The duties of the physician from a woman's view

- The dueties of the physician from a woman's view (C.L.  Kent)

We are learning that plant-remedy patients, like plants themselves, are often very sensitive to stimulation from sound, smell, temperature and touch -it has even been proven that plants are also sensitive to human feelings. It is interesting to note that most of the remedies mentioned in this article about delicate sensitivities are plant remedies.
 Considering the fact that most of your patients will be women, it may be well to mention some of the things that irritate and annoy a nervous woman and often result in a change of doctors, to the surprise of the doctor first called. If you are guilty of any of the peculiarities mentioned, let us hope you will promptly reform. A patient has a hard Bryonia headache, every sound causes an agony of throbbing pain in the back of the head; the doctor comes up the stairs with a pair of heavy shoes that squeak at every step; the patient vows then and there that never again will she call that doctor.
 Another instance of the carelessness of the doctor was shown in the case of a patient that had been sick two months, unable to leave her bed, extremely sensitive to touch. The doctor picked up a newspaper that was on the table and when he was finished looking at it tossed it lightly on the abdomen of the patient. She saw it coming and screamed at the same time placing both hands over the body to protect herself from what to her was a dreadful blow. She said to the doctor: "Don't ever do that again, you nearly killed me." The doctor laughed in his pleasant way and said: "Oh! that's nonsense" but the patient had no sleep that night and was much worse the next day.
 A doctor may throw away his cigar or put his pipe in his pocket before going to the patient's room, but her Ipecac headache is much aggravated by the smell of dead tobacco smoke and she says to her aunt: "Don't let that man in here again when I have one of these headaches or I shall be sick all over the bed."
 A patient telling the doctor about her aches and pains, and how hard her head aches when she has to walk in the open air, is interrupted by the doctor telling of a headache he has just had with the aggravation from going into a heated room, concluding with the remark that the patient has her room too warm and it would be better to let in a little fresh air. The patient is not interested in her doctor's symptoms nor his headaches; she wishes to tell her symptoms and not be compelled to listen to his, and what is more she had a Nux headache and needed the hot room to ameliorate the pain and his suggestion that the window should be opened to let in a little fresh air only made her mad after the manner of a Nux patient. The doctor's personal affairs, especially his symptoms, are of absolutely no interest to a patient; she waits with a thinly veiled impatience for him to finish, thinking all the time how sick she feels and hoping he will soon give her something to make her feel better.
 A rocking chair has been productive of much nausea and vertigo by the doctor's rocking back and forth without thought of the effect it would have on his patient. The patient feels as though she were in a boat on very rough water and with every rock back and forth she grows worse, and hurries the telling of her symptoms to get through with the doctor and the rocking chair. When the doctor makes his next call at that house a straight chair will be placed for him. A patient's bed may be so situated that it faces a window.
 It may be necessary for the doctor to raise the shade to see the patient's face, but he should not let it fly up with a click such as would startle a well person and he should lower that curtain or see that it is lowered before leaving the room, as the mother or sister may leave the room with the doctor to talk over the patient with him and the patient is facing that bright light with nerve-quivering pain in the eyeballs growing rapidly worse, unable to raise herself from the bed and it may be two hours before anyone has time to run up stairs to the patient's room to see if she is comfortable and to pull down that shade. Sometimes the doctor cracks his finger joints in an absentminded manner while listening to his patient, or he will have a little rubber band which he will snap at regular intervals and these things nearly bring a nervous patient to her feet at every crack of the finger joints or every snap of the rubber band. One patient expressed it, "Every snap of that rubber band seemed to hit me right in the back of the head." I have noticed that some of the students of this college have acquired the rubber band habit.
 A profane man can have no more idea of the sentiments of a gentle, highly religious woman than can a lobster. -J. T. Kent
 Dissolving a powder in a glass of water need not be made a torture to the patient by the doctor's stirring that powder round in the glass, hitting the side of the glass with the spoon at every round, until the patient is threatening with vertigo; this may sound like an extreme case of nervousness, but she is only a sensitive woman. Let the doctor turn away from the bed to do his mixing so that the patient in her highly wrought nervous state does not find it necessary to watch his every movement.
