THE MEDICAL WISDOM OE MARK TWAIN By LOUIS J. BRAGMAN, M.D.

SYRACUSE, N.Y.

SEARCH through the works of needed for his father, who up until the time of Mark Twain for material touching his death was prostrated every spring with on medical topics reveals a wealth “sun-pain,” an acute form of headache, of references, all the more inter- nerve-racking in character, and a complete esting for the extreme diversity of content. obstacle to any kind of labor. AWhether to be found in the swift stroke of His wife was a frequent source of solici- a maxim by “Pudd’nhead Wilson,” or in tude, as she was an invalid the greater share the casual reminiscences of his boyhood of her life. A fall when she was about days, or in the well-rounded phrases of one eighteen had left her paralyzed. Despite who has seen and pondered much, there arc persistent treatment she had remained always to be gleaned ideas of more than unable to Finally a widely-heralded passing worth for the physician. For he quack healer was summoned. Inasmuch dealt with medical matters as with other as he, in miraculously short order, restored subjects, purely in the light of an absorbing her power of locomotion, it is not too pre- phase of human activity. sumptuous to state that there could have There is but narrow ground for specula- been no organic disturbance. However, this tion in attempting to derive the source of episode was bound to leave an impression his medical wit and wisdom. Discerning no upon the anxious husband and to direct the particular contact with the healing profes- trend of his later thoughts. sion other than that which is encountered One of his daughters suffered from epi- by any cosmopolite, one is compelled lepsy and was treated for a time by Kellgren, to fall back on the medical experiences who was popularizing in London what were that occurred directly within his own called the Swedish movements. Although at family circle. first he was strongly enthusiastic, Mark He himself was of a high-strung and Twain later admitted that her progress undoubted neurotic make-up, as is evi- was discouragingly slow. Her death in her denced by many events in his colorful early twenties following a convulsive seizure career. He often fell into states of pessimism, was a severe blow to him. and once declared that around 1866 he had He survived her by only four months. felt so despondent that he put a loaded “He was tired, and with Jean’s death his pistol to his head, but found the final strength snapped.” courage to pull the trigger lacking. These scant items truly provide a slim It was furthermore his lot to bear the background for his many ventures into the constant harrowing burden of chronic bron- medical sphere. Perhaps it was, after all, chial colds and rheumatism. Of angina merely the universal interest that notes on pectoris, which terminated his life at the health and illness always arouse that age of seventy-four, he remarked: “This is prompted his pen on these occasions. The such a mysterious disease. If we only had truth remains that he left behind many a bill of particulars, we’d have something medical facts and fancies of worthy and to swear at.” enduring caliber. He was well acquainted with the ways of the family doctor, as will be seen in his The Mind of Man various comments on the stern allopathic Insanity. The murder of the Empress days of his youth, with the inevitable heavy of Austria1 by an obscure, “mangy tramp” dosings. Medical attention was frequently caused him to express the opinion that: No man has a wholly undiseased mind; that the insane, we should run out of building one way or another all men are mad . . . materials.” All the whole list of desires, predilections, aver- Brain versus Mind. In a philosophical sions, cares, griefs, regrets, remorses, are discourse5 attempting to prove that man is incipient madness, and ready to grow, spread, an automaton, he submitted the viewpoint and consume when the occasion comes. There that “A man’s brain is so constructed that are no healthy minds, and nothing saves any it can originate nothing whatever. It can only man but accident—the accident of not having use material obtained from the outside. It is his malady put to the supreme test. merely a machine and it works automati- Of the relation between psychosis and cally, not by will power.” crime he wrote2: As an example of the materialistic nature Insanity is certainly on the increase in the of the mind, he argued to this effect:5 “A world, and crime is dying out. Formerly if you cracked skull has resulted in a crazy mind. killed a man, it was possible that you were Why should that happen if the mind is insane—but now, if you, having friends and spiritual, and independent of physical influ- money, kill a man, it is evidence that you are a ences? . . . When you have a pain in your lunatic. In these days, too, if a person of good foot, you do not feel it until the nerve reports family and high social standing steals any- the hurt to your brain. Yet the brain is thing, they call it kleptomania, and send him the seat of the mind.” to the lunatic asylum. If a person of high social Mental Telegraphy. He was a firm standing squanders his fortune in dissipation, believer in the workings of the phenomena and closes his career with strychnine or a bullet, described under this head. He himself “Temporary Aberration” is what was the invented the phrase which later was altered trouble with him. to read “mental telepathy.”6 Is not this insanity plea becoming rather common? Is it not so common that the reader I have never seen any mesmeric or clair- confidently expects to see it offered in every voyant performances which were in the least criminal case that comes before the court? . . . degree convincing . . . but I am forced to Of late years it does not seem possible for a man believe that one human mind (still inhabiting to so conduct himself, before killing another the flesh) can communicate with another over man, as not to be manifestly insane. If he talks any sort of a distance and without any artificial about the stars, he is insane. If he weeps over a preparation of “sympathetic conditions” to great grief, his friends shake their heads, and act as a transmitting agent. fear that he is “not right” . . . Really, what The Decline ofi the Mind. A note on this we want now, is not laws against crime, but a topic recalls an old controversy:6 “Is it law against insanity. true that the sun of a man’s mentality In a similar vein he dedicated one of his touches noon at forty and then begins to books “To the Late Cain”3: wane towards setting? Dr. Osler is charged Not on account of respect for his memory, for with saying so.” it merits little respect; not on account of sym- pathy with him, for his bloody deed placed him Clini cal Obs erv ations without the pale of sympathy; but out of a mere The Black Death. While journeying human commiseration for him that it was his through the Orient4 he came in contact misfortune to live in a dark age that knew not with the ravages of the bubonic affliction. the beneficent Insanity Plea. “The plague,” he related, “carries with it a He summed up his attitude on the impor- terror which no other disease can excite, for tant problem with the following witticism:4 of