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DEVILS, DRUGS,

AND

DOCTORS

HOWARD W. HAG G ARD

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DEVILS, DRUGS, AND DOCTORS

THE STORY

Of the Science of Healing from ^edicine-<:^an to Doctor

By Ho\vARD W. Haggard, M.D.

Associate Professor of Applied Physiology, Yale University Author of ''Tun Science of Health and Disease"

WITH many illustrations FROM

original sources

William Heinemann (Medical Books) Ltd. LONDON

PRINTED IN THE UNITED STATES OF AMERICA

THIS BOOK IS DEDICATED TO

. ' :'A

HI lid

JOSEPHINE F. HAGGARD ici-l

CONTENTS

Part One THE CONQUEST OF DEATH AT BIRTH

I. Childbirth and Civilization 3

The care given the child-bearing woman; an index of civilization — Medieval in- difference to the suffering of women — Baptism before birth — Filthy ages of faith — Conditions for the woman of today — Leaders in the conquest of death — The cultural lag — Low position of women in the United States — How primitive women bear their children — Why they have few difficulties — The detrimental influences of civilization — -Native confinements — Customs of purification — Labor believed a voluntary act on the child's part — Rough assistance in difficult labor — Saliva as a healing agent — ^The rise of the midwives— Early regulations to con- trol midwives — The obstetrical chair — Innovation of using a bed for childbirth — Indian obstetrical practices — The medicine of the ancient Greeks — Legends of y€!sculapius — Hygeia — A celestial professor — Restoring the population of Ha- des— Treatment in the Temple of ^Esculapius — Discrimination against child- bearing women — The oath of yEsculapius — Hippocrates the Great — Manifold duties of Greek midwives — Infant exposure — Abortion — Systematized supersti- tions of the Romans — The Greek physicians migrate to Rome — ^They collect their fees — Cato's prediction — Pliny — No laws against malpractice — The Greek physicians misbehave themselves — Royal intrigue — Greek medicine develops in Rome — Soranus — ^The peak of ancient midwifery — ^The opinion of Soranus on abortion.

II. Sairey Gamps and the Midmen x5

Medicine declines and fanaticism rises — The most unfortunate period in the history of womankind — Woman pays for the fall of man — A ban put upon abor- tion—C^csarean section advocated — Crude surgery — Sex concepts and theology — The supervision of midwives and prostitutes — Sairey Gamps and vagabond sur- geons— Shepherds and herdsmen excluded from obstetrical cases — A sign of advancing civilization — Sanitary conditions in medieval cities — Unpaved streets and pigpens — Before the time of handkerchiefs and nightgowns — The Garden of Roses for Pregnant Women — The Byrth of Mankynde — A physician burned for attend- ing childbirth — A gentler influence in civilization — Ambroise Pare — A place for God's hospitality — Conditions at the Hotel Dieu — Nordau's description of its horrors — Two hundred infants in eight beds — Managerial difficulties settled — Pare becomes an army surgeon — His experiences at the battle of Turin — Military compassion — "I dressed his wounds and God healed him" — Catherine de' Medici — Pare becomes chief surgeon to four kings of France — Massacre of St. Bartholomew's night — ^Treatment of gunshot wounds — Boiling oil — Pate's

vii

viii CONTENTS

gentler treatment — "A man very impudent and without any learning" — Par6 reintroduces podalic version — Conditions existing before its use — How the Cesarean operation got its name — The beginning of obstetrics — A school for midwives — Changing customs — A physician attends the mistress of Louis XIV — The midraen — Clement made royal accoucheur — The accoucheurs become fashionable.

III. "The Compassion of Peter Chamberlen" 44

The Chamberlen family flees to London — The invention of the obstetrical for- ceps— The invention kept a secret — The Chamberlens attempt to control mid- wifery— A Voice in Ra/nah — The compassion of Peter Chamberlen — Obstetricians opposed — Amazing prudery — Violent derision — William Smellie — Mrs. Nihell, the Hay Market midwife — "AndrianusSmelvgot" — "Dr. Slop"' — The "dangers and immorality" of employing "men in midwifery" — Survival of contemptuous attirude toward obstetricians — Hugh Chamberlen attempts to sell his secret in France — An unsuccessful demonstration— Medical ethics — Famous charlatans of the seventeenth and eighteenth centuries — Queen Anne's weak eyes — Sir William Reed and Dr. Grant — Chevalier Taylor — The most ignorant man Dr. Johnson ever met — Literary men inclined to quacks — "Spot" Ward— Satire of Moliere — Hugh Chamberlen sells his secret in Holland — A grim joke — "Dr. Slop's" for- ceps slip — Purpose of the obstetrical forceps — Pare's erroneous idea — His tale of an execution — A book for midwives "fitted to the meanest capacities" — Distor- tion of the pelvis — Rickets — Sunlight and cities — Measurement of the pelvis — Revival of abortion and premature labor to avoid difficult childbirth — The attitude of the French — Guy Patin's comments on the prevalence of abortion — Abuse of obstetrical instruments — Meddlesome midwifery — An extreme reac- tion— William Hunter's example — Princess Charlotte's death — Obstetrics cease to be a branch of surgery.

