Wednesday, September 21, 2016

within a toxi-alimentary dyspnoea grove

As my chokings had persisted long after any congestion remained that could account for them, my parents asked for a consultation with Professor Cottard. It is not enough that a physician who is called in to treat cases of this sort should be learned. Brought face to face with symptoms which may or may not be those of three or four different complaints, it is in the long run his instinct, his eye that must decide with which, despite the more or less similar appearance of them all, he has to deal. This mysterious gift does not imply any superiority in the other departments of the intellect, and a creature of the utmost vulgarity, who admires the worst pictures, the worst music, in whose mind there is nothing out of the common, may perfectly well possess it. In my case, what was physically evident might equally well have been due to nervous spasms, to the first stages of tuberculosis, to asthma, to a toxi-alimentary dyspnoea with renal insufficiency, to chronic bronchitis, or to a complex state into which more than one of these factors entered. Now, nervous spasms required to be treated firmly, and discouraged, tuberculosis with infinite care and with a 'feeding-up' process which would have been bad for an arthritic condition such as asthma, and might indeed have been dangerous in a case of toxi-alimentary dyspnoea, this last calling for a strict diet which, in return, would be fatal to a tuberculous patient. But Cottard's hesitations were brief and his prescriptions imperious. "Purges; violent and drastic purges; milk for some days, nothing but milk. No meat. No alcohol." My mother murmured that I needed, all the same, to be 'built up,' that my nerves were already weak, that drenching me like a horse and restricting my diet would make me worse. I could see in Cottard's eyes, as uneasy as though he were afraid of missing a train, that he was asking himself whether he had not allowed his natural good-humour to appear. He was trying to think whether he had remembered to put on his mask of coldness, as one looks for a mirror to see whether one has not forgotten to tie one's tie. In his uncertainty, and, so as, whatever he had done, to put things right, he replied brutally: "I am not in the habit of repeating my instructions. Give me a pen. Now remember, milk! Later on, when we have got the crises and the agrypnia by the throat, I should like you to take a little clear soup, and then a little broth, but always with milk; au lait! You'll enjoy that, since Spain is all the rage just now; olé, olé!" His pupils knew this joke well, for he made it at the hospital whenever he had to put a heart or liver case on a milk diet. "After that, you will gradually return to your normal life. But whenever there is any coughing or choking—purges, injections, bed, milk!" He listened with icy calm, and without uttering a word, to my mother's final objections, and as he left us without having condescended to explain the reasons for this course of treatment, my parents concluded that it had no bearing on my case, and would weaken me to no purpose, and so they did not make me try it. Naturally they sought to conceal their disobedience from the Professor, and to succeed in this avoided all the houses in which he was likely to be found. Then, as my health became worse, they decided to make me follow out Cottard's prescriptions to the letter; in three days my 'rattle' and cough had ceased, I could breathe freely. Whereupon we realised that Cottard, while finding, as he told us later on, that I was distinctly asthmatic, and still more inclined to 'imagine things,' had seen that what was really the matter with me at the moment was intoxication, and that by loosening my liver and washing out my kidneys he would get rid of the congestion of my bronchial tubes and thus give me back my breath, my sleep and my strength. And we realised that this imbecile was a clinical genius.
from In the Shadow of Young Girls in Flower by Marcel Proust, Moncrieff translation.

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