Thursday, February 16, 2017

IX - Magnetism Used for Painless Leg Amputation in 1843

Dr. John Elliotson put his life and reputation on the line many time in support of the discipline commonly called Mesmerism or Magnetism.  He told that, “I should be untrue to myself if I should shrink for a moment from saying that I am a believer, and that I became so against all my preconceived opinions.”

John Elliotson, M.B., M.D., F.R.C.P., F.R.S., was professor of the principles and practice of medicine at University College London, and senior physician to University College Hospital for many years early in the 19th century. He had a large and lucrative practice, wrote medical textbooks based on his highly-regarded knowledge, and was adored by his students at the associated medical school.

Life changed for him in many ways when Elliotson was introduced over time to animal magnetism by the Scottish chemist Richard Chenevix and later by the Frenchman Baron du Potet. By the late 1830s, Elliotson had become a devoted convert to mesmerism aka magnetism and used it to a greater and greater degree with patients. He also became a showman and promoter of magnetism. This eventually caused great distress among his colleagues and eventual loss of his position at University College.

In 1843 while relieved of medical school teaching duties, Elliotson started his own medical journal centered largely on magnetism and phrenology to add to his numerous other publications. He called it The Zoist, and wrote voluminously on his favorite method of healing.

The following episode – which occurred before the appearance of ether and chloroform anesthesia – is taken from his book entitled Numerous Cases of Surgical Operations Without Pain in the Mesmeric State.

Details of this particular case are followed by excerpts of records and commentary by Elliotson on responses of physicians and surgeons to the extraordinary operation – which themselves appear quite extraordinary.

A Surgeon and His Knife in the 1840s.

Last November 22 the Royal Medical and Chi­rurgical Society of London assembled to hear read an “Account of a Case of Successful Amputation of the Thigh, During the Mesmeric State, Without the Knowledge of the Patient,” in the district hospital of Wellow, Nottinghamshire. The mesmerizer was W. Topham, Esq., barrister, of the Middle Temple: the operator, W. Squire Ward, Esq., surgeon, of Wellow Hall. The patient was a laborer, six feet high and forty-two years of age, named James Wombell. He had suffered for nearly five years from neglected disease of the left knee, the interior of the joint of which was found after the amputation deeply and extensively ulcerated. “The slightest motion of the joint was attended by the most excruciating agony; his nights were almost wholly sleepless in consequence of the painful startings of the limb; his pulse weak and rapid; his face constantly marked with a hectic flush; his tongue foul; appetite gone.”

In truth, when Mr. Topham first saw him, on September 9, “He was sitting upright upon a bed in the hospital—the only position which he could bear—he complained of great pain from his knee and of much excitability and loss of strength from his constant restlessness and deprivation of sleep, for he had not, during the three previous weeks, slept more than two hours in seventy.”
On this day he was first mesmerized by Mr. Topham, and for thirty-five minutes. “The only effect produced was a closing of the eyelids, with that quivering appearance that so commonly results from the process, and though awake and speaking, he could not raise them until after a lapse of a minute and a half.”

On the tenth he was sent to sleep in twenty minutes. On the eleventh, “He was suffering great agony, and distressed even to tears.’’ Mr. Topham “commenced by making passes longitudinally over the diseased knee; in five minutes he was comparatively easy, and on proceeding further to mesmerize him, at the expiration of ten minutes more he was sleeping like an infant. Not only his arms were then violently pinched but also the diseased leg itself, without his exhibiting any sensation: yet his limb was so sensitive to pain in his natural state, he could not bear even the lightest covering to rest upon it. That night he slept seven hours without interruption.”

“On September 22, the patient was first apprised of the necessity of an early amputation. The communication seemed almost unexpected, and affected him considerably, and destroyed his natural sleep that night.”

The next day he was still “fretting, restless, and in consequent pain.” Yet he was put to sleep mesmerically in four and a half minutes.

Although in this mesmeric coma the sensibility to mechanical causes of pain was so far lessened that violent pinching and sudden pricking, of even the diseased limb, produced no evidence of sensation, and he lost all pain in his knee while this was in perfect rest, the exquisitely sensitive interior of the diseased joint was not proof against the torture of motion, which, however slight, agonized and awoke him.