IV. "A Gentleman with Clean Hands May Carry the Disease" 66

The rise of a pestilence — Ravages of puerperal fever from the seventeenth to the nineteenth century — Hospitals where the disease flourished — "Laudable pus"— An extract from the record of a case of puerperal fever — A physician philoso- phizes— Midwifery in Colonial America — Disease and bigotry — The first regula- tion to control midwives in America — Mr. John Dupuy, M.D., man midwife, dies — New York champions "Granny" Brown — Dr. Shippen opens a school of midwifery in Philadelphia — He advertises for women who have virtue enough to admit their ignorance — The medical school of Philadelphia — King's College of New York — Yale University and the Colony of Rhode Island give irregular medical degrees — Dr. Turner — Dr. Shippen becomes surgeon-general of the army of the Revolution — Dr. Benjamin Rush — Oliver Wendell Holmes tells the cause of puerperal infection — His papers condemned — A quotation from his medical writings — "A gentleman with clean hands" — Ludwig Ignaz Philipp Semmelweis — Vienna in the eighteenth century — The old Vienna school of medicine — Baron van Swieten — Mesmer forced to leave Vienna — The AUgemeine Krankenhaus — The methods of Dr. Boer— Semmelweis becomes an assistant at the hospital — Horrible conditions in the lying-in-hospitals — The two divisions of the Vienna hospital — A difference in death rate — Semmelweis's problem — His discovery— Official injustice — The death of Semmelweis— Mortality at childbirth in the United States contrasted with that in other countries — An expression of indifference.

CONTENTS ix

Part Two

THE STORY OF ANESTHESIA

V. "In Sorrow Thou Shalt Bring Forth Children" 93

Anesthesia discovered in the nineteenth century — A new method of administer- ing drugs — Narcotics — Soporific potions — ^The mandrake and its legends — Pare ties his patients — Surgical operations verge on sleight-of-hand — A punishment for prudery — Soporific potions at childbirth — The prescription of Zerobabel Endecott of Salem — Biblical quotation on the pain of childbirth— Sir Humphry Davy uses nitrous oxide — Horace Wells repeats his experiments — William Morton — Dentistry before the days of anesthesia — "Ether jags" — Charles Jack- son— Morton experiments with ether — He administers it for a surgical opera- tion—Oliver Wendell Holmes applies the word anesthesia — Attempts to patent ether — The ether controversy — Dr. Long's operation — Hayden describes an operation before and after the discovery of anesthesia — James Y. Simpson dis- covers the anesthetic properties of chloroform — He administers it at childbirth — An extract from his paper describing his results — He enters a controversy — A reformer with a sense of humor — The clergy condemn anesthesia on religious grounds — Simpson's reply — Objections to all innovations — Anesthesia given Adam at the birth of Eve — Simpson's reply to the objections of the medical pro- fession— Simpson honored — Sir Walter Scott's suggestion — The loss of maternal instinct, an objection to the use of anesthesia — Those who objected — Queen Victoria accepts chloroform — The medical difficulties of Louis XIV — Painless childbirth not yet fully achieved — The cause of the pain — Childbirth without anesthesia — Twilight sleep — Difficulties of administering anesthesia — Recent advances in the search for means to make childbirth painless.

Part Three THE PROGRESS OF SURGERY

VI. Making an Anatomy izy

Surgical operations in ancient Egypt — Forty-three centuries of wound surgery — The great change that came in the nineteenth century — Essentials of surgery — Egyptians lacked knowledge of anatomy — Their method of embalming — Need for surgery shown by archeological surveys — Surgery of the Babylonians and He- brews— Bone of Luz and Adam's missing rib — Anatomical knowledge of the Greeks — Arabs subordinate surgery — Jewish surgeons during the Middle Ages — The crude surgery of that time — Treatment of wounded soldiers — Barbarities during the siege of Metz — Queen Elizabeth's physician — Sir John Pringle and the first Red Cross agreement — Thomas Gales tells of quacks in the army serv- ice— Surgeons in jeopardy of life — Dr. Radcliff and Queen Anne — The medical school of Salerno — The story of treatment given Robert, Duke of Normandy — A medical home health book in verse — A translation by Sir John Harington, the inventor of the water closet — A selection from the medical poems — Medical etiquette in the Middle Ages — Priests enter medicine and the Church issues edicts against this practice — Surgery not respectable — Three classes of men practicing surgery — "Making an Anatomy" — ^Andreas Vesalius dissects the human body —

X CONTENTS

He publishes his work — Violent opposition — Galenic anatomy overthro>»'n — Vesalius diplomatic toward theological concepts — Servetus burned — Vesalius destroys his manuscripts and retires — Scarcity of bodies for dissection — Grave robbers — Diary of Judge Samuel Sewell — The first announcement of a course of anatomy in America — Dr. Shippen's course at Philadelphia — He is attacked — The doctors" mob at New York — The first anatomy law of Massachusetts — Body- snatching — The notorious Burke and Hare of Scotland — The attitude towuid dissection today — Dowie's description of a dissecting-room — "Damnation and Hell hold high carnival."

