or professional success.
I was aware that, in spite of my lack of experience and the presence of a most painful sense of general insufficiency, my sick and wounded were about as safe in my hands from professional harm, even from the first, as the patients of the most experienced medical officer in the hospital.
With high professional ideals, with no ability to make use of hazy conceptions or ideas, having no pride in knowledge that had not become my own, I began at once to reinforce myself from the experience and wisdom of my brother officers, whose advisory services were always readily and kindly rendered.
From the first and all through my military service my severely sick had the advantage of all the borrowed skill and experience I could command. As for surgical operations, they were all performed in the presence of most of the medical staff, some of whom were of great experience.
The surgery of the army hospitals of 1864 was of the highest character in skill and in careful attention to all the details involved, and the fatalities were generally due to the gravity of the wounds requiring operations and lack of constitutional power for recovery, rather than to the absence of the germ-killer. At that time the microbe was not a factor in the probabilities of life or death. In all else the care of the wounds could hardly be surpassed.
As for the medicinal treatment of my sick, it was unsatisfactory from first to last. After all the years since I cannot believe that, except for the relief of pain, any patient was made better by my dosage; and in all fatalities the post-mortem revealed the fact that the wisest dosage would have been without avail.
But in the study of the history of disease as revealed by symptoms my hospital experience was invaluable. I have since found that my greatest service at the beds of the sick is as an interpreter of symptoms rather than a vender of drugs. The friends of the sick read indications for good or bad with wonderful acuteness, as a rule; and I have rarely found myself mistaken in my ability to read the condition of patients in the faces of the friends, even before I enter the rooms of the sick.
As my experience enlarged so did my faith in Nature; and, since there was no similarity in the quality, sizes, and times of the doses for like diseases, my faith in mere remedies gradually declined.
After a year and a half of large opportunities to study the diseases of men in the early prime of life, in the care of the simple surgery of shot and shell, I left the army with such familiarity with grave diseases and death in various forms as to enable me ever after to retain complete self-possession in the presence of dying beds in private practice.
I began the general practice of medicine in Meadville in the autumn of 1866. Among the many physicians located in the city at that time were men of ability and large experience. There were those who administered with sublime faith doses too small for mathematical estimate; those who with equal faith administered boluses to the throat's capacity for deglutition; those who fully believed in whiskey as nourishment, that milk is liquid food, and who with tremendous faith and forceful hands administered both until human stomachs were reduced to barren wastes and death would result from starvation aggravated by disease.
Most of the cases of disease that fall to the care of the physician are trivial, self-limited, and rapidly recover under even the most crucifying dosages; Nature really winning the victories, the physician carrying off the honors.
This is so nearly true that it may be stated that, aside from the domain of surgery, professional success in the general sense depends upon the personal qualities and character of the physician rather than the achievements of the materia medica.
People have a confidence in the power of medicine to cure disease scarcely less than the dusky warrior has in the Indian medicine-lodge of the Western wilderness, and a confidence about as void of reason.
The physician goes into the rooms of the sick held to the severest accountability in the matter of dosage; and the larger his own faith in medicines the greater his task; and, if he is of my own, the so-called "old school," or Allopathic, the more dangerous he is to the curing efforts of Nature.
With the people the disease is simply an attack, and not the summing up of the results of violated laws going on perhaps from birth. With the people the symptoms are merely evidences of destruction, and not the visible efforts to restore the normal condition. Hence the failures to relieve always raise more or less questioning, among friends in painful concern, as to the ability of the physician to discharge his grave duties.
This unreasoning, unreasonable "blind faith" in remedial means is as strong in the most intelligent as in the most ignorant, and it has ever given me more trouble than the care of the sick. Another serious complication of the sick-room arises from near-by friends who are very certain that their own physicians are better fitted by far for the serious work of prescribing for the sick.
In addition to the serious work of attacking the symptoms of disease as so many foes to life, there is also a care as to what unbidden food shall go into unbidden stomachs, that the system shall be supported while life seems to be in the hands of its greatest enemy.
The universal conception of disease as a foe to life, and not as a rational process of cure; the boundless faith in remedies as means to resist the attack, revealed by symptoms, makes the professional care of the sick the gravest of all human occupations, and the most trying to both head and heart.
With all these taxing conditions confronting me, I opened an office in a field which seemed to be more than occupied by men of large experience.
With all my army experience I still had a hazy conception as to Nature in disease. That the vital forces needed the support of all the food the stomach of the sick could dispose of, was not a question of the remotest consideration. That medicine did in some way act to cure disease I could not fully question.
I was now to enter a service in which, from the care of infancy in its first breathings to old age in its last, every resource of the materia medica, of the reason, judgment, and of the soul itself, was to be called in in every grave case, and to be held to a responsibility measured by preposterous faith in medicines.
I entered upon my duties with a determination to win professional success by the most thorough attention to all the details of service upon the sick and their friends, and I confined my efforts almost wholly to acute cases. None of my professional colleagues were winning laurels by the treatment of chronic diseases, and not having faith in drugs for such I had my scruples about fees for failures that seemed inevitable.
And yet with the most painstaking service fortune would play with me at times in the most heartless manner. At one time four of my adult patients were awaiting burial within the radius of a half mile. As they were all physical wrecks, and died after short illnesses, there could be no question raised in any just sense as to the character of my services, but the fatalities were scored against me. Such fortune would be annihilating but for the fatalities inevitable with all practitioners.
For full ten years I visited the sick and dosed them according to the books, but with far less force of hands and faith than any of my brethren, and all were enjoined to take nourishment to keep up the strength for the combat with disease.
My doses were confined to only a few Sampsons of the materia medica, and these were administered with a watching for favorable results that could hardly be surpassed, and yet always with disappointment.
I was innocent enough to believe that a large practice could only be built up by the most painstaking and persistent effort; later on I found that a large practice was but little dependent upon the skill and learning displayed in the sick-room. One physician could immediately secure a large patronage because she was a woman; another, because he belonged to this or that nationality, or there was something in the personal outfit rather than in the professional that incited large hopes for
