The Atlantic Monthly, Volume 18, No. 105, July 1866

The Atlantic Monthly, Volume 18, No. 105, July 1866
Various

The Atlantic Monthly, Volume 18, No. 105, July 1866 / A Magazine of Literature, Science, Art, and Politics

THE CASE OF GEORGE DEDLOW

The following notes of my own case have been declined on various pretexts by every medical journal to which I have offered them. There was, perhaps, some reason in this, because many of the medical facts which they record are not altogether new, and because the psychical deductions to which they have led me are not in themselves of medical interest. I ought to add, that a good deal of what is here related is not of any scientific value whatsoever; but as one or two people on whose judgment I rely have advised me to print my narrative with all the personal details, rather than in the dry shape in which, as a psychological statement, I shall publish it elsewhere, I have yielded to their views. I suspect, however, that the very character of my record will, in the eyes of some of my readers, tend to lessen the value of the metaphysical discoveries which it sets forth.

I am the son of a physician, still in large practice, in the village of Abington, Scofield County, Indiana. Expecting to act as his future partner, I studied medicine in his office, and in 1859 and 1860 attended lectures at the Jefferson Medical College in Philadelphia. My second course should have been in the following year, but the outbreak of the Rebellion so crippled my father's means that I was forced to abandon my intention. The demand for army surgeons at this time became very great; and although not a graduate, I found no difficulty in getting the place of Assistant-Surgeon to the Tenth Indiana Volunteers. In the subsequent Western campaigns this organization suffered so severely, that, before the term of its service was over, it was merged in the Twenty-First Indiana Volunteers; and I, as an extra surgeon, ranked by the medical officers of the latter regiment, was transferred to the Fifteenth Indiana Cavalry. Like many physicians, I had contracted a strong taste for army life, and, disliking cavalry service, sought and obtained the position of First-Lieutenant in the Seventy-Ninth Indiana Volunteers,—an infantry regiment of excellent character.

On the day after I assumed command of my company, which had no captain, we were sent to garrison a part of a line of block-houses stretching along the Cumberland River below Nashville, then occupied by a portion of the command of General Rosecrans.

The life we led while on this duty was tedious, and at the same time dangerous in the extreme. Food was scarce and bad, the water horrible, and we had no cavalry to forage for us. If, as infantry, we attempted to levy supplies upon the scattered farms around us, the population seemed suddenly to double, and in the shape of guerillas "potted" us industriously from behind distant trees, rocks, or hasty earthworks. Under these various and unpleasant influences, combined with a fair infusion of malaria, our men rapidly lost health and spirits. Unfortunately, no proper medical supplies had been forwarded with our small force (two companies), and, as the fall advanced, the want of quinine and stimulants became a serious annoyance. Moreover, our rations were running low; we had been three weeks without a new supply; and our commanding officer, Major Terrill, began to be uneasy as to the safety of his men. About this time it was supposed that a train with rations would be due from the post twenty miles to the north of us; yet it was quite possible that it would bring us food, but no medicines, which were what we most needed. The command was too small to detach any part of it, and the Major therefore resolved to send an officer alone to the post above us, where the rest of the Seventy-Ninth lay, and whence they could easily forward quinine and stimulants by the train, if it had not left, or, if it had, by a small cavalry escort.

It so happened, to my cost, as it turned out, that I was the only officer fit to make the journey, and I was accordingly ordered to proceed to Block House No. 3, and make the required arrangements. I started alone just after dusk the next night, and during the darkness succeeded in getting within three miles of my destination. At this time I found that I had lost my way, and, although aware of the danger of my act, was forced to turn aside and ask at a log-cabin for directions. The house contained a dried-up old woman, and four white-headed, half-naked children. The woman was either stone-deaf, or pretended to be so; but at all events she gave me no satisfaction, and I remounted and rode away. On coming to the end of a lane, into which I had turned to seek the cabin, I found to my surprise that the bars had been put up during my brief parley. They were too high to leap, and I therefore dismounted to pull them down. As I touched the top rail, I heard a rifle, and at the same instant felt a blow on both arms, which fell helpless. I staggered to my horse and tried to mount; but, as I could use neither arm, the effort was vain, and I therefore stood still, awaiting my fate. I am only conscious that I saw about me several Graybacks, for I must have fallen fainting almost immediately.

