Chapter XI: Part 11

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.

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"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.

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Transcriber's Notes

Obvious typographical errors have been silently corrected, but the variations in spelling, punctuation, accents and hyphenation remain as in the original.

Chapter IX

The paragraph originally read: "This recognition of our profession was accorded much more unstintingly nearly two thousand years ago, at a time when it was much less deserved, when Cicero wrote (_De Natura Deorum_) "_Homines ad inibus dando._" (Men are never more godlike than when giving health to mankind)."

The missing line in the Latin quotation has been restored.

Italics are represented thus _italic_.