VII. The Greatest Surgeon 159

Pare and Vesalius hold a consultation at the deathbed of Henry II — ^Red-hot iron and molten pitch to control hemorrhage— Pare reintroduces the ligature — His patient returns home gayly on a wooden leg — Former limitations of surgery — Pare's tale of the wounded King of Navarre — -A fatal wound in the shoulder — Pare treats the Marquise d'Arnet — Consultation with five surgeons — ^The course of treatment — The convalescence — Pare plays the part of a trained nurse — Femi- nine aid at the Siege of Metz — Servant nurses in the London hospitals — Women of drunken and dubious habits — Florence Nightingale dignifies the profession of nursing — Her part in the Crimean War — ^Training the "new-style nurses" — The beginning of hospital cleanliness — Lister and the antiseptic principle — "Laudable pus" — Wound infection and blood-poisoning in the hospitals — Fre- quent amputations — Lister applies Pasteur's discoveries — His experiments — Opposition to his work — The fourth essential of surgery supplied — Where the infection came from — Prevention of infection in modern surgery — ^The great change in surgery — A statement made in 1876.

Part Four THE PASSING OF PLAGUE AND PESTILENCE

VIII. The Black Death 179

Gibbon selects a period during which the human race was most happy and prosperous — A period of great pestilences — ^The bubonic plague — Malaria and other diseases — Gibbon justified — Conditions in his time and before — Diseases of the past — Influenza an uncontrolled pestilence — Stationary populations — The control of pestilence influences death at childbirth — Disease as an affliction from God — Example of this belief — Cosmic disturbances as a cause of disease — Medi- cine an accessory to theology — Cotton Mather's views of disease — The asafetida bag — Medicine comes into its rights — Contrast between medicine and surgery — Modern civilization founded on preventive medicine — A supreme benefit con- ferred on mankind — Medicine and the level of civilization — ^Typhoid fever during wars — Burning the lepers — The control of leprosy — Lazarettos of the Middle Ages — The "great killer" — The plague-ridden ages — The plague of Justinian — Omens of the plague — The plague at Constantinople — Gibbon's comments — ^The plague lies dormant for eight hundred years — The "black death" — Men's be- havior during the plague — Boccaccio's description of an epidemic — Comfort by absolution — Death of the holy pilgrims — A Pope in isolation — Waves of piety — Dice factories that made rosary beads — A quarter of the population swept off — Conditions in cities during epidemics — Persecution of the Jews — Plague spread-

CONTENTS xi

ers — Legal torture — The criminal code of Maria Theresa — Pictures of the plague — The plague in literature — Relation of rats to the plague — Quarantine applied by the Venetian Republic — Origin of the word quarantine — Rousseau detained — Napoleon infringes the regulations — Sieyes's motion to have him shot — Ravages of plague forgotten — An epidemic in the United States — Prevention controls the plague — ^Treatment futile — Medieval plague doctors — Origin of eau de Cologne — "Three adverbial pills" — ^The nobility desert the cities.

IX. Pestilence and Personal Liberty ziz

Asiatic cholera in New York City — ^The "white man's grave" — An epidemic of yellow fever in Philadelphia — Description of conditions there — Part played by the mosquito — Means of prevention — An achievement for civilization — St. Anthony's fire — Patron saints of disease — Shriveled limbs and maimed bodies — Recourse to the monasteries — The cause of St. Anthony's fire — A pesti- lence turned to the service of women — Personal liberty and the prevention of disease — Popular indifference — Smallpox — Famous victims of the disease — Ma- caulay writes of the smallpox of Queen Mary II — The diseases of William III — Smallpox in New England — ^The disease "clears the way for a better growth" — Inoculation as a means of prevention — Lady Mary Wortley Montagu's de- scription— Cotton Mather introduces inoculation into America — Oliver Wendell Holmes describes the introduction — ^The inadequacy of quarantine — Simpson draws some analogies and gives some examples — A beggar woman at Leith — Peddlers with smallpox — Jenner introduces vaccination — An unfavorable reception — ^The American Indians appreciate vaccination — Indifference and for- getfulness, obstacles to vaccination — -Jenner and Napoleon, a contrast.

