medical essays-第44部分
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all is mystery in the movements of organization; as profound as in the fall of a stone or the formation of a crystal。
To the chemist and the microscopist the living body presents the same difficulties; arising from the fact that everything is in perpetual change in the organism。 The fibrine of the blood puzzles the one as much as its globules puzzle the other。 The difference between the branches of science which deal with space only; and those which deal with space and time; is this: we have no glasses that can magnify time。 The figure I here show you a was photographed from an object (pleurosigma angulatum) magnified a thousand diameters; or presenting a million times its natural surface。 This other figure of the same object; enlarged from the one just shown; is magnified seven thousand diameters; or forty…nine million times in surface。 When we can make the forty…nine millionth of a second as long as its integer; physiology and chemistry will approach nearer the completeness of anatomy。
Our reverence becomes more worthy; or; if you will; less unworthy of its Infinite Object in proportion as our intelligence is lifted and expanded to a higher and broader understanding of the Divine methods of action。 If Galen called his heathen readers to admire; the power; the wisdom; the providence; the goodness of the Framer of the animal body;〃if Mr。 Boyle; the student of nature; as Addison and that friend of his who had known him for forty years tell us; never uttered the name of the Supreme Being without making a distinct pause in his speech; in token of his devout recognition of its awful meaning;surely we; who inherit the accumulated wisdom of nearly two hundred years since the time of the British philosopher; and of almost two thousand since the Greek physician; may well lift our thoughts from the works we study to their great Artificer。 These wonderful discoveries which we owe to that mighty little instrument; the telescope of the inner firmament with all its included worlds; these simple formulae by which we condense the observations of a generation in a single axiom; these logical analyses by which we fence out the ignorance we cannot reclaim; and fix the limits of our knowledge;all lead us up to the inspiration of the Almighty; which gives understanding to the world's great teachers。 To fear science or knowledge; lest it disturb our old beliefs; is to fear the influx of the Divine wisdom into the souls of our fellow…men; for what is science but the piecemeal revelation;uncovering;of the plan of creation; by the agency of those chosen prophets of nature whom God has illuminated from the central light of truth for that single purpose?
The studies which we have glanced at are preliminary in your education to the practical arts which make use of them;the arts of healing;surgery and medicine。 The more you examine the structure of the organs and the laws of life; the more you will find how resolutely each of the cell…republics which make up the E pluribus unum of the body maintains its independence。 Guard it; feed it; air it; warm it; exercise or rest it properly; and the working elements will do their best to keep well or to get well。 What do we do with ailing vegetables? Dr。 Warren; my honored predecessor in this chair; bought a country…place; including half of an old orchard。 A few years afterwards I saw the trees on his side of the fence looking in good health; while those on the other side were scraggy and miserable。 How do you suppose this change was brought about? By watering them with Fowler's solution? By digging in calomel freely about their roots? Not at all; but by loosening the soil round them; and supplying them with the right kind of food in fitting quantities。
Now a man is not a plant; or; at least; he is a very curious one; for he carries his soil in his stomach; which is a kindof portable flower…pot; and he grows round it; instead of out of it。 He has; besides; a singularly complex nutritive apparatus and a nervous system。 But recollect the doctrine already enunciated in the language of Virchow; that an animal; like a tree; is a sum of vital unities; of which the cell is the ultimate element。 Every healthy cell; whether in a vegetable or an animal; necessarily performs its function properly so long as it is supplied with its proper materials and stimuli。 A cell may; it is true; be congenitally defective; in which case disease is; so to speak; its normal state。 But if originally sound and subsequently diseased; there has certainly been some excess; deficiency; or wrong quality in the materials or stimuli applied to it。 You remove this injurious influence and substitute a normal one; remove the baked coal…ashes; for instance; from the roots of a tree; and replace them with loam; take away the salt meat from the patient's table; and replace it with fresh meat and vegetables; and the cells of the tree or the man return to their duty。
