We sat in solemn conclave for over an hour, discussing the pros and cons of the case, and then, having decided upon the course of treatment, we took our departure. Some days later we were again sent for, and found our patient in great pain, and the whole house crowded with his innumerable friends, who had hurriedly come together at the rumour of his approaching death.

Our patient was in a very excited state, angrily refusing the consolation offered by his disciples and friends, and violently shouting, "A thousand tomans (200) to any one who can take away this pain." Then, as he felt an extra bad twinge, "Ten thousand tomans to any one who will cure this pain" (about 2000).

However, we soothed him, injected a little morphia, a.s.sured him there was no immediate danger, and as the sedative commenced to work, and the pain disappeared, with it went all thought of rewarding his benefactors: on the contrary, he took extra trouble to explain how poor a man he really was, and that it was due to the malice of his enemies that rumour reputed him wealthy. However, to cut a long story short, by means of a simple operation, and much patient care and attention on the part of Dr. Aganoor, he ultimately made a good recovery, and was really grateful, using his influence afterwards rather to restrain than augment the anti-European fanaticism of his other two brethren. Later a nephew of the chief mujtihed, himself a mullah, actually consented to come into hospital to undergo an urgently needed operation, and this proving successful, gained for us another staunch friend from priestly quarters, whose friendship stood us in good stead on another occasion which might have ended rather differently, but for his intervention. A few months had elapsed: rumours still reached us from the city of occasional attempts made to stir up the fanaticism of the people against us, the chief offender being the third and youngest brother of the mujtihed before mentioned.

One day Dr. Aganoor and I were both sent for in a great hurry. We heard that the whole city was in an uproar, that this fanatical mullah had been poisoned, some said "by order of the Shah," others that the governor had asked him to a feast, and as he returned, ere reaching home, the symptoms had started; others that the women of his "anderoon"

(quarter of the house in which no man but the husband may enter) had given him "oil of bitter almonds" by mistake. On approaching the house we found a crowd round the door, and the house itself packed with disciples and friends of the great man. We were hurriedly shown into a large hall, with marble pillars and floor, densely crowded with a ma.s.s of human beings, all engaged in watching the last gasps of the poor mullah, who was lying on a pile of carpets stretched on the marble floor. We learnt to our dismay that he had been unconscious for four hours, and apparently precautions had been taken that the English doctors should not be called in until that amount of time had elapsed. Before that intent, silent, fanatical crowd, we did all that could be done to save the life of the man who had been our bitter enemy, taking turns to perform artificial respiration, &c., but all in vain, for, as in my turn I worked the dying man's arms, he took his last breath, and I whispered Dr. Aganoor that all was over. It was getting towards midnight. Julfa was three miles distant, and we were alone in the midst of that fanatical crowd. Well did my colleague know that once the intimation was given that the end had come, the scene would baffle description; the whole city would be roused, and our lives might even be in danger; knowing these things, he whispered me to go on performing artificial respiration while he got ready to go. So I went on with my task, working the dead man's arms until all was ready for our instant departure. Then reverently folding his hands on his breast, I drew over his face the coverlet, as an intimation that all was over. I never again wish to hear such a yell as then arose from the throats of that great throng. Doors were flung open, the mob from without rushed into the room, women poured in belonging to the dead man's household, shrieking, wailing, tearing their clothes and hair. Some of them made a wild rush at us as they pa.s.sed, and it really looked a bit serious, for already amidst the uproar we could detect occasional cries of "The Feringhis have poisoned him." To my relief, amidst the excited throng I noticed the face of my old friend the mujtihed's nephew, who had been an in-patient in the hospital, and when he noticed that I had observed him, he beckoned us to follow him. We obeyed gladly, and he led us away by a private pa.s.sage, which finally emerged into a public square a long distance from the dead man's house. There our good Samaritan left us, promising to send us our horses and servants, whom we had left waiting outside the patient's house. As we waited for them to come, we could hear the sound of cries from all parts of the city, followed by wailing of women, and the scurrying of many feet, as all flocked to the quarter where the holy man's body lay. At last our servants and animals arrived, and we made haste to escape, reaching home after midnight, thankful to G.o.d for preserving us from what might have proved a very dangerous position. Next day we heard that the whole city had gone into mourning; all the bazaars were shut, and the shops draped with black, and this mourning was kept up five whole days. Rumours were persistently circulated that the English doctors had poisoned the mullah, but no one really believed it, and I was able to attend the city dispensary as usual, even during the funeral ceremonies, and patients rather increased than diminished, some of the dead man's relatives even coming for treatment.

So ended priestly opposition; the chief mujtihed himself was frightened at the mode of his brother's death, and kept very quiet, for fear, perhaps, that a similar accident might happen to him. His surviving brother and relatives were now quite friendly, and a few years later Dr. Carr was able to obtain ground and build an excellent hospital in Isphahan itself, welcomed alike by officials and priests. There is also an excellent Women's Hospital (C.M.S.), in charge of Dr. Emmeline Stuart, who has for many years given her life to work amongst Moslem women, and whose name is held dear by many a poor Persian village woman, who has found relief and loving care at her hands, and those of her staff.

CHAPTER XIII

PIONEER MEDICAL MISSION WORK IN KERMAN [3]

Pioneer Medical Mission work in Kerman--Waiting for drugs and instruments--Native a.s.sistant proves a broken reed--First operation in Kerman--An anxious moment--Success--Doctrine of "savab" convenient to the Moslem--Fanaticism tempered with prudence--Opium slaves--Persian therapeutics--Persian quacks and their methods--Sure way of curing cancer--Hysteria.

"Charms for lovers, charms to break, Charms to bind them to you wholly, Medicines fit for every ache, Fever and fanciful melancholy."

R. Bridges.

We had been appointed to open a Medical Mission in this city, and as soon as our temporary residence in Isphahan was finished, proceeded to our original destination. We arrived at Kerman early in 1901, and received a hearty welcome from the only other European there--the Rev. A. R. Blackett, also of the Church Missionary Society. Two houses were secured, both outside the city wall; in one we took up our residence, while the other was made into a dispensary, and small temporary hospital. Unfortunately we arrived before our supply of drugs and surgical instruments, so we had to do our best with the very small stock of medicines borrowed from our stations in Isphahan and Yezd. However, patients began to come in large numbers, and the out-patient department was soon in full swing. We had brought with us from Isphahan two Armenians to act as a.s.sistants, one for dispensing, the other (a man who had been employed in the Mission for many years) to interpret and help generally in the work. I had hoped much from this last-named a.s.sistant, and had relied upon him greatly for advice and help, as he had been in Kerman before, and knew the people; but I soon found him a "broken reed." He was married and had a large family, which he had been obliged to leave behind in Isphahan, and very soon he began to show signs of home-sickness. Then he commenced to imagine himself ill, and developed symptoms of different ailments. In the first place he one day came to me with a woeful face, and besought me to carefully examine his chest, for he was convinced he was developing phthisis. After being rea.s.sured on this point, he became absolutely sure that he had heart disease; next his kidneys troubled him, and so on, until he became a confirmed hypochondriac, and completely useless for work. One day I remember his coming to me imploring that I would inject morphia to relieve him of the intense pain from which he was suffering. I gravely took the hypodermic syringe, and carefully injected distilled water, and the pain disappeared with lightning rapidity!

However, I had to send him home, and I believe that, once safely reunited to his family, he at once lost all his symptoms, and was able to resume his old work at the hospital.

In the meanwhile my surgical patients were clamouring for operations, more especially those afflicted with cataract. I had opened another dispensary in the city itself, and many poor blind people had come for treatment. It went to one's heart to have to send them away day after day with the same disheartening story. "The instruments have not yet come; until they arrive, nothing can be done." I fear that many commenced to think that the English doctor was a fraud, and that his excuses concerning the instruments resembled those framed by their own "hakims" to hide their own ignorance. At last the boxes actually arrived. They had to be brought by caravan from Bushire (the port in the Persian Gulf) to Kerman, via Shiraz and Yezd, a distance of some eight hundred miles, taking a couple of months.

