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."
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.
Everything was done for my neuralgia which the doctors could think of; and at length, at my suggestion, I was removed to the above-named hospital. It was a pleasant, suburban, old-fashioned country-seat, its gardens surrounded by a circle of wooden, one-story wards, shaded by fine trees. There were some three hundred cases of epilepsy, paralysis, St. Vitus's dance, and wounds of nerves. On one side of me lay a poor fellow, a Dane, who had the same burning neuralgia with which I once suffered, and which I now learned was only too common. This man had become hysterical from pain. He carried a sponge in his pocket, and a bottle of water in one hand, with which he constantly wetted the burning hand. Every sound increased his torture, and he even poured water into his boots to keep himself from feeling too sensibly the rough friction of his soles when walking. Like him, I was greatly eased by having small doses of morphia injected under the skin of my shoulder, with a hollow needle, fitted to a syringe.
As I improved under the morphia treatment, I began to be disturbed by the horrible variety of suffering about me. One man walked sideways; there was one who could not smell; another was dumb from an explosion. In fact, every one had his own grotesquely painful peculiarity. Near me was a strange case of palsy of the muscles called rhomboids, whose office it is to hold down the shoulder-blades flat on the back during the motions of the arms, which, in themselves, were strong enough. When, however, he lifted these members, the shoulder-blades stood out from the back like wings, and got him the soubriquet of the Angel. In my ward were also the cases of fits, which very much annoyed me, as upon any great change in the weather it was common to have a dozen convulsions in view at once. Dr. Neek, one of our physicians, told me that on one occasion a hundred and fifty fits took place within thirty-six hours. On my complaining of these sights, whence I alone could not fly, I was placed in the paralytic and wound ward, which I found much more pleasant.