causes to which, through life, every one must be occasionally exposed, we would particularly notice the peculiar delicacy of the delicately reared Limenian. When somewhat weakened by bad health, or a slight indisposition which confines him to his apartments for a few days, should he happen to shave and wash the face with cold water, he is thereby put in danger of being visited by a spasmodic affection of one side of the mouth, or affected, as is more likely to take place, with a cold in the head; so that the inflammation thus induced in the nostrils and fauces may soon be observed to extend itself along the continuous mucous membrane, and through the windpipe into the cavity of the chest; and there it is hard to foretel what ravages it may commit.
We need not therefore be surprised to hear the often reiterated query of the convalescent in the words, “No me hara daño lavar y afeytarme?”—will it not do me harm to shave and wash? Nor should we indulge in a smile at his expense, as we see him gradually venture on the first degrees of ablution, by rubbing over the hands and face with a cloth dipped in tepid water sharpened with aguardiente, or the common spirits of the country.
XII.—Morir en regla. This expression, which means to die according to rule, is one which all good Catholics are most solicitous to realize for themselves and friends; and the custom it refers to is deemed of the utmost importance in a religious and professional point of view.
When a physician visits a patient, and finds him in a doubtful or critical state, he must never omit to warn the patient or his friends of his real situation, with a view to enable them to call a medical consultation, and allow time for testamentary preparations and spiritual confession. The neglect of this precautionary measure would, in the event of the disease terminating fatally, bring great blame on the physician; but, after he has notified what he considers to be the patient’s real condition, then, whether the parties interested in such communication choose to act upon his advice or not, he has acquitted himself properly; and when the patient, previously confessed and sacramented, dies with the benefit of a consultation, or duly assisted by a medical junta, he is said to die according to rule, that is, morir en regla.
The great medical juntas in Lima, by which we understand consultations where more than four or five doctors are met together, are remarkable occasions of oratorical display. The warmest discussion frequently turns on the dose, composition, or medicinal operation of some common drug; and all the learning, method, and criticism, sometimes discovered at these solemn debates, terminate not unfrequently in the most simple practice, by which the nurse is enjoined to have recourse to the jeringa, and the patient told he must drink “agua de pollo,” or chicken-tea, until the return of the junta. In former times such consultations were called oftener than necessary, because a great junta became a sort of ostentatious exhibition, in which all who could afford to cite a group of doctors desired to imitate the great and the wealthy.
A sample, on a little scale, of such fashionable follies, is familiar to the Limenian in the well-known local story of the two doctors, who, for a month or more, daily met in consultation at the house of a family in town, where, as they retired to the supposed privacy of a consulting-room, the one would clear his throat, and ask the other, “Come el enfermo hoy?”—May the patient eat to-day?—to which the second doctor would reply, “Como no? si, comera.”—Why not? yes, he shall eat. Thus, day after day, began and ended the consultation, as far at least as its topics of discussion concerned the patient; while the good old doctors spun out a regular allowance of time before they rejoined the patient, or his attendants, serenely to announce the well-matured result of their conference. A man of nous, accustomed to listen behind the scenes, at length broke in upon their consultation; and dismissed them one day by paying to each his usual fee, and telling them both how happy he was to find that he now knew as much as themselves, for that he could repeat as well as anybody, “Come el enfermo hoy?—Como no? si, comera.”
A medical junta in Lima is commonly continued morning and evening, and from day to day, till the patient is pronounced to be out of danger. As the junta breaks up after each separate meeting, it is customary for the president of the meeting, or one of the physicians, to say, as he leaves his seat, “Vamos a consolar al enfermo,”—Let us go to console the patient; and then all the doctors present re-enter the patient’s apartment to soothe and to console him; and after this one of the number steps forward to lay down the regimen—“a dar el regimen”—agreed upon in consultation, and which one or more nurses and attendants are now ready to receive from the mouth of the physician. After the formality of a junta is thought no longer necessary, it often happens that, by wish of the patient or his relatives, two or more of the medical advisers return at separate hours, but by mutual agreement, for several days, by way of further security to the sick, or as a source of satisfaction to his family.
After all the care possible bestowed on the part of doctors, it often happens that, when the patient recovers, San Antonio, or any other saint after whom the individual is named, has all the credit of the cure; but, when the case is unprosperous, then all the evil is ascribed to human agency.
In Lima, as elsewhere, it will readily enough be admitted in general terms that all must die; but regarding this proposition, when death strikes any one in particular, difficulties at once suggest themselves; for the surviving friends are ever ready to assign many reasons why they are quite sure the deceased might have escaped, had it not been for this or that physician that misunderstood his malady. Hence it may be said that it is only in well-regulated juntas, and in public hospitals, that the people of Lima are supposed to glide to their latter end by fair and natural means. Upon this subject we heard it remarked by a sagacious native, “Should a gambler lose at a cock-fight, he does not attribute the loss to any fault in the cock, but to some trick done to him; if a horse lose in a race, his owner never acknowledges the cause of the failure to be in the animal, but assigns it to some accident thrown in his way: and surely, when we know that on such comparatively trivial occasions men thus talk and think, it is but natural for them, in an affair of such moment and interest as life itself, never to believe that a friend or relative loses his existence from any fault of his own, or any defect in his organization, but rather that his demise should be charged, as we see it is, though often unjustly, on the blind and stumbling ignorance, or unpardonable carelessness and indifference of the physicians.”
One common consequence of this mode of thinking is, that, by a single fatal case in practice, all the former success of the practitioner is overlooked, at least for a time; from which it follows that various medical advisers are sure to replace one another often in those families where death is a frequent visitor.
We seldom meet in families that shyness or reserve in divulging bodily ailments which can render them reluctant to change their family physician; and no physician, though specially entrusted with a patient, can be sure that others of the profession do not, at secret interviews, tamper with his peculiar treatment. This baneful custom leads to professional jealousies and mutual distrust. We believe many families countenance it from motives of consideration for the doctor ostensibly in trust, whose self-love they propose to spare by this clandestine practice, when they think a more open manner of proceeding would be repulsive to his feelings. There is, however, another very obvious reason which lends its influence to this furtive system of visiting the sick; and it is, that by this means the opinion of several advisers may be had at comparatively little expense. Should only two individuals be called to meet at the bedside of the patient at an appointed hour to consult on his case, the meeting is a bonâ fide junta, and each member of it is entitled to his four or four and a half dollars; whereas the single visits are only valued at one dollar each, and such detached visits are in many instances not paid by the sick, but by the friends at whose request the professional calls are made. Here then is great economy; eight opinions (and if the patient be poor, so that he is only expected to pay a half dollar fee for a detached visit, sixteen opinions) may be procured for the standard price of two when given in consultation; and custom, as well as reason and prudence, require that several opinions should be taken in cases of hazard and difficulty.
Owing in a considerable degree to the comparative poverty of the present times, medical
