"The doctor sniffed. He always knew that a h.o.m.oeopathic humbug could not diagnose a case, and would be likely to get just about as near the facts as a light cold would come to tuberculosis.
""How long did this last?" he inquired of the smiling boy.
""I think--it seems to me--
""A half-hour?" queried the doctor; "twenty minutes?"
""I think so. Yes, sir. About half an hour--twenty minutes," responded the obliging youth.
"I heard that talk. Common-sense told me the boy"s lungs were all right; but it was none of my business, and so I watched him treated, off and on, for lung trouble for over a month before I got a chance to ask him any questions. Then I asked, incidentally:
""What made you spit that blood that time, Gihi?" ""I didn"t know I ought to swallow him," he replied, wide-eyed and anxious. "Dentist pull tooth He say to me, "Spit blood here." I do like he tell me. Your doctor say ver" bad for lungs, spit blood. Next time I swallow him."
"I helped another pract.i.tioner, in good and regular standing, to examine a man"s heart. He found a pretty bad wheeze in the left side. I had to nurse that man. He had been on a bat, and all on earth that ailed him was that spree, but he got treated for heart trouble. It scared the man almost to death.
"I"d learned how a heart should sound, so one day I tried his. He was in bed then, and it sounded all right, so when the doctor came in, I took him aside, and told him that I didn"t want to interfere, but that man was scared about to death over his heart, and it seemed to me it was all right--sounded like other hearts--and his pulse was all right too. The doctor was mad as a March h*are, though he had told me to make two or three tests, and keep the record for him against the time of his next visit. Well, to make a long matter short, the final discovery was--the man don"t know it yet, and he is going around in dread of dropping off any minute with heart failure--that at the first examination the man had removed only his coat and vest, and his new suspender on his starched shirt had made the squeak. That is a cold fact, and that man paid over eighty dollars for the treatment he had for his heart, or rather, for his suspender."
I was so interested in the drollery of this ex-nurse, and in his scorn for one branch of a profession, while he entertained almost a superst.i.tious awe and admiration for surgery _per se_, that I decided upon my return to New York to visit a great surgeon, and ask him to allow me to see an operation that would fairly represent the advance-guard so to speak, the upward reach of the profession as it is to day.
We all know the physician who follows his profession strictly and solely as a means of support. Most of us also happily know something of one or more medical men who are a credit to humanity, in that they subordinate their ability to extort money from suffering to their desire to relieve pain, even though such relief conduces not to their own financial opulence. Very few of us who are not close students of the medical profession realize, I think, some of the magnificent developments not only of surgery, but of the character of the surgeon. We are led to think of them as rather hard and brutal men. The side of their work and nature that means tenderness and devotion to the relief of those who, but for the skilled and brave surgeon, must die or suffer for life, is seldom laid before us. The quiet, sweet, and simple devotion of such men does not reach the public ear.
The operation of which I learned, and which is the first of its kind on record, was so strange, so great, and so far-reaching in its suggestion and promise that it seemed to me it could not fail to interest and inspire the general reader, who never sees a medical or surgical journal, and who would not read it if he did.
Can you think of an operation that would create a mind? Can you conceive of the meaning to humanity of a discovery that would transform a congenital imbecile into a rational being? Such an operation was the one I was privileged to see.
The patient was a child about one year old, of good parentage and of healthy bodily growth, aside from the fact that its skull was that of a new-born child, and it had hardened and solidified into that shape and size. The "soft spot" was not there, and the sutures or seams of the skull had grown fast and solid, so that the brain within was cramped and compressed by its unyielding bony covering.
The body could grow--did grow--but the poor little compressed brain, the director of the intelligent and voluntary actions of the body, was kept at its first estate. Even worse than this, its struggle with its bony cage made a pressure which caused distortion and aimless or unmeaning movement--the arm and leg turned in, in that helpless, pathetic way that tells of imbecility. In short, the baby was a physically healthy imbecile--the most pathetic object on this sad earth. Upon examination, the surgeon, a gentle, sweet-natured man, whose enthusiasm for his profession--for the relief of suffering--makes him the object of devotion of many to whom he has given life and health, and the inspirer and final appeal for many a brother pract.i.tioner, discovered what he believed to be the trouble. Led by that most uncommon of all things, common sense, he believed that this little victim of nature"s mistake might be changed from a condition far worse than death to one of comfort for itself, and to those who now looked upon it only in anguish of soul.
After explaining to the parents and the surgeons who had come to witness the wonderful experiment (for, after all, at this stage it was but an experiment based upon common-sense) that it might fail; after a modest and simple statement of his reason for undertaking so dangerous an operation, with no precedent before him; after explaining that the parents fully understood that not to try it meant hopeless idiocy, and that the trial might mean death--he began the work. I shall try to tell what it was in language that is not scientific, and may seem to those accustomed to surgical terms inadequate and unlearned; but to those who are not technical medical students I believe the less technical language will be far clearer.
