His Chapter Six deals with the course by which blood is carried from the right into the left ventricle, and here one must admire the large number of experimental demonstrations which Harvey had undertaken upon all classes of animals, for he speaks even of that which occurs in small insects, whose circulation he had studied so far as he could with the simple lens. Furthermore he described the prenatal circulation, omitting practically nothing of that which is taught to-day, showing that in embryos, while the lungs are yet in a state of inaction, both ventricles of the heart are employed, as if they were but one, for the transmission of blood. In concluding this chapter he again states briefly the course of the blood, and promises to show, first, that this may be so and, then, to prove that it really is so.
His Chapter Seven is devoted to showing how the blood passes through the substance of the lungs from the right ventricle and then on into the pulmonary vein and left ventricle. He alludes to the multitude of doubters as belonging, as the poet had said, to that race of men who, when they will, assent full readily, and when they will not, by no matter of means; who, when their assent is wanted, fear, and when it is not, fear not to give it. A little later on he says: "As there are some who admit nothing unless upon authority, let them learn that the truth I am contending for can be confirmed from Galen's own words, namely, that not only may the blood be transmitted from the pulmonary artery into the pulmonary veins and then into the left ventricle of the heart, but that this is effected by the ceaseless pulsation of the heart and the movements of the lungs in breathing." He then shows how Galen explained the uses of the valves and the necessity for their existence, as well as the universal mutual anastomosis of the arteries with the veins, and that the heart is incessantly receiving and expelling blood by and from its ventricles, for which purpose it is furnished with four sets of valves, two for escape and two for inlet and their regulation.
Harvey then noted a well-known clinical fact, that the more frequent or forcible the pulsations, the more speedily might the body be deprived of its blood during hemorrhage, and that it thus happens that in fainting fits and the like, when the heart beats more languidly, hemorrhages are diminished and arrested. The balance of the book is practically devoted to further demonstration and corroboration of statements already made. A study of this work of Harvey's illustrates how much respect even he and his contemporaries still showed for the authority of Galen. It shows still further how nearly Galen came to the actual truth concerning the circulation. Had the latter not adopted too many of the notions of his predecessors concerning the nature of the soul (Anima) and the spirits (Pneuma) of man, he might himself have anticipated Harvey by a thousand years, and by such announcement of a great truth have set forward physiology by an equal period. Independent and original as Harvey showed himself, he seems to have failed to get away from the notion of the vapors and spiritual nature of the blood which he had inherited from the writings of Galen and many others. Nevertheless he also alludes to this same blood as alimentive and nutritive. We must not forget, however, that this was years before Priestly's discovery of oxygen and that Harvey had, like others, no notion of the actual purpose of the lungs, believing that the purification and revivification of the blood was the office of the heart itself.
Along with its other intrinsic merits Harvey's book possesses a clear and logical arrangement, the author first disposing of the errors of antiquity, describing next the behavior of the heart in the living animal, showing its automatic pumplike structure, its alternate contractions and the other phenomena already alluded to, thus piling up facts one upon another in a manner which proved quite irresistible. The only thing that he missed was the ultimate connection between the veins and the arteries, i. e., the capillaries, which it remained for Malpighi to discover with the then new and novel microscope, which he did about 1657, showing the movement of the blood cells in the small vessels, and confirming the reality of that ultimate communication which had been held to exist. Malpighi discovered the blood corpuscles in 1665, but it remained for Leeuwenhoek, of Delft, in 1690, by using an improved instrument to demonstrate to all observers the actual movements of the circulating blood in the living animal. One historian has said that with Harvey's overthrow of the old teachings regarding the importance of the liver and of the spirits in the heart "fell the four fundamental humors and qualities" while Daremberg exclaims: "As in one of the days of the creation, chaos disappeared and light was separated from darkness."
It remains now only to briefly consider how Harvey's great discovery was received. To quote the words of one writer: "So much care and circumspection in search for truth, so much modesty and firmness in its demonstration, so much clearness and method in the development of his ideas, should have prepossessed everyone in favor of the theory of Harvey; on the contrary, it caused a general stupefaction in the medical world and gave rise to great opposition."
During the quarter of a century which elapsed after Harvey's announcement there probably was not an anatomist nor physiologist of any prominence who did not take active part in the controversy engendered by it; even the philosopher Descartes was one of the first adherents of the doctrine of the circulation, which he corroborated by experiments of his own.
Two years after the appearance of Harvey's book appeared an attack, composed in fourteen days by one Primerose, a man of Scotch descent, born and educated in France, but practising at Hull, in which he pronounced the impossibilities of surpassing the ancients or improving on the work of Riolan, who already had written in opposition to Harvey, and who was the only one to whom the latter vouchsafed an answer. It was Riolan who procured a decree of the Faculty of Paris prohibiting the teaching of Harvey's doctrine. It was this same Riolan who combated with equal violence and obstinacy the other great discovery of the age, namely,—the circulation of the lymph.
One of the earliest and fiercest adversaries of Harvey's theory was Plempius, of Louvaine, who, however, gave way to the force of argument and who finally publicly and voluntarily passed over to the ranks of its defenders in 1652, becoming one of Harvey's most enthusiastic advocates.
