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Design Thinking

This design focused series publishes books aimed at helping Designers,

Design Researchers, Developers, and Storytellers understand what’s
happening on the leading edge of creativity. Today’s designers are being
asked to invent new paradigms and approaches every day – they need
the freshest thinking and techniques. This series challenges creative
minds to design bigger.
More information about this series at https://​www.​springer.​com/​
series/​15933
Yu Zhang and Mathias Funk

Coding Art
The Four Steps to Creative Programming with the
Processing Language
1st ed.
Yu Zhang
Eindhoven, The Netherlands

Mathias Funk
Eindhoven, The Netherlands

Any source code or other supplementary material referenced by the

author in this book is available to readers on GitHub via the book’s
product page, located at www.​apress.​com/​978-1-4842-6263-4. For
more detailed information, please visit http://​www.​apress.​com/​
source-code.

Design Thinking
ISBN 978-1-4842-6263-4 e-ISBN 978-1-4842-6264-1
https://doi.org/10.1007/978-1-4842-6264-1

© Yu Zhang, Mathias Funk 2021

This work is subject to copyright. All rights are reserved by the

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specifically the rights of translation, reprinting, reuse of illustrations,
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absence of a specific statement, that such names are exempt from the
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at the date of publication. Neither the publisher nor the authors or the
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Acknowledgments
We started this book in October 2018 and went through the process of
writing for several months, ending with an intensive summer writing
retreat at Tenjinyama Art Studio in Sapporo. We are grateful for the
hospitality and kindness of Mami Odai and her team, and we will
always remember these weeks on the hill with the wind rushing
through the dark trees.
From October 2019, we sent out the manuscript to reviewers, and
we would like to acknowledge their hard work and sincerely thank
them for great feedback and suggestions, warm-hearted
encouragement, and praise: Loe Feijs (Eindhoven University of
Technology), Jia Han (Sony Shanghai Creative Center), Garyfalia Pitsaki
(3quarters.design), Bart Hengeveld (Eindhoven University of
Technology), Joep Elderman (BMD Studio), Ansgar Silies (independent
artist), and Rung-Huei Liang (National Taiwan University of Science and
Technology). Without you, the book would not have been as clear and
rich. We also thank the great team at Apress, Natalie and Jessica, and
especially Bin Yu for his excellent technical review. Finally, we deeply
appreciate the support from friends and family for this project.
Table of Contents
Chapter 1:​Introduction
1.​1 Coding art
1.​2 Motivation
1.​2.​1 How to talk with a “machine”
1.​2.​2 Practice a practice
1.​2.​3 Do it and own it
1.​3 How to read this book
1.​3.​1 Calling all creatives
1.​3.​2 Four steps, one example, one zoom
1.​3.​3 Getting ready
Part I: Creative coding
Chapter 2:​Idea to visuals
2.​1 Visual elements
2.​1.​1 Shapes
2.​1.​2 Shaping up in Processing
2.​1.​3 Colors, transparency, and filters
2.​1.​4 Working with form and texture
2.​2 Canvas secrets
2.​2.​1 Scaling visual elements
2.​2.​2 Resetting or restoring the canvas
2.​2.​3 Rotation and translation
2.​3 Animation:​From frames to motion
2.​3.​1 Animation basics
2.​3.​2 Simple movement
2.​3.​3 Rhythm in motion
 2.​4 Interaction as input for animation
2.​4.​1 Combining mouse presses and movement
2.​5 Summary
Chapter 3:​Composition and structure
3.​1 Data and code structure
3.​1.​1 Creating many things
3.​1.​2 Controlling many things
3.​2 Visual structure
3.​2.​1 Composition and alignment
3.​2.​2 Composing with layers
3.​2.​3 Controlling layers
3.​3 Summary
Chapter 4:​Refinement and depth
4.​1 Randomness and noise
4.​1.​1 Working with randomness
4.​1.​2 Controlling randomness
4.​1.​3 Selecting and making choices with randomness
4.​1.​4 Working with noise
4.​2 MemoryDot
4.​2.​1 Smoothing
4.​2.​2 Smoothly working with many things
4.​3 Using computed values
4.​3.​1 Computing values with functions
4.​3.​2 Interpolation
4.​3.​3 Interpolation with functions
4.​4 Interactivity
 4.​4.​1 Mouse interaction
4.​4.​2 Keyboard interaction
4.​4.​3 Other input
4.​5 Summary
Chapter 5:​Completion and production
5.​1 Making things big for print
5.​1.​1 High-resolution rendering
5.​1.​2 Migrating to scalable version
5.​1.​3 Rendering snapshots of dynamic work
5.​2 A backstage for control
5.​2.​1 Tweak mode in Processing
5.​2.​2 Centralizing control with variables
5.​2.​3 “Backstaging” with the keyboard
5.​3 More stable and less risky code
5.​3.​1 The right things in the right place
5.​3.​2 Avoiding resource bloat
5.​3.​3 Code structure
5.​3.​4 Don’t reinvent the wheel
5.​4 Testing before deployment
5.​4.​1 Depending on dependencies
5.​4.​2 Anticipating differences
5.​4.​3 Preparing for unattended operation
5.​5 Moving to mobile
5.​5.​1 Structure of mobile Processing content
5.​5.​2 From Processing to p5.​js
5.​5.​3 Fine-tuning the presentation
 5.​5.​4 How to spot errors?​
5.​5.​5 Deploying for mobile use
5.​6 Summary
Part II: An example: MOUNTROTHKO
Chapter 6:​Inspiration
6.​1 Context and starting point
6.​2 Concept and artwork
Chapter 7:​From idea to completion
7.​1 Idea to visuals
7.​2 Composition and structure
7.​2.​1 Composition:​The fog
7.​2.​2 Composition:​Creating the mountains
7.​2.​3 Structure:​Creating the particles
7.​3 Refinement and depth
7.​3.​1 Refinement:​Reshaping the particles
7.​3.​2 Depth:​Adding interaction
7.​4 Completion and production
7.​4.​1 Completion:​Installation in space
7.​4.​2 Production in print
7.​5 Summary
Part III: Coding practice
Chapter 8:​Dealing with problems
8.​1 Helping yourself
8.​1.​1 Error messages or nothing happens
8.​1.​2 Working with copy–paste
8.​1.​3 Reference documentation
 8.​1.​4 Searching for symptoms
8.​2 Getting help from others
8.​2.​1 Finding help
8.​2.​2 Asking the right questions right
8.​2.​3 Minimal working example
8.​3 Working with experts
8.​3.​1 How can experts help you?​
8.​3.​2 How to manage a project with experts?​
Chapter 9:​Learning path
9.​1 Going deeper into Processing
9.​1.​1 Challenges to pick
9.​1.​2 Building your own tool set
9.​1.​3 Sharing your tool set with others
9.​2 Different technologies
9.​2.​1 Enhancing Processing
9.​2.​2 Assessing feasibility
9.​2.​3 Moving away from Processing
Chapter 10:​Creative processes
10.​1 Two types of ideation
10.​1.​1 Concept-based ideation
10.​1.​2 Material-based ideation
10.​2 Using abstraction layers
10.​2.​1 First loop:​Behavior to output
10.​2.​2 Second loop:​Adding data
10.​2.​3 Third loop:​Adding input and interaction
10.​2.​4 Fourth loop:​Adding a backstage
 10.​2.​5 Creative processes with layers
Conclusion
Epilogue
References
Index
About the Authors
Yu Zhang
An artist by training, Yu Zhang finished her PhD in 2017 on the theory
and artistic practice of interactive technologies for public, large-scale
installations. She approaches visual art with mixed reality installations
and projections, sensor-based interactives, and computational arts. She
roots her artistic intent in the symbolism of Asian traditions and
transforms the artistic unpacking of drama and cultural signifiers into
experiences of interactivity and connectivity that ultimately bridge
artistic expression and audience experience. She uses systems design
toolkit, to realize a complex multifaceted experience playing with the
spatiotemporal context of the audience’s interaction with the
installations when digital and physical converge. Starting from
interactivity, she constructs layers of different connections between
artist, artwork, audience, and the environment to express how far such
connectivity can impact and reshape the structure and relations of
objects, space, and time within a dynamic audience experience. Apart
from her artistic research and practice, Yu’s teaching experiences cover
over ten years and a broad space including traditional classrooms and
design-led project-based learning activities.

