Part 5 (1/2)
”Why doest thou whet thy knife so earnestly?
... Shylock must be merciful.
On what compulsion must I? Tell me that!”
Victorious in this encounter, he turned to those who urged that anaesthetics were responsible for various kinds of ills such as a tendency to haemorrhage, convulsions, paralysis, pneumonia, and various kinds of inflammatory mischief as well as mental derangement. He combated these contentions until the end of his career; and not only proved that the objections were visionary, but showed that for one of the alleged evils formerly often seen after operations, viz., convulsions, chloroform, far from being a cause, was one of our most powerful remedies.
But the professional opponents of anaesthesia were most emphatic in the denunciation of its use in midwifery. Pain in the process of parturition was, they said, ”a desirable, salutary, and conservative manifestation of life-force”: neither its violence nor its continuance was productive of injury to the const.i.tution. Strong opposition on these grounds came from the Dublin School, and with characteristic boldness Simpson turned to the statistics of their own lying-in hospital to prove his contention that to abolish parturient pain was to diminish the peril of the process. Again the statistics stood him in good stead; he flourished them triumphantly before his opponents, and proceeded to deal with those who a.s.serted that the use of anaesthetics was accompanied by danger to life. He pointed out that, although unquestionably there were some dangers connected therewith, they were insignificant compared with the dangers in both surgery and midwifery which their use averted. Pain itself was a danger; shock in surgery was responsible for many untimely deaths upon the operating table; by preventing these chloroform saved countless lives. His arguments were characterised by painstaking thoroughness and evidenced wide reading. In addressing Professor Meigs, of Philadelphia, he said:--
”First, I do believe that if improperly and incautiously given, and in some rare idiosyncrasies, ether and chloroform may prove injurious or even fatal--just as opium, calomel, and every other powerful remedy and strong drug will occasionally do. Drinking cold water itself will sometimes produce death. 'It is well known,' says Dr. Taylor, in his excellent work on Medical Jurisprudence, 'that there are _many_ cases on record in which cold water, swallowed in large quant.i.ty and in an excited state of the system, has led to the destruction of life.'
Should we therefore never allay our thirst with cold water? What would the disciples of Father Mathew say to this? But, secondly, you and others have very unnecessary and aggravated fears about the dangers of ether and chloroform, and in the course of experience you will find these fears to be, in a great measure, perfectly ideal and imaginary.
But the same fears have, in the first instance, been conjured up against almost all other innovations in medicine and in the common luxuries of life. Cavendish, the secretary to Cardinal Wolsey, tells us in his life of that prelate, that when the cardinal was banished from London to York by his master--that regal Robespierre, Henry the Eighth--_many_ of the cardinal's servants refused to go such an enormous journey--'for they were loath to abandon their native country, their parents, wives, and children.' The journey which can _now_ be accomplished in six hours was considered then a perfect banishment.... In his Life of Lord Loughborough, John Lord Campbell tells us that when he (the biographer) first travelled from Edinburgh to London in the mail-coach the time had been reduced (from the former twelve or fourteen days) to three nights and two days; 'but,' he adds, 'this new and swift travelling from the Scots to the English capital was wonderful, and I was gravely advised to stop a day at York as several pa.s.sengers who had gone through without stopping had died of apoplexy from the rapidity of the motion' ('Lives of the Lord Chancellors'). Be a.s.sured that many of the cases of apoplexy, &c., &c., alleged to arise from ether and chloroform, have as veritable an etiology as this apoplexy from rapid locomotion, and that a few years hence they will stand in the same light in which we now look back upon the apoplexy from travelling ten miles an hour. And as to the supposed great moral and physical evils and injuries arising from the use of ether and chloroform, they will by and by, I believe, sound much in the same way as the supposed great moral and physical evils and injuries arising from using hackney coaches, which were seriously described by Taylor, the water-poet, two or three centuries ago when these coaches were introduced. Taylor warned his fellow-creatures to avoid them, otherwise 'they would find their bodies tossed, tumbled, rumbled, and jumbled' without mercy. 'The coach,' says he, 'is a close hypocrite, for it hath a cover for knavery; they (the pa.s.sengers) are carried back to back in it like people surprised by pirates, and moreover it maketh men imitate sea-crabs in being drawn sideways, and altogether it is a dangerous carriage for the commonwealth.' Then he proceeds to call them 'h.e.l.l-carts,' &c., and vents upon them a great deal of other abuse very much of the same kind and character as that lavished against anaesthetics in our own day.”
