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145 patient must in imagination turn him inside out." This knowledge is manifestly to be acquired from the dead body. We may, therefore, rejoice at the wise unprejudiced laws which afford now such abundant opportunities of dissecting.
Dissection is the third great element in medical and surgical education, and its necessity has never been questioned. The opportunities which are now possessed by students are most abundant, as science has gradually overcome prejudice existing against dissecting the human body since the days of Erasistratus and Herophilus, who first did so. Dissection was first legalized by Henry VIII. in 1540, in a very limited way; and an act passed in the twenty-seventh year of Elizabeth's reign gives the bodies of four executed criminals for that purpose annually. Even within this century popular prejudice ran so high, and diminished so injuriously facilities for dissection, that the illustrious Professor Macartney bequeathed his body for dissection. Under the Anatomy Act, 1832, an inspector of anatomy is appointed for London, the provinces, Ireland, and Scotland. From the poorhouses in Dublin an abundant supply is obtained, which might be supplemented by the unclaimed bodies on which inquests are held. The pauperism which is unfortunately so extensive produces at least this good. The subjects are preserved by injecting through the arteries chloride of zinc, or some other chemical-a secret in some schools-and then these vessels are filled with wax and red lead. In Dublin formerly a body was apportioned to six students, two for the head and neck, two for the chest and arms, and two for the abdomen and legs; but twelve are now accommodated by; the sub-apportionment of these parts. In London eight dissect the same body, the head, neck, and chest being the very disproportionate gift to two students. It is by this method of gaining knowledge that one can see, feel, minutely examine, and
thoroughly understand the regions and organs wherein reside the morbid actions which the professor of the healing art is called on to combat. Thus alone can he comprehend and remember the complicated relations of so many parts crowded together in so small but so intricate a space as the human body; thus is acquired that familiarity with the places in which operations are conducted, and that facility in the use of instruments so essential to their performance. No book knowledge can ever be a substitute. Mr. Guthrie, so many years a member of the Court of Examiners in the London College of Surgeons, used to speak of a candidate who most eloquently described the biceps, yet when shown that familiar muscle he did not recognise it. Is not such a strong argument for a practical method of examination? Above all important is an intimate knowledge of the bones, as they constitute much of the surgeon's care, and without it other anatomical parts cannot be studied with advantage. This knowledge is best gained by reading a description, with the bone in the student's hand. Vesalius used to say, an anatomist should be able to recognise every bone and their important points even when blindfolded. Lord Bacon's advice that a student should thoroughly learn a part or a single disease before attempting the study of another was most sagacious.
With this foundation dissection of the soft parts can be pursued, the skeleton, however, being still constantly referred to. As dissection is doubtless difficult, and anatomical nomenclature imperfect and varied by every book and teacher, the assistance of demonstrators, to teach the method of displaying the relations of the various parts, is indispensable, as otherwise the student's attempts would be mere mangling. Reliance, however, is to be placed by the student on no one save himself. Lectures on the subject must not be underrated, as without them indeed a student's first essays would be fruitless, for in
the theatre the organs and regions, with the best methods of displaying them, are exhibited by one thoroughly accustomed to communicate knowledge. Besides, various practical facts derived from the lecturer's experience or reading are mentioned, and specimens of abnormal and developmental varieties are demonstrated, which cannot fail to make this a most certain as well as agreeable method of instruction. Weights and measures for determining these data of organs and parts, and handy microscopes, should be availablo in every dissecting room, else abnormalities will not be recognised in post-mortems afterwards. By thus exercising every faculty and sense in learning a part, the facts will be fixed on the memory.
Harvey, the Hunters, Liston, and other great lights of the surgical profession, owed all their success to their knowledge of anatomy; and Sir A. Cooper boasted that even in the zenith of his practice he never passed a day “ without dissecting some part of the human body.” Lawrence well illustrates the superiority of anatomical knowledge gained by dissection to that which is theoretical, by comparing it to the knowledge of a traveller who has seen a place, which is clearly more exact than that of him who has merely read a written description. So important is anatomy, that nearly all the great men of our profession attained excellence by its pursuit, yet it is a common thing on the part of those who get into practice by the touting and toadying plan, to decry the demonstrator or teacher of anatomy. The examples of the Hunters, Baillie, Cooper, Brodie, Colles, Crampton, Cusack, Adams, Hargrave, Power, Mayne, and many others, might be readily adduced to abash such detractors.
In all the continental and many of the London schools there is a special professor of pathological anatomy, whose labours are confined to the post-mortem room. This is not wise, for morbid anatomy without the history of the
disease is very useless. As Sir D. Corrigan has said, an architect could ill judge of an intricate building by examining the ruin. The inspection of the body should be made by the physician who has treated the disease. General pathology is, however, somewhat neglected in Dublin. Where there are two professors of medicine or surgery, one should adopt his part of pathology, leaving the practical division to his colleague. As it is so hard to draw the line between the normal and abnormal in such subjects as cell-growth, the constituents of the blood, urine, &c., perhaps general pathology might be added to the physiological chair. Some one of those teachers should establish a laboratory in which morbid products should be examined microscopically and chemically, and the leading practitioners of the city could indirectly contribute to its support.
Physiology, or the science of life, yields to none in interest or importance, for while it tends above all to improve and render positive the healing art, it informs the public on the means for preserving health and consequent happiness. It explains the wondrous mechanism of the actions by which life is carried on, and the derangements which it is the province of medicine to investigate. This subject must be approached with some preliminary knowledge of chemistry, of physics, and of the structure and functions of less complicated beings, otherwise it is confused and most difficult of attainment. Prof. Struthers, the able anatomist, asserts that as much of this science belongs to the invisible, and may be therefore read up, lectures need be only given thrice weekly; but the intelligent instructor in this branch will call to aid experiments, prepared specimens, the external and transparent parts of animals, microscopical sections, diagrams, and applied facts, to illustrate every lecture. Nearly half the candidates for the first half of
the last quarterly examination in the College of Surgeons failed from want of knowledge of physiology, which indicates want of zeal of the teachers of that branch. It was formerly the habit to perform many vivisections of even the higher animals to illustrate the established facts of this science, a practice as cruel as it is unnecessary. As, however, many brilliant discoveries have arisen in this way, vivisections might still be occasionally performed, with the aid of anæsthetics, in instances where benefit to science or mankind was likely to accrue. Brodie thought that physiology was better taught in Great Britain than elsewhere, as its practical uses were kept in view. Disease very often affords spontaneous experiments, as it were, in physiology ; until Sir C. Bell showed that the seventh nerve supplied the superficial muscles of the face for motion, it often suffered division, although innocent of a disease (tic doloreux) attributed to it. This division entailed many a misfortune on the poor patient, and no relief whatever from pain was given. I have elsewhere stated that ignorant homeopaths have perpetuated the error. Gastro-intestinal irritation often produces remote nervous affections which physiology alone could discover, and appropriate treatment may follow. Advances in pathology have invariably been founded on close observation of natural phenomena, and there is no science so calculated to exalt the treatment of disease above mere empiricism. John Hunter found surgery little more than a mechanical art from ignorance of the laws of the vital functions in health and disease. He therefore devoted his whole energies to the study of the laws of life in man and animals, and left surgery a science, having enriched it more than any man who lived before him or after him. I have before endeavoured to show the need there is for educating the masses in physiology; and in the highest studies-theology, mental science, or the fine arts—a knowledge of it is most useful.