X. Pestilence and Moralists 133

Moral concepts and fanaticism — ^Two plagues that could be eradicated — Igno- rance and bigotry the allies of syphilis — Plagues involved in the greatest problem of civilization — An imputation of divine origin — Sex is kept a problem — The corruption of the good word moral — False moralists — ^The panderers of the venereal diseases — All disease is immoral — Five centuries of syphilis — An his- torical problem — ^Theory that Columbus brought syphilis from America — A "disease which hath power over all Europe, especially among the Frenchmen" — " Fruit of All Saints againft the Disease of the Island of Espanola" — "A thorn joined to the Rose" — "Every Man His Own Doctor or the Foor Planter s Physician" — A doubt cast on the situation — Charles VIII in Naples — ^The spread of syphilis — Civilization and syphilization advance together — Cardinal Wolsey accused of giving syphilis to Henry VIII — ^The quarantine in Paris— "Four Paris sous to leave the city" — ^The Scottish regulation — Finding a name for the new plague — The fable of "Syphilos" — Syphilis among the American Colonists — John Win- throp records a case — "Blameless Manners" — ^The attitude toward syphilis — Ethics change but disease persists — Some famous victims and some who were not — Speculation as to the cause of syphilis — A patron saint — ^The origin of the name venereal — The leprous taint — Paracelsus advances a theory — Francis Bacon attributes syphilis to cannibalism — An absurd theory close to the truth — The discovery of the organism of syphilis — Animal inoculation — ^The character of the spirochete — Modes of infection — Syphilis a mild disease but persistent — The stages of syphilis — John Hunter's heroic experiment — The late effects of syphilis — Locomotor ataxia and paresis — Syphilis not hereditary — Contact in- fection— Gonorrhea a local disease — Consequences in women — Blind chil- dren— Humane laws for economic reasons.

xii CONTENTS

KI. The Medical Thread in the Moral Snarl 159

Moses on venereal disease — Prostitution held responsible for the spread of dis- ease— Bernard Mandeville's satiric defense of "Public Stews" — "The Exchange Wench" — Mandeville's plan — A home for superannuated courtesans — A house of prostitution under royal charter— It supports a university — The prostitutes revolt — A plan of treatment that failed — The old Statues of the Stews of Avig- non— Discrimination against the Jews — Antiquity of the distinguishing badge for prostitutes — The story of Judah and Tamar — Moses attacks the "strange women" — Solomon allows the regulations to relax — The Greek courtesans set the fashions — Prostitution a social institution — Socrates advises Aspasia — Pericles defends her — She marries a wealthy grain merchant — The moral stand- ard among the Romans — Prostitution grows — The crime of adultery tolerated — Promiscuity results — Glorified vice and the inmates of the fornices — The rise of the Christian religion — Its emotional appeal — Chastity becomes a religious virtue — The sexual instinct underrated — The sublimation of the instinct — Sup- pression and distortion — A strange manifestation of the suppressed instinct — The saints of the desert — St. Simeon Stylites — St. Mary of Egypt, a reformed prostitute — Theology seeks a way out — Sin preferable to demoralization — Pros- titution sanctioned — Continence as a cause of "corruption of the flesh" — A medieval fallacy — Benjamin Franklin's views — "Itinerant wives and maidens" — The brothel system reestablished — Prostitution under ecclesiastical control — A changing attitude and a persisting problem — Theodora's solution — Edicts of Louis IX — Futile attempts to suppress prostitution — Prevalence of syphilis among prostitutes — Man's responsibility and his hypocrisy — Early marriage, a possible solution — The medical thread in the moral snarl.

Parf Five THE HEALING ART

XII. The Halt, The Lame, and the Blind 2.81

Faith healing — Hygienic therapy — Drug cures — Civilization and the type of medical treatment — Primitive man's conception of disease — The medicine-man's method — Faith healing persists among civilized peoples — Inspired confidence — Excommunicated May bugs — Faith healing under many names — A useful form of treatment — The physiological basis for faith healing — ^Testby ordeal — Predic- tions of death — The martyr's anesthesia — Rage and pain— Male demons that attack women — Marks of their violence — Hysteria — Pseudo-pregnancy — Pseudo-hydrophobia — Shell shock — Loss of confidence — Railroad spine — Mind and body are one — Allegorical elevation of organs — Peculiar beliefs concerning blood transfusion — The correlation of bodily functions — Three classes of dis- ease— The body usually cures itself — Patients who die — Hoc ergo f rafter hoc — A royal touch for the king's evil — Edward the Confessor — Examination by the king's physicians — Dr. Samuel Johnson touched by Queen Anne — Touch pieces — The opinions of various kings — Louis XIV — Charles II the busiest toucher — Cramp rings of Henry VIII — Queen Elizabeth's blessed ring — The ages of faith — Christianity and the return of superstition — Demoniac cause of disease — Miraculous cures — The origin of hospitals — Conception of disease among early Christians — Possession by devils — King Charles II of Spain — Harmfulness of night air -Cure by exorcism — ^Testimonials — Brutal treatment of the sick — A

