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USE OF THE DEAD

TO THE

LIVING.

FROM THE WESTMINSTER REVIEW.

_ALBANY_:

PRINTED BY WEBSTERS AND SKINNERS.

1827.




ADVERTISEMENT.


The following pages contain an article extracted from the Westminster
Review, an English periodical of considerable reputation. On its
appearance in Great Britain, it excited great attention; and, indeed,
has been there reprinted in a cheap form for general distribution. The
author (Dr. SOUTHWOOD SMITH) deserves the thanks of the community for
the talents he has displayed, and the lucid and powerful manner in which
he has investigated the important subject under consideration.

The editors believe that they are discharging a duty to the community in
presenting it to them for perusal and consideration. They will not
conceal their wishes, that it may have a favorable effect on a bill now
pending before the Legislature. Both in a general point of view, as well
as with reference to the particular institution to be benefitted, the
arguments are particularly applicable; nor will an enlightened body of
men be deterred from doing what they may deem their duty by the
unparalleled impudence of those who _now_ cry out against monopoly, when
they have risen into importance by monopoly, and have, always, while it
suited their views, been its most persecuting and vindictive advocates.

It is due to truth to state, that the suggestion of the republication of
this article, originated with a member of the Senate of this state, and
who does not belong to the profession.

_February, 1827._




USE OF THE DEAD TO THE LIVING.

FROM THE WESTMINSTER REVIEW.

     _An Appeal to the Public and to the Legislature, on the necessity
     of affording Dead Bodies to the Schools of Anatomy, by Legislative
     Enactment._ By WILLIAM MACKENZIE. Glasgow. 1824.


Every one desires to live as long as he can. Every one values health
"above all gold and treasure." Every one knows that as far as his own
individual good is concerned, protracted life and a frame of body sound
and strong, free from the thousand pains that flesh is heir to, are
unspeakably more important than all other objects, because life and
health must be secured before any possible result of any possible
circumstance can be of consequence to him. In the improvement of the art
which has for its object the preservation of health and life, every
individual is, therefore, deeply interested. An enlightened physician
and a skilful surgeon, are in the daily habit of administering to their
fellow men more real and unquestionable good, than is communicated, or
communicable by any other class of human beings to another. Ignorant
physicians and surgeons are the most deadly enemies of the community:
the plague itself is not so destructive; its ravages are at distant
intervals, and are accompanied with open and alarming notice of its
purpose and power; theirs are constant, silent, secret; and it is while
they are looked up to as saviours, with the confidence of hope, that
they give speed to the progress of disease and certainty to the stroke
of death.

It is deeply to be lamented that the community, in general, are so
entirely ignorant of all that relates to the art and the science of
medicine. An explanation of the functions of the animal economy; of
their most common and important deviations from the healthy state; of
the remedies best adapted to restore them to a sound condition, and of
the mode in which they operate, as far as that is known, ought to form a
part of every course of liberal education. The profound ignorance of the
people on all these subjects, is attended with many disadvantages to
themselves, and operates unfavorably on the medical character. In
consequence of this want of information, persons neither know what are
the attainments of the man in whose hands they place their life, nor
what they ought to be; they can neither form an opinion of the course of
education which it is incumbent on him to follow, nor judge of the
success with which he has availed himself of the means of knowledge
which have been afforded him. There is one branch of medical education
in particular, the foundation, in fact, on which the whole
superstructure must be raised, the necessity of which is not commonly
understood, but which requires only to be stated to be perceived.
Perhaps it is impossible to name any one subject which it is of more
importance that the community should understand. It is one in which
every man's life is deeply implicated: it is one on which every man's
ignorance or information will have a considerable influence. We shall,
therefore, enter into it with some detail: we shall show the kind of
knowledge which it is indispensable that the physician and surgeon
should possess; we shall illustrate, by a reference to particular cases,
the reason why this kind of knowledge cannot be dispensed with: and we
shall explain, by a statement of facts, the nature and extent of the
obstacles which at present oppose the acquisition of this knowledge. We
repeat, there is no subject in which every reader can be so immediately
and deeply interested, and we trust that he will give us his calm and
unprejudiced attention.

