Señor Manuel Garcia.

805 forced to the conclusion that facts ought to be substituted for the hypotheses which were in vogue in the middle of the last century and that facts could only be ascertained by inspection of the healthy living larynx when engaged in the act of singing. He was unaware that the problem had occupied the attention of medical minds for nearly a century and that although none of his predecessors had found the solution, some of them, notably AVERY, and BABINGTON, who LONDON: SATURDAY, MARCH 25, 1905. succeeded in obtaining a glimpse of the glottis in 1829, had not been far from doing so. It was only after many of Manuel Garcia. the thinking upon years subject that one day in 1854, ALTHOUGH it has been said by some physiologists, we when strolling in the Palais Royal, GARCIA saw in his mind’s hardly know with what degree of accuracy, that 100 years eye the position of the mirrors which would render the would be the proper age of man in these latitudes, the actual larynx visible ; and, as he has himself described in a attainment of that age is still sufficiently uncommon to charming fragment of autobiography, he rushed into the excite wondering remark. Its attainment by a philosopher shop of CHARRIERE, the well-known instrument maker, and whose work has been eminently beneficial to his race bought for six francs a dental mirror which had been one of is necessarily still more remarkable, even if only by the failures of the London Exhibition of 1851. Having reason of the small numerical ratio borne by such procured a hand-glass he hurried home, warmed the little men to their fellow creatures, and it need, therefore, mirror, placed it in his own throat below the uvula, be no matter for surprise that all civilised countries were threw the rays of the sun upon it by means of united on Friday, March 17th, in doing honour to Sefior the hand-glass, and on his first attempt had the immense The MANUEL GARCIA on the occasion of the 100th anniversary satisfaction of seeing his own glottis wide open. of his birthday. Not only Spain, the land of his birth, results of his observations were presented to the Royal and England, the land of his adoption, and Germany, Society in a paper entitled, "Physiological Observawhich has contributed so much to the advancement of tions on the Human Voice," which was published on laryngology, but even Russia and Japan were represented on March 22nd, 1855, the birthday of a discovery which was the occasion and turned for the moment from the realities destined to revolutionise our knowledge of the larynx in of war to offer their tributes of laurel to the man who health and disease. How far the former knowledge has been had achieved one of the great victories of peace. of practical utility in Senor GARCIA’S own profession, how The KING, with the graceful and kindly tact which far, that is, it has conferred upon teachers of singing and renders him an unfailing exponent of the best feelings elocution increased powers of training the vocal organs of of his subjects, initiated the proceedings of the day by their pupils or of preserving them from erroneous methods of conferring the Commandership of the Royal Victorianphonation, it is somewhat beyond our special province to inOrder upon the venerable father of laryngoscopy; and this quire, but at least we have not been made acquainted with was followed by his investiture by the Spanish Charge any discoveries in this direction which are at all comparable d’Affaires with the Royal Order of ALPHONSE XII. Fromwith those bearing upon the investigation and treatment of the German EMPEROR he received at the same time dis-. disease. It cannot be doubted, of course, that a teacher tinction even more marked than any which Royal orders, of philosophical mind would render his experience in the can confer, in the shape of the "great gold medal forchighest degree fruitful, and no one can question that Senor science," hitherto bestowed only upon Professor VIRCHOW, GARCIA’S many illustrious pupils, among whom JENNY LIND,

THE LANCET.

Señor

,

Professor KOCH, Professor EHRLICH, and Professor MOMMSEN, MATHILDE MARCHESI, JOHANNA WAGNER, ANTOINETTE while the offerings and addresses presented to him by the STERLING, the Misses MACINTYRE, ORRIDGE, LARCOM, and scientific bodies and societies of the world were almostt THUDICHUM, JULIUS STOCKHAUSEN, BATAILLE, and uncountable. The last of them, a portrait painted by CHARLES SANTLEY were mentioned by Sir FELIX SEMON ,

Mr. SARGENT, R.A., and subscribed for by international,1 at the dinner, would be of one mind in the conviction that the benefits which they had derived from his in,r contributions from the many personal friends of Senor GARCIA, was a gift which brought the proceedings of thee struction would be incomparably greater than any which would have been likely to accrue to them from teaching morning meeting held in his honour to a fitting close. The scene of the ceremonial being in England it is hardly y based upon tradition or "experience"alone. Such benefits, needful to say that a dinner was necessary to its entire -e e great as they presumably were, and eminently conducive completion and this dinner afforded to Sir FELIX SEMON,T, to the enjoyment of countless audiences, must still be who proposed the principal toast, an opportunity of )f looked upon as subordinate to the application of the invensketching the career of the guest of the evening and of)f tion along lines which the inventor himself was not qualified describing the successive steps by which he was led;d to pursue, the lines of medical and surgical discovery and to the discovery that the larynx might be rendered id manipulation. visible by a combination of mirrors and that the actiom is From this aspect of the question we think it is someof its several parts in phonation might thus be studied. i. what to be regretted that no endeavour seems to have When Senor GARCIA was occupied, said Sir FELIX SEMON. sr, been made to associate the great name of CZERMAK with with the solution of the great problem of the productior )n the honours of the day. GARCIA is not more incontestably of sound in the human larynx his scientific mind waf as the father of laryngology as a whole than CZERMAK is

