Popular Science Monthly/Volume 19/July 1881/Editor's Table
A CHANGE is gradually coming over the meaning of the word science or, rather, there is a growing appreciation of its true meaning, which is of great significance. In the newspaper column of "Science" we have a list of results of late experiments of all kinds. In looking over many scientific periodicals it would be inferred that the term is restricted to physical science. From the text-books we should conclude that science consists of the facts and principles that have been established and collected in different groups under this name. But it now begins to be understood that science properly means a method by which all these results are produced. It is a method of thought, a method of investigation, having for its simple object the establishment of the truths of nature. This method has grown up gradually in modern times to greater and greater perfection, and has widened in scope, until now it includes many subjects with which it was at first supposed to have no relation.
There has of course been great resistance to this tendency. For, while people admit that truth is valuable and precious, they generally think that they are also in full possession of it, and are, therefore, in little need of methods to arrive at it. Their beliefs are truth, and therefore not to be disturbed. Science doubts, with a view to reinvestigation, and is hence unwelcome. Especially where men band together in parties and sects and declare their opinions, there arises at once a spirit of hostility to any thorough inquiry which might unsettle the views to which they are committed. Meantime, in spite of this resistance, the spirit of investigation has gained strength and spread rapidly in all directions of research.
The latest and most impressive proof of the progress of the scientific spirit is seen in the recent treatment of the Christian Scriptures. Biblical criticism has long been affected by the scientific method, and is now to be controlled by it. How far the critical spirit is already advanced and diffused, so that the Bible is regarded as a book with a human and an imperfect side, and containing errors that can be removed with better knowledge, is shown by the fact that the English translation of two hundred and fifty years' standing has been lately attacked by a body of able and learned revisers, who, after eleven years of labor, have just given us a corrected edition of the New Testament. This is a great step in the direction of rationalism. It concedes that the Scriptures must be subjected to the tests of reason, and this concession is due entirely to the modern scientific movement, which demands higher standards of proof, and more inexorable questioning as to what is true.
The revisers of the New Testament have fairly and formally entered the critical wedge, but the driving it home is to be no holiday affair. Professor Robertson Smith, one of the most learned, able, and candid of Biblical critics, having undertaken to treat the history of some parts of the Old Testament in a great encyclopædia, was met by his church and silenced in his professorship in the Aberdeen University. But the world gains by this act of intolerance. Professor Smith left the college halls and went out to give a course of popular lectures upon the critical history of the Bible, which were attended by crowds of eager listeners. The lectures are collected in a volume that at once becomes a text-book of modern Biblical criticism. The true scientific ground is here openly and broadly taken, and it is generally admitted that Professor Robertson Smith's book represents authoritatively the scope and objects and method of the critical school which has been growing during the last half-century. It has thus at length become the benign office of Science to bring its methods to the responsible task of throwing a better light on the origin, history, and true character of the Christian oracles than has been derived from uncritical tradition. Nor does the critical attitude taken by Professor Smith at all compromise his Christian position. He is no skeptic, trying to undermine the Scriptures. He holds to their essential truth, but recognizes that on earth and in time, and among ignorant, selfish, and prejudiced men, truth is liable to be obscured. Professor Smith is in no sense an enemy of the Bible, as the following passage from his lectures sufficiently attests. He says:
But a majority of the Free Church of Scotland think that this is insufficient, and demand that he shall cease his critical studies. A large minority, however, see plainly that it is neither possible nor desirable to arrest the great inquiry that is now so far advanced and so securely established.
Of all the forms of hostility to science indulged in by narrow-minded, prejudiced people, the anti-vivisection movement is unquestionably the most ridiculous. Vivisection is cutting the living; surgery is, therefore, human vivisection. The human person is liable to a thousand accidents and diseases, which can only be relieved by vivisection. The surgeon, with his cutting instruments of innumerable shapes, operates boldly upon the living system, inflicting pain that pain may be relieved, saving damaged organs, restoring health, and prolonging life. There is, indeed, no art practiced by man that is so valuable and important as that of human vivisection—and this, moreover, everybody knows.
But human vivisection, pursued for its beneficent purpose, is a difficult and dangerous practice. It requires the most accurate and thorough knowledge of the organization of the human body, and extensive experience in working upon it. In its early stages, when little was known of the living system, it was a dreadful-, barbarism, a manipulation of torture, and, in serious cases, more liable to injure than to benefit. The province of surgery has ever depended upon knowledge and experience, and it has become successful in proportion as knowledge has increased and the opportunities of practice have been enlarged. Modern surgery has advanced with the most rapid strides, and at every step has made humanity its debtor. And this, also, everybody knows.
Yet, from the beginning, men have combined to hinder the development of this art upon which so much of human welfare depends. For thousands of years the dissection of the dead human body—the only source of knowledge to the surgeon—was held a horrible thing by the multitude, was denounced as sacrilege by the Church, and was forbidden by the state.
In recent times it has been discovered that there is a unity of method and law running through all forms of organic life, such as was never suspected in former ages. This was a great step in the progress of science, and a great opening for the physician and surgeon, as the whole realm of inferior life was at once made tributary to the development of the physician's art—that is, the human vivisector, who had been hitherto greatly cramped and embarrassed by the difficulties and limited scope of his operations, could now carry on his inquiries more thoroughly and comprehensively by experiments upon the lower animals. It was a grand possibility, and, broadly considered, forms the most important step in the progress of medical and surgical science and art.
