首页 >出版文学> Medical Essays>第38章

第38章

  IwishtoclosethisLecture,ifyouwillallowmeafewmomentslonger,withabriefsketchofaninstructorandpractitionerwhosecharacterwasasnearlyamodeloneinbothcapacitiesasIcanfindanywhererecorded。
  Dr。JAMESJACKSON,ProfessoroftheTheoryandPracticeofMedicineinthisUniversityfrom1812to1846,andwhosenamehasbeensinceretainedonourrollsasProfessorEmeritus,diedonthe27thofAugustlast,intheninetiethyearofhisage。Hestudiedhisprofession,asIhavealreadymentioned,withDr。HolyokeofSalem,oneofthefewphysicianswhohavebornewitnesstotheirknowledgeofthelawsoflifebylivingtocompletetheirhundredthyear。I
  thinkthestudenttookhisOldMaster,ashealwayslovedtocallhim,ashismodel;eachwasworthyoftheother,andbothwerebrightexamplestoallwhocomeafterthem。
  IrememberthatinthesermonpreachedbyDr。GrazerafterDr。
  Holyoke’sdeath,oneofthepointsmostinsisteduponascharacteristicofthatwiseandgoodoldmanwastheperfectbalanceofallhisfaculties。Thesameharmoniousadjustmentofpowers,thesamesymmetricalarrangementoflife,thesamecompletefulfilmentofeveryday’sduties,withouthasteandwithoutneedlessdelay,whichcharacterizedthemaster,equallydistinguishedthescholar。A
  glanceatthelifeofourownOldMaster,ifIcandoanyjusticeatalltohisexcellences,willgiveyousomethingtocarryawayfromthishour’smeetingnotunworthytoberemembered。
  >FromDecember,1797,toOctober,1799,heremainedwithDr。Holyokeasastudent,aperiodwhichhehasspokenofasamostinterestingandmostgratifyingpartofhislife。AfterthishepassedeightmonthsinLondon,andonhisreturn,inOctober,1800,hebeganbusinessinBoston。
  HehadfollowedMr。Cline,asIhavementioned,andwascompetenttopractiseSurgery。ButhefoundDr。JohnCollinsWarrenhadalreadyoccupiedthegroundwhichatthatdayhardlycalledformorethanoneleadingpractitioner,andwiselychosetheMedicalbranchoftheprofession。Hehadonlyhimselftorelyupon,buthehadconfidenceinhisprospects,conscious,doubtless,ofhisownpowers,knowinghisownindustryanddetermination,andbeingofaneminentlycheerfulandhopefuldisposition。Nobetterproofofhisspiritcanbegiventhanthat,justayearfromthetimewhenhebegantopractiseasaphysician,hetookthateventfulstepwhichinsuchamanimpliesthatheseeshiswaycleartoaposition;hemarriedaladyblessedwithmanygifts,butnotbringinghimafortunetoparalyzehisindustry。
  Hehadnotmiscalculatedhischancesinlife。Heverysoonroseintoagoodpractice,andbeganthefoundingofthatreputationwhichgrewwithhisyears,untilhestoodbygeneralconsentattheheadofhischosenbranchoftheprofession,tosaytheleast,inthiscityandinallthisregionofcountry。Hisskillandwisdomwerethelasttribunaltowhichthesickandsufferingcouldappeal。Thecommunitytrustedandlovedhim,theprofessionrecognizedhimasthenoblesttypeofthephysician。Theyoungmenwhomhehadtaughtwanderedthroughforeignhospitals;wheretheylearnedmanythingsthatwerevaluable,andmanythatwerecurious;butastheygrewolderandbegantothinkmoreoftheirabilitytohelpthesickthantheirpoweroftalkingaboutphenomena,theybegantolookbacktotheteachingofDr。Jackson,ashe,afterhisLondonexperience,lookedbacktothatofDr。Holyoke。Andsoitcametobeatlastthatthebarementionofhisnameinanyofourmedicalassemblieswouldcallforthsuchatributeofaffectionateregardasisonlyyieldedtoagewhenitbringswithittherecordofalifespentinwelldoing。
