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of studying pathology that 'STARTING POINT' will never be discovered." The path which M. Magendie proposes, instead of our present mode of studying pathology, is by experiments on animals. Now, we unhesitatingly declare our solemn conviction that the present mode of observing symptoms during life, and recording the post-mortem phenomena is infinitely more likely to gain the starting-point, than that of torturing animals to death, either by food, physic, or the scalpel, and then observing the phenomena in the dead body. And here we will point out a fundamental error which vitiates every experiment that Magendie makes, and every inference that he draws. Let the practical reader reflect on the following sentiment, and ask himself whether its author has the remotest title to that of a careful clinical observer.
"For my part I declare loudly that I look upon these ideas about vitality, and the rest of it, as nothing more than a cloak for ignorance and laziness."
Thus all the phenomena observed in sickness and in health are to be explained by the laws of chemistry and mechanics! Let us just glance at some of the errors and absurdities into which this humoro-chemico-pathology will constantly lead its disciples. Dolorous mental impressions will, we know, change and derange the gastric juice, the chyme, the chyle, the bile, the urine, and, in short, every secretion that issues from every gland in the alimentary canal—and, as M. Magendie admits-will vitiate the blood itself. This will take place almost instantaneously when the individual is in good health, but crossed by grief or misfortune. Now if blood were drawn from such a person, and taken, to M. Magendie, like a bottle of urine to Dr. Laing, the chemical pathologist would pronounce the individual to be in a most desperate condition-most likely in the last stage of typhus. But, in a few days, the dolorous impressions clear away -digestion and assimilation become restored, and the blood assumes its normal condition. The blood then drawn and shewn to the professor would be pronounced the blood of a person in sound health. See then the monstrous absurdity into which the chemical pathology, in exclusion of vitality, leads M. Magendie. According to his doctrine the vitiated state of the blood must have been the cause and not the effect of the mental emotions! This comes of throwing overboard the agency of the nervous system, or, in other words, of vitality, in the disorders of digestion and the vitiation of the fluids.
After ridiculing the theories which have been broached to account for the passage of the blood from the arterial to the venous capillaries by so slight a force as the heart and vessels exert, we are dazzled by the following effulgent explanation.
"My inquiries up to the present time, go to prove, that the passage of the blood from the arterial to the venous capillaries, is effected by means of the nice adaptation of its physical properties to the physico-vital endowments of the vessels."
Most brilliant elucidation! The light which is here thrown on the subject is too bright for human eye to bear—and consequently we are just as much in the dark as ever.
If we can understand our lecturer, he conceives that the passage of the blood through the capillaries depends not on the liquid but coagulable fibrine contained in it; for if alkalies be injected into the veins of an animal, the coagulability of the fibrine is lost-the blood stagnates in the capillaries-and congestion, effusions, or even inflammation ensues. This, he affirms to be the case in most of the epidemics, and especially in the late one called the "grippe." Without questioning these assertions or opinions, we will now extract a passage which will make every practical man stare.
"Again, in acute rheumatism, as I once before explained to you, the painful parts become the seat of engorgement due to the stoppage and accumulation of the blood in its canals. The liquid stagnates, its temperature falls, and hence the sensation of cold felt by the patient, and which may, in some cases be felt by a bystander on the application of the hand."
Have we practised for forty years, and yet were so blind and unobservant as not to perceive that the joints in acute rheumatism felt cold, even to hands of byestanders ! If the Seine is ever to be set on fire by mortal hand, M. Magendie will be the man.
M. Magendie has found or fancied (which is the same thing) that acetate of ammonia facilitates the passage of blood through the capillaries, and avers that he cures his rheumatic patients by this remedy alone. He says he has never lost a single patient in acute rheumatism, either in his hospital or in private practice -and we can well believe him—if they presented cold joints in this painful disease. The following sentence is praiseworthy—and it is more applicable than the author means it to be.
