vacated.   It has been  a good  thing
for me in  many ways—not the  least in  saving me
from becoming a stereotyped example of  my pro-
fession.  No stranger—and I have met with  many
—ever, to my knowledge, " set  me  down" as a
doctor of medicine from characteristic  manner or
conversation. *  One  often needs a stimulus to keep
him  out of the ruts of his calling; " bayonets be-
hind him," as an  eminent lecturer said to me not
long ago, " to  drive him  out  of routine  tenden-
cies." '   Besides, it gave me some acquaintances of
inestimable value.  To it I owe the ever-continued 
          PROFESSIONAL  REMINISCENCES.       71

and  confiding friendship of the late  Prof.  Louis
Agassiz.  He always, to the last, made my  house
his resort for rest from  the labors  and anxieties of
his multifarious enterprises and schemes—one time
remaining six weeks or more.   He, with Dr. A. A.
Gould, gave my home its name, • and always mani-
fested great affection for it and its inmates.
  In 1S53,  I  was elected a fellow of the American
Academy of Arts and Sciences, a  further evidence
of the affectionate regard of Drs. Hayward and A.
A. Gould, and Professor Agassiz.
  On retiring from its council by legal  limitation I
started a  subscription,  which resulted in a liberal
fund for printing  the Academy's  papers, " a good
plant springing from the seed you sowed," said, in
a  recent  note to me, the treasurer in office at  that
time.  In presenting my offering  to start a'project
which had  for a time been ineffectually talked of, I
merely added that I felt  it to be the most valuable
paper it was  possible for me to offer the Academy
for the advancement of science. '
  The State Medical Societies of  New Hampshire
and  Connecticut gave  me  most grateful evidences
of good  will  and kind consideration,  by electing
me to Honorary membership.   With the members
of these  associations I  have  passed  many most 
 72       PROFESSIONAL REMINISCENCES.

 pleasant and improving hours of professional profit
 and friendly enjoyment,—especially with  those of
 the  former Society  on  their semi-annual  social
 re-unions. *

   One day, in the earlier months of my practice, a
 vagrant near by my  office, despairing of being of
 any further use to the community, swallowed nearly
 two ounces of arsenic, and I was  called to smooth
 his way out of  the world.  The  affair becoming
 somewhat notorious, the then editor of the Boston
 Medical and Surgical fournal called on  me for
 notes of the case.  He was ever  on  the  alert for
 remarkable cases, and I could not resist his persist-
 ent importunities. *  This was the beginning and the
 cause, on the principle that one good turn deserves
 another, of a multitude of articles and scraps which
 editors of the  Journal  have subsequently, from
time to time, drawn from  me to fill up with when
other practitioners, older,  abler and more experi-
 enced, had declined.   Every thoughtful and pro-
gressive  practitioner  necessarily wishes  to keep
himself  informed  of the improvements  in  the
science  and art of his  calling, and to know how
others are treating disease.  This can be done only
through periodical  publications, wherein  for  such 
          PROFESSIONAL  REMINISCENCES.       73

purpose each should  feel bound to contribute his
portion to the general stock.   The  usual plea that
one  has not anything of interest or value amounts
to nothing.   Even the most trivial case may unex-
pectedly  prove of importance.    The  immature
report of the case just alluded to became the basis
of a  solid argument  in a  capital  trial  not  many
years afterwards.
  One of my papers had unusual sequences—mind,
I do not say consequences.   In 1852 the reader for
the annual meeting of the Norfolk District Society
failed near the last  moment,  and I  was "pressed"
in to  supply his place.  The paper which was then
read  the  Society voted to  print.  I resisted ;  but
after  six  months' importunities surrendered it to
the Secretary.   He published  it in the Medical
fournal.  '  Some  time  afterwards  the then vene-
rated Nestor of the profession addressed me with
some  friendly  criticism, and, in   conclusion,  re-
marked :  " Well,  I shall have to write you young
men  a letter."  His " Letters to a  Toung Physi-
cian" followed.  While this volume was in prepa-
ration another professor,  getting a  little the start,
issued a  collection of papers under  the  title of
" Nature in Disease."   This happened by chance
to be the title of my own paper above referred to, 
 74       PROFESSIONAL  REMINISCENCES.

 published two years previously.  He came to me
 with the proof sheets and  asked  me  to  write  a
 notice of his book for the Medical fournal.  I did
 so, and had  the satisfaction of hearing  myself ac-
 cused of officiousness and playing "toady"  to  a
 great man.
   A copy of this book having been sent to Sir John
 Forbes, then writing on similar  subjects, Sir John
 called his next publication " Nature and Art i?i
 the  Cure of Disease" avowedly based on the title
 of the book  sent to him.  Not  long afterwards  a
 third professor called at  my  house, and, after al-
 luding  to  the other professors'  publications,  and
 adding that  he, too, probably  had loose papers
 enough to make a similar volume, produced a big
 bundle and asked  me to arrange, edit, and publish
 the same!  This cost me midnight oil for a number
 of winter weeks thereafter.   The  work appeared
 with the title of " Surgical Reports" and I wrote
 a  notice for this also, by request.
   I may add  further that on the appearance of Sir
John  Forbes's  volume, Dr. Jacob  Bigelow asked
 me to collect, edit, and publish with him a series
 of suitable medical books and  papers, the series to
 be entitled " Rational Medicine," and the  first
 volume to be a republication of Forbes.   Dr. Bige- 
         PROFESSIONAL REMINISCENCES.       75

low wrote  a  preface for the series, and I gathered
together documents for the  second volume.   A
publisher had already begun  his  part when a re-
print of Sir John Forbes's  book appeared  in New
York and killed the scheme. Dr. Bigelow's preface
was  afterwards published in his " Modern In-
quiries" where also, p. 245, may  be found a list of
my collection, with one addition, which Dr. Bige-
low insisted on including in the number.
  A rather unusual concurrence of  sequences this,
after all.

  Thus it was that I happened at  first to be called
upon  to contribute to the Boston Medical and
Surgical fournal. Thus it  was that  I became
interested  in its welfare, and  was induced to help
fill it up when others  did  not.  In  later times the
demands for "copy"  became quite frequent.  In
1872 the editor was taken very ill  and  obliged at
last  to  give up  his  charge.   The case seemed
desperate,  and  1 was called upon  by the assistant'
and requested to " lend a hand."  After months of
continued  exertion with his able aid a new interest
was  awakened, especially in the  younger  men.
The  present plan was  adopted,  and  more than
thirty medical  men (besides  editor and  assistant) 
 76       PROFESSIONAL REMINISCENCES.

 were secured as regular collaborators, and  put in
 responsible positions in its service.  Moreover, the
Journal was purchased  of  the  publishers, *  who
 had owned it  for many  years, and placed  in the
 hands of the profession.   All this of course cost
 time, labor,  and thousands  of dollars, cheerfully
 bestowed without  a  farthing's return to those who
 contributed, * except the  abundant  satisfaction of
 seeing a worthy and prosperous medical journal in
 the possession  of the profession, solely for their
 use, and  wholly independent of external  or trade
 influences. *  It  is but fair to  say, however, that the
 former owners of the fournal were in its  manage-
 ment ever unselfish and liberal toward the profes-
sion so far as permitted by its limited patronage.

