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PUBLISHED EVERY SATURDAY BY

THE LIVING AGE COMPANY, BOSTON.

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FOR SIX DOLLARS remitted directly to the Publishers, THE LIVING AGE will be punctually forwarded for a year, free of postage.

Remittances should be made by bank draft or check, or by post-office money order, if possible. If neither of these can be procured, the money should be sent in a registered letter. All postmasters are obliged to register letters when requested to do so. Drafts, checks, and money-orders should be made payable to the order of THE LIVING AGE Co.

Single copies of THE LIVING AGE, 15 cents.

MIDSUMMER NIGHT.

FOLK SONGS.

Mother of balms and soothings manifold. Our lives are tunes by untaught voices Quiet-breathed night, whose brooding

hours are seven,

To whom the voices of all rest are given And those few stars whose scattered names are told,

Far off, beyond the westward hills outrolled,

Darker than thou, more still, more dreamy even,

The golden moon leans in the dusky

heaven,

And under her, one star, a point of gold.

And all go slowly lingering toward the

west,

As we go down forgetfully to our rest, Weary of daytime, tired of noise and light,

Ah, it was time that thou should'st come,

for we

Were sore athirst and had great need of thee,

sung

In widest range. Some breathe but few bars' lease,

And thenceforth silence; some a minor piece.

From pallid lips are grievous dirges wrung;

By valiant knights loud trumpet-blasts While gay hearts trip to dancing jigs at are flung;

ease.

Strange hands oft add what harmony they please,

Roaming the wide world's ivory keys

among.

Yon cantus haply with full chords is set; Through this the florid counterpoint flits

fast.

And here, 'mid changeful notes that throb and fret,

Thou sweet physician, balmy-bosomed One deep-toned chime of pain's recurrent Night.

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Of this old sea that gnaws around the By feathers green, across Casbeen, land.

The pilgrims track the Phoenix flown,

How lonely are the surges and the By gems he strewed in waste and wood,

strand!

The fishermen are gone, and fled the ships: The billows, that the cruel tempest whips, Shake their grey manes and plunge along the sand;

Round dying day no stars attendant stand;

Far o'er the foam the floating beacon dips. When last I wandered here in childhood's hour,

And jewelled plumes at random thrown.

Till wandering far, by moon and star, They stand beside the fruitful pyre, Whence breaking bright with sanguine light,

Th' impulsive bird forgets his sire.

Those ashes shine like ruby wine, Like bag of Tyrian murex spilt,

The sky was blue, the waves were all The claw, the jowl of the flying fowl

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From The Nineteenth Century, THE PROGRESS OF MEDICINE DURING

THE QUEEN'S REIGN.

Not many months ago the Duke of Cambridge, speaking at St. George's Hospital on the occasion of the opening of a new operating theatre, said:

I do not believe that amid all the im

provements, the advantages, and the addi tions that have occurred during the prolonged reign of her Majesty, anything has made so much progress as medical and surgical science. Whether we look at what has been or is going on in this country, or whether we turn to foreign lands, it strikes me that there has been an advance made which has been of such enormous advantage to the human race that that alone would mark this period to which I am alluding.

His Royal Highness, with the practical sense of a man of affairs, in a few plain words expressed the exact state of the matter. It will be my purpose in the following pages to show how fully justified he was in making the statement which has been quoted.

It is no idle boast, but the simple unvarnished truth, that medicine - in which term I include the whole art of healing, and the scientific laws on which its practice is based-has made greater progress during the last sixty years than it had done in the previous sixty centuries. The medical knowledge of the Egyptians, though considerable compared with that of other ancient peoples, was, as may be gathered from the fragments of their nosology and therapeutic formularies that have come down to us, but little above the traditional lore in such matters with which old women have in all ages been credited. The practical mind of Greece began by trying with Hippocrates to see things as they really were, but later fell away into the making of systems and the spinning of cobwebs of theory instead of observing facts. The Romans had for medicine and its professors a robust contempt, akin to that which Squire Western had for French cooks and their kickshaws. In the later days of the Republic, indeed, the Græculus

