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T H E O X F O R D HI S T O R Y O F P R O T E S T A N T
D I S S E N T I N G TR A D I T I O N S ,
VOLUME V
OUP CORRECTED PROOF – FINAL, 21/8/2018, SPi

THE OXFORD HISTORY OF


PROTESTANT DISSENTING TRADITIONS
General Editors:
Timothy Larsen and Mark A. Noll
The Oxford History of Protestant Dissenting Traditions, Volume I
The Post-Reformation Era, c.1559–c.1689
Edited by John Coffey
The Oxford History of Protestant Dissenting Traditions, Volume II
The Long Eighteenth Century, c.1689–c.1828
Edited by Andrew C. Thompson
The Oxford History of Protestant Dissenting Traditions, Volume III
The Nineteenth Century
Edited by Timothy Larsen and Michael Ledger-Lomas
The Oxford History of Protestant Dissenting Traditions, Volume IV
The Twentieth Century: Traditions in a Global Context
Edited by Jehu J. Hanciles
The Oxford History of Protestant Dissenting Traditions, Volume V
The Twentieth Century: Themes and Variations in a Global Context
Edited by Mark P. Hutchinson
OUP CORRECTED PROOF – FINAL, 21/8/2018, SPi

The Oxford History of


Protestant Dissenting Traditions
Volume V

The Twentieth Century: Themes and


Variations in a Global Context

Edited by
MARK P. HUTCHINSON

1
OUP CORRECTED PROOF – FINAL, 21/8/2018, SPi

3
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OUP CORRECTED PROOF – FINAL, 21/8/2018, SPi

Acknowledgements

Attempting to address global themes on any subject takes one out of one’s
frame, and ‘stretches’ the scholar’s imagination and skill set in often painful
ways. Despite a recent (re)turn to ‘world’ and transnational history, historians
are largely careful creatures who like to stay close to their sources and contexts.
The sort of ‘meaning projection’ required of the authors (and the editor) of
this volume in almost every case required a high level of vulnerability, a
willingness to be ‘wrong’ on this or that detail so that something larger
might be achieved. I thank each of the authors for their willingness to throw
themselves into such a difficult task, particularly Candy Gunther Brown
(Indiana) for her willingness to see material moved so that the connecting
tissue of the volume could be constructed and repetition minimized. To Tim
Larsen and Mark Noll, we corporately thank you for entrusting us with this
impossible remit: you won’t be surprised, however, if a later approach to do
likewise receives the reply ‘not known at this address’! On a more serious note,
my personal thanks go to Tim Larsen (Wheaton), Mark Noll (Notre Dame),
David Bebbington (Stirling), Stuart Piggin (Macquarie), and John Wolffe
(Open University), who have been treasured colleagues and fellow-travellers
in the craft of history for many decades. Without the sage advice (and
extensive networks) of these friends, and of expert figures such as Brian
Stanley (Edinburgh), during the preparation of this volume, the range of
authorial input would have been more limited than it is. They performed
repeated ‘saves’ when (as is inevitable when operating across five continents in
every imaginable academic context) some participating authors dropped out,
refused to answer emails, moved, or just went silent. The reader’s indulgence is
sought if the result of this global treasure hunt has been that rather more of
this volume was written by the editor than was originally intended. This is
partially the cost of real working relationships with scholars who—in Ghana,
or India, or even on the transitory edges of the academic edifices of the West—
often don’t work in positions where study leave or funding is available. This, to
me, makes their work all the more remarkable, and I admire them for it.
Finally, to the third generation who knocked quietly at the closed editorial
door—Lily and Oliver, Simona, Will, and Allegra—the often absent figure
known variously as nonno or zio would like you know that you are always in
his heart. The world is yours and your talents great: treat them both kindly.
OUP CORRECTED PROOF – FINAL, 21/8/2018, SPi
OUP CORRECTED PROOF – FINAL, 21/8/2018, SPi

Contents

List of Contributors ix
Series Introduction by Timothy Larsen and Mark A. Noll xiii

Introduction: Dissenting Traditions in Globalized Settings 1


Mark P. Hutchinson and Candy Gunther Brown
1. Encounters with Modernity among Received Spiritualities and
Traditions 26
Candy Gunther Brown
2. Dissenting Traditions and Politics in the Anglophone World 61
Gordon L. Heath
3. The Bible in the Twentieth-Century Anglophone World 91
Mark P. Hutchinson
4. Biblical Interpretation in the Majority World 131
K. K. Yeo
5. Dissenting Preaching in the Twentieth-Century
Anglophone World 170
Mark P. Hutchinson
6. Preaching in the Global South 199
Jason A. Carter
7. Emergent and Adaptive Spiritualities in the Twentieth Century 224
Andy Lord
8. Glocalized and Indigenized Theologies in the Twentieth Century 258
Mark P. Hutchinson
9. Organizing for Ministry in the Anglophone World: Reception,
Adaptation, and Innovation 296
Barry Ensign-George
10. The Manufacture of Dissent: Reflexive Christian Traditions
in a Global Setting 326
Graham A. Duncan
11. Dissenting Traditions and Missionary Imaginations: Novel
Perspectives on the Twentieth Century 377
Justin D. Livingstone
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viii Contents

12. Gender, Race, and Twentieth-Century Dissenting Traditions 416


Laura Rademaker
13. Mission, Evangelism, and Translation: From the West
to Elsewhere 443
Atola Longkumer
14. From Reverse to Inverse to Omni-Nodal Dissenting
Protestant Mission 466
Mark P. Hutchinson
15. Communications, New Technologies, and Innovation 491
J. Kwabena Asamoah-Gyadu

Index 523
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List of Contributors