   It seems to have been fated that I  should have
 more than an  ordinary share in  "mending"  the
fortunes of Medical Societies.
   In  1S42,  I was asked  to  become the President
and revive the Boylston Medical Society of Harvard
University, a Students' Society, but having a young
 graduate for its chief officer.   For several  years it
had been dead,  buried, and  apparently past resur-
rection.  Taking five or  six students  into  confi-
dence and telling them  my plans, we formed a 
          PROFESSIONAL REMINISCENCES.       77

 governing board, and announced by a large printed
 placard  a  meeting of the Society.   This done,
 inquiries of  its  nature  and objects  soon  became
 frequent.   Meanwhile (all the Society's previous
 records and regulations  having been irretrievably
 lost), we had adopted by-laws, and began to admit
 members, by ballot,  on condition  that they would
 take active part in its exercises and pay an entrance
 fee.  Thus  membership  soon became  a  privilege
 and a distinction. *   Good work was done, and the
 College year ended with a full and  active Society
 of over forty members.  The same plans have been
 continued, with like  success, to the present time.
  I was sought out and called to preside at the first
 meeting for the formation of the Obstetrical Society
 of Boston ; and afterwards when, in the commotion
 of war time and from other causes, it seemed about
 to expire, I then, with a member, now years ago
 gathered to his fathers, arranged the plan by which
 it has enjoyed unusual prosperity ever since. '
  In 1855, on the lamented death of my class-mate,
Parkman, I was chosen to  his place as recording-
secretary  of  the  Massachusetts  Medical  Society.
How this could  happen  greatly disturbed some of
my  professional neighbors who, I hope, were satis-
fied when they were told, by one of the gentlemen 
78       PROFESSIONAL REMINISCENCES.

himself, that two of them had proposed my election
without consulting me, and without any knowledge
on my part of their purpose.   I was continued in
the office and that of corresponding  secretary for
more than eight years.   Among other labors I
prepared a Digest  of  the  State Laws relating to
the Society, and suggested  and carried  through a
number of its more important By-Laws ;  notably
one on ethics, then suggested, afterwards adopted,
and  now in  active force, by  which  all personal
matters, and  matters of discipline, are at once re-
moved from  public meetings,  where  they  always
created great disturbance, and relegated  to a stand-
ing committee, to be dealt with according  to merit
—in private. *   I also prepared the " Annual  Dis-
course" read to the Society in  1S65, which created
unusual  discussions  and  criticism ;  and   I  had
thought  with that  my duties done, and  my course
finished with the Society.
  But when, some years later, the Society was in
need of renovation and awakening, I was  asked,
at whose suggestion  I  never knew, to assist with
others in  restoring  its former  prestige,  and  in
placing it on its present prosperous course.   It was
a laudable project and was supported by the best
men  in  the  profession all over the State.   But it 
         PROFESSIONAL REMINISCENCES.       79

required much labor, and not a little self-sacrifice.
What was  done  is well known  to  the profession.
Called and convinced of the necessity, I  trust that
I did my share of the  work.  Many disinterested
fellows  were personally engaged  in  the matter, and
the results  seemed  to  gratify the well-wishers of
the Society.  . .  .
  Thus the  State  Society,  now  on its  renovated
career, is  a power for good to the  profession,  un-
surpassed by any institution of the kind in the land.
Its  membership  gives to the community also  the
surest  evidence  it can  have  that the aspirant for
practice is a Regular Physician—a happy term, '
a truly  fortunate one, as it indicates that its posses-
sor has taken in preparation the  regular estab-
lished  course, approved from all time ;  that he is
thoroughly loyal to professional  obligations ;  that
he  continues regular in  following with assiduity
every laudable means to acquire, from  every and
all  sources,  any  and everything that will conduce
to the good of the sick, and the advancement of his
Science and Art,—untrammelled  by dogmas, unre-
strained by sects, and not bound to any "exclusive
or  irregular system" ;  never fearing to heed  the
dicta of nurses, when apt  and fitting, or the wl say-
ings" of old women—willing even ab hoste doceri. 
80       PROFESSIONAL REMINISCENCES.
  To this large and influential Society, now num-
bering  over sixteen  hundred  members, and  ever
increasing,  the profession,  and  the individuals'
composing  it, may look  for adequate support, and
a high position which not all the laws of legislatures
can  insure, and,  if but true to itself, not  all  the
machinations of detractors and charlatans can  ever
take away.
  The local semi-social  association, the " Roxbury
Society for  Medical Improvement," has  had from
the start my earnest efforts, and whatever  I could
do for its interests and prosperity.
  And further, I  am  the only surviving member
of the committee  appointed to organize this, the
Norfolk District Medical  Society, in 1850.   Its
early  developments were  not  fully  satisfactory.
Social meetings having been suggested to increase
good fellowship, to bring out greater numbers and
to incite them to extra work, I  was the first to have
such  meetings  at  my  house;  and  subsequently
there were  many  more such  at the same place,
with best results.
  For a long time this  Society was noted  for the
social and friendly relations of  its members, among
whom, from the  first, were as  high-minded  and
true men—able and experienced —as ever belonged 
          PROFESSIONAL REMINISCENCES.        81

to the profession.   It was a pleasure and privilege
to be associated with them.   I  cannot withhold an
instance of the amenities of times alluded  to.  The
late Dr. Monroe, Sr..  was always  my opponent in
Society discussions—and  naturally so, being as he
was, originally, of the  most "heroic" school.
   Once hearing that I was to read a  paper, he rose
from  a  sick bed, came to the  meeting (where he
was  obliged  to  lie upon  a sofa),  and  earnestly
assailed my positions.   After adjournment he called
me to his side, said that he was ill, and  wished my
diagnosis and advice.   I  took him in my  chaise to
my own  house, where he remained  several davs.
During  this time I examined  his case, gave him
my opinion, and my advice which he promised to
follow.
   In illustration of our contention :  Dr. Monroe
always  declared that  membranous croup  could be
"broken  up"  without failure,  by heavy  doses of
subsulphate  of mercury ;  that, with  this remedy,
he never lost  a case  in  that disease.  I, on  the
contrary, maintained that it was a self-limited  dis-
ease, especially dangerous  by  its local affection ;
that, when  recovered  from, it was through  the
normal  separation of the peculiar membrane ;  that
the inhalation  of soothing vapors was most likely
           6 
82       PROFESSIONAL REMINISCENCES.

to bring on a favorable issue, while  more humane
in any event;  and  in  such discussions as ours, no
case should be cited, unless the characteristic tubular
membrane  had been secured, before or after death. *
To  which  he would  rejoin that the subsulphate
arrested any such formation or tendency to it, and
therefore he could not exhibit a membrane as I had
done.  I again answered that  the drug had never
had this effect on any case where I had seen it
tried ;  and that I  could only say that probably, by
some fortunate chance, the  real  disease  had not
appeared  in his  circuit,  for I  had  known of its
absence from places for a  long  time, to return and
prevail again without known reasons. *  If it had
been  in his  town, I  thought, cases  must have
occurred wherein  the membrane had  completely
formed before he  could have  been called to  the
patient,— the disease often being so insidious as not
to  be  recognized until danger from  the membrane
is  imminent.  For example, I  once  gained greater
reputation for predicting a fatal result than in any
successful  case of  the  disease.   The child was
called in  from  its play in snow-slop in the street.
The  disease was found fully  developed ;  but my
opinion that there was hourly danger was  indig-
nantly scouted by the bystanders.  The child died 
          PROFESSIONAL REMINISCENCES.        83

before the next  morning;   and for years, I was
pointed out by amazed  attestants as the man who
said the child would die I
  Thus we argued, earnestly  but without  offence.
We could differ radically on professional questions
without personal estrangement.
  At one time this Society was one of the foremost
in the State in active and   good work, and its ex-
ample aroused other societies from their lethargy.
  It is now looking up again ;  and, under  its pres-
ent able and efficient officers, and its intelligent and
aggressive leader, permeated  with the new  and
fresher blood of  its recent  acquisitions, bids fair to
regain its old position among the District Societies,
and to be a source of usefulness to the profession
and the public, as well as to its members.
  The  social  reunion to follow this meeting  is a
proof, perhaps the last  one I can give, of my con-
tinued belief in the real utility of mingling pleasant
with useful  things, even  at meetings for the  ad-
vancement of  science.

   How it happened that I  should  get involved in
so many  of these and such like professional matters
outside  of  my personal routine work, I  cannot,  I
must repeat, even now comprehend.   It  certainly 
S4       PROFESSIONAL REMINISCENCES.

was not of my  own  seeking.   Much of it was
foreign  to  my personal instincts and private in-
terests.  No selfish motive could ever have induced
it.  I had  all  the practice I wanted.   The  labor
required, turned   to  personal  ends,  would  have
greatly increased  my acquisitions ;  the time taken
could have been occupied with far more congenial
matters; and  the money  spent,  from  my  own
earnings solely *  (literally, from first to last, more
than "tithes of all I possess"), would be a  very
desirable addition to the little  I have been able to
accumulate for the shutting-in clouds of life.
  I sought no place,  but  whenever duties  were
imposed on me  I  have endeavored with  earnest
effort to perform them. •   I never  expected any
personal advantage therefrom, and,  to  the best of
my knowledge, never received  any.  Performed as
duties, if any  good  has resulted to the profession
that is a satisfaction.  If not, the intention and the
effort were there all the same.

