Anaesthesia, hospitalism, hermaphroditism, and a proposal to stamp out small-pox and other contagious diseases

Front matter

/ddl

TRANSFERRED TO

YALE MEDICAL LIBRARY

Chap. III. Modern History of Anaesthesia {continued) . 18

1. Tendency to Confusion from the Discovery of Chloroform

rapidly following that of Sulphuric Ether . . 23

2. Earliest Anaesthetic Operations in America, and their

Connection with Hartford and Boston . . 25

3. Etherisation, or Anaesthesia, in Midwifery . . 31

4. Alleged Neglect of American Claims in writing a Sketch

of the History of Anaesthetics . 35

Part Ii.— Defences Of Anaesthesia

Chap. I. Answer to the Eeligious Objections advanced against the employment of Anaesthetic Agents in Midwifery and Surgery . . 42

Chap. II. Same Subject continued, in a Letter to Dr. Protheroe Smith

of London . . ... 56

Chap. III. Mere Opinions and Prejudgments not sufficient to settle the Question of the Propriety or Impropriety of Anaesthetic Agents : Illustrated from the History of Vaccination . 65

Chap. IV. The Prevention of Pain in Surgical Operations alleged to be Unnecessary and Improper . 75

C'HAr. V. Pain in Operations from a Patient's Point of View . . 86

Chap. VI. Does Anaesthesia increase or decrease the Mortality attendant upon Surgical Operations ? . 93

V1U CONTENTS.

FAOE

Chap. VII. Answer to Objections to Anaesthesia in Midwifery . 108

Chap. VIII. Answer to the Objections to Anaesthesia in Midwifery, adduced

by Professor Meigs of Philadelphia . . 117

Chap. IX. Reply to other Minor Objections to Anaesthesia in Midwifery 138

Chap. X. Alleged Difficulties in the Superinduction of Anaesthesia . 141

Chap. XI. Remarks on the occasional Fatal Result of the Administration

of Chloroform, with cases of Sudden Death during Surgical

Operations without Anaesthetics 143

PART HI.— THE NATURE AND POWER OF VARIOUS ANAESTHETIC AGENTS.

Chap. II. On the production of Local Anaesthesia in the Lower Animals . 256

Chap. III. On the production of Local Anaesthesia in the Human Subject 260 Chap. IV. Practical Application of Chloroform as a Topical Anaesthetic

to Mucous and Cutaneous Surfaces . 269

Chap. V. Carbonic Acid Gas as a Local Anaesthetic . 276

Chap. VI. Parts and Surfaces to which Carbonic Acid may be applied . 285 1 to 5. Vagina and Uterus ; Rectum and lower end of Intestinal Canal ; the Interior of the Stomach ; the Surface

of the Tongue ; the ulcerated Surface of the Skin, etc. 285

6. The Mucous Surface of the Eye . . 285

7. The Mucous Surface of the Bladder . 285

8. The Mucous Surface of the Trachea and Lungs 287

9. To External Wounds and Burns . 287

HOSPITALISM.

Chap. I. Country Amputation Statistics 289

1. Preliminary Remarks . . . 289

2. Mortality of the Major Amputations of the Limbs in

Private Country and Provincial Practice . 292

C 2098 Country Amputations i Chap. II. Statistics of \ I ' 305

( 2089 Hospital Amputations J

1. Some minor points pertaining to the Collection of Ampu-

tations ... . 305

2. Causes of Death in the Fatal Cases of Amputation 310

3. Classes of Patients on whom the Two Thousand Amputa-

tions were performed, and the general Character of their Habitations . . 313

4. Severity of some of the Cases that recovered 317

5. Opinions as to Amputations, etc., succeeding better in

Private Country than in Public Hospital Practice 322

6. Evidence of Increased Success in Amputations from

Increased Experience . . . 324

7. On the Results of Limb-Amputations in Private Practice

in other Countries . 327

8. Mortality of the Four Major Amputations in Large and

Metropolitan Hospitals . . . 329

9. The Proportionate Death-rate and the excess of Mortality

of Limb-Amputations in large and Metropolitan Hospitals as compared with Country Practice . 338

X CONTENTS.

PAOE

Chap. VI. How our Present Hospitals could be most easily altered, in

order to render them more Salubrious . . 400

HERMAPHRODITISM.

