BODY-SNATCHING.

                             Published by

                      BALDWIN, CRADOCK, AND JOY,

                                LONDON.

                                 1824.


                            T. C. HANSARD,
                        Pater-noster-row Press.




ADVERTISEMENT.


The following pages are reprinted, with some modification, from the
third Number of the Westminster Review. They treat of a subject on which
it is of great importance that the public should be well informed, and
it is in order to facilitate the circulation of the knowledge which they
communicate respecting it, that the proprietors of the above-mentioned
work have liberally consented to the re-publication of this article in
the form of a pamphlet.




BODY-SNATCHING.


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 which 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 a 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 unfavourably 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 upon 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 some influence. We shall therefore,
show the kind of knowledge which it is indispensable that the physician
and the surgeon should possess: we shall illustrate, by a reference to
particular cases, the reason why knowledge of this kind 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 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, 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 neighbourhood 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 known 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 labour 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 the truth of those principles, 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
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
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
either instantaneously from loss of blood, or by degrees from repeated
losses. When left to itself, it almost uniformly proves fatal in one or
other of these modes; 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 have had no conception of 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 persons who must have
perished by this disease, from the beginning of the world to the time of
Galen, it would convey some conception of the extent to which anatomical
knowledge is the means of saving human life.

The only way in which it is possible to cure this disease is, to produce
an obliteration of the cavity of the artery. This is the object of the
operation. The diseased artery is exposed, and a ligature is passed
around it, above the dilatation, by means of which the blood is
prevented from flowing into the sac, and inflammation is excited in the
vessel; in consequence of which its sides adhere together, and its
cavity becomes obliterated. The success of the operation depends
entirely on the completeness of the adhesion of the sides of the vessel,
and the consequent obliteration of its cavity. This adhesion will not
take place unless the portion of the artery to which the ligature is
applied be in a sound state. If it be diseased, as it almost always is
near the seat of the aneurism, when the process of nature is completed
by which the ligature is removed, hemorrhage takes place, and the
patient dies just as if the aneurism had been left to itself. For a long
time the ligature was applied as close as possible to the seat of the
aneurism: the aneurismal sac was laid open in its whole extent, and the
blood it contained was scooped out. The consequence, was that a large
deep-seated sore, composed of parts in an unhealthy state, was formed:
it was necessary to the cure, that this sore should suppurate,
granulate, and heal: a process which the constitution was frequently
unable to support. Moreover, there was a constant danger that the
patient would perish from hemorrhage, through the want of adhesion of
the sides of the artery. The profound knowledge of healthy and of
diseased structure, and of the laws of the animal economy by which both
are regulated, which John Hunter had acquired from anatomy, suggested to
this eminent man a mode of operating, the effect of which, in preserving
human life, has placed him high in the rank of the benefactors of his
race. This consummate anatomist saw, that the reason why death so often
followed the common operation was, because that process which was
essential to its success was prevented by the diseased condition of the
artery. He perceived that the vessel, at some distance from the
aneurism, was in a sound state; and conceived that, if the ligature were
applied to this distant part, that is, to a sound instead of a diseased
portion of the artery, this necessary process would not be counteracted.
To this there was one capital objection, that it would often be
necessary to apply the ligature around the main trunk of an artery,
before it gives off its branches, in consequence of which the parts
below the ligature would be deprived of their supply of blood, and would
therefore mortify. So frequent and great are the communications between
all the arteries of the body, however, that he thought it probable, that
a sufficient supply would be borne to these parts through the medium of
collateral branches. For an aneurism in the ham, he, therefore, boldly
cut down upon the main trunk of the artery which supplies the lower
extremity; and applied a ligature around it, where it is seated near the
middle of the thigh, in the confident expectation that, though he thus
deprived the limb of the supply of blood which it received through its
direct channel, it would not perish. His knowledge of the processes of
the animal economy led him to expect that the force of the circulation
being thus taken off from the aneurismal sac, the progress of the
disease would be stopped; that the sac itself, with all its contents,
would be absorbed; that by this means the whole tumour would be removed,
and that an opening into it would be unnecessary. The most complete
success followed this noble experiment, and the sensations which this
philosopher experienced when he witnessed the event, must have been
exquisite, and have constituted an appropriate reward for the
application of profound knowledge to the mitigation of human suffering.
After Hunter followed Abernethy, who, treading in the footsteps of his
master, for an aneurism of the femoral, placed a ligature around the
external iliac artery; lately the internal iliac itself has been taken
up, and surgeons have tied arteries of such importance, that they have
been themselves astonished at the extent and splendor of their success.
Every individual on whom an operation of this kind has been successfully
performed, is snatched by it from certain and inevitable death!

The symptom by which an aneurism is distinguished from every other
tumour is, chiefly, its pulsating motion. But when an aneurism has
become very large, it ceases to pulsate; and when an abscess is seated
near an artery of great magnitude, it acquires a pulsating motion;
because the pulsations of the artery are perceptible through the
abscess. The real nature of cases of this kind cannot possibly be
ascertained, without a most careful investigation, combined with an
exact knowledge of the structure and relative position of all the parts
in the neighbourhood of the tumour. Pelletan, one of the most
distinguished surgeons of France, was one day called to a man who, after
a long walk, was seized with a severe pain in the leg, over the seat of
which appeared a tumour, which was attended with a pulsation so violent
that it lifted up the hand of the examiner. There seemed every reason to
suppose that the case was an aneurismal swelling. This acute observer,
however, in comparing the affected with the sound limb, perceived in the
latter a similar throbbing. On careful examination he discovered that,
by a particular disposition in this individual, one of the main arteries
of the leg (the anterior tibial) deviated from its usual course, and
instead of plunging deep between the muscles, lay immediately under the
skin and fascia. The truth was, that the man in the exertion of walking
had ruptured some muscular fibres, and the uncommon distribution of the
artery gave to this accident these peculiar symptoms. The real nature of
this case could not possibly have been ascertained, but by an anatomist.
The same surgeon has recorded the case of a man who, having fallen twice
from his horse, and experienced for several years considerable
uneasiness in his back, was at length afflicted with acute pain in the
abdomen. At the same time an oval, irregularly circumscribed tumour made
its appearance in the right flank. It presented a distinct fluctuation,
and had all the appearance of a collection of matter depending on caries
of the vertebræ. The pain was seated chiefly at the lower portion of
that part of the spine which forms the back, which was, moreover,
distorted; and this might have confirmed the opinion that the case was a
lumbar abscess with caries. Pelletan, however, who well knew that an
aneurism, as it enlarges, may destroy any bone in its neighbourhood, saw
that the disease was an aneurism, and predicted that the patient must
perish. On opening the body (for the man lived only ten days after
Pelletan first saw him) an aneurismal tumour was discovered, which
nearly filled the cavity of the abdomen. If this case had been mistaken
for lumbar abscess, and the tumour had been opened with a view of
affording an exit to the matter, the man would have died in a few
seconds. There is no surgeon of discernment and experience whose
attention has not been awakened, and whose sagacity has not been put to
the test, by the occurrence of similar cases in his own practice. The
consequence of error is almost always instantaneously fatal. The
catalogue of such disastrous events is long and melancholy. Richerand
has recorded, that Ferrand, head surgeon of the Hotel-Dieu, mistook an
aneurism in the armpit for an abscess; plunged his knife into the
swelling, and killed the patient. De Haen speaks of a person who died in
consequence of an opening which was made, contrary to the advice of
Boerhaave in a similar tumour at the knee. Vesalius was consulted about
a tumour in the back, which he pronounced to be an aneurism; but an
ignorant practitioner having made an opening into it, the patient
instantly bled to death. Nothing can be more easy than to confound an
aneurism of the artery of the neck with a swelling of the glands in its
neighbourhood: with a swelling of the cellular substance which surrounds
the artery; with abscesses of various kinds; but if a surgeon were to
fall into this error, and to open a carotid aneurism, his patient would
certainly be dead in the space of a few moments. It must be evident,
then, that a thorough knowledge of anatomy is not only indispensable to
the proper treatment of cases of this description, but also to the
prevention of the most fatal mistakes.

There is nothing in surgery of more importance than the proper treatment
of hemorrhage. Of the confusion and terror occasioned by the sight of a
human being from whom the blood is gushing in torrents, and whose
condition none of the spectators is able to relieve, no one can form an
adequate conception, but those who have witnessed it. In all such cases
there is one thing proper to be done, the prompt performance of which is
generally as certainly successful, as the neglect of it is inevitably
fatal. It is impossible to conceive of a more terrible situation than
that of a medical man who knows not what to do on such an emergency. He
is confused; he hesitates: while he is deciding what measures to adopt
the patient expires: he can never think of that man’s death without
horror, for he is conscious that, but for his ignorance he might have
averted his patient’s fate. The ancient surgeons were constantly placed
in this situation, and the dread inspired by it retarded the progress of
surgery more than all other causes put together. Not only were they
terrified from interfering with the most painful and destructive
diseases, which experience has proved to be capable of safe and easy
removal, but they were afraid to cut even the most trivial tumour. When
they ventured to remove a part, they attempted it only by means of the
ligature, or by the application of burning irons. When they determined
to amputate, they never thought of doing so, until the limb had
mortified, and the dead had separated from the living parts; for they
were absolutely afraid to cut into the living flesh. They had no means
of stopping hemorrhage, but by the application of astringents to the
bleeding vessels, remedies which were inert; or of burning irons, or
boiling turpentine, expedients which were not only inert but cruel.
Surgeons now know that the grand means of stopping hemorrhage is
compression of the bleeding vessel. If pressure be made on the trunk of
an artery, though blood be flowing from a thousand branches given off
from it, the bleeding will cease. Should the situation of the artery be
such as to allow of effectual external pressure, nothing further is
requisite: the pressure being applied, the bleeding is stopped at once:
should the situation of the vessel place it beyond the reach of external
pressure, it is necessary to cut down upon it, and to secure it by the
application of a ligature. Parè may be pardoned for supposing that he
was led to the discovery of this invaluable remedy by inspiration of the
Deity. By means of it the most formidable operations may be undertaken
with the utmost confidence, because the wounded vessels can be secured
the moment they are cut: by the same means the most frightful
hemorrhages may be effectually stopped: and even when the bleeding is so
violent as to threaten immediate death, it may often be averted by the
simple expedient of placing the finger upon the wounded vessel, until
there is time to tie it. But it is obvious that none of these expedients
can be employed, and that these bleedings can neither be checked at the
moment, nor permanently stopped, without such a knowledge of the course
of the trunks and branches of vessels, as can be acquired only by the
study of anatomy.