all diseases known to man it is the “The way it is now, the asylums can hold deadliest . . . ‘Fifty-two fresh cases—all the sane people, but if we tried to shut up fatal’: It is the Black Death alone that slays like that.” It was truly malignant with its Teratisms. He has described here a “terrors that creep into a man’s heart veritable pathological side-show, of which at such a time until they themselves breed he himself was an eye-witness:20 the fatal sign in the armpit, and then the If you would see the very heart and home of delirium with confused images . . . and cripples and human monstrosities, go straight then the sudden blank of death.” to Constantinople. A beggar in Naples who The following especially vivid passage can show a foot which has all run into one which he thought worthy of quoting at horrible toe, with a shapeless nail on it, has a length is by Kinglake, an English traveler fortune—but such an exhibition as that would who was in Cairo during an epidemic of not provoke any notice in Constantinople . . . the Black Death:4 How could he stand against the three-legged woman, and the man with his eye in his cheek? The parched mouth is a sign—his mouth is How would he blush in the presence of the man parched; the throbbing brain—his brain does with fingers on his elbows? Where would he throb; the rapid pulse—he touches his own hide himself when the dwarf with seven fingers wrist (for he dare not ask counsel of any man on each hand, no upper lip, and his under jaw lest he be deserted), he touches his wrist, and gone, came down in his majesty? Bismillah! feels how his frighted blood goes galloping out The cripples of Europe are a delusion and a of his heart. There is nothing but the fatal fraud. The truly gifted flourish only in the by- swelling that is wanting to make his sad con- ways of Pera and Stamboul. viction complete; immediately he has an odd That three-legged woman lay on the bridge, feeling under the arm—no pain, but a little with her stock-in-trade so disposed as to com- straining of the skin; he would to God it were mand the most striking effect—one natural his fancy that were strong enough to give him leg, and two long, slender, twisted ones with that sensation; this is the worst of all. It now feet on them like somebody else’s forearm. Then seems to him that he could be happy and con- there was a man further along who had no eyes, tented with his parched mouth, and his throb- and whose face was the color of a fly-blown bing brain, and his rapid pulse, if only he knew beef-steak, and wrinkled and twisted like a that there were no swelling under his left arm; lava-flow—and verily so tumbled and distorted but dares he try?—in a moment of calmness and were his features that no man could tell the deliberation he dares not; but when for a while wart that served him for a nose from his cheek- he has writhed under the torture of suspense, a bones. In Stamboul was a man with a prodi- sudden strength of will drives him to seek and gious head, an uncommonly long body, legs know his fate; he touches the gland, and finds eight inches long, and feet like snow-shoes. He the skin sane and sound, but under the cuticle traveled on those feet and his hands, and was as there lies a small lump like a pistol-bullet, that sway-backed as if the Colossus of Rhodes had moves as he pushes it. Oh! but is this for all been riding him . . . Ah, a beggar has to have certainty, is this the sentence of death? Feel exceedingly good points to make a living in the gland of the other arm. There is not the Constantinople. same lump exactly, yet something like it. Have Note on the Awa Root. In Honolulu24 he not some people glands naturally enlarged?— saw the following: would to Heaven he were one! So he does for himself the work of the plague, and when the A crowd of natives [was] buying the awa root. angel of Death thus courted does in deed and It is said that but for the use of this root the truth come, he has only to finish that which has destruction of the people in former times by cer- been so well begun; he passes his fiery hand over tain imported diseases would have been far the brain of the victim, and lets him rave for a greater than it was, and by others it is said that season . . . there’s the devil to pay in the brain this is mere fancy. All agree that poi (prepared of the poor Levantine . . . and the next night from the taro plant) will rejuvenate a man who is he becomes the “life and soul” of some squal- used up and his vitality almost annihilated by ling jackal family, who fish him out by the foot hard drinking, and that in some kinds of dis- from his shallow and sandy grave. eases it will restore health after all medicineshave failed; but all are not willing to allow to the At the Heal th Reso rts awa the virtues claimed for it. The natives Austria. In the guise of humor he has manufacture an intoxicating drink from it which here set forth,8 according to Howells, a is fearful in its effects when persistently indulged very sound idea concerning dietetics: in. It covers the body with dry, white scales, inflames the eyes, and causes premature The Austrian Empire is made up of health decrepitude. resorts; it distributes health to the whole world. Its waters are all medicinal. They are Pers onal Hyg ien e bottled and sent throughout the earth; the Smoking. He had smoked, by his own natives themselves drink beer . . . All admission, since the age of nine, and natur- unhealthy people ought to domicile themselves ally wondered whether any deleterious in Vienna, and use that as a base, making flights result would ensue. from time to time to the outlying resorts, accord- “I am an excessive smoker, and I said to need. A flight to Marienbad to get rid of fat; that some of us must take warning by bis a flight to Carlsbad to get rid of rheumatism; a flight to Kaltenleutgeben to take the water case, but Dr. Douglas said that this result cure and get rid of the rest of the diseases. must not be attributed altogether to smok- ing.”7 This remark was in reference to the Marienbad he designated the “health cancer at the root of the tongue from which factory,” and Aix the “paradise of General Grant was suffering. The doctor rheumatics.” added that “it was probable that it had its He himself went to the Appetite Anstalt, origin in excessive smoking, but that was at Hochberghaus, where defunct appetites are not the certain reason of its manifesting restored. When he was first shown the menu, itself at this time; that more than likely the his “stomach threw a handspring. At the real reason was the General’s distress of top stood ‘tough, under-done, overdue tripe mind and year-long depression arising from garnished with garlic; halfway down the the failure of the Grant and Ward firm,” bill stood ‘young cat; old cat; scrambled producing an embarrassing state of cat’; at the bottom stood ‘sailor-boots, poverty. softened with tallow, served raw’ . . . Abstention. In an anti-Puritanic tone The idea of coaxing a sick man’s appetite he flayed the so-called ascetics :7 back with this buzzard fare is clear insanity.” I doubt if God has given us any refreshment Of course the concept was to create a which, taken in moderation, is unwholesome, craving by first causing a repulsion. After