Chapter V: The Malay (21)
The general perspiration of every man seems to be of a peculiar nature. Savages can distinguish their friends and foes by the scent. The boy born deaf and dumb, whose history is related by Dugald Stewart, distinguished persons by their odour; and the dealers in hair can ascertain by the smell the nation to which the hair belongs.
The quantity of perspiration secreted by a well-grown adult weighing about one hundred and forty-six pounds, is at the rate of twenty-eight ounces in the twenty-four hours, sixteen ounces during the period usually allotted to waking, and twelve ounces during sleep.[49] It is not so much increased by moderate elevation of temperature as might be imagined; it appears increased after meals and during sleep. While the skin thus secretes so considerable a quantity of watery fluid, its powers of absorption are wonderful, and are frequently resorted to for medicinal purposes. This absorption evidently tends to assist in repairing the strength. A boy at Newcastle who had been greatly reduced for a race, gained thirty ounces in weight in the course of an hour, during which time he had only taken a glass of wine. Dr. Home, after going to bed much fatigued and supperless, gained two ounces before the morning. Keill says that one night he gained eighteen ounces in his sleep. Immersion in water and damp air materially increases this power. Frogs, toads, even lizards, increase in weight although only partially dipped in water; and remarkably so if previously deprived of part of their moisture by exposure to air. The power of absorbing medicinal substances when immersed in their solution has been demonstrated by Dr. Massy, an American physician, who found that if the body was immersed in a decoction of madder,[50] this substance immediately tinged the renal secretion. Dr. Rousseau made a similar experiment with rhubarb. It is now clearly demonstrated that friction is not necessary to produce absorption.
The keenness of the deaf and dumb boy in ascertaining the effluvium of various individuals, to which I have alluded, induces me to give a short sketch of this curious individual. His name was James Mitchell; and having no other source by which he could discover or keep up a connexion with surrounding objects than those of smell, taste, and touch, he depended chiefly upon the first, like a domestic dog, in distinguishing persons and things. By this sense he identified his friends and relations; and conceived a sudden attachment or dislike to strangers. It was difficult, however, to ascertain at what distance he could thus exercise this faculty; but, from Mr. Wardrop's observations, it appears that he possessed it at a considerable distance. This was particularly striking when a person entered the room, as he seemed to be aware of this before he could derive any information from any sense than that of smell. When a stranger approached him, he eagerly began to touch some part of the body, commonly taking hold of his arm, which he held near his nose; and, after two or three strong inspirations through the nostrils, he appeared to form a decided opinion concerning him. If it were favourable, he showed a disposition to become more intimate, examined more minutely his dress, and expressed in his countenance more or less satisfaction; but if it happened to be unfavourable, he suddenly went off to a distance, with expressions of carelessness or disgust.
SMALLPOX.
The first description we have of this dreadful disease is to be found in the writings of Almansor of Rhazes, published about the end of the ninth or the beginning of the tenth century. He, however, quotes an Alexandrian physician of the name of Aaron, who had treated the same subject so early as the year 622. There is no substantial ground to warrant a belief that it was known to the Greeks or Romans. The opinion of Hahn, who considered it to have been their anthrax, is absurd. Had this pestilence prevailed amongst the ancients, and left the traces of its ravages,--which have marked most fearfully so many individuals,--it is probable that these impressions would have been attached to their names, as they were in the habit of designating many of their illustrious personages by their physical peculiarities, either natural or accidental. Hence we find Ovidius _Naso_, Tullius _Cicero_, Horatius _Cocles_, Scipio _Nasica_, Curius _Dentatus_.
The term _variolae_, which this disease bears, was first applied to a malady presenting the same symptoms, by Marius, bishop of Avanches, and appears to be derived from _varius_, spotted. Howbeit, to whatever region we may be indebted for this scourge, it appears that it existed in Asia, and especially in China, long before its introduction into Europe. About the middle of the sixth century, it was supposed to have been carried from India to Arabia by trading vessels, where no doubt the Arabian and Saracenic armies introduced it into the Levant, Spain, and Sicily. In 640, under the caliphate of Omar, the Saracens spread the contagion over Syria, Chaldaea, Mesopotamia, Egypt, and Persia. Its appearance in Europe may be referred to the eighth century. In the ninth century, as I have stated, we find it described by the Arabian physicians. In the tenth century we find it described by other Arabian writers, chiefly Avicenna and Hali Abbas. In 962, Count Baudouin of Flanders, died from its attack. It appears certain that it prevailed in Gaul long before; we find in the works of Marius, already mentioned, the following passage: "Hoc anno (570) morbus validus, cum profluvio ventris et _variolis_, Italiam Galliamque valde afflixit." About the same period we find Dagobert and Clodobert, sons of Chilperic, falling victims to the disorder; and Austregilda, wife of Gontran King of Burgundy, died of it in 580, at the age of thirty-two, so enraged with her physicians, Nicholas and Donet, that she insisted that they should accompany her to the other world, to reward them for causing her untimely end. Her affectionate and disconsolate husband Gontran of course had both their throats cut upon her tomb.
In the eleventh and twelfth centuries we find the smallpox in all the southern parts of Europe. The north was for a long time tolerably exempted from the scourge, until the Holy War introduced it into those regions; and it appears to have been the only trophy that the English and Germans brought home to commemorate their exploits in the Crusades.
