Travels in Europe and the East, embracing observations made during a tour through Great Britain... in the years 1834, '35, '36, '37, '38, '39, '40, and '41.

Front matter

1 ■

Mn

^v

Preface

In reflecting upon a suitable subject for an introductory lecture, after accepting of the Professorship of Surgery in the University of this city, with which I was honoured before my return from abroad, I knew of nothing that seemed more appropriate than a summary of the general observations which I had made on the progress and condition of medicine and surgery in the different countries I had visited during my six years' absence.

I found, however, that, to do justice to the theme I had proposed, it expanded to such volume on matters of miscellaneous interest to the general reader as well as on those strictly professional, that it might more properly assume the form of a book of travels.

In Great Britain, France, Germany, and Switzerland, it will be perceived that I have studiously avoided touching upon those tedious and trite subjects which have been completely worn threadbare by guide-books and tourists, and become repugnant and insipid by their repetition. My attention has been confined, in those countries named, almost exclusively to subjects of more special and piquant interest in my own profession. Instead of dilating on castles and cathedrals, palaces and parliaments, crowns and coronets, chateaus and courtiers,

VI PREFACE.

peers and princes, the military or commercial power, and statistical condition of this or that people, I have selected a theme which more deeply interests the welfare of the whole human race, and appeals more directly to all the sympathies and charities of the heart than anything w^hich is purely political, or which relates merely to that artificial state of society which constitutes the difference between one nation, or form of government, and another.

The healing art is one which concerns alike the whole human family ; and wherever I have travelled I have endeavoured to study the masses of population in all those physical and social relations, habits, and customs, mental and corporeal pursuits, localities and climates, which might seem to me to suggest anything curious or useful, in illustrating the progress and present condition of the most useful of sciences, that which may remove or relieve human suffering, and add to the general amount of human happiness in every part of the earth.

While, therefore, the first third of this book, under the heads of Great Britain, Ireland, France, Belgium, Holland, Germany, and Switzerland, will be found to embrace almost exclusively matters seldom dwelt upon by tourists, and that relate to medical science and to details of interviews with some of the more extraordinary individuals of my profession, and visits to the more celebrated hospitals and medical schools; it will be perceived that, as we advance into the more ancient countries of Southern Europe and the East, the degraded

PREFACE. Vll

condition of medicine there, and the consequent prevalence of various endemial and epidemic diseases w^hich have thereby become almost hereditary among those enslaved nations, furnish again occasion to revert to the prouder epochs of their history in bygone ages, and w^hich are vividly recalled to us in the magnificent and classic ruins which they have left as monuments of the elevated intellectual and social rank which they once had reached.

In the greater and concluding portion of this volume, therefore, which comprises Italy, Greece, Egypt, Asia Minor, and Turkey, it will be found that professional subjects necessarily occupy but a very limited space, and that we have consequently dwelt upon those objects in that part of the world which so intensely absorb and captivate all who make a pilgrimage thither to mourn over the ruins of a land that was once adorned by the most powerful and polished nations that ever existed.

At every step some vast edifice, some shattered column or mouldering temple, some pointed obelisk or towering pyramid, furnishes a theme for fruitful meditation, and admonishes us of the transitory duration of human glory. They foretel that the same sceptre of power and of civihzation which has passed from the Pharaohs and the Ptolemies, from Cambyses and Xerxes, and Alexander and Titus, and the Caesars and the Caliphs — which descended successively to the Egyptian, the Mede, the Persian, the Greek, and the Roman, and the Saracen, ultimately into the possession of Northern and Western Europe — will, in all probabihty, continue its onward

Vlll PREFACE.

course to this other and American hemisphere, to whom, next to Western Europe, seems to be assigned the destiny to become the inheritors of the unextinguished and unextinguishable and Divine Ught of mental and of moral culture, but which may again depart from us to be revived once more in that benighted Eastern Asia, which was, perhaps, the first cradle of its existence.