except microbes. Yet there are people who this would follow hunger, “nature’s appetite strictly deprive themselves of each and every cure, the best and wisest in the world.” eatable, drinkable, and smokable which has in The scheme was simple: “Don’t eat ‘till any way acquired a shady reputation. They pay this price for health! And health is all they you are hungry. If the food fails to taste get for it. How strange it is! It is like paying good, fails to satisfy you, rejoice you, out your fortune for a cow that has gone dry. comfort you, don’t eat again until you are very hungry. Then it will rejoice you—and Fasting. One wonders whether the fol- do you good, too.’” lowing explanation arose from personal He knowingly put his theory in this form: experience:4 All diets are wholesome. Some are whole- “I think that all the Dr. Tanners and somer than others, but all the ordinary diets those others who go forty days without are wholesome enough for people who use them. eating do it by resolutely keeping out the Whether the food be fine or coarse it will taste desire to eat, in the beginning, and that good, and it will nourish if a watch be kept after a few hours the desire is discouraged upon the appetite and a little starvation intro- and comes no more.” duced every time it weakens. In a very whimsical manner he revealed with a spoonful of salt from the Carlsbad the secret springs of the spas : springs dissolved in it. That is a dose not to be forgotten right away. Do you know the tricks that the health- resorts doctors play? . . . Covert starvation. One goes to the Leukerbads to remove Grape-cure, bath-cure, mud-cure—it is all the fat and cure skin diseases. The water at this same. The grape and the bath and the mud make particular place runs continuously, other- a show and do a trifle of the work—the real wise “a patient with a ringworm might work is done by the surreptitious starvation. take a bath with only a partial success, The patient accustomed to four meals and late since while he was ridding himself of the hours—at both ends of the day—now consider ringworm, he might catch the itch.” what he has to do at a health resort. He gets up Australia. The period in which the at six in the morning. Eats one egg. Tramps up following remarks4 were made was obviously and down the promenade two hours with the pre-VoIsteadian: other fools. Eats a butterfly. Slowly drinks a glass of filtered sewage that smells like a buz- It is in Auckland that one goes to Rotorua, the zard’s breath. Promenades another two hours, region of the renowned hot lakes and geysers but alone; if you speak to him he says anxiously, . . . The Government has a sanitarium there, ‘My water!—I am walking off my water!— and everything is comfortable for the tourist please don’t interrupt,’ and goes stumping and the invalid. The Government’s official along. Eats a candied rose-leaf. Lies at rest in physician is almost overcautious in his estimates the silence and solitude of his room for hours; of the efficacy of the baths, when he is talking musn’t speak, musn’t read, musn’t smoke. The about rheumatism, gout, paralysis, and such doctor comes and feels of his heart, now, and things; but when he is talking about the his pulse, and thumps his breast, and his back, effectiveness of the waters in eradicating the and his stomach, and listens for results through whiskey-habit he seems to have no reserves. a penny flageolet; then orders the man’s bath— The baths will cure the drinking-habit no matter half a degree, Reamur, cooler than yesterday. how chronic it is—and cure it so effectively After the bath, another egg. A glass of sewage that even the desire to drink intoxicants will at three or four in the afternoon and promenade come no more. There should be a rush from solemnly with the other freaks. Dinner at six— Europe and America to that place; and when half a doughnut and a cup of tea. Walk again. the victims of alcoholism find out what they can Half-past eight, supper—more butterfly; at get by going there, the rush will begin. nine, to bed. Six weeks of this regime—think India. of it. It starves a man out and puts him in At the Keda Ghat you will find a long flight splendid condition. It would have the same of stone steps leading down to the river. Half effect in London, New York, Jericho—any where. way down is a tank filled with sewage. Drink Germany. At Baden-Baden:8 as much of it as you want. It is for fever. Go straight from there to the Central Ghat. They are racked with rheumatism, and they At its upstream end you will find a small white- are there to stew it out in the hot baths . . . washed building which is a temple sacred to People say that Germany with her damp stone Gitala, goddess of small-pox.4 houses is the home of rheumatism. If that is so, Providence must have foreseen that it would be Thus do men in different climes pursue so, and therefore filled the land with these the evanescent shadow of health and healing baths. Perhaps no other country is so well-being. generously supplied with medicinal springs as Prac tica l Ther ap y Germany. Some of these baths are good for one ailment, some for another; and again, peculiar The Everlasting Cold. He once remarked, ailments are conquered by combining the indi- pertinent to a life-long annoyance:3 “I do vidual virtues of several different baths. For not mention a couple of colds in my head, instance, for some forms of disease, the patient because I hardly mind them as much as I drinks the native hot water of Baden-Baden, would the erysipelas.” Experience had taught him a simple Membranous Croup. This story27 depicts rationale of treatment:10 the usual pediatric difficulty. The doctor “When you have any ordinary ailments, had ordered a teaspoonful of medicine for particularly of a feverish sort, eat nothing at the sick child, to be given every hour. all during twenty-four hours. That will “Once an hour!” the mother strenuously cure it. It will cure the stubbornest cold in objected, “as if we had a whole year before the head, too. No cold in the head can us to save the child.” survive twenty-four hours of modified So she gave, instead, “a tablespoonful starvation.” every half hour, plus belladonna, aconite, Except, of course, the unyielding cold, goose-grease to the chest, flax-seed poultice, as he found on a certain occasion :10 sinapisms, and other sorts of blisters where My constitution succumbed to a severe cold unoccupied places could be found upon the . . . The first time I began to sneeze, a friend child.” told me to go and bathe my feet in hot water Medi cal Histo ry and go to bed. I did so. Shortly afterwards Reminiscences. How well he knew the another friend advised me to get up and take a physician of the period around 1850, of the cold shower bath. I did that also. Within an days of his youth.7 hour another friend assured me that it was I remember two of the Florida doctors . . . policy to “feed a cold and starve a fever.” I had They not only attended an entire family for both. So I thought it best to fill myself up for the twenty-five dollars a year, but furnished the cold, and then keep it dark and let the fever medicines themselves. Good measures, too. starve a while. Only the largest persons could hold a whole But to