The success of amputation is closely connected with the knowledge of the
means of stopping hemorrhage. Not to amputate, is often to abandon the
patient to a certain and miserable death. And all that the surgeon
formerly did, was to watch the progress of that death: he had no power
to stop or even to retard it. The fate of sir Philip Sidney is a
melancholy illustration of this truth. This noble-minded man, the light
and glory of his age, was cut off in the bloom of manhood, and the midst
of his usefulness, by the wound of a musket bullet in his left leg, a
little above the knee, “when extraction of the ball, or amputation of
the limb,” says his biographer, “would have saved his inestimable life:
but the surgeons and physicians were unwilling to practice the one, and
knew not how to perform the other. He was variously tormented by a
number of surgeons and physicians for three weeks.” Amputation indeed
was never attempted except where mortification had itself half performed
the operation. The just apprehension of an hemorrhage which there was no
adequate means of stopping, checked the hand of the boldest surgeon, and
quailed the courage of the most daring patient--and if ever the
operation was resorted to, it almost always proved fatal: the patient
generally expired, according to the expression of Celsus, “_in ipso
opere_.” How could it be otherwise? The surgeon cut through the flesh of
his patient with a red hot knife: this was his only means of stopping
the hemorrhage: by this expedient he sought to convert the whole surface
of the stump into an eschar: but this operation, painful in its
execution, and terrible in its consequences, when it even appeared to
succeed, succeeded only for a few days; for the bleeding generally
returned and proved fatal as soon as the sloughs or dead parts became
loose. Plunging the stump into boiling oil, into boiling turpentine,
into boiling pitch, for all these means were used, was attended with no
happier result, and after unspeakable suffering, almost every patient
perished. In the manner in which amputation is performed at present, not
more than one person in twenty loses his life in consequence of the
operation, even taking into the account all the cases in which it is
practised in hospitals. In private practice, where many circumstances
favour its success, it is computed that 95 persons out of 100 recover
from it, when it is performed at a proper time, and in a proper manner.
It seems impossible to exhibit a more striking illustration of the great
value of anatomical knowledge.

But if there be any disease which, from the frequency of its occurrence,
from the variety of its forms, from the difficulty of discriminating
between it, and other maladies, and from the danger attendant on almost
all its varieties, requires a combination of the most minute
investigation, with the most accurate anatomical knowledge, it is that
of hernia. This disease consists of a protrusion of some of the viscera
of the abdomen, from the cavity in which they are naturally contained,
into a preternatural bag, composed of the portion of the peritoneum (the
membrane which lines the abdomen) which is pushed before them. It is
computed that one sixteenth of the human race are afflicted with this
malady. It is sometimes merely an inconvenient complaint, attended with
no evil consequences whatever: but there is no form of this disease,
which is not liable to be suddenly changed, and by slight causes, from a
perfectly innocent state, into a condition which may prove fatal in a
few hours. The disease itself occurs in numerous situations; it may be
confounded with various diseases; it may exist in the most diversified
states; it may require, without the loss of a single moment, a most
important and delicate operation; and it may appear to demand this
operation, while the performance of it may really be not only useless,
but highly pernicious.

The danger of hernia depends on its passing into that state which is
technically termed strangulation. When a protruded intestine suffers
such a degree of pressure, as to occasion a total obstruction to the
passage of its contents, it is said to be strangulated. The consequence
of pressure thus producing strangulation is, the excitement of
inflammation: this inflammation must inevitably prove fatal unless the
pressure be promptly removed. In most cases this can be effected only by
the operation. Two things, then, are indispensable: first, the ability
to ascertain that the symptoms are really produced by pressure, that is,
to distinguish the disease from the affections which resemble it; and
secondly, when this is effected, to perform the operation with
promptitude and success. The distinction of strangulated hernia from
affections which resemble it, often requires the most exact knowledge
and the most minute investigation. The intestine included in a hernial
sac may be merely affected with colic, and thus give rise to the
appearance of strangulation. It may be in a state of irritation,
produced, for example, by unusual fatigue; and from this cause may be
attacked with the symptoms of inflammation. Inflammation may be excited
in the intestine, by the common causes of inflammation, which the hernia
may have no share in inducing, and of which it may not even participate.
Were this case mistaken, and the operation performed, it would not only
be useless, but pernicious: while the attention of the practitioner
would be diverted from the real nature of the malady; the prompt and
vigorous application of the remedies which alone could save the patient
would be neglected, and he would probably perish. On the other hand, a
very small portion of intestine may become strangulated, and urgently
require the operation. But there maybe no tumor; all the symptoms may be
those, and, on a superficial examination, only those, of inflammation of
the bowels. Were the real nature of this case mistaken, death would be
inevitable. Nothing is more common than fatal errors of this kind. It is
only a few months ago, that a physician was called in haste to a person
who was said to be dying of inflammation of the bowels. Before he
reached the house the man was dead. He had been ill only three days. On
looking at the abdomen, there was a manifest hernia; the first glance
was sufficient to ascertain the fact. The practitioner in attendance had
known nothing of the matter; he had never suspected the real nature of
the disease, and had made no inquiry which could have led to the
detection of it. Here was a case which might probably have been saved,
but for the criminal ignorance and inattention of the practitioner.
Whenever there are symptoms of inflammation of the bowels, examination
of the abdomen is indispensable: and the life of the patient will often
depend on the care and accuracy with which the investigation is made.

But it is possible that inflammation may attack the parts included in
the hernial sac, without arising from the hernia itself. The
inflammation may be produced by the common causes of inflammation: there
may be no pressure: there may be no strangulation: the swelling may be
the seat, not the cause of the disease. In this case, too, the operation
would be both useless and pernicious. Now all these are diversities
which it is of the highest importance to discriminate. In some of them
life depends on the clearness, accuracy, and promptitude, with which the
discrimination is made. Promptitude is of no less consequence than
accuracy. If the decision be not formed and acted on at once, it will be
of no avail. The rapidity of the progress of this disease is often
frightful. We have mentioned a case in which it was fatal in three days,
but it not unfrequently terminates fatally in less than twenty-four
hours. Sir Astley Cooper mentions a case in which the patient was dead
in eight hours after the commencement of the disease. Larrey has
recorded the case of a soldier in whom a hernia took place, which was
strangulated immediately. He was brought to the “ambulance” instantly,
and perished in two hours with gangrene of the part, and of the
abdominal viscera. This was the second instance which had occurred to
this surgeon of a rapidity thus appalling. What clearness of judgment,
what accuracy of knowledge, what promptitude of decision, are necessary
to treat such a disease with any chance of success!

The moment that a case is ascertained to be strangulated hernia, an
attempt must be made to liberate the parts from the stricture, and to
replace them in their natural situation. This is first attempted by the
hand, and the operation is technically termed the _taxis_. The patient
must be placed in a particular position; pressure must be made in a
particular direction; it is impossible to ascertain either, without an
accurate knowledge of the structure of the parts. If pressure be made in
a wrong direction, and in a rough and unscientific manner, the organs
protruded instead of being urged through the proper opening are bruised
against the parts which oppose their return. Many cases are on record,
in which gangrene and even rupture of the intestine have been occasioned
in this manner. When the parts cannot be returned by the hand, assisted
by those remedies which experience has proved to be beneficial, the
operation must be performed without the delay of a moment. To its proper
performance two things are necessary. First, a minute anatomical
knowledge of the various and complicated parts which are implicated in
it; and secondly, a steady, firm, and delicate command of the knife. In
the first place, the integuments must be divided; the cellular substance
which intervenes between the skin and the hernial sac must be removed
layer by layer with the knife and the dissecting forceps; the sac itself
must be opened: this part of the operation must be performed with the
most extreme caution: the sac being laid open, the protruded organs are
now exposed to view. The operator must next ascertain the exact point
where the stricture exists; having discovered its seat, he must make his
incision with a particular instrument--in a certain direction--to a
definite extent. On account of the nature of the parts implicated in the
operation, and the proximity of important vessels, life depends on an
exact knowledge and a precise and delicate attention to all these
circumstances. How can this knowledge be obtained, how can this
dexterity be acquired without a profound acquaintance with anatomy, and
how can this be acquired without frequent and laborious dissection? The
eye must become familiar with the appearance of the integuments, with
the appearance of the cellular substance beneath it, with the
appearance of the hernial sac, and of the changes which it undergoes by
disease; with the appearance of the various viscera contained in it, and
of their changes; and the hand must pay that steady and prompt obedience
to the judgment which nothing but knowledge and the consciousness of
knowledge can command. Even this is not all. When the operation has been
performed thus far with perfect skill and success, the most opposite
measures are required according to the actual state of the organs
contained in the sac. If they are agglutinated together--if portions of
them are in a state of mortification, to return them into the cavity of
the abdomen in that condition would in general be certain death.
Preternatural adhesion must be removed; mortified portions must be cut
away: but how can this possibly be done without an acquaintance with
healthy and diseased structure, and how can this be obtained without
dissecting the organs in a state of health and of disease?

