My next shock was a surgical one. On a certain Sunday morning a carriage-and-pair drew up in front of the dining-room window, to my great alarm. In walked a stout old fellow in tile hat and surtout, accompanied by his wife. He said never a word; but his mouth remained wide open. The wife also sat down breathless and speechless! What was I to do? I had hastily donned my long coat on recognizing their arrival. I rushed to the bookcase next door, took out Druitt’s Surgeon’s Vade Mecum, and turned up JAW.
There it was: “Dislocation and its treatment.” Adopting my most imposing manner, and now some what reassured, I re-entered with both thumbs up in clean napkins, backed my patient into a strong armchair with a high back, and inserting both thumbs into his mouth pressed hard down on his back molars slightly raising the chin at the same time. O blessed sound, in went the jaw with a loud click, the napkins shielding my thumbs from a good bite! And away they drove, back again to Haggerston Castle, whence they had come.
Reducing the dislocated jaw. From pages 25-26 of Leaves From the Life of A Country Doctor by Clement Gunn.
It’s hard to imagine a time when a carriage could draw up unwarned in front of a house. Even more so, a carriage with someone seeking medical help. Clement Gunn, a young medical student who was a locum tenens – a temporary replacement for a doctor, is faced with a medical emergency that calls for his immediate attention. Even though he hasn’t had much experience, he gathers enough courage and confidence to be able to alleviate his patient’s suffering almost instantaneously. It was common practice for medical students to serve as locum tenens in the 1880s, before they had graduated from medical school. He earned a few guineas per week in return (a guinea = £1.05). The practice continued, in more supervised hospital posts, into the 1980s.
The simple technique used by Gunn is used today. Clement Gunn’s adventures as a medical student are not all about ‘getting it right the first time’. With the mention of books he consulted, a mentor he admired, and lessons he learnt, the chapters are filled with detailed narrations of his life as both a medical student and a physician.
Clement Bryce Gunn was a physician-writer from Edinburgh. His book Leaves from the Life of a Country Doctor, consist of chapters of his own life from medical school to starting his own medical practice in the town of Peebles, and more. Whether it was describing his mode of travel by horses to visit patients, or his clinical sessions with Joseph Bell (the model for Sherlock Holmes) and his fellow classmate Conan Doyle, his description of what was ordinary may not seem very ‘ordinary’ to us. Written with astonishing detail of Edinburgh and Peebles in the late nineteenth century, his book is worth a mental journey to embark on.
- Clement Gunn – A brief description of Dr Gunn’s personality from the history of Peebles website
- Find Leaves From the Life of A Country Doctor in a library, or second-hand online
- Reducing the dislocated jaw – a youtube link demonstrating how to do so.
- Image – Reducing a dislocated jaw, from Points in Nursing, Emily A. M. Stoney, 1910, via Wikimedia Commons
- Compare Mikhail Bulgakov’s accounts of desperate interventions in an isolated location with only a textbook to help: Suppose they bring me a hernia, and The steel windpipe.
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