Another mode of stimulating or exciting the whole system is, by putting into it a larger quantity of blood than it naturally contains. This is entirely similar to the breathing of oxygen; especially if arterial blood be used, which has already imbibed its spiritous part from the atmosphere. In the last century the transfusion of blood was proposed not only as a mode of curing diseases, but of restoring old people to youth; and Dr. McKenzie, in his Treatise on Health, quotes from the memoirs of the Academy of Sciences several instances of the blood of brute animals being infused into human veins, without any inconvenience. It seems, however, not only a bold but an unnatural attempt to use the blood of beasts for such a purpose; and, however lavish mankind may be of their blood upon certain occasions, it is to be feared that there are few who would be willing to spare any to relieve another from sickness; but indeed little can be said about the practice; as, on account of some bad consequences, or failures, it was forbidden by the king of France, and by the pope’s mandate in Italy, and has now fallen into disuse. In a paragraph at the end of Heister’s surgery (4to edition) it is asserted that the transfusion of blood was productive of madness. Dr. Darwin, however, in his Zoonomia, still proposes the transfusion of blood as a remedy, and even describes a convenient apparatus for performing the operation. In one part of his work he says, “Might not the transfusion of blood, suppose of four ounces daily, from a strong man, or other healthful animal, as a sheep or an ass, be used in the early state of nervous or putrid fevers?” In another place he mentions his having proposed it to a gentleman whose throat was entirely closed up by an incurable swelling, so that he could swallow nothing. This is a disease not very rare, and which always must be fatal; because the patients, though not affected by any sickness, die of hunger; and, to relieve them from this miserable situation, extraordinary attempts are not only allowable but laudable. The Doctor proposed to his patient, “to supply him daily with a few ounces of blood taken from an ass, or from the human animal, who is still more patient and tractable, in the following manner: To fix a silver pipe, about an inch long, to each extremity of a chicken’s gut, the part between the two silver ends to be measured by filling it with warm water; to put one end into the person hired for that purpose, so as to receive the blood returning from the extremity; and when the gut was quite full, and the blood running through the other silver end, to introduce that end into the vein of the patient, upwards towards the heart, so as to admit no air along with the blood. And, lastly, to support the gut and silver ends on a water plate filled with water of 98 degrees of heat; and, to measure how many ounces of blood were taken away, to compress the gut from the receiving pipe to the delivering pipe.” The gentleman desired a day to consider of this proposal, and then another; after which he totally refused it, saying that he was now too old to have much enjoyment of life, and that, being so far advanced in a journey which he must certainly accomplish sooner or later, he thought it better to proceed than return. The Doctor informs us that he died a few days afterwards, seemingly very easy, and careless about the matter. One experiment of this kind I have been witness to; not indeed on a human creature, but on a calf. This creature received into one of its jugular veins a considerable quantity of blood from the carotid artery of another, nearly of the same age (about a month, or little more.) It was impossible to say any thing about how much was transfused; only the bleeding was continued till the animal which lost the blood began to shew signs of faintness. The artery was then tied up, and the orifice in the jugular vein closed. The calf which had lost the blood appeared very languid and faint, but lived a few days in a drooping state; when it either died of itself, or was killed, as being supposed past recovery. The other, which had received the blood, appeared to be in every respect highly excited. It became playful, even in the room where the operation was performed, its eyes assumed a bright and shining appearance, and its appetite was greatly increased. Thus it continued for about a fortnight; appearing all the time to be in high health, and eating much more than usual; but at last died suddenly in the night. From these effects on healthy subjects, however, we cannot infer what would happen in such as are diseased; but it is plain that if the cure of diseases were to depend upon mere excitation, the means are in our power, without any local irritation, which always must take place in some degree by the use of ordinary medicines. This path is not absolutely untrodden: the pneumatic practitioners of the present day have tried oxygen in consumptions, and found it pernicious; and Dr. McKenzie informs us that the transfusion of blood was tried ineffectually in the same.
7. As all the medicines usually prescribed at present are only to be accounted partially stimulant, or as acting upon particular parts of the system, we see that some may promote one evacuation, and some another; while all produce some change in the organization, which may prove useful or detrimental, may increase the disease or cure it, or may produce another, according to the judicious or injudicious application. But for a knowledge of all this we must be indebted to experience: there is not a theory on earth that can lead us a single step.
