Class ~RT fcS-. 

Book.. £L2_ 

Copyright N° 



CDEffilGHT DEPOSIT 



PITFALLS 



BY 

A. J. CAFFREY, M.D. 

Instructor in Physiology at Milwaukee Medical College, from 1901 

to 1910. Assistant Professor of Medicine at Marquette 

University School of Medicine, from 1913 to 1920 




BOSTON 
RICHARD G. BADGER 

THE GORHAM PRESS 



COPYRIGHT, 1921, BY A. J. CAFFREY 



All Rights Reserved 



< 



Made in the United States of America 

*s > i — i . 

The Gorham Press, Boston, U. S. A. 



AUG 11 '21 

©CI.A622403 



TO MY DEAR WIFE 

WHO HAS FOR MANY YEARS STOOD 
BETWEEN ME AND THE TELEPHONE 

THIS BOOK IS DEDICATED 



'Oh, Thou who didst with Pitfall and with Gin 
Beset the Road I was to wander in, 
Thou wilt not with Predestination round 
Enmesh me, and impute my Fall to Sin?" 

Quatrain LVII, First Ed. 
Rubaiyat. 



PREFACE 

In the writing of this book, the author has had 
always one object in mind and that was to bring 
before the minds of medical men, as well as the pub- 
lic at large, the many pitfalls into which they are 
ever in danger of being precipitated. 

If the warnings contained in the following chap- 
ters should have the effect of opening our eyes to 
certain dangers, thereby preventing any future mis- 
takes, I will feel that its object will be fulfilled, as 
we all know "It is human to err, and to forgive 
divine." 

The chapters are taken from notes of twenty 
years' experience and — barring some frills — are true 
to life, showing the many peculiar incidents — tragic 
and otherwise — that crop up in the life of a doctor. 

As to the author's connection with what is written 
here, all that may be said, my dear reader, is that 
they are only "Twice-Told Tales." 

A. J. C. 



CONTENTS 



CHAPTER PAGE 

I. Koplik's Spots 13 

II. "Belladonna"— "A Fool and His Doctor" . 18 

III. The Man with the Laughing Mask ... 23 

IV. A Bronzed Man 30 

V. Look Before You Operate 33 

VI. Rose Spots 36 

VII. "The Meanest Man" 40 

VIII. "The Lodge Doctor" 47 

IX. The Physiological Tumor 54 

X. "The Major of the Men of Life" .... 60 

XI. "The Night Doctor"— "Vultures" ... 65 

XII. All the Wives Wondered 70 

XIII. "The Hippodrome"— "No Doctor" .... 75 

XIV. "Twins— Vert Much Alike" 81 

XV. "Cum Grano Salis" t . . 87 

XVI. "Ratiocination"— "A Poet's Sign" ... 90 

XVII. "Gurgling Scream" 96 

XVIII. "Hiccups"— "Two Lives Saved" 118 

XIX. "Children that Might Have Been" — "Get 

the Doctor" 126 

XX. "Tickled to Death" 132 

XXI. "Quick, Watson" 137 

9 



10 Contents 

CHAPTER PAGE 

XXII. "Thou Shalt Not Kill" 142 

XXIII. "Buried Alive"— "Oriental Orgies" . . . 151 

XXIV. "Silence Is Golden" 157 

XXV. "The Man or Mystery of Bones Island" . 162 

XXVI. "Sawbones" 168 

XXVII. "Good Pickings" 173 

XXVIII. "Judas Iscariot" 178 

XXIX. How Long, O Lord! How Long? .... 186 

XXX. "Let Him Who Is Without Sin" .... 193 



PITFALLS 



PITFALLS 



CHAPTER I 



One night Doctor X. said to me: "I have been 
waiting for four days for a call from the parents 
of a child, a little girl five years old, whom the 
father asked me to attend five days ago, but after my 
first visit, I was promptly discharged and another 
physician was employed." 

Now, whenever Doctor X. makes some eccentric 
or puzzling remark I always know from past experi- 
ence that he has something on his mind usually 
worth getting off. 

I have for many years been what he calls a "boon 
companion" and, I dare say, that I have heard 
many things from him that to my mind were techni- 
cally exquisite. 

On the evening that he made this remark, I said: 
"Well, did you get the call?" He smiled and said: 
"Yes, to-day." 

But that is all I could get out of him until a long 
13 



14 PitfaMs 

time after when I asked him how he came out with 
that case where they called him back after dismissal. 

He said, when he was called the first time he found 
the child up and running around, but her mother 
said she complained of a headache and just felt a 
little "dumpish" and "out of sorts." 

He thought the mother was unnecessarily alarmed, 
because the girl being the only child she pampered 
her somewhat, but on closely examining her throat 
and mouth, he saw something that gave him a clue 
as to what was brewing and caused her dumpishness. 

So he advised the mother to put the child to bed 
and keep her there and not allow other children to 
come to see her because she was coming down with 
measles, and while measles in themselves were not so 
bad, the child, if it is let run around, might get a 
chill and pneumonia set in which might prove serious. 

The father came home at noon and when his wife 
told him that Viola — as they called her — had measles, 
he looked at the little girl and naturally said: 
"Where are they: I don't see any measles?" 

So when his wife told him Doctor X. said they 
would come out in a few days, he doubted it very 
much and called in another doctor who always made 
it a practice to be optimistic and set the parents' 
minds at ease whenever they became alarmed. 

Anyway this doctor told the parents that he could 
not understand why Doctor X. said Viola had 



Koplik's Spots 15 

measles, so he told them to let the little girl run out 
with the other children of the neighborhood, which 
they did, "because it was a shame to keep her in bed," 
and poor little Viola was happy to get the chance to 
run around again with her little playmates. The 
parents were happy to think they were not going 
to be quarantined. So they promptly discharged 
Doctor X. 

He told me that the funny part of it was that 
both the mother and father as well as Doctor Y., 
had a good laugh at Doctor X.'s "ridiculous diag- 
nosis," for a few days at least. 

When I asked Doctor X. how he knew he was go- 
ing to be called again as he said he was "waiting 
for four days for a call," he told me that on ex- 
amining the child's mouth, he saw little white spots 
with red areola around them on the inside of the 
mouth scattered around on the buccal membrane; 
these little spots are known as "Koplik's spots" and 
they are a sure sign of approaching measles. 

He told me that when he was discharged he sus- 
pected they called some one else who differed from 
him in his diagnosis — but he felt that when they 
found the other doctor was mistaken, they probably 
would discharge his colleague and call him back 
which was just what they did. 

However, Doctor X. said, the worst part of the 
story, or the tragic part of it was, Viola started 



16 Pitfalls 

an epidemic of measles among all her playmates in 
the thickly populated neighborhood and the poor 
little girl developed a virulent pneumonia with the 
measles and for three weeks lingered between life and 
death and the poor parents were worn out with worry 
and loss of sleep watching anxiously at her bedside 
all this time, but fortunately she recovered. 

However, unfortunately two of her little play- 
mates lost their lives from pneumonia accompany- 
ing the measles contracted from Viola when she was 
allowed to run around and play with them until she 
broke out into a rash. 

Had the doctor understood why Doctor X. said 
Viola was coming down with the measles, this tragedy 
to Viola's two little playmates might have been 
avoided. 

Doctor X. said he often wondered why people 
make so light of measles ; he said it is an extremely 
dangerous disease, owing to the fact that there is 
always a bronchial irritation that goes with it, that 
very often develops into a septic bronchial pneu- 
monia which is deadly in its effect on many children 
every year. 

"Measles is a preventable disease and it is not 
necessary, as some mothers are foolish enough to 
think, for children to have this, or any other of the 
childhood diseases for that matter." 

Children that grow up without going through dis- 
eases in their childhood are apt to be healthier men 



Koplik y s Spots 17 

and women than those who have the diseases, and one 
thing is certain, that they who escape the childhood 
diseases naturally escape the defects that very often 
follow them. 



CHAPTER II 



One evening I was sitting in Doctor X.*s office 
waiting for him to return from a call. 

When he came in I knew he had gone through some 
exciting ordeal, for his collar was wilted and his 
hair tousled and his face all perspiration, so I said : 
"What in the world is the matter, doctor?" He 
looked at me with that smile and passed into his 
wash room to clean up. When he came out we went 
into his study, which he uses for a smoke room, too, 
and he lit his pipe and puffed away for awhile and 
said : "Wasn't it Shakespeare who said, that 'a fool 
will always be his own doctor'?" I thought to my- 
self, gee I don't know, but I admitted it was. Then 
he said he could improve the aphorism by adding, 
"A damn fool will make his neighbor his doctor." 

He said he was called in consultation that evening 
with Doctor V. who was in attendance on a patient 
who was suffering from lumbago. The patient was 
a very large stout lady who weighed probably £50 
lbs. She was getting along finely under Doctor 
V.'s care and was around attending to some of her 

18 



"Belladonna"— 6 A Fool and His Doctor" 19 

household duties. She was the mother of five chil- 
dren, the oldest of which was 22 years and the 
youngest 11 years of age. Her husband was living 
and well; his occupation as traveling salesman kept 
him away from home a great deal. The patient was 
about fifty years of age. Doctor X. said when he 
arrived at the house everything was in an uproar, 
the children crying and hysterical over the condi- 
tion of their mother. Doctor V. was there doing all 
he could. The first thing Doctor X. noticed on 
seeing the patient was that the pupils of her eyes 
were widely dilated as if she had atropin drops in- 
serted, but the family and Doctor V. said no. Doctor 
X. thought then that she might have been taking it 
internally, but Doctor V. said no, he had her under 
treatment with the salicylates. Doctor X. found the 
patient's heart rapid, her skin was dry, but she pre- 
sented a wild appearance with the dilated pupils 
and he knew he had to think fast as the patient 
seemed about as far gone as was possible and still 
be alive; so while he was going over her he saw 
"something" which gave him a clue as to what was 
the cause of her collapse. He had no time to wait 
to get much of her history, but when he discovered 
the edge of a plaster sticking up above the patient's 
gown at the shoulder, he quickly stripped the gown 
down from her body and there found pasted on her 
large broad back six large-sized belladonna plasters 
from which she was absorbing the belladonna through 



20 Pitfalls 

her skin and being gradually poisoned from having 
them on for four or five days without Doctor V. or 
the family knowing anything about it. 

Doctor X. said he stripped them off quickly and 
had to scrape the sticky paste off her back and have 
her daughter get soap and hot water to wash the 
back. In the meantime he injected pilocarpin and 
stimulants into her arm and after some hustling and 
hard work he finally with the assistance of Doctor V. 
revived her and then gave her a bawling out for using 
so many poisonous plasters on her back. 

The history he subsequently obtained from her 
was that a neighbor had told her what was good for 
her lumbago. That she should go into a drug store 
and get as many belladonna plasters as her back 
would hold — and Doctor X. said, believe me, that 
back had room for many, and by this method she 
thought she could get rid of her pains. 

The family were happy to find that Doctor X. 
discovered the trouble just in time to save the life 
of their mother and the Doctor said that he was 
sure she would have died within an hour as her con- 
dition was such that they both — Doctor V. and him- 
self — had no hope until he accidently discovered 
what was wrong. Then Doctor X. told me of an- 
other ridiculous case where a lady came into his 
office one day with an abscess of the cervical gland 
and it looked to him as if it was just ready to break 
and evacuate the pus. The Doctor said when he 



"Bellado7ma"—"A Fool and Hn Doctor" 81 

saw it could be opened without her feeling it, he 
reached for his lance but she was watchful and sus- 
picious, so when she saw him take the lance she 
"beat it." Doctor X. said : "Well, that would have 
been all right, it would open of its own accord any- 
way," but the lady went home and on reaching her 
place of residence she met an old colored woman 
who lived in the rear of her residence and whose 
husband was chef at one of the hotels. This hus- 
band, it seems, always kept frogs in his cellar, I be- 
lieve, for the serving of frog legs to the patrons of 
the hotel. When the old colored lady saw what was 
wrong with her neighbor and heard her complain 
about how Doctor X. was going to cut her with a 
"big" knife she said: "Neah yo' mine, honey, I'se 
got sumpin' 'at'l fix dat all right; doan you' have 
any fummi-diddles wit' dem fool doctahs." So she 
goes into her own cellar and brings in an old ban- 
danna handkerchief a large yellow bellied live frog. 
The afflicted woman didn't know just what the wench 
was going to do so she allowed her to tie the frog 
in the bandanna handkerchief to the abscess with 
its slimy yellow belly against the skin. Then the 
frog began to squirm and wriggle, and the lady be- 
gan to scream — yelling "What is it? It's alive! Oh, 
mercy! Take it away!" But the wench persisted 
and held the knot tight over her head until the frog 
in its struggles scratched the abscess open and the 
pus run down into the bandanna and the lady's face, 



22 Pitfalls 

neck and clothing became smeared with pus. Doctor 
X. said the abscess being opened of course got all 
right after a few days, and would have gotten bet- 
ter without this grewsome treatment if it were let 
alone. Also the woman took a terrible chance; the 
frog might have set up a septic condition where she 
would have lost her life, but the worst part of the 
story, Doctor X. said, was these two ignoramuses; 
the lady and the negro wench think that the only 
cure for an abscess is to apply a big yellow bellied 
live frog to it, and the poor unfortunate children 
anywhere in the neighborhood who happen to get 
an abscess of any kind are frightened to death by 
the treatment recommended and administered by 
those two fools. 



CHAPTER III 



One evening Doctor X. was sitting in his study 
after office hours and his rounds of the day, and a 
young man about eighteen years of age called and 
was led into the doctor's study. Doctor X. had the 
habit of "taking in" everything unusual that showed 
externally on any one, before the patient was seated 
in his presence. He noticed this young man limped 
when he walked and that he had a peculiar expres- 
sion on his face that made him think of "The man 
with the laughing mask." Doctor X. thought to 
himself, "Why does this man make me think of 'The 
man with the laughing mask'? Then, naturally, 
his thoughts ran back to his medical knowledge of 

1 This case was reported in a more technical manner in the 
Journal of the American Medical Association, Nov. 5, 1910, 
and Doctor X. received a kindly personal letter from the late 
lamented Sir William Osier of Oxford, England, who saw the 
article in the Journal, congratulating him on the manner in 
which he stood by the young man and persisted in his treatment. 

It was published also as a "prize story" under the caption 
"The Most Difficult Thing I Ever Did," in the American Maga- 
zine, November, 1915. 

23 



M Pitfalls 

a grin-like expression that a patient acquires fol- 
lowing an infection that results in a grave and fright- 
ful disease. This all ran through the doctor's mind 
before the young man said a word. Doctor X. asked 
the man why he limped and obtained a history as 
follows: He said, while out in the country, near 
one of the lakes, where he was taking a week-end, a 
number of men were having what they call a Mara- 
thon race across country, barefooted. He joined 
in the race, and when crossing the runway of an 
old barn, he stubbed his big toe, and it swelled up. 
He said he consulted Doctor Y. who was one of the 
party at the lake, and Doctor Y. said he had sprained 
the toe, and recommended hot compresses, of a solu- 
tion of boric acid, which would be a rational treat- 
ment for a sprained toe, but he kept on getting worse 
and he decided to consult Doctor X. Doctor X. 
paid particular attention to the manner in which 
he stubbed his toe, "at the runway of an old barn." 
This brought to his mind that he had read some- 
where in medical literature that certain virulent 
germs are found plentifully in manure and dirt 
around old barns, so he wondered if it was possible 
that the young man had a splinter buried in his 
toe, so he examined it carefully and sure enough 
noticed a spot near the top of the toe, where a 
splinter entered five days before, and which had 
closed quickly after the injury, so the doctor opened 
it under local anaesthesia and with a small mouse- 



The Man With the Laughing Mask 25 

tooth forceps removed the splinter of wood about 
three-quarters of an inch long. While he was remov- 
ing the splinter, he noticed the young man was con- 
tinually throwing his head backward and snapping 
and grinding his teeth, so this led the doctor to 
believe what he formerly suspected, when he noticed 
the grin-like expression, that lockjaw or tetanus, 
as it is termed by physicians, was setting in, so with- 
out saying anything that would scare the young man 
he immediately injected three thousand units of 
tetanus antitoxin and after dressing the wound, took 
the young man home and put him to bed. The next 
morning he called early, and the mother said the 
boy was complaining of an earache. Doctor X. knew 
it was not an earache, but a pain in muscles over the 
angle of the jaw, near the ears, that patients call an 
earache, so Doctor X., knowing how the parents 
loved their only boy, dreaded the ordeal of telling 
them that he had lockjaw. Still he knew it was 
his duty, so he called the father and mother aside and 
told them and made them promise that they would 
leave the boy in his care entirely and not disturb him 
in any way while he was trying to save his life and 
after the first shock of knowing the worst was over, 
they never saw the boy again for a whole week. 
Doctor X. had another physician take charge of 
his other patients and during the seven days and 
seven nights that Doctor X. remained by the bedside 
of this young man, he never slept one minute. He 



26 Pitfalls 

found that tobacco kept him awake, so he chewed 
tobacco continually and drank black coffee that was 
handed into the room, with food for himself and 
his patient. He had the druggist get all the anti- 
toxin that was in the city at the time and when 
this was getting low he had more shipped from an- 
other city, so he kept on injecting three thousand 
units of tetanus antitoxin into his patient's body 
every three or four hours, night and day. Doctor 
X. knew that if he got a nurse and left the patient 
in her care, it would only add more excitement and 
that would bring on more convulsions. As it was, 
the young man was having violent convulsions, com- 
ing on every few minutes, when his jaw would snap 
suddenly, and if the tongue happened to protrude 
during the relaxation between the convulsions, he 
would bite pieces off the edge and tip of the tongue 
and blood would run from his mouth. Doctor X. 
made a sort of gauze gag that held the tongue back 
and this fixture saved a great deal of suffering. As 
I said before, Doctor X. gave his other patients over 
to the care of another physician and stuck by the 
bedside of this young boy continually, nursing as 
well as doctoring him. After he had injected about 
fifty thousand units of the antitoxin he noticed that 
following each injection the convulsions were not so 
violent as the first three days. During the first three 
days when the paroxysms occurred, the patient would 
arch like a bow. The convulsions would come with 



The Man With the Laughing Mask 87 

a sudden snap and the doctor feared the patient 
would tear his abdominal muscles. He would rest 
on the back of his head and heels, his body would 
arch into a bow-like "oposthotonos position," as the 
physicians called it, and would remain in a tense 
manner for about three or four minutes and then 
he would gradually relax his body and sink down 
on the bed and rest again until another convulsion 
would come, which reappeared usually about every 
five to eight minutes during the first three days, but, 
as I said before, after Doctor X. had injected fifty 
thousand units his rest between convulsions seemed 
to last longer, fifteen to twenty minutes. This en- 
couraged the doctor to persist in injecting the drug, 
so he continued his labors to save the boy, and his 
anxiety and excitement in such a grave case with 
the tobacco and coffee kept him awake night after 
night and day after day at his task of life-saving, 
but after he had injected about eighty thousand 
units, following each injection, his patient would 
drop off into a sound sleep for two or three hours. 
Then he would wake with a sudden convulsion com- 
ing on but not so severe as at first. On the morning 
of the sixth day the patient was somewhat delirious ; 
at times, singing and whistling and thinking he was 
with his companions, and talking foolish in general, 
but Doctor X. found that his heart was strong and 
did not worry about the delirium, but persisted in 
the injections. Doctor X. noticed the boy's body 



28 Pitfalls 

was literally covered with a strawberry-like rash but 
knew such a thing occurs as a rule on injecting any 
serum in large quantities, so he knew it was from 
the antitoxin. The boy began to swallow more 
nourishment on the sixth day and had longer rest 
between the convulsions. Doctor X. continued the 
injections until the morning of the eighth day, when 
the boy was conscious, having no more convulsions or 
delirium, but only just weak after his horrible ordeal, 
and on that beautiful morning the doctor gave the 
boy back to two anxious parents, alive and on the 
road to health again. The gratitude expressed in 
their faces on seeing their boy alive, after that try- 
ing week, was something Doctor X. will never put 
from his memory. During the week he injected into 
his patient's body one hundred and twelve thousand 
five hundred units of tetanus antitoxin, which was 
the most ever used in the treatment of lockjaw in 
any human being up to that time. Doctor X. always 
felt that enough antitoxin had never been used be- 
fore because of the expense of the drug, so he felt 
that a human life was worth more than money ex- 
pended for the drug and did not consider the ex- 
pense, thereby saving the life of his patient. The 
grin-like expression that made Doctor X. think of 
"The man with the laughing mask" is what physi- 
cians call the "risus sardonicus" which is a grinning 
expression produced by spasms of the facial muscles 
and later on in the disease come on spasms of the 



The Mam With the Laughing Mask 29 

chest muscles and all the muscles. The young man 
who went through this ordeal is now a very capable 
physician practicing in the same city as Doctor X. 
and many times helps the doctor out when his tasks 
become too hard and Doctor X. has a feeling toward 
him akin to that of his own son. 



CHAPTER IV 



A BRONZED MAN 



One summer Doctor X. and his family were at a 
cottage out at one of the lakes and friends of a den- 
tist who was ill for a long time heard of the doctor 
being at the lake which was near the village in which 
the dentist lived. They called and asked the doctor 
to come to the village and consult with Doctor Z. 
who was in attendance on the case. Doctor X., be- 
ing reluctant to interfere without being called by 
Doctor Z., told them he would come if the doctor re- 
quested him, so the relatives told Doctor Z. to call 
him, which he did. Doctor X., on entering the sick 
room with Doctor Z., immediately saw "something" 
that gave him a clue to a diagnosis made later. 

Doctor Z. told Doctor X. that his patient was ill 
for a year or more with a very grave stomach trouble 
and his condition was so bad that he had decided 
to take him to the city for an operation, which was 
necessary to save the patient's life. He also said 
his patient consented to go and have the operation, 
but relatives first thought it best to have a consul- 
tation. Doctor Z. privately told Doctor X. that his 

30 



A Bronzed Mem 31 

patient was suffering from cancer of the stomach 
and an operation was his only chance. Now I said 
Doctor X. saw "something" on entering the sick 
room. The "something" he saw was that the pa- 
tient looked like a "bronzed man" lying in bed. So, 
having his implements for examination along, he 
proceeded to get the facts and found first that all 
over the man's body the skin looked somewhat 
bronzed; then, his patient having an irritable 
stomach, that was his second clue to a later diag- 
nosis. Doctor X. proceeded with a thorough exami- 
nation and found that the man had an extremely low 
blood-pressure, being only 80 mm. systolic, where 
in a normal person it should be 130 mm. systolic. 
This gave him the third clue. And then, after find- 
ing by laboratory tests that his blood only showed 
slight reduction of hemoglobin and red cells and 
Wassermann negative. He made his patient get up 
on his feet and by tests found him to be extremely 
asthenic and dizzy and fatigued on the slightest ex- 
ertion. This clinched the four cardinal symptoms 
that he was looking for; the bronzed skin, the ir- 
ritable stomach, low blood-pressure and extreme 
fatigue on exertion are the four cardinal symptoms 
of "Addison's Disease." So Doctor X. called Doctor 
Z. into another room and told him not to take his 
patient to the city for operation or he would die on 
the operating table, so that's how Doctor X. added 
about ten years more to the dentist's life. Of course 



32 Pitfalls 

the disease is incurable, but there can be remissions 
with proper tonics, and in this case the patient got 
out of bed again and partly attends to his duties, but 
he is a very sick, incurable man, and will die in from 
eight to ten years. As far as medical men know 
about Addison's disease, it is said to be a tubercu- 
losis of the adrenals, which means the suprarenal 
capsules or capsules of the kidneys, and no cure is 
known for it, but if recognized early, life can be pro- 
longed. The disease is quite rare and is very often 
mistaken for cancer of the stomach, owing to the 
fact that people who have cancer have a discolored 
skin, but the discoloration is more ashy and not so 
bronzed or dark as in Addison's Disease. The dis- 
ease is named after Thomas Addison, a physician 
who lived in London and first described the symp- 
toms, away back in 1855. 



CHAPTER V 

LOOK BEFORE YOU OPERATE 

One day a lady called on Doctor X. for some 
minor trouble, and in the course of her conversation 
said her sister, a beautiful young girl, about twenty 
years of age, was at a hospital for three months past 
with a stiff knee. She said Doctors D. and E., two 
well-known surgeons, had operated on her knee five 
times in the three months she was at the hospital, 
but her knee stiffened up just as bad as ever after 
each operation. She said the surgeons would put 
her under an anaesthetic and break up the adhesions 
in the ankylosed knee, but the next day it would be 
swollen and inflamed and painful, and in a day or 
two the pain would leave but the joint would be as 
stiff as ever. She said all this cost her father nearly 
a thousand dollars. 

