A CHAPTER WHEREIN STUDENTS IN SURGERY MAY FIND SOME FACTS WHICH WERE
NEW TO THEM IN THE HISTORY OF THEIR OWN PROFESSION.
If I have more to spin
The wheel shall go.
HERBERT.
Another reproach to which the medical profession was exposed arose
from the preparatory studies which it required. The natural but
unreflecting sentiment of horror with which anatomy is everywhere
regarded by the populace, was unfortunately sanctioned by the highest
authorities of the Roman Church. Absolutely necessary for the general
good as that branch of science indisputably is, it was reprobated by
some of the Fathers in the strongest and most unqualified terms; they
called it butchering the bodies of the dead; and all persons who
should disinter a corpse for this purpose, were excommunicated by a
decree of Boniface the 8th, wherein the science itself was pronounced
abominable both in the eyes of God and man. In addition to this cause
of obloquy, there was a notion that cruel experiments, such as are now
made upon animals, and too often unnecessarily, and therefore wickedly
repeated, were sometimes performed upon living men. The Egyptian
Physician who is believed first to have taught that the nerves are the
organs of sensation, is said to have made the discovery by dissecting
criminals alive. The fact is not merely stated by Celsus, but
justified by him. Deducing its justification as a consequence from the
not-to-be disputed assertion _cum in interioribus partibus et dolores,
et morborum varia genera nascantur, neminem his adhibere posse
remedia, quæ ipse ignoret:—necessarium ergo esse,_ he proceeds to say,
_incidere corpora mortuorum, eorumque viscera atque intestina
scrutari._ LONGEQUE OPTIME FECISSE _Herophilum et Erasistratum, qui
nocentes homines à regibus ex carcere acceptos,_ VIVOS INCIDERINT;
_considerarintque,_ ETIAM SPIRATU MANENTE, _ea quæ natura antea
clausisset, eorumque posituram, colorem, figuram, magnitudinem,
ordinem, duritiem, mollitiem, lævorem, contactum; processus deinde
singulorum et recessus; et sive quid inseritur alteri, sive quid
partem alterius in se recipit._ As late as the sixteenth century
surgeons were wont to beg (as it was called) condemned malefactors,
whom they professed to put to death in their own way, by opium before
they opened them. It might well be suspected that these disciples of
Celsus were not more scrupulous than their master; and they who thus
took upon themselves the business of an executioner, had no reason to
complain if they shared in the reproach attached to his infamous
office.
A French author[1] of the sixteenth century says that the Physicians
at Montpelier, which was then a great school of medicine, had every
year two criminals, the one living, the other dead, delivered to them
for dissection. He relates that on one occasion they tried what effect
the mere expectation of death would produce upon a subject in perfect
health, and in order to this experiment they told the gentleman (for
such was his rank) who was placed at their discretion, that, as the
easiest mode of taking away his life, they would employ the means
which Seneca had chosen for himself, and would therefore open his
veins in warm water. Accordingly they covered his face, pinched his
feet without lancing them, and set them in a foot-bath, and then spoke
to each other as if they saw that the blood were flowing freely, and
life departing with it. The man remained motionless, and when after a
while they uncovered his face they found him dead.
[Footnote 1: BOUCHET.]
It would be weakness or folly to deny that dangerous experiments for
the promotion of medical or surgical practice may, without breach of
any moral law, or any compunctious feeling, be tried upon criminals
whose lives are justly forfeited. The Laureate has somewhere in his
farraginous notes _de omnibus rebus et quibusdam aliis_, produced a
story of certain Polish physicians who obtained permission to put on
the head of a criminal as soon as it had been cut off, and an
assurance of his pardon if they should succeed in reuniting it. There
is nothing to be objected to such an experiment, except its utter
unreasonableness.
When it was necessary that what was at that time a most difficult and
dangerous surgical operation should be performed upon Louis XIV,
enquiry was made for men afflicted with the same disease, they were
conveyed to the house of the minister Louvois, and there in presence
of the King's physician Fagon, Felix the chief surgeon operated upon
them. Most of these patients died; they were interred by night, but
notwithstanding all precautions it was observed that dead bodies were
secretly carried from that house, and rumours got abroad that a
conspiracy had been discovered, that suspected persons had been
brought before the minister and had either died under the question or
been made away with by poison under his roof. The motive for this
secresy was that the King might be saved from that anxiety which the
knowledge of what was going on must have excited in him. In
consequence of these experiments, Felix invented new instruments which
he tried at the Hotel des Invalides, and when he had succeeded with
them the result was communicated to the King, who submitted to the
operation with characteristic fortitude. The surgeon performed it
firmly and successfully; but the agitation which he had long struggled
against and suppressed, produced then a general tremour from which he
never recovered. The next day, in bleeding one of his own friends he
maimed him for life.
This was a case in which the most conscientious practitioner would
have felt no misgiving; there was no intentional sacrifice of life, or
infliction of unnecessary suffering. So too when inoculation for the
small-pox was introduced into this country; some condemned criminals
gladly consented to be inoculated instead of hanged, and saved their
lives by the exchange.