no avail. Next he tried drinking dose. Castor oil was the principal beverage. a quart of warm salt water (more friendly The dose was half a dipperful, with half a dipper- advice). The consequence was that he ful of New Orleans molasses added to help it thought he had “thrown up his immortal down and make it taste good, which it never soul.” did. The next standby was calomel; the next rhubarb; and the next, jalap. Then they bled Then a woman offered her services as the patient, and put mustard plasters on him. administering angel. “She mixed a decoction It was a dreadful system, and yet the death rate composed of molasses, aquafortis, turpen- was not heavy. The calomel was nearly sure to tine, and various other drugs, and instructed salivate the patient and cost him some of his me to take a wine-glassful of it every teeth. There were no dentists. When teeth fifteen minutes. I never took but one dose; became touched with decay or were otherwise that was enough; it robbed me of all moral ailing the doctor knew of but one thing to do— principles, and awoke every unworthy he fetched his tongs and dragged them out. impulse of my nature.” If the jaw remained it was not his fault. Doctors Naturally the last remedy employed were not called in cases of ordinary illnesses; received the credit. the family grandmother attended to those. Every woman was a doctor, and gathered her Plain gin was recommended. I took it. Then own medicines in the woods, and knew how to gin and molasses. I took that also. Then gin compound doses that would stir the vitals of a and onions. I added the onions, and took all cast-iron dog. And then there was the “Indian three ... A lady told me to drink a quart doctor,” a grave savage, remnant of his tribe, of whisky every twenty-four hours, and a friend deeply read in the mysteries of nature, and the recommended precisely the same course. Each secret properties of herbs; and most backwoods- advised me to take a quart; that made half a men had high faith in his powers and could tell gallon. I did it and still live . . . of wonderful cures achieved by him. I offer for the consideration of consumptive patients the variegated course of treatment I Ancient Medicine. He had often laughed have lately gone through. Let them try it; if it at a curious medical work early in his career. don’t cure, it can’t more than kill. It was the “Dictionary of Medicine,” by Dr. James, of London, and was first pub- way to make a bank or a body healthy is to lished in 1745. The advice it contained was squander its capital; but in our author’s time believed in with utmost confidence and the physician went around with a hatful of faith, and as a consequence it enriched lancets on his person all the time, and took a the earth with its slain for over three and a hack at every patient whom he found still half generations. alive. He robbed a man of pounds and pounds of blood at a single operation . . . Apparently Being rich in uncritical praise of ancient even the healthy did not escape, but were bled lore merely because of its antiquity, it proved twelve times a year, on a particular day of the to be, in the hands of Mark Twain, an easy month, and exhaustively purged besides. butt for ridicule:11 Strenuous measures were used to combat Take a single detail, for example—medicine. headaches, which were treated, one might Galen could have come into my sick-room at say, with a vengeance: any time during my first seven years—I mean any day when it wasn’t fishing weather, and There is no harm in trying to cure a headache there wasn’t any choice but school or sickness— in our day. You can’t do it, but you get more or and he could have sat down there and stood my less entertainment out of trying, and that is doctor’s watch without asking a question. He something; besides, you live to tell about it, and would have smelt around the wilderness of cups that is more. A century or so ago you could have and bottles and vials on the table and the had the first of these features in rich variety, shelves, and not missed a stench that used to but you might fail of the other once—and once gladden him two thousand years before, nor would do. I quote: discover one that was of a later date. He would “A certain Merchant, about forty years of examine me and run across only disappoint- Age, of a Melancholic Habit, and deeply ment—I was already salivated; I would have involved in the Cares of the World, was during him there, for I was always salivated, calomel the Dog-days, seiz’d with a violent pain of his was so cheap. He would get out his lancet then; Head, which some time after oblig’d him to keep but I would have him again, our family doctor his Bed. didn’t allow blood to accumulate in the system. “I, being called, order’d Venesection in the However, he would take a dipper and ladle, Arms, the Application of Leeches to the Vessels and freight me up with old familiar doses that of the Nostrils, Forehead, and Temples, as had come down from Adam to his time and also to those behind his Ears. I likewise pre- mine; and he would go out with a wheelbarrow scrib’d the Application of Cupping-glasses, with and gather weeds and offal, and build some more Scarification, to the Back. But notwithstanding while those others were getting in their work. these precautions, he dy’d. If any Surgeon, skill’d And if our reverend doctor came and found in Arteriotomy, had been present, I should him there, he would be dumb with awe, and also have order’d that Operation.” would get down and worship thim. Whereas if “Now that we know,” was Mark’s biting Galen should appear among us to-day, he could commentary, “what this butcher did to not stand anybody’s watch; he would inspire no relieve a Head-ach, it is no trouble to infer awe; he would be told he was a back number, and it would surprise him to see that fact that if he wanted to comfort a man that had counted against him, instead of in his favor. a Stomach-ach he disemboweled him.” He wouldn’t know our medicines; he wouldn’t Mysticism received its due measure of know our practice; and the first time he tried to disapproval: introduce his own, we would hang him. “They liked a touch of mystery along with their medicine in the olden times. Blood-letting truly was a fine art in those The medicine-man of that day, like the sanguinary days: medicine-man of our Indian tribes, did what Phlebotomy, Venesection—terms used to he could to meet the requirement.” As an signify bleeding—are not often heard in our day, example of one of the secretive and awe- because we have ceased to believe that the best inspiring “earthquakes which the old-time doctor used to introduce into his patient “ If you have studied drugs you ought to when he could find room,” he itemized in be able to judge how much an eighth of a detail, “Alexander’s Golden Antidote,” a grain would be,” Mark urged. patent medicine built up of seventy-three The student finally yielded and “ladled odd drugs, and “good for—well, pretty out, in the old-fashioned way, on the point much everything.” of a knife-blade, what he believed to be the The signature, he added, should have right amount.” read: “Serve with a shovel.” Female Medical Education. One is afforded This shot-gun system was soon super- here14 an interesting glimpse of the early seded by another extreme form of practice: days of the woman physician:

