Delphi Complete Works of Sir Arthur Conan Doyle (Illustrated), page 573
This train of thought is the after-swell from an argument with Cullingworth this evening. He holds that the human race is deteriorating mentally and morally. He calls out at the grossness which confounds the Creator with a young Jewish Philosopher. I tried to show him that this is no proof of degeneration, since the Jewish Philosopher at least represented a moral idea, and was therefore on an infinitely higher plane than the sensual divinities of the ancients. His own views of the Creator seem to me to be a more evident degeneration. He declares that looking round at Nature he can see nothing but ruthlessness and brutality. “Either the Creator is not all-powerful, or else He is not all-good,” says he. “Either He can stop these atrocities and won’t, in which case He is not all-good; or else He would stop them but can’t, in which case He is not all-powerful.” It was a difficult dilemma for a man who professes to stick to reason to get out of. Of course, if you plead faith, you can always slip out of anything. I was forced to get behind a corner of that buckler with which you have so often turned my own thrusts. I said that the dilemma arose from our taking it for granted that that which seemed evil really was EVIL. “It lies with you to prove that it isn’t,” said he. “We may hope that it isn’t,” said I. “Wait until some one tells you that you have cancer of the pyloric end of the stomach,” said he; and he shouted it out again every time I tried to renew the argument.
But in all soberness, I really do think, Bertie, that very much which seems to be saddest in life might be very different if we could focus it properly. I tried to give you my views about this in the case of drink and immorality. But physically, I fancy that it applies more obviously than it does morally. All the physical evils of life seem to culminate in death; and yet death, as I have seen it, has not been a painful or terrible process. In many cases, a man dies without having incurred nearly as much pain, during the whole of his fatal illness, as would have arisen from a whitlow or an abscess of the jaw. And it is often those deaths which seem most terrible to the onlooker, which are least so to the sufferer. When a man is overtaken by an express and shivered into fragments, or when he drops from a fourth-floor window and is smashed into a bag of splinters, the unfortunate spectators are convulsed with horror, and find a text for pessimistic views about the Providence which allows such things to be. And yet, it is very doubtful whether the deceased, could his tongue be loosened, would remember anything at all about the matter. We know, as students of medicine, that though pain is usually associated with cancers and with abdominal complaints; still, in the various fevers, in apoplexy, in blood poisonings, in lung diseases, and, in short, in the greater proportion of serious maladies, there is little suffering.
I remember how struck I was when first I saw the actual cautery applied in a case of spinal disease. The white hot iron was pressed firmly into the patient’s back, without the use of any anaesthetic, and what with the sight and the nauseating smell of burned flesh I felt faint and ill. Yet, to my astonishment, the patient never flinched nor moved a muscle of his face, and on my inquiring afterwards, he assured me that the proceeding was absolutely painless, a remark which was corroborated by the surgeon. “The nerves are so completely and instantaneously destroyed,” he explained, “that they have no time to convey a painful impression.” But then if this be so, what becomes of all the martyrs at the stake, and the victims of Red Indians, and other poor folk over whose sufferings and constancy we have wondered? It may be that Providence is not only not cruel itself, but will not allow man to be cruel either. Do your worst, and it will step in with a “No, I won’t allow this poor child of mine to be hurt”; and then comes the dulling of the nerve and the lethargy which takes the victim out of the reach of the tormentor. David Livingstone under the claws of the lion must have looked like an object lesson of the evil side of things, and yet he has left it upon record that his own sensations were pleasurable rather than otherwise. I am well convinced that if the newly-born infant and the man who had just died could compare their experiences, the former would have proved to be the sufferer. It is not for nothing that the first thing the newcomer into this planet does is to open its toothless mouth and protest energetically against fate.
Cullingworth has written a parable which makes a paragraph for our wonderful new weekly paper.
“The little cheese mites held debate,” he says, “as to who made the cheese. Some thought that they had no data to go upon, and some that it had come together by a solidification of vapour, or by the centrifugal attraction of atoms. A few surmised that the platter might have something to do with it; but the wisest of them could not deduce the existence of a cow.”