Varieties of Hermaphroditism . . 407

Spurious Hermaphroditism . . 410

True Hermaphroditism . . . 432 Hermaphroditism as manifested in the General Conformation of the

Body and in the Secondary Sexual Characters . . 479

Kemarks on the Natoe of True Hermaphroditic Malformations . 500

Causes of Hermaphroditic Malformations . . . 532

Bibliography . 540

PROPOSAL TO STAMP OUT SMALL- POX AND

OTHER CONTAGIOUS DISEASES 543

PAET L

HISTORY OF ANESTHESIA.

CHAPTEE I.

ANCIENT HISTORY OF ANESTHESIA.

The idea of saving by some artificial means the human body from the pains and tortures inflicted by the knife of the surgeon is by no means a thought first broached or first acted upon in recent times. For the production of anaesthesia a variety of measures had been suggested and employed long before the introduction of sulphuric ether and chloroform.

We may consider these means under several heads, according as the insensibility to pain was to be effected either —

1. By the inhalation of gases or vapours.

2. By mechanical means.

3. By the internal administration of drugs.

1. Ancesthesia by the inhalation of vapours or gases. — Under this head I may mention the following suggestions: — In 1795 Dr. Pearson proposed the inhalation of sulphuric ether (and he appears to have been the first to do so), but apparently only for the purpose of relieving the cough in asthma, etc., and not for producing general anaesthesia. In 1816 Nysten introduced a special apparatus for its inhalation. In 1800 Sir H. Davy recommended the employment of nitrous oxide gas for the relief of pain in the extraction of teeth and other minor surgical operations, and he also described the effects it had on himself when he inhaled it to relieve local pain. Thus, he says : — " The power of the immediate operation of the gas in removing intense physical pain, I had a very good opportunity of ascertaining. In cutting one of the unlucky teeth called dentes sapientise, I experienced an extensive inflammation of the gum, accompanied with great pain, which equally destroyed the power of VOL. II. B

2 IIISTOKY OF AN/ESTHESIA.

repose and of consistent action. On the day when the inflammation was most troublesome I breathed three large doses of nitrous oxide. The pain always diminished after the first four or five inspirations, the thrilling came on as usual, and uneasiness was for a few minutes swallowed up in pleasure. As the former state of mind, however, returned, the state of organ returned with it ; and I once imagined that the pain was more severe after the experiment than before." '

Sir H. Davy recommended its employment in surgery in the following words : — " 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."2

Dr. Hickman also, in 1828, suggested the inhalation of carbonic acid, as a means of producing insensibility in surgical operations.

There were other agents used for this purpose in more ancient times, which, although they produced their effects by inhalation of their vapours, I may describe more conveniently under the third of these divisions.

2. Anastlicsia by mechanical means. — In 1784 Dr. Moore proposed to bring about local anaesthesia of limbs during surgical operations, by compressing the nerves supplying them. He tried this method in a case in Dr. Hunter's practice, applying a tourniquet for an hour before the operation, to compress the nerves, with, however, only partial success. Malgaigne also tried the tourniquet, but with no better result, for he found that the instruments used for the compression of the nerves themselves produced considerable pain. This mode had been suggested, I may observe, by Ambrose Pare long before Moore's time. It was supposed at one time that compression of the carotid arteries, and consequent diminution of the supply of blood to the brain, would be successful in producing anaesthesia; and this plan was even put into practice by Valverdi, Hoffman, and others, in the sixteenth and seventeenth centuries. Morgagni mentions that this practice was followed in the dissecting-room on animals to induce anaesthesia, and he also suggests its use in the human subject. There is not the least doubt that it will induce stupor or coma, and that, moreover, with extreme rapidity. This is too frequently proved in cases of garrotting, of which an instance is on record where stupor was successfully produced, and robbery committed, between the time of the victim ringing his door-bell and the servant answering the summons. This method was again lately

1 Chemical and Philosophical Experiments, p. 464. 2 Idem, p. 566.

ANCIENT HISTORY. 3

proposed for employment in surgery some years ago by Professor Fleming.

3. Ancesthesia by internal administration of drugs. — In various authors, both of ancient and modern times, we read of drugs used to induce anaesthesia, but we can seldom make out exactly what were the substances employed.

