FOOTNOTES:
[1] “At nostris temporibus, Medici quasi religio est, ægrotis, postquam deplorati sint, assidere; ubi meo judicio, si officio suo, atque adeo humanitati ipsi deesse nolint, et artem ediscere et diligentiam præstare deberent, qua animam agentes facilius et mitius e vita demigrent—Hanc autem partem, inquisitionem de Euthanasia exteriori (ad differentiam ejus euthanasiæ quæ animæ præparationem respicit) appellamus; eamque inter desiderata reponimus.” (Verulamus, De Augmentis Scientiarum, lib. iv. cap. ij.)
[2] “Εὐθανασία naturalis nobis dicitur facilis et quam minimo cum cruciatu e vita exitus, qua tenus moriendi facilitas e causis naturalibus proxime pendet.... Ad medicinam hujus εὐθανασίας contemplatio pertinet: est enim naturalis, non moralis, nisi qua tenus hæc ad illam momenti habet plurimum. Exteriorem idcirco Verulamius appellavit.” (Nicolai Paradysii, Opuscula Academica, 8vo, Lugd. Batav, 1813. Oratio de Εὐθανασία naturali et quid ad eam conciliandam Medicina valeat, pp. 63 et 65.)
[3] “A medicis vix inchoatum, nedum pertractatum huc usque esset.” (Paradysius, p. 63.)
[4] “Etiam plane censeo ad officium medici pertinere, non tantum ut sanitatem restituat: verum etiam ut dolores et cruciatus morborum mitiget: neque id ipsum solummodo, cum illa mitigatio doloris, veluti symptomatis periculosi, ad convalescentiam faciat et conducat: imo vero cum abjecta prorsus omni sanitatis spe, excessum tantum præbeat e vita magis lenem et placidum. Siquidem non parva est felicitatis pars, illa Euthanasia.” (De Augmentis Scientiarum.)
[5] Sir Henry Halford, Essays and Orations read and delivered at the Royal College of Physicians. Third edition, 12mo, London, 1842. p. 84.
[6] “Magnus ille veræ philosophiæ instaurator Verulamus, queritur studium Euthanasiæ medicis haud satis cultum fuisse. Medici profecto munus est ægrotis sanitatem reddere; cum tamen ex lege naturæ erit tandem unicuique mortalium ægrotatio nulla arte medicabilis, benevolæ hujus artis professoribus conveniret, mortem inevitabilem, quantum fieri potest, terrore omni spoliare; et ubi non datum est prædam morti extorquere, sed vita necessario amittenda est, operam saltem dare, ut cum minima crudelitatis specie amittatur.” (Heberdeni Gulielmi, Commentaria de Morborum Historia et Curatione. Cap De Ileo.)
[7] Essays and Orations, ut supra passim.
[8] John Ferriar, M.D., Medical Histories and Reflections. 8vo, London, 1798. Vol. iii. p. 196.
[9] John Ferriar, M.D., On the Treatment of the Dying, ut supra, p. 191.
[10] The Works of Sir Benjamin Collins Brodie. Arranged by Charles Hawkins. 3 Vols., 8vo, London, 1865. Vol. i. p. 184.
[11] On Life and Death. 8vo. London, 1863, p. 175.
[12] “Ipsæ animæ discessus a corpore fit, sine dolore, et fit plerumque sine sensu, nonnunquam etiam cum voluptate.” (Vopisci Fortunati Plempii. de Togatorum Valetudine tuenda Commentatio. 4to. Bruxellis, 1670. p. 26.)
[13] Autobiographical Memoir of Sir John Barrow, Bart. 8vo, London, 1847, p. 398.
[14] “A sailor who had been snatched from the waves, after lying for some time insensible on the deck of the vessel, proclaimed on his recovery that he had been in Heaven, and complained bitterly of his being restored to life as a great hardship. The man had been regarded as a worthless fellow; but from the time of the accident having occurred, his moral character was altered, and he became one of the best conducted sailors in the ship.” (The Works of Sir Benjamin Brodie, vol. i. p. 184.)