Doctor X. questioned her as to how her sister's 
knee became stiff and she said the doctors all said it 
was due to rheumatism. Doctor X. told her that 
rheumatism was only a symptom of some other in- 
fection and questioned her as to the condition of 
her sister's teeth and tonsils. She immediately be- 

33 



34 Pitfalls 

came interested and said she knew her sister had an 
infected tooth that broke out on her upper gum 
every once in awhile and discharged pus. Doctor 
X. told her he thought her sister needed a dentist's 
care first before she consulted a surgeon. After the 
lady left Doctor X.'s office she went to her father 
and told him what Doctor X. said. The father took 
his girl out of the hospital and the care of the sur- 
geons to his home, and called Doctor X. to see her. 
Doctor X. found she had a badly infected tooth and 
also suspicious looking tonsils. The girl was piti- 
fully lame and her knee was ankylosed at an obtuse 
angle so when she walked she had to step on her toes 
and ball of the foot. Her father had a dentist ex- 
tract the tooth and a throat specialist removed the 
infected tonsils. Doctor X. put her on a general 
tonic with all the other things that go with it, such 
as good food and plenty fresh air and rest, etc., and 
built her up generally, and after two months he took 
a young physician with him to her home one day 
and they fixed up an operating table out of the 
kitchen table, laid her on it, and the young physician 
put her sound asleep with ether, and Doctor X. broke 
up the adhesions in the ankylosed knee, working the 
leg up and down like a pump handle, after he had 
the thigh bent up on the abdomen. As I say, he 
worked the leg up and down until it seemed as limber 
as a normal knee. After this he let the lady come 
out of the anaesthetic and told the family to let her 



Look Before Yom Operate 35 

rest for that day, but he warned them that the leg 
would be sore for a week or so, but he would call 
every day and help her to get some motion in the 
knee joint. So Doctor X. called every day and in a 
skilful manner kept up the motion. He advised in 
his absence that some one should massage the leg 
with alcohol first, then after with olive oil, and in 
one week he had her where she could walk on the sole 
of her foot like any other woman, and inside of a 
month she went to dances with her young friends and 
danced as well as anyone, and to-day no one would 
ever know she was crippled and, not only crippled, 
but was despondent because she and her family 
thought she was going to be crippled for life. 

The moral in this case is that surgeons should look 
before they operate. 

If there are foci of infection in the system any- 
where, very frequently the articular surfaces, such 
as the knee or ankle joints, have an affinity for the 
toxins and become inflamed and stiff. It is of no 
use to break up the stiffness until you remove the 
foci. 



CHAPTER VI 



ROSE SPOTS 



One afternoon Doctor X. was called to a married 
lady who had four small children and who was sick 
in bed and no one to take care of her or her children, 
the oldest of which was only seven years of age. Her 
husband had been called home from his work by a 
neighbor at the request of his wife. And Doctor X. 
found by questioning him that she had been sick 
about ten days and was trying to take care of the 
home and children until she collapsed, and they sent 
for the husband and Doctor X. 

In this case the first thing he found out was that a 
lady upstairs in the same house was taken to a hos- 
pital a week before and had her appendix removed. 
To a non-medical mind or even to another physician, 
this would not seem germane to the case at hand, 
but not so with Doctor X. He fitted it in with the 
history and followed it up. After completing his 
history he proceeded to make a thorough examina- 
tion. He found the temperature 103° F., pulse 100, 
and respirations 28 ; he found the tongue coated and 
red at the edges and tip. It was during an epi- 

36 



Rose Spots 37 

demic of influenza and many another physician would 
have influenza in mind. There was no other case in 
the city of the kind of disease that Doctor X. had 
in mind. In his observations and physical exami- 
nation of this patient, he found that she had a large 
spleen, tenderness all over the abdominal region. Her 
blood count showed about 6,000,000 red cells and 
about 5,000 white cells and hemoglobin decreased rel- 
atively. He found also what the doctors call a posi- 
tive Widal. He saw little rose-colored spots scat- 
tered about on the chest and abdomen. He saw also 
an unsanitary home with defective plumbing. So 
after he saw all this, I believe the reader, even though 
he or she may be of non-medical mind, would predict 
that this patient had typhoid fever, but like the 
story of Columbus and the egg, it is easy when you 
know, but the physician knows from many sad ex- 
periences that it is not so easy and you can see from 
the thorough manner in which Doctor X. observed 
everything, that even he took some time before he 
clinched the diagnosis which was typhoid fever. Then 
he said: 

"Now my main object in telling you of this case 
is to show a pitfall into which a so-called surgeon 
fell headlong. If you will pardon my digressions, I 
want to say a word about many of our medical and 
surgical brethren that may hurt the feelings of some 
of the more sensitive ones, but others whom the shoe 
doesn't pinch will say I am right. There are too 



38 Pitfalls 

many men with signs that read "Dr. P. Percival 
Blank, Physician and Surgeon." The American Col- 
lege of Surgeons knows that a man, in order to do 
major operations on a human being, or to pose as a 
surgeon, should be one who, after he finished college 
and had his hospital interneship, should go as an 
apprentice or assistant to a capable surgeon for at 
least three to five years, before he starts out as a 
surgeon himself. I say the surgeons know that, but 
the laity and the government do not, at least they 
do not insist on having a law to protect the public. 
"The field of internal medicine is too large for a 
man to attempt to be both a physician and surgeon, 
and life is too sacred for a bungling inexperienced 
doctor to attempt to do an operation that he prob- 
ably never attempted before, while there are master 
men who are doing operations of the same kind every 
day and the life of the patient might be saved many 
times by having the man skilled in the technique of 
operating. Now that I've got that out of my system 
I'll go on with the case in hand." Doctor X. found 
that a week before he was called on this typhoid case 
a surgeon was called to a woman in the same house 
and he took her to a hospital and removed her 
appendix. Doctor X. took his typhoid patient 
to the same hospital and coincidentally she was 
put in the bed next to the appendixless patient. 
By "accident" every day when Doctor X. called 
to see his patient he would pick up the wrong chart 



Rose Spots 39 

and their temperatures were so much alike that you 
couldn't blame poor Doctor X. for looking at the 
chart belonging to another case; in other words, 
the woman who lost her appendix had typhoid fever 
from the start and not appendicitis, but she 
called a "surgeon" instead of a physician and had 
an operation. This operation was a bad start for 
the poor woman and she was handicapped in fight- 
ing the disease, and finally succumbed to a hem- 
orrhage from the bowels. 



CHAPTER VII 



We were sitting in the club one evening smoking 
and somehow the subject came up about finding the 
"meanest man in the world." One of the party said 
that he read in the newspapers about some one find- 
ing him down South somewhere ; another said he had 
heard of him being found up North ; and another in- 
sisted that he was found in the East; and another 
found him in the West; and Doctor X., who hap- 
pened to be in the party, said no, that they were all 
wrong, the meanest man in the world was right here 
in our own city; that he had found him, and, not 
only that, but he felt sure that the man's wife was 
the "meanest woman in the world," and this is the 
story he told, without giving us any idea who the 
man and woman were, because in discussing medical 
cases Doctor X. never mentioned names : 

He said he was called one evening to a drug store 
where they carried a woman who was struck by a 
street car and who was badly injured about the head. 
When he arrived an ambulance was there before him, 
and they were about to take the injured woman to 

40 



"The Meanest Mem" 41 

the city hospital, but when her husband saw Doctor 
X. coming he told them to take her to his home, which 
was not far from where the accident occurred. 

Doctor X. noticed that the husband of the unfor- 
tunate woman seemed extremely happy, he danced 
around the ambulance giving orders and joking and 
laughing about the accident as though it was a good 
joke. When Doctor X. saw the police carry the 
woman out of the drug store he saw that she was 
badly injured, or at least looked so from the fact that 
her head and face were all covered with blood, her 
clothes were muddy and torn, and her hair hanging 
matted with clots of blood. When Doctor X. saw 
the man so happy under those circumstances he first 
thought that the man was either hysterical from 
what had happened or that he was drunk, and did 
not realize the full import of what had happened. 
But on going with the man to his home to attend 
the injured woman he found that such was not the 
case, but that he was perfectly sober and not at all 
hysterical, but was only extremely happy because 
his wife was struck by a street car and was so badly 
injured that he was sure she was going to die and 
the street railway company would have to pay him 
two or three thousand dollars for the loss of his 
"poor dear" helpmate who was the mother of four 
little children. It is needless for me to say that we 
all agreed that Doctor X. had found "him" all right. 
Doctor X. then went on to tell us that when he found 



42 Pitfalls 

this fellow was so contemptible, he made up his mind 
that if attention and care could save that unfor- 
tunate woman he would give all that was possible for 
him to give, so he took off his coat, rolled up his 
sleeves, and scrubbed up and made himself as aseptic 
as was possible and cleaned off the woman's head 
and cut the matted hair away and examined the skull 
carefully and found there was no fracture, only there 
was a frightful laceration of the scalp that started 
above her forehead just about where the hair parts 
and ran back over the top of her head to a point that 
Doctor X. called the "occiputal protuberance." This 
gaping cut made the unfortunate woman look fright- 
ful because the scalp was loosened from the bony 
skull and fell down over her ears, making her look, 
as Doctor X. said, like a weasened old baldheaded 
man with big ears, that sometimes sits in the front 
row of a theatre when a burlesque show entitled 
"Paris Milk Fed Broilers" is on. Anyway, Doctor 
X. said he brought up the flaps of the scalp in ap- 
position and stitched them carefully across the top 
of the head, using in all twenty-two stitches. Then 
he swathed the head in a hot boric compress of 
gauze and bandaged her up. He called every day 
for three weeks and gave her what care was needed 
and pulled her through fine, but I'm getting a little 
ahead of my story. 

Doctor X. said when he fixed up this man's wife 
that night, and came out of the room, he was asked 



"The Meanest Man" 4*3 

by the husband "How is she?" And when Doctor X. 
told him she would be all right in a couple of weeks, 
all the joy that was expressed on his face disap- 
peared suddenly and his jaw dropped and he became 
very, very sad. Well, as I said before, Doctor X. 
attended to her dressings every day and fixed her 
up fine, took the stitches out and told her she would 
be all right, and didn't call any more. After four 
or five months, one day Doctor X. was subpoenaed 
to court to testify in a trial, Mr. and Mrs. O. B. vs. 
T. T. Traction Railway Company. Doctor X. ap- 
peared at court the next day and saw 0. B. and his 
wife with a number of the neighbors for witnesses, 
all assembled in the court room, and the trial was 
on. Mrs. O. B. was looking as pathetic as was pos- 
sible and moved around her attorneys on two 
crutches. Doctor X. knew she had not had any in- 
jury to her legs and wondered why she was there 
with crutches. Anyway, there she was on crutches, 
and her attorney called Doctor W., a bright-looking 
young, dapper doctor, to the stand and after ad- 
ministering the usual oath, he said he was called to 
Mrs. O. B. and found her suffering from a badly in- 
jured leg. He said the leg was swollen and looked 
dark from the ankle up above her knee. He said he 
applied all kinds of "antiphlogistics" to it but 
couldn't get any results, it always remained swelled 
and was still as bad as ever. Mr. O. B. was called 
and he said that while Doctor X. fixed up his wife's 



44 Pitfalls 

head all right he neglected her leg and that his wife 
would now be crippled for life and he thought that 
since she was as good as dead as far as taking care 
of him and the children, he thought that the railway 
company ought to pay him $10,000, which was the 
amount they were suing for. Mrs. O. B. was called to 
the stand and said also that Doctor X. neglected her 
leg and she said she was willing to show how bad it 
was to the jury, which she did, by lifting her skirt 
above her knee and pulling down her stocking. The 
jury all rubbered and craned their necks and saw a 
swollen thick leg from the knee, all the way down, 
including her ankle, which looked so edematous that 
it reminded one of a leg that the doctors call ele- 
phantiasis. 

Then Doctor X. was called by the railway attor- 
ney who subpoenaed him and was asked about the 
case. Doctor X. told how he examined her thoroughly 
all over the body, looking for broken bones and cuts, 
etc., and only found the large laceration of the scalp, 
which he sewed up. The railway attorney asked 
Doctor X. if he thought that the woman's leg be- 
came so crippled by the accident that happened the 
night he fixed up her head. Doctor X. said no, be- 
cause before he was discharged from attendance on 
her head she was walking around and there was 
nothing the matter with her leg. The attorney for 
the plaintiff made some objections to this and called 
Doctor W. back to the stand, and he swore that he 



"The Meanest Mem" 45 

didn't know of any other way that her leg could 
have been in the condition it was only from the ac- 
cident. Doctor X. was called back to the stand again 
and was asked by the plaintiff's attorney in a cross- 
examination why, after neglecting the poor woman's 
leg, he comes in here to court and swears she didn't 
receive injury to her leg at the time of the accident 
in question? Doctor X. repeated the word "Why?" 
"Why?" "Why, because I was subpoenaed," he said. 
But the attorney wanted to know why he said she 
didn't have the injury to her leg at the accident that 
evening. Doctor X. told him she didn't, and said 
he could prove it now if the plaintiff is willing, and 
the Court was willing to let him examine her leg 
right there before the court. The jury immediately 
woke up and became interested. Doctor X. testi- 
fied that when she was showing her leg to the jury 
before that he saw "something," but the jury, while 
they strained their eyes and craned their necks, saw 
nothing; even one old rascal got out of the jury box, 
but he couldn't see. The attorney for the plaintiff 
inadvertently asked Doctor X. what he saw. Doc- 
tor X. said that if the Court pleased he would show 
on examination of the plaintiff right there what he 
saw. The Court "pleased" and ordered the exami- 
nation. The jury gathered so quickly around the 
plaintiff that Doctor X. could hardly reach her. 
However, before the plaintiff realized just what Doc- 
tor X. was going to do he had her skirts raised up 



46 Pitfalls 

near her hips, and lo and behold, there was a rub- 
ber band wrapped around her thigh about ten times, 
and the circulation was nearly shut off in her leg 
which looked swollen and dark from the band which 
she and her husband applied that morning before she 
went to court, and which she applied always on the 
days that Doctor W. was to call on her in order to 
fool him and use him in the courts when they made 
up their minds to get damages. 

It is needless to say that the case was dismissed 
against the railway company and the costs put on 
the plaintiff, and they were subsequently arrested 
by the district attorney for fraud and false pretense. 

You may ask, How did Doctor X. know she 
had a band about her leg so high up that the court 
or jury could not see it. Well, he didn't know posi- 
tively, but the "something" that he saw was the 
edematous and dark appearance of the leg that 
made him surmise, knowing the type of humanity 
he was dealing with, that there must be some con- 
striction to the circulation that was artificial, be- 
cause edema of the legs from a failing circulation 
or kidney troubles usually is bilateral and not in only 
one leg and he knew positively from his first thorough 
examination of this woman that she received no in- 
jury to her leg the evening of the accident. 



CHAPTER VIII 



THE LODGE DOCTOR 



I called one evening on my old friend Doctor X. 
as is my custom when I get restless and do not 
know what to do. I always run over to his office 
just about the time I think he is through with his 
evening office hour. He always seems happy to 
have me call and we light our pipes and lounge 
around and chat about the happenings of the day, 
but I must confess that if Doctor X. knew my real 
reason for my being such a "boon companion" as 
he calls me, he might not let me in on the secrets 
and intricacies of his many professional experiences, 
but I must say that while I love his company my 
real reason is to get at truths which are the ma- 
terials I want for my writing. So much fiction has 
been written on medical subjects that one is amazed 
at the audacity of authors for the manner in which 
they get away with it, while facts which would 
make volumes of wonderful literature rarely reach 
the public only in a distorted manner through the 
public press. 

Doctor X. said that he was tired and felt some- 
47 



48 Pitfalls 

what Hue and discouraged with things in general 
and particularly with the conduct of some of his 
colleagues, and he said he was always glad to have 
someone in whom he might confide his troubles, 
which sometimes became burdensome. 

I asked him what was on his mind? He said 
there was a poor fellow who lived in a little cot- 
tage up the street a short distance and who had a 
hard-working wife and seven children to feed, who 
was in the hospital and had his right leg ampu- 
tated that day. This poor man was a sober, in- 
dustrious fellow, and they got along fairly well until 
finally one day "the thing happened,'* as Jack Lon- 
don would say. Doctor X. said the man came to him 
one day and wanted to know what to do for a lump 
that seemed to bother him low down on the right 
side near the groin. On examination Doctor X. 
found it to be a hernia or rupture, as it is com- 
monly called. The doctor told him to go to a 
capable surgeon, giving him the names and ad- 
dresses of four or five good, capable men, and have 
an operation, and then he would be better able to 
take care of his large family. He went to one 
whom the Doctor recommended, and this surgeon, 
who without doubt is a very able man, but didn't 
know just what the man's financial standing was, 
made his fee for the operation too high. Doctor X. 
told me that he knew that if his poor neighbor had 
confided his circumstances to the surgeon he would 



"The Lodge Doctor 9 ' 49 

have gone ahead and operated without considering 
any fee, but sometimes, while people are poor, they 
are too proud to receive any charity, while there 
are others who could well afford paying, take ad- 
vantage of the physician's and surgeon's services 
without paying ; anyway, this poor fellow came home 
and told his wife of his visit to the surgeon and they 
made up their minds to let the operating go and 
wear a truss. 

In the evening the man went to his lodge and 
while there got into communication with his "Lodge 
Doctor." 

He told him about Doctor X. sending him to a 
prominent surgeon, but the surgeon's fee was too 
high. The "Lodge Doctor" told him he could op- 
erate for hernia and it would cost him only one 
fourth as much as what the surgeon mentioned as 
his fee. 

In the course of the evening he talked with some 
of his friends about the ability of the Lodge Doctor 
and they, being brothers and having a fraternal 
spirit, of course, naturally boosted the "Lodge 
Doctor." 

So the poor man went the next day to the "Lodge 
Doctor" and was taken to a hospital — where the 
"Lodge Doctors" usually take their cases — and was 
charted for an operation. 

By way of digression, Doctor X. said it was right 
and proper that medical and surgical men got a law 



50 Pitfalls 

passed which prevents surgeons from splitting fees 
with physicians who take surgical cases to them, 
but he told me also that such a law would never have 
been needed if the internist had more respect for him- 
self and charged a reasonable fee for making his 
diagnosis. 

People should know that the life of the patient 
is really in the hands of the physician who is called 
in and if he is skilled enough to make the proper 
diagnosis, differentiating a surgical case from a non- 
surgical case, thereby saving the life of his patient, 
he certainly is entitled to collect more for his serv- 
ices than the price of one visit. 

But no, the public seems to think that the sur- 
geon is the great spectacular hero of the hour, who 
saves the life of the patient, by the dexterous use 
of his scalpel. 

The surgeon sure is entitled to all the glory for 
performing the operation in a skillful manner, but 
the internist should not be looked on as an insig- 
nificant little fellow to whom you would throw two 
or three dollars as a tip for coming in and using 
his scientifically trained medical mind in making a 
diagnosis on which the life of the patient hangs. As 
I said before, the internist is more to blame than 
anyone else for conditions that made this law; if 
he had more respect for himself he would charge his 
patient for the responsibility he assumes when he is 



"The Lodge Doctor' 9 51 

called in to be used as a diagnostician and not send 
in a bill for an ordinary call. 

Doctor X. said, while he never considered the split- 
ting of fees ethical, the public pays the penalty 
sometimes in a tragic way that he never heard men- 
tioned when this subject is discussed by medical men 
and the public should know it; that is, since this 
law was passed a number of unskilled doctors who 
formerly took their patients to well-known skilled 
surgeons, who did the operations successfully, now 
because they have not nerve enough to charge a de- 
cent fee for their ability as diagnosticians, and also 
because of the loss of what the surgeon gave them, 
they become daring surgeons themselves and thus 
endanger the lives of hundreds of people who have 
explicit confidence in doctors who are not skilled. 

The public should also know that this law did not 
protect their pocketbook. They pay the same fee 
since the law was passed as they did before. And 
one should wonder why so much fuss was ever made 
over it. 

As a rule, people have to pay a surgeon according 
to his reputation and according to their financial 
ability. 

Doctor X. told me that he knows two middle-aged 
ladies, mothers of families, who consulted a daring 
young doctor, who formerly used to take his surgi- 
cal cases to a capable surgeon, but since this law 



52 Pitfalls 

was passed he decided to do his own operations, with 
the damning result that these two mothers of fam- 
ilies now sleep "neath the crosses row on row" while 
the sun shines on his few successes, but the earth 
covers his many failures. 

Doctor X. said this is a peculiar phase of this 
anti-fee splitting law, that he never heard brought 
out and the public — who pays the penalty — should 
know of it. 

To come back to our friend with the hernia, the 
"Lodge Doctor," whose name Doctor X. said he 
doesn't even know, came next morning and after the 
usual preparations in the operating room, and the 
man fully anaesthetized, began the operation which 
resulted so fatally to Doctor X.'s poor neighbor. 

The "Lodge Doctor" cut down through the skin 
and muscles to get at the sac of the hernia and in his 
nervousness, which was apparent to those in the 
operating room, he cut down through the sac and not 
being familiar with the anatomical landmarks in this 
region, he accidentally or ignorantly severed the 
femoral artery and the blood welled up in the wound 
like a bubbling spring; then the poor inexperienced 
"surgeon" fainted and fell on the floor and lay there 
for a while, during which time the life's blood of 
his patient was fast ebbing away. However, he 
"came to," as the women say, and with hot com- 
presses and pressure of some kind cleared the field 
so that he could ligate or tie off the femoral artery 



"The Lodge Doctor 9 ' 53 

and stop the bleeding and finished the operation and 
sent his patient back to his bed. This would have 
been all right had he not bungled and cut off the 
circulation in the man's right leg by severing the 
femoral artery. After a few days the man's leg 
turned black and he had to have it amputated at the 
hip or lose his life. This, Doctor X. said, was what 
made him feel blue that evening, "thinking of the 
poor man and his family." 



CHAPTER IX 



THE PHYSIOLOGICAL TUMOR 



Doctor X. told me that when he was a student 
years ago in Baltimore, Maryland, he had a pro- 
fessor who was remarkably efficient in his line, which 
was teaching the students at the university the 
subject of obstetrics. He said that this man was 
a phenomenon and he owed him a debt of gratitude 
for the manner in which he drilled them, not only in 
diagnosis and care of pregnancy, but also in the 
ethics of this particular branch. He said his pro- 
fessor gave the students a history of every abor- 
tionist in the city of Baltimore for a hundred years 
back and he showed that every one of them ended 
their lives in a tragic manner, except those that 
were still alive, and practicing their nefarious busi- 
ness at that time, but he predicted the same end- 
ing for them too. Doctor X. said he often thought 
of those lessons and felt that every man in the chairs 
of ethics and obstetrics in every medical university 
should spend more time in drilling the young stu- 
dents in not only diagnosis and treatment of preg- 
nancy, but on the moral side of the question, and 

54 



The Physiological Tumor 55 

they should show the young men when they leave 
college that when temptations arise, if they should 
stoop to the immoral practice of abortion, that their 
endings would sure be as tragic as the men whose 
history this professor gave. Some committed sui- 
cide, some were in prison, some became so nervous 
that they were sent to insane asylums ; one was shot 
in his office, another was immoral with one of his pa- 
tients and her husband pummeled him so badly that 
he was blind for life; others defaulted; some com- 
mitted forgery, etc. Doctor X. said this is so in 
every city as well as Baltimore, because he had 
been following it up right here in our own city, and 
he proved it to me by the same manner that his 
teacher proved it to him. He showed me while there 
were still some in our city prospering and getting 
rich at this nefarious business, that all the old ones 
that were in our midst years ago terminated their 
lives in a tragic manner, similar to those just men- 
tioned in Baltimore. If this is not a lesson to the 
young man starting out in the practice of medi- 
cine, then he is doomed. One other thing Doctor X. 
impressed on me, and that was that the great body 
of medical men are made up of men of good moral 
stamina, and that it is only a few men, a very few, 
in every city that fall to this low practice, and those 
parasites, as he called them, are ostracized from 
the medical societies, and they are being weeded out 
now by laws that take their license away when they 



56 Pitfalls 

are convicted of crime. In the course of our con- 
versation, he got on the subject of how some of his 
colleagues in another city fell headlong into a pitfall. 
Then Doctor X. told me a story so weird that it 
got on my nerves. He told how one day a lady 
about forty years of age called on him with a note 
from a prominent surgeon, asking him to make a 
thorough examination and report his findings to 
him. The lady, who was from another city about 
thirty miles away, gave a history of being married 
about twenty years, but never had any children. 
She was a fairly stout woman and said she was al- 
ways healthy up until the last few months, when 
she noticed herself getting larger, and she said that 
she came to the city because she heard of this sur- 
geon being a good man to operate on a tumor, which 
she seemed absolutely positive was her own complaint. 
Her husband, she said, was a sickly fellow and 
only weighed 110 pounds and was very thin and stoop 
shouldered; he was a bookkeeper in a large manu- 
facturing plant. 

On physical examination, Doctor X. found many 
things very puzzling. There was no history of 
vomiting at any time and though menstruation 
ceased two or three months before, still she claimed 
that often happened, and that did not worry her. 
Her whole mind seemed to be set on the idea that a 
tumor was growing within the abdomen and that she 
should be operated upon. 



The Physiological Tumor 57 

After going over her thoroughly, using the dif- 
ferent tests and signs for early pregnancy diag- 
nosis, Doctor X. could only elicit one which he found 
positive both directly and indirectly, and that was 
ballottement. 

Doctor X. told me that it is unusual for women 
to come to the doctor with the idea that they have 
a pathological condition, when it is really preg- 
nancy. He said the case is usually the opposite, 
many women of a psychopathic mind, come to the 
physician insisting that they are pregnant when 
they are not. They even are convinced that they 
are getting larger each week and when the doctor 
makes examination, he must be on his guard with 
this type of patient, or she will convince him that she, 
is pregnant and even exhibit signs of pregnancy, 
which are only hysterical in type. The physician 
may be able to map out the large uterus, as he pal- 
pates the abdomen, but if he takes the trouble to 
put his patient under an anaesthetic he will find that 
this "phantom tumor" — as it is called — will disap- 
pear and that the abdomen becomes absolutely 
normal with no signs of pregnancy. As I say this 
type of patient turns up very often and they are 
women usually well on in life, near the menopause. 

However, in this case Doctor X. became con- 
vinced that the lady was pregnant and told her to 
report back to the surgeon and he would advise her 
what to do. So when she left he wrote his findings 



58 Pitfalls 

to the surgeon and when she called on him, he told 
her that both he and Doctor X. thought she was 
pregnant between two and three months, and she 
should not think of having an operation. 

