July 27: The Halls of Medicine, or, Against Nostalgia

"The Gross Clinic"! Eakins! Culture up your Sunday!

I think you need to be a bit of an antiquarian for a project like this to be appealing, although my suspicion is that the culture trapped between the covers of the Classics was, in 1908 (or even 1930, which is my edition), a usable past and not just a curio like it is now. There have been, like, two or three modernities since then, and so an interest in Plutarch et al. is now as eccentric as a straw boater.

But of course drinking in a love of the past can quickly turn into a bender of nostalgia, which has always seemed to me to be a decadent and narcotic emotion. Today's reading, Joseph Lister on the antiseptic principle brings us a little cure for it:

I left behind me in Glasgow a boy, thirteen years of age, who, between three and four weeks previously, met with a most severe injury to the left arm, which he got entangled in a machine at a fair. There was a wound six inches long and three inches broad, and the skin was very extensively undermined beyond its limits, while the soft parts were generally so much lacerated that a pair of dressing forceps introduced at the wound and pushed directly inwards appeared beneath the skin at the opposite aspect of the limb.

The 1867-era language (this is an extremely polysyllabic selection today) helpfully puts a little bit of a screen over how gross that is. Or this:

In April last, a volunteer was discharging a rifle when it burst, and blew back the thumb with its metacarpal bone, so that it could be bent back as on a hinge at the trapezial joint, which had evidently been opened, while all the soft parts between the metacarpal bones of the thumb and forefinger were torn through. I need not insist before my present audience on the ugly character of such an injury.

No, you needn't. Lister's point is, before is invention of antiseptic bandaging, these people would have been prime suspects for raging infections, which, in a hospital, have a cascading effect:

Previously to its [antiseptics] introduction the two large wards in which most of my cases of accident and of operation are treated were among the unhealthiest in the whole surgical division of the Glasgow Royal Infirmary, in consequence apparently of those wards being unfavorably placed with reference to the supply of fresh air; and I have felt ashamed when recording the results of my practice, to have so often to allude to hospital gangrene or pyæmia.

"Hospital gangrene" -- so common it had a name. (And, in fact, hospitals are still dandy places to catch infections, but that's a consequence of our eternal arms race against tiny microbes. At least hospitals aren't miasmas, as before.)

Out of which I draw the following two obvious conclusions: 1) While some things never change in human affairs, some things do. Perhaps infection once seemed as inevitable as nuclear weapons do today. It doesn't do to be to pessimistic. 2) Not to get too Julian Simon, but Lister was inspired by Pasteur's work, and, having invented away to keep people around longer, no doubt helped springboard more useful inventions. In some ways the cause of our current environmental fix -- billions and billions of people around -- could also be the solution to it, if the billions are sufficiently inventive.

That's a little more portentous than I like to be, so here's a picture of a straw boater: