John Lord.

Beacon Lights of History, Volume 14 The New Era; A Supplementary Volume, by Recent Writers, as Set Forth in the Preface and Table of Contents online

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into modern therapeutics in the way of animal products lends at least
some theoretical justification to the ancient use of the dried organs of
various animals. It is but a few years since the "ductless glands" - such
organs, as, for example, the thyreoid gland (an organ situated in the
front of the neck, a small affair in its normal state, but prominent and
even pendulous when by its permanent enlargement it comes to constitute
a goître) - were looked upon as puzzles, as structures destitute of any
known function. Some observers even affirmed that they had no function,
though the constancy of goître in cretins ought to have shown the
fallacy of this allegation in the case of the thyreoid. We do not now
need to be told that the thyreoid gland plays a very important part in
the economy, for we know that its surgical removal gives rise to a
special disease known as myxoedema, which, in addition to its physical
manifestations, is characterized by impairment of the mental powers.
Consequently, this ductless gland - a gland, that is to say, which has no
obvious canal by which it throws off any product of its activity - must
elaborate some material that is necessary to the health of the organism
and is imparted to the blood. That material, whatever it may be, is
termed an "internal secretion." Some of the internal secretions have
turned out to be of singular value medicinally. It is apparently not the
ductless glands alone that furnish internal secretions; the glands that
are provided with ducts and yield a definite and observable product
secrete also a substance (perhaps more than one) which they give up to
the blood.

Prominent among the therapeutic advances of the century is the direct
reduction of the high temperature of sunstroke and certain fevers by the
use of cold. Although foreshadowed by Currie early in the century by his
use of cold affusion in the treatment of scarlet fever, it did not come
into general use until the closing decades. It is employed principally
in typhoid fever, on the theory that a condition of high fever is in
itself a source of danger quite distinct from the other injurious
effects of a febrile disease. On the other hand, the employment of high
degrees of heat has of late been shown to be a potent agency in the
treatment of certain forms of disease, notably in various affections
classed as rheumatic. Applications of very hot air, provided it is
thoroughly dry, are borne without serious discomfort, and their
employment promises to be of greater service in the conditions in which
it is resorted to than that of any other agent.

A revelation in the treatment of heart disease has been effected by the
Bad Nauheim system of effervescent baths and resisted exercises. It is
not only functional disorders of the heart that are relieved, but grave
organic diseases also. Somewhat elaborate explanations of the way in
which the treatment proves beneficial have been given, but they are not
altogether satisfactory.

Thus far we have dealt chiefly with those developments of medicine that
seem to have been the outgrowth of much thought and experiment, but
there was one that can hardly be viewed as other than a happy discovery,
yet it was one that was fraught with unspeakable mitigation of human
suffering, and that wrought a boundless extension of the field of
surgery. It was that of anaesthesia. The first to discover an efficient
surgical anaesthetic was Crawford W. Long, of Georgia. It has been
established that he performed several minor operations with the patient
anaesthetized with sulphuric ether, but he did not proclaim his
discovery, and so it was reserved for William T. G. Morton, of Boston
(then a dentist, but subsequently a physician), to make the first public
demonstration of the efficiency of ether as an anaesthetic, which he did
in the operating theatre of the Massachusetts General Hospital, in
Boston, in the year 1846. The news of Morton's achievement spread
broadcast, and it was at once realized that it was destined to
revolutionize surgery. It certainly has done that, and in no less
degree than was afterward accomplished by Listerism. Ether did not long
remain the only anaesthetic known; Simpson, of Edinburgh, soon
discovered that chloroform was possessed of even more decided
anaesthetic properties. The inhalation of ether is disagreeable, and it
is slow in producing the desired effect, whereas that of chloroform is
not unpleasant, and it acts more rapidly. Consequently chloroform soon
came to be generally preferred; but abundant experience has finally
shown that ether is much the safer agent of the two, and improved
methods of administration have almost entirely done away with the
objections to its use, so that now it is looked upon as the preferable
general anaesthetic. But general anaesthesia - meaning the suspension of
sensibility in the whole organism, including unconsciousness - is not
always necessary, and sometimes it is undesirable. We have now
trustworthy local anaesthetics, the chief of which is cocaine, wherewith
we are able to anaesthetize the part to be operated on without rendering
the patient unconscious, and the co-operation that a conscious patient
may be able to render is sometimes valuable. It was not alone in the
direct saving of human suffering that anaesthetics proved a boon to the
world; they have made possible an amount of experimental work on animals
in the way of vivisection that humane investigators would otherwise have
shrunk from, necessary as it has been and still is for the advancement
of the healing art.

