Philip Henry Pye-Smith

“ Anyone conversant with a single branch of Natural Science is aware that experiment, as well as observation, is necessary. Who would expect discoveries in physics, or in chemistry, without laboratories and experiments? Do not botanists investigate the functions of plants by dissection, by microscopic and chemical investigation, and by experiment? ”

“ He was a man of science, the friend of Hunter and of Cavendish, an anatomist and natural philosopher. The fruits of Tenner's discovery are spread over the whole earth. This humble village doctor has saved more lives than the most glorious conqueror destroyed, but his name is little honored, and the only monument to his memory has been banished from association with vulgar kings and skillful homicides to an obscure corner of the great city where his only homage is the health and beauty of the children who play around his statue. ”

“ He begins his treatise by pointing out the many inconsistencies and defects in the Galenical theory, quoting the writings of Galen himself, of Fabricius, Columbus and others, with great respect, but with unflinching criticism. For, in his own noble language, wise men must learn anatomy, not from the decrees of philosophers, but from the fabric of nature herself, “nec ita in verba jurare antiquitatis magistrae, ut veritatem amicam in apertis relinquant, et in conspectu omnium deserant.” ”

“ But even such a broad and liberal education, even familiarity with the daily advances of medical science recorded in periodicals and archives and year-books, or transmitted by telegraph to the wondering readers of the daily newspapers, is not all that is needful to make a learned Physician. We know well the difference between reading of an experiment, or even seeing it performed, and doing it with our own hands. ”

“ Galen had discovered that the arteries were not, as their name implies, merely air-pipes, but that they contained blood as well as vital air or spirit. And it had been gradually ascertained that the nerves (νεῠρα) which arose from the brain and conveyed "animal spirits" to the body were different from the tendons or sinews (νεῠρα) which attach muscles to bones. First, then, the physicians of the time of Linacre knew that the blood is not stagnant in the body. So did Shakespeare and Homer, and every augur who inspected the entrails of a victim, and every village barber who breathed a vein. ”

“ They see in the helplessness of the dumb animals an appeal for pity, almost like that of childhood, and are justly indignant with the selfish cruelty so often exercised upon them. All honor to the efforts which have banished so many cruel sports from England; all honor to the society which seeks to prevent cruelty to animals! If it can point to any additional means by which the sufferings of animals in the cause of science can be diminished, we shall be anxious to adopt them. ”

“ The great anatomist Fabricius, Harvey’s teacher at Padua, described the valves of the veins more perfectly than had Sylvius. Carlo Ruini, in his treatise on the Anatomy and Diseases of the Horse (1590) , taught that the left ventricle sends blood and vital spirits to all parts of the body except the lungs—the ordinary Galenical doctrine. Yet on the strength of this phrase Professor J. B. Ercolani actually put up a tablet in the veterinary school at Bologna to Ruini as the discoverer of the circulation of the blood! ”

“ If the art of keeping a community in health is but the application of plain physiological laws, it is no less true that the art of restoring the health, curative as distinct from preventive medicine, rests upon the same basis. In former days the physician was one who recognized what he called the disease of his patient, who referred to his books of precedents as a lawyer to his statutes, and who prescribed a proper remedy to cast out the disease. We now know that disease is, as the name implies, a purely subjective conception. ”

“ He says in the admirable letter to Dr Argent, president of the College of Physicians, which follows the dedication of his treatise to Charles I., that he should not have ventured to publish "a book which alone asserts that the blood pursues its course and flows back again by a new path, contrary to the received doctrine taught so many ages by innumerable learned and illustrious men," if he had not set forth his theory for more than nine years in his college lectures, gradually brought it to perfection, and convinced his colleagues by actual demonstrations of the truth of what he advanced. ”

“ With regard, for instance, to the physiology of the circulation, it is not only curious but instructive to follow its gradual growth from Galen and Vesalius, Columbus, Caesalpinus and Servetus, to Harvey and Lower and Malpighi, to Hales and Vierordt, to Ludwig, to Chauveau and Marey, to Gaskell, and Roy. The only true scientific method is the historical one. If we only know the results of a science without the steps by which they have been reached, we have indeed its practical use, but lose half its educational value. ”