J. Kwabena Asamoah-Gyadu is Baeta-Grau Professor of Contemporary African


Christianity and Pentecostal Studies at the Trinity Theological Seminary, Legon,
Accra, Ghana. He has published widely on World Christianity, including articles
and book chapters on conservative evangelicalism and media in Africa and
among African immigrant communities in Europe and North America. His
publications include Contemporary Pentecostal Christianity: Interpretations
from an African Context (Eugene, 2013); Pentecostal Mission and Global
Christianity (Eugene, 2014); and Sighs and Signs of the Spirit: Ghanaian Perspec-
tives on Pentecostalism and Renewal in Africa (Oxford, 2015).
Candy Gunther Brown is Professor of Religious Studies at Indiana University,
Bloomington. A historian and ethnographer of religion and culture, her
particular focus is the United States (understood within broader global cultural
flows), and global charismatic healing practices. She has published widely,
including The Word in the World: Evangelical Writing, Publishing, and Read-
ing in America, 1789–1880 (Chapel Hill, 2004); Global Pentecostal and Cha-
rismatic Healing (edited; New York, 2011); Testing Prayer: Science and Healing
(Cambridge, 2012); The Healing Gods: Complementary and Alternative Medi-
cine in Christian America (New York, 2013), and The Future of Evangelicalism
in America (co-edited with Mark Silk; New York, 2016).
Jason A. Carter has been involved in the training and equipping of pastors
and leaders for over ten years in Central Africa. In Equatorial Guinea, he has
served as a full-time Professor of Theology, Mission, and Biblical Studies at
Instituto Bíblico ‘Casa de la Palabra’ (IBCP Seminary). He is the author of
Inside the Whirlwind: The Book of Job through African Eyes (Eugene, 2017).
Graham A. Duncan is Emeritus Professor of Church History and Church
Polity at the University of Pretoria. A church historian and missiologist, his
particular focus is on South African mission history with a special interest in
the history of Presbyterianism and theological education. He has published
widely, including Lovedale—Coercive Agency: Power and Resistance in Mission
Education (Pietermaritzburg, 2003); Partnership in Mission (Cape Town, 2008);
and The Native School that Caused all the Trouble: A History of the Federal
Theological Seminary of Southern Africa (with Philippe Denis; Pietermaritzburg,
2011). He is also involved in the work of the National Research Foundation and
the Council on Higher Education in South Africa.
Barry Ensign-George served for twelve years as Associate for Theology in
the Office of Theology & Worship of the Presbyterian Church, USA. He has
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x List of Contributors

written and taught extensively on the nature of church law and denomin-
ational/ministry forms, including Denomination: Assessing an Ecclesiological
Category (co-edited with Paul M. Collins; London, 2011).
Gordon L. Heath is Professor of Christian History, Centenary Chair in World
Christianity, and Director of Canadian Baptist Archives at McMaster Divinity
College. His research interests lie particularly in the area of church–state and
church–war issues. He is the author of A War with a Silver Lining: Canadian
Protestant Churches and the South African War, 1899–1902 (Montreal, 2009)
and The British Nation is Our Nation: The BACSANZ Baptist Press and the
South African War, 1899-1902 (Milton Keynes, 2017).
Mark P. Hutchinson is Professor of History at Alphacrucis College in Sydney.
As an Australian intellectual historian he has published widely in the history
of evangelical Protestantism (with a particular focus on Italian Protestantism)
and Australian higher education. He is a Core Member of the Religion and
Society Research Cluster at Western Sydney University, and Dean of the
Faculty of Education, Arts, and Social Sciences, Alphacrucis College, Sydney.
He has published fifteen books and over one hundred research papers, includ-
ing Iron in our Blood: A History of the Presbyterian Church in NSW, 1788–2001
(Sydney, 2001); A Short History of Global Evangelicalism (Cambridge, 2012);
and A University of the People (North Sydney, 2014).
Justin D. Livingstone is Queen’s Research Fellow in the School of Arts,
English, and Languages at Queen’s University Belfast. He is a literary critic
and cultural historian, with interests in Victorian travel writing (particularly
the literary culture of African exploration), missionary literature, and colonial
fiction. He is the author of Livingstone’s ‘Lives’: A Metabiography of a Victor-
ian Icon (Manchester, 2014) and is currently editing a digital edition of
Missionary Travels and Researches in South Africa (1857) for publication on
Livingstone Online (http://livingstoneonline.org).
Atola Longkumer is a Baptist from Nagaland and teaches Religions and
Missions at the South Asian Institute of Advanced Christian Studies, Bangalore,
India. Her recent writings include Faith and Culture in South and Central Asia
in the Edinburgh Companions to Global Christianity series. She also serves as
the book review editor of the Mission Studies journal (Brill).
Andy Lord is Associate Tutor at St John’s College, Nottingham, UK and
pastors three Anglican churches. He teaches in areas of church, mission, and
spirituality and is a member of the Society for Pentecostal Studies. He is the
author of Spirit-Shaped Mission (Milton Keynes, 2005); Network Church
(Leiden, 2012); and Transforming Renewal (Eugene, 2015).
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List of Contributors xi

