A Doctor in 1887.

In my younger days, discipline at home and in schools was harsh, even to the upper classes. It was a case of doing what you are told without delay or protest, or suffer the firm consequences.

A time when necessity ranked far above luxuries and Calvinism influenced our daily thoughts and action.
Later came inevitable changes to this harsh existence and medical treatments correspondingly followed suit. First there was a continuation of the old ways and then an embracing of newer procedures. Whether these changes were a real improvement I cannot say, except I have been subject to much criticism in my daily life and work. To this disapproval I am almost immune.

I am for the simpler life and give the following grounds for adopting such a policy.
Younger doctors tend to follow the teaching of the Medical schools without reservation or hesitation, as it is easier to be guided by an authority than to think for oneself. There seems to be far more freedom of thought outside the profession than within and I am convinced medical teaching and methods are more than often wrong.

Round about 1845 the tide of learning changed mainly due to the teaching of an eminent London doctor, who died relatively young of liver disease.

This doctor advocated stimulation by good food and drink which in a very short period of time became the vogue. Whereas, I tended to pursue the good counsel of medio tutissimis ibis.

( You will go safely by the middle way). Which suited my long observations of medical science and helped me so much in my later tasks.

Medical instruments circa 1887
Some surgical  instruments!
I began my M.D. degree in 1841 at Edinburgh and became a Fellow of the College of Physicians four years later. During which I attended the Edinburgh Infirmary to my great advantage, then a year under Professor  Schoepf Merei at Perth hospital for children. (one of only three in Scotland). Then a winter in Paris at the Ecole de Medecine and later assistant to Sir James Simpson, then departed to Italy, Palestine and Syria. In the latter, I had clients from Turkish Pashas to the poorest in wrenched towns and tents.
From this, you may gather I had a varied experience of diverse methods of treatments from different places and schools of thought. I have to say there was little science and treatment for the most part empirical, with few valid remedies.

Reform could be seen in Paris by Majendie and Forbes of London, who considered the strong approach to severe ailments were of no effect.

In pneumonia cases, patients improved by merely keeping them in bed and not disturbed by useless treatments. Following this theory others used very small doses of medicine to better effect that the more often used stronger doses. There was of course opposition such as Dr Erskine’s  treatment of consumption by placing the patient on a more bountiful diet. 
An excellent example is my own father when aged 44 and a strong man, was treated for a wee case of pneumonia. For this predicament he was bled and given less food, then sent for a change of air. Unfortunately he left a bed room window open and caught a cold. Two famous doctors thought he was about to contract consumption. He was ordered to have his room set at 60 degrees in winter and placed on the strictest of diets. The result as you may imagine reduced his ability to improve.
Attentive friends fortunately sent him for another change of air and sensibly stopped the treatment the doctors had ordered, after which he soon improved. He lived until he was 89 and walked from 5 miles to 70 miles in excellent health.

On the use of drugs I saw an old lady being treated by Dr Alison for a gall bladder complaint. She was starved to the point of emaciation and nurtured with mercurial therapy. She did not improve and her case seemed hopeless, surgery was now on the horizon. She was near the point of death when I ended the treatment, more in hope of her dying in peace. I put her on a small dose of milk and lime water and was pleased to find her improve steadily. Her own doctor resumed the previous cures and she died soon after.
As a child I was often sickly and had to take a large doses of a drug named Calomel, from which I suffered terribly. It was then that I resolved if I even became a doctor I would refrain from the its use on children. This pledge I have held ever since.

During a visit to Rio and English gentleman had dyspepsia and then contacted haematuria. A sea voyage was recommended and a plentiful intake of  good food. The latter was to make up for the continual loss of blood and to keep up his vitality. Each and every remedy was used except, turpentine, his own doctor freely admitted. The case seemed quite hopeless.

One night I offered to take him to my own house for the night. Once there I placed him on a full diet. The patient was so ill he was willing to try anything other than more medicines. Weeks later I received a letter from his nephew saying he had improved slowly and credited it to my advice.
I have to admit this is not always the case.

For adults and growing youths, natural milk is one of the most perfect of foods. Ideal for a healthy body and bone. I have known people to live for 30 years on it alone and enjoying the best of health.
Simple water is a necessity, as in a case where a child had been left to two elderly aunts, while the parents went to India. On a visit I found the child in a dangerous condition. Food could not be held in the child’s stomach and extremities were cold and shrivelled. The stomach of the young patient was hot and distended, with eyes that had a glistening begging look. As if something were wrong and desperate to impart that information. I asked the aunts if they had given the child any water. In fear of being chastised they said they boiled the water first. I asked for a jug of water and placed it into eager hands. Soon the water was gone and several more jugs were demanded. The result was the stomach heat had dispelled and the extremities became warmer. It was a relief to see the patient fall into a natural deep sleep.
I must admit, I was angry at the aunts and did not hold back my feelings.

It was a miracle according to the Aunts, when all that was needed was a little common sense.

A lady from Ceylon with a bad case of diarrhoea and told me of her desperate plight. She had gone off to die quietly in her country house, when a friend told her to come to see me in Edinburgh. She was quite ill, yet still took large quantities of foods and medicines. The patient had tried every known cure to no avail.
Not long before her visit I had read of a Russian treatment called the skim-milk cure. This had to be taken on its own without stimulants. I later added some malt and hot water and found her in excellent health  six weeks later.

When disease comes upon us unnatural restorers are at best doubtful and often cause us unnecessary injury. Excessive food and stimulants assisted by drugs do their evil work unobserved.

I have been adopting the middle course for half a century and have been given praise and credit as a successful physician from fellows and patients alike.

This is a short excerpt from two books by George S. Keith, MD., LL.D., F.R.C.P.E. from - PLEA  for A SIMPLER LIFE- 1885 and FADS of AN OLD PHYSICIAN - both printed by Adam and Charles Black 1887. We are not in a position to comment on medical facts and hope the reader will appreciate this.             
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