“ Is not this the very excuse which is held valid in the case of sport? Doubtless we ought to be ever mindful of every branch of duty, but such occasional forgetfulness does not show hardness of heart. It is an excusable weakness for a student of medicine to shudder or to faint at the sight of blood, but he learns that this merely physical sensibility becomes selfish and mischievous if indulged: he is taught to suppress all such exhibition of emotion, and to let it stimulate without paralyzing his efforts to relieve. ”

“ Harvey could not discover the capillary channels by which the blood passes from the arteries to the veins. This gap in the circulation was supplied several years later by the great anatomist Marcello Malpighi, who in 1661 saw in the lungs of a frog, by the newly invented microscope, how the blood passes from the one set of vessels to the other. Harvey saw all that could be seen by the unaided eye in his observations on living animals; Malpighi, four years after Harvey’s death, by another observation on a living animal, completed the splendid chain of evidence. ”

“ If the liver, for example, were the possible seat of every tumour described in our college nomenclature of disease, it would be hopeless to attempt the diagnosis of an hepatic growth; if the small intestine were subject to every morbid change which can affect a mucous membrane, we should be lost amid such a crowd of possibilities. But Morbid Anatomy teaches us that each organ has its peculiar liabilities to disease, so that when we have determined the seat of a malady we have gone far towards establishing its nature. ”

“ If you could be persuaded that chemistry can make progress without retorts and balances, that a geologist's hammer is a useless incumbrance, or that engineers can build bridges just as well by the rule of thumb as by the knowledge gained in a workshop, then you might believe that physiology also is independent of experiment. ”

“ For physiology is the study of natural conditions, and must first be studied by physicians, inasmuch as what is normal is healthy, and the rule for its own rightness, as well as for every abnormal deviation therefrom. But when deviations from health, or any abnormal conditions are defined by the light of healthy structures, then pathology, the science of disease, becomes intelligible. Then also from a knowledge of pathology the practice and art of healing, and numberless new methods of treatment, will naturally spring. ”

“ The work on which he had been chiefly engaged at Oxford, and indeed since the publication of his treatise on the circulation in 1628, was an investigation into the recondite but deeply interesting subject of generation. Charles I. had been an enlightened patron of Harvey’s studies, had put the royal deer parks at Windsor and Hampton Court at his disposal, and had watched his demonstration of the growth of the chick with no less interest than the movements of the living heart. Harvey had now collected a large number of observations, though he would probably have delayed their publication. ”

“ There is, I fear, another reason which animates much of the opposition to physiological experiments. It is nothing else than aversion from the methods and the results of science. It may be that an excuse for this dislike has been furnished by the pretense of false science, and the arrogance of much even which is true. But surely no reasonable creature, from such trivial irritation, can deliberately wish to check the progress of accurate knowledge by observation and experiment. ”

“ Again, we can most of us remember using very imperfect physiological knowledge to fix, more or less successfully, the locality of an organic lesion in the brain. I also remember such attempts being described as a mere scientific game, which could only be won after the player was beaten, since when the accuracy of diagnosis was established, its object was already lost; but who would say this now, when purely physiological research and purely diagnostic success have led to one of the most brilliant achievements of practical Medicine, the operative treatment of organic diseases of the brain? ”

“ I would, moreover, exhort Fellows of the College to see that, while all the new methods of Experimental Pathology and of Pharmacology are carried out by duly trained physiologists, we do not neglect the fundamental method taught and practised by Harvey of inspecting the bodies of those who have died of disease. It was this union of Morbid Anatomy with Clinical Observation which made the discoveries of Laennec and of Bright really fruitful. Without these autopsies, clinical medicine is but an empirical art, diagnosis a sham, and treatment little better than quackery. ”

“ Of those persons who answer that they consider vivisection for the sake of sport to be almost as detestable as vivisection for the sake of duty, I would only ask first that they should deal impartially with both offenses, and secondly that since in the one case their opinions are opposed to the practice of genteel society, and in the other to the convictions of all who are qualified to judge, they should at least contemplate the possibility of being mistaken. ”