CONTENTS xiii

thriving business in relics— A fearher from the Holy Ghost — St. Peter's toe nails — Monastic rivalry — Relics of the three wise men from the East — Saint Ursula and her virgin martyrs — Loundres and St. Anne de Beaupre — Peace and security even though death results. "

XIII. White Magic and Black 303

Healing cults of today — Revival of medieval practices — Changing cults — Cagli- ostro — The "celestial beds" of James Graham — Lady Hamilton — Valentine Greatrakes the stroker — Robert Boyle's testimony — The Earl of Sandwich has the "gift of healing" — Andrew Jackson Davis, the seer of Poughkeepsie — His book of revelations — Attempts to make spiritualism a national institution — Davis's cult and his following — His principle opposite to that of Christian Science — George O. Barnes, the mountain evangelist — The Mormons set bones by faith — Francis Schlatter — A postal fraud — John Alexander Dowie — Doctors, Drugs and Devils — Phineas Quimby of Maine — Animal magnetism — Hypnotism — Quimby treats the ills of "misunderstood women" — New Thought — Mrs. Mary A. Morse Baker Glover Patterson Eddy — Her hysterical ailments — She appeals to Quimby — She becomes a faith healer — Science and Health — Disputes in the Christian Science organization — Delusions of persecution — Malicious animal magnetism — Queen Elizabeth makes witchcraft a capital offense — King James I writes a book on witchcraft — Persecution of witches — Trial of witches in Pennsylvania and New England — Mrs. Eddy attempts to revive witchcraft — White magic and black magic — Modern philosophies that are plagiarisms — The principle used by Mrs. Eddy — An ancient theory — Bishop Berkeley — Mrs. Eddy in a dilemma — Cleanliness not a cardinal virtue in her time — An index of moral frailty — Mrs. Eddy on bathing children — Disadvantages of white magic — The advantages of Christian Science — An impressive forn. of faith healing — Chiro- practic manipulation — Bone setters — Mrs. Mapp — Crazy Sal — Hogarth's cari- cature—Andrew Still gives bone-setting a new name — Osteopathy — Laying on of hands with impressive force — ^The English opinion — Disease from dislocated spines — Faith healing by diet — Cyril's liver — Fish and brains — Vitamins — Yeast — Appliance cures — Dr. Perkins of Yale — The famous Dr. DuBuke branded for stealing indigo — Perkins tractors — Cures with blue glass — Doctors avoid faith healing — An unsympathetic attitude.

XIV. A Drug on the Market 3Z?

Drugs as a form of faith healing — The history of a drug told in the definition — Potatoes as a medicament — Potable gold — The treatment of Sir Unton — A bottle of medicine and a box of pills — The belief in their necessity for treatment — An example by Oliver Wendell Holmes — Carlyle and his wife's medicine — Drugs and superstition — Egyptian mummy — A protest by Pare — Unicorn's horn — A gift from Pope Clement VII^ — Unicorn used by kings of France — Its properties investigated by the Royal Society — Governor Endicott loans Governor Win- throp a horn — The bezoar stone of Charles IX — The king and Pare experiment on a condemned criminal — The bezoar fails as an antidote — The moss from the skull of a criminal — A piece of the hangman's rope — Cotton Mather prescribes sow bugs — Robert Boyle includes the sole of an old shoe — Urine recommended as a mouth wash — Madame de Sevigne — Richelieu's potion — ^The sympathetic powder of Sir Kenelm Digby — King James tries it — Proprietary medicines as faith cures — A fallacious test for drug — Drugs and spices — The drug trade — Sea supremacy and exploration — The Dutch control the drug trade — Bloodshed

xiv CONTENTS

for the clove — ^The death of King Charles II — ^The medical treatment he re- ceived— An endless array of drugs — King James I resists medical treatment — Poison lore — Cleopatra as a medical writer — Mithridates, King of Poncus, ex- periments— Egyptian medicine — The universal antidote — Theriac — Discordes compiles the medical drugs — Medieval Herbals — Galen's system of treatment — Vegetable simples — Galen's life — His medical theories — The qualities of the bodv — "Cool as a cucumber" — Herb doctors — The apothecaries' trade at Rome — Apothecaries of Europe — The grocers sell drugs — Conserves and other things for Sir Walter Raleigh and a physic for Mr. Edward Nichols — "Retired for physic" — An appalling amount of unnecessary purging — Bleeding as a form of treatment — Dr. Sangrado — Apothecaries that prescribed — The objections of the phvsicians — Situation in France and England — The comments of Pope and Dr. Johnson.