 You will often be asked to say what foods should be given the patient. Because one likes milk is no reason why all patients should thrive on that food; milk is to some patients the most nauseating food that can be mentioned, and to insist that all patients will get well faster on a milk diet than on any other food is foolish and sometimes a cruelty. Mutton broth may be a delicious diet to one, and to another quite the reverse, and this will apply to almost every article of diet usually recommended for the sick. The homoeopathic physician makes use of the desires and aversions, the aggravations and ameliorations, as a basis for the curative remedy. The old adage that "What is one's meat is another's poison," is based upon the universal law of similars. In acute disease the language of the patient for acids, pungent things, sweets and water are to be gratified. In chronic diseases the longings of the patient are to be restrained; in the latter, longings for tea, coffee, pungent things, acids, beer, wine and alcoholic stimulants are symptoms of great importance, often furnishing valuable aid to the discovery of the needed medicine. In a chronic sickness when the patient takes coffee and tea, though he does not long for them and could easily give them up, it is not so important that he discontinue their use unless the remedy selected for him is antidoted by tea or coffee. When he longs for these substances and feels that he cannot do without them, they are acting with him as a stimulant, or as a crutch, and will in most cases prevent symptoms from manifesting themselves as an index to the remedy he requires. We know that hard drinkers crave their whiskey, and old coffee drinkers declare they cannot do without their coffee, and so it is with all habituated beverages. As long as these longings are supplied, no benefit need be expected from treatment. It is true that patients often become miserable when discontinuing their beverages, and at such times the physician can be of the greatest service; the selected remedy will now take the place of his crutch and correct his morbid desires. What the patient shall eat and what he shall drink must be selected with due regard to the remedy he is taking and his own constitutional demands; this will become more important to you after you have sufficiently observed the wonderful powers of medicines upon the sick.
 When your patient is under the influence of either Carbo vegetabilis or Pulsatilla you will learn not to be surprised if the stomach becomes wonderfully disordered after eating fats or greasy, rich food; when your patient has been many days under Bryonia, Lycopodium, or Petroleum, and she comes in and complains of an unusually disordered stomach, you may often hit the nail on the head by saying: "You must have been eating cabbage." Those who have been drinking coffee a long time without any disturbance or wakeful nights will report to you that your medicine has caused them much disturbance of the nervous system, and they come in to ask about it: you look up the record and find you have given them Chamomilla or Nux vomica and will be compelled to request your patient to discontinue coffee at once. Coffee must never be used when Chamomilla or Nux vomica is the remedy. It would be equally true if you were treating a nervous paralytic with Causticum. Again it is often very important to warn patients against indulging in cold or frozen foods after giving Arsenic, Lycopodium, Nux vomica, Rhus t. or Pulsatilla. It is well to warn patients under the influence of Thuja to avoid onions and fats, or when under the influence of Lycopodium to avoid oysters for a while. You should not be surprised when patients tell you that they have suddenly become disturbed from drinking milk if under the influence of Calcarea, Nitric acid, or Sepia -and be sure to warn patients under the influence of Antimonium carb to avoid sour things, vinegar and sour wine. Be sure to tell mothers whose children are under the influence of Ignatia or Argentum nitricum to keep candy away from them, or you will have disordered stomach and diarrhoea to contend with which may interfere with the management of deeper seated troubles. Be not surprised if the patient under the influence of Ipecac or Kali nitricum should become distressingly sick with nausea and diarrhoea from eating veal. Occasionally you will meet with over-sensitive women who get all sorts of complaints, headache, anxiety, heat and other nervous phenomena from eating and drinking warm food; they want most things cool; it is well to bear this in mind when patients are under the influence of Lachesis, Phosphorous, or Pulsatilla. All these phases regarding food and drink are idiosyncrasies; from traditional medicine these have received no sympathy; they have been called nervous, finical and even at times hysterical or whimsical, but it should be remembered that idiosyncrasies are only states of susceptibility, and without susceptibility there could be no Homoeopathy. The relation of similitude between a homoeopathic remedy and the patient might be called idiosyncrasy or homoeopathicity; the study of idiosyncrasies is only the study of the degrees of similitude varying in intensity in accordance with the tension or relaxation in different constitutions. Despise not the small things because they often furnish the deciding features between convulsions, and the life of a woman is made of small things. These patients are women; many of these patients are very sensitive women; if you succeed with them they will continue as your patients and introduce to you increasing opportunities for usefulness; all sensitive women have been buffeted by traditional medicine, and when once they find a homoeopathic physician that fully appreciates woman's sensitivity to indicated medicines, to kind and prudent attention, to honorable sympathy, they become supporters of Homoeopathy because it is the first medical counsel in the history of the world that has ever given them physical tranquillity.