In the thirteenth century the Muscovites, Laplanders, and Norwegians were free from the disorder, the progress of which seemed to have been delayed by the cold; although at the same time, according to the relation of Gordon, it was most destructive all over France. Most physicians at this period partook of the opinion of the Arabians, who considered the disease as being in the blood, thrown by it into a state of ebullition, particularly in childhood and youth. According to the Arabian Auaron, or Ahron, it sometimes affected the same individual twice. This doctrine of the boiling up and bubbling forth of the blood to throw out its peccant qualities, tended not a little to increase the mortality and exasperate the disease; as the physicians, to encourage this concoction, were in the habit of wrapping up their patients in warm clothing, and keeping their apartments as hot as possible;--a fatal practice that subsequent experience has rejected as destructive.
In 1517 the Spaniards carried it to St. Domingo, nearly depopulating the country. South America soon received this additional visitation, said to have been carried amongst them by a negro. So terrific were the ravages of this pestilence, that the Americans considered its invasion as one of the _data_ of their melancholy chronicles. The brother of the noble Montezuma was one of its earliest victims; worthy attendant on the Spanish banners, it accompanied their detested hordes in all their conquests.
The northern districts of America were free from the contagion, when the English carried it with their commercial productions amongst the natives of Boston in 1649, and subsequently to Virginia and Carolina, and the remaining provinces. The Spaniards infected Nootka Sound, and the Russians desolated Kamtschatka about the same period.
Inoculation appears nearly as ancient as the disease, if we can credit the missionaries, who were sent into China by the Church of Rome, and who, from their address and insinuation, gained access to the historical records: they have transmitted detailed accounts of the history of the Chinese, and of their knowledge in various branches of science. There is a memoir written on the smallpox by the missionaries at Pekin, the substance of which is extracted from Chinese medical books, and especially from a work published by the Imperial College of Medicine, for the instruction of the physicians of the empire. This book is entitled _Teou-tchin-fa_, or a treatise from the heart to the smallpox; which states that the disease was unknown in the very early ages, and did not appear until the dynasty of Tcheou, which was about 1122 years before Christ. The Chinese name for the malady is a singular one, _Tai-tou_, or venom from the mother's breast; and a description is given of the fever, the eruption of the pustules, their increase, flattening, and crusting. In the same Chinese book there is also an account of a species of inoculation discovered seven centuries previously; but, according to a tradition, it had been revealed in the dynasty of Long, that is, about 590 years before Christ. Father d'Entrecolles, the Jesuit, in his correspondence from China, gives some information respecting the smallpox, which confirms the material part of the above information; for he notices having read some Chinese work which mentions the smallpox as a disease of the earliest ages. He also describes a method of communicating the disease, which was called _sowing the smallpox_; this was generally performed by planting some of the crusts upon the nose,--an operation which was approved of by some but disapproved by others.
Although the tradition of the smallpox being a disease originally transmitted to man by camels may be fanciful, yet the existence of the vaccine in cows might give some probability to its having been the case. Moore thus expresses himself on the subject: "This notion probably took its rise from the circumstance that land commerce from Egypt to India was only practicable by means of this animal. But such kind of traffic was tedious and difficult, and it is conjectured that no person known to have the smallpox would ever have been suffered to join himself to a caravan." Now this observation would rather confirm the fact than invalidate it; since, if no individual affected with the malady could have carried the contagion, the disease might have been spread by their camels.
In regard to the antiquity of the practice of inoculation amongst the Chinese, I cannot do better than give Mr. Moore's own words on so very interesting a subject. "No account is handed down of the origin of this custom; but the reverence in which agriculture is held by the Chinese may have suggested the name (sowing of the smallpox) and the usual manner of performing the operation: for they took a few full dried smallpox crusts, as if they were seeds, and planted them in the nose; a bit of musk was added in order to correct the virulence of the poison, and the whole was wrapped up in a bit of cotton to prevent it dropping from the nostrils. The crusts employed were always taken from a healthy person who had had the smallpox favourably; and, with the vain hope of mitigating their acrimony, they were sometimes kept in close jars for years, and at other times fumigated with salutary plants. Some physicians beat these crusts into powder, and advised their patients to take a pinch of this snuff; and when they could not prevail upon them, they mixed it with water into a paste, and applied it in that form. In Hindostan, if tradition may be relied upon, inoculation has been practised from remote antiquity. The practice was in the hands of a particular tribe of Brahmins, who were delegated from various religious colleges, and who travelled through the provinces for this purpose. The natives were strictly enjoined to abstain during a preparatory month from milk and butter; and, when the Arabians and Portuguese appeared in that country, they were prohibited from taking animal food also. These were commonly inoculated on the arm; but the girls, not liking to have their arms disfigured, chose that it should be done low on the shoulder: and whatever part was fixed upon was well rubbed with a piece of cloth, which afterwards became a perquisite of the Brahmin. He then made a few slight scratches on the skin with a sharp instrument, and took a bit of cotton, which had been soaked the preceding year in variolous matter, moistened it with a drop or two of the holy water of the Ganges, and bound it upon the punctures. During the whole of this ceremony, the Brahmin always preserved a solemn countenance, and recited the prayers appointed in the _Attharna Veda_, to propitiate the goddess who superintended the smallpox. The Brahmin then gave his instructions, which were regularly observed. In six hours the bandage was to be taken off, and the pledget allowed to drop spontaneously. Early next morning, cold water was to be poured upon the patient's head and shoulders, and this was to be repeated until the fever came on. The ablution was then to be omitted; but, as soon as the eruption appeared, it was to be resumed and persevered in every morning and evening till the crusts should fall off. Confinement to the house was absolutely forbidden; the inoculated were to be freely exposed to every air that blew; but when the fever was upon them, they were sometimes permitted to lie on a mat at the door. Their regimen was to consist of the most refrigerating productions of the climate; as plantains, water-melons, thin gruel made of rice or poppy-seeds, cold water, and rice."
While sowing the disease was thus prevalent in some countries, selling and buying it was adopted in others, when children bartered fruit in exchange for the infection. It does not appear that the faculty took any notice of inoculation until the year 1703, when Dr. Emmanuel Timoni Alpeck wrote an account of his observations in Constantinople, in a letter to Woodward: a Venetian physician, of the name of Pylamus, about the same time noticed the success of the practice in Turkey. Lady Mary Wortley Montagu pursued the inquiry in her voyage to that country, by causing her son Edward to be inoculated by Maitland, surgeon to the embassy, and, on her return to England in 1722, had the operation tried with successful results on her daughter. Still, although two of the princesses of the royal family had also been inoculated with equal benefit, inoculation was furiously opposed by the profession, and even from the pulpit; and so successful was this opposition, that it succeeded in bringing it into disuse both in England and throughout Europe, many cases of smallpox of a confluent character having made their appearance after inoculation, and in 1740 the practice had nearly fallen into disuse. In this virulent controversy, a singular circumstance was observed: while regular practitioners stated the practice to be unsuccessful, whenever it was adopted by quacks, monks, and old women, the result was invariably favourable; and the report that reached Europe of a Carmelite friar having inoculated thousands of Indians, an old woman being equally fortunate in Greece, while at the same time a planter in St. Christopher's inoculated three hundred persons without the loss of a single patient, the practice was again resumed, chiefly in our seaports, and gradually extended over the country. Mead materially assisted its progress by stating that the Circassian ladies chiefly owed their beauty to this salutary preservative. In the year 1763, Daniel Sutton, son of a surgeon in Suffolk, recommended the practice, modified, however, in the treatment of the malady, and brought inoculation into general repute.
It appears, however, that inoculation was by no means a novel introduction even in England, as it had been long practised in Pembrokeshire and several parts of Wales. On the Continent it had been tried at Cleves. Bartholinus mentions it as adopted in Denmark; and traces of its adoption were evident in Auvergne and Perigord.
Various modes of performing this operation were adopted. The Arabians inserted the virus with a pointed instrument between the thumb and the index; the Georgians on the fore-arm; and the Armenians on the thigh. The traveller Motraye mentions a Circassian old woman who used to inoculate with three pins tied together. It appears that this practice was generally prevalent in Turkey in 1673. Trinoni and Pilarini observed that the natural smallpox was generally fatal in Constantinople, while the disease produced artificially was most benign. Bruce relates that from time immemorial inoculation was practised in Nubia by old Negresses or Arabs.
Strange to say, it was only in 1727 that inoculation became general in France; and its adoption was materially forwarded by Voltaire, who also took special care to acquaint the fair sex that it was to this practice that the Circassian and Georgian odalisks owed their beauty.
The terrific mortality that attended this disease was much increased by the injudicious treatment to which patients were submitted. Instead of adopting the natural plan resorted to by eastern nations, and allowing the patients a free current of air, with a refrigerant diet, cordials and a hot regimen were enforced, under which the disorder soon assumed a destructive malignity. Cold affusion, which has also been extolled by modern physicians as a recent improvement in medical practice, we have seen, was also employed centuries ago. Sutton, who is generally, but erroneously, considered as being the introducer of inoculation, did nothing more, as I have already observed, than modify the treatment of the disorder. Thus do we daily see impudence and quackery receiving rewards for supposed discoveries, and the keepers of the public purse on such occasions seem much less careful of it than of their own. In our days, for instance, chain-cables have been decreed a discovery, and their inventor entitled to a national recompence, whereas we read the following passage in Caesar's Commentaries, when speaking of the shipping of the Gauls,--"Anchorae, pro funibus, ferreis catenis revinctae:" any schoolboy could have given this information to our sapient legislators.
The reappearance or supposed increased prevalence of the smallpox after vaccination, for the last few years, may call for some observation. Ever since the year 1804 a belief was entertained by many persons that the cowpox only afforded a temporary security. This doubt, however, never did rest upon any solid foundation. Dr. Jenner maintained in the most strenuous manner, that to render the cowpox efficient, it was absolutely necessary to attend most carefully to the character of the pustule, and the time and quality of the lymph taken from it; on the very same principle inoculation of the smallpox also failed. For it must be clearly understood, that Jenner considered the smallpox and the cowpox as identic maladies, and by no means dissimilar in their nature: on this important subject I feel much gratification in quoting a passage from a late valuable publication,[51] to which I refer the reader. "It was then clearly ascertained, that there were deviations from the usual course of smallpox, which were quite as common and infinitely more disastrous than those which took place in vaccination. These deviations regarded two apparently different states of the constitution. In the one the susceptibility of smallpox, was not taken away by previous infection, while, on the other hand some constitutions seem to be unsusceptible of smallpox infection altogether. It was found, that similar occurrences took place in the practice of vaccination, but as the security which the latter afforded was never more likely to be interfered with by slight causes than the former, it became absolutely necessary that great care should be shown in watching the progress and character of the pustule. Dr. Jenner had from the beginning felt the propriety of this watchfulness; and had distinctly announced that it was possible to propagate an infection by inoculation conveying different degrees of security, according as that affection approached to or receded from the full and perfect standard. He also clearly stated that the cause of the vaccine pustule might be so modified as to deprive it of its efficacy. That inoculation from such a source might communicate an inefficient protection, and that all those who were thus vaccinated were more or less liable to the subsequent smallpox."