XV. The Turning-Point 345

Paracelsus introduces metallic poisons — Physicians that go off on a tangent of mysticism— Emmanuel Swedenborg — ^The life of Paracelsus — Medical practice, low company, and mysticism — His lectures at Basel— "From the obscene into the incomprehensible" — Charges against the character of Paracelsus — Medicine and nonsense — The fountain head of mysticism — Specific remedies — A remedy for svphilis — Physicians fail to cure syphilis — Vagabond quacks succeed — Over- dosing with poisons — How antimony got its name — The controversy over its use — King Louis XIV gets well — Napoleon takes one emetic and refuses a second — A type of reasoning in medical matters — The physician asks a question — Con- trol observations — An obvious method and its limited employment — Even an economist may be a medical faddist — Scientific methods — A complete revision of medicine — ^The rise of homeopathy — ^The signature of disease — Like cures like — Hahnemann — Oliver Wendell Holmes separates the valuable drugs and sinks the rest — The specifics he chooses — "Not discovered by our art" — Alexander the Great and Cromwell die of malaria — Louis XIV is cured with quinine — ^The introduction of coffee, tea, and tobacco — "Tobacco-drinkers" have their "noses slit" — Captain Cook finds a way to prevent scurvy — Fewer drugs but more attention to the needs of the body — Vitamins, iron, sunlight and salt — Goiter and cretinism — A suggestion of ancient beliefs — Fallacies of rejuvenation.

XVI. Toward a Better Civilization 358

Treatment gives way to prevention — Bacteria as a cause of infectious disease — The strongest weapon for the betterment of mankind — Louis Pasteur — From the diseases of wine to the diseases of man — A study of fermentation — Sponta- neous generation — A control experiment — Wines are cured — The diseases of silkworms — Pasteur discouraged — Lister's letter — Pasteur studies the diseases of animals — Vaccines — A challenge and a demonstration — Pasteur studies the dis- eases of man — Hydrophobia — Little Joseph Meister — Berger Gulippe — The chil- dren from New Jersey — Metchnikoff develops a prophylaxis against syphilis — He receives the Nobel Prize — Diphtheria conquered — The diagnosis of syphilis — Diagnosis as important as cure — A test for cancer needed — The demand for a better treatment for syphilis — Ehrlich exercises his chemical imagination — He develops a cure — Physicians and moralists, a contrast — ^The control of public opinion — The least developed field of medicine — Ancient customs in diagnosing insanity — An indication of uncertainty — ^The abuse of the insane — Bedlam — "A keeper the which the madde man do fear" — "Toms o' Bedlam" — Shake-

CONTENTS XV

speare anticipates physicians by a century — "A mind diseased" — The Lunatics tower — Treating symptoms — Philippe Fine! — The champion of the insane^ Dorothea Dix — Establishment of asylums — Paresis a form of syphilis — Noguchi's discovery — Salvarsan fails to cure paresis — Discrimination against syphilitics — Clinics— Ignorance and a moral attitude— The arrest of paresis— The civiliza- tion toward which the medical sciences lead.

Part Six MEDICINE THROUGH THE AGES

XVII. Civilization and Medicine 383

New York in darkness or New York deserted— Consequences of rising pesti- lences— Medical science ranks in importance with food supply — Indifference towards medical science — Active opposition and its consequences — Smallpox does not stay where legislation favors it— Modern people who cling to ancient philosophies — Savages riding in automobiles — Primitive medicine and rational medicine — Superstition and reason— The mystery of disease— Man is ancient but civilization is new— Modern men controlled by primitive instincts — Instincts overcome by education— Intelligent people who are controlled by- faith— Rational medicine a measure of civilization— The transition from primi- tive to rational medicine — Moses on sanitation — Divine healing among the Greeks — A reform in the temple cult — Hippocrates founds rational medicine — His precepts — His aphorisms — The first physician to differentiate diseases — The kind of treatment he gave — Decline of Greek civilization and medicine — Galen's theories — Medicine deteriorates — A theology hostile to science — ^Theology controls the western civilization — Subordination of body to perfection of spirit — A time of low civilization — Medicine reverts to its primitive state — Idealism leads to the founding of hospitals — Intellectual efforts in the Middle Ages — ^The Arabic civilization — Rational medicine revived — It returns to Europe — Revolt against bigotry and obscurantism — Paracelsus sets an example — Founding of human anatomy — Revival of the scientific spirit — Harvey demon- strates the circulation of the blood — The state of medicine at the beginning of the eighteenth century — Morgagni founds clinical medicine — Revival of the Hippocratic principles — Vaccination — The state of medicine at the beginning of the nineteenth century — ^The scientific spirit amplified — Great advances that resulted — Anesthesia— Control of puerperal infection — Trained nurses — Aseptic surgery — Preventive medicine — The healthiest period the world has ever known — The possibilities of scientific medicine — No assurance that these pos- sibilities will be realized — Medicine depends upon advancing civilization — Civilization prone to regress — ^The dangers to civilizatioa and to medicine— The persistence of bigotry and obscurantism.

