Young James Herriot
Page 16
Examination: temp 103°F
The horse was struck smartly under the chin and there was no sign of the third eyelid – thus eliminating the possibility of tetanus.
An Ayrshire cow also received the physical treatment. ‘Her responses were all right as demonstrated when a knife was inserted between the clit [hooves].’
Fleming’s methods may have sometimes lacked finesse but were sound and conscientious. Diagnosis was the vet’s forte in the Thirties. It was just a pity about the limitations of the cures.
Even a country practice like Tom Fleming’s was seeing more and more pets, particularly dogs, on the client list as the Thirties wore on. Like everything else in the world, dog breeds go in fashions: Pekingese, Spaniels and Fox Terriers headed the Thirties must-have list and Labradors, today’s most popular breed, were far less sought after.
The Pekingese, it might be said, was the vet’s best financial friend. One of the world’s oldest dog breeds, dating back to 2000 BC, the Pekingese had long been the exclusive property of the Chinese imperial family; it had been introduced into Britain in 1860 following the occupation of Peking at the end of the Second Opium War, when five of the dogs belonging to the Empress Dowager Ci’an were found in the sacked Summer Palace and shipped west. Queen Victoria had received one of the plundered Pekes (which she had archly named ‘Looty’), so keeping the breed’s connection to royalty and matrons. By 1904 the Pekingese breed had become sufficiently established for the Pekingese Club of England to be founded, and ten years later it had become the most popular dog breed in the Western world, loved for its loyalty and dignity.
The Pekingese – believed in Chinese legend to be the result of a mating between a lion and a monkey – is also wilful, obstinate and dominant. As the American writer Dorothy Parker acidly observed: ‘No woman who owns that lily of the field, a Pekingese, can be accused of selfishness. She simply hasn’t the time to think of herself. His Serene Highness demands unceasing attention.’
The Peke can also require much attention from the veterinary profession, because it has a hereditary disposition to respiratory and eye ailments. It also tends towards alimentary illnesses when overfed, which it frequently is, being so often the spoiled lap dog, or baby substitute, of the Mrs Pumphreys of the world.
There were definite shades of Tricky-Woo, ruler of Mrs Pumphrey in Thirsk, in almost every encounter Fleming had with a Peke. On 31 August Alf entered in his casebook:
History: Previously visited & found to be exhibiting symptoms of vesical calculi. Cystotomy had been advised.
Operative procedure: The bitch, after being prepared by morphia injection, was anaesthetized by pumping air through a bottle containing chloroform. She had previously been secured to the four corners of the table by hobbles. After the hair had been removed from the abdominal wall, the site of operation was bathed with iodo-benzol. The abdomen was then wrapped in surgical gauze & the first incision made through the gauze. On reaching the bladder a ¾″ incision was made & 33 calculi of various sizes removed by expression. The site was kept clear by continuous use of swabs. The incision on the bladder was closed by means of two layers of continuous suture, the second layer burying the first, thus preventing leakage. The skin incision was then closed by interrupted sutures.
The bitch was then put in her pen, and put on a regimen of a ‘few laps’ of water only for a day or two. A week later, Fleming and Alf treated an 11-month old Pekingese bitch, which was ‘continually scratching and biting’ at the root of its tale. This was discovered to be suffering from impacted anal glands – what Mrs Pumphrey would rather more charmingly call ‘flop-bot’ – which were duly evacuated by manipulation. Since the irritated skin was likely caused by a worm infestation, Fleming prescribed a 24-hour fast and anthelmintic pill. If ineffectual, a ‘dose of castor oil’ was to be administered.
Another Pekingese was urinating frequently and on palpitation calculi were found in the bladder, and a cystorectomy advised; another Pekingese bitch had an ascitis and was treated by an incision into the abdominal wall and the dropsical fluid run off; an eight-year-old Pekingese dog visited had a growth on the dorsal surface of the left hind paw, which Fleming diagnosed as a papilloma and excised, after anaesthetizing the part with novocaine.