At the time of the operation, October 1, it was found impossible, without such torture as aroused him from his mesmeric coma, to remove him from his bed to the table. Indeed, his coma was not so deep but that it was dissipated by attempting to converse with him, and in general it ceased spontaneously in half an hour, his waking being “slow and gradual and without the least start.”
Instead of being placed upon a table, he was therefore lifted with his low bed upon a temporary platform, and “he was soon put into the mesmeric sleep, although he was considerably excited by hearing the cries of another patient upon whom Mr. Ward had been performing a tedious and painful operation.”

He was then “drawn by means of the bedclothes beneath him toward the end of the bed.” Even this movement excited the pain and awoke him. But the pain soon ceased, and his limb being “raised about two inches from the mattress” by a surgeon present (Mr. Wood), who “rested the heel upon his shoulder and supported the joint with his hand,” he was mesmerized into coma again in four minutes.

Mr. Topham continued to mesmerize him for fifteen minutes and then informed Mr. Ward that the operation might be begun, and “brought two fingers of each hand gently in contact with the patient’s closed eyelids; and there kept them, still further to deepen the sleep.” This is a circumstance of no little importance to remember. Of all parts of the body, the eyes are the most ready receivers and transmitters of mesmerism.

The operation was now commenced. “Mr. Ward, after one earnest look at the man,” in the words of Mr. Topham, “slowly plunged his knife into the center of the outside of the thigh, directly to the bone, and then made a clear incision round the bone, to the opposite point on the inside of the thigh. The stillness at this moment was something awful; the calm respiration of the sleeping man alone was heard, for all other seemed suspended. In making the second incision, the position of the leg was found more inconvenient than it appeared to be,” and Mr. Ward, to use his own words, “having made the anterior flap…was under the necessity of completing the posterior one in three stages. First, by dividing a portion of the flap on the inside; then a similar portion on the outside. This proceeding, which was of course far more tedious and painful than the ordinary one, was necessary to enable me to pass the knife through under the bone and thus complete the whole, as I could not sufficiently depress the handle to do so, without the two lateral cuts.” Yet, notwithstanding all this, the patient’s “sleep continued as profound as ever. The placid look of his countenance never changed for an instant; his whole frame rested, uncontrolled, in perfect stillness and repose; not a muscle was seen to twitch.To the end of the operation, including the sawing of the bone, securing the arteries, and applying the bandages, occupying a period of upward of twenty minutes, he lay like a statue.”

Soon after the second incision, “a low moaning” was heard at intervals until the conclusion of the operation, that is, after the leg was off and while the arteries were tying and the bandages putting on, giving “to all present the impression of a disturbed dream.”

That it arose from troubled dreaming I have no doubt, for in the mesmeric coma it is common for patients, after the lapse of a certain time, to dream and talk, and especially of anything which has just before strongly impressed them. Had it arisen from the operation, it would have occurred during the most painful periods—would have occurred, as it did not, exactly and only at moments of the proceeding most likely to be painful, whereas it occurred as much at moments when nothing was doing to give pain. The man could not have moaned from pain in spite of himself at moments when there was nothing to make him moan in spite of himself. It would have been increased, and indeed changed to a sudden and louder noise, whenever the end of the sciatic nerve was roughly treated.

For, still further to test his insensibility, Mr. Ward “twice touched” and, as he informs me, pretty roughly and with the points of the forceps, so that he in fact pricked “the divided end of the sciatic nerve without any increase of the low moaning.” Mr. Ward further informs me that he “once put his thumb roughly upon the nerve in taking the posterior flap in his hand to sponge, and also used the sponge very roughly.”

The mesmeric state of the patient usually lasted half an hour, and after this lapse of time, he “gradually and calmly,” as usual, awoke.

“At first,” said the surgeon, Mr. Wood, “he uttered no exclamation, and for some moments seemed lost and bewildered,”—a characteristic and striking phenomenon so familiar to mesmerists when any visible change in external circumstances has occurred while the patient was asleep. But, after looking around, he exclaimed, “I bless the Lord to find it’s all over.”