Before we dismiss the consideration of medical theories, however, it will still be necessary to give some account of the new system as it hath branched out in various ways: for though the fundamental principle is now received by a great number of physicians, yet the superstructure is exceedingly different from what Dr. Brown himself erected and, indeed, from the very same principles we find conclusions made as directly opposite to one another as can be expressed in words. Drs. Yates and McLean, for instance, at Calcutta in the East Indies, have concluded that the plague “is a disease of a very high degree of exhaustion;” which Dr. Brown would have called debility. Dr. Rush at Philadelphia, proceeding also upon the Brunonian principles, determines it to be the most inflammatory of all diseases,[62] and which Dr. Brown would have called a disease of excitement. These two doctrines are, in every sense of the word, as distant from one another as east from west. Let us then consider both, if any consideration can avail us on the subject.
By the ancients it was supposed that diseases were occasioned by something either bred in the body or received into it, and that the power of nature produced, during the course of the disease, a certain change in this matter, called coction, or concoction; which, if we please, we may express by the English word cooking. The matter of the disease, called also morbific matter, thus cooked, was in a state proper for expulsion, and was therefore thrown out by sweat, vomit, stool, &c. or it might be expelled artificially, which could not have been attempted with safety before. Modern systems deny the existence of morbific matter, and resolve all into an affection of the nerves, according to Dr. Cullen by certain sedative causes, but according to Dr. Brown by an accumulation in some cases, and an exhaustion in others, of the excitability or excitement of the body. The Science of Life commences with stating what they suppose to be an improvement of the Brunonian principles, and from which the following account of the origin of diseases is extracted. “Upon the different states of excitability depend all the phenomena of health and disease. There are three states of the excitability. 1. The state of accumulation; when a portion of the usual stimuli is withheld. . . . When a portion of the usual stimuli is withheld, the excitability accumulates, and the body becomes susceptible of impression in the direct ratio of the subduction. This state constitutes diseases of accumulation, or of direct debility. 2. The middle state; when the excitability is such that the application of the accustomed degree of exciting powers produces tone or health. 3. The state of exhaustion. When the application of stimuli has been greater than that which produces healthy action, the excitability is exhausted, and the body becomes less susceptible of impression in the direct ratio of the excess. This state constitutes diseases of exhaustion, or of indirect debility. The states of accumulation and exhaustion of the excitability, in their different degrees, constitute all the diseases to which living bodies are subject.”
Here the chime runs on the word excitability, which is not defined. If we call this property life, then we are only informed, that, as life is more or less vigorous, the body enjoys a greater or smaller degree of health; which we know without any medical instructor. If, instead of the accumulation and exhaustion of excitability, we take the original doctrine of excitement and debility laid down by Dr. Brown himself, we are nothing better. The whole theory is lost for want of the definition of a single word. As long as excitability remains an unknown property, we can explain nothing by it. We may indeed vary our terms. We may call it nervous influence with Dr. Cullen, or sensorial power with Dr. Darwin; but we shall still be as much in the dark as ever; and all that can be made out of our theories, when our language is decyphered, must be, that sometimes people are well, and sometimes they are sick!
Dr. Rush, in his Treatise on the Proximate Cause of Fever, adopts in part Dr. Brown’s system pretty nearly as the author himself laid it down. “Fevers of all kinds (says he) are preceded by general debility. This debility is of two kinds, viz. direct and indirect. The former depends upon an abstraction of usual and natural stimuli; the latter upon an increase of natural, or upon the action of preternatural, stimuli upon the body. . . . Debility is always succeeded by increased excitability, or a greater aptitude to be acted upon by stimuli. . . . The diminution or abstraction of one stimulus is always followed by the increased action of others.” Here it is evident we are as much in want of definitions as ever. We know neither what excitability is, nor what debility is, and yet they are both held out as the causes, and proximate or immediate causes, too, of symptoms produced by things quite obvious to our senses. Thus cold and heat, with which we are daily conversant, are only called the predisposing causes of fever; while debility and excitement, words to which we have no meaning, are said to be the proximate cause. It would certainly be better to throw away such words altogether, and say that cold, heat, &c. cause fevers, without troubling ourselves farther about the matter.
