FROM THE WESTMINSTER REVIEW.
ALBANY:
PRINTED BY WEBSTERS AND SKINNERS.
——
1827.
The following pages contain an article extracted from the Westminster Review, an English periodical of considerable reputation. On its appearance in Great Britain, it excited great attention; and, indeed, has been there reprinted in a cheap form for general distribution. The author (Dr. Southwood Smith) deserves the thanks of the community for the talents he has displayed, and the lucid and powerful manner in which he has investigated the important subject under consideration.
The editors believe that they are discharging a duty to the community in presenting it to them for perusal and consideration. They will not conceal their wishes, that it may have a favorable effect on a bill now pending before the Legislature. Both in a general point of view, as well as with reference to the particular institution to be benefitted, the arguments are particularly applicable; nor will an enlightened body of men be deterred from doing what they may deem their duty by the unparalleled impudence of those who now cry out against monopoly, when they have risen into importance by monopoly, and have, always, while it suited their views, been its most persecuting and vindictive advocates.
It is due to truth to state, that the suggestion of the republication of this article, originated with a member of the Senate of this state, and who does not belong to the profession.
February, 1827.
FROM THE WESTMINSTER REVIEW.
An Appeal to the Public and to the Legislature, on the necessity of affording Dead Bodies to the Schools of Anatomy, by Legislative Enactment. 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 own individual good is concerned, protracted life and a frame of body sound and strong, free from the thousand pains that flesh is heir to, are unspeakably more important than all other objects, because life and health must be secured before any possible result of any possible circumstance can be of consequence to him. In the improvement of the art which has for its object the preservation of health and life, every individual is, therefore, deeply interested. An enlightened physician and a skilful surgeon, are in the daily habit of administering to their fellow men more real and unquestionable good, than is communicated, or communicable by any other class of human beings to another. Ignorant physicians and surgeons are the most deadly enemies of the community: the plague itself is not so destructive; its ravages are at distant intervals, and are accompanied with open and alarming notice of its purpose and power; theirs are constant, silent, secret; and it is while they are looked up to as saviours, with the confidence of hope, that they give speed to the progress of disease and certainty to the stroke of death.
It is deeply to be lamented that the community, in general, are so entirely ignorant of all that relates to the art and the science of medicine. An explanation of the functions of the animal economy; of their most common and important deviations from the healthy state; of the remedies best adapted to restore them to a sound condition, and of the mode in which they operate, as far as that is known, ought to form a part of every course of liberal education. The profound ignorance of the people on all these subjects, is attended with many disadvantages to themselves, and operates unfavorably on the medical character. In consequence of this want of information, persons neither know what are the attainments of the man in whose hands they place their life, nor what they ought to be; they can neither form an opinion of the course of education which it is incumbent on him to follow, nor judge of the success with which he has availed himself of the means of knowledge which have been afforded him. There is one branch of medical education in particular, the foundation, in fact, on which the whole superstructure must be raised, the necessity of which is not commonly understood, but which requires only to be stated to be perceived. Perhaps it is impossible to name any one subject which it is of more importance that the community should understand. It is one in which every man's life is deeply implicated: it is one on which every man's ignorance or information will have a considerable influence. We shall, therefore, enter into it with some detail: we shall show the kind of knowledge which it is indispensable that the physician and surgeon should possess; we shall illustrate, by a reference to particular cases, the reason why this kind of knowledge cannot be dispensed with: and we shall explain, by a statement of facts, the nature and extent of the obstacles which at present oppose the acquisition of this knowledge. We repeat, there is no subject in which every reader can be so immediately and deeply interested, and we trust that he will give us his calm and unprejudiced attention.
The basis of all medical and surgical knowledge is anatomy. Not a single step can be made either in medicine or surgery, considered either as an art or a science without it. This should seem self evident, and to need neither proof nor illustration: nevertheless, as it is useful occasionally to contemplate the evidence of important truth, we shall show why it is, that there can be no rational medicine, and no safe surgery, without a thorough knowledge of anatomy.
Disease, which it is the object of these arts to prevent and to cure, is denoted by disordered function: disordered function cannot be understood without a knowledge of healthy function; healthy function cannot be understood without a knowledge of structure; structure cannot be understood unless it be examined.
The organs on which all the important functions of the human body depend, are concealed from the view. There is no possibility of ascertaining their situation and connections, much less their nature and operation, without inspecting the interior of this curious and complicated machine. The results of the mechanism are visible; the mechanism itself is concealed, and must be investigated to be perceived. The important operations of nature are seldom entirely hidden from the human eye; still less are they obtruded upon it, but over the most curious and wonderful operations of the animal economy so thick a veil is drawn, that they never could have been perceived without the most patient and minute research. The circulation of the blood, for example, never could have been discovered without dissection. Notwithstanding the partial knowledge of anatomy which must have been acquired by the accidents to which the human body is exposed, by attention to wounded men, by the observance of bodies killed by violence; by the huntsman in using his prey; by the priest in immolating his victims; by the augur in pursuing his divinations; by the slaughter of animals; by the dissection of brutes; and even occasionally by the dissection of the human body, century after century passed away, without a suspicion having been excited 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 considerable progress, that the valves of the veins and of the heart were discovered, and subsequently that the great Harvey, the pupil of the anatomist who discovered the latter, by inspecting the structure of these valves; by contemplating their disposition; by reasoning upon their use, was led to suspect the course of the blood, and afterwards to demonstrate it. Several systems of vessels in which the most important functions of animal life are carried on—the absorbent system, for example, and even that portion of it which receives the food after it is digested, and which conveys it into the blood, are invisible to the naked eye, except under peculiar circumstances: whence it must be evident, not only that the interior of the human body must be laid open, in order that its organs may be seen; but that these organs must be minutely and patiently dissected, 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, absolutely necessary, in order to ascertain the seats of disease; but for the reasons already assigned, their situation cannot be learnt, without the study of anatomy. In several regions, organs the most different in structure and function are placed close to each other. In what is termed the epigastric region, for example, are situated the stomach, the liver, the gall bladder, the first portion of the small intestine, (the duodenum) and a portion of the large intestine (the colon); each of these organs is essentially different in structure and in use, and is liable to distinct diseases. Diseases the most diversified, therefore, requiring the most opposite treatment, may exist in the same region of the body; the discrimination of which is absolutely impossible, without that knowledge which the study of anatomy alone can impart.