She became very indignant and left the surgeon's 
office furious and said both he and Doctor X. were 
"crazy," because she had been married twenty years 
and never was pregnant in her life and now in her 
"old age," and a sickly husband, she was sure they 
were mistaken. 

So she left the city and went back home and told 
her husband the result of her visit and he wrote 
Doctor X. an indignant letter, telling him he had 
a "hell of a nerve" to charge his wife ten dollars 
for such a fool diagnosis. 

However, on the advice of her husband she went 
to a doctor in her own town and he was of the 
opinion that it was a tumor and that she should 
be operated upon. 

So when she came home and told her husband, 
he said: "Well, you knew that, why didn't you go 
there in the first place?" 

They kept putting the operation off and months 
went by and the tumor was getting larger, and while 
they both worried very much about it, they kept 
putting off the operation until finally one day, they 
went back to this same doctor and he said she just 
came in time ; if she put it off any longer, she would 
lose her life. 






The Physiological Tumor 59 

So he took her to a hospital in that little city and 
prepared her for operation ; he and another surgeon 
made an incision in the median line down the abdo- 
men, and a large uterus presented itself in the gaping 
wound, which at first they thought was the large 
tumor, but when they took this in their hands to 
remove it, they felt "something" through the walls 
of the uterus that was strenuously objecting to be- 
ing removed, and then when their eyes were opened 
and they discovered it was a pregnant uterus, their 
faces became blanched with fear, so they quickly 
pressed the uterus back into the abdomen and with 
trembling hands sewed up the gaping wound and 
sent the woman back to bed. 

Doctor X. told me that the strangest thing about 
this case was, that when the woman was first sent 
to him by the surgeon in this city for examination, 
she was only between two and three months preg- 
nant, but the doctor in the little town where she 
lived allowed her to go on to nearly full term with- 
out finding out she was pregnant. 

A week following the operation, she gave birth to 
a dead child, probably due to the disturbance. 

The lady herself has an abdominal hernia and 
will probably have it all her life, but she was fortu- 
nate that she did not lose her life too. 



CHAPTER X 

"the major of the men of life" 

I can always tell by the expression on Doctor X.'s 
face when he has something on his mind that worries 
him; he has a habit of twisting a lock of hair while 
he sits in a lounging chair, with one leg crossed over 
the other, looking straight ahead at nothing. 

One evening, when he was so occupied, I said to 
him, "What's on your mind, Doc?" He turned and 
smiled at me, and then got up and found his pipe 
and filled and lit it and puffed for awhile, following 
with his eyes the rings of smoke slowly rising in 
the room which he used as his study, and then said 
to me, "Well, old scout" — which was a pet name 
with which he usually addressed me — "you have 
heard me tell many times about pitfalls that we med- 
ical men are always in danger of falling into." I ad- 
mitted that his tales of the experiences of medical 
men were always absorbingly interesting to me, and 
then he said that Doctor "Blank," — mentioning a 
prominent surgeon of national reputation, — and he 
had been saved from going over a "precipice" — he 
called it — by a young interne in the hospital who 

60 



"The Major of the Men of Life" 61 

had not even received his license to practice medi- 
cine yet. When he saw me looking surprised he told 
me the following story : 

A middle-aged lady called on him one day to find 
out what was ailing her and Doctor X. said he 
noticed when she first called that she was somewhat 
jaundiced and her face looked flabby and wrinkled 
where the lines before showed that she was naturally 
fat, but something must be wrong because she was 
fast losing flesh. This he found was actually 
true from her subsequent history. Her family his- 
tory was negative, except that they were all in- 
clined to be obese. She was a woman about fifty 
years old and had two sisters living, one younger 
and one older than she. She was married and had 
seven children, three of which died in infancy. She 
had one miscarriage. Her husband was living and 
well and was an engineer on the railroad. Doctor X. 
said he examined her and found that her legs were 
somewhat swollen and her heart was beating hard 
and fast and her blood pressure was quite high, 
about 160 systolic, but when he was examining her 
about the abdomen he saw "something" or, as he put, 
he thought he felt "something." After going over 
the patient in a thorough manner, as was his cus- 
tom with all patients, he found her so debilitated 
and exhausted that he advised her to go to a hospital 
for further study, as it was his opinion that he would 
have to call a surgeon to operate. After he had her 



62 Pitfalls 

in the hospital she improved somewhat and Doctor 
X., with a prominent surgeon, went over her to- 
gether, and they found what seemed to be a tabu- 
lated mass protruding down under her ribs on the 
right side. So with the history of such rapid 
emaciation and the jaundiced appearance and swell- 
ing of the legs, and her age, etc., they came to the 
conclusion that the mass felt was a malignant growth 
that necessitated immediate operation. Doctor X. 
said that her condition became so grave after a day 
or two at the hospital, although it improved the 
first day, that they didn't have time to take tests 
of her blood and urine. So they thought they would 
go ahead and prepare her for operation. 

The surgeon was all ready and Doctor X. said 
he was there only out of curiosity to see the can- 
cerous condition of her liver, which was their diag- 
nosis, and for which they were to explore. When 
the interne came to give the anaesthetic he saw Doc- 
tor X. standing around waiting, and asked the 
doctor if this lady was his patient, so Doctor X. 
said yes, but she belonged to the surgeon just now. 
Then the interne, who was sitting on a stool at the 
head of the operating table, beckoned Doctor X. 
to come and have a look at the patient's head, 
which he did, pulling the hair apart in different 
places. He was astonished to find four or five 
large gummatous lesions scattered around at dif- 
ferent points on the scalp, a condition that he 



"The Major of the Mm of Life" 63 

never noticed before because in this case the lady 
said nothing of those sores, but Doctor X. said that 
he "got what was coming to him" because he neg- 
lected for the first time in his life to start at the 
top of the head of a patient and finish the physical 
examination at the top of the toes. Doctor X. 
called the surgeon from the wash room and showed 
what the interne discovered, so they made up their 
minds that the same thing that caused the gumma- 
tous lesions on the scalp was the cause of the lobu- 
lated mass at the region of the liver, so they decided 
not to operate because the condition was syphilis 
of the liver which immediately responded to anti- 
syphilitic treatment. The patient recovered her 
strength and as she gained weight again all the 
symptoms cleared up, her swelling left her legs, but 
before she left the hospital Doctor X. examined her 
blood and found what he expected, a positive Was- 
sermann test, which proved she was syphilitic. And 
when I asked Doctor X. if he thought she would 
have been under much risk if she did have an opera- 
tion with such a skilled surgeon, he told me she 
never would have gotten out of the operating room 
alive, because since that day he found both her blood 
and urine loaded with sugar. She had diabetes com- 
plicating syphilis, and a stout diabetic of this type 
usually dies on the operating table. So that was 
how a young interne saw "something" and saved 
a lady's life. And I often think that the late la- 



64 Pitfalls 

merited Osier was too modest when he used Bunyan's 
phraseology applied to tuberculosis, that pneu- 
monia was the "Captain of the Men of Death" when 
he didn't add that the physician was the "Major 
of the Men of Life." 






CHAPTER XI 

"the night doctor'* — "vultures" 

One night I found Doctor X. in a very jolly and 
carefree mood. He said his reason for feeling happy 
that evening was because he found all his patients 
doing well and could rest one night anyway without 
fear of being called out. He said to me he wondered 
why some young doctor, when he finished school, 
didn't start out for a year or so as a "night doctor." 

Doctor X. said he was sure there was a fortune 
in store for the ethical young doctor who would 
employ someone to attend his telephone and take 
calls as they came in while he would be out making 
a call. He could get a double fee for every call, 
he could send out cards to every physician in the 
city stating that he would make their night calls 
and turn the patient back to the family physician 
next day, as the night doctor only was to make calls 
between 7 P. M. and 7 A. M. Doctor X. said the 
man who will do this in every large city will get 
rich in a few years, because night calls will be cash 
and he can get all the way from $3 to $10 a call 
from people, according to their means. Doctor X. 

65 



66 Pitfalls 

said he would give the "night doctor" on an average 
seven calls a week where now he has to turn over 
calls at night to young men who are competitors 
during the day. I thought the plan was a good 
one and wondered why some young man never ven- 
tured on it. After a year or two Doctor X. said the 
man would have wealth enough to go and take a post- 
graduate course in some large medical school and 
branch out in any specialty he wished. Doctor X. 
said there are hundred of doctors in every city who 
don't want to make night calls and if he could give 
on an average seven calls a week you can imagine 
what the others would give when they knew there 
was a man in the city who specialized as a "night 
doctor." 

In the course of our conversation we drifted onto 
the subject of quacks and their methods of fooling 
the public, and Doctor X. told me that if the public 
would write to the American Medical Association, 
535 North Dearborn St., Chicago, and obtain a 
copy of a book entitled "Nostrums and Quackery," 
they could find therein an extremely interesting ex- 
pose of every "fake medicine" and every "fake doc- 
tor" in the United States for the past twenty years. 
I happened to see a copy of this book in the doc- 
tor's waiting room one day and in glancing over it 
found a fake remedy that a stout lady friend of mine 
was telling how she was "cured" of gall stones by 
taking it. The description of the manner in which 






"The Night (Doctor"— "Vultures" 67 

the "fakers" exploit this cure would be funny if it 
were not for the fact that so many tragedies happen 
to poor dupes who fall for it. This friend of mine 
thought she was cured by it, but Doctor X. said 
the only way to be cured of gall stones was to get 
into the hands of a good surgeon, because there is 
absolutely no medicine that a doctor or anyone can 
give that will make gall stones pass, although he 
said gall stones sometimes pass but the condition 
that makes gall stones is still there, and the victim 
of gall stones is always subject to another attack. 
He said many people have them all through life 
without much suffering, but they are always in dan- 
ger of becoming septic or by irritation over a long 
period might start up a cancer of the gall tract. 
This same lady friend of mine has had two attacks 
since she had claimed to be cured. I can't resist the 
temptation of telling how this fake gall stone cure 
is worked on the poor unsuspecting public. Doctor 
X. said it was made up of about six or eight ounces 
of olive oil disguised by a trace of anise oil so the 
people will not know it is olive oil, then there is a 
Seidlitz powder that goes with it, under another 
name, to augment its laxative effect. The poor dupe 
takes all the oil at bedtime and is instructed to take 
the powders early next morning. 

Doctor X. said this is what happens in the vic- 
tim's system: Soapy concretions are formed by the 
action of the Seidlitz powder on the oily contents 



68 PitfaUs 

of the intestines; these are rolled into little round 
green balls by the peristaltic action of the intes- 
tines. The victim thinks she has had anywhere from 
twenty to one hundred gall stones, which of course 
are not gall stones at all. So when she sees them it 
leads her to think that she has gotten rid of her 
trouble and she runs and tell her neighbors about 
the wonderful cure she has found, and this goes 
on like an endless chain, and the fakers grow rich 
and fat and when the dupe finds out she has been 
humbugged she can't go back over her tracks and 
undo all the boosting she did for the fake, and it, 
goes merrily on. 

Doctor X. told me of another unscrupulous faker 
who exploited a "cure" for Bright's disease. He 
said this faker conceived a damnable spectacular 
idea of making every victim think he had Bright's 
disease. He said this vulture sent out free to his 
victims a small vial of a weak solution of silver ni- 
trate, whom he told could make their own urinalysis 
by adding the contents of the vial to a small quan- 
tity of their urine. The quack told them if they saw 
a "white precipitate" after adding the contents of 
the vial, Ihey had Bright's disease. But Doctor X. 
showed me by an experiment right in his office that 
there is a white precipitate in everybody's urine, 
formed when you add a weak solution of silver ni- 
trate because the chlorids naturally present in all 
urine causes a white precipitate. When the victim 



"The Night \Doctor"— "Vultures" 69 

sees this he naturally thinks he has the disease and 
adds more to the vulture's exchequer by buying a bot- 
tle of his "fake cure." Doctor X. said this is all ex- 
posed in the book called "Nostrums and Quackery," 
published by the American Medical Association, and 
the only way to stop this and other nefarious frauds 
is to get this volume into the hands of the general 
public. 



CHAPTER XII 



ALL THE WIVES WONDERED 



Doctor X. said to me one night, "You cannot im- 
agine, Old Scout," the number of unique and bizarre 
types of pitfalls that are ever yawning their abysmal 
depths to medical men, ready to gulp the unwary 
physician or surgeon, much in the manner of "Lis- 
bon Town, when she saw the earth open and gulp 
her down." 

Then he told me of an unsuspected pitfall into 
which a good friend and very capable and respected 
colleague of his was innocently precipitated. I say, 
"innocently" because Doctor X. told me, that it 
was really through the kindness and goodness of his 
colleague's heart that he was led to mistake trickery 
for modesty which was assumed, and thereby neg- 
lected to subject a sensitive patient to a critical ex- 
amination, because he had known the man for many 
years and always thought him to be of an exemplary 
character. 

This subject came up one night when we were 
discussing medical topics, especially the live ques- 
tion "Eugenics" and "Eugenic Laws" passed by sev- 

70 



All the Wives Wondered 71 

eral states, and after arguing the subject pro and 
con Doctor X. told the following strange story : 

Going back some years, he told how one evening 
he was called to a lady who was nervous and hys- 
terical from the manner in which she said her hus- 
band treated her. Doctor X. said he noticed she 
was of a neurotic type and jealous of her husband, 
whom she claimed was running around nights with 
another woman. She said, "If he didn't look out 
she would fix him." And every once in awhile his 
patient would say : "Oh, if they only knew ! If they 
only knew!" Doctor X. attributed this outburst 
to her hysterical tendency and paid little attention 
to it at first, but when she repeated it so often he 
finally asked "If they only knew what?" All the 
answer she gave was, "You're a doctor, you ought 
to know. Haven't you seen him?" Doctor X. told 
me he couldn't make much out of the case but at- 
tributed the whole thing to what he called "Psycho- 
pathic condition," but after being called to the pa- 
tient again and heard her repeat the peculiar phrase 
"Oh, if they only knew," his curiosity was aroused, 
and he went into the other room where the husband 
was smoking a cigarette and playing solitaire at a 
table, with his cap set jauntily on the back of his 
head. He said the husband glanced or "flashed" two 
black eyes at him quickly and smiled, showing a 
double row of white teeth, and said in a sort of 
tenor-alto-baritone voice, "What in the hell is the 



72 Pitfalls 

matter with her?" And then Doctor X. saw "some- 
thing" and said to himself, no wonder she says "Oh, 
if they only knew !" This was the first time the doc- 
tor saw the husband, and he told me he lay awake 
most of the night thinking of what a strange, weird, 
psychopathic, phenomenal case he had on his hands. 

Doctor X. said he made it his business to follow 
up the husband and find out all about him since the 
time he came to the city from another state some 
years before. He found that he worked in the office 
of an industrial plant and was quite popular with 
his fellow workers; also his employers had no com- 
plaint to make, as he did his work well, even though 
he run around nights. He seemed to have provided 
for his wife fairly well for the salary he was get- 
ting. Doctor X. smiled when he told me how this 
fellow went on week-end trips with his fellow workers 
and their wives to a nearby lake. The men bunked 
in the attic of the cottage every night, while all 
their wives slept downstairs. He entered into all 
sports, such as baseball, fishing, boxing, gambling, 
smoking and drinking; in short was a happy-go- 
lucky and jolly good fellow all around, and always 
ready for any old game he could get in on. 

Doctor X. said he noticed that he and his wife 
were becoming more and more estranged and she 
seemed to suffer mentally from the estrangement, 
and wanted to keep him and begged Doctor X. to 
use his kind influence to make him come back and 



All the Wives Wondered 73 

support her, but he said he couldn't make him see 
his duty ; in fact, he told Doctor X. she was not his 
wife, that he was going to marry another, "a better 
housekeeper," he said. All this time Doctor X. said 
he did not like to mix in their peculiar family af- 
fairs, but he told the fellow that if the "something" 
that he recognized the first time he ever saw him 
was true, he would have one hell of a time getting 
married in this state. The fellow only "flashed" his 
two black surprised eyes on him again and said in 
a casual way, "Leave it to me, Doc." 

I asked Doctor X. how he would have a hard time 
getting married in this state, and the doctor said 
that we had a "eugenic law" in this state and any 
man who wanted to get married had to have a certifi- 
cate from a physician stating that he examined him 
thoroughly and found he was free from all venereal 
diseases. I said : "Good heavens ! Doc, was the vil- 
lain diseased? Doctor X. looked at me and said, "Old 
Scout, if you only knew! Oh, if you only knew! 
But it isn't ethical for any medical man to say 
anyone is diseased or not diseased, but it will not 
be the disease — if he has any — that will prevent him 
from getting married in this state." That's how 
Doctor X. left me, wondering and puzzled about 
his psychopathic case that night, and I heard no 
more about the case for a few months, until I was 
startled by big black headlines in all the newspapers, 
and I ran over to Doctor X. and showed him the 



74 Pitfalls 

papers. He said he had all the facts, or most of 
them, beforehand and told me first hand how the 
thing happened. 

He said the woman, who was his patient, was not 
this party's wife, of course "couldn't be" ; that they 
both came from another state to this state where 
they were not known. The "husband" was a capable 
trained nurse in the other state but got it into her 
head that if she masqueraded as a man, a married 
man at that, they could live better, and she could 
make more wages and the "wife" could stay home 
and cook and keep house. Doctor X. said there 
was at first an unnatural love between them but that 
wore off as time went on and the "husband" de- 
veloped another unnatural love which eventually 
became her Nemesis. When she left her first para- 
mour she thought, "Now if I marry the other, the 
first one cannot have any claim on me." But that's 
where she met her fate. The first one, when she heard 
of her "husband" being married again, ran to the 
police inspector and told her strange tale, which I 
dare say astounded the police officers. Then they 
began to wonder, as Doctor X. was wondering, since 
he heard of the new marriage "where in the hell did 
he, or she, get the marriage certificate?" "And all 
the world wondered," and all the wives wondered, 
"and into the mouth of hell," into the fathomless 
pitfall, rode the doctor who blundered. 



CHAPTER XIII 

f NO DOCTOR" 

One night we were talking about the psychology 
of the public mind with regard to advertisements by 
which quacks fool the public, and Doctor X. told 
the following story on himself, although he was en- 
tirely innocent of any advertising: 

He said for a long time he kept a prominent 
orthopedic surgeon busy with hip cases that were 
coming to him. He said women would come nearly 
every day with their children and always there was 
something wrong with the hip, either tuberculous 
troubles, or congenital dislocation, or something. So 
he said that he would always refer the cases to a 
man who knew more about the cure of these troubles 
than he did. 

Doctor X. said he noticed that this hip business 
started suddenly, as for years before he never noticed 
that he had many of this class of cases consulting 
him, so he asked a number of women how they came 
to consult him with regard to their children's hip 
disease, but they would say some neighbor told them 
that he was a "hip doctor," but Doctor X. always 

75 



76 Pitfalls 

told them no, he specialized only in internal medi- 
cine, and he then referred them to the orthopedic sur- 
geon. Still the cases kept coming and coming, and 
when he would meet the surgeon, as he did occasion- 
ally at the hospitals, the surgeon would say, "X., 
Old Scout, where the hell do you get all those hip 
cases you send to me?" And all Doctor X. could 
say was, "Damned if I know; I've been trying to clear 
up the mystery myself, but it is beyond me." So 
the thing went on, and there was no let-up, the hip 
cases kept coming. But finally it was getting on 
Doctor X.'s nerves. He began to think there must 
be some way that the mystery could be solved, so he 
questioned his patients more in detail, how they 
came to call on him, why they didn't go to an ortho- 
pedic man, but would always get the same answer, 
and that was that a neighbor or friend sent them 
who said he was a "hip doctor." 

So finally one night, after office hours, a colleague 
of his came running in and said, "Come on, X., let's 
go down to the 'Hip' and see the prize fight." Doc- 
tor X. said he looked at his friend and couldn't 
speak for a minute, and his colleague said, "Gee! 
what's the matter? Aphasia?" Doctor X. said, 
"No, I just saw 'something,' but what a 'puddin' 
head I must be not to have seen it before." There, 
outside Doctor X.'s office was a large, electric sign on 
the main street which read "H IP" which was hang- 
ing right under X.'s modest sign. The "Hippo- 






"The Hippodrome"— "No Doctor" 77 

drome" where the prize fight was to take place was 
down the street some distance from the corner where 
Doctor X. had his office, and they placed this al> 
breviated sign to direct the public. Since then Doc- 
tor X. said he believed "in signs" and he was sure 
the public did too. 

Then, after we had the laugh out on Doctor X. 
he told us of a peanut vender who used to keep a 
peanut stand at the entrance to the building where 
a quack was doing a thriving business. This peanut 
vender was a sort of a mongrel, who "shivered for a 
cent." Anyway, this fellow, standing all day at 
the entrance used to see many dupes go up and down 
and he thought to himself, "Gee, that fellow upstairs 
is making dollars where I am only making pennies." 
So he conceived the idea of getting into the doctor 
business himself. Doctor X. said the tragic part 
of the story was that this scheming mongrel got 
away with it for nearly two years before he was 
arrested, after he robbed and nearly poisoned many 
of the credulous fools who run to quack doctors. 

Doctor X. told how this peanut vender rented a 
room in the same building in competition with the 
other quack, while his wife continued the peanut 
stand downstairs. He had his wife trained to steer 
victims to the room in which he was trying to "play" 
doctor. By the way, this idea of steering victims 
was the thing that first started the plan in his head 
to be a doctor. So many people used to stop at the 



78 Pitfalls 

stand and look around and finally ask him where 
is that Doctor W. that cures "everything," and of 
course since he could do that for the other quack, 
his wife at the peanut stand could do it for him. So 
he rented a room, as I said before, and hung out a 
"shingle" with his name on it and the word "Doctor" 
on it too. But the reader will realize what a rogue 
and scheming faker he was if he studies this "shingle" 
or sign closely. It is awfully hard to write a de- 
scription of this sign which the peanut vender dis- 
played to the public, letting them know that now 
instead of selling them peanuts he would cure their 
ills by selling them medicine. So before I come to 
the description of the sign I'll tell what happened. 

As I said before, this peanut vender robbed many 
victims on promises to cure anything at all that was 
the matter with them; in fact, he advertised in the 
newspapers that he was a "specialist" in everything. 
The other quack was afraid to make a complaint to 
the "powers that be" because he couldn't come with 
clean hands complaining of this new quack, so the 
thing ran along and he was coining money upstairs 
and his wife continued the peanut business down- 
stairs, not for what she made out of it, but to be 
on duty to direct victims up to her husband. Finally 
this wife of his became his Nemesis. She began to 
notice that very many women were asking her where 
her husband's office was located, and the wife be- 
gan to feel the "green-eyed monster" of jealousy 



"TEe Hippodrome"— "No Doctor" 79 

taking hold of her, and she became very watchful. 
This peanut vender not being drilled in medical 
ethics and having a low standard of morals began 
to be familiar with patients and naturally he even- 
tually came in contact with a female patient whose 
immorality equalled his own, and his wife caught him 
redhanded. The scene that took place is indescrib- 
able. Pandemonium reigned around the whole 
neighborhood, people passing on the street stopped 
and gathered around the entrance asking, "What's 
the matter?" when they heard weird, wild yells ema- 
nating from the windows of the faker's office. So 
finally the police took a hand and bundled faker 
with his paramour and wife into a police patrol and 
they delivered the "triangle" at the station house. 

Doctor X. said that it is strange how the "powers 
that be" allow medical fakers to go on in their ne- 
farious game of robbing and poisoning people until 
something happens that brings them into court and 
then they ask, "How did this fellow come to be a doc- 
tor?" That's just what the authorities did in this 
case, and they brought a charge of practicing medi- 
cine and hanging a doctor sign out without a license. 

When the state tried to prove he practiced medi- 
cine they couldn't get any of his victims to testify 
because of the notorious character of the case. So, 
the state set out to prove that he had a sign hanging 
out signifying that he was a doctor, but the de- 
fendant's attorney denied this to the court's amuse- 



80 Pitfalls 

merit. So the sign was brought into the court by 
the state in order to prove to the jury he posed as 
a doctor, and this is how the sign looked to the jury: 



NO DOCTOR 
515 BLANK 



After the jury saw this sign they wagged their 
heads, as much as to say, this sure is a doctor's 
sign. But the defendant's attorney called him to 
the stand and after the preliminary questions asked 
the defendant if he hung out a sign telling the public 
he was a doctor. He said, no. Then his attorney 
asked him if he hung out a sign telling the public 
he was not a doctor. He said "Yes." Then he told 
him to tell the court and jury how he was such an 
honest man that he always wanted his patients to 
know he was not a doctor. He told them he put 
the sign out especially for that purpose, and if they 
noticed the top line of the sign said he was "NO 
DOCTOR," and the 515 was the number of the office. 
Doctor X. said the worst part of it was this fellow 
was freed from the charge which the state had 
against him, but his wife punished him. I asked 
Doctor X. what this case had to do with "pitfalls" 
and he smiled and said that had reference to the pit- 
falls into which the public and lawyers are being 
precipitated. 



CHAPTER XIV 



While I am on the subject of quacks I must tell 
you a story about how I investigated two quacks 
who did a land office business in this city for years 
and grew fat and wealthy on their victims. They 
occupied a suite of offices in a prominent building 
and sent out glaring advertisements in all the papers 
in the city and surrounding cities and villages 
throughout the state. These two crooks were twin 
brothers, and looked so much alike that when a vic- 
tim would accuse one of them he would always find 
some way of proving an alibi. In their advertise- 
ments they made it always appear that there was 
one "great specialist" in men's diseases, which they 
made their graft. It was Doctor X. that put me 
wise to these two fakers and asked me one evening 
if I would go and pretend I was sick with some trou- 
ble peculiar to men and see the manner in which 
they conducted their nefarious game. Doctor X. 
warned me not to let them get any money from me 
and I was surprised at his warning until "run the 
gantlet of the crooks," to tell the truth they nearly 

81 



82 Pitfalls 

got my pocketbook. Anyway, I called one day and 
as I stepped off the elevator a suave, polished-look- 
ing fellow, who seemed to be on the lookout for 
victims, in other words, a "runner" for the fakers, 
asked me if I was looking for the great specialist, 
and when I said yes, he ushered me back through a 
long corridor into a waiting room, where there were 
a number of dupes waiting their turn. 

