It was during the eighteenth century that a number of our best-known educational institutions were founded in the different colonies,—among them, Yale College, in 1701; Princeton (College of New Jersey), in 1746; University of Pennsylvania, in 1749; Columbia (King's College), in 1754; and others, only a little less known. In most of these latter were established medical departments, but the method of apprenticing students to physicians was still in general observance, no preliminary education whatever, as a rule, being demanded. In 1766, however, the New Jersey Medical Society ordained that no student be taken as an apprentice by any member of the society unless he had competent knowledge of Latin and some initiation in the Greek. About the middle of the century Drs. Bard and Middleton, in New York, and Dr. Cadwallader, in Philadelphia, began giving lectures in anatomy, while at Newport, Rhode Island, Dr. William Hunter, between 1754 and 1756,—a near relative of the famous Hunters of London, and a pupil of the elder Monro,—gave a course of lectures on human and comparative anatomy. Dr. William Shippen. Jr. (1736-1808),—a student of John Hunter's,—returned in 1762 to America, and gave his first course of lectures on anatomy and midwifery during the years immediately following. His lectures led to the formation of a Medical Department of the College of Philadelphia, in 1765, in which lectures were continued regularly until the winter of 1775, when the War of the Revolution interfered. In July of 1776 Shippen was made Chief-Physician of the Continental Army, and in the following year was elected by the Provincial Congress Director-in-General of army hospitals. During the latter years of the war he returned to Philadelphia each winter, and delivered a course of lectures, shortened by the necessities of the case. Thus he was the first public teacher of midwifery in this country. He was ably seconded in his work by Dr. John Morgan (1735-1789),—also a pupil of Hunter and Monro, who received a prominent army appointment in 1775, but who, two years later, was unfortunately dismissed on charges subsequently proved false. Shippen and Morgan were for some time the only professors in the Medical Department of the College of Philadelphia. In 1768 Kuhn—a pupil of Linnæus—was made Professor of Materia Medica and Botany; and Benjamin Bush, a year later, was given the Chair of Chemistry. The commencement of this institution occurred in 1768, when the degree of M.B. was given to seventeen graduates. In 1779 political reasons led to the abolition of the College of Philadelphia, the University of Pennsylvania taking its place. Ten years later the former institution was restored, and in 1791 the two institutions were united. The present Medical Department of the University of Pennsylvania is, therefore, the legitimate continuation of the first medical school in America.
The Medical Department of King's College, New York, now Columbia College, was organized in 1767, by Clossey, an Irishman; Middleton, a Scotchman; James Smith, a graduate of Leyden; Tenant, an alumnus of Princeton College; and Bard, who was by far the most eminent of the group, a Philadelphian by birth, who had studied under the best masters in England.
The Medical Department of Harvard University was organized in 1783. Most prominent in connection with it was Dr. John Warren, the first teacher of anatomy and surgery, and the founder of a family of eminent medical men, whose descendant, Dr. J. Collins Warren, is to-day an occupant of the chair of surgery in the same school. The Medical Department of Dartmouth College was organized in 1798 by Dr. Nathan Smith,—a man of great energy and unusual versatility.
While these medical colleges were developing their strength the medical profession were not idle, and institutions and libraries sprang up in various places. The Pennsylvania Hospital, for instance, founded in 1762, is to be credited with the oldest medical library in this country, many of its volumes having been selected especially for it by Louis, of Paris, and the famous Lettsom, of London. It now contains nearly fifteen thousand volumes. The library of the New York Hospital, not quite so large, was founded in 1776; that of the College of Physicians, in Philadelphia, in 1788. The profession of New Jersey organized the State Medical Society in 1765. In 1781 was founded the Massachusetts Medical Society. In 1787 arose the College of Physicians of Philadelphia.
