[Original]
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.
CHAPTER XII.
THE HISTORY OF ANÆSTHESIA.
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.