Courier Democrat. (Langdon, N.D.) 1891-1920, 1907-10-31
THE HEART
OR THE LIVER?
[Original.]

tOriginal.]
A young girl in a becoming morning
gown sat in an easy chair, her head
supported by pillows. Her physician
was beside her.
doctor, you have been months treat
ing me without doing me any good,
and now you are going abroad. 1
suppose a new physician will have to
study my case all over again"
II can write out a statement of the
symptoms"
"Please do So"
The doctor wrote:
The patients symptoms are similar to
those resulting from nostalgia (homesick-
ness), religious monomania or deep seated
grief. She is troubled with melancholy,
supplemented in rare instances by spas
mode bursts of happiness. All the organs
ppear to be In a normal condition,
though it is a medical fact that an organ
may be diseased and not show the dis.
ease in itself. The symptoms in this case
are those of a diseased liver. I have ex-
amined this organ, but found no especial
indications. 1t would not be professional
in me to suggest treatment to my sue
cessor. r. M. GURNEY, NJ. D.
DR.. Tinkham succeeded DR.. Quincy,
and at his first call the patient handed
him his predecessors statement. DR..
Tinkham took out his glasses, wiped
them on a fine cambria handkerchief,
read the paper carefully and sat with
1t in his hand mlsingly. Then he fold
ed it, slipped it in his pocketbook and
wrote a prescription. When a doctor
writes a prescription it is evident that
something is being done. DR.. Tink-
hams prescription was aqua pura,
with something in it to make it taste
pleasant. 1t was to satisfy the patient
and her family till he found time to
study the matter.
The monthly meeting Of the Medical
society occurred a few evenings later,
and DR.. Tinkham stated the case to
the assembled members, reading to
them DIR. Gurney's catalogue of symp-
toms.
DR.. Spinney suggested that the pa
tient might be drifting into melancho-
liza and recommended that she be care
fully watched lest she do herself in
jury.
DR.. Thane-Brooks, liver specialist.
was of opinion that the cause was in
the gall ducts.
DR.. Kunkel, professor of ophthalmol-
ogy in st. Luke's hospital, gave sew
eralI instances that had come under his
observation wherein the same symp-
toms had resulted from defects of
vision.
DR.. Busby, kidney specialist, said
that persons suffering from diseases in
his line manifested the same symp-
toms as the patient under discussion.
DR.. Cords suggested that the trouble
lay in the heart.
DR.. Tinkham was disappointed in
not getting a unanimous opinion from
his associates and determined to de-
vote himself to studying the case and
discovering the cause if possible. The
next day he visited the patient. He
found her in n Of the conditions
mentioned by DR.. Quincy. She was in
q high state Of exhilaration. The pulse
was strong, the temperature normal.
and but for the exhilaration the pa.
tient seemed much improved. Having
asked if anything had excited her, the
doctor was Informed that nothing un
usual had occurred. She had had sew
eral visitors. but none who was not
used to seeing her often. The doctor
prescribed a sedative and went away
more puzzled than ever. Subsequently
he took several of his colleagues, spe-
~cialists, to see the patient. Each pro-
nounced the disease a result of trouble
In the organs of which he had made a
study. DR.. Tinkham gave their views
to the father of the young lady, giving
his own opinion that DR.. Thane-
Brooks, liver specialist, should be
called in for consultation. DR.. Thane-
Brooks, though no marks Of disease
could be detected in the organ, was of
opinion that the disease was there.
The symptoms clearly indicated 1t. A
vigorous course of liver treatment was
decided upon.
The patient failed to endure the
treatment. the stomach breaking down
under the quantities of medicine pour
ed into it. DR.. Vermaton, stomach spe-
cialist. remarked f%acetieusly that the
liver must be stronger than the stom-
ach and they would do we'll to look
for the seat of the disease in the latter
organ.
The case having bafled the doctors,
a trip was recommended. A trip for
incurables serves several purposes. 1t
takes the patient away from medicines,
gives change Of scene and air, and the
doctors are relieved. However, in this
case all these benefits were aborted
from the fact that the patient would
not take a trip. She persisted in re-
naming at home, subjected to the
same routine each day, and each day
growing worse.
But her physician, having recon-
mended a trip, considered himself not
further responsible. One morning he
received by the post a letter from the
father of his former patient. 1t was
very caustic:
I beg leave to inform you-and through
you the medical gentlemen who were in
terested in my daughters case-that your
nafiapf has cI1dGop1v raoovorad re 1,o,,