Dr. Bacon is of opinion that the cowpox is now what it was at the beginning. There are instances, in which it has passed from one human subject to another for more than thirty years, consequently through fifteen or sixteen hundred individuals, but yet in which no degeneration has taken place. He nevertheless admits that recent lymph from the cow should be preferred, when it can be procured; he is further of opinion that the occurrence of smallpox after inoculation does not exceed in number the cases of smallpox after smallpox. My own experience confirms these views. I was in practice in Bordeaux during the prevalence of what is called smallpox in vaccinated cases,--the cases were rare, doubtful, and very seldom fatal.
There is little doubt that the smallpox would sweep away thousands of our dense population but for the protecting power of vaccination, the failure of which, ought more frequently to be attributed to the vaccinator, or the constitution of the patient, than to Jenner's immortal discovery. Dr. Severn has just published an essay on this most important subject, and it appears by his statistical tables, that such has been the decrease of mortality since the introduction of vaccination, that the number of patients admitted into the smallpox hospital from 1775 to 1800,--were 7017--the deaths 2277--whereas from the year 1800 to the year 1825, the number admitted was 3943, and the deaths 1118--not half the number, although the population of London had doubled during that period. Dr. Severn further calculates that the proportion of failures is 6 in 3000.
We read with feelings of deep regret in his late bibliography, that the man at whose intercession the magic of his name obtained the liberation of Napoleon's prisoners, could not obtain an appointment for the members of his own family from the British Government; nay, the College of Physicians despite the exertions of Dr. Baillie, refused to admit him to a fellowship in their learned body. It was when reflecting on such national ingratitude, that he wrote to a friend, "Never aim, my friend at being a public character, if you love domestic peace." And not long before he terminated his invaluable career he made this remarkable expression: "I am not surprised that men are not thankful to me; but I wonder that they are not grateful to God for the good which he has made me the instrument of conveying to my fellow-creatures."
It is in vain that France with her usual _jactance_ pretends that the first idea of vaccination arose in that country, they have no more claim to the discovery than their Marshals to Wellington's immortal glory.
GENERATIVE ANIMALCULES.
Microscopic experiments daily demonstrate the existence of myriads of animalcules in every substance. They have recently been discovered in the progress of certain crystallizations; and some philosophers maintain that most inorganic bodies are formed of the remains of organic substances. The existence of animalcules in the generative secretion was first noticed by Lewis Hamme, a young German student, and shown by him to Leeuwenhoeck, who published an account of them. Hartzoeken wrote upon the subject the following year, and asserted that he had seen these animalcules three years before they had been observed by Hamme. This curious subject soon attracted the notice, not only of physiologists, but of priests, artists, and even courtiers, for we find our Charles II. making curious inquiries on this investigation. Although many opticians could not discover these creatures, the eyes of courtiers were more keen than theirs, and to gratify their royal master's depravity, described them most minutely. Their length was 3/100000 of an inch, their bulk such as to admit the existence of 216,000 in a sphere whose diameter was the breadth of a hair, and their rate of travelling nine inches in the hour. They saw them in the seminal secretion of every animal; and, what was still more remarkable, they were of a similar size whatever might have been that of the animal: they saw them in the sprat and in the whale; they could distinguish the male from the female; and they all moved along in gregarious harmony like a flock of sheep: nay, more; Dalenpatius actually saw one of them, more impatient than his companions, burst from his ignoble shackles, and actually assume the human form. At other times they were discovered swimming in shoals to given points, turning back, separating, meeting again, and frisking about like golden fish in a pond. Kauw, Boerhaave, Maupertius, Lieuland, Ledermuller, Monro, Nicholas, Haller, and indeed most of the philosophers of Europe, were convinced of their existence.
Buffon, however, and other naturalists, contended that these were not animalcules, but organic particles; and Linnaeus imagined them to be inert molecules, thrown into agitation by the warmth of the fluid. Finally, to determine the question, Spallanzani began an assiduous course of observations and experiments. He found these animalcules in the human species to be of an oval form, with a tail tapering to a point. This appendage, by moving from side to side, propelled them forward. They were in constant motion in every direction. In about twenty-three minutes their movements became more languid, and in two or three hours they generally died. The duration of their life, however seemed to depend, in a great measure, on the temperature of the medium: at 2 deg. (Reaumur) they died in three quarters of an hour; while at 7 deg. they lived two hours, and at 12-1/2 deg. three hours and three quarters. If the cold was not too intense, they recovered upon the temperature being raised; when only 3 deg. or 4 deg., they recovered after a lethargy of fourteen hours; and according to the less intensity of the cold, they might be made to pass from the torpid to the active state more frequently. They were destroyed by river, ice, snow, and rain water; by sulphur, tobacco, camphor, and electricity; even the air was injurious to them: in close vessels their life was prolonged to some days, and their movements were not constant and hurried. They were of various sizes, and perfectly distinct from all species of animalcules found in vegetable infusions, &c. In short, Spallanzani completely confirmed the principal observations of Leeuwenhoeck, and satisfactorily explained the sources of the inaccuracies of other inquirers. Prevost and Dumas have recently confirmed the observations of the Italian physiologist.