“He was then removed to another room, and following immediately,” Mr. Topham “asked him in the presence of all assembled to describe all he felt or knew after he was mesmerized. His reply was, ‘I never knew anything more and never felt any pain at all; I once felt as if I heard a kind of crunching.’” Mr. Topham asked if that were painful. He replied, “No pain at all.”


The following are quotes from Dr. Elliotson’s book [I have added italics to especially striking notes]:

Then Mr. Coulson [Surgeon] believed that the man had disciplined himself to bear pain without expressing his feelings.

Dr. Moore, a physician-accoucheur, living in Saville Row, immediately followed, and made no objections, but protested, in a loud voice and rapid manner, that really such a statement ought to have been accompanied by affidavits, and asked if affidavits before the Lord Mayor or some other magistrate had been made.

The next in eagerness to speak was Mr. Blake, a young surgeon. He urged that this man shammed, because persons often bear operations without expressing pain: and mentioned that he had seen a tooth extracted from a girl who was not, but pretended to be, in the mesmeric state, in University College Hospital, without any sign of pain, although she was strictly observed and even her pulse felt. Now he knew well formerly, for he was present as well as myself, that a friend of his, who counted her pulse during the extraction, declared to us all, truly or not I cannot of course say, that the pulse rose eight beats during the extraction.

Another young surgeon, named Alcock, followed in the same line of argument; not thinking that the absence of pain ever admitted of evidence, and discrediting the reality of the case because he had often seen persons in an ordinary state bear severe operations without manifesting the slightest pain.

Dr. James Johnson, the reviewer, and another doctor whose name I hear was Truman, followed in the same strain with the preceding speakers. Dr. Johnson added that he would not have believed the facts mentioned in the paper had he witnessed them himself.

Dr. Marshall Hall, some years ago, when my Demonstrations went on at University College Hospital, called mesmerism “trumpery” that “polluted the temple of science;” and now, being, like all the other opponent speakers, totally ignorant of the subject, and glorying in his ignorance, very consistently considered the present case to be one of imposition [imposture], because the poor man's sound leg did not start or contract while the diseased leg was amputated! The case, he said, “proved too much, or rather flatly contradicted itself” because the sound leg did not contract when the diseased one was cut. He asserted that,” in cases of insensibility in brutes, from intercourse of any portion with the brain being stopped by division  of the spinal chord, or from absolute decapitation, or from stunning by a blow upon the head, such an injury of an insensible leg as pricking it with any thing, lacerating, or cutting,—such an injury for instance as plunging a sharp instrument into the muscles,” (I sat next to Dr. M. Hall and those were his very words),” invariably causes both legs to contract; and, unless man differs from all other animals, the same must take place in the human being; and, as this man did not move his other leg, did not enact the reflex motions, he was no physiologist.”

Dr. Copland rose to oppose the motion on two grounds,—the character of the paper, and the publication of it by the authors without the permission of the society. He would allow no trace to remain that such a paper had been read. The president stopped his arguments on the first point, as the paper had been discussed at a previous meeting and thanks been voted for it. The deadly hostility of Dr. Copland to mesmerism is well known. But to-night he was particularly unwise. He protested that the paper ought not to have been read, because the author was not a medical man!—As though knowledge was ever to be despised from any source. Why one of the authors was a surgeon, though neither was a fellow of the society. I have heard papers read at the meetings of the College of Physicians (of which he rejoices to be a fellow) by persons not medical, once by the very reverend Dean of Westminster; and the society has of course no law as to who may be authors of papers: and several members of the society are not medical men. On this point he was set right by more than one member. He then contended that, if the account of the man experiencing no agony during the operation were true, the fact was unworthy of their consideration, because pain is a wise provision of nature, and patients ought to suffer pain while their surgeon is operating; they are all the better for it, and recover better! Will the world believe that such folly was gravely uttered? This will be remembered as a doctor's speech in 1842, when the doctor himself shall be forgotten.

Next post will be on a surgeon who did hundreds of painless operations without anesthesia in the same era.

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Monday, February 6, 2017

VIII - Anton Mesmer: The Great Physician and Healing Magician

Anton Mesmer was the greatest physician healer of the past 500 years even as he stands in a long line appearing over many centuries. Even with predecessors, the Doctor told that his discoveries and abilities came to him largely through his experiences with nature. Mesmer was a trained physician and held two if not three doctorates, but his most valuable knowledge came through his unusual studies and experiments. 