 The doctor must sometimes seek information of the most secret character to fill out the contour of the sick image, but never to burden himself with secrets, and hence it is wise to parry all that cannot be used for the good of the patient. The prudent doctor will never talk about his patients, or their complaints, or his wonderful cures. I once heard a man say about a doctor whom he had just consulted "I would not call that doctor to my family, he talks too much about his patients." To attend to all business promptly, politely, earnestly, quietly, patiently, and with dignity should be the doctor's endeavor; for him to do more would be extraordinary, unexpected, useless and often mischievous.
 In managing nervous women it is often necessary to answer them evasively. They frequently ask the doctor, "Am I hysterical?" to which it would be well for the doctor to answer, "Scarcely that, but your nerves are in a fret." It is quite true that she knows she is hysterical and that the doctor thinks so, but if he admits it he will offend or at least interfere with his own government. This woman must be given latitude, and as long as the doctor has not called her hysterical she will proceed to reveal symptoms of far greater expression, she will use the freedom given her until her symptoms fully represent the nature of her sickness. This patient must never be reprimanded or restrained until everything in the nature of her case has been revealed, which may require many visits as she will cross and re-cross her statements, some of which are true and some imaginary. The course to be pursued when the time has arrived for treatment cannot be predicted during the series of examinations.
 Let me say a few words about your attitude toward your patient's household. You will often be invited to stay and dine, or you will be given a lunch at midnight when called to an all night case, and one of the ladies of the family will remain with you at table to see that you are well served. If after stirring the sugar in your tea or coffee you leave the spoon in that cup instead of placing it on the saucer where it belongs, and the maid hits that teaspoon while waiting on the table, the fluid in the cup will be spilled all over the tablecloth or on the dining room rug, to your great mortification and the vexation of your hostess. While in camp last summer, our guide gave us an example of the disagreeable use that may be made of a knife. It is almost incredible that even long practice should have enabled him to load that knife from the tip to the handle and carry the food to his mouth. We had forks, good ones, too, but he preferred the knife. He spoiled many a meal for me until I learned to take my share and sit behind him or turn my back to the fire. When we go north next summer we will not employ that guide.
 A lady of prominence and unusual refinement once said she wished she could find a physician who could prescribe as well as her old doctor, as she would be glad to make a change. She was satisfied with his prescribing but his personal habits were so objectionable. Upon inquiry it was revealed that while taking an evening luncheon at her house he had picked his teeth with a toothpick while at her table. This woman was willing to put up with moderate prescribing if she could only find a gentleman. Much is said to the children of a family about wiping their feet on the door mat, placed there for that purpose. One little boy on being reprimanded more severely than usual said: "I just saw the doctor walk right in without wiping his feet and he made tracks as big as a bear all over the hall and all the way up stair." For this offense a doctor need not be surprised if he forfeit the family to a more thoughtful competitor.
 A good woman desires to be secure against the misapprehensions of her doctor. Let her say what she may and keep her at ease so she may be free to express her inmost feelings without fear of being misunderstood. A woman expects that her doctor will listen to her symptoms, no matter how whimsical, with a reverential respect. Do not force her to mask her symptoms by cramping her speech, which she will always do if she cannot repose full confidence in her doctor. Let the doctor jestingly turn her careless word into the borderland of Rome and forever after he may guess at her symptoms until, failing to cure, he finds a more sincere man, and likely a less skillful physician, in charge of the family. If the discharged physician ever hears a reason for it, it will most likely be that "he was too coarse."
 One of the poorest prescribers may secure a large business if he is happy and cheerful in the sick room without overdoing it, and firm without brusqueness, commanding without being over-bearing, sympathetic to the extent of kindly thoughtfulness, and yielding when principle is not involved. How much better should the physician do who joins the skill with tact!
 If the young physician has learned the science and art of healing he may acquire tact by taking lessons from his wife, who should be able to see how much he lacks of being a well-rounded figure in his chosen profession.
 The Dunham may train you in the science, but a woman can teach you to grow increasingly useful and commanding among the figures that move in the world of science, art and society. Neglect neither opportunity, partnership nor tact, and the doctor may become a friend, adviser, and citizen in this country and his departure cause a lamentation to be long maintained.
 (As taken from the Journal of Homeopathics Volume 5, 1901.) In 1901, Clara Louise Kent, MD, lived in Chicago with her husband, James Tyler Kent, MD.