&c. CHAP. I. by study, most members of the profession, in every department, must LANGUAGE, imperatively have become familiar with most of the usual materials of medicine, and of their powers and proportions, and of all the most approved prescriptions, and at all events of the language and signs in which all prescriptions would usually be expressed by any duly licensed physician, and that, therefore, the frequency of mistakes in the prescriptions themselves must be inconsiderable; and they object, that if prescriptions were in English, the patient and their attendants would too frequently ascertain the dangerous tendency of the suspected disorder, which, according to acknowledged principles and rules, it may be most important to his welfare, and consequently the duty of the physician, to keep secret, lest the patient should become alarmed, and thereby impede, if not endanger, his recovery. (r) Again, that patients and their attendants, by the exact knowledge of the components of a medicine fully prescribed in English, and which they had perceived in one or more instances had succeeded, would become apt, without due regard to the variations in disorders and in constitutions and other varying circumstances, to administer the same medicine on other occasions when wholly inapplicable, and thereby produce the most baneful consequences. These observations are certainly entitled to grave consideration, and upon the whole it would seem that no inconvenience would result from the continuance of the existing practice, if there were better regulations introduced and strictly enforced with mended al- regard to chemists and druggists and persons having the care of drugs terations. and medicines, and allowed to mix and prepare medicines from Latin Recom Plan of prescriptions: but still, for greater precaution, it would be laudible if physicians would avoid all contractions, and would, when there is the least ground to fear the consequence of ignorance or mistake, subscribe a translation in English, at least as regards the names and exact quantities of ingredients, with English directions as to the quantities and times of admi. nistering the aggregate preparation. To assist medical students and legal practitioners, especially on the circuit, where Greek and Latin works may not be accessible, we have in regards exgeneral anglicised each foreign term, and we have in the index printed planation in italic most of the technical terms used in anatomy and physic, with their origin and meaning in the Greek or Latin or other languages; and with reference to the parts of the work where authors of authority have used them in the same sense; and we have introduced a few Plates by a superior artist, pointing out the principal parts of the human frame, with their technical terms, referring at the same time to the best works to enable the student to enlarge upon each subject. terms. Foreign ments. It will be found, that frequently our English physiologists, translating admeasure- or borrowing from the continental authors, refer to their modes of admeasurement, and very frequently to the term "line," which throughout the continent means the twelfth part of an inch.(s) A scale of all admeasurements and weights, as applicable to medical subjects, will be given when the subject of medicines is considered. (r) Dr. G. Smith, 537; Lizar's Pref. ix.; 2 Bell, 190, Sir J. Halford, Med. Gaz. 600 to 603. The depressing passions may produce fever, 1 Par. & Fonb. 197; and see effect of grief, 2 Par. & Fonb. 26, 29, 30, 100; 4 Good, 96; also Rush on the Mind, 318. Effect of mental emotion, the fear of death may occasion it, 3 Rush, Med. Inq. 4. The same duty in a surgeon, Coop. Surg. Dict. tit. Apparatus. It may be otherwise as regards preparing a patient for death, Sir H. Halford, Med. Gaz. 600 to 603; 2 Bell, 90. (s) Horner's and Bell's Anatomy, &c. OF THE MATERIALS, &c., OF THE HUMAN FRAME. 13 CHAPTER II. OF THE MATERIALS, COMPOSITION, STRUCTURE, ORGANS, FUNCTIONS, PRO- I. Importance of the Subject, and general outline. II. The materials, organs, functions, and divisions in general, &c. First. The Fluids. 2. Blood. 3. Secretions. Secondly. The Solids. 1. Bones, Joints, Ligaments, 2. Muscles and Tendons. 3. Membrane. 1. Head and Neck. 2. Trunk. 1. Thorax. 2. Abdomen, 3. Upper extremities. Sixthly. Of the Progress of Growth Thirdly. Of Organization and the IH. Essential Properties and vital and various Organs and Apparatus. Fourthly. Of the Functions. 1. Ofthe vital Functions. 1. Respiration. 2. Circulation. 4. Absorption. 5. Secretion. 