  Noaccidentevercarriesamantoeminencesuchashisinthemedicalprofession。Hewholooksforitmustwantitearnestlyandworkforitvigorously;Naturemusthavequalifiedhiminmanyways,andeducationmusthaveequippedhimwithvariousknowledge,orhisreputationwillevaporatebeforeitreachesthenoon-dayblazeoffame。HowdidDr。Jacksongainthepositionwhichallconcededtohim?Intheanswertothisquestionsomeamongyoumayfindakeythatshallunlockthegateopeningonthatfairfieldofthefutureofwhichalldreambutwhichnotallwilleverreach。
  Firstofall,hetrulylovedhisprofession。Hehadnointellectualambitionsoutsideofit,literary,scientificorpolitical。Tohimitwasoccupationenoughtoapplyatthebedsidethebestofallthatheknewforthegoodofhispatient;toprotectthecommunityagainsttheinroadsofpestilence;toteachtheyoungallthathehimselfhadbeentaught,withallthathisownexperiencehadadded;toleaveonrecordsomeofthemostimportantresultsofhislongobservation。
  Withhispatientshewassoperfectatallpointsthatitishardtooverpraisehim。IhaveseenmanynotedBritishandFrenchandAmericanpractitioners,butIneversawthemansoaltogetheradmirableatthebedsideofthesickasDr。JamesJackson。Hissmilewasitselfaremedybetterthanthepotablegoldandthedissolvedpearlsthatcomfortedthepraecordiaofmediaevalmonarchs。Didapatient,alarmedwithoutcause,needencouragement,itcarriedthesunshineofhopeintohisheartandputallhiswhimstoflight,asDavid’sharpclearedthehauntedchamberofthesullenking。Hadthehourcome,notforencouragement,butforsympathy,hisface,hisvoice,hismannerallshowedit,becausehisheartfeltit。Sogentlewashe,sothoughtful,socalm,soabsorbedinthecasebeforehim,nottoturnroundandlookforatributetohissagacity,nottobolsterhimselfinafavoritetheory,buttofindoutallhecould,andtoweighgravelyandcautiouslyallthathefound,thattofollowhiminhismorningvisitwasnotonlytotakealessoninthehealingart,itwaslearninghowtolearn,howtomove,howtolook,howtofeel,ifthatcanbelearned。TovisitwithDr。Jacksonwasamedicaleducation。
  Hewasveryfirm,withallhiskindness。Hewouldhavethetruthabouthispatients。Thenursesfounditout;andtheshrewderonesneverventuredtotellhimanythingbutastraightstory。AclinicaldialoguebetweenDr。JacksonandMissRebeccaTaylor,sometimenurseintheMassachusettsGeneralHospital,amistressinhercalling,wasasgoodquestioningandansweringasonewouldbeliketohearoutsideofthecourt-room。
  Ofhispracticeyoucanformanopinionfromhisbookcalled“LetterstoaYoungPhysician。“LikeallsensiblemenfromthedaysofHippocratestothepresent,heknewthatdietandregimenweremoreimportantthananydrugorthanalldrugsputtogether。Witnesshistreatmentofphthisisandofepilepsy。Heretained,however,moreconfidenceinsomeremedialagentsthanmostoftheyoungergenerationwouldconcedetothem。Yethismateriamedicawasasimpleone。
  “WhenIfirstwenttolivewithDr。Holyoke,“hesays,“in1797,showingmehisshop,hesaid,’Thereseemstoyoutobeagreatvarietyofmedicineshere,andthatitwilltakeyoulongtogetacquaintedwiththem,butmostofthemareunimportant。Therearefourwhichareequaltoalltherest,namely,Mercury,Antimony,BarkandOpium。’“AndDr。Jacksonadds,“Icanonlysayofhispractice,thelongerIhavelived,Ihavethoughtbetterandbetterofit。“
  Whenhethoughtitnecessarytogivemedicine,hegaveitinearnest。
  Hehatedhalf-practice——givingalittleofthisorthat,soastobeabletosaythatonehaddonesomething,incaseaconsultationwasheld,orastillmoreominouseventoccurred。Hewouldgiveopium,forinstance,asboldlyasthelateDr。FisherofBeverly,buthefollowedtheaphorismoftheFatherofMedicine,andkeptextremeremediesforextremecases。