It is within the memory of some old members of the profession, that a
man was sentenced to death at the Old Bailey, who had a wen upon his
throat weighing between thirty and forty pounds. To hang him was
impossible without circumstances of such revolting cruelty as would,
even at that time, have provoked a general outcry of indignation. The
case found its way from the lawyers to the surgeons; the latter
obtained his pardon, and took off the tumour. John Hunter was the
operator; the man, his offence not having been of a very heinous kind,
though the indiscriminating laws made it at that time capital, was
taken into his service, and used to show his own wen in his master's
museum; it was the largest from which any person had ever been
relieved. The fate of the poor Chinese who underwent a similar
operation in London with a different result, is fresh in remembrance
and will long be remembered. The operation was made a public
exhibition for medical students, instead of being performed with all
circumstances that could tend to soothe the patient; and to the
consequent heat of a crowded room, and partly perhaps to the
excitement which such an assemblage occasioned in the object of their
curiosity, the fatal termination was with too much probability
imputed. We may be sure that no such hazardous operation will ever
again be performed in this country in the same public manner.
The remarks which were called forth on that occasion are proofs of the
great improvement in general feeling upon such points, that has taken
place in modern times. In the reign of Louis XI. a franc-archer of
Meudon was condemned to be hanged for robbery and sacrilege; he
appealed to the Court of Parliament, but that Court confirmed the
sentence, and remanded him to the Provost of Paris for execution. The
appeal however seems to have brought the man into notice, and as he
happened to afford a surgical case as well as a criminal one, the
surgeons and physicians of the French capital petitioned the King for
leave to operate upon him. They represented that many persons were
afflicted with the stone and other internal disorders; that the case
of this criminal resembled that of the Sieur de Bouchage who was then
lying dangerously ill; it was much to be desired for his sake that the
inside of a living man should be inspected, and no better subject
could have occurred than this franc-archer who was under sentence of
death. This application was made at the instance of Germaine Colot, a
practitioner who had learned his art under one of the Norsini, a
Milanese family of itinerant surgeons, celebrated during several
generations for their skill in lithotomy. Whether the criminal had his
option of being hanged, or opened alive, is not stated; but Monstrelet
by whom the fact is recorded, says that permission was granted, that
the surgeons and physicians opened him, inspected his bowels, replaced
them, and then sewed him up; that the utmost care was taken of him by
the King's orders, that in the course of fifteen days he was perfectly
cured, and that he was not only pardoned but had a sum of money given
him. To such means were the members of this profession driven, because
anatomy was virtually if not formally prohibited.
A much worse example occurred when the French King Henry II. was
mortally wounded in tilting with Montgomery. It is stated by most
historians that a splinter from Montgomery's spear entered the King's
visor and pierced his eye; but Vincent Carloix, who probably was
present, and if not, had certainly the best means of information,
shows that this is altogether an erroneous statement. He says that
when the Scot had broken his spear upon the King, instead of
immediately throwing away the truncheon, as he ought to have done, he
rode on holding it couched; the consequence of this inadvertence was
that it struck the King's visor, forced it up, and ran into his eye.
His words are these, _ayans tous deux fort valeureusement couru et
rompu d'une grande dexterité et adresse leurs lances, ce mal-habile
Lorges ne jecta pas, selon l'ordinaire coustume, le trousse qui
demoura en la main la lance rompue; mais le porta tousjours baissé, et
en courant, rencontra la teste du Roy, du quel il donna droit dedans
la visiere qui le coup haulsa, et luy creva un œil._
The accuracy of this account happens to be of some importance, because
the course which the King's surgeons pursued in consequence
illustrates the state of surgery at that time, and of manners and laws
also; for with the hope of ascertaining in what direction the broken
truncheon had entered the brain and how they might best proceed to
extract the splinters, they cut off the heads of four criminals, and
drove broken truncheons into them, as nearly as they could judge at
the same inclination, and then opened the heads. But after these
lessons, five or six of the most expert surgeons in France were as
much at a loss as before.
It was well that there were criminals ready upon the occasion,
otherwise perhaps, in the then temper of the French Court, the first
Huguenots who came to hand might have been made to serve the turn. And
it was well for the subjects that it was not thought advisable to
practise upon them alive; for no scruples would have been entertained
upon the score of humanity. When Philip Von Huten, whom the Spanish
writers call Felipe de Utre, made his expedition from Venezuela in
search of the Omeguas, an Indian wounded him with a spear, under the
right arm, through the ribs. One Diego de Montes, who was neither
surgeon nor physician, undertook to treat the wound, because there was
no person in the party better qualified to attempt it. A life was to
be sacrificed for his instruction, and accordingly a friendly Cacique
placed the oldest Indian in the village at his disposal. This poor
creature was drest in Von Huten's coat of mail (_sayo o escaulpil_)
and set on horseback; Montes then ran a spear into him through the
hole in this armour, after which he opened him, and found that the
integuments of the heart had not been touched, this being what he
wished to ascertain. The Indian died; but Von Huten's wound was opened
and cleansed in full reliance upon the knowledge thus obtained, and he
recovered.