Index 397

Part One THE CONQUEST OF DEATH AT BIRTH

"To overthrow superstition, to protecf motherhood from pain, to free childhood from sickness, to bring health to all man- kind:

"These are the ends for which, through the centuries, the sciiolars, heroes, prophets, saints and martyrs of medical science have worked and fought and died, as are here recounted."

— Yandell Henderson

"On either side of the river, was there the tree of life, which bare twelve manner of fruits, and yielded her fruit every month: and the leaves of the tree were for the healing of the nations."

— ^Revelation, xxii, 2,

C H A P T E R I

CHILDBIRTH AND CIVILIZATION

He position of woman in any civilization is an index of the advancement of that civilization; the position of woman is gauged best by the care given her at the birth of her child. Accordingly, the advances and regressions of civilization are nowhere seen more clearly than in the story of '-J childbirth.

Child-bearing has always been accepted among primitive peoples as a natural process, and as such treated with indifference and

BIRTH OF CLEOPATRA'S CHILD

From a bas-relief on the Temple of Esneh. The amazingly large size in which the child is represented is indicative of its royal parentage. The position taken by Cleo- patra is still used during childbirth by many primitive peoples.

brutality. At the height of the Egyptian civilization and again at the height of the Greek and Roman civilizations the art of caring for the child-bearing woman was well developed. With the decline of the Greek and Roman civilizations the care of woman deterio- rated; for thirteen centuries the practices developed by the Greeks were lost or disregarded in Europe. The art of caring for the child-

4 DEVILS, DRUGS, AND DOCTORS

bearing \Noman was not brought back to its former development until the sixteenth or seventeenth century of our era.

The medieval Christians saw in childbirth the result of a carnal sin to be expiated in pain as defined in Genesis III: 16. Accord- ingly, the treatnient given the child-bearing woman was vastly worse than the mere neglect among the primitive peoples. Her sufferings were augmented by the fact that she was no longer a primitive woman, and child-bearing had become more difficult. Urbanization, cross-breeding, and the spread of disease made child- bearing often unnatural and hazardous. During medieval times the

BAPTISMAL SYRINGE For applying this rite to infants before birth in cases of difficult labor. The par- ticular syringe shown here was designed and described by Mauriceau in the seven- teenth century and Laurence Sterne, in Tristram Shandy, quotes the original descrip- tion in full. This syringe was the "squirt" of his "Dr. Slop." In some varieties of the instrument the opening of the nozzle was made in the form of a cross to add sanctity to its use.

mortality for both the child and the mother rose to a point never reached before. This rise of mortality was in part the consequence of indifference to the suffering of women. It was due also to the cultural backwardness of the civilization and the low value placed on life. It was aggravated by the increasing difficulty attending childbirth. These were the "ages of faith," a period characterized as much by the filth of the people as by the fervor and asceticism of their religion; consequently nothing was done to overcome the enormous mortality of the mother and of the child at birth. It was typical of the age that attempts were made to form intrauterine baptismal tubes, by which the child, locked by some ill chance in its mother's womb, could be baptized and its soul saved before the mother and the child were left to die together. But nothing was

CHILDBIRTH AND CIVILIZATION 5

done to save their lives. No greater crimes were ever committed in the name of civilization, religious faith, and smug ignorance than the sacrifice of the lives of countless mothers and children in the first fifteen centuries after Christ among civilized mankind.

With the Renaissance of European civilization there came a change in the care given the child-bearing woman. This change was slower in advancing than were many of the other changes which marked this period. Material advancement was made before humanitarian advancement.

The care of the child-bearing woman is an index of the civilization of the community as a whole and not alone of the leaders of the civilization. These leaders blaze the way, they show the path to a better civilization, but that civilization comes only when the path is followed. Throughout the story of childbirth these leaders of the conquest of death at birth stand out from other men like giants in their times. These men, whose praise is unsung and whose names are unknown to most people, rank higher in the advance of our civilization and are greater men by every standard than any of the kings and statesmen whose names are taught to school children and whose works are measured by the ephemeral boundaries which they won for the countries where they fought and intrigued. The great men who were the champions in the conquest of death at birth have not fought in vain. Their glory, to the measure which the advance of civilization will allow, is in every child who lives today and in every woman who bears a child.

The modern conquest of death at birth was started in the six- teenth century. As a result of its advance, the woman of today, if she will and if the civilization of her community gives her the privilege, may look upon pregnancy not as a curse, not as the inevitable result of a "sin," but as a privilege of her sex, to be indulged in only when she chooses to do so. Hers is a pregnancy no longer darkened with the shadow of the wing of death, but illuminated with the clear light of the precise medical knowledge of her condition. She is told in advance the safety of her state and delivered of her child with a minimum of suffering never dreamed of by her primitive sister of twenty-five centuries ago, nor even by her sister of three centuries ago, as she expiated her sin in the

6 DEVILS, DRUGS, AND DOCTORS

heritage of Nvomankind or was butchered to death by the midwife or the barber.