In 1789 the profession of Maryland organized the so-called Medical and Chirurgical Faculty of Maryland, constituting thereby the same organization as the societies of other States. Before the close of the century, Delaware, New Hampshire, and South Carolina had also organized societies. In the larger cities extensive hospitals were also founded,—the Pennsylvania Hospital, in Philadelphia, in 1751, inside of which the first clinical instruction in this country was given by Dr. Thomas Bond. The New York Hospital began in 1769, simultaneously with the organization of the Medical Department of King's College. The first insane-asylum in America was built at Williamsburgh, Va., in 1773, although the charter of the Pennsylvania Hospital, dated 1751, provided for the care of lunatics, though not at that time in a separate institution.
The most conspicuous medical character of the century in American history was undoubtedly Benjamin Rush (1745-1813). He was one of Shippen's earliest students in anatomy, studied widely abroad, was a member of the Continental Congress, and one of the signers of the Declaration of Independence. After him is named Rush Medical College of Chicago. He was an extensive writer on a variety of subjects, not only professional, but political, philosophical, etc. He recognized but two kinds of remedies,—stimulants and depressants,—and held it to be the principal duty of the physician to decide as to which were most advisable in a given case. He called calomel the "Samson" of the materia medica, and his opponents contended that he was right, since it had undoubtedly slain its thousands. As an accurate observer of disease, he was correct and exact, and his descriptions are to-day both classic and reliable.
The study of practical anatomy lias always been carried on in this country under great disadvantages. At first only the bodies of executed criminals were sparingly furnished.
In 1788, in New York, occurred the celebrated "doctor's mob," which attested the vehemence of public objection to dissection, and which for two days defied the control of all the authorities. Secret dissections had been practiced in Harvard College so early as 1771, but the practice was against the law even for sixty years later in Massachusetts. Physiology, as such, was not taught in any medical school in this country during the century, and experimental physiology was practically unknown. Surgery was eagerly studied, especially during war times, and Dr. John Jones (1729-1791), of the King's College School, was, perhaps, the most eminent of the surgeons of his day. Others who vied with him were William Shippen, Jr., the first teacher of surgery in the College of Philadelphia; John Warren, of Boston; Richard Bayley, of Connecticut; Baynham, of Virginia; and McKnight, of New York.
The position of midwifery during the earlier years of the country may be, perhaps, understood by the following extract from the New York Weekly Post-Boy, of July, 1745:—
"Last night died, in the prime of life, to the almost universal regret and sorrow of this city, Mr. John du Puy, M.D., man-midwife," etc.
The first practitioner of obstetrics in New England was Dr. Lloyd (1723-1810), a pupil of Hunter and Smelley; while Dr. Shippen, in Philadelphia, endeavored to organize a school for the instruction of midwives, in which, however, he met with insuperable difficulties.
The first attempt to regulate practice in colonial times was an act passed by the General Assembly of 1760, providing for at least a form of examination in physic and surgery, registration, etc. The first medical journal to appear in the United States appeared about 1790. It was entitled A Journal of the Practice of Medicine and Surgery and Pharmacy in the Military Hospitals of France, consisting merely of translations from the French journals of military medicine. The first real American medical journal was the Medical Repository, begun in 1797 and discontinued in 1824.
The present century, now drawing to its close, saw in its earlier half the rise of a large number of American physicians and surgeons who have made their names illustrious for all time by their teachings, their writings, and their invention and originality. While it is, of course, invidious to select names, the following certainly deserve honorable mention in this list, without the slightest disrespect or intentional slight to many others whose names must be omitted for want of space.
John R. Cox (1773-1864), an early student of Benjamin Rush, filled the chair of Materia Medica and Pharmacy in the University of Pennsylvania, and published the American Dispensatory in 1806. Caspar Wistar (1761-1818) was the author of a System of Anatomy,—held in great favor in his day as a text-book. Nathaniel Chapman (1780-1853) was Professor of Theory and Practice in the University of Pennsylvania until 1850. John Eberle held the similar chair of the Jefferson School from 1825-1831. The former wrote on Materia Medica and Therapeutics, the latter on the Practice of Medicine, both works being exceedingly popular. John W. Francis (1789-1861) taught obstetrics in the College of Physicians and Surgeons from 1826-1830. Franklin Bache (1792-1864) was one of the authors of the Dispensatory of the United States of America, published in conjunction with George B. Wood, who was Professor of Materia Medica in the University of Pennsylvania, and who wrote also extensively on his chosen subject in monographs and large works.
