USA > Massachusetts > Suffolk County > Boston > Metropolitan Boston; a modern history; Volume I > Part 34
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Walter was successfully inoculated June 27, 1721, a date well worthy of remembrance by every American. Within a year, 286 persons had undergone the treatment, of which six had died. Of these six, three are said to have contracted smallpox before the inoculation. Within the same period 5,759 had taken the disease in the natural way, of whom 840 had died, a proportion of one in seven as compared with one in forty- eight under inoculation. The demonstration of the cure won the atten- tion of the laymen by its success; and it was not long before the doctors swung into line, and like Douglass, who later practiced it, tried to claim merit for their acceptance.
However one may view it, the practice of inoculation for smallpox was one of the most notable medical events in America, and possibly the second principal advance introduced in medicine by Boston. The novelty of it, the boldness of it, is not lessened by the fact that six weeks before the trial on Walter, Lady Mary Wortley Montagu had been inoculated in London. It was a method that had been used in a blind way by several races for centuries. But not until after 1721 did it become the established
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method among intelligent people of combatting one of the most dreaded diseases of mankind. Its value was well tested during the Revolution, and it continued to be the standard practice until a better method was discovered by Jenner near the end of the century. It is interesting to note that two years before the announcement by Jenner, vaccination had been introduced by Waterhouse of Harvard, and practiced by Jackson of Boston.
Dr. Boylston was probably the only truly great physician during the first hundred years in Boston. Mumford says that "Boylston was the only American physician who deserves a permanent place among the masters." Not that there were not many faithful doctors who did well according to their knowledge. But there were few that branched out into lines other than had been laid down, there were few, or no, discoverers of better methods, there was really none who introduced anything that was a real advance either in ideas or the art of healing.
The Introduction of Hospital Treatment-One of the results of the use of inoculation was the introduction of hospitals for the treatment of the contagious diseases, particularly for the safe inoculation and later treatment of smallpox. Boston, because of its position as a seaport, was subject to the ailments brought to it from the four quarters of the earth by vessels and their crews. These first institutions, if so large a name can be applied rightly to so small a thing, were lazarettos intended for the reception of diseased sailors. The scope of these was enlarged to handle smallpox. But even these did not come until well on toward the middle of the next century. The first inoculation hospitals near Boston were started in the winter of 1764 when another epidemic of smallpox was raging; one at Point Shirley, the other at Castle William. The Point Shirley hospital was established by the Governor of the Province and placed under the charge of a Doctor Barnett and other physicians. The Castle William hospital was opened to enlarge the facilities of Point Shirley. Doctors Gelston and Warren were the resident physicians, and there were rooms in the "Barracks" for patients of Dr. Nathaniel Perkins, Dr. Whitworth and Dr. Lloyd. Dr. Gelston was from Nantucket where he had managed a small hospital at Martha's Vineyard. It is said that people came from all over the province to be treated in these hospitals, and that during the first five weeks after their establishment, more than 3,000 persons had been treated, without a single fatality.
All this gives the impression of being very modern ; one has a vision of hospitals somewhat after the character of those of today. They seem to be a very decided improvement in the methods of treatment, methods greatly appreciated by the folk of long ago. Little has been recorded to give us a true picture of what these first lazarettos were like, but they
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were evidently few in number, the medical attendance was limited, and the care of the patients "inefficient and often abominable." Sanitation was unknown, inoculation disgusting and dangerous, the places and the patients filthy. The fee for inoculation, medicines and attendance was limited to four dollars, and "three dollars per week for diet, nursing and lodging, during his or her illness." It is not surprising that these hos- pitals were unappreciated, and that in some cases opposition to them reached such heights that attempts were made to destroy them. An inoculation hospital, opened near Marblehead in 1773, was burned by a mob three months later.