Laura Rademaker is Postdoctoral Research Fellow at the Australian National


University with expertise in histories of race, gender, and religion. Her research
received the Council of Humanities, Arts and Social Sciences 2017 Future
Leaders Prize and the 2016 Taylor and Francis prize for best article in History
Australia. She is the author of Found in Translation: Many Meanings on a
North Australian Mission (Hawai’i, 2018).
K. K. Yeo is currently Harry R. Kendall Professor of New Testament at
Garrett-Evangelical Seminary, and Affiliate Professor at the Department of
Asian Languages and Cultures at Northwestern University (Evanston). He
is also a Visiting Professor of Peking University, Peking Normal University,
Zhejiang University, Huaqiao University, and Fudan University in China. He
has published widely in English and Chinese, and is one of the editors of the
Majority World Theology series that includes Trinity Among the Nations
(Grand Rapids, 2015) and So Great a Salvation (Grand Rapids, 2017).
OUP CORRECTED PROOF – FINAL, 21/8/2018, SPi
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Series Introduction
Timothy Larsen and Mark A. Noll

There is something distinctive, if not strange, about how Christianity has been
expressed and embodied in English churches and traditions from the Refor-
mation era onwards. Things developed differently elsewhere in Europe. Some
European countries such as Spain and Italy remained Roman Catholic. The
countries or regions that became Protestant choose between two exportable
and replicable possibilities for a state church—Lutheran or Reformed. Denmark
and Sweden, for example, both became Lutheran, while the Dutch Republic and
Scotland became Reformed. The Peace of Westphalia (1648) established the
right of sovereigns to choose a state church for their territories among those three
options: Roman Catholic, Lutheran, or Calvinist. A variety of states adopted a
‘multi-confessional’ policy, allowing different faiths to coexist side by side. The
most important alternative expression of Protestantism on the continent was one
that rejected state churches in principle: Anabaptists.
England was powerfully influenced by the continental Reformers, but both
the course and outcome of its Reformation were idiosyncratic. The initial
break with Rome was provoked by Henry VIII’s marital problems; the king
rejected the Reformation doctrine of justification by faith and retained the
Latin mass, but swept away monasteries and shrines, promoted the vernacular
Scriptures, and had himself proclaimed Supreme Head of the Church of
England. Each of his three children (by three different wives) was to pull the
church in sharply different directions. The boy king Edward VI, guided by
Archbishop Cranmer and continental theologians like Martin Bucer and Peter
Martyr Vermigli, set it on a firmly Reformed trajectory, notably through
Cranmer’s second Prayer Book (1552) and the Forty-Two Articles (1553).
Mary I reunited England with Rome, instigating both a Catholic reformation
and a repression of Protestants that resulted in almost three hundred execu-
tions. Finally, Elizabeth I restored the Edwardian settlement (with minor
revisions), while sternly opposing moves for further reformation of the kind
favoured by some of her bishops who had spent the 1550s in exile in Reformed
cities on the continent. In contrast to many Reformed churches abroad, the
Church of England retained an episcopal hierarchy, choral worship in cath-
edrals, and clerical vestments like the surplice.
The ‘half reformed’ character of the Elizabethan church was a source of
deep frustration to earnest Protestants who wanted to complete England’s
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xiv Series Introduction


reformation, to ‘purify’ the church of ‘popish’ survivals. From the mid-1560s,
these reformers were called ‘Puritans’ (though the term was also applied
indiscriminately to many godly conformists). They represented a spectrum
of opinion. Some were simply ‘nonconformists’, objecting to the enforcement
of certain ceremonies, like the sign of the cross, kneeling at communion, or the
wearing of the surplice. Others looked for ‘root and branch’ reform of the
church’s government. (All Dissenting movements would remain expert at
employing biblical images in their public appeals, as with ‘root and branch’,
taken in this sense from the Old Testament’s book of Ezekiel, chapter 17.)
They wished to create a Reformed, Presbyterian state church, that is, to make
over the Church of England into the pattern that ultimately prevailed north of
the border as the Church of Scotland. Still others gave up on the established
church altogether, establishing illegal separatist churches. Eventually, England
would see a proliferation of home-grown sects: Congregationalists (or Inde-
pendents), General Baptists, Particular Baptists, Quakers (or Friends), Fifth
Monarchists, Ranters, Muggletonians, and more.
These reforming movements flourished during the tumultuous mid-
century years of civil war and interregnum, when the towering figure of Oliver
Cromwell presided over a kingless state and acted as protector of the godly.
But when the throne and the established church were ‘restored’ in 1660,
reforming movements of all sorts came under tremendous pressure. The
term ‘Dissent’ came to serve as the generic designation for those who did
not agree that the established Church of England should enjoy a monopoly
over English religious life. Some of the sects—such as the Ranters, Muggle-
tonians, and Fifth Monarchists—soon faded away. Others, especially Inde-
pendents/Congregationalists, Baptists, and Quakers survived. Crucially, they
were now joined outside the established church by the Presbyterians, ejected
from the livings in 1660–62. Although Presbyterians continued to attend
parish worship and work for comprehension within the national church,
they were (as Richard Baxter noted) forced into a separating shape, meeting
in illegal conventicles. In 1689, Parliament confirmed the separation between
Church and ‘Dissent’ by rejecting a comprehension bill and passing the
so-called Act of Toleration. The denominations of what became known as
‘Old Dissent’—Presbyterians, Congregationalists, Baptists, and Quakers—now
enjoyed legally-protected freedom of worship, even as their members remem-
bered being second-class citizens, excluded from public office unless they
received Anglican communion.
Over the course of the seventeenth century, all of these Dissenting move-
ments had established a presence in the British colonies of North America.
(They became ‘British’ and not just ‘English’ colonies in 1707, after the Union
of England and Scotland that created ‘Great Britain’.) In the New World began
what has become a continuous history of English Dissent adapting to condi-
tions outside of England. In this instance, Congregationalists in New England
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Series Introduction xv
set up a system that looked an awful lot like a church establishment, even as
they continued to dissent from the Anglicanism that in theory prevailed
wherever British settlement extended.
Complexity in the history of Dissent only expanded in the eighteenth
century with the emergence of Methodism. This reforming movement within
the Church of England became ‘New Dissent’ at the end of the century when it
separated from Anglican organizational jurisdiction. In America, that separ-
ation took place earlier than in England when the American War of Inde-
pendence ruled out any kind of official authority from the established church
across the sea in the new nation.
In the great expansion of the British Empire during the late eighteenth and
throughout the nineteenth century, Anglophone Dissent moved out even
farther and evolved even further. Canada, Australia, New Zealand, South
Africa, and other imperial outposts in Africa and Asia usually enjoyed the
service of Anglican missionaries and local supporters. But everywhere that
Empire went so also went Dissenting Protestants. The creation of the Baptist
Missionary Society (1792) and the London Missionary Society (1795) (which
was dominated by Congregationalists) inaugurated a dramatic surge of over-
seas missions. Nowhere in the Empire did the Church of England enjoy the
same range of privileges that it retained in the mother country.
Meanwhile, back in England, still more new movements added to the
Protestant panoply linked to Dissent. Liberalizing trends in both Anglican
and Presbyterian theology in the later eighteenth century saw the emergence
of the Unitarians as a separate denomination. Conservative trends produced
the (so-called Plymouth) Brethren who replicated the earlier Dissenting pat-
tern by originating as a protest against the nineteenth-century Church of
England—as well as lamenting the divisions in Christianity and longing to
restore the purity of the New Testament church. The Salvation Army (with
roots in the Methodist and Holiness movement) was established in response to
the challenges of urban mission.
Even further complexity appeared during the twentieth and twenty-first
centuries when Pentecostal movements arose, usually with an obvious Methodist
lineage, especially as developed by the Holiness tradition within Methodism,
but also sometimes with a lineage traceable to representatives of ‘Old Dissent’ as
well. Historically considered, Pentecostals are grandchildren of Dissent via a
Methodist-Holiness parentage.
Whether ‘New’ or ‘Old’—or descended from ‘New’ or ‘Old’—all of these
traditions have now become global. Some are even dominant in various
countries or regions in their parts of the globe. To take United States history
as an example, in the eighteenth century Congregationalism dominated
Massachusetts. By the early nineteenth century, Methodism was the largest
Christian tradition in America. Today, the largest Protestant denomination in
the United States is the Southern Baptist Convention. Or with Canada as
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xvi Series Introduction


