Use of the Dead to the Living
USE OF THE DEAD
FROM THE WESTMINSTER REVIEW.
PRINTED BY WEBSTERS AND SKINNERS.
The following pages contain an article extracted from the WestminsterReview, an English periodical of considerable reputation. On itsappearance in Great Britain, it excited great attention; and, indeed,has been there reprinted in a cheap form for general distribution. Theauthor (Dr. Southwood Smith) deserves the thanks of the community forthe talents he has displayed, and the lucid and powerful manner in whichhe has investigated the important subject under consideration.
The editors believe that they are discharging a duty to the community inpresenting it to them for perusal and consideration. They will notconceal their wishes, that it may have a favorable effect on a bill nowpending before the Legislature. Both in a general point of view, as wellas with reference to the particular institution to be benefitted, thearguments are particularly applicable; nor will an enlightened body ofmen be deterred from doing what they may deem their duty by theunparalleled impudence of those who now cry out against monopoly, whenthey have risen into importance by monopoly, and have, always, while itsuited their views, been its most persecuting and vindictive advocates.
It is due to truth to state, that the suggestion of the republication ofthis article, originated with a member of the Senate of this state, andwho does not belong to the profession.
USE OF THE DEAD TO THE LIVING.
FROM THE WESTMINSTER REVIEW.
An Appeal to the Public and to the Legislature, on the necessityof affording Dead Bodies to the Schools of Anatomy, by LegislativeEnactment. By William Mackenzie. Glasgow. 1824.
Every one desires to live as long as he can. Every one values health"above all gold and treasure." Every one knows that as far as his ownindividual good is concerned, protracted life and a frame of body soundand strong, free from the thousand pains that flesh is heir to, areunspeakably more important than all other objects, because life andhealth must be secured before any possible result of any possiblecircumstance can be of consequence to him. In the improvement of the artwhich has for its object the preservation of health and life, everyindividual is, therefore, deeply interested. An enlightened physicianand a skilful surgeon, are in the daily habit of administering to theirfellow men more real and unquestionable good, than is communicated, orcommunicable by any other class of human beings to another. Ignorantphysicians and surgeons are the most deadly enemies of the community:the plague itself is not so destructive; its ravages are at distantintervals, and are accompanied with open and alarming notice of itspurpose and power; theirs are constant, silent, secret; and it is whilethey are looked up to as saviours, with the confidence of hope, thatthey give speed to the progress of disease and certainty to the strokeof death.
It is deeply to be lamented that the community, in general, are soentirely ignorant of all that relates to the art and the science ofmedicine. An explanation of the functions of the animal economy; oftheir most common and important deviations from the healthy state; ofthe remedies best adapted to restore them to a sound condition, and ofthe mode in which they operate, as far as that is known, ought to form apart of every course of liberal education. The profound ignorance of thepeople on all these subjects, is attended with many disadvantages to[Pg 4]themselves, and operates unfavorably on the medical character. Inconsequence of this want of information, persons neither know what arethe attainments of the man in whose hands they place their life, norwhat they ought to be; they can neither form an opinion of the course ofeducation which it is incumbent on him to follow, nor judge of thesuccess with which he has availed himself of the means of knowledgewhich have been afforded him. There is one branch of medical educationin particular, the foundation, in fact, on which the wholesuperstructure must be raised, the necessity of which is not commonlyunderstood, but which requires only to be stated to be perceived.Perhaps it is impossible to name any one subject which it is of moreimportance that the community should understand. It is one in whichevery man's life is deeply implicated: it is one on which every man'signorance or information will have a considerable influence. We shall,therefore, enter into it with some detail: we shall show the kind ofknowledge which it is indispensable that the physician and surgeonshould possess; we shall illustrate, by a reference to particular cases,the reason why this kind of knowledge cannot be dispensed with: and weshall explain, by a statement of facts, the nature and extent of theobstacles which at present oppose the acquisition of this knowledge. Werepeat, there is no subject in which every reader can be so immediatelyand deeply interested, and we trust that he will give us his calm andunprejudiced attention.
The basis of all medical and surgical knowledge is anatomy. Not a singlestep can be made either in medicine or surgery, considered either as anart or a science without it. This should seem self evident, and to needneither proof nor illustration: nevertheless, as it is usefuloccasionally to contemplate the evidence of important truth, we shallshow why it is, that there can be no rational medicine, and no safesurgery, without a thorough knowledge of anatomy.
Disease, which it is the object of these arts to prevent and to cure, isdenoted by disordered function: disordered function cannot be understoodwithout a knowledge of healthy function; healthy function cannot beunderstood without a knowledge of structure; structure cannot beunderstood unless it be examined.