“ We know that the real difficulty is to ascertain the nature and origin of our patient’s disorder; when that is done, the treatment in most cases is obvious, and in many effectual; when it is not done, our treatment is vacillating, and either futile or mischievous. We have already ample means at our disposal for influencing almost every organ of the body. A new tool is occasionally offered us which deserves proving, but what we want far more is knowledge how to use the tools that we have. ”

“ We, who are familiar with human suffering and sorrow, which our knowledge is all too feeble to prevent, best understand how, in testing some new remedy on a less precious fellow creature than a man, one who is truly humane may be tempted to forget the comparatively trivial suffering of a rabbit or a frog.
But some enthusiastic opponent will say: "I can not pretend to doubt that these experiments are in every sense of the word useful; but we ought not to purchase the benefit they confer by inflicting pain upon innocent creatures. ”

“ If Harvey’s doctrine of the circulation was not new, why was it opposed by men in the position of Riolanus and Hoffmann, and welcomed as a discovery by Bartolinus and Schlegel and Descartes? Surely his contemporaries were better judges of the novelty of his views than we are!
2nd. Admitting that Servetus and Columbus taught the doctrine of the lesser circulation, we need but a moment’s thought to convince us that no complete knowledge of this part of the subject was possible until the existence of a systemic circulation was established; for the one is physically impossible without the other. ”

“ Whatever may be thought of the duty of the state directly to encourage the pursuit of animal and vegetable physiology, one would have supposed that at least what diplomatists call a benevolent neutrality would be shown to a pursuit so laborious and costly, which demands trained workmen and the devotion of a lifetime, which is so important for the national wealth and health, and which, by reason, by experience, and by testimony, we know to be the only guarantee for advance in the various branches of the healing art. ”

“ Let us hope that on the one hand increasing humanity and gentler manners will extend compassion for the lowest of God’s creatures from the educated classes of England and America until it permeates all ranks and all nations ; and that on the other full liberty will be given to the prosecution of researches, laborious and thankless in themselves, but of the utmost value for the relief and prevention of disease in man and brute alike. ”

“ All that the art of medicine can do is to apply a knowledge of natural laws, of mechanics and of hydrostatics, of botany and zoōlogy, of chemistry and electricity, of the behavior of living cells and organs when subjected to the influence of heat and of cold, of acids and alkalies, of alcohols and ethers, of narcotics and stimulants, so as to modify certain deviations from ordinary structure and function which are productive of pain, or discomfort, or death. ”

“ Now, the ambition of every intelligent student—and in Medicine we are life-long students—is to fix upon the most objective, certain, and important of the symptoms of a patient, to follow out this clue, to determine the organ affected and the nature of the affection, so that in his mind’s eye the tissues become transparent and he sees the narrow orifice for the blood-stream and the labouring muscle behind it ”

“ The disease of a host is the health of the parasite, and we cure a human sufferer by poisoning the animals or plants which interfere with his comfort. The same changes which in the old man are the natural steps of decay, the absence of which after a certain age would be truly pathological, are the cause of acute disease in the young. Pathology has no laws distinct from those of physiology.
When these now obvious considerations are thoroughly understood, it clearly follows that all "systems of medicine" are in their very nature condemned. ”

“ No one would easily believe how greatly the viscera are altered by disease, particularly in chronic cases, and how extraordinary the anatomical effects of prolonged sickness often are. Indeed, I am confident that the opening and thorough inspection of one dead body, which has been wasted by slow disease or by infection, is of more real service to the art of healing than the dissection of ten corpses of healthy criminals. ”

“ Still more important is the relation of physiology to the national health. The commonplaces of hygiene which are now, one may be thankful to say, taught, if not practiced, in almost every schoolroom and factory in England, are the direct results of the abstruse researches of Boyle and Priestley, of Lavoisier and Pasteur. Ages of experience did not teach mankind the value of fresh air, or the innocence of clean water. ”