When I left my country, the impaired state of my health too much occupied me to suppose that I should ever have it in my power to undergo the perils and fatigues, the severe personal sufferings, in fact, from climate, want of food, and every comfort, which I found myself, as I advanced in my travels, more and more capable of enduring. My nerves became strengthened and hardened, in truth, by these privations ; and to this, therefore, am I indebted for being enabled now to present some of the fruits of the trials and dangers which I cheerfully and voluntarily submitted to, and which I hope may not prove unacceptable to my countrymen.

The following observations, which comprise the exordium of the introductory lecture to which I have alluded, will explain the object of my visit abroad, and the fortunate issue which it had in the restoration of my health.

Introduction

Through the favour of a Divine and Superintending Providence, which has protected me in my long absence, and restored me to health, am I indebted for this opportunity of addressing myself to my fellow-citizens.

To my countrymen, in truth, am I placed under lasting obligations for their very kind and flattering opinion of me ; and to this, doubtless, am I greatly indebted for the many courtesies extended towards me during my residence abroad. Their sympathies for me, when my health and energies were overtasked by laborious professional duties, tended to cheer my darkest hours of despondency, in whatever land or clime I travelled or sojourned.

The efficacy of foreign travel, as a remedial measure, is felt in a particular manner in that distressing class of maladies commonly known as Nervous Diseases. They are, for the most part, imputable to exhausted excitability, from over exertion of the mental and corporeal faculties, undermining that primary source of life, of sensation, and motion — the brain. The pressure of unremitted and severe application had, in my own case, wrought a dangerous dilapidation of all the vital forces. The digestive organs partook largely of the general debility ; and, as is usual in such cases, a train of alarming symptoms were produced, which closely counterfeited, by sympathetic influence, all the phenomena of radical organic disease. Though our medical judgment, under such circumstances, may come to the full conviction that no serious lesion or injury of an organic character exists, and that the symptoms may be legitimately deducible solely from those of an atonic or debilitated condition of the nervous functions, yet is the facsimile to real disease so ex-

X INTRODUCTION.

act and perfect, and the sufferings of the patient, both in body and mind, so entirely in accordance with those of positive mutations of structure, that argument can but poorly contend with the fearful and depressing images with which our morbidly excited feelings and ideas are discoloured. In their effect, therefore, upon the mind, these idiopathic or purely nervous derangements of the functions only of the cerebral tissues, are as painful and distressing in their results as where actual organic alterations have become hopelessly ingrafted upon the system.

To pluck out these ideal sorrows from the mind, no other alternative remains but that of severing, for the time, all connexion with those associations, scenes, or pursuits which have been the fostering and insidious source of the mischief. In resorting to this expedient, my friends may be assured that the trial was one of intense suffering to me. But neither the pleasures nor attractions of foreign climes have had sufficient power to make me forget my native land, or to corrode or break that chain which must forever bind me to my country.

When the invalid, whose health has been broken down by the causes mentioned, bids adieu, to his own shores, his mind clings with fond recollection only to the brightest side of the picture that he has left behind. It revels on all those endearing thoughts of home, of kindred, and of friends, that have from birth, and the joyous days of childhood, twined their treasured associations around the heart. It finds a delightful solace in recurring to that valued esteem with which our name or usefulness is cherished in the memory of those from whom we are separated, and which, to me, has been my support and consolation throughout my wanderings. The darker side of the picture, the lacerated and wounded feelings, the humiliated pride, which our profession are doomed to encounter at the bedside of the sick and dying, when all our efforts to give relief prove vain ; together with all other painful reminiscences, are

" In the deep bosom of the ocean buried."

INTRODUCTION. XI

In exchange for these, the mind is renovated and refreshed by the tonic influence of those ever-changing novel scenes, which the tableau of human life in the Old World is constantly unfolding to our observation. New ideas, and feelings, and impressions arise, upon the ruins of corroding thoughts, that have been suspended or crushed ; and while the intellectual repast is thus constantly being offered to our acceptance, in some more and more grateful excitement, none are permitted to imprint themselves so deeply upon the mind as to fatigue or weary by their monotony or insipidity. The magic wand of health is in our own hands, and may be called to dissipate all morbid fancies, or summon to our aid whatever is most pleasing.

