techniques of surgery, but not, to any marked extent, its results. The agonies of the fully conscious patient “had naturally and rightly compelled the public to demand rapid if not slapdash surgery, and the surgeon to pride himself on it. Within decent limits of precision, the quickest craftsman was the best.” (There were famous specialists who could perform an operation for stone in fifty-eight seconds flat.) Thanks to chloroform, “the surgeon was enabled to be not only as cautious and sedulous as he was dexterous, but also to venture on long, profound and intricate operations which, before the coming of anesthetics, had been out of the question. But unfortunately this new enfranchisement seemed to be but an ironic liberty of Nature, who with the other hand took away what she had given.” Bigger and better operations were performed under chemical anesthesia, but the patients went on dying at almost the same ghastly rate. In the twenty years following the introduction of chloroform and preceding Lister’s advocacy of aseptic surgery, the death rate from postoperative infections fell by only six percentage points—from twenty-nine in every hundred cases to twenty-three. In other words, almost a quarter of every Early Victorian surgeon’s clients were still regularly slaughtered. Chloroform had abolished the pain of operations, but not the virtual certainty of infection afterwards, nor the one-in-four chance of a lingering and unpleasant death.
Meanwhile, what was happening in Bengal? The answer is startling in the extreme. In a debilitating climate and among sickly and undernourished patients, Doctor Esdaile was performing major surgery without any deaths on the operating table (a distressingly frequent event in the early days of badly administered chloroform) and with a mortality from postoperative infection of only five per cent. How are we to account for this extraordinary state of affairs? First of all, Esdaile never allowed his patients’ morale to be undermined by apprehension. The men and women who came to him were not told in advance when they were to be operated, nor even, in many cases, that an operation would be necessary. After examination by the surgeon, they were taken into a dark room, asked to lie down on a couch, and then put to sleep by “magnetic passes,” which were made by relays of orderlies, who would work on the patient, if it seemed necessary, for three and four hours at a stretch. When the passes had taken effect and the patient was in a deep hypnotic coma, he would be taken into the operating room, have his leg cut off, or his forty-pound elephantiasis tumor removed, be stitched up and carried, still unconscious, to his bed. In most cases patients remained in trance for several hours after being operated, and would wake up unaware of what had happened and feeling no pain whatever. In the days that followed they were frequently re-mesmerized, and so spent most of their time in a state of trance. But in trance, as in natural sleep, the
Five deaths to every hundred operations—it was the biggest medical news since the days of Hippocrates! But when Esdaile published the facts, what happened? Were his colleagues delighted? Did they hasten in a body to follow his example? Not at all. Most of them were extremely angry when they heard of his achievement, and the bigwigs of the faculty did everything in their power to prevent Dr. Esdaile from continuing his beneficient work and, when that proved impossible (for Esdaile was backed up by the Governor General of India), to suppress the, to them, embarrassing and distasteful facts.
Doctor James Simpson, the first surgeon to advocate the use of chloroform and a most courageous crusader, in the teeth of Fundamentalist opposition, for painless childbirth, was at first intensely interested in mesmeric anesthesia. In a letter to Esdaile he wrote that he had “always considered the few deaths out of so many formidable operations one of the most remarkable things in the history of surgery.” Furthermore, says Esdaile, “Dr. Simpson sent me a message that I owed it to myself and my profession to let my proceedings be known in England, and that, if I wrote an article, he would get it published in the journal he was connected with. I therefore sent him an account of one hundred and sixty-one scrotal tumors removed in the mesmeric trance.” This paper was rejected on the ground that parts of it had appeared (in a greatly garbled form) in another medical journal. “A more general paper was offered; but after some compliments and considerable delay,” Esdaile was informed that Dr. Simpson’s brother editors had declined it as “not being sufficiently practical.” “One of the most remarkable things in the history of surgery!” is Neilson’s justifiably bitter comment. “Namely, how to reduce 23 per cent of deaths to 5 per cent—
This sort of thing had happened before Esdaile’s day and was destined to happen again, and yet again, thereafter. Doctor John Elliotson, an eminent physician and Professor of Physiology at the University of London, had been derided and boycotted for his advocacy of mesmerism in surgery and general practice. Some of his critics had gone so far as to assert that a mesmerized man who had a leg amputated without showing the slightest sign of discomfort was a mere impostor—pretending that he felt no pain just to annoy the orthodox doctors. And one of them, Doctor Copland, solemnly declared that “pain is a wise provision of Nature; and patients
But mesmerism and its absurdities were observable facts and, in spite of everything, they refused to disappear. It therefore became necessary to legislate against them. For almost half a century after the publication of Esdaile’s book, any English doctor who made use of hypnotism ran the risk of being hounded out of his profession. It was not until 1892 that the British Medical Association officially admitted the reality of hypnosis and officially sanctioned hypnotic treatment.
In France hypnotism fared better than in England. The first Royal Commission on Mesmerism (of which Benjamin Franklin was a member) had denied the existence of the “magnetic fluid,” which was supposed to account for the phenomena of hypnotism, but had not pronounced on the reality of the physical and psychological phenomena induced by mesmeric procedures. The second commission pronounced in favor of mesmeric treatment. The third, dominated by the orthodox party, pronounced against mesmerism. Later, Charcot tried to prove that hypnosis was a form of hysterical epilepsy. But in spite of everything the practice of hypnotism continued and, at the close of the nineteenth century, was being extensively used for the relief of pain and the cure of sickness. Today, strangely enough, hypnotism is almost unknown among medical circles in France. It is as though such pioneers as Liebault and Bernheim had lived and labored in vain. The remarkable successes achieved by those men and their followers have been more or less completely forgotten.
These ups and downs in the popularity of hypnotism are characteristic of its history in every country. At one moment hypnotism seems to be on the point of entering medicine as a widely used form of therapy; then, a few years later, the public and the professional men seem to lose interest in this kind of treatment, which is either quietly ignored or else denounced as dangerous or vaguely immoral. In the United States, for example, hypnotism enjoyed wide popularity in the years following the Civil War. Three quarters of a century ago the editor of the American edition of
Why has the history of hypnotism been so strangely checkered? Why is it that, in the words of a great