  Whenitcametothe“non-naturals,“ashewouldsometimescallthem,aftertheoldphysicians,——namely,air,meatanddrink,sleepandwatching,motionandrest,theretentionsandexcretions,andtheaffectionsofthemind,——hewas,asIhavesaid,oftheschoolofsensiblepractitioners,indistinctionfromthatvastcommunityofquacks,withorwithoutthediploma,whothinkthechiefendofmanistosupportapothecaries,andarenevereasyuntiltheycangeteverypatientuponaregularcourseofsomethingnastyornoxious。
  Nobodywassopreciseinhisdirectionsaboutdiet,air,andexercise,asDr。Jackson。Hehadthesamedisliketotheapeupres,theaboutsomuch,aboutsooften,aboutsolong,whichIafterwardsfoundamongthepunctiliousadherentsofthenumericalsystematLaPitie。
  Heusedtoinsistononesmallpointwithacertainphilologicalprecision,namely,thetruemeaningoftheword“cure。“Hewouldhaveitthattocureapatientwassimplytocareforhim。Irefertoitasshowingwhathisideawasoftherelationofthephysiciantothepatient。Itwasindeedtocareforhim,asifhislifewereboundupinhim,towatchhisincomingsandoutgoings,tostandguardateveryavenuethatdiseasemightenter,toleavenothingtochance;
  notmerelytothrowafewpillsandpowdersintoonepanofthescalesofFate,whileDeaththeskeletonwasseatedintheother,buttoleanwithhiswholeweightonthesideoflife,andshiftthebalanceinitsfavorifitlayinhumanpowertodoit。Suchdevotionasthisisonlytobelookedforinthemanwhogiveshimselfwhollyuptothebusinessofhealing,whoconsidersMedicineitselfaScience,orifnotascience,iswillingtofollowitasanart,——thenoblestofarts,whichthegodsanddemigodsofancientreligionsdidnotdisdaintopractiseandtoteach。
  Thesamezealmadehimalwaysreadytolistentoanynewsuggestionwhichpromisedtobeuseful,ataperiodoflifewhenmanymenfindithardtolearnnewmethodsandacceptnewdoctrines。Fewofhisgenerationbecamesoaccomplishedasheintheartsofdirectexploration;comingstraightfromtheParisianexperts,Ihaveexaminedmanypatientswithhim,andhavehadfrequentopportunitiesofobservinghisskillinpercussionandauscultation。
  Oneelementinhissuccess,atrivialonecomparedwithothers,butnottobedespised,washispunctuality。Healwayscarriedtwowatches,——Idoubtifhetoldwhy,anymorethanDr。Johnsontoldwhathedidwiththeorange-peel,——butprobablywithreferencetothisvirtue。Hewasasmuchtobedependeduponattheappointedtimeasthesolsticeortheequinox。TherewasanotherpointIhaveheardhimspeakofasanimportantrulewithhim;tocomeatthehourwhenhewasexpected;ifhehadmadehisvisitforseveraldayssuccessivelyatteno’clock,forinstance,nottoputitoff,ifbecouldpossiblyhelpit,untileleven,andsokeepanervouspatientandananxiousfamilywaitingforhimthroughalong,wearyhour。
  IfIshouldattempttocharacterizehisteaching,Ishouldsaythatwhileitconveyedthebestresultsofhissagaciousandextendedobservation,itwassingularlymodest,cautious,simple,sincere。
  Nothingwasforshow,forself-love;therewasnorhetoric,nodeclamation,notriumphant“Itoldyouso,“buttheplainstatementofaclear-headedhonestman,whoknowsthatheishandlingoneofthegravestsubjectsthatinteresthumanity。Hispositiveinstructionswerefullofvalue,butthespiritinwhichhetaughtinspiredthatloyalloveoftruthwhichliesatthebottomofallrealexcellence。
  Iwillnotsaythat,duringhislongcareer,Dr。Jacksonnevermadeanenemy。Ihaveheardhimtellhow,inhisveryearlydays,oldDr。
