第28章
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  Forcedoesnotadmitofexplanation,norofproperdefinition,anymorethanthehypotheticalsubstratumofmatter。IfweassumetheInfiniteasomnipresent,omniscient,omnipotent,wecannotsupposeHimexcludedfromanypartofHiscreation,exceptfromrebellioussoulswhichvoluntarilyexcludeHimbytheexerciseoftheirfatalprerogativeoffree-will。Force,then,istheactofimmanentDivinity。Ifindnomeaninginmechanicalexplanations。Newton’shypothesisofanetherfillingtheheavenlyspacesdoesnot,I

  confess,helpmyconceptions。Iwill,andthemusclesofmyvocalorgansshapemyspeech。Godwills,andtheuniversearticulatesHispower,wisdom,andgoodness。ThatisallIknow。Thereisnobridgemymindcanthrowfromthe“immaterial“causetothe“material“

  effect。

  Theproblemofforcemeetsuseverywhere,andIprefertoencounteritintheworldofphysicalphenomenabeforereachingthatoflivingactions。Itisonlythenamefortheincomprehensiblecauseofcertainchangesknowntoourconsciousness,andassumedtobeoutsideofit。FormeitistheDeityHimselfinaction。

  IcanthereforeseealargesignificanceinthesomewhatboldlanguageofBurdach:“Thereisformebutonemiracle,thatofinfiniteexistence,andbutonemystery,themannerinwhichthefiniteproceedsfromtheinfinite。Sosoonaswerecognizethisincomprehensibleactasthegeneralandprimordialmiracle,ofwhichourreasonperceivesthenecessity,butthemannerofwhichourintelligencecannotgrasp,sosoonaswecontemplatethenatureknowntousbyexperienceinthislight,thereisforusnootherimpenetrablemiracleormystery。“

  Letusturntoabranchofknowledgewhichdealswithcertaintiesuptothelimitofthesenses,andisinvolvedinnospeculationsbeyondthem。Incertainpointsofview,HUMANANATOMYmaybeconsideredanalmostexhaustedscience。Fromtimetotimesomesmallorganwhichhadescapedearlierobservershasbeenpointedout,——suchpartsasthetensortarsi,theoticganglion,orthePacinianbodies;butsomeofourbestanatomicalworksarethosewhichhavebeenclassicformanygenerations。TheplatesofthebonesinVesalius,threecenturiesold,arestillmasterpiecesofaccuracy,asofart。ThemagnificentworkofAlbinusonthemuscles,publishedin1747,isstillsupremeinitsdepartment,astheconstantreferencesofthemostthoroughrecenttreatiseonthesubject,thatofTheile,sufficientlyshow。Morehasbeendoneinunravellingthemysteriesofthefasciae,buttherehasbeenatendencytooverdothiskindofmaterialanalysis。AlexanderThomsonsplitthemupintocobwebs,asyoumayseeintheplatestoVelpeau’sSurgicalAnatomy。IwellrememberhowheusedtoshakehisheadoverthecoarseworkofScarpaandAstleyCooper,——asifDenner,whopaintedtheseparatehairsofthebeardandporesoftheskininhisportraits,hadspokenlightlyofthepicturesofRubensandVandyk。

  Notonlyhaslittlebeenaddedtothecatalogueofparts,butsomethingslongknownhadbecomehalf-forgotten。Louisandothersconfoundedthesolitaryglandsofthelowerpartofthesmallintestinewiththosewhich“thegreatBrunner,“asHallercallshim,describedin1687asbeingfoundintheduodenum。ThedisplayofthefibrousstructureofthebrainseemedanoveltyasshownbySpurzheim。OneisstartledtofindthemethodanticipatedbyRaymondVieussensnearlytwocenturiesago。IcanhardlythinkGordonhadeverlookedathisfigures,thoughhenamestheirauthor,whenhewrotethecaptiousandsneeringarticlewhichattractedsomuchattentioninthepagesofthe“EdinburghReview。“

  Thisistheplace,ifanywhere,tomentionanyobservationsIcouldpretendtohavemadeinthecourseofmyteachingthestructureofthehumanbody。Icanmakenobettershowthanmostofmypredecessorsinthiswell-reapedfield。Thenucleatedcellsfoundconnectedwiththecancellatedstructureofthebones,whichIfirstpointedoutandhadfiguredin1847,andhaveshownyearlyfromthattimetothepresent,andthefossamasseterica,ashallowconcavityontheramusofthelowerjaw,forthelodgmentofthemassetermuscle,whichacquiressignificancewhenexaminedbythesideofthedeepcavityonthecorrespondingpartinsomecarnivoratowhichitanswers,mayperhapsbeclaimedasdeservingattention。Ihavealsopleasedmyselfbymakingaspecialgroupofthesixradiatingmuscleswhichdivergefromthespineoftheaxis,orsecondcervicalvertebra,andbygivingtoitthenamestellamusculosanuchaee。Butthisscantycatalogueisonlyanevidencethatonemayteachlongandseelittlethathasnotbeennotedbythosewhohavegonebeforehim。