The operation of ovariotomy, first performed by Ephraim McDowell, of
Kentucky, can hardly be classed with the happy accidents; but so little
had been said about it or thought concerning it that when the news of it
reached Europe "from the wilds of America" the editor of a ponderous
English quarterly journal of medicine recorded his incredulity in the
words "_Credat Judoeus, non ego_" An ovarian tumor inevitably proves
fatal in the long run if it is not removed. In a certain percentage of
cases it is malignant and will kill whether it is removed or not, but
the general result of ovariotomy has been the saving of thousands of
women from untimely death. Bell, of Edinburgh, had imagined the
operation and had mentioned it in his lectures, but none the less to
McDowell is due the credit of demonstrating its feasibility.

Medicine bore quite its full share in the mitigation of the horrors and
hardships of war that marked the Nineteenth Century. Its work was shown
in the great reduction of pestilential disease incident to camp life, in
prompt aid to the wounded, in the establishment of salubrious field and
general hospitals, and in improved methods of transportation of the sick
and wounded. Certainly the soldier on the sick list never before had
such a fair prospect of rejoining his comrades safe and sound as he
has now.

In the care of the insane, too - care not only in the sense of humane
treatment, but in the systematic employment of measures for their
restoration to mental soundness - the century has been marked by notable
progress. This has been chiefly in the direction of preventing insanity,
and although mental disease is said to be on the increase, it may
undoubtedly be said with entire truth that its growing prevalence is not
in proportion to the heightened frequency of "the strenuous life." We
may confidently expect that a more pronounced mastery over diseases of
the mind will come when physicians in general are taught psychiatry
clinically, so that the beginnings of mental alienation may be
intelligently met by the family practitioner.

The supreme achievement of the medicine of the Nineteenth Century
undoubtedly has been the development of its preventive feature. When we
recall the fact that but a few years ago an attack of infectious disease
was interpreted as a visitation of Providence, by a perversity that even
the triumphs of vaccination did not serve to do away with; when we
contemplate the well-ordered and well-understood measures that are now
resorted to in an ever-increasing number of communities (and resorted to
not solely on the outbreak of an epidemic, but at all times), to purify
the air we breathe, the food we eat, and the water we drink; and when we
reflect upon the greatly reduced morbidity as well as mortality of most
infectious diseases - we must realize the immense service that has been
rendered by preventive medicine. No doubt we must all die some time, and
the day is yet far remote when the only causes of death will be old age
and injury; but a decided prolongation of the average lifetime, such as
the life-insurance companies recognize, is an unquestionable gain to the
human race.

A great blessing that has been brought about in great measure by medical
men has been the establishment of the profession of nursing. The work of
caring for the sick between the physician's visits is no longer, at
least in large communities and in cases of severe illness, left to
over-sympathetic and uninstructed relatives or to outsiders who traded
on mystery. An intelligent and intelligible record is now kept of all
important happenings in the sick room, remedies are administered as they
were ordered, needless alarm at something deemed by the patient to be of
ill omen is quelled, and in case of real emergency, overlooked as it
might otherwise have been, the physician is summoned to meet it. The
advent of the trained nurse marked an era in medicine.

The literature of medicine has fully kept pace in volume with the
progress of the art itself, and its quality has steadily improved. To
this the great tomes of that gigantic work, the "Index-Catalogue of the
Library of the Surgeon-General's Office, United States Army," bear
solid testimony. It is a consolidated catalogue, by subjects and by
authors' names, of practically every medical book published throughout
the world and of every article in the periodical literature of medicine.
For its existence the world is indebted to Dr. John S. Billings,
formerly a surgeon of high rank in the army and now the director of the
New York Public Library, and for its continued existence to the United
States Government, and it is to be hoped that Congress will never cease
to provide adequately for its continued publication. Its completeness
and its accuracy long ago led to its being prized everywhere.

There are some problems of which medicine has hardly yet entered upon
the solution. Prominent among them is that of cancer. Little as we now
know of the real nature of that disease, we know quite as much of it as
we knew but a few years ago concerning other diseases equally
destructive and far more prevalent, which, however, we have now
practically mastered. Who can say that we shall not triumph over cancer
while the Twentieth Century is still young? Our final triumph is
indubitable.

