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.
FOOTNOTES:
[1] A Presidential Address before the Buffalo Society of Natural Sciences.
[2] Appeared first in the Journal of the American Medical Association, April 27, 1912.
[3] A Presidential Address before the Buffalo Society of Natural Sciences.