We admitted our first in-patient, a well-known merchant in the city, who had been blind for three years with cataract. The Persian surgeons also operate for this disease, using the old Eastern operation known as "couching." An incision is made into the white of the eyeball (without any anaesthetic), then a thick, blunt probe is worked into the interior of the eye, directed so as to dislocate the lens. If successful, the lens drops back into the posterior chamber of the eye, and the patient "sees," but alas, the vision obtained is, in ninety-eight cases out of a hundred, only temporary! Twenty-four hours later, inflammation of the eye supervenes, and the sight is gone, and the eye lost. Needless to say, the operator obtains his fee either before the operation is done, or during the few hours that his patient is rejoicing in his newly found vision; then if he is wise he disappears from the town, and resumes his practice elsewhere. However, during eight years'

practice in the East, and having had the opportunity of examining thousands of eyes, I can remember two cases only where this operation had been done and there had been no subsequent inflammation, but the great majority of eyes are lost.

Well, we had our first Kerman cataract patient, and it seemed to us as though the whole future of the little pioneer Medical Mission depended upon the success or failure of that operation.

The day fixed for the operation arrived: a Persian doctor practising in the city had requested leave to be present, no doubt on behalf of the many friends of the patient, to report particulars and see fair play. The patient was brought in, looking exceedingly nervous. After a short prayer (a practice almost invariably adopted in medical missionary hospitals, and much appreciated by the patient, even though he be a fanatical Moslem), the operation was started. I am afraid we were all unduly nervous, the possible consequences for good or ill to the Mission a.s.suming undue proportions. At any rate everything went wrong; the cocaine (used as the anaesthetic) would not work, the old man could not keep his eye still, and would look up when he was told to look down. I was only able to complete the incision, and that with the greatest difficulty; and fearing to proceed further, the patient getting more and more excited, I had reluctantly to postpone the operation for a couple of days. We all felt very depressed, except, perhaps, the Persian "hakim," who doubtless greatly relished the failure of the English doctor. However, two days later we tried again, the Persian hakim once more being amongst the spectators. Much prayer had been offered up that this time there might be no hitch. Everything at first went well; the patient lay quite quietly, moved his eye exactly as he was told, the cocaine proved satisfactory, the incision was remade, and other preliminary steps in the operation disposed of: then came the hitch. In the European method of operating for cataract, the opaque lens is extruded from the eye by gentle pressure, through the incision first made. Well, when the time came for the lens to be extruded, it would not budge! I tried all possible means of extraction without success (afterwards I discovered that adhesions had formed between the lens and the curtain of the eye, as a result of the first operation). The perspiration ran down my face, as I realised what this second failure meant, not so much for my own reputation, but the hindrance it would prove to the success of the work I loved. I glanced at my wife: she was looking very anxious. I looked at my a.s.sistants: their faces were pictures of dismay. They had seen me before in Isphahan do many a cataract, and could not imagine what had gone wrong. The Persian doctor looked particularly happy: he smiled as he politely expressed his sorrow that I was experiencing any difficulty in bringing the operation to a successful issue. It certainly was an awkward fix--perhaps the most awkward that I have ever been in; but as I lifted up my heart in silent prayer to G.o.d, asking for guidance, the thought flashed into my mind, "The man has both eyes blind: you have failed with the one; do the other at once, and it will prove successful."

Gently covering the eye that had proved a failure, I explained matters to the patient, obtained his permission, thoroughly cleansed his other eye, and proceeded to operate, meeting with no difficulty and easily extracting the lens, to the palpable disappointment of my Persian medical friend, and was overjoyed to find that the patient old man had obtained exceedingly good vision. After a week the patient went back to his friends, seeing well, and full of grat.i.tude for all the kindness and care he had received. I saw him some months later, and inquired whether he cared to let me have another try at the eye that had proved unsuccessful; but he refused, saying he was an old man, and had obtained good sight with the one, and did not need to see with the other. Of course the result of this first operation had been anxiously awaited by many, and since it proved successful, we soon had our little temporary hospital full, and had no further trouble in getting in-patients. I have described this case rather fully, avoiding technical terms as far as possible, as it ill.u.s.trates fairly well the difficulties and responsibilities met with and tackled by pioneer workers, be they missionary or official.

