It is new, it is progress!

‘If the patient survives the treatment, he’ll survive the illness,’ Ephraim said. ‘But this new dosing method sounds much more efficient — and safe!’

‘Convenient, too. Regrettably some physicians condemn it as quackery,’ his young colleague replied.

‘Why? Clearly this is not watered-down plants in sugar-pills, it’s alkaloids: measured, isolated, active principles. It is new, it is progress, a God-send!

Before the month was out Ephraim wrote to the Abbott Alkaloidal Company for a subscription to their journal and got with it, free, a leather-bound pocket case containing nine vials, each filled with one hundred alkaloidal granules. Among his choices: aconitine for fever, digitalin for heart and circulation, codeine for pain, coughs and colics, morphine sulphate for pain. A month of using the method — easy to handle, pleasant, efficient, effective — and he knew this was a cause he must champion. His passion drove him to action.

When Ephraim’s medical career began in 1859, bleeding, purging and herbal medicine guess-work were the modes of healing; click here  and here for a quick time-travel back to his life as a med student. In The Last Cause (Chapter 37) Dr Epstein happens upon a new form of medication and decides this is the future of medicine. He writes letters, then articles for the company’s journal. Finally in 1895 he travels to Chicago to meet Dr Wallace C Abbott, company founder. Ephraim was right, this era saw the vanguard of today’s scientific medicine. Abbott Pharmaceuticals now is a huge international corporation. Only a couple of years earlier the Chicago World’s Fair (lit up at night in the photo) displayed the latest in electricity, machinery, transport, industry, agriculture. Medicine, too, is part of the glittering future ahead.

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Once his life as a medical student…

…had settled to a routine, the course of study at New York’s College of Physicians and Surgeons was intensive. The college had two main halls — the upper, with a skylight, was for anatomy, physiology and surgery. The afternoons saw Ephraim next door in the lab building, training in dissection and sciencemuseumukchemistry. His entire being — even that part of him committed to the Lord — was engaged, stimulated and challenged by the pace and breadth of learning. He thought of his father forbidding such worldly learning. He tried not to think of Mama at all.

In Chapter 12, Bellevue, Ephraim embarks on three years of sponsored medical study and training, finding friends and a new mentor but now severed from his wife and beloved Mama. It’s 1856-7 when advanced medicine relied on ‘heroic therapy’ — drastic treatments including purging, sweating and bleeding. Photo here is from the Science Museum, London, a case and lancet for opening a vein. It is dated 1792, but bleeding was the common treatment from earliest known history up into the later days of Ephraim’s practice as a physician.