Mathias Funk
is Associate Professor in the Future Everyday group in the Department
of Industrial Design at the Eindhoven University of Technology (TU/e).
He has a background in Computer Science and a PhD in Electrical
Engineering (from Eindhoven University of Technology). His research
interests include complex systems design, remote data collection,
systems for musical expression, and design tools such as domain-
specific languages and integrated development environments. In the
past, he has worked in research positions at ATR Japan, RWTH Aachen,
and he has been Visiting Researcher at Philips Consumer Lifestyle, the
Netherlands. He is also the co-founder of UXsuite, a high-tech spin-off
from Eindhoven University of Technology. He has years of experience in
software architecture and design, engineering of distributed systems,
and web technologies. Further areas of interest and practice are
domain-specific languages and code generation, sound and video
processing systems, and data and information visualization approaches.
He has been involved extensively in the business side of innovation, the
transfer of research to commercial products, and he loves to think
about a design’s real-world impact. As a teacher, he teaches various
technology-oriented courses in the Industrial Design curriculum about
designing with data and visualization approaches, systems design, and
technologies for connected products and systems. He is regularly
invited to give international workshops on large-scale interactive
systems, group music improvisation interfaces, and expressive
(musical) interaction. He has been an active musician for years and is
very interested in the intersection of music, art, and design in
particular.
About the Technical Reviewer
Bin Yu
received his MS in biomedical engineering from Northeastern
University, Shenyang, China, in 2012, and his PhD in industrial design
from the Eindhoven University of Technology, in 2018. He is currently a
Data Designer at Philips Design, the Netherlands, and specializes in
both human–computer interaction and data visualization.
© Yu Zhang, Mathias Funk 2021
Y. Zhang, M. Funk, Coding Art, Design Thinking
https://doi.org/10.1007/978-1-4842-6264-1_1

1. Introduction
Yu Zhang1 and Mathias Funk1
(1) Eindhoven, The Netherlands

The art world is interwoven with technology and actually quite

innovative and playful. From cave paintings to the use of perspective,
novel colors, and lighting, to printing techniques and direct inclusion of
machines and code, there are examples of how art broke ground and
changed its shape forever. Already before the beginning of the twenty-
first century, artists used code and programmed machines to generate
art or even be part of it.
There are so many examples of technology in art. It is also
interesting to see the path of how it has grown in the past 70 years.
Famous examples are, for instance, of earlier pioneers in Computer Art
like Georg Nees, Michael Noll, Vera Molná r, and Frieder Nake who
brought the use of pseudo-randomness and algorithm about fractals
and recursion in code drawing. The young generation of artists like
Casey Reas, who is well-known for developing the Processing software,
extend artistic ideas through the programming language. Some artists
like Jared Tarbell introduce real data into art creation and connect the
complexity with the data availability. It is remarkable that for most of
their works, computer artists open the source code to the public, so we
can learn from them.
In this book, we want to make the point that the use of modern
technology and machines in creative work does not contradict “creative
expression.” Instead, if used well, technology can help creatives take
steps in new directions, think of new ideas, and ultimately discover
their ideal form of expression.
 Why data and information in art? The use of data can connect
artworks to the human body, signals from outer space, or contemporary
societal issues, important events happening all over the world. With
data streams, creative works can become “alive.” As they represent data
in visual or auditory forms, they comment on what is happening in the
world; they provide an alternative frame to news and noteworthy. They
can react and even create their own data as a response.
Why is interaction interesting for creatives? Interaction in an
artwork opens a channel for communication with individual viewers or
an entire audience. Interaction can make a work more immersive and
let viewers engage in new ways with the artist’s ideas. Some might
want to engage with art emotionally; some others prefer a more
rational approach. The creative is in charge of defining and also limiting
interactivity – from fully open access to careful limitations that
preserve the overall aesthetics and message of the work. Interaction
can help create multifaceted artworks that show different views on the
world, or even allow for exploration of unknown territory.
Using computation and code can help a creative express ideas
independent of medium and channel – the work is foremost conceptual
and can be rendered in any form susceptible to the viewer. So, when we
express an artistic concept in the form of code or machine instructions,
we can direct the machine to produce its output in a number of ways:
print a rendered image on a postcard or t-shirt, project an animation
onto a building, or make an expressive interaction accessible from a
single screen or for a global audience on the Internet. By disconnecting
from physical matter, we create ephemeral art that might even change
hands and be changed by others.
Ultimately, technology transforms what it is applied to. We show
you how to do this with creativity.

1.1 Coding art

What is “coding art” all about? The title is intentionally ambiguous,
ranging in meaning from how to code art to coding as creative
expression. Probably the message that resonates most with you is
somewhere in the middle.
 Tips We are curious what you think during or after reading and
working with this book. Please let us know on our website.1

In this book, “coding” simply means an action that translates meaning

from one language into another, for example, from natural language
into a computer language. This translation, as any translation, implies a
change in who can and will interpret what we express in the new
language. It also implies thinking about how this interpretation might
work out toward a result. For natural languages, we empathize with
other people, how they think and act. For machines, we need something
called “computational thinking” [3, 6, 21].
Learning how to code is quite similar to learning how to speak
another language. Some people might follow a more theoretical
approach and learn vocabulary and grammar before attempting to
speak and converse. Some others start with a conversation and
gradually understand the structure of the language behind it.
Depending on the circumstances, any approach might work well.
For teaching how to code in a computer or programming language,
both approaches have been used in the past. There are very theoretical
ways to approach coding. They often come with a steep learning curve
and the full richness of what the language creators intend you to know
about it. And there are also ways to playfully get used to simple
examples that teach the basics before moving to more complicated
examples. In the context of creative work, we strongly feel that the
second approach, starting with the “conversation,” works far better.
However, we have seen in practice that the playful approach often hits a
limitation: how to make the step from toy examples to something that is
useful and also complex and intricate. This is hard and the reason why
we write this book.

1.2 Motivation
Every profession, every vocation, is about doing something difficult
with high quality, often using specific approaches or techniques. This
works for engineers, researchers, marketing, and doing business. For
creatives, the “difficult thing” is the invention of meaning and purpose
out of a large set of options, constraints, and relations. It is a very
human thing to create, which means we apply both our intuition and
our training and knowledge to a challenge. Creatives apply various
technologies in a creative process, and coding is a part of that. In this
book, the use of coding in creative work is based on the situation that
we try to construct meaning through understanding the logic and
structure of coding. We use coding as a creative tool rather than being
hardcore programmers or mere end users.