The Persians (especially the Kermanis) have a great idea of doing "savabs" (good works), hoping to reap their reward hereafter. This is common to the West as well as the East; but the Kermanis in addition hold a convenient doctrine, namely, the appropriation of the savabs of infidels for themselves! At least one of the chief mullahs in Kerman surprised me somewhat by the cordial reception he accorded me; but later said, "How glad he was that I had come to Kerman and was doing such 'good works' amongst the sick and poor, as hereafter G.o.d would credit the true Moslems with all the savabs done by infidels, who of course could derive no benefit at all from their performance."

As Kerman is a city proverbial amongst the Persians for its great wickedness, I could understand the old mullah's satisfaction, as doubtless he felt that many of their savab accounts were rather low and needed a trifle of "credit," which might with advantage be obtained from the savabs of an infidel doctor!

Once yearly the Persians celebrate the death of the martyrs Ha.s.sain and Hussein, as has already been described in a previous chapter. We had a good opportunity of witnessing this Persian Pa.s.sion Play while in Kerman. The sword-dancers, clad in white garments, work themselves up into a frenzy, gashing their heads with the swords and sometimes inflicting severe wounds. A true believer is supposed to have his self-inflicted wounds healed spontaneously through the agency of Hazrati Ali (grandson of the prophet Mohammed); but I was a little amused by the appearance of several of these devotees at my out-patient clinique some days previous to the "celebration,"

all of them begging for a little English ointment to keep by them for use in case miraculous healing should be delayed.

As has been already mentioned, the curse of Kerman is opium; everybody smokes or eats it--generally the former. The native doctors are partly responsible, as they recommend the drug as a "cure-all"; but even the cultured Kermani smokes opium, possibly to relieve the monotony of his life! Cases of poisoning repeatedly occur, and some of these we were called upon to treat. Our dispensary had a small garden attached to it, and when the Mission had gained the confidence of the people it was no uncommon sight to see several opium patients being treated at the same time in this garden. The treatment used, though somewhat vigorous, proved very effective. A man would arrive at the dispensary, escorted by an excited throng of relatives. On inquiry we would find that he had taken a big dose of opium to end his life: afterwards repenting, he had confessed to his relatives, and they had at once brought him to the English doctor. The treatment began with the administration of a strong emetic followed by repeated doses of strong coffee; then he would be handed over to the care of an attendant, with instructions to walk him round and round the garden and prevent his going to sleep. The native a.s.sistants and the patient's friends, armed with sticks, carried out these instructions, and at the first signs of languor exhibited by the unfortunate man he would be beaten and kept effectually awake!

One day I was summoned in haste to the house of an influential Kermani; his only son, a child of two years, had been poisoned with opium. It is a common practice in Kerman for mothers to keep their babies from crying by giving them a little opium to suck. This boy's mother had given him a big lump by mistake, and grew alarmed when she found that all her attempts to wake him were ineffectual! On arriving at the house with my a.s.sistant, we had considerable difficulty in making our way into the courtyard, as it was thronged with all the relatives and friends; the neighbouring houses were crowded, a great mult.i.tude thronging the flat roofs, which commanded a good view of the courtyard belonging to the patient's father. On examining my little patient I found him nearly dead, exhibiting all the symptoms of an overdose of opium. However, for over an hour we worked away, washing out the child's stomach, injecting strong coffee, &c., all in the open air before the excited mult.i.tude, and gradually the little patient showed signs of recovery. When he had come completely round and was crying vigorously, there was great rejoicing. Thinking the opportunity too good a one to be lost, I asked my a.s.sistant to tell the father that G.o.d had heard prayer and restored him his child, and that we would now like him to join with us and thank G.o.d for answering our prayers, if he would tell the crowd what we intended doing. Although the father was a mullah, and had the reputation of being very fanatical in his hatred of Christians, he at once consented to our proposition, announcing to the crowd our intention. During the short thanksgiving prayer every head was bowed and not a sound of protest heard, while Christian and Moslem alike returned thanks to the great G.o.d who had heard and answered prayer. Medical Missions had once again won a triumph over Moslem fanaticism, and the scowls and threatening looks which had greeted our arrival were replaced by cordial thanks and vehement expressions of grat.i.tude!