The conquest of death at birth has made its victories. In its means of advancement it has run ahead of the slowly moving civilization. It now waits for that lag of culture, the slow pulling of the feet out of the mire of medieval ignorance, which must end before woman can benefit to the fullest by the victories of the con- quest. The neglect of the parturient woman and her child, seen in the deaths at birth and in the hazard of bearing children, is no fault of the medical profession. That profession has led in the conquest, but it can give no more than the community will accept. It cannot of itself overcome the inertia of civilization, nor say what value shall be placed on the lives of women and children.

Young civilizations are like adolescent boys: they are strong and aggressive, they take a noisy pride in the toys of their material advancement, but the very uncertainty of their unproven strength makes them ashamed to stoop to acts of kindness for fear they will be accused of weakness. They have the Utopian ideals of adoles- cence, but they have, too, its self-consciousness and blindness and ignorance; they reach for the stars and tread the lilies underfoot; they ignore the real problems of life and civilization. There are twenty civilized countries in the world which record the proportion of mothers and children who die at childbirth. The order of those fatalities places the civilization of a country. The United States ranks nineteenth from the top. In only one of these twenty countries, and that one in South America, is there a greater hazard for the child- bearing woman.

Child-bearing among primitive peoples is today what child-bear- ing was to our ancestors twenty-five centuries ago, and little different from what it was three centuries ago, except that some of the hazards were greater at the later period than at the earlier. Intuition would lead the primitive woman, as it would the animal, to bear her young, and by laceration with her teeth to sever the cord which attaches the child to its mother. The primitive woman had little difficulty with childbirth; but she had not been exposed to the evils of civilization. Distortion of the bones of her pelvis by rickets, and the consequent difficulty or impossibility of natural birth, did not affect her, for she

CHILDBIRTH AND CIVILIZATION 7

had not yet been subjected to the diet evolved by civiUzation nor did she shut herself from the radiations of the sunlight by glass and clothing. Furthermore, she was not subject to that mongrelization characteristic of civilization, the cross-breeding which commerce makes possible. Her people were of one size; her baby was suited to the size of the pelvis through which it must emerge.

The native woman led a life of active work; in consequence, her child was small. By her exertions, carried on to the day of her delivery, the child was literally shaken into the normal head-down position for the easiest and safest birth. Even in urban communities today hard work and some privation have their effects in making childbirth easier. Among women who do no heavy manual work the babies are heavier at birth than among those women who do manual work; the easier births among the working class are not, as is often supposed, due to a nearer approach to natural conditions — often far from it — but, if they occur, are due to the smaller size of the children born. •

The woman of native or primitive peoples was not in horror of the devastation of childbed fever. The hand of no medical student or accoucheur of the pre-antiseptic age brought to her the con- tamination from the autopsy room or from her stricken sisters. Nor did she take her place in the filthy bed of a hospital of the seven- teenth, eighteenth and even early nineteenth centuries, to lie perhaps with four other patients in a bed five feet wide, as at the Hotel Dieu at Paris, and wait, if she survived the fetid air, the pestilence of the place, and the butchery of the midwife or student, for the fever, engendered by the "weather," which killed from two to twenty of every hundred of her sisters who were forced to accept the fatal charity of such places. The primitive woman met all of these refine- ments of civilization later — when she met the civilized peoples. She met also other things which influenced her child-bearing; she met syphilis and tuberculosis, plague and typhus fever, gonorrhea and alcohol, and worst of all she met the crowding into cities and the shame taught by the Christian religion.

The fact that labor is a more natural process among primitive women does not imply that most civilized women cannot bear their children with little help. But a vastly higher percentage are unable

8 DEVILS, DRUGS, AND DOCTORS

to do so than was the case with the primitive women. CiviUzation. and its blessings imposed an increasing number of penalties upon child-bearing, and for centuries, while our modern type of civiliza- tion was developing, no progress was made to counteract these penalties. Modern science has intervened at last and is able to compensate, and more than compensate, for the handicap of civiliza- tion. It can now save lives that would have been lost even under the most natural conditions. It can do more, for it can minimize for women the effects that child-bearing might have upon length of life, a consideration that did not affect the short-lived primitive peoples. The primitive woman had but one great fear in child- birth; that was that the child she carried would be in an abnormal position — as, for instance, transversely across the pelvis instead of in the normal head-down position — so that it could not be born. Such cases were fatal to both the child and the mother, but they are so no longer.

In childbirth among primitive peoples the woman usually retired from her tribe as the birth of the child became imminent. In some cases she would go alone, but more often she would be accom-