It is true that no American, with the sound and luminous conceptions of political rights in which he has been educated, breathing from birth the pure air of liberty, and nurtured under the sun of our own brilliant and transparent skies, that shine alike on all, can, in other countries, much as he beholds to astonish and delight him, feel otherwise than disappointed with their political and social abuses, and proud when he compares the population of the New World with that of the Old.

Beautiful as are " the solemn temples and gorgeous palaces," which cast the shadow of their ivy-mantled towers over widely-extended fields of flowery verdure ; instructive as are these ancient monuments which we behold, of the glorious achievements of the past, the reflection involuntarily forces itself upon the judgment of every American who contemplates them, that these proud productions of human art and skill are but too often the chroniclers of human suffering, of the triumphs of overgrown monarchical power, and of the reign of dark superstition.

Even in that second Eden, England, that " imperial gem set in the silver sea," these evidences of the concentrated wealth and overshadowing dominion of Church and State, strike the observer with peculiar force. But even here, where every hamlet and hedge seems invested with the enchantment of poesy and of fable ; where every le-

Mil INTRODUCTION.

gend, ballad, and tradition of by-gone days are mirrored in each mouldering battlement and clustering woodbine ; where such outward and imposing signs of comfort and opulence arrest our notice at every step, we cannot exclude from our thoughts the conviction, so revolting to the sensibilities of a true philanthropist, that, even under this pleasing exterior, the most deplorable extremes of poverty and affluence constitute the two dominant attributes of social existence.

To my own beloved country, then, I gladly and exultingly return, with attachments tenfold stronger, if possible, to her matchless institutions, than even those which I felt pressing and crowding around my thoughts as I (lingered on the last crimson gleams of the twilight, fading behind' the blue hills of the Neversink, and/ bade my native land adieu I I come back, if possible, a still better American than when I left ; and, from the comparison I have made of the condition of the populations of other countries, feel still more deeply impressed with the conviction, that our own republican form of government is infinitely and immeasurably preferable to that of any other that has ever existed. That the blessings of liberty and equality, and of that bulwark and ark of our future hopes, education and the freedom of the press, are here alone prodigally and equably diffused, and alike shared and enjoyed by every citizen ; that the laws under which we live are here enacted and enforced, and may be modified or abrogated by our own free-will and consent ; that there are no hereditary classes, nor lordly castles, nor grasping nobles, nor mitred prelates, to arrogate to themselves a divine authority over their fellow-creatures, and the privilege to hold in bondage, and depredate upon the rights, the person, and the property of vassal serfs and peasantry.

To our own bright skies and pure air, to our own spangled banner, whose

" Hues were born in heaven,"

I look upward again with unmingled pride, as emblems of the land whose people have had the inborn grandeur of mind, and nobleness of heart, and directness of purpose, to project

INTRODUCTION. XllI

and complete a superstructure of government, which confers the same measure of political and social privileges, and a far greater amount and aggregate of human happiness upon every citizen, than was ever distributed to any nation, either in past or present times.

That political edifice is the chef d'csuvre of two hundred years of sleepless toil, of patient investigation, and bloody struggles in the discussion and defence of human rights, through the long and dark night of colonial servitude, till the sacred principles of civil and religious liberty, which our early forefathers planted upon these then wild and inhospitable shores, were consummated to ripe maturity under the bright dawn, and through the matchless heroism, of our immortal Revolution.

That beautiful structure possesses the elements of enduring strength and prosperity ; for the parts of which it is composed have been carefully and wisely selected, and joined together in felicitous proportions ; not forged from the chains and bolts of dungeons, nor commanding obedience through the embrasures of frowning battlements. Nor can it decay and crumble into ruins, like the gloomy fabrics that have passed down the stream of time, to be replaced by others that are tottering on their base, so long as we cherish with unabated love the wholesome and legitimate principles of democracy, upon which the plan of its organization was designed and executed.