Harvey's conduct through the controversy was always of the most dignified character; in fact, he rarely ventured to reply in any way to his adversaries, believing in the ultimate triumph of the truths which he had enunciated. His only noteworthy reply was one addressed to Riolan, then Professor in the Paris Faculty and one of the greatest anatomists of his age, to whose opinion great value was always attached. Even in debating or arguing against him, Harvey always spoke of him with great deference, calling him repeatedly The Prince of Science. Riolan was, however, never converted, though whether he held to his previous position from obstinacy, from excess of respect for the ancients, or from envy and jealousy of his contemporary, is not known.
Another peculiar spectacle was afforded by one Parisunus, who died in 1643, a physician in Venice, who, like Harvey, had been a pupil of Fabricius of Aquapendente, who had been stigmatized by Riolan as an ignoramus in anatomy, but who joined with others in declaring that he had seen the heart beat when perfectly bloodless, and that no beating of the heart and no sounds were to be heard as Harvey had affirmed.
With the later and more minute studies into the structure and function of the heart we are not here concerned. The endeavor has been rather to place before you the sentiments, the knowledge and the habits of thought of the men of Harvey's time, with the briefest possible epitome of what they knew, or rather of how little they knew, to account for this later slavish adherence to authority by unwillingness to reason independently, or to observe natural phenomena intelligently, still less to experiment with them. It is, then, rather the brief history of an epochal discovery than an effort to trace out its far-reaching consequences that I have endeavored to give.
Here must close an account which perhaps has been to you tedious, and yet which is really brief, of Harvey's life and labors. He lived to see his views generally accepted and to enjoy his own triumph, a pleasure not attained by many great inventors or discoverers. Lessons of great importance may be gathered from a more careful study of this great historical epoch, but they must be left to your own powers of reasoning rather than to what I may add here. I commend it to you as a fertile source of inspiration, and a line of research worthy of both admiration and imitation. Few men have rendered greater service to the world by the shedding of blood than did Harvey, in his innocent and wonderful studies of its natural movement. Perhaps it might be said of him that he was the first man to show that "blood will tell." What he made it tell has been thus briefly told to you.
I know not how I may better close this account than by quoting the concluding words of his famous book, and especially repeating the lines which he has quoted from some Latin author whom I have not been able to identify. His paragraph and his quotation are as follows:
"Finally, if any use or benefit to this department of the republic of letters should accrue from my labors, it will, perhaps, be allowed that I have not lived idly, and, as the old man in the comedy says:
IN COMMEMORATION OF THE SEMI-CENTENNIAL OF THE INTRODUCTION OF ETHER AS AN ANAESTHETIC AGENT
Fifty years ago to-day—that is to say, on the 16th of October, 1846,—there occurred an event which marks as distinct a step in human progress as almost any that could be named by the erudite historian. I refer to the first demonstration of the possibility of alleviating pain during surgical operations. Had this been the date of a terrible battle, on land or sea, with mutual destruction of thousands of human beings, the date itself would have been signalized in literature and would have been impressed upon the memory of every schoolboy, while the names of the great military murderers who commanded the opposing armies would have been emblasoned upon monuments and the pages of history. But this event was merely the conquest of pain and the alleviation of human suffering, and no one who has ever served his race by contributing to either of these results has been remembered beyond his own generation or outside the circle of his immediate influence. Such is the irony of fate. The world erects imposing monuments or builds tombs, like that of Napoleon, to the memory of those who have been the greatest destroyers of their race; and so Cæsar, Hannibal, Genghis Khan, Richard the Lion-hearted, Gustavus Vasa, Napoleon and hundreds of other great military murderers have received vastly more attention, because of their race-destroying propensities and abilities, than if they had ever fulfilled fate in any other capacity. But the men like Sir Spencer Wells, who has added his 40,000 years of life to the total of human longevity, or like Sir Joseph Lister, who has shown our profession how to conquer that arch enemy of time past, surgical sepsis, or like Morton, who first publicly demonstrated how to bring on a safe and temporary condition of insensibility to pain, are men more worthy in our eyes of lasting fame, and much greater heroes of their times, and of all time,—yet are practically unknown to the world at large, to whom they have ministered in such an unmistakable and superior way.
This much, then, by way of preface and reason for commemorating in this public way the semi-centennial of this really great event. Because the world does scant honor to these men we should be all the more mindful of their services, and all the more insistent upon their public recognition.
Of all the achievements of the Anglo-Saxon race, I hold it true that the two greatest and most beneficent were the discovery of ether and the introduction of antiseptic methods,—one of which we owe to an American, the other to a Briton.
The production of deep sleep and the usual accompanying abolition of pain have been subjects which have ever appeared, in some form, in myth or fable, and to which poets of all times have alluded, usually with poetic license. One of the most popular of these fables connects the famous oracle of Apollo, at Delphi, whence proceeded mysterious utterances and inchoate sounds, with convulsions, delirium and insensibility upon the part of those who approached it. To what extent there is a basis of fact in this tradition can never be explained, but it is not improbable from what we now know of hypnotic influence.