  In  a former part of this  paper  I told of my
studies  in  the natural history of disease, and  how
it was shown that, disease having a  beginning,
middle and ending of its own, medication, however
useful it might be, was not essential  for restoration 
         PROFESSIONAL REMINISCENCES.        85

to health.    I  have  myself been  through several
severe attacks without resort  to  drugs.  A few
years ago, during an unusual prevalence and fatality
of the disease, I passed safely through a desperate
attack of acute pneumonia without a particle  of
medicine of any kind ;  to the anxious apprehension
of attendants,  who  thought all was over with me
on that account.  Even in the occasional delirium
my wishes were complied with in  respect to medi-
cation.  Convalescence was as speedy and perfect
as it ever is,  and no  vestige of disease has remained.
  With  such experiences, strange as it may seem, I
have a stronger faith  in drugs than  in  my earlier
days—in their proper places.  Their proper places,
however, are not in " breaking up " disease, or in
continuous administration during its usual course.
  It will be  a happy day for patients, to say nothing
of the true  physician,  when the medical attendant
can  unreservedly speak to confiding  and obedient
listeners, the  solemn  truths of his  profession in
regard to  its  limitations.   Invaluable and  indis-
pensable as  the profession is and  always will be to
individuals  and  to  the community, its worth rests
on  far  different  foundations  than a  capacity  for
dosing.   In this  respect I cannnot forbear re-quot-
ino-  the words of Dr. Moore (the father of Sir John, 
S6        PROFESSIONAL  REMINISCENCES.

the hero of Corunna), as  true now and ever will be
as when uttered a hundred years ago :   " The dif-
ference between  a good  physician and  a  bad one
is certainly very great; but the difference  between
a good physician and  no  physician at all, in many
cases, is very little" *—a  truth worthy of all accep-
tation.  A good physician, often seeing  that his
patient  will  be  as  well,  if  not better,  without
medicine, will, regardless of outside pressure how-
ever great, wisely withhold it.   "Fools rush in" is
a fraction of a favorite quotation of an old profes-
sional  friend, which at the present time I forbear
to complete.
  I have myself proved,  to my own satisfaction at
least, that drugs are no  more  requisite  for the
" cure" of disease than splints are for the  healing
of fractured bones.  Both  may be of greatest service,
but neither are absolutely necessary, and on neither
does recovery actually depend.  I have successfully
treated  many  hundreds of cases of disease without
drugs, and a few fractures without splints.   One of
the most satisfactory unions of a fractured  clavicle
in an adult was so treated ; * and I have seen results
quite as good  as  after best attention and care, in a
case of a smashed-up elbow (condyles, olecranon
and  all), when  undesirably  left to itself, unsup- 
          PROFESSIONAL REMINISCENCES.       87

ported after first  adjustment.   This is no argument
against splints, or drugs even, but shows  only that
they, while useful,  are not necessarily essential.
  Nature indeed restores the sick and  the injured,
but  the  physician  should "cure"  the patient  by
taking the  most judicious care of him.   For the
present,  and, if  "indications" are of any worth,
for some time to come,  the physician's duty will
chiefly consist in restraining his own and  people's
tendency to over-dosing, and perturbating  interfer-
ences.   It is truly a pity that the ill should have to
endure so much  more than their ailments, from the
hands of mistaken kindness.
  The  inordinate  use of quinine  affords a  good
illustration.   Its  reputed power  to  "jugulate"
intermittent fever has induced  its  almost universal
use  for  all  manner  of diseases,  especially where
any  periodicity can be attributed to the ailment, or
any  " malaria,"  so-called, suspected,  however ir-
rational  such suspicion may be.   The evil thus done
can  hardly be over-estimated.  It  may be doubted
even, speaking not without some knowledge thereof,
whether the " quininism," or " quininitis," thus en-
gendered, worse sometimes than the original disease
itself uninterfered  with,  may not more than  over-
balance  any " jugulation" ever actually effected, so
recklessly has the drug been used. 
88        PROFESSIONAL REMINISCENCES.

  Moreover, its reputation as a " specific" has  led
to an amount of harmful  experimentations,  in  the
hope of finding " specifics" for other diseased, that
is painful to contemplate.  Possibly more  mischief
has  resulted from this source  than all the good
achieved by the drug, even taking the estimation of
its most ardent advocates.
  More  than three  million (3,000,000) ounces of
quinine were consumed in the United States alone
last year (1886), and  the amount used is greatly on
the  increase.  What if it were  all of  standard
quality and strength ! •
  But the popular idea  of a physician,  and  the
necessity of drugs, even  in the profession itself, is
far different from that we advocate.  Most  people
regard  a doctor, especially  their  own  attendant,
skilful, if a ready doser,  one who can hit upon the
right medicine even without examining the patient.
More than once have I, in case of supposed  urgency,
to satisfy an eager demand for it, sent a remedy (a
harmless  one of course),  ahead by the messenger,
and, on my arrival,  found friends assiduously ad-
ministering it.  Tins before I had  seen the patient
or had any  adequate  idea of  his  malady.   Think
for a moment how unwise their so doing ;  and  yet
these people were accounted  among the  most in- 
          PROFESSIONAL REMINISCENCES.       89

telligent in the community !  '  On the other hand,
and  not  a  solitary instance,  a  well-to-do  patient
has objected to his bill, saying:  "No doubt you
have  made the visits, but  only  on three or  four
occasions did you write a recipe.  I am willing to
pay for  those,  but not  for  visits  when you did
nothing."
  Many persons like to  have their ailments  magni-
fied, as  though it  were a meritorious  distinction,
but in attendance  upon  my patients, whether  rich
or poor, I have always  endeavored  to render their
calamity (for sickness is a  calamity and nothing
else) ' as little dispiriting and otherwise burdensome
as possible.  I was never an alarmist.   Having an
eye to the possibilities of the situation, I have made
everything  as  quiet as  practicable with  as  little
disturbance to family routine, and, I may add, with
as little expense ' as circumstances permitted.  San-
itation, so-called, has not been  neglected—guided
not by rules, often  absurd in given cases, but by
what  little common  sense I  possessed, and by the
possibilities of improving the surroundings of the
case.   As to the patient  himself,  I  have sought his
best treatment  as a sick man rather than as a  man
sick of a nominated disease. *  Depending less on
routine prescriptions than on general rational man- 
90       PROFESSIONAL REMINISCENCES.

agement, I have of course been guided by the best
diagnosis of the case obtainable by myself, or others
when assistance  seemed  requisite.    Still  I  have
always, regardless of pecuniary or personal conse-
quences, withheld  drugs  as far as  possible,  as I
would wish done  in my own case in like circum-
stances.   This having  been generally understood
from my start  in  practice,  has deprived me of the
patronage  of a number, who said that when they
were sick  they knew that  they needed medicine,
but if they sent for me  they were not always sure
to get it.
  Nevertheless, as new  medicines   and methods
have been  suggested, I have tried them  as oppor-
tunity offered, in order that I might not be rightfully
charged with  ignorance or  unreasonable doubt  of
their value.  In reviewing my cases  I find no cause
to regret omission.  I wish  I could conscientiously
say  the same  of professional commission.  May I
not  charge some  of the latter to  the  irresistible
tendency of the times?

   General office practice I have always avoided,
wishing my house to be my home,  a private resi-
dence,  as  much  as possible.   I never  had  office
 hours. 
         PROFESSIONAL REMINISCENCES.        91

  Practice as  a consultant I  never inclined  to,
being, constitutionally, in a great measure unfitted
for it.   It has cost me more for consultations than I
have ever received from them.   After a consultation
I have too often lost  the patient;  sometimes to the
consultant, who should never take a case in  such
circumstances!   Autopsies in my  circuit,  when
paid for, have been usually paid for by myself.