After he closed the door and went back to his post 
at the elevator, I was trying to see if I had any 
gift of perception like my friend, Doctor X., but 
the place got on my nerves and I know there were 
many things that I missed, but I'll try to tell what 
I saw. I first noticed that no one could leave the 
waiting room without going through the rooms oc- 
cupied by the specialist and his assistants, so after 
waiting awhile I thought I would go out and I man- 
aged to get past the first room in which a young 
man was questioning a patient and by the time I 
reached the next room a big professional-looking 
fellow, who was none other than the great specialist 
himself, stepped out and said, "What's your hurry? 
Just sit down ; we will look into your trouble next." 
Well, I thought all right, so I went back to the 
waiting room and waited until someone came in and 
said, "Where's that young Colonel who has to catch 
the next train to Washington?" No one got up, 
but they all looked at each other. Then he said, "I 
mean the one the great specialist said he would take 



"Twins— Very Much Alike" 83 

next," so I arose and went with him, although I 
was tempted to tell the dupes in the waiting room 
that I was not a Colonel and not going to take a 
train for Washington, but I thought better of it, 
and followed the young man into the first office 
where he took my "history" and asked all kinds of 
questions particularly about my financial affairs , 
which I stretched out a little so they would think 
they had a good rich victim. I told him I had some 
minor ailment that men are apt to have and he 
looked wise and said that was too serious for him 
to tackle, I better see the great specialist. Then 
I heard a shuffle through a thin partition, like some 
one slipping out of the next room quietly. After a 
little while the first "doctor" who took my history 
led me on through two or three offices fitted up with 
"fake cabinets" and "fake" X-ray machines, etc., 
until we came to the great wise specialist seated at 
a mahogany desk and poring over a ponderous 
volume of science. I was introduced to the same man 
that impeded my exit some time before. 

So the "doctor," who is really nothing more than 
some young man employed, left me in the hands of 
the faker and went out. I said to the specialist that 
I saw his ad in the papers that he gave free con- 
sultation, and I thought I would consult him and get 
his advice, and if he would cure me I would pay him. 
He said, "Your trouble is quite serious," but he could 
cure it, and he launched out into a description of 



84 Pitfalls 

what was the matter with me and told me the name 
of my trouble, said how I only had a short time to 
live unless I would take his treatment. I asked him 
how he knew I had the trouble, he didn't examine me. 
He said, "My dear man, I can look into the eyes of 
any patient and tell just what is wrong with him. 
I cure hundreds of your kind of disease every day." 
Then he told me I should pay him twenty-five dollars 
now and sign this note and he pushed a legal-looking 
paper under my nose, all the time talking, telling 
what a dangerous trouble I had and how simple it 
was for him who was the only living specialist that 
could save my life. I saw that this crook worked 
his victims by trying to overawe them and use his 
persuading personality to extract coin from the 
victim and make him sign up, giving fake guaranties 
of cure, and believe me, he was getting on my nerves 
and I was beginning to feel that I would part with 
some of my roll to get out of his clutches. I re- 
fused, of course, to sign with the excuse that I would 
come again. He stood up over me and said, "Well, 
my fee for this visit is twenty dollars and I'll de- 
duct it from the price when you take my treatment." 
But I said, "Doctor, you advertise that consultation 
is free." "Oh," he said, "that's for the advice you 
get from the first doctor. I must have my fee; I've 
been examining you since you entered this office." 
I said, "Yes, and you've been eavesdropping the other 
side of a thin partition in the first office, and then 



"Twins — Very Much Alike" 85 

when you heard what I told the young clerk you 
have there you sneaked back here to make a vic- 
tim. Now you let me out, you big faker, or I'll 
have you in jail before you realize who I am." Oh, 
I was brave, but all the time I was shaking in the 
knees. When I told him I had no such trouble and 
just wanted to see his system of working the dupes, 
he threatened to have me arrested, but I put on a 
bold front and beat it. That's how this faker nearly 
got my money. I told Doctor X. and we had a 
good laugh over it. Doctor X. told me he knew of 
a poor fellow who had an incurable trouble — and men 
with incurable troubles grasp at any last straw, — 
who went to the great specialist, who gave him a 
written guaranty to cure his trouble in three months 
for three hundred dollars, and after the first month 
the man complained that there was no improvement. 
He said that the faker told the poor victim there was 
a certain apparatus he had to buy to use in his 
special case and that would cost him three hundred 
more, and again he gained the confidence of this 
poor fellow who was anxious to be cured, and he 
gave him the three hundred, making six hundred. 
Then the faker bought some kind of cheap apparatus 
and used it in his bluff treatment. When the three 
months were up there was no improvement and the 
faker again told him how, in order to complete a 
cure, he should have his "mechano-therapeutic de- 
vice" that would absolutely cure him, and again 



86 Pitfalls 

gained this poor fellow's confidence and got five 
hundred dollars from him, after the poor fellow 
mortgaged his little cottage. When the poor fish's 
eyes were opened and he was left penniless with 
a mortgaged home and unable to work and his wife 
and children in want, he went to a lawyer who 
started suit against the quack and got the case into 
court. The crook that got the eleven hundred dol- 
lars wasn't to be seen at all, but the lawyer and the 
dupe discovered they were trying their case against 
a fellow who looked like the crook, and this fellow 
was none other than the twin brother who was some- 
where in California at the time the dupe was taking 
his treatment. Of course they could not convict one 
brother for the actions of another. 



CHAPTER XV 



CUM GRANO SAMS 



Doctor X. said one evening, that he noticed many- 
times in the clinics when he and his students were 
taking histories of patients that happened to have 
any defect, such as being cross-eyed or clubfooted, 
or curved spined and hunchbacked, in fact anything 
out of the ordinary, the patient or the mother or 
any members of the family who happened to be with 
the patient would always blame it on either the nurse 
or the doctor who was in attendance on the patient 
some time. If the patient happened to be a hunch- 
back they usually said "the nurse 'dropped' him when 
he was a baby." If it happened to be a clubfooted 
patient, they always said the doctor twisted the 
foot some way at the time of birth. Usually they 
blamed cross-eyes on something running in their eyes 
when they were small. Doctor X. said that those 
people told the story so often in making excuses for 
defects in their own children that they really be- 
lieved it themselves, and a doctor always had to be 
on his guard and take such stories "cum grano 
salis." 

87 



88 Pitfalls 

He said one day he was called to a little boy 
about four years old, who had been taken home from 
a hospital where he was treated for an "injury" to 
the hip and was kept in plaster cast in the hospital 
for six months. Doctor X. obtained the following 
history from the parents : 

They said about seven months before, the boy was 
playing with other children in a building that was 
under construction and that he fell through or be- 
tween the joists in a part of the floor that wasn't 
finished, into the cellar. When he was helped out he 
said he wasn't hurt much and had only scraped 
his leg a little. The parents said they made him 
stay in the rest of the day, but he played around 
the house all right and wasn't even lame. During 
the night the child became delirious and developed 
a high fever and vomited often. They said he was 
thirsty and when they would give him a drink of 
water or milk or anything he would "shoot it back 
in their faces." 

This expression Doctor X. said gave him his 
first clue that caused him to doubt the boy was 
injured. The parents said the boy's fever seemed 
to be down in the morning, but if they attempted 
to touch his hip or leg anywhere he would scream 
and then they called a doctor. The doctor was a 
capable man, but placed too much confidence in what 
the parents told him in regard to the "injury" the 
day before. He took the boy to a hospital and put 



"Cum Grano Salis" 89 

him under an anaesthetic and applied a plaster cast 
to the hip. As time went on and the boy's leg was 
much smaller than the other, he attributed it to 
the fact that it was immovable during the six 
months that it was in the cast. When the cast was 
removed and the boy sent home, Doctor X. found, 
from a thorough examination of the boy and from 
the history of the case, that it was really a case of 
infantile paralysis, which had been treated for an 
"injured" hip. 

The surgeon who was called first had his atten- 
tion drawn too much to the fall the day before, 
which was only a coincidence. Doctor X. found 
that the boy had a typical flail-leg that is only 
found in infantile paralysis, and he said this condi- 
tion was more exaggerated because of the fact that 
so much time had passed without the boy having the 
benefit of the care of a good orthopedic surgeon. 
Doctor X. said that this case was one of the many 
that was referred to him at the time the hippodrome 
or "Hip" sign was displayed by the Hippodrome 
Company outside his office, and he referred the case 
to a prominent orthopedic surgeon who verified his 
diagnosis of what happened seven months before. 



CHAPTER XVI 



Since I've been in the habit of dropping in on 
Doctor X. after his office hour in the evening, I've 
been startled many times by the manner in which 
he reaches conclusions and solves difficult problems 
that to another mind would seem to have no solution. 

One night I asked him how he came to be so 
adept that he had the reputation of being always 
correct in his diagnosis. He looked at me, and 
smiled, and said, "Old Scout, you surely kissed the 
'Blarney stone.' " But, he said, that while he made 
mistakes too, as well as anyone, if I wanted to know 
how he happened to be correct in cases that seemed 
difficult to others many times, it was due chiefly to 
constant application to study of books on "Physical 
diagnosis" and his experience in the clinics describ- 
ing the variety of peculiar cases that frequent clin- 
ics, to the students, and, secondly, to what Edgar 
Allan Poe called "ratiocination." When he men- 
tioned ratiocination, my mind went back to some- 
where in Poe's literature, I think it was in the "Mur- 
ders of the Rue Morgue," where I read of "Dupin" 

90 



"Ratiocination"— "A Poet's Sign" 91 

being gifted with this process of reasoning, but 
whom I could not just recall to mind before the 
mention of the word ratiocination. 

I was surprised this same evening at an exhibi- 
tion of his skill, which to me seemed to border on 
the supernatural. I happened to be in the drug 
store before I went to the doctor's office and while 
I was talking to the druggist a middle-aged man 
came in and asked the druggist what kind of a doctor 
was Doctor X.? He said he was a total stranger 
in the city and wanted to consult a physician. I 
heard the druggist tell him he would make no mistake 
in consulting Doctor X. and the man asked if he was 
in his office now, and when the druggist said yes, 
he said he would go and see him. I left the drug 
store and went to the Doctor's office, and after some 
time the thought struck me to tell him a man who 
was a stranger in the city was coming to see him, 
and in order to test him out on his "ratiocination" 
I bet him a good cigar that he could not tell anything 
about this fellow, as I had seen him do many times 
before with patients when they first came in the of- 
fice. He laughed and brushed back his hair and 
said, "Well, all right, maybe I can't, but I'll accept 
the bet, if the cigar will be a better one than the 
last one you gave me." 

About this time the man came into the waiting 
room, and I watched him and the doctor closely. 
The man said, "Is this Doctor X. ?" and stood wait- 



92 Pitfalls 

ing, not knowing which one of us was the doctor. 
Doctor X. stood for a period of about ten seconds 
looking at him closely, and then stepped forward 
and said, "Hello, Schultz, I'm sorry you lost your 
mother recently, didn't you? You called to see me 
about your heart, didn't you?" The surprised ex- 
pression on the man's face was only equalled by my 
own, bat I feared, or at least had a suspicion that 
he knew the man but found out later that wasn't so. 
I heard the man say, "Why, doctor, how did you come 
to know my name? I'm a total stranger here and 
just came to the city today; and my mother too, 

that surprises me most, she died only " By this 

time Doctor X. had him inside the private office and 
I couldn't hear just when she died, and Doctor X. 
in shutting the door looked at me with that fasci- 
nating smile of his and said, "Go get that cigar now, 
and a good one too." 

So I went out while the doctor attended his pa- 
tient. I bought the best one I could find, and the 
druggist looked surprised too. 

After the patient went away we lighted our smokes 
and Doctor X. said, "Gee, Old Scout, you did blow 
yourself this time." We settled down in his cozy 
upholstery and he saw that I was showing by my 
actions that I was impatient to know how he did 
it. He said, "It's the simplest thing in the world; 
any doctor can do it, especially if he cultivated the 
faculty for it." He said it helps wonderfully in 



"Ratiocination"— 'A Poet's Sign" 93 

medicine. In fact he kept teasing me for a long 
time, but finally I got it out of him by insisting that 
he had some supernatural gift for it. But he said, 
"Ah, rats, no!" And then he told me how simple 
it was. 

"First, you noticed that fellow had in his upper 
left hand outside pocket a letter, and just above the 
seam of the pocket were the letters — ultz. Now, 
what do you think that fellow's name was or is?" I 
dare say I was dumfounded. Doctor X. laughed 
at me and said, "Now, isn't that simple?" I had 
to admit it sure was, but I was thinking to myself, 
who else would see that. Doctor X. said, "Well, 
Old Scout, you didn't answer my question." So I 
said, of course his name is Schultz. "Well," he said, 
"there you have it." I said, "But, Doctor, how did 
you know about this fellow, who was a total stranger 
to you, losing his mother?" He looked at me with 
that smile and said, "Simple as finding that his name 
is Schultz." Then he asked me if one of my parents 
died, which one would I put a crepe on my hat for? 

I said, "Well, I'll be d d, of course my mother." 

Well, he said, "There you have it, you sure noticed 
that this fellow had a crepe on his hat." I didn't 
notice it, but when I met the fellow again I saw he 
was wearing crepe on his hat. But Doctor X. saw 
that I was anxious to know how he knew the fellow 
consulted him about his heart trouble. And when 
I asked him about that he said "Well, I couldn't 



94 Pitfalls 

expect you to know, but any doctor should see it," 
and he told me that on examination of the patient 
he corroborated the first diagnosis he made imme- 
diately in his own mind about just what was wrong 
with the man's heart when he first saw him. 

And believe me, this seemed to be the greatest 
mystery to me. And, to add more mystery, Doctor 
X. said he had Louis Charles Alfred de Musset, a 
French poet, who died away back in 1857 at the 
age of forty-seven years, to thank for his diagnosis 
of this fellow's heart trouble. 

Then Doctor X. told me that every patient who 
is really sick and consults a doctor always "thrusts 
forth" some symptom or group of symptoms to a 
doctor, and if the doctor is wide-awake he will get 
those "presenting symptoms" — Doctor X. called 
them — every time, and have a clue to work on. That 
seemed very plausible, but it was mysterious and 
remarkable to me. He said, "Now, if you noticed 
this fellow when he said, 'Is this the doctor?' well, he 
seemed to be out of breath, or have 'dyspnea' as med- 
ical men call it." I admitted I noticed that. "Well," 
Doctor X. said, "that wasn't all, I couldn't form a 
conclusion from that alone. He might have been 
asthmatic. You might have noticed, while he stood 
there awhile waiting he had a rhythmic-like movement 
of the head, synchronous with every pulsation of the 
heart. This nodding movement of his was due to 
what is called aortic regurgitation which is the dis- 



"Ratiocination" — "A Poet's Sign' 9 95 

ease from which this poor fellow is suffering. This 
rhythmic movement is called 'Musset's sign,' after 
the poet who discovered it in himself, and the disease 
from which the poet died in 1857 was aortic 
regurgitation." 



CHAPTER XVII 



Many times you see criticisms and complaints in 
the newspapers about local and national detectives 
bungling and blundering in murder cases. The criti- 
cisms are made usually by reporters who are anxious 
and too officious in finding a "scoop" for their papers. 
So when the detectives or police inspectors refuse 
to let them know all the facts, they go away with 
the determination of "getting the bulls," as they 
call them, and then write many things that are not 
facts, and this sometimes sways public opinion 
against the men who protect our homes and lives 
from human fiends, gunmen, and other prowlers of 
the underworld. We were talking on this subject 
one evening and I asked Doctor X. if he really 
thought the police and detectives deserved such criti- 
cism, and he told me that he was astonished some- 
times, at the efficiency of those officials, in ferreting 
out the criminals in difficult murder cases and rob- 
beries when he considered the difficulties under which 
they worked. He said when the police department 
goes into a pitfall and blunders in arresting innocent 

96 



"A Gurgling Scream" 97 

victims, it is due many times to their being dragged 
in bodily by coroners or coroner's physicians. He 
told me that the average coroner's physician was 
a man who paid a great deal of attention to poli- 
tics and very little to scientific medicine. 

Then Doctor X. launched out into a story that 
gave me a creepy feeling and caused me to have 
weird dreams that night from which I would start 
up out of bed in a sort of nightmare. 

He told me how, some years ago, he was called 
one beautiful July morning, between four and five 
o'clock, to a young married lady, who was found 
lying on the floor of her kitchen where she was pre- 
paring breakfast for herself and her husband, who 
worked as a clerk nights at one of the hotels, ap- 
parently murdered. Doctor X. said when he ar- 
rived some of the neighbors, mostly women, and 
one or two men, were already there, and what he 
gleaned from the stories of those people was that 
they heard a door bang two or three times and a 
peculiar "gurgling scream" as though someone was 
being "throttled" or choked. The houses were built 
close together and it being a warm summer morning 
the windows were open and they were all sure of the 
sounds as they described them. One of the women 
said after the noises stopped she couldn't sleep and 
she got up and dressed and went to the house from 
whence the noises came. The back door was closed, 
but it was unlocked so she opened it and stepped into 



98 Pitfalls 

the kitchen and was horrified to find such a grewsome 
sight, so she ran frightened to some of the neighbors 
and aroused them, and called Doctor X. This, 
Doctor X. said, was all that this lady knew, but an- 
other said she heard footsteps on the walk between the 
houses like someone walking in a hurry, and this oc- 
curred just shortly before she heard the peculiar 
banging sounds and scream. She said it was in a 
neighborhood where there were so many screams 
that she didn't pay much attention to it, but she 
was sure of the footsteps. The men didn't hear any- 
thing until their wives aroused them, so they stood 
around mute. Doctor X. said he noticed the floor 
was spattered with blood, the woman was lying near 
the gas stove and there was a chair upset beside the 
table. The table contained part of the breakfast 
she was apparently eating, and a clean plate with cup 
and saucer which was set for the husband who had 
not yet arrived. He said the unfortunate woman's 
hair was dishevelled and partly hanging down, and 
there was a bruise or bump on the right side of her 
head. He said life was extinct, but rigor mortis 
had not yet set in, and he could pry open her jaws 
and saw in her mouth and throat clots of blood. On* 
the right side of her throat were four bruised and 
contused marks like as if they were made by finger- 
nails, and one contusion on the left side that would 
lead one to think she was choked to death by a left- 
handed murderer. Two or three of the teeth were 



"A Gurgling Scream" 99 

missing from her upper right jaw, her face was livid 
and lips bluish and her tongue partly protruding, 
There were particles of food in her mouth mixed 
in with clots of blood, which would prove she was 
eating when it happened. A coffee pot was setting 
on the gas stove, with coffee in it, but the gas was 
turned off. On the bar or pipe that runs across the 
gas stove containing the stop cocks he found on the 
end a few strands of her hair. The fingernails of 
her left hand were cracked and bent outwards like 
as if she scratched wildly at her assailant. The 
thumb and two fingers of her right hand were bloody. 
There was a bottle of milk on the table partly used 
and one full bottle setting on the window sill, which 
proved the milkman had already made his rounds. 
There was a French roll on her plate, showing how 
she was biting it when attacked. The blood on the 
floor must have come from her mouth, since the con- 
tusion on her head did not bleed. 

The neighbors said she was a quiet sort of woman, 
and was only married a few months, and she and 
her husband seemed devoted to each other and kept 
very much to themselves, and while they spoke pleas- 
antly to the neighbors they never visited, and they 
did not know much about them. Doctor X. said he 
inquired about her health and they said she always 
looked the "picture of health." He said what led 
him to ask was he was wondering what made so 
much blood well up into her mouth and spatter 



100 Pitfalls 

around on the floor. Being choked by a powerful 
murderer would impede the flow of blood even if the 
capillaries in the throat were ruptured during the 
act. He said the motive of this murder could not 
have been robbery because in the next room, which 
was the dining room, lay a purse with two ten dol- 
lar bills in it, and some silver sixty-five cents. This 
was lying on a buffet in full view of anyone who 
entered the room. The murdered woman had a sort 
of morning gown or kimono on and her neck was 
exposed, making it an easy matter to see the marks. 
Her eyes were glassy in death and bulged, giving all 
the evidence of her struggle for air. 

By this time a thin, goiterous looking woman, 
whom Doctor X. had not seen before, edged in and 
said she knew something, but her rambling talk was 
so incoherent that he didn't pay much attention 
to her, but he heard her say something about hear- 
ing a wagon just before the scream and noises, that 
she thought was the milk wagon; she said she knew 
the milkman, and this lady had some quarrel or dif- 
ficulty about the milk bill. But Doctor X. said 
he could see no motive in that for such a grewsome 
revenge. Then Doctor X. was prompted by instinct 
to follow up some clue he had on his mind after he 
first observed this horrible sight, and he went over 
her again before the muscles became rigid, and by 
tactile exploration felt "something" that later 
proved he was correct in his reasoning, and about 



"A Gurglmg Scream" 101 

the time he finished this second exploration the 
coroner arrived with three detectives, and he said 
he was astonished at the manner in which the women 
of the neighborhood collected around the detectives 
and at the variety of stories which they told them. 
He said each detective had a group of five or six 
women about him and they were all talking at once, 
they knew all about it, and were talking for publi- 
cation, because Doctor X. discovered there was a re- 
porter in the crowd. 

The patrolman on the beat was not to be seen 
because it occurred at the time when he was chang- 
ing shifts, which by the way is a very opportune 
time for a hardened criminal to carry on his ne- 
farious business, and Doctor X. said he often won- 
dered why "the powers that be" never found a plan 
to keep the patrol on some way until the relief pa- 
trol arrived. 

Shortly after the arrival of the coroner, the poor 
husband came running in wild and his pathetic con- 
dition would wring the hearts of the hardest. The 
poor fellow fell on the floor bemoaning his loss, and 
became smeared and stained with the life's blood 
of his wife. Doctor X. said he had to turn away, 
although he was trained in sorrow and conscience* 
he said he couldn't stand this man's pathetic con- 
dition. But it was not so with the coroner and the 
"bulls." They pried him with questions, even when 
he was in the midst of it, but maybe they were to 



102 Pitfalls 

be excused in their anxiety to get a clue to work on 
and ferret out the murderer. The husband appeared 
to be a handsome fellow, about twenty-eight years 
of age, and he told them, after he became quiet and 
left the kitchen and went into the dining room, 
that he didn't know of any enemy that would stoop 
to such a crime. He said he was of Irish descent, 
but was born in America, and his wife was an 
American too, but of German descent. She was 
twenty-four years old, and once in awhile he would 
try to tell something but would break down and say, 
"Oh, no! Oh, no! It couldn't be! It couldn't 
be!" And then he would cry. Doctor X. said the 
detectives kept at him trying to find out what he 
meant by that, asking "What couldn't be?" So 
finally the husband said that he was afraid to tell 
them, because he may be wrong, and he would ex- 
claim again, "Oh, no, it couldn't be !" The detectives 
treated him soothingly and gentlemanly, and he 
quieted down and told them the following story, 
which to their mind gave them a clue, and set them 
on the trail of the murderer. 

The husband said, "For a year before I met my 
wife she was keeping company with a Brazilian, 
who came to this city about two years before. My 
wife seemed to like him, but she said he told so many 
stories to her about his business, which she found 
later were not so, that she tried hard to break off 
with him, but he was so infatuated with her that 



"A Gurgling Scream" 103 

he persisted in his attentions and made her life miser- 
able up to the time I met her, and even then he in- 
truded himself on her one night while I was with her, 
and we had some words and he went away making 
some threats, but his threats were against me. This 
was the last I saw of him, although he has been liv- 
ing on the south side all the time." The detectives 
seemed to nonchalantly dismiss the affair then, and 
the coroner took the body to the morgue where the 
coroner's physicians performed an autopsy and after 
a day or so the verdict came to the newspapers "That 
the woman was murdered by being hit on the head 
with a blunt weapon and then throttled to death by 
some person unknown." 

Doctor X. said he became acquainted with the 
husband and made it his business to find out all he 
could about his wife, although he hated to bring up 
the subject, as he knew the fellow's great bereave- 
ment, but he found many things that dovetailed with 
his reasoning and deductions made the morning of 
the murder. So he was startled one morning when 
he picked up the newspaper, to see in big black typed 
headlines that the murderer was captured. He read 
on to find out how they caught one Lazado Sampaio, 
a Brazilian, somewhere on the outskirts of the city, 
and everything pointed to this man, from what the 

detectives found, as the murderer of Mrs. , and 

that the husband identified him as the former lover 
of his wife, etc., etc., and that Lazado Sampaio 



104 Pitfalls 

would appear in court to plead guilty or not guilty 
next morning. Doctor X. said he made it his busi- 
ness to go to the Municipal Court the next morning 
out of curiosity to see this fellow, and he said 
the fellow surely looked guilty by his nervous ac- 
tion, and he had the earmarks of a scuffle of some; 
kind a few days before, because his face was some- 
what contused, although it was full of pimples and 
might only have appeared so. 

His old habit of lying stood against him in court 
too, because he told contradicting stories, and Doc- 
tor X. said there is an old adage which says, "He 
that lies hath need to have a good memory." This 
Brazilian was a big, swarthy, powerful fellow with 
two rows of white teeth, and a pimply but not un- 
pleasant face. Doctor X. said everything was 
against him, so they held him for trial of murder 
in the first degree. 