The Revolution and American Medical History-The history of American medicine. like that of our country, really begins with the Revo- lution. Especially is this true of Boston. Before this time the town was dependent almost entirely upon medical men coming from abroad. Medi- cine was not one of the favorite professions in the early settlement, and the average of the abilities of the first to locate in the colony was not high. Religion lay behind the founding of Massachusetts, and as a result the minister led in colony affairs. Next behind him in rank came the lawyer and orator. It followed that the class from which came later the most of the medical profession, inclined toward the ministry or the law. Many of the sons of the educated and wealthy, although inclined toward medi- cine, were forced by the class prejudices of the time to enter other pro- fessions. The doctor was loved, but seldom honored except when he became prominent in some other line. The surgeon was still too close to the barber to even merit a title.
The Revolution changed all this. It created a demand that was never met fully, for surgeons and physicians, and the war gave men a chance to handle diseases and learn, as never had before been possible. Political freedom brought emancipation from class prejudice, and the class that had furnished the most of the clergy, now entered the medical profession. The Revolutionary period gave a great impulse towards the establish- ment of hospitals on a large scale and the founding of medical schools. The war was hardly ended when, almost simultaneously the Massachu- setts Medical Society and the Harvard Medical School were established. The Society was empowered to grant certificates of competence, but not to confer degrees. It seems strange that the first of our colleges should have waited nearly a century and a half before founding a medical school, and that after others had been formed in smaller places and institutions. That the hospital should have taken so long before becoming recognized as a necessity of life, is almost as puzzling. Certainly it meant more to the physician than it does today, although it is perhaps the greatest prac- tical teacher we now have. To the layman, the hospital is a place ready
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to receive the ill and the sufferer from an accident. To the doctor it is an educational institution, to which the doctor and the student come for the perfecting of their training. In the day when there were no medical schools, the hospital was the sole institution in which he might learn medicine. The only other method was by apprenticeship to an older physician.
The Medical Organizations of the War-During the Revolution, the chiefs of the medical department were, for the most part, citizens of Philadelphia, but the greater number of the medical force came from Massachusetts, Boston supplying the principal share from the State. Most of the colonies had no competent men fitted for surgery, and American surgery in the armies of that time was not something to make the profession proud. For some time there was no medical organization in the ranks, and so great was the need of war equipment, medical sup- plies were quite overlooked. Instruments were few, drugs scarce, ether was as yet unknown; smallpox was the only disease successfully com- bated. Too often the regimental surgeon received his appointment for political reasons, and was inexpert, inexperienced or worse. Massachu- setts is said to have been the only one of the colonies that did not neglect its sick and wounded. Congress made few provisions in aid of the med- ical corps. Late in 1776, and the condition held almost throughout the war, Congress provided that six doctors should have the medical care of 5,000 men. The hospital surgeon was to be paid $1.60 a day, his mates $1, but fortunately was ranked above the regimental surgeons.
The First Surgeon-General of the Continental Army-There are only two Boston names that stand out in the dark age of Revolutionary medi- cine, Warren and Church, although John Brooks, of Boston and Med- ford, Minot, Prescott, Thacher and others served well. Benjamin Church of Boston had the honor of receiving the appointment as the first sur- geon-general of the American army. The medical service was, at first, called "The Hospital." Church became the head, shortly after the Bat- tle of Bunker Hill, and seems to have proven himself an able man in the administration of his office. He was a leader among his profession in the town, and enjoyed a large practice. Massachusetts has the deserved reputation of providing the proper man when a crisis demanded one, and seemingly it had done so in the surgeon-general. To the dismay of the army, he was found to be in correspondence with the English up to Washington's siege of Boston. A letter of his was intercepted and its contents decoded. His guilt seemed evident, although he made a strong defense at his court martial, claiming he was using this method to secure information from the enemy. The truth of the matter will never be known. Church was convicted and sent to jail for a year. His expulsion
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from the Assembly, of which he was a member, followed the court- martial. Given his freedom, he set sail with his family to the West Indies. Nothing more was ever heard of him, his ship probably having been lost at sea.