1.2.1 How to talk with a “machine”

Confronted with the particular but different characteristics of art,
design, and technology, we have seen creatives struggle with questions
about “how to start,” “how to continue,” and “how to end” while
working with code and coding practice. Like writing a book or essay, it
is difficult to code an idea in an individual context and condition, so that
a machine can produce something meaningful for us. Unlike writing,
the machine will respond swiftly to anything we feed it. It will never
complain about too much work and always accurately reflect what we
write in coded language. And when we get things wrong, make a
mistake, which happens more often than we are comfortable with, then
this is on us. The machine is a “stupid” thing, dull and rational.
Whatever creativity emerges is ours only. This book is essentially about
how to let the machine express and amplify our human creativity by
using precise instructions (“code”) and input (“data”).
For many creatives, the use of code in their projects brings new
challenges, beyond successfully completing a project. For example, an
unforeseen challenge is to let the work operate reliably for hours, days,
and weeks. With traditional “static” material, creative output eventually
turns into a stable form that rests in itself. Paper, photo, clay, concrete,
metal, video, or audio documentary are stable. There are established
ways to keep them safe and maintain their quality. If you want, you can
study this conservation craft as a university subject even.
Things are different for art or design based on code. Code always
needs a machine to run on, an environment to perform its function.
This essentially counteracts technological progress: there is always a
newer machine, a more modern operating system, a more powerful way
to program something. Any of these get in and code written for earlier
machines may stop working. This does not happen that easily to a
painting or a designed and manufactured object.

1.2.2 Practice a practice

When we write about “coding” as a practice, we try to combine the
creative process with computational thinking. Over the years, our art or
design students, inevitably, encounter similar problems. They often ask
questions like “why do we need to learn coding?”, “coding is so difficult
to continue once you are stuck, what is it worth?”, and “I could
understand the examples (from the programming software references)
well, but I cannot do my idea just by using those examples, how to do
that?”. These questions (or often passionate complaints) point at the
difficulty of learning coding as a new language. It seems that there is a
big disconnect of “brainy” coding from creative practice. There is a
common understanding that creative expression is fueled by
inspiration and directed by intuition. In contrast, “coding” or working
with technology seems to be very rational and thought through. Yes,
nice try. Creative coding is only slightly “brainy” at the beginning. Soon
after, it will turn into something intuitively creative and much faster
than learning to wield a brush and master the skills to paint.

1.2.3 Do it and own it

Before we can start, here is yet another big “why” question: even if
coding is an indispensable part of a creative project, why do artists or
designers need to do the code themselves? Cooperative skills are basic
for any contemporary artist and designer. Although there are cases of
successful international artists who command a multidisciplinary team
to work on their ideas, these people are absolutely not the norm. More
realistically, we see creatives who cannot afford a team of qualified
experts and who work on smaller budgets and projects. Our point in
this book is: without understanding coding and technology to some
extent, it will be very difficult to work with experts productively or get
help when you run into problems. The point about creative technology
is: you want something? Then do it and own it.
We are aware that creatives who are learning or exploring
interactive art, digital art, and new media art are no longer just
following one traditional approach. Instead, they need to work with
their ideas from a broader perspective – in the principles of science,
technology, engineering, and mathematics (STEM). When we move into
the field where art meets code, creatives may need a new way of
thinking and working which can help them see this new field through
the lens of an old field where they have been active in and professional
at.
In projects where code is involved, you as the creative need the
ability to read code, understand code, perhaps even write code, and
think in a computational structure. This is necessary for effectively
communicating with technology experts in a common “language.” We
think these are essential abilities creatives today need to have. Besides,
creatives who rely mostly on the help of experts often feel uncertain as
to how much control they have to relinquish to achieve the goal. We
actually have a section on working with technology experts towards the
end of the book.

1.3 How to read this book

This book can be read in different ways, from different perspectives and
also with different pre-knowledge and backgrounds. It is hard to find a
common ground, but we hope that with patience and openness, you
will soon see our point.

1.3.1 Calling all creatives

First of all, this book is dedicated to creatives who might be designers,
artists, design or art students. We also wrote this book for architects,
engineers, and researchers. They all share that creativity makes their
profession special and their work unique. The creative will benefit
mostly by taking the main road from beginning to end, visiting all
examples and typing along. Why not bring this book to your favorite
café once a week and slowly make your way through the different
chapters. If you space it out over several weeks, you will see that the
breaks will spark new thoughts of how to code art and what you could
do yourself with the current week’s topic.
We also wrote this book for educators who could take a jump to the
last part first. There we explain more about the rationale behind the
concepts we introduce and our methodology. We show how everything
fits together, also from an educational point of view.
Third, this book is written for technical experts, who know it all
actually and who might be surprised by the simplicity of the code
examples. Why would they read this book? Because they realize that
knowing code as a second native language and being able to construct
the architecture of code is not enough, by far. The embedding of code in
a process, driven by creativity or business interests, is where the
challenges lie. As a technical expert, you will find the third part most
interesting and can use it as a lens to scan the first two parts.

1.3.2 Four steps, one example, one zoom

In the first main part of this book, we will go through a creative process
in four steps and explain how coding works in each step. The steps will
each unfold through several practical examples and conclude with a
short summary.
The first step, idea to visuals, gives you a short primer into working
with Processing and the different visual elements that are readily
available to you. We quickly proceed to working with the visual canvas
before diving into animation and interaction. From this point onward,
you know how to draw moving things on a canvas that might even
respond to your interactive control. The second step is about
composition and structure, that is, how we let art emerge from a
multitude of different elements on the canvas. We will introduce data
and code structure that help you in working with many visual elements
at the same time. Together, we apply this in several examples around
visual structure. In the third step, we show you how to work things out
in more detail and how to give depth to your creations. You will learn
about randomness and noise and how to control them artistically. We
show you how to create smooth animations and transitions between
different elements and colors. Interactivity returns in this step, and we
show you how to combine interactive input with composition and
refinement. The fourth step is about production, how to bring your
creation to the stage, how to produce and present it well in different
media from high-resolution printing to interactive installations.
On the next page, we show an example that we created inspired by
an abstract geometrical painting of Kazimir Malevich (“Suprematisme,”
1915) as inspiration (Figure 1-1). We chose this work because, for us, it
visually hinted at a very interesting motion of otherwise static blocks
that seems to be captured in a moment just before toppling over. We
started with a recreation of the visual composition of ten basic
elements in similar primary colors on a cream-colored canvas (step 1).
In a second step, we connected to the impression of inherent motion
and work with the blocks: we shifted and redrew the same composition
recursively, adding more and more layers over time (step 2). The third
step involved adding three large-scale rotated copies of the
composition to complete the circular perspective. We also fine-tuned
the timing of adding the different elements and operations over time, so
the work developed in a few minutes from the first screen and visually
stabilized in the last screen. Finally, we added a gradual shift of the
entire canvas that, over several minutes, zoomed out and shifted the
center of the canvas from the left top to the right bottom (step 3). In the
fourth step, we “produce” the images that you see: we let the animation
play and live select tens of frames to be automatically rendered. From
these frames, we finally select eight frames as they exhibit good
composition individually and also show the motion of the entire work
well (step 4).
This example shows how we borrow from the four large steps
described in this book, by picking a few pieces from each step that
match our concept. From a process point of view, steps 1, 3, and 4 were
relatively straightforward. We took more time for the second step
because we went into two different directions, one more playful and
one more technical, of which the playful was the right one at the end
after trying both. Only after resolving this, we could move faster again.
There are chances that you will struggle as well while working with this
book; don’t forget to take breaks and never let go.
Figure 1-1 Example of generative art taking an abstract geometrical painting of
Kazimir Malevich (“Suprematisme,” 1915) as inspiration
Throughout these four steps, we will teach you about creative
computation, and, at some point, you will see also bits of strategies,
patterns, and more complex concepts appear. Afterward, we will roll up
all steps in a larger art project, MOUNTROTHKO, in the second part of
this book. Finally, in the third part, we zoom out and turn toward the
practice of creative coding, through learning and collaboration. This
part shows you how you can make progress using this book and
beyond, what you can do when you feel stuck, and how to get help. It’s
all there, you just need to go step by step toward it.