It has been stated that the progress of strangulated hernia to a fatal
termination is often frightfully rapid; in certain cases to delay the
operation, even for a very short period, is, therefore, to lose the only
chance of success. But ignorant and half-informed surgeons are afraid to
operate. They are conscious that the operation is one of immense
importance: they know that in the hands of an operator ignorant of
anatomy, it is one of extreme hazard: they therefore put off the time as
long as possible: they have recourse to every expedient: they resort to
every thing but the only efficient remedy, and when at last they are
compelled by a secret sense of shame to try that, it is too late. All
the best practical surgeons express themselves in the strongest language
on the importance of performing the operation early, if it be performed
at all. On this point there is a perfect accordance between the most
celebrated practitioners on the continent, and the great surgeons of our
own country: all represent, in many parts of their writings, the
dangerous and fatal effects of delay. Mr. Hey in his Practical
Observations, states that when he first began practice, he considered
the operation as the last resource, and only to be employed when the
danger appeared imminent. “By this dilatory mode of practice,” says he,
“I lost three patients in five, upon whom the operation was performed.
Having more experience of the urgency of the disease, I made it my
custom, when called to a patient who had laboured two or three days
under the disease, to wait only about two hours, that I might try the
effect of bleeding (if that evacuation was not forbidden by some
peculiar circumstance of the case) and the tobacco clyster. In this mode
of practice I lost about two patients in nine, upon whom I operated.
This comparison is drawn from cases nearly similar, leaving out of the
account those cases in which gangrene of the intestine had taken place.
I have now, at the time of writing this, performed the operation
thirty-five times; and have often had occasion to lament that I
performed it too late, but never that I had performed it too soon.”

These observations are sufficient to show the importance of anatomy in
certain surgical diseases. The state of medical opinion from the
earliest ages to the present time, furnishes a most instructive proof of
its necessity to the detection and cure of disease in general. The
doctrines of the father of physic were in the highest degree vague and
unmeaning. Every thing is resolved by Hippocrates into a general
principle, which he terms nature; and to which he ascribes intelligence;
which he clothes with the attribute of justice; and which he represents
as possessing virtues and powers which he says are her servants, and by
means of which she performs all her operations in the bodies of animals,
distributes the blood, spirits, and heat, through all the parts of the
body, and imparts to them life and sensation. He states that the manner
in which she acts, is by attracting what is good or agreeable to each
species, and retaining, preparing, and changing it: or, on the other
hand, by rejecting whatever is superfluous or hurtful, after she has
separated it from the good. This is the foundation of the doctrine of
depuration, concoction, and crisis in fevers, so much insisted on by him
and by other physicians after him; but when he explains what he means by
nature, he resolves it into heat, which he says appears to have
something immortal in it.

The great opponent of Hippocrates was Asclepiades. He asserted that
matter, considered in itself, is of an unchangeable nature: that all
perceptible bodies are composed of a number of small ones, termed
corpuscles, between which there are interspersed an infinity of small
spaces totally void of matter: that the soul itself is composed of these
corpuscles: that what is called nature is nothing more than matter and
motion: that Hippocrates knew not what he said when he spoke of nature
as an intelligent being, and ascribed to her various qualities and
virtues: that the corpuscles, of which all bodies are composed, are of
different figures, and consist of different assemblages: that all bodies
contain numerous pores, or interstices, which are of different sizes:
that the human body, like all other bodies, possesses pores peculiar to
itself: that these pores are larger or smaller, according as the
corpuscles which pass through them differ in magnitude: that the blood
consists of the largest and the spirits and the heat of the smallest. On
these principles Asclepiades founded his theory of medicine. He
maintains that, as long as the corpuscles are freely received by the
pores, the body remains in its natural state: that, on the contrary, as
soon as any obstacle obstructs their passage, it begins to recede from
that state: that, therefore, health depends on the just proportion
between these pores and corpuscles: that, on the contrary, disease
proceeds from a disproportion between them: that the most usual obstacle
arises from a retention of some of the corpuscles in their ordinary
passages, where they arrive in too large a number, or are of irregular
figures, or move too fast or proceed too slow: that phrensies,
lethargies, pleurisies, burning fevers, for example, are occasioned by
these corpuscles stopping of their own accord: that pain is produced by
the stagnation of the largest of all these corpuscles, of which the
blood consists: that, on the contrary, deliriums, languors,
extenuations, leanness and dropsies derive their origin from a bad state
of the pores, which are too much relaxed, or opened: that dropsy, in
particular, proceeds from the flesh being perforated with various small
holes which convert the nourishment received into them into water; that
hunger is occasioned by an opening of the large pores of the stomach and
belly: that thirst arises from an opening of the small pores: that
intermittent fevers have the same origin: that quotidian fever is
produced by a retention of the largest corpuscles; tertian fever by a
retention of corpuscles somewhat smaller; and quartan fever by a
retention of the smallest corpuscles of all.

Galen maintained that the animal body is composed of three principles,
namely, the solids, the humours, and the spirits: that the solid parts
consist of similar and organic: that the humours are four in number,
namely, the blood, the phlegm, the yellow bile, and the black bile: that
the spirits are of three kinds, namely, the vital, the animal, and the
natural; that the vital spirit is a subtle vapour which arises from the
blood, and which derives its origin from the liver, the organ of
sanguification: that the spirits, thus formed, are conveyed to the
heart, where, in conjunction with the air drawn into the lungs by
respiration, they become the matter of the second species, namely, of
the vital spirits; that in their turn the vital spirits are changed into
the animal in the brain, and so on.

At last came Paracelsus, who was believed to have discovered the elixir
of life, and who is the very prince of charlatans. He delivered a course
of lectures on the theory and practice of physic at the University of
Basle, which he commenced, by burning the works of Galen and Avicenna in
the presence of his auditory. He assured his hearers that his
shoe-latchets had more knowledge than both these illustrious authors put
together: that all the academies in the world had not so much experience
as his beard; and that the hair on the back of his neck was more learned
than the whole tribe of authors. It was fitting that a person of such
splendid pretensions should have a magnificent name. He, therefore,
called himself PHILIPPUS AUREOLUS THEOPHRASTUS PARACELCUS BOMBAST VON
HOHENHEIM. He was a great chemist, and, like other chemists, he was a
little too apt to carry into other sciences “the smoke and tarnish of
the furnace.” He conceived that the elements of the living system were
the same as those of his laboratory, and that sulphur, salt, and
quicksilver were the constituents of organised bodies. He taught that
these constituents were combined by chemical operations: that their
relations were governed by Archeus, a demon, who performed the part of
alchemist in the stomach, who separated the poisonous from the nutritive
part of the food, and who communicated the tincture by which the food
became capable of assimilation: that this governor of the stomach, this
_spiritus vitæ_, this astral body of man, was the immediate cause of all
diseases and the chief agent in their cure: that each member of the body
had its peculiar stomach, by which the work of secretion was effected:
that diseases were produced by certain influences, of which there were
five in particular, viz. _ens estrale_, _ens veneni_, _ens naturale_,
_ens spirituale_, and _ens deale_; that when the Archeus was sick,
putrescence was occasioned, and that either _localiter_ or
_emunctorialiter_, &c. &c.

It would be leading to a detail which is incompatible with our present
purpose to follow these speculations, or to give an account of the
doctrines of the mechanical physicians, who believed that every
operation of the animal economy was explained by comparing it to a
system of ropes, levers, and pulleys, united with a number of rigid
tubes of different lengths and diameters, containing fluids which, from
variations in their impelling causes, moved with different degrees of
velocity: or of the chemical physicians, whose manner of theorizing and
investigating would have qualified them better for the occupation of the
brewer or of the distiller than for that of the physician. All these
speculations are idle fancies, without any evidence whatever to support
them; and it has been argued that, for this very reason, they must have
been without any practical result, and that, therefore, if they were
productive of no benefit, they were, at least, innoxious. No opinion can
be more false or pernicious. These wretched theories not only
pre-occupied the mind, prevented it from observing the real phenomena of
health and of disease, and the actual effect of the remedies which were
employed, and thus put an effectual stop to the progress of the science:
but they were productive of the most direct and serious evils. It is no
less true in medicine than in philosophy and morals, that there is no
such thing as innoxious error; that men’s opinions invariably influence
their conduct; and that physicians, like other men, act as they think.
Asclepiades, whose mind was full of corpuscles and interstices, was
intent on finding suitable remedies, which he discovered in gestation,
friction, and the use of wine. By various exercises he proposed to
render the pores more open, and to make the juices and corpuscles, the
retention of which causes disease, to pass more freely. Hence he used
gestation from the very beginning of the most burning fevers. He laid it
down as a maxim that one fever was to be cured by another; that the
strength of the patient was to be exhausted by making him watch and
endure thirst to such a degree that for the first two days of the
disorder he would not allow them to cool their mouths with a drop of
water. Abernethy’s regulated diet is luxurious living compared to his
plan of abstinence. For the three first days he allowed his patients no
aliment whatever; on the fourth, he so far relented as to give to some
of them a small portion of food; but from others he absolutely withheld
all nourishment till the seventh day. And this is the gentleman who laid
it down as a maxim that all diseases are to be cured “_Tutò, celeriter
et jucunde_.” To be sure he was a believer in the doctrine of
compensation; and in the latter stage of their diseases endeavoured to
recompence his patients for the privations he caused them to endure in
the beginning of their illness. Celsus observes that though he treated
his patients like a butcher during the first days of the disorder, he
afterwards indulged them so far as to give directions for making their
beds in the softest manner. He allowed them abundance of wine which he
gave freely in all fevers; he did not forbid it even to those afflicted
with phrenzy; nay, he ordered them to drink it till they were
intoxicated; for, said he, it is absolutely necessary that persons who
labour under phrenzy should sleep, and wine has a narcotic quality. To
lethargic patients he prescribed it with great freedom, but with the
opposite purpose of rousing them from their stupor. His great remedy in
dropsy was friction, which, of course, he employed to open the pores.
With the same view he enjoined active exercise to the sick; but what is
a little extraordinary, he denied it to those in health.