This doctrine of life being perpetuated by the transmission of animated particles, or animalcules, is by no means of modern date. We find this theory advanced by Hippocrates, and Aristotle, and Plato. Democritus described worms that assumed, in the progress of their development, the human form; and Lactantius thus refuted his ideas: "Erravit ergo Democritus, qui vermiculorum modo putavit homines effusos esse de terra, nullo auctore, nullaque ratione." Hippocrates plainly says, that the seminal secretion was full of animalcules, whose several parts were developed, and grew afresh; that nothing did exist that had not pre-existed; and that what we term birth was nothing more than that transition of these hitherto imperceptible animalcules from darkness to light.
Gesner has endeavoured to prove that the word [Greek: psyche], so frequently found in the writings of Hippocrates, and translated _anima_, was synonymous with _insectum_, _animalculum_, _papilio_. Plato, when expressing himself on this curious subject, compares the matrix to a fertile field, in which animalcules are gradually developed, at first of such a small size that they are imperceptible, but, by taking the food prepared for them, grow in strength until they are brought to light in a state of perfect generation; and St. Augustine thus follows: "Hunc perfectionis modum sic habent omnes ut cum illo concipiantur atque nascuntur; sed habent in ratione, non in mole, sicut ipsa jam membra omnia sunt latenter in semine; cum etiam natis nonnulla desint, sicut dentes, ac si quid ejusmodi." In the works of Seneca we also find the same notions: "In semine omnis futuri hominis ratio comprehensa est, et legem barbae et canorum nondum natus infans habet; totius enim corporis, et sequentis aetatis, in parvo occultoque lineamenta sunt."
It may be said that these opinions were similar to those of the _Ovarians_, who, as we have observed already, believed that every thing arose from the egg. Such were Aristotle, Empedocles, and other philosophers: "For the egg is the conception," said the first of these great men, "and after the same manner the animal is created;" but there was a manifest difference in their systems. Harvey, Haller, De Graef, were amongst the most warm advocates of this doctrine, which indeed prevails to the present day, as it would be difficult to find organized beings that did not spring from an original germ.
It thus appears that, notwithstanding the absurd doctrines of generation being founded upon the existence of these animalcules, they clearly do exist. Modern microscopic experiments daily confirm the fact; not only in the generative secretion, but in the other fluids of the body: creatures of an inch to an inch and a quarter in length have been found to inhabit the mesenteric arteries of asses and horses. Mr. Hodgson found them in seven asses out of nine. They have also been found in the blood of female frogs, salamanders, and tadpoles. What wonders are perhaps in store for the microscopic observer and the physiologist! All living matter seems to be animated by particles, by atoms, equally possessed of life. Does the vitality of these constituent molecules hold any influence over our existence? Is their life necessary to the preservation of ours? Is any agency destructive to them injurious or destructive to us? In a former paper I have recorded recent observations, where animalcules of a peculiar description were found in the purulent secretion attending various affections. A morbid condition seems thus to produce a new series of animated beings, or this new series of living atoms perhaps have produced a morbid state. Many eruptive maladies are either caused by the presence of insects, or insects are subsequently developed in their pustules. Wichmann, and many other physicians, have maintained that the itch was produced by an insect of the genus _acarus_, or _tick_.
Latreille has given a minute description of this creature in his _Genera crustaceorum et insectorum_, and calls this offensive species the _sarcoptes scabiei_. Linnaeus classed it among the _aptera_, and termed it the _acarus scabiei_. This insect is nearly round, with eight legs; the four fore-legs terminated with a small head, the hind ones with a silky filament. The Arabian Avenzoar had long since observed them, and it was from his writings that Mouffet was induced to pursue the inquiry. Redi, an Italian physician, was the first propagator of this doctrine in modern times, and published, in 1685, a paper of Cestoni of Leghorn, who had frequently observed mendicants and galley-slaves extracting these insects from the pustules of itch with the point of a pin, in the same manner as _chigoes_ are extracted from their cyst in the West Indies.
It was this communication of Cestoni that led to a further and more minute investigation. Curiosity was every where excited, and the most learned and intelligent naturalists and physicians, amongst whom we find the illustrious names of Borelli, Etmuller, Mead, Pringle, Pallas, Bonani, Linnaeus, Morgagni, strove with incessant diligence to ascertain this important fact, which certainly was likely to shed a new light on our pathological speculations. The existence of the acarus was established.
The most conclusive experiments on the subject were those of Gales, in 1812. The following is the account of them: "I placed under a microscope a watch-glass with a drop of distilled water, after having carefully ascertained that it did not contain any visible animalcules. I then extracted from an itch pustule a small portion of the virus, which I diluted in the water with the point of a lancet. I watched most attentively for upwards of ten minutes, without having been able to notice any animation. Two similar experiments were equally ineffectual. Disappointed in my expectations, I was about giving up the task, when an idea struck me of submitting the liquid of the first experiment to another trial. I had left it in the watch-glass, exposed to solar heat. I then was not a little surprised when I discovered a perfect insect struggling with its legs to extricate itself from the viscid fluid that confined it. Having succeeded in reaching a more limpid part of the liquor, its form was so distinct that Mr. Patrix, who was with me, was enabled to take an exact drawing of its configuration."
This curious result naturally induced Gales to pursue his inquiries, and he discovered that this insect chiefly occupies the pustules that are filled with a thin serum, and avoids those that contain a thicker secretion. Hence the watery pimples in itch are invariably those that produce the most intolerable prurience.
The next important question was to decide whether this insect was the cause of the disgusting disorder. For this purpose Gales placed several of them on the back of his hand. He then covered the part with a small watch-glass, kept in place with a bandage. Three hours after he awoke, experiencing a sensation of itching on the part. The following morning three itch pustules were evident, and convinced him that he had succeeded in inoculating himself with the loathsome complaint. This fact he communicated to Olivier, Dumeril, Latreille, and Richerand. Experiments in the hospital were immediately directed to be made, and all produced a similar result; affording a convincing proof that these insects could produce the affection, which they had merely been thought to have complicated.