Often in my travels in distant lands, when meditating upon the depths of human misery, and of moral and political degradation to which our fellow-creatures have been ground down under the iron hoof of oppression, have I turned with innate and shuddering horror from the contemplation of their majestic and magnificent ruins ; because I could not help reading in them but the history of the accumulated wrongs and crimes which, for so many ages past, cruel and despotic forms of government have wantonly inflicted upon the great human family.

Even in those European monarchies where the shadow of human rights is inspected by the bayonet ; even in Eng-

XiV INTRODUCTION.

land, where there is at least some portion of liberty preserved to the subject, my republican education, and the feelings of commiseration with which I have looked professionally upon human suffering, have caused me to shrink from the scenes of misery and unnatural social distinctions I have everywhere encountered, and to revert back with emotions of inward delight and conscious satisfaction to my own, my native land.

Whether amid the enchanting scenery of England — the gay vineyards of France — the gloomy fortresses of the Rhine — the snowy avalanches and gorges of Alpine Switzerland — the pageantry and splendours of the European capitals — the architectural ruins of the Roman Empire — or the chaste monuments of fallen, unhappy Greece — the godlike Pyramids, scattered over the burning sands of wondrous and mysterious Egypt — or the mosques and minarets of the debased hordes of the Ottoman ; the thought that this outward pomp conceals within it so vapt and frightful an accumulation of human wretchedness, and that it is but the painted sepulchre or the funeral cortege in which the dearest rights of our fellow-creatures are consigned to a hopeless tomb, has dominated at times over every sentiment or association of a pleasing character with which, in the rapid change from place to place, I might otherwise have regarded them, and carried me forcibly and vividly back in my irnagination to the substantial comforts, the inappreciable blessings, to that priceless treasure above all other treasures — human liberty — allotted by Divine Providence to our own favoured and happy people.

When bidding adieu, therefore, forever, as I doubtless have done, to the wide-spread scenes of human wo that I have so often had cause to mourn over, especially in Eastern countries, that are still enduring the yoke of Mohammedanism, I have, in my unavailing regrets, welcomed the moment when the curtain was drawn between me and the appalling suffering I could not relieve.

And when our gallant bark had speeded me over the wide waters of the Atlantic, and I hailed again in the western sky the waving outline, and the clear and cloudless heaven

INTRODUCTION. XV

of my own beloved and romantic shores, I felt, as my feet pressed once more the virgin soil of my own home, of my own kindred and my countrymen, that I conld kneel in devout prayer and gratitude to that All-merciful Being, who had shielded me and brought me safe through every peril, and that, with undissembled fulness of heartfelt joy, I could kiss the very earth on which I trod.

TRAVELS

IN

EUROPE AND THE EAST.

EI^ GLAND.

During thirty-five years' absence from England, being the period elapsed since I was completing my education there, I found almost a new medicine had sprung up, a novum 07'ganon, under the extending and wholesome conquests of the Baconian philosophy, which holds, it may be said, the juste milieu or equipoise of inductive reasoning between the finespun abstractions of theory and an undue multiplication of embarrassing details. A philosophy which must prevail and spread its light over the earth, while founded as it is on such just principles, to whatever science those principles be applied.

I had scarcely set foot in London, when my natural anxiety to see my old preceptor. Sir Astley Cooper, induced me almost immediately to call upon him. I found him out, but, wishing to surprise him, I did not leave a card, and, ascertaining the hour he would be at home to receive patients, repaired thither the following day. While waiting in the antechamber. Sir Astley and lady arrived in their carriage and passed through the hall. I awaited my turn with the crowd that daily resorted for professional advice to the mansion of this

C now deceased and lamented man, one of the greatest ornaments of our profession ; and when the number came to my turn, made my appearance before him, and, standing face to face, could not resist the pleasure of offering him my hand. He returned the salutation, and I remarked, " Do you remember me 1" He paused, and gazed for some seconds, when I was going on to explain, though at that time my ill health would have well justified me in appearing under the plain cognomen of a patient. But the gratification of once more beholding my revered and beloved preceptor was too great to allow me much longer to conceal myself under an assumed incognito. Sir Astley, seeing me about to unravel the mystery, exclaimed, " Stop ! don't tell me !" and instantly afterward said, " It is Dr. Mott ;" when, of course, mutual greetings ensued, and a most refreshing and agreeable interview, in glancing at the reminiscences of the past, and in hooking-up and comparing notes for the long interval that had elapsed since we had seen each other.