Following out the same line of reasoning he brought to the minds of medical opponents how the introducers of such useful drugs as mercury, antimony, and cinchona bark had met with now long-forgotten but stubborn opposition; and he reminded surgeons of the stern obstinacy with which the introduction of the ligature of arteries had been long objected to and the barbarous method of arresting bleeding with red-hot irons had been preferred. But in the history of the discovery and introduction of vaccination by Jenner he found a strong parallel; and he wrote a pregnant article to prove that mere opinion and prejudgments were not sufficient to settle the question of the propriety or impropriety of anaesthetic agents, ill.u.s.trating it from the story of vaccination. The result of vaccination had been to save during the half century since its introduction a number of lives in England alone equal to the whole existing population of Wales; and in Europe during the same period it had preserved a number of lives greater than the whole existing population of Great Britain. And yet Jenner, when he first announced his discovery, had encountered the most determined opposition on the part of many of his professional brethren, who ridiculed and bitterly denounced both him and his discovery; whilst ignorant laymen announced that smallpox was ordained by heaven and vaccination was a daring and profane violation of holy religion. He pointed out that these objections had been slowly and surely crushed out of existence by acc.u.mulated facts, and predicted that the ultimate decision concerning anaesthesia would come to be based, not upon impressions, opinions, and prejudices, but upon the evidence of ”a sufficient body of accurate and well-ascertained facts.” To these facts, as has been indicated, he subsequently successfully appealed.
Those who objected to anaesthesia on _moral_ grounds directed their attacks chiefly against its use in midwifery. They not only condemned that application as iniquitous, but went the length of a.s.serting that the birth of past myriads without it proved how unnecessary it was, and that Nature conducted the whole process of birth unaided in a greatly superior manner. The pains a.s.sociated with parturition were actually beneficial, they said. Simpson answered this by showing that the proper use of anaesthetics shortened parturition, and by diminis.h.i.+ng the amount of pain led to more rapid and more perfect recoveries. The leading exponent of the Dublin School of Midwifery at that time foolishly wrote that he did not think any one in Dublin had as yet used anaeesthetics in midwifery; that the feeling was very strong against its use in ordinary cases, merely to avert the ordinary amount of pain, which the Almighty had seen fit--and most wisely, no doubt--to allot to natural labour; and in this feeling he (the writer) most heartily concurred. Simpson's private comment on this remarkable epistle at once showed his opinion of it, and ridiculed the objection out of existence. He skilfully parodied the letter thus:--”I do not believe that any one in Dublin has as yet used a carriage in locomotion; the feeling is very strong against its use in ordinary progression, merely to avert the ordinary amount of fatigue which the Almighty has seen fit--and most wisely, no doubt--to allot to natural walking; and in this feeling I heartily and entirely concur.”
He twitted the surgeons who opposed him with their sudden discovery, now that anaesthetics were introduced, that there was something really beneficial in the pain and agony caused by their dreaded knife. Such a contention contraverted his cherished principle that the function of the medical man was not only to prolong life, but also to alleviate human sufferings. He quoted authorities of all times to show that pain had been always abhorred by physicians and surgeons, commencing with a reference to Galen's aphorism--”_Dolor dolentibus inutile est_”
(”pain is useless to the pained”); citing Ambroise Pare, who said that pain ought to be a.s.suaged because nothing so much dejected the powers of the patient; and, finally, reproducing the words of modern authors, who a.s.serted that, far from being conducive to well-being, pain exhausted the principle of life, and in itself was frequently both dangerous and destructive. He brought forward a collection of cases where in former days patients had died on the operating-table, even before the surgeon had begun his work, so great was the influence of the mere fear of pain; and reminded those who attributed occasional deaths on the operating-table to the influence of the anaesthetic of the numerous cases in bygone days where death occurred whilst the surgeon was at work. He recalled also how the great surgeon of St.
Thomas's Hospital, Cheselden, had abhorred the pain which he caused in the process of his work, and longed for some means for its prevention.
”No one,” said Cheselden, ”ever endured more anxiety and sickness before an operation” than himself.
Simpson did not forget to look at the subject from the patient's point of view, and reproduced the letter from an old patient, which has been already quoted (Chapter VI.).
The soldier and sailor, brave unto heroism in facing the enemy, never fearing the death which stared them in the face in its most horrible form whilst answering the call of duty, would quail like children at the mere thought of submitting to the deliberate knife of the surgeon. Were quibbles about the efficacy of pain to stand in the way of the merciful prevention of such suffering by the process of anaesthetisation?
Those who opposed him with this curious idea, that pain after all was beneficial, were some of them men of no mean standing in the profession. Gull, Bransby Cooper, and Nunn were amongst those whom he had to silence. After replying to their arguments _seriatim_ with all his polemic power, he referred them once more to the evidence of facts and of facts alone as set forth by his statistics. Had he lived but a twelvemonth longer than he did he would have been able to conjure up a picture of the incalculable amount of suffering prevented by the eighteen hundred pounds of chloroform which were forwarded to the rival armies from one firm of chemists alone during the Franco-Prussian war; happily for the wounded within and around Paris, there was then no longer any doubt as to the propriety of employing anaesthetics.
The _religious_ objections to the use of anaesthetics could scarcely be met with statistics. Foolish as they now appear to us after the lapse of time, and with the practice they attempted to repel universally adopted, they were nevertheless urged in good faith by clergy and laity of various denominations. The same kind of bigotry had met the introduction of vaccination, and Simpson himself remembered how many people had opposed the emanc.i.p.ation of the negroes on the ground that they were the lineal descendants of Ham, of whom it was said ”a servant of servants shall he be unto his brethren.” Sir Walter Scott reminds us, in ”Old Mortality,” of the spirit which met the introduction of fanners to separate the chaff from the corn, which displaced the ancient method of tossing the corn in the air upon broad shovels. Headrigg reproved Lady b.e.l.l.e.n.den for allowing the new process to be used on her farm, ”thus impiously thwarting the will of Divine Providence by raising a wind for your leddys.h.i.+p's ain particular use by human art, instead of soliciting it by prayer or waiting patiently for whatever dispensation of wind Providence was pleased to send upon the sheeling hill.”
To-day in South Africa the same spirit is seen. Honest countryfolk of European descent are earnestly counselled by their spiritual advisers to submit patiently to the plague of locusts on the ground that it comes as a punishment from Providence. These worthy men stolidly witness their cornfields and their gra.s.s lands being eaten bare before their eyes in a few hours, whilst their more enlightened neighbours, brought up in another faith, resort with success to all sorts of artifices to ward off the destructive little invaders.
It is pleasant to be able to record that Dr. Chalmers, one of the heroes of Scots religious history, not only countenanced chloroform by witnessing operations performed under it in the Royal Infirmary, but when requested to deal in a magazine article with the theological aspect of anaeesthesia refused on the ground that the question had no theological aspect, and advised Simpson and his friends to take no heed of the ”small theologians” who advocated such views. This was futile advice to give to one of Professor Simpson's controversial propensities; he entered with keen enjoyment into the fray with these ”religious” opponents. His famous pamphlet, ent.i.tled, ”Answer to the Religious Objections advanced against the employment of Anaeesthetic Agents in Midwifery and Surgery,” fought his enemies with their own weapons by appealing with consummate skill to Scripture for authority for the practice. The paper was headed with two scriptural verses:--”For every creature of G.o.d is good, and nothing to be refused if it be received with thanksgiving” (1 Timothy iv. 4).
”Therefore to him that knoweth to do good and doeth it not to him it is sin” (James iv. 17).
The princ.i.p.al standpoint of the religious opponents was the primeval curse upon womanhood to be found in Genesis. Simpson swept the ground from under his opponents' feet by reference to and study of the original Hebrew text. The word translated--”sorrow” (”I will greatly multiply thy sorrow ... in sorrow shalt thou bring forth”)--was the same as that rendered as ”sorrow” in the curse applied to man (”in sorrow shalt thou eat of it all the days of thy life”). Not only did the Hebrew word thus translated sorrow really mean labour, toil, or physical exertion; but in other parts of the Bible an entirely different Hebrew word was used to express the actual pain incident to parturition. The contention, then, that sorrow in the curse meant pain was valueless. Chloroform relieved the real pain not referred to in the curse, whereas it had no effect upon the sorrow or physical exertion.
If, however, the curse was to be taken literally in its application to woman as these persons averred, and granting for the moment that sorrow did mean pain, their position was entirely illogical. If one part of the curse was to be interpreted literally, so must be the other parts, and this would have a serious effect of a revolutionary nature upon man and the human race all over the face of the earth.
Literally speaking, the curse condemned the farmer who pulled up his thorns and thistles, as well as the man who used horses or oxen, water-power, or steam-traction to perform the work by which he earned his bread; for was he not thereby saving the sweat of his face?
Pushed further, the same argument rendered these contentions more absurd and untenable. Man was condemned to die--”dust thou art and unto dust thou shalt return.” What right had the physician or surgeon to use his skill to prolong life, at the same time that he conscientiously abstained from the use of anaesthetics on the ground that they obviated pain sent by the Deity? Nay, more; sin itself was the result of the Fall; was not the Church herself erroneously labouring to turn mankind from sin?
In a truer and more serious religious spirit he reminded his foolish opponents of the Christian dispensation, and pointed out how the employment of anaesthesia was in strict consonance with the glorious spirit thereof.
Some persons broadly stated that the new process was unnatural; even these he condescended to answer. ”How unnatural,” exclaimed an Irish lady, ”for you doctors in Edinburgh to take away the pains of your patients.” ”How unnatural,” said he, ”it is for you to have swam over from Ireland to Scotland against wind and tide in a steam-boat.”