Under these circumstances there was, of course, not the slightest reason to make an examination of the bladder unless from curiosity or with the object of earning a fee. the cystoscope is a biggish tube, with an electric light and a mirror at the end of it. Using it the surgeon can visually inspect every portion of the bladder wall and the openings where the urine from the kidneys flows into the bladder. I do not see much purpose in making this dangerous examination except if an operation has been injured for life by the rash or clumsy use of the cystoscope.
The poor old man went to the surgeon to be examined. He was put under an anesthetic. Consequently he did not feel pain. He did not realise that fearful internal damage was done. Brutally or clumsily the instrument was inserted, and after entirely purposeless examination it was withdrawn. Immediately on the withdrawal blood gushed out in torrents. The unfortunate individual collapsed, an ambulance had to be called, and he was taken home in a desperate condition.
Examination of the body openings with the finger can be done with the utmost gentleness or roughly. One should rather waste some time than give unnecessary pain to the patient. Gentleness on the part of the prescriber is always greatly appreciated by the sick.
If a doctor or lay prescriber calls upon patients, he must observe the best standards of department. It is a great mistake to go into the house of poor people and treat them as inferiors because they are poor, to talk to them roughly or talk down to them. Humble individuals do not like to be made to suffer. They are very sensitive to slights. Moreover, the doctor should enter the poorest cottage with a much consideration as he would show in entering the house of the wealthy. Even a poor working woman does not like to see her floor soiled by the doctors dirty boots.
When the doctor had ended his interrogation and has made a thorough physical examination, then he should tackle the all- important question of diet : “Many patients will airily say when asked about their diet : “I eat and drink what everyone eats and drinks.” Most people make a choice of their own. One can ascertain the true facts only if one takes down on paper all that is eaten and drunk at every meal and in between meals.
Doctors should ask : “What do you have before breakfast ? What do you have at breakfast ? Do you take tea strong or very strong, hot or very hot ? How much milk do you put in, and how much sugar ? Do you use tinned of fresh milk ? Do you use white or brown sugar, white bread or whole meal bread ? How much salt do you take with your egg ? What cooking implements do you use ? Do you use implements made of aluminium or copper ?” After all, there is aluminium poisoning, copper poisoning lead poisoning, if water is taken from hot water taps, etc.
When all that has been taken at the various meals and in between has been put down on paper, then the prescriber will cast his eye over the statement, and he may discover that the patient takes fifteen cups of boiling hot tea daily as black as ink, with together a pound or more of white sugar.
Or he may discover that the individual takes prodigious quantities of salt, pepper, mustard, vinegar pickles, or that the patient takes hardly any liquid, or that he takes prodigious quantities of liquids and hardly any solids. The prescriber cannot be sufficient careful in ascertaining all the facts of patients. A patients will say : “I smoke four or five cigarettes in the course of the day.” In reality he may smoke thirty, forty or fifty, and he is afraid that the doctor may curtail that number.
There are parents who chiefly eat food produced by means of a tin opener. They may feel ashamed of the fact and mislead the prescriber. One must preface ones enquiry by a few remarks pointing out the importance that the patient should tell the truth, the whole truth and nothing but the truth.
The prescriber should not only ask what is eaten and drunk. He should ascertain the way in which the food is cooked. Overlong cooking of vegetables and stews destroys the vitamins. Simmering for countless hours will make the food more palatable, but will ruin it. The addition of soda or bicarbonate of soda to the water in which vegetables are cooked destroys the vitamins. If potatoes are peeled before they are cooked, the valuable alkalies are leeched out and go down the sink.
James Ellis Barker wrote a very large number of books, both under the name James Ellis Barker and under his real German name Otto Julius Eltzbacher, The Truth about Homœopathy; Rough Notes on Remedies with William Murray; Chronic Constipation; The Story of My Eyes; Miracles Of Healing and How They are Done; Good Health and Happiness; New Lives for Old: How to Cure the Incurable; My Testament of Healing; Cancer, the Surgeon and the Researcher; Cancer, how it is Caused, how it Can be Prevented with a foreward by William Arbuthnot Lane; Cancer and the Black Man etc.