Blaker Family of Sussex - Reminiscences

Reminiscences

Guy's Hospital.



I ENTERED at Guy's in 1855, and spent my first winter session chiefly in the dis-secting-room, attending, however, a few lectures, notably Dr. Addison's last course, being fascinated by his manner and eloquence. The second winter session I spent in much the same manner, getting to the dissecting-room at 9 a.m. and remaining the greater part of the day, till towards the end, when, after feeling for a few days a little out of health, one day at lecture I noticed a good deal of pain of the right side in breathing. This increased, and the next day I was obliged to lie up. Mr. Corbould, of Sydenham, where I had rooms in the Railway Station with the station-master, attended me, and finding things rather serious, asked Sir William, then Dr. Gull, to see me, who said I had effusion into the right pleura, a friction sound at the base of the left lung and a mitral murmur. These two latter disappeared in the course of a few days. I must not omit to mention Dr. Gull's very great kindness to me at this time. He was then in full work, but found time to come to Sydenham to see me, two or three times a week, for eight or nine weeks. He thought the mischief was rheumatic, from the profuse perspiration; probably it would now be thought septic.

About the fourth week I was one day seized with spasmodic cough, lasting seven hours, and followed by profuse expectoration, a pint or more, purulent and tinged with blood. I imagine a communica-tion with a bronchus formed at this time. About ten weeks from the commencement of the attack I returned to my father's house at Alborne, apparently in the last stage of phthisis, depressed shoulder, contracted chest, clubbed fingers, con-stant cough, profuse expectoration and night sweats. By slow degrees I got a little better, and could walk a few yards, and in a short time could ride on horseback at a foot pace. Mr. Richard Burt, Veterinary Surgeon, most kindly lent me a quiet pony, and rubbed my chest every evening for a quarter of an hour, and this was the only remedy to which I could trace the least benefit. The chest very gradually resumed to a great extent its natural shape, but the manner in which the expansion took place was very curious. About once in a fortnight or three weeks there was, for two or three days, a marked aggravation of all the symptoms, especially the cough; this was followed by an evi-dent expansion of the chest, as if absorption of adventitious matter having gone on to a certain extent, the elasticity of the walls came into play, and air entered a portion of hitherto compressed lung.

At the end of eighteen months, although clubbed fingers and cough and other symptoms still re-mained in a minor degree, I had very much im-proved. My chief amusement at this time was shooting on my uncle's farm at Pyecombe, but this was attended with difficulties, as breath-lessness prevented my walking. I got over this by making a holster out of an old stirrup leather and a piece of carpet, which I could buckle on to the staple at the bow of the saddle of the quiet pony lent me by Mr. Burt; I then got a heavy leaden weight to which I attached a cord eight or ten yards long, and passed the other end of the cord through one ring of the snaffle-bit and tied it to the other, thus forming a gag. Then when my old setter found any game, I could "cast anchor" by throwing down the weight, which prevented the pony moving, and get off and have a shot. In this was I sometimes killed four or five head of game in two or three hours.

I have given my own case rather at length, because, in these days of tapping the chest, a case of pus in the pleura, left to Nature, is rare. I tried drugs of various kinds but I cannot say that I derived the slightest benefit from any, except opium, and to this drug I think I owe my recovery. It quieted my cough and gave me sleep; I took from 30 to 40 minims of Tincture of Opium every night for five or six months, and then gradually reduced the dose both in quantity and frequency. It produced no ill effects, and I felt no craving for the drug when I left off.

At this time I was seized with a desire to pass the Hall and College, but any idea of returning to Guy's was out of the question. Circumstances, however, favoured me. It was the last year of the old "regime," which required only three winter and two summer sessions at a recognised Hospital, and the examination for which con-sisted of one hour's "viva voce," divided into four quarters, a quarter of an hour being spent at each of four tables. Though I had not com-pleted the usual curriculum at Guy's, I had spent nearly five years at a recognised Hospital,—the Sussex County Hospital being recognised for practice,—and it occurred to me to petition the two Courts of Examiners to allow me to come up for examination. I consulted Dr. Ormerod and he quite approved, and wrote to both Hall and College. I sent up my petition, and received practically the same answer from both, that I might try but should be required to pass a good examination. I then arranged with Dr. Barron, the "Grinder" or Coach at Guy's, for an hour's preparatory examination, at the end of which he said I was certain to pass, so on July 22nd, 1858, I went to London, got to the Hall at 8 p.m. and left about 10 p.m. with the Apothecaries Hall Diploma. The College still remained to be passed. I again made an appointment with Dr. Barron, who said I was almost certain to get through. On October 15th, 1858, I passed College. On the morning of that day, after breakfast, I walked to a farm close by, where I had permission to shoot, and killed a snipe, my dog pleasing me by swim-ming a wide stream and retrieving it. I then returned home and rested till the mid-day dinner, after which I went to London and stayed at the Bridge House Hotel, London Bridge, till I went to the College where I had to be at a little before 8 p.m.

There were, I think, eleven candidates; I was one of the last three, and had therefore, twenty minutes at three tables, instead of fifteen minutes at four. At the first table was Mr. Skey, who was then advocating free incisions and stimulants in phlegmonous erysipelas. His first question was "What would you do if you had a case of cellulitis?" I said, of course, "Free incisions and plenty of stimulants." "How large incisions?" "Large enough to relieve tension." "And how much stimulant?" "Enough to affect the pulse." At the next table I had a few questions on the physiology of breath-ing, and also on the veins, and the propriety of putting a ligature on them. It has been con-sidered that it was most dangerous to put a liga-ture on a vein, because it was thought that when the ligature separated, the pus was sucked into the open mouth of the vein and produced pyćmia. This doctrine was, just then, questioned. At the last table was Mr. Thomas Wormald, noted for his rough manner and kindness of heart. Seeing, I suppose, that I was tired and out of health, his first question was "Where do you come from?" "Brighton, sir." "Oh, a Sussex pudding, I suppose." He then asked me some very good questions about dislocation of the ankle joint, with fracture of the lower end of the fibula, which, thanks to Dr. Ormerod, who had induced me to study "Cooper on Dislocations and Fractures of the Joints" at the Sussex County Hospital, I was able to answer. At the end of the hour, when the names of the successful candidates were called over, mine was among them.

I was much disappointed at not being able to compete for the office of House Surgeon, which just then became vacant at the Hospital and which had always been my object; indeed I had given up all idea of ever being able to practice the profession, but

" There's a Divinity that shapes our ends
   Rough-hew them how we will."

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