The Progress of Invention in the Nineteenth Century.

by Edward W. Byrn

FIG. 174.—THE OPHTHALMOMETER.

Instruments.—Laennec’s discovery in 1819 of auscultation, and the stethoscope, for determining internal conditions by sound, was a great step in diagnosing diseases. The binaural stethoscope was invented by Cammann in 1854, and a later improvement is the phonendoscope, by Bianchi. The opthalmoscope is an instrument for inspecting the interior of the eye, which was invented by Prof. Helmholtz, and described by him in 1851. The laryngoscope, for obtaining a view of the larynx, was said to have been constructed by Mr. John Avery, of London, as early as 1846. The opthalmometer, [Fig. 174], is a comparatively recent invention. It is designed to ascertain variations in corneal curvature for the correction of corneal astigmatism. Electric lights with reflectors are arranged on each side of the patient’s head, while the operator looks into the eye with a telescope. The sphygmograph, a little instrument to be strapped on to the wrist to record the action of the pulse, was first reduced to a practically useful form by Marey in 1860. A later development of these devices, by Verdin, known as the sphygmometrograph, is shown in [Fig. 175]. The endoscope, for looking into the urethra, and the cystoscope, for looking into the bladder, are other useful instruments of the modern practitioner. Greater than them all, however, is the modern X-ray apparatus, for locating foreign substances in the body and making visible the bones through the flesh, for which see [special chapter]. The use of the thermometer in recording the progress of fevers is also a valuable modern application, and the list of instruments and small tools is beyond enumeration. There are series of obstetrical appliances, instruments relating to bone surgery, to the taking up of arteries, cupping instruments, trepanning instruments, speculums, hypodermic syringes, electric cauteries, fracture appliances, instruments for lithotrity, bandages for varicose veins, atomizers, breast pumps, inhalers, nasal douches, trusses, pessaries, catheters, abdominal supporters, and an endless variety of proprietary articles, such as electric baths and belts, plasters, chest protectors, liver pads, and so forth, all of which are practically the products of the Nineteenth Century. The surgeon of to-day can straighten the eyes of a cross-eyed man, or take the bow out of his bandy legs, can make him a new nose of his own flesh, patch his skull with a silver plate, remove the stone from his bladder, supply him with a wind-pipe, wash out his stomach, and perform many other operations even more difficult. Among such more important operations may be mentioned ovariotomy, which was first performed by Dr. Ephraim McDowell, of Danville, Kentucky, in 1809, and the tying of the great arteries. The operation of lithotrity, for removing stone from the bladder by crushing the stone, was introduced by Civiale, 1817-1824, who devised successful instruments and modes of using them. In 1836 to 1840 Richard Bright, an English physician, made important researches and discoveries in relation to the functions and diseases of the kidneys, and established the nature of the so-called “Bright’s disease.”

FIG. 175.—VERDIN’S SPHYGMOMETROGRAPH, FOR RECORDING THE ACTION OF THE PULSE.

Schools of Medicine.—While the regular school of medicine (called by some “Allopathy”) has held the leading place in medicine, various other schools have sprung up in the Nineteenth Century, all of which represent advances in a knowledge of the laws of health, and the modes of preventing and curing diseases. Hahnemann, in his “Organon der Rationellen Heilkunde,” in 1810, gave homœopathy its name, and reduced it to a system. The doctrine of similia similibus curantur (like cures like), has gained great popularity in the latter part of the century. Hydropathy, as a school, also made its appearance in the early part of the Nineteenth Century. Priessnitz was its first disciple, and the Grafenberg cure, established in 1826, was a noted institution for many years. The useful application of water in the form of baths and cold packs, has been known for centuries, and will always be used as a valuable agency in sickness and in health. The “Thompsonian” system of treating diseases was covered by patents in 1813, 1823 and 1836, and attained considerable notoriety in the early half of the century. Sweating by hot bricks and hot tea made of “Composition Powders,” vomiting with lobelia to produce relaxation, and a fiery liquid for cramps, called “No. 6,” were the chief remedies, and very few boys who had once taken the treatment were ever willing afterwards to admit that they were sick. In the latter part of the Nineteenth Century electro-therapeutics has received a large share of attention, many forms of medical batteries have been devised, and probably no more promising field of study and research exists in the whole domain of medicine.

