At a time when too many colons were being removed following Lanes idea of disposing of toxic effects in that way, Dr. Von Strensch asked me to see a man suffering from a mania and who required two attendants day and night. He screamed so loudly and so constantly that a number of private sanitoria had refused to keep him.
I found that the ascending and transverse colons were constantly distended, and that he became temporarily better after colonic irrigation. I consented to remove these distended parts on the understanding that the procedure was one of questionable character, but permissible in view of the hopelessness of the case. The man promptly became well enough to dispose of all attendants and to take up again the management of a large business. (To-day I would try treatment for a toxic psychosis first.).
Another case of mania, cyclical in type, was brought to me later by the same physician. The patient, a beautiful girl, nineteen years of age, was very destructive during the depressive stage and would run about the room tearing down works of art and curtains, meanwhile putting her right hand to the right side of her head frequently. An examination of her head was made, to see if there might not be an old injury.
Someone then recalled that she had fallen from a chair and injured her head when a little child. Irritable dural adhesions had resulted. These were separated and there was no recurrence of mania subsequently. Surgery was the only thing for that patient.
A big, burly ice-man at Ithaca brought me his baby daughter suffering from prolapse of the rectum. When I began the operation of taking out alternate strips of mucous membrane the haemorrhage was not controlled very well by the device which was employed and it was necessary to back out of the case defeated. I told the father that we would have to employ another kind of operation when his little girl was older. About a month later the father came in and said that he had not received any bill, pulling out a roll of cash as he spoke. I said there would be no bill, and asked how baby was getting on.
His reply filled me with joy, “Oh, shes all well. After we got home my wife remembered that alum was kind of puckering. She mixed up a lot of it in water and put it on two or three times a day. Baby got all well in a week.” He still insisted upon paying me, and when I declined to accept anything on the ground that it was his wife and not I who had brought about the cure, he said, “Why, Doc., we all done the best we could and you had a whole lot the most trouble”.
A similar incident occurred some years later in New York. a charming young woman developed an ugly crop of warts on both hands. Several experts treated her expensively without gaining any result. Some neighbor told the mother to apply the castor oil locally at night. This cured the warts. The neighbor made no charge.
Surgeon are frequently asked if they are nervous when about to do an operation. I cannot imagine such a thing. We concentrate attention upon the idea of doing something that will help somebody out of trouble. How can one become nervous over the idea of being useful? My only worry has been that the wrong patient might be rolled into the operating-room out of turn at the hospital when several operations were on the schedule for an afternoon. Patients are prepared and covered up in such a way in the anaesthetizing-room that the particular patient who is brought in. The schedule is sometimes changed at the last moment.
In October 1820, newspaper reported that a Russian cobbler by the name of Kolesnikof, who had fraudulently acquired the licence and documents of a deceased Dr. Meski, went to surgery and actually became chief surgeon of the Kieff hospitals. He did six hundred major operations with a mortality percentage which was much lower than the average. Upon discovering his identity, Kieff surgeons were astounded at his record. At the trial it was testified that he operated with “brutal rapidity”. That was the reason for his success, but they did not know it. A brutal rapidity may be kindly.
Tait sneered at antiseptic or aseptic surgery at a time when it was close to our hearts. He presented better statistics in abdominal surgery than were presented by any surgeon of his day who was following Listerian principles. His results called for explanation which we could not then give.
Tait was a speedy operator through small incisions. He worked lightly, by the sense of touch. He did play to the gallery a bit, but with a sense of humour that seemed to be directed towards Treves. Tait was depending upon the patients naturals powers of resistance which, through rapid operating and the infliction of a small degree of surgical injury, were not shocked and put out of commission. It looked very much as if his patients were meeting infection better than the patient of the rest of us.
The renowned New York doctor, Robert T. Morris (1857-1945), who struggled with a reactionary profession to pioneer sterility, small incisions, and better wound-healing in surgery. Blessed with abundant energy, sagacity, and long life, he also achieved distinction as a naturalist, horticulturist, and explorer, celebrating nature with brilliant prose and poetry. For those days, Morris was a rare visionary, grounded in science and courageously fighting on the side of suffering humanity, though few remember him today.