Authors: Richard Holmes
Tags: #History, #Modern, #19th Century, #Biography & Autobiography, #Science & Technology, #Science, #Philosophy & Social Aspects, #Fiction
♣
In 1795 Pitt had levied a tax on hair powder, to help raise funds for military campaigns abroad. The ribbon fell out of Beddoes’s letter as I unfolded it in the Truro archive, and I let out a republican whoop! that almost led to my ejection.
♣
The present square is subdued and beautiful, if distinctly run-down. No. 7 has no plaque behind its wisteria, and No. 6 has become the offices of a builders’ merchant. Nevertheless the distant memory of its great, subversive medical tradition still haunts the square: one worn old stone plate reads: ‘Robert Young, Surgeon’, while another ancient brass proclaims ‘Clifton Dispensary’.
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These confessional poems include ‘Written After Recovery from a Dangerous Illness’ (1808,
Memoirs,
pp.114-16); ‘The Massy Pillars of the Earth’ (1812,
Memoirs,
p.234); ‘The Fireflies’ (1819,
Memoirs,
pp.251-4); ‘The Eagles’(1821,
Memoirs,
p.279 and
Salmonia,
pp.98-100); ‘On the Death of Lord Byron’ (1824,
Memoirs,
p.285); ‘Ulswater’ (1825,
Memoirs,
pp.320-2); ‘Thoughts’ (1827,
Memoirs,
p.334); ‘The Waterfall of the Traun’ (1827,
Memoirs,
p.360). They will all appear later in this narrative.
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To this day there is still much controversy in the medical literature about Davy’s and Beddoes’s failure to pursue anaesthesia at this time, a debate hosted by the Association of the History of Anaesthesia. Several scholars suggest a ‘cultural’ as much as a technical inhibition. They argue that the late-eighteenth-century attitude to pain, in a surgical context, did not admit to the concept of a ‘pain-free’ operation. Pain itself was a natural and intrinsic part of the surgical procedure, and a surgeon’s ability to handle a patient’s pain-through his imposed psychological authority, his dexterity, and above all his sheer speed of amputation and extraction-was an essential part of his profession. In a word, there was the need for a ‘a paradigm shift’ to conceive of pain-free surgery. See Stephanie J. Snow,
Operations without Pain
(2005), Dr A.K. Adam, ‘The Long Delay: Davy to Morton’, in the
Journal of the Royal Society of Medicine,
vol 89, February 1996. For a masterly overview of surgical pain and procedure in the early nineteenth century, see Druin Burch,
Digging Up the Dead
(2007). The whole question will be pursued in my Chapter 7, ‘Dr Frankenstein and the Soul’.
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Davy had tried various versions of this prudential sentence in his notebooks, and it had evidently given him some trouble. He had, for example, first written not ‘sources of power’, but ‘germs of power in civilized life’, a much more tentative idea. Also, the uncharacteristic word ‘soul’ had originally been the more exuberant ‘spirit of life’. Most striking of all, he had finally deleted from the text of his
Discourse
any ideal of a cooperative society, in which the wealthy had a duty to fund research, an essential aspect of Beddoes’s vision. In his manuscript he had originally written: ‘What might we not hope for in a state of society in which the character of the philosopher [scientist] was united with that of the artist, and in which it became the business of men of property and power eminently to patronise the sciences?’ (Davy Archive, Royal Institution, Ms Box 13 (c), pp.57-8.)
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The temporary laboratory assistant in 1807 was Davy’s young cousin Edmund Davy. The following year the post was handed over to his brother John, then eighteen, who remained until 1811. The tense, excited, youthful atmosphere of the laboratory was crucial at this stage in Davy’s work. It would be recreated with the young Michael Faraday eight years later. The explosive appeal of potassium and sodium to young chemists is wonderfully caught in Oliver Sacks’s autobiography,
Uncle Tungsten: Memories of a Chemical Boyhood.
Sacks and two teenage friends first watch as ‘a frenzied molten blob’ of potassium threatens to set light to his bedroom laboratory, and then go out to throw a three-pound lump of sodium in Highgate Ponds. ‘It took fire instantly and sped around and around the surface like a demented meteor, with a huge sheet of yellow flame above it. We all exulted-this was chemistry with a vengeance!’ Oliver Sacks,
Uncle Tungsten
(2001), pp.122-3.