Women were overwhelmingly Peke owners in the Thirties, as Hollywood drolly reflected in the character of dizzy socialite Angela Bullock in the 1936 screwball comedy My Man Godfrey, and in Trixie Lorraine in the Busby Berkeley musical, the Golddiggers of 1933. But Wire Fox Terriers also stole the scene, led by Asta the sniffer-out of corpses and clues on behalf of Nick and Nora Charles in the Thin Man detective films and Snowy, the travelling companion of Tin Tin. Asta and Snowy sparked a veritable craze for Wire Fox Terriers, which is why they were such a regular item on Fleming and Alf’s client list.
A visit to an ‘off colour’ Fox Terrier pointed up a real problem with keeping a dog in the hard times of the Thirties. The dog ‘had been receiving very little meat, its diet consisting largely of biscuits’, which in turn had caused eczema. Fleming advised bathing the dog in warm water medicated with derris root, with ‘liquor arsenicalis’ to be taken internally. He added that ‘more meat’ was to be given in the canine’s diet. Most vets had an unofficial sliding scale of charges, but pet owners who could not afford even the vet’s lowest fee might find a local branch of the People’s Dispensary for Sick Animals, the veterinary charity founded by Marie Dickin in 1917.
Some of the cases Alf saw with Tom Fleming were heartbreaking, reminders that one of the worst aspects of a vet’s life (and one of the reasons that vets are prone to depression) is that the job entails the killing of animals. A Scotch Terrier with tumours was destroyed ‘on owner’s instructions’ by ‘choloroform inhalation (1oz. in mask)’; a cross-bred dog with chronic nephritis or Stuttgart’s disease ‘too advanced to have any hope of recovery’ was destroyed by injection of prussic acid; a Springer Spaniel was likewise killed by injection of prussic acid on 23 March 1937, Alf writing in his casebook:
Destroyed dog. Spaniel 14 years old. Smelling strongly. Teeth bad. Growth on nose, & eyes & tumour at base of tail. Prussic acid into thoracic cavity, quick panting respirations, barks, then a howl. Slight convulsion.
Down the years, the relief given to the Labrador seen on 28 August 1937 is almost palpable:
Labrador-retriever dog, 8 months old.
History – had previously been treated for hysteria which had been evidenced by occasional fits of barking, running eye. ‘Luminal’ had been given, the result being unsatisfactory.
Treatment: a rectal injection of warm soapy water was made producing evacuation of considerable amount of faeces. 3ozs of liquid paraffin was given, producing further evacuation in 12 hours. A worm capsule was then administered.
In the Thirties, ‘knackeries’ or ‘knacker’s yards’ sprinkled the British farming countryside, being the places where fallen livestock were carted to be processed. The knackery was a Brueghelian world: heaps of dead decomposing animals lay all over the yard, most in some state of dismemberment, as the knacker bled them, stripped them of their skin, and took out their bones and bowels. Here buckets of blood, there a mound of shiny intestines, everywhere the suffocating stench of carcasses being boiled. In the corners awaiting collection, a pile of bleached bones and skulls (to be turned into fertilizer) and a mound of fly-covered meat for the cat or dog food shop in town.
It was a unique learning environment, if a gruesome one, for a vet in training like Alf. On a visit to a knackery in 1937, he saw, in the flesh, a version of colic that was untreatable, torsion of the intestine, or twisted bowel. Alf’s first solo case in Thirsk would be a hunter with colic, and not just any old hunter but one of Lord Fulton’s best hunters, as his lordship’s manager so unpleasantly pointed out. Those hands-on hours with Tom Fleming would help Alf diagnose a torsion and firm his resolve to put the horse out of pain.
Knackeries were a sight not easily forgotten. Or stomached. On his first visit to
the knackers in Dumfries, Alf did what every first visitor to the knackers did. He spewed up his breakfast. This was much to the amusement of the knacker’s man sitting on a carcase, a sandwich in one blood-stained hand, a teacup in the other. Surrounded by pretty much every disease known to animalkind, the knacker’s mate was a pink-skinned advert for health, when common sense said he should be pale, wheezing and ailing. As a breed, though, knackers were conspicuously hale and hearty, the proof being Jeff Mallock and his family, whom Alf encountered on moving to Thirsk. In the Mallock’s family bungalow, which was plop in the middle of their yard, lived cherubic Jeff, his comely wife, and a family which ranged from a beautiful girl of nineteen down to feisty boy of five. ‘There were eight young Mallocks, and they spent their lifetimes playing among tuberculous lungs and a vast spectrum of bacteria from Salmonella to Anthrax. They were the healthiest children in the district.’
