464 



NA TURE 



[September 17, 1896 



still denser than the osseous structures, these rays can show a 

 bullet embedded in a bone or a needle lodged about a joint. 

 At the last conversazione of the Royal Society a picture pro- 

 duced by the new photography displayed with perfect distinct- 

 ness through the bony framework of the chest a halfpenny low 

 down in a boy's gullet. It had been there for six months, 

 causing uneasiness at the pit of the stomach during swallowing ; 

 but whether the coin really remained impacted, or if so, what 

 was its position, was entirely uncertain till the Riintgen rays 

 revealed it. Dr. Macintyre of C.lasgow, who was the photo- 

 grapher, mforms me that when the presence of the halfpenny 

 had been thus demonstrated, the surgeon in charge of the case 

 made an attempt to extract it, and although this was not 

 successful in its immediate object, it had the effect of dis- 

 lodging the coin ; for a subsequent photograph by Dr. Macintyre 

 not only showed that it had disappeared from the gullet, but 

 also, thanks to the wonderful penetrating power which the rays 

 had acquired in his hands, proved that it had not lodged further 

 down in the alimentary passage. The boy has since completely 

 recovered. 



The Rontgen rays cause certain chemical compounds to 

 fluoresce, and emit a faint light plainly visible in the dark ; and 

 if they are made to fall upon a translucent screen impregnated 

 with such a salt, it becomes beautifully illuminated. If a part 

 of the human body is interposed between the screen and the 

 source of the rays, the bones and other structures are thrown in 

 shadow upon it, and thus a diagnosis can be made without the 

 delay involved in taking a photograph. It was in fact in this 

 way that Dr. Macintyre first detected the coin in the boy's 

 gullet. Mr. Herbert Jackson, of King's College, London, early 

 distinguished himself in this branch of the subject. There is no 

 reason to suppose that the limits of the capabilities of the rays 

 in this way have yet been reached. By virtue of the greater 

 density of the heart than the adjacent lungs with their contained 

 air, the form and dimensions of that organ in the living body 

 may be displayed on the fluorescent screen, and even its move- 

 ments have been lately seen by several different observers. 



Such important applications of the new rays to medical 

 practice have strongly attracted the interest of the public to 

 them, and I venture to think that they have even served to 

 stimulate the investigations of physicists. The eminent Professor 

 of Physics in the University of College of this city (Prof. Lodge) 

 was one of the first to make such practical applications, and I 

 was able to show to the Royal Society at a very early period a 

 photograph, which he had the kindness to send me, of a bullet 

 embedded in the hand. His interest in the medical aspect of 

 the subject remains unabated, and at the same time he has been 

 one of the most distinguished investigators of its purely physical 

 side. 



There is another way in which the Rontgen rays connect 

 themselves with physiology, and may possibly influence medicine. 

 It is found that if the skin is long exposed to their action it 

 becomes very much irritated, affected with a sort of aggravated 

 sun-burning. This suggests the idea that the transmission of 

 the rays through the human body may be not altogether a 

 matter of indifference to internal organs, but may, by long-con- 

 tinued action, produce, according to the condition of the part 

 concerned, injurious irritation or salutary stimulation. 



This is the jubilee of Ana:sthesia in surgery. That priceless 

 blessing to mankind came from America. It had, indeed, been 

 foreshadowed in the first year of this century by Sir Humphry 

 Davy, who, having found a toothache from which he was suffer- 

 ing relieved as he inhaled laughing gas (nitrous oxide), threw out 

 the suggestion that it might perhaps be used for preventing pain 

 in surgical operations. But it was not till, on September 30, 

 1846, Dr. W. T. G. Morton, of Boston, after a series of experi- 

 ments upon himself and the lower animals, extracted a tooth 

 painlessly from a patient whom he had caused to inhale the 

 vapour of sulphuric ether, that the idea was fully realised. He 

 soon afterwards, publicly exhibited his method at the Massa- 

 chusetts General Hospital, and after that event the great 

 discovery spread rapidly over the civilised world. I witnessed 

 the first operation in England under ether. It was performed 

 by Robert Li.ston in University College Hospital, and it was a 

 complete success. Soon afterwards I saw the same great 

 surgeon amputate the thigh as painlessly, with less complicated 

 anaesthetic apparatus, by aid of another agent, chloroform, 

 v/hich was being powerfully advocated as a substitute for ether 

 by Dr. (afterwards Sir James Y. ) Simpson, who also had the 

 great merit of showing that confinements could be conducted 



NO. 1403, VOL. 54] 



painlessly, yet safely, under its influence. These two agents 

 still hold the field as general anajsthetics for protracted opera- 

 tions, although the gas originally suggested by Davy, in con- 

 sequence of its rapid action and other advantages, has taken 

 their place in short operations, such as tooth extraction. In the 

 birthplace of anesthesia ether has always maintained its ground ; 

 but in Europe it was to a large extent displaced by chloroform 

 till recently, when many have returned to ether, under the idea 

 that, though less convenient, it is safer. For my own part, I 

 believe that chloroform, if carefully administered on right 

 principles, is, on the average, the safer agent of the two. 



