THE FIGHT FOR ANAESTHESIA. 1847 ONWARDS
His faith in chloroform--Confused public opinion on the
subject--Personal attacks--Opposition on professional
grounds--His reply--Opposition on moral grounds--His
reply--Opposition on religious grounds--His reply--Her Majesty
the Queen anaesthetised--Indiscrete supporters--The Edinburgh
teaching of anaesthesia administration--The far-reaching effects
of the successful introduction of anaesthesia.
Professor Simpson firmly believed that he possessed now in chloroform
an anaesthetic agent "more portable, more manageable and powerful, more
agreeable to inhale, and less exciting" than ether, and one giving him
"greater control and command over the superinduction of the anaesthetic
state." Fortified by this belief, full of facts relating to the
subject, and fired with zeal and enthusiasm, he was prepared to meet
the opposition which from his knowledge of human nature he must have
anticipated. So bravely and so emphatically did he champion the cause
that he became identified with it in the public mind. The revelation
of anaesthesia, the discovery of chloroform, and the application of
anaesthetics to surgery as well as to midwifery were attributed to him
by all classes of the community, not even excepting many of his own
profession. Chloroform was spoken of as if ether had never existed;
and chloroform and chloroforming displaced the terms anaesthetic and
anaesthetising in ordinary talk--such unwieldy terms were naturally
abandoned when there was the excuse that chloroform was universally
considered the best substance of its class. Simpson made no attempt as
Morton had done to patent his discovery under a fanciful name for his
own pecuniary profit; but widely spread abroad every particle of
knowledge concerning it that he possessed, so that every practitioner
was forthwith enabled to avail himself thereof for the benefit of his
patients.
Partly owing to his own enthusiasm and his strong belief in the
superiority of chloroform over ether, and partly owing to the
confusion prevailing in general circles as to the history of
anaesthesia, no small number of attacks were directed against Simpson
personally by those who either were jealous of his achievements, or
who considered that the part taken by themselves or their friends in
the establishment of this new era in medical science had been slighted
or overlooked. Simpson took all these as part of the fight into which
he had entered. His nature was not sensitive to such personal
attacks; he replied to them, cast them off, and went on his way
unaffected. He handled some of these opponents somewhat severely when
they accused him of encouraging the public belief in him as the
discoverer of anaesthesia. It is clear to us to-day after anaesthesia
has been on its trial for fifty years that Simpson magnified the
superiority of chloroform over ether, and was led by that feeling to
look on the history of ether as but a stage in the history of the
greater chloroform. He regarded chloroform as the only anaesthetic; his
utterances betrayed this feeling, and offence was naturally taken by
the introducers and advocates of ether. His opinion of chloroform was
shared by the leading European surgeons to such an extent in his day
that shortly after his death Professor Gusserow, of Berlin, stated
that with a few exceptions almost all over the earth nothing else was
used to produce anaesthesia but chloroform.
The real fight for anaesthesia was against those who found in the
practice something which ran contrary to their beliefs or principles.
There were first those who objected on purely _medical_ grounds;
secondly, those who took exception to it from a _moral_ point of view;
and thirdly, those who found their _religious_ convictions seriously
offended by the new practice.
The _medical_ opponents were, perhaps, the most powerful; certainly it
was they who had first to be won over, for without the support of the
profession the cause was in danger. It was urged first of all that the
use of anaesthetics would increase the mortality, then very great, of
surgical operations, and those who took their stand upon this ground
were men who had at first denied the possibility of making operations
painless, and had been driven to abandon that opinion only by a clear
demonstration of the fact. To meet this form of opposition he
instituted a laborious and extensive statistical investigation in
order to compare the results obtained in hospitals where anaesthetics
were used with those where the operations were performed on patients
in the waking state. He took care that the reports dealt with the same
operations under, as nearly as possible, similar conditions in each
case. He obtained returns from close upon fifty hospitals in London,
Edinburgh, Dublin, and various provincial towns. One of the most fatal
operations in those days, and one dreaded by patient and surgeon
alike, was amputation of the thigh. In 1845 Professor Syme said that
the stern evidence of hospital statistics showed that the average
frequency of death after that operation was not less than 60 to 70 per
cent., or above one in every two operated upon. Simpson fearlessly
collated statistics of this operation amongst the others, and proved
that when performed under anaesthetics amputation of the thigh had its
mortality reduced to 25 per cent. His figures were as follows:--
TABLE OF THE MORTALITY OF AMPUTATIONS OF THE THIGH.