1.3.3 Getting ready

This book contains a lot of examples, and they are written in code
(“source code”). Most examples can be used directly, and the resulting
visual output is shown close to the source code.

Code examples // How to quickly find code

examples in the book?

Look for text in a box like this!

All source code listed in this book is written in the open source
software Processing. Processing itself is available from
https://processing.org, and we recommend that you install it
on your computer to get the most out of this book. Processing is a
medium for understanding the structure and logic of code. We will
explain this shortly. The code examples are available online from our
Processing library.2 Although it might be tempting to just download the
examples and play with them, we recommend typing them yourself (at
least some of them). This way, you will pick up the programming style
much faster and allow your muscle memory to support your learning.
And if you are lucky, you will make a few small mistakes that give you
surprising results.
Finally, we will address you, the reader, informally. Think of this
book as a conversation in your favorite café over coffee and your laptop
is right in front of you. Feel free to pause the conversation and dive into
a topic on your own, or explore the code of the examples, and then
resume to the next page. Let’s begin.
Footnotes
1 https://codingart-book.com/feedback

2 The Processing library can be found here: https://codingart-

book.com/library. You can install it using the Processing library manager.
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twenty-four years of age. Returning to England he received a
doctor's degree at Cambridge, and shortly afterward married a
daughter of a London physician and entered upon the practice of
medicine in London.
In the great city his practice as a physician seems to have been from
the outset successful, and his knowledge and ability procured him
various valuable appointments. He was made a Fellow of The
College of Physicians in 1607. This Royal College of Physicians was
given a grant of incorporation by Henry VIII in 1518, at the
intercession of Chambers, Linacre and Ferdinand Victoria, the King's
Physicians, it being under the patronage of Cardinal Wolsey. The first
meetings were held at Linacre's house which he bequeathed to the
corporation at his death. Until this College was founded practitioners
of medicine were licensed to practise by the Bishop of London or by
the Dean of St. Paul's.
A few years later Harvey was appointed Physician-Extraordinary to
King James I, and later yet, after the publication of his great treatise
and its dedication to the King, he was made Physician-in-Ordinary to
Charles I, whom he attended during the Civil Wars.
It must have been about 1615 when Harvey first began expounding
his views on the circulation of the blood, during lectures which were
delivered at The College of Physicians, but it was not until thirteen
years later, i. e., in 1628, that his great work DE MOTU CORDIS was
published in Latin, as was customary among scholars, and at
Frankfort-on-the-Main, since that was then the great center of the
book publishing trade.
The treatise was dedicated to King Charles I, in a manner which to
us would seem servile, and yet which was according to a custom
followed by nearly all of the scholars of the day, who desired to
attract not only the attention of royalty, but, in most instances, their
benevolent assistance. It is worth while to quote at this point the
first sentence or two of his dedication:
 "To the
Most Serene and Invincible
C H A R L E S,
of Great Britain, France and Ireland,
KING: DEFENDER of the FAITH,
Most Serene King,
"The heart of animals is the basis of their life, the principle of the
whole, the Sun of their Microcosm, that upon which all movement
depends, from which all strength proceeds. The King in like manner
is the basis of his Kingdom, the Sun of his World, the heart of the
Commonwealth, whence all power derives, all grace appears. What I
have here written of the movements of the heart I am the more
emboldened to present to your Majesty, according to the Custom of
the present age, because nearly all things human are done after
human examples and many things in the King are after the pattern
of the heart."
The dedication was followed by a Proemium which one may hardly
read to-day without emotion. In it he sets forth the mystery that has
surrounded the subject of the motion and function of the heart, as
well as the attendant difficulties of the subject, speaking of his own
early despair that he would ever be able to clear up the subject. He
even said that at one time he found the matter so beset with
difficulties that he was inclined to agree with Fracastorius "that the
movements of the heart and their purpose could be comprehended
by God alone." Only later was this despair dispelled by a suggestion
when, as he says: "I began to think whether there might not be a
movement in a circle" when thus the truth dawned fully upon him.
We shall have to speak later of the opposition provoked by the
appearance of this work and its almost general rejection. It is
perhaps, however, but just to those who disputed Harvey's
discoveries to recall that no complete and actual demonstration of
the actual circulation was possible at that time, nor for many years
after, and until the introduction of the microscope, the common
magnifying glass of that day being the only lens in use. It remained
for Malpighi to demonstrate the blood actually in circulation in the
lung of a frog some three or four years after Harvey's death, in
1657. But Harvey lived long enough to see his views gain general
acceptance, and though at first, and as the result of the opposition
provoked by his publication, his practice fell off mightily, he later
regained his professional position and rose to the highest eminence,
being elected in 1654 to the Presidency of the College of Physicians.
To this institution he proved a great benefactor, making considerable
additions to the building after its destruction in The Great Fire of
1666 and its subsequent restoration. He also left a certain sum of
money as a foundation for an annual oration, to be delivered in
commemoration of those who had been great benefactors of the
College. This oration is still regularly delivered on St. Luke's Day, i.
e., the 18th of October, and is ordinarily known as the Harveian
oration. In these orations more or less reference to Harvey's work
and influence is always made.
This great man passed away on the 3d of June, 1657, within ten
months of his eightieth birthday, thus affording a brilliant exception
to the list of men who have rendered great service to the world and
not lived long enough to see it appreciated.
As one reads Harvey's own words, the wonder ever grows that it
should have remained for him, after the lapse of so many centuries,
to not only call attention to what had been said by Galen but
apparently forgotten by his successors, namely, that "the arteries
contained blood and nothing but blood, and, consequently, neither
spirits nor air, as may be readily gathered from experiments and
reasonings," which he elsewhere furnishes. He furthermore shows
how Galen demonstrated this by applying two ligatures upon an
exposed artery at some distance from each other, and then opening
the vessel itself in which nothing but blood could be found. He calls
attention also to the result of ligation of one of the large vessels of
an extremity, the inevitable result being just what we to-day know it
must be, and the procedure terminating with gangrene of the limb.
Not long before Harvey's own publication, Fabricius, he of
Aquapendente, had published a work on respiration, stating that, as
the pulsation of the heart and arteries was insufficient for the
ventilation and refrigeration of the blood, therefore were the lungs
fashioned to surround the heart. Harvey showed how the arterial
pulse and respiration could not serve the same ends, combating the
view generally held, that if the arteries were filled with air, a larger
quantity of air penetrating when the pulse is large and full, it must
come to pass that if one plunge into a bath of water or of oil when
the pulse is strong and full it should forthwith become either smaller
or much slower, since the surrounding fluid would render it either
difficult or impossible for air to penetrate. He also called attention to
the inconsistencies between this view and the arrangement of the
prenatal circulation; also to the fact that marine animals, living in the
depths of the sea, could under no circumstances take in or emit air