another example, Anglicans remained stronger than did Episcopalians in the
United States, but Methodists and Presbyterians often took on establishment-
like characteristics in regions where their numbers equalled or exceeded the
Anglicans. In different ways and through different patterns of descent, these
North American traditions trace their roots to English Dissent. The same is
true in parallel fashion and with different results in many parts of Africa, Asia,
Latin America, and elsewhere, where Pentecostalism is usually the dominant
style of Protestantism.

THE F IVE VOLUMES OF THIS SERIES

The five-volume Oxford History of Dissenting Protestant Traditions is gov-


erned by a motif of migration (‘out-of-England’, as it were), but in two senses
of the term. It first traces organized church traditions that arose in England as
Dissenters distanced themselves from a state church defined by diocesan
episcopacy, the Book of Common Prayer, the Thirty-Nine Articles, and
royal supremacy, but then follows those traditions as they spread beyond
England—and also traces newer traditions that emerged downstream in
other parts of the world from earlier forms of Dissent. Second, it does the
same for the doctrines, church practices, stances toward state and society,
attitudes toward Scripture, and characteristic patterns of organization that also
originated in earlier English Dissent, but that have often defined a trajectory of
influence independent ecclesiastical organizations. Perhaps the most notable
occasion when a major world figure pointed to such an influence came in 1775
when Edmund Burke addressed the British Parliament in the early days of the
American revolt. While opposing independence for the colonies, Burke yet
called for sensitivity because, he asserted, the colonists were ‘protestants; and
of that kind, which is the most adverse to all submission of mind and opinion’.
Then Burke went on to say that ‘this averseness in the dissenting churches
from all that looks like absolute government’ was a basic reality of colonial
history. Other claims have been almost as strong in associating Dissenters with
the practice of free trade, the mediating structures of non-state organization,
creativity in scientific research, and more.
This series was commissioned to complement the five-volume Oxford
History of Anglicanism. In the introduction to that series, the General Editor,
Rowan Strong, engaged in considerable handwringing about the difficulties of
making coherent, defensible editorial decisions, beginning with the question
of how fitting the term ‘Anglicanism’ was for the series title. If such angst is
needed for Anglicanism, those whose minds crave tidiness should abandon
all hope before entering here. Beginning again with just the title, ‘Dissenting’
is a term that obviously varies widely in terms of its connotations and
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Series Introduction xvii