It remains now to take into consideration the pneumatic theories, founded upon the discoveries made by Dr. Black, Dr. Priestley, Lavoisier, and others, concerning various kinds of aerial fluids, or gases,[63] as they are also called. Some of these, particularly that afterwards called fixed air, were discovered by Van Helmont. Considerable advances were made by a German chemist, named Mayow, in the last century; but his book had fallen into such oblivion that his name was scarce ever mentioned, until his discoveries were repeated, and still greater advances made by others. Dr. Hales obtained air from a great many different substances, but was unable to ascertain any thing concerning its nature. Dr. Black of Edinburgh laid the foundation of pneumatic chemistry, by discovering that a certain species of air is capable of being absorbed by earths of different kinds, and that many very heavy substances owe at least one half of their weight to this condensed air. The discovery was accidental. Wishing to obtain a very pure and white lime, he had recourse to the fine white earth called magnesia alba. Some of this he distilled with a heat sufficient to make the vessel red hot. Only a very small quantity of water came over, but the magnesia had lost almost two thirds of its weight. This immense loss was found to arise from an emission of air during the operation; and by other experiments it was likewise found that the air might be transferred from one portion of magnesia to another from which it had been previously expelled; that the existence of this species of air in certain bodies was the cause of that fermentation which takes place when any acid is poured upon them, as vinegar upon chalk or potash. Hence if any of these substances be deprived of its air, it will not any longer ferment in this manner. It must not be forgot, however, that when air thus unites itself with any terrestrial substance it no longer has its former properties. It is reduced exceedingly in bulk, and in proportion to this reduction only the body is increased in weight; and therefore though we say that the air is absorbed, we must still remember that only one part of it is so, and that by far the least considerable in bulk. A violent fire will always expel the air again, and restore it to its former bulk; and again the condensation or absorption of the air is always attended with the production of heat. This last property was not much attended to by Dr. Black, but others have observed it; and the late Dr. Charles Webster of Edinburgh published a theory in which he maintained that condensation was in all cases the cause of of heat. But, however true it may be that condensation of any kind is followed or accompanied by heat, it is evidently necessary to know the cause of the condensation also, otherwise we make no advance in solid theory.
The aerial fluid, discovered by Dr. Black, was one of those most commonly met with. He called it fixed air, from its property of adhering or fixing itself to different bodies. It was found to be the same with that which had been discovered by Van Helmont, and by him named gas sylvestre (spirit of wood)[64] or the fume of charcoal; it was found to be the same with the steam of fermenting liquor, and with that very frequent and dangerous vapour, met with in coal mines, called in Scotland the choke-damp. Like other discoveries, this was quickly pushed beyond its proper bounds, and applied to the solution of phenomena which it could not solve. Dr. MBride, particularly, supposed it to be the bond of union between the particles of matter, or in other words the principle of cohesion itself. It was also supposed to be the substance of those scorching winds, called samiel, met with in Asia and Africa, and which sometimes prove fatal to travellers. The pernicious vapours called mofetes, which sometimes issue from the old lavas of Vesuvius in Italy, were likewise supposed to be the same;[65] but of this, particularly with regard to the samiel, there seems to be no sufficient evidence.
The industry of other experimenters did not long leave theorists without abundance of materials upon which they might exercise their talents. It is impossible in this place to assign to each his proper rank in the way of discovery, or indeed to mention their names. Dr. Priestley has distinguished himself far above the rest. He not only repeated and improved Dr. Black’s experiments on fixed air, but likewise found out a number of other kinds; particularly that from animal substances in a state of putrefaction, which is so pernicious to living creatures, insects excepted; for these last will thrive amazingly in air that would prove certain death to a man. He also discovered that this kind of air, and some others, were absorbed by vegetables, and thence inferred the use of vegetables in purifying the atmosphere. He even analysed the atmosphere itself, and found that it consisted of two different kinds of fluids, one of which he called dephlogisticated, the other phlogisticated air. The former was found to support animal life for a time, the latter to destroy it instantly. Their effects upon fire were the same; the former exciting the most vehement heat and bright flame, the latter extinguishing a fire at once.
The fame of Dr. Priestley’s discoveries quickly reached the continent of Europe; the French chemists repeated his experiments with improvements, as they thought; and indeed certainly made many curious discoveries. Lavoisier was particularly remarkable for his numerous and accurate experiments; but, by his changing entirely the language of former chemists, and substituting a set of new terms of his own invention, he certainly entailed the greatest curse upon the science it ever met with. It belongs not to this treatise to give an account of his system farther than to say, that, from the immense proportion of condensed aerial matter found in most terrestrial substances, he and his followers were led to conclude, that different species of air constitute almost the whole of the terraqueous globe. Water particularly they have absolutely and most positively determined to be a composition of two airs condensed, viz. the dephlogisticated and inflammable, which they call oxygen and hydrogen. However, this doctrine is still opposed by Dr. Priestley and some others.