[15] I was once told by a near relative of mine—says De Quincey—that having in her childhood fallen into a river, and being on the very verge of death but for the assistance which reached her at the last critical moment, she saw in a moment her whole life, clothed in its forgotten incidents, arrayed before her as in a mirror, not successively, but simultaneously; and she had a faculty developed as suddenly for comprehending the whole and every part. The heroine of this remarkable case, continues De Quincey, was a girl about nine years old; and there can be little doubt that she looked down as far within the crater of death—that awful volcano—as any human being ever can have done that has lived to draw back and to report her experience. Not less than ninety years did she survive this memorable escape, and I may describe her as in all respects a woman of remarkable and interesting qualities. She enjoyed throughout her long life serene and cloudless health; had a masculine understanding; reverenced truth not less than did the Evangelists; and led a life of saintly devotion, such as might have glorified Hilarion or Paul! I mention these traits as characterising her in a memorable extent, that the reader may not suppose himself relying upon a dealer in exaggerations, upon a credulous enthusiast, or upon a careless wielder of language. Forty-five years had intervened between the first time and the last time of her telling me this anecdote, and not one iota had shifted its ground amongst the incidents, nor had any of the most trivial of the circumstances suffered change. How long the child lay in the water was probably never inquired earnestly until the answer had become irrecoverable: for a servant to whose care the child was then confided, had a natural interest in suppressing the whole case. From the child’s own account it would seem that asphyxia must have announced its commencement. A process of struggle and deadly suffocation was passed through half-consciously. This process terminated in a sudden blow apparently on or in the brain, after which there was no pain or conflict: but in an instant succeeded a dazzling rush of light; immediately after which came the solemn apocalypse of the entire past life. (De Quincey’s Works, Edinb., 1862, Vol. I., Confessions of an English Opium-Eater, p. 259.) Sir Dyce Duckworth reminds us that the mental condition of some who have been put to sleep with anæsthetics may throw some light on this matter. “Patients,” says he, “have told us they dreamed they were transported from earth and carried off into space, were supremely happy and at rest: but that on gradually recovering consciousness, they seemed to light back again upon this world, were most reluctant to leave the Elysium they had reached, and to recommence their earthly toils and struggles.” (The Agony of Dying, in Monthly Paper of the Guild of St. Barnabas for Nurses. Vol. iii. p. 81).
[16] J. A. Symonds, M.D., Art. Death, in the Cyclopædia of Anatomy and Physiology, 4 vols., royal 8vo, Lond. Vol. i. p. 800.
[17] Halford, p. 18.
[18] Halford, p. 14.
[19] Savory, ut supra, p. 178.
[20] p. 74.
[21] On Life and Death, 8vo, London, 1863, p. 177.
[22] Brodie ut supra, p. 185.
[23] “I think there is reason for affirming that the risk of evil from this cause is rated generally above the truth. In cases of imminent danger, the mind is not always, or even commonly, to be interpreted by the rule of health. Mental emotions are often altered in kind, or greatly abated in degree. Death itself is beheld under different views—a fact familiar to all who have watched over these scenes, and regarded the patient apart from those who are grieving around his death-bed. Suspicion of a painful truth often disturbs much more than the truth plainly stated.” (Sir Henry Holland’s Medical Notes and Reflections. Third edition, 8vo. Lond. 1853, p. 362).
[24] Halford, p. 76.
[25] Halford, p. 75.
[26] Cyclopædia of Anatomy and Physiology, art. Death, vol. i. p. 799.
[27] Symonds ut supra, p. 799.
[28] Lord Campbell, Lives of the Chief Justices of England, vol. i.
[29] On the Καῦσος of Aretæus, p. 96.
[30] Halford, On the Cautious Estimation of Symptoms, p. 17.
[31] Halford ut supra, p. 19.
[32] On the Καῦσος of Aretæus, p. 91.
[33] A. P. Wilson Philip, On Sleep and Death, 8vo, London, 1834, p. 165.
[34] Cyclopædia of Anatomy and Physiology, vol. i. p. 799.
[35] Dr. Symonds continues, “The previous habits and conduct of the individual have sometimes been such as to incline spectators to inquire, whether in the mode of his departure from existence, he might not already be receiving retribution, just as, in other cases, celestial dreams and colloquies have seemed fitting rewards for blameless lives and religious meditation.”
[36] Cyclopædia of Practical Medicine, art. Disease, vol. i. p. 629.
[37] Brodie, ut supra, vol. i. p. 281.
[38] Brodie ut supra, p. 182.
[39] Brodie, p. 182.
[40] The Anatomy and Philosophy of Expression. Fourth Edition, 1847, p. 185.
[41] Symonds, ut supra, p. 803.
[42] “At Medicus moriendi initium altius repetet, et jam ab eo inde tempore ducet, quo signis minime dubiis cognoverit, morbum naturæ artique non tantum insuperabilem esse, sed et sub eo vires sic perire ut reparari nequeant.” (Paradys, Oratio de Εὐθανασία naturali, p. 67).
[43] In the words of Lucretius, vi. 1, 190—
Or, as rendered by an accomplished physician, Dr. Mason Good—
[44] “Omnia tum vero vitai claustra lababant.”
(Lucretius, vi. 1,151).
“Then all the powers of life were loosen’d.”
(Mason Good).
[45] Lectures on the Principles and Practice of Physic. Fifth edition, 2 vols. 8vo, London, 1871, vol. i. p. 62. Sir Thomas Watson in his admirable lecture on the Different Modes of Dying, has treated the whole subject so graphically, that I shall follow him as closely as possible in what I have to adduce on this part of my subject.
[46] Watson, p. 66.
[47] Watson, p. 68.
[48] Ibid., p. 70.
[49] On the Treatment of the Dying. Medical Histories and Reflections. Vol. iii. p. 195.
[50] Watson, p. 76.
[51] Medical Notes and Reflections. Third edition, 8vo, London, 1855, p. 379.
[52] Robert Willis, M.D., On Urinary Diseases, 8vo, London, 1838, p. 100.