We are at one, he and I, in thinking that the infinite is beyond our perception. We differ only in that he sees evil and I see good in the working of the universe. Ah, what a mystery it all is! Let us be honest and humble and think kindly of each other. There’s a line of stars all winking at me over the opposite roof — winking slyly at the silly little person with the pen and paper who is so earnest about what he can never understand.
Well, now, I’ll come back to something practical. It is nearly a month since I wrote to you last. The date is impressed upon my memory because it was the day after Cullingworth shot the air-dart into my finger. The place festered and prevented my writing to any one for a week or two, but it is all right again now. I have ever so much of different sorts to tell you, but really when I come to think of it, it does not amount to very much after all.
First of all, about the practice. I told you that I was to have a room immediately opposite to Cullingworth’s, and that all the surgical cases were to be turned over to me. For a few days I had nothing to do, except to listen to him romping and scuffling with his patients, or making speeches to them from the top of the stairs. However, a great “Dr. Stark Munro, Surgeon,” has been affixed to the side of the door downstairs, opposite Cullingworth’s plate; and a proud man was I when first my eyes lit upon it. On the fourth day, however, in came a case. He little knew that he was the first that I had ever had all to myself in my life. Perhaps he would not have looked quite so cheerful if he had realised it.
Poor chap, he had little enough to be cheery over either. He was an old soldier who had lost a good many teeth, but who had continued to find room between his nose and chin for a short black clay pipe. Lately there appeared a small sore on his nose which had spread, and become crusted. On feeling it I found it as hard as a streak of glue, with constant darting pains passing through it. Of course, there could be no question as to diagnosis. It was epitheliomatous cancer, caused by the irritation of the hot tobacco smoke. I sent him back to his village, and two days after I drove over in Cullingworth’s dog-cart, and removed the growth. I only got a sovereign for it. But it may be a nucleus for cases. The old fellow did most admirably, and he has just been in (with a most aristocratic curl to his nostrils) to tell me that he has bought a box full of churchwardens. It was my first operation, and I daresay I was more nervous about it than my patient, but the result has given me confidence. I have fully made up my mind to let nothing pass me. Come what may, I am prepared to do it. Why should a man wait? Of course, I know that many men do; but surely one’s nerve is more likely to be strong and one’s knowledge fresh now than in twenty years.
Cases came dribbling in from day to day — all very poor people, and able to pay very poor fees — but still most welcome to me. The first week I took (including that operation fee) one pound seventeen and sixpence. The second, I got two pounds exactly. The third, I had two pounds five, and now I find that this last week has brought in two pounds eighteen; so I am moving in the right direction. Of course, it compares absurdly enough with Cullingworth’s twenty pound a day, and my little quiet back-water seems a strange contrast to the noisy stream which pours for ever through his room. Still, I am quite satisfied, and I have no doubt at all that his original estimate of three hundred pounds for the first year will be amply justified. It would be a pleasant thing to think that if anything were really to happen at home, I should be able to be of some use to them. If things go on as they have begun, I shall soon have my feet firmly planted.
I was compelled, by the way, to forego an opening which a few months ago would have been the very summit of my ambition. You must know (possibly I told you), that immediately after I passed, I put my name down as a candidate for a surgeonship on the books of several of the big steamship lines. It was done as a forlorn hope, for a man has usually to wait several years before his turn comes round. Well, just a week after I started here, I got a telegram one night from Liverpool: “Join the Decia to-morrow as surgeon, not later than eight in the evening.” It was from Staunton & Merivale, the famous South American firm, and the Decia is a fine 6000-ton passenger boat, doing the round journey by Bahia and Buenos Ayres to Rio and Valparaiso. I had a bad quarter of an hour, I can tell you. I don’t think I was ever so undecided about anything in my life. Cullingworth was dead against my going, and his influence carried the day.
“My dear chap,” said he, “you’d knock down the chief mate, and he’d spread you out with a handspike. You’d get tied by your thumbs to the rigging. You’d be fed on stinking water and putrid biscuits. I’ve been reading a novel about the merchant service, and I know.”
When I laughed at his ideas of modern sea-going he tried another line.
“You’re a bigger fool than I take you for if you go,” said he. “Why, what can it lead to? All the money you earn goes to buy a blue coat, and daub it with lace. You think you’re bound for Valparaiso, and you find yourself at the poor-house. You’ve got a rare opening here, and everything ready to your hand. You’ll never get such another again.”