In conversing with Sir Astley upon the immediate cause which had led to my visit to Europe, he fully accorded with me in the belief that I had embraced the only remedy left for me ; and that all the ills I was labouring under were imputable to the broken-down state of my nervous system, from incessant and unwearied occupation in my profession. For, said he, no man but a surgeon knows the exhausting demands made, not only upon our physical, but upon our moral and mental energies. Indeed, I asked him if he did not believe that the vulgar opinion in respect to the proverbial insensibility or apathy of surgeons was, in fact, the reverse of the truth. For certainly, I remarked, no persons are thrown into situations so peculiarly calculated to harrow up the feelings even of those whose hearts are deemed to be of Stone, and their nerves callous to ordinary impressions. He replied that such was the truth, and that, for that very reason, there were no classes whom he had evej* remarked to be so liable to diseases of the hearty both functional and organic, as soldiers and surgeons. And this may not seem so paradoxical when we reflect that the attractive brilliancy and applauding honours that follow those who have acquired distinction by master operations in surgery, invite to our profession men of the most finely-constructed minds, and keenest perception and sensibility. Such men are strongly influenced by the motive to acquire and win the approbation of their fellow-men, and are prompted also in the pursuit of surgical distinction as well by the virtuous ambition for honourable fame, as by the enthusiastic impulses of benevolent sentiments to devote their lives to the rehef of their fellow-creatures.

Sir Astley said he had no doubt, if I relaxed myself by tTavel from the pursuit of my profession, I w^ould entirely recover. And the judgment of this truly eminent man was in this, as in so many other cases, verified to the letter.

We frequently met at each other's residences during my difierent visits to London, and he often reverted in our conversation to the delight he felt in recollecting his American pupils, and what our country had done for surgical as well as medical science. I never shall forget one of those interviews. Even at the advanced age of sixty-eight, he insisted on my accompanying him from his study to his dissecting-room, which, as is usual with surgeons of his rank in Europe, was in his own house. Here he commenced showing to me the fruits of one of his last curious and interesting researches, the thymus gland, of which, while he discoursed with all the intense ardour of youth, he exhibited to me a series of most remarkable preparations, completed by his own hands, and demonstrating an anatomical accuracy and pathological acumen which, though astonishing, did not astonish me, who from my youth had marked the course of his life, and knew that there was nothing of a patient or investigating character in our profession that his great mind could not encompass. A mind not brilUant, but sound, inductive, and of sleepless energies, and specially adapted for abstruse anatomical inquiry ; while, also, his dexterity with the knife enabled him to give to his operations a finish and a neatness seldom or never surpassed. There could not, perhaps, be offered a more beautiful testimonial of his passion for his own profession than the subject to which I have alluded, and upon which he bestowed so much attention. Though apparently humble and obscure, the thymus gland was, for that very reason, one that he deemed of sufficient importance to require the light of his most profound examination. And let me here add, in tribute to the virtues and abilities of this illustrious surgeon, that there are none who are more indebted to him than the fairer portion of our race ; for to them he devoted the last energies of his life, and for them accomplished one of his noblest triumphs. We mean his work on the Diseases of Female ^Breasts. In this his last labour he expired ; and it may truly be said that he died with the harness of his profession upon him.

The last interview I had with my honoured preceptor was the evening before I left London, when he called at my lodgings ; and before I grasped his hand, which I feared would be, as it mournfully proved, for the last time, he in the most touching and affectionate manner begged me to accept a beautiful case of surgical instruments, of his own invention, as a souvenir of his regard, and as a token of friendship for me.