When you reflect that your father had to take The [Woman’s] College, in 1870, was a small such medicines as the above, and that you would one, and it sustained itself not without difficulty be taking them yourself but for the introduction in this city [Philadelphia], which is so con- of homeopathy, which forced the old-school servative, and is yet the origin of so many radical doctor to stir around and learn something of a movements. There were not more than a dozen rational nature about his business, you may attendants on the lectures altogether, so that honestly feel grateful that homeopathy sur- the enterprise had the air of an experiment for vived the attempts of the allopathists to destroy those engaged in it. There was one woman it even though you may never employ any physician driving about town in her carriage, physician but an allopathist while you live. attacking the most violent diseases in all quarters with persistent courage, like a modern From several important standpoints “A Bellona in her war-chariot, who was popularly Majestic Literary Fossil” is worthy of supposed to gather in fees to the amount of ten careful perusal. or twenty thousand dollars a year. Perhaps Prescription Writing. The doctor casu- some of the students looked to the near day ally scribbled off a prescription:13 when they would support such a practice, and a husband besides. But it is unknown that any It was one of Galen’s; in fact it was Galen’s of them went further than practice in hospitals favorite, and had been slaying people for sixteen and their own nurseries, and it is feared that hundred years. Galen used it for everything, some of them were quite as ready as their applied it to everything, said it would remove sisters, in emergencies, to “call a man.” everything from warts all the way through to lungs, and it generally did. Galen was still the The Vagarie s of Ther ape uti cs only medical authority recognized in Missouri; The Stability of Medicine. This undoubt- his practice was the only practice known to the edly is his rational and more composed Missouri doctors; and his prescriptions were the opinion of the doctor in contradistinction to only ammunition they carried when they went his subsequent heated indictments:16 out for game. To heal the body of all its ills and pains is a A Note on Opium. His brother was dying mighty benefaction, but in our day our physi- of burns, in 1858.12 The doctor left word cians and surgeons work a thousand miracles— that the young medical student in charge prodigies which would have ranked as miracles at night should give an eighth of a grain fifty years ago—and they have so greatly of morphine, if the patient were restless. extended their domination over diseases that Along toward midnight Mark thought we feel so well protected that we are able to that the sedative ought to be given. But look with a good deal of composure and absence it was a new drug then, he related, and the of hysterics upon the claims of new competitors in that field. student was reluctant to use it. “I have no way of measuring it. I don’t Osteopathy. He had many kind words know how much an eighth of a grain for this system, and at one time inclined would be.” very favorably towards it:3 “Dr. Still in the middle of Kansas, in a desirous that you should try their strange magic village, began to experiment in 1874, only when you were going to try the familiar five years after Kellgren began the same medicines. work obscurely in the village of Gotha, According to his Boswell, Paine, he never Germany.” This refers to Heinrich Kell- had any quarrel with Christian Science or gren, who practiced Swedish movements mental healing, or with the empirics, but originally in Sanna, Sweden, as the pre- acknowledged the good in them and wel- cursor of Osteopathy. By the time Still comed most of them in preference to materia began to experiment, Kellgren had com- medica. His contention with Mary Baker pleted the development of the principles of Eddy lay in the conviction that she was his system, and established himself in good “a very unsound Christian Scientist her- practice in London. He continued: self,” and that she suffered from a “serious I was greatly surprised to find that this new malady—self-edification.” science was well known in America under the His book entitled “Christian Science” is a name of Osteopathy. Since then (1900), I find vigorous arraignment of that pseudo-scien- that in the past three years it has got itself tific system. His also wrote a sketch, as yet legalized in fourteen states in spite of the unpublished, called “Eddypus,” an imagi- opposition of the physicians; that it has estab- nary history of the world a thousand years lished twenty Osteopathic schools and colleges; hence, when Eddyism should rule supreme that among its students are seventy-five allo- over all. pathic physicians; that there is a school in And yet despite his harsh words he could Boston and another in Philadelphia; that there are about seven hundred students in the parent not but feel3 that: college (Dr. Still’s at Kirksville, Missouri); Christian Science is humanity’s boon. Mother and that there are about two thousand grad- Eddy . . . has organized and made available uates practicing in America. a healing principle that for two thousand years In 1899 he wrote, in a prophetic vein has never been employed, except as the merest that was to prove disastrous :3 kind of guesswork . . . Many an ass in America is getting a good deal of benefit out of Christian Ten years hence no sane man will call a doctor Science’s new exploitation of an age-old healing except when the knife must be used—and such principle—faith, combined with the patient’s cases will be rare. The educated physician will imagination. himself be an osteopath . . . I do not believe there is any difference between Kellgren’s Although, as he felt sure, Mrs. Eddy stole science and Osteopathy. I want Osteopathy the idea originally from one Phineas Park- to prosper; it is common sense and scientific, hurst Quimby, a healer of sorts who had and cures a wider range of ailments than the treated her in the early days for hysterical doctor’s method can reach. paralysis, yet “its healing principle (its What bizarre cults would he, in his most valuable asset) possesses the same therapeutic enthusiasm, be lauding to-day? force now that it possessed a million years Christian Science. William Dean Howells ago before Quimby was born.”3 said: He was strongly impressed with the worth of psychotherapy: He allowed the miracles of its healers to be tried on his family if they wished it. He had a The mind cannot heal broken bones, and tender heart for the whole generation of empirics, doubtless there are other physical ills which it as well as the newer sorts of scienticians, but cannot heal, but it can greatly help to modify he seemed to base his faith in them largely the severities of them all without exception, and upon the failures of the regulars, rather than there are mental and nervous ailments which it upon their own successes, which also he believed can wholly heal without the help of physician or in. He was recurrently, but not