And so it ended by my letting them have a wire to say that I could not come. It is strange when you come to a point where the road of your life obviously divides, and you take one turning or the other after vainly trying to be sure about the finger-post. I think after all I chose rightly. A ship’s surgeon must remain a ship’s surgeon, while here there is no horizon to my possibilities.
As to old Cullingworth, he is booming along as merrily as ever. You say in your last, that what you cannot understand is how he got his hold of the public in so short a time. That is just the point which I have found it hard to get light upon. He told me that after his first coming he had not a patient for a month, and that he was so disheartened that he very nearly made a moonlight exodus. At last, however, a few cases came his way — and he made such extraordinary cures of them, or else impressed them so by his eccentricity, that they would do nothing but talk of him. Some of his wonderful results got into the local press, though, after my Avonmouth experience, I should not like to guarantee that he did not himself convey them there. He showed me an almanac, which had a great circulation in the district.
It had an entry sandwiched in this way:
Aug. 15. Reform Bill passed 1867.
Aug. 16. Birth of Julius Caesar.
Aug. 17. Extraordinary cure by Dr. Cullingworth of a case of dropsy in Bradfield, 1881.
Aug. 18. Battle of Gravelotte, 1870.
It reads as if it were one of the landmarks of the latter half of the century. I asked him how on earth it got there; but I could only learn that the woman was fifty-six inches round the waist, and that he had treated her with elaterium.
That leads me to another point. You ask me whether his cures are really remarkable, and, if so, what his system is. I answer unhesitatingly, that his cures are very remarkable, indeed, and that I look upon him as a sort of Napoleon of medicine. His view is that the pharmacopaeal doses are in nearly every instance much too low. Excessive timidity has cut down the dose until it has ceased to produce a real effect upon the disease.
Medical men, according to his view, have been afraid of producing a poisonous effect with their drugs. With him, on the contrary, the whole art of medicine lies in judicious poisoning, and when the case is serious, his remedies are heroic. Where, in epilepsy, I should have given thirty-grain doses of bromide or chloral every four hours, he would give two drachms every three. No doubt it will seem to you very kill-or-cure, and I am myself afraid that a succession of coroners’ inquests may check Cullingworth’s career; but hitherto he has had no public scandal, while the cases which he has brought back to life have been numerous. He is the most fearless fellow. I have seen him pour opium into a dysenteric patient until my hair bristled. But either his knowledge or his luck always brings him out right.
Then there are other cures which depend, I think, upon his own personal magnetism. He is so robust and loud-voiced and hearty that a weak nervous patient goes away from him recharged with vitality. He is so perfectly confident that he can cure them, that he makes them perfectly confident that they can be cured; and you know how in nervous cases the mind reacts upon the body. If he chose to preserve crutches and sticks, as they do in the mediaeval churches, he might, I am sure, paper his consulting room with them. A favourite device of his with an impressionable patient is to name the exact hour of their cure. “My dear,” he will say, swaying some girl about by the shoulders, with his nose about three inches from hers, “you’ll feel better to-morrow at a quarter to ten, and at twenty past you’ll be as well as ever you were in your life. Now, keep your eye on the clock, and see if I am not right.” Next day, as likely as not, her mother will be in, weeping tears of joy; and another miracle has been added to Cullingworth’s record. It may smell of quackery, but it is exceedingly useful to the patient.
Still I must confess that there is nothing about Cullingworth which jars me so much as the low view which he takes of our profession. I can never reconcile myself to his ideas, and yet I can never convert him to mine; so there will be a chasm there which sooner or later may open to divide us altogether. He will not acknowledge any philanthropic side to the question. A profession, in his view, is a means of earning a livelihood, and the doing good to our fellow mortals, is quite a secondary one.