"All this is accurately true; nevertheless, did I assert it in too exclusive a manner, I should, in my turn, be guilty of an error. Nothing is so easy as to deceive oneself into the belief of the universal applicability of any important fact one may be fortunate enough to discover. Against such self-deception it is my duty to guard you."
We doubt if there is a single spot on the surface of civilized Europe, except Paris, where a medical audience would listen to the absurdities broached in Magendie's lectures, without bursting into laughter, or deserting the room.
We have already alluded to M. Magendie's crotchets respecting soda, and its properties of causing inflammation, by making the blood so thin as to run through the sides of the arteries, but incapable of running through their patulous mouths into the venous capillaries. Listen, readers, to the proofs which he adduces of this important doctrine.
"My experiments have demonstrated the property possessed by this body of liquefying the blood, by combining with its fibrine. Now, I have not a doubt but that its long-continued medicinal use produces similar results on the blood, causes infiltration of the lungs, and acts, in short, so long as persisted in, as an inexhaustible source of pneumonia; at least, I am authorised in this belief by what occurred to a friend of mine, one of the most celebrated men of the present day. He has been compelled to give up taking the carbonate by a succession of pneumonic attacks, that followed each other while he was in the habit of employing it."
Thus, because a friend of M. Magendie's happened to have a series of pulmonic attacks, while using carbonate of soda, these attacks were the consequence of its use! And such reasoning is issued and swallowed in the year 1838! Alas for physic! No wonder that our profession is becoming the laughing-stock of the scientific and rational world, when animal magnetisers and hæmato-maniacs are listened to by men professing to have brains in their skulls!
Lecture 4.-This lecture commences with a kind of determination to throw overboard sensibility, contractility, and other vital phenomena in the circulation, and to adopt physics and hydraulics in their stead.
"There is a fact, in physics, remarkable for the excellent term of comparison which it serves to establish between the phenomena of the movement of the blood in our organs and the circulation of liquids in inert tubes. I allude to the enormous pressure which is required in order to make water pass through a tube of very small diameter, while the blood traverses with ease the infinitely more minute tubes that abound in our tissues. There must be some particular conditions to facilitate its passage. What proves their existence is, that if certain alterations are effected in the composition of the blood, it stops, undergoes morbid changes, becomes extravasated and decomposed, and produces the various disorders which pathologists have vainly attempted to explain by the words inflammation and irritation. What sense, in truth, is there in applying the words inflammation to our organs? Do our tissues really take fire? I confess I know of no example of such a phenomenon."
Thus M. Magendie's assumptions that the capillary vessels have nothing to do with the capillary circulation, and that the passage of the blood through them depends entirely on certain qualities of the fluid itself, are perfectly gratui. tous and unsupported by facts or reasoning. Upon the principles of physics and hydraulics, how will he account for the crimson cheek, in shame, while no other part of the surface turns red? Has the heart power to direct more blood to the capillaries of the face than to any other capillaries? The idea is absurd. He tells us, in direct words, that the vessels do not possess contractility!
"The questions we have so far treated of belong, in great measure, whatever may be said to the contrary, to the subjects of physics and hydraulics. You will find that, in elucidating them, we shall have no occasion to avail ourselves of the so-called contractility of the vessels, which, in reality, does not exist; and we shall be quite as independent of the species of sensibility, termed insensible, and of the entire collection of absurd terms by the help of which no few romances, doubtless very clever, but very empty too, have been got up about the capillary circulation."
As to his objection to the term "INFLAMMATION," it is the most puerile effort at wit which we ever remember to have seen. Because the great toe of a man in gout does not flare up, like a gas-lamp, the term " INFLAMMATION" is ridiculous!
Against "irritation" too, our author wages war to the knife.
"What on earth is the meaning of the word irritation? An obstacle of some sort or other modifies the course of the blood in any given organ, and instead of simply stating that there is a modification produced by a mechanical impediment to the progress of that fluid, you tell us the part is irritated, and actually employ the very term the worst fitted to designate the disorder manifested in the circulation How long, I should be glad to know, have our organs been proved susceptible of feeling passions-of becoming irritated—I had almost said of getting angry?"