The discovery of anaesthesia inaugurated a new era in surgery. 

 Not only was the pain of operations abolished, but the serious 

 and sometimes mortal shock which they occasioned to the system 

 was averted, while the patient was saved the terrible ordeal of 

 preparing to endure them. At the same time the field of surgery 

 became widely extended, since many procedures in themselves 

 desirable, but before impossible from the protracted agony they 

 would occasion, became matters of routine practice. Nor have 

 I by any means exhausted the list of the benefits conferred by 

 this discovery. 



AniESthesia in surgery has been from first to last a gift of 

 science. Nitrous oxide, sulphuric ether, and chloroform are all 

 artificial products of chemistry, their employment as ancesthetics 

 was the result of scientific investigation, and their administra- 

 tion, far from being, like the giving of a dose of medicine, a 

 matter of rule of thumb, imperatively demands the vigilant 

 exercise of physiological and pathological knowledge. 



While rendering such signal service to surgery, anesthetics 

 have thrown light upon biology generally. It has been found 

 that they exert their soporific influence not only vertebrata, but 

 upon ani!nals so remote in structure from man as bees and other 

 insects. Even the functions of vegetables are suspended by 

 their agency. They thus afford strong confirmation of the great 

 generalisation that living matter is of the same essential nature 

 wherever it is met with on this planet, w'hether in the animal or 

 vegetable kingdom. Anaesthetics have also, in ways to which I 

 need not here refer, powerfully promoted the progress of 

 physiology and pathology. 



My next illustration may be taken from the work of Pasteur 

 on fermentation. The prevailing opinion regarding this class of 

 phenomena when they first engaged his attention was that they 

 were occasioned primarily by the oxygen of the air acting upon 

 unstable animal or vegetable products, which, breaking up 

 under its influence, communicated disturbance to other organic 

 materials in their vicinity, and thus led to their decomposition. 

 Cagniard-Latour had indeed shown several years before that 

 yeast consists essentially of the cells of a microscopic fungus 

 which grows as the sweetwort ferments ; and he had attributed 

 the breaking up of the sugar into alcohol and carbonic acid to 

 the growth of the micro-organisin. In Germany Schwann, who 

 independently discovered the yeast plant, had published very 

 striking experiments in support of analogous ideas regarding the 

 putrefaction of meat. Such views had also found other advocates, 

 i)ut they had become utterly discredited, largely through the 

 great authority of Liebig, who bitterly opposed them. 



Pasteur, having been appointed as a young man Dean of the 

 Faculty of Sciences in the University of Lille, a town where the 

 products of alcoholic fermentation were staple articles of manu- 

 facture, determined to study that process thoroughly ; and as a 

 result he became firmly convinced of the correctness of Cagniard- 

 Latour's views regarding it. In the case of other fermentations, 

 however, nothing fairly comparable to the formation of yeast 

 had till then been observed. This was now done by Pasteur for 

 that fermentation in which sugar is resolved into lactic acid. 

 This lactic fermentation was at that time brought about by 

 adding some animal substance, such as fibrin, to a solution of 

 sugar, together with chalk that should combine with the acid as 

 it was formed. Pasteur saw, what had never before been 

 noticed, that a fine grey deposit was formed, differing little in 

 appearance from the decomposing fibrin, but steadily increasing 

 as the fermentation proceeded. Struck by the analogy presented 

 by the increasing deposit to the growth of yeast in sweetwort, he 

 examined it with the microscope, and found it to consist of 

 minute particles of uniform size. Pasteur was not a biologist, 

 but although these particles were of extreme minuteness in com- 

 parison with the constituents of the yeast plant, he felt convinced 

 that they were of an analogous nature, the cells of a tiny micro- 

 scopic fungus. This he regarded as the essential ferment, the 

 fibrin or other so-called ferment serving, as he believed, merely 