insistently, surgeon.3 And again: Eclecticism. He had liberal ideas on the No one doubts that the mind exercises a subject of specialization:3 powerful influence over the body. From the My notion is, that no art of healing is the beginning of time, the sorcerer, the interpreter best for all ills. I should distribute my ailments of dreams, the fortune-teller, the charlatan, the around; surgery cases to the surgeon; lupus to quack, the wild medicine-man, the educated the actinic-ray specialist; nervous prostration physician, the mesmerist, and the hypnotist to the Christian Scientist; most ills to the allo- have made use of the client’s imagination to path and the homeopath; and (in my own help in their work . . . Many faithcures particular case) rheumatism, gout, and bron- probably do no harm, since they do not forbid chial attacks to the osteopath. the patient to help out the cure with medicines if he wants to; but the others bar medicines, Medical Pessimism. Perhaps here, more and claim ability to cure every conceivable than anywhere else, does he reveal his human ailment through the application of their tendency to both praise and condemn in mental forces alone. There would seem to be an an inconsistent fashion:3 element of danger here. It has the look of We do not guess, we know that nine in ten of claiming too much, I think.16 the species are pudd’nheads. We know it by Nostrums. The visionary Colonel Sellers, various evidences; and one of them is, that the who was always chasing new enterprises, race has respected (and almost venerated) the enthusiastically took a flyer in the thera- physican’s grotesque system—the emptying of peutic field:14 miscellaneous and harmful drugs into a person’s stomach to remove ailments which in many I’ve been experimenting on a little prepara- cases the drug could not reach at all; in many tion for curing sore eyes—a kind of decoction cases could reach and help, but only at cost nine-tenths water and the other tenth drugs of damage to some other part of the man; and that don’t cost more than a dollar a barrel . . . in the remainder of the cases the drug either Before many weeks I wager the country will retarded the cure, or the disease was cured by ring with the fame of Beriah Seller’s Infallible nature in spite of the nostrums. The doctor’s Imperial Oriental Optic Liniment and Salvation insane system has not only been permitted to for Sore Eyes—the Medical Wonder of the Age! continue its follies for ages, but has been pro- . . . It’s a patent medicine whose field of tected by the State and made a close monopoly operations is the solid earth. —an infamous thing, a crime against a free- Tom Sawyer’s aunt15 was described as man’s right to choose his own assassin or his follows: own method of defending his body against [She was] one of those people who are infatu- disease or death. ated with patent medicines and all new-fangled And yet at the same time, with curious and methods of producing health or mending it . . . senile inconsistency, the State has allowed the Whenever something fresh in this line came out man to choose his own assassin—in one detail— she was in a fever, right away, to try it, not on the patent-medicine detail—making itself the herself, for she was never ailing, but on anybody protector of that particular business, collecting else that came handy. She was a subscriber for money out of it, and appointing no committee all the “Health” periodicals and phrenological of experts to examine the medicines and forbid frauds; and the solemn ignorance they were them when they are dangerous. inflated with was breath to her nostrils. All the I have by me a list of fifty-two human ail- “rot” they contained was gospel to her . . . ments—common ones—and in this list [which She gathered all her quack periodicals and her he unfairly omits to give] I count nineteen quack medicines, and thus armed with death, which the physician’s art cannot cure. But went about on her pale horse, metaphorically there isn’t one which Osteopathy or Kellgren speaking, with hell following after. But she cannot cure if the patient comes early. never suspected that she was not an angel of Fifteen years ago I had a deep reverence for healing and the balm of Gilead in disguise, to the the physician and the surgeon. But six months of suffering neighbors. closely watching the Kellgren system has revolutionized all that, and now I have neither of sympathy. A woman’s intuition is better reverence nor respect for the physician’s trade than a man’s. Nobody knows anything, really, and scarcely any for the surgeon’s. I am con- you know, and a woman can guess a good deal vinced that of all quackeries, the physician’s nearer than a man . . . is the grotesquest and the silliest. And they But I should want to choose my doctor. An know they are shams and humbugs. They have ugly woman would ruin me; the disease would taken the place of those “augurs who couldn’t be sure to strike in and kill me at the sight of her. look each other in the face without laughing.” I think a pretty physician, with engaging From these diversified (and highly sea- manners, would coax a fellow to live through almost anything. soned) notes on the vagaries of therapeutics Medic al Wit it is evident that the attitude of Mark Twain on medicine was as uncertain as that He was afflicted at times with carbuncles, of a weather-vane in March. hence the following gem was founded on Medicine and Religion. Speaking of the self-knowledge:4 “The dictionary says a cultivation of blind faith in times of stress, carbuncle is a kind of jewel. Humor is out he said:3 of place in the dictionary . . . I wish I had been born with false teeth and a false liver We do not trust in God, in the important and false carbuncles. I should get along matters of life, and not even a minister of the Gospel will take any coin for a cent more than better.” its accepted value because of that motto. If He made an interesting contribution to cholera should reach these shores we should the study of helminthology:4 “In Australia probably pray to be delivered from the plague, is prevalent a horrible disease due to an but we would put our main trust in the Board ‘unperfected tape-worm.’ Unperfected— of Health. that is what they call it. I do not know why, And apropos of Christian Science:16 “It for it transacts business just as well as if it is a fine thought, marrying religion to were finished and frescoed, and gilded, and medicine, instead of medicine to the under- all that.” taker in the old way; for religion and A publisher sent him a book for criticism, medicine properly belong together, they which was composed of mistakes made by being the basis of all spiritual and physical school-children in their examination papers. health.” He quoted several elucidating examples:18 The Qua lity of the Doct or Physillogigy is to study about your bones stummick and vertebry. The Well-Informed Physician. There is We have an upper and lower skin. The upper much truth behind this observation:14 skin moves all the time and the lower skin Whether medicine is a science, or only an moves when we do. empirical method of getting a living out of the The body is mostly composed of water and ignorance of the human race, there are other about one half is avaracious tissue. things one needs to know quite as much as that The stomach is a small pear-shaped bone which is taught in medical books . . . Does situated in the body. your doctor know anything—I don’t mean about The gastric juice keeps the bones from creak- medicine, but about things in general, is he a ing . . . The salivary glands are used to sali- man of information and good sense? If he vate the body. doesn’t know anything but medicine the chance In the stomach starch is changed to cane is that he doesn’t know that. sugar and cane sugar to sugar cane. The Woman Physician. A beautiful Rumor had spread that he was dying. To woman has a fortune waiting her in medi- counteract it he wrote to the press:12 “The cine, according to him:14 report of my death is greatly exaggerated.” Medicine is particularly women’s province. A similar false notion became current The treatment of disease is a good deal a matter when he was seventy-four. This time he retaliated with:7 “I would not think of cured; nervous prostration is cured; con- doing such a thing at my age.” sumption is cured; and St. Vitus Dance is There is more than a grain of truth in made a pastime. Even without a fiddle.” these jests:4 He sounded a curious note of praise regarding an important article of diet:14 The Autocrat of Russia possesses more power than any other man in the earth; but he cannot Turnips are mighty sustaining—brimful of stop a sneeze. nutriment—all the medical books say so. Just He had much experience of physicians, and eat from four to seven good-sized turnips at a said “the only way to keep your health is to meal, and drink from a pint and a half to a eat what you don’t want, drink what you don’t quart of water, and then just sit around a couple like, and do what you’d druther not.” of hours and let them ferment. You’ll feel like If there is one thing in the world that will a fighting cock the next day. make a man peculiarly and insufferably self- He once fell off a cliff, and when he was conceited, it is to have his stomach behave picked up, he was16 “an incoherent series itself the first day at sea, when nearly all his comrades are sea-sick. of compound fractures extending from the Do not undervalue the headache. While it is scalplock to the heels, and the comminuted at its sharpest it seems a bad investment; but projections caused him to look like a when relief begins, the unexpired remainder hatrack.” is worth $4 a minute. On another occasion the doctor, “with scientific relish,” presented this diagnosis:13 He told of a certain doctor who excused himself from his guests in this style when Without going too much into detail ... I he had to leave to make an impromptu call:3 concede that great care is going to be necessary here; otherwise exudation of the oesophagus “Entertain yourself while I go out and is nearly sure to ensue, and this will be followed reduce the population.” by ossification and extradition of the maxillaris He was constantly receiving prescriptions superioris, which must decompose the granular and remedies in the mail whenever the surfaces of the great infusorial ganglionic sys- papers reported that he was suffering from tem, thus obstructing the action of the posterior one of his frequent bronchial or rheumatic varioloid arteries, and precipitating compound attacks. He would answer routinely:3 “Dear strangulated sorosis of the valvular tissues, and Sir (or Madam)—I try every remedy sent to ending unavoidably in the dispersion and com- me. I am now on No. 87. Yours is 2,653. I bustion of the marsupial fluxes and the con- am looking forward to its beneficial results.” sequent embrocation of the bicuspid populo He had prepared notes on a story, as yet redax referendum rotulorum. unprinted, “in which the various characters His five-day old son had summarily were to have a weird, pestilential nomen- attained a ponderous philosophy:3 “Life clature; such as ‘Lockjaw Harris’; ‘ Influenza seems a serious thing, what I have seen of Smith’; ‘Sinapism Davis’; and a dozen or it—and my observation teaches me that two more, a perfect outbreak of disorders.”12 it is made up of hiccups, unnecessary wash- Another unfinished work, entitled: “3,000 ings, and colic.” Years among the Microbes,” was intended to be a scientific revelry, a satire like Medi cal Phra se an d Figur e “Gulliver’s Travels,” in the form of an This analogy strikes hard and true:7 autobiography of a microbe that had once “He had not even income enough to been a man and through the failure of a enable him to live as respectable as a third- biological experiment was transformed into rate physician.” a cholera germ.12 Concerning the difficulty a certain person Speaking of Christian Science testimo- had in grasping an important concept, he nials, he solemnly declared:16 “Milk leg is stated :7 “A cancer of old habit and long experi- There are nerves and muscles in our frames ence could as easily understand the sugges- whose functions and whose methods of working tion that it board itself awhile.” it seems a sort of sacrilege to describe by cold His biceps muscle was being examined by physiological and surgical technicalities . . . an expert who was to teach him to ride the Fancy a surgeon, with his nippers lifting tendons, bicycle:23 muscles, and such things into view, out of the complex machinery of a corpse, and observ- “It is pulpy, and soft, and yielding, and ing, “Now this little nerve quivers—the vibra- rounded; it evades pressure and glides from tion is imparted to this muscle—from here it is under the fingers; in the dark a body might passed to this fibrous substance; here its ingre- think it was an oyster in a rag. But you dients are separated by the chemical action of needn’t worry about that; in a little while the blood—one part goes to the heart and thrills you can’t tell it from a petrified kidney.” with what is popularly termed emotion; another The following figures of imagery are part follows this nerve to the brain and com- appropriate as well as expressive: municates intelligence of a startling character— He has “no more sex than a tapeworm.”7 the third part glides along this passage and “He had teeth which made his mouth touches the spring connected with the fluid look like a neglected churchyard.”4 receptacles that lie in the rear of the eye. Thus, The atmosphere of the town “was as by this simple and beautiful process, the party languid as a consumptive girl.”24 is informed that his mother is dead, and weeps.” The supposed horrors of the study of Medic al Quot ati ons human anatomy were mitigated in this These quotations are from chapter head- fashion:14 ings in “The Gilded Age.” One of the She began her anatomical practice upon leading female characters in this novel is a detached portions of the human frame, which medical student, which accounts for the were brought into the demonstrating room— references:4 dissecting the eye, the ear, and a small tangle of She, gracious lady, yet no paines did spare muscles and nerves—an occupation which To doe him ease, or doe him remedy: has not much more savor of death in it than the Many restoratives of vertues rare analysis of a portion of a plant out of which the And costly cordialles she did apply, life went when it was picked up by