♣
Beddoes was recovered in the fine biography by Dorothy Stansfield (1984), and through the work of the late, lamented Roy Porter in a number of brilliant essays, notably ‘Thomas Beddoes and Biography’ in
Telling Lives in Science,
ed. Michael Shortland and Richard Yeo (1996), and finally in Porter’s masterwork on the history of medicine,
The Greatest Benefit to Mankind
(2001).
1
In September 1811 the Herschels’ old friend Fanny Burney, by then the married Madame d’Arblay, underwent an agonising operation for breast cancer without anaesthetic. It was carried out by an outstanding French military surgeon, Dominique Larrey, in Paris, and so successfully concluded that she lived for another twenty years. What is even more remarkable, Fanny Burney remained conscious throughout the entire operation, and subsequently wrote a detailed account of this experience, watching parts of the surgical procedure through the thin cambric cloth that had been placed over her face. At the time the surgeon did not realise that the material was semi-transparent. ‘I refused to be held; but when, bright through the cambric, I saw the glitter of polished steel-I closed my eyes. I would not trust to convulsive fear the sight of the terrible incision.’
On the subject of pain, and Humphry Davy’s failure to pursue anaesthesia, it is worth considering what Fanny Burney wrote about her terror
before
this mastectomy operation: ‘All hope of escaping this evil being now at an end, I could only console or employ my mind in considering how to render it less dreadful to [my husband] M. d’Arblay. M. Dubois had pronounced: “you must expect to suffer-I do not wish to mislead you-you will suffer-you will suffer
very much
!” M. Ribe had
charged
me to cry! To withhold or restrain myself might have seriously bad consequences, he said. M. Moreau, in echoing this injunction, enquired whether I had cried or screamed at the birth of Alexandre. Alas, I told him, it had not been possible to do otherwise. “Oh then,” he answered, “there is no fear!”-What terrible inferences were here to be drawn!’
1
Indeed, she screamed throughout the operation. ‘When the dreadful steel was plunged into the breast-cutting through veins-arteries-flesh-nerves-I needed no injunction not to restrain my cries. I began a scream that lasted unintermittingly during the whole time of the incision-& I almost marvel that it rings not in my ears still! So excruciating was the agony…All description would be baffled…I felt the Knife
rackling
against the breast bone-scraping it!’
One of Burney’s many extraordinary reflections was whether extreme physical pain could not only induce unconsciousness-‘I have two total chasms in my memory of this transaction’-but actually force the soul out of the body. She also found that the act of recollection carried its own pain, and that she had taken three months to complete the account, as a letter of nearly 10,000 words to her sister Esther. She had severe headaches every time she tried to go on with it. Once finished, she could not look back over what she had written. ‘I dare not revise, nor read, the recollection is still so painful.’ It is an astonishing record of courage, not least in Fanny’s determination to protect her husband from the trauma of the operation. But it also recalls what the real conditions of surgery were at this period.
Throughout the Napoleonic Wars, medical science had been spurred on by the immediate bloody demands of the battlefield. It became ever more daring and more ruthless. Larrey, for example, had performed 200 amputations in twenty-four hours after the battle of Borodino, and been awarded the Légion d’Honneur.
2
But as the conflict wound down, it began to turn again to more speculative enquiries. France was still held to lead Europe in medicine and surgery, and its great state hospitals in Paris, notably the Hôtel Dieu and La Salpêtrière on the Left Bank, still pioneered surgical techniques and anatomical theory. Here Xavier Bichat and Baron Cuvier reigned supreme. Nevertheless, the collapse of the French wartime economy, and the overwhelming demands made on the country’s medical resources by returning veterans and
mutilés de guerre,
began to hinder its scientific advances.
By contrast, the teaching hospitals of London and Edinburgh were now gaining an international reputation. Ever-vigilant, Joseph Banks was anxious to foster this growing advantage and prestige through elections to the Royal Society. Medicine was fashionable, and the hospitals began to attract a new and gifted generation of medical students and teachers, such as Henry Cline (St Thomas’s), John Abernethy (St Bartholomew’s), Joseph Henry Green (Guy’s) and Astley Cooper (Guy’s).