From all time it has been known that many different plants and herbs contained principles which were narcotic, stupefying or intoxicating. These properties have especially been ascribed to the juices of the poppy, the deadly nightshade, henbane, the Indian hemp and the mandrágora, which for us now is the true mandrake, whose juice has long been known as possessing soporific influence. Ulysses and his companions succumbed to the influence of Nepenthe; and, nineteen hundred years ago, when crucifixion was a common punishment of malefactors, it was customary to assuage their last hours upon the cross by a draught of vinegar with gall or myrrh, which had real or supposititious narcotic properties. Even the prophet Amos, seven hundred years before the time of Christ, spoke of such a mixture as this as "the wine of the condemned," for he says, in rehearsing the iniquities of Israel by which they had incurred the anger of the Almighty: "And they lay themselves down upon the clothes laid to pledge by every altar, and they drink the wine of the condemned in the house of their God," (Chap. II, verse 8), meaning thereby undoubtedly that these people, in their completely demoralized condition, drank the soporific draught kept for criminals. Herodotus mentions a habit of the Scythians, who employed a vapor generated from the seed of the hemp for the purpose of producing an intoxication by inhalation. Narcotic lotions were also used for bathing the people about to be operated upon. Pliny, who perished at the destruction of Herculaneum, A. D. 79, testified to the soporific power of the preparations made from mandrágora upon the faculties of those who drank it. He says: "It is drunk against serpents and before cuttings and puncturings, lest they should be felt." He also describes the indifference to pain produced by drinking a vinous infusion of the seeds of eruca, called by us the rocket, upon criminals about to undergo punishment. Dioscorides relates of mandrágora that "some boil down the roots in wine to a third part, and preserve the juice thus procured, and give one cyathus of this to cause the insensibility of those who are about to be cut or cauterized." One of his later commentators also states that wine in which mandrágora roots have been steeped "does bring on sleep and appease pain, so that it is given to those who are to be cut, sawed or burnt in any parts of their body, that they may not perceive pain." Apuleius, about a century later than Pliny, advised the use of the same preparation. The Chinese, in the earlier part of the century, gave patients preparations of hemp, by which they became completely insensible and were operated upon in many ways. This hemp is the cannabis Indica which furnishes the Hasheesh of the Orient and the intoxicating and deliriating Bhang, about which travelers in the East used to write so much. In Barbara, for instance, it was always taken, if possible, by criminals condemned to suffer mutilation or death.
According to the testimony of medieval writers, knowledge of these narcotic drugs was practically applied during the last of the Crusades, the probability being that the agent principally employed was this same hasheesh. Hugo di Lucca gave a complete formula for the preparation of the mixture, with which a sponge was to be saturated, dried, and then, when wanted, was to be soaked in warm water, and afterward applied to the nostrils, until he who was to be operated upon had fallen asleep; after which he was aroused with the vapor of vinegar.
Strangely enough, the numerous means of attaining insensibility, then more or less known to the common people, and especially to criminals and executioners, do not appear to have found favor for use during operations. Whether this was due to unpleasant after-effects, or from what reason, we are not informed. Only one or two surgical writers beside Guy de Chauliac (1498) refer in their works to agents for relief of pain, and then almost always to their unpleasant effects, the danger of producing asphyxiation, and the like. Ambrose Paré wrote that preparations of mandrágora were formerly used to avert pain. In 1579, an English surgeon, Bulleyn, affirmed that it was possible to put the patient into an anaesthetic state during the operation of lithotomy, but spoke of it as a "terrible dream." One Meisner spoke of a secret remedy used by Weiss, about the end of the XVII Century, upon Augustus II., king of Poland, who produced therewith such perfect insensibility to pain that an amputation of the royal foot was made without suffering, even without royal consent. The advice which the Friar gave Juliet regarding the distilled liquor which she was to drink, and which should presently throw her into a cold and drowsy humor, although a poetic generality, is Shakespeare's recognition of a popular belief. Middleton, a tragic writer of Shakespeare's day, in his tragedy known as "Women beware Women," refers in the following terms to anesthesia in surgery:
Of course, of all the narcotics in use by educated men, opium has been, since its discovery and introduction, the most popular and generally used. Surgeons of the last century were accustomed to administer large doses of it shortly before an operation, which, if serious, was rarely performed until the opiate effect was manifested. Still, in view of its many unpleasant after-effects, its use was restricted, so far as possible, to extreme cases.
Baron Larrey, noticing the benumbing effect of cold upon wounded soldiers, suggested its introduction for anesthetic purposes, and Arnott, of London, systematized the practice, by recommending a freezing mixture of ice and salt to be laid directly upon the part to be cut. Other surgeons were accustomed to put their patients into a condition of either alcoholic intoxication or alcoholic stupor. Long-continued compression of a part was also practised by some, by which a limb could, as we say, be made to "go to sleep." A few others recommended to produce faintness by excessive bleeding. It was in 1776 that the arch-fraud Mesmer entered Paris and began to initiate people into the mysteries of what he called animal magnetism, which was soon named mesmerism, after him. Thoroughly degenerate and disreputable as he was, he nevertheless taught people some new truths, which many of them learned to their sorrow, while in the hospitals of France and England severe operations were performed upon patients thrown into a mesmeric trance, and without suffering upon their part. That a scientific study of the mesmeric phenomena has occupied the attention of eminent men in recent years, and that hypnotism is now recognized as an agent often capable of producing insensibility to pain is simply true, as these facts have been turned to the real benefit of man by scientific students rather than by quacks and charlatans.
