Hermann Snellen (born 1834), an oculist of Utrecht, introduced test types for ascertaining the distinctness of vision.
R. Brudenell Carter, the eminent ophthalmologist, is a well-known and graceful writer on medical and scientific subjects.
CHAPTER II.
MEDICAL REFORMS.
Discovery of Anæsthetics.—Medical Literature.—Nursing Reform.—History of the Treatment of the Insane.
Conservative Surgery.
What is known as “conservative surgery” is the distinguishing feature of the art as practised at the present day. Whatever Lord Tennyson may have had in his mind in his lines on the children’s hospital, the highest surgical practice now is to save diseased and injured parts as much as possible, instead of removing them. Antiseptic surgery and the discovery of anæsthetics have alone made this possible.
Discovery of Anæsthetics.
The Chinese have a drug named Mago, by which they have been able, so they maintain, to destroy pain for thousands of years past. The vapour of hemp seed and the drug mandragora have for ages been employed for anæsthetic purposes previous to surgical operations. In Homer’s time the properties of opium were well understood, and other narcotic drugs were used for the same purpose. Patients were also sometimes stupefied by strong drink, and among some savage tribes banana wine was copiously administered so as to intoxicate the patient. It was not, however, until the discovery of the true anæsthesia produced by sulphuric ether and chloroform that grave surgical operations could be performed without causing pain to the patient. Nitrous oxide gas, discovered by Priestley in 1776, was recommended as an anæsthetic by Davy in 1800, and its use was begun in America by Wells, the dentist, in 1844. The discovery that by inhaling ether the patient is rendered unconscious of pain is due to Dr. C. T. Jackson, of Boston, U.S. Mr. T. Morton, of the same city, first introduced it into surgical practice in 1846. Chloroform was discovered by Souberain in 1831, and independently by Liebig in 1832. Dumas determined its composition in 1834. Jacob Bell in London, and Dr. Simpson in Edinburgh, first applied chloroform experimentally. The late Professor James Miller thus describes the discovery of the anæsthetic effects of chloroform:[1035] “The trial proceeded, and the safety as well as suitableness of anæsthesia, by ether, became more and more established. But a new phase was at hand. My friend, Dr. Simpson, had long felt convinced that some anæsthetic agent existed superior to ether, and, in the end of October, 1847, being then engaged in writing a paper on ‘Etherization in Surgery,’ he began to make experiments on himself and friends in regard to the effects of other respirable matters—other ethers, essential oils, and various gases; chloride of hydrocarbon, acetone, nitrate of oxide of ethyl, benzine, the vapour of iodoform, etc. The ordinary method of experimenting was as follows: Each ‘operator’ having been provided with a tumbler, finger glass, saucer, or some such vessel, about a teaspoonful of the respirable substance was put in the bottom of it, and this again was placed in hot water, if the substance happened to be not very volatile. Holding the mouth and nostrils over the vessel’s orifice, inhalation was proceeded with, slowly and deliberately, all inhaling at the same time, and each noting the effects as they advanced. Late one evening—it was the 4th November, 1847—Dr. Simpson, with his two friends and assistants, Drs. Keith and Matthews Duncan, sat down to their somewhat hazardous work in Dr. Simpson’s dining-room. Having inhaled several substances, but without much effect, it occurred to Dr. Simpson to try a ponderous material, which he had formerly set aside on a lumber-table, and which, on account of its great weight, he had hitherto regarded as of no likelihood whatever. That happened to be a small bottle of chloroform. It was searched for, and recovered from beneath a heap of waste paper. And, with each tumbler newly charged, the inhalers resumed their vocation. Immediately an unwonted hilarity seized the party; they became bright-eyed, very happy, and very loquacious—expatiating on the delicious aroma of the new fluid. The conversation was of unusual intelligence, and quite charmed the listeners—some ladies of the family, and a naval officer, brother-in-law of Dr. Simpson. But suddenly there was a talk of sounds being heard like those of a cotton-mill, louder and louder; a moment more, then all was quiet, and then a crash. On awaking, Dr. Simpson’s first perception was mental. ‘This is far stronger and better than ether,’ said he to himself. His second was to note that he was prostrate on the floor, and that among the friends about him there was both confusion and alarm.” Each of the investigators related his experience of the new drug, and the experiments were repeated, always, however, on this first occasion, stopping short of unconsciousness. They were all convinced that the new agent had full anæsthetic power when pushed. Thus was it satisfactorily proved that chloroform was something much better than ether. Dr. Simpson continued to pursue his experiments upon himself until he had perfected the method he had so happily discovered.
A curious incident connected with anæsthesia is mentioned by Dr. Paris in his well-known work Pharmacologia.[1036] He relates an anecdote which he heard from the poet Coleridge, which illustrates the curative influence of the imagination.