The strongest individuality in the medicine of the Nineteenth Century
was without doubt that of Rudolf Ludwig Karl Virchow (commonly written
by him simply Rudolf Virchow). Although he took no direct part in any
of the striking advances in practice that appeal to the laity, yet he
was recognized the world over, among all classes of educated and
well-informed persons, as the one beacon light of Nineteenth-Century
medicine whose glow had been the steadiest and the most enduring. This
is because of the wide range of his learning in matters not pertaining
closely to his profession. His professional brethren hold the same view,
and this is because he so well controlled himself - checked himself at
every turn by the severest application of system - that he continued for
more than half a century an anchor to hold medical thought strictly down
to fact. This was from no natural lack of volatility, for he was an
_Acht-und-vierziger_ (Forty-eighter). In 1846, as a prosector in the
University of Berlin, Virchow entered with Reinhardt upon a series of
pathological investigations which at once received wide attention. In
conjunction with Reinhardt, he founded the _Archiv für pathologische
Anatomie und Physiologie und für klinische Medicin_[6] (a periodical
familiarly called "Virchow's _Archiv_"), the publication of which was
begun in the year 1847. Reinhardt died in 1852, leaving the editorship
in the hands of Virchow alone, and he was still its editor up to the
time of his death, on September 5, 1902.

[Footnote 6: Archives of Pathological Anatomy and Physiology and of
Clinical Medicine.]

In consequence of his having openly proclaimed himself a Democrat in
1848, Virchow was forced to retire from the University of Berlin in the
following year. He was at once made a professor in the University of
Würzburg, whence seven years later, in 1856, as the result of the
strenuous interposition of various medical organizations, he was
recalled to Berlin, where he was made a professor and director of the
Pathological Institute. He was appointed medical privy councillor in
1874, having several years before that entered upon an active political
career and been one of the founders of the Progressive party, which he
ably represented in the Landtag and the Reichstag. In 1869 he took part
in founding the German and the Berlin Anthropological Societies, of each
of which he was several times president.

Virchow investigated the most diverse subjects, as his profound studies
of Schliemann's discoveries, as well as his other archaeological
researches, show, and he was a rather prolific writer. The most
important of his early works was _Die Cellularpathologie_, the first
edition of which was published in 1858. Chance's English translation
appeared in 1860, and Picard's French version came out in 1861. It is
safe to say that no book of the century exerted a profounder influence
on medical thought than Virchow's exposition of the cellular pathology.
His next notable publication was a collection of thirty lectures on
Tumors (_Die krankhaften Geschwülste_,[7] Berlin, 1863-67). That he was
not too absorbed in these lectures to bring his great powers to bear
upon topics of the day is shown by the fact that before their
publication was completed he brought out his work on Trichinae
(_Darstellung der Lehre von den Trichinen_, 1864). Old age found him
with industry and versatility unabated, for it was in 1892 that his
_Crania ethnica americana_ appeared, and after that time he wrote a
vigorous protest against the new-fangled spelling of the German language
which he accused the schoolmasters of trying to foist on the people.
This was published in his _Archiv_. It may well be that his arguments
have not been unavailing, since it is observable that several German
publications that had adopted the new spelling have now dropped it.

[Footnote 7: Morbid Tumors.]

It must not be supposed that it was by his literary work alone, founded
though it was manifestly on his profound study, that Virchow impressed
his personality upon medicine; it was in his lectures and in his
laboratory teaching, too, that he made himself felt. In all civilized
countries there are many devoted workers in medical science who caught
their first real inspiration from Virchow.

The writer once saw Virchow - only once, but it was a sight never to be
forgotten. It was at a banquet given as one of the festivities incident
to the annual meeting of the British Medical Association in London in
1873. The company was not a large one, but it included such celebrities
as Professor J. Burdon Sanderson, Sir William Jenner, Professor
Chauveau, and Professor Marey. Virchow was conspicuously the man toward
whom the eyes of all others were oftenest directed. Virchow met with the
love as well as the admiration of his contemporaries, and both
sentiments will descend to their successors, for his impress on the
records of medicine is indelible, both as an instructor and as a friend
of all real truth-seekers.


AUTHORITIES.

There is no full and connected account of the progress of medicine
during the Nineteenth Century, but the reader may consult with profit
the various medical biographies, also the following works: Silliman's "A
Century of Medicine and Chemistry;" Jenner's "The Practical Medicine of
To-day;" Buck's "Reference Handbook of the Medical Sciences;"
Eulenburg's "Real-Encyclopädie der gesammten Heilkunde;" the "Annus
Medicus," published in the _Lancet_ at the close of each year; and
Tinker's "America's Contributions to Surgery" (Bulletin of the Johns
Hopkins Hospital, Aug.-Sept., 1902).



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Online LibraryJohn LordBeacon Lights of History, Volume 14 The New Era; A Supplementary Volume, by Recent Writers, as Set Forth in the Preface and Table of Contents → online text (page 26 of 26)