By Robert Plummer
"Ach, it was nothing," remarked Dr. Jacob Schwinn, Wheeling's venerable phusician and surgeon in dismissing inquiries on an operation performed a year ago at the Ohio Valley General hospital.
It was a different kind of operation from the countless others that Dr. Schwinn had performed during more than a half century of practice. For this one was on himself. A young interne, marking down the case history seemed surprised that the ailment had been so long neglected. No one told him that it was probably the first opportunity Dr. Schwinn had had to be a patient; that for more than fifty years he had been too busy in his efforts to relieve other people's ailments.
A lot of people seeme to disagree with Dr. Schwinn about his operation, too. They seemed to think it was quite an unusual event for a man of 83 to lay on an operating table and chat with attending surgeons while they were going about their work. He was given only a local anesthetic and followed every move that was made.
Even the Associated Press seized upon the story and called in to the hospital to comfirm a small news item to the effect that an 83-year old surgeon has "directed his own operation." The story went out over the news wires and for weeks letters and "get well" cards came from every section of the United States, even his native country, where the story had been reproduced.
It is characteristic that Dr. Schwinn was dismayed at all the fuss over such a "simple thing" and that he should express embarrassment over the inference that the attending surgeons needed any directing.
"The only time I was consulted," he said was when Dr. Glass asked me whether he should close the incision with a `hemstitch or a cross-stitch.'" Dr. E.F. Glass was the surgeon.
Dr. Schwinn's operation was for strangulated hernia. He could look back on another day when he was five years old and this same affliction had proved fatal to his father. That was only 79 years ago; when the wisest medical men were still saying that there were three regions into which the surgeon could never enter with impunity--the brain, the chest and the abdomen.
At that time it was the practice to treat such a hernia with an internal dose of "quicksilver." If this heavy liquid passed through the intestines, it sometimes was known to bring relief, but it was more often fatal than not.
It has been a speedy road that surgery and medicine have traveled during Dr. Schwinn's lifetime.
It can be said, in all truth, that the real progress of surgery and medicine has run parallel with his career as a student and a doctor. Dr. Schwinn was a boy of 13 when Lister discovered that a preventable bacterial infection was the cause of supperation.
Anesthesia was hardly past it earlies stages of development.
Before that time there was lurking everywhere the grave danger of infection; no attempts were made at even simple cleanliness; hemorrhage could only be controlled by tourniquets during the operation and cauterizing afterwards; only the crudest operations could be done under the direst necessity, and with the chances ten to one they would be followed by fatal infection. During the same time or mostly within the past sixty years, the succesful therapeutic means of combatting disease were being discovered or invented.
By contrast with present knowledge, Dr. Schwinn recalls when he was a boy of 10 and a girl in his home town in Switzerland was taken will with pulmonary tuberculosis. Here is how he described the treatment declaring that every doctor in those days would have done likewise: The patient was kept in bed under a mountain of feather ticks, all the windows tightly closed, even during the hot summer months; she was given little liquid nourishment, the doctor tried to starve out the disease, and she was given nauseating medicine that took away the last vestige of appetite she might have had. Under this treatment she wasted away bathed in perspiration and between chills in the morning and light fever in the evening she finally was relieved of her suffering by death.
In those times, such a thing as a compound fracture was invariably fatal he says. The break would be set and then bound in hospital dressing obtained, perhaps, from housewives who would be asked to donate bundles of the old linen. And these dressings were not even washed before they were put on wounds.
Between 1867 and 1890 all surgery had undergone a great change, with the development of antiseptic technique proving to the surgical world that the so-called "laudable pus" was not laudable at all; that it can and should be prevented; and hospital wards finally showed fewer and fewer cases of dreaded gangrene, erysipelas, septicemia; and filthy wards, beds, hospitals, and unclean surgeons disappeared.
"I well remember" Dr. Schwinn says "when the great Kocher,(Dr. Emil T. Kocher, Swiss surgeon) returned from England where he had been watching Lister's epochal work,when he brought home a remarkable steam kettle with which he produced a carbolic acid laden cloud that would envelop operator, assistants and half the audience in an almost impenetrable mist. He was so enthused over this new addition to his armamentarium that he devoted a whole clinic to its praise and finally wound up by saying: Long live the Kettle!" But a year passed by and one morning the Kettle was missing and the professor in the course of another clinical lecture told us that there were other ways now to keep a wound from being infected and he wound up by saying: `Down with the Kettle!'"