The basis of all medical and surgical knowledge is anatomy. Not a single
step can be made either in medicine or surgery, considered either as an
art or a science without it. This should seem self evident, and to need
neither proof nor illustration: nevertheless, as it is useful
occasionally to contemplate the evidence of important truth, we shall
show why it is, that there can be no rational medicine, and no safe
surgery, without a thorough knowledge of anatomy.

Disease, which it is the object of these arts to prevent and to cure, is
denoted by disordered function: disordered function cannot be understood
without a knowledge of healthy function; healthy function cannot be
understood without a knowledge of structure; structure cannot be
understood unless it be examined.

The organs on which all the important functions of the human body
depend, are concealed from the view. There is no possibility of
ascertaining their situation and connections, much less their nature and
operation, without inspecting the interior of this curious and
complicated machine. The results of the mechanism are visible; the
mechanism itself is concealed, and must be investigated to be perceived.
The important operations of nature are seldom entirely hidden from the
human eye; still less are they obtruded upon it, but over the most
curious and wonderful operations of the animal economy so thick a veil
is drawn, that they never could have been perceived without the most
patient and minute research. The circulation of the blood, for example,
never could have been discovered without dissection. Notwithstanding the
partial knowledge of anatomy which must have been acquired by the
accidents to which the human body is exposed, by attention to wounded
men, by the observance of bodies killed by violence; by the huntsman in
using his prey; by the priest in immolating his victims; by the augur in
pursuing his divinations; by the slaughter of animals; by the dissection
of brutes; and even occasionally by the dissection of the human body,
century after century passed away, without a suspicion having been
excited of the real functions of the two great systems of vessels,
arteries and veins. It was not until the beginning of the 17th century,
when anatomy was ardently cultivated, and had made considerable
progress, that the valves of the veins and of the heart were discovered,
and subsequently that the great Harvey, the pupil of the anatomist who
discovered the latter, by inspecting the structure of these valves; by
contemplating their disposition; by reasoning upon their use, was led to
suspect the course of the blood, and afterwards to demonstrate it.
Several systems of vessels in which the most important functions of
animal life are carried on--the absorbent system, for example, and even
that portion of it which receives the food after it is digested, and
which conveys it into the blood, are invisible to the naked eye, except
under peculiar circumstances: whence it must be evident, not only that
the interior of the human body must be laid open, in order that its
organs may be seen; but that these organs must be minutely and patiently
dissected, in order that their structure may be understood.

The most important diseases have their seat in the organs of the body;
an accurate acquaintance with their situation is, therefore, absolutely
necessary, in order to ascertain the seats of disease; but for the
reasons already assigned, their situation cannot be learnt, without the
study of anatomy. In several regions, organs the most different in
structure and function are placed close to each other. In what is termed
the epigastric region, for example, are situated the stomach, the liver,
the gall bladder, the first portion of the small intestine, (the
duodenum) and a portion of the large intestine (the colon); each of
these organs is essentially different in structure and in use, and is
liable to distinct diseases. Diseases the most diversified, therefore,
requiring the most opposite treatment, may exist in the same region of
the body; the discrimination of which is absolutely impossible, without
that knowledge which the study of anatomy alone can impart.