Erisistratus, who was a great speculator, and whose theories had the
most important influence on his practice, banished blood-letting
altogether from medicine, for the following notable reasons: because, he
says, we cannot always see the vein we intend to open; because we are
not sure we may not open an artery instead of a vein; because we cannot
ascertain the true quantity to be taken; because if we take too little,
the intention is not answered; if too much, we may destroy the patient:
and because the evacuation of the venous blood is succeeded by that of
the spirits, which thus pass from the arteries into the veins;
wherefore, blood-letting ought never to be used as a remedy in disease.
Yet, though he was thus cautious in abstracting blood, it must not be
supposed that he was not a sufficiently bold practitioner. In tumour of
the liver, he hesitated not to cut open the abdomen, and to apply his
medicines immediately to the diseased organ; but though he took such
liberties with the liver, he regarded with the greatest apprehension the
operation of tapping in dropsy of the abdomen: because, said he, the
waters being evacuated, the liver which is inflamed and become hard like
a stone, is more pressed by the adjacent parts, which the waters kept at
a distance from it, whence the patient dies.

One physician conceived that gout originated from an effervescence of
the synovia of the joints with the vitriolated blood: whence he
recommended alcohol for its cure: a remedy for which the court of
aldermen ought to have voted him a medal. A more ancient practitioner
who believed that the finger of St. Blasius was very efficacious “for
removing a bone which sticks in the throat,” maintained that gout was
the “grand drier,” and prescribed a remedy for it which the patient was
to use for a whole year, and to observe the following diet each month:
in September he must eat and drink milk; in October he must eat garlic;
in November he is to abstain from bathing; in December he must eat no
cabbage; in January he is to take a glass of pure wine in the morning;
in February to eat no beef; in March to mix several things both in
eatables and drinkables; in April not to eat horse-radish; nor in May
the fish called Polypus; in June he is to drink cold water in a morning;
in July to avoid venery; and lastly, in August to eat no mallows.

A third physician deduced all diseases from inspissation of the fluids;
hence he attached the highest importance to diluent drinks, and
believed that tea, especially, is a sovereign remedy in almost every
disease to which the human frame is subject: “tea,” says Bentakoe, who
is loudest in his praises of this panacea, and who, as Blumenback
observes, ‘deserved to have been pensioned by the East India Company for
his services,’ “tea is the best, nay, the only remedy for correcting
viscidity of the blood, the source of all diseases, and for dissipating
the acid of the stomach, as it contains a fine oleaginous volatile salt,
and certain subtle spirits which are analogous in their nature to the
animal spirits. Tea fortifies the memory and all the intellectual
faculties: it will therefore furnish the most effectual means of
improving physical education. Against fever there is no better remedy
than forty or fifty cups of tea swallowed immediately after one another;
the slime of the pancreas is thus carried off.”

Another physician derived all diseases from a redundancy or deficiency
of fire or water. He maintained that where the water predominated the
fluids became viscid, and that hence arose intermittent fevers and
anthritic complaints. His remedies are in strict conformity to his
theory. These diseases are to be cured by volatile salts, which abound
with fiery particles; venesection in any case is highly pernicious;
these fiery medicines are the only efficacious remedies, and are to be
employed even in diseases of the most inflammatory nature. “Life,” says
Dr. Brown, “is a forced state:” it is a flame kept alive by excitement;
every thing stimulates; some substances too violently; others not
sufficiently; there are thus too kinds of debility, indirect and direct,
and to one or other of these causes must be referred the origin of all
diseases. According to this doctrine the mode of cure is simple: we have
nothing to do but to supply, to moderate, or to abstract stimuli. Typhus
fever, in this system, is a disease of extreme debility: we must
therefore give the strongest stimulants. Consumption and apoplexy,
also, are diseases of debility; of course the remedies are active
stimulants. Humanity shudders, and with reason, at the application of
such doctrines to practice. And not less destitute of reason, and not
less dangerous in practice, is the great doctrine of debility
promulgated by Cullen. This celebrated professor taught that the
circumstance which invariably characterized fever, that which
constituted its essence, was debility. The inference was obvious, that,
above all things, the strength must be supported. The consequence was,
that blood-letting was neglected, and that bark and wine were given in
immense quantities, in cases in which intense inflammation existed. The
practice was in the highest degree mortal; the number of persons who
have perished in consequence of this doctrine is incalculable. So far
then is it from being true that medical theories are of no practical
importance, that there is the closest possible connection between the
speculations of the physician in his closet, and the measures which he
adopts at the bed side of his patient. Truth to him is a benignant power
which stops the progress of disease, protracts the duration of life, and
mitigates the suffering it may be unable to remove: error is a fearfully
active and tremendously potent principle. There is not a medical
prejudice which has not slain its thousands, nor a false theory which
has not immolated its tens of thousands. The system of medicine and
surgery which is established in any country, has a greater influence
over the lives of its inhabitants than the epidemic diseases produced by
its climate, or the decisions of its government concerning peace and
war. The devastations of the yellow fever will bear no comparison with
the ravages committed by the Brunonian system; and the slaughter of the
field of Waterloo counts not of victims, a tithe of the number of which
the Cullenian doctrine of debility can justly boast. Anatomy alone will
not teach a physician to think, much less to think justly; but it will
give him the elements of thinking; it will furnish him with the means of
correcting his errors; it will certainly save him from some delusions,
and will afford to the public the best shield against his ignorance,
which may be fatal, and against his presumption, which may be
devastating.

We have entered into this minute detail at the hazard, we are aware, of
tiring the reader; but in the hope of leaving on his mind a more
distinct impression of the importance of anatomical knowledge than could
possibly be produced by a mere allusion to the circumstances which have
been explained. In all ages formidable obstacles have opposed the
prosecution of anatomical investigations. Among these, without doubt,
the most powerful has its source in a feeling which is natural to the
heart of man. The sweetest, the most sacred associations are
indissolubly connected with the person of those we love. It is with the
corporeal frame that our senses have been familiar: it is that on which
we have gazed with rapture: it is that which has so often been the
medium of conveying to our hearts the thrill of extacy. We cannot
separate the idea of the peculiarities and actions of a friend from the
idea of his person. It is for this reason that “every thing which has
been associated with him acquires a value from that consideration; his
ring, his watch, his books, and his habitation. The value of these as
having been his is not merely fictitious; they have an empire over my
mind; they can make me happy or unhappy; they can torture and they can
tranquillize; they can purify my sentiments and make me similar to the
man I love; they possess the virtue which the Indian is said to
attribute to the spoils of him he kills, and inspire me with the powers,
the feelings, and the heart of their preceding master.” It is nothing,
the survivor may justly say, to tell me, when disease has completed its
work, and death has seized its prey, that that body, with which are
connected so many delightful associations, is a senseless mass of
matter: that it is no longer my friend, that the spirit which animated
it and rendered it lovely to my sight and dear to my affections, is
gone. I know that it is gone. I know that I never more shall see the
light of intelligence brighten that countenance, nor benevolence beam in
that eye, nor the voice of affection sound from those lips: that which I
loved, and which loved me, is not here: but here are still the features
of my friend: this is his form, and the very particles of matter which
compose this dull mass, a few hours ago were a real part of him, and I
cannot separate them, in my imagination, from him. And I approach them
with the profounder reverence; I gaze upon them with the deeper
affection because they are all that remain to me. I would give all that
I possess to purchase the art of preserving the wholesome character and
rosy hue of this form that it might be my companion still: but this is
impossible: I cannot detain it from the tomb: but when I have “cast a
heap of mould upon the person of my friend and taken the cold earth for
its keeper,” I visit the spot in which it is deposited with awe: it is
sacred to my imagination: it is dear to my heart. There is a real and
deep foundation for these feelings in human nature: they arise
spontaneously in the bosom of man, and we see their expression and their
power in the customs of all nations, savage as well as civilized, and in
the conduct of all men, the most ignorant and uncultivated no less than
the most intelligent and refined. It has been the policy of society to
foster these sentiments. It has been conceived that the sanctity which
attaches to the dead, is reflected back in a profounder feeling of
respect for the living; that the solemnity with which death is regarded
elevates, in the general estimation, the value of life; and that he who
cannot approach the mortal remains of a fellow creature without an
emotion of awe, must regard with horror every thing which places in
danger the life of a human being. Religion has contributed indirectly,
but powerfully, to the strength and perpetuity of these impressions; and
superstition has availed herself of them to play her antics and to
accomplish her base and malignant purposes. It is not the eradication of
these feelings that can be desired, but their control: it is not the
extinction of these natural and useful emotions that is pleaded for, but
that they should give way to higher considerations when these exist.
Veneration for the dead is connected with the noblest and sweetest
sympathies of our nature: but the promotion of the happiness of the
living is a duty from which we can never be exonerated.