by the movements of their arteries and beneath the infinite mass of
waters, inasmuch as "to say that they absorb the air that is present
in the water and emit their fumes into this medium, were to utter
something very like a figment;" furthermore "when the windpipe is
divided, air enters and returns through the wound by two opposite
movements, but when an artery is divided blood escapes in one
continuous stream and no air passes."
Discussing further the views which he stigmatized as so incongruous
and mutually subversive that every one of them is justly brought
under suspicion, he reverts again to the statements of Galen, calling
attention to the fact that from a single divided artery the whole of
the blood of the body may be withdrawn in the course of half an
hour or less, and to the inevitable consequences of such an act; also
that when an artery is opened the blood is emptied with force and in
jets, and that the impulse corresponds with that of the heart; again
that in an aneurism the pulsation is the same as in other arteries,
appealing for corroboration in this matter to the recent statements of
Riolan, who later became his avowed enemy. Harvey also called
attention to the fact that while ordinarily there was a seemingly fixed
relation between respiration and pulse-rate, this might vary very
much under certain circumstances, showing that respiration and
circulation were two totally different processes. Harvey utilized also
the results of his researches in comparative anatomy and physiology,
for early in his work he called attention to the fact that every animal
which is unfurnished with lungs lacks a right ventricle.
In his Proemium he then proceeds to ask certain very pertinent
questions which can only be briefly summarized in this place. He
asks: First, why, inasmuch as the structure of both ventricles is
practically identical, it should be imagined that their uses are
different, and why, if tricuspid valves are placed at the entrance into
the right ventricle and prove obstacles to the return of blood into
vena cava, and if similar valves are situated at the commencement
of the pulmonary artery, preventing return of blood into the
ventricle, then why, when similar valves are found in connection with
the other side of the heart, should we deny that they are there for
the same purpose of prevention "here the egress" and "there the
regurgitation of the blood?"
Secondly, he asks why, in view of the similarity of these structures, it
should be said that things are arranged in the left ventricle for the
egress and regress of spirits, and in the right ventricle for those of
blood?
Thirdly, he enquires why, when one notes the resemblance between
the passages and vessels connected with the opposite sides of the
heart, one should regard one side as destined to a private purpose,
namely, that of nourishing the lungs, the other to a more public
function? Furthermore, he enquires, since the lungs are so near, and
in continual movement, and the vessels supplying them of such
dimensions, what can be the use of the pulse of the right ventricle,
which he had often observed in the course of his experiments? He
sums up his inability to accept the explanations previously offered
with a phrase which reads rather strangely, even in original Latin:
"Deus bone! Quomodo tricuspides impediunt aëris egressum, non
sanguinis." i. e., "Good God! how should the mitral valves prevent
the regurgitation of air and not of blood?"
He then takes up the views of those who have believed that the
blood oozed through the septum of the heart from the right to the
left side by certain secret pores, and to them he replied "By
Hercules, no such pores can be demonstrated, nor, in fact, do any
such exist." Again, "Besides, if the blood could permeate the
substance of the septum, or could be emptied from the ventricles,
what use were there for the coronary artery and vein, branches of
which proceed to the septum itself, to supply it with nourishment?"
Further on in the treatise Harvey sets forth his motives for writing,
stating how greatly unsettled had become his mind in that he did
not know what he himself should conclude nor what to believe from
others. He says: "I was not surprised that Laurentius should have
written that the movements of the heart were as perplexing as the
flux and reflux of Euripus had appeared to Aristotle." He apologizes
for the crime, as some of his friends considered it, that he should
dare to depart from the precepts and opinions of all anatomists. He
acknowledged that he took the step all the more willingly, seeing
that Fabricius, who had accurately and learnedly delineated almost
every one of the several parts of animals in a special work, had left
the heart entirely untouched.
Passing more directly to the actual work of the heart, he shows that
not only are the ventricles contracted by virtue of the muscular
structure of their own walls, but further that those fibers or bands,
styled "Nerves" by Aristotle, that are so conspicuous in the ventricles
of larger animals when they contract simultaneously, by an
admirable adjustment, help to draw together all the internal surfaces
as if with cords, thus expelling the charge of contained blood with
force. Later on he says that if the pulmonary artery be opened,
blood will be seen spurting forth from it, just as when any other
artery is punctured, and that the same result follows division of the
vessel which in fishes leads from the heart. He furnishes a very
happy simile to prove that the pulses of the arteries are due to the
impulses of the left ventricle by showing how, when one blows into a
glove all of its fingers will be found to have become distended at one
and the same time. He quotes Aristotle, who made no distinction
between veins and arteries, but said that the blood of all animals
palpitates within their vessels and by the pulse is sent everywhere
simultaneously, all of this depending upon the heart.
It is in Chapter Five of the treatise that he gives, probably for the
first time, an accurate published account of just what transpires with
one complete cycle of cardiac activity. The passage need not be
quoted here, but deserves to be read by everyone interested in the
subject, as who should not be? One sentence, however, is worth
quotation or, at least, a summary, as follows: "But if the divine Galen
will here allow, as in other places he does, that all the arteries of the
body arise from the great artery, and that this takes its origin from
the heart; that all the vessels naturally contain and carry blood; that
the three semilunar valves situated at the orifice of the aorta prevent
the return of the blood into the heart, and that they were here for
some important purpose,—I do not see how he can deny that the
great artery is the very vessel to carry the blood, when it has
attained its highest triumph of perfection, from the heart for
distribution to all parts of the body."
His Chapter Six deals with the course by which blood is carried from
the right into the left ventricle, and here one must admire the large
number of experimental demonstrations which Harvey had
undertaken upon all classes of animals, for he speaks even of that
which occurs in small insects, whose circulation he had studied so
far as he could with the simple lens. Furthermore he described the
prenatal circulation, omitting practically nothing of that which is
taught to-day, showing that in embryos, while the lungs are yet in a
state of inaction, both ventricles of the heart are employed, as if
they were but one, for the transmission of blood. In concluding this
chapter he again states briefly the course of the blood, and promises
to show, first, that this may be so and, then, to prove that it really is
so.
His Chapter Seven is devoted to showing how the blood passes
through the substance of the lungs from the right ventricle and then
on into the pulmonary vein and left ventricle. He alludes to the
multitude of doubters as belonging, as the poet had said, to that
race of men who, when they will, assent full readily, and when they
will not, by no matter of means; who, when their assent is wanted,
fear, and when it is not, fear not to give it. A little later on he says:
"As there are some who admit nothing unless upon authority, let
them learn that the truth I am contending for can be confirmed from
Galen's own words, namely, that not only may the blood be
transmitted from the pulmonary artery into the pulmonary veins and
then into the left ventricle of the heart, but that this is effected by
the ceaseless pulsation of the heart and the movements of the lungs