The child"s skull was laid bare in front. Two tracks were cut from a little above the base (or top) of the nose up and over to the back of the head. One of these tracks was cut on each side, the surgeon explained, because it would give equal expansion to the two sides of the brain, and because it would cause death to cut through the middle of the top of the head, where lies "the superior longitudinal sinus." He left, therefore, the solid track of bone through the middle, and cut two grooves or tracks through the bone, one on either side, where nature (when she does not make a mistake) leaves soft or yielding edges, by means of which the normal skull expands to fit the needs of the brain within.
The trench made displaced, or cut away, one-quarter of an inch of solid bone all the way from near the base of the nose to the back part of the head. In the middle of the top of the head on each side a cross-wise cut was made, and one inch of bone divided. Another cut was made on either side, slanting toward the ears. This was one inch and a half long. The surgeon then tenderly inserted his forefinger, pressed the internal ma.s.s loose from the bones where it adhered, and pushed the bones wider apart.
This process widened the trenches to one inch.
The wound was now dressed with the wonderfully effective new aseptics, and the flesh and skin closed over. The operation had taken an hour and a half. There was little bleeding. The baby was, of course, unconscious during the entire time. Oh, the blessings of anaesthetics! And now comes the wonderful result of this bold and radical but tender and humane operation.
The baby rallied well. In three days it showed improved intelligence.
In eight days this improvement was marked. From a creature that sat listless, deformed, and unmindful of all about it, it began to "take notice," like other children. From an "it," it had been transformed into a "he." It had been given personality. It ate and slept fairly well.
On the tenth day the wound was exposed and dressed. It had healed, or "united by first intention," as the doctors say; and again one can but exclaim, "Oh, those wonderful aseptic dressings!" It had united without suppuration. It was a clean wound, cleanly healing.
One month after the operation the feet and hands had straightened out, and lost their jerky, aimless movements. The child is now a child. It acts and thinks like other children, laughs and cooes and makes glad the hearts of those who love it.
Not like other children of its age, perhaps, for it has several months yet to "catch up," but the last report, in one of the leading medical journals, said:
"One month after the operation the change in its condition was surprising and gratifying. The deformities in the extremities had entirely disappeared, and there was evidently a remarkable increase in intelligence. It noticed those about it, took hold of objects offered it, laughed, and behaved much as children of ordinary development at six or eight months. The pupils were no longer widely dilated, but appeared normal. It eats and sleeps well, and is in general greatly improved as a result of the operation."
If in one month the little imprisoned brain was able to "catch up" six or eight months, we may surely believe that the remaining four or five months which it lost, because nature sealed the little thinking-machine firmly in too small a casket, will be wiped away also, and the little victim of nature"s mistake be given full and normal opportunity through the skill and genius of man.*
*It has now been several years since the operation, and the child is like other children.--H. H. G.
Is not that common-sense in surgery?
Could anything be more wonderful? Could any operation open to the future of the race wider possibilities and offer more brilliant hope? I may quote here farther from the same medical journal the report of Dr.
Wyeth, himself:
"The operation differs from any yet done. Lanne-longue, Keen, and others cut a trench about a quarter of an inch in width, and on one side, at a single operation. It seemed to me if the brain was penned in by premature ossification of the cranial bones, these should be torn loose and permanently lifted, thus allowing a thorough expansion. Should only temporary benefit be secured, the operation should be repeated.
Experience alone can demonstrate whether the expansion of the brain will be able to spread the cranial bones to such an extent that it may reach even an ordinary development. The condition of these patients is so hopeless and deplorable that, in my opinion, very great risk is justifiable in any surgical interference which offers even a hope of amelioration."
Thus the race is quietly achieving mastery over the blind forces of nature, and the steady hand of science, coupled with tenderness and sincerity, is pushing back some of the worst horrors of life, and throwing a flood of light and hope into the future! It makes one"s step lighter and one"s face happier only to think of these marvellous achievements and victories. A new impulse of hope and happiness dawns upon life. I owed this new inspiration to my pessimistic acquaintance--he of the Hunt Club Kennel--and the introduction he gave me to the rudiments of applied surgery. It was indeed a long sweep from the one operation to the other.
My first and second glimpses of the operating-room were surely the two extremes, and yet when I suggested this to Dr. Wyeth, the great and gentle surgeon who performed this operation, he smilingly replied that, after all; either or both--indeed, all of it--was simply common-sense in surgery.
HEREDITY: IS ACQUIRED CHARACTER OR CONDITION TRANSMITTIBLE?
It has been well said by Herbert Spencer, and more recently by Professor Osborn, the able biologist of Columbia College, that the question involved in the discussion of heredity is not a temporary issue and that its solution will affect all future thought. Whether or not acquired character is transmitted to children is the most important question that confronts the human race; for it is upon the character of the race that depends and will depend the condition of the race.
No school of scientists questions the fact of heredity; but there is a warm and greatly misunderstood contest over the exact method used by nature in the transmission. Now so far as the general public is concerned, so far as the sociological features of the case go, so far as personal conduct is involved, it does not matter a straw"s weight whether the theory of heredity held by Lamarck and Darwin, or the one advanced recently by Weismann, be correct.