Robley Dunglison (1789-1869) taught for a number of years in the University of Virginia, but removed later to the Jefferson School in Philadelphia. He was a man of great industry and versatility, and wrote on a variety of subjects, his best-known work being his Medical Dictionary.
W. E. Horner (1793-1853) taught anatomy and histology in the University of Pennsylvania, and will long be remembered for his researches in these branches. John W. Draper (1811-1882) made himself eminent as well by his researches in photography and in general science, as by the publication of his treatise on Human Physiology, which first appeared in 1853. Better known as physiologist was John C. Dalton (18251889), whose text-book is to-day studied in many colleges and who first introduced the method of vivisectional classroom demonstrations in our own school here in Buffalo.
Alonzo Clark (1807-1887) was one of the most eminent teachers of medicine that this country has produced. Austin Flint (1812-1886) was also a famous teacher of medicine in New York, who made his first reputation in the then small school in Buffalo.
His text-book on Practice is the most popular American work on the subject that has ever appeared, and is still in general use. William P. Dewees (1768-1841) was the author of a treatise upon Diseases of Children, which reached a tenth edition and which rivaled the similar treatise of John Forsyth Meigs. The best-known teacher of dermatology and venereal diseases was Freeman J. Bumstead (1826-1879), author of the most popular work upon the latter subject that has been issued from the medical press. He wras professor of these diseases at the College of Physicians in New York. His text-book vied with that produced by William H. Van Buren (1819-1883), who, in connection with Dr. Keyes (still living), wrote a treatise upon the Surgical Diseases of the Genito-Urinary Organs, including syphilis, which has been, since its appearance, exceedingly popular with the medical profession.
Among the best-known neurologists and alienists of the century since Benjamin Rush wrote his Inquiries and Observations upon Diseases of the Mind (1812) was Dr. Isaac Ray, who, in 1838. published a work upon the medical jurisprudence of insanity.
Dr. Brigham ( 1798-1849) was superintendent of the Utica Insane-asylum for some years before his death; and Dr. Kirkbride, who died in 1883, had been superintendent of the Philadelphia Asylum for over forty years. Dr. John P. Gray followed Brigham as superintendent of the Utica Asylum, where he remained for thirty-two years, and founded the Journal of Insanity.
The first independent writer upon diseases of the eye was Dr. Frick (1793-1870), of Maryland. As illustrating how little our present specialties were then separated, it is worth while to remark that Dr. Edward Delafield (1794-1875), who, in 1826. was Professor of Obstetrics and Diseases of Women and Children in the College of Physicians and Surgeons, New York, delivered at the same time a special course of lectures upon diseases of the eye. The first man in the United States to make these diseases his exclusive specialty was Dr. Williams (1822-1888), of Cincinnati.
It would be very wrong, in this connection, to omit the mention of the name of Oliver Wendell Holmes, the genial "Autocrat of the Breakfast Table," but recently dead at a ripe old age, who used to say that he was "seventy years young." who was for a long time Professor of Anatomy at Harvard Medical College, but who was much more widely known and endeared to the English-speaking public by his beautiful poems and most attractive prose writings.—who, as author of the Chambered Nautilus, for instance, will be remembered so long as the English language has a literature and is read, he rendered a great service to the medical profession by first calling attention to the contagiousness of puerperal fever. Of his prose writings, his medical essays—entitled Currents and Counter-currents—make perhaps the most delightful reading.