In the Medical Gazette, vol. xli. p. 515, Dr. Sylvester quotes a passage from a German work by Meissner, called Skizzen, published in 1782, to the following effect : —

" Augustus, King of Poland and Elector of Saxony, suffered from a wound in his foot, which threatened to mortify. The Court medical men were opposed to the operation of amputation, but during sleep, induced by a certain potion surreptitiously administered, his favourite surgeon, Weiss, a pupil of Petit of Paris, cut off the decaying parts. The royal patient was disturbed by the proceeding, and inquired what was being done, but on receiving a soothing answer he again fell asleep, and did not discover till the following morning, after his usual examination, that the operation of amputation had really been performed."

Opium has been suggested at various times, but the dose which would be required to produce anaesthesia would be so large that no one could safely administer it. We know, however, that formerly two substances were held in great repute by patients about to undergo surgical operations, and also by criminals condemned to suffer torture. Those drugs were Indian hemp (Cannabis sativa, var. Indica) and mandragora (Atropa mandragora, but now called Mandragora officinalis). It will be interesting, if not advantageous, to consider the history of each of these separately, and somewhat in detail.

Indian Hemp. — Sir Joseph Banks alludes to the preparation and use of this drug in various parts of the east from Morocco to China, in which countries it goes under the names of bang, churrus, and gunjah. He mentions that, when any preparation of this plant is swallowed, the mind is immediately filled by a delicious succession of pleasant ideas, which banish all cares and produce a perfect indifference to pain. This state is, however, soon followed by sleep. The drug is more especially used by criminals doomed to suffer torture, and it seems to be what is taken by the Hindoo Suttee to give her powers of endurance. Some years ago an old Chinese manuscript was laid before the French Academy by M. Julien, in which the use of Indian hemp for annulling the pain in cauterisation and surgical operations is mentioned as having been had recourse to by a practitioner by name Hoa-tho, as early as the third century, that is about 1500 years ago.

In this manuscript, which is called Koukin-i-ting, we find the following passage : — " He (Hoa-tho) gave to the patient a preparation of hemp (Ma-yo), and at the end of some instants he became as insensible as if he had been drunk, or deprived of life ;" and a little farther on it is remarked that, " after a certain number of days the patient found himself re-established, without having experienced the slightest pain during the operation."

We can trace the use of Indian hemp still farther back, for some divines maintain that the draught offered to our Saviour on the cross was some preparation of Indian hemp.

A preparation of the same drug is probably referred to by the prophet Amos, 700 years before Christ, as the " wine of the condemned."2

The effect of the inhalation of the vapour of burning hemp is mentioned by Herodotus, who also tells us of its use by the Massagetee and by the Scythians to produce excitement. Thus, talking of the Massagetse, he says " that they have discovered other trees that produce fruit of a peculiar kind, which the inhabitants, when they meet together in companies, and have lit a fire, throw on the fire as they sit round in a circle ; and that, by inhaling the fumes of the burning fruit that has been thrown on, they become intoxicated by the odour, just as the Greeks do by wine ; and that the more fruit is thrown on the more intoxicated they become, until they rise up to dance, and betake themselves to singing."3

Again, when describing another tribe of the Scythians, he informs us that " they have a sort of hemp growing in this country, very like flax, except in thickness and height ; in this respect the hemp is far superior ;"4 and a little farther on he informs us that, "when therefore the Scythians have taken some seed of this hemp, they creep under the cloths, and then put the seed on the red-hot stones ; but this being put on, smokes, and produces such a steam that no Grecian vapour-bath would surpass it. The Scythians transported with the vapour, shout aloud ; and this serves them instead of washing, for they never bathe the body in water."

Homer also gives us an account of the effect on Ulysses and his companions of drinking some preparation, which he called Nepenthe, and the phenomena he describes are so like those produced

1 Mark xv. 36. 2 Amos ii. 8. 3 Cary's Herodotus, i. 202.

* Cary's Herodotus, iv. 74.