Step by step, following the discoveries of Lister, Dr. Schwinn recalls how the path was opened for what we call today, major surgery, which invades all the cavities, attacks all the organs, including heart and brain.
What he considers the crowning triumph was added when Semelweiss and our own Oliver Wendel Holmes brought Listerism to the bedside of the parturient woman. And the medical men, laboring to free the human family from the perils and ills that have beset it since time immemorial, have made equal progress with the surgeon, he says. He cited one important discovery after another during little more than a half century; the cause of typhoid fever by Ebert in 1880; the causes of pneumonia by Pasteur, Sternberg, Frankel and Friedlander in 1881 to 1883; of tuberculosis by Koch in 1882; of diptheria by Klebs in 1883; of lockjaw by Nicolaier in 1884;of meningitis by Weichselbaum in 1887; of syphilis by Schaudinn in 1905.
He can point to the remarkable progress made in still another field. Witness, he says, the birth of bacteriology, endocrinology, the doctrine of immunity, the advent of diagnostic, phophylactic and curative sera and vaccines; the chemistry and microscopy of blood, urine and other fluids, the diagnosis of malaria, sleeping sickness, and a host of other conditions; the discovery of the importance of hidden foci of infection in the teeth, tonsils, gall bladder and other parts of the body. And all this is why, we believe, Dr. Schwinn could only laugh at the impression that there is anything the least bit unusual about undergoing a modern operation. Why thinking as he must have been of all the tedious forward steps his profession has traced he could only see his own operation, even at 83, as "nothing".
It has often been said that Dr. Schwinn is a ultra-modest man. One commentator has said that "he is one of the few men in the world who could walk daily, past a picture of himself bearing the inscription 'A fitting tribute to his ability' without once turning his head."
Perhaps the secret of this modesty can befound in Dr. Schwinn's own words. Speaking at the unveiling of a bust of himself, which was dedicated in his honor at the Ohio Valley General hospital, and reviewing a part of the progress made by medicine during his lifetime, he declared that "no one is able to grasp more than an insignificant part of what he would like to know."
"I have gone to school now fully 75 years and have not even learned the A. B. C.s" he said. "All we know is so infinitely less than all that still remains unknown."
"I am thankful and happy for a kind Providence permitting me to live the greater part of a century and watch the magnificent progress of a new civilization during a period of our history, such as there has never been before. During the short space of a hundred years,the outposts of human knowledge have been advanced farther that in a thousand years before.
"But we are merely writing our chapter in the great book now. It is not finished. What the next centuries will bring no one can guess, but I am sure that the march of progress will keep on for centuries to come. The last chapter of our book will not be written for millions of years."
Dr. Schwinn has long been a student of astronomy and of Darwin's works on evolution. A man able to conceive distance in millions of light years and who can describe the development of the animal kingdom from the time of the earliest microscopic forms of life down to the present, is not much inclined to take himself too seriously.
At least we may think that, because turning to the bronze design of himself which had been the occasion for many laudatory remarks, Dr. Schwinn, saying that he had opposed the honor conferred on him, concluded with these words: "Well, my friends I have been 'busted' many times and, after all, I suppose this is the best kind of a 'bust' I could have."
With all the remarkable progress in medical science, Dr. Schwinn managed to keep in stride by paying the price in labor and study. He has always been an omniverous reader and student. There was seldom a night when he was not busy on calls, or at the hospital, that he failed to give a great part of his evening to his books and medical journals.
Yet this not the way Dr. Schwinn became known as a noted surgeon.
He says nothing about skill, of course, but he does describe his methods of learning in a paper which he addressed to the members of the Ohio County Medical Society at a recent Schwinn Scientific Lecture, which the society has made an annual event. The illness, which now has Dr. Schwinn confined to his bed, prevented him from attending, and he expressed his regret in this message:
"Your society has bestowed upon me an honor which is far more than my feeble efforts at serving our profession deserve.
"Looking back over a long and busy professional career now, when twilight sets in as it does for all sooner or later I am happy to say that life to me has been a most interesting experience.
"There is no profession, the study of which is as fascinating as that of medicine, for it borrows from every branch of science and its practical results have been nothing short of miraculous, especially during the period in which I have had the good fortune of watching its progress. And I can assure you that I would not sell my experience for all the gold of an Indian prince.
"Most of my post-graduate work has been done in my office and at the bedside, where, with the aid of a few insruments, good books, and a trusting patient, I was able to keep up fairly well with the profession, and what I learned in this simple way was greatly added to by attending medical meetings wherever and whenever possible.
"In a fairly extensive consulting practice I have often learned more than I was able to offer towards clearing up the problems before us, and so I have learned early in my practice to respect the views of others.
"As to my patients I have always held that when a man is sick he needs the physician's assistance whether he be rich or poor, and no matter what his color or creed or the cause of his sickness. And I have always tried to offer the best that was in me, though Heaven knows it was often litle enough, and all I could do in such cases was to try and create a more or less reassuring and cheerful atmosphere in the sick room.
"I regret that illness prevents me from being present at your instructive meetings and hope that these words from a doctor of the old horse-and-buggy times may be taken for what they are worth."
Dr. Schwinn had no stuffy conceptions of his calling.
If there was one thing in which he did take pride it was that he had served in his earlier years as a member of that sturdy band of old-fashioned doctors who were standardized in but one thing: the will to serve and strive unceasingly against human suffering, and who knew the roads of the back country as well as they knew the streets of the town or city.
On a Sunday automobile drive, he can point still to almost any side road between Wheeling and Sistersville, or as far south as Sardis, on the Ohio side of the river, and recall how he traveled them to visit patients.
In this part of the country the doctor did not drive his horse and buggy such distances from Wheeling. Roads were too few. And when the weather was inclement, as it always seemed to be when most sicknesses occurred, what few roads there were became nearly impassable. But the doctors got there somehow.
On trips down river the Wheeling doctors with country practice used the train, and usually were picked up by one of the patient's family at the station. They used ferry boats at various points for trips to Ohio. There was more of a spirit of universal helpfulness, too, Dr. Schwinn says. A doctor struggling to reach his patient was always sure of assistance. He recalls conductors who would slow down their train at unscheduled stops or volunteers who would find the ferryman at any hour of the night. And when the doctor arrived at his destination he usually found more neighbors assembled to offer assistance than the farm home could accommodate.
The commercial side of medicine was a problem only for the doctor in those days were told.
Members of Dr. Schwinn's family distinctly recall Mrs. Schwinn planning a surprise party for the doctor. The guests arrived promptly but they waited in vain for the host. He had been called to Cameron it was later learned, and it was not until the next day he returned. There was no telephones then to report one's movements. And he came home toting a side of bacon as his pay for the trip.
On another occation the entire family assembled for a Christmas dinner. But Dr. Schwinn was again missing. He had been called to New Martinsville and passed his Christmas day attending a farmer's wife. His pay on that occasion was a basket of apples.
There was not so much complaining about hardships in thoses days as we hear now, Dr. Schwinn says, and certainly not from the horse-and-buggy doctor, although the expenses of some of his most tiring trips came out of his own pocket.
We can safely conclude, it would seem, that underpriviledged as many of the patients of the horse-and-buggy doctor must have been, they knew one essential of the more abundant life at least: the brotherhood of man.
The horse-and-buggy times had special problems, too, for a man as active and as concentrated on his work as Dr. Schwinn. He was once called to Martins Ferry to consult Dr. Messerly. He took the trolley to the latter's office. the patient's home was back in the country and as they reached the pavement the two doctors got into a buggy and started to drive off. "Here you two thieves!" shouted an excited bystander, as he rushed out and grabbed at the reins.
"Isn't this your horse and buggy?" Dr. Schwinn inquired of Dr. Messerly.
"No,I thought it was yours," Dr. Messely said.
And it took some little time to convince the doubting owner of their honest intentions.
Another night Dr. Schwinn was attending an obstetric case in East Wheeling. Toward early morning a stablehand at the Erb delivery called Mrs. Schwinn to say that the horse had come in, but without the doctor. "Why the doctor has been in bed for hours'" came the surprising reply from Mrs. Schwinn.
And so he had. He had forgotten his horse and buggy, and walked home. And the horse, knowing the rounds of the town as well almost as the doctor, found his own way to the stable in time for his morning oats.
How, as a farmer's son in a family of five boys and five girls, of whom he was the youngest, did Dr. Schwinn get the notion to study medicine?
He explains that it was the wish of his mother. Although medicine was a difficult goal for an average Swiss boy in those days, she had somehow set her heart on this ambition. The older boys and girls were able enough to look after the farm, and so Jacob went on to the university at Heidelberg, Germany, after completing his studies in the local gymnasium.
Dr. Schwinn was born on a farm near Schaffhausen, capital of the most northerly canton of Switzerland, which bears the same name. Pictures of modern Schaffhausen show it to be a town that might have come to us right out of the middle ages. Its towers and churches and even every one of its houses, built of grey stone, seem to go far back into the centuries. There are buildings with elaborately decorated turrets at each of the corners. The great round tower of the castle of munot still arrayed in its sixteenth century trappings of war, frowns down upon the town.
Schaffhausen is indebted for its name, which signifies "the town of the boots," and its existance to the falls of the Rhine. These falls are described as the most impressive in the world with the exception of Niagara or the Victoria falls. To Dr. Schwinn, they are a never-to-be-forgotten memory of his childhood. He could see them on his long trudge to school and hear their roar through the night.
Perhaps we can read some significance in Goethe's phrase summing up his description of the falls, where he says"If we wish to get an idea of the sources of the ocean, we have them before us here."
Dr. Schwinn would laugh at the idea that there might have been some mystic power in the fascinating swirl of the waters, fighting their way down toward far seas, that drew youthful fancy toward the great outer world to which they were racing.
Yet, the Swiss farm boy, beating his way through wintry snowdrifts, back and forth to school, was soon to follow this same river down to the sea and find his life's work in far-off America.
Before that time came however, he had attended the Universities of Heidelberg, Zurich,Wurzburg, Berlin and Berne. He was graduated at Berne.
This number of schools was not unusual for a medical student of those days, Dr. Schwin explains. Then few universities offered complete courses; one or two outstanding professors were the best that most of them could hope to have, and students sought the professors from place to place.
Thus at Heidelberg were Robert Bunson, renowned chemist, and Karl Gegenbaur, famous anatomist. At Zurich was Karl Eberth, bacteriologist and anatomist. It was Ebert who later demonstrated the cause of typhoid fever. At Wurzburg was Professor Koelliker, anaother widely known anatomist. Berlin offered the famous Rudolf Virchow, pathologist and publicist, noted for his discoveries and writings on cellular pathology; also Laugenbeck, a leading surgeon of his day, and at Berne was the great Swiss surgeon, Kocher, who ws the first to remove the thyroid gland as a deliberate surgical procedure. It was under the latter that Dr. Schwinn received his diploma. He studied under all these different men.
At Zurich and again at Berne, Dr. Schwinn formed a friendship that was to have most important influence on his future. This was the meeting with Dr. Gregory Ackermann, who was his roommate at both schools. It was Dr. Ackermann who started first for the United States, locating in Wheeling after a brief service as a ship surgeon. He, too, became one of the city's widely known surgeons. An elder brother, John Schwinn also had come to the United States and settled in Toledo, O.
With correspondance from both Dr. Ackermann and his brother, picturing the opportunities in America, Dr. Schwinn was finally pursuaded that the place for a young doctor, after all, might be in a new and growing country.
Recalling his schooling in Europe, Dr. Schwinn is sure of this fact that one learned, through necessity, to be studious. Instructors lectured, and it was up to the student to absorb their teachings. Let the student beware of examination day! What was known then, as compared to the present, was thoroughly taught and fundamentals were ground into students too thoroughly to be easily forgotten. Particularly, this was true of anatomy, Dr. Schwinn says. the student now, he says, knows a little about many things undreamed of in the earlier days, but as for thoroughness and the knack of instilling studious habits, Dr. Schwinn thinks there is much to be said for the old schools.