Not a few Americans deserve special mention as surgeons and surgical teachers of eminence during the past hundred years. Without being invidious, there must, nevertheless, be mentioned John Collins Warren (1778-1856), first Professor of Anatomy and Surgery in the Harvard School, under whose auspices ether was first administered for the purpose of surgical anæsthesia, and who was the founder, in 1828, of the Boston Medical and Surgical Journal. He wrote an extensive treatise upon tumors, and, it is stated, first successfully tapped the pericardium.
Philip S. Physick (1768-1837), a pupil of Hunter, has been spoken of as the "father of American surgery," which he taught in the University of Pennsylvania. He was a tremendous worker, but wrote very little. He employed animal ligatures made of buckskin. John Syng Dorsey (1783-1818) was a nephew of Physick; taught anatomy in the University of Pennsylvania; wrote a treatise on surgery, which was the second surgical text-book published in this country, and was the first in the United States to tie the external iliac artery. He died at the age of thirty-five, at a time when he was giving promise of exceeding eminence. Nathan Smith taught in Dartmouth, Yale, and Bowdoin Colleges, and 'was considered the best man of his day in New England.
To him is justly due the great honor of having performed the first rational and deliberate ovariotomy, which he did in 1809, his patient living for thirty-two years. The operation was performed without an anæsthetic, and considering the circumstances under which it was carried out has shed a lustre upon his name and brain which nothing can ever dim. By this performance he became practically the father of modern abdominal surgery, and to him Americans and Europeans alike are delighted to render all the honor that is his due.
Perhaps the most eminent surgeon of the country was Valentine Mott (1785-1865), a pupil of Cooper and Bell, who taught in the College of Physicians and Surgeons, New York, until 1840, and in the University Medical School until 1860. He was a man of exceeding boldness and brilliancy, whose operations were performed at a time when anaesthesia was unknown, or was in its infancy, and who probably did more work in the surgery of the vascular system than any other surgeon who has ever lived. He was the first to tie the arteria innominata,—in 1818. As Gross wrote of him, he had a record of one hundred and thirty-eight ligations of various large arteries,—a record probably never equaled. He was also the first to do a successful extirpation of the clavicle for tumor,—an operation which at that time was considered very formidable. Though not a great writer himself, he is best known among students as the translator and editor of Velpeau's large work upon operative surgery.
Dr. George McClellan (1796-1847) was the founder of the Jefferson Medical School, and its first Professor of Surgery. He was followed later by Dr. Thomas D. Mutter, who left his surgical museum to the College of Physicians of Philadelphia and endowed a lectureship there. J. K. Rodger, of New York; John Rhea Barton, of Philadelphia; William Gibson, of Philadelphia; Gurdon Buck, of New York; Willard Parker, of New York; Frank H. Hamilton, of New York, who made his reputation while teaching in our Buffalo school, author of a most popular and valuable treatise upon fractures and dislocations; and Henry B. Sands, of New York, were men of greatest prominence during the middle and latter portion of the present century, each of whom has contributed in his way either to the science or to the literature of surgery. The most prominent figure in American surgery of the past forty years was Samuel D. Gross, of Philadelphia, professor in the Jefferson School, to which he moved from Kentucky, where he laid the foundation for his attainments and reputation.
He was an early writer upon surgical pathology and anatomy, but is best known for his elaborate System of Surgery, in two large volumes, which has survived several editions and is still most highly esteemed. Among others who ought to be mentioned are Nathan R. Smith, of Baltimore, the inventor of the anterior splint; Paul F. Eve, of Nashville; John T. Hodgen, of St. Louis; Daniel Brainard, of Chicago, and his successor, Moses Gunn; Alden March, of Albany; Henry J. Bigelow, of Boston, who performed the first excision of the hip in this country, in 1852, and who invented the method of crushing and removing stone from the bladder at a single operation, known as litholapaxy; and D. Hayes Agnew, of Philadelphia, who finished, before his death, a large and elaborate treatise on surgery, in three thick volumes.