Many writers, who, like Mason Good, had decided that "whenever these insects appear, they are not a cause but a consequence of the disease," opposed and contradicted the statement of Gales, and the numerous practitioners who had procured and witnessed facts, which are never "stubborn things" to speculative minds. These writers maintained that whenever any organ was weakened, or in a morbid condition, it was apt to become a nidus for some insects or worms to burrow in. Hence the numerous varieties of invermination in debility of the digestive organs. But it is needless to observe that their objections cannot stand against the imbodied evidence brought forward in proof of their error. Bosc, Huzard, Latreille, Dumeril, and many other naturalists, subsequently found these acari in the eruptive diseases of many animals.
I repeat it, this subject is replete with interest; and microscopic experiments may some time or other throw a material light on the practice of medicine. Those substances that are known to destroy the insect that produces the itch, cure the malady. May not this analogy lead to singular results?
CIRCULATION OF THE BLOOD.
The circulation of the blood was first taught by the unfortunate Servetus in 1553, who was burnt to death as a heretic; and, a century afterwards, demonstrated by our Harvey, who is justly considered as having discovered the wonderful mechanism of the motion of the vital fluid.
There is no doubt, however, that the ancients had formed, if not a correct, at least an ingenious, idea of it. Hippocrates tells us "that all the veins communicate with each other, and flow from one vessel into others; and that all the veins that are spread over the body carry a flux and movement originating in a single vessel." He avows that he is ignorant of the principle whence it arises, or of its termination, it appearing to be a circle without beginning or end. He further states, that the heart is the source of the arteries, through which blood is carried over the body, communicating life and heat; and he adds, that they are so many rivulets that irrigate the system, and carry vitality into every part: the heart and veins are in constant motion; and he compares the circulation of blood to the course of rivers, that return to their source by extraordinary deviations. He therefore directs blood-letting to restore a free current of the blood and other spirits in apoplexies and other diseases of a similar nature, which he attributed to obstruction in the vessels intercepting the flow of their contents. He also observes, that when bile enters the blood, it deranges its consistence, and disturbs its ordinary course towards another point: and he compares the circulation to balls of thread, the threads of which return to each other in a circuitous manner, terminating at the point whence their motion arose.
Plato thought that the heart was the source of the veins, and of the blood, that was rapidly borne to every part of the body. Aristotle tells us that the heart is the principle and source of the veins and of the blood. He considered that there were two veins proceeding from this organ, one from the left side, the other from the right; the first he termed _aorta_: and he further maintained that the arteries communicated with the veins, with which they were intimately connected.
Julius Pollux taught, in his _Gnomasticon_, that the arteries are the channels through which the spirits circulate as the veins propel the blood; and he describes the heart as having two cavities, one communicating with the arteries, and the other with the veins. Apuleius tells his disciples that the heart propels the blood through the lungs, to be afterwards distributed over the system.
In the writings of Nemesius, bishop of Emissa, we read that the movement observed in the pulse originates in the heart, chiefly from the artery of the left ventricle of the viscus. This artery is dilated, and then contracted, by a constant and powerful harmonious action. When dilated the vessel draws towards it the most subtile portions of the neighbouring blood, and the vapour or exhalation of this fluid, that feeds the animal spirits; but when it contracts, it exhales, through various channels of the body, all the vapours that it contains.
Strange as it may appear, doubts were once entertained as to the actual situation of the heart, whether it was lodged in the right or the left side of the body. The question was finally settled by a professor of Heidelberg, who for the purpose killed a pig in the presence of the Margrave of Baden, Durlach, who then laboured under a supposed disease of that organ, which it was then clearly shown occupied the left side. The result of this experiment, however proved somewhat detrimental to his Highness's physician, who was dismissed, although he maintained with all becoming courtesy and respect, that the heart of his princely master could not _possibly be_ in the same position as that of a hog.
Michael Servetus, in his work, _De Christianismi restitutione_, also in the 7th book, _De Trinitate Divina_, for which he was sentenced to the stake a very short time after its publication, gives us the following description of this important function: The blood, which is a vital spirit, is diffused all over the body by _anastomoses_, or inosculation of two vessels through their extremities. The air in the lungs contributes to the elaboration of the blood, which it draws for that purpose from the right ventricle of the heart through the pulmonary artery. This blood is prepared in the lungs by a movement of the air that agitates it, subtilizes it, and, finally, mingles it with that vital spirit which is afterwards retransmitted to the heart by the movement of the diastole, as a vital fluid proper to maintain life. This communication and preparation of the blood, he further states, is rendered evident by the union of the arteries and veins in this organ; and he concludes by affirming that the heart, having thus received the blood prepared by the lungs, transmits it through the artery of the left ventricle, or the aorta, to every part of the body.
Great care was of course taken to destroy this abominable heretical publication, which was burnt by the common hangman in Geneva, Frankfort, and several provinces of France. The work thence became so scarce, that it is said only three or four copies of it are in existence. One of them was in the library of the Landgrave of Hesse-Cassel.
John Leonicenus relates that the celebrated Paul Sarpi otherwise named Fra Paolo, had also discovered this circulation, and demonstrated the valves of the veins, which open to afford a free passage to the blood, and close to prevent its return. This discovery, it is pretended, was made known to Fabricius ab Aquapendente, professor of medicine in Padua in the sixteenth century, and successor of Fallopius, and who communicated the fact to Harvey, then a student in that university.