in breathing." He then shows how Galen explained the uses of the
valves and the necessity for their existence, as well as the universal
mutual anastomosis of the arteries with the veins, and that the heart
is incessantly receiving and expelling blood by and from its
ventricles, for which purpose it is furnished with four sets of valves,
two for escape and two for inlet and their regulation.
Harvey then noted a well-known clinical fact, that the more frequent
or forcible the pulsations, the more speedily might the body be
deprived of its blood during hemorrhage, and that it thus happens
that in fainting fits and the like, when the heart beats more
languidly, hemorrhages are diminished and arrested. The balance of
the book is practically devoted to further demonstration and
corroboration of statements already made. A study of this work of
Harvey's illustrates how much respect even he and his
contemporaries still showed for the authority of Galen. It shows still
further how nearly Galen came to the actual truth concerning the
circulation. Had the latter not adopted too many of the notions of his
predecessors concerning the nature of the soul (Anima) and the
spirits (Pneuma) of man, he might himself have anticipated Harvey
by a thousand years, and by such announcement of a great truth
have set forward physiology by an equal period. Independent and
original as Harvey showed himself, he seems to have failed to get
away from the notion of the vapors and spiritual nature of the blood
which he had inherited from the writings of Galen and many others.
Nevertheless he also alludes to this same blood as alimentive and
nutritive. We must not forget, however, that this was years before
Priestly's discovery of oxygen and that Harvey had, like others, no
notion of the actual purpose of the lungs, believing that the
purification and revivification of the blood was the office of the heart
itself.
Along with its other intrinsic merits Harvey's book possesses a clear
and logical arrangement, the author first disposing of the errors of
antiquity, describing next the behavior of the heart in the living
animal, showing its automatic pumplike structure, its alternate
contractions and the other phenomena already alluded to, thus piling
up facts one upon another in a manner which proved quite
irresistible. The only thing that he missed was the ultimate
connection between the veins and the arteries, i. e., the capillaries,
which it remained for Malpighi to discover with the then new and
novel microscope, which he did about 1657, showing the movement
of the blood cells in the small vessels, and confirming the reality of
that ultimate communication which had been held to exist. Malpighi
discovered the blood corpuscles in 1665, but it remained for
Leeuwenhoek, of Delft, in 1690, by using an improved instrument to
demonstrate to all observers the actual movements of the circulating
blood in the living animal. One historian has said that with Harvey's
overthrow of the old teachings regarding the importance of the liver
and of the spirits in the heart "fell the four fundamental humors and
qualities" while Daremberg exclaims: "As in one of the days of the
creation, chaos disappeared and light was separated from darkness."
It remains now only to briefly consider how Harvey's great discovery
was received. To quote the words of one writer: "So much care and
circumspection in search for truth, so much modesty and firmness in
its demonstration, so much clearness and method in the
development of his ideas, should have prepossessed everyone in
favor of the theory of Harvey; on the contrary, it caused a general
stupefaction in the medical world and gave rise to great opposition."
During the quarter of a century which elapsed after Harvey's
announcement there probably was not an anatomist nor physiologist
of any prominence who did not take active part in the controversy
engendered by it; even the philosopher Descartes was one of the
first adherents of the doctrine of the circulation, which he
corroborated by experiments of his own.
Two years after the appearance of Harvey's book appeared an
attack, composed in fourteen days by one Primerose, a man of
Scotch descent, born and educated in France, but practising at Hull,
in which he pronounced the impossibilities of surpassing the ancients
or improving on the work of Riolan, who already had written in
opposition to Harvey, and who was the only one to whom the latter
vouchsafed an answer. It was Riolan who procured a decree of the
Faculty of Paris prohibiting the teaching of Harvey's doctrine. It was
this same Riolan who combated with equal violence and obstinacy
the other great discovery of the age, namely,—the circulation of the
lymph.
One of the earliest and fiercest adversaries of Harvey's theory was
Plempius, of Louvaine, who, however, gave way to the force of
argument and who finally publicly and voluntarily passed over to the
ranks of its defenders in 1652, becoming one of Harvey's most
enthusiastic advocates.
Harvey's conduct through the controversy was always of the most
dignified character; in fact, he rarely ventured to reply in any way to
his adversaries, believing in the ultimate triumph of the truths which
he had enunciated. His only noteworthy reply was one addressed to
Riolan, then Professor in the Paris Faculty and one of the greatest
anatomists of his age, to whose opinion great value was always
attached. Even in debating or arguing against him, Harvey always
spoke of him with great deference, calling him repeatedly The Prince
of Science. Riolan was, however, never converted, though whether
he held to his previous position from obstinacy, from excess of
respect for the ancients, or from envy and jealousy of his
contemporary, is not known.
Another peculiar spectacle was afforded by one Parisunus, who died
in 1643, a physician in Venice, who, like Harvey, had been a pupil of
Fabricius of Aquapendente, who had been stigmatized by Riolan as
an ignoramus in anatomy, but who joined with others in declaring
that he had seen the heart beat when perfectly bloodless, and that
no beating of the heart and no sounds were to be heard as Harvey
had affirmed.
With the later and more minute studies into the structure and
function of the heart we are not here concerned. The endeavor has
been rather to place before you the sentiments, the knowledge and
the habits of thought of the men of Harvey's time, with the briefest
possible epitome of what they knew, or rather of how little they
knew, to account for this later slavish adherence to authority by
unwillingness to reason independently, or to observe natural
phenomena intelligently, still less to experiment with them. It is,
then, rather the brief history of an epochal discovery than an effort
to trace out its far-reaching consequences that I have endeavored to
give.
Here must close an account which perhaps has been to you tedious,
and yet which is really brief, of Harvey's life and labors. He lived to
see his views generally accepted and to enjoy his own triumph, a
pleasure not attained by many great inventors or discoverers.
Lessons of great importance may be gathered from a more careful
study of this great historical epoch, but they must be left to your
own powers of reasoning rather than to what I may add here. I
commend it to you as a fertile source of inspiration, and a line of
research worthy of both admiration and imitation. Few men have
rendered greater service to the world by the shedding of blood than
did Harvey, in his innocent and wonderful studies of its natural
movement. Perhaps it might be said of him that he was the first man
to show that "blood will tell." What he made it tell has been thus
briefly told to you.
I know not how I may better close this account than by quoting the
concluding words of his famous book, and especially repeating the
lines which he has quoted from some Latin author whom I have not
been able to identify. His paragraph and his quotation are as follows:
"Finally, if any use or benefit to this department of the republic of
letters should accrue from my labors, it will, perhaps, be allowed
that I have not lived idly, and, as the old man in the comedy says:
'For never yet hath anyone attained
To such perfection, but that time, and place,
And use, have brought addition to his knowledge;
Or made correction, or admonished him,
That he was ignorant of much which he
Had thought he knew; or led him to reject
What he had once esteemed of highest price.'"
 XIII
HISTORY OF ANAESTHESIA AND
THE INTRODUCTION OF
ANAESTHETICS IN SURGERY[10]
IN COMMEMORATION OF THE SEMI-CENTENNIAL OF THE INTRODUCTION OF ETHER AS
AN ANAESTHETIC AGENT