  Having known much of the profession from very
early youth  upwards,  with a somewhat  clear ap-
prehension of its responsibilities and difficulties, its
perplexities  and trials, I entered it  in  the  laudable
hope of  gaining  an honest  and reasonable liveli-
hood, and of being  able to render adequate service
in  return.   I  do not remember that I  specially
considered,  as  some  pretend to,  the  profession
as  one to "do the  most  good in."  I  diligently
labored to, be able to do " well" (as  my first patient
expressed it) the duty of a good " family physician "
in the full sense of the term,  as then understood—a
term almost without meaning  at the present day. *
Further than that no definite purpose entered into
my anticipations ; certainly no ambition, or thought
even, for place or position.   If either of these have
fallen to my lot, a more selfish temperament would 
92        PROFESSIONAL REMINISCENCES.

have saved me from yielding to others' wishes and
accepting them.   Position  could give nothing but
discomfort to one of  my disposition ;  my profes-
sional work was enough, and more than  enough,
to occupy all my time.   I had nothing personal to
gain by taking office, but much to lose in case of
unsatisfactory discharge of its duties.  I  have no
apologies, however, for self-forgetfulness  in these
matters ; let others take warning and do better.
  As a  result, I have no complaint to  make against
the world, professionally or personally, having de-
liberately determined,  in whatever state therein to
be content.   If any have differed from me,  or taken
offence, they have been allowed to  go their own
way unmolested.   I have seldom, if ever, stopped
to notice  abusive words or acts, to which  all in a
really active  life  in every profession are  more or
less subject.  Fortunately, very few such hrve ever
come to my hearing ; and those have fallen generally
upon deaf ears. '
  In my  dealings with professional  brethren, as
well as  others, I have always striven to ignore any
such neighborly tendency in  human beings,  and
have especially endeavored  not to allow the possi-
bility of anything of the kind to have influence in
any  public or private  act of mine.   The  medical 
          PROFESSIONAL  REMINISCENCES.       93

profession, through its constant contact with misery
and affliction, naturally tends to moderate personal
estimation and  to  assuage personal griefs.   What
are such trifles to the actual trials of the wretched ?
Its members are often unjustly reproached as being
over-sensitive and quarrelsome.    There  may be
such ill-constituted mortals in  it (they  are every-
where),' but the truth is, no other calling, as such,
engenders  so much fraternal  respect   among its
members,  or can  show  more numerous instances
of  enduring friendship—-in my  own  case it has
enhanced one which has lasted from infancy, now
so many years.   "Who shall decide when doctors
disagree,"  was  originally said of  casuists, not of
medical men.
  The profession demands of its members, through-
out  their whole career,  a cheerful willingness to
devote more than  half their time and  labor to the
fitful needs of illness  and penury,  without  thanks
or  hope of  pecuniary reward.   It even expects
them to become, as it were, upper servants to the
rich, and   attendants-of-all-work  to the helpless
poor ;  and in  its own uncertain  issues gives but
little chance  for assumption and false pride.  It is a
calling often to be tired by, but never to be tired of.
It offers little promise to seekers  of personal ease, 
94       PROFESSIONAL REMINISCENCES.

or expectants of large possessions.  Nevertheless,
its compensations are neither few nor small ;  and
its brotherhood is not among the least of these.
  Qua? cum ita sint—in spite of the initial famine
incident to  the profession,  and the inevitably slow
advancement  in  it—a patient's confidence, as  said
an eminent professor, being  the hardest thing  to
acquire and the easiest thing to lose ; * in  spite of
its privations and hard work ;  in spite of its annoy-
ances and  trials ; in spite of its reputed jealousies
and  quarrelsome habits  (which, after much  and
long observation, 1  can  confidently aver are much
less  than among pure scientists and literary men,
or in other  professions,  restrained as medical men
are by  a  reasonable  etiquette) ;  in  spite  of its
vexations and unrequited  efforts;  in spite of its
thankless patients and wilful  maligners ;  in spite
of defections, when and where least expected, un-
explained and unexplainable ;  in spite of all these
drawbacks, so much and so often  complained of,
but  no  greater,  probably, than in other callings
— I  am fully persuaded that  even the  life of a
physician is worth living.
  In so long and  so  varied  a service, there must
have been  many and  great shortcomings.   These
doubtless are better  known  and more fully appreci- 
          PROFESSIONAL REMINISCENCES.        95

ated by my neighbors than by myself.   Thus am I
rendered happy in  the conviction that  any attempt
on my part to recount them on the present occasion
would be merely a work of complete supererogation.
  " A man's life," said the wise man, " is like an
arrow  shot through  the air, leaving  no mark";
fortunate, we may add, if it  reach the target aimed
at, though it hit not the bull's-eye.
  For myself, the arrow has nearly sped its course.
How far short of the target it will have fallen  may
soon be known ;
              — moriturus sum —
and  if,  perchance, a  professional  epitaph be ever
sought  for—to indicate  a  life-aim, and to conform
more nearly to truth than most such tributes to the
dead, let it be :
     HE CURED  THE  SICK WITHOUT  DRUGS. 
 
NOTES.
  The inverted period (•) in the text indicates a note;  which
         may be found below by the prefixed page and line.

  P. 7,1. 3.—See Phi Beta Kappa Poem, Harvard University, i8n,by
Jacob Bigelow, M.D., LL.D., etc., our " American Hippocrates."
  P. 7,1. 12.—Fevers, the first e as in prey — Hibernice.   Dr. O. W.
Holmes said that every young Doctor's new sign declares this.
  P. 9,1. 10.—George Hayward, M.D.,  etc., Professor of Surgery in
Harvard University.  The silver pitcher, now in possession  of the
Massachusetts Medical Society, he gave to  me, some years later.
  P. 13, 1. 1.—I was happy to have present  at the reading a gentle-
man, the friend of my earliest youth, who was with  me and assisted
in the  operadon just referred to — W. W.  Wellington, M.D., etc., of
Cambridgeport,  Mass. — and who, too, was not one of those  who
counselled hesitation.
  P. 13,1.3.—This instance  shows that  the youngest beginner  may
have to confront at once most difficult and  trying cases.
  P. 15,1.19.—Among unusual and notable  courses, which I attended
and took notes of, were those on the  Eye and Ear,  by Dr. John
Jeffries who only, beside Dr. Edward Reynolds, then gave " especial
attention " to affections of those organs.
  P. 16, 1. 9.—Friend W. reminds me that  we were once sent, in our
student days, to ask for an autopsy of a child we had seen with our
teacher. We attempted to persuade the mother to consent by stating
the importance of the procedure — that we wished to know the results
of the disease, and that we felt  sure that the time would come when
she would be very glad that the examination had been allowed.  She
cut us short with the significant question, " And what's the good of a
doctor who cannot tell what ails a child until after it is dead? "  We left.
  I once made an autopsy on  condition  that the  diseased por-
tions  be  carried off—the widow insisting that nothing morbid  be
buried with her husband.
            7 
98         PROFESSIONAL  REMINISCENCES.
   P. 24, 1. 3.— Loammi Baldwin, Esq., then Superintendent of the
 building of the United States  Dry-Dock at Boston Navy Yard
 (Charlestown), told a young applicant for apprenticeship, that " to be
 a good engineer one should know how to bore with a jack-knife and
 to whittle with a gimlet."
   The member  alluded to was  the  late Horatio G.  Morse,  A.M.,
 M.D.—a quiet, unpretentious but able  practitioner, much esteemed
 by a large circle of patients and friends.
   P. 26,  1. 7.—These pills were at one time in great repute with the
 towns-people;  one  good old maiden lady declared to me that  she
 could not do without them, for she  " had all her life-time been sub-
 ject to bondage."
   P. 27,  1. 6.—The  late Dr. John B.  Brown, of  Boston—a very
 ingenious man, and quite an inventor.  I have a cane-gun, of his
 construction, with which I have captured many a specimen.  I some-
 times made plaster casts for him, previous to and after his operations
 for club feet.
   P. 28,1. 10.—A few years ago an absurd story was started, but was
 soon cut short.  It was that I always  gave a new-comer a horse or a
 vehicle 1   It had some foundation, it is true, inasmuch as I had given
 to three young practitioners one or  other of these articles—rather
 worn perhaps, but with several  years  good service  in them still
 remaining.  To six or eight others I had done as much, in the way of
 rents, loans, assistance, small appointments, always privately, some-
 times without the knowledge of the  recipients—this  in addition  to
 unnumbered patients transferred as occasion permitted.
  In two or three instances only was  evil towards me attempted in
 return—in spite of the saying that " if you wish to make a man your
 enemy, do him  a favor."
  P. 28,1. 16.—The selling of a practice,  the taking a portion of the
 gains of a locum tenens, or the receiving  of a  percentage on recipes
 from a conniving apothecary, through  an  agreed-upon  cypher or
 otherwise, I never could see the  professional morality of, though
 advocated and practised, it  is said, by  some  prominent practitioners.
 Each laborer should be worthy of  the proceeds of his own work, and
 should receive  them;  even the fee for a single visit for another__■
 unless on all sides " a labor of  love."
  P. 28,1. 26.—It would  " do me proud " to tell of the  first class of
these patients.  I will mention one of the second—one only—unpar-
 alleled, I  hope, hereabouts, but in  result not of the worst kind.  One 
NOTES.
99
winter's night, in a storm of rain and sleet, a wretched mortal sought
shelter in a deserted, windowless, tumble-down shanty, and took to
its half-submerged floor.  By day-light severe cold had followed the
storm.  Discovered by her cries and groans, she was found frozen to
the floor with, at her side, and still attached to her,  a new-born
infant—seemingly kept from freezing to  death by  its convulsive cries
and  sobs.  Sent for at once, I attended to her needs.  Kind persons
soon arrived.  But to release the patient from the  floor, to which she
was frozen, required strong arms, and the use  of  laborers' shovels—
she being literally shovelled up.   Removed  to comfortable  shelter,
and properly cared for, she and her child did well.
  Among not a  few strange cases that might be mentioned, one
may be related for its extraordinary  singularity.   Two school-boys
had  a difference  through rival interests in a young lady of their
acquaintance.  Taking with them a mutual friend, another lad, and
a single pistol, they retired  to  a wood to adjust the matter.  Having
drawn lots, they took their places.  The  first boy's fire was without
effect.  The friend then prepared the pistol and gave it to the other
boy, who also missed his aim.   But the  first, on again receiving the
pistol, was more deliberate, and this time  hit his antagonist. The ball
struck upon the clavicle, glanced over it,  diagonally to the shoulder—
a narrow escape.  Honor  satisfied—the  wounded boy was taken to
his home, and I there removed the bullet  through  a counter opening.
  For a case of small-pox of peculiar origin,  see  Boston Med. and
Surg. Journal, August 10, 1882.
  P. 30, 1. 2. —One year I had (unrecorded except on lists to  prevent
neglect  by overlooking)  four  hundred  and ninety three separate
poor patients, not up  to the grade  of  so-called " charity " cases.
Some  of these  I  attended many  weeks,  occasionally aiding with
supplies, &c.
  P. 30, 1. 24.—Among the anomalies  in this  regard—a parish once
discussed the propriety  of raising their clergyman's salary, one argu-
ment brought forward  being his large  doctor's-bill—I, the medical
attendant, having never charged  a fee  or received  any remuneration.
  The clergymen,  whose  families I have attended, have generally
been very appreciative ; and loyal to the regular medical  profession.
One of the noblest and most eminent of them left  me gracious words
and a legacy of five hundred dollars.
  P. 31,1. 24.—On one  occasion, a father  wishing to weigh a very
large child, sent  Bridget  for  scales. She  brought  a  small pair. 
 IOO        PROFESSIONAL REMINISCENCES.