In ancient times the voice of reason could not be heard. Superstition,
and customs founded on superstition, excited an influence which was
neither to be resisted nor evaded. Dissection was then regarded with
horror. In the warm countries of the East the pursuit must have been
highly offensive and even dangerous, and it was absolutely incompatible
with the notions and ceremonies universally prevalent in those days. The
Jewish tenet of pollution must have formed an insuperable obstacle to
the cultivation of anatomy amongst that people. By the Egyptians every
one who cut open a dead body was regarded with inexpressible horror. The
Grecian philosophers so far overcame the prejudice as occasionally to
engage in the pursuit, and the first dissection on record was one made
by Democritus of Abdera, the friend of Hippocrates, in order to discover
the course of the bile. The Romans contributed nothing to the progress
of the art: they were content with propitiating the Deities who presided
over health and disease. They erected on the Palatine Mount a temple to
the goddess Febris, whom they worshipped from a dread of her power. They
also sacrificed to the goddess Ossipaga, who, it seems, presided over
the growth of the bones, and to another styled Carna, who took care of
the viscera, and to whom they offered bean-broth, and bacon, because
these were the most nutritious articles of diet. The Arabians adopted
the Jewish notion of pollution, and were thus prohibited by the tenets
of their religion from practising dissection. Abdollaliph, who
flourished about the year 1200, a man of learning and a teacher of
anatomy, never saw and never thought of a human dissection. In order to
examine and demonstrate the bones, he took his students to burying
grounds and earnestly recommended them, instead of reading books, to
adopt that method of study: yet he seems to have had no conception that
the dissection of a recent subject might be a still better method of
learning. Christians were equally hostile to dissection. Pope Boniface
the 8th issued a bull prohibiting even the maceration and preparation of
skeletons. The priests were the only physicians, and so greatly did they
abuse the office they assumed, that the evil at length became too
intolerable to be borne. The church itself was obliged to prohibit the
priesthood from interfering with the practice of medicine. All monks and
canons who applied themselves to physic, were threatened with severe
penalties, and all bishops, abbots, and priors who connived at their
misconduct were ordered to be suspended from their ecclesiastical
functions. But it was not till three hundred years after this
interdiction, that, by a special bull which permitted physicians to
marry, their complete separation from the clergy was effected.

In the 14th century, Mundinus, professor at Bologna, astonished the
world by the public dissection of two human bodies. In the 15th century,
Leonardo da Vinci contributed essentially to the progress of the art, by
the introduction of anatomical plates which were admirably executed. In
the 16th century, the Emperor, Charles the 5th, ordered a consultation
to be held by the divines of Salamanca, to determine whether it was
lawful, in point of conscience, to dissect a dead body in order to learn
its structure. In the 17th century, Cortesius, professor of anatomy at
Bologna, and afterwards professor of medicine at Messina, had long begun
a treatise on practical anatomy which he had an earnest desire to
finish, but so great was the difficulty of prosecuting the study even
in Italy, that in 24 years he could only twice procure an opportunity
of dissecting a human body, and even then with difficulty and in a
hurry; whereas, he had expected to have done so, he says, once every
year, according to the custom of the famous academies of Italy. In
Muscovy, until very lately, both anatomy and the use of skeletons were
positively forbidden; the first as inhuman, and the latter as
subservient to witchcraft. Even the illustrious Luther was so biassed by
the prejudices of his age, that he ascribed the majority of diseases to
the arts of the devil, and found great fault with physicians when they
attempted to account for them by natural causes. England acquired the
bad fame of being the country of witches, and opposed almost insuperable
obstacles to the cultivation of anatomy. Even at present the prejudices
of the people on this subject are violent and deeply-rooted. The measure
of that violence may be estimated by the degree of abhorrence with which
they regard those persons who are employed to procure the subjects
necessary for dissection. In this country there is no other method of
obtaining subjects but that of exhumation: aversion to this employment
may be pardoned: dislike to the persons who engage in it is natural, but
to regard them with detestation, to exult in their punishment, to
determine for themselves its nature and measure, and to endeavour to
assume the power of inflicting it with their own hands, is absurd.
Magistrates have too often fostered the prejudices of the people, and
afforded them the means of executing their vengeance on the objects of
their aversion. The press, with a few honourable exceptions, has
uniformly allied itself with the ignorance and violence of the vulgar,
and has done every thing in its power to inflame the passions which it
was its duty to endeavour to soothe. It is notorious that the winter
before last there was scarcely a week in which many of the papers did
not contain the most exaggerated and disgusting statements: the appetite
which could be gratified with such representations was sufficiently
degraded: but still more base was the servility which could pander to
it.

As one among many of the cases which illustrate this bad feeling, we may
refer to that of Samuel Clark who was indicted at the Essex Quarter
Sessions, in January, 1824, for feloniously stealing at Little Leighs,
on the 26th of December, a woman’s shift, a bed-gown, a night-cap, and a
pair of cotton stockings, the property of James Chinnery. It appeared in
evidence, that a young woman the wife of a labouring man named James
Chinnery, had been buried in Little Leighs Church-yard, on Sunday the
21st of December. Previous to her death she expressed a wish to be
interred in a night-cap, shift, bed-gown and cotton stockings, and her
request had been complied with. The body was discovered on the morning
of the 26th, in a ditch near the church-yard. A few rods from this spot
was found a horse yoked to a chaise cart and tied to a tree. It appeared
that “the box under the chaise cart was calculated to hold a couple of
human bodies, when rolled up; and on examining it, a most offensive
odour proceeded from it, as if it had been recently used in the
prisoner’s _unhallowed_ occupation.” The prisoner owned this horse and
cart, and this is the whole of the evidence, at least, as stated in the
report of the trial, which implicated him in the robbery of the grave.
Under these circumstances, the counsel for the prisoner submitted to the
Court that there was no case to go to the jury on three grounds:--first,
that there was no proof of any asportation of the articles alleged to
have been stolen: secondly, that supposing the asportavit made out, the
prisoner could not be convicted of this offence, unless it was manifest
that he had a felonious intention of taking the clothes and converting
them to his own use; and thirdly, that, at all events, there was no
evidence upon which the jury could safely be called upon to act, so as
to implicate him in the alleged offence. The counsel for the prosecution
in answer urged, first, that the finding of the body naked, after proof
that it had been interred in the clothes mentioned in the evidence, was
sufficient proof of asportation: and that even stripping the body
without removing the clothes out of the grave, was, in law, enough to
support the indictment: secondly, that although the primary intention of
the prisoner might be, to steal the body only, yet, if the clothes were
taken, the law would construe them to have been feloniously taken: that
it might as well be said that although a man’s intention might be to
steal a valuable jewel, yet it was no offence to take the casket in
which it was contained: and thirdly, that whether the defendant was the
party to whom guilt was imputed, was a question solely for the
consideration of the jury. On the prisoner’s counsel insisting that his
objections had not been answered, the Chairman overruled the two first
objections, and then summed up the evidence, on which the jury, after
deliberating a few minutes, found the prisoner _Guilty_. The verdict, it
is recorded, _was received by the auditory with a general expression of
pleasure_. The Court after animadverting in strong terms on the
_abominable_ offence of which the prisoner had been found guilty, said
they were determined that he should not have an opportunity of pursuing
his _odious_ trade in this country, at least for some years, and
_therefore_ sentenced him to be transported for seven years. The account
of this case is taken from the report of the trial contained in the
Globe and Traveller newspaper of Jan. 20, 1824; a paper honorably
distinguished for its endeavours to enlighten the public mind on this
subject, not to foster its prejudices.

In this case there was no sufficient evidence to convict the prisoner of
the alleged offence: even if that evidence had been perfectly
satisfactory, the punishment inflicted was unjust: the circumstance
essential to constitute the felony did not exist: the Chairman, with an
ignorant and vulgar mind, stretched the law to gratify ignorant and
vulgar prejudice: he relied upon the public feeling for protection in
the illegal exertion of his power: he administered the law badly: he
endeavoured to justify his conduct by loading the prisoner with odious
epithets, and he did not miscalculate the feeling of his auditory: they
witnessed the transaction “with a general feeling of pleasure.” This
case exhibits but too faithfully, the spirit often displayed both by the
magistracy and the people.