F
ifty years ago to-day—that is to say, on the 16th of October,
1846,—there occurred an event which marks as distinct a step
in human progress as almost any that could be named by the
erudite historian. I refer to the first demonstration of the possibility
of alleviating pain during surgical operations. Had this been the date
of a terrible battle, on land or sea, with mutual destruction of
thousands of human beings, the date itself would have been
signalized in literature and would have been impressed upon the
memory of every schoolboy, while the names of the great military
murderers who commanded the opposing armies would have been
emblasoned upon monuments and the pages of history. But this
event was merely the conquest of pain and the alleviation of human
suffering, and no one who has ever served his race by contributing
to either of these results has been remembered beyond his own
generation or outside the circle of his immediate influence. Such is
the irony of fate. The world erects imposing monuments or builds
tombs, like that of Napoleon, to the memory of those who have
been the greatest destroyers of their race; and so Cæsar, Hannibal,
Genghis Khan, Richard the Lion-hearted, Gustavus Vasa, Napoleon
and hundreds of other great military murderers have received vastly
more attention, because of their race-destroying propensities and
abilities, than if they had ever fulfilled fate in any other capacity. But
the men like Sir Spencer Wells, who has added his 40,000 years of
life to the total of human longevity, or like Sir Joseph Lister, who has
shown our profession how to conquer that arch enemy of time past,
surgical sepsis, or like Morton, who first publicly demonstrated how
to bring on a safe and temporary condition of insensibility to pain,
are men more worthy in our eyes of lasting fame, and much greater
heroes of their times, and of all time,—yet are practically unknown
to the world at large, to whom they have ministered in such an
unmistakable and superior way.
This much, then, by way of preface and reason for commemorating
in this public way the semi-centennial of this really great event.
Because the world does scant honor to these men we should be all
the more mindful of their services, and all the more insistent upon
their public recognition.
Of all the achievements of the Anglo-Saxon race, I hold it true that
the two greatest and most beneficent were the discovery of ether
and the introduction of antiseptic methods,—one of which we owe to
an American, the other to a Briton.
The production of deep sleep and the usual accompanying abolition
of pain have been subjects which have ever appeared, in some form,
in myth or fable, and to which poets of all times have alluded,
usually with poetic license. One of the most popular of these fables
connects the famous oracle of Apollo, at Delphi, whence proceeded
mysterious utterances and inchoate sounds, with convulsions,
delirium and insensibility upon the part of those who approached it.
To what extent there is a basis of fact in this tradition can never be
explained, but it is not improbable from what we now know of
hypnotic influence.
From all time it has been known that many different plants and
herbs contained principles which were narcotic, stupefying or
intoxicating. These properties have especially been ascribed to the
juices of the poppy, the deadly nightshade, henbane, the Indian
hemp and the mandrágora, which for us now is the true mandrake,
whose juice has long been known as possessing soporific influence.
Ulysses and his companions succumbed to the influence of
Nepenthe; and, nineteen hundred years ago, when crucifixion was a
common punishment of malefactors, it was customary to assuage
their last hours upon the cross by a draught of vinegar with gall or
myrrh, which had real or supposititious narcotic properties. Even the
prophet Amos, seven hundred years before the time of Christ, spoke
of such a mixture as this as "the wine of the condemned," for he
says, in rehearsing the iniquities of Israel by which they had incurred
the anger of the Almighty: "And they lay themselves down upon the
clothes laid to pledge by every altar, and they drink the wine of the
condemned in the house of their God," (Chap. II, verse 8), meaning
thereby undoubtedly that these people, in their completely
demoralized condition, drank the soporific draught kept for criminals.
Herodotus mentions a habit of the Scythians, who employed a vapor
generated from the seed of the hemp for the purpose of producing
an intoxication by inhalation. Narcotic lotions were also used for
bathing the people about to be operated upon. Pliny, who perished
at the destruction of Herculaneum, A. D. 79, testified to the soporific
power of the preparations made from mandrágora upon the faculties
of those who drank it. He says: "It is drunk against serpents and
before cuttings and puncturings, lest they should be felt." He also
describes the indifference to pain produced by drinking a vinous
infusion of the seeds of eruca, called by us the rocket, upon
criminals about to undergo punishment. Dioscorides relates of
mandrágora that "some boil down the roots in wine to a third part,
and preserve the juice thus procured, and give one cyathus of this to
cause the insensibility of those who are about to be cut or
cauterized." One of his later commentators also states that wine in
which mandrágora roots have been steeped "does bring on sleep
and appease pain, so that it is given to those who are to be cut,
sawed or burnt in any parts of their body, that they may not
perceive pain." Apuleius, about a century later than Pliny, advised
the use of the same preparation. The Chinese, in the earlier part of
the century, gave patients preparations of hemp, by which they
became completely insensible and were operated upon in many
ways. This hemp is the cannabis Indica which furnishes the
Hasheesh of the Orient and the intoxicating and deliriating Bhang,
about which travelers in the East used to write so much. In Barbara,
for instance, it was always taken, if possible, by criminals
condemned to suffer mutilation or death.
According to the testimony of medieval writers, knowledge of these
narcotic drugs was practically applied during the last of the
Crusades, the probability being that the agent principally employed
was this same hasheesh. Hugo di Lucca gave a complete formula for
the preparation of the mixture, with which a sponge was to be
saturated, dried, and then, when wanted, was to be soaked in warm
water, and afterward applied to the nostrils, until he who was to be
operated upon had fallen asleep; after which he was aroused with
the vapor of vinegar.
Strangely enough, the numerous means of attaining insensibility,
then more or less known to the common people, and especially to
criminals and executioners, do not appear to have found favor for
use during operations. Whether this was due to unpleasant after-
effects, or from what reason, we are not informed. Only one or two
surgical writers beside Guy de Chauliac (1498) refer in their works to
agents for relief of pain, and then almost always to their unpleasant
effects, the danger of producing asphyxiation, and the like. Ambrose
Paré wrote that preparations of mandrágora were formerly used to
avert pain. In 1579, an English surgeon, Bulleyn, affirmed that it was
possible to put the patient into an anaesthetic state during the
operation of lithotomy, but spoke of it as a "terrible dream." One
Meisner spoke of a secret remedy used by Weiss, about the end of
the XVII Century, upon Augustus II., king of Poland, who produced
therewith such perfect insensibility to pain that an amputation of the
royal foot was made without suffering, even without royal consent.
The advice which the Friar gave Juliet regarding the distilled liquor
which she was to drink, and which should presently throw her into a
cold and drowsy humor, although a poetic generality, is
Shakespeare's recognition of a popular belief. Middleton, a tragic
writer of Shakespeare's day, in his tragedy known as "Women
beware Women," refers in the following terms to anesthesia in
surgery:
"I'll imitate the pities of old surgeons
To this lost limb, who, ere they show their art,
Cast one asleep; then cut the diseased part."
Of course, of all the narcotics in use by educated men, opium has
been, since its discovery and introduction, the most popular and
generally used. Surgeons of the last century were accustomed to
administer large doses of it shortly before an operation, which, if
serious, was rarely performed until the opiate effect was manifested.
Still, in view of its many unpleasant after-effects, its use was
restricted, so far as possible, to extreme cases.
Baron Larrey, noticing the benumbing effect of cold upon wounded
soldiers, suggested its introduction for anesthetic purposes, and
Arnott, of London, systematized the practice, by recommending a
freezing mixture of ice and salt to be laid directly upon the part to be
cut. Other surgeons were accustomed to put their patients into a
condition of either alcoholic intoxication or alcoholic stupor. Long-
continued compression of a part was also practised by some, by
which a limb could, as we say, be made to "go to sleep." A few
others recommended to produce faintness by excessive bleeding. It
was in 1776 that the arch-fraud Mesmer entered Paris and began to