Dentistry.—George Washington had false teeth, and it is said that the teeth of some of the mummies of Egypt had gold fillings, but it remained for the Nineteenth Century to establish dentistry as an art, and its influence in securing better mastication and digestion of food, more sanitary mouths and shapely faces, cannot be estimated. Few people can be found to-day who have not either filled teeth, bridge work, gold caps, or artificial sets of teeth. The most important advance in the art was in the invention of the rubber plate for holding the porcelain teeth. This was the invention of J. A. Cummings, and was covered by him in his patent No. 43,009, June 7, 1864. In more recent years “bridge-work” represents the most important advance. In this practice one or more artificial teeth are firmly held in the place of missing teeth by a strong bridge-piece of metal, which at its ends is anchored to the adjacent natural teeth. This was first done by Bing (British Pat. No. 167, of 1871), and was afterwards patented in somewhat different form in the United States by J. E. Lowe, No. 238,940, March 15, 1881, No. 313,434, March 3, 1885, and Richmond, May 22, 1883, No. 277,933. Porcelain and gold crowns and dental pluggers run by electricity represent other important advances in this art. It is said that there are 20,425 dentists in the United States, and that in 1899 they employed in their practice 20,499,000 false teeth.

Artificial Limbs.—With the successful work of the surgeon came the effort to repair, as far as possible, the loss of the limb. Until about the middle of the Nineteenth Century the survivor of an operation was an unsymmetrical, unique, and pitiful object. The peg-leg of Peter Stuyvesant lives in history, and the arm-hook of Capt. Cuttle is familiar to every reader. The first United States patent for an artificial leg was granted to B. F. Palmer, Nov. 4, 1846, No. 4,834. Wooden legs with a restricted back and forward ankle motion and a spring, were constructed by A. A. Marks from 1853 to 1863. On Dec. 1, 1863, a patent, No. 40,763, was granted to Mr. Marks for the use of sponge rubber for constructing artificial feet and hands that dispensed with the articulated joints, and made a great improvement. In patent No. 366,494, July 12, 1887, to G. E. Marks, the foot and leg portion of a wooden leg are made from wood which grows with a crook, as at the root of a tree, where the strength and lightness of a continuous natural grain is obtained at the instep. About 300 patents have been granted for artificial legs and arms. Modern improvements have extended to every detail of construction, and so perfect to-day is the average wooden leg that it is hardly to be detected. Men with wooden legs ride horseback, are expert users of the bicycle, and have even performed feats on the tight rope. The inventor’s genius has not stopped at repairing limbs, however, for artificial eyes, artificial ear drums, the audiphone, foot extensions for short legs, crutches, braces, abdominal supporters, and various other applications to supplement the defects of the body have been devised.

Digestion.—The physiology of digestion had, perhaps, the first real light shed upon it by Beaumont’s observations from 1825 to 1832. A Canadian boatman, Alexis San Martin, was wounded in the abdomen from a charge of buckshot, and the wound healed, leaving a permanent opening in the stomach, through which the operation of digestion could be observed. This furnished visible evidence of the relative digestibility of different kinds of foods, and the general functions of the stomach. The peculiar and different conditions governing the digestion of the starch foods, the albumenoids (such as meat and fish), and the sugars and fats, have been clearly ascertained, and “what is one man’s food is another man’s poison” is now susceptible of intelligent diagnosis and effective adjustment. Of late years the stomach has been greatly aided in its functions by prepared or predigested foods. The action of diastase, in converting starch into grape sugar, has been taken advantage of, and cereals treated with diatase, malted milk, lactated and peptonized foods, have proven a boon to the enfeebled digestion, while the intelligent study of dietetics has done much to relieve the physician and promote the health of the individual by right living.