CHAPTER CXXII.

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 author1 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.

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.