THE HORSE & BUGGY DOCTOR

 Author : Arthur E Hertzler (MD)

 Publisher : Harper, Year 1938 to 1942 -15 printing; Doubleday, Year 1941-2 printing; Pocket Books, Year 1946; 304 pages

 

Excerpts :

( ) I once rode dozing slumped over in a cart when a large dog attacked my horse. He raised up and gave a sudden lunge forward in an effort to strike the horse. Unwarned and unprepared, this precipitated me completely behind the cart and I found myself sitting flat in the road. Fortunately this so surprised the dog that he took to his heels.

 ( ) A good many times the team wandered off and I awakened to find myself in unknown surroundings. On clear nights the North Star gave me the direction. One drove until the railway track was reached, which went east and west; and then turned right or left as the case might be. On cloudy nights nothing remained but to find a farmhouse and enquire one’s way. Usually the bellowing of dogs indicated its location long before it came into view, but those same dogs prevented approaching it. The occupant if not up by then, the Colt six-shooter invariably got response. The resident usually appeared with a shotgun in hand, but convinced that it was a doctor, help was certain, even to the extent of riding with me to locate the proper road.

( ) When afoot, these big dogs sometimes were a real menace. One night when I was walking down a road, a dog, known throughout the neighbourhood as dangerous, came tearing out and made a dive for my throat. I parried with the instrument bag I was carrying and as he started to fall backward I placed a bullet in his chest, from my six-shooter, shooting from the hip. That was fast and fine shooting and no audience to acclaim it.

( ) One night I had to cross a considerable stream which had a ‘low water’ bridge. As I crossed on the out trip the water was just flowing over the floor of the bridge. When I returned, after several hours, the bridge was no longer visible but I estimated the water had risen only about a foot, which would be easy crossing. But my horse had other ideas. He positively refused even to approach the water, so I turned around and came home by a circuitous route. Some days later an occurrence in a neighbouring town caused me to go and inspect the bridge. It was gone. The same horse saved me on two other occasions.

( ) I awoke with a start and my team was gone. There I was in a buggy on a snow covered prairie without a team. The fact was that the team had run into a snow filled ditch, the loose snow covered them completely and were quite invisible to sleepy eyes. It was necessary to take my shovel and dig away the snow, unhitch the team, push the buggy away from the ditch, hitch up again and start in a different direction.

( ) One summer I was attending a series of typhoid patients, and had been on the road almost constantly for many weeks. All the sleep I had for six days was in the buggy. I did not even have my shoes off during this time. The weather was very hot and when the time finally came when I could take my shoes off, my socks had so intimately attached themselves to the skin of my feet that they had literally to be peeled off. The next morning my feet were so swollen I had to go about in bedroom slippers.

( ) With the coming of the automobile new problems presented themselves. They were too expensive and too unreliable to make them practical. The roads were such that they could be used for few months only. Horses were terror stricken by them, becoming uncontrollable, turning back or upsetting the buggy. At night their flickering acetylene light, which could be seen for long distances, added to their terror. One had to drive into a farmyard and wait for the apparition to pass. The waiting was long as the car wheezed slowly past. After cars became more practical I acquired one with an assistant to drive. They still remained unreliable. Once I had six tyre punctures on a sixty mile trip. The old chain drive was a annoyance as the chain broke several times.

( ) Usually trips to distant towns were part train, part car and part buggy. These trips involved several days. In Jan 1916 my peak was 26 nights. The train drivers knew me and would slow down the train to 4 to 5 mph at the small town destination, which were not a train stop, so that I could ‘hop’ off.

( ) The country hotels could be divided into two classes, with or without bedbugs. I recall the worst hotel in my experience, after a five-hour ride in a mule cart in a sleet storm over frozen roads. One window pane of my room was broken, covered by a bundle of rags. The room was colder than outside. Damp from the ride, I lay down in my overcoat and pulled the frosted musty covers over me. I had put a newspaper under my vest which did some good. Because of the forbidding hotel accommodation, I preferred to spend the night at the depot with the telegrapher.

