Be Careful In There

by Thomas Stone and William Henry Wills

Household Surgery: Or, Hints On Emergencies,
by John Flint South,
first published c. 1850, 400 pp.

An innocent-looking little book lies on our parlour-table, an extensive demand for which would imply that English households abound in perils, and are hourly at the mercy of emergencies. Harmless as it looks, its purpose is alarming. It is called “Household Surgery; or, Hints on Emergencies.” Its object appears to be to establish a surgery in every house, as Buchan introduced a Domestic Medicine Chest into every dressing-room. It is meant to arm the heads with power over the limbs of families; but it teaches masters and mistresses, husbands and wives, fathers and mothers, the theory of what they can never learn without practice; yet the very aim, end, and purpose of their existence—their prayers at night, their smallest actions by day —are all so much anxious prudence, so many fervent hopes, that they may have no practice. Happily their caution is nearly always rewarded, and their prayers granted; for although it is said that accidents happen in the best regulated families, they don’t happen often.

If staircases were precipices, door-steps glaciers, coal-cellars powder-magazines, and kitchen-ranges steam-boilers continually bursting; if shower-baths were cataracts, lucifer-matches blunderbusses, and if copper flues made a point of exploding on washing-days; if little girls preferred swallowing pins to plums, and little boys liked oil of vitriol better than almond hardbake; if half-sovereigns were coined expressly to choke little children with, and flat-irons forged only to burn fingers; if good plain cooks were seized with frequent propensities to sweeten apple-pies with sugar of lead; if carving-knives were daggers for footmen to wound inflexible housemaids with; if an impulse natural to nurses impelled them to throw babies out of window—then “Household Surgery” would be a very useful manual. But in the present mode of arranging houses, and conducting domestic establishments, the occasions for such knowledge as it conveys, occurs too seldom to provoke occasion for the book itself.

What is the use of Hints on Emergencies that only happen once in a life-time; or pages of precautions against accidents which do not afflict one in a hundred? As a linendraper won’t learn navigation in case he may be ever called on to pilot a ship; nor a tinker master pneumatics lest somebody may some day ask him to construct a diving-bell; so a gentleman in easy circumstances will assuredly not acquire the science of surgery, lest himself, or somebody belonging to him, might at some moment between this and this day twenty years break a leg. Indeed if either of these works of super-erogation were to be called into action, and drawn into either emergency, the ship would inevitably founder; the diver would be smothered, and the patient lamed for life. In operative surgery, especially, a little learning is not merely a dangerous, it is a fatal thing.

Theodore Hook’s “Cousin William” has already painted the perils of domestic medicine in the proceedings of that bold Buchaneer his aunt, who robbed everybody within her power of their health, as thoroughly as Dick Turpin cleaned out everybody in his power of their wealth: but she was a harmless nuisance compared with an Uncle Thomas, a Mr. Briggs, or an Aunt Margery, armed with a pair of forceps, a lancet, or a scalpel. Euphemia has swooned! “Open an artery!” exclaims Uncle Tom, and rushes to his textbook, ties up the arm, opens his lancet, then the vein; and lastly, being perfectly innocent of its existence—the artery below. This is a mortal injury. Euphemia lingers, and only revives after the application of much professional skill and a year’s illness.

How very straight-forward and mechanical appears the act of tooth-drawing! Mr. Briggs tries his hand on the dentals of his heir; but breaks down the gums, lacerates the cheeks, and fractures the jaw-bone of his eldest-born. Everybody supposes it easy to lance an infant’s gums, or divide, with a pair of scissors, the little membrane which holds down the tongue and causes what is called “tongue tie,” but there are blood-vessels around, which cannot be wounded without danger. Aunt Margery brings the sweetest of her nieces to death’s door by trying that very operation. The art of surgery is so much a matter of tact and manual dexterity, that even some professionals cannot always practise it with certain impunity to patients. It is not every member of the Royal College of Surgeons who can apply a common bandage with the requisite evenness, smoothness, and neatness. The hand of the surgeon should be of this peculiar character; it should combine muscular power with very great delicacy of touch. The late Mr. Listnn’s hand was likened to the trunk of the elephant. Its grasp was all powerful, but the delicacy of his touch was so exquisite, that he could lay distinct hold of the minutest object. But where is this exquisite combination of manual aptitude to be found in families? Mrs. Briggs may be very clever in picking up pins, and Mr. Briggs’s grasp has possibly all the power of a vice; but of what use are these accomplishments, unless combined, in one person, with a Listonian knowledge of anatomy, and dexterity in the use of the Lisfranc-knife, the gum-fleam, the lancet?  Yet all these instruments are committed and commended, by the author of Household Surgery, to the hands of parents and guardians (together with the probe, the scalpel, and the forceps,) as freely as if they were knives and forks—as remorselessly as if their darling “younger branches ‘ ” little locomotives were legs of lamb!

