SYNOPSIS OF COUNTRY PRACTICE A HALF CEN

TURY AGO.

1

BY HENRY GAITHER, M. D., OXFORD, Ga.

You invite me to write something for the approaching session of the Medical Association of Georgia on any subject I might select.

As you have so many literary delicacies served up annually by our honored and learned brethren, I conclude to vary the entertainment by giving you a running desultory narrative of country experience, touching only a few points in this very wide field.

Well, I am a country doctor and have been ab initio ; I say country doctor, because most of my practice has been in the country, although I live, and have lived from the start, in a little town, and have shared satisfactorily the practice there with my worthy competing brethren.

I am no surgeon; have no special pretentions in that line, but have had to do some things (in all the departments) that meet the general practitioner, such as broken and dislocated bones, from head to foot. Also accouchments, in number somewhere between 3,000 and 5,000, in a half century, embracing the extremes of from "do nothing" to forceps, and more formidable instrumental cases. I recoiled from surgery, not from fear of blood, but from the belief that no one could become highly proficient therein, outside of a large city, with its facilities and patronage. Moreover, in the country one must accept cases of all kinds as they

occur, or cripple his business, or quit the calling. In those far-back days there were no railroads to take the patient to the city, or the surgeon to the country. Hence the necessity of being well "read up" for any emergency. To illustrate: Mrs. M., a primipara, in the hands of a midwife, had a succession of convulsions and continued profound coma. This was my first case of the kind. No consultation within twelve miles. Relief must be speedy or death ensue. I felt the awful responsibility. Two human lives at stake, and I had never seen instruments used. Prompt action needed. How glad I was, that I knew what the books said on the subject, as well as I knew the A, B, C's. My lancet did its work freely. The forceps, warmed, oiled and applied secundum artem, and co-operating with the pains, a large, male child soon delivered, apparently lifeless but soon resuscitated, and then the mother received attention. No abrasion on the child or injury to the mother. She was soon well and the child grew finely.

As to hare-lip, I have operated often, and with success, sooner or later in all cases. The patients from three months to adult age; I give a case: Miss H, a beautiful girl, in a deep and dark recess of the country, whose penurious father had long refused the operation, fearing the cost. Accidentally seeing her, I tendered my services gratuitously. A successful operation was soon followed by her happy marriage. By the way, the rule of my life has been, when I tender my services. (that my motive be not misunderstood), I never accept a fee. To the rich I never tender them.

"Esq." T., a rich farmer and money lender, called me to see his son, a young man who had been bleeding three days from a tooth the blacksmith had extracted. He could hardly turn in bed or have his head raised without fainting. A large clot, from under which the blood flowed, was removed. Pul

verized alum, a dossil of lint, and a bit of cork to keep it adjusted, cured the "heir apparent" at once. This success, after the failure of "soot and sugar," and the blacksmith, made the father think I could "conjure;" he asked the price of operating for hare-lip on a negro boy; $25.00 was the reply. The benevolent millionaire could not stand that, and the boy, so far as I know, wears his deformity to this day. I was more than willing to serve God's poor, but not willing to reward and cultivate covetousness I wanted to follow, in faith and practice, good old Sydenham (and later Dr J. A Eve), that while the rich pay for themselves, God pays for the poor.

Mrs. H. had for years suffered the horrors of recto-perineum laceration, occasioned by the mismanagement of an ignorant midwife. I pared the edges and closed the awful gaping chasm with interrupted sutures, constipated the bowels, according to the books, for I had no experience in that line, and no older help could be had in that distant place and day. In due time she was well, and after an interruption of years, a new series of children appeared, and continued in regular succession until the menopause. fore leaving this branch of the subject, I should say I have had quite a number of instrumental eases, either of my own. or when consulted. More of forceps than of other instruments, yet carrying out practically the teachings of Denman, Baudaloque, Burns and others of that type; I conclude my instrumental cases have been relatively fewer than more modern teachings, and less reliance on the resources of nature would have yielded.

As to fracture of the skull, I have had many cases, mostly of boys thrown from horses or mules. After minor preliminaries and venesection, we attempt to move the bowels, actively, often hard to do, from nausea and vomiting, but per

sistence in repetition and variety of cathartics, seldom if ever fail, and under rigid antiphlogistic treatment, recovery follows, even when there is continued depression of the bone, especially in boys, and after attaining maturity, I have not known epilepsy to follow. I remember a man of mature age who had deep depression from a fall from his horse. Coma, constant and profound, aided by the gifted Dr. W. P. Graham, my ever lamented friend, the trephine was used, the bone elevated and perfect and permanent recovery followed.

It is said that Baron Wenzel admitted he had destroyed a "hatful of eyes" before he became proficient in his specialty on the eye. This had a chilling effect on the young ambition of most of us country doctors.

While we lingering sojourners hold fondly to the lancet and scarificator, we joyfully accept modern improvements in implements and medicines. Notably the hypodermic syringe and clinical thermometer among the former and quinia and morphia among the latter. My hair would not have whitened so fast, nor my heart ached so much, nor my patients suffered so long, if I could have put a soothing dose out of the reach of a refractory stomach. Now we no longer give bark in substance and infusion of serpentaria to a revolting stomach in paroxysmal fevers, but cure them in a day or two with almost unvarying success, even cases that formerly lingered for weeks with painful uncertainty of issue. Thus, owing much to our enterprising predecessors, we will emulate their example, and try to leave to our successors tangible evidence that we have not lived and labored in vain.