esuriens brought his physic as well as his philosophy to the great market of Rome, and under the Empire medicine men flourished exceedingly. Medicine itself, however, was at its best a mere empiric art, and in this condition it remained practically till Harvey's discovery of the circulation of the blood in 1628 laid the corner-stone of modern

pysiology, and thus prepared a founda

tion for a scientific medicine. From the seventeenth till the early part of the nineteenth century, though many improvements were made in the details of the art of healing, there was no great advance either in the conception of disease or in the principles of treatment. The discovery of vaccination itself, though one of the greatest practical importance, was merely the observation of a fact, not the enunciation of a law.

Fevers were

When the queen came to the throne in 1837, it is hardly too much to say that the average medical practitioner knew little more about the diseases of the heart, lungs, stomach, liver, and kidneys than was known to Hippocrates. Auscultation had indeed been introduced some years before, but long after the commencement of her Majesty's reign elderly gentlemen might be seen, when a stethoscope was offered to them at a consultation, to apply the wrong end to their ear. classified with a sweet simplicity into "continued" and "intermittent," and as late as in the 'Fifties an eminent professor of surgery complained that his colleague, the professor of medicine, had invented a number of new-fangled varieties. Of nervous diseases nothing was known. The larynx was a terra incognita; of the ear it was said by the leading medical journal of the day, many years later than 1837, that the only thing that could be done in the way of treatment was to syringe out the external passage with water. The diagnosis and treatment of diseases of the skin had advanced little beyond John Hunter's famous division of such affections into those which sulphur could cure. those which mercury could cure, and those which the devil himself couldn't

upon to use the knife, in the very year of the queen's accession, he says:

cure. Pathology was a mere note-book of post-mortem appearances-a list of observations as dead as the bodies on which they were made. The New World of bacteriology had not yet found perienced men, and groaned to the horror its Columbus.

In the domain of surgery progress had been far greater, and as regards operative skill and clinical insight Astley Cooper, Robert Liston, Dupuytren, and Larrey were certainly not inferior to the men of the present day. Anæsthesia was, however, unknown, and the operating theatre was a place of unspeakable horrors. Wounds were dressed with wet rags, and suppuration was encouraged, as it was believed to be an essential part of the process of healing.

Broadly speaking, it may be said that the advance of the art of healing during the last sixty years has been along two main lines-the expansion of the territory of Surgery, and the development of Pathology, which concerns itself with the causes, processes and effects of disease. It will probably help the reader to a clearer understanding of the present position of medicine if each of these two lines of evolution is considered in some detail.

The progress of surgery in the present age is due to two discoveries of an importance unequalled in the previous history of the healing art-anesthesia, or the artificial abolition of pain, and antisepsis, or the prevention of infective processes in wounds. The former discovery was not made until her Majesty had been nearly ten years on the throne; the latter nearly twenty years later. Let us take a brief glance backwards at what surgery was before the introduction of these two far-reaching improvements.

Of the horrors of operations before the discovery of anesthesia there are men still living who can speak. Not long ago Dr. B. E. Cotting, ex-president of the Massachusetts Medical Society, contributed some personal reminiscences of pre-anaesthetic surgery to the Boston Medical and Surgical Journal. Speaking of the first case in which he was called

Our patient (a woman) writhed beyond the restraining power of strong and ex

of the terrified household, and afterwards to the day of her death could not think of the operation without convulsive shudders. Often did she hold up her hands, exclaiming, "Oh, that knife! that awful knife! that horrible knife!"

Dr. Cotting sums up his recollections of such scenes as follows:

No mortal man can ever describe the agony of the whole thing from beginning to end, culminating in the operation itself with its terrifying expressions of infernal suffering.