Of obstetricians and gynaecologists America has had no lack, and, in fact, the United States may almost be said to be the first home of gynaecology. Dr. Bard was the first Professor of Midwifery in King's College, now Columbia, New York, and the author of the first work upon the subject published in this country. In Philadelphia, Dr. Thomas C. James (1756-1835) was the first distinct teacher of obstetrics, his chair falling later to Dewees, already mentioned, who wrote extensively on midwifery and the diseases of children and of women. The same chair in the University of Pennsylvania was filled later by Hugh L. Hodge (1796-1873), a man of great originality and independence, who published a most elaborate and beautiful work upon his branch, which will always remain a classic. Charles D. Meigs, professor in the Jefferson School, Philadelphia, was the first to direct attention to thrombosis as a cause of sudden death in childbirth. He wrote both on gynaecology and midwifery. Bedford, of Baltimore, was another popular teacher and writer, with whom deserves to be mentioned William H. By ford, of Chicago, who wrote on both obstetrics and gynaecology.
Gynaecology owes much to the efforts of American schools and practitioners. The first successful attempt of McDowell's, already alluded to, was imitated by Nathan Smith in 1821; and during the next forty years thirty-six ovariotomies had been performed by eighteen different surgeons, with a record of twenty-one recoveries.
Probably the most prominent passed figure in American gynaecology is J. Marion Sims (1813-1883), born in the South, where he invented his well-known speculum in 1852, whose introduction marked an epoch in the treatment of the pelvic diseases of women. It was also in South Carolina, among poor negro patients, that he perfected his method of plastic operations in the vagina for the relief of vesical fistulæ, which he later demonstrated in Paris to the astonishment of incredulous Parisian surgeons, who had almost uniformly failed in their attempts, and which he later successfully and brilliantly performed in all the capitals of Europe, where, as in this country, he enjoyed the greatest reputation. He was the founder of the great Woman's Hospital in New York, in 1855, an institution from which has proceeded more good gynæcological teaching than from any similar institution in the world Other ovariotomists and gynaecologists of great merit were John L. Atlee, and his brother Washington Atlee, of Pennsylvania; Dunlap, of Springfield, Ohio; Peaslee, of New York, who wrote the first American treatise on ovarian tumors; Kimball, of Lowell, Massachusetts; and D. H. Agnew, of Philadelphia, who is, perhaps, yet better known as a general surgeon because of his magnum opus,—his Treatise on Surgery, in three large volumes, already mentioned.
After this brief résumé of the names and achievements of the best-known American physicians and surgeons no longer living, it remains only to say a few words with regard to the general character of their work and attainments. It certainly was the case, during the earlier and middle portions of this century, that men had much to gain, beside addition to their vernacular, by study in foreign countries. Edinburgh and London were, at first, the centres to which men flocked; during the middle of the century they gathered in Paris, attracted by such men as Broussais, Velpeau, and others; after which the tide of travel turned toward Germany, where the government does more for the education of medical men and the furnishing of distinct opportunities than is done in any other part of the world. But, thanks to the influence of the foreign schools and the receptivity and natural quickness of the American mind, we have reached a point in this country when it is no longer necessary for American students to visit the foreign centres for this purpose, advantageous as these may be in many respects. The only feature in which we are yet lacking is the matter of government aid and the government control of medical institutions, by which better opportunities may be afforded for pathological study. Aside from this, and the centralization of cases which government control permits, it may be said that the Americans are in all respects as good practitioners as—and in most respects better than—their foreign colleagues. They evince more of humanity, more of real interest and care in their patients, and more consideration for their comfort and welfare; while, in all that pertains to fertility of invention, to originality of performance, and accuracy of work, they, as a rule, excel. Divested of glamour, American surgery, both general and special, is ahead of most of that which one can see abroad, and the therapeutics of the American profession certainly surpass those of any other nationality. No one need feel, then, that it is necessary to go abroad for any purpose, unless it may be that polish and wide range of general information that necessarily come from travel and observation among other nations and peoples. In practical medicine, then, as in practical living, America leads the world.
