Erisistratus, who was a great speculator, and whose theories had the most important influence on his practice, banished blood-letting altogether from medicine, for the following notable reasons: because, he says, we cannot always see the vein we intend to open; because we are not sure we may not open an artery instead of a vein; because we cannot ascertain the true quantity to be taken; because if we take too little, the intention is not answered; if too much, we may destroy the patient: and because the evacuation of the venous blood is succeeded by that of the spirits, which thus pass from the arteries into the veins; wherefore, blood-letting ought never to be used as a remedy in disease. Yet, though he was thus cautious in abstracting blood, it must not be supposed that he was not a sufficiently bold practitioner. In tumour of the liver, he hesitated not to cut open the abdomen, and to apply his medicines immediately to the diseased organ; but though he took such liberties with the liver, he regarded with the greatest apprehension the operation of tapping in dropsy of the abdomen: because, said he, the waters being evacuated, the liver which is inflamed and become hard like a stone, is more pressed by the adjacent parts, which the waters kept at a distance from it, whence the patient dies.
One physician conceived that gout originated from an effervescence of the synovia of the joints with the vitriolated blood: whence he recommended alcohol for its cure: a remedy for which the court of aldermen ought to have voted him a medal. A more ancient practitioner who believed that the finger of St. Blasius was very efficacious “for removing a bone which sticks in the throat,� maintained that gout was the “grand drier,� and prescribed a remedy for it which the patient was to use for a whole year, and to observe the following diet each month: in September he must eat and drink milk; in October he must eat garlic; in November he is to abstain from bathing; in December he must eat no cabbage; in January he is to take a glass of pure wine in the morning; in February to eat no beef; in March to mix several things both in eatables and drinkables; in April not to eat horse-radish; nor in May the fish called Polypus; in June he is to drink cold water in a morning; in July to avoid venery; and lastly, in August to eat no mallows.
A third physician deduced all diseases from inspissation of the fluids; hence he attached the highest importance to diluent drinks, and believed that tea, especially, is a sovereign remedy in almost every disease to which the human frame is subject: “tea,� says Bentakoe, who is loudest in his praises of this panacea, and who, as Blumenback observes, ‘deserved to have been pensioned by the East India Company for his services,’ “tea is the best, nay, the only remedy for correcting viscidity of the blood, the source of all diseases, and for dissipating the acid of the stomach, as it contains a fine oleaginous volatile salt, and certain subtle spirits which are analogous in their nature to the animal spirits. Tea fortifies the memory and all the intellectual faculties: it will therefore furnish the most effectual means of improving physical education. Against fever there is no better remedy than forty or fifty cups of tea swallowed immediately after one another; the slime of the pancreas is thus carried off.�
Another physician derived all diseases from a redundancy or deficiency of fire or water. He maintained that where the water predominated the fluids became viscid, and that hence arose intermittent fevers and anthritic complaints. His remedies are in strict conformity to his theory. These diseases are to be cured by volatile salts, which abound with fiery particles; venesection in any case is highly pernicious; these fiery medicines are the only efficacious remedies, and are to be employed even in diseases of the most inflammatory nature. “Life,� says Dr. Brown, “is a forced state:� it is a flame kept alive by excitement; every thing stimulates; some substances too violently; others not sufficiently; there are thus too kinds of debility, indirect and direct, and to one or other of these causes must be referred the origin of all diseases. According to this doctrine the mode of cure is simple: we have nothing to do but to supply, to moderate, or to abstract stimuli. Typhus fever, in this system, is a disease of extreme debility: we must therefore give the strongest stimulants. Consumption and apoplexy, also, are diseases of debility; of course the remedies are active stimulants. Humanity shudders, and with reason, at the application of such doctrines to practice. And not less destitute of reason, and not less dangerous in practice, is the great doctrine of debility promulgated by Cullen. This celebrated professor taught that the circumstance which invariably characterized fever, that which constituted its essence, was debility. The inference was obvious, that, above all things, the strength must be supported. The consequence was, that blood-letting was neglected, and that bark and wine were given in immense quantities, in cases in which intense inflammation existed. The practice was in the highest degree mortal; the number of persons who have perished in consequence of this doctrine is incalculable. So far then is it from being true that medical theories are of no practical importance, that there is the closest possible connection between the speculations of the physician in his closet, and the measures which he adopts at the bed side of his patient. Truth to him is a benignant power which stops the progress of disease, protracts the duration of life, and mitigates the suffering it may be unable to remove: error is a fearfully active and tremendously potent principle. There is not a medical prejudice which has not slain its thousands, nor a false theory which has not immolated its tens of thousands. The system of medicine and surgery which is established in any country, has a greater influence over the lives of its inhabitants than the epidemic diseases produced by its climate, or the decisions of its government concerning peace and war. The devastations of the yellow fever will bear no comparison with the ravages committed by the Brunonian system; and the slaughter of the field of Waterloo counts not of victims, a tithe of the number of which the Cullenian doctrine of debility can justly boast. Anatomy alone will not teach a physician to think, much less to think justly; but it will give him the elements of thinking; it will furnish him with the means of correcting his errors; it will certainly save him from some delusions, and will afford to the public the best shield against his ignorance, which may be fatal, and against his presumption, which may be devastating.