applicability, depending on the particular time, place, and tradition. In some
cases, it has been used as a self-identifier. In many other cases, groups whom
historians might legitimately regard as descendants of Dissent find it irrele-
vant, incoherent, or just plain wrong. An example mentioned earlier suggests
some of the complexity. In colonial Massachusetts, ‘Dissenting’ Congrega-
tionalists in effect set up an established church supported by taxes and
exercising substantial control over public life. In that circumstance, ‘Dissent’
obviously meant something different than it did for their fellow Independents
left behind in England. Nevertheless, Massachusetts Congregationalism is still
one of the traditions out-of-England that we have decided to track wherever
it went—even into the courthouse and the capitol building. Much later and far,
far away, Methodism in the Pacific Island of Fiji would also take on some
establishmentarian features, which again suggests that ‘Dissent’ points to a
history or affinities shared to a greater or lesser extent, but not to an unchan-
ging essence. Indeed, because Dissent is defined in relation to Establishment, it
is a relative term.
Another particularly anomalous case is Presbyterianism, which has been a
Dissenting tradition in England but a state church in Scotland and elsewhere.
When one examines it in other parts of the world, a sophisticated analysis is
required—for example, in the United States and Canada (where Presbyterian-
ism was once a force to be reckoned with) and in South Korea (where it still is).
In these countries one encounters a tradition originally fostered by mission-
aries and emigrants with both Dissenting and establishmentarian roots. By
including Presbyterians in these volumes, we communicate an intention to
consider ‘Dissent’ broadly construed.
Other terms might have been chosen for the title, such as ‘Nonconformist’
or ‘Free Churches’. Yet they suffer from the same difficulty—that all groups
that might in historical view be linked under any one term will include many
who never used the term for themselves or who do not acknowledge the
historical connection. Yet ‘Dissenting Studies’ is a recognized and flourishing
field of academic studies, focused on the history of those Protestant move-
ments that coalesced as Dissenting denominations in the seventeenth century
and on the New Dissent that arose outside the established church in the
eighteenth and nineteenth centuries.
Still, the problem of fitting terminology to historical reality remains. The
farther in geographical space that one moves from England and the nearer in
time that one comes to the present, the less relevant any of the possible terms
becomes for the individuals and Protestant traditions under consideration.
Protestants in China or India, for example, generally do not think of their faith
as ‘Dissenting’ at all—at least not in any way that directly relates to how that
word functioned for Unitarians in nineteenth-century England. Even in the
West, a strong sense of denominational identity or heritage has been waning
due to increasing individualism and hybridization. Such difficulties are
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xviii Series Introduction


inevitable for a genealogy where trunks and branches outline a common
history of protest against church establishment, but very little else besides
broadly Protestant convictions.
The five volumes in this series, as well as the individual chapters treating
different regions, periods, and emphases, admittedly brave intellectual anomal-
ies and historical inconsistencies. One defence is simply to plead that untidiness
in the volumes reflects reality itself rather than editorial confusion. Church and
Dissent, Anglicanism and Nonconformity, were defined by their relationship,
and the wall between them was a porous one; while it can be helpful to think it
terms of tightly defined ecclesiastical blocs, the reality of lived religion often
defied neat lines of demarcation. Many eighteenth- and nineteenth-century
Anglicans read Puritan works, while many Dissenters imbibed the works of
great Anglicans. Besides, an editorial plan that put a premium on tidiness would
impoverish readers by leaving out exciting and important events, traditions,
personalities, and organizations that do fall, however remotely or obscurely, into
the broader history of English Protestant Dissent.
Which brings us to the second, more significant justification for this five-
volume series. On offer is nothing less than a feast. Not the least of Britain’s
contributions to world history has been its multifaceted impact on religious
life, thought, and practice. In particular, this one corner of Christendom has
proven unusually fertile for the germination of new forms of Christianity.
Those forms have enriched British history, while doing even more to enrich all
of world history in the last four centuries. By concentrating only on the history
of Dissent, these volumes nonetheless illuminate the extraordinary contribu-
tions of some of the greatest preachers, missionaries, theologians, pastors,
organizations, writers, self-sacrificing altruists and (yes, also) some of the most
scandalous, self-defeating, and egotistical episodes in the entire history of
Christianity. Taken in its broadest dimensions, this series opens the story of
large themes and new ways of thinking that have profoundly shaped our
globe—on the relationships between church and state, on the successes and
failures of voluntary organization, on faith and social action, on toleration and
religious and civil freedom, on innovations in worship, hymnody, literature,
the arts, and much else. It is a story of traditions that have significantly
influenced Europe, North America, Latin America, Africa, Asia, the Pacific
Islands, and even the Middle East (for example, the founding of what is now
the American University of Beirut). Especially the two volumes on the twen-
tieth century offer treatments of vibrant, growing forms of Christianity in
various parts of the world that often have not yet received the scholarly
attention they deserve. All five volumes present the work of accomplished
scholars with widely recognized expertise in their chosen subjects. In specif-
ically thematic chapters, authors address issues of great current interest,
including gender, preaching, missions, social action, politics, literary culture,
theology, the Bible, worship, congregational life, ministerial training, new
OUP CORRECTED PROOF – FINAL, 21/8/2018, SPi

Series Introduction xix


technologies, and much more. The geographical, chronological, and ecclesi-
astical reach is broad: from the Elizabethan era to the dawn of the twentieth-
first century, from Congregationalists to Pentecostals, from Cape Cod to Cape
Town, from China to Chile, from Irvingite apostles in nineteenth-century
London to African apostles in twenty-first-century Nigeria. Just as expansive
is the roster of Dissenters or descendants of Dissent: from John Bunyan to
Martin Luther King, Jr., from prisoner-reformer Elizabeth Fry to mega-
mega-church pastor Yonggi Cho, from princes of the pulpit to educational
innovators, from poets to politicians, from liturgical reformers to social
reformers. However imprecise the category of ‘Dissent’ must remain, the
volumes in this series are guaranteed to delight readers by the wealth of
their insight into British history in the seventeenth and eighteenth centuries,
by what they reveal about the surprising reach of Dissent around the world in
later periods, and by the extraordinary range of positive effects and influences
flowing from a family of Christian believers that began with a negative protest.
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Fig. 460. Fig. 461.
Dupuytren Method.

Serre Method.—This author advises dissecting up a flap from the


upper lip, including the skin only, leaving it attached just above the
vermilion border, as in Fig. 462.
The free and upper end is sutured to the lobule. When union has
taken place, the pedicle is divided and is brought upward and
sutured into place. The secondary wound repaired by suturing finally.
There is some difficulty in dressing the wound during the time
required to have it unite to the skin of the lobule, because of the
danger of pressure and consequent gangrene.
Fig. 462.—Serre Method.