( ) In case of fracture one went out in the backyard and hunted himself a suitable board, a loose one if he could find it – otherwise he forcibly removed one from its moorings, to fashion a splint, with the aid of a bed sheet. X-rays were unknown but the results obtained by the country doctor of experience were surprisingly good.

( ) A serious and arduous problem was epidemic of typhoid fever. Cases were scattered over a wide territory. It required a great deal of time, since it was supposed that an attentive doctor would see each patient at least once a day – during the most serious period of the disease, sometimes several times a day – and stay all night at the terminal stages.

( ) The doctors of the day were not subjected to malpractice suits – there being no lawyers around- but were tried at the quilting bees (gossip of women) of the community. This made it necessary for the doctors to make a display of great activity, a show staged for the benefit of the relatives. There being no trained nurse, it fell to the doctor’s lot to do the job. It usually required one to two hours of sponging to reduce the temperature. During the summer season digestive-tract diseases were common, particularly in children, and when I was not sponging typhoid patients I was giving enemas to convulsing babies.

( ) In a case of empyema, I battled mud for three hours to reach  a call eight miles from town. As I entered the sickroom I saw a boy fourteen years of age half sitting up in bed in deep cyanosis, with grayish-blue skin and heaving chest, his mouth open and eyes bulging. It seemed that each gasp would be his last. I threw down my instrument bag, sat flat on the floor with my legs spread under the bed. Grabbing a scalpel I made an incision in his chest wall with one stab – he was too near death to require an anaesthetic. As the knife penetrated his chest, a stream of puss the size of a finger spurted out, striking me under the chin and drenching me. After placing a drain in the opening, I wrapped a blanket about my puss-soaked body and spent another three hours reaching home. The patient promptly recovered and is now a useful citizen in his town.

( ) The patient was nearly forty years of age, small, chunky. A glance indicated that a difficult job was ahead. The night was stormy. As soon as I arrived, the husband, a half wit, departed for destination unknown and I was left alone with the patient. After a delay of many hours it became evident that instruments would be required. I had no anaesthetic. The patient was in great distress and just one jump ahead of her husband in intelligence. I had to get on the bed and hold the patient’s legs with my knees and apply the forceps. I finally got a boy who grew up to be fine young man.

( ) I can scarcely think of a single disease that the doctors actually cured during those early years of my memory. The possible exceptions were malaria and the itch. Doctors knew how to relieve suffering, set bones, sew up cuts and open boils on small boys.

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Background of the book :  This is an autobiographical account written in 1938 by Dr A E Hertzler (July 1870- Sept 1946),  documenting the medical methods of the period (1890 onwards). The patients lived in the country and the doctor had to go out to visit them. There was little office practice because people used simple remedies at home until it seemed threatening and the pain became too great to bear. Tuberculosis was considered a constitutional disease and not connected to malnutrition; its patients going about merrily coughing into everyone, living cooped up in a small room with several children. Poor housing conditions gave pneumonia. Antibiotics were not yet discovered and Smallpox was the only infection curable by vaccination.   

A child being nearsighted was considered ‘dim/dumb’ instead of understanding his need of glasses. Children were neglected as was custom of the times; unless obviously acutely ill – no attention was paid. People had several children to beat the mortality rate. Children became dumpy, listless, feverish, and breathless; dying of Diphtheria with no cure.

My Take :

This is not a book of anecdotes, but a history of the medical practice in country side of America from the mid 1800s to the 1930s, written by a doctor who describes it as it was when he began, and how it changed through the years. He is thorough in his descriptions, confessing that much of his practice was ineffective in a scientific way, the best he could do in most cases was diagnose and make the patient comfortable, reflecting to the prejudices of his times.

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Subject Type - Reminiscences

Narrative Style – Excellent

Readability – Excellent

Maintaining Readers Interest – Excellent

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