ANCIENT UISTOIIY. 5

by hemp that we may conclude it was of this substance they made use. He tells us that the Jove-descended Helen planned other things, and that " she straightway cast a drug into the wine, from whence they were drinking, that frees men from grief and from anger, and causes oblivion of all ills. Whoever should drink down this, when it is mixed in a cup, would not shed a tear down his cheeks for a whole day, not even if both his mother and father should die, nor if they should slay with the steel a brother or a beloved son before him, and he should behold it with his eyes. Such cunning and excellent drugs the daughter of Jove possessed, which Polydamnia, the wife of Thon, gave her, an Egyptian." 1

Pliny also mentions this drug (Indian hemp) in his Natural History? but he does not speak of its inhalation, but merely remarks that it was used for making ropes.

Mandragora. — This plant was most extensively used by Hugo of Lucca in the twelfth century, and the preparation employed by him is described to us by his son and successor, Theodoric, who died in 1298, under the name of the Spongia somnifera, that is the somniferous ball, or sponge, or apple. In his Chirurgial, which he published on entering the church, and in which he made known most of the chemical preparations and rules of the art of surgery which had been followed by Hugo, who had, however, kept them all secret, we find that this somniferous sponge was prepared according to the following prescription : — " Take of opium, of the juice of the unripe mulberry, of hyoscyamus, of the juice of hemlock, of the juice of the leaves of mandragora, of the juice of the woody ivy, of the juice of the forest mulberry, of the seeds of lettuce, of the seeds of the dock which has large round apples, and of the water-hemlock — each an ounce ; mix all these in a brazen vessel, and then place in it a new sponge ; let the whole boil, as long as the sun lasts on the dog-days, until the sponge consumes it all, and it has boiled away in it.'"1

He then goes on to describe the way in which this sponge is to be used — " As oft as there shall be need of it, place this sponge in hot water for an hour, and let it be applied to the nostrils of him who is to be operated on, until he has fallen asleep, and so let the surgery be performed."

He then tells us how to rouse the patient after the operation is over. " This being finished, in order to awaken him, apply another

1 Homer by Buckley, Odyssey, iv. 219. 2 Hist. Kid. xix. 36.

3 Chirurgial, iv. 3.

sponge, dipped in vinegar, frequently to the nose, or throw the juice of the root of fenugrek into the nostrils ; shortly he awakens."

This preparation was, however, gradually abandoned, perhaps from its occasionally causing, as we are told by Aretseus, convulsions and coma, and in some cases even death. In the works of M. Chamappe, published in 1534, we learn that this somniferous sponge was still in use in his time ; but it must have been very nearly abandoned then, for towards the close of that century Pare tells us that it was a practice " used formerly " by operators.

But we find many allusions made to the anaesthetic effect of mandragora by ancient authors, among which I may mention the following : —

Dioscorides refers to the effects of the drug in several passages thus : —

" Some persons boil the root in wine down to a third part, and preserve the decoction, of which they administer a cyathus in want of sleep and severe pains of any part, and also before operations with the knife or the actual cautery, that they may not be felt."1

" There is prepared also, besides the decoction, a wine from the bark of the root, three niinse being thrown into a cask of sweet wine ; and of this three cyathi are given to those who are to be cut or cauterised as aforesaid ; for, being thrown into a deep sleep, they do not perceive pain."2

Again, when speaking of another kind of mandragora, which he calls morion, he says —

" They relate that a drachm of it being taken as a draught, or eaten in a cake or other food, causes infatuation, and takes away the use of the reason. The person sleeps without sense, in the attitude in which he ate it, for three or four hours afterwards. Medical men also use it when they have to resort to cutting or burning."3

Pliny, speaking of mandragora, says, " It has the power of causing sleep in those who take it. The dose is half a cyathus. It is taken against serpents, and before cuttings and puncturings, lest they be felt. For these purposes it is sufficient for some persons to have sought sleep from the smell." 4 Apuleius, after telling us that there are two plants of mandragora, one male and the other female, which have the power of even causing death, remarks —

" If any one eat it he will immediately die, unless he be treated with butter and honey, and vomit quickly. Further, if any one is

1 Dioscorides, iv. 76. 2 Ibid. 8 Ibid. 4 Hist. Nat. xxv. 94.

ANCIENT HISTOEY. 7

to have a member mutilated, burned, or sawn, let him drink half an ounce with wine, and let him sleep till the member is cut away without any pain or sensation.'"