Aside from knackers and their kin, everyone else in the British countryside lived in dread of tuberculosis, which went by an array of names, sometimes being consumption, the Great White Plague, Piner’s Disease, Grapes or Phthisis. However termed, the disease made up a large proportion of the vet’s workload in the inter-war period because infected cattle could transmit the disease to humans via milk and flesh. In 1934 alone, there were 2500 human deaths in Britain from bovine TB; it was the vet’s job to determine whether cattle were ‘TB’-free by testing, which was done by injecting tuberculin, a solution of the poisons of tubercle bacilli, into the skin along the cow’s neck or into the skin at the fold of the tail. A positive reaction, meaning that tuberculosis was present, would be evidenced by a swelling of the skin up to the size of a walnut.
In 1931, 15 per cent of the dairy herds that supplied Glasgow were discovered to be contaminated with TB, and possibly as many as 33,000 of Scotland’s 450,000 dairy cows and heifers were infected. Perhaps not surprisingly, then, Glasgow had the highest death rate from TB in the country before the Second World War. Under the government’s 1925 Tuberculosis Order, all farmers who suspected their cattle of having TB were instructed to notify the local authority. Many ignored the injunction because the compensation was £3 a head whereas the cow’s market value was more like £12. Farmers peddled on cows that were not yet showing definite clinical signs of the disease.
Milk could be deadly, a white soup of bacteria causing typhoid, scarlet fever, listeria and salmonella, as well as TB. The milking machines, which were replacing hand milking, if anything spread infection. To ensure production of safer milk, the government’s Milk Order of 1922 provided a scheme whereby ‘Milk may be graded and supplied under certain conditions of comparative bacteriological purity.’
Three premium grades of milk were introduced – Grade A (Tuberculin Tested); Grade A (Pasteurized); Grade A – the definition was whether the herd was tuberculosis-free, what other diseases might be present, and whether the milk was pasteurized or raw.
All the rest of Britain’s milk was ‘non-graded’. The difference in price between ungraded and Grade A was a significant 1d a pint. Hardly anyone could afford to buy it, and therefore farmers did not think the effort of producing it worthwhile. About 1 per cent of milk drunk in the early Thirties was Grade A. Not until the Milk Marketing Board introduced a 1d premium per gallon to the farmer did supplies take off and consumption increase.
A vet received £20 per day from the government for undertaking TB testing, and most were desperate for the work. A routine day’s work in a mixed practice usually garnered £2–3. Founded in 1897, the Veterinary Benevolent Fund to aid destitute vets received tens of begging letters a day in the Thirties. A common reason for the destitution of vets, aside from the poor economics of veterinary medicine, was that the work could make them ill, and therefore unable to work.
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Doc Whitehouse had promised Alf that veterinary surgery contained variety, if not money, and it did. On 24 March 1937 alone, Alf attended a ewe with her placenta out, a lamb with incurable ‘joint ill’, a cow that required irrigation (‘ineffectual’) to remove cleansings, a dog with an abscess on its jaw (‘cut out & pus liberated’), a Dalmatian puppy with hysteria that the owner wanted destroyed (Fleming refused), a calving case (Fleming got the calf out and tried to induce breathing by pressing on thoracic walls but the animal died, and lastly a mare suffering peritonitis.
In between his case work with Fleming, Alf also had to slog away at Buccleuch Street at Senior Anatomy, Pharmacology and Hygiene, and he made very good progress in all of them. Sitting the professional exams in July 1937, he passed with 45 (Senior Anatomy), 57 (Pharmacology) and 56 per cent (Hygiene) respectively. So, it was on to the fourth year of study: Pathology, Parasitology, and Medicine and Surgery. Pathology, of course, was taught by the dreaded Emslie, who entered into the student report book at the end of the autumn term under the name J. A. Wight: ‘Attendance good … Pleasant manner.’ The killer detail came in the middle, though: ‘Performance rather poor.’ In the spring term of 1938, Alf improved, but it was not going to be a surprise to either Emslie or Alf that the latter was ‘referred Pathology’ in the professional examination in July 1938 with a mark of 40 per cent. Having failed to conquer Pathology, he went off and summitted Streap mountain near Loch Arkaig in broiling weather. He and Pathology were to be closely acquainted for another year yet.