The only comment we shall make on such exquisite absurdities shall be in the words of Magendie himself.
"The verbiage and subtlety of the bar seem to have spread to the members of our profession. Whoever talks loudest and longest usually triumphs, and, of course, settles the matter his own way: he does so often in defiance of truth; but what matters for that? he gets himself spoken of and makes a name. On the other hand, the man who does not possess that extraordinary gift of the tongue, by which white is made black and black white, remains unknown, vegetates, and passes for an ignoramus in the eyes of the public."
We should be inclined to laugh heartily at the new-fangled doctrines of the profession, did we not know that no doctrine or practice can be so preposterous or pernicious as not to entrap a considerable number of medical practitioners, and especially of medical students. We must therefore endeavour to check the evils which M. Magendie's lectures are calculated to disseminate through society. What will the practitioner say to the following passage?
"We were speaking of the viscidity requisite for the circulation of the blood through our organs. Now here is the blood of an individual who had an attack of hemoptysis, and was bled freely for it. You know well what I think of that remedy,-worse, perhaps, than the disease. Be that as it will, you may perceive that this blood is very slightly viscous; I, in consequence, presume that further mischief will occur.'
Heaven help the unfortunate hæmoptisical patients who may come under the care of this visionary enthusiast, whom experience (if he really has any) must have blinded rather than enlightened! We are almost weary of exposing the matchless absurdities that crowd every page of these lectures; yet still we must proceed a little farther. Who, out of Bedlam, would compare the effects resulting from injections into the veins with ingurgitation into the stomach? No. LIX. P
None but Magendie. He injects mucilage of gum-arabic into the veins of an animal till the vessels are choaked up and the animal dies, and he does not appear to think that there is the slightest difference between this process and that of taking gum-arabic into the stomach, where it has to undergo digestion and assimilation before it enters the circulation !!
"You remember the experiments we made to exemplify this question. We added a viscid matter, innocuous in itself-gum, for example,-to some water, and, after colouring the fluid, injected it into the jugular vein of an animal. So long as the injection traversed the large venous trunks no disorder was occasioned; but once it had arrived through the pulmonary artery, amongst the minute ramusculi of the lung, its degree of viscidity ceased to be in just proportion to the capacity of the tubes. The consequence was, that the circulation almost instantly stopped, and, as the encephalon no longer received the necessary excitement of arterial blood, its functions ceased, and the animal quickly perished. The autopsy was immediately made, and, on incising the pulmonary parenchyma perpendicularly to the direction of its principal vessels, we invariably found them stuffed with the substance injected. Let us admit, however, that this liquid had succeeded in making its way through the capillary system of the lung. You are aware that the diameter of the ultimate tubes varies almost in every organ, and that in some of them it is still smaller than in the lungs. Let us suppose, then, any substance that has passed through the pulmonary parenchyma with great difficulty, arriving at other capillaries of greater tenuity. It will, beyond question, be arrested in its course by this new obstacle; and its stagnation and subsequent effusion will produce, according to the nature of the parts with which it is in contact, various disorders, more or less analogous to those already described."
Lecture V. In this lecture, after slaying, for the tenth time, the doctrines of vitality, irritability, &c. our Professor rises into the miraculous, and assumes the attributes of a modern Prometheus.
"But, Gentlemen, it has been shown to demonstration, that the empire of inflammation is even more widely extended than it was the habit to assume ; and, what is remarkable, it is I who, like a generous enemy, have conferred on it powers of which even its very warmest partisans had deprived it. They limited its action to living organs, I have extended it to the tissues when they have ceased to live. Many and many a time have I proved, by experiment, that its most terrible symptoms develop themselves in parts wholly inanimate."