Reporter. Cases. Deaths. % of Deaths.
Not anaesthetised.
Parisian hospitals--Malgaigne 201 126 62 in 100
Edinburgh " --Peacock 43 21 49 "
General collection--Phillips 987 435 44 "
Glasgow hospitals --Lawrie 127 46 36 "
British " --Simpson 284 107 38 "
Cases on patients in an
anaesthetised state 145 37 25 "
He pointed to the above table as a proof that far from increasing the
mortality of this operation the introduction of anaesthetics had
already led to a saving of from eleven to twenty lives out of every
hundred cases. He acknowledged that the number of cases he had
collected (145) was somewhat small from a statistical point of view;
but he confidently asserted that future figures would show greater
triumphs. The tables of other operations showed similar results, and
he entered exhaustively into the subject in a paper published in 1848.
The paper was entitled, "Does Anaesthesia increase or decrease the
mortality attendant upon surgical operations?" According to his wont,
he headed it with a quotation from Shakspeare:
"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 constitution. 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 asserted 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 quantity 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 passengers who had gone through without stopping had died of
apoplexy from the rapidity of the motion' ('Lives of the Lord
Chancellors'). Be assured 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 passengers) 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 'hell-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, illustrating 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 accumulated 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 asserting 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 associated with parturition were
actually beneficial, they said. Simpson answered this by showing that
the proper use of anaesthetics shortened parturition, and by
diminishing 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 assuaged because nothing so much dejected the powers
of the patient; and, finally, reproducing the words of modern authors,
who asserted 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 emancipation 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 Bellenden 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 leddyship'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 grass 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, entitled, "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 God 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 principal 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."
A son of De Quincey in his graduation thesis humorously supported
Professor Simpson. He argued that the unmarried woman who opposed
anaesthetics on the ground that her sex was condemned by the curse to
suffer pains, broke the command herself "in four several ways,
according to the following tabular statement":--
"1. She has no conception.
2. She brings forth no children.
3. Her desire is not to her husband.
4. The husband does not rule over her."
De Quincey himself supported his son in a letter appended to the
thesis thus:--"If pain when carried to the stage which we call agony
or intense struggle amongst vital functions brings with it some danger
to life, then it will follow that knowingly to reject a means of
mitigating or wholly cancelling the danger now that such means has
been discovered and tested, travels on the road towards suicide. It is
even worse than an ordinary movement in that direction, because it
makes God an accomplice, through the Scriptures, in this suicidal
movement, nay, the primal instigator to it, by means of a supposed
curse interdicting the use of any means whatever (though revealed by
Himself) for annulling that curse."
But the Bible furnished Simpson with the most powerful argument of all
in Genesis ii. 21, where it is written: "And the Lord God caused a
deep sleep to fall upon Adam; and he slept; and He took one of his
ribs and closed up the flesh instead thereof." He strengthened his
position by explaining that the word rendered "deep sleep" might more
correctly be translated "coma" or "lethargy." He had taken the full
measure of his opponents when he answered them with this quotation; it
was a reply characteristic of the man, and completely defeated these
self-constituted theologians with their own weapons. They had attacked
him as a man of science, and found that his knowledge of the
Scriptures excelled their own. He did not fail to read these people a
lesson, and point out the harm done to true religion by such conduct
and arguments as theirs, reminding them that if God had willed pain to
be irremovable no possible device of man could ever have removed it.
Such was the great fight--the fight for anaesthesia--which Simpson
fought and won. He was the one man who by his own individual effort
established the practice of anaesthesia, while Morton has the honour of
being the one man without whom anaesthesia might have remained unknown.