We must not, however, forget that cases and emergencies do occasionally occur in domestic life, in which some knowledge of medicine and surgery is demanded, and may be most effectually put into practice. Such are the occasions when ” a little knowledge” is not “a dangerous thing,” for we may thereby mitigate suffering, and even save human life. The line of demarcation, however, must be drawn between those cases which an unprofessional person may deal with “pro tem” and those which it would be dangerous for him to meddle with at all. “Thus far shalt thou go and no farther.” Every good housewife should know as well how to make a poultice as a plum pudding, and whether made of bread-and-water, linseed-meal, bran, yeast, treacle, or mustard, she should bear
in mind the emphatic words of Abernethy, “Poultices are either blessings or curses as they are well or ill-made.” She should have some knowledge of embrocations, she should be learned in liniments and lotions—hence, with hartshorn and oil, opodeldoc, soap-liniment, and Goulard Water, her acquaintance should be intimate. She should be able to dress a blister, put on leeches, apply poor man’s plaister, bandage a sprain, foment chilblains, put on sticking plaister, and administer other harmless styptics, including burnt and intact rag. She might also be allowed to dispense simple medicines like senna-tea, magnesia, rhubarb, Epsom salts; but we should strictly prohibit her from using opiates, mercurial preparations, including that eternal “hydrarg.” Which appears at the top of every preliminary prescription of every routine practitioner, besides iodine, and many other potent remedies which may be seriously misapplied. It should always be remembered that Medicines differ from poisons only in their doses, in other words all medicine is poison if administered ignorantly and in excess.

For advice and instruction in these harmless helps in need, the little work we are now considering will be found exceedingly efficacious. It is to the surgical operations it recommends and describes that the force of objection is greatest. The practice of domestic surgery, ought to be exceedingly limited. The idea of “Every man his own Surgeon,” which we now contend against, would be curiously absurd, if it were not a problem how far any man may be trusted to deal surgically with his own frame. Our own opinion is, that his legitimate agency is extremely contracted, and that all conceivable ” Hints on Emergencies” of that nature are entirely thrown away. We candidly confess that we see no objection to certain self-surgical operations in which men, from long practice, have, more or less, attained a certain degree of proficiency. We see not the slightest objection to the operation of shaving: a man may pare his own nails; if he be blessed with strong nerves, and a steady hand, he may cut his own corns; and if he be a stoic and don’t mind ridicule, or being mistaken now and then for an escaped convict, he may cut his own hair; but we do most emphatically protest against his setting his own broken thigh, or drawing his own teeth, or cupping himself, or reducing the fracture of his own arm; or actively treating tetanus instead of hastening to a professional surgeon, and, till then, resolutely holding his jaw. Cowper, the poet, vowed, that if any son of his ever made himself wings and flew from Exeter to Falmouth he would be excessively angry with him; the same motive for indignation would exist from precisely the same cause towards any person who should attempt on his own person any of the surgical feats we have named.

Amateur surgeons should be equally chary of their advice and interference with the limbs and diseases of their neighbours. They should not be appointed Surgeons to the household without a regular training; but in some stations and non-medical professions that training is necessary. Clergymen living in remote districts, who may not have even a village doctor to consult in a case of emergency; captains on board ships, who may be deprived of the services of their medical officers; travellers on land, especially in the East: intelligent emigrants taking their families into a thinly populated colony, should be provided with certain surgical instruments and such articles as may be found in every well-stored medicine chest. To this extent we must enlarge the prescribed boundary, and recommend that all such persons should acquire as much knowledge of household surgery and medicine as they possibly can; there is no secret mystery to unravel, for happily, the principles of medical science have been so clearly elucidated that any man of ordinary intelligence may, with application and study, soon acquire sufficient knowledge to guide him on his way to alleviate human suffering, and restore health to the afflicted. As a manual, such persons, but such only, will find “Household Surgery; or, Hints on Emergencies,” very useful.

Piece first published in Household Words, Vol II., No. 28, October 5, 1850