Joseph Warren-A more pleasing record to scan is that of the two Warrens, Joseph the elder, thirty-five, and John, only twenty-three. Joseph Warren played so brilliant a part on Bunker Hill that his name is known to every one who knows the smallest bit about American his- tory. He had everything to make him a popular idol, looks, talent, suc- cess. He was an orator, and for so young a man, was an important figure in the inner councils of the patriots. The story of his exploits still in- trigue the imagination. He it was who burst through the window of Old South Church, and standing before the pulpit, denounced in fiery words the British soldiers, the officers of whom were crowded at his very feet. And it was this Warren who started Paul Revere off on his memorable ride to warn the farmers of Middlesex. After the Lexington-Concord fight, Warren was elected president of the Provincial Congress, and three days before the battle of Bunker Hill, he received his appointment as a major-general. The office of physician-general to the army had been offered him, but declined because he preferred active service. How he came to be engaged on Bunker Hill is not known. By right of his rank he could have been in command, had he courteously refused after his sudden appearance upon the hill. In the ranks he fought that day, and, when, with powder exhausted his companions were forced to retreat, Warren, one of the last in the redoubt, was shot dead by the English. General Howe, when he heard of Warren's death, said he was worth 500 men. Famous for what he did during his short career, one can but regret that he did not survive to attain even greater fame as a physi- cian and surgeon.
John Warren-Fortunately his younger brother, John, was spared to become one of the very few notables in the medical world of his day; the best known, and rightly so, of the Boston medical fraternity during the first century and a half of the existence of the town. Only twenty-three, he had practiced medicine in Salem for a year before the outbreak of the Revolution. A surgeon in the militia, he had come under the command of Washington at Cambridge after Bunker Hill, and had a share in the reorganization of the medical department of the newly created Conti- nental Army. He rose in the favor of Washington, although he was somewhat a thorn in the flesh of his commanding officer because of his insistent cry for medical supplies. After the evacuation of Boston War- ren went with his general to face the smallpox which was ravaging the
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town. In 1776 he was fighting dysentery, which was ruining the troops in New York. Just before the Battle of Long Island, he received the famous "razor letter" in which was the sentence, "I send you two scal- pels in which case if you want more use a razor as an incision knife."
In April, worn and ill from the hardships endured in the army, War- ren returned to Boston where extensive military preparations were being carried on. A hospital was needed, and one was established near the site of the present Massachusetts General Hospital, to which he was ap- pointed the senior surgeon, July 1, 1777, a position he held until the close of the war. The doctor had a strong bent for anatomy, and in 1780 he gave a course of anatomical lectures to physicians and students. These inspired the Massachusetts Medical Society, in the formation of which Warren had joined with others (May 14, 1780) to establish the lectures on a permanent basis. His efforts at teaching impressed the Harvard corporation with the need of a medical school, the plans for which he was asked to draw up. Out of this came the organization of the Harvard Medical School, the first lectures of which were given by War- ren in 1783. There is much more that should be told concerning John Warren, but enough has been given to indicate the important place he has in the medical history of Boston. He lived only until 1815. Never strong, suffering many ailments, he nevertheless had the happy faculty of keeping up with the work in which he was engaged.
Succeeding him came his son, John Collins Warren, born in 1778, and living until 1856, who, associated with Doctors Jackson, Gorham, Jacob Bigelow and Channing, established the Massachusetts General Hospital in 1811. He also founded the Boston "Journal of Medicine and Surgery," the Warren Museum of Comparative Anatomy, and the Warren Museum of Natural History. He stood sponsor for the first experiments made with ether at the Massachusetts General Hospital. Mason Warren (1811-67), John Collins' son, was in turn father of the present J. Collins Warren (1842). A truly remarkable family.
Benjamin Waterhouse and Vaccination-With the beginning of the nineteenth century, medicine began to advance with a remarkable speed, and Boston had many physicians who were in the fore-front of the move- ment. Edward Jenner had discovered, in England, the protective power of vaccination, the news of which had come to this country. Dr. Ben- jamin Waterhouse, of Cambridge, an associate of Warren in the first Harvard Medical School, became the champion of the idea in this coun- try, thereby bringing on his head both ridicule and abuse. He first wrote concerning it on March 12, 1799, and again in July of the next year, when he described his method of vaccinating his son, Daniel Oliver, a boy of five. From the arm of this boy he vaccinated another son only three
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years of age. All this was before Jenner's report had been published in this country. Just as Boston had been the first to introduce smallpox inoculation, so was it the first to adopt this newer and better protection against the plague that so often ravaged the early colonists.