In 1799, Sir Humphrey Davey, being at that time an assistant in the private hospital of Dr. Beddoes, which was established for treatment of disease by inhalation of gases, and which he called The Pneumatic Institute, began experimenting with nitrous oxide gas, and noticed its exhilarating and intoxicating effects; also the relief from pain which it afforded in headache and toothache. As the results of his reports, a knowledge of its properties was diffused all over the world, and it was utilized both for amusement and exhibition purposes. Davey even wrote as follows of this gas:
As nitrous oxide, in its extensive operation, appears capable of destroying physical pain, it may probably be used with advantage during surgical operations in which no great effusion of blood takes place.
It is not at all unlikely that Colton and Wells, to be soon referred to, derived encouragement, if not incentive, from these statements of Davey. Nevertheless, Velpeau, perhaps the greatest French surgeon of his day, wrote in 1839, that "to escape pain in surgical operations is a chimera which we are not permitted to look for in our day."
Sulphuric ether, as a chemical compound, was known from the XIII Century, for reference was made to it by Raymond Lully. It was first spoken of by the name of ether by Godfrey, in the Transactions of the London Royal Society, in 1730, while Isaac Newton spoke of it as the ethereal spirits of wine. During all of the previous century it was known as a drug, and allusion to its inhalation was made in 1795 in a pamphlet, probably by Pearson. Beddoes, in 1796, stated that "it gives almost immediate relief, both to the oppression and pain in the chest, in cases of pectoral catarrh." In 1815, Nysten spoke of inhalation of ether as being common treatment for mitigating pain in colic, and in 1816 he described an inhaler for its use. As early as 1812 it was often inhaled for experiment or amusement, and so-called "ether frolics" were common in various parts of the country. This was true, particularly for our purpose, of the students of Cambridge, and of the common people in Georgia in the vicinity of Long's home. It probably is for this reason that a host of claimants for the honor of the discovery appeared so soon as the true anesthetic properties of the drug were demonstrated.
There probably is every reason to think that, either by accident or design, a condition of greater or less insensibility to pain had been produced between 1820 and 1846, by a number of different people, educated and ignorant, but that no one had the originality or the hardihood to push these investigations to the point of determining the real usefulness of ether. This was partly from ignorance, partly from fear, and partly because of the generally accepted impossibility of producing safe insensibility to pain. So, while independent claims sprang up from various sources, made by aspirants for honors in this direction, it is undoubtedly as properly due to Morton to credit him with the introduction of this agent as an anesthetic as to credit Columbus with the discovery of the New World, in spite of certain evidences that some portions of the American continent had been touched upon by adventurous voyagers before Columbus ever saw it.
The noun "anesthesia" and the adjective "anesthetic" were suggestions of Dr. Oliver Wendell Holmes, who early proposed their use to Dr. Morton in a letter which is still preserved. He suggests them with becoming modesty, advises Dr. Morton to consult others before adopting them, but, nevertheless, states that he thinks them apt for that purpose. The word anesthesia, therefore, is just about of the same age as the condition itself, and it, too, deserves commemoration upon this occasion.
As one reads the history of anesthesia, which has been written up by a number of different authors, each, for the main part, having some particular object in view, or some particular friend whose claims he wishes especially to advocate, he may find mentioned at least a dozen different names of men who are supposed to have had more or less to do with this eventful discovery. But, for all practical purposes, one may reduce the list of claimants for the honor to four men, each of whose claims I propose to briefly discuss. These men were Long, Wells, Jackson and Morton. Of these four, two were dentists and two practising physicians, to whom fate seems to have been unkind, as it often is, since three of them at least died a violent or distressing death, while the fourth lived to a ripe old age, harassed at almost every turn by those who sought to decry his reputation or injure his fortunes.
Crawford W. Long was born in Danielsville, Ga., in 1816. In 1839 he graduated from the Medical Department of the University of Pennsylvania. In the part of the country where Long settled it was a quite common occurrence to have what were known as "ether frolics" at social gatherings, ether being administered to various persons to the point of exhilaration, which in some instances was practically uncontrollable. Long's friends claim that he had often noticed that when the ether effect was pushed to this extent the subjects of the frolic became oblivious to minor injuries, and that these facts, often noticed, suggested to his mind the use of ether in surgical operations. There is good evidence to show that Long first administered ether for this purpose on the 30th of March, 1842, and that on June 6th he repeated this performance upon the same patient; that in July he amputated a toe for a negro boy, but that the fourth operation was not performed until September of 1843. In 1844 a young man, named Wilhite, who had helped to put a colored boy to sleep at an ether frolic in 1839, became a student of Dr. Long's, to whom Long related his previous experiences. Long had never heard of Wilhite's episode, but had only one opportunity, in 1845, to try it, again upon a negro boy. Long lived at such a distance from railroad communication (130 miles) as to have few advantages, either of practice, observation or access to literature. Long made no public mention of his use of ether until 1849, when he published An Account of the First Use of Sulphuric Ether by Inhalation as an Anesthetic in Surgical Operations, stating that he first read of Morton's experiments in an editorial in the Medical Examiner of December, 1846, and again later; on reading which articles he determined to wait before publishing any account of his own discovery, to see whether anyone else would present a prior claim. No special attention was paid to Long's article, as it seemed that he merely desired to place himself on record. There is little, probably no reasonable doubt as to Long's priority in the use of ether as an anesthetic, although it is very doubtful if he carried it, at least at first, to its full extent. Nevertheless Long was an isolated observer, working entirely by himself, having certainly no opportunity and apparently little ambition to announce his discovery, and having no share in the events by which the value of ether was made known to the world. Long's strongest advocate was the late Dr. Marion Sims, who made a strong plea for his friend, and yet was not able to successfully establish anything more than has just been stated. As Dr. Morton's son, Dr. W. J. Morton, of New York, says, when writing of his father's claim: "Men used steam to propel boats before Fuller; electricity to convey messages before Morse; vaccine virus to avert smallpox before Jenner; and ether to annul pain before Morton."
