A day with the out-patients of a hospital / Tilbury Fox.

  • Fox, William Tilbury, 1836-1879.
Date:
[1866]
Catalogue details

Licence: Public Domain Mark

Credit: A day with the out-patients of a hospital / Tilbury Fox. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    23C A DAY ITH OUT-PATIENTS. Lo<K>d wonu, April 2. is*.. years ago come the 9th of next mouth,” her child was run over, under her own eyes, by a train, and suffered great agony till the third day, when it died. The nights are always worse than the days ; she tries to pluck up, but can’t. This case is a type of a host, in which debility is the occasion for the play of sorrows and griefs. Given a man iu health, he has his resistant power strung up; but depress him, and the blue-devils have him at an awful advantage. Feed this poor woman and put more flesh on her bones, and for a while the sharp edge of her misery is blunted. Several “no letter” cases follow: the standing orders are to prescribe once or twice, but after that a letter must be produced. An old man, aged sixty-five, is “bilious has a little annuity, lives as closely as he can, so much so that he “never has a pint of beer unless it will do him good.” No. 47 follows in the shape of a stableman, a rheumatic subject. “ Last uight, when in bed, something rolled about in his head like a wheel, and so it does now, and he has got to mind he don’t fall; his head feels as big as two heads.” He is forty-nine years old, and has consumed a very respectable amount of beer, the daily average being about four or five pints. Six hours abed is as much as he gets, and he works under the influence of changes of temperature from six a.m. till twelve or one. He is a thorough muddler in his house- hold, and tells you he has had very bad luck in the shape of the erysipelas last spring, which laid him up seven or eight weeks, aud then, as he has never joined any club, he’s been badly off, and so have his family, of w’hom there are five—two at home and three out. His logic is unassailable : “If I comes to have three or four bouts a year, I gets pulled back, of course, very much.” Here is a specimen, then, of improvidence in young days, ! and of effects that might have been entirely pre- I vented ;—first of all, want; and, secondly, as a consequence of drinking, threatened apoplexy, and I disease elsewhere, which will probably give him j dropsy, and he will linger on, now better, now worse, not fit for any hard or continuous work, till, by-and-by, he enters a hospital aud dies. The next patient is a young woman with rheu- matism, followed by another trivial case, a womau (No. 50), aged forty-nine, “who feels all to pieces,” and whose side has been “ terrible bad ” these two days. She is the mother of ten children, six of whom are at home. She has “to do for” her husband, who works in the brickfields, is not kind, and has beeD away three weeks, not haviug sent her anything. She cannot go out to work because of her house; two of the children go to school. When she rests she is better, but the washing knocks her up. “She has worked hard for her children all her life, and they can’t help her much now.” Three “ no letter ” cases succeed—a case of dys- pepsia ; a laundress out of health ; a little boy four years and a half old, suflering from inflam- mation of the ear. These bring us to the case of an older boy with threatened fever,—“delirious tremors” as the mother calls it,—seven years old, who had always been a deal of trouble, and, ac- cording to the mother’s notions, is very delicate. ^ No. 57 is a married woman, aged thirty-two, who has lost her voice, and has a violent cold “all oven her.” Her husband is a labourer, out of work at present, aud she is acting the part of cook in a family. No. 58 is a womau who does not look you straight in the face, aud keeps her hands covered up with her shawl. She has all the appearance of a dram-drinker. She can’t eat, feels debilitated, aud so on, but declares that she is almost a tee- totaller. However, one must take the liberty of not exactly believing her. The day’s work finishes up with another example of improvidence. An engineer, bronchitic, aged thirty-five, married, and with a family qf three. He is out of work, and allows that he has been a drinker. His earnings have averaged 34s. to 3G*. a week ; but he has not cared to keep his club payments up, and now that illness has overtaken him he is unable to derive any benefit from former payments. You now imagine you have quite done. To chat to some sixty people, and to guess the exact remedies for each case, are no easy matters. Give them three minutes apiece, — which is decidedly below the average, — aud you will have been at work for three consecutive hours. But on your exit from the consulting-room you are beset by half-a-dozen or more of your clients, who put all manner ol questions to you about things they have “for- gotten to ask you.” One wishes just one wort] about her daughter; another shows a huge orauge- wine bottle, and wants to know whether “this is the right medicine;” a fourth puts in a claim tc know whether you said “ before or after meals, ” aud so on. Now, it is no little puzzle to recollect the exact detail you have recommended to the wlioli sixty, or heard from them. Still, this is expectec of you; and it is wonderful how easy it becomes after a little practice. You leave the hospital, am never fail to see several of your frieuds consulting over their cases, comparing notes, giving vent tc their views on the doctor, the treatment, and tin quality of the physic, with a stray suggestion tc “ ask next time for the stuff as he give me for mi cough.” Occasionally there is a dose taken it the opeu air, aud au interchange of friendly physi* between two parties (generally old women). On* never fails to get a smile of recognition, aud on* should never fail to return it. I believe this doe as much good as the physic, and gives a body to it as it were. Such is a true picture, without a grail of exaggeration. I admit the existence of intemperance in some o the applicants, but these are the minority. One ha no uccd to be harsh even if it were more frequent for sobriety is inconsistent with the want of varioa