When the case came up for trial the newspapers 
made the most of it and added all the tragic sen- 
sational frills that appeal to the morbidity of the 
public, and the court room was packed, chiefly with 
women, every day hours before the case opened. 
Doctor X. said he was intensely interested in it him- 
self because of the fact of his anxiety about the out- 
come. He said the first day when Sampaio was 
brought into court he could see or feel a wave of 
prejudice and animosity spread over the audience, 



"A Gurgling Scream" 105 

including the jurors. Of course, considering the 
heinous crime for which he was charged, the doctor 
didn't wonder much at the public feeling. 

The prisoner was guarded well against any at- 
tempts at lynching because many rumors reached 
the authorities that such an attempt would be made. 
After all was ready and jury selected, the prosecut- 
ing attorney for the state called as first witnesses 
the coroner and his physicians, and each one told 
briefly and concisely how they found that the woman 
was murdered, probably by being struck first on the 
head by some blunt instrument, because on the right 
side of the head they saw a bruised or contused 
wound, and then she was choked to death after being 
knocked unconscious. They said the victim must 
have fought or defended herself before she was 
knocked unconscious, because they found the nails 
of her left fingers broken like as if she scratched 
ferociously at her assailant. The marks on the 
neck left no doubt in their minds, and they were 
sure she was throttled to death. 

The neighbors were called, one after the other, 
and each told of hearing the banging noises and of 
the terrible scream, in short, everything that was 
noted before in these pages was brought out by the 
witnesses. The detectives told how they captured 
the murderer Lazado Sampaio, and his denial of 
knowing anything about the affair, and also how 



106 Pitfalls 

he resisted arrest, and of his denying that he knew 
the murdered woman, although he admitted later that 
he did know her, and what with having scratches on 
his face, which he claimed was caused by a fight which 
he had with a Greek during a quarrel they had in a 
south side coffee house, and what with his being a 
gambler, although posing as representing some 
South American Coffee Company, but was unable to 
show any credentials, and what with his nervous 
actions when being confronted with the charge, all 
this Doctor X. said, and more too, stamped him as 
the murderer. But the climax of damning and con- 
vincing circumstantial evidence was reached when 
the detectives discovered that Lazado Sampaio was 
left-handed. 

The coroner's physicians were of the opinion too 
that the woman was choked to death by a left-handed 
assailant. After the state rested its testimony, the 
defendant's attorney inadvertently put Sampaio on 
the stand, after all the other character witnesses had 
testified. His incoherence and nervous denials of 
everything helped to convince the jury that he was 
an arch fiend and liar, especially when he was under 
cross-examination of the prosecuting attorney. He 
denied things that he admitted before, and he ad- 
mitted things that he denied before; his eyes were 
shifty, and the whites of his eyes were exaggerated 
by the background of his dark, swarthy skin; his 



"A Gurgling Scream" 107 

black oily hair was sleek, and Indian-like grew low 
on his forehead; in short, he looked and acted the 
picture of guilt and the opinion was that if there 
were no other evidence, he would have convicted 
himself. So Lazado was doomed, and everybody 
knew it, especially the jury. 

For some reason, Doctor X. said, the trial had 
gone on a few days before they discovered that there 
was another physician who saw the body besides the 
coroner's physicians. This was found by testimony 
of some neighbor on the witness stand. And the 
prosecuting attorney subpoenaed him. He knew 
eventually that he would be called by the defense, 
so he was glad to be called by the state during the 
rebuttal evidence. So after the defense had finished 
he was the first new witness called. 

After the district attorney and the attorney for 
the defense waived the question of his qualifications, 
the lawyer for the state asked, "Were you called on 

the morning of July 16th to Mrs. at 

Street?" Doctor X. answered "Yes." The District 
Attorney's questions: "Who called you, Doctor?" 

Answer : "I don't know." 

Question : "How long do you think she was dead 
when you arrived?" 

Answer: "I should judge about an hour." 

Question: "Were you there before the coroner 
and detectives?" 



108 Pitfalls 

Answer : "Yes." 

Question: "What was the position of the body 
when you first observed it?" 

Answer: "Lying on her back near the gas stove 
in the kitchen." 

Question: "Did the kitchen look as if there was 
a struggle?" 

Answer: "Yes, I think so." 

Question : "What made you think so ?" 

Answer: "Well, the floor was spattered with 
blood between the gas stove and the door leading 
out from the kitchen to the back yard, a chair was 
upset near the table ; in fact, the general appearance 
of the kitchen looked as if there was some kind of a 
struggle." 

Question: "Did you notice any of the marks 
found by the coroner's physicians on the woman's 
neck?" 

Answer : "Yes." 

Question: "Now, Doctor, do you think those 
marks were made by fingers?" 

Answer: "Yes, I do." 

Question : "Was it possible, Doctor, for those to 
be made by anyone other than a left-handed person?" 

Objections to this were made by the defendant's 
attorney. 

Court: "Has Doctor X. qualified as an expert 
witness ?" 

District Attorney: "No, but we are willing, if 



"A Gurgling Scream" 109 

the court please, to have his opinion on conditions 
as he found them that morning, as he was the first 
physician to see the murdered woman." 

Defendant's Attorney: "Your honor, we object 
to this question. Doctor X. is not qualified to 
answer." 

Court: "Well, Doctor X. may qualify by an- 
swering it and file his expert witness fee against the 
state. Answer the question, Doctor." 

Answer: "Yes, it was possible." 

The prosecuting attorney jumped up and told 
the Court this answer should be stricken out of the 
records as it proved Doctor X. was not qualified 
as expert witness and he took exception to the Court 
allowing his filing expert fee. The defendant's at- 
torney was on his feet insisting that the answer 
should stand and that the doctor was fully quali- 
fied. This caused a wave of laughter to spread over 
the audience which brought raps from the Court's 
gavel. 

Court : "Go on with the case, the answer stands." 

Question: "You heard the coroner's physicians 
state that the lady was murdered by a left-handed 
person. Now, Doctor, how is it you think, after 
seeing those marks, that it could be otherwise?" 

Answer: "Well, I think if the woman was knocked 
unconscious, as the coroner's doctors said, then if 
she was throttled, as they said she was, it could 
have been done by her assailant standing at her head 



110 Pitfalls 

and bending over grappling her throat with his 
right hand." 

There was some excitement and murmurings in 
the audience following this answer, probably each 
one telling the other "he thought of that too." The 
defendant's attorney began to pick up in spirits and 
take more interest in the doctor's answers. 

Question : "I'm glad you brought out that point, 
Doctor; I see you may be right. Now you feel that 
she was hit on the head first and throttled to death 
after by someone right- or left-handed, no matter 
which?" 

Answer: "No, I don't say that I do." 

Question: "What?" 

Answer: "I said, I don't say that I do." 

The district attorney, taking off his glasses and 
wiping them, turned his head and smiled, winking at 
the jury, then said in a pompous manner, "That's 
all!" 

Doctor X. was reluctant to leave the witness stand 
as he had a great deal on his mind that he wanted 
to bring out in this case. He told me that on that 
July morning, before the coroner and detectives left, 
he threw out some hints to them, which were his ob- 
servations made in a painstaking way, but "they 
knew their business" and paid very little attention 
to what the coroner, at least, might have profited by. 

The defendant's attorney arose and asked for per- 



"A Gurgling Scream" 111 

mission to cross question, which the Court said was 
his right. 

The defendant's attorney, with urbane suavity, 
asked Doctor X. to tell the Court and jury how he 
thought the unfortunate woman was murdered. 

The prosecuting attorney was on his feet imme- 
diately with objections. He said he had other wit- 
nesses and this was rebuttal evidence, and Doctor 
X.'s answer would be immaterial, irrelevant, etc., etc. 

Court: "Objections overruled, answer the ques- 
tion, doctor." 

Answer: "I do not think this unfortunate woman 
was murdered." 

Doctor X. said that words could not describe the 
surprised look even on the defendant's attorney's 
face, as well as those of the Court and jury and 
everyone within his view. He said Sampaio jumped 
up appealingly dragging his guard to whom he was 
shackled, and babbled off a pathetic speech to the 
Court in broken English, interspersed with many 
Portuguese and Spanish words. All that fright-like 
guilt disappeared from his countenance as he stood 
up with his massive handsome body holding the guard 
as though he was standing holding a child by the 
hand, and cried out: "0 Judge, Honorable Judge! 
The doctor says true, the doctor says true, I 
wouldn't do it, I didn't do it, I couldn't do it. I loved 
the poor lady, and she loved me too, one time. I 



112 Pitfalls 

bought her flowers, I bought her candy, Carissima 
mia! How I loved her! Por Dios ! Por que Senor? 
Oh, God! Why would I do it, Judge? Pobrecita! 
The poor lady! The poor little lady, I loved so 
much, and I would marry her, she liked me! She 
loved me too ! But I was a wild fellow and she didn't 
like my business, I play too much cards ! I go with 
gamblers ! I keep bad company ! She found it out ! 
She told me to come no more ! I beg her to forgive ! 
I promise get good job, I fall on my knees, I cry out 
Carissima mia ! Carissima mia !" Doctor X. said 
by this time the tears were streaming down his dark 
cheeks, and he could see the change of feeling spread 
like a wave over the court room, and women and men 
in the audience who formerly bore him malice and 
looked at him with horror as the brutal murderer 
and hardened criminal, now looked at him pityingly 
and handkerchiefs became in evidence, and a woman 
here and there in the audience could be heard to sob. 

Sampaio stood there in court, his big athletic form 
quivering with emotion. He raised his unshackled 
hand to wipe the tears away, and then looking around 
at the lawyers and Court and jury cried out in sono- 
rous tones, "Por Dios, Seiiors ! I swear I am inno- 
cent." 

He was led back sobbing and shaking with emo- 
tion to the prisoner's bench. 

The stillness that remained in Court following this 
pathetic eloquence was only broken by occasional 



"A Gurgling Scream" 113 

sniveling here and there from women in the audience. 
Finally the Court aroused the defendant's attorney 
with the command, "Go on with your cross-exami- 
nation." 

Question : "When did you first get the idea that 
this woman was not murdered, Doctor?" 

Answer: "On the morning of July 16th." 

Question : "What first led you to think there was 
no crime committed?" 

Answer: "So much blood." 

Question: "So much blood?" 

Answer: "Yes." 

Question : "How would that make one think there 
was no crime?" 

Answer: "Well, on first thought a physician 
would think of a hemorrhage from the lungs or 
stomach when he couldn't see an external wound that 
would cause so much blood." 

Question: "How do you account for the wound 
on the woman's head?" 

Answer: "When she fell in the last throes of her 
struggle she struck her head against the end of the 
pipe which runs across the gas stove." 

Question: "How did you know that, Doctor?" 

Answer: "From the position in which she was 
lying and the abrasion on her head, and this" (Doc- 
tor X. taking an envelope from his pocket from 
which he took a small tuft of hair), "which proves 
to be the unfortunate woman's hair and small shreds 



114 Pitfalls 

of her scalp, I found on the end of the gas pipe." 

After some discussion the lawyers agreed on the 
admission of the evidence and the defendant's attor- 
ney continued the cross-examination of Doctor X. 

Question: "A witness stated she heard footsteps 
just before the peculiar 'gurgling scream' and bang- 
ing noises. Wouldn't that lead you to think, Doctor, 
that some one committed the crime?" 

Answer: "Not necessarily." 

Question: "Why?" 

Answer: "The footsteps were probably the milk- 
man going out to his wagon, after delivering the 
milk. The witness stated it was before the scream, 
and that she heard a wagon ; the milkman probably 
drove off and never heard the noises." 

Question: "Doctor, to come back to the marks 
on the woman's neck, would that not signify violence 
from an assailant?" 

Here the prosecuting attorney addressed the 
Court: "Your Honor, I object to the circumlocu- 
tionary manner in which the defendant's attorney is 
carrying on this cross-examination." 

The defendant's attorney was on his feet saying, 
"If it pleases the Court, I want to bring out the 
details of the evidence for the benefit of the jury. 
From what we have seen here so far it proves that 
Doctor X. has made startling observations which 
should have been made by others before my client 
was arrested for a murder he never committed." 



"A Gurgling Scream" 115 

Court: "Suppose you would make a brief hypo- 
thetical question that would take in all the evidence 
not already reached. That would probably facilitate 
matters." 

After some bickerings and dickerings between the 
lawyers for the defendant and those of the prosecu- 
tion, they finally agreed. 

Hypothetical Question : "Admitting a case where 
a woman is found dead, while her husband is absent, 
she being alone in the house at an early hour, and 
marks of violence found on head and neck, blood 
spattered on the floor and witnesses found who heard 
noises and a peculiar gurgling scream and hurrying* 
footsteps, and the back door unlocked, would it not 
lead a physician to believe the woman was mur- 
dered?" 

Answer : "I'll have to answer that by saying yes, 
providing the physician found no other evidence 
which would prove she was not murdered. Such evi- 
dence I have found and if the Court is willing I will 
give it in detail." 

Court: "Go ahead, Doctor." 

Doctor X. : "After first observing this grewsome 
sight I formed in my mind the theory of death from 
hemorrhage of the lungs ; but on seeing marks on the 
neck I made a close study of them and found that 
they were made by the woman herself pushing up 
frantically with her fingernails towards her chin in 
a wild attempt to get something out of her larynx. 



116 Pitfalls 

Then I noticed what a frantic effort she had made by 
seeing the fingernails of her left hand broken and 
bent outwards. The other hand was used in an ef- 
fort to reach the object that was strangling her and 
also probably in an attempt to make herself vomit. 
The blood on the thumb and first two fingers would 
indicate this. On studying a gap in her upper right 
jaw I saw where a small crown bridge of probably 
two teeth was recently broken away. Then I no- 
ticed on her plate on the table a French roll into 
which she was biting, and I have this with me (Doc- 
tor X. removed from his pocket a small black box 
and withdrew a biscuit that was stale and dried from 
time.) And, if you notice, when this unfortunate 
lady bit into it, the crescent form of her bite shows 
the teeth were all intact and none missing. Now, 
I'll break off this fragment or bite that she never 
finished, and here you see a hard sharp piece of an 
oyster shell that somehow or another was baked in 
the biscuit. When her teeth struck this the small 
bridge broke and the gasp or sudden inspiration she 
underwent from the pain drew the object back and 
it slipped down under her epiglottis into the larynx. 
Then her struggle to dislodge it began. It cut the 
vessels of the throat and the blood welled up into 
her mouth and her attempts by tearing at her throat 
only made matters worse. There was only one 
'gurgling scream' heard. This was when she saw 
her predicament. She probably tried to scream 



"A Gurgling Scream" 117 

many times but wasn't heard as the vocal chords 
were out of commission. Then she banged the kitchen 
door in her frantic attempts to call help, but be- 
came too weak to run out or keep up the noise, and 
in her struggle back and forth in the room, spitting 
blood, she eventually fell near the gas stove, strik- 
ing her head on the pipe, and died of asphyxia. On 
palpating the larynx before rigor mortis set in, the 
muscles were soft, and I was enabled to confirm those, 
deductions by feeling a hard object in the larynx. 
This the coroner's physicians probably couldn't do 
as she was rigid when they observed her, but if the 
body is exhumed this object will be found." 

Following this sensational testimony the Court ad- 
journed after ordering the body exhumed, which 
was done next day, and on opening the larynx the 
coroner's physician, in the presence of Doctor X. 
and the jury, found below the epiglottis a small 
bridge containing a gold crown and small artificial 
tooth. 



CHAPTER XVIII 

"hiccups' 

We were chatting about the way physicians met 
in their clubs and medical societies one night and dis- 
cussed papers and medical topics, and the benefits 
that could be derived if only the medical men would 
attend meetings of their county medical societies 
more than they do. 

Doctor X. told me that night after night at the 
meetings of their county medical society he sees the 
same crowd of twenty to thirty men while they have 
in good standing as many as five hundred members. 
This should not be, as there are many things in a 
scientific way brought out at those meetings that 
might redound beneficially to the patients of the 
great body of medical men who are conspicuous by 
their absence. 

He said there are a number of phyisicians who 
are so "obsessed" with their own knowledge that they 
not only refuse to attend medical meetings, but 
wherever they can get out of it refuse to call in con- 
sultation men who many times might save the lives 
of their patients by suggesting some change in their 

118 



"Hiccups"— "Two Lives Saved" 119 

treatment. Doctor X. said if those fellows would 
only mix, and get better acquainted with their col- 
leagues, they would find that the other fellow is not 
so bad after all, and most frequently it is the man we 
do not know who is the man we do not like. There- 
fore, by comingling with our colleagues we may learn 
a great deal and lose some of our own "exaggerated 
ego." 

Then Doctor X. told me how two lives were saved 
by the suggestion of a consultant that he called in 
one day to help him with a patient who was dying 
with "hiccups." He said he was called to a big 
healthy looking fellow who gave a history of having 
the hiccups for four days before he consulted or 
called him. Of course the patient himself tried every- 
thing that the neighbors told him, from "tickling 
his soft palate with a rabbit's foot" to "standing 
on his head with his fingers in his ears," but it was 
of no use, he was fast loosing his healthy appear- 
ance and jerking his life away. Doctor X. found 
that his trouble started after taking two or three 
glasses of cold beer, but of course he wasn't sure but 
that it might be a coincidence as the man often took 
beer before and didn't get hiccups. So he said he pre- 
scribed antispasmodics and sedatives but the next 
day the man was as bad as ever. He said before 
the fellow got his hiccups he was of two hundred 
pound weight, but judged that in the four da}^s he 
lost twenty-five pounds. The next day he called 



120 Pitfalls 

early and found that while he had some sleep from 
his sedatives he hiccuped in his sleep, and was fast 
losing out. Doctor X. said he resorted to stronger 
sedatives and antispasmodics, but of no use. He 
went back to his office and went over the medical lit- 
erature and found some suggestions on the treatment 
of hiccups and then went back to his patient and 
tried them, but could only get temporary relief. 
Then he resorted to cathartics and purgatives and 
the hiccups persisted and the man was getting weaker 
and weaker. Then he called up some of his colleagues, 
and they gave him some suggestions, but still the 
poor fellow kept jerking away without any signs of 
let-up. Then he tried enemas ; then he tried efferves- 
cent drinks, to create pressure on the diaphragm; 
then he tried pressing down with his fist on the epi- 
gastrium, but of no use, the poor fellow kept it up, 
and he noticed that his heart was getting very slow, 
beating only forty or fifty per minute, showing that 
something toxic was causing the hiccups as well as 
irritating the inhibitory fibers of the vagus nerve, 
thereby causing a slow beat of the heart. In short, 
Doctor X. tried everything he could find, and the 
family was getting alarmed as he was now in his 
eighth day of the hiccups, so Doctor X. called a 
prominent consultant and after stating the case as 
he knew it, the consultant asked him if he tried 
"atropin"? And he said he was dumfounded to 
think he had been such a "blockhead" because of all 



"Hiccups"— "Two Lives Saved" 121 

the remedies that should have been used, this was the 
one that was indicated from the symptoms that were 
as plain as the nose on his face. The slow pulse 
alone might have shown him that the same toxemia 
that was irritating the vagus nerve was irritating the 
phrenic nerve and causing the spasms of the dia- 
phragm. But he had to admit he never thought of 
that. So Doctor X. said he took out his hypodermic 
syringe, but in fear and trembling, he was afraid he 
was too late, as the man appeared to be dying. Then 
he injected 1-25 grain of atropin and the hiccups 
stopped in less than five minutes. Then he stayed 
there with his patient, giving light nourishment all 
night with stimulants, and the hiccups never re- 
turned, and he nursed the poor fellow back to health 
again, and after three or four days he was up and 
in a week he was strong enough to return to his 
work again. 

I said to Doctor X. that he said there were "two 
lives saved." "Who was the other?" He told me 
that the other was a physican down in Tennessee 
whose case was exactly the same as the one described, 
except that the doctor in Tennessee didn't have the 
history of drinking cold beer. 

Then I asked, "How the hell could he save a doc- 
tor's life away down in Tennessee?" He told me 
that whenever a medical man finds out something 
that will save life, it is his duty, or should be his duty, 
to publish it for the benefit of all the other physicians 



lm Pitfalls 

in the world, and that he knew of no other medium, 
or better way to get it to all the physicians in the 
world than by publishing the report of the case in the 
Journal of the American Medical Association. And 
this he did, and by a strange and lucky coincidence 
the Journal reached the hospital where the doctor 
was dying just in the nick of time, and his physi- 
cians, seeing the article described a case just like they 
had on their hands, took advantage of it just as 
he did of the suggestion of his consultant, and in- 
jected the atropin and saved the doctor's life. 

Then Doctor X. said, "I wonder if the doctor 
down in Tennessee would have any objections to my 
showing or publishing his letter of thanks to me for 
publishing my article which he claims saved his life." 
I told him I thought he would be glad to if it would 
do any good. And after some persuasion Doctor X. 
gave me, reluctantly, the following letter. 

"C , Tenn., 6-25-13. 

"Dear Doctor X. : 

"Every physician, I suppose, is more or less 
pleased when he learns that the publication of his 
experience has been helpful to some coworker. The 
report of your case of 'Persistent Hiccups' was pub- 
lished at a most opportune time for the relief of the 
most distressing affection in my own person. My own 
condition resembled that of your patient to such an 
extent that possibly a detailed description on my 



"Hiccups" — "Two Lives Saved" 123 

part would be pardonable, although my physician 
said he would report my case to you and furnish the 
record. However, I did not come under his care until 
after the hiccups had persisted for six days. On 
June 12th, after suffering with a burning pain in 
the epigastric region, all the forenoon, and after 
eating a rather hearty dinner (for it did not inter- 
fere with my appetite) a rather violent attack of 
hiccups came on about one o'clock and was only re- 
lieved by emptying my stomach. I immediately con- 
cluded that some irritant was at the bottom of my 
trouble, and proceeded to take Epsom salts in re- 
peated doses. To my surprise the hiccups returned 
later in the day, and a good sized dose of calomel 
was taken. On Friday the condition persisted more 
or less, although I endeavored to disregard it, con- 
sidering the affection a trivial affair. Friday night 
brought no especial relief, although I had begun to 
take some of the milder antispasmodics. On Satur- 
day morning I ran down to C , some eight 

miles distant, where it was necessary to meet an en- 
gagement, and it seemed that the hiccups were try- 
ing to keep pace with the exhaust of my motor. By 
this time my trouble began to attract attention and 
numerous remedies were recommended by my col- 
leagues. For the next three days the usual reme- 
dies for hiccups were tried, without avail, that is, 
only temporary relief was obtained. Carbonated 
ice water would give me relief for about two hours, 



124* Pitfalls 

hypodermics of morphine and the inhalation of chlo- 
roform to complete anaesthesia would give me only 
temporary relief. On Wednesday morning, after a 
turbulent night, I decided to take my chances in a 
nearby hospital. On entering the hospital a physi- 
cian was called. He recommended an ice bag to the 
epigastrium and ten grains of chloral every two 
hours. I was disgusted for the hiccups were rapidly 
jerking the life out of me, and I had already taken 
chloral 4 ad nauseam.' However, the treatment was 
accepted and accordingly begun. The ice bag was 
helpful for it was kept up continuously until the fol- 
lowing Saturday night. On Wednesday afternoon 
the hiccups were still persisting, and my medical 
friends had begun to search the latest literature. 
Your article was found simultaneously by several, 
and after a hasty consultation the atropin was be- 
gun. Marked relief from pain was experienced from 
the first dose, though it was only after four doses 
of between 1-30 and 1-100 of a grain was given that 
permanent relief was obtained. No other treatment 
was given me after the atropin was begun, except the 
application of the ice bag. My A. M. A. Journal 
reached me on Monday before going to the hospital, 
and had I felt like looking over its contents, much 
suffering might have been avoided. Or again, had 
I remained in bed at home, as I did after leaving 
home, relief might have been obtained. At any rate, 
I feel grateful to you for the report of your case, 



"Hiccups"— 'Two Lives Saved" 125 

and trust it may be as helpful to others similarly af- 
flicted as it has been to me. I remain, with all good 
wishes, 

"Yours fraternally, 

"R. S. P , M. D." 



CHAPTER XIX 



Somehow or other we got on the subject of 
race-suicide one evening, and I asked Doctor X. 
what has gotten into the women nowadays that 
you rarely see the large families that our good old 
mothers used to raise in days gone by. 

He told me that he marvelled at the large num- 
ber of children that some of the good mothers in 
poorer districts have. He said when he is making 
calls on patients in this region he has to be always 
on the lookout for fear he will run over some of 
their kiddies, who use the middle of the street for 
their playground. If it wasn't for this class our 
country would be depopulated. Then he compared 
one of those streets with one of the boulevards where 
there were large brownstone mansions and beautiful 
lawns, which would be an ideal place to raise children 
but what have we, nothing but solitude and archi- 
tecture, never the remotest sound of a child's happy 
voice. The inhabitants of those mansions spend too 
much time running back and forth to Europe and 

126 



"Children That Might Have Been" 127 

their social duties are more important to them than 
taking the responsibility of raising children. So 
block after block on the boulevards you will not hear 
the sound of a child's voice, while in one block of 
the poorer district of a summer's evening you will 
find swarms of children running into the thousands. 
Doctor X. said he regretted the condition of affairs 
that have arisen in recent years, which is causing 
the middle class or bourgeosie to enter into the bar- 
ren field of race suicide. But this is not due to the 
same reasons as the other class, but to housing con- 
ditions which have become critical these late years. 
Some owners of apartment buildings will taboo a 
good honest mother with a child in her arms, but 
readily admit an "insipid female of the species" with 
a sore-eyed, long-haired white poodle in her arms. 
Then, if they are in the modern apartment of one 
or two rooms and a kitchenette and the stork hap- 
pens to come, they have to move out. 