Anaesthesia and Analgesia. Drugs Possessing Narcotic Properties in use since Prehistoric Times. Mandragora; Hemp; Hasheesh. Sulphuric Ether and the Men Concerned in its Introduction as an Anaesthetic—Long, Jackson, Wells, and Morton. Morton's First Public Demonstration of the Value of Ether. Morton Entitled to the Credit of its Introduction. Chloroform and Sir James Simpson. Cocaine and Karl Roller.
It is not, perhaps, generally understood that we owe the term anaesthesia and the adjective anaesthetic to the genius of Dr. Oliver Wendell Holmes, who suggested their use to Dr. Morton. The term anaesthesia is applied to the artificial loss or deprivation of all sensation, which may be either local or general. It should be distinguished from analgesia, which means simply freedom from pain, consciousness being retained. In this respect local anaesthesia is really local analgesia, although the terms are confused in this regard.
Anaesthesia, in its present sense, is truly a modern discovery, which is to be credited to the United States. In its less restricted sense, however, it is a condition brought about by numerous drugs,—intoxicants, narcotics, etc.,—some of which have been more or less in use for centuries. Anaesthesia is also a condition which may be produced in the hypnotic sleep,—a fact well recognized by the ancients, although the attention of scientific men was scarcely drawn to the fact until the days of the notorious Mesmer. The substances which may produce loss of consciousness may be taken intentionally or unintentionally, and maybe taken into the stomach, beneath the skin, or, when gaseous, through the lungs, in which absorption of the same into the blood is very speedy. It is not at all unlikely that the curious effects ascribed to some of the ancient oracles were due to the inhalation of gases arising from natural springs or produced from other sources.
The most common source of narcotic drugs has always been the vegetable kingdom; and the peculiar effects of the juices or other ingredients of the poppy, henbane, deadly-nightshade, Indian hemp, mandragora, etc., have been sung in poetry, rehearsed in prose, and known from almost prehistoric time. Ulysses and his companions were stupefied by nepenthe; a draught of vinegar and myrrh, or gall, was offered to Christ upon the cross, as it often was to malefactors; and Herodotus speaks of a peculiar habit of the Scythians, who produced some stupefying vapor,—probably from the seed of the hemp. From Biblical times, at least, the most common narcotic seems to have been alcohol in some of its numerous combinations. Furthermore, the effect of hemlock has been celebrated since the days of Socrates, who was permitted to drink it in order to soothe himself during his last hour.
Mandragora seems to have had a great reputation in times past,—so much so that it is probable that more than one substance was included under this term. Apuleius, who lived about a century later than Pliny, wrote: "If any one is to have a member mutilated, burned, or sawed, let him drink half an ounce of mandragora with wine, and let him sleep till the member is cut away, without any pain or sensation." Among the Chinese and the Indians similar drugs seem to have been in frequent use, especially the bhang, ordinarily known as hasheesh. In many parts of the East something of this kind was administered to condemned criminals, as well as those compelled to undergo rude operations. It is said, also, that mild intoxication was produced among the fanatics of the East for the purpose of firing them to the point of heroic deeds, as it is also said that among the Druids the practice prevailed of partially stupefying the novitiates before initiating them into the most sacred and secret rites of their cult.
Guy de Chauliac was almost the only surgical writer of previous centuries who has referred to agents for the relief of pain, although during and before his time it was customary to give something to those about to undergo torture, by which to deaden their sensibility; and, though in the fables of all lands and all times something has always figured to which was ascribed the power of making people oblivious to pain or to the peculiarities of their situation, it is very difficult to learn just what, if any, particular composition was referred to or deserved such mention. There is allusion to something of the kind in Romeo and Juliet; again, in Cymbeline; and in one of Middleton's tragedies, published in 1567, entitled Women Beware Women, occurs this passage:—
"I'll imitate the pities of old surgeons
To this lost limb, who, ere they show their art,
Cast one asleep, then cut the diseased part."