We have entered into this minute detail at the hazard, we are aware, of tiring the reader; but in the hope of leaving on his mind a more distinct impression of the importance of anatomical knowledge than could possibly be produced by a mere allusion to the circumstances which have been explained. In all ages formidable obstacles have opposed the prosecution of anatomical investigations. Among these, without doubt, the most powerful has its source in a feeling which is natural to the heart of man. The sweetest, the most sacred associations are indissolubly connected with the person of those we love. It is with the corporeal frame that our senses have been familiar: it is that on which we have gazed with rapture: it is that which has so often been the medium of conveying to our hearts the thrill of extacy. We cannot separate the idea of the peculiarities and actions of a friend from the idea of his person. It is for this reason that “every thing which has been associated with him acquires a value from that consideration; his ring, his watch, his books, and his habitation. The value of these as having been his is not merely fictitious; they have an empire over my mind; they can make me happy or unhappy; they can torture and they can tranquillize; they can purify my sentiments and make me similar to the man I love; they possess the virtue which the Indian is said to attribute to the spoils of him he kills, and inspire me with the powers, the feelings, and the heart of their preceding master.� It is nothing, the survivor may justly say, to tell me, when disease has completed its work, and death has seized its prey, that that body, with which are connected so many delightful associations, is a senseless mass of matter: that it is no longer my friend, that the spirit which animated it and rendered it lovely to my sight and dear to my affections, is gone. I know that it is gone. I know that I never more shall see the light of intelligence brighten that countenance, nor benevolence beam in that eye, nor the voice of affection sound from those lips: that which I loved, and which loved me, is not here: but here are still the features of my friend: this is his form, and the very particles of matter which compose this dull mass, a few hours ago were a real part of him, and I cannot separate them, in my imagination, from him. And I approach them with the profounder reverence; I gaze upon them with the deeper affection because they are all that remain to me. I would give all that I possess to purchase the art of preserving the wholesome character and rosy hue of this form that it might be my companion still: but this is impossible: I cannot detain it from the tomb: but when I have “cast a heap of mould upon the person of my friend and taken the cold earth for its keeper,� I visit the spot in which it is deposited with awe: it is sacred to my imagination: it is dear to my heart. There is a real and deep foundation for these feelings in human nature: they arise spontaneously in the bosom of man, and we see their expression and their power in the customs of all nations, savage as well as civilized, and in the conduct of all men, the most ignorant and uncultivated no less than the most intelligent and refined. It has been the policy of society to foster these sentiments. It has been conceived that the sanctity which attaches to the dead, is reflected back in a profounder feeling of respect for the living; that the solemnity with which death is regarded elevates, in the general estimation, the value of life; and that he who cannot approach the mortal remains of a fellow creature without an emotion of awe, must regard with horror every thing which places in danger the life of a human being. Religion has contributed indirectly, but powerfully, to the strength and perpetuity of these impressions; and superstition has availed herself of them to play her antics and to accomplish her base and malignant purposes. It is not the eradication of these feelings that can be desired, but their control: it is not the extinction of these natural and useful emotions that is pleaded for, but that they should give way to higher considerations when these exist. Veneration for the dead is connected with the noblest and sweetest sympathies of our nature: but the promotion of the happiness of the living is a duty from which we can never be exonerated.