Starting with ideas gathered from Isaac Newton and Rene Descartes, Edmond Halley and Richard Mead, and experiments with the plain old iron magnet, Dr. Mesmer learned that he himself had more magnetic power than any piece of metal. In subsequent years, Mesmer shared his learnings and beliefs that all beings are magnetic to one degree or another. Herr Doctor Mesmer was exceptionally magnetic and powerful, charismatic and clairvoyant as well.

Thence, he became the greatest publicist and advertiser of magnetism that the world has ever known. Yet, his gifts and efforts were not universally recognized – in great part because they threatened the medical profession and orthodox authority.

Anton Mesmer’s most unusual work may have been done early on with a young woman in her 18th year who had lost her vision over night, but not as the result of illness, at the age of three. The evidence is abundant that the Doctor brought about the return of her sight – at least for a time. Her father, a Councillor of the Empress in Vienna, published some of his observations of Mesmer’s work during his daughter’s treatment in the writing which follows.

The following snippet was taken from a book [Pioneers of Spiritual Reformation] by Mary Ann Howitt Watts which includes a brief biography of Justinus Kerner, a German physician who wrote his own biography of Anton Mesmer. Kerner found this version of Herr Paradis’s published letter in Mesmer’s personal effects some years after the Doctor’s death.


This young girl, who had become a famous and highly accomplished pianoforte player, and who was protégée of the Empress Maria-Theresa, from her fourth year, according to the examination and belief of the most distinguished physicians in Vienna, had lost her eyesight from paralysis of the optic nerve.
Having experienced the treatment and mistreatment of numerous physicians, she was placed under the care of Mesmer, and recovered unquestionably—at least, for a short time—her eyesight through the use of his magnetic system.

“After a brief but powerful magnetic treatment from Dr. Mesmer, Fraulein Paradis began to distinguish the outline of bodies and figures brought near to her. Her returning sense of vision was, however, so extremely sensitive, that she could only recognise these objects in a room darkened by window shutters and curtains. If a lighted candle were placed before her eyes, although they were bound with a cloth doubled five times, she would fall to the ground like one struck by lightning.

“The first human figure which she recognised was that of Dr. Mesmer. She observed with much attention his person, and the various waving movements of his body which he made before her eyes, as a test of her powers of sight. She appeared somewhat alarmed, and said — ‘That is terrible to behold! Is that the form of a  human being?’ 

“At her request, a large dog, which was very tame, and a favourite of hers, was brought before her. She observed him with great attention. ‘This dog,’ she said, ‘pleases me better than man—at least, his appearance is more endurable to me.’ 

“Especially was the nose on the  human countenance repugnant to her. She could not restrain her laughter on seeing this feature. She thus expressed herself regarding noses: ‘They seem to threaten me as though they would bore my eyes out.’ After seeing a greater number of  human countenances, she became more reconciled to the nose. It cost her much trouble to distinguish colours and their names, and to calculate relative distances, her restored powers of vision being as inexperienced as that of a newly-born child. 

“She was mistaken in the contrast existing between different colours, but she confused the names of the colours, and this especially when she was not led to draw a contrast between the colours with which she was already familiar. Looking at black, she observed that that hue was the picture of her former state of blindness. The colour of black always excited in her a tendency towards melancholy—a condition, be it observed, to which she appeared predisposed during the course of her cure. She would frequently break forth into sudden weeping. Indeed, she was upon one occasion seized with so violent a fit of despair, that she flung herself upon a sofa, wrung her hands, tore off the bands from her eyes, drove every one from her presence, and, in fact, midst cries and sobs, comported herself in such a  manner that any great actress might have taken her as a model of dire melancholy and mental anguish.

“Within a few moments all was over, and she had regained her usual cheerful, pleasant frame of mind; only, however, within a short space again to fall back into her melancholy. A great concourse of relations, friends, and people of fashion, having presented themselves, owing to the report of the recovery of her sight which had been spread abroad, she was much annoyed. She once expressed herself to me as follows, regarding this annoyance: ‘How comes it that I find myself much less happy now, than formerly? Everything that I see causes me an unpleasant agitation. Ah! I was much quieter in my blindness.’