  Danforthgotintoatoweringpassionwithhimaboutsomeprofessionalconsultation,andexplodedamonosyllableortwoofthemoreenergetickindontheoccasion。Irememberthatthatsomewhatpeculiarpersonage,Dr。Waterhouse,tookithardlywhenDr。JacksonsucceededtohisplaceasProfessorofTheoryandPractice。AyoungmanofDr。Jackson’stalentandenergycouldhardlytakethepositionthatbelongedtohimwithoutcrowdingsomebodyinaprofessionwherethreeinabedisthecommonruleofthehousehold。Buthewasapeacefulmanandapeace-makerallhisdays。Nomaneverdidmore,ifsomuch,toproduceandmaintainthespiritofharmonyforwhichweconsiderourmedicalcommunityassomewhatexceptionallydistinguished。
  Ifthisharmonyshouldeverbethreatened,Icouldwishthateveryimpatientandirritablememberoftheprofessionwouldreadthatbeautiful,thatnoblePrefacetothe“Letters,“addressedtoJohnCollinsWarren。IknownothingfinerinthemedicalliteratureofalltimethanthisPrefatoryIntroduction。Itisagoldenprelude,fittogowiththethreegreatPrefaceswhichchallengetheadmirationofscholars,——Calvin’stohisInstitutes,DeThou’stohisHistory,andCasaubon’stohisPolybius,——notbecauseofanylearningorrhetoric,thoughitischarminglywritten,butforaspiritflowingthroughittowhichlearningandrhetoricarebutasthebreaththatiswastedontheairtotheMoodthatwarmstheheart。
  OfasimilarcharacteristhisshortextractwhichIampermittedtomakefromaprivateletterofhistoadearyoungfriend。Hewaseighty-threeyearsoldatthetimeofwritingit。
  “IhavenotlovedeverybodywhomIhaveknown,butIhavestriventoseethegoodpointsinthecharactersofallmenandwomen。AtfirstImusthavedonethisfromsomethinginmyownnature,forIwasnotawareofit,andyetwasdoingitwithoutanyplan,whenoneday,sixtyyearsago,afriendwhomIlovedandrespectedsaidthistome,’Ah,James,Iseethatyouaredestinedtosucceedintheworld,andtomakefriends,becauseyouaresoreadytoseethegoodpointinthecharactersofthoseyoumeet。’“
  IclosethisimperfectnoticeofsomefeaturesinthecharacterofthismosthonoredandbelovedofphysiciansbyapplyingtohimthewordswhichwerewrittenofWilliamHeberden,whosecareerwasnotunlikehisown,andwholivedtothesamepatriarchalage。
  “Fromhisearlyyouthhehadalwaysentertainedadeepsenseofreligion,aconsummateloveofvirtue,anardentthirstafterknowledge,andanearnestdesiretopromotethewelfareandhappinessofallmankind。Bythesequalities,accompaniedwithgreatsweetnessofmanners,heacquiredtheloveandesteemofallgoodmen,inadegreewhichperhapsveryfewhaveexperienced;andafterpassinganactivelifewiththeuniformtestimonyofagoodconscience,hebecameaneminentexampleofitsinfluence,inthecheerfulnessandserenityofhislatestage。“
  SuchwasthemanwhomIoffertoyouasamodel,younggentlemen,attheoutsetofyourmedicalcareer。IhopethatmanyofyouwillrecognizesometraitsofyourownspecialteachersscatteredthroughvariouspartsofthelandinthepictureIhavedrawn。Letmeassureyouthatwhateveryoumaylearninthisoranyothercourseofpubliclectures,——andItrustyouwilllearnagreatdeal,——thedailyguidance,counsel,example,ofyourmedicalfather,forsuchtheOathofHippocratestellsyoutoconsideryourpreceptor,will,ifheisinanydegreelikehimofwhomIhavespoken,bethefoundationonwhichallthatweteachisreared,andperhapsoutlivemostofourteachings,asinDr。Jackson’smemorythelastlessonsthatremainedwithhimwerethoseofhisOldMaster。
  THEMEDICALPROFESSIONINMASSACHUSETTS。
  ALectureofaCoursebymembersoftheMassachusettsHistoricalSociety,deliveredbeforetheLowellInstitute,January29,1869。
  Themedicalhistoryofeightgenerations,toldinanhour,mustbeinmanypartsamereoutline。ThedetailsIshallgivewillrelatechieflytothefirstcentury。Ishallonlyindicatetheleadingoccurrences,withthemoreprominentnamesofthetwocenturieswhichfollow,andaddsomeconsiderationssuggestedbythefactswhichhavebeenpassedinreview。