In ancient times the voice of reason could not be heard. Superstition, and customs founded on superstition, excited an influence which was neither to be resisted nor evaded. Dissection was then regarded with horror. In the warm countries of the East the pursuit must have been highly offensive and even dangerous, and it was absolutely incompatible with the notions and ceremonies universally prevalent in those days. The Jewish tenet of pollution must have formed an insuperable obstacle to the cultivation of anatomy amongst that people. By the Egyptians every one who cut open a dead body was regarded with inexpressible horror. The Grecian philosophers so far overcame the prejudice as occasionally to engage in the pursuit, and the first dissection on record was one made by Democritus of Abdera, the friend of Hippocrates, in order to discover the course of the bile. The Romans contributed nothing to the progress of the art: they were content with propitiating the Deities who presided over health and disease. They erected on the Palatine Mount a temple to the goddess Febris, whom they worshipped from a dread of her power. They also sacrificed to the goddess Ossipaga, who, it seems, presided over the growth of the bones, and to another styled Carna, who took care of the viscera, and to whom they offered bean-broth, and bacon, because these were the most nutritious articles of diet. The Arabians adopted the Jewish notion of pollution, and were thus prohibited by the tenets of their religion from practising dissection. Abdollaliph, who flourished about the year 1200, a man of learning and a teacher of anatomy, never saw and never thought of a human dissection. In order to examine and demonstrate the bones, he took his students to burying grounds and earnestly recommended them, instead of reading books, to adopt that method of study: yet he seems to have had no conception that the dissection of a recent subject might be a still better method of learning. Christians were equally hostile to dissection. Pope Boniface the 8th issued a bull prohibiting even the maceration and preparation of skeletons. The priests were the only physicians, and so greatly did they abuse the office they assumed, that the evil at length became too intolerable to be borne. The church itself was obliged to prohibit the priesthood from interfering with the practice of medicine. All monks and canons who applied themselves to physic, were threatened with severe penalties, and all bishops, abbots, and priors who connived at their misconduct were ordered to be suspended from their ecclesiastical functions. But it was not till three hundred years after this interdiction, that, by a special bull which permitted physicians to marry, their complete separation from the clergy was effected.
In the 14th century, Mundinus, professor at Bologna, astonished the world by the public dissection of two human bodies. In the 15th century, Leonardo da Vinci contributed essentially to the progress of the art, by the introduction of anatomical plates which were admirably executed. In the 16th century, the Emperor, Charles the 5th, ordered a consultation to be held by the divines of Salamanca, to determine whether it was lawful, in point of conscience, to dissect a dead body in order to learn its structure. In the 17th century, Cortesius, professor of anatomy at Bologna, and afterwards professor of medicine at Messina, had long begun a treatise on practical anatomy which he had an earnest desire to finish, but so great was the difficulty of prosecuting the study even in Italy, that in 24 years he could only twice procure an opportunity of dissecting a human body, and even then with difficulty and in a hurry; whereas, he had expected to have done so, he says, once every year, according to the custom of the famous academies of Italy. In Muscovy, until very lately, both anatomy and the use of skeletons were positively forbidden; the first as inhuman, and the latter as subservient to witchcraft. Even the illustrious Luther was so biassed by the prejudices of his age, that he ascribed the majority of diseases to the arts of the devil, and found great fault with physicians when they attempted to account for them by natural causes. England acquired the bad fame of being the country of witches, and opposed almost insuperable obstacles to the cultivation of anatomy. Even at present the prejudices of the people on this subject are violent and deeply-rooted. The measure of that violence may be estimated by the degree of abhorrence with which they regard those persons who are employed to procure the subjects necessary for dissection. In this country there is no other method of obtaining subjects but that of exhumation: aversion to this employment may be pardoned: dislike to the persons who engage in it is natural, but to regard them with detestation, to exult in their punishment, to determine for themselves its nature and measure, and to endeavour to assume the power of inflicting it with their own hands, is absurd. Magistrates have too often fostered the prejudices of the people, and afforded them the means of executing their vengeance on the objects of their aversion. The press, with a few honourable exceptions, has uniformly allied itself with the ignorance and violence of the vulgar, and has done every thing in its power to inflame the passions which it was its duty to endeavour to soothe. It is notorious that the winter before last there was scarcely a week in which many of the papers did not contain the most exaggerated and disgusting statements: the appetite which could be gratified with such representations was sufficiently degraded: but still more base was the servility which could pander to it.