"Those will not  do," said he, "they are not half large enough."
" Oh," said Bridget, " then put 'im in twice."
  Sometimes the calculations of the most experienced will fail—e. g.
 two patients, multiparse, engaged  the same  nurse for  consecutive
months.  She attended them both, in the inverse order of the engage-
ments—the one a month  before, the other a month after the care-
fully estimated and expected time.   Both  children appeared to be of
full term.
  P. 34,1. 11.--The portion of the original paper omitted  at this  place
may be found in Boston Med. and Surg. Journal, Jan. 5, 1888, p. 6.
  P. 37,1. 21.—Boston Med. and Surg. Journal, Sept. 19,  1861.
  P. 37,1. 24.—Ibid. Feb. 13, 1862.
  P. 42, 1. 15.—" Perpendendce et Numerandoc Observatidnes " was the
motto of a Paris Medical  Society.
  P. 42,1. 23.—In the discourse on " Self-Limited Diseases," delivered
before the Massachusetts Medical Society at the Annual Meeting in
May, 1835, by Jacob Bigelow, M.D.,  he gives the following definition :
  " By a self-limited disease, I would be understood to  express one
which receives limits from its  own nature, and  not from foreign
influences; one which, after  it has  obtained foothold in the system,
cannot in the present state of our knowledge be eradicated or abridged
by art—but to which there is due a  certain succession of processes,
to be completed in a certain time, which time and processes may vary
with the constitution and condition  of the  patient, and  may tend to
death or recovery, but are not known to be  shortened or greatly
changed by medical treatment."
  Velpeau's answer to Leverrier in the  Academy of Sciences  (in
 1865) is worthy of constant remembrance.  "Many affections yield
without treatment, and, it must be acknowledged, sometimes in spite
of all treatment.  To this fact we must not be wilfully blind. * * *
After the exhibition of a  remedy, the  symptoms have yielded  once,
twice, thrice, or oftener;  hence it is  inferred that the cure has been
in consequence of the treatment.  The inference is a natural one, but
 almost invariably incorrect."
  P. 43,1. 4.—See Boston Med.  and  Surg. Journal, July 4, 1872.
  P. 43,1. 8.—The late Joseph H. Dorr, M.D., etc.  He was the most
accomplished conversationist I ever met with.
  P. 44,1. 27.—Although  the doors  of the Society had been liberally
opened, for twenty years  or more, and frequent requests had been
made for these irregulars to withdraw quietly and without  observation, 
NOTES.
IOI
they would not leave; but, while defaming the Society as superannu-
ated and " bigoted, " they well knew that they derived standing from
its membership, and therefore resisted with all the public noise and
tumult possible, to the very last, every attempt to  dislodge  them.
The Supreme Court, which they invoked to their aid, confirmed the
Society in its rights.  From this  time these irregulars and their sup-
porters lost caste.  " No one knows except one of ourselves," I  heard
a prominent one of them assert  in a  lugubrious manner  before a
legislative committee, "what a daily trial it is to practise our system
since the Massachusetts Medical  Society put  its ban upon it."  No
doubt  he was  right, for the community  had thus  found  out  the
worthlessness of the system in the opinion of those best able to  judge
of it.   Every one, nowadays, who  resorts to it seems to feel obliged to
give personal excuses or apologies for so doing.   Nothing of the kind
appears to be required of those employing regular physicians.
  The Society gained prestige and power by its action in this matter,
and never stood so high in the estimation of all as at  the present
time.   It should keep wholly  aloof from any  kind of affiliation with
irregular organizations, however plausible the motives of advocates.
It has never accomplished any great good or obtained any advantage
by readiness to favor proselytes from other associations.
  More recently a younger practitioner of the same " school" is said
to have  remarked that it  was  not  pleasant to be  considered "a
knave  or a  fool"  for so  practising, or, as  he might  have said  more
truly, for pretending to so practise.  Some ways are indeed  ways of
pleasantness; others are not, even if for the time pecuniarily profitable!
  P. 47, 1. 13.—See also Typhoid Fever in Limited Localities, Boston
Med. and Surg. Journal, Feb. 4, 1869, p. 5.
  P. 48, 1. 9.—See Disease, a Part of the Plan of Creation—Medical
Addresses.  D. Clapp & Son, 1875.
  P. 49, 1. 15.—Roxbury City Documents, No. 7, Jan. 31,  1849, p. 61.
  P. 50,  1. 18.—Some leading apothecaries  about this time  were
reported to have said that, in their estimates, a very much less amount
of medicine  was  then given in  the neighborhood than that dis-
pensed for the same number of similar cases before my coming to
Roxbury.
  Within a year one of the most prominent of Boston's apothecaries
said to me in a confidential way that he " never knew or heard of a
physician who could get  so  little  medicine into a perscription as"
myself, but that " no complaint had ever come to his knowledge that 
 102        PROFESSIONAL REMINISCENCES.