Coming to America when he was 28 years old Dr. Schwinn spent two years in Chicago and at Des Moines, Iowa, then came to Wheeling shortly after the 1884 flood. He passed his state examination in April of the following year. Only recently his examination papers were brought to light among the posessions of the late Dr. L. D. Wilson. the questions were in English, but the answers were written in German. and all the while he was busy perfecting himself in a new language.
Opportunity did not hurry about knocking on the young doctor's door. Quietly and modestly he took his place in the medical fraternity as an assistant to Dr. Ackermann. but it was not long until he was starting his own practice. Even then he recalls how glad he was to add to meagre fees by occasionally extracting a tooth.
Doctors as well as patients, nowadays would think that without a hospital, an operation would not be possible. Dr. Schwinn has been privileged to work for many years under the most modern conditions in hospital appointments and with every scientific device at hand. but prior to 1892, when the old City hospital was opened most of his operations were performed in the patient's home. A doctor then had to be content with the barest essentials and he learned many things about minimizing infections that we suspect the younger surgeon today is never troubled to think about.
The home surgeon had no one but himself to consult; he alone had to decide and this responsibility was an excellent teacher, Dr. Schwinn believes. Forced to conservatism, too, kitchen surgeon adopted it as a priciple and never attempted to do more than absolutely necessary. Cleanliness, speed in operating so that tissues would not be long exposed and instruments well boiled in the family dishpan were the chief essentials of "kitchen" technique and where these were scrupulously observed, the successes of those days would not compare unfavorably with those of many hospitals. But Dr. Schwinn, nevertheless, prefers the modern hospital with its assured asepsis.
The horse-and-buggy doctor also faced other problems, he says.
At the top of these was typhoid fever. "When I was young in practice we had typhoid fever with us all year around," Dr. Schwinn relates. "The Mortality was high and a doctor was not considered a first-class man unless he had two or three cases of typhoid on hand and one could almost make a living from it alone. Nowadays, the disease is seldom mentioned. I have not seen a case for over ten years and if a sporadic case turns up once in a while, the health authorities are hot on its trail and either stamp it out or keep it at its place of origin. This has been one of the greatest gains in medicine.
"Another yearly visitor that took heavy toll every summer among the little ones was what we called summer complaint or cholera infantum. Children in the best of health would be seized with intense vomiting, purging and high fever and in the course they would be reduced to mere skeletons, due to the rapid dehydration and exhaustion and many would go into coma and die. We rarely hear of summer complaint any more due to the improvement in hygienic conditions, the better education of mothers in sanitary matters, but most of all due to the improvement of the drinking water and milk.
"The milk of those days was an abdominable mixture of germs, poisons and dirt. by the time it reached the baby's cradle it was no more fit to drink than an emulsion of dirt. Stables were not kept clean. Cows were never tested for tuberculosis; the milk containers contaminated, the baby's nursing bottle had seen many helpings before it was cleaned, the nipple was usually left on the window sill between feedings for the edification of countless flies and to top it all a great many mothers had no more knowledge of sanitary matters than the man in the moon. All this is changed now and millions of children have been spared an untimely death. Medicine had made one of its greatest advances, too, in the education of the public in sanitation.
"Then there was diphtheria. No one who has gone through one of those severe epidemics of diphtheria in former days can appreciate their seriousness and the agony of the parents, the suffering of the children, the helplessness of the doctor. For we had no specific and all we could do was swab the throat, give a supporting treatment and wait for the outcome. If the child's resistance was fair, or good, a recovery was probable, but if the infection was stronger than the patient, the case was lost. Thanks to one of the greatest discoveries in medicine the incidence of this terrible scourge is reduced to a minimum and by early use of anti-toxin the disease can be cure in the great majority.
Looking back over the remarkable progress made in medicine and surgury during his lifetime Dr. Schwinn sees stronger trends toward an age of specialties, but along with it more triumphal progress for his profession.