Doctor X. told me that any man and wife who, 
for economic, social, "apartment" or other reasons in 
their early life, play the morbid game of "race sui- 
cide," will suffer nature's penalties tenfold in later 
years. There will come many cravings for the pat- 
ter of the little child's feet to both husband and 
wife, but to them it will be nothing but "the foot- 
steps on Soho's corner," because then to them there 
will be only ghostly memories' of children "that might 
have been," but now when they want them the nervous 



128 Pitfalls 

wrecks they have made of themselves have become 
barren wastes. 

Doctor X. told me that it is absolutely impossible 
to transgress the laws of nature without paying 
heavy penalties later on in life. 

And while we were on this subject he said that only 
recently he knew of a prominent lady whose social 
and selfish duties kept her from bearing children, 
and when she began to crave for a child and was 
becoming estranged from her husband who had al- 
ways craved for children, she attempted to bring her 
husband back to her by a scheming diabolical trick 
and in her planning and attempt at "putting it over" 
dragged a respected and prominent physician inno- 
cently over the precipice down deep into a pitfall 
which eventually landed him in the courts, which sure 
is hell. Doctor X. saw that this subject made me 
sit up, and went on to tell how all this happened. 

You know, he said, I often wonder why the father 
and mother of young girls between sixteen and 
eighteen or twenty years of age out in the farming 
districts and villages of the state, leave them come 
to the city with all its temptations, to live and work 
around in the different stores and restaurants. While 
they are good innocent girls when they first come, 
they are sure to be caught in the maelstrom of 
city life, and in their tender years, without proper 
protection, naturally drift in the direction of least 
resistance. If you can show me a man with a brain 



"Children That Might Have Been" 129 

so sodden and dead as this "man with the hoe," this 
farmer or villager who lets his little girlie leave 
her home and mother's care and come alone into the 
whirlpool of vice in the city, eventually meeting 
with some of the cabaret lizards and "men about 
the town" who have no more respect for the virtue 
of a young girl than a hellhound for holy water, then 
I would be tempted to say, like the rube at the circus, 
when he saw a giraffe : "They ain't no sech animal." 
But, alas, there are many. And this father whom 
the doctor had in mind, when he started out with 
his story, allowed his little girl, sixteen years old, 
to come into the city and room around in boarding 
houses, while working in a restaurant. She of course 
met some rascal, and her life became the old, old 
story, ruined. 

About the time she was about to become a mother, 
this prominent lady, aforesaid mentioned, came to 
her rescue, and if the authorities had never discovered 
the hoax it would not be so diabolical after all, and 
would have been a good thing all around. But, as 
these chapters have to do with pitfalls of the medical 
profession, the doctor at least will consider it a 
diabolical trick. 

Doctor X. said the lady got the unfortunate girl 
into a maternity hospital and an illegitimate child 
was born, and accordingly reported to the health 
authorities by the hospital doctors. The prominent 
lady, having everything prearranged with the girl, 



130 Pitfalls 

took the child away to her home. She had been 
writing to her husband, who was away in another 
town, telling him he would soon become a father, and 
the man of course, while doubting at first, still he 
knew he wasn't entirely estranged from her, and 
many times had visited home, began to think, well, at 
last! at last! So he did as all proud fathers do, 
threw out his chest and put his thumbs in the arm- 
holes of his vest and strutted back and forth across 
the floor like the "chanticleer" he thought himself 
to be. The lady, after arriving home with the baby 
she "borrowed for keeps" went to bed and rolled the 
baby up in swaddling clothes and tucked it inside 
under the covers, snuggled up close to her. Then 
she had some one telephone for a doctor and tell 
him to "hurry" and cried out, "Oh, oh, get the doc- 
tor and tell him to hurry !" This of course was for 
the benefit of the neighbors, and other "doubting 
Thomases" that may be within hearing. At three 
or four in the morning one can realize how sounds 
of this kind can disturb sleep, and everybody knew 
there was something doing. So the doctor arrived 
posthaste, but by this time the sounds had died 
down and when he entered the room could hear only 
the "musical" sound of the baby. The pseudo- 
madonna lay there with that heavenly expression 
which doctors see on their faces when they complete 
such ardent task and said, "Too late, Doctor! Oh, 
why didn't you hurry?" Of course the doctor said 



"Children That Might Have Been" 131 

he did hurry as fast as he could. She said, "Well, 
I am sorry, but you must look after the report of 
my baby. Of course, I'll pay you just as though 
you were in time to attend me," so she paid the 
doctor, and he of course innocently made out a re- 
port of the baby. 

Now, if the incident would have closed here, all 
would be well, they would all be happy, the husband 
would be happy, and probably have gone back to his 
wife and raised a fine child; the child would have 
been well taken care of and have a good home in- 
stead of it being an institutional child as it is at 
present. The girl could have hidden her shame where 
now her downfall is known to the public, the pseudo- 
mother would become attached to the baby and have 
her motherly cravings satisfied and her husband's 
affection restored. The parents of the girl in the 
country would not have to hang their heads in 
shame. But they deserved some punishment for let- 
ting their little girl come to the city. And, last 
but not least, the doctor would never have known 
that he was wallowing in the mire of a pitfall. But 
no, "tattling neighbors," "busy-bodies" managed 
some way to let the authorities in on the game, and 
the doctor was arrested for filing a false birth report, 
and they took the child away from its foster-mother. 



CHAPTER XX 



I asked Doctor X. one night how the chiroprac- 
tors, according to their reports to newspapers, come 
to have a lower mortality during the epidemics of 
influenza and influenzal pneumonia than the doctors. 
I said, if he noticed they said they had only one 
per cent, of deaths where the doctors had thirty 
per cent. 

Doctor X. told me that not only the chiropractors 
but all the other cults that have arisen these late 
years, could say the same thing and it would be true 
too, but who were the unfortunate victims that lay 
on their marble slabs, or "mauling tables," so long to 
be "tickled to death" to make up the one per cent? 

Then he went on to tell how many people who 
really had the "flu" were kept coming to those men 
and women for treatments, when they should have 
been in bed. Then, after not having the proper care, 
in bed, suddenly developed influenzal pneumonia and 
of course when they were too late called a doctor, 
and in many cases died of pneumonia, which might 
have been prevented had they been under proper 

132 



"Tickled to Death" 133 

care from the first day of their illness. So you 
see that the mortality in those instances was passed 
on to the doctors. "Great Scott," Doctor X. said, 
"how could any one be fool enough to continue this 
back tickling business until he is dead?" They 
naturally should have no mortality. I saw he was 
right and thought to myself the cults only used that 
means to get themselves before the public, especially 
that class of the public who do not think — and I dare 
say there are a great many of them. 

Doctor X. told me of some of the amusing methods 
these different "paths" have in working up business. 
They usually start by getting a list of chronics or 
neurotic people's addresses and like the mediums send 
out letters to the prospective dupes to come on cer- 
tain evenings to a "free lecture" to be given at their 
offices. Then, on a chart they show how they can 
"cure" everything from "locomotor ataxia" to tic 
of the "levator labii superioris alseque nasi." After 
those lectures they talk up business. They are past 
masters at soliciting and advertising themselves, so 
you see it isn't long until they have them coming 
and a crowded office always, to the laity, is an in- 
dication of a good doctor. But to the medical mind 
it usually is an indication of a good bluffer. Tins 
is not only true of the osteopaths and chiropractors, 
but of the doctors ; and Doctor X. told me that re- 
cently the American Medical Association sent out 
as a slogan and warning "Beware of the busy doc- 



134* Pitfalls 

tor!" The reason was that the busy man cannot 
take time enough to give you a good thorough exami- 
nation, he cannot give the time to the study of your 
case to detect disease in its incipiency, and cure it 
while the curing is good. The "busy doctor," then, 
is the one who looks at your tongue, listens to your 
lungs through all your clothes including your over- 
coat, takes your pulse, makes a "snap diagnosis," 
writes a 3J and yells out "Next." Oh, I forgot, he 
takes his fee too, but he doesn't earn it. 

To come back to the chiropractors and all the 
other "cults" and "paths," Doctor X. said: If you 
notice whenever a great calamity suddenly strikes the 
world, or any section of the world, that may bring 
about injury or sickness, all these "cults," "paths," 
and "sects" sneak into their holes and hide. Then the 
government and people turn to the legitimate physi- 
cians and surgeons to give succor to the sick and 
bind the wounds of the maimed and always find them 
willing and ready to respond to the most ardent 
duties where life and health are at stake. 

Then, after the great calamity is over and peace 
is restored, and the public settled down to its usual 
life, this element comes sneaking back into the lime- 
light again and in their "Pecksniffian" audacity tell 
the public that "they are the great benefactors and 
protectors of life and health." This makes one cry 
out like David of old, "How long, O Lord, how 
long?" 



''Tickled to Death" 135 

Then Doctor X. put it up to me this way : If you 
read in a newspaper some morning when you sat down 
to breakfast "A great plague or grave disease of some 
kind broke out down south and the government sent 
a thousand Christian Scientists down to read Mary 
Baker Glover Patterson Eddy's Science and Health 
to bring about a cure of the victims, and the gov- 
ernment also sent a thousand osteo-chiro-vita-napro- 
paths to adjust their spinal columns and dance a 
tattoo on their backs and give their nerves "im- 
pingement," and "pull their poisons" out through 
the soles of their feet and show the poisons on copper 
plates, and wriggle their ligaments and connective 
tissue, wouldn't you think our dear government had 
gone crazy? By Jove! I had to admit I would. 
Well, he said, that's just where the poor dupes have 
gone who place their lives in the hands of this same 
class of pseudo-scientists. Then he said, "Now if 
you read that the government sent a thousand sur- 
geons and physicians and trained nurses to the scene 
of the plague or disaster, you would probably think 
that was the proper thing to do, would you not?" 

Doctor X.'s reasoning was so sound that I stored 
it away for the benefit of some of my friends whom 
I knew liked to trifle with their health because they 
thought they felt better after having their backs 
tickled. 

Doctor X. told me that only recently he saw an 
advertisement in a prominent newspaper in this city 



136 Pitfalls 

where they were making a bid for the modest young 
maidens to come to them for treatment. He said 
this is on record in the files of the newspapers, and 
they cannot deny it. The advertisement ran some- 
thing like this: "All young unmarried ladies, no 
matter how modest they may be, should have no 
hesitancy in consulting us for treatment, no matter 
what their ills may be. We are perfect gentlemen, 
and all that is necessary for the young lady to do is 
to wear a dress that opens up her back." 



CHAPTER XXI 



We were talking about commercialism in drugs 
one evening and my old pal, Doctor X., said he was 
surprised and astonished sometimes at some of the 
wholesale pharmaceutical houses for the manner in 
which they are so persistent in detailing physicians 
with samples of drugs and proprietary compounds, 
not even conforming with the rules or accepted by 
the Council of Pharmacy and Chemistry of the 
A. M. A. 

He told me that some of those fellows who travel 
over the country visiting physicians with their differ- 
ent samples are physicians who have "fallen by the 
wayside," but they have medical nomenclature always 
at their command, and use their persuasive powers 
very often in persuading doctors to try out their 
different elixirs, vaccines and bacterins, polyvalent 
and otherwise, on their unsuspecting clientele, 
thereby prescribing worthless preparations, some- 
times deterimental to the health and welfare of their 
patients. 

The well-trained medical man nowadays pays lit- 
137 



138 Pitfalls 

tie attention to this sample junk that is sent out 
with men who mean well and must earn their liveli- 
hood. 

They stick more closely to the U. S. Pharmacopoeia 
and National Formulary, as well as to what is ac- 
cepted by the Council of Pharmacy of the A. M. A. 
published under the caption of "New and Non-Offi- 
cial Remedies" in the Journal of the A. M. A. 

This council is composed of men of experience who 
are experts in testing out the pharmacodynamic and 
therapeutic value of all preparations submitted to 
them by the different drug houses and manufacturing 
chemists throughout the world; so when the council 
places its official stamp of approval on a prepara- 
tion submitted to it the physician knows the drug 
has all the ingredients and value that is claimed 
for it. 

Then Doctor X. told me a story of how one Doc- 
tor "B. Quick Watson" went headlong into a pitfall 
because of his enthusiasm fostered by drug agents, 
in using a certain proprietary preparation, said to 
be a filtrate of bacterial cultures which when in- 
jected into the patient was supposed to stimulate 
defensive anti-bodies, but which preparation was not 
endorsed by the Council of Pharmacy. 

This big bluff doctor was one of the wildest en- 
thusiasts in the city over the hypodermic and intra- 
venous use of serums, vaccines and bacterins. He 
was one of those doctors that would "try anything 



"Quick Watson" 139 

once," or oftener, if some detail man said it was 
good. 

The extent of his medical literature was made up 
of pamphlets that pharmaceutical houses and their 
detail men gave him, and also an odd little peculiar 
doughnut quarterly that came regularly m his mail 
every three months. 

Doctor X. predicted that some day he would make 
a faux pas and his Nemesis would loom up on the 
horizon with all her retributive vengeance; but, un- 
fortunately, some poor confiding patient would have 
to pay the penalty because of his enthusiasm for this 
questionable method of treating all diseases. 

So finally "the thing happened" in this manner: 
One day a beautiful young married lady limped into 
Doctor X.'s office to consult him in regard to her 
"rheumatism" of the hip and knee. She was one of 
those expressive types of women whose facial expres- 
sion and poise reminded the doctor of "Mrs. Tom 
Duff." 

After going over her carefully and taking her his- 
tory he found that he could not get at the bottom of 
her trouble by physical examination, so he recom- 
mended that she should go to a hospital where she 
could have better care and he would have a better 
chance to study her condition, and with blood and 
X-Ray examinations possibly find the focus of her in- 
fection which caused the arthritis. 

She took his advice and went to a hospital but the 



140 Pitfalls 

X-Ray examination of her teeth proved negative, 
the blood picture was normal and Wassermann nega- 
tive. Her heart and lungs were normal but her ton- 
sils looked suspicious and Doctor X. had a throat 
specialist remove them, but his patient received no 
benefit from their removal. 

After a time she seemed fairly comfortable from 
large doses of the salicylates but her rheumatism 
jumped from one joint to another until it went the 
rounds of all the joints of her body, and the poor 
woman suffered so much that she became very much 
discouraged and complained to her husband that 
Doctor X. was not doing her much good. 

The husband called at his office to talk over her 
condition and in a gentlemanly way satisfactory to 
the doctor released him from the case and employed 
another. 

After the change of doctors, the lady of course 
improved somewhat — patients usually do improve 
with a change of physicians, for a while at least, as 
they are usually optimistic with a change of treat- 
ment — but she relapsed back again after a few days 
as bad as ever, and run on in this way for a month 
or so and after the warm weather came, she became 
more comfortable and left the hospital, but the joints 
were stiff and sore although the infection never 
seemed to affect the heart. 

So in this condition she did what most all suf- 
ferers do, start in the rounds of naprapaths and 



"Quick Watson" 141 

chiropractors and all the other sects and fads, try- 
ing to obtain relief. But, their manipulating only 
made her worse because the real cause of her trouble 
was not found. 

Finally one of Doctor "B. Quick Watson's" fe- 
male boosters landed her in his office and he treated 
her hypodermically every other day with gradually 
increasing doses of a questionable drug in a normal 
salt solution and again from her optimism and con- 
fidence in the doctor she improved for awhile, but 
her pains never left her joints entirely and she showed 
no reaction following the hypodermic treatment. 

So one day, he decided to give her a good-sized 
dose of the drug intravenously in a normal salt solu- 
tion, so he sent her home so that if a reaction would 
occur she would be in bed and have proper care. 

In the afternoon he called and gave her the in- 
travenous injection after which she developed a 
frightful chill that lasted about a half hour, then 
her breathing became irregular, she became nause- 
ated and cyanosed and was dead in about one hour 
following this intravenous injection. 



CHAPTER XXII 



'THOU SHALT NOT KILL 7 



Only recently the newspapers were making a big 
sensation about the question of whether or not phy- 
sicians should destroy the life of a child in order to 
save the life of the mother. This sensation was 
brought about by five professors in a certain medi- 
cal college resigning because they couldn't agree 
with, or subscribe to, the ethics of the University, 
with which the medical school is an integral part. 
I asked Doctor X. what his opinion on this question 
was and he told me that while he believed that the 
men who disagreed with the president were honest in 
their belief, that they had the right to kill the child 
in utero to save the mother, still he thought that 
the head of the University was right in asking their 
resignation if they couldn't subscribe to the ethics 
of the school, as it is morally wrong to destroy life 
under any circumstances with such exceptions as, 
first, in a just war, secondly, in legal capital punish- 
ment, and thirdly, in self-defense. Doctor X. told 
me according to the teaching in many schools the 

142 



"Thou Shalt Not Kill" 143 

physicians believe they are justified in performing 
abortion on women whom they think after competent 
consultation will die if the abortion is not done. But 
if those same physicians would stop to consider the 
moral side of the question, I mean the command- 
ment that says, "Thou shalt not kill," they might 
conscientiously hesitate to destroy a life that in after 
years might be a hundredfold more important to the 
world than the mother ever would or could be. He 
said also that the real reason of course of physi- 
cians having this belief is because they think their 
first duty is to protect the life of their patient, but 
in this thought they forget that the unknown unborn 
child is their patient too. Then, again, the affec- 
tion of the family for the mother enters into it, and 
unless the physician holds to the commandment he 
may be persuaded to destroy the child. 

I asked Doctor X. would not the physician kill 
the mother by omission if he let her die in order to 
save the child. He told me that this is the question 
that naturally always comes up when this subject is 
discussed by medical men as well as the laity. In 
order to express his own opinion as to the answer 
of it he would say at the outset, there never should 
be any omission by physician or physicians in charge 
of the case. 

That is, they should do all in their power to save 
the mother; at the same time they should always re- 



144 Pitfalls 

member that the child has a right to live. The Com- 
mandment does not say : "Thou shalt kill the mother 
to save the child." 

Save the mother wherever it is possible, but never 
kill the child, because that child has had no say in 
its creation, and is entitled to live some time on this 
mundane sphere, where the mother has lived a num- 
ber of years at least up to the age of nubility. 

You must remember one thing, he said, and leave 
out all sentiment and that is that the mother and the 
child are both human beings. Still, I felt that the 
poor mother had some right to this "Self-defense" 
he had spoken of. So I said: "Yes, but Doctor, 
what about the physician letting the mother die when 
killing the child might save her?" He looked at me 
with that sympathetic smile of his and I thought, 
now I had him; but instead of answering my ques- 
tion immediately he put it up to me this way : "But 
why pick on the poor doctor? Why through senti- 
ment and love for one human being more than an- 
other, should you call in the doctor to commit your 
murders ?" 

Then he said: "If you noticed the last part of 
your question, which says, 'might save her' — how 
many crimes have been committed under that phrase 
'might save her' ?" 

He told me that if all the physicians in the world 
made it a rule never to commit abortion — therapeu- 
tic or otherwise — many more mothers' lives would be 



"Thou Shalt Not KM" 145 

saved, because by this meddlesome interference with 
nature's laws by physicians who sometimes use poor 
judgment in the choice of operations, there are more 
mothers lost than are saved, and surely what is best 
for the greatest number of mothers is the best policy 
to pursue. 

He told me the greatest medical minds are now 
leaning towards the policy that therapeutic abor- 
tion is never justifiable, because there are so many 
other ways to get around it that are less dangerous 
to both mother and child. 

He told me that many mothers come to physicians 
pregnant, with a history of having convulsions — or 
"eclampsia " as he called it — in former pregnancies, 
but who came through the former pregnancies with- 
out disastrous results, although it is an extremely 
grave condition, but were afraid to take the chance 
again, so they ask to be aborted because some of 
their friends told them, even some physicians told 
them, they would die if they had another child. These 
women may show albumin in the urine and every- 
thing that may indicate that they would have con- 
vulsions again, but who can say positively that they 
will, or that they will die either, even though they 
are in more danger than a woman who goes through 
normal gestation? And the meddlesome doctor or 
doctors who may attempt to bring about abortion in 
those women may precipitate the convulsions and 
kill both woman and child in the act of trying to 



146 Pitfalls 

save the mother, when if he let her go on as she did 
before she may come through the second ordeal even 
in a normal manner, with the assistance of a physi- 
cian of good sound judgment in his treatment all 
through her months of gestation. Then, again, take 
for instance a woman who becomes pregnant and it 
is discovered that her pelvis is so contracted that 
it is absolutely impossible for her to give birth to 
an infant at full term, do you think the doctor is 
justified in performing an abortion on her? I said, 
if she were my wife I fear I would request it. Doctor 
X. told me then I would be party to the crime of 
murder. 

Then he said that the technique of aseptic sur- 
gery was so improved the last quarter of a century, 
that by letting a woman with a contracted or de- 
formed pelvis go on in her gestation to full term and 
then delivering the child by Cesarian section that 
the mother would be in less danger of dying than 
she would if an abortion was performed in the early 
months of her pregnancy. 

Then he told me of an instance where a lady who 
was married some two or three years ago and who 
had a deformed pelvis that would appear to a physi- 
cian by measurement that it would be impossible for 
her to have a child through the normal channel. Her 
husband called into consultation, when she became 
pregnant, prominent physicians, and they all 
thought on account of not only the deformed pelvis 



"Thow Shalt Not Kill" 147 

but the fact of her having a dislocated hip joint that 
made her frightfully lame, an abortion was indicated 
and advised. The lady herself stood out against it, 
much to her credit and welfare after. Doctor X. 
said this lady carried her baby to full term and while 
her labor was hard she came through it normally, 
even without instruments, and now has a beautiful 
little girl whom the prominent doctors were willing 
to kill. Even the Cesarian section was not neces- 
sary, although Doctor X. said he thought it would 
be, and had her in a hospital at the time of labor and 
everything ready for the operation if it became neces- 
sary. 

The child is a normal healthy child and not only 
that, but the mother is not nearly as lame as she 
was before the birth of her child because the spread- 
ing of the pelvis at the time of labor seems to have 
set the hip joint at a more proper angle to the pelvis 
and thereby making walking less troublesome. 

Then Doctor X. told me of another lady who had 
tuberculosis who became pregnant and her physician, 
who specialized in tuberculosis, sent her to him, to 
see if he would abort her because it is known that 
sometimes pregnancy lights up the condition and the 
mother is in danger. This woman not only had 
tuberculosis but showed albumin in her urine. Doc- 
tor X. said he told her that carrying her baby may 
do her less damage than having some doctor produce 
an abortion on her that in itself may light up her 



148 Pitfalls 

disease quicker and not only that, but she needed 
good care and advice all through her pregnancy and 
by that and rest she may come out better than if 
she would submit to such horrible operation, which 
some men have no scruples about performing. Any- 
way, with the proper care this woman went through 
her gestation to full term and had a fine healthy 
baby without any trouble either from convulsions 
or the lighting up of her tuberculosis any worse than 
before, and both she and her husband are happy in 
the possession of the child, and many times thanked 
Doctor X. for his advice and care. 

Doctor X. told me he was surprised and astonished 
at the number of people who think so lightly of de- 
stroying the life of an unborn child. He said when 
he first started in the practice of medicine he became 
so worked up and indignant at the request of some 
women who called with such criminal instinct that 
he used to lose his temper and "bawl" them out for 
it, but he found that by changing his tactics he many 
times persuaded, especially unfortunate girls, not to 
have it done, where otherwise they used to leave his 
office and go to some criminal doctor who would do 
it for the coin that was in it. He told me, how he 
rubbed it in good one day when a married woman 
came and told him brazenly that she had a little 
child two years old and she was pregnant again and 
didn't want any more children, one was enough. And 
would he perform an abortion on her? Doctor X. 



"Thou Shalt Not Kill" 149 

said to her, "My good (?) lady, you are foolish to 
take such a risk. Why not carry this child through 
and if you only want one child, bring the other one 
you have at home here and have it murdered." She 
fired up immediately and said, "Oh, Lord, you brute ! 
You would not want to murder my baby, would you?" 
Doctor X. said he looked at her and said, "You 
'criminal hyena,' you 'female of the species,' isn't 
that just what you asked me to do with your other 
child? What's the difference whether you murder 
the child within your body or the one you have at 
home?" He said, "Isn't it murder either way?" The 
woman sat down from the excitement and from a 
faint condition broke out into a hysterical state for 
awhile and then quieted down and said she was sorry, 
that at last she saw she was wrong, but no other 
doctor ever put it in that light before to her. She 
cried bitterly for fifteen minutes, and then got up 
and thanked him for opening her eyes and setting her 
thinking right. 

This lady carried the child through and now has 
six in all, and has not only gained the respect of 
Doctor X. but is respected by every one who knows 
her. 

Then Doctor X. put it up to me in this manner: 
What would the world have lost if this class of phy- 
sicians were in attendance on the mothers of such 
men as Edison, Marconi, Osier, Pasteur, Alexander 
Pope, George Washington, Lincoln, Burbank, Roent- 



150 Pitfalls 

gen, Ehrlich, Gorgas, von Behring, Lister, Jenner, 
Dickens, Shakespeare, Leo XIII, Currie, Morton, 
Bell, and hosts of others, too numerous to mention, 
providing the same question should have arisen in 
their prenatal state? 



CHAPTER XXIII 



I was reading an article one day in the newspaper 
describing how a woman came near being buried alive, 
somewhere up in Minnesota, and how she was de- 
clared dead by two physicians and was laid out in 
her coffin by an undertaker, and the night before the 
funeral the watchers were scared to death by the 
woman sitting up in her coffin and crying out: 
"Where am I?" "What's the matter?" "Am I 
dreaming?" "I was sound asleep"; and how the 
watchers scuttled out of the house and ran for their 
lives thinking it was the woman's ghost, etc., etc. 
And my poor wife, who was listening — for I was 
reading out loud — said: "Could that be true? 
My, oh, my, I would have been frightened too !" 