Another case of splendid instruments (being for amputation) v^as also kindly presented to me as a souvenir by his distinguished nephew^, Brandshy Cooper, Esq. They are of rare and exquisite beauty, the handles being of the wood of Old London Bridge, and the blades of the iron from the same. The wood is of old English oak, and in perfect preservation, though, as appears by the date engraved on the handles, they were taken from timbers laid down in 1176, and not removed until 1831, being a space of 655 years.

I cannot leave the subject of Sir Astley Cooper at this moment, when we all deplore his loss, without a retrospective glance at some incidents connected with his brilliant professional career as a surgeon.

While a pupil of his in 1807, 1 saw him perform the first successful operation ever performed of tying the common carotid for aneurism, this now everyday operation being then deemed one of the boldest strokes of scientific surgery : a fact alone sufficient to show what rapid strides the art has made within the short space of thirty years, among the actors in which scenes of its greatest triumphs Sir Astley Cooper could have truly said,

He was among the first, also, with his distinguished and original contemporary, John Ahernethy, to tie successfully the external iliac. This his j^r^^ essay in that operation I also witnessed. And he was also the first in the bold attempt, though unsuccessful for want of the improved American artery instruments used to-day, to*' tie the left subclaman within the scaleni muscles.

Amid all his arduous occupations in the practice of his profession, he never lost sight of that primary and useful object, the transmission to posterity of the valuable results of his own labours. The professional world owe to him the publication of his well-known gigantic work on Hernia, in all its anatomical and surgical details : a work of which we have seen ourselves the translations in various languages, disseminating thus his name and his fame to remote parts of the earth, where the modest author little dreamed, perhaps, that he was so well known, and held in such high appreciation.

His next great work was on Fractures and Dislocations, which, though a common and everyday subject, for that very reason required a master mind like his to give interest and originality to its dry details. But, with the true feelings of a philanthropist and of a sincere lover of his profession, he preferred to walk in the paths, however beaten, in which he could render himself most useful to his fellow-man.

Besides all these great and original works, he constantly contributed some of the most sound and practical papers to the periodicals of the day, showing a mental activity and energy, as is proverbial in our profession, which curtailed with him also the period of his life within the average age of those of other occupations ; for the temper of his mind, like that of the Damascus blade, wore out its own scabbard : in this respect unlike his immediate contemporary. Sir William Blizzard, whose death happened in my previous visit to London. Inquiring of Sir Astley what had finally put a period to the protracted life of this almost centenarian, who attained the extreme age, we believe, of ninety-nine, I was answered by him that, like the last flickering glimmer of the light in the socket, he literally went out.

To crown all it can be said of this great surgeon, that in the latter years of his life he was a faithful observer of the important rites of Christianity, and hved in the conscientious conviction of the truth of that rehgious faith, and in the daily observance of those ennobling duties, which, when all worldly sources of consolation — that " keep the word of promise to the ear and break it to the hope" — have deserted us forever, can alone extract the thorn from the couch of pain, disarm death of its terrors, and bring hope and cheering joy to the wounded and wearied spirit.

And it gives me particular gratification to be enabled to present in this place the example of so illustrious and sincere a convert to Christian truth as this ornament of our profession, in contradiction to the erroneous and proverbial reproach, that medical men are too often insensible to the imperious obligations of religion.

I was happy to see in London, in all the hospitals — Guys^ St. Thomas's, Bartholomeid'Sy Middlesex, St. George's, &c. — everywhere strong evidences, in the amplification and extension of all the means of accommodation, comfort, and relief — that the police of these estabhshments, like the schools of medicine and surgery, had kept pace with the march of the age, and with the vigorous impulses which those sciences have received within the last thirty years. The accommodations for the sick are now on a scale of much greater magnitude, better ventilation, and more perfect cleanliness and discipline. All the new operations which surgery, in its brilliant progress, has added to our art, are now performed by English surgeons with admirable skill and dexterity ; and by the more perfected modes of treatment, discovered through the conjoint improvements that have taken place at the same time in medicine, strictly so called, far more successful results, the great criterion of the utility of an art, have been obtained than in former years.