"Some day we shall reach the end of the trail," he says. "Some day in the far future will come that millennium where people can say: "Now there is no more disease!" That may seem a bold prophecy, but we must remember that when I was a boy there was a research worker here and there, a professor, a chemist, but today there are hundreds of thousands of these workers, toiling day and night oer their problems, and as a result we are already in possession of a wealth of knowledge no one ever dreamed of. The world in and around us is searched every minute, and truth is wrested from its mysteries by the use of scientific methods more powerful, more wonderful than ever. The past century has not only seen progres in medicine. It has given us the steam engine, telegraph, telephone, wireless, radio and scores of other things to make life more easy and more comfortable. All of this indicates the wonderful possibilities promised by the future.
"In medicine there will always be certain bodily disorders, and there will be need for the surgeon, for there will always be accidents, industrial and other kind. But the medical man per se, the old time practitioner, who treats everything from an ingrown toenail to hydrophobia, will gradually vanish from the scene, like the American Indian had to yield to the onslaught of civilization.
"Even now our age is one of specialities, and already the healing fraternity is divided up into a dozen or more sections, each with their own interests and their own troubles, and rightly so, for no man nowadays can boast of more than a mere tithe of all medical knowledge, and every speciality has its right to live and prosper provided it does not stray too far from its origin.
"But with all our various specialities and more coming every year, I can readily see where the medical man of the old school is going to lose out and sooner or later there will be little left for him except to act as a sort of medical traffic officer who will direct his patients along the various streets and lanes of specialism."
How does life sum up for Dr.Schwinn at 84, after the many years he has put in working day and night at his profession?
"I believe this world has been given to us in order to enjoy it," he said not long ago, "to enjoy every bit of it, to learn all about it we possibly can; it is little enough, for human life is much too short, even if you reach eighty or more. I like the epitaph on the tombstone of an old doctor down in Georgia, who in a long and hard country practice, had plenty of bitters to mix with the sweet, but never lost courage and good humor. The words are: 'I have been here, have gone, have had a good time.' "
A part of Dr. Schwinn's "good time" seems tohave been given in service to colleagues as well as his patients.
When the Wheeling Rotary club unveiled a portrait of Dr. Schwinn as a tribute for his work in connection with the Rotarian clinic for crippled children, the late Dr. Harry M. Hall made this contribution to the professional estimate of the veteran surgeon.
"Today, no one is trying to offer Dr. Schwinn as an idol to be worshipped for there are many others who deserve testimonials of gratitude, too. But it is felt by the profession that Dr. Schwinn more surely typifies for all of us what we all want to be some day. Doctors are not interested in gratitude because they know they are taken as a matter of course and rarely receive it when they really deserve it.
"But the doctors offer Dr. Schwinn somewhat as a modern Isiah or Jeremiah. We go to him as the people did for counsel and advice, and receive it without being patronized."
We read that Dr. Schwinn was present and accepted, "in his usual quiet way the many things said of him," although Dr. Hall disclosed that during the course of his presentation address, Dr. Schwinn had located the speaker's leg with several well-directed kicks under concealment of the table, in attempts to "choke him off."
When the Wheeling Rotary club, with several civic organizations, took up the cause of the crippled children, Dr. Schwinn placed his professional services at their disposal.
Over a period of several years scores of children were transformed from a condition of helpless invalidism to happy, active and useful childhood.
Describing the work of this clinic and the work of Dr. Schwinn, the late Dr. John McClure once said:
"He did work which only he could do. The children loved and trusted him and the results in many cases were almost miraculous. And all this work and worry over a period of years without any tangible reward, except that which comes in the knowledge of service, was gladly rendered.
"Some day, we hope not soon, the last long bugle call will sound for Dr. Schwinn and when he has crossed the great divide, I feel that at least figuratively speaking, he will find a very fine harp and an exceptionally radiant halo waiting for him, and I feel that across the clouds he may see these words, 'Inasmuch as ye have done to one of these, the least of my brethren, ye have done it unto Me.' "
It was Dr. Schwinn's 84th brthday yesterday. One of many messages was from a young school boy in Martins Ferry. It told of the good progress he was making in school. He had been a clinic patient. Several others were from children treated in the clinic.
Not a word was said about it, but it was to be observed that these letters were carefully laid aside. They will be answered with words of advice and cheer, even from his own sick bed. One can depend on that.
December 11 1938
@copy; Ogden Newspapers; Reproduced with permission.
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