When I awoke, I was lying in the cabin near by, upon a pile of rubbish. Ten or twelve guerillas were gathered about the fire, apparently drawing lots for my watch, boots, hat, etc. I now made an effort to find out how far I was hurt. I discovered that I could use the left forearm and hand pretty well, and with this hand I felt the right limb all over until I touched the wound. The ball had passed from left to right through the left biceps, and directly through the right arm just below the shoulder, emerging behind. The right hand and forearm were cold and perfectly insensible. I pinched them as well as I could, to test the amount of sensation remaining; but the hand might as well have been that of a dead man. I began to understand that the nerves had been wounded, and that the part was utterly powerless. By this time my friends had pretty well divided the spoils, and, rising together, went out. The old woman then came to me and said, "Reckon you'd best git up. Theyuns is agoin' to take you away." To this I only answered, "Water, water." I had a grim sense of amusement on finding that the old woman was not deaf, for she went out, and presently came back with a gourdful, which I eagerly drank. An hour later the Graybacks returned, and, finding that I was too weak to walk, carried me out, and laid me on the bottom of a common cart, with which they set off on a trot. The jolting was horrible, but within an hour I began to have in my dead right hand a strange burning, which was rather a relief to me. It increased as the sun rose and the day grew warm, until I felt as if the hand was caught and pinched in a red-hot vice. Then in my agony I begged my guard for water to wet it with, but for some reason they desired silence, and at every noise threatened me with a revolver. At length the pain became absolutely unendurable, and I grew what it is the fashion to call demoralized. I screamed, cried, and yelled in my torture, until, as I suppose, my captors became alarmed, and, stopping, gave me a handkerchief,—my own, I fancy,—and a canteen of water, with which I wetted the hand, to my unspeakable relief.

It is unnecessary to detail the events by which, finally, I found myself in one of the Rebel hospitals near Atlanta. Here, for the first time, my wounds were properly cleansed and dressed by a Dr. Oliver Wilson, who treated me throughout with great kindness. I told him I had been a doctor; which, perhaps, may have been in part the cause of the unusual tenderness with which I was managed. The left arm was now quite easy; although, as will be seen, it never entirely healed. The right arm was worse than ever,—the humerus broken, the nerves wounded, and the hand only alive to pain. I use this phrase because it is connected in my mind with a visit from a local visitor,—I am not sure he was a preacher,—who used to go daily through the wards, and talk to us, or write our letters. One morning he stopped at my bed, when this little talk occurred.

"How are you, Lieutenant?"

"O," said I, "as usual. All right, but this hand, which is dead except to pain."

"Ah," said he, "such and thus will the wicked be,—such will you be if you die in your sins: you will go where only pain can be felt. For all eternity, all of you will be as that hand,—knowing pain only."

I suppose I was very weak, but somehow I felt a sudden and chilling horror of possible universal pain, and suddenly fainted. When I awoke, the hand was worse, if that could be. It was red, shining, aching, burning, and, as it seemed to me, perpetually rasped with hot files. When the doctor came, I begged for morphia. He said gravely: "We have none. You know you don't allow it to pass the lines."

I turned to the wall, and wetted the hand again, my sole relief. In about an hour, Dr. Wilson came back with two aids, and explained to me that the bone was so broken as to make it hopeless to save it, and that, besides, amputation offered some chance of arresting the pain. I had thought of this before, but the anguish I felt—I cannot say endured—was so awful, that I made no more of losing the limb than of parting with a tooth on account of toothache. Accordingly, brief preparations were made, which I watched with a sort of eagerness such as must forever be inexplicable to any one who has not passed six weeks of torture like that which I had suffered.

I had but one pang before the operation. As I arranged myself on the left side, so as to make it convenient for the operator to use the knife, I asked: "Who is to give me the ether?" "We have none," said the person questioned. I set my teeth, and said no more.

I need not describe the operation. The pain felt was severe; but it was insignificant as compared to that of any other minute of the past six weeks. The limb was removed very near to the shoulder-joint. As the second incision was made, I felt a strange lightning of pain play through the limb, defining every minutest fibril of nerve. This was followed by instant, unspeakable relief, and before the flaps were brought together I was sound asleep. I have only a recollection that I said, pointing to the arm which lay on the floor: "There is the pain, and here am I. How queer!" Then I slept,—slept the sleep of the just, or, better, of the painless. From this time forward, I was free from neuralgia; but at a subsequent period I saw a number of cases similar to mine in a hospital in Philadelphia.

It is no part of my plan to detail my weary months of monotonous prison life in the South. In the early part of August, 1863, I was exchanged, and, after the usual thirty days' furlough, returned to my regiment a captain.