Dieffenbach Method.—This author took up the skin flap


transversely or obliquely, as shown in Fig. 463, and twisted it into
position, as shown in Fig. 464.
The objection to the direction of making the flap in this manner is
that the consequent cicatrization has a tendency to draw the mouth
out of its normal position on the wounded side.
Fig. 463. Fig. 464.
Dieffenbach Method.

The following methods show the taking of the flap from the skin of
the nose itself. Unless the defect be very small such methods are
objectionable.
Fig. 465.—Heuter Method.

Fig. 466.—Szymanowski Method.

Szymanowski Method.—In the latter method of Szymanowski the


flap must be stretched considerably, to close over a lengthy
deformity, encouraging gangrene. The deformity is not so great,
however, as with the two preceding methods.
Fig. 467. Fig. 468.
Szymanowski Method.

The author believes a nonpedunculated flap with or without a


cartilaginous support should be tried before other methods are
resorted to, in all cases, with the hope of healing the graft in place.
The fact that the mucosa can in some cases be sutured to the
margins of the flap adds much to the possibility of its subsequent life
by adding its nutriment to the graft.
CHAPTER XVI
COSMETIC RHINOPLASTY

The operations herein considered have to do with overcoming


deformities, congenital or acquired, as a result of traumatism, and in
which there is no loss of tissue, the sole object being to give to the
nasal organ a more desirable size and contour.
There are many types of abnormalities involving both the size and
shape of the nose. Some of these deformities may be readily
corrected by subcutaneous or submucous operations, while others
involve more or less cutting of the skin.
The object of the surgeon at all times is to accomplish the best
results with as little disfigurement as possible.
Anesthesia.—All the cosmetic operations of the nose should be
done under local anesthesia, unless there be serious objections to
its employment.
The author advocates the use of a four-per-cent solution of β
Eucain, in preference to all others. It is less toxic than cocain and
harmless to the patient; no untoward symptoms are exhibited from
its use post-operatio. Various patients complain of slight uneasiness
about the epigastrium, and many speak of a peculiar weakness
about the knees, but these symptoms pass away quickly.
More or less stinging is felt in the wounds made in this manner,
immediately after the operations, especially about the lobule of the
nose, as with blepharoplasties, but this usually subsides in less than
an hour. It may persist, however, in some cases, for several hours. It
is well, therefore, to acquaint the patient with this fact to avoid worry
or fear.
Where severe, hot applications, dry or moist, may be used to
overcome it.
More or less edema follows the employment of local anesthetics,
which passes away in various lengths of time, from one to four, or
even five days, according to the amount used and the site and
circulation of the part operated upon.
In over ten thousand hypodermic injections of eucain the author
has observed only two cases of collapse, which responded readily to
the usual treatment employed in such event, and has never met with
a single fatality.
Sutures.—Twisted silk sutures are to be preferred, as they do not
invite sepsis, as softening catgut does, and retain the parts during
the entire time required for healing, while the latter is liable to
become separated by uneven absorption, allowing the wound to
gape at that point and causing more or less of a cicatrix, so intolerant
to patients of this class.
Dressings.—Bulky bandages are not required; they heat the
parts, and look unsightly. The author employs antiseptic adhesive
silk plaster for covering all external wounds, except where the hair
prevents its use. Moist dressings are never indicated, except in the
later treatment of infected wounds.

ANGULAR NASAL DEFORMITY


This is, perhaps, the most common of all nose deformities. The
nose is overprominent about the osseous bridge, extending outward
and downward, hook or hump fashion. It may be congenital or the
result of external violence.
There are various methods of reducing the redundant bones and
cartilage; those involving submucous excision are difficult to perform
for the inexperienced operators, and the external means of reduction
are advised to be followed. The resultant scar, if the skin has been
properly incised and not damaged by retracting pressure, and, lastly,
properly and neatly sutured, should be barely visible.
Monk’s Method.—This author made a small incision through the
skin just posterior to the inferior edge of the lobule, as in Fig. 469a.
Then with a dull instrument, introduced through the opening, he
detached the connecting tissue that binds the skin along the anterior
dorsum as far as the root of the nose, giving more or less width to
this freed area about the nasal bones.
A dull-pointed scissors is introduced through the sublobular
opening, and the bones and cartilage are reduced until the desired
nasal line has been attained.
The method of procedure is shown in Fig. 469b.

Fig. 469a. Fig. 469b.


Monk’s Method.

The wound is cleansed of all spiculæ of bone or bits of cartilage


and the skin opening is closed by suture. Healing takes place with
more or less ecchymosis in about six days.
The difficulty the author finds with this method is that it is
practically impossible to do good work with the scissors in this
position.
The use of an electric drill has been advocated to do away with the
scissors, but it is a dangerous instrument and requires great skill for
its manipulation and reduces the bone particles to such fine
fragments that much of it is left in the wound, which may induce
sepsis or cause unevenness of the skin surface until later absorbed
or removed. The same fault is observed with cartilage, which it
grinds into pulpy pieces and for which it should never be used.
Anterior Median Incision.—This, perhaps the oldest method, has
been extensively employed. The incision is made down the median
line of the dorsum of the nose, beginning above the deformity, and
ending slightly below the inferior bone line, as shown in Fig. 470.
The skin is incised obliquely.
An assistant separates the wounds with hook tenaculi, exposing
the osseous bridge, as in Fig. 471.

Fig. 470. Fig. 471. Fig. 472.