But these men are not generally credited with their introduction by the world at large and, he argues, neither should Long or the other contestants be given the credit due Morton himself. In fact, Long writes of his own work that the result of his second experiment was such as to make him conclude that ether would only be applicable in cases where its effects could be kept up by constant use; in other words, that the anesthetic state was of such short duration that it was to him most unsatisfactory. Sir James Paget has summed up the relative claims of our four contestants in an article entitled Escape from Pain, published in the Nineteenth Century for December, 1879. He says:
"While Long waited, and Wells turned back, and Jackson was thinking, and those to whom they had talked were neither acting nor thinking, Morton, the practical man, went to work and worked resolutely. He gave ether successfully in severe surgical operations; he loudly proclaimed his deeds and he compelled mankind to hear him."
Horace Wells was born in Hartford, Vt., in 1815. In 1834 he began to study dentistry in Boston, and after completing his studies began to practise in Hartford, Ct. He was a man of no small ingenuity, and devised many novelties for his work. In December, 1844, he listened to a lecture delivered by Dr. Colton, who took for his subject nitrous oxide gas, the amusing effects of which he demonstrated to his audience upon a number of persons who visited the platform for that purpose. Wells was one of these. Wells, moreover, noticed that another young man, who bruised himself while under its influence, said afterward that he had not hurt himself at all. Wells then stated to a bystander that he thought that if one took enough of that kind of gas he could have a tooth extracted and not feel it. He at once called upon a neighboring dentist friend and made arrangements to test the anesthetic effects of the gas upon himself the next morning. Accordingly Colton gave him the gas, and Riggs, the friend, extracted the tooth; and Wells, returning to consciousness, assured them both that he had not suffered a particle of pain. He began at once to construct an apparatus for its manufacture. Dr. Marcey, of Hartford, then informed Wells that while a student at Amherst he and others had often inhaled nitrous oxide as well as the vapor of ether, for amusement, and suggested to Wells to try ether. After a few trials, however, it was found more difficult to administer, and Wells accordingly resolved to adhere to gas alone. This was in 1844, two years after Long's obscure experiments, of which, of course, they were ignorant. In 1845, Wells visited Boston for the purpose of introducing his discovery, and among others called upon his former partner, Morton, trying to establish the use of the gas. He soon became discouraged, however, and returned to Hartford, resuming his practice. There he continued to use gas for about two years, but failed to secure its introduction into general surgery, owing to prejudice and ignorance on the part of dentists and physicians alike.
Wells's claims have been advocated by many of his fellow-citizens, and in Bushnell Park, in Hartford, stands a monument erected by the city and the state, dedicated to Horace Wells, "who discovered anesthesia, November, 1844."
C. T. Jackson was born in Plymouth, Mass., in 1805. He graduated in the Harvard Medical School in 1829, after which he went abroad, where he remained for several years, made the acquaintance of the most distinguished men, experimented in general science, electricity and magnetism and even devised a telegraphic apparatus, similar to that which Morse patented a year later. Returning, in 1835, he opened in Boston a laboratory for instruction in analytical chemistry, the first of its kind in the country. He also made quite a reputation as a geologist and mineralogist and received official appointments from Maine, Rhode Island, New Hampshire and other states. In 1845 he discovered and opened up copper and iron mines in the Lake Superior district. In 1846 and 1847 he was much aroused by Morton's experiments with sulphuric ether, and claimed even that he had suggested the use of ether to Morton, claiming also that he had himself been relieved of an acute distress by inhalation of ether vapor, and that it was from reflection on the phenomena presented in his own case that the possibility of its use for relief of pain during surgical operations suggested itself to him. This led to a triangular conflict for the priority of discovery between Wells, Jackson and Morton, each claiming the honor for himself. Wells health soon gave way. He went abroad and got recognition from the French Institute and the Paris Academy of Sciences, which did not, however, endorse his claim as discoverer nor accept nitrous oxide as an anesthetic. Wells returned to find that Morton was on the tide of popular favor, the public having endorsed ether as the only reliable anesthetic. His mind became unbalanced, and in a fit of temporary aberration he ended his own life in a prison cell, in New York city in 1848.
Wells being out of the way, Jackson became Morton's most violent opponent, and the two indulged in a most bitter fight and unseemly discussion. A few years later, Jackson, who, as remarked, had an extensive acquaintance abroad, visited Europe and presented his claim to the credit of the discovery of ether before various individuals and learned bodies, and so well did he work upon the French Institute as to be recognized as the discoverer of modern anesthesia. A select committee of the House of Representatives, to whom in 1854 Congress referred the matter, announced the following conclusions:
"First, that Dr. Horace Wells did not make any discovery of the anesthetic properties of the vapor of ether which he himself considered reliable and which he thought proper to give to the world. That his experiments were confined to nitrous oxide, but did not show it to be an efficient and reliable anesthetic agent....