The seat of pain is often at a great distance from that of the affected
organ. In disease of the liver, the pain is generally felt at the top of
the right shoulder. The right phrenic nerve sends a branch to the liver:
the third cervical nerve, from which the phrenic arises, distributes
numerous branches to the neighborhood of the shoulder: thus is
established a nervous communication between the shoulder and the liver.
This is a fact which nothing but anatomy could teach, and affords the
explanation of a symptom which nothing but anatomy could give. The
knowledge of it would infallibly correct a mistake, into which a person
who is ignorant of it, would be sure to fall: in fact, persons ignorant
of it do constantly commit the error. We have know several instances in
which organic disease of the liver has been considered, and treated as
rheumatism of the shoulder. In each of these cases, disease in a most
important organ might have been allowed to steal on insidiously, until
it became incurable; while a person, acquainted with anatomy, would have
detected it at once, and cured it without difficulty. Many cases have
occurred of persons who have been supposed to labor under disease of the
liver, and who have been treated accordingly: on examination after
death, the liver has been found perfectly healthy, but there has been
discovered extensive disease of the brain. Disease of the liver is often
mistaken for disease of the lungs: on the other hand, the lungs have
been found full of ulcers, when they were supposed to have been
perfectly sound, and when every symptom was referred to disease of the
liver. Persons are constantly attacked with convulsions--children
especially; convulsions are spasms: spasms, of course, are to be treated
by antispasmodics. This is the notion amongst people ignorant of
medicine: it is the notion amongst old medical men: it is the notion
amongst half educated young ones. All this time these convulsions are
merely a symptom; that symptom depends upon, and denotes, most important
disease in the brain: the only chance of saving life, is the prompt and
vigorous application of proper remedies to the brain; but the
practitioner whose mind is occupied with the symptom, and who prescribes
antispasmodics, not only loses the time in which alone any thing can be
done to snatch the victim from death, but by his remedies absolutely
adds fuel to the flame which is consuming his patient. In disease of the
hip-joint pain is felt, not in the hip, but, in the early stage of the
disease, at the knee. This also depends on nervous communication. The
most dreadful consequences daily occur from an ignorance of this single
fact. In all these cases error is inevitable, without a knowledge of
anatomy: it is scarcely possible with it: in all these cases error is
fatal: in all these cases anatomy alone can prevent the error--anatomy
alone can correct it. Experience, so far from leading to its detection,
would only establish it in men's minds, and render its removal
impossible. What is called experience is of no manner of use to an
ignorant and unreflecting practitioner. In nothing does the adage, that
it is the wise only who profit by experience, receive so complete an
illustration as in medicine. A man who is ignorant of certain
principles, and who is incapable of reasoning in a certain manner, may
have daily before him for fifty years cases affording the most complete
evidence of their truth, and of the importance of the deduction to which
they lead, without observing the one, or deducing the other. Hence the
most profoundly ignorant of medicine, are often the oldest members of
the profession, and those who have had the most extensive practice. A
medical education, founded on a knowledge of anatomy, is, therefore, not
only indispensable to prevent the most fatal errors, but to enable a
person to obtain advantage from those sources of improvement which
extensive practice may open to him.

To the surgeon, anatomy is eminently what Bacon has so beautifully said
that knowledge in general is: it is power--it is power to lessen pain,
to save life, and to eradicate diseases, which, without its aid, would
be incurable and fatal. It is impossible to convey to the reader a clear
conception of this truth, without a reference to particular cases; and
the subject is one of such extreme importance, that it may be worth
while to direct the attention for a moment to two or three of the
capital diseases which the surgeon is daily called upon to treat.
Aneurism, for example, is a disease of an artery, and consists of a
preternatural dilatation of its coats. This dilatation arises from the
debility of the vessel, whence, unable to resist the impetus of the
blood, it yields, and is dilated into a sac. When once the disease is
induced, it commonly goes on to increase with a steady and uninterrupted
progress, until at last it suddenly bursts, and the patient expires
instantaneously from loss of blood. When left to itself, it almost
uniformly proves fatal in this manner; yet, before the time of Galen, no
notice was taken of this terrible malady. The ancients, indeed, who
believed that the arteries were air tubes, could not possibly have
conceived the existence of an aneurism. Were the number of individuals
in Europe, who are now annually cured of aneurism, by the interference
of art, to be assumed as the basis of a calculation of the number of