James Jackson, the "Beloved Physician of Boston"-It was James Jackson, for half a century the "beloved physician" of Boston, who brought to this country, in 1800, the new therapeutic agency, the vaccine virus, and who became conspicuous for his effective use of it. James Jackson was only twenty-three at the time. He had graduated from Harvard in 1794, and had been studying medicine in England for the year just before his return to this country. He began practice at once, specializing on the new treatment which, after the usual criticism that follows any innovation, brought him into a prominence that was both re- markable and helpful to one so young. John Collins Warren came to Boston the year following, and Warren as the skilled surgeon, and Jackson, preëminently the physician, may almost be said to have divided the medical field in Boston between them. Jackson was instrumental in bringing the Harvard Medical School to Boston ; was, with Warren, one of the founders and a very notable worker in the Massachusetts General Hospital; he also was instrumental in bringing about a needed reorgani- zation in the Massachusetts Medical Society, three very notable things for one man to have accomplished. He died on August 27, 1867, when within a few weeks of being ninety years old, after a well rounded useful life.
The Bigelows in the Medical Annals of the City-There are few names which loom larger in the medical annals of Boston than that of the Bigelows, father and son. Both lived long, their active professional lives covering more than eight decades. Henry J. Bigelow, the son, is better known by the present generation as surgeon and teacher, but what a father he had! Jacob Bigelow, born in 1787 and living until 1879, saw many of the greatest events in our history from the adoption of the Fed- eral Constitution to the days of the post-Civil War reconstruction, and many of the men having highest place in the later events were his friends, and in many of the events he had no small part. From every standpoint he was one of the most brilliant figures in the history of American med- icine. There can be no attempt made here to even outline his life ; it has too many sides to it, covers too wide a field. Although a physician, he was a great educational reformer, one of the most learned of American botanists, and might have been eminent in several other spheres of activity. He gave himself mostly to therapeutics and internal medicine, but he might have, with equal ease, become a great surgeon. "He was
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the born artist, artificer, craftsman, mechanician and inventor, and there probably never has been a man better equipped by natural endowment for all branches of success in the healing art." When the distinguished Count Rumford left a sum for the establishment of a professorship and lecturer on the Application of Science to the Useful Arts at Harvard, there was no one so well fitted for the place because of his many sided- ness than Jacob Bigelow. His hobby was botany, a subject upon which he lectured and wrote. When he needed models and drawings for this work he not only knew what he wanted, but also how to draw and make them. Desirous of illustrating his "Medical Botany" with colored engravings- this was before modern photography and lithographing had been dis- covered-he invented a process of his own. Later in life, realizing that our "Cities of the Dead" could no longer be continued within our munic- ipalities, he suggested the founding of a forest cemetery, and was respon- sible for that most beautiful of burial places, Mount Auburn, and proved himself to be a thoroughly practical landscape designer and gardener, the first of our landscape architects. He was a member of most of the important societies of his day, such as the Massachusetts Medical, Massa- chusetts Historical and American Society of Arts and Sciences. When but twenty-five he was elected to the famous literary club of Boston, the Anthology Club, which later grew into the even more famous Athen- aeum. His writings and books covered many subjects, medical and other ; one little pamphlet, first delivered as a lecture, "Self-limited Diseases," seems relatively unimportant as compared with his "Medical Botany" with his own invented 6,000 colored engravings, or the "United States Pharmacopoeia" which, with Spalding, Howson, Ives and Butts, he edited in 1820. Yet of the little booklet, Oliver Holmes wrote: "This remarkable essay had more influence on medical practice in Amer- ica than any other similar brief treatise, we might say than any work published in this country." Blind for the last five years of his life, and bedridden the greater part of that period, Jacob Bigelow's mind was undimmed at ninety-two when he died, January 10, 1878, and was laid away in the beautiful cemetery which he had created.
