Curiosities of Medical Experience Part 45

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 a.s.sumed, 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 c.u.m illo concipiantur atque nasc.u.n.tur; sed habent in ratione, non in mole, sicut ipsa jam membra omnia sunt latenter in semine; c.u.m 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 a.s.ses and horses. Mr. Hodgson found them in seven a.s.ses 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 const.i.tuent 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 cla.s.sed 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 ill.u.s.trious 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-gla.s.s 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-gla.s.s, 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-gla.s.s, 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 pract.i.tioners 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 a.n.a.logy 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 b.a.l.l.s 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 rest.i.tutione_, 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-Ca.s.sel.

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 pa.s.sage 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 quac.u.mque corporis parte, si vinculum adhibeatur, aut alia ratione occludantur venae: c.u.m enim tollitur permeatio, intumesc.u.n.t 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:

c.u.m vini penetravit-- Consequitur gravitas membrorum, praepediuntur Crura vacillanti, tardescit lingua, madet mens, Nant oculi; clamor, singultus, jurgia glisc.u.n.t.

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 const.i.tution and our state of health. Extreme abstinence on some occasions may prove as prejudicial as intemperance; and there are peculiar idiosyncrasies where a certain quant.i.ty of stimulus is absolutely requisite to keep up the animal spirits, and at the same time a.s.sist a.s.similations 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 cla.s.ses, 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 a.s.sisted 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, ent.i.tled "_Non ergo singulis mensibus repet.i.ta 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 const.i.tution than the practice of daily taking a moderate quant.i.ty 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 quant.i.ties 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 r.e.t.a.r.ded, 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 quant.i.ty 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 refres.h.i.+ng 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 G.o.d. 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.

To add to the intoxicating power of wine various means were resorted to, and a mixture of myrrha was supposed to produce this effect. Such was the _murrhina_ of the Romans, mentioned in St. Mark's gospel, and which was given to malefactors before their execution.

Notwithstanding the sobriety of the ancients, my fair readers may perhaps be glad to know that the ladies were allowed to indulge in an occasional stoup; and the Greek matrons and virgins were by no means restricted in a moderate use of the grape's delicious juice, as ill.u.s.trated by Homer in Nausica and her companions. In the ancient entertainments the first libation was offered up to Vesta, as being, according to Cicero, _rerum custos intimarum_, or keeper of things most concealed; or, according to Aristocritus, for the services rendered by this G.o.ddess to Jupiter in his war against the Giants. However, without any erudite comments, it is very probable that even the poor Vestals were sometimes delighted when they could take a drop of wine to beguile their solitude.

The phenomena of drunkenness have been so ably described by Macnish, that I most gladly transcribe the following pa.s.sage from that author's excellent work, called the "Anatomy of Drunkenness."

"First an unusual serenity prevails over the mind, and the soul of the votary is filled with a placid satisfaction. By degrees he is sensible of a soft and not unmusical humming in the ears, at every pause of the conversation. He seems, to himself, to wear his head lighter than usual upon his shoulders. Then a species of obscurity, thinner than the finest mist, pa.s.ses before his eyes, and makes him see objects rather indistinctly. The lights begin to dance and appear double, a gaiety and warmth are felt at the same time about the heart. The imagination is expanded, and filled with a thousand delightful images. He becomes loquacious, and pours forth, in enthusiastic language, the thoughts, which are born, as it were, within him.