my prescriptions were less efficacious than those of other practitioners
—quite the contrary."
  Not  a week ago another nearer home, equally well qualified by
age and experience, stated that " many years ago the contrast, in this
respect, between the recipes received  from me and  those of other
local prescribers had often been not unfavorably noticed and com-
mented on in his establishment." But these are merely straws.
  P. 50, 1. 25.—The Works of Hippocrates, Vol. 1, p. 162—Syd. Society
Edition.
  P. 57,1. 2.—See Boston Med. and Surg. Journal, March 10, 1870.
  P. 59,11. 7 and 12.—F. W. Goss, M.D., &c, Rec. Sec. M. M. S.   See
Boston Med. and Surg. Journal, July 23,  1874,  also April 25, 1878.
  P. 59,1. 21.—See paper by G. E. Hersey, M.D., in New Hampshire
State Medical Society's Communications.  1875, p. 39.
  P. 60.1. 18.—" Nouveau Systeme de Deligation Chirurgicale," Paris,
1838.   By the way, the inhabitants of Lausanne were a staid  and
reasonable people.  When I was there in 1848 they had temperance
societies, which  restricted the members  to  two bottles of wine each
meal.
  P. 61.1. 1.—Boston Med. and Surg. Journal, April 7, 1887.
  P. 61,1. 8.—Sometimes a  subscription is raised by neighbors and
friends to pay for an operation;  but for my part I never could consent
to accept a fee on such t^rms.  I have  preferred to take my share in
the charity, though this has not been always adequately or correctly
appreciated.  I  once took a man's leg off in the field when a terribly
crushed foot and ankle seemed  to the attending physician to forbid
his removal at once.  The patient recovered " remarkably well."   The
operator only suffered in a few dollars for injured instruments, &c. &c.
  In the coldest day of the following winter the  fellow called me out
into the freezing air to demand an artificial  limb! As I had cut off
the real one, he  had a just claim on  me, he said, for such a substitute!
One could have wished him in a warmer place!
  P. 62,1. 8.—Occasionally we had  a little  adventure somewhat but
not strictly medical to enliven our progress. In Spain travelling was
mostly by night—in a kind of a composite omnibus, there being  then
but one  railroad, that  from  Valencia to Madrid.   One night  near
Carolina we were stopped about midnight  by  military officials, made
to descend  to the road-side, and be put  through a thorough exami-
nation, lest we might be of the party, spies  perhaps, of  an insurgent
then attempting a Revolution.  No  indignity however was offered us, 
NOTES.
IO3
 and after awhile we were released, and the vehicle allowed to proceed.
 Subsequently on going from Gibraltar to Malaga in a steamer, over-
 crowded with Spanish troops returning from Algesiras, we gained a
 little idea of what our situation, in restraint and sanitation, might have
 been as military prisoners under suspicion.
   P. 64, 1. 24.—I returned my acceptance of the honor conferred upon
 me in a Greek letter which President Felton, H. U., said was a credi-
 table performance.  I  have since bad  several  Greek letters  from
 Athenian physicians; notwithstanding Greek is said  to be a  dead
 language, not worthy the attention of educated men.
   P. 67, 1. 4.—Losing my way in Dublin, I asked  a  trig and trim
 policeman the direction of St. Stevens Green.  " Go," said he, " right
 square round, to the left, and you'll soon find it after mating (meeting)
 you."   Pretty well for a native!
   P. 67,1. 5.—I went to Brazil, chiefly if not wholly, to see other coun-
 tries and other scenes, especially those in the Torrid Zone. Early in the
 winter of 1864-5, Prof. Louis Agassiz  consulted me with reference  to
 his taking a vacation.   He was not well, was greatly overworked, and
 an entire change,  with  complete rest from his many labors  and
 anxieties, seemed  essential  for re-establishing his health.   It was a
 question with  him whether to make a tour through his  old European
 resorts, or a voyage  to Brazil—the Emperor having urged him  in
 autographic letters to visit that  country.  At length  he decided to go
 to Brazil.
   Not long after this decision, he invited my wife and myself to accom-
 pany Mrs. Agassiz and himself.   It would be a private affair—a simple
 party of four  friends,  " une partie  carrte"  as  they called it while
 discussing the matter  with us.   But, after personal preparations were
 quite completed, unforeseen events occurred which gave the project
 somewhat the  character of a public  expedition.  Thus labors  were
 imposed upon Prof. Agassiz, certainly not contemplated  in the original
 advice and plans, which were rather for diversion and relaxation.
 Before this, however, it had been mutually agreed that in any event I
should return, if possible, in season for the Lowell Institute Lectures
in the coming autumn—even if he found it desirable to remain longer.
  Wc went as arranged, from New York in a chance steamer, a new
ship  going to San Francisco to  join the Pacific Line.   We  were to
return as opportunity  offered,  by way of Europe probably as there
was then no direct communication  with the United States.  It hap-
 pened that when on our part we had accomplished most, if not all, our 
IO4        PROFESSIONAL  REMINISCENCKS.
original purposes, and many more not  contemplated,  a  chance
offered  itself in a favorite  ship  going to  Southampton.   Taking
affectionate leave, therefore,  of our friends in  their ever  increasing
scientific accumulations, we crossed and  recrossed the ocean, and
reached home within a few hours of the time originally designated.
  P. 70,1. 20.—A short time  ago  a newspaper, recognizing this ten-
dency, said that " a doctor or a lawyer, or a merchant-chief, wears
the stamp of his profession with a less  distinctive assertion than an
instructor  of youth."  This "stamp" or "assertion" thus recog-
nized I have always endeavored to avoid.
  Another paper recently said that I " had  heard more good lectures
than any other man in the  country."   It may be so, for very few bad
ones  have  ever been heard at  the  Lowell Institute.  Prof. Louis
Agassiz always asserted that there was nothing  of the kind equal to
these lectures except  at the Sorbonne at Paris.
  P. 70,1. 24.—In connection with the Lowell Institute, among  other
things, I devised a drawing school of a  somewhat peculiar character.
  In the spring of 1850, when about  to leave for Europe for several
years, the Trustee, John Amory Lowell, Esq., wished me to establish a
Drawing School before his departure, and  to have it in full operation
on his return. I thereupon submitted to him, in writing, two plans; and
he selected the one that was afterwards  followed.
  It was peculiar in that it required  the pupil to begin, and to con-
tinue through his whole course, to draw from real objects only —" the
round"  as technically called—from cubic forms  up to  the living
model—and  never from copies  or " flat" surfaces.  The principle
and plan, as well as most of the details, were of my own devising.  In
very few drawing schools of the country, if  in any, had "the  round "
nominal place up to that time, and its  exclusive  use  obtained  in none
so far as known.
  After preliminaries were arranged, it was found  difficult to get a
teacher who would undertake to  carry  out such a  plan.  Very few
believed in  it. Some  months later in the following summer, by chance
I overheard an artist, not  then a teacher, express at random views
somewhat similar to those  incorporated  in  my  plan.   He  knew
nothing of this proposed school, or what plans were already prepared.
I interviewed him. After numerous meetings  and much persuasion,
with great distrust on his part, his services were secured.   He proved
a most successful teacher,  and as long as the school lasted continued
its chief. His enthusiasm was its life ; his devotion its unfailing support. 
NOTES.
105
  The school began in the autumn of 1850.  At first it met with much
criticism and ridicule from  professional teachers and others; but it
soon grew popular with pupils.   Many curious anecdotes  might be
told of its early days, and of its later progress.  Its chief, Mr. George
Hollingsworth, was an original; and his efficient assistant, Mr. William
T. Carlton, also had valuable parts.
  This  school  continued more  than a quarter of a century—was
eminently successful—and had the satisfaction of being imitated all
over the country, almost to an  entire  revolution in the teaching of
drawing.   Nowadays  no school or  teaching is  without  its " real
objects"—on its programme, if not in actual use.  In 1878,  on the
loss of its rooms taken for commercial purposes, to  the  regret of
many applicants, the school came to an honorable termination.
  P. 71,1. 6.—Called Kci)£iKa&&ui>,  or K. K. for brevity—a  name in-
vented by Prof. L. Agassiz,  Dr. A.  A. Gould,  and myself, at one of
our many pleasant reunions within its walls.
  P. 71, 1. 21.—I was, for about fifteen years, a trustee of the Roxbury
Latin School.  Mr. Israel M. Spelman, H. U. 1836 (now Of Cambridge)
and myself, as a sub-committee built the present Latin-School house
—a cheap affair, one may say, but it is  said to be the only one here-
abouts built within original appropriations.  (See Dillaway's History
of the School, p. 96.) It is as good as the houses the pupils come from,
and in my opinion that's good enough.   It were well, for pupils who
attend and  parents who pay for them, if there were more like it,
instead of the costly structures  with their many flights of stairs and
other objections.
  In putting me on to the building committee, the late Rev. Dr. George
Putnam, the chairman  of trustees, said " I put him on for he has
more to do  than any of us;  and the man who has the most to do,
can do the  most additional work; we  want the building within the
specified time."  The building was up and occupied as desired.   Mr.
Spelman was a man of promptness and energy; and " further this
deponent may say naught."  The late Mr. Weston, a veteran school-
master,  not long ago  said " It is  the best  school  house I  ever
taught in."                                '
  P. 72, 1. 4.—I  have seldom received a higher compliment, or  one
more keenly appreciated, than when Prof. A. B. Crosby asked of the
society to be allowed to  personally  present to me in full meeting the
diploma  of  Honorary Membership.  His fraternal confidences  were
most grateful and  assuring—conveyed  in terms so kindly  flattering
            8 
106        PROFESSIONAL  REMINISCENCES.
that even the bravest heart would  have quailed.  That mine nearly
collapsed need not be affirmed.
  P. 72,1. 14.—Boston Med. and Surg. Journal, March 7, 1838, p. 78.
  P. 73, 1. 17.—Entitled  Nature in Disease.  See Boston  Med.  and
Surg. Journal, October 13, 1852.
  P. 75,1. 20.—Frank W. Draper, M.D.,  Med. Examiner, Asst.  Prof.
of Legal Medicine, Harv. Med. School, A.A.S., &c.
  P. 76,1. 3.—Mr. David Clapp, a gentleman to whom the profession
is in many  ways greatly indebted,—for  loyal zeal and interest in its
support through many years.   He owned and managed the Journal
from 1834 to  1874—his son becoming his assistant and partner in
later years.
  P. 76,1. 12.—A  full account of all these  matters  and the plans
devised has been recorded in a report to the owners of the Journal
by William L.  Richardson, M.D.,  Prof, of Midwifery, Harv. Med.
School.  The report is not yet printed, but should be.
  P. 77,1. 10.—People do not  care  for what they can have at any
moment for the asking.  The Society had  expired of inanition after
years of free entrance, without restrictions or conditions of any kind,
and without assessments—come and go when you please and do as
little as you please—defects,  sufficient to ruin any society.  Even
larger institutions nearly succumb to such methods—through which
laxity the most offensive or least desirable always thrust themselves
in, and  capture by stratagem the offices—conferring notoriety on a
few, honor on none.  Is not the " Great  American " a conspicuous
example?
  P. tj, 1. 20.—Any one  interested  may find a full  account in the
Historical Sketch prepared and printed for the Society, 1881.
  P. 78,1. 15.—This  by-law has proved  so efficacious, that,  as  a
member of the present committee recently told me, cases of  com-
plaint or misdemeanor are becoming less and less  frequent under
its enforcement, and the committee's decisions.
  I once, some years  later, by appointment  and direction of the
Councillors of the Massachusetts Medical Society, made a collection
of all the Ethical rules in force in, or adopted by, the profession and
medical societies, here  and elsewhere;  and, reducing details to the
simplest terms, compiled a draft-code of " positive laws " for our State
Society.  This was  not accepted,  but  instead of  it an  imperfect
abridgment of the self-same (printed) draft was adopted—one which
by  its  generalities  and  "etceteras"—its imperfect  foundation  on 
NOTES.                        I07
 implied  "principles,"  is  rendered  nearly  nugatory  or valueless.
 Judge Cooley says :  Corrective judgments cannot be based on pr'mci-