the roots. To mitigate his stubborn malady. Spencer’s “Faerie Queene.” How vivid does he make his analogies! It would be some humanity to stand The following are strongly descriptive: His dutiful physician! What delight Would it not be to lay thy healing hand A great Indian river at low water suggests the Upon the young man’s breast! familiar anatomical picture of a skinned human Tasso’s “Jerusalem Delivered.” body, the intricate mesh of interwoven muscles I think the healing art ought to be based on and tendons to stand for water-channels, and reason to be sure, and too that it should be the archipelagoes of fat and flesh inclosed by founded on unmistakable evidences, all uncer- them to stand for the sandbars.4 tainties being rejected, not from the serious I dreamed that the visible universe is the attention of a physician, but from the very physical person of God; that the vast worlds profession itself. that we see twinkling millions of miles apart in Celsus. the fields of space are the blood corpuscles in The Herit age of Man His veins; and that we and the other creatures Disease. According to Satan:25 “Man are the microbes that charge with multitudinous is a museum of diseases, a home of impuri- life the corpuscles.4 ties.” And from the standpoint of evolution, One would have to look far for a more he is indeed a sorry specimen:12 skillful dissection of the mechanism of the Man starts in as a child and lives on diseases emotions :20 to the end as a regular diet. He has mumps, measles, whooping cough, croup, tonsillitis, Think—in this battered Caravanserai, diphtheria, scarlet fever, as a matter of course. Whose Portals open stand all Night and Day, Afterward, as he goes along, his life continues How Microbe after Microbe with his Pomp to be threatened at every turn by colds, cough, Arrives unasked, and comes to stay. asthma, bronchitis, quinsy, consumption, yellow Our Ivory Teeth, confessing to the Lust fever, blindness, influenza, carbuncles, pneu- Of Masticating, once, now own Digust monia, softening of the brain, diseases of the Of Clay-plug’d Cavities—full soon our Snags heart and bones, and a thousand other maladies Are emptied, and our Mouths are filled with Dust. of one sort and another. He’s just a basketful of festering, pestilent corruption, provided for Our Gums forsake the Teeth, and tender grow, the support and entertainment of microbes. And fat, like over-ripened Figs—we know Look at the workmanship of him in some of its The Sign—the Rigg’s Disease is ours, and we particulars. What are his tonsils for? They per- Must list this Sorrow, add another Woe; form no useful function; they have no value. They are but a trap for tonsillitis and quinsy. Our Lungs begin to fail, and soon we Cough, And what is the appendix for? It has no value. And chilly Streaks play up our Backs, and off Its sole interest is to lie and wait for stray grape- Our fever’d Foreheads drips an icy Sweat— We scoffed before, but now we may not scoff. seeds and breed trouble . . . Man’s sight and smell and hearing are all So let me grateful drain the Magic Bowl inferior. Think of man—that poor thing!—the That medicines hurt Minds and on the Soul animal of the wig, the ear-trumpet, the glass The Healing of its Peace doth lay—if then eye, the porcelain teeth, the wooden leg, the Death claims me—welcome be his Dole. trepanned skull, the silver wind-pipe—a crea- ture that is mended and patched all over from And the dole that finally did come to top to bottom. him was17 “the sweet placidity of death He’s the poorest, clumsiest excuse of all the . . . more beautiful than sleep.” Long- creatures that inhabit this earth. He has got suffering and long-enduring,28’29 to him such a to be coddled and housed and swathed and blessing was deserving, no less than welcome. bandaged and upholstered to be able to live His life today is more than a memory; at all. his works are imbued with the enviable quality of durability. And not the least of Death. Scientific burial is still far in the the products of his pen is the Medicana of distant future:4 “We are drifting slowly— Samuel Langhorne Clemens. but hopefully towards cremation in these days . . . When cremation becomes the Refe renc es rule we shall cease to shudder at it; we 1. The Memorable Assassination. should shudder at burial if we allowed 2. A New Crime. ourselves to think what goes on in the 3. Letters. grave.” 4. Following the Equator. 5. What is Man? And despite man’s bitter heritage, he 6. Mental Telegraphy. clings sturdily to the very end:4 “Each 7. Autobiography. person is born to one possession which 8. At the Appetite Cure. 9. A Tramp Abroad. outvalues all his others—his last breath.” 10. Curing a Cold. The following paraphrase of the Rubaiyat 11. A Majestic Literary Fossil. discloses the pessimistic mood into which 12. Biography. he often fell:26 13. Those Extraordinary Twins. 14. The Gilded Age. From Cradle unto Grave I keep a House 15. The Adventures of Tom Sawyer. Of Entertainment where may drouse 16. Christian Science. Bacilli and kindred Germs—or feed—or breed 17. The Death of Jean. Their festering Species in a deep Carouse. 18. English as She Is Taught. 19. A Double-Barrelled Detective Story. 26. My Boyhood Dreams. 20. The Innocents Abroad. 27. Experience of the McWilliamses with Mem- 21. Sketches. branous Croup. 22. Pudd’nhead Wilson. 28. Brooks, Van W. The Ordeal of Mark Twain. 23. Taming the Bicycle. 29. O’Higgins, H., and Reede, E. H. m.d ., The 24. Roughing It. American Mindin _ Action. Chap. 2, in 25. The Mysterious Stranger. Mark Twain.

A POEM IN PRAISE OF OPHTHALMOLOGISTS

People usually forget about the doctor Blum en until they need his services, but most people (Dem Augenarzt von seinen Kranken). who have to use their eyes much are, at least, grateful to the men who have saved Sie kommen aus dem Schoss der Nacht: them from whole or partial blindness on Doch wären unten sie geblieben, Wenn nicht das Licht mit seiner Macht occasion. Of all the poems in praise of our Hinauf ins Leben sie getrieben. profession which I have patiently perused and segregated, I know of only one in praise Holdselig aus der Erde bricht’s, Und blüht nun über allen Schranken; of these physicians. It is by Theodor Du bist der Freund des holden Lichts: Storm, one of the German novelists of the Lass dir des Lichtes Kinder danken! Romantic Period, the Storm whose “Immensee” we read in the High School as Which I render into the following bald children. He is a writer of rare grace and verses: charm, and of the group which includes Ebner Eschenbach, Rudolf Lindau, Fanny Flow ers Lewaid, Louise von François, Theodor Fon- Imprisoned in the womb of night, tane, writers of the romantic German past, They lived afar from warmth and love, distinguished not so much by cynical knowl- Until the spell of kindly light edge of the brutalities of existence as by Released them to the world above. genuine depth of thought and feeling. In fragrance now they bloom, despite The charm of Theodor Storm is that like The ugliness their charms displace; Thou art the friend of heavenly light: Turgenieff, he seems ever hovering on the Light’s children thank thee, of their grace. verge of the great secret. The little poem runs as follows: F. H. Garr ison , m . d .