2. Of the sensitive or nervous Function and Motion. Fifthly. General Division into Parts, as other Powers and Incidents. First. Contractility and Resistance Reaction. Secondly. Power of Motion. Thirdly. Sensation, Sensitiveness, or Nervous Power. Fourthly. Mental Faculties. IV. Of Temperaments. CHAP. II. IMPORT ANCE OF KNOW LEDGE, &C. WE propose in this chapter to examine of what Materials the human I. Importframe is composed, and what are its Properties, and a general division ance of a of the subject. knowledge outline. A common observer might suppose that the human frame is composed, of the subexternally, merely of the integuments, (comprehending the skin, hair, ject, and a and nails,) and internally, the bones, blood vessels, with the brain, and general general viscera and the blood. But the analyzing powers of chemistry have enabled us to discover that so general a description would be wholly insufficient to enable us to ascertain diseases, or apply with any degree of precision the various remedies for the numerous deviations from the healthy state. and cohe sion, and In physics or natural history, no points are better established than that of atoms, man, like vertebrated animals, is composed of certain imperceptibly small attraction, atoms or globules, all of the same size, namely, each in diameter about the 7500th part of an inch, (a) which, although cohering by attraction, of repulhave not in reality any connecting texture, and the same by chemical sion or seanalysis may readily be separated from each other; and it has been estab- paration of lished beyond contradiction, that in man and in most male animals in a atoms. perfect adult state, there are, in a certain fluid, hereafter described, living animalcules, so imperceptibly small to the unassisted eye, that 10,000 of (a) Dr. M. Edwards' observation on the elementary structure of the body, as stated in 3 Bost. 273. (But authors differ in their views on this subject, 1 Dunglis. Phy. 29.] CHAP. II. them may exist in a space not larger than a grain of sand.(b) By a law IMPORT- of nature, called Attraction, these atoms would naturally cohere or cling ANCE, &c. together in masses of various forms and magnitudes; and were it not for Atoms in man con the counteracting influence of another law, that of Repulsion, occasioned by heat or caloric, the whole materials of creation would rush into close contact, and form one huge solid mass of stilness and death. (c.) But heat or caloric, constituting the cause of such repulsion, counteracts attraction and induces atoms, more or less, to separate from each other, and singularly modifies the result, so as to render them cellular or porous, and no where in actual contact, though apparently so to the naked eye.(d) By attraction on the one hand and repulsion on the other, all atoms are thus more or less approximated according to the quantity of intervening heat or caloric. (e) It will be found that these laws of nature are constantly practically applicable to the living human frame, so as to render it more or less subject to the influence of physical causes.(ƒ) The essential atoms or constituents of the human frame, as indeed of all animate compounds, are principally carbon, hydrogen, oxygen, and sist princi- nitrogen, also sometimes called azote,(g) besides which there are in gepally of neral, in small quantities, phosphorus, sulphur, iron, and earthy and sacarbon, hydrogen, oxline matters; and all these are variously combined, and then have other names, such as albumen, &c.(h) These will be explained as we proceed. ygen nitrogen, with sul phur, &c. General The human body is composed externally of the Integuments, which consist of skin, in three distinct layers of different materials and properties, and of hair and nails.(i) The skeleton is composed of about 260 combined bones, with joints, ligaments, and cartilages of various construction; Muscomposi- cles, from 450 to 500, with numerous tendons, giving motion to the bones tion, externally of in- thus united by their joints and ligaments, whilst Cellular Tissue interteguments, venes in all parts, and fills up and gives roundness to the appearance of internally the whole. There are also many hundred arteries with their innumeraof skeleton ble capillary hair-like ramifications or terminations: about three times as of bones, many veins with their numerous valves; also lacteals, and lymphatic vesjoints, liga- sels, with glands and ducts; also secernent organs and vessels, which perform the function of secretion, such as the kidneys, ureters, &c. All these vessels contain their appropriate fluids, being either blood in its