As one among many of the cases which illustrate this bad feeling, we may refer to that of Samuel Clark who was indicted at the Essex Quarter Sessions, in January, 1824, for feloniously stealing at Little Leighs, on the 26th of December, a woman’s shift, a bed-gown, a night-cap, and a pair of cotton stockings, the property of James Chinnery. It appeared in evidence, that a young woman the wife of a labouring man named James Chinnery, had been buried in Little Leighs Church-yard, on Sunday the 21st of December. Previous to her death she expressed a wish to be interred in a night-cap, shift, bed-gown and cotton stockings, and her request had been complied with. The body was discovered on the morning of the 26th, in a ditch near the church-yard. A few rods from this spot was found a horse yoked to a chaise cart and tied to a tree. It appeared that “the box under the chaise cart was calculated to hold a couple of human bodies, when rolled up; and on examining it, a most offensive odour proceeded from it, as if it had been recently used in the prisoner’s unhallowed occupation.â€� The prisoner owned this horse and cart, and this is the whole of the evidence, at least, as stated in the report of the trial, which implicated him in the robbery of the grave. Under these circumstances, the counsel for the prisoner submitted to the Court that there was no case to go to the jury on three grounds:—first, that there was no proof of any asportation of the articles alleged to have been stolen: secondly, that supposing the asportavit made out, the prisoner could not be convicted of this offence, unless it was manifest that he had a felonious intention of taking the clothes and converting them to his own use; and thirdly, that, at all events, there was no evidence upon which the jury could safely be called upon to act, so as to implicate him in the alleged offence. The counsel for the prosecution in answer urged, first, that the finding of the body naked, after proof that it had been interred in the clothes mentioned in the evidence, was sufficient proof of asportation: and that even stripping the body without removing the clothes out of the grave, was, in law, enough to support the indictment: secondly, that although the primary intention of the prisoner might be, to steal the body only, yet, if the clothes were taken, the law would construe them to have been feloniously taken: that it might as well be said that although a man’s intention might be to steal a valuable jewel, yet it was no offence to take the casket in which it was contained: and thirdly, that whether the defendant was the party to whom guilt was imputed, was a question solely for the consideration of the jury. On the prisoner’s counsel insisting that his objections had not been answered, the Chairman overruled the two first objections, and then summed up the evidence, on which the jury, after deliberating a few minutes, found the prisoner Guilty. The verdict, it is recorded, was received by the auditory with a general expression of pleasure. The Court after animadverting in strong terms on the abominable offence of which the prisoner had been found guilty, said they were determined that he should not have an opportunity of pursuing his odious trade in this country, at least for some years, and therefore sentenced him to be transported for seven years. The account of this case is taken from the report of the trial contained in the Globe and Traveller newspaper of Jan. 20, 1824; a paper honorably distinguished for its endeavours to enlighten the public mind on this subject, not to foster its prejudices.
In this case there was no sufficient evidence to convict the prisoner of the alleged offence: even if that evidence had been perfectly satisfactory, the punishment inflicted was unjust: the circumstance essential to constitute the felony did not exist: the Chairman, with an ignorant and vulgar mind, stretched the law to gratify ignorant and vulgar prejudice: he relied upon the public feeling for protection in the illegal exertion of his power: he administered the law badly: he endeavoured to justify his conduct by loading the prisoner with odious epithets, and he did not miscalculate the feeling of his auditory: they witnessed the transaction “with a general feeling of pleasure.� This case exhibits but too faithfully, the spirit often displayed both by the magistracy and the people.