I told her that Doctor X. said many times that 
such stories were usually concocted by reporters 
when news was scarce and they wanted something to 
start the people talking about what they saw in the 
newspapers. "But," my wife said, "how can they 
put the name and address in the paper like that if 
it isn't true?" "Well," I said, "they probably in- 

151 



152 Pitfalls 

vented the name and address too." I clipped the arti- 
cle out of the newspaper, and, after carrying it 
around in my pocket a week or two, thought of show- 
ing it to Doctor X. He often told me that it is 
absolutely impossible for any one to be buried alive, 
even if the doctors declare the patient dead when he 
is not, because of the method of embalming nowa- 
days. 

One night we were together and somehow I hap- 
pened to take some letters out of my pocket and 
the clipping fell on the floor. So I handed it to the 
doctor, and after he read it he searched his files and 
found a letter from the postmaster of the little town 
in Minnesota, which he handed to me. It read as 
follows : 

"M , Minnesota, July 26, — . 

"Doctor X.: 

"I received your letter regarding the affair of 

Miss , who was supposed to have died and was 

laid out and come to life again, as described in the 
newspaper clipping you sent. Well, all I can say 
is that I don't know of any one by that name in this 
little burg. I guess some 'nut' started the story, be- 
cause if it happened in this town I would know it, 
'cause I know everything that goes on here, being the 
postmaster. 

"Yours truly, 

"John Doe, Postmaster." 



"Buried Alive" — "Oriental Orgies" 153 

Then Doctor X. told me that for the last ten 
years he had been watching for this type of "news," 
which appears from time to time in the newspapers, 
and where they mentioned the town he usually wrote 
to the postmaster or the mayor, and always received 
a reply that coincided with the letter written above. 
He told me he often wondered why the papers per- 
sisted in that one classical lie, telling the people how 
"some one was declared dead by physicians and was 
about to be buried when he or she kicked the lid off 
the coffin and sat up and scared the mourners." He 
told me he thought it was because so many people 
believe everything they see in print, and that starts 
them talking about , the particular newspaper in 
which they see the article. 

Then he told me of a story of a similar type that 
was true but it never got into the newspapers, and 
probably it was a good thing too, because a promi- 
nent physician in this city would have had his good 
reputation blasted by it if it did get into the papers, 
He said one night he was called to a Chinaman, who 
worked in a chop suey restaurant for another promi- 
nent Chinaman. This "Chink" to whom he was 
called had gotten hold of a few jars of confection 
of opium and had eaten the contents. They had 
sent for the physician, when they found him lying 
apparently dead on the floor in the back room of the 
restaurant, with both his hands and fingers smeared 
with the confection, also his lips and face — like a 



154 Pitfalh 

kid who had gotten at a jar of jam. When this 
prominent doctor arrived he found that the China- 
man's respiration had ceased and his pulse was im-< 
perceptible, so he came to the conclusion that he was 
dead, after he made a cursory examination ; also, too, 
because a number of Chinks told him he was too 
late, the "Chink eatee too much dopee." So, as I 
say, this prominent physician declared him dead, 
and he sent for the coroner. While they were waiting 
for the coroner to arrive, the "Chinks" were holding 
some kind of an Oriental orgy over him, and one of 
them noticed he took one deep breath, so they sent 
a hurry call for Doctor X. He said when he arrived 
he could see his respiration had ceased and his pulse 
could not be felt at the wrist, and on stripping his 
clothing down he placed his stethoscope over the 
heart, and for a time could not tell whether he heard 
his own heart or the "Chink's" heart, he had hurried 
so fast to the place. So he said he took out his hypo- 
dermic and injected atropin and strychnia into his 
arms and then placed the stethoscope again over the 
heart and waited awhile until he proved that the 
Chinaman still had a faint heart beat. Then he 
started in forcing an artificial respiration. He 
made them open all the windows, and, with the as- 
sistance of the other Chinamen, he raised and lowered 
the "Chink's" arms, imitating the normal respira- 
tion, and keeping it up continually, occasionally in- 
jecting atropin, while the other Chinamen assisted 



"Buried Alive" — "Oriental Orgies" 155 

in keeping up the respiration. This Doctor X. con- 
tinued for hours, also washing out his stomach with 
a stomach pump, when he first heard the faint beat 
of his heart. This, with the injection of atropin, 
strychnin and digitalin, also a solution of potassium 
permanganate under the skin, stimulated the poor 
fellow to such an extent that Doctor X. began to 
feel a perceptible pulse at the wrist, and with injec- 
tion of normal salt solution and stimulants and arti- 
ficial respiration kept up from seven P. M. to one 
A. M., the "Chink" began to show signs of life and 
started in breathing of his own accord, and then 
Doctor X. began a system of pinching him over the 
kidneys, which started him rolling from side to side 
and swearing in Chinese language. This, and slap- 
ping him in the face with wet towels, and raising him 
on his feet and using every possible effort to keep 
him going, finally aroused him, and he started blab- 
bering in his own language to his friends. Doctor 
X. said he stayed all night with a crowd of China- 
men, keeping this "Chink" awake by injections and 
pouring strong black coffee into him, and finally, 
after a cold bath in the morning, he was thoroughly 
aroused and never lapsed back into the deep coma 
which happened so many times during the night. 

This "Chink" can be found now in perfect health 
in the same chop suey restaurant, serving the pub- 
lic, but the lesson he got from this experience cured 
him of the habit of eating the confection of opium, 



156 Pitfalls 

and the prominent physician, who declared the 
"Chink" dead, is still enjoying a lucrative practice 
in this city, and Doctor X. said he realizes how near 
he was to being precipitated into oblivion if the 
newspapers had gotten hold of the story of how he 
declared the Chinaman dead and sent for the Cor- 
oner. 



CHAPTER XXIV 



I was sitting in Doctor X.'s study one evening, 
waiting for him to return from a call he received 
some time before I had arrived. I knew when he 
came back he would be glad to see me, as he had a 
habit of sitting up late smoking and chatting about 
the many happenings of the day. I, also, never 
could sleep if I went to bed early, so I enjoyed noth- 
ing better than his company. And, if I do say it, I 
am a good listener, especially if Doctor X. is doing 
the talking. 

Finally I heard his car humming through the 
driveway into his garage, and after a time he came 
tramping in with that happy smile on his face, and 
immediately when I saw him I knew I was in for a 
pleasant evening, because he was in the best of 
humor. After he found his pipe and tobacco he 
squatted on his chair and looked at me and began 
to chuckle and shake with laughter and said: "Oh, 
say, Old Scout, I came near going into one of those 
'damn' pitfalls to-night which you've so often heard 
me speak of." I, of course, sat up and became in- 

157 



158 Pitfalls 

terested and said, "How, Doctor?" He said he was 
called to one Madame Blankski, who was playing at 
one of our prominent theatres and who was taken ill 
on the stage and carried to the dressing room back 
of the scenery. When he arrived many of the 
actresses and actors were gathered around and they 
all looked worried, including the manager. The 
theatre was packed and it was the beginning of the 
first act when the Madame was taken ill, and she 
was the star and the manager was afraid he would 
have to return the money, because there was no un- 
derstudy who could take Madame's place. 

Doctor X. said when he first glanced at her he 
noticed a twitching of the eyelids, which made him 
suspect she was hysterical, but something prompted 
him not to say she was, so he proceeded to take a 
history of how she was taken sick. They told him 
she collapsed on the stage wher she was about to 
sing, and said she groaned with pain and pressed 
her hands down low, claiming to be suffering from 
cramps. Then she turned deathly white and fainted, 
and they carried her to the nearest dressing room 
and sent for him. Then Doctor X. said, "I tell 
you, Old Scout, that 'silence is golden' sometimes for 
a physician when he gets in a predicament where he 
don't know just what is wrong with his patient." 
He said this patient had all the earmarks of hysteria 
with some menstrual trouble, but he noticed "some- 
thing," so he kept silent and didn't say what was 



"Silence is Golden" 159 

wrong, although the manager and a half dozen of the 
actors and actresses kept plying him with questions : 
"What's the matter with her, Doctor?" "Is it seri- 
ous?" "Do you think she is in danger?" etc., etc. 

Doctor X. said by this time, on account of her 
prominence, they had two more doctors, who were 
known as skilled diagnosticians, come, and when they 
arrived Doctor X. invited them into the dressing 
room to look her over and find what they thought 
was wrong. So they deftly went over the Madame 
and made records of her history, and both were 
thinking of the same thing that Doctor X. had 
thought of at first until he noticed "something" while 
he was palpating the region of her pain. Doctor X. 
said he gleaned from their questions and the manner 
in which they went about the examination that they 
hadn't a doubt but that her trouble was peculiar to 
many other women whom they found with the same 
symptoms, so they came to a final conclusion that 
Madame Blankski was suffering from "hysteria" and 
"uterine cramps," and without taking Doctor X. 
into their confidence, got their two heads together 
and formed a prescription and gave it to the man- 
ager, whom they told to get the medicine at the drug- 
store, and the Madame would be all right after a few 
doses in hot water, as she was only suffering from a 
trouble peculiar to many other women. 

Doctor X. said he could see a funny expression 
on the manager's face, and he heard him ask the 



160 Pitfalls 

doctors: "Is this prescription going to get her all 
right so she can go on with the show?" They ad- 
vised that he should get an understudy and let her 
rest. The manager said, 'Rest, hell ! She's the whole 
show; I can't get anyone in the country to take her 
place." Then Doctor X. said the manager kept on 
watching him with a funny grin and he said, "What 
do you think about the case, Doctor X.? Do you 
think this prescription will help her? You haven't 
said what was wrong with her yet, and you were 
the first to see her." So he handed the prescription 
to Doctor X. and it read: 

"3J § v iii- Take one tablespoonful in hot 

water every four hours. 

(Signed) "Drs. Y. and Z." 

When I saw Doctor X. take this prescription out 
of his pocket, for he still had it, and read it, and 
throw his head back and laugh until he shook all 
over, I feared something was going to happen. His 
face was as red as a danger signal and I thought he 
would break a vessel. So I said: "What the hell 
was the matter with her, Doctor? I don't quite 
get your joke. Were the doctors not right in their 
diagnosis?" He told me, when the manager asked 
him if he thought the prescription would help her, 
he said he told him that was not a fair question to 
ask him, because one doctor should not criticize an- 



"Silence is Golden 9 ' 161 

other doctor's prescription, so he told the manager 
that it was a good prescription for any woman 
with cramps at certain times, but if he were to write 
one in this case it would not be for a woman's cramps 
but for a man's cramps, probably following too much 
booze. 

Doctor X. said the two diagnosticians stared at 
him and thought he was crazy until they heard the 
manager and all the actors and actresses roar with 
laughter, and finally the manager turned and said, 
"Oh, Lord, Doctor! Where will I get some one to 
take the place of my 'female impersonator, Madame 
Blankski'?" 

Then the two diagnosticians went out into the 
night. 



CHAPTER XXV 



One night Doctor X. and I were talking about the 
condition of people in the slums of the city, how they 
managed to live on year after year with poor hous- 
ing and food, clothing, fuel and other necessities, 
that one would think impossible to get along without. 
I said, I wondered how those people could raise fam- 
ilies in this district and have their children grow up, 
sometimes even to become good citizens. Doctor X. 
said this class of people in the slums have so many 
children that some of them grow up, but many die 
in infancy. He said the mortality among children 
in the slums was much greater years ago, but in re- 
cent years the Child Welfare Committees have been 
quite active in sending trained nurses into those dis- 
tricts teaching ignorant and overworked mothers 
how to take better care of their infants, and with 
this, and better milk, and discarding of the old time 
dirty tubes which were used on milk bottles, prevent 
intestinal diseases, which formerly killed babies by 
the thousands; and thereby raised the average life 
up to forty-seven years, where formerly, in years 

162 



"The Man of Mystery of Bones Island ' 163 

gone by, it was as low as nineteen years. Adults 
die as they did formerly, but we are saving the babies. 

Doctor X. said that once they pass the first few 
years of life, the people in this region of the city 
— barring accidents — have almost as good a chance 
to grow up as in some of the finer resident districts, 
because the children run out in the fresh air all day 
and become accustomed to roughing it, and forage 
around and manage to get something to satisfy their 
appetites, even if the food is not as dainty as that 
which is fed to the children in richer families. 

Then Doctor X. told me a peculiar story of how 
the municipal health authorities made a blunder in 
their anxiety to better the condition of a recluse 
who lived in filth and dirt in the mecea of the slums 
down on an island in the lower part of this city, 
where we have garbage and sewerage plants, and 
who foraged on the garbage and the flotsam and jet- 
sam of the river and lake and was in good health ap- 
parently for many years. He told me this fellow 
never came out of his hole in the garbage bank in 
the day time, but at night or very early in the morn- 
ing he would sneak out and wander along the river 
and lake shore, but if he happened to see a human 
being he would disappear with the swiftness of a deer 
back into his hiding place, concealed in the garbage 
bank. This garbage bank is down on an island 
known as "Bones Island" and old settlers who have 
lived on this island for the past forty years said that 



164 Pitfalls 

this recluse had been there, living in the hut all this 
time, but he hid himself with such success that they 
only remembered of seeing him three or four times in 
all those years, and then only early in the morning, 
when they were out a little ways on the lake fishing, 
when they would see him come out of his hut and go 
down to the point where the river enters the lake, 
for water. They said if he happened to see they were 
looking in his direction, he disappeared suddenly, 
and the most peculiar part of it was they never could 
find the entrance to his hut. They said the point 
where he entered the garbage bank was usually closed 
up when they tried to follow him to investigate his 
peculiarities. He became the "butt" and "jest" of 
the island, and mothers and fathers used him as the 
"goblin" to scare their children and to keep them 
in after dark. 

His hair and beard were long, and would prob- 
ably have been white but for dirt and garbage; his 
hair and beard were "garbage gray." There were 
many superstitions about him on the island. Some 
one started the rumor that he was the lost "French 
dauphin" and in later years some said he was 
"Dowie's spirit" who came to establish a new Zion 
City on the island. Anyway, he was never known 
to harm any one and on account of his manner of 
suddenly disappearing, he became one of the greatest 
mysteries of the age in this region. Every one won- 
dered where he got his food, but it was found later 



"The Man of Mystery of Bones Island" 165 

that he lived on garbage, because his home, which 
was originally a small hut in the bank, was widened 
out into three rooms, which were partitioned off by 
boards, and the roof braced with two-by-four props ; 
also, it was found he was eating another room for 
himself at the time he was captured. 

Eventually, when the people of the island could 
not stand the mystery of his life any longer, they 
appealed to the health authorities of the city, and 
they sent detectives to the island, but they reported 
back that the people down there were "nuts" and only 
imagined they saw a ghost, that they investigated the 
garbage bank and could find no trace of the recluse. 
But the residents retaliated and told the authorities 
if they would send good, watchful detectives at night, 
they would probably catch him when he went to the 
river. So what with the newspapers becoming in- 
terested and ridiculing the detective force, and what 
with the citizens jibing the authorities for their in- 
ability to capture this man of mystery, they sent a 
force of detectives and workmen down to clear the 
whole bank of garbage away, and eventually cap- 
tured him inside a veneer or shell of the bank of 
garbage, which was so petrified by time that he 
could lift a panel-like lid and slip behind it into a 
passageway that led to his hut, about fifty feet 
distant from his point of entry. 

When they captured this fellow they found he had 
no language, but instead, a gutteral-like, snapping 



166 Pitfalls 

and sepulchral gibbering resembling an aged gorilla, 
and he fought like a gorilla, and buried himself into 
his newly gormandized garbage room in his attempt 
to get away from his intruders. When they took 
hold of him, Doctor X. said, he reminded them of 
Ambrose Bierce's "Damned Thing," or what was 
found in Marion Crawford's "Upper Berth," he was 
so slimy and slippery from the moist garbage in 
which he lived for so many years ; also he naturally 
got to be of a garbage color, so in an environment 
like this he was invisible. 

Anyway, they finally got him and took him in an 
ambulance to the Emergency Hospital, and when 
they arrived with him the doctors and nurses cried: 
"Phew! What the devil have you got here?" They 
told them that at last they caught the "man of 
mystery" of "Bones Island." 

So the doctors and nurses, in the goodness of 
their hearts, proceeded to strip the filth and scrape 
the garbage from his skin — he wore no clothes — 
whiskers and hair, and scrub him up, but all the 
time he fought like a tiger against this new method 
of torture. But they persisted in their unintentional 
"cruel" treatment, and finally clipped and cleaned 
and scraped the dirt and garbage off his skin and 
hair and beard, and found a clean nightgown, and, 
eventually, after a long, laborious task, put him into 
a clean bed in the ward, and just as they settled him 
down in his downy bed the nurse decided to take his 



"The Man of Mystery of Bones Island" 167 

pulse for her record in the chart, but the poor fel- 
low had no pulse. She became startled and called the 
doctor. He placed the stethoscope over his heart 
and listened — not a sound — dead!! 
"Death due to sanitation." 



CHAPTER XXVI 



SAWBONES 7 



Somehow or another we got on to the subject 
of hospitals and their management one night, and 
Doctor X. told me that while years ago before there 
was a standardization of the hospitals they had per- 
mitted, much to their detriment, many physicians ano^ 
surgeons who lacked skill, and who were ignorant of 
the proper technique in operating, to take patients 
in, and many lives were sacrificed by bungling and 
daring young operators who had the mistaken idea 
that in order to become skilled surgeons they had to 
first make fat graveyards. But thanks to the Ameri- 
can College of Surgeons and the American Medical 
Association for the manner in which they have edu- 
cated the management of the different hospitals, 
especially in the large cities, this waking up or pub- 
licity which was given to their mistakes caused them 
to raise their standards and keep out this class of 
unskilled daring operators, thereby lowering their 
death rate by a large percentage. 

Doctor X. said that a well-managed hospital now 
is one that not only sees to it that the physicians 

168 



"Sawbones" 169 

and surgeons who take cases to the hospital for 
operation or treatment are men that are above re- 
proach, but that the attendants and nurses are men 
and women of intelligence whom they can trust with 
the care and nursing of the sick and injured who 
are constantly passing in and out of their institu- 
tions. 

Then he told me a story, so pathetic that it is 
almost unbelievable, but he insists that it is Gospel 
truth, although he claims that the mistake was orig- 
inally made by the orderly of a hospital, which hos- 
pital was not one that came under this proper 
standardization, but one that was conducted by the 
management for "revenue only." He said this or- 
derly was in the habit of bringing up to the operating 
room every day a little chap of about seven years 
of age who had a minor injury to his foot that was 
healing up all right, but needed dressings daily. This 
"little Tommy," as he was known, happened to be 
in the same ward with a boy who had a malignant 
disease of the bone and flesh of his foot, which to 
medical and surgical men is known as osteomyelitis. 
The osteomyelitis had gone on so far that the cir- 
culation was impeded and the foot was becoming 
gangrenous and it being useless to let it rot off and 
probably endanger his life, the surgeon finally de- 
cided to operate or amputate it. So after he 
obtained permission to do so from the parents, he 
came to the hospital one morning to prepare to 



170 Pitfalls 

amputate the foot. The surgeon was a capable man 
and one who had a reputation of doing good work, 
but he always did his operating in this questionable 
hospital. Whether he was interested financially in 
it or otherwise Doctor X. said he did not know. 
Anyway, he came one morning, as I said before, and 
ordered his osteomyelitis patient to be brought up to 
the operating room for amputation. The nurse 
on surgical duty told the orderly to go down to the 
ward and bring up the boy to the operating room, 
and the orderly took his hospital cart and went 
down in the elevator to the ward, and in his stupidity 
— for he was an ignorant, stupid fellow — took little 
Tommy up to the operating room, and he being 
about the same age as the little fellow with malignant 
osteomyelitis and resembled him somewhat, also hav- 
ing the same foot bandaged, didn't the nurses — who 
were stupid too — prepare the poor fellow for ampu- 
tation below the knee, without removing the dressing 
from his foot. The little fellow, not knowing what 
was going on, offered no protest until the anaesthetist 
started in administering the ether, then he fought 
and cried and screamed pathetically against this, 
but they held him until he finally succumbed to the in- 
fluence of the anaesthetic. All this time the surgeon 
and his assistants were some distance away in the 
sterilizing room making themselves aseptic for the 
operation, so when they came into the operating 
room the patient was fully anaesthetized and ready 



"Sawbones" 171 

with sterilized towels and cloths wrapped about the 
leg and one space left bare for the surgeon to do 
the amputation. Doctor X. told me that while this 
surgeon was fully capable to do almost any opera- 
tion, he deserved the contempt of his colleagues for 
his blundering criminal stupidity in not looking over 
his patient and be sure he was right before he went 
ahead; but no, the blundering idiot, taking it for 
granted that the hospital attendants and nurses had 
the proper patient on the table, took his scalpel and 
deftly slashed through the skin and muscles ; this 
blundering "saw bones" then picked up his damn 
saw and sawed through little Tommy's tibia and 
fibula and the foot was severed and placed in a re- 
ceptacle to show the parents what a "good" job 
he had done and how he had saved their darling boy's 
life by removing such a putrid and gangrenous foot 
before its sepsis or toxins got into the boy's system, 
which would destroy him. But, alas ! ah, alas ! when 
the surgeon took this foot which he so deftly ampu- 
tated and unwound the bandage, he saw a foot that 
was formerly healthy and had only a slight sore that 
was nearly healed. Then, in a startled manner he 
turned and looked at the boy's face and his own face 
became ashen in color and he cried out, "Oh, my 
God! what have I done? What have I done? This 
is not my patient! This is a healthy foot I've am- 
putated." And, in remorse, he collapsed on the floor 
of the operating room. 



172 Pitfalls 

Doctor X. said that this surgeon was sued for 
damages by little Tommy's parents, but knowing in 
his heart he was criminally negligent, he settled the 
suit, which was for a very large sum, and in the set- 
tlement, which was a conscience settlement, he became 
penniless. But he never had the heart to do another 
operation since the day of that tragic mistake. Doc- 
tor X. said little Tommy had forgiven him and is as 
happy and lively as ever with his artificial foot. The 
parents have forgiven him, and his medical and 
surgical fraternity have forgiven him, and his neigh- 
bors have forgiven him, but the poor surgeon's heart 
is still heavy with the thought of how he went head- 
long into a pitfall inadvertently staged and ar- 
ranged by inefficient hospital attendants and nurses. 



CHAPTER XXVII 



One night I asked Doctor X. why it was that there 
were so many lawsuits in the courts this last year 
against physicians and surgeons. I said if he noticed 
every day there are reports in the newspapers where 
some doctor is being sued for malpractice of some 
kind or another. He told me he noticed that too, 
but he had been following up every case that came 
to trial and found that the doctor won out in every 
instance. 

He told me that many times those suits are 
instigated by the physician being too persistent in 
collecting his fee, for services honestly and con- 
scientiously rendered. The patient being at heart 
a "Dead Beat" looks for revenge by bringing a 
counter claim for alleged injury following the physi- 
cian's or surgeon's treatment. 

Then again, he said, a number of states have what 
they call a "Compensation Act" for the workingmen. 
So under this "Workman's Compensation Act" a 
commitee settles all the disputes that come up about 
damages for any injury to men while at work in 

173 



174 Pitfalls 

the factories or business houses or any of the indus- 
trial plants of the state. 

This law, of course, takes away a lot of business 
from lawyers and also puts entirely out of business 
a number of fellows who were dubbed "Ambulance 
chasers." 

Then, of course, a number of lawyers had to look 
around for something else to do and they — especially 
those of the shyster type — thought they might find 
some "good pickings" as Dickens would say — in su- 
ing doctors. 

Doctor X. said, "Believe me, if the lawyers were 
made to pay the costs of all the suits that they lost 
against the physicians, instead of their poor dupes 
of clients having to pay, there would not be one dam- 
age suit against a doctor for a hundred years to 
come." 

Then Doctor X. told me a story of what happened 
to a beautiful young lady in this city, who called a 
surgeon one day for a trouble which surgeons some- 
times call the "acute abdomen." 

This surgeon, who is capable enough as a skilled 
operator, for some reason took the young lady to a 
hospital, where the attendants and assistants were 
not very efficient, in other words the hospital never 
came under what would be called a proper standard, 
and performed what the surgeons call a laparotomy, 
from which she seemed to recover promptly, but after 
she left the hospital she never seemed to gain her 



"Good PkTcmgs" 175 

normal strength and during her menstrual periods 
suffered intensely and called in different physicians 
trying to obtain relief; a number of the physicians 
made light of her trouble and advised her to get mar- 
ried and then she would be all right. 

So finally she took their advice and married a fine 
young man and they were happy — but not "happy 
ever after" as the novelist usually ends his story. 

Doctor X. told me that sometimes surgeons who 
are really skilled in operating make a mistake and 
go headlong into a pitfall by becoming too careless 
at the end of the operation, by leaving the closing 
and dressing of the wound to the attendants such as 
assistants and nurses who may not be always compe- 
tent and conscientious and who are not as responsible 
for the outcome of the operation as is the surgeon. 

He said a surgeon who follows this plan and will 
not stand by and see that the operation is finished 
and dressing applied properly, is deliberately walk- 
ing blindly on the brink of a pitfall, but for a time 
he will only think that some damn petty thief is 
stealing his instruments. 

After a few months of married life this young lady 
who had a laparotomy performed on her became 
pregnant and as she went on in her gestation she 
found the pains gradually getting worse, so finally 
when she got to be about six months advanced the 
pains became so severe that both she and her hus- 
band were afraid she was going to abort so they 



176 Pitfalls 

called in Doctor X. and wnile he was examining her 
he found a peculiar hard mass in the abdomen just 
above the scar of the operation. 