Just as he had roamed the hills as a boy, he roamed them as a student, going camping almost every weekend from Easter to October, ‘leaving the smoke and dirt of Glasgow behind us’ as Alf expressed it in Vets Might Fly. Loch Lomond was a regular venue, where the beauty of the birch-lined shore at Rowardennan made sufficient an impression on Alf that he later named his house in Yorkshire after it. His other favourite place to pitch a tent was Rosneath on a peninsula in the Firth of Clyde, where Alf found a ‘fairyland which led me into the full wonder and beauty of the world’.
Such were the demands of studying for the MRCVS diploma, however, that Alf had to always sherpa his textbooks with him on his hill jaunts, so he could swot in the sun and cram under canvas in the rain.
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In 1938 Chamberlain returned from his Munich meeting with Hitler promising ‘Peace in our Time’, and 13,500,000 people attended the Empire Exhibition (Scotland) at Bellhouston Park, and the whole of Britain danced away to the sound of ‘The Lambeth Walk’. It was also the year Alf saw practice with a vet in Sunderland, a vet who was to become friend, eventual employer and, disguised as boozing Angus Grier, a character in the Herriot gallery. This was J. J. McDowall, whose surgery was handily just around the corner from Alf’s Auntie Jinny Wilkins on Beechwood Terrace. In Jock McDowall’s suburban Sunderland practice, dogs and cats were the bread and butter. Or, as McDowall, brick-red of face, hot of temper, with a clipped-colonel moustache and colourful tongue put it, ‘The folk around here will rush their pet to me at the drop of a hat. They’re in through the door if it coughs, sneezes or farts!’ He even had customers willing to pay 5 shillings for the vaccine against canine distemper, an almost miraculous advance in veterinary medicine, but the cost of which was judged prohibitive by most dog-owners.
And, truly, not many vets of the time performed an ovariotomy on a cat. Alf wrote in his casebook that year:
The cat was anaesthetised [and] The site of operation (the flank) was clipped, shaved and rubbed with iodine. An incision (1½ inches long) was made through skin and two layers of muscle. The final incision through the deepest layer of muscle was only ½ inch long. The ovary was sought (recognised by colour and shape) and seized by forceps & drawn out through the incision. A pair of artery forceps was clipped over the horn of the uterus and another over the ovarian vessels. Ligature were applied and the horn of the uterus & the vessels were severed.
McDowall then inserted sutures and covered the area in antiseptic dusting powder before repeating the procedure for the other ovary. The cat was then swaddled in pads of cotton wool and bandages. When the cat was visited a week later the wounds were clean and healing nicely. Un
fortunately, the cat was not taking any food.
McDowall’s unflappable advice was ‘try her with a kipper’.
One of McDowall’s mottos was, ‘It’s not what you do, it’s the way that you do it.’ If in doubt, with dogs he diagnosed ‘hysteria’ (caused by some combination of ‘teething, worms, gastric problems’) and prescribed a sedative, a wormer and ‘keeping the bowels open’.
Like veterinary practices everywhere, the caseload Nature provided for treatment at 1 Thornhill Terrace, McDowall’s surgery, was only increased by the stupidities of humans. One farmer who should have known better called in the ‘v’itnry’ to look at a black-faced ewe. Alf’s casebook recorded that the ewe:
Had developed a swelling on the left side of the face which had been thought to be an abscess.
Examination: The swelling had been caused simply by an accumulation of grass between the lower molar teeth & the left cheek. This was removed.
Following an appointment to see a Cocker Spaniel, Alf entered in his casebook:
History: The owner had been dosing the animal somewhat drastically for worms & yesterday the animal had had a ‘fit’. He was off his food and occasionally vomiting…
Diagnosis: gastric ulcer. The fit was caused by the pain consequent on the administration of a ‘soap fill’.
McDowall put the Cocker Spaniel on a milky diet, with regular doses of a stomach and sedative mixture. More tragic was the case of another Cocker Spaniel, who was suffering a dislocated hip after a road accident; unfortunately the dog had been ‘treated by a quack’ for several days, who had made bad matters worse. ‘Had the dog been brought in shortly after the accident,’ Alf wrote, ‘it would have been a fairly easy matter to replace the dislocation but it was now too late to do anything & destruction was advised.’