ples unless the principles are made into positive laws.—Const. Limi-
 tations, ch. xiii. 472.
  In explanation of this seeming inconsistency of the Councillors,
 some rather pessimistic individuals unreservedly  intimated that the
positive laws of the  draft-code, if adopted, would press too heavily
 on the pedal digits of  many of the  limping objectors; and thence
 their tears !   What an  unwarranted intimation !
  The compilation, drawn from  all  quarters of the globe,  showed
 that everywhere the profession makes laudable  effort to  restrain its
 members from objectionable and trade-like practices, which,  small
 or great,  ultimately injure  individuals resorting to them, and degrade
 the profession in its own estimation and in the  estimation of the
 public at large.  That there is ever recurring need of such restraint,
 even  upon  those who perchance—though thus  unworthily—hold
 prominent positions,  the  profession of  London has had  painful
 experience during the passing winter.
  P. 79,1. 13.—My friend  Dr. Townsend, of South Natick, says  the
 term  is  an  " unfortunate"  one.—Mass.  Med. Soc.  Com., 1887, p.
 12.   Unfortunately for me I cannot agree with him.   We have
 indeed the same spirit, but  I would  adhere to the old term, with all
 its associations.
  P. 80,1. 3.—If some complain that the Society is of no use to  them,
 such  complainants have generally  been  of the least  use to  the
 Society;  been remiss in dues while asking concessions, and unwilling
 to leave  or resign fellowship.   The Society can well afford  to let
 such depart on the first intimation.
  P. 82, 1. 4.—This disease  is quite  a different thing from  the  so-
 called " croup " which children are sometimes  said to be " subject
 to " (a phrase which shows its freedom from danger).  The latter is
 often  noisy  and  frightening, but  is  in reality  a  comparatively
 harmless accompaniment of " colds " and similar affections, and re-
 quiring no separate treatment. The frequent applications of mustard,
 iodine, tobacco, and other  stupes, with  vomitings by subsulphate,
 antimony, or ipecac, and even venesection (jugular), are all harmful
 cruelties.  A little pleasant drink  may be useful, but is not essential.
 If left alone it will soon pass off.  Soothing care will re-assure  the
 sufferer, often terrified  out of his wits by the onslaughts upon him.
  P. 82,1. 14.—I may add, as a curious fact, that  in  my own neigh- 
108        PROFESSIONAL  REMINISCENCES.
borhood where I have formerly known it to  occur at the same time
in several families, and several cases in a  single family, there  has
been for years little or no membranous croup, some prominent prac-
titioners not yet  having seen a case of it here.  Of a truth  the
migrations of disease are beyond our ken.
   P. 84,1.9.—My donations were not from inherited abundance (my
share I  allowed to be divided  among  other heirs who needed it
more), nor from an overflowing purse, but from  moderate savings, a
portion of which I was willing to  part with for the important objects
in view.  I feel constrained to say this to correct a current error, and
to prevent further misapprehension.
   P. 84,1. 15.—As  a  matter of fact " the Peerage sought me, not I
the Peerage."   " But," as a commenter, not  given to commendation
nor then apparently  intending  it, recently said, "when you went
in, you went in all  over ! "  This, if I  understand myself, is rather a
characteristic—quiescent, shrinking  even, quite  willing that others
assume tasks  or  undertake enterprises, and have the honors and
emoluments resulting from success  in them; but, when called  out
and motives given, inclined at once to take full interest and to  spare
no labor or effort in accomplishing the object—tenacious to the last.
   A readiness to name others for  prominent  places of trust or honor
led immediate  friends to call  me "John"  (he  was bidden  while
asking for another)—a sobriquet  not uncomplimentary nor untrue.
   As all reserve with  the reader has already been thrown off,  I  feel
impelled to give an abbreviated extract or two from the numerous
letters received from friends on retiring from the Presidency of the
Massachusetts Medical Society in 1876.
   Samuel A. Fisk,  M.D., an ex-president of the Society, writes :  "In
review—It  was a  success!   From the first to retirement, your ad-
ministration has been marked by great interest in the Society and its
welfare.  Such was the testimony as it came on all  sides; that the
administration has been unusually successful, and that the condition
of the  Society was never so good  as on the day you gave up the
chair.  * * *  And then what a blaze of glory you went out in—an
Emperor to grace your retirement!  * * * one so filled with learning
and so  sensible in all his ways, in  honoring whom  the Society has
greatly honored itself.   The rest of  us have heretofore thought a
Governor quite enough to assist at our meetings, but you alone will
have the honor of presenting the  Society to an Emperor." 
NOTES.                        IO9
  Edward  Jarvis,  M.D., of Dorchester, for twenty years  the  most
active of secretaries and fac-totum of the Norfolk District  Society—
than whom no one could speak more authoritatively of my " sacri-
fices "  (as he calls them) for the various societies and professional
matters we were interested in, having followed me up for all  such
things with pitiless demands and importunities; and he it was, I dis-
covered after his death, who latently named me for many  places of
responsibility and work—Dr. Jarvis, indulging in unusual laudation,
says : " Your administration has been remarkably successful.  You
have discharged the fanctions  of your office with ability, energy,
faithfulness and wisdom.  Never has a President watched the interest
of the  Society so closely, and labored for them with more devotion.
I am grateful for what  you have done, and doubtless every member
of the Society feels thankful to you for your sacrifices  and  your
influence in behalf of its prosperity."
  Joseph Sargent, M.D., of Worcester, my college class-mate, and
Vice-President of the Society, declining  promotion, jocosely  said:
" You have filled the chair so amply that any other man would seem,
for a time at least, to be only rattling about in it."
  P. 86,1.6.—Med. Observations, John Moore, M.D., Lond., 1786, p. 21.
  P. 86, 1. 23.—This patient took the responsibility, and would not
permit bandages or other restraining applications.  He put himself
in the most comfortable  position he could, in  bed;  and  allowed
pillows only to be placed about the shoulders for needed support.
  Some  French  veterinary surgeons  have  recently  been  treating
fractures in animals  without splints or other apparatus, and claim
unusual  success.—Journal de  Medecine  et Chirurgie  Pratiques,
February, 1888, p. 65.
  P. 88, 1. 12.—I  had  once a  somewhat singular experience with
quinine. A very long time ago a  family that I attended  moved to
Virginia.   Some of them, returning for a visit to friends, experienced
while here  their well known symptoms of " chills and fever "; and
sent for me. Thinking that in  this region these symptoms would
soon spontaneously pass  away, I suggested a  little  delay before
medicine, but at once found they would  be satisfied with  nothing
less  than the reputed specific, and that they must see its name on the
recipe.   Therefore, I wrote the following in the usual forms: Mix a
grain of quinine with one quarter of a grain of morphine,  and make
twenty-four pills of the  compound; take three to  six of these pills,
p. r.«., at suitable  intervals, each twenty-four hours. 
IIO        PROFESSIONAL  REMINISCENCES.
  Before my next visit, an unexpected summons took them back to
Virginia, and I never  saw  them again.  Years afterwards the war
came on and armies separated the South from the North.  In some
untold manner this family succeeded in getting a letter to me through
the hostile lines to a northern post office.   The  letter simply said
that, having been driven from their home, in the total wreck of every-
thing they had lost their recipe.  They wanted a copy.  They stated
emphatically that originally  it had  immediately  restored  them to
health—that they had given the medicine to  unnumbered neighbors
and persons afflicted as they were, and always with marked success!
  What if intermittent fever should  sometime be acknowledged to
be after all a self-limited disease, a not very unreasonable expectation.
It is not a new thing to so consider it   A century or so ago,  Pinel
confirming Pussin's observation, that, in his own department, certain
affections become  their  own remedy, added that  this  happens
" de la mime maniere qu'on voit souvent la  cause des fievres inter-
mittentes se  delruire par son nombre d'acces deter mini!'—Cm; a.MS,
Paris, 1828, Vol.  II. p. 371.
  A name on a  recipe often  has a wonderful  effect.  The patients
above  would never have been " cured " had the  desired one been
absent.  I  have had other similar  instances;  a patient in  painful
malignant disease, who  took with avidity and great comfort as well
as advantage, hundreds of full  doses of morphine  under a different
name, would invariably experience great commotions, violent head-
aches, vomitings, etc.,  if the real  name appeared on  the recipe,
though the whole quantity prescribed did not contain a thousandth of
a grain.  This was observed in the case by others as well as myself.
  In the first eight or ten years of my practice, including  pupilage,
I gave quinine right and left, according  to rule, and in full doses, to
all cases considered suitable for it.  I made many ears ring and buzz
from its so-called cinchonism, but never obtained  any special good
from the drug—any that  could not be as quickly reached by  less
damaging measures. Since then I  have not  administered an ounce
of the  drug, all  told.   Verily,  nominis  umbra sometimes seems as
substance itself, without disastrous results afterwards.
  P. 89, 1. 1.—I have always tried to impress  upon my patients  that
it is better to wait and  do nothing  than to administer medicines in
ignorance of their nature and of  the  nature  of the disease, often
quoting the saying of Prest. Kirkland, H. U., that  "when you know
not what to do, take care lest you do you know not what." 
NOTES.
Ill
  P- 89,1. 7.—I was once asked to give in my fees that the deceased
might have a larger or a little more elaborate monument!
  P. 89, 1. 13.—I never knew  of but  one person made  permanently
better by disease.  In this case a violently ugly temper was decidedly
mollified  by a chronic  affection  which ultimately  destroyed life!
Generally, disease is damaging, often ruinous, morally and physically
—a few post hoc cases giving a different but not well founded impres-
sion.  Disease may  sometimes temporarily sharpen intellect, as in
some cases of on-coming fever or some  forms of insanity, but even
Pliny (the younger) would not have written as he did (to  Maximus,
VII.  26) had  he been a practising physician.  His subjunctive ut
perseveremus,  however,  is indicative  of distrust in his premises.
Profitemur infirmi—not to  become monks, any more than the fallen
angel did—hypocrites rather.
  P.  89, 1. 18.—More than  one subsequently  paying family  has
recently told me that had I exacted  payment  of them in their early
struggles and first years of sickness, they could never have risen out
of their poverty.   And these were never considered " poor people."
Nor is such experience peculiar to one neighborhood.   It is  related
of a notable family by one of themselves, " our circumstances have
been such that the increase of expense which would necessarily have
attended upon the sickness of any one of us  might have reduced us
to real distress."—Cabot's Memoir of Emerson, 1887, Vol. 1. p. 28.
  P. 89, 1. 25.—Possibly this may be  cavilled at as unscientific treat-
ment of symptoms or attention to non-essentials, but we are inclined
to think that pain, more than any other thing, primarily induces a sick
man to send for a physician ; and that distress (real, or  apparent as
in some convulsive actions where the patient  is unconscious)  excites
greater alarm and sympathy, often, than  real  danger unaccompanied
by suffering.  At any rate to gain  confidence  and control, in peace
and quietude, such things must be early  attended to, and  the physi-
cian who ignores this (the  necessity of attending to symptoms) loses
half the battle from the start, no matter how correct his  diagnosis or
how new  and scientific his routine  prescriptions or appliances—fre-
quently unnecessary it may be, not to say sometimes injurious.
  P. 91, 1. 21.—The London Lancet, Jan.  7th, 1888, on " The Family
Physician of  the  Future," says,  "The  general practitioner of
the future, we consider, should still  essentially resemble his prede-
cessors.  More learned he certainly will be, as well as  more skilful
in details  of practice, because endowed  with  greater advantages of 
 112         PROFESSIONAL  REMINISCENCES.