Persian therapeutics are very simple, dating back to the time of Hippocrates. All diseases are divided into two cla.s.ses--hot and cold--to be treated accordingly with hot or cold remedies. All foods are similarly cla.s.sified. With this knowledge, plus a few Persian medical books and an appropriate turban, the native quack sets up as a doctor. His impudence and native wit are inexhaustible; he will cheer his patients with extracts from Hafiz or Ferdosi (the great Persian poets), talk learnedly of vapours, and have a specific for every mortal ailment. The quack physician is amusing, and probably confines himself to fairly harmless compounds; but the Persian surgeon is a man to be avoided at all costs. Of course, I am only here speaking of quacks; in Teheran there is a good medical school, and many of the graduates from that school proceed to Paris or Berlin, and return fully qualified to exercise their profession; but they also have to compete with these native quacks.

I remember one case of a poor man brought to the dispensary with a big swelling on the left knee, which prevented his straightening the leg. Careful examination convinced me that the case was one of malignant cancer of the thigh bone, and that nothing could be done but amputation. This was explained to the patient and his father, who indignantly rejected the proposed operation. I lost sight of the man, but some weeks later one of my a.s.sistants asked me if I remembered the case; on my replying in the affirmative, he informed me that the patient had since died. It seems after leaving the dispensary the father had taken his son (a young man twenty years old) to a native surgeon (who combined the exercise of his profession most appropriately with the trade of a butcher) and asked his advice, saying the English doctor had advised amputation of the leg; but he had refused, as the swelling caused little pain, and all his son wanted was to be able to straighten his leg so that he might once again walk. "Oh,"

replied the butcher, "that's easily done; that English doctor knows nothing; I will cure him." So he got the father and other men to hold the unfortunate youth firmly and some other helper to seize the leg; then seizing a huge slab of stone in both his hands, he brought it down with all his force on the bent knee. The leg was straightened ... and needless to add, the poor patient only survived a few days.

My wife has written quite sufficient about the Persian women to enable her readers to appreciate the monotony of their lives behind the veil. This is more especially true of the upper cla.s.ses, who have no need to work for their living. In Kerman the usual result is that many of these poor women suffer from hysteria. I have often been called in to treat some of these patients, and have found them develop almost all the varying types of that curious disease; but one of the most interesting cases I ever remember occurred in Kerman.

I had been treating the unmarried daughter of one of the wealthiest men in the city, and had prescribed for her some simple bis.m.u.th mixture, as she had complained of indigestion. Two days later her brother came galloping his horse to the dispensary, and demanded to see me immediately. He was greatly excited, and said that his sister had been taking the medicine I had prescribed for her and had suddenly gone blind. This was in the early days of the Medical Mission, and I was especially anxious to win the confidence of the people, so did not at all appreciate this complication. I a.s.sured the brother that I would return with him at once, and informed him that the medicine could not possibly have caused the blindness; but he was not at all appeased. Upon reaching the house I found all the family distracted with grief, and not at all inclined to be cordial. Moreover, they had called in a native eye-doctor, who had gravely announced that the blindness was most certainly due to the patient having taken the infidel's medicine! In order to rea.s.sure the parents I bade them bring the bottle of medicine, and, finding there were still two or three doses left, called for a gla.s.s, poured out the remainder, and drank it. This seemed to rea.s.sure them partially, so they allowed me to examine the girl. She was a nervous, highly-strung patient, and I had expected to find that she had been malingering; but to my surprise, upon thorough examination I convinced myself that she had really gone blind. Examination of the interior of the eyes showed no disease, and upon inquiry, finding that she was the subject of periodical hysterical attacks, I ventured to predict to the parents that with suitable care and supervision the girl would regain her sight. They were still inclined to be sceptical, but ten days later I heard that my prediction had come true and that she was quite cured. Similar cases of hysterical loss of vision are on record, but are exceedingly rare.

Barely had we managed to get the little Medical Mission well started when circ.u.mstances connected with my wife's health arose that forced us to leave at a moment's notice the people we had learnt to love. Fortunately the work was not given up; another doctor succeeded me, and now there is a flourishing Medical Mission with two hospitals, one for men and the other for women patients, with a lady doctor and nurse; while the influence exerted by that Mission is felt throughout the whole of the great Kerman province, which stretches eastwards to the border of Beloochistan, and is bounded on the south by the Persian Gulf.

CHAPTER XIV

MEDICAL MISSION WORK IN YEZD [4]

A hospital--A friendly governor--A suspicious case--Superst.i.tion--The opium habit--A case of cataract--We return to England.