Larrey, in his military campaigns, noticed the effect of cold in diminishing sensitiveness, and suggested that cold might be made a useful local anæsthetic. Many surgeons used to operate upon patients under the influence of alcoholic narcotization. It was in 1776 that Mesmer arrived in Paris and became the exponent of so-called "animal magnetism,"—later termed "mesmerism," now known as hypnotism,—under the influence of which he reduced to the state of unconsciousness of pain (i.e., analgesia, as well as the more complete condition, anæsthesia) a number of patients, who were operated upon without feeling the slightest suffering.
But, in spite of the earnest attempts of humane surgeons in various parts of the world, no agent had been discovered which was proven safe and generally effectual, up to the time, for instance, of Velpeau, who in 1839 wrote: "To escape pain in surgical operations is a chimera which we are not permitted to look for in our time."
The substance known as sulphuric ether has been known since the thirteenth century, when, as it appears, Raymond Lulli made certain—perhaps ambiguous—references to it. In 1540 it was known as the sweet oil of vitriol. It was not called an ether until 1730, when Godfrey spoke of it as such. It was frequently referred to during the last century by various writers, and the first reference to its inhalation seems to have been published in 1795 by Pearson. In a work by Beddoes, on Factitious Airs, published at Bristol, in 1796, is a statement that "Ether in pectoral catarrh gives almost immediate relief, both to the oppression and pain in the chest." Beddoes also states that after inhaling two spoonfuls he soon fell asleep. Later it was in somewhat general use internally for mitigating the pains of colic. By 1812 it was often inhaled for experiment or diversion, its peculiar exhilarating effects being generally known. So it is, perhaps, not strange that so soon as it was definitely recommended for purposes of surgical anæsthesia, a number of claimants for the honor of its discovery should quickly arise.
It was the same with nitrous-oxide gas, which had been knowrn for a number of years, and which was repeatedly used for the purpose of anæsthesia before the introduction of ether for the same purpose.
Chloroform was discovered in the year 1831 by Guthrie, of Sackett's Harbor, New York, and about the same time by Soubeiran, in France, and Liebig, in Germany. But, although before the profession for sixteen years, it was not recommended for the same purpose as sulphuric ether until 1847, and then by Doctor—later, Sir—James Simpson.
For all practical purposes we may limit further consideration of the history of anæsthesia to these three substances, and mainly to the consideration of the introduction and adoption of ether, which displaced nitrous oxide, preceded chloroform, and has held its own to the present day as the anaesthetic in most general use, although in many respects inferior to chloroform. But the glamour of history pertains mostly to ether, because of the peculiar difficulties and incidents attending its production.
For the honor of its discovery there are four claimants:—Crawford W. Long, of Danielsville, Ga.; Charles T. Jackson, of Plymouth, Mass.,—both physicians; Horace Wells, of Hartford, Vt., and William T. G. Morton, of Charleston, Mass.,—both dentists. It is only fair to each of these four men to consider briefly the merits of the claims made for each, while at the same time attributing the final success of the new agent to the happy accidents which permitted Morton to make a public demonstration of its power in the Massachusetts General Hospital, before such eminent men as Warren, Bigelow, and others, by whose influence and reputation the agent was at once received upon its merits. This was on the sixteenth of October, 1846,—a year which deserves to be memorable in the history of medicine.
