首页 >出版文学> Medical Essays>第30章

第30章

  Dowegainanythingbyattemptingtogetridoftheideaofaspecialvitalforcebecausewefindcertainmutuallyconvertiblerelationsbetweenforcesinthebodyandoutofit?Ithinknot,anymorethanweshouldgainbygettingridoftheideaandexpressionMagnetismbecauseofitscorrelationwithelectricity。Wemayconcedetheunityofallformsofforce,butwecannotoverlookthefixeddifferencesofitsmanifestationsaccordingtotheconditionsunderwhichitacts。Itisamistake,however,tothinkthemysteryisgreaterinanorganizedbodythaninanyother。Weseeastonefalloracrystalform,andthereisnothingstrangerlefttowonderat,forwehaveseentheInfiniteinaction。
  Justsofaraswecanrecognizetheordinarymodesofoperationofthecommonforcesofnature,——gravity,cohesion,elasticity,transudation,chemicalaction,andtherest,——weseetheso-calledvitalactsinthelightofalargerrangeofknownfactsandfamiliaranalogies。Matteuecci’swell-rememberedlecturescontainmanyandstrikingexamplesoftheworkingofphysicalforcesinphysiologicalprocesses。Whereverrigidexperimentcarriesus,wearesafeinfollowingthislead;butthemomentwebegintotheorizebeyondourstrictobservation,weareindangeroffallingintothosemechanicalfollieswhichtruesciencehaslongoutgrown。
  Recognizingthefact,then,thatwehavelearnednothingbutthemachineryoflife,andarenonearertoitsessence,whatisitthatwehavegainedbythisgreatdiscoveryofthecellformationandfunction?
  ItwouldhavebeenrewardenoughtolearnthemethodNaturepursuesforitsownsake。IfthesovereignArtificerletsusintohisownlaboratoriesandworkshops,weneednotaskmorethantheprivilegeoflookingonathiswork。Wedonotknowwherewenowstandinthehierarