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Round The Red Lamp - A Medical Document

1. Behind the Times

2. His First Operation

3. A Straggler of '15

4. The Third Generation

5. A False Start

6. The Curse of Eve

7. Sweethearts

8. A Physiologist's Wife

9. The Case of Lady Sannox

10. A Question of Diplomacy

11. A Medical Document

12. Lot No. 249

13. The Los Amigos Fiasco

14. The Doctors of Hoyland

15. The Surgeon Talks

Medical men are, as a class, very much too busy
to take stock of singular situations or dramatic
events. Thus it happens that the ablest chronicler
of their experiences in our literature was a lawyer.
A life spent in watching over death-beds--or over
birth-beds which are infinitely more trying--takes
something from a man's sense of proportion, as
constant strong waters might corrupt his palate. The
overstimulated nerve ceases to respond. Ask the
surgeon for his best experiences and he may reply
that he has seen little that is remarkable, or break
away into the technical. But catch him some night
when the fire has spurted up and his pipe is reeking,
with a few of his brother practitioners for company
and an artful question or allusion to set him going.
Then you will get some raw, green facts new plucked
from the tree of life.

It is after one of the quarterly dinners of the
Midland Branch of the British Medical Association.
Twenty coffee cups, a dozer liqueur
glasses, and a solid bank of blue smoke which
swirls slowly along the high, gilded ceiling gives a
hint of a successful gathering. But the members have
shredded off to their homes. The line of heavy,
bulge-pocketed overcoats and of stethoscope-bearing
top hats is gone from the hotel corridor. Round the
fire in the sitting-room three medicos are still
lingering, however, all smoking and arguing, while a
fourth, who is a mere layman and young at that, sits
back at the table. Under cover of an open journal he
is writing furiously with a stylographic pen, asking
a question in an innocent voice from time to time and
so flickering up the conversation whenever it shows a
tendency to wane.

The three men are all of that staid middle age
which begins early and lasts late in the profession.
They are none of them famous, yet each is of good
repute, and a fair type of his particular branch.
The portly man with the authoritative manner and the
white, vitriol splash upon his cheek is Charley
Manson, chief of the Wormley Asylum, and author of
the brilliant monograph--Obscure Nervous Lesions in
the Unmarried. He always wears his collar high like
that, since the half-successful attempt of a student
of Revelations to cut his throat with a splinter of
glass. The second, with the ruddy face and the merry
brown eyes, is a general practitioner, a man of
vast experience, who, with his three assistants
and his five horses, takes twenty-five hundred a year
in half-crown visits and shilling consultations out
of the poorest quarter of a great city. That cheery
face of Theodore Foster is seen at the side of a
hundred sick-beds a day, and if he has one-third more
names on his visiting list than in his cash book he
always promises himself that he will get level some
day when a millionaire with a chronic complaint--the
ideal combination--shall seek his services. The
third, sitting on the right with his dress shoes
shining on the top of the fender, is Hargrave, the
rising surgeon. His face has none of the broad
humanity of Theodore Foster's, the eye is stern and
critical, the mouth straight and severe, but there is
strength and decision in every line of it, and it is
nerve rather than sympathy which the patient demands
when he is bad enough to come to Hargrave's door. He
calls himself a jawman "a mere jawman" as he modestly
puts it, but in point of fact he is too young and too
poor to confine himself to a specialty, and there is
nothing surgical which Hargrave has not the skill and
the audacity to do.

"Before, after, and during," murmurs the general
practitioner in answer to some interpolation of the
outsider's. "I assure you, Manson, one sees all
sorts of evanescent forms of madness."

"Ah, puerperal!" throws in the other,
knocking the curved grey ash from his cigar.
"But you had some case in your mind, Foster."

"Well, there was only one last week which was new
to me. I had been engaged by some people of the name
of Silcoe. When the trouble came round I went
myself, for they would not hear of an assistant. The
husband who was a policeman, was sitting at the head
of the bed on the further side. `This won't do,'
said I. `Oh yes, doctor, it must do,' said she.
`It's quite irregular and he must go,' said I. `It's
that or nothing,' said she. `I won't open my mouth
or stir a finger the whole night,' said he. So it
ended by my allowing him to remain, and there he sat
for eight hours on end. She was very good over the
matter, but every now and again HE would fetch a
hollow groan, and I noticed that he held his right
hand just under the sheet all the time, where I had
no doubt that it was clasped by her left. When it
was all happily over, I looked at him and his face
was the colour of this cigar ash, and his head had
dropped on to the edge of the pillow. Of course I
thought he had fainted with emotion, and I was just
telling myself what I thought of myself for having
been such a fool as to let him stay there, when
suddenly I saw that the sheet over his hand was all
soaked with blood; I whisked it down, and there was
the fellow's wrist half cut through. The woman
had one bracelet of a policeman's handcuff over her
left wrist and the other round his right one. When
she had been in pain she had twisted with all her
strength and the iron had fairly eaten into the bone
of the man's arm. `Aye, doctor,' said she, when she
saw I had noticed it. `He's got to take his share as
well as me. Turn and turn,' said she."

"Don't you find it a very wearing branch of the
profession?" asks Foster after a pause.

"My dear fellow, it was the fear of it that drove
me into lunacy work."

"Aye, and it has driven men into asylums who
never found their way on to the medical staff. I was
a very shy fellow myself as a student, and I know
what it means."

"No joke that in general practice," says the

"Well, you hear men talk about it as though it
were, but I tell you it's much nearer tragedy. Take
some poor, raw, young fellow who has just put up his
plate in a strange town. He has found it a trial all
his life, perhaps, to talk to a woman about lawn
tennis and church services. When a young man IS
shy he is shyer than any girl. Then down comes an
anxious mother and consults him upon the most
intimate family matters. `I shall never go to that
doctor again,' says she afterwards. `His manner is
so stiff and unsympathetic.' Unsympathetic!
Why, the poor lad was struck dumb and paralysed. I
have known general practitioners who were so shy that
they could not bring themselves to ask the way in the
street. Fancy what sensitive men like that must
endure before they get broken in to medical practice.
And then they know that nothing is so catching as
shyness, and that if they do not keep a face of
stone, their patient will be covered with confusion.
And so they keep their face of stone, and earn the
reputation perhaps of having a heart to correspond.
I suppose nothing would shake YOUR nerve, Manson."

"Well, when a man lives year in year out among a
thousand lunatics, with a fair sprinkling of
homicidals among them, one's nerves either get set or
shattered. Mine are all right so far."

"I was frightened once," says the surgeon. "It
was when I was doing dispensary work. One night I
had a call from some very poor people, and gathered
from the few words they said that their child was
ill. When I entered the room I saw a small cradle in
the corner. Raising the lamp I walked over and
putting back the curtains I looked down at the baby.
I tell you it was sheer Providence that I didn't drop
that lamp and set the whole place alight. The head
on the pillow turned and I saw a face looking up at
me which seemed to me to have more malignancy and
wickedness than ever I had dreamed of in a
nightmare. It was the flush of red over the
cheekbones, and the brooding eyes full of loathing of
me, and of everything else, that impressed me. I'll
never forget my start as, instead of the chubby face
of an infant, my eyes fell upon this creature. I
took the mother into the next room. `What is it?' I
asked. `A girl of sixteen,' said she, and then
throwing up her arms, `Oh, pray God she may be
taken!' The poor thing, though she spent her life in
this little cradle, had great, long, thin limbs which
she curled up under her. I lost sight of the case
and don't know what became of it, but I'll never
forget the look in her eyes."

"That's creepy," says Dr. Foster. "But I think
one of my experiences would run it close. Shortly
after I put up my plate I had a visit from a little
hunch-backed woman who wished me to come and attend
to her sister in her trouble. When I reached the
house, which was a very poor one, I found two other
little hunched-backed women, exactly like the first,
waiting for me in the sitting-room. Not one of them
said a word, but my companion took the lamp and
walked upstairs with her two sisters behind her, and
me bringing up the rear. I can see those three queer
shadows cast by the lamp upon the wall as clearly as
I can see that tobacco pouch. In the room above
was the fourth sister, a remarkably beautiful girl in
evident need of my assistance. There was no wedding
ring upon her finger. The three deformed sisters
seated themselves round the room, like so many graven
images, and all night not one of them opened her
mouth. I'm not romancing, Hargrave; this is absolute
fact. In the early morning a fearful thunderstorm
broke out, one of the most violent I have ever known.
The little garret burned blue with the lightning, and
thunder roared and rattled as if it were on the very
roof of the house. It wasn't much of a lamp I had,
and it was a queer thing when a spurt of lightning
came to see those three twisted figures sitting round
the walls, or to have the voice of my patient drowned
by the booming of the thunder. By Jove! I don't
mind telling you that there was a time when I nearly
bolted from the room. All came right in the end, but
I never heard the true story of the unfortunate
beauty and her three crippled sisters."

"That's the worst of these medical stories,"
sighs the outsider. "They never seem to have an

"When a man is up to his neck in practice, my
boy, he has no time to gratify his private curiosity.
Things shoot across him and he gets a glimpse of
them, only to recall them, perhaps, at some quiet
moment like this. But I've always felt, Manson,
that your line had as much of the terrible in it as
any other."

"More," groans the alienist. "A disease of the
body is bad enough, but this seems to be a disease of
the soul. Is it not a shocking thing--a thing to
drive a reasoning man into absolute Materialism--to
think that you may have a fine, noble fellow with
every divine instinct and that some little vascular
change, the dropping, we will say, of a minute
spicule of bone from the inner table of his skull on
to the surface of his brain may have the effect of
changing him to a filthy and pitiable creature with
every low and debasing tendency? What a satire an
asylum is upon the majesty of man, and no less upon
the ethereal nature of the soul."

"Faith and hope," murmurs the general

"I have no faith, not much hope, and all the
charity I can afford," says the surgeon. "When
theology squares itself with the facts of life I'll
read it up."

"You were talking about cases," says the
outsider, jerking the ink down into his stylographic

"Well, take a common complaint which kills many
thousands every year, like G. P. for instance."

"What's G. P.?"

"General practitioner," suggests the surgeon with
a grin.

"The British public will have to know what G. P.
is," says the alienist gravely. "It's increasing by
leaps and bounds, and it has the distinction of being
absolutely incurable. General paralysis is its full
title, and I tell you it promises to be a perfect
scourge. Here's a fairly typical case now which I
saw last Monday week. A young farmer, a splendid
fellow, surprised his fellows by taking a very rosy
view of things at a time when the whole country-side
was grumbling. He was going to give up wheat, give
up arable land, too, if it didn't pay, plant two
thousand acres of rhododendrons and get a monopoly of
the supply for Covent Garden--there was no end to his
schemes, all sane enough but just a bit inflated. I
called at the farm, not to see him, but on an
altogether different matter. Something about the
man's way of talking struck me and I watched him
narrowly. His lip had a trick of quivering, his
words slurred themselves together, and so did his
handwriting when he had occasion to draw up a small
agreement. A closer inspection showed me that one of
his pupils was ever so little larger than the other.
As I left the house his wife came after me. `Isn't it
splendid to see Job looking so well, doctor,' said
she; `he's that full of energy he can hardly keep
himself quiet.' I did not say anything, for I
had not the heart, but I knew that the fellow was as
much condemned to death as though he were lying in
the cell at Newgate. It was a characteristic case of
incipient G. P."

"Good heavens!" cries the outsider. "My own lips
tremble. I often slur my words. I believe I've got
it myself."

Three little chuckles come from the front of the

"There's the danger of a little medical knowledge
to the layman."

"A great authority has said that every first
year's student is suffering in silent agony from four
diseases," remarks the surgeon. " One is heart
disease, of course; another is cancer of the parotid.
I forget the two other."

"Where does the parotid come in?"

"Oh, it's the last wisdom tooth coming through!"

"And what would be the end of that young farmer?"
asks the outsider.

"Paresis of all the muscles, ending in fits,
coma, and death. It may be a few months, it may be a
year or two. He was a very strong young man and
would take some killing."

"By-the-way," says the alienist, "did I ever tell
you about the first certificate I signed? I came as
near ruin then as a man could go."

"What was it, then?"

"I was in practice at the time. One morning a
Mrs. Cooper called upon me and informed me that her
husband had shown signs of delusions lately. They
took the form of imagining that he had been in the
army and had distinguished himself very much. As a
matter of fact he was a lawyer and had never been out
of England. Mrs. Cooper was of opinion that if I
were to call it might alarm him, so it was agreed
between us that she should send him up in the evening
on some pretext to my consulting-room, which would
give me the opportunity of having a chat with him
and, if I were convinced of his insanity, of signing
his certificate. Another doctor had already signed,
so that it only needed my concurrence to have him
placed under treatment. Well, Mr. Cooper arrived in
the evening about half an hour before I had expected
him, and consulted me as to some malarious symptoms
from which he said that he suffered. According to
his account he had just returned from the Abyssinian
Campaign, and had been one of the first of the
British forces to enter Magdala. No delusion could
possibly be more marked, for he would talk of little
else, so I filled in the papers without the slightest
hesitation. When his wife arrived, after he had
left, I put some questions to her to complete the
form. `What is his age?' I asked. `Fifty,' said
she. `Fifty!' I cried. `Why, the man I
examined could not have been more than thirty!
And so it came out that the real Mr. Cooper had never
called upon me at all, but that by one of those
coincidences which take a man's breath away another
Cooper, who really was a very distinguished young
officer of artillery, had come in to consult me. My
pen was wet to sign the paper when I discovered it,"
says Dr. Manson, mopping his forehead.

"We were talking about nerve just now," observes
the surgeon. "Just after my qualifying I served in
the Navy for a time, as I think you know. I was on
the flag-ship on the West African Station, and I
remember a singular example of nerve which came to my
notice at that time. One of our small gunboats had
gone up the Calabar river, and while there the
surgeon died of coast fever. On the same day a man's
leg was broken by a spar falling upon it, and it
became quite obvious that it must be taken off above
the knee if his life was to be saved. The young
lieutenant who was in charge of the craft searched
among the dead doctor's effects and laid his hands
upon some chloroform, a hip-joint knife, and a volume
of Grey's Anatomy. He had the man laid by the
steward upon the cabin table, and with a picture of a
cross section of the thigh in front of him he began
to take off the limb. Every now and then, referring
to the diagram, he would say: `Stand by with
the lashings, steward. There's blood on the chart
about here.' Then he would jab with his knife until
he cut the artery, and he and his assistant would tie
it up before they went any further. In this way they
gradually whittled the leg off, and upon my word they
made a very excellent job of it. The man is hopping
about the Portsmouth Hard at this day.

"It's no joke when the doctor of one of these
isolated gunboats himself falls ill," continues the
surgeon after a pause. "You might think it easy for
him to prescribe for himself, but this fever knocks
you down like a club, and you haven't strength left
to brush a mosquito off your face. I had a touch of
it at Lagos, and I know what I am telling you. But
there was a chum of mine who really had a curious
experience. The whole crew gave him up, and, as they
had never had a funeral aboard the ship, they began
rehearsing the forms so as to be ready. They thought
that he was unconscious, but he swears he could hear
every word that passed. `Corpse comin' up the
latchway!' cried the Cockney sergeant of Marines.
`Present harms!' He was so amused, and so indignant
too, that he just made up his mind that he wouldn't
be carried through that hatchway, and he wasn't,

"There's no need for fiction in medicine,"
remarks Foster, "for the facts will always beat
anything you can fancy. But it has seemed to me
sometimes that a curious paper might be read at some
of these meetings about the uses of medicine in
popular fiction."


"Well, of what the folk die of, and what diseases
are made most use of in novels. Some are worn to
pieces, and others, which are equally common in real
life, are never mentioned. Typhoid is fairly
frequent, but scarlet fever is unknown. Heart
disease is common, but then heart disease, as we know
it, is usually the sequel of some foregoing disease,
of which we never hear anything in the romance. Then
there is the mysterious malady called brain fever,
which always attacks the heroine after a crisis, but
which is unknown under that name to the text books.
People when they are over-excited in novels fall down
in a fit. In a fairly large experience I have never
known anyone do so in real life. The small
complaints simply don't exist. Nobody ever gets
shingles or quinsy, or mumps in a novel. All the
diseases, too, belong to the upper part of the body.
The novelist never strikes below the belt."

"I'll tell you what, Foster," says the alienist,
there is a side of life which is too medical for the
general public and too romantic for the professional
journals, but which contains some of the richest
human materials that a man could study. It's
not a pleasant side, I am afraid, but if it is good
enough for Providence to create, it is good enough
for us to try and understand. It would deal with
strange outbursts of savagery and vice in the lives
of the best men, curious momentary weaknesses in the
record of the sweetest women, known but to one or
two, and inconceivable to the world around. It would
deal, too, with the singular phenomena of waxing and
of waning manhood, and would throw a light upon those
actions which have cut short many an honoured career
and sent a man to a prison when he should have been
hurried to a consulting-room. Of all evils that may
come upon the sons of men, God shield us principally
from that one!"

"I had a case some little time ago which was out
of the ordinary," says the surgeon. "There's a
famous beauty in London society--I mention no names--
who used to be remarkable a few seasons ago for the
very low dresses which she would wear. She had the
whitest of skins and most beautiful of shoulders, so
it was no wonder. Then gradually the frilling at her
neck lapped upwards and upwards, until last year she
astonished everyone by wearing quite a high collar at
a time when it was completely out of fashion. Well,
one day this very woman was shown into my consulting-
room. When the footman was gone she suddenly tore
off the upper part of her dress. `For Gods sake
do something for me!' she cried. Then I saw what the
trouble was. A rodent ulcer was eating its way
upwards, coiling on in its serpiginous fashion until
the end of it was flush with her collar. The red
streak of its trail was lost below the line of her
bust. Year by year it had ascended and she had
heightened her dress to hide it, until now it was
about to invade her face. She had been too proud to
confess her trouble, even to a medical man."

"And did you stop it?"

"Well, with zinc chloride I did what I could.
But it may break out again. She was one of those
beautiful white-and-pink creatures who are rotten
with struma. You may patch but you can't mend."

"Dear! dear! dear!" cries the general
practitioner, with that kindly softening of the eyes
which had endeared him to so many thousands. "I
suppose we mustn't think ourselves wiser than
Providence, but there are times when one feels that
something is wrong in the scheme of things. I've
seen some sad things in my life. Did I ever tell you
that case where Nature divorced a most loving couple?
He was a fine young fellow, an athlete and a
gentleman, but he overdid athletics. You know how
the force that controls us gives us a little tweak to
remind us when we get off the beaten track. It may
be a pinch on the great toe if we drink too much
and work too little. Or it may be a tug on our
nerves if we dissipate energy too much. With the
athlete, of course, it's the heart or the lungs. He
had bad phthisis and was sent to Davos. Well, as
luck would have it, she developed rheumatic fever,
which left her heart very much affected. Now, do you
see the dreadful dilemma in which those poor people
found themselves? When he came below four thousand
feet or so, his symptoms became terrible. She could
come up about twenty-five hundred and then her heart
reached its limit. They had several interviews half
way down the valley, which left them nearly dead, and
at last, the doctors had to absolutely forbid it.
And so for four years they lived within three miles
of each other and never met. Every morning he would
go to a place which overlooked the chalet in which
she lived and would wave a great white cloth and she
answer from below. They could see each other quite
plainly with their field glasses, and they might have
been in different planets for all their chance of

"And one at last died," says the outsider.

"No, sir. I'm sorry not to be able to clinch the
story, but the man recovered and is now a successful
stockbroker in Drapers Gardens. The woman, too, is
the mother of a considerable family. But what are
you doing there?"

"Only taking a note or two of your talk."

The three medical men laugh as they walk towards
their overcoats.

"Why, we've done nothing but talk shop," says the
general practitioner. "What possible interest can
the public take in that?"

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