But, here again, ignorance and prejudice have, even in our day, combined to hinder the use and extension of knowledge vital to human benefit. As the human body was once forbidden to be dissected, so now it is forbidden to vivisect the lower animals. Anti-vivisection societies are formed, and antivivisection legislation is sought and has been obtained to defeat the work of the experimental physiologist. The antivivisectionists express great sympathy for the poor dumb animals, and assume to be their protectors. The sympathy is commendable, the function assumed a most proper one, and the field for the exercise of both boundless, so that these friends of the suffering animals can exhaust all their energies in protective work, without meddling with the physiologists.
But these stupid zealots deny that there is any use in vivisection, or that any good has ever come from it. They profess to know more about the matter than the physiologists and surgeons, and demand that Government shall stop the practice entirely. We have now a fresh illustration of what it it is that they would suppress. A malignant case of cancer of the stomach, such as have hitherto resisted all remedies, has been cured by a surgical operation which could never have been successfully performed but for long apprenticeship in vivisection. A large fibrous cancer had grown over the pyloric orifice of the stomach through which the food passes into the intestine, which was nearly closed, and must soon have killed the patient. The stomach was opened, the cancerous tumor removed, a new orifice prepared, the intestinal tube sewed fast to the stomach, and the patient recovered. The operation was performed by Professor Theodor Billroth, of Vienna, and his account of it was translated by the United States Minister to Austria, Hon. John A. Kasson, and sent to the "New York Tribune," from which we copy it. Professor Billroth says:
I have stated this for the benefit of those who are of the opinion that my operation is a reckless experiment on a human life. Such an opinion can not be entertained for one moment. The operation of cutting out parts of the human stomach has, like any other new operation, been prepared anatomic-physiologically and technically by myself and my assistants. Every surgeon, having any experience in experiments on animals, and similar operations upon the human body, arrives at the conclusion that this operation must and will succeed. Pean, the Paris surgeon, was of the same opinion. He attempted the removal of a cancerous pylorus, about six centimetres in diameter, in the case of a patient very much reduced by suffering, and who died four days after the operation. His method of operating, and especially his choice of catgut as sewing material, did not seem to me a good one. He has not attempted to repeat the operation, so far as I know, and no other surgeon has ventured to undertake this by no means easy task.
cutting a cancer from the stomach.
The few cases which came under my notice in the course of the past year did not seem to me to be proper ones for a first operation of this kind. It was only recently that the case of a woman was presented to me where the diagnosis of a cancerous pylorus was certain. After a few days of observation, the patient assenting, I made up my mind to undertake the operation. The woman, about forty-three years of age, and mother of eight children, was taken sick—very suddenly, it would seem—in October, 1880, with vomiting. The symptoms of cancer of the stomach with stenosis of the pylorus soon showed themselves. The only thing she was able to retain for any length of time was sour milk. The preparations for the operation consisted in accustoming the patient to peptonized injections, and the cleansing of the stomach by the well-known method of injection and pumping. The room, specially prepared for the occasion, was heated to 24° Réaumur, and the narcotic administered by one of my assistants, every one of whom seemed to be conscious of the importance of the undertaking. No interruption and not a minute of unnecessary delay occurred. The movable tumor, lying a little to the right, seemed to be of the size of an ordinary apple. A diagonal incision about eight centimetres long was made over the tumor, which proved to be a knotty and infiltrated cancer of the pylorus, occupying more than a third of the lower portion of the stomach. Separation of the adhesion to the omentum and the transverse colon followed; then the division of the large and small omentum. Every vessel was tied before being cut, the loss of blood being very small. The tumor was turned out over the abdominal walls, and a cut was then made through the stomach, one centimetre beyond the Infiltrated part, at first only backward, then in the same manner through the duodenum. The attempt to put together the edges of the cut parts showed the possibility of joining them. Six stitches were taken through the edges, but the threads were not yet tied, and only used to retain the edges in position. A further cutting through the stomach was then made diagonally from the upper and inner to the lower and outer side, but always at a distance of one centimetre from the infiltrated portion of the coating of the stomach. The next thing done was to join the diagonal cut upward, until the opening was small enough to fit the duodenum to it. A complete separation of the tumor from the duodenum was effected next by an Incision one centimetre on the other side of the infiltrated portion, and parallel to the cut through the stomach. Then the duodenum was Introduced into the opening left in the stomach. About fifty stitches were taken with Czerny's carbolized silk. The whole was cleansed with a two per cent, carbolized solution. The stitches were then examined, and a few more added where there seemed to be weak spots. The whole was replaced in the abdominal cavity, the outer wound closed, and the bandages applied.
The operation lasted about one hour and a half. No weakness, no vomiting, and no pain seemed to be apparent after the operation. The patient was given ice only In the first twenty-four hours, then peptonized injections with wine; on the following day, at first every hour only, then every half-hour, a tablespoonful of sour milk. The woman slept the greater part of the night, with the aid of a small injection of morphine. The only food taken for some days after the operation consisted of sour milk, one litre a day, as an attempt to nourish the patient with broth did not seem acceptable to her. The peptonized injections were dispensed with, as they produced flatulence and colic. Injections of wine three times daily were therefore substituted. The patient, upon her own request, was a few days later removed to the general ward, and she has since been discharged from the hospital, cured. The excised part measures at the greater curvature (horribile dictu!) fourteen centimetres, and it is with difficulty only that I am enabled to pass a goose-quill through the pylorus. The shape of the stomach is changed little by the operation. It is only a little smaller than formerly.