806 the father of its applications to the study and the treatment of disease, applications which, it will be remembered, were made early and extensively in this country. The instrument itself was improved by CZERMAK who

brought it to London during the course of the great - Exhibition of 1862 and gave many demonstrations to the profession. He revealed for inspection and treatment many previously unsuspected only enabled surgeons

forms of throat disease and not to see and to remove growths

springing from the vocal cords but also disclosed certain forms of paralysis to which the cords are exposed, sometimes from disease of the brain, sometimes from pressure upon their the chest.

we can discover of any attempt is to be found in CELSUS. lesion repair important In the seventh book of his work, " De Re Medica," he mentions the practice of repairing noses by sliding flaps from the cheek and the description is sufficiently full and accurate to enable the operation to be performed. Except for a few slight references we find nothing definite after CELSUS until 1442 when MANZANO seems to have

The earliest notice which

to

this

employed

a

method for

restoring

a

lost

nose.

BENEDICTUS

in 1539, in his very elaborate work "Omnium a Vertice ad Calcem Morborum Ligna, Causae," the title of which shows its all-comprehensiveness, describes fully the method of

by aneurysms and other All branches of the medical

swellings within restoring the nose by means of a flap taken from the arm but profession may he does not approve of the operation. In 1548 GILBERT unite cordially with musicians in doing honour to the CousiN published a work called Narrationum Sylva"and philosopher to whom both callings owe so much; but in this he speaks of a certain BRANCA DE CATANI who our debt, or rather the debt of the public through us, re-made noses, ears, and lips. In 1573 ANDREAS A CRUCE is by far the more considerable of the two and our wrote a book called"Chirurgia Magna " and in it he speaks recognition of the master must not render us forgetful with disapproval of the operation. GASPARO TAGHACOZZi, of the great disciple by whom the applications of the better known by his Latinised name TALIACOTIUS or, as it is laryngoscope were first extended along paths which could often written, TA&LlACOTlus, published in Venice in 1597 a not have been followed by the inventor. large folio volume entitled " De Curtorum Chirurgia per Insitionem," and a second edition appeared at Frankfort in nerves

Plastic

1598 under a much more elaborate devotes no small amount of space to

Surgery.

As the learned Mr. ISAAC BICKERSTAFF has nose is a very becoming part of the face "

title. a

TALIACOTIUS

dissertation

on

the

quotes in support of his of ; many writers. He describes opinions value in this respect is never fully appreciated until it is most minutely the method, always called by his name, of lost. Such a deprivation, however it may have been brought fashioning a new nose or other part from a flap of The °skin the arm the the sufferer extreme raised from of entails on absence about, misery. patient. A bridge of skin - of a nose is so utterly obvious that it must be seen by was first dissected up of the required width and length the

observed, importance and its

of the

nose

and he

contention the

defective

.everyone and the effect on the patient may be much greater and under this was passed a piece of lint, and when granulathan might have been anticipated. "The patient con- tions had fully formed the upper end of the bridge was sequently shuns society and every appearance in public and separated and the flap of skin was inserted in the required

often is

self-loathing and abasement position, the arm being retained by an apparatus in such almost blackest despair." A nose may an attitude as to prevent any traction on the new flap. be lost by accident or through gangrene from cold After some days the attachment of the flap to the arm was and MAISONNEUVE has described a case in which the organ divided and the arm was released. Many illustrations are was congenitally absent but undoubtedly the absence given showing the mode of performing the operation and of a nose is in many cases to be attributed to a less the instruments used and in addition the figures of several reputable cause and it is not improbable that this popular persons on whom the operation had beer performed ; ascription of the origin of the lesion is, in part at least, if we mayjudge by these illustrations the results were the explanation of the very great mental effect of the loss of extremely successful. The Taliacotian operation, as it was It must, however, be recognised that syphilis is not called, became very widely known and was much employed. a nose. responsible for a large number of the cases ; in many lupus From our knowledge of the descriptions given by one is the cause. In some parts of the world, especially Italy or two previous authors it is certain that an operation and India, it has been customary to employ removal of identical in all essentials had been devised some years the nose as a form of punishment, sometimes judicial, but previously and it seems that BRANCA DE CATANI performed - chiefly as a mode of carrying out private revenges. the operation many times, even if he did not invent it. Especially in some districts of India is it considered a Nevertheless, the credit of the method is generally attrisuitable form of punishment for a husband to inflict on a buted to TALIACOTIUS and his name is given to it. It is not improbable that the wide extension of syphilis in wife of whose conduct he does not approve. Among the Romans this penalty was not at all rarely inflicted, both Europe in the sixteenth century, with the consequent great by the law and by private animosity. Inasmuch as the increase in the number of the noseless, contributed to the
oppressed with amounting to the

a

"

"