inceptive or perfect state, or other fluids secreted from it. ments, muscles, tendons, blood, and other vessels, and nerves. Superiorly the Head contains the Brain, to which is connected the spinal marrow, and from the two arise the nerves of the five organs of Sense, namely, sight, hearing, smell, taste, and touch. Next, in the Neck and Thorax or chest are the organs of Respiration, the trachea or windpipe and the lungs, with their investing membrane, called the pleura. Then are the organs of Circulation, the Heart, and its pericardium or sur (b) See the works of Leeuwenhoek, (c) 1 Arnott's El. Phys. 69. (e) 1 Arnott's El. Phys. 48, 56 to 75. sided, it will frequently be found that numerous parts will by attraction be collected and floating together; hence also, although the Moon is 240,000 miles from the Earth, yet it attracts the ocean, and forms what we term Tide. 1 Arnott's, El. Phys. 16. (f) 1. Dunglis. Phy. 6. (g) Dr. Turner, El. Chemistry, 532. (h) See post, the description of membrane. (i) See a full description of the skin, hair, and nails, post, rounding sac. And again, in the Neck and Abdomen is the alimentary CHAP. II. canal; namely, the Esophagus or gullet, and the Stomach, with the small IMPORTand large intestinal Canal or Entrails, and the Collateral viscera or or- ANCE, &C. gans called the Liver, Gall-bladder, and Pancreas, with the Spleen, the organs of assimilation, or conversion of the aliment into blood, and one of the great emunctories or cleansers of the body, the kidneys. In the bony cavity below the abdomen, called the Pelvis, (from its form resembling a basin,) are placed the organ for the collection and discharge of urine,— namely, the bladder, and some of those of generation, as the vesiculæ seminales, &c., and the organs of Absorption and Secretion, including in the latter the Kidneys with the Bladder and its vessels. All these will, in the following chapters, have distinct consideration, since each is subject to peculiar diseases and injuries, and has its appropriate remedies; whilst the whole of the organs are scientifically divided and arranged into different functions, the principal of which are Respiration, Circulation, Digestion, Absorption, Secretion, and the Nervous Function, including that of Motion. of the It has been well observed, that the magnitude of a disease or of an in- General jury is in proportion to its deviation from the healthy state, not only as outline and regards the whole of the human frame, but also of each part in particular; importance and the extent of that deviation can only be correctly ascertained by him knowledge who is perfectly acquainted with the healthy state.(k) In other words, of the whether to prevent or to cure disease or injury, a perfect knowledge of component eight different points should be acquired: First, The usual healthy or materials perfect state of the body or part affected: Secondly, The usual state in and prothe morbid or diseased or injured condition of the body: Thirdly, The perties of usual causes of the deviations: Fourthly, The usual appropriate remedies: the human Fifthly, The diseased or injured state in the particular case or patient: Sixthly, His temperament and habits: Seventhly, The particular cause First, To of the patient's apparent disease or injury: Eighthly, The application of the best remedy in that particular case, with reference to the constitu- member of tion, temperament, and existing strength of the patient, and his conse- the mediquent probable ability to bear any sudden or powerful change that might cal profesbe effected by medicine or operation.(7) Thus, if the cause of inflammation be the defect or want of energy in the ordinary healthy state of the blood vessels, stimulants may be proper to be administered; but, if the cause be undue increased action, then sedatives; (m) and if we know the healthy state of the blood, and detect a particular deviation, we may then know the appropriate remedy.(n) To be well acquainted with the healthy state, every composition and every function of each fluid and solid, or, in other words, of every atom, must be well known, and then the particular temperament and state of the patient. Having ascertained these, we may then be led to the discovery of the appropriate medicine or remedy; thus, if the blood, in fever or disease, be found deficient in saline principles, the administering saline medicines probably will be efficacious.