  OfcourseIdonotthinkitnecessarytoincluderare,butalreadydescribedanomalies,suchastheepisternalbones,therectussternalis,andotherinterestingexceptionalformationsIhaveencountered,whichhaveshownacurioustendencytopresentthemselvesseveraltimesinthesameseason,perhapsbecausethefirstspecimenfoundcallsourattentiontoanywemaysubsequentlymeetwith。

  Theanatomyofthescalpelandtheamphitheatrewas,then,becominganexhaustedbranchofinvestigation。Butduringthepresentcenturythestudyofthehumanbodyhaschangeditsoldaspect,andbecomefertileinnewobservations。Thisrejuvenescencewaseffectedbymeansoftwoprincipalagencies,——newmethodsandanewinstrument。

  Descriptiveanatomy,asknownfromanearlydate,istothebodywhatgeographyistotheplanet。NowgeographywasprettywellknownsolongagoaswhenArrowsmith,whowasbornin1750,publishedhisadmirablemaps。ButinthatsameyearwasbornWerner,whotaughtanewwayofstudyingtheearth,sincebecomefamiliartousallunderthenameofGeology。

  Whatgeologyhasdoneforourknowledgeoftheearth,hasbeendoneforourknowledgeofthebodybythatmethodofstudytowhichisgiventhenameofGeneralAnatomy。Itstudies,nottheorgansassuch,buttheelementsoutofwhichtheorgansareconstructed。Itisthegeologyofthebody,asthatisthegeneralanatomyoftheearth。TheextraordinarygeniusofBichat,towhommorethananyotherweowethisnewmethodofstudy,doesnotrequireMr。Buckle’stestimonytoimpressthepractitionerwiththeimportanceofitsachievements。IhaveheardaverywisephysicianquestionwhetheranyimportantresulthadaccruedtopracticalmedicinefromHarvey’sdiscoveryofthecirculation。ButAnatomy,Physiology,andPathologyhavereceivedanewlightfromthisnovelmethodofcontemplatingthelivingstructures,whichhashadavastinfluenceinenablingthepractitioneratleasttodistinguishandpredictthecourseofdisease。Weknowaswellwhatdifferencestoexpectinthehabitsofamucousandofaserousmembrane,aswhatmineralsubstancestolookforinthechalkorthecoalmeasures。YouhaveonlytoreadCullen’sdescriptionofinflammationofthelungsorofthebowels,andcompareitwithsuchasyoumayfindinLaennecorWatson,toseetheimmensegainwhichdiagnosisandprognosishavederivedfromgeneralanatomy。

  Thesecondnewmethodofstudyingthehumanstructure,beginningwiththelaborsofScarpa,Burns,andColles,grewupprincipallyduringthefirstthirdofthiscentury。Itdoesnotdealwithorgans,asdidtheearlieranatomists,norwithtissues,afterthemannerofBichat。Itmapsthewholesurfaceofthebodyintoanarbitrarynumberofregions,andstudieseachregionsuccessivelyfromthesurfacetothebone,orbeneathit。Thishardlydeservesthenameofascience,althoughVelpeauhasdignifieditwiththattitle,butitfurnishesanadmirablepracticalwayforthesurgeonwhohastooperateonaparticularregionofthebodytostudythatregion。Ifwearebuyingafarm,wearenotcontentwiththeStatemaporageologicalchartincludingtheestateinquestion。Wedemandanexactsurveyofthatparticularproperty,sothatwemayknowwhatwearedealingwith。Thisisjustwhatregional,or,asitissometimescalled,surgicalanatomy,doesforthesurgeonwithreferencetothepartonwhichhisskillistobeexercised。Itenableshimtoseewiththemind’seyethroughtheopaquetissuesdowntotheboneonwhichtheylie,asiftheskinweretransparentasthecornea,andtheorgansitcoverstranslucentasthegelatinouspulpofamedusa。

  ItiscuriousthattheJapaneseshouldhaveanticipatedEuropeinakindofruderegionalanatomy。IhaveseenamanikinofJapanesemaketracedalloverwithlines,andpointsmarkingtheirintersection。Bythistheirdoctorsareguidedintheperformanceofacupuncture,markingthesafeplacestothrustinneedles,aswebuoyoutourship-channels,anddoubtlessindicatingtolearnedeyesthespotswhereincautiousmeddlinghadledtothoselittleaccidentsofshipwrecktowhichpatientsareunfortunatelyliable。