"Second, that Dr. Charles T. Jackson does not appear at any time to have made any discovery in regard to ether which was not in print in Great Britain some years before.
"Fifth, that the whole agency of Dr. Jackson in the matter appears to consist entirely in his having made certain suggestions to aid Dr. Morton to make the discovery."
In 1873, Jackson's mind gave way, and after seven years of confinement in an asylum he died in 1880, at the age of 75, having been the recipient of many honors from foreign potentates and learned societies.
William T. G. Morton was born in Charleston, Mass., in 1819. After a disastrous experience in business he was sent to Baltimore in 1840 and began the study of dentistry. In 1841 he entered the dental office of Horace Wells as student and assistant, becoming a partner in 1842. In 1843 partnership was dissolved, Wells removing to Hartford, as before stated. Morton, ambitious for a medical degree, entered his name as a student in the office of Charles T. Jackson, in 1844, and the same year matriculated in the Harvard Medical School, though he never graduated. Having learned through Wells of the latter's successful use of nitrous oxide gas, but not knowing how to make it, he sought the advice of Dr. Jackson, who informed him that its preparation entailed considerable difficulty, and inquired for what purpose he wanted it. On Morton's replying that he wished to use it to make patients insensible to pain, Jackson suggested the use of sulphuric ether, as Marcey had suggested it to Wells two years previously, saying that it would produce the same effect and did not require any apparatus. Jackson also told Morton of the ether frolics common at Cambridge among the students. That same evening, September 30, 1846, Morton administered ether to a patient and extracted a tooth for him without pain. The next day he visited the office of a patent lawyer, for the purpose of securing a patent upon the new discovery. This lawyer ascertained that Jackson had been intimately connected with its suggestion, and came to the conclusion that a patent could not safely issue to either one independently of the other. But Jackson being a member of the State Medical Society, against whose ethical code it is to patent discoveries that pertain to the welfare of patients, and fearing the censure of his colleagues, agreed at once to assign his right over to Morton, receiving in return a 10 per cent. commission upon all that the latter made out of it. Morton, as a dentist, having no more compunction then than dentists have now upon the securement of a patent,—in other words, being actuated by no fine ethical scruples,—secured the patent, and then called upon Dr. J. Mason Warren, one of the surgeons in the Massachusetts General Hospital. Warren promised his coöperation and appointed the 16th of October, 1846, for the first public trial. Upon this occasion the clinic room was filled with visitors and students, when Morton placed the young man under the influence of his "letheon," as he called it then; after which Warren removed a tumor from his neck. The trial was most successful. Another took place on the following day, and on November 7th an amputation and an excision of the jaw were made, both patients being under the influence of letheon and oblivious to pain. At this time the nature of the anesthetic agent was kept a secret, the vapor of ether being disguised by aromatics, so as not to be recognized by anyone present.
True to the highest traditions of their craft, the staff of the Massachusetts General Hospital now met and declined to make further use of a drug whose composition was thus kept secret. It was then that Morton revealed the exact nature of it as sulphuric ether, disguised with aromatic oils. In a report made by the commissioner of patents, it was set forth that:
"For many years it had been known that the vapor of sulphuric ether, when freely inhaled, would intoxicate as does alcohol when taken into the stomach, but that the former was much more temporary in its effects. But notwithstanding the records of its effects to this extent, which were familiar to so many, no surgeon had ever attempted to substitute it for the palliatives in common use previous to surgical operations. That, in view of these and other considerations, a patent had been granted for the discovery."
In 1846 an English patent was obtained.
Morton soon began the attempt to sell office rights, as do the dentists of to-day, while the medical profession was then, as ever, antagonistic to patents, holding them to be subversive of general good. His patent was soon opposed and then generally infringed upon. Litigation followed without end, and the government stultified itself by refusing to recognize the validity of the patent issued by itself. And so, without any compensation to the discoverer, ether soon came into general use in this country as abroad. While receiving many congratulations from friends and humanitarians, Morton's success aroused the jealousy of some of his professional brethren, among them one Dr. Flagg, who commenced a terrible onslaught upon the new application of ether and its promoter. By his machinations a meeting of Boston dentists was called and a committee of twelve appointed to make a formal protest against anesthesia. This committee published a manifesto in the Boston Daily Advertiser, in which all sorts of untoward effects and unpleasant results were attributed to the new anesthetic. This proclamation was spread broadcast, and did Morton, for the time, very much harm. Equally obstreperous was Dr. Westcott, connected with the Dental College in Baltimore. He made fun of Morton's "sucking bottles," as his inhalers were dubbed; and in various of the medical and secular journals of the day, bitter, often foolish and absurd, attacks were made. The editors of the New Orleans Medical and Surgical Journal said:
"That the leading surgeons of Boston could be captivated by such an invention as this, heralded to the world under such auspices and upon such evidences of utility and safety as are presented by Dr. Bigelow, excites our amazement. Why, mesmerism, which is repudiated by the savants of Boston, has done a thousand times greater wonders, and without any of the dangers here threatened. What shall we see next?"