training; but he will also, doubtless, like them, continue to  treat the
whole man by prevention and  by cure, and will be limited in the
exercise of his functions  only by necessary considerations of time
and opportunity."
  P. 92,1. 20.—Every mortal, unless utterly insignificant, will some-
times be obliged, however unwillingly, to repel aggressions  by word
or deed. In a few, very few, instances, professional or other, being
constrained to do this, and having done it, I trust, effectively—I have,
" with malice towards none," let the matter go, disremembered, into
the waste-basket of forgotten things.   It would be difficult,  at this
late day, to recover therefrom shreds enough to patch up a connected
story in any instance. "Carper"  must, therefore, forgive me for not
gratifying his request to give " some  disagreeables" to  qualify the
story of a seemingly contented and prosperous life.
  P. 93,1. 8.—Were  one  perfect,  that  alone would be sufficient to
induce detraction from the envious and ill-disposed.  Why are you con-
tinually abusing----(the questioner's friend, whose better reputation
greatly annoyed the assailant), was asked of an ugly and quarrelsome
fellow.  "Oh," said he,  " he has  no pluck, he won't fight!"  The
friend, however, thought that, as it takes two to make a quarrel, he
would  have no contention with such   a person, and so contented
himself with ignoring the abuse and its author, to the latter's infinite
vexation.  The true way  to treat such  fellows, evidently.
  P. 94, 1. 8.—I once lost  a profitable and apparently  devoted family
for  not seeing the father in a crowded  street-car.   That he saw me,
and did not speak to me, was of no account!   My offence was  un-
pardonable, and they were ever after my professional detractors.
  P. 1,1. 8.—Erratum insuave—for III. 19, read 11. 19.

  N. B.—The foregoing Reminiscences—originating as narrated and
begun  for a  temporary  purpose—grew, fragment by  fragment,  to
unwieldy quantities, which  threatened to become interminable.
Selected portions  were  read  to  the  Society (October 25th, 1887)
as required; and, subsequently, the Editor of the Boston Medical
and Surgical Journal was allowed to take what he wanted for that
publication.  Hence a  reprint;  with  Notes, illustrative or  addi-
tional.  The outcome of flattering  hortation, frailty apparent, its utility
                     vehementer addubitem. 
V .
PROFESSIONAL
REMINISCENSES
/
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