The Introduction of Ethereal Anaesthesia-The temptation is great to continue recounting the stories of the "giants" of the early days. We are far enough away from the time in which they lived to get a fair perspective, and there were under the conditions then holding in medi- cine, so few who stood out from the crowd. But space must be given to events, and to men only as they are responsible for the events. Probably the most remarkable of all medical occurrences connected with the history of Boston was the first introduction to the world of ethereal anaesthesia by Thomas Green Morton in 1846. Much has
OLD STREET VIEW OF BOSTON
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been written concerning this greatest of beneficent discoveries in med- icine, the value of which can hardly be estimated. Boston has attempted to commemorate the event by a weird marble group placed in a basin of water in the Public Garden. A child interested in it once cried : "That's Abraham, and he's going to kill little Isaac." Unless one stops to read the inscriptions on the faces of the pedestal, one is likely to have no clearer idea of what the statue stands for than that child. The only two of these inscriptions, other than Biblical quotations, read: "To com- memorate the discovery that the inhaling of ether causes insensibility to pain, first proven to the world at the Massachusetts General Hospital in Boston, October, A. D. MDCCCXLVI." The second is: "In gratitude for the relief of human suffering by the inhaling of ether, a citizen has erected this monument. . . . The gift of Thomas Lee." No mention is made of the discoverer W. T. G. Morton.
W. T. G. Morton-Morton was a dentist, who in experiments with a Dr. Wells, another dentist, in Hartford, had tested "laughing gas" (nitrous oxide). He moved to Boston in 1842 and began a series of researches in the use of gasses to produce an unconsciousness to pain. Morton was secretive, and had the not unnatural intention to make money with any discovery that he made, so we do not know just how he arrived at the ideas which led to his final success. Sulphuric ether re- ceived the greater part of his attention, and he made many tests of its effect upon animals, and later upon himself. Convinced of the effective- ness and harmlessness of the inhaling of ether, he wanted to give a public demonstration of it, but also wanted to give it in a way that would not reveal the fact that ether was the basis of his inhalent. Warren, the foremost surgeon of his time, although now an old man, gave him the opportunity in the General Hospital, and Jackson, of whom we have written, had told him of odorents that would disguise the smell of the ether. It was Jackson who conducted the test.
First Operation Under Ether-On October 16, 1846, a subject with a tumor consented to a trial of the new inhalent before undergoing an operation. The test was a complete success, but that there should be no question, a second demonstration was made the following day. Not long afterward an amputation of a leg was made with the patient under ether. Morton called his mixture "letheon," but from its smell, ether was quickly recognized as the effective ingredient. Public announcement was made of the great discovery, with the consent of Morton, by Henry J. Bigelow, who also took steps to insure the use of ether in Europe. The name letheon was soon dropped ; Oliver Wendell Holmes is credited with suggesting the words now used in connection with the subject-"anae-
Met. Bos .- 20
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thesia" and "anaesthetic." On November 12, 1846, Morton secured a fourteen-year patent for the use of ether, but profited little from his dis- covery. Because his marvelous gift to man was grudgingly given, be- cause he placed the dollar above man's need, Morton only received a tardy recognition, and died while still young, a poor man. He may have erred, but surely he was punished beyond his deserts. Of the man, Jacob Bigelow said: "The suffering and now exempted world have not for- gotten the poor dentist who, amid poverty, privation, and discourage- ment, matured and established the most beneficent discovery that has blessed humanity since the primeval days of Paradise." And, spake Holmes to his students of the event: "Here the unborrowed discovery first saw the light of day, which has compassed the world before the sun could complete his circle of the zodiac. There are thousands who never have heard of the Revolution, who know not whether the American cit- izen has the color of the Carib or the Caucasian, to whom the name of Boston is familiar through this medical discovery. In this very hour, while I am speaking, how many human creatures are cheated of the pangs which seemed inevitable as the common doom of mortality, and lulled by the strange magic of the enchanted goblet, held for a moment to their lips, into a repose which has something of ecstasy in its dreamy slumber."
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