Aurelianus talks of the " wandering of the mind " which occurs " in those who have drunk mandragora or altercus." 2 Baptista Porta, in his Natural Magic,3 which was published in 1608, speaks of the account given of the drug by Dioscorides, who " says that those men who have drunk mandragora will sleep, all their senses being entirely lost, for three or four hours after they have taken it, and that medical men use this plant when they wish to cut or burn anybody." A little further on he informs us how to prepare a sleeping apple " with opium, mandragora, juice of the water-hemlock, seeds of hyoscyamus, and to these musk is added to impart an agreeable odour, collected into a mass as large as one can hold in his fist ; this, he adds, " when repeatedly smelt, softens down and binds the eyes in sleep." Subsequently he states that " it is possible to extract from several soporific plants a quintessence, which is tp be shut up in well covered leaden vessels, lest the drug should evaporate. When it is to be used, the lid is to be removed and the medicament held to the nostrils, when its vapour will be drawn in by the breath and attack the citadel of the senses, so that the patient will be sunk in the deepest sleep, not to be shook off without much labour. After sleep no headache remains, nor any suspicion of art. Such things," he adds, " are clear to a wise physician, to a wicked one obscure."

Columella also mentions mandragora, but does not say much about its use.4 Demosthenes mentions anaesthesia.5 The effects of mandragora are also alluded to by Galen, who concludes by remarking that those who are thus affected quickly lose the sense and motion of the whole body.6

Innumerable passages occur among more modern authors, from which we learn that deep sleep was brought on by anaesthetising draughts, but in most of those which I shall bring forward their nature and compositions are not told us.

In Le Proces Criminel by Claude Lebrun de la Eochette, we have the following remark as to the employment of such drags by criminals about to suffer torture : — " As to their artifices not to feel the pain of the rack, I saw in the first year of my reception at the

3 Natural Magic, viii. i. 4 Book x. 17. 5 Demosthenes, by Eeiske, 564-12.

0 Galen, vii. 207.

8 HISTOKY OF ANESTHESIA.

bar of Beaujolais, which was iu the year 1588, that one of four thieves, who were prisoners, — the chief named Grand Francois, a man of gigantic stature, was put to the rack, fell asleep, and the toes were torn from both his feet, without his manifesting any signs of pain. One of his companions observed that he had eaten soap which stupified the nerves. The remedy to the artifice is to give wine, which being brought and drunk, he then said he was dead, and without any further torture, freely confessed an infinite number of murders and robberies, to atone for which he and his companions were broken in the wheel by sentence of Master Thomassot, Provost of the Mareschals in Beaujolais."1

Shakespeare, in the tragedy of " Eomeo and Juliet," says —

"Within the infant rind of this weak flower Poison hath residence, and med'cine power : For this, being smelt, with that part cheers each part ; Being tasted, slays all senses with the heart." 2

And a little farther on he says —

" Take thou this phial, being then in bed, And this distilled liquor drink thou off : When, presently, through all thy veins shall run A cold and drowsy' humour ; for no pulse Shall keep his native progress, but surcease.

No warmth, no breath, shall testify thou liv'st ; The roses in thy lips and cheeks shall fade To paly ashes ; thy eyes' windows fall, Like death, when he shuts up the day of life ; Each part deprived of supple government, Shall still", and stark, and cold, appear like death ; And in this borrow'd likeness of shrunk death Thou shalt continue two-and-forty hours, And then awake as from a pleasant sleep. " 3

So also in " Cymbeline " we find the following lines :

" Those she has Will stupify and dull the sense awhile : Which first, perchance, she'll prove on cats and dogs ; Then afterward up higher ; but there is No danger in what show of death it makes, More than the locking up the spirits a time, To be more fresh, reviving." 4

In the works of Dio Bartas the following passage occurs :

" As the surgeon who desires to remove some incurable limb, before he approaches the knife to the diseased part, sends the patient

1 Book ii. p. 144. 2 Act ii. Scene 3.

3 Act iv. Scene 1. 4 Act i. Scene 6.

ANCIENT IIISTOKY. 9

to sleep by an iced beverage, then without any pain, guided by use and art, to save the entire man, cuts off a part." '