Banks drew them into the Royal Society wherever possible. For example, he ensured that Astley Cooper’s pioneering operation of piercing the human
membrane tympani
(eardrum) to relieve potentially fatal innerear infection reached a wide audience by being written up for the Society’s
Philosophical Transactions
in 1801.
3
Thanks to Banks, Cooper was elected to the Royal Society and awarded the famous Copley Medal for this work, at the age of thirty-three. Cooper’s students would include John Keats at Guy’s Hospital in 1814. Other medical men made important contacts in the literary world. The radically minded Henry Cline befriended the writers Horne Tooke and John Thelwall, and even acted as a character witness during their trial for treason in 1794. John Abernethy treated Coleridge for opium addiction, and J.H. Green would become Coleridge’s amanuensis in 1818. In 1816 Byron chose as his travelling companion in exile the young Dr William Polidori, newly qualified at Edinburgh Hospital. Polidori secretly contracted with the publisher Murray to keep a diary of Milord’s exploits (perhaps not quite in accordance with his Hippocratic oath).
Banks kept his all-seeing eye on all these too. Among them, he soon became aware of a talented and unorthodox young surgeon, William Lawrence, working at St Bartholomew’s Hospital under John Abernethy. As early as 1802, when Lawrence was a mere medical student aged only nineteen, Banks had spotted him and recommended him to William Clift, the conservator of the Hunterian Collection. ‘Sir, I beg leave to introduce to your acquaintance the bearer Mr William Lawrence, a Comparative Anatomist who is able to give-as well as receive-information. He wishes to see the [skeletons of the] Elephant & the Rhinoceros, & will probably find in the Collection many more things that he will desire to look at.’
4
It was Lawrence who would rekindle one of the most disturbing scientific debates of the Romantic period, and stir up the controversy that became known as the Vitalism Debate in 1816-20.
In 1813, Banks had carefully supported the election of Lawrence to the Royal Society, at the strikingly early age of thirty. Two years later, in 1815, Lawrence was given his first academic appointment of real public significance when he was made a Professor of Anatomy at the Royal College of Surgeons. Promotion within the medical profession was still largely in the hands of an oligarchy, and the appointment depended on the good offices of his mentor John Abernethy. As Abernethy himself had long held one of these professorships, this was an expression of great personal confidence. A glittering career now opened before Lawrence under the wing of Abernethy.
John Abernethy was a powerful ally, at the height of his powers and influence. Born in 1764, he had originally trained at the world-famous medical schools at Edinburgh, then came south to study under the great surgeon John Hunter (1728-93), working among the bodies at his grim dissecting rooms in Windmill Street. (There is a curious
Ackroydian
historical resonance in the fact that a century later this became the home of the first English burlesque and nude tableaux shows.) Later he pursued a successful career in surgery, built a highly lucrative practice as a consultant physician in Mayfair, and was appointed senior surgeon at Bart’s Hospital in 1815. At fifty-one he was at the top of his profession, and also held a Professorship of Anatomy at the Royal College of Surgeons.
A squat, sandy-haired figure, Abernethy was a pious, plain-spoken Scot of ‘unconquerable shyness’ in society, but famed for his blunt bedside manner with patients, and his brusque diagnoses.
5
Brought up a Calvinist, he had no time for niceties. He made no secret of his opinion that most of the diseases of his richer clients could be cured by cutting back on food and alcohol, and saying their prayers. When consulted by Coleridge in 1812 for a huge range of complex stomach complaints and subtle nervous afflictions (including chronic nightmares), he unhesitatingly diagnosed a simple case of opium addiction, and indirectly helped Coleridge find asylum with the physician James Gillman in Highgate four years later.
6
Among the medical students at Bart’s, Abernethy was one of the most popular lecturers of his time, partly because of his cussedness and eccentricity. So there was great interest when in 1814, as Professor of Anatomy at the Royal College of Surgeons, he began the series of annual public lectures known as the Hunterian Orations. He chose a subject for his discourse inspired by his old anatomy teacher: what he called ‘An Enquiry into the Probability and Rationality of Mr Hunter’s Theory of Life’.