The organs on which all the important functions of the human bodydepend, are concealed from the view. There is no possibility ofascertaining their situation and connections, much less their nature andoperation, without inspecting the interior of this curious andcomplicated machine. The results of the mechanism are visible; themechanism itself is concealed, and must be investigated to be perceived.The important operations of nature are seldom entirely [Pg 5]hidden from thehuman eye; still less are they obtruded upon it, but over the mostcurious and wonderful operations of the animal economy so thick a veilis drawn, that they never could have been perceived without the mostpatient and minute research. The circulation of the blood, for example,never could have been discovered without dissection. Notwithstanding thepartial knowledge of anatomy which must have been acquired by theaccidents to which the human body is exposed, by attention to woundedmen, by the observance of bodies killed by violence; by the huntsman inusing his prey; by the priest in immolating his victims; by the augur inpursuing his divinations; by the slaughter of animals; by the dissectionof brutes; and even occasionally by the dissection of the human body,century after century passed away, without a suspicion having beenexcited of the real functions of the two great systems of vessels,arteries and veins. It was not until the beginning of the 17th century,when anatomy was ardently cultivated, and had made considerableprogress, that the valves of the veins and of the heart were discovered,and subsequently that the great Harvey, the pupil of the anatomist whodiscovered the latter, by inspecting the structure of these valves; bycontemplating their disposition; by reasoning upon their use, was led tosuspect the course of the blood, and afterwards to demonstrate it.Several systems of vessels in which the most important functions ofanimal life are carried on—the absorbent system, for example, and eventhat portion of it which receives the food after it is digested, andwhich conveys it into the blood, are invisible to the naked eye, exceptunder peculiar circumstances: whence it must be evident, not only thatthe interior of the human body must be laid open, in order that itsorgans may be seen; but that these organs must be minutely and patientlydissected, in order that their structure may be understood.
The most important diseases have their seat in the organs of the body;an accurate acquaintance with their situation is, therefore, absolutelynecessary, in order to ascertain the seats of disease; but for thereasons already assigned, their situation cannot be learnt, without thestudy of anatomy. In several regions, organs the most different instructure and function are placed close to each other. In what is termedthe epigastric region, for example, are situated the stomach, the liver,the gall bladder, the first portion of the small intestine, (theduodenum) and a portion of the large intestine (the colon); each ofthese organs is essentially different in structure and in use, and isliable to distinct diseases. Diseases the most diversified, therefore,requiring the most opposite treatment, may exist in the same region ofthe body; the discrimination of which is absolutely impossible, [Pg 6]withoutthat knowledge which the study of anatomy alone can impart.
The seat of pain is often at a great distance from that of the affectedorgan. In disease of the liver, the pain is generally felt at the top ofthe right shoulder. The right phrenic nerve sends a branch to the liver:the third cervical nerve, from which the phrenic arises, distributesnumerous branches to the neighborhood of the shoulder: thus isestablished a nervous communication between the shoulder and the liver.This is a fact which nothing but anatomy could teach, and affords theexplanation of a symptom which nothing but anatomy could give. Theknowledge of it would infallibly correct a mistake, into which a personwho is ignorant of it, would be sure to fall: in fact, persons ignorantof it do constantly commit the error. We have know several instances inwhich organic disease of the liver has been considered, and treated asrheumatism of the shoulder. In each of these cases, disease in a mostimportant organ might have been allowed to steal on insidiously, untilit became incurable; while a person, acquainted with anatomy, would havedetected it at once, and cured it without difficulty. Many cases haveoccurred of persons who have been supposed to labor under disease of theliver, and who have been treated accordingly: on examination afterdeath, the liver has been found perfectly healthy, but there has beendiscovered extensive disease of the brain. Disease of the liver is oftenmistaken for disease of the lungs: on the other hand, the lungs havebeen found full of ulcers, when they were supposed to have beenperfectly sound, and when every symptom was referred to disease of theliver. Persons are constantly attacked with convulsions—childrenespecially; convulsions are spasms: spasms, of course, are to be treatedby antispasmodics. This is the notion amongst people ignorant ofmedicine: it is the notion amongst old medical men: it is the notionamongst half educated young ones. All this time these convulsions aremerely a symptom; that symptom depends upon, and denotes, most importantdisease in the brain: the only chance of saving life, is the prompt andvigorous application of proper remedies to the brain; but thepractitioner whose mind is occupied with the symptom, and who prescribesantispasmodics, not only loses the time in which alone any thing can bedone to snatch the victim from death, but by his remedies absolutelyadds fuel to the flame which is consuming his patient. In disease of thehip-joint pain is felt, not in the hip, but, in the early stage of thedisease, at the knee. This also depends on nervous communication. Themost dreadful consequences daily occur from an ignorance of this singlefact. In all these cases error is inevitable, without a knowledge of[Pg 7]anatomy: it is scarcely possible with it: in all these cases error isfatal: in all these cases anatomy alone can prevent the error—anatomyalone can correct it. Experience, so far from leading to its detection,would only establish it in men's minds, and render its removalimpossible. What is called experience is of no manner of use to anignorant and unreflecting practitioner. In nothing does the adage, thatit is the wise only who profit by experience, receive so complete anillustration as in medicine. A man who is ignorant of certainprinciples, and who is incapable of reasoning in a certain manner, mayhave daily before him for fifty years