It matters not whether your drunkenness, for example, is transmitted to your child directly as plain drunkenness, or whether it descends to him as a merely weakened and undermined "germ plasm" which "will tend to inebriety, insanity, imbecility" or what not. It matters not a farthing"s worth, from the point of view of the laity, whether the transmission is direct, via "pangenesis," or whether it is indirect, via a weakened and vitiated "germ plasm" as per Weismann, or whether the exact method and process may not still lie in the unsolved problems of the laboratory. Whichever or whatever the exact process may be (which interests the scientist only), the facts and results are before us and concern each of us more vitally than does the question of what we shall eat or what we shall drink or wherewithal we shall be clothed. It is all the more unfortunate, therefore, that even an untested scientific theory cannot be advanced without the ignorant, the half-educated and the vicious taking it in some distorted form as a basis of action. Indeed it would seem to be wise, if one is about to make a scientific suggestion of importance, to take the precaution to say in advance that you don"t mean it--for the benefit of that large cla.s.s of intellectual batrachians who hop to the conclusion that you said something totally different from your intent.
Because a surgeon might say to you that he knows a boy who carries a bullet about in his brain and that the youth appears to be no worse for it in either body or mind, it would not be safe to imply that he proposes to teach you that it would be a particularly judicious thing for you to attempt to convert your skull into a cartridge box.
Because Weismann a.s.serts and attempts to prove that nature"s method of hereditary transmission precludes (for example) the possibility of producing a race of short-tailed cats from Tom and Tabby from whose caudal appendages a few inches have been artificially subtracted, some of his followers exclaim in glee: "It does not make the least difference in the world what we do or refrain from doing in one lifetime. Our children do not receive the results; we cannot transmit to them our vices or our virtues. We cannot taint their blood by our ill conduct nor purify it by our clean living. The "germ plasm" from which they came is and has been immortal; we are simply its transmitters--not its creators. Our children were created and their characters and natures determined centuries before we were bom. We are in no sense responsible for what they may be; germ plasm is eternal; we are exempt from responsibility to posterity. Long live Weismann!"
Now this is about the sort of thing that is springing up on every side as a result of the new discussion as to how we are to account for the facts of heredity. One sometimes hears, also, from these half-informed jubilators that "Weismann does not believe in heredity; that old theory is quite exploded." The fact is that Weismann is particularly strong in his belief in heredity--so strong as to give almost no weight to any possible process of intervention in its original workings. He simply holds that the transmission of "acquired character" is not proven, and he doubts the fact of these "acquired" transmissions. In his ill.u.s.trations he deals chiefly (when in the higher animals) with mutilations, and in the human race shows that the most proficient linguist does not produce children who can read without being taught!
Of course there are many and varied points in his theory of heredity with which only the biologist is capable of dealing. But as I intimated at first, the Lamarck-Darwin-Weismann controversy, so far as the sociological aspect of the question is involved, does not touch us.
It belongs to the laboratory--to the how and not to the fact of transmission. But since the opposite impression has taken root in even some thoughtful minds, it is well to meet it in a direct and easily grasped form. There is a simple and direct method; I undertook it. I went to a number of well-known biologists and physicians and asked these questions;--
1. Are there any diseases known to you, which you are absolutely certain are contracted by individuals whose ancestors did not have them, which diseases you can trace as to time and place of contraction, and which are of a nature to produce physical and mental changes that are recognizable in the child as due to the parent"s condition?
2. Have you ever had such cases under your own care?
3. Have you a record of cases where the children of your patients received the effects of the disease of the parent in a manner that would show that "acquired character or condition" is transmittible?
4. Is this true in a kind of disorder which would produce in the child a change of structure or condition so profound as to change its character and run it in a channel distinctly the result of the "acquirement" of the parent?
I thought it best to go to specialists in brain and nerve disorders and to those who had had large hospital or asylum experiences. One of these, Dr. Henry Smith Williams, ex-medical superintendent of Randall"s Island, where the city of New York sends its imbecile and epileptic children, and where many hundreds of these came under his care, replied that there could be no doubt of the fact that such "acquired" characters or conditions are transmitted. One case which he gave me, however, from his private practice will ill.u.s.trate the point most clearly. B., a healthy man with no hereditary taint of the kind, acquired syphilis at a given time and in a known way. Before this time he was the father of one daughter. Several years later another daughter was born to him. The first girl is and has always been absolutely free from any and all taint. The other one has all the inherited marks of her father"s "acquired character" and condition, which even went the length in her of producing the recognized change in the form of the teeth due to this disease. Now for all practical purposes it does not matter in the faintest degree whether that transmission was in accordance with pangenesis or by means of a vitiated environment of the "germ plasm."
The fact is the appalling thing for the reader to face. And I give this case only because it was one of a vast number of similar ones which came to me in reply to my questions addressed to different pract.i.tioners and specialists.
Among other places, I went to the head of a maternity hospital. This is what I got there: "If Weismann or any of his followers doubts for one second the distinct, absolute, unmistakable transmission of acquired disease of a kind to modify "character" both mental and physical--if they doubt its results on humanity--they have never given even a slight study to the hospital side of life.