Half a century ago there was in Scotland no difficulty in obtaining the
subjects which were necessary to supply the schools of anatomy. The
consequence was, that medicine and surgery suddenly assumed new
life--started from the torpor in which they had been spell-bound--and
made an immediate, and rapid, and brilliant progress. The new seminaries
constantly sent into the world men of the most splendid abilities, at
once demonstrating the excellence of the schools in which they were
educated, and rendering them illustrious. Pupils flocked to them from
all quarters of the globe, and they essentially contributed to that
advancement of science which the present age has witnessed. In the 19th
century the good people of Scotland, that intelligent, that cool and
calculating, that most reasonable and thinking people, have thought
proper to return to the worst feeling and the worst conduct of the
darkest periods of antiquity. There is at present no offence whatever
which seems to have such power to heat and to exalt into a kind of
torrent the blood which usually flows so calmly and sluggishly in the
veins of a Scotchman. The people of 1823 (to compare great things with
small) emulate the spirit of those of their forefathers who “_were out
in the forty-five_;” the object, to be sure, is somewhat different, but
it is amusing to see the intensity and seriousness of the excitement.
About twelve months ago an honest farmer of the name of Scott, who
resides at Linlithgow, apprehended a poor wight who was pursuing his
vocation, we presume, in the church-yard of that place; and this service
appeared so meritorious to the people in his neighbourhood, that they
absolutely presented him with a piece of plate. In the winter sessions
of 1822-3, a body was discovered on its way to the lecture-room of an
anatomist in Glasgow, and, in spite of the exertions of the police,
aided by those of the military, this gentleman’s premises and their
contents, which were valuable, were entirely destroyed by the mob. For
some time after this achievement, it was necessary to station a military
guard at the houses of all the medical professors in that city. In the
spring circuit of the justiciary court last year at Stirling, while the
judges were proceeding to the court, the procession was assaulted with
missiles; several persons were injured, and it was necessary to call in
the protection of a military force. The object of the mob was, to
inflict summary punishment on a man who was about to be tried for the
exhumation of a body. We happen to know that the most disgraceful
proceedings were some time ago instituted in that town against a young
gentleman of respectable family and connections, who was in fact
expatriated, and whose prospects in life were entirely changed, if not
ruined, because he had too much honour to implicate his instructors in a
transaction which would have put them to inconvenience, and in which
they had engaged from a desire faithfully to discharge their duty to
their pupils. Within the last five years three men were lodged in the
county gaol at Haddington, charged with a trespass in the church-yard of
that town. So enraged was the mob against them, that an attempt was made
to force the gaol in order to get at them. On their way to the court the
men were again attacked, forced from the carriage, and severely maimed.
After examination they were admitted to bail; but, when set at liberty,
they were assailed with more violence than ever, and were nearly killed.
On the 29th of June, 1823, being Sunday, a most extraordinary outrage
was perpetrated in the streets of Edinburgh. A coach containing an empty
coffin and two men, was observed proceeding along the south bridge. The
people suspecting that it was intended to convey a body taken from some
church-yard, seized the coach. It was with difficulty that the police
protected the men from the assaults of the populace: the coach they had
no power to preserve. The horses were taken from it, and together with
the coffin, after having been trundled a mile and a half through the
streets of the city, it was deliberately projected over the steep side
of the mound, and smashed into a thousand pieces. The people following
it to the bottom, kindled a fire with its fragments, and surrounded it
like the savages in Robinson Crusoe, till it was entirely consumed. In
this case there was no foundation for their suspicions. The coffin was
intended to have conveyed to his house in Edinburgh the body of a
physician who that morning had died in a cottage in the neighbourhood. A
similar assault was some time ago made on two American gentlemen, who
went to visit the Abbey of Linlithgow after nightfall. The churchyards
of the “gude Scots” are now strictly guarded by men and dogs;
watch-towers are erected within the grounds, and _mort-safes_ as they
are called, that is to say, strong iron frames are deposited in the
ground over the graves. These people sometimes declare that they will
put an end to anatomy, and certainly they are succeeding in the
accomplishment of this menace as rapidly as they can well desire. The
average number of medical students in Edinburgh is 700 each session. For
several years past the difficulty of procuring subjects in that place
has been so great, that out of all that number, not more than 150 or 200
have ever attempted to dissect; and even these have latterly been so
opposed in their endeavours to prosecute their studies that many of them
have left the place in disgust. We have been informed by a friend, that
he alone was personally acquainted with twenty individuals who retired
from it at the beginning of last session, and who went to pursue their
studies at Dublin, and we know that vast numbers followed their example
at the end of the winter course. The medical school at Edinburgh, in
fact, is now subsisting entirely on its past reputation; in the course
of a few years it will certainly be at an end, unless the system be
changed. Let those who have the prosperity of the university at heart,
and who have the power to protect it, consider this before it be too
late: they may be assured it is no idle prediction; for we give them
notice that it is at this moment the universal opinion and the current
language of every well-informed medical man in England.

An excellent system of anatomical plates, which has been well received
by the profession, has lately been published by Mr. Lizars, a lecturer
on anatomy and physiology, in Edinburgh. This gentleman states that he
has been induced to undertake the work, in order to obviate the most
fatal consequences to the public; as far, at least, as a reference to
art, instead of nature is capable of obviating those consequences. He
affirms, that the difficulty of obtaining instruction from nature has
risen to such a pitch, owing to the extraordinary severity exercised by
the legal authorities of the kingdom against persons employed in
procuring subjects for dissection, as to threaten the ultimate
destruction of medical and anatomical science. In his preface to the
second part of his work, he apologizes to his readers for dividing one
portion of it from another, with which it ought to have been connected;
but states that he has been compelled to do so from the prejudices of
the place, which prevented him for upwards of five months, from
procuring a subject from which he might make his drawings. “In place of
living,” he says, “in a civilized and enlightened period, we appear as
if we had been thrown back some centuries into the dark ages of
ignorance, bigotry, and superstition. Prejudices, worthy only of the
multitude, have been conjured up and appealed to, in order to call forth
popular indignation against those whose business it is to exhibit
demonstratively the structure of the human body, and the functions of
its different organs. The public journals, from a vicious propensity to
pander to the vulgar appetite for excitement, have raked up and
industriously circulated stories of the exhumation of dead bodies,
tending to exasperate and inflame the passions of the mob; and persons,
who, by their own showing, are friendly to the interests of science,
have, in the excess of their zeal that bodies should remain undisturbed
in their progress to decomposition, laboured to destroy in this country,
that art, whose province it is, to free living bodies from the
consequences inseparable from accident and disease. And, which is worst
of all, the prejudices of the multitude have been confirmed and rendered
inveterate by the proceedings in our courts of justice, which have
visited with the punishment due only to felons, the unhappy persons
necessarily employed in the present state of the law, in procuring
subjects for the dissecting-room.”

He then goes on to state that, until anatomy be publicly sanctioned in
Edinburgh, the school of medicine there can never flourish; that, upon
the present system, young men obtain a degree or a diploma after a year
or two of grinding, that is, of learning by rote the answers to the
questions which the examiners are in the habit of putting to the
candidates; that ignorant of the very elements of their profession
numbers of persons thus educated annually go to the East and West
Indies, and to the army and navy, where they have the charge of hundreds
of their suffering fellow creatures, to whom they are in fact the
instruments of cruelty and murder. In the preface to the 4th Part, he
adds, that when Part II. was published, in the early part of the
session, he took occasion to express his sorrow for the degraded state
of his profession, and the threatened ruin of the Medical School of his
native place, owing to the scarcity of subjects: that, for doing this,
he has incurred considerable censure; that he regrets that he has yet
found no reason to alter his opinion, for the winter session is now
near its conclusion, and, he candidly declares, that such has been the
scarcity of material, that _no teacher of anatomy or surgery has been
able either to follow the regular plan of his course, or to do his duty
to his pupils_; the consequence of which has been, that many of the
students have left the school in disgust, and gone either to Dublin or
Paris; while a still greater number, deprived of the means of
dissecting, have contented themselves with lectures or theories, and
with grinding; and entered on the practice of their profession ignorant
of its fundamental principles.

Much of this opposition on the part of the people arises from the
present mode of procuring subjects. Fortunately, there is in Great
Britain no custom, no superstition, no law, and we may add, no prejudice
against anatomy itself. There is even a general conviction of its
necessity; there may be a feeling that it is a repulsive employment, but
it is commonly acknowledged that it must not be neglected. The
opposition which is made, is made not against anatomy, but against the
practice of exhumation: and this is a practice which ought to be
opposed. It is in the highest degree revolting; it would be disgraceful
to a horde of savages; every feeling of the human heart rises up against
it: so long as no other means of procuring bodies for dissection are
provided, it must be tolerated; but, in itself, it is alike odious to
the ignorant and the enlightened, to the most uncultivated and the most
refined.

But the capital objection to this practice is, that it necessarily
creates a crime, and educates a race of criminals. Exhumation is
forbidden by the law. It is, indeed, prohibited by no statute, either in
England or in Scotland: in both it is an offence punishable at common
law. There is a statute of James the First, which makes it felony to
steal a dead body for the purpose of witchcraft; there is none against
taking a body for the purpose of dissection. In the case of the King
against Lynn (1788), the Court decided that the body being taken for the
latter purpose, did not make it less an indictable offence; and that it
is without doubt cognizable in a criminal court, because it is an act
“highly indecent; at the bare idea of which nature revolts.” It is
punishable, therefore, by fine or imprisonment, or both: in Scotland it
is also punishable by whipping, and even by transportation.

