Oliver Wendell Holmes, M.D., 1809-1894

s we approach the 158th anniversary of the use of sulfuric ether by William T.G. Morton at the Massachusetts General Hospital to produce insensibility during surgery, it is appropriate to remember that only 36 days after this seminal event, the eminent Boston physician and poet Oliver Wendell Holmes (Sr.) in a letter to Morton dated November 21, 1846, proposed a name to describe this most peculiar state of mind.¹ This was considered by many to be the greatest contribution to the world of practical medicine originating in America.² He stated:

“Everybody wants to have a hand in a great discovery. All I will do is to give you a hint or two as to the names — or the name — to be applied to the state produced and the agent. The state should, I think, be called Anesthesia. This signifies insensibility — more particularly (as used by Linnaeus and Cullen) to objects of touch. The adjective will be Anesthetic. Thus we might say the state of Anesthesia, or the anesthetic state … ”

A recent addition to the Maurice S. Albin Collection of Rare Books and Papers at the Wood Library-Museum of Anesthesiology included a collected work of poetry³ and a montage of a six-line poem autographed and dated March 22, 1871, juxtaposed to a carte de visite with a life-like image of the physician-poet. It is certainly fitting that these two items were purchased in a Boston bookstore.

The Complete Poetical Works of Oliver Wendell Holmes, Cambridge Edition, 1895.

Well-Versed: This original six-line poem written by Dr. Holmes is now a part of the Maurice S. Albin Collection at the Wood Library-Museum of Anesthesiolgy. Click image to view at a larger size.

Oliver Wendell Holmes is a name closely associated with the introduction of surgical anesthesia in Boston. His life, career and contribution to literature and medicine, vis-à-vis his role on the history of anesthesia, should be of interest to anesthesiologists and historians.

As a physician-poet, his book of poetry reveals his humane sensitivity to medicine and reflects his sensitive observation of human nature in captivating narration. Between lines of his poetry, the mind, the personality and the life of the poet-physician are obvious.

Born in 1809, Dr. Oliver Wendell Holmes graduated from Harvard at age 20, intending to pursue a literary career. The reality of financial limitations on a career of letters made him reconsider his direction. He chose a profession appealing to his humane interests of a scientific nature, which for him was medicine. Dr. Holmes began his study of practical medicine with physicians and surgeons in Boston who also were on the faculty at Harvard Medical School. In addition he attended lectures at the medical school. By 1833, Dr. Holmes left Boston to further his medical training in Paris, where he remained until 1835 when he returned to Boston. He received his medical degree in 1836.

A poet by nature, Dr. Holmes admitted that he experienced “repulsive sentiments and painful sensitivities” when he encountered anatomical skeletons and sick patients in hospitals. His training in Paris steered him to scientific investigation and moved his practice to experimental, rather than therapeutic, medicine. At age 30, in 1839, he was appointed professor of anatomy and physiology at Dartmouth University and continued to practice medicine in Boston. He assumed the same academic title at Harvard Medical School and became Parkman Professor in 1847, a post he had since held until his retirement in 1882. Dr. Holmes also was the Dean at Harvard Medical School from 1847 to 1853.

Although Dr. Holmes published his first volume of verses in 1836, it was as a youth of 21 years, concerned that the famous U.S.S. Constitution might be sent to the scrap heap, that he wrote his well known poem “Old Ironsides,” which galvanized our nation into preserving this ship for posterity.³

One of Dr. Holmes’ greatest contributions to medicine concerned his observations on puerperal fever, which was a constant threat to the parturient, with descriptions of its symptomatology dating back to Hippocrates. Mortality was elevated, reaching 20 percent of delivered mothers in epidemic years. Dr. Holmes’ classic article, “The Contagiousness of Puerperal Fever,” was first published in 1843 in the New England Quarterly Journal of Medicine.⁴ This paper contained an elaborate review of puerperal fever and established the role of the physician as the vector in propagating the disease.⁵ He particularly targeted not only physicians involved with patients who had succumbed to the disease but also those who conducted autopsies on these females and then proceeded to do deliveries. Dr. Holmes states prophetically in the midst of his paper, “While I attended these women in their fevers, I changed my clothes and washed my hands in a solution of chloride of lime after each visit. I attended seven women in labor during this period, all of whom recovered without sickness” [emphasis added].

The findings by Dr. Holmes that puerperal fever was a contagious disease also was a theme pursued by Ignaz Semmelweis who reported similar results in 1845, two years after the publication by Dr. Holmes. Dr. Semmelweis also was able to reduce the postpartum mortality to a negligible percentage by the use of chloride of lime prior to patient contact. It was indeed a tragedy that the medical world did not pick up the lessons from the works of Dr. Holmes and Dr. Semmelweis. Think of how many tens of thousands of lives would have been saved during the Mexican-American, Crimean and the U.S. Civil War!

As a litterateur, the works of Dr. Holmes covered poetry, autobiography, history, theology and patriotism, and he wrote numerous essays. The artistic dexterity, sensitivity and imagery created by Dr. Holmes can be noted in the six-line verse seen in the previously mentioned montage:

“Soft is the breath of a maiden’s Yes;
Not the light of gossamer stirs with less;
But never a cable that holds so fast
Through all the battles of wave and blast;
And never an echo of speech or song
That lives in the babbling air so long!”

He shows the power of the three-letter word “Yes” as it impregnates the atmosphere with the strength of love that is more powerful than the furies of nature and physical restraint. We were unable to identify this fragment and thought perhaps we were fortunate to be in possession of an original stanza. We have recently discovered, however, that the six-line stanza was from Dr. Holmes’ famous poem, “Dorothy Q., a Family Portrait.” The fragment in question was indeed part of his poetic tribute to his great-grandmother Dorothy Quincy.

Dr. Oliver Wendell Holmes is a quintessential physician of all the ages. His dual role of physician-poet contributes to such honored status, setting him as a model for all who take the Hippocratic oath. His indelible role in association with the introduction of surgical anesthesia brings him into the fold of anesthesiology. Anesthesiology is a discipline fusing the art and science of medicine. The expertise and wisdom of Dr. Holmes epitomize the true calling of medicine of which anesthesiology is a vital branch. He exemplifies a model physician anesthesiologist who practices medicine with skill, heart and soul. The Wood Library-Museum of Anesthesiology is fortunate to have this priceless treasure in its Maurice S. Albin Collection.

References:

1. OW Holmes note to Dr. Morton, November 21, 1846. In: Edward Warren. Some Account on the Letheon: Or, Who Is the Discoverer. Boston: Dutton & Wentworth; 1847:84-85.

2. Clarke EH. Practical Medicine. A Century of American Medicine, 1776-1876. Brinklow, MD: Old Hickory Bookshop (1876); 1962:66-67.

3. The Complete Poetical Works of Oliver Wendell Holmes, Cambridge Ed. Boston: Houghton Mifflin (Riverside Press, Cambridge); 1895.

4. Holmes OW. The contagiousness of puerperal fever. New Engl J Med & Surg. April 1843.

5. Clarke EH. Practical Medicine. A Century of American Medicine, 1776-1876. Brinklow, MD: Old Hickory Bookshop (1876); 1962:48-49.

Maurice S. Albin, M.D., M.Sc.(Anes) is Professor of Anesthesiology, University of Alabama School of Medicine, Birmingham, Alabama.

Patrick Sim, M.S., is head librarian at the Wood Library-Museum of Anesthesiology in Park Ridge, Illinois.