The topic was unexpected. Hunter’s celebrity had been based on his practical-indeed terrifying-skills as a surgeon, and his vast knowledge of comparative anatomy. His characteristic last paper, published posthumously, was ‘A Treatise on Blood, Inflammation and Gunshot Wounds’ (1794). Hunter had established a sophisticated collection of comparative anatomy specimens. After his death in 1793 they were purchased by the state, and in 1800 entrusted to the newly established Royal College of Surgeons in Lincoln’s Inn Fields. The Hunterian Museum exists there to this day. In a way the collection was an intellectual timebomb, for, sequentially displayed, the specimens visibly demonstrated, to anybody who cared to examine them, how directly and evidently man’s skeletal structures (skull, hands, feet) and internal organs (heart, liver, lungs) had evolved from ‘lower’ animal forms. They were compelling proof of a certain kind of continuous physiological ‘evolution’, and they clearly suggested that man had developed directly from the animal kingdom, and was not a unique ‘creation’.
But this was not the subject that Abernethy chose. His old master Hunter, like many scientific men towards the end of their lives, had developed certain undefined mystical yearnings. Abernethy had found among his bloodstained and chaotic manuscripts various ill-defined theories of a Life Force or Life Principle, which suddenly seemed of great contemporary interest. Hunter speculated that this Force was somehow associated with spontaneous motions inherent in the human physiology: systolic and diastolic pulses of the heart, the circulation of the blood, healing inflammation, male erection, and female blushing. Above all he believed that blood itself held the secret of Vitality: ‘it is the most simple body we know of, endowed with the principle of life’.
7
Building on Hunter’s speculations, Abernethy proposed a theory of human life based on a semi-mystical concept of a universal, physiological life force. Blood itself could not explain life, though it might carry it. This universal ‘Vitality’ was a ‘subtle, mobile, invisible substance, super-added to the evident structure of muscles, or other form of vegetable and animal matter, as magnetism is to iron, and as electricity is to various substances with which it may be connected’. Abernethy further suggested that this theory brought scientific evidence-if not exactly proof-to the theological notion of the soul. If the Life Force was ‘super-added’, some power outside man must obviously have added it.
8
In drawing his analogies between Vitality and electricity, Abernethy also called on the authority of Humphry Davy’s Bakerian Lectures at the Royal Society. Like many scientific men of the day he was entranced by the potentialities of the voltaic battery, and its possible connections with ‘animal magnetism’ and human animation. Electricity in a sense became a metaphor for life itself. ‘The experiments of Sir Humphry Davy seem to me to form an important link in the connexion of our knowledge of dead and living matter. He has solved the great and long hidden mystery of chemical attraction, by showing that it depends upon the electric properties which the atoms of different species of matter possess…Sir Humphry Davy’s experiments also lead us to believe, that it is electricity, extricated and accumulated in ways not clearly understood, which causes those sudden and powerful motions in masses of inert matter, which we occasionally witness with wonder and dismay.’
9
The lectures excited great interest in the medical profession, but not yet among the general public. This would soon change. In 1816, to his surprise and irritation, Abernethy found his fashionable speculations on the mysteries of the Life Force, and the role of electricity in animating ‘inert matter’, scathingly attacked and denounced. The critic was none other than his fellow Professor of Anatomy, his youngest and most gifted pupil, the thirty-three-year-old William Lawrence.
It was a wholly unexpected blow, though later Abernethy said that Lawrence had been known ‘to decry and scoff’ at his views behind his back on the wards at Bart’s.
10
He felt bitterly about it, as Lawrence had been Abernethy’s assistant since the age of sixteen, and Demonstrator at Bart’s from 1803 until 1812, largely under his protection and patronage. He had even lodged with Abernethy for three years, and was considered his protégé.
Clearly, Lawrence felt that none of these claims weighed against scientific truth, and had grown impatient with his old chief. Temperamentally Lawrence was the opposite of his patron. Tall, thin, ambitious, elegant and highly articulate, he regarded medicine as a pure science, with no outside allegiances. European in his outlook, flamboyant and radical in his thinking, he was well read in French and German medical literatures. He knew the writings of the Jena University circle, and had developed strong leanings towards Cuvier and Bichat and the materialist view of human life. If not an avowed atheist, he had little time for conventional pieties.