We expected better things of America. We cannot express our astonishment
and indignation, when we found that the state of New York has actually
made it felony to remove a dead body from the place of sepulture for the
purpose of dissection, without providing in any other mode for the
schools of anatomy. This is worse than any thing that exists in any
other part of the world. If these pages should meet the eye of any of
our American brethren, we intreat them to read with attention, the facts
which have been stated in the former part of this pamphlet, and to
consider with seriousness the mischief they are doing. It will not be
believed in England, that such scenes can have been witnessed in
America, as were actually exhibited there scarcely a month ago. To
satisfy our readers, however, that we do not misrepresent the state of
things in that country, we transcribe the following accounts from _The
New York Evening Post_, of _May_ 20th:--“At the late Court of Sessions,
Solomon Parmeli was indicted for a misdemeanor, in entering Potter’s
Field, and removing the covers of two coffins deposited in a pit, and
covered partly with earth. _The statute of this state making it a
felony, to dig up or remove a dead human body with intent to dissect
it_, did not embrace this case; because the prisoner had not dug up or
removed the body. Mr. Schureman, the present keeper of Potter’s Field,
suspected that some person had entered it for the purpose of removing
the dead; and, after sending for two watchmen, and calling his faithful
dog, he went to ascertain the fact. On arriving at the grave, he found
his suspicion confirmed; and requested the person concealed in the pit,
to come out and show himself: no answer being given, Mr. Schureman sent
his dog into the pit, and in the twinkling of an eye a tall stout fellow
made his appearance, and took to his heels across the field. The night
being dark, he might have effected his escape had it not been for the
sagacity and courage of the dog, who pursued him for some distance; but
at last came up with him, seized and held him fast until the arrival of
Mr. Schureman and the watchmen who secured him. The jury convicted the
prisoner, and the Court sentenced him to six months’ imprisonment in the
Penitentiary. _The young gentlemen attending the Medical School of this
city will take warning by this man’s fate. They may rest assured, that
the keeper of Potter’s Field will do his duty, and public justice will
he executed on any man, whatever may be his condition in life, who is
found violating the law, and the decency of christian burial!_” The same
paper gives the following account of a transaction, which took place at
Hartford, in Connecticut, May 17. “Yesterday morning, two ladies were
taking a walk in the South burying ground, when they discovered a
tape-string, and a piece of cloth, which upon examination was found to
be the piece that was laced upon Miss Jane Benton’s face, who came to
her death by drowning, and was buried a few days since. The ladies then
went to the grave, and found that it had been disturbed--that she was
taken out of her coffin, and a rope around her neck. The circumstance
has produced great excitement in the public mind; and every one is on
the alert to discover the perpetrators of this unfeeling, brutal act.
_The citizens turned out in a body yesterday, and interred the corpse
again._”

These scenes are highly disgraceful, and disgraceful to all, though not
_alike_ to all, parties. We do not blame the Americans for abolishing
the practice of exhumation; but we blame them for stopping there. We
maintain, that it is both absurd and criminal, to make this practice
felony, without providing in some other method for the cultivation of
anatomy.

In Great Britain, the law against the practice of exhumation is not
allowed to slumber. There may be other cases which have not come to our
knowledge; but we have ascertained that there have been 14 convictions
for England alone during the last year. The punishments inflicted have
been imprisonment for various periods, with fines of different sums. The
fines in general are heavy, considering the poverty of the offenders.
Several persons are, at this moment, suffering these penalties; among
others, there is now in the gaol of St. Albans, a man who was sentenced
for this offence to two years’ imprisonment and a fine of £.20. The
period of his confinement has expired some time; but he still remains in
prison, on account of his inability to pay the fine. Since the passing
of the new Vagrant Act, it has been the common practice to commit these
offenders to hard labour for various periods. Very lately, two men,
convicted of this offence, were sent to the Tread-Mill, in Cold Bath
Fields; one of whom died in one month after his commitment. It is an
error to suppose that these punishments operate to prevent exhumation;
their only effect is to raise the price of subjects: a little reflection
will show that they can have no other operation. At present, exhumation
is the only method by which subjects for dissection can be procured; but
subjects for this purpose must be procured; and be the difficulties what
they may, will be procured: diseases will occur, operations must be
performed, medical men must be educated, anatomy must be studied,
dissections must go on. Unless some other means for affording a supply
be adopted; whatever be the law or the popular feeling, neither
magistrates, nor judges, nor juries, will, or can put an entire stop to
the practice. It is one which, from the absolute necessity of the case,
must be allowed. What is the consequence? So long as the practice of
exhumation continues, a race of men must be trained up to violate the
law. These men must go out in company for the purpose of nightly
plunder, and plunder of the most odious kind, tending in a peculiar and
most alarming measure to brutify the mind, and to eradicate every
feeling and sentiment worthy of a man. This employment becomes a school
in which men are trained for the commission of the most daring and
inhuman crimes. Its operation is similar, but much worse than the
nightly banding to violate the game laws, because there is something in
the violation of the grave, which tends still more to degrade the
character and to harden the heart. This offence is connived at, nay, it
is rewarded; these men are absolutely paid to violate the law; and paid
by men of reputation and influence in society. The transition is but too
easy to the commission of other offences in the hope of similar
connivance, if not of similar reward.

It is an odious thing that the teachers of anatomy should be brought
into contact with such men: that they should be obliged to employ them,
and that they should even be in their power; which they are to such a
degree, that they are obliged to bear with the wantonness of their
tyranny and insult. All the clamour against these men, all the
punishment inflicted on them, only operate to raise the premium on the
repetition of their offence. This premium the teachers of anatomy are
obliged to pay, which these men perfectly understand, who do not at all
dislike the opposition which is made to their vocation. It gives them no
unreasonable pretext for exorbitancy in their demands. In general they
are men of infamous character; some of them are thieves, others are the
companions and abettors of thieves. Almost all of them are extremely
destitute. When apprehended for the offence in question, the teachers of
anatomy are obliged to pay the expenses of the trial, and to support
their families while they are in prison; whence the idea of immunity is
associated, in these men’s minds, with the violation of the law, and
when they do happen to incur its penalties, they practically find that
they and their families are provided for, and this provision comes to
them in the shape of a reward for the commission of their offence. The
operation of such a system on the minds of the individuals themselves is
exceedingly pernicious, and is not a little dangerous to the community.

Moreover, by the method of exhumation, the supply after all is scanty;
it is never adequate to the wants of the schools; it is of necessity
precarious, and it sometimes fails altogether for several months. But it
is of the utmost importance that it should be abundant, regular, and
cheap. The number of young men who come annually to London for the
purpose of studying medicine and surgery, may be about a thousand. Their
expenses are necessarily very considerable while in town; they have
already paid a large sum for their apprenticeship in the country; the
circumstances of country practitioners, in general, can but ill afford
protracted expenses for their sons in London; few of them stay a month
longer than the time prescribed by the College of Surgeons. But the
short period they spend in London is the only time they have for
acquiring the knowledge of their profession. If they mis-spend these
precious hours, or if the means of employing them properly be denied
them, they must necessarily remain ignorant for life. After they leave
London they have no means of dissecting. We have seen that it is by
dissecting alone, that they can make themselves acquainted even with the
principles of their art; that without it they cannot so much as avail
themselves of the opportunities of improvement, which experience itself
may offer, nor, without the highest temerity, perform a single
operation. We have seen that occasions suddenly occur, which require
the prompt performance of important and difficult operations; we have
seen that, unless such operations are performed immediately, and with
the utmost skill, life is inevitably lost. In many such cases there is
no time to send for other assistance. If a country practitioner (and
most of these young men go to the country) be not himself capable of
doing what is proper to be done, the death of the patient is certain. We
put it to the reader to imagine what the feelings of an ingenuous young
man must be, who is aware of what he ought to do, but who is conscious
that his knowledge is not sufficient to authorise him to attempt to
perform it, and who sees his patient die before him, when he knows that
he might be saved and that it would have been in his own power to save
him, had he been properly educated. We put it to the reader to conceive
what his own sensations would be, were an ignorant surgeon, with a
rashness more fatal than the criminal modesty of the former, to
undertake an important operation. Suppose it were a tumour, which turned
out to be an aneurism; suppose it were a hernia, in operating on which
the epigastric artery were divided, or the intestine itself wounded;
suppose it were his mother, his wife, his sister, his child, whom he
thus saw perish before his eyes, what would the reader then think of the
prejudice which withholds from the surgeon that information without
which the practice of his profession is murder?

The study of anatomy is a severe and laborious study; the practice of
dissection is on many accounts highly repulsive: it is even not without
danger to life itself.[A] To men of clear understandings, to those
especially of a philosophical turn of mind, the pursuit is its own
reward; they are so fully satisfied that the more it is cultivated the
more satisfaction it will afford, that they need no stimulus to induce
them to undergo the drudgery. But this is by no means the case with
ordinary minds. The fatigue and disgust of the dissecting-room are
appalling to them, and they need the stimulus of necessity to urge them
to the task. The court of examiners of the College of Surgeons requires
from the candidates for surgical diplomas certificates that they have
gone through at least two courses of dissections; the examiners at
Apothecaries’-hall do not require such certificates. The consequence is,
that many young men content themselves with attending lectures, and with
passing their examinations at Apothecaries’-hall, and do not apply for a
diploma at the College of Surgeons. This single fact is sufficient to
demonstrate to the public that, instead of throwing obstacles in the way
of dissection, it is a duty which they owe to themselves to afford every
possible facility to its practice, and to hold out to every member of
the profession, the most powerful inducements to engage in it, by
rewarding with confidence those who cultivate anatomy, by making
excellence in anatomy indispensable to all offices in dispensaries and
hospitals, and by thus rendering it impossible for any one who is
ignorant of anatomy, to obtain rank in his profession. When a candidate
presents himself for a diploma in Denmark, in his first trial he is put
into a room with a subject, a case of instruments, and a memorandum, and
informed that he is to display the anatomy of the face and neck, or that
of the upper extremity or that of the lower extremity: that by the
anatomy is to be understood, the blood-vessels, nerves and muscles; and
that as soon as he has accomplished his task, the professors will attend
his summons to judge of his attainments. These professors are the true
examiners!