No man can,
The animal magnetisers may now hide their diminished heads-if they have any heads left—and the Okeys may go back to their old occupations in the garret. with more adroitness than M. Magendie, dilute a small quantum of truth with a large mixture of misrepresentation, when an opponent is to be turned into ridicule. Yet no process is more dangerous, or more dishonorable. Thus, after giving a short, and by no means graphic sketch of a chlorotic girl, M. Magendie observes-" in order to remedy these organic disorders (what a phrase) the practitioner bleeds the patient, and gives preparations of iron." Now if the professor were closely questioned as to the practice of bleeding in chlorosis-merely as chlorosis-he would probably reply that he knew not whether such was the practice-nor did he care. His object was to produce a "sensation" amongst his elèves, no matter at what expense of his professional brethren !
The beautiful and accurate deductions of Laennec and all our modern auscultators are thrown overboard, and from some squirting experiments in leathern and metallic tubes, M. Magendie boldly avers that the bruit de soufflet," "bruit de scie," 'bruit de diable," &c. have nothing to do with affections of the heart itself, but merely with the composition of the blood! With a man
who outrages reason-denies facts-and maintains fictions-it is useless to argue.
We shall not, therefore, pursue these lectures any further at present. We have pointed out sufficient samples of their unparalleled absurdity-their shameless illiberality-their unsparing criminations of the profession at large-and, worse than all, their most pernicious tendency. Let the medical students, and the junior practitioners beware how they embrace M. Magendie's tenets, or act on his principles. If they do not, they will sacrifice their own reputationsand, what is of more consequence, the lives of their patients.
AN INTRODUCTORY DISCOURSE ON THE STUDIES REQUIRED FOR THE MEDICAL PROFESSION. ADDRESSED TO THE STUDENTS OF THE MEDICAL SCHOOL OF ST. GEORGE'S HOSPITAL, OCTOBER 1, 1838. By Sir BENJAMIN C. BRODIE, Bart. F.R.S. Serjeant-Surgeon to the Queen, and Surgeon to St. George's Hospital.
This Discourse was delivered in the School of the Hospital, to a crowded audience, at the commencement of the present session. Sir Benjamin Brodie has not only attained the highest place amongst existing British surgeons, but he has fully deserved it. His early diligence has been equalled by his subsequent industry, and the acuteness of observation and soundness of judgment, which form the characteristics of his mind, have struck all who have perused his writings, or enjoyed the honour of his acquaintance. A discourse on medical study, from him, must command attention and respect. The old may compare his experience with their own-the young may learn the road to success from one who has himself trod it.
We shall extract such passages from this Address, as are calculated to be useful. They are far from few. Sir Benjamin is essentially a practical man, and his strong sense detects and exposes the fallacies and sophisms of the day.
1. Speaking of the Treatment of Disease, Sir Benjamin observes :
"Let it always be borne in mind that this last is the real object which you have in view. I address you as future medical practitioners. If, taking another course, you choose to study anatomy and physiology, merely as interesting branches of human knowledge, you are at liberty to do so, and you will be as well rewarded for your labours as if you had applied yourselves to geology, optics, or astronomy. In like manner, if any one apply himself, as a philosopher, altogether to the study of pathology, he will find much in it that may interest himself, and that may be useful afterwards to those who carry their researches further. But as medical practitioners, you must not stop at either one or the other of these points; and, never losing sight of the ultimate object of all your investigations, you must estimate the value of whatever other knowledge you acquire by the degree in which you find it to be directly or indirectly applicable to the healing art.
It is one advantage arising from the peculiar constitution of the London medical schools, that, with few exceptions, the instructions, which you here receive, have, in a greater or less degree, a tendency to practice. The ambition of the teacher of anatomy is not limited to success in his present vocation. He looks forward to the time when his profession as a physician or surgeon will elevate him to fame and fortune. His mind is naturally directed to those inquiries, a proficiency in which will most assist him in the attainment of these objects; and that which is useful to himself cannot fail to be useful to his pupils. I have no doubt that the praises which are bestowed on some of the continental anatomists are well founded: that there are universities in which the anatomical professors, devoting their whole time, and industry, and intellect, to this one