I do not know that we ever apply to a plant any element which is not a natural constituent of the vegetable structure; except perhaps externally; for the accidental purpose of killing parasites。 The whole art of cultivation consists in learning the proper food and conditions of plants; and supplying them。 We give them water; earths; salts of various kinds such as they are made of; with a chance to help themselves to air and light。 The farmer would be laughed at who undertook to manure his fields or his trees with a salt of lead or of arsenic。 These elements are not constituents of healthy plants。 The gardener uses the waste of the arsenic furnaces to kill the weeds in his walks。
If the law of the animal cell; and of the animal organism; which is built up of such cells; is like that of the vegetable; we might expect that we should treat all morbid conditions of any of the vital unities belonging to an animal in the same way; by increasing; diminishing; or changing its natural food or stimuli。
〃That is an aliment which nourishes; whatever we find in the organism; as a constant and integral element; either forming part of its structure; or one of the conditions of vital processes; that and that only deserves the name of aliment。〃 〃 I see no reason; therefore; why iron; phosphate of lime; sulphur; should not be considered food for man; as much as guano or poudrette for vegetables。 Whether one or another of them is best in any given case;whether they shall be taken alone or in combination; in large or small quantities; are separate questions。 But they are elements belonging to the body; and even in moderate excess will produce little disturbance。 There is no presumption against any of this class of substances; any more than against water or salt; provided they are used in fitting combinations; proportions; and forms。
But when it comes to substances alien to the healthy system; which never belong to it as normal constituents; the case is very different。 There is a presumption against putting lead or arsenic into the human body; as against putting them into plants; because they do not belong there; any more than pounded glass; which; it is said; used to be given as a poison。 The same thing is true of mercury and silver。 What becomes of these alien substances after they get into the system we cannot always tell。 But in the case of silver; from the accident of its changing color under the influence of light; we do know what happens。 It is thrown out; in part at least; under the epidermis; and there it remains to the patient's dying day。 This is a striking illustration of the difficulty which the system finds in dealing with non…assimilable elements; and justifies in some measure the vulgar prejudice against mineral poisons。〃
I trust the youngest student on these benches will not commit the childish error of confounding a presumption against a particular class of agents with a condemnation of them。 Mercury; for instance; is alien to the system; and eminently disturbing in its influence。 Yet its efficacy in certain forms of specific disease is acknowledged by all but the most sceptical theorists。 Even the esprit moqueur of Ricord; the Voltaire of pelvic literature; submits to the time… honored constitutional authority of this great panacea in the class of cases to which he has devoted his brilliant intelligence。 Still; there is no telling what evils have arisen from the abuse of this mineral。 Dr。 Armstrong long ago pointed out some of them; and they have become matters of common notoriety。 I am pleased; therefore; when I find so able and experienced a practitioner as Dr。 Williams of this city proving that iritis is best treated without mercury; and Dr。 Vanderpoel showing the same thing to be true for pericarditis。
Whatever elements nature does not introduce into vegetables; the natural food of all animal life;directly of herbivorous; indirectly of carnivorous animals;are to be regarded with suspicion。 Arsenic… eating may seem to improve the condition of horses for a time;and even of human beings; if Tschudi's stories can be trusted;but it soon appears that its alien qualities are at war with the animal organization。 So of copper; antimony; and other non…alimentary simple substances; everyone of them is an intruder in the living system; as much as a constable would be; quartered in our household。 This does not mean that they may not; any of them; be called in for a special need; as we send for the constable when we have good reason to think we have a thief under our roof; but a man's body is his castle; as well as his house; and the presumption is that we are to keep our alimentary doors bolted against these perturbing agents。
Now the feeling is very apt to be just contrary to this。 The habit has been very general with well…taught practitioners; to have recourse to the introduction of these alien elements into the system on the occasion of any slight disturbance。 The tongue was a little coated; and mercury must be given; the skin was a little dry; and the patient must take antimony。 It was like sending for the constable and the posse comitatus when there is only a carpet to shake or a refuse…barrel to empty。 'Dr。 James Johnson advises persons not ailing to take ;five grains of blue pill with one or two of aloes twice a week for three or four