This puzzled Doctor X. very much. The lady 
was having intense pains at intervals of from ten to 
twenty minutes. She said when the pain came on 
"It felt as if her womb was being stabbed with a 
knife." 

He sat by the bedside and waited for a pain to 
come on and when it did she would let out an un- 
earthly scream showing what intense suffering she 
was undergoing. At each pain the doctor noticed 
the uterus was contracting and the contortions of 
her face indicated that the poor lady was undergoing 
horrible tortures. So he gave her a hypodermic of 
morphine to relieve the suffering. She had some re- 
lief for a while but eventually she began to show 
some hemorrhage and after a few hours aborted. 

Her screams aroused the whole neighborhood, al- 
though the doctor repeated the hypodermic in his 
efforts to relieve her. 

Both the lady and her husband were awfully anx- 
ious to have a baby and they were both heart-broken 
to think she lost it. 

When Doctor X. attempted to express the placenta 
by Crede's method she suffered the same stabbing 
pains which she experienced during the contraction 
of the uterus. 

This led Doctor X. to suspect that there was 



"Good Pickings" 177 

something within this mass felt in the abdomen that 
was really stabbing her womb, so he told his sus- 
picions to the husband and they decided to call a 
surgeon and take her to a hospital. 

Qn opening the abdomen down through the fibrous 
mass which was due to irritation of the tissues in 
which some foreign substance was enmeshed, the sur- 
geon found this foreign substance which proved to be 
an artery forceps with its point sticking into the 
fundus of the uterus. 

This proved to Doctor X. what he suspected, and 
on following up the history of the operation a year 
before he found that the surgeon who did the opera- 
tion had a habit of leaving his assistant to remove 
all instruments at the end of the operation and close 
the wound. However, the assistant forgot to remove 
this one, and closed up the wound over it. Doctor 
X. said that of course while the assistant made the 
mistake the surgeon is responsible. The lady re- 
covered eventually but her convalescence was long 
and lingering. 

The surgeon found considerable amount of extrav- 
asated blood in the surrounding tissues and in the 
peritoneal cavity. 



CHAPTER XXVIII 



One night I asked Doctor X. why it was that the 
physicians never organized to protect themselves 
against "Dead Beats" as other trades and profes- 
sions do, and he told me that the real reason was 
that the physician supposedly takes what he calls 
a "Hippocratic Oath" to give his service at all times 
to the sick and injured whenever his services may be 
needed without considering the financial end. Then, 
of course, if the party to whom he has rendered the 
service is so financially fixed that he can pay for 
the service, he may present his bill and force pay- 
ment even in the courts if necessary; but if the pa- 
tient is too poor to pay, the physician is under moral 
obligation to attend him if he is called, and once 
he takes charge of the case if the doctor neglects 
the patient, pay or no pay, the doctor is liable if 
there are any bad results through his neglect. 

Then Doctor X. told me that a great many people 
think a doctor must according to law respond to a 
call. He said they are mistaken in this; any doctor 
may refuse to respond to a call at any time provid- 

178 



"Judas Iscariot" 179 

ing he has not had charge of the case before, but 
if he is attending the patient and something goes 
wrong that his services become urgent, he must re- 
spond to the call or see that some other physician 
responds, if he is unable to reach his patient. 

Then Doctor X. told me what happened to about 
twenty physicians who organized a club, away down 
on the south side of the city where we have a large 
foreign population, who have their "Gezellschaften" 
and "Vereinen" or lodges, and who always employ 
their doctors by the year at from seventy-five cents 
to a dollar a year for each family. 

This club organized with the expressed purpose 
of eliminating this evil, and they pledged themselves 
not to give their services at those ridiculously low 
prices and they set a standard reasonable fee for 
each call. 

Doctor X. told me that the doctors in this neigh- 
borhood depended entirely on all those people be- 
longing to the different "Vereinen" for their 
livelihood. 

But they thought now that they were organized, 
the members of the different "Vereinen," when any 
of their families became ill, would have to call some 
one of them anyway and since the doctor could make 
the head of the family pay a reasonable fee for each 
visit, this would enable the physician to take better 
care of his own family. 

However, as time went on, the doctors discovered 



180 Pitfalls 

that instead of getting the usual number of calls 
which kept them fairly busy when they were "lodge" 
doctors, their calls seem to fall off entirely after 
they resigned. 

Then they began to worry and wonder what was 
the cause of all the people becoming so painfully 
healthy all of a sudden. 

So finally the chairman of the Doctors' Club called 
a meeting to look into the matter, because like him- 
self a number of the other members were thinking 
that there must be a "Judas" amongst them and the 
best way to find out who the traitor was, was to 
call an open meeting to hear from each member 
individually. 

On the night of the meeting, it was found while 
there were twenty members in the Club in good stand- 
ing, only nineteen were present — which I think is a 
good percentage of attendance, don't you? 

However, when they tried to get the absent mem- 
ber on the telephone to find out why he didn't come 
to the meeting, whoever was on the line said, "He 
was busy making calls, that he had made about 
twenty-five calls that day and was not expected home 
until late — and then he had to go to one of his 
'Verein' meetings to make his report." 

When the other members heard this they all sat 
and looked at each other and each member hesitated 
to say just what was on his mind. 

Finally the chairman said he was ready to enter- 



"Judas Iscariot" 181 

tain a motion, and one man moved "that an investi- 
gating committee be appointed to endeavor to find 
out how the absent member happened to have so 
many calls, while they were practically idle." 

The upshot of the investigation proved that this 
fellow, who in their meeting was the loudest to decry 
and censure the different "Vereinen" for not pay- 
ing doctors a living wage, immediately on the resig- 
nation of all the other doctors grabbed up every job 
as doctor to the "Vereinen," at one dollar a year, 
and for the first time in his life become what is known 
as a "Busy Doctor." 

The other members would have no more dealings 
with him and when he needed help in difficult cases 
he had to call in outside physicians. They excom- 
municated him from the Physicians' Club, but he had 
all the family practice and the other physicians 
had to build up a new practice all over again. 

Doctor X. said that's what happens when phy- 
sicians try to organize. 

The doctors individually should refuse to accept 
positions as "Lodge Doctors" because it only cheap- 
ens them in the eyes of the public. 

As for organizing against "Dead Beats" Doc- 
tor X. said the idea is distasteful to the average 
medical man, because many poor unfortunate 
fathers of families are in such a poor financial con- 
dition that he cannot pay the doctor, and if a phy- 
sician should list a poor fellow of this type as a 



182 Pitfalls 

"Dead Beat" he would be going contrary to all 
medical ethics. 

Doctor X. told me a story of what happened to 
an unfortunate fellow who was known to all the 
physicians in the city as thoroughbred when it came 
to beating the doctor. 

This fellow used to brag among his friends about 
never paying for medical service, although he was 
known to have plenty of money and was known as 
a "sport about the town." 

Whenever any of his family became ill he called 
a physician and when the physician tried to collect, 
he never could be found. But his poor wife would 
have to stall off all the collectors as he was never 
home. 

When the physicians or collecting agencies got 
judgment against him, they discovered their judg- 
ments were no good. 

He seemed to have a great deal of sickness in the 
family, but he always called a different physician 
and for many years managed to obtain medical care, 
but finally retribution came to the poor fellow in a 
cruel manner. 

He was sitting at home with his family one day 
eating his dinner and a large bolus of meat suddenly 
lodged in his throat and he could get it neither up 
nor down. 

The family became frightened and scuttled in dif- 



"Judas Iscariot" 183 

ferent directions to call a doctor. When they reached 
the different doctors either by racing to the doctors' 
homes or calling them on the telephone, it seems 
that the different physicians, who were stung so 
often by this man, had left word to say "they were 
not in" when a call should be sent in from him, so 
the poor family tried hard for two hours to get a 
physician but the reply always was that "The doc- 
tor was not at home." 

This poor fellow struggled all this time — two^ 
hours — and if a physician could have been secured, 
no doubt he would have saved his life; but no, he 
finally choked to death and at autopsy the coroner 
found this bolus of meat that could easily have been 
forced down into the esophagus by a doctor. 

Doctor X. said, that when the family mentioned 
the name and address of this poor fellow, they would 
not listen to any further explanation for a hurry 
call but just hang up the phone after saying that 
the doctor was out, or that he could not come. 

,It was really unfortunate that this tragedy should 
have occurred, but our martyred president's 
aphorism could apply to this case in a modified 
manner: "You can fool some of the doctors all the 
time, and all of the doctors some of the time, but 
you cannot fool all of the doctors all of the time." 

Doctor X. told me that physicians should never 
"strike" as an organization, because the idea of 



184 Pitfalls 

withholding services from people who are sick or in- 
jured is contrary and revolting to every doctor's 
professional instinct. 

He told me that over in England the employees of 
a railroad that was the only source for supplies of 
a small town went on a strike and when the hos- 
pital management needed some medical supplies, they 
sent a truck to the city to bring supplies; but the 
strikers drew a steel wire across the road and the 
first trip the truck made it was overturned on the 
roadway and a young physician who had just been 
married a week or so was killed. 

Then the wife of one of the perpetrators of this 
crime was taken to this same hospital in confine- 
ment but she had an obstructed labor and the young 
doctor who was killed was the one surgeon on whom 
they depended to save her, as he was looked upon 
as an expert in this Cesarian operation, which was 
badly needed to save both the mother and child. 

In their excitement the hospital authorities 
hardly knew what to do ; they finally telephoned to 
another city for a prominent surgeon, but he was a 
particular friend of the young surgeon who was 
killed by this woman's husband and others, so he 
refused to go. 

There were no other surgeons within the radius 
of many miles and the poor woman and child were 
dying. Remorse and regret for his crime were the 
striker's retribution ; he pleaded and begged some one 



"Judas Iscariot" 185 

to save his wife, but his hands were still red with 
blood of the only surgeon who could have saved her. 

Finally the heart of the young surgeon's widow 
was softened and touched by the pathetic condition 
of the wife of the striker and she took a cab and 
went posthaste to the other city and pleaded with 
the surgeon to come, and save the poor woman as 
she was not to blame for the action of the strikers. 

At the request the surgeon came and performed 
a Cesarian operation on the poor woman and saved 
both the woman and child. 

After the recital of this pathetic story, Doctor X. 
looked at me with that sympathetic smile of his and 
said: "Oh, for the pen of a Holmes, or an Osier or 
a Quinet to describe all the sympathy and goodness 
found in the heart of a 'Doctor's Wife' !" 



CHAPTER XXIX 

HOW LONG, O LORD! HOW LONG? 

We were discussing the subject of the different 
schools of medicine one evening and Doctor X. said 
he wondered often why the powers that be did not 
step in and make some of the irregular schools of 
medicine come up to the Standard of Medical Edu- 
cation established by the American Medical Asso- 
ciation and College of Surgeons. 

He told me there are some schools known as 
"Class C" Medical Colleges that still persist in 
graduating students who lack the proper education 
on entrance and who have bizarre ideas about the 
practice of medicine when they graduate. 

Then he told me the following story of his expe- 
rience with one of this type of medical men prac- 
ticing in this city. 

He said he was called some time ago to a young 
girl about twelve years of age who was suffering 
from chills and fever and obtained the following 
history: 

The parents moved from the South to this city 
about a year before and the father, who was a me- 

186 



How Long, O Lord! How Long? 187 

chanic, gave a history of having had malaria while 
living in the South, as did three other members of 
the family, which consisted of father and mother 
and five children, three boys and two girls, ranging 
in ages from six to eighteen years. 

Although the child to whom Doctor X. was called 
never had malaria while living in the South and 
Doctor X. thought it strange that she should show 
the symptoms of malaria after one year in this city, 
as we have the good fortune to rarely see any pa- 
tients with that debilitating disease here, however, to 
make sure he took some of her blood and on exami- 
nation could not find the plasmodium of malaria, 
so he had to attribute her chills and fever to some 
other cause, which was later found to be toxemia, 
from eating overripe fruit. 

Physical examination of the patient was negative, 
and the patient was sick with the chills and fever 
only for a day or two. 

Doctor X. said after he took a specimen of the 
child's blood for microscopic examination he thought 
it best to prescribe quinine in three-grain capsules 
every four hours, so that he should have an early 
start if the blood did show the microorganism of 
malaria. 

However, when Doctor X. called the next day he 
found his little patient's body covered all over with 
an erythematous rash ; while Doctor X. felt that this 
condition could possibly be due to the fruit toxemia 



188 Pitfalls 

which was her original complaint, still he knew from 
past experience that it was more likely to be caused 
by the quinine administered the day before. He 
found the patient felt fairly comfortable with the 
exception of some ringing noises in the head and 
ears. 

While Doctor X. explained to the parents that 
their child evidently showed an anaphylaxis for the 
quinine, still they were very much alarmed over her 
condition, although the child's temperature was 
normal. 

So he tried to calm their fear by telling them 
their child's rash would disappear and he imme- 
diately discontinued the quinine and prescribed bis- 
muth and milk of magnesia. 

When he called again the next day, he found his 
patient's temperature normal and she was feeling 
fine, her throat was absolutely normal and tongue 
very slightly coated and nothing at all to alarm the 
parents except that the rash, while it was milder, 
still it had not disappeared and the parents were 
worried about it although the child herself did not 
mind it. 

So after he left, some of the neighbors — of course 
— told the parents that they thought the child had 
scarlet fever and this thought being in their minds all 
the time, they decided to call in another physician 
recommended by some old woman in the neighbor- 
hood. So they called in this doctor who always 



How Long, Lord! Horn Long? 189 

claimed to be an eclectic physician. At this point 
I asked Doctor X. what the hell's an eclectic 
doctor? 

I told him the reason I asked was that my old 
grandmother was "stewed" all the time by alcoholic 
concoctions of indigenous herbs given by an "eclec- 
tic doctor." He told me that the word "Eclectic" is 
really a misnomer as far as the medical schools are 
concerned, because it means a sect or school which 
professes to select what is best from all other sys- 
tems of medicine, but their schools are of such a low 
grade that they are absolutely afraid to allow 
thorough inspection, and some of their schools are 
not recognized by as many as thirty-two states, so 
their graduates are not allowed to practice medi- 
cine in those states. 

Anyway, to come back to the tragedy that hap- 
pened to this poor family, by calling in an unskilled 
eclectic, which, as Doctor X. said, could have been 
avoided, but for this blundering idiot entering in 
on the scene. 

When this doctor was called he immediately diag- 
nosed the case as scarlet fever and Doctor X. said 
he doubts if he ever looked at the child's throat. 

However, he gained the confidence of the parents 
because his diagnosis coincided with their own, and 
also by his plausible talk — and believe me he could 
hand out some line of talk. So Doctor X. was im- 
mediately dismissed from the case and it was re- 



190 Pitfalls 

ported as scarlet fever to the health authorities 
and owing to the environment and the number of 
other children in the house he sent her to the isola- 
tion hospital on the outskirts of the city, but after 
the child was there for a day or two the physician 
in charge sent her home with the statement that the 
patient should never have been sent out there, as 
she had absolutely no contagious disease and that 
they had only exposed her to the contagion of a 
hospital of that kind. 

Still the doctor managed to keep the confidence 
of the parents, telling them that the medicine he gave 
her before she went to the hospital shortened her 
course of the scarlet fever and "cured" her, and 
also that they could see with their own eyes that 
their little girlie had a "scarlet fever rash." 

However, after the child was home and running 
around four or five days she developed a sore throat 
and began to feel dumpish and drowsy and could 
not eat very much, had headache and felt "creepy 
all over," etc., so they called the same doctor back, 
but instead of the damn fool making a culture to 
find the Klebs-Loeffler bacillus and immediately ad- 
ministering diphtheria antitoxin he stupidly treated 
the child with his damn antiquated method of irri- 
tating swabs and indigenous plant remedies. And 
what with the diphtheria exudate in the child's larynx 
and the swabbing of the throat, he set up an 
edematous condition of the throat, the inflammation 



How Long, Lord! How Long? 191 

becoming so severe that the child became cyanosed 
from lack of oxygen and the result was that she 
died of asphyxia rather than from the toxemia of 
diphtheria. 

While the poor parents were heart-broken, still he 
kept their confidence by telling them that no doctor 
living could save their child because "black diph- 
theria" is incurable, which was a damn lie, and also 
he managed to shift the blame onto the shoulders 
of the health authorities by telling the parents they 
were at fault for letting the child contract the dis- 
ease while at the isolation hospital. 

Dr. X. told me that what people called "black 
diphtheria" is only diphtheria with asphyxia due 
to edema of the larynx, the patient becoming 
cyanosed, or dark colored. 

But this is not all : the second youngest child, a boy 
about eight years of age, came down with diphtheria 
and Doctor X. said he could not understand the 
blind confidence those parents held for this same 
doctor. But they continued with him, and while 
the boy did not die he developed an external squint 
from paralysis of the ocular muscles. And also for 
a long time had difficulty in swallowing because of 
paralysis of the soft palate and during deglutition 
of liquids they came back through his nose. 

But the climax of this fellow's work was reached 
when the poor mother developed diphtheria from 
close contact and constant attendance on the two 



192 Pitfalls 

children, but still the doctor neglected to use anti- 
toxin and followed the same line of treatment and 
the poor woman lingered along for three or four 
weeks but the effect of the diphtheria toxin was too 
much for her heart and she died, leaving her other 
four children and poor husband in a very sad plight. 

The health authorities were innocent of any negli- 
gence in this unfortunate affair unless it should be 
their discredit for not calling the doctor on the 
carpet for not using antitoxin in all three cases. 

Doctor X. said as long as the "powers that be" 
persist in allowing different sects, cults, and pseu- 
doscientists, who do not understand or believe in 
the efficacy of antitoxins and other drugs of proved 
scientific and therapeutic value, to go undisturbed 
in their unique and bizarre methods of treating and 
imposing on the credulity of the public, just so long 
will tragedies of this kind occur in families through- 
out the land where the average layman has no way 
of distinguishing one doctor from another. 

Or, I might say in a better way — that the average 
layman has no way of distinguishing a pseudo- 
scientist from a true scientist when it comes to a 
question of medicine. 



CHAPTER XXX 



I ran over to Doctor X.'s office one evening not 
long ago thinking to have a pleasant evening with 
him, but oh, Lord! when I saw how his usually 
pleasant smile was absent from his countenance, I 
knew something was radically wrong with my old 
chum. So I said, "What's the trouble, Doctor? 
Why so downcast tonight? You don't seem to enter 
into the spirit of a pleasant chat this evening?" He 
didn't answer me for a while, but sat there in his 
chair twisting a lock of his iron gray hair and a woe- 
begone look on his face that I never saw before. I 
was about to pick up my hat and go, so I said, 
"Well, Doctor, I think you better go to bed early 
tonight and you may feel better tomorrow." But 
he said, "Don't go, 'Old Scout,' you've been my 
boon companion for so many years and have heard 
me tell so many times of the mistakes and pitfalls 
of my colleagues, although — thanks to professional 
ethics — you have never heard me mention names, you, 
'Old Scout,' whom I've watched for night after night 
in pleasant anticipation of a social smoke and chat, 

193 



194 Pitfalls 

you who have been my nearest and dearest friend 
outside of my own family, you who in your confi- 
dence think I am almost infallible, you, I say, should 
know of my own mistakes and pitfalls. I am not 
'without sin' although 'I have cast many stones,' 
and one of those same 'stones' that was hurled at my 
friend and colleague of whom I told you, went 'into 
the mouth of hell,' was hurled back by that same 
colleague today, like the German hand grenade which 
was hurled at the doughboy by the boche but went 
a-sizzling back before it exploded and 'beaned' the 
boche in his own roost while he was singing 'Die 
Wacht am Rhein,' and believe me, I was 'beaned' in 
a similar manner. 

Then Doctor X. told me how one night, during 
the week — I think it was Monday night — he was 
called to a young druggist who gave a history of 
having a hemorrhage. He said in taking the his- 
tory he was particularly careful to know whether 
the young man vomited the blood or coughed it up 
from the lungs. The young druggist insisted he 
coughed it up but his mother insisted that he vomited 
it up ; but what with the young man having a cough 
and showing a slight fever, and what with his finding 
some rales in the apex of the lungs, and knowing 
wherever there is a true hemoptysis that it is indic- 
ative of lung destruction; all this Doctor X. said, 
as well as finding in the apex of the left lung what 
he thought was an infiltration, led him to believe the 



"Let Him Who is Without Sw^—" 195 

young man had tuberculosis, and like a young grad- 
uate lie made a "snap diagnosis" and a "snap prog- 
nosis," thereby going into one of those damn pit- 
falls that he told me of so often. I asked Doctor 
X. where the hell did all this hemorrhage come from 
if he didn't cough it up? He looked at me for thirty- 
three seconds and took eleven puffs from his pipe and 
said: "His nose!" I said, "Well, didn't he give a 
history of coughing it up?" The doctor said yes, 
but while lying on his back of course the blood would 
run down and irritate the bronchi and larynx and 
then he would naturally have to cough it up to clear 
his throat, so this made him think the hemorrhage 
came from the lungs, and his history led Doctor X. 
to think so too. "But," I said, "Doctor, your find- 
ing the rales and the infiltration, wouldn't that lead 
you to think his lungs were affected?" He said "Yes, 
but you see we are having an epidemic of acute 
respiratory infections that make many people bleed 
from the nose a great deal and that was this fel- 
low's trouble. You remember his mother said he 
vomited too; well, he swallowed some of this blood 
from the nose and vomited it up as well as 'cough- 
ing it up,' but what I am trying to tell you 'Old 
Scout' is, I blundered when I made the diagnosis and 
told his mother and brother he had evidently tubercu- 
losis, and that I scared them so much that they de- 
cided to get another doctor and see what he thought 
about his trouble. So my friend and colleague was 



196 Pitfalls 

called and he showed them how the blood came from 
the nose, and the cough and fever were only due to 
influenza, and this latter diagnosis was correct, be- 
cause the young man is all right now, after a few 
days." So that's how Doctor X. blundered, he said, 
after twenty years' experience and all his preaching 
about "silence being golden," etc. 

Then Doctor X. told how another stone came hurl- 
ing back like a boomerang. 

One day he was called to a man about sixty years 
of age and on examination he found that he was 
emaciated and fast losing weight, his heart was skip- 
ping, and he was extremely asthenic. So, on taking 
some of his urine and examining it, he said it was 
running about 4 per cent sugar; then when the wife 
asked what was wrong with her husband Doctor X. 
told her emphatically that he had diabetes, but he 
told me that if he had been wide awake here he would 
have explored further, but he said he examined the 
urine on the first visit and his findings led him to 
make another of those fool "snap diagnoses," and 
that's where he stupidly blundered. Then he told 
me that when he made this diagnosis, the man's wife 
said, "Why, Doctor, I've had a number of good phy- 
sicians and surgeons see my husband and they all 
tell me he is suffering from cancer." Doctor X. 
said when she told him this he tried hard to think 
out how the devil can this fellow not have diabetes 
with so much sugar. Then he said he went back 



"Let Him Who is Without Sm- — " 197 

over his tracks again and on examination of his 
abdomen he found a tumorous mass that felt some- 
thing like a sausage which was none other than the 
pancreas, and then the doctor said his dull brain was 
beginning to perform its natural functions and he 
realized that this man was suffering from cancer of 
the pancreas which involved the "islands of Langer- 
hans" and thereby allowing sugar to appear in the 
urine, because these "islands of Langerhans" are 
ductless glands within the pancreas that have an 
internal secretion which has to do with the metabo- 
lizing of sugar within the body, and when they are 
destroyed in cancer or extirpated, sugar always 
appears in the urine and blood. Doctor X. said 
that his colleague aforementioned made a correct 
diagnosis which he proved in an autopsy, and 
poor Doctor X. said he had a hell of a time trying 
to change his diagnosis from diabetes to cancer of 
the pancreas. 

Then Doctor X. told of another pitfall which 
might be interesting, he said, to compare with the 
one just told. He was called one day to a little 
child about seven years of age, a girl who gave a 
history of her mother dying a year before with 
tuberculosis. Doctor X. said the child was so wasted 
that it was pathetic to look at her body ; you could 
count all her ribs and see plainly the contour and 
pulsations of her weak heart under her bony and 
cartilaginous ribs. The poor girl was so thin that 



198 Pitfalls 

Doctor X. said when he looked at her triangular 
face she reminded him of a child with hydrocephalus, 
but she didn't have hydrocephalus ; her forehead only 
seemed bulged because her cheeks were so sunken 
and her eyes so large. He said he found, while in 
attendance on the child, that the grandmother, who 
lived with them and took care of the child and kept 
house for her son-in-law, who was the father of the 
girl, had active tuberculosis too, her sputum being 
positive to tubercle bacilli. This, with many other 
things, Doctor X. found on physical examination 
led him to the conclusion that her condition was 
tuberculosis and she being so wasted he feared that 
she would never gain her immunity and would grad- 
ually sink to her grave another victim of the so- 
called "white plague." Doctor X. told me that the 
worst of it was he was in attendance on the girl 
for about a month, but in that time he never exam- 
ined her urine because when he would ask for the 
specimen they usually forgot to save it. So it ran 
along this way for a while, and finally the father 
and grandmother called in one of Doctor X.'s col- 
leagues — one whom he had thrown some stones at 
too — and this colleague made a urine analysis on his 
first visit and discovered her urine loaded with sugar, 
and told the parents her condition was not tubercu- 
losis but she was suffering from diabetes, which is a 
grave disease in a child so young, and this diagnosis 
of his colleague proved to be correct. 



"Let, Him Who is Without Sim " 199 

Then I was delighted to see Doctor X. — after un- 
loading his heart and mind of these melancholy bur- 
dens — smile again in his fascinating manner, and 
he looked at me and said, "You see, Old Scout, the 
scriptures are right when they say: 'Let him who 
is without sin cast the first stone.' "