With the country child it is quite different. Not only does he have purer air, plainer food, more regular hours and less excitement, but scene and events are brought to his notice in a less hurried manner, and he instinctively begins to think and reason about them; and at the same time by watching, as he can hardly help doing, the various processes of nature, the bud emerging from the stem and becoming developed first into a blossom and then into fruit, the bird hatched from the egg, the caterpillar changing first into a chrysalis and then into a butterfly, and the growth of the various young domestic animals, his ideas are constantly carried forward and he naturally gets a wider view, as well as a habit of looking into the future, and it may be, of considering what may be the ultimate effect of his own words and deeds. Is it too fanciful to see in this an analogy to the human eye? It is a well-known fact that town children, from constantly looking at small objects and at objects close to them, become short-sighted more often than country children; and it is also a fact, I believe, but perhaps a less well-known one, that the majority of town children have a more limited vision that country children, and that, if they are asked to look at a distant clock or any such object at a distance, they are unable to perceive what a country child sees with greatest ease.
But if a country life is an advantage too an ordinary child, it seems to me the best possible preparation for the education of a surgeon or physician, especially if his time is spent on a farm. There he is brought into contact with life in both plants and animals, indeed he may be regarded as watching a very large experiment, or rather a series of experiments on a large scale, continued for a long time, and of such a nature that Mr. Stephen Coleridge, with all his ingenuity, would find it difficult to suggest even an imaginary cause of complaint. I cannot help thinking that, although immeasureable strides have been made in the last fifty years in the general manage-ment of patients, the medical man, his attention being fixed on the scientific treatment of his patient, occasionally overlooks details in food and its manner of administration, and other small matters, which sometimes make all the difference between success and failure, and in regard to which he might occasionally take a useful hint from a simple herdsman or shepherd. On looking back I feel conscious that my treatment of patients has been occasionally modified to their advantage by what I learned from watching animals and their management in my boyish days. I will here relate an incident which, though it occurred at least fifty years ago, will illustrate my meaning. My father took great interest in his herd of Sussex cattle, and occasionally exhibited them at Agricultural Shows, and he had an excellent man to attend to these animals. At that time it happened that a near relative became unable to manage his business, and his farm, a rather large one, was carried on by his bailiff for a considerable time; at his death my father felt bound to take this man into his employment, and it became his work to attend to and feed the cattle intended for market and exhibition. In this, although he had been with cattle from his infancy, and had proved himself perfectly honest and trustworthy and was most anxious to succeed, he entirely failed, and my father was obliged to reinstate his former herdsman. In this case the cattle, though not absolutely the same animals, were bred and brought up in exactly the same manner, and the food, housing and water were precisely identical. The only difference was one of minute details in the administration of the food and general management. Breeders and exhibitors of pedigree and fat stock are well aware of the value of a man who is technically termed "a good hand with stock." The good and successful management of animals seems innate in some men and can never be acquired by others, and it is, I believe, generally accepted among farmers that a placid and quiet disposition and manner is most essential. Does not this show us the necessity of keeping patients as quiet and cheerful and free from all disturbance of any kind, both of mind and body, as possible, and that very minute and almost unrecognizable causes may interfere with the organs of digestion and nutri-tion, as Darwin has shown they interfere with those of generation in many animals. Shakespeare seems to have alluded to this in the lines :—
" Let me have men about me that are fat,|
Sleek headed men and such as sleep o'nights;
Yon Cassius hath a lean and hungry look,
He thinks too much."
Many years ago Sir Spencer Wells made the statement that the only experiments on animals he made were with the object of ascertaining whether or not the peritoneum should be in-cluded in the suture of the abdominal wall or not. He might have seen experiments of this sort by the hundred on a farm, for not so many years ago all female pigs, except those required for stock purposes, were speyed or ovariotomised when about eight weeks old. The operation was done by a Veterinary Surgeon very dexterously, though in a somewhat rough and ready manner. He knelt on one knee and the pig being on its side, he fixed its head and shoulders under his ankle, while a man held its hind legs and pulled them back pretty firmly. An incision a little in front of the thigh was made through the skin and abdominal muscles into the peritoneal cavity, just large enough to admit the finger. From constant practice the operator quickly found the cornuated uterus and brought it out through the wound, cut off the ovary from the extremity of each cornu and returned the uterus. The hind leg was then brought forward to relax the muscles and the wound was closed with a continuous suture, great care being taken to include the peritoneum. The operation lasted only a minute or two. No dressing was applied, and in two or three days the pig was running about apparently quite well. A Veterinary Surgeon told me that he had never seen general peritonitis occur, though he had seen adhesions from local peritonitis prove fatal. The time chosen for the operation on bitches was about the fourteenth day from the com-mencement of gestation, when all the parts were in full functional activity and considerably enlarged. In the cornua the exact situation of each embryo was marked by the appearance at regular intervals of a round knob of the size perhaps of a small walnut, in a large dog.
The ovaries were removed, and the wound closed with a continuous suture including the peritoneum, as in the case of pigs, and recovery was very rapid. Speyed bitched were much in request formerly, and there was a saying "Six speyed bitched are a pack," meaning that they were keen hunters and always ready. They had, however, a tendency to obesity. These operations have now become obsolete. When I first went to the Hospital as pupil, and, after witnessing hundreds of these operations, was told that a wound of the peritoneum was almost always fatal, I could not understand it; nor can I do so now, unless we admit that the lower animals possess an immunity against septic germs, or that septic germs do not exist, at all events in such large quantities or of so virulent a form, in country districts, for the rustic operator's hands are rarely clean and he took no pains to make them so.
The effect of consanguinity, or as it was termed "breeding in and in," was occasionally to be observed, and it was interesting to watch how under these circumstances, the animals became more and more delicate and feeble, their muscle and bone smaller and more deteriorated, and how deformities tended to increase, especially a shorten-ing of the lower jaw, in the country termed "hog-jaw".
There are countless other things well known to agriculturists which are not, I believe, yet under-stood, but which give great cause for reflection. It is a well-known fact that animals of one species will not thrive and get on, or even retain their health, if kept too long on the same ground, al-though animals of a different species can im-mediately take their place without any ill effects. Indeed these frequent changes seem as necessary for the purpose of keeping the grass and herbage in good condition as they are for the health of the animals. It is also, I believe, a fact that animals can be kept and can remain for a longer time on arable land, which is frequently exposed to the air by the necessary tillage, than on meadows. This injurious effect on the land seems to last for a very considerable time, for if sheep are pas-tured on some land, especially wet land, in the autumn, their successors in the spring are almost certain to suffer from intestinal disorders; and every gamekeeper knows that if he wishes for success in raising young pheasants he must change his ground every year.
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