Abernethy was very far from any such narrow views; whilst, in regard to other organs, to which some of our most distinguished men had paid particular attention, it is not too much to say, that, more clear and precise than Curry, and equally careful with Hunter, not less painstaking than our excellent Prout, he is more practically penetrating and comprehensive on this subject than any of them. But as to the charge of exclusive reference to the stomach, we shall easily see there was no foundation for it.
In speaking of the reciprocal affections of the brain and the digestive organs, he says: "The stomach is said to be chiefly concerned in producing these effects; but the cause of the sympathetic affection is probably more general." Page 48. He then goes on to exemplify causes acting on the Liver, and so forth. Page 49.
He distinctly contends that other of the chylopoetic organs may disturb the brain as well as the stomach. Again, at page 52, he repeats a similar opinion, and especially adds, that when the alimentary canal is affected, we can never be sure that it is primarily so.
He also says, at page 53, that, in some cases, the disorder of the digestive organs is dependent on disease of the brain.
I have alluded to these passages, because nothing is more unjust to Abernethy than to suppose that he attributed everything to the stomach, or restricted his attention to that or any other organ. Such a misapprehension also tends indefinitely to impede the practical application of his principles, and to deprive us of the advantages which are so constantly derivable from them.
This is so important, that it may be useful to consider a little the circumstances which may have thus misled the public, and we fear, not unfrequently, the profession also, in the interpretation of Abernethy's views.
In conducting the treatment of diseases of the digestive organs, whatever organ we may desire to influence, either by inducing tranquillity of the nervous system, or by the selection of food appropriate to the actual condition of the organ specially affected, the stomach is necessarily a primary consideration.
The reasons for this are sufficiently obvious, but have not perhaps been always adequately regarded. Digestion is, on the whole, a manufacture, so to speak, of a raw material (food) into a fluid (blood), which is to be absolutely adapted to purposes for which it is designed. This is effected not by one, but by several organs, which each produce their respective changes in the materials submitted to them. If we desire, therefore, to adapt the work to any organ which is engaged in this process, however remote it may be from the stomach, which, with the teeth and other auxiliaries, execute the first process in the manufacture, it is quite clear that we must begin with the first process to which we subject the said raw material or food. Say that in a machine for the manufacture of cloth the spinning apparatus were out of order, we must begin by giving out a less quantity of wool to the carding machine, or whatever represented the first process; because, having once delivered the wrong quantity or quality, we have no means of recalling it, and we should only still further derange the defective machinery.
So in the body; the liver, kidney, and other organs, not excepting the lungs and skin; their work must all bear relation to the quantity or quality of raw material, whether their function be the manufacture of the new product, or the rejection of that which is useless. So that supposing there were no other reason, no other than this mechanical relation (which is very far from the real state of the case), still we must de facto begin with the stomach, even where we entertain no idea of any special derangement of that organ. The stomach, however, is very important in another sense, and has a power of indicating the necessity of attention to those points which I have endeavoured to illustrate by the homely similitude of a manufacture.
Wherever impressions first act on the body, nature has placed a most vigilant guard. This is variously managed in different cases; the result is the same, and, as it would appear, the final cause also. In the eye, there is the most beautiful contrivance for moderating the ingress of light, as also any abrupt increase of intensity. Fringed curtains are provided which can close with electrical celerity. Again, the aperture by which light is finally admitted into the eye is vividly contractile or expansive, as the occasion may require; then again there are various media of different densities, through the influence of which even the velocity of light undergoes practical retardation by repeated refractions; and lastly, there are powers of sensual adaptation in the nerve with which the light is ultimately brought in contact, more wonderful than all.