(o) It has been observed, how (k) It was the maxim of Celsus, and indeed almost too evident to need observation, that he can best cure diseases who can best discover their cause; and see Park's Inquiry, p. 345; and, indeed, it seems almost self-evident that the manner in which any particular function is deranged can never be understood so long as the function itself is not understood, &c. Park's Inquiry, 358. Jackson, Prin. Med. xvii. (1) Galen's Methodus Medendi. Blumenbach, by Doctor Elliotson, Preface. Good's Study of Medicine, 1 vol. Preface. Broussais' Physiology, Pref. (m) 1 Bost. Phy. 341. Quære if not "antiphlogistics' "instead of "sedatives." (n) 2 Dunglis. Phy. 116. (0) Dr. Stevens' Observations on the Healthy and Diseased State of the Blood; and Good's Study Med. per tot. frame. every sion. CHAP. II. fatal may become the practice of medicine if not founded on sound phyIMPORT- siology.(p) And suppose that from the actual state or cause of a disorANCE, &C. der being unknown, stimulants instead of sedatives should be erroneous Import- ly administered, how fatal might be the consequences.(q) Hence, the absolute necessity for all members of the medical profession to be well informed upon anatomy, and of the physical and chemical properties of every particle; and yet it has been observed how lamentable it is that so little is as yet known, and especially of the functions of secretion and absorption, and hence the great uncertainty and incessant disputes still prevailing, even as to the properties of so important a fluid as the blood. It has been well observed, that by ascertaining the composition of a particular part, and its appropriate remedy in disease or injury, we are taught that another similarly composed part, although in quite a different part of the body, will be equally affected by the same remedy. Thus the lungs are surrounded by a serous membrane, called the pleura, well known to form its coat and to be placed in the cavity of the thorax, and which, in respect of its component materials, is subject to certain peculiar diseases, and principally to an inflammation called pleuritis. Now the study of anatomy informs the physician that the peritoneum, which surrounds the whole of the intestinal canal and the viscera of the abdomen, is also composed of the like materials, and which are consequently subject to a similar inflammation. Hence, he may be led to expect, and he actually finds that the same remedies appropriate for the cure of the former are applicable to the latter, and he will proceed accordingly. So it will be found throughout, that when there is a striking similarity in structure, properties and anatomical characters of membranes, although situate in different parts of the body, they may be properly ranged under one head and form one class, and that their diseases also form one group, and the like remedies may be successfully applied. Hence, the advantages resulting from a systematic knowledge of anatomy.(r) Nor is the importance of these subjects confined to the medical profession, they are essential to all concerned in legislation or administering or construing or giving effect to the laws respecting health or offences against the person, and to all whose philanthropy interests them in the welfare of mankind. Supposing that any epidemic disease, such as the plague or the cholera, recently so prevalent, be not, as supposed, infectious, but erroneously supposed to be so, how uselessly detrimental may have been the regulations affecting them, to commerce, in requiring the performance of quarantine. So why should the absurd distinction in punishment, even of death, for endeavouring to cause miscarriage at certain periods be continued, if it be established that the foetus is, at all times, whilst in the uterus, equally alive, and ought, on principle, to be equally entitled to the protection of the law? Again, when we have ascertained that not less than a certain quantity (as 600 cubic feet) of air should be supplied for each individual in a closed apartment, and that below that proportion it is impossible to maintain, for any length of time, the requisite purity of the air, and that a man cannot live more than an hour in five cubic feet of confined air, we shall know, practically, how to have hospitals and other buildings constructed, and individually should cautiously avoid the risk incident to remaining long in too limited a confined atmosphere.(s) So by the application of a knowledge of the course of nature in certain functions, feigned diseases whether of madness or otherwise, and (p) Jackson, Prin. Med. Pref. (r) Amer. Cyclop. Prac. Med. tit. Ana (q) 1 Bost. 341. Quære "antiphlo- tomy. gistics" for "sedatives." (8) 2 Bost. 49 to 98; 2 Par. & Fonb. 48, 111, n. 6. |