Some time before Harvey's discovery, Cesalpinus had described with great precision the pulmonary circulation; and, on finding that veins swelled under a ligature, he attributed this enlargement to the warmth of the blood. This warmth, he says, proceeds from a spirit residing in the blood. The left ventricle is filled with blood of a spirituous nature; and one can trace the movement of the blood towards the superior parts, and its return (_retrocessus_) to the internal ones,--that is to say, a return by which it comes back from the extremities to the heart, when awake or sleeping, from every part of the body; for if you tie the vessels, or if they are obstructed, the current of the blood is stopped, and then their smaller ramifications tumefy towards their origin. The following are his words: "Sic non obscurus est ejusmodi motus in quacumque corporis parte, si vinculum adhibeatur, aut alia ratione occludantur venae: cum enim tollitur permeatio, intumescunt rivuli qua parte fluere solent." From these expressions it is clear that Cesalpinus suspected the great circulation, and had a fair idea of its nature; yet there is no doubt but that it was to our Harvey that the first demonstration of this wondrous function was reserved.
DRUNKENNESS.
At all periods this degrading vice appears to have been more or less prevalent. We find it frequently mentioned in the early history of the Jews. Tacitus informs us that it was common amongst the ancient Germans; and in Greece and Rome it was not only common, but frequently extolled as beneficial--as medicinal:
Si nocturna tibi noceat potatio vini,
Hora matutina rebibas, et erit medicina.
Socrates considered the indulgence in wine pardonable. Thus, C. Gallus:
Hoc quoque virtutem quondam certamine, magnum
Socratem palmam promeruisse ferunt.
According to Horace, Cato the Censor had often recourse to its exhilarating virtues:
Narratur et prisci Catonis
Saepe mero incaluisse virtus.
Seneca informs us that even the Roman ladies frequently indulged in these potations. The drunkenness of the ancients bore all the disgusting character of the present day, and was thus admirably described by Lucretius:
Cum vini penetravit--
Consequitur gravitas membrorum, praepediuntur
Crura vacillanti, tardescit lingua, madet mens,
Nant oculi; clamor, singultus, jurgia gliscunt.
However, from the language of the ancients, we cannot come to the conclusion that Socrates, and other great men who were accused of inebriety, were habitual drunkards, or even that, under the influence of their potations, they were occasionally deprived of their reason. On the contrary, there is every reason to believe that the ancients both ate and drank a great deal during their repasts; and thus mingling their wine and their food, like most of the continental nations, they were less subject to the inconveniences that arose from their indulgence in liquor. Indeed, the term sobriety applies to a proper regulation of our ingesta, according to our constitution and our state of health. Extreme abstinence on some occasions may prove as prejudicial as intemperance; and there are peculiar idiosyncrasies where a certain quantity of stimulus is absolutely requisite to keep up the animal spirits, and at the same time assist assimilations which become languid under mental depression. No doubt, this necessity has arisen from habit,--most probably a very bad habit; still, when it does exist, physicians should be cautious in suddenly forbidding customary indulgences: we must also consider on such occasions the pursuits of different individuals. The laborious classes, who require more frequent refection, from the constant exhaustion to which their avocations expose them, can bear with impunity a moderate use of strong liquors. Such a practice would destroy the sedentary and the studious. Temperance is essentially requisite to perfect not only our intellectual faculties, but many of our physical functions. The senses both of man and the brute creation are rendered much more keen by abstinence. The scent of the dog, the vision of the hawk, are less acute after feeding; and this is one of the chief causes of the greater perspicuity in our ideas when fasting in the morning. The ancients had an axiom founded upon observation, "_if you wish to become robust, eat and labour; if you wish to become wise, fast and meditate_." The Greeks called sobriety, [Greek: sophrosune]; or, according to Aristotle, as though they said, [Greek: sozousan ten phronesin], it assisted our intellectuals. Plato tells us that Socrates termed this quality [Greek: soterian tes psroneseos], or the health of the mind. Xenophon maintained that it prevented men from spitting or blowing their noses, as we were not in need of superfluities when we decreased the consumption of what was necessary. The ancients looked upon sobriety as a bent bow, that required occasional relaxation.
It is said, but I know not on what authority, that Hippocrates recommended an indulgence in potations once a month. Celsus recommends persons in perfect health not to be too rigorous in their diet; sometimes to fast, and at others to live more freely. In more modern times this supposed precept of Hippocrates has been advocated, and we find two theses on the subject, entitled "_Non ergo singulis mensibus repetita ebrietas salubris_," and "_Non ergo unquam ebrietas salubris_," by Hammet and Langlois. Zacchias, in his medical questions, asks if a physician can recommend such a departure from the laws of temperance without committing a sin. This query has been also debated by divines. Frederick Hoffmann maintained that poets required this indulgence, and attributes in a great measure the falling off of genius amongst the modern Greeks to the destruction of their vineyards by the Turks. In ancient Iconography we oftentimes find Bacchus placed near Minerva. The allusions of Heathen mythology to drunkenness, its effects, and the means of tempering its influence, are curious. Silenus, the preceptor of Bacchus, although represented as always intoxicated, was a philosopher, who accompanied his pupil in his Indian expedition, and aided him by the soundness of his judgment. Virgil makes him deliver the principles of the epicurean doctrines on the formation of the world, and the nature of things. Aelian gives us his conversation with Midas regarding the unknown world of Plato and other philosophers. He was also considered an able warrior and a wit. Aelian derives his name from _Sillainein_. The nymphs who follow his train were considered as typical of the water necessary to dilute his potations, and the influence of love in checking intemperance.