Crawford Long graduated, in 1839, from the medical department of the University of Pennsylvania, and settled in Jefferson, Georgia, where it seems to have been a common thing to have what was known as "ether frolics," during which the exhilarating effects of the inhalation of the drug were matters of common sport and amusement at various small gatherings. Long himself frequently inhaled the drug and often felt its benumbing effects. It is stated that it finally occurred to him to give it a trial in a surgical operation, and that, in May of 1842, he removed a small tumor from the neck of a patient thus anaesthetized and without any pain. Owing to the sparseness of the population and the lack of dissemination of medical knowledge in those days, no public report was made of these operations, which produced nothing more than local town-talk. A young student of Long's, named Wilhite, kept a negro boy under the influence of ether for some time, to Long's surprise. Long lived one hundred and thirty miles from any railroad, and the first published account of his operations appeared in 1849, which was suggested by an account of Morton's work, which he had read in the editorials of the Medical Examiner for December, 1846. Long died in 1878, the unfortunate controversy in which the four claimants already mentioned participated being not yet concluded. Nevertheless, there is every reason to think that he is entitled to the credit of having first anaesthetized a patient with sulphuric ether for the purpose of producing insensibility to pain.
Horace Wells began the study of dentistry in 1834, in Boston, and later opened an office in Hartford, Connecticut. He seems to have been a young man of great ingenuity, continually making new instruments and devising new experiments. To him is to be credited the first operation ever performed without pain by the use of nitrous-oxide gas. In 1844 a Dr. Colton delivered a lecture in Hartford upon the subject of this gas. A young man who inhaled it, and became excited, ran against some furniture, badly bruising himself, but made no complaint of pain. Wells, noticing this, said to a by-stander that he believed that one, by inhaling a sufficient quantity, could have a tooth extracted or a leg amputated without pain. The following day he inhaled the gas himself and had a tooth extracted by a Dr. Higgs. Wells remained unconscious for a little while, and, on recovering consciousness, cried out: "A new era in tooth-pulling! It did not hurt me as much as the prick of a pin! It is the greatest discovery ever made!"
He at once began the manufacture and use of the gas, which became quite general in that locality. His attention was also called to the action of the vapor of ether, which Dr. Marcy, a physician of Hartford, suggested to him to try as a substitute for gas; but Wells, finding it more difficult to administer, discontinued it and confined himself to the use of nitrous oxide. A month later Dr. Marcy gave ether to a sailor for a small operation, the man feeling no pain. These experiences of Wells and Marcy occurred two years after Long's work with ether, each being in total ignorance of the experiments of the other.
In 1845 Wells visited Boston for the purpose of introducing nitrous oxide as an anaesthetic, and called upon his fellow-dentist and old partner, Morton, among others. He was discouraged, with his lack of success, returned to Hartford, and continued the frequent use of gas for a couple of years longer, but met with no encouragement in introducing it for general surgical purposes, on account of prejudice and fear upon the part of physicians and surgeons. Wells died in January, 1848, a few days before the Medical Society of Paris passed a resolution that to him is due all the honor of having first discovered and successfully applied the use of vapors or gases whereby surgical operations could be performed without pain. There stands to-day in Hartford the monument erected by the city and the State, with the following inscription:—
"Horace Wells, who discovered anæsthesia, November, 1844."
William T. G. Morton was born in 1819, and, after failing in business in Boston, in 1840 went to Baltimore and studied dentistry. In 1841 he entered the office of Horace Wells, above alluded to, as assistant, and in 1842 became his partner, after having introduced a new kind of solder for fixation of artificial teeth to gold plates. In 1843 this partnership was dissolved, Wells moving to Hartford, while Morton, in 1844, entered the office of Dr. C. P. Jackson as a medical student, matriculating in the Harvard School, but never graduating. After Wells's visit to Boston, during which he tried to introduce "laughing gas," Morton and he had numerous interviews, especially with regard to this gas. Morton was not well versed in chemistry, and sought the advice of his medical preceptor, Jackson, with regard to its manufacture. Asking why Morton wished to make it and being told the reason, Jackson suggested the use of' sulphuric ether, just as Marcy had suggested its use to Wells, saying that it was easy to procure, safe in employment, and equally productive of results. He also stated that the students at Cambridge College often inhaled ether for amusement.