On the 19th of September, 1863, occurred the battle of Chickamauga, in which my regiment took a conspicuous part. The close of our own share in this contest is, as it were, burnt into my memory with every least detail. It was about six p. m., when we found ourselves in line, under cover of a long, thin row of scrubby trees, beyond which lay a gentle slope, from which, again, rose a hill rather more abrupt, and crowned with an earthwork. We received orders to cross this space, and take the fort in front, while a brigade on our right was to make a like movement on its flank.

Just before we emerged into the open ground, we noticed what, I think, was common in many fights,—that the enemy had begun to bowl round-shot at us, probably from failure of shell. We passed across the valley in good order, although the men fell rapidly all along the line. As we climbed the hill, our pace slackened, and the fire grew heavier. At this moment a battery opened on our left,—the shots crossing our heads obliquely. It is this moment which is so printed on my recollection. I can see now, as if through a window, the gray smoke, lit with red flashes,—the long, wavering line,—the sky blue above,—the trodden furrows, blotted with blue blouses. Then it was as if the window closed, and I knew and saw no more. No other scene in my life is thus scarred, if I may say so, into my memory. I have a fancy that the horrible shock which suddenly fell upon me must have had something to do with thus intensifying the momentary image then before my eyes.

When I awakened, I was lying under a tree somewhere at the rear. The ground was covered with wounded, and the doctors were busy at an operating-table, improvised from two barrels and a plank. At length two of them who were examining the wounded about me came up to where I lay. A hospital steward raised my head, and poured down some brandy and water, while another cut loose my pantaloons. The doctors exchanged looks, and walked away. I asked the steward where I was hit.

"Both thighs," said he; "the Doc's won't do nothing."

"No use?" said I.

"Not much," said he.

"Not much means none at all," I answered.

When he had gone, I set myself to thinking about a good many things which I had better have thought of before, but which in no way concern the history of my case. A half-hour went by. I had no pain, and did not get weaker. At last, I cannot explain why, I began to look about me. At first, things appeared a little hazy; but I remember one which thrilled me a little, even then.

A tall, blond-bearded major walked up to a doctor near me, saying, "When you've a little leisure, just take a look at my side."

"Do it now," said the doctor.

The officer exposed his left hip. "Ball went in here, and out here."

The Doctor looked up at him with a curious air,—half pity, half amazement. "If you've got any message, you'd best send it by me."

"Why, you don't say its serious?" was the reply.

"Serious! Why, you're shot through the stomach. You won't live over the day."

Then the man did what struck me as a very odd thing. "Anybody got a pipe?" Some one gave him a pipe. He filled it deliberately, struck a light with a flint, and sat down against a tree near to me. Presently the doctor came over to him, and asked what he could do for him.

"Send me a drink of Bourbon."

"Anything else?"

"No."

As the doctor left him, he called him back. "It's a little rough, Doc, isn't it?"

No more passed, and I saw this man no longer, for another set of doctors were handling my legs, for the first time causing pain. A moment after, a steward put a towel over my mouth, and I smelt the familiar odor of chloroform, which I was glad enough to breathe. In a moment the trees began to move around from left to right,—then faster and faster; then a universal grayness came before me, and I recall nothing further until I awoke to consciousness in a hospital-tent. I got hold of my own identity in a moment or two, and was suddenly aware of a sharp cramp in my left leg. I tried to get at it to rub it with my single arm, but, finding myself too weak, hailed an attendant. "Just rub my left calf," said I, "if you please."

"Calf?" said he, "you ain't none, pardner. It's took off."

"I know better," said I. "I have pain in both legs."

"Wall, I never!" said he. "You ain't got nary leg."

As I did not believe him, he threw off the covers, and, to my horror, showed me that I had suffered amputation of both thighs, very high up.

"That will do," said I, faintly.

A month later, to the amazement of every one, I was so well as to be moved from the crowded hospital at Chattanooga to Nashville, where I filled one of the ten thousand beds of that vast metropolis of hospitals. Of the sufferings which then began I shall presently speak. It will be best just now to detail the final misfortune which here fell upon me. Hospital No. 2, in which I lay, was inconveniently crowded with severely wounded officers. After my third week, an epidemic of hospital gangrene broke out in my ward. In three days it attacked twenty persons. Then an inspector came out, and we were transferred at once to the open air, and placed in tents. Strangely enough, the wound in my remaining arm, which still suppurated, was seized with gangrene. The usual remedy, bromine, was used locally, but the main artery opened, was tied, bled again and again, and at last, as a final resort, the remaining arm was amputated at the shoulder-joint. Against all chances I recovered, to find myself a useless torso, more like some strange larval creature than anything of human shape. Of my anguish and horror of myself I dare not speak. I have dictated these pages, not to shock my readers, but to possess them with facts in regard to the relation of the mind to the body; and I hasten, therefore, to such portions of my case as best illustrate these views.