We shall have entered into the discussion of this subject to little
purpose, if we have not produced in the minds of our readers a deep
conviction, that anatomy ought to form an essential part of medical
education; that anatomy cannot be studied without the practice of
dissection; that dissection cannot be practised without a supply of
subjects, and that the manner in which that supply is obtained in
England is detestable and ought immediately to be changed.

The plan we would propose to substitute is the following:--

1. That the bodies of those persons who die in all infirmaries and
hospitals throughout the kingdom, _unclaimed by immediate relatives_, be
appropriated to the purpose of anatomy.

2. That the bodies of those persons who die in all work-houses and
poor-houses be appropriated to the same purpose.

3. That the bodies of those persons who die in all houses of correction,
in all prisons, and in the hulks, be thus appropriated.

An objection may be anticipated to such an appropriation of the bodies
of those who die in infirmaries and hospitals. And it is admitted, that
in the present state of public feeling it would not be right thus to
appropriate the bodies of _all_ who die in those public charities. But
this is not proposed: what is proposed is to appropriate to this use the
bodies of those ONLY _who die unclaimed by immediate relatives_. No
reasonable objection can be urged to this measure thus guarded. No one
who has not inquired into the subject can have any conception of the
number of persons who die in the public hospitals in London, unvisited
by friends during life, unclaimed by them after death. Surely to devote
to this use the bodies of those who die under such circumstances can
inflict no wound on any private individual--can violate no public right.
Still there is one objection to the measure which is specious but not
solid. It is urged that it might be the means of deterring this class of
persons from entering the hospitals. The answer to this objection is
complete, because it is an answer derived from experience. The measure
has been actually adopted, and found in practice to be unattended with
this result: it was tried in Edinburgh and the hospital was as full as
it is at present: it is universally acted on in France, and the
hospitals are always crowded.

It has been stated that this plan has been tried in Edinburgh, and that
experience has proved its efficacy. It was, in fact, adopted in that
city with perfect success more than a century ago. In the Council
Register for 1694, it is recorded that all unclaimed dead bodies in the
charitable institutions or in the streets, were given for dissection to
the College of Surgeons, to one or two of its individual members, and to
the professor of anatomy. This regulation, at that period, excited no
opposition on the part of the people, but effectually answered the
desired object. All the medical schools on the continent are supplied
with subjects, by public authority, in a similar manner. The following
account of the mode in which those of Paris in particular are supplied,
has been obtained from the gentleman who is at the head of the
anatomical department in that city. It is stated; 1. That the faculty of
medicine at Paris is authorized to take from the civil hospitals, from
the prisons, and from dépôts of mendicity, the bodies which are
necessary for teaching anatomy. 2. That a gratuity of eight-pence is
given to the attendants in the hospitals for each body. 3. That upon the
foundation by the National Convention, of schools of health, the
statutes of their foundation declare, that the subjects necessary for
the schools of anatomy shall be taken from the hospitals, and that since
this period, the council of hospitals, and the prefect of police, have
always permitted the practice. 4. That M. Breschet, chief of the
anatomical department of the faculty of Paris, sends a carriage daily to
the different hospitals, which brings back the necessary number of
bodies: that this number has sometimes amounted to 2,000 per annum, for
the faculty only, without reckoning those used in L’Hôpital de la Pitié,
but that since the general attention which has recently been bestowed
upon pathologic anatomy, numbers of bodies are opened in the civil and
military hospitals, and that the faculty seldom obtain more than 1,000
or 1,200. 5. That, besides the dissections by the faculty of medicine,
and those pursued in L’Hôpital de la Pitié, theatres of anatomy are
opened in all the great hospitals, for the pupils of those
establishments: that in these institutions anatomy is carefully taught,
and that pupils have all the facilities for dissection that can be
desired. 6. That the price of a body varies from four shillings to eight
shillings and sixpence. 7. That after dissection, the bodies are wrapt
in cloths, and carried to the neighbouring cemetery, where they are
received for ten-pence. 8. That the practice of exhumation is abolished:
that there are insurmountable obstacles to the return to that system,
and that bodies are never taken from burial grounds, without an order
for exhumation, which is given only when the tribunals require it for
the purpose of medico-legal investigations. 9. That though the people
have an aversion to the operations of dissection, yet they never make
any opposition to them, provided respect be paid to the laws of decency
and salubrity, on account of the deep conviction that prevails of their
utility. 10. That the relatives of the deceased seldom or never oppose
the opening of any body, if the physicians desire it. That all the
medical students in France, with scarcely any exception, dissect, and
that that physician or surgeon who is not acquainted with anatomy, is
universally regarded as the most ignorant of men.

To the other parts of the plan proposed above for supplying the
anatomical schools in Great Britain, there appears to be no objections
whatever. No one can object to such a disposal of the bodies of those
who die in prisons; no one can reasonably object to such a disposal of
the bodies of those who die in poor-houses. These persons are pensioners
upon the public bounty: they owe the public a debt: they have been
supported by the public during life; if, therefore, after death they
can be made useful to the public, it is a prejudice, not a reason--it is
an act of injustice, not the observance of a duty, which would prevent
them from becoming so. It is true that many of these persons are honest
and respectable; and have been reduced to indigence by misfortune: were
they all so it would not alter the state of the argument. Some
concession and co-operation on the part of the public, for this great
public object, is indispensable, without which nothing can be done: but
if any concession be made, it can be made with respect to this class of
persons better than any other, because it can be made with less
violation of public feeling. Nor is any indignity either intended or
offered to these persons. They are appropriated to this service not
because they are poor, but because they are friendless: because, that
is, no persons survive them who take such an interest in their fate as
to be rendered unhappy by this disposal of their remains. That they are
without friends is no good reason why their memory should be treated
with indignity; but it is a good reason, it is the best possible reason
why they should be selected for this public service. Poverty, it is
true, is a misfortune: poverty, it is true, has terror and pain enough
in itself: no legislature ought by any act to increase its wretchedness;
but the measure here proposed is pregnant with good to the poor, and
would tend more than can be estimated to lessen the misery of their
condition. For it would give knowledge to the lowest practitioners of
the medical art; that is, to the persons who are at present lamentably
deficient, and into whose hands the great bulk of the poor fall. And,
after all, the true question is, whether the surgeon shall be allowed to
gain knowledge by operating on the bodies of the dead, or driven to
obtain it by practising on the bodies of the living. If the dead bodies
of the poor are not appropriated to this use, their living bodies must
be--and will be. The rich will always have it in their power to select,
for the performance of an operation, the surgeon who has signalized
himself by success: but that surgeon, if he have not obtained the
dexterity which ensures success, by dissecting and operating on the
dead, must have acquired it by making experiments on the living bodies
of the poor. There is no other means by which he can possibly have
gained the necessary information. Every such surgeon who has attained
deserved eminence, must have risen to it through the suffering which he
has inflicted, and the death which he has brought upon hundreds of the
poor. What would be the immediate and constant effect of an abolition of
the practice of dissecting the dead? It would be to convert poor-houses
and public hospitals into so many schools where the surgeons, by
practising on the living bodies of the poor, would learn to operate on
those of the rich with safety and dexterity. Thus the poor would be
tortured, and many of them would be put to death in order that the rich
might be saved from pain and danger. This would be the certain and
inevitable result--this would indeed be to treat this class of the
people with real indignity and horrible injustice, and proves how
possible it is to show an apparent consideration for the poor, and yet
practically to abuse them in the most cruel manner.

The plan now proposed for remedying the evils which have been stated
would accomplish the object easily and completely: it would inflict no
injury on any private individual: it would do no violence to the public
feeling: it would render the dread of anatomy, as far as that dread were
really operative, directly beneficial to the community: it would
terminate at once the evils of the present system: it would put an end
to the education of daring and desperate violators of the law: it would
tranquillize the public mind: the dead would rest undisturbed: the
sepulchre would be sacred, and all the horrors which the imagination
connects with its violation would cease for ever.

We submit these observations to the calm and serious consideration of
our countrymen. We address them especially to the members of our
legislature. Upon the attention of the latter we would particularly urge
this further consideration, the importance of which they well know how
to estimate. In consequence of the difficulty of procuring subjects in
England, every medical student in Great Britain who can possibly afford
the time now goes to Paris to perfect himself in anatomy. Accordingly
the number of English students in Paris is already immense: that number
increases rapidly every year: it increases by the desertion of the
schools in Edinburgh and London. The consequence is obvious, and will be
surely and deeply felt in a few years. Anatomy will be neglected in
England, and for this indispensable branch of knowledge England will
become entirely dependent on France. There cannot be a doubt that there
is good sense enough among the people of England to submit to whatever
regulations may be necessary to prevent evils so serious and so fatal,
provided such regulations are framed in a proper spirit, and observed
with a due regard to decorum, and it is certain that those persons who
co-operate to establish these regulations will ultimately receive, as
they will deserve, the gratitude of their country.


                                FINIS.


                T. C. Hansard, Pater-noster-row Press.


FOOTNOTE:

[A] A winter never passes without proving fatal to several students who
die from injuries received in dissection.