These and similar statements created a very strong prejudice against Morton, who, in December, 1846, sent to Washington, to a nephew of Dr. Warren, to endeavor to urge upon the government the advantages of employing ether in the army during the Mexican war, then in progress. The chief of the Bureau of Medicine and Surgery reported that the article might be of some service for use in large hospitals, but did not think it expedient for the department to incur any expense by introducing it into the general service; while the acting surgeon-general believed that the highly volatile character of the substance itself made it ill-adapted to the rough usage it would necessarily encounter upon the field of battle, and accordingly declined to recommend its use.
In January of 1853, Morton demonstrated at the infirmary in Washington, before a congressional committee and others, the anesthetic effect of ether, which he continued through a dangerous and protracted surgical operation. This was the result of a challenge to compare the effects of nitrous oxide and those of ether, the advocates of the former not putting in an appearance.
The balance of Morton's life seems to have been spent in continued jangles. The government, having repudiated its own patent, was repeatedly besought by memorials and through the influence of members of Congress to bestow some testimonial upon or make some money return to Morton for his discovery. Several times he came near a realization of his hopes in this respect, when the action of some of his enemies or the termination of a congressional session, or some other accident, would doom him again to disappointment. The pages of evidence that were printed, the various reports issued through or by government officers, the memorials addressed from various individuals and societies, if all printed together, would make a large volume; but all of these were of no avail. Morton spent all his means, as he spent his energies and time, in futile endeavor to get pecuniary recognition of his discovery, but was doomed to disappointment. He seemed alike a victim of unfortunate circumstances and of treachery and animosity upon the part of his opponents. Especially did the fight wage warm between him and his friends and Jackson. Plots to ruin his business were repeatedly hatched and his life was made miserable in many ways. Mere temporary sops to wounded vanity and impaired fortune were the honorary degrees and the testimonials that came to him from various institutions of learning and foreign societies. In 1850 both Morton and Jackson received from the French Academy prizes valued at 2,500 francs each. Finally, Morton fell into a state of nervous prostration, suffered from anxiety and insomnia, and in a fit of temporary aberration exposed himself in Central Park, New York, became unconscious, and was taken to St. Luke's hospital, dying just as he reached the institution, on the 15th of July, 1868. In Mount Auburn cemetery, in Boston, there stands a beautiful monument to William T. G. Morton, bearing this inscription: "Inventor and revealer of anesthetic inhalation, before whom in all time surgery was agony; by whom pain in surgery was averted and annulled; since whom science has control of pain."
Again, in the Public garden in Boston there was erected, in 1867, a beautiful monument to the honor of the discoverer of ether, upon whom at that time they could not decide. Upon the front are these words: "To commemorate that the inhaling of ether causes insensibility to pain, first proven to the world at the Massachusetts General hospital, in Boston, October, A. D. 1846." Upon the right side are the words: "'Neither shall there be any more pain.'—Revelations." Upon the left: "'This also cometh forth from the Lord of Hosts, which is wonderful in counsel and excellent in working.'—Isaiah." And upon the other: "In gratitude for the relief of human suffering by the inhaling of ether, a citizen of Boston has erected this monument, A. D. 1867. The gift of Thomas Lee."
Summing up, then, the claims of our four contestants in the light of a collected history of the merits of each, it would appear that Wells first made public use of nitrous oxide gas for limited purposes, but failed to introduce it into general professional use. That Long, in an isolated rural practice, a few times used ether, with which he produced probably only partial insensibility to pain, and that he had apparently discontinued its use before learning of Morton's researches. That Jackson made no claim to the use of the agent on his own part, but simply of having suggested it to Morton. And, finally, that Morton quickly accepted the suggestion, made careful and scientific use thereof, but especially, and above all other things, first demonstrated to the world at large the capability and the safety of this agent as an absolute, reliable and efficient anesthetic. So, though Morton permitted his cupidity to run away with finer ethical considerations, and attached a higher pecuniary than humanitarian value to sulphuric ether, he, nevertheless, must be generally credited with having, to use the modern expression, "promoted" its introduction, and having shown to the world at large what an inestimably valuable therapeutic agent had been added to our resources for the control of pain.
The synthetic compound known as chloroform was discovered independently by three different observers between 1830 and 1832. These were respectively Guthrie, of Sackett's Harbor, N. Y.; Soubeiran, of France, and Liebig, of Germany. The honor of introducing it to the profession as an anesthetic for surgical purposes is universally accorded to James Y. Simpson, then of Edinburgh.
Yet claim was at one time advanced in favor of Surgeon-Major Furnell, of the Madras Army Medical Corps, who in the summer preceding the announcement of Simpson's brilliant discovery experimented with what is known as chloric ether, which is not an ether at all, but a solution of chloroform in alcohol. It is said that he found that it would produce the same results as sulphuric ether, with less unpleasant sensations, and suggested its use to Coote, a well-known London surgeon. However, such claims as those made in favor of Furnell are no more entitled to recognition than are those of Wells or Long in the matter of the introduction of ether to the public; for although individual observations were favorable to the compound, it never came to public notice on this surmise.
