The funeral [for Jean] has begun...The scene is the library in the Langdon homestead. Jean's coffin stands where her mother and I stood, forty years ago, and were married; and where Susy's coffin stood thirteen years ago; where her mother's stood five years and a half ago; and where mine will stand after a little time." A little time indeed: Twain died on April 21, 1910.

Another health issue: Twain on smoking and the University of Rochester's use of Twain's writing

In his What is Man? And Other Essays book (pp. 216-219), one hundred and fifty years before there would be any reliable information on the link between cancer and tobacco use, Twain talks about superstitions and interesting habits regarding tobacco, and quips, "...me, who came into the world asking for a light." He pokes fun at those who thinks they know what a good cigar should taste like, and explains the "danger" into going into "rich people's houses," since their cigars, when smoked, develop "a dismal black ash and burn down the side and smell, and will grow hot to the fingers..."

As for his own tastes, Twain wrote that he liked "French, Swiss, German, and Italian domestic cigars, and would have never cared to inquire what they are made of..."

Meanwhile, health-related studies nearly two hundred years after Twain wrote that essay tapped into the author's literature. Indeed, in October, 1991, the Brown University Digest of Addiction Theory and Application published an article ("Mark Twain enlightens us about smoking cessation") that reported how doctors at the University of Rochester used Twain's writing to "encourage (or discourage) patients to quit smoking."

The study - conducted by members of the Human Motivation Program (HMP) at the University of Rochester - utilized a "self-determination theory from Twain's story, 'The Facts Concerning the Recent Carnival of Crime in Connecticut'." In the story, Twain's conscience appears as a "malformed but nimble dwarf who goads the rebellious Twain" into proper behavior. His Aunt Mary is the Authority Figure, who tries to get him to quit smoking his cigars.

Meanwhile, the three characters in the story, the Conscience, the Authority Figure, and the Rebellious Self (the real Twain), are part of a parable that the HMP used to illustrate that "many smokers are struggling with their Consciences over the advisability of their health behaviors. A controlling and punitive Authority Figure such as an Aunt Mary [in Twain's story] or a family physician" could cause the Rebellious Self to rebel even further, and reject any good judgment that self may have earlier exhibited.

Did the Twain-inspired model work? "Authors conclude that the...model is promising but not a panacea; 'it is not guaranteed to work, but then nothing is'," the study concluded. "It does, however," the report states, "proceed from the patient's frame of reference and, as such, we believe it holds the greatest likelihood for success."

Twain, however, would probably spin around in his grave were he to hear that one of his published stories was plugged into a seemingly pseudo-scientific research project to get people to quit doing something he loved - smoking cigars (or cigarettes, for that matter).

Summary on Twain and his views (humorous and cryptic) about medicine from a variety of his quotations

It should be mentioned that Twain was born during the Andrew Jackson presidency, and in that era, medical practices were basically unregulated. "Licensure laws were almost non-existent, and any citizen could practice medicine," according to an article in the journal, American College of Physicians ("The Pre-Flexnerian Reports: Mark Twain's Criticism of Medicine in the United States") (Ober, 1997).

The regularly practice medicine at that time ("allopathic") was also in competition with practitioners employing at least twenty-four other sects. The therapies offered by allopathic medicine - even though allopathic doctors proclaimed themselves "the norm" - had "no proven advantage over the so-called "quackery."

Twain, meanwhile, "doubted the competence and intentions of physicians as a group even as he maintained confidence in the abilities of his own physicians.

Ober quotes Twain from...

From the Unabridged Mark Twain (Budd, 1982), the author and humorist seemed to be saying that the natural course of a sickness might be better than whatever treatment a doctor might offer:
During Monday, Tuesday and Wednesday the twins grew steadily worse; but then the doctor was summoned south to attend his mother's funeral and they got well in forty-eight hours."

Another excerpt that illustrates Twain's ability to take his skepticism and lack of faith towards doctors and medicine, and turn it into cryptic humor is found in the Unabridged Mark Twain as well. In this passage Twain rips into the pretentiousness and pseudo-intellectualism of the current medical jargon by pretending to be a doctor offering advice to a female patient.

Without going into much detail, madam - for you would probably not understand it anyway - I concede that great care is going to be necessary here; otherside exudation of the aesophagus is nearly sure to ensue...followed by ossification and extradition of the maxilaris superioris, which must decompose the grandular surfaces of the great infusorial ganglionic system..."

From the Autobiography of Mark Twain, the author writes about the common situation of a man practicing medicine without having any formal medical education:

Every old woman was a doctor and gathered her own medicines in the woods, and knew how to compound doses that would stir the vitals of a cast-iron dog." Twain also writes in the Autobiography of Mark Twain about the "Indian Doctor" who was "a grave savage." He was a "remnant of his tribe, deeply read in the mysteries of nature and the secret properties of herbs; and most backwoodsmen had a high faith in his powers and could tell of wonderful cures achieved by him."

Also from his autobiography, he was less kind to medicine then he was in the paragraph above, as he dumped his literary scorn upon the various medical treatments of his day, treatments which featured the most popular and yet the largely ineffective allopathic methods:

Castor oil was the principal beverage. The dose was half a dipperful, with half a dipperful of New Orleans molasses added to help it down and make it taste good, which it never did." And after trying "calomel" and then "rhubarb" and finally "jalap," Twain wrote that the doctor "bled the patient and put mustard plasters on him." As to the system, it was "dreadful" and yet, "the death rate was not heavy."

Twain wrote a letter in 1900 that very poignantly and pointedly reflected his thoughts on the medical practices of his earlier years:

The physician's grotesque system - the emptying of miscellaneous and harmful drugs into a person's stomach to remove ailments which in many cases the drugs could not reach at all..." In many cases, he continued, "the drug either retarded the cure, or the disease was cured by nature in spite of the nostrums."

In many cases, Twain's writing about medicine shows that he studied the various approaches carefully, perhaps interviewing patients who had received the many kinds of attempts at therapy that were commonplace, especially in the early 19th Century. In his usual cryptic humorous style, he writes (in Collected Tales, Sketches, Speeches and Essays) (Sheldon, 1958):

If a citizen was inclined to take salts by the ton, ipecac by the barrel, mercury by the quart, or quinine by the load, and thus be cured of his ailment or his sublunary existence by the wholesale, he was at perfect liberty to invite the services of a medicus of the allopathic style..."

In Mark Twain Speaking he is quoted (at the University of Iowa) (Fatout, 1976) as to his childhood remembrances regarding cures his mother provided. "I can remember when the cold water cure was first talked about. I was then about nine years old, and I remember how my mother used to stand me up naked in the back yard every morning and throw buckets of cold water on me." She did it, he continued, "just to see what effect it would have."

Twain and psychology

Phrenology: "the study of the conformation of the skull based on the belief that it is indicative of mental faculties and character" - Merriam Webster Online.

Whether Phrenology falls perfectly into the category of "psychology" or "medicine" - or in some middle ground between the two - it is worthy of a close look in terms of the medical and psychological explorations in this paper.

It's well-known that Mark Twain took a dim view of the work of Lorenzo Niles Fowler, who was, according to an article in the journal, Skeptical Inquirer (Lopez, 2002), a "great celebrity of the day," who "rode to fame" on one of the leading trends of the day, phrenology. Lopez writes that the belief in phrenology "colored much of the country's thinking at that time regarding what motivated human behavior."

In other words, for many…