Median Nasal Incision.
The author advocates dividing the periosteum and dissecting it
well back to either side of the bony elevation. By bringing it back
over the denuded surface after the chiseling has been done, it aids
materially in establishing a smooth surface and hastens the bone
repair.
The periosteum being held aside, the straight chisel and mallet are
used to reduce the bone. The operator may proceed to do this from
above down or vice versa, according to the formation and position of
the protuberance.
The redundant cartilage is removed with the knife from above
downward, cutting from side to side.
Usually the operator does not remove enough of the cartilage and
a new angulation of the nose appears after the swelling has
disappeared, necessitating a second operation.
The wound is closed as shown in Fig. 472.
Lateral Incision.—The incision in this case is made slightly
posterior to the beginning of the lateral border, as shown in Fig. 473.
The skin is held back, as shown in Fig. 474, and the same mode
of procedure is followed as that just given.
Fig. 473. Fig. 474.
Lateral Nasal Incision (Author’s method).

The operator will have some difficulty to reach the opposite


anterior border of bone elevation, especially if the incision has not
been made long enough. This should be done. At no time should the
assistant employ too much force in retracting the anterior flap to
better expose the field of operation; it is certain to cause gangrene of
the skin.
To overcome a long scar line, and to facilitate the cutting away of
the bone, the author had a special set of chisels made with curved
cutting blades, one angular and the other straight-edged. There are
two each for working from the right and left sides. The striking point
lies midway between the blade and the end of the handle.
They are shown in Figs. 475 and 476.
Fig. 475. Fig. 476.
Author’s Chisel Set.

To the set the author has added a suitable metal mallet, an


instrument very hard to obtain for osteoplastic operating. All the
mallets obtainable are too large and heavy for delicate work (see
Fig. 477).

Fig. 477.—Author’s Metal Mallet.

After the bone is reduced to the proper level, the cartilage is cut
away as before described, and the wound is sutured.
The resultant scar is much better than when made in the median
line, and is not so noticeable in this position.
This operation gives the best results of all external methods
employed for this purpose.

CORRECTION OF ELEVATED LOBULE


(Retroussé Nose)
This condition is frequently a deformity. The base of the nose is
tilted upward, unduly exposing the nares.
The author prefers to bring the lobule down by excision of the
anterior third of the subseptum in preference to submucous
dissection of the cartilaginous tissue, causing the deformity.

Fig. 478. Fig. 479.


Author’s Method.

With an angular scissors introduced through the nares, a triangular


section of the septum is removed, as shown in Fig. 478. The apex of
the triangle should be placed well up into the septum to break the
elasticity of its structure, the base of the triangle being sufficiently
wide to somewhat overcorrect the deformity.
Such noses are usually narrow at the lobule, and no interference
with the lower lateral cartilages is called for.
The septal mucoid and the subseptal skin wounds are brought
together by suture, as shown in Fig. 479, leaving only a slight
transverse linear scar on the subseptum.

CORRECTION OF BULBOUS LOBULE


Roe corrects this deformity by making an incision, either vertically
or horizontally, in the mucosa in one or both nares, through which he
introduces the blades of a fine curved scissors, with which sufficient
redundant tissue is removed to bring the lobule down into the
desired contour.
The mucosa should be sutured to facilitate rapid cicatrization. The
operation should be overdone to get the desired result.
Not infrequently the extreme convexity of the lower lateral cartilage
must be overcome by either removal submucously or by excision of
the cartilage itself, employing an elliptical incision in the mucosa for
the purpose.
The alæ are kept in position after such ablation by compress
dressings or by a suture made transversely through both wings of
the nose and the septum, and tied over a quill or cork support placed
externally upon the skin at either side of the nose. This is removed
about the sixth day.
Sheet lead or a splint of aluminum of proper thickness and
covered with gauze may also be used to retain the parts during
cicatrization.

ANGULAR EXCISION TO CORRECT LOBULE


When the lobule is unduly broad at its base and is more or less
concave above the rim of the alæ, it can be reduced by removing a
diamond-shaped piece of tissue at either side of the subseptum.
The bases of the two triangles making up the diamond at its widest
area meet at the anterior rim of the nostrils, extending with their
apices upward and backward, as shown in Fig. 480.
If there be a prominence of the cartilaginous structure of the
lobule, this may be removed subcutaneously after the two ablations
have been made.

Fig. 480. Fig. 481.


Author’s Method.

Before suturing the wounds, it is advisable to free the skin of the


inferior lobule to overcome tension.
The sutures are applied as in Fig. 481. None are used to unite the
mucosa unless the interior wounds are large enough to permit of
their use.