Sir James Y. Simpson was born in 1811, took the degree of doctor of medicine in 1832 and advanced rapidly in his professional career until, in January, 1847, he was appointed one of her majesty's physicians in Scotland. Having already obtained a large reputation, particularly in midwifery and gynecology, he directed his special attention toward the use of anesthetics in childbirth, and he had quickly recognized the value of sulphuric ether when introduced the previous year. He sought, however, for a substitute of equal power, having less disagreeable odor and unpleasant after effect. Upon inquiry of his friend Waldie, Master of Apothecaries Hall of Liverpool, if he knew of a substance likely to be of service in this direction, Waldie, familiar with the composition of chloric ether, suggested its active principle chloroform; with which Simpson experimented, and, upon the 4th of November, 1847, established its anesthetic properties. These he first made known to the Medico-Chirurgical Society of Edinburgh in a paper read November 10th. Three days later a public test was to have been made at the Royal Infirmary, but Simpson, who was to administer the chloroform, being unavoidably detained, the operation was done as heretofore without an anesthetic, and this patient died during the operation. You can readily see that had this occurred under chloroform it would have been ascribed to the new drug, which would then and there have received its death blow. As it was, the first public trial took place two days later and the test was most successful.
One would think that such a boon as Simpson had here offered to the world would have been gratefully—not to say greedily—accepted by all. Simpson's position was such as to give the new anesthetic every advantage that his already great reputation could attach to it, and it became at once the agent in common use in midwifery practice. But the Scotch clergy of his day still possessed altogether too much of the old fanatic spirit of the church of the middle ages. One is never allowed to forget, in scanning the history of medicine, how bitterly the church has opposed, until recently, every advance in our science and our art. It was in A. D. 995, for instance, that the son of one of the Venetian Doges was married, in Venice, to a sister of the emperor of the Eastern Roman Empire. At the marriage feast the princess produced a silver fork and gold spoon, table novelties which excited both amusing and angry comment. But the Venetian aristocracy took up with this new table fad, and forks and spoons as substitutes for fingers soon became the fashion. But the puissant church disapproved most strongly even of this arrangement, for priests went so far as to say, "to use forks was to deliberately insult the kind Providence which had given to man fingers on each hand." It was this same spirit that led the Scotch clergy to attack Simpson most vehemently and denounce him from their pulpits as one who violated the moral law, for they said: "Is it not ordained in Scripture, 'in sorrow shalt thou bring forth children?' and yet this man would introduce a substance calculated to mitigate this sorrow." We of to-day can scarcely imagine the rancor with which these attacks were made for many months. Finally, however, these fanatic defenders of the faith were routed by a quotation from the same Scriptures in which they claimed to find their authority; for Simpson, most adroitly turning upon them with their own weapons, called their attention to the first chapter of Genesis, in which an account of Eve's creation appears, and reminded them that when Eve was formed from the rib of Adam, the Lord "caused a deep sleep to fall upon" him. So weak was their cause that with this single quotation their opposition subsided and within a week or two the entire Scotch clergy was silenced. Sir James Simpson received from his own government that which was never accorded to Morton: that is, due recognition of the great service he had rendered humanity. He died in 1870, and upon his bust, which stands in Westminster Abbey, are the following words: "To whose genius and beneficence the world owes the blessings derived from the use of chloroform for the relief of suffering."
It is scarcely necessary that I delay you now with an account of all of the other ethereal anesthetic agents which have from time to time been advocated since the memorable days to which I have devoted most of my time to-night. Two only are at present ever thought of—namely, bichloride of methylene and bromide of ethyl!—and these are used by only a few, though each has its advantages. It is well known that nearly all of the ethers have more or less of anesthetic property, coupled with many dangers and disadvantages. Sulphuric ether and chloroform hold the boards to-day as against any and all of their competitors.
Nitrous oxide gas, as already mentioned, was known to and used by Wells, in Hartford. With the advent of ether this gas fell at once into disuse, to be revived some fifteen years after the death of Wells, mainly through the use of Dr. G. Q. Colton. Since this time its use has been quite universal, although confined for the main part to the offices of dentists. Its great advantages are ease of administration and rapidity of recovery, making it especially useful for their purposes, while the difficulties attendant upon prolonged anesthesia by it makes it less useful for the surgeon.
I will spend no further time upon it nor upon the subject save to do justice to modern anesthesia by a very different method and by means of a very different drug, which is to-day in so common use that we almost forget to mention the man to whom we owe it. I allude to Cocaine and its discoverer, Koller.
Cocaine is now such a universally recognized local anesthetic that there is the best of reason for referring to it here—the more so because it affords another opportunity to do honor to a discoverer, who has rendered a most important service to not only our profession, but to the world in general.
This principal active constituent of cocoa leaves was discovered about 1860 by Niemann, and called by him cocaine. It is an alkaloid which combines with various acids in the formation of salts. It has the quality of benumbing raw and mucous surfaces, for which purpose it was applied first in 1862 by Schroff, and in 1868 by Moreno. In 1880, Van Aurap hinted that this property might some day be utilized. Karl Koller logically concluded from what was known about it that this anesthetic property could be taken advantage of for work about the eye, and made a series of experiments upon the lower animals, by which he established its efficiency and made a brilliant discovery. He reported his experiments to the Congress of German Oculists, at Heidelberg, in 1884. News of this was transmitted with great rapidity, and within a few weeks the substance was used all over the world. Its use spread rapidly to other branches of surgery, and cocaine local anesthesia became quickly an accomplished fact. More time was required to point out its disagreeable possibilities, its toxic properties and the like, but it now has an assured and most important place among anesthetic agents, and has been of the greatest use to probably 10 per cent. of the civilized world. To Koller is entirely due the credit of establishing its remarkable properties.