[53] “When there is a sudden cessation, or intermission, of acute pain, sleep frequently comes on instantaneously at every such interval of ease. The records of judicial torture furnish much striking evidence as to these effects.” (Sir Henry Holland’s Medical Notes and Reflections, p. 369.)
[54] I except hydrophobia, tetanus, &c., against which it is almost powerless.
[55] “Præstantissimum remedium cardiacum (unicum pene dixerim) quod in rerum natura hactenus est repertum.” Sydenham Thomæ Opera Omnia, edidit G. A. Greenhill, M.D., 8vo, London, 1844, p. 175.
[56] “Vires ægri somno recreatæ sunt, atque etiam ubi salus ejus prorsus desperata fuerit, et angor summus cruciaverit, opium utique sollicitudinem aliquantum levavit. Mors quidem neque serius, neque citius venit, sed tamen minore cum cruciatu.” (Heberden De Ileo.)
[57] Hufeland’s remarks on opium are so valuable that I give them at length. “Who would be a physician without opium in attendance on cancer or dropsy of the chest? How many sick has it not saved from despair? For one of the great properties of opium is, that it soothes not only corporal pains and complaints, but affords also to the mind a peculiar energy, elevation, and tranquility. The soothing virtue manifests itself in the most splendid manner in relieving death in severe cases, in effecting the euthanasia, which is a sacred duty and the highest triumph of the physician, when it is not in his power to retain the ties of life. Here, it is not only capable of taking away the pangs of death, but it imparts even courage and energy for dying; it promotes in a physical way even that disposition of mind which elevates it to heavenly regions. A man who had laboured for a long time under complaints of the chest and vomicas finally approached death. The most dreadful anguish of death with a constant danger of suffocation seized him, he got into real despair and his state was an insurmountable torment even for the persons around him. He now took half a grain of opium every hour. After three hours he became quiet, and after he had taken two grains he fell asleep, slept quietly for several hours, awoke quite cheerful, free from pain and anxiety, and at the same time so much strengthened and appeased in his mind, that he bade farewell with the greatest composure and satisfaction to his relatives, and after he had given them his blessing and many a good admonition fell again asleep and passed away while sleeping.” (The Three Cardinal Means of the Art of Healing, p. 46.)
Somewhat to the same purport writes De Quincey. “Simultaneously with the conflict the pain of conflict has departed, and thenceforward the gentle process of collapsing life, no longer fretted by counter-movements slips away with holy peace into the noiseless deeps of the Infinite.” (Confessions of an English Opium-Eater, p. 149.)
[58] Ut supra, p. 516.
[59] Holland, ut supra, p. 518. To the same effect writes Dr. James Gregory of this remedy, “Neque dubium est, utcunque periculosus videatur usus talis medicamenti vix non venenati; ægros plus fere incommodi et damni percepisse a nimis parva, quam a nimia ejus quantitate. Medici igitur est, medicamentum adeo validum et sæpe perniciosum caute et prudenter adhibere, et in illis tantum morbis ad id confugere, qui aliquid istiusmodi plane requirunt; ubi vero talis necessitas urget, oportet remedium libere et cum fiducia præscribere; tunc enim non sperare modo potest, sed fere polliceri, se effectum illum salutarem, quem cupit, per suum medicamentum esse præstiturum. Quod si timide et nimis parce datum fuerit, longe alium effectum habebit, et iisdem ægrotis haud parum nocebit, quibus largius datum multum profuisset.” (Conspectus Medicinæ Theoreticæ, § MCCXXII.)
[60] Ut supra, p. 518.
[61] “Audivi plus semel ægros temporarium a narcoticis levamen enixe deprecantes, quod sensuum obscuratione nimis care querebantur emi.” (p. 71.)
[62] “Conspectus Medicinæ Theoreticæ,” § MCCXXII.
- ℞ Aq. Menthæ Viridis, f. ℥ v ss.
- Sacchari, ℥ ss.
- Acid. Sulphurici diluti ♏︎ XL.
- Sp. Ætheris comp. f. ʒ ij.
Misce ft Mistura. Pars quarta pro dose.
[64] Elliotson, Human Physiology, p. 1043.
[65] Ut supra, p. 193.
[66] Miss Nightingale’s observations on whispered conversation in the room, or just outside the door, at p. 26 of her “Notes on Nursing,” have great value and a wide application. On these points in the management of the dying chamber Professor Paradys has the following: “Sed præterea adhiberi hoc loco moderatæ sensuum externorum impulsiones utiliter possunt, quæ vividiores phantasmatum impressiones obscurent: vitari itaque nimiæ tenebræ et silentia nimis alta debent, concedi contra modica lux, permitti notæ amicorum voces, immo excitari debent lenes, placidi, animum blande demulcentes affectus.” (p. 74.)
[67] Ferriar, p. 193.
[68] Ibid., p. 194.
[69] Human Physiology, p. 1043.
[70] Ferriar, p. 203.
[72] “Cyclopædia of Anatomy and Physiology,” vol. i. p. 802.
[73] P. 200.
[74] P. 203.
[75] Miss Nightingale’s Notes on Nursing, p. 47.
[76] Ferriar, ut supra, p. 196.