Montaigne informs us that the celebrated Sylvius recommended an occasional debauch; and the late Dr. Gregory was of opinion than an occasional excess is, upon the whole, less injurious to the constitution than the practice of daily taking a moderate quantity of any fermented liquor or spirit. Experience, however, does not uphold the doctor's opinion; and, as I have observed in a preceding article, occasional excesses are far more injurious than habitual indulgences, under which, in the most unfavourable climates, men attain advanced years. An occasional excess actually brings on a state of sickness, which, in persons habitually sober, may not only last for several days, incapacitating them from any pursuit, but be frequently followed by serious accidents. Of course I am not alluding to a constant state of intoxication, which will often bring on delirium, tremor, apoplexy, and other destructive accidents.
The appearances after death in drunkards exhibit great derangement in organic structure. The brain is generally firmer than usual. Serum is not unfrequently found effused in its cavities; and, what is singular, this watery fluid is often impregnated with the odour of the deceased's potations, such as rum, gin, or brandy. Schrader relates several instances of the kind. Aether has also been detected after the medicine had been freely exhibited. Dr. Ogston states that above four ounces of fluid were found in the ventricles of a drunkard's brain, that had all the physical qualities of alcohol. He thinks that this effusion takes place previously to the coma of intoxication, as he found it in considerable quantities in two cases of drowning in the stage of violent excitement from spirituous liquors. The mucous coats of the stomachs of drunkards, instead of being "worn out," according to the vulgar expression, are thickened, and sometimes softened; but in most cases they are found hardened. This condition is not likely to accelerate death; on the contrary, the stomach is less susceptible of the action of stimulating articles of diet, or excess in eating or drinking, than when in a healthy state of excitability. When drunkenness proves fatal, it appears that a portion of the spirituous part of the liquor is actually absorbed and carried into the circulation and the brain. Dr. Copeland has given the following very luminous and correct view of the pathology of drunkenness. "During the general nervous and vascular excitement consequent on the stimulus, increased determination to the head takes place, attended by excited vascular action, which soon terminates in congestion as the excitement becomes exhausted, and gives rise to drowsiness, sopor, and coma. With this state of the disorder effusion of serum takes place in the ventricles and between the membranes, heightening the sopor and coma. When the congestion or effusion amounts so high as to impede the functions of the organs at the basis of the encephalon and of the respiratory nerves, respiration becomes unfrequent and laborious, and consequently the changes produced by it on the blood insufficiently performed. In proportion as the blood is less perfectly changed in the lungs, the circulation through them is retarded, and the phenomena of asphyxy,--congestion of the lungs, right side of the head, brain, and liver; the circulation of unarterialized blood; the imperfect evolution of animal heat, and sedative effects upon the brain and nervous system generally,--follow in a more or less marked degree, according to the quantity of the intoxicating fluid that has been taken, and either gradually disappear after some time, or increase until life is extinguished. These phenomena are heightened by cold, which depresses the vital action in the extremities and surface to which it is applied, and increases the congestion in the above organs. The fatal consequences of intoxication are often averted by the occurrence of vomiting, the stomach thereby being relieved from a great part of the poison."
Besides wine and spirituous liquors various other substances have been employed to bring on this supposed pleasurable state. The Syrian rue (_Peganum Harmala_), was constantly used by Sultan Solyman. The _Hibiscus Saldarissa_ of the Indians, which furnishes their _bangne_, is supposed to be the _Nepenthes_ of the ancients. The _Penang_ or Indian beetle, the _Hyosciamus Niger_. The _Belladonna_, the _Cocculus Indicus_, are drugs that have been resorted to by various nations. The last ingredient has made the fortune of many of our wealthy brewers, at the expense of public sobriety and health.
In the accidents that follow intoxication, bleeding has frequently been resorted to. Nothing can be more hazardous than this practice, justly condemned by Darwin, Trotter, and most physicians, who have had frequent opportunities of witnessing the distressing train of symptoms that inebriety brings on. Coffee and green tea will be found the most efficacious antidotes, when no sickness prevails. Nausea is counteracted by effervescent and aromatic draughts, such as soda-water, (so highly appreciated by Byron, when accompanied by a sermon, after a night's conviviality,) spruce-beer, Seidlitz powders, &c. The ancients had recourse to various means to counteract the effects of wine, and amongst others we find olives and olive oil, wormwood, and saffron. The Greeks used a solution of salt, a common remedy among seafaring men to the present day; and the Romans surrounded their heads with wreaths of various refreshing plants. When Aristotle tells us that Dionysius of Syracuse remained in a state of intoxication for eighty days, we must suppose that he got drunk every morning.
That the ancients were in the habit of diluting their wine with water, there cannot be a doubt. The Lacedaemonians accused those who drank it pure of acting like Scythians,--an expression introduced ever since Cleomenes the Spartan had learned to drink freely amongst them. The Thracians were also accused of this practice, which clearly proves that it was not general. Philochorus reports that Amphictyon, king of Athens, learned to mix wine and water from Bacchus himself, on which account he dedicated an altar to the god. According to Athenaeus, this dilution was of various strength; sometimes in the proportion of one to two, at others of one to five. The Lacedaemonians used to boil their wine till the fifth part was consumed, under the impression that they thus deprived it of its spirituous qualities. Sometimes this boiled wine was laid by for four years.
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Curiosities of Medical ExperienceChapter V: The Malay (21)
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