CORRECTION OF MALFORMATIONS ABOUT THE


NASAL LOBULE
The operations herein described apply particularly to the
correction or reduction of an overprominent nasal tip due to an
excessive growth of congenital malformation of that part of the nose,
giving the organ undue prominence and a hooklike appearance,
usually associated with a narrow, sharply upward inclined upper lip.
Pozzi Method.—The same operation, on a larger scale, can be
readily employed for the correction of hyperplasia nasi and
rhinophyma.
In the operation of Pozzi (Bulletin et mémoire de Société de
chirurgie, 1897, p. 729) an elliptical section of skin and cartilage are
removed from the lobule with its widest part corresponding to the
point of the nose; the cicatrices occasioned thereby are practically as
bad, if not worse, than the unscarred overprominent nose, while the
submucous procedure of Roe (Medical Record, July 18, 1891) is not
only insufficient in these cases, but, according to my experience,
practically useless.
Roe Method.—Roe’s method requires a submucous extirpation of
the redundant cartilage at the tip through a necessarily small
opening within the nasal orifice, also the division in several places of
the anterior fold of the lower lateral cartilage with the object of
reducing the undue convexity of the alæ. The latter is, we might say,
impossible, since the cartilages will be reduced by such a method,
even under pressure dressings, which are likely to cause gangrene
of the skin of the wings; or if this be avoided, the cicatrix resulting
from such division usually restores the very fault that it is expected to
overcome, while the mucous lining of the alæ becomes thickened
and more firmly tied down than previous to the operation.
One is tempted to exsect the major curvature of the lower lateral
cartilage, but this leads to a flattening of the wings of the nose,
partial atresia of the nasal orifice, and a decided lack in its symmetry.
Secondly, in Roe’s operation there is always a lack of knowing
how much or how little to remove of the cartilage of the tip, a second
cosmetic operation being made necessary after the parts have
contracted and healed, a common fault with most cosmetic plastic
operations performed under local anesthesia, owing to the
immediate edematous enlargement following its hypodermic use.
Operation as Commonly Practiced.—The operation heretofore
most commonly practiced is one in which an elliptical piece of skin is
cut from the tip of the nose, followed by the extirpation of the anterior
prominences of the lateral cartilages, and amputation of the septal
cartilages. Unfortunately, the result, at first quite satisfactory to the
eye, culminates in the pulling apart of the cicatrix formed by bringing
the sides of the wound together along the median line with a later
depression of the tip in this median line, occasioned by the outward
traction of the lower lateral cartilages. Even a second or third
operation does not overcome this result entirely, and at best leaves
an ugly irregular gash in the median line of the tip and the columna.
In one of the cases here cited this same operation had been
unsuccessfully tried twice by another surgeon, with very
unsatisfactory and unsightly result. (Case II.)
The ideal operation for all of this type of cases from the view of the
surgeon is to leave as little disfigurement as possible, and the
method to be here considered, when properly followed, leaves no
scar whatever, except for a slight white line across the columna of
the nose, where it is out of view, and when contracted offers no
objection on the part of the hypercritical patient.
Author’s Method.—The method of the author is as follows: Given
a nose, typified by the illustration in Fig. 482, the skin above the site
of the operation is thoroughly cleansed with soap and hot water, then
rinsed with alcohol, ninety-five per cent, and vigorously scrubbed
with gauze sponges, dipped into hot bichlorid solution, 1 to 2,000,
followed with a thorough lavage with sterilized water. Both nostrils
are now cleansed with warm boric-acid solution by the aid of small
tufts of absorbent cotton wound over a dressing forceps. The patient
is then instructed to breathe through the mouth during the operation.
A number of small round gauze sponges dipped into sterilized water
and squeezed dry are placed within reach of the assistant. About
one drachm of two-per-cent Beta Eucain solution is now injected
about the tip of the nose, the columna, and the alæ, as far back as
their posterior fold.
Fig. 482. Fig. 483.
Author’s Method.

A thin bistoury is then thrust into the nose from right to left,
entering at the point E (Fig. 483), and brought down parallel to the
anterior line of the nose, and emerging below the tip in a line with the
anterior border of the nasal orifices. This procedure leaves a strip (A)
about one quarter inch wide, laterally, rounded at its inferior
extremity, and attached superiorly to the nose. Next the round
inferior tip (B) is cut away obliquely, sloping inward toward the nose
by the aid of a small angular scissors. Each blade of the angular
scissors is now placed into each nostril, the tips of the blades
inclined forward, and the columna or subseptum is divided at C, also
the septum along the line D up to a point a little above the first
incision made externally at E. The two arterioles of the columna are
controlled by the use of mosquito-bill forceps. The two projecting
folds of the lower lateral cartilage in the columna are next severed as
deeply as possible to give mobility to the stump, a step necessary to
overcome the changed position, otherwise resulting in a droop,
which would have to be corrected at a later sitting.
The next step is to give the needed shape to both wings. This is
accomplished with a specially designed scissors, so curved on the
flat that its convexity facing upward corresponds to the normal
curvature of the orificial rim. A clean cut with these scissors,
beginning at G and ending at the point E, is made, leaving the base
of the nose, as shown in Fig. 484. The anterior flap A is now bent
backward to meet the stump of the columna at C. If it does not fall
readily into place a little more of the septal cartilage is removed
along the line D until this is accomplished.
It may be necessary to shorten the flap A in cases where a very
prominent hook is to be corrected.

Fig. 484. Fig. 485.


Base of Nose After Excisions.

The free end of the flap A is now sutured with No. 4 sterilized
twisted silk to the stump of the columna at B. Two stitches usually
suffice (see Fig. 485). One or two sutures may also be taken across
the angles of union of the alæ and the flap A. The inferior raw
surface of each wing may be found to be too wide, owing to the
presence of the thickened cartilage at this point of the wing. The skin
and the mucous membrane are then carefully peeled away from the
cartilage, and the latter cut away as high as possible, or a gutterlike
incision is made along its edges as shown in C (Fig. 485), excising
the elongated elliptical piece of tissue which includes the cartilage.
The raw mucocutaneous edges of the wings are now brought
together with a No. 1 twisted silk continuous suture, completing the
operation.
An antiseptic powder is dusted over the parts operated on, and
small gauze dressings are applied with the aid of strips of silk
isinglass plaster. A small tampon of cotton, well dusted over with an
antiseptic powder, is placed into each nostril.
The dressings are changed the second day, when the resultant
swelling will have practically subsided. The sutures in the columna
are removed the fourth day preferably, and those of the wings about
the sixth day. Complete cicatrization follows in about ten days, when
the patient can be discharged.
The following cases are given to show the types of cases thus far
operated upon and to illustrate the results obtained:

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