In January, 1864, I was forwarded to Philadelphia, in order to enter what was then known as the Stump Hospital, South Street. This favor was obtained through the influence of my father's friend, the late Governor Anderson, who has always manifested an interest in my case, for which I am deeply grateful. It was thought, at the time, that Mr. Palmer, the leg-maker, might be able to adapt some form of arm to my left shoulder, as on that side there remained five inches of the arm bone, which I could move to a moderate extent. The hope proved illusory, as the stump was always too tender to bear any pressure. The hospital referred to was in charge of several surgeons while I was an inmate, and was at all times a clean and pleasant home. It was filled with men who had lost one arm or leg, or one of each, as happened now and then. I saw one man who had lost both legs, and one who had parted with both arms; but none, like myself, stripped of every limb. There were collected in this place hundreds of these cases, which gave to it, with reason enough, the not very pleasing title of Stump-Hospital.

I spent here three and a half months, before my transfer to the United States Army Hospital for nervous diseases. Every morning I was carried out in an arm-chair, and placed in the library, where some one was always ready to write or read for me, or to fill my pipe. The doctors lent me medical books; the ladies brought me luxuries, and fed me; and, save that I was helpless to a degree which was humiliating, I was as comfortable as kindness could make me.

I amused myself, at this time, by noting in my mind all that I could learn from other limbless folk, and from myself, as to the peculiar feelings which were noticed in regard to lost members. I found that the great mass of men who had undergone amputations, for many months felt the usual consciousness that they still had the lost limb. It itched or pained, or was cramped, but never felt hot or cold. If they had painful sensations referred to it, the conviction of its existence continued unaltered for long periods; but where no pain was felt in it, then, by degrees, the sense of having that limb faded away entirely. I think we may to some extent explain this. The knowledge we possess of any part is made up of the numberless impressions from without which affect its sensitive surfaces, and which are transmitted through its nerves to the spinal nerve-cells, and through them, again, to the brain. We are thus kept endlessly informed as to the existence of parts, because the impressions which reach the brain are, by a law of our being, referred by us to the part from which they came. Now, when the part is cut off, the nerve-trunks which led to it and from it, remaining capable of being impressed by irritations, are made to convey to the brain from the stump impressions which are as usual referred by the brain to the lost parts, to which these nerve-threads belonged. In other words, the nerve is like a bell-wire. You may pull it at any part of its course, and thus ring the bell as well as if you pulled at the end of the wire; but, in any case, the intelligent servant will refer the pull to the front door, and obey it accordingly. The impressions made on the cut ends of the nerve, or on its sides, are due often to the changes in the stump during healing, and consequently cease as it heals, so that finally, in a very healthy stump, no such impressions arise; the brain ceases to correspond with the lost leg, and, as les absents ont toujours tort, it is no longer remembered or recognized. But in some cases, such as mine proved at last to my sorrow, the ends of the nerves undergo a curious alteration, and get to be enlarged and altered. This change, as I have seen in my practice of medicine, passes up the nerves towards the centres, and occasions a more or less constant irritation of the nerve-fibres, producing neuralgia, which is usually referred to that part of the lost limb to which the affected nerve belongs. This pain keeps the brain ever mindful of the missing part, and, imperfectly at least, preserves to the man a consciousness of possessing that which he has not.

Where the pains come and go, as they do in certain cases, the subjective sensations thus occasioned are very curious, since in such cases the man loses and gains, and loses and regains, the consciousness of the presence of lost parts, so that he will tell you, "Now I feel my thumb,—now I feel my little finger." I should also add, that nearly every person who has lost an arm above the elbow feels as though the lost member were bent at the elbow, and at times is vividly impressed with the notion that his fingers are strongly flexed.

Another set of cases present a peculiarity which I am at a loss to account for. Where the leg, for instance, has been lost, they feel as if the foot was present, but as though the leg were shortened. If the thigh has been taken off, there seems to them to be a foot at the knee; if the arm, a hand seems to be at the elbow, or attached to the stump itself.

As I have said, I was next sent to the United States Army Hospital for Injuries and Diseases of the Nervous System. Before leaving Nashville, I had begun to suffer the most acute pain in my left hand, especially the little finger; and so perfect was the idea which was thus kept up of the real presence of these missing parts, that I found it hard at times to believe them absent. Often, at night, I would try with one lost hand to grope for the other. As, however, I had no pain in the right arm, the sense of the existence of that limb gradually disappeared, as did that of my legs also.