initiate people into the mysteries of what he called animal
magnetism, which was soon named mesmerism, after him.
Thoroughly degenerate and disreputable as he was, he nevertheless
taught people some new truths, which many of them learned to
their sorrow, while in the hospitals of France and England severe
operations were performed upon patients thrown into a mesmeric
trance, and without suffering upon their part. That a scientific study
of the mesmeric phenomena has occupied the attention of eminent
men in recent years, and that hypnotism is now recognized as an
agent often capable of producing insensibility to pain is simply true,
as these facts have been turned to the real benefit of man by
scientific students rather than by quacks and charlatans.
In 1799, Sir Humphrey Davey, being at that time an assistant in the
private hospital of Dr. Beddoes, which was established for treatment
of disease by inhalation of gases, and which he called The
Pneumatic Institute, began experimenting with nitrous oxide gas,
and noticed its exhilarating and intoxicating effects; also the relief
from pain which it afforded in headache and toothache. As the
results of his reports, a knowledge of its properties was diffused all
over the world, and it was utilized both for amusement and
exhibition purposes. Davey even wrote as follows of this gas:
As nitrous oxide, in its extensive operation, appears capable of
destroying physical pain, it may probably be used with advantage
during surgical operations in which no great effusion of blood takes
place.
It is not at all unlikely that Colton and Wells, to be soon referred to,
derived encouragement, if not incentive, from these statements of
Davey. Nevertheless, Velpeau, perhaps the greatest French surgeon
of his day, wrote in 1839, that "to escape pain in surgical operations
is a chimera which we are not permitted to look for in our day."
Sulphuric ether, as a chemical compound, was known from the XIII
Century, for reference was made to it by Raymond Lully. It was first
spoken of by the name of ether by Godfrey, in the Transactions of
the London Royal Society, in 1730, while Isaac Newton spoke of it as
the ethereal spirits of wine. During all of the previous century it was
known as a drug, and allusion to its inhalation was made in 1795 in
a pamphlet, probably by Pearson. Beddoes, in 1796, stated that "it
gives almost immediate relief, both to the oppression and pain in the
chest, in cases of pectoral catarrh." In 1815, Nysten spoke of
inhalation of ether as being common treatment for mitigating pain in
colic, and in 1816 he described an inhaler for its use. As early as
1812 it was often inhaled for experiment or amusement, and so-
called "ether frolics" were common in various parts of the country.
This was true, particularly for our purpose, of the students of
Cambridge, and of the common people in Georgia in the vicinity of
Long's home. It probably is for this reason that a host of claimants
for the honor of the discovery appeared so soon as the true
anesthetic properties of the drug were demonstrated.
There probably is every reason to think that, either by accident or
design, a condition of greater or less insensibility to pain had been
produced between 1820 and 1846, by a number of different people,
educated and ignorant, but that no one had the originality or the
hardihood to push these investigations to the point of determining
the real usefulness of ether. This was partly from ignorance, partly
from fear, and partly because of the generally accepted impossibility
of producing safe insensibility to pain. So, while independent claims
sprang up from various sources, made by aspirants for honors in this
direction, it is undoubtedly as properly due to Morton to credit him
with the introduction of this agent as an anesthetic as to credit
Columbus with the discovery of the New World, in spite of certain
evidences that some portions of the American continent had been
touched upon by adventurous voyagers before Columbus ever saw
it.
The noun "anesthesia" and the adjective "anesthetic" were
suggestions of Dr. Oliver Wendell Holmes, who early proposed their
use to Dr. Morton in a letter which is still preserved. He suggests
them with becoming modesty, advises Dr. Morton to consult others
before adopting them, but, nevertheless, states that he thinks them
apt for that purpose. The word anesthesia, therefore, is just about of
the same age as the condition itself, and it, too, deserves
commemoration upon this occasion.
As one reads the history of anesthesia, which has been written up by
a number of different authors, each, for the main part, having some
particular object in view, or some particular friend whose claims he
wishes especially to advocate, he may find mentioned at least a
dozen different names of men who are supposed to have had more
or less to do with this eventful discovery. But, for all practical
purposes, one may reduce the list of claimants for the honor to four
men, each of whose claims I propose to briefly discuss. These men
were Long, Wells, Jackson and Morton. Of these four, two were
dentists and two practising physicians, to whom fate seems to have
been unkind, as it often is, since three of them at least died a violent
or distressing death, while the fourth lived to a ripe old age,
harassed at almost every turn by those who sought to decry his
reputation or injure his fortunes.
Crawford W. Long was born in Danielsville, Ga., in 1816. In 1839 he
graduated from the Medical Department of the University of
Pennsylvania. In the part of the country where Long settled it was a
quite common occurrence to have what were known as "ether
frolics" at social gatherings, ether being administered to various
persons to the point of exhilaration, which in some instances was
practically uncontrollable. Long's friends claim that he had often
noticed that when the ether effect was pushed to this extent the
subjects of the frolic became oblivious to minor injuries, and that
these facts, often noticed, suggested to his mind the use of ether in
surgical operations. There is good evidence to show that Long first
administered ether for this purpose on the 30th of March, 1842, and
that on June 6th he repeated this performance upon the same
patient; that in July he amputated a toe for a negro boy, but that the
fourth operation was not performed until September of 1843. In
1844 a young man, named Wilhite, who had helped to put a colored
boy to sleep at an ether frolic in 1839, became a student of Dr.
Long's, to whom Long related his previous experiences. Long had
never heard of Wilhite's episode, but had only one opportunity, in
1845, to try it, again upon a negro boy. Long lived at such a distance
from railroad communication (130 miles) as to have few advantages,
either of practice, observation or access to literature. Long made no
public mention of his use of ether until 1849, when he published An
Account of the First Use of Sulphuric Ether by Inhalation as an
Anesthetic in Surgical Operations, stating that he first read of
Morton's experiments in an editorial in the Medical Examiner of
December, 1846, and again later; on reading which articles he
determined to wait before publishing any account of his own
discovery, to see whether anyone else would present a prior claim.
No special attention was paid to Long's article, as it seemed that he
merely desired to place himself on record. There is little, probably no
reasonable doubt as to Long's priority in the use of ether as an
anesthetic, although it is very doubtful if he carried it, at least at
first, to its full extent. Nevertheless Long was an isolated observer,
working entirely by himself, having certainly no opportunity and
apparently little ambition to announce his discovery, and having no
share in the events by which the value of ether was made known to
the world. Long's strongest advocate was the late Dr. Marion Sims,
who made a strong plea for his friend, and yet was not able to
successfully establish anything more than has just been stated. As
Dr. Morton's son, Dr. W. J. Morton, of New York, says, when writing
of his father's claim: "Men used steam to propel boats before Fuller;
electricity to convey messages before Morse; vaccine virus to avert
smallpox before Jenner; and ether to annul pain before Morton."
But these men are not generally credited with their introduction by
the world at large and, he argues, neither should Long or the other
contestants be given the credit due Morton himself. In fact, Long
writes of his own work that the result of his second experiment was
such as to make him conclude that ether would only be applicable in
cases where its effects could be kept up by constant use; in other
words, that the anesthetic state was of such short duration that it
was to him most unsatisfactory. Sir James Paget has summed up the
relative claims of our four contestants in an article entitled Escape
from Pain, published in the Nineteenth Century for December, 1879.
He says:
"While Long waited, and Wells turned back, and Jackson was
thinking, and those to whom they had talked were neither acting nor
thinking, Morton, the practical man, went to work and worked
resolutely. He gave ether successfully in severe surgical operations;
he loudly proclaimed his deeds and he compelled mankind to hear
him."
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