“Why the devil should we do all the good, Munro?” he shouts. “Eh, what? A butcher would do good to the race, would he not, if he served his chops out gratis through the window? He’d be a real benefactor; but he goes on selling them at a shilling the pound for all that. Take the case of a doctor who devotes himself to sanitary science. He flushes out drains, and keeps down infection. You call him a philanthropist! Well, I call him a traitor. That’s it, Munro, a traitor and a renegade! Did you ever hear of a congress of lawyers for simplifying the law and discouraging litigation? What are the Medical Association and the General Council, and all these bodies for? Eh, laddie? For encouraging the best interests of the profession. Do you suppose they do that by making the population healthy? It’s about time we had a mutiny among the general practitioners. If I had the use of half the funds which the Association has, I should spend part of them in drain-blocking, and the rest in the cultivation of disease germs, and the contamination of drinking water.”
Of course, I told him that his views were diabolical; but, especially since that warning which I had from his wife, I discount everything that he says. He begins in earnest; but as he goes on the humour of exaggeration gets hold of him, and he winds up with things which he would never uphold in cold blood. However, the fact remains that we differ widely in our views of professional life, and I fear that we may come to grief over the question.
What do you think we have been doing lately? Building a stable — no less. Cullingworth wanted to have another one at the business place, as much, I think, for his patients as his horses; and, in his audacious way, he determined that he would build it himself. So at it we went, he, I, the coachman, Mrs. Cullingworth, and the coachman’s wife. We dug foundations, got bricks in by the cartload, made our own mortar, and I think that we shall end by making a very fair job of it. It’s not quite as flat-chested as we could wish; and I think that if I were a horse inside it, I should be careful about brushing against the walls; but still it will keep the wind and rain out when it is finished. Cullingworth talks of our building a new house for ourselves; but as we have three large ones already there does not seem to be any pressing need.
Talking about horses, we had no end of a fuss here the other day. Cullingworth got it into his head that he wanted a first-class riding horse; and as neither of the carriage ones would satisfy him, he commissioned a horse dealer to get him one. The man told us of a charger which one of the officers in the garrison was trying to get rid of. He did not conceal the fact that the reason why he wished to sell it was because he considered it to be dangerous; but, he added, that Captain Lucas had given L150 for it, and was prepared to sell it at seventy. This excited Cullingworth, and he ordered the creature to be saddled and brought round. It was a beautiful animal, coal black, with a magnificent neck and shoulders, but with a nasty backward tilt to its ears, and an unpleasant way of looking at you. The horse dealer said that our yard was too small to try the creature in; but Cullingworth clambered up upon its back and formally took possession of it by lamming it between the ears with the bone handle of his whip. Then ensued one of the most lively ten minutes that I can remember. The beast justified his reputation; but Cullingworth, although he was no horseman, stuck to him like a limpet. Backwards, forwards, sideways, on his fore feet, on his hind feet, with his back curved, with his back sunk, bucking and kicking, there was nothing the creature did not try. Cullingworth was sitting alternately on his mane and on the root of his tail — never by any chance in the saddle — he had lost both stirrups, and his knees were drawn up and his heels dug into the creature’s ribs, while his hands clawed at mane, saddle, or ears, whichever he saw in front of him. He kept his whip, however; and whenever the brute eased down, Cullingworth lammed him once more with the bone handle. His idea, I suppose, was to break its spirit, but he had taken a larger contract than he could carry through. The animal bunched his four feet together, ducked down his head, arched his back like a yawning cat, and gave three convulsive springs into the air. At the first, Cullingworth’s knees were above the saddle flaps, at the second his ankles were retaining a convulsive grip, at the third he flew forward like a stone out of a sling, narrowly missed the coping of the wall, broke with his head the iron bar which held some wire netting, and toppled back with a thud into the yard. Up he bounded with the blood streaming down his face, and running into our half-finished stables he seized a hatchet, and with a bellow of rage rushed at the horse. I caught him by the coat and put on a fourteen-stone drag, while the horse dealer (who was as white as a cheese) ran off with his horse into the street. Cullingworth broke away from my grip, and cursing incoherently, his face slobbered with blood, and his hatchet waving over his head, he rushed out of the yard — the most diabolical looking ruffian you can imagine. However, luckily for the dealer, he had got a good start, and Cullingworth was persuaded to come back and wash his face. We bound up his cut, and found him little the worse, except in his temper. But for me he would most certainly have paid seventy pounds for his insane outburst of rage against the animal.