"By medicine life may be prolonged....

With the help of a surgeon he may yet recover."

Shakespeare.

The last of our three years' sojourn in Persia was spent in Yezd. Here there was already a small Mission Hospital, all the pioneer work having been done by Dr. White of the C.M.S. A wealthy Pa.r.s.ee merchant had presented the site for a hospital in the form of an old caravanserai (an Eastern inn). This had been gutted and made into a nice little hospital, with an out-patient department. Dr. White being on furlough, the doctor taking his place in Yezd exchanged with me, as it was hoped that my wife would be able better to stand the lower alt.i.tude of Yezd than the heights of Kerman. Yezd is an island city in a sea of sand. The waves, driven by the winds, surge against the city walls and threaten to engulf the whole place. At some parts of the wall, the drifted sand reaches almost to the level of the wall itself.

The Governor of Yezd during the time we lived there was H.R.H. Jalal-el-Dowleh, the eldest son of the Prince-Governor of Isphahan (the Zil-es-Sultan). The Jalal-el-Dowleh had the reputation, like his father, of being a strong man, and ruled with a firm hand. He had already proved a good friend to the Mission, and was accustomed to pay a state visit once yearly to the hospital, where, after being entertained at the doctor's house, he would proceed to make a very thorough tour of inspection, and before leaving would hand the English doctor a sealed envelope containing the munificent sum of 40 as a donation. During our stay in Yezd we saw a good deal of the governor, and I had to add to my duties those of court physician.

In Yezd, as in other Persian cities, there are many quacks, who not unnaturally resent the presence of a European doctor. I had not been long in the city before I made the acquaintance of some of these gentry, in a somewhat dramatic manner.

Early one morning I was hurriedly called to the house of the chief native doctor, as his brother had been taken seriously ill.

On entering the patient's room, I found it crowded with his friends, the patient himself lying upon a mattress placed on the ground. One glance at the patient sufficed: he was dead, and had apparently been so for some hours. When I announced the fact to the brother, he became very angry, and a.s.sured me that I was mistaken. He begged me to pour some medicine down the man's throat, or to do something to rouse him, as he had only fainted!

Upon further inquiry, I found that he had been poorly for some days, and his brother had been treating him. My suspicions were aroused, as the brother and his friends crowded round me, imploring that English medicines should be tried, and after further careful examination only served to confirm my first opinion, I refused absolutely to comply with their entreaties, and left the house with my a.s.sistant. The brother and some of his friends pursued us, offering large fees if only we would give some medicine, absolutely refusing to accept my verdict. It is a necessary custom in Persia and the East generally, to bury a dead body within a few hours of death, but we heard that the brother refused to allow this corpse to be buried for three whole days, alleging that the English doctor was mistaken: however, in the end they were obliged to bury him. The native doctor was strongly suspected of having poisoned his brother, and this doubtless accounted for the urgent manner in which he begged me to pour something down the dead man's throat, so that he could accuse me of being responsible for his death.

All Persians are superst.i.tious, and are great believers in goblins and 'jinns.' One day a young man was brought to me suffering from an acute attack of ch.o.r.ea (St. Vitus' dance). He was well educated, and had been employed as a clerk in a merchant's office: now he was unable to hold a pen in his hand, and exhibited all the symptoms of the disease in a very marked degree. He was promptly admitted to hospital, and discharged cured in a few weeks. According to his own statement the cause of the attack was as follows. He had gone for a walk in the desert outside the city after his day's work was over, and had wandered on further than usual. Suddenly he came across an old well, and round the well were numbers of hideous dwarf-like goblins pelting each other with stones. When they saw him they crowded round laughing, jeering, pulling his clothes, and then began to pelt him with stones. He turned and fled, running the whole way back to the city, and to this shock he attributed the commencement of his symptoms.

In my last chapter I referred to the prevalence of the opium habit in Kerman, but we found many addicted to it also in Yezd. So much was this the case, that I started admitting some of those who expressed a desire to give up the habit into the hospital, submitting them to a special treatment, with very good results. It was a curious sight to see these patients grouped together in the ward, smoking their carefully weighed out amount of opium, which was gradually reduced day by day, until they could go without altogether.