Half a century ago there was in Scotland no difficulty in obtaining the subjects which were necessary to supply the schools of anatomy. The consequence was, that medicine and surgery suddenly assumed new life—started from the torpor in which they had been spell-bound—and made an immediate, and rapid, and brilliant progress. The new seminaries constantly sent into the world men of the most splendid abilities, at once demonstrating the excellence of the schools in which they were educated, and rendering them illustrious. Pupils flocked to them from all quarters of the globe, and they essentially contributed to that advancement of science which the present age has witnessed. In the 19th century the good people of Scotland, that intelligent, that cool and calculating, that most reasonable and thinking people, have thought proper to return to the worst feeling and the worst conduct of the darkest periods of antiquity. There is at present no offence whatever which seems to have such power to heat and to exalt into a kind of torrent the blood which usually flows so calmly and sluggishly in the veins of a Scotchman. The people of 1823 (to compare great things with small) emulate the spirit of those of their forefathers who “were out in the forty-five;â€� the object, to be sure, is somewhat different, but it is amusing to see the intensity and seriousness of the excitement. About twelve months ago an honest farmer of the name of Scott, who resides at Linlithgow, apprehended a poor wight who was pursuing his vocation, we presume, in the church-yard of that place; and this service appeared so meritorious to the people in his neighbourhood, that they absolutely presented him with a piece of plate. In the winter sessions of 1822-3, a body was discovered on its way to the lecture-room of an anatomist in Glasgow, and, in spite of the exertions of the police, aided by those of the military, this gentleman’s premises and their contents, which were valuable, were entirely destroyed by the mob. For some time after this achievement, it was necessary to station a military guard at the houses of all the medical professors in that city. In the spring circuit of the justiciary court last year at Stirling, while the judges were proceeding to the court, the procession was assaulted with missiles; several persons were injured, and it was necessary to call in the protection of a military force. The object of the mob was, to inflict summary punishment on a man who was about to be tried for the exhumation of a body. We happen to know that the most disgraceful proceedings were some time ago instituted in that town against a young gentleman of respectable family and connections, who was in fact expatriated, and whose prospects in life were entirely changed, if not ruined, because he had too much honour to implicate his instructors in a transaction which would have put them to inconvenience, and in which they had engaged from a desire faithfully to discharge their duty to their pupils. Within the last five years three men were lodged in the county gaol at Haddington, charged with a trespass in the church-yard of that town. So enraged was the mob against them, that an attempt was made to force the gaol in order to get at them. On their way to the court the men were again attacked, forced from the carriage, and severely maimed. After examination they were admitted to bail; but, when set at liberty, they were assailed with more violence than ever, and were nearly killed. On the 29th of June, 1823, being Sunday, a most extraordinary outrage was perpetrated in the streets of Edinburgh. A coach containing an empty coffin and two men, was observed proceeding along the south bridge. The people suspecting that it was intended to convey a body taken from some church-yard, seized the coach. It was with difficulty that the police protected the men from the assaults of the populace: the coach they had no power to preserve. The horses were taken from it, and together with the coffin, after having been trundled a mile and a half through the streets of the city, it was deliberately projected over the steep side of the mound, and smashed into a thousand pieces. The people following it to the bottom, kindled a fire with its fragments, and surrounded it like the savages in Robinson Crusoe, till it was entirely consumed. In this case there was no foundation for their suspicions. The coffin was intended to have conveyed to his house in Edinburgh the body of a physician who that morning had died in a cottage in the neighbourhood. A similar assault was some time ago made on two American gentlemen, who went to visit the Abbey of Linlithgow after nightfall. The churchyards of the “gude Scotsâ€� are now strictly guarded by men and dogs; watch-towers are erected within the grounds, and mort-safes as they are called, that is to say, strong iron frames are deposited in the ground over the graves. These people sometimes declare that they will put an end to anatomy, and certainly they are succeeding in the accomplishment of this menace as rapidly as they can well desire. The average number of medical students in Edinburgh is 700 each session. For several years past the difficulty of procuring subjects in that place has been so great, that out of all that number, not more than 150 or 200 have ever attempted to dissect; and even these have latterly been so opposed in their endeavours to prosecute their studies that many of them have left the place in disgust. We have been informed by a friend, that he alone was personally acquainted with twenty individuals who retired from it at the beginning of last session, and who went to pursue their studies at Dublin, and we know that vast numbers followed their example at the end of the winter course. The medical school at Edinburgh, in fact, is now subsisting entirely on its past reputation; in the course of a few years it will certainly be at an end, unless the system be changed. Let those who have the prosperity of the university at heart, and who have the power to protect it, consider this before it be too late: they may be assured it is no idle prediction; for we give them notice that it is at this moment the universal opinion and the current language of every well-informed medical man in England.