A distinguished physician, who himseif came under the surgeon's knife in the days before anæsthesia, has left on record a vivid account of his experience. Speaking of the operation, he says:

SO

Of the agony occasioned I will say nothing. Suffering great I underwent cannot be expressed in words, and thus fortunately cannot be recalled. The particular pangs are now forgotten; but the black whirlwind of emotion, the horror of great darkness, and the sense of desertion by God and man, bordering close upon de spair, which swept through my mind and overwhelmed my heart, I can never for get, however gladly I would do so. Before the days of anesthesia a patient preparing for an operation was like a condemned criminal preparing for execution. He counted the days till the appointed that day till the appointed hour came. day came. He counted the hours of He listened for the echo on the street of the surgeon's carriage. He watched for his pull at the door-bell; for his foot on the stairs; for his step in the room; for the production of his dreaded instruments; for his few grave words and his last preparations before beginning. And then he surrendered his liberty, and. revolting at the necessity, submitted to be held or bound, and helplessly gave himself up to the cruel knife.. The excitement. disquiet, and exhaustion thus occasioned could not but greatly aggravate the evil effects of the operation, which fell upon a physical frame predisposed to magnify, not to repel, its severity.

The pain caused by operations prevented their being undertaken except as a last resource, and many patients preferred death to the surgeon's knife. Sir Charles Bell used to pass sleepless nights before performing a critical operation; and men like Cheselden, John Hunter, and Abernethy had an almost equal dislike of operations. It is related of one distinguished surgeon that when a patient, whose leg he was about to cut off, suddenly bounced off the operating-table and limped away, he said to the bystanders, "Thank God, he's gone!" Men otherwise well fitted to advance surgery were prevented from devoting themselves to it by their inability to inflict or witness pain. Sir James Young Simpson in his student days was so distressed by the sufferings of a poor Highland woman, on whom Robert Liston was performing excision of the breast in the Edinburgh Royal Infirmary, that he left the operating theatre with his mind made up to seek employment in a lawyer's office. Fortunately for mankind he did not carry out his intention, but set himself to grapple with the problem how sensibility to pain in surgical operations could be abolished.

The solution of the problem came from America. On the 30th of September, 1846, W. T. G. Morton, a dentist of Boston, U.S.A., who had previously experimented on animals and on himself, made a man unconscious by breathing sulphuric ether, and extracted a tooth without the patient feeling any pain. On the 16th of October of the same year Morton administered ether, in the Massachusetts General Hospital, to a man from whose neck a growth was excised without a groan or a struggle on his part. The doctors who came to scoff remained to praise, and the operator, Dr. John C. Warren, who had at first been sceptical, said, when all was over, in a tone of conviction, "Gentlemen, this is no humbug!" A distinguished physician who witnessed the scene said on leaving the hospital, "I have seen something to-day that will go round the world." It did so with a

rapidity remarkable for those days, when as yet the telegraph was not, and the crossing 'of the Atlantic was not a trip but a voyage. On the 22nd of December, 1846, Robert Liston, in University College Hospital, London, performed amputation through the thigh on a man who was under the influence of ether, and who knew nothing of what had been done till he was shown the stump of his limb after the operation. The "Yankee dodge," as Liston had contemptuously called ether anæsthesia before he tried it, was welcomed with enthusiasm by surgeons throughout Europe. In January, 1847, Simpson of Edinburgh used ether for the relief of the pains of labor. Not being entirely satisfied with it, however, he sought for some other substance having the property of annulling sensation, and in November, 1847, he was able to announce that he had found "a new anesthetic agent as a substitute for sulphuric ether" in chloroform, a substance then unknown outside the laboratory, and within it looked upon as only a chemical curiosity. Chloroform for a long time held the field in Europe as the agent for medicining sufferers to that sweet sleep in which knife, gouge, and cautery do not hurt and the pangs of motherhood are unfelt. With characteristic courage the queen submitted to what was then a somewhat hazardous experiment, allowing herself to be made insensible with chloroform at the birth of the Duke of Albany, and at that of Princess Henry of Battenberg. The late Dr. John Snow, who administered the anesthetic on both these occasions, described her Majesty as a model patient, and her example had a powerful effect in dispelling the fears and prejudices as to the use of such agents which then existed in the minds of many.

These feelings were by no means confined to the non-scientific public. There was strong opposition from some surgeons who held that pain was a wholesome stimulus; on this ground the use of chloroform was actually forbidden by the principal medical officer of our

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