Boccaccio, in his Decameron, published in 1461, says — " It occurred that the surgeon had in hand a patient, one of whose limbs was diseased, and knowing whence the evil proceeded, told the man's friends that if a rotten bone in the leg was not removed, it would be necessary to cut off the limb or the patient would die ; but by removing the bone it might be cured ; however, he would not undertake the operation unless the patient were given up as dead. To this the family agreed. The surgeon, thinking that if the patient were not sent to sleep he would be unable to bear the pain, and would not permit the operation, deferred performing it till the following evening ; and distilled in the morning a water of a certain composition of his own, which, when the patient had drunk of it, would keep him asleep as long as the operation might last."8

Jacques Yver of Poitou remarks, in his " Printemps " — " And if I am so delighted (pardon me if I cannot lie) that, like a patient set to sleep with mandragora, for the purpose of cutting off a limb, I do not feel my disease." 3

The following extracts are from Guillaume Bouchet's work entitled Les Screes, published in 1554 : — " Others have written that if you take some marble from Grand Cairo, called by the ancients memphitis, reduce it to powder, and apply it as a liniment with vinegar, and lubricate with it the part to be cut off or cauterised, the patient will not feel much pain or inconvenience " (p. 39). " But if they have taken certain beverages, replied some one, what can the judge do ? For Albert affirms that the stone denominated memphitis, when pulverised and mixed with water and butter, and taken by the malefactor who is to be tortured, causes him to feel no pain. Cardow also says that a person anointed with opium, celandine, saffron, and the marrow and fat of a man, with oil of lizards, or if he drinks wine in which the seeds of portulasa marina has been steeped for a weeke, that will prevent him from feeling any pain, and consequently from confessing anything. However, according to some, De Marsilis, who believed in these charms, and employed counter-charms, is worthy of ridicule only ; they say it is proved that all the recipe for persons tortured, in order that they may feel no pain, is nothing more than soap dissolved in clean water, which

1 See Journal of Practical Medicine and Surgery, 1861. Eng. Edn. p. 139. 2 Idem. 3 Idem, pp. 139 and HO.

10 HISTOKY OF ANAESTHESIA.

is given to them to drink, and has the property of lulling the senses. I should deem it still better, says another — if Pliny tells the truth — that they gave in wine an herb named archimenides, to criminals suspected of any offence ; which, being drunk, sets to sleep, and in their sleep the confession of the fact may be drawn from them much better than by any other kind of torture and rack" (pp. 63 and 64). "And I think, added he, they could give me a potion which would prevent me from hearing the thunder, since the Turks administer to those they are about to castrate, cauterise, or amputate, a composition which makes them sleep so soundly that they suffer no pain " (p. 11 3).

I shall close my remarks on the ancient history of anesthetics in surgery, by quoting the following passage from Middleton's tragedy of " Women, beware Women,'' in which he alludes to the practice of setting patients to sleep before performing operations on them : —

" 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."

Tlic Hhslwy of Ancesthetics in Midwifery. — The ancients appear also to have attempted to relieve the pain attendant upon parturition by anaesthetising agents, as we may learn from various Greek writers. Such a practice is mentioned by Plautus in his Ophelion, and I may also quote the following passage. Theocritus says —

" For then the daughter of Antigone, weighed down with throes, called out for Lucina, the friend of women in travail, and she with kind favour stood by her, and in sooth poured down her whole limbs an insensibility to pain, and so a lively boy, like to his father, was born."' That author calls the insensibility to pain nodynia (vuduvia), which is a better word than anesthesia ; and I have often regretted not adopting it, rather than the latter. The composition of the various narcotic draughts in use for this purpose is not, however, recorded.

In Jocelyn's Life of St. Kentigern or St. Mungo of Glasgow,2 which is contained in the Vitoz Antiques Sanctorum Scotice, we read that Thenu, the saint's mother, was impregnated without her knowledge, under the influence of some anaesthetic potion. In consequence of this she was condemned to be cast down from the top of a high hill called Dunpelder, which was accordingly done, but, wonderful to say, she received no hurt. Not satisfied with this apparently divine interference, her judges then sentenced her to be

1 Idyl xviii. 2 Cap. i. et. seq.

ANCIENT HISTORY. 11

cast adrift in a small boat on the Firth of Forth, but she was safely floated across to Fife, and her boat stranded near a place called Collotious (Culross), where she was received and taken care of by St. Servanus, who taught near there, and in due time she was safely delivered of a son, the afterwards famous St. Kentigern, the first Christian in Scotland.