“I consoled her with the representation that her present agitation was only occasioned by her sensitiveness to the new spheres into which she had entered. The new condition into which she must feel transported by the recovery of her eyesight, would necessarily occasion an agitation entirely novel to her. She would undoubtedly grow as calm and contented  as other people, when she once became accustomed to her gift of sight. She replied that this was well, because, were she to experience continued agitation at the sight of fresh objects, she would rather have returned into the state of her blindness. 

“She repeatedly fainted when relatives or intimate friends were presented to her. The same thing occurred upon beholding the pictures of her two uncles, officers in the Imperial army, and towards whom she had always entertained a warm affection. She stretched her hand over the picture, in order to feel the features, but drew it back with surprise, her hand having glided over the smooth glass of the miniature. She imagined that the painted features would have stood forth like the features of a living person. The high head-dresses worn by the ladies here, especially those à la Matignon, are not at all to her taste, although formerly, during her blindness, she wore with pleasure her hair dressed in the same style.

“According to her fancy, the new-fashioned style of headdress is out of proportion with the size of the face; in which opinion she is not far wrong. She asked a lady  who was present to let her see her train, and how it appeared when she walked. But neither did she admire this fashion more than the head-dress. She says that this drapery sweeping behind is heavy. Thus strange are her remarks when she first observes objects. 

“Her newly-awakened sensations place her in the first stage of natural-existence; she judges without prejudice, and names objects from the natural impression which they make upon her. She reads the characters of persons from their countenances with remarkable accuracy. The reflections in a mirror caused her great astonishment. She could not at all comprehend how the surface of a looking-glass should catch up objects and represent them to the eye. She was led into a splendid room where there was a very large mirror. She could not satisfy herself with looking into it at herself. She made the most extraordinary bends and attitudes before it. She laughed much, observing that the reflection of herself stepped towards her as she approached the mirror, and withdrew as she withdrew. 

“All objects which she beholds at a certain distance, appear small to her, and they increase in size to her perceptions as they approach her. When with open eyes she dips a rusk in chocolate and lifts it towards her mouth, it appears to her so greatly increased in size, that she imagines that she cannot put it into her mouth.

“She was shown one evening, through the window, the star-bespangled heaven. She besought permission to go out into the garden, there freely to behold the sky. She was accompanied and led to the terrace of the garden. Here the spectators beheld a touching sight. She raised her hands in deep silence towards the glorious, gleaming heavens, probably uttering from the depths of her heart an ardent, silent thanksgiving. After a few moments, she exclaimed, ‘Oh, how earnestly do those stars gaze down upon me! Nothing in nature can be more glorious than this! If nowhere else, an ardent impulse of worship towards the Highest were felt by the human soul, here, where I stand, surely it must be felt, beneath this shining canopy!’

“She was then shown the reservoir, which she called ‘a large soup-plate.’ The trellis walls appeared to walk along beside her, and upon her return to the house the building appeared to approach her. Its illuminated windows especially pleased her. 

“On the following day, in order to satisfy her, she was again taken into the garden. She re-examined every object attentively, but not with so much pleasure as on the previous evening. She called the Danube, which flowed past the garden, a long, broad white stripe. She pointed out the places where she saw the river begin and end. She thought that with outstretched hands she could touch the trees growing in the so-called Prater-meadow, about a thousand steps on the other side of the river. It being a bright day she could not long endure looking around in the garden. She herself requested that her eyes might again be bound, as the sensation of light was too strong for her and occasioned dizziness. 

“When she now has her eyes bandaged, she does not trust herself to walk a single step without guidance, although formerly, in her blindness, she was used to move about confidently, without the assistance of any one in her well-known chamber. This new disturbance of her senses occasions her now, to use reflection when playing the piano, whereas formerly she was accustomed to execute the most difficult pieces with the greatest accuracy, conversing at the same time with those  who stood around her. With open eyes it is now difficult for her to play any piece. If her eyes are open she regards her fingers as they slip about over the piano, and misses, however, the greater number of the keys.”

The next post will be on magnetism used in a surgical case in the early 19th century, reported by Dr. John Elliotson in one of his books.

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