  Achangeofmethod,then,hasgivenusGeneralandRegionalAnatomy。

  These,too,havebeenworkedsothoroughly,that,ifnotexhausted,theyhaveatleastbecometoagreatextentfixedandpositivebranchesofknowledge。Butthefirstofthem,GeneralAnatomy,wouldnever,havereachedthispositiveconditionbutfortheintroductionofthat,instrumentwhichIhavementionedasthesecondgreataidtomodernprogress。

  Thisinstrumentistheachromaticmicroscope。Forthehistoryofthesuccessivestepsbywhichitbecametheeffectivescientificimplementwenowpossess,ImustreferyoutotheworkofMr。

  Quekett,toanexcellentarticleinthe“PennyCyclopaedia,“ortothatofSirDavidBrewsterinthe“EncyclopaediaBritannica。“Itisamostinterestingpieceofscientifichistory,whichshowshowtheproblemwhichBiotin1821pronouncedinsolvablewasinthecourseofafewyearspracticallysolved,withasuccessequaltothatwhichDollondhadlongbeforeobtainedwiththetelescope。Itisenoughforourpurposethatwearenowinpossessionofaninstrumentfreedfromallconfusionsandillusions,whichmagnifiesathousanddiameters,——amilliontimesinsurface,——withoutseriousdistortionordiscolorationofitsobject。

  Aquarterofacenturyago,oralittlemore,aninstructorwouldnothavehesitatedtoputJohnBell’s“Anatomy“andBostock’s“Physiology“intoastudent’shands,asgoodauthorityontheirrespectivesubjects。Letusnotbeunjusttoeitheroftheseauthors。JohnBellistheliveliestmedicalwriterthatIcanrememberwhohaswrittensincethedaysofdelightfuloldAmbroisePare。Hispicturesquedescriptionsandboldfiguresareasgoodnowastheyeverwere,andhisbookcanneverbecomeobsolete。ButlistentowhatJohnBellsaysofthemicroscope:

  “Philosophersofthelastagehadbeenatinfinitepainstofindtheultimatefibreofmuscles,thinkingtodiscoveritspropertiesinitsform;buttheysawjustinproportiontotheglasseswhichtheyused,ortotheirpracticeandskillinthatart,whichisnowalmostforsaken。“

  Dr。Bostock’swork,neglectedasitis,isonewhichIvalueveryhighlyasareallylearnedcompilation,fulloforiginalreferences。

  ButDr。Bostocksays:“Muchasthenaturalisthasbeenindebtedtothemicroscope,bybringingintoviewmanybeingsofwhichhecouldnototherwisehaveascertainedtheexistence,thephysiologisthasnotyetderivedanygreatbenefitfromtheinstrument。“

  Theseareonlyspecimensofthemannerinwhichthemicroscopeanditsresultsweregenerallyregardedbythegenerationjustprecedingourown。

  Ihavereferredyoutotheproperauthoritiesfortheaccountofthoseimprovementswhichabouttheyear1830renderedthecompoundmicroscopeanefficientandtrustworthyinstrument。Itwasnowforthefirsttimethatatruegeneralanatomybecamepossible。Asearlyas1816Treviranushadattemptedtoresolvethetissues,ofwhichBichathadadmittednolessthantwenty-one,intotheirsimplemicroscopicelements。Howcouldsuchanattemptsucceed,Henlewellasks,atatimewhenthemostextensivelydiffusedofallthetissues,theareolar,wasnotatallunderstood?AllthatmethodcoulddohadbeenaccomplishedbyBichatandhisfollowers。Itwasfortheopticiantotakethenextstep。Thefutureofanatomyandphysiology,asanenthusiasticmicrologistofthetimesaid,wasinthehandsofMessrs。SchieckandPistor,famousopticiansofBerlin。

  InthoseearlierdaysofwhichIamspeaking,allthepointsofminuteanatomywereinvolvedinobscurity。Somefoundglobuleseverywhere,somefibres。Studentsdisputedwhethertheconjunctivaextendedoverthecorneaornot,andworriedthemselvesoverGaultierdeClaubry’sstratifiedlayersoftheskin,orBreschet’sblennogenousandchromatogenousorgans。Thedartoswasapuzzle,thecentralspinalcanalamyth,thedeciduaclothedinfableasmuchasthegoldenfleece。Thestructureofbone,nowsobeautifullymadeout,——eventhatoftheteeth,inwhicholdLeeuwenhoek,peepingwithhisoctogenarianeyesthroughtheminutelenseswroughtwithhisownhands,hadlongagoseenthe“pipes,“ashecalledthem,——washardlyknownatall。Theminutestructureofthevisceralayinthemistsofanuncertainmicroscopicvision。TheintimaterecessesoftheanimalsystemweretothestudentsofanatomywhattheanteriorofAfricalongwastogeographers,andthestoriesofmicroscopicexplorerswereasmuchsneeredatasthoseofBruceorDuChailly,andwithbetterreason。

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