Such was the opposition encountered, and such was the timidity of his
professional brethren, that but for Simpson's courageous efforts it
would have been the work of years to bring about what it was granted
to him to accomplish in a brief period; if fear, ridicule, contempt,
and bigotry had not perhaps sunk the new practice into oblivion. Of
the hundreds who are daily mercifully brought under the influence of
chloroform and ether, few are aware what they owe to Simpson, even if
they know how great is the suffering which they are spared.
Simpson felt that the victory was indeed complete when in April, 1853,
he received a letter from Sir James Clark, physician in ordinary to
Her Majesty, informing him that the Queen had been brought under the
influence of chloroform, and had expressed herself as greatly pleased
with the result. It was at the birth of the late Prince Leopold that
Her Majesty set her subjects this judicious example.
Much trouble to the cause was occasioned by enthusiasts who
administered chloroform with more zeal than discretion, and
without any study of the principles laid down by Simpson. As a result
of imperfect trials, some persons went the length of saying that
there were people whom it was impossible to anaesthetise at all, and
others who could be only partially anaesthetised. Wrong methods of
administration were used. Simpson patiently corrected these, and
carefully instructed his students, so that the young graduates of
Edinburgh University carried his teaching and practice into all
parts of the world. Syme also took up the cause, and valuable work
was done in London by Snow, and later by Clover. The teaching of
Simpson and Syme led to such successful results that their methods
are followed by the Edinburgh School to this day practically
unaltered. So satisfactory an agent is chloroform in Edinburgh
hands, that other anaesthetics are in that city but rarely called
into requisition. All the world over it is the anaesthetic in which
the general practitioner places his trust.
Having seen what Simpson did for anaesthesia, we may briefly review
what anaesthesia has done for humanity. That it has entirely abolished
the pain attendant upon surgery is easily recognised by the profession
and patients alike. The patient never begs for mercy nowadays; he
dreads the anaesthetic more than the knife; he has no anxiety as to
whether he will feel pain or not, but rather as to whether he will
come round when the operation is over; happily after one experience he
realises that his fears were unfounded, and, if need be, will submit
cheerfully to a second administration.
The horrors of the operating-room referred to in the preceding chapter
were vanquished with the pain; the surgeon has no longer to steel
himself for the task as formerly, to wear a stern aspect and adopt a
harsh manner. The patient has no longer to be held down by assistants;
instead of having to be dragged unwillingly to the operating-table--a
daily occurrence sickening to the hearts of fellow-patients and
students, while it served only to harden the surgeon and the
experienced old nurse of those days--he will walk quietly to the room,
or submit patiently to be carried there, and at a word from the
surgeon prepare
"... to storm
The thick, sweet mystery of chloroform,
The drunken dark, the little death-in-life."
The operation is no longer a race against time; order, method,
cleanliness, and silence prevail, where there was formerly disorder,
bustle, confusion, dirt, and long-drawn shrieks. Nothing illustrates
better the progress of surgery than a picture of the operating-room in
the first decade placed beside that of an operating theatre in one of
our leading hospitals in this the last decade of the nineteenth
century. In the quiet of the patient, in the painlessness of the
operation, in the calm deliberation of the operator, and the
methodical order of all around him, in the respectful silence that
prevails in the room so soon as the patient is laid on the table, we
see the direct results of the introduction of anaesthetics. But there
are other great, if less direct, results, each making its presence
known to the professional spectator. By anaesthesia successful
operations previously unheard of and unthought of were made possible
after the principle of antiseptic surgery had been established; by
anaesthesia experimental research, which has led to numerous beneficent
results in practical surgery and medicine, was made possible. Its
introduction is an achievement of which the Anglo-Saxon race may well
be proud. Wells, Morton, and Simpson are its heroes. The United States
has by far the greater share of the honour of its discovery; but to
Scotland is due the glory which comes from the victorious fight. No
event in surgery up to 1847 had had such far-reaching effects. Simpson
himself looked forward to the discovery of some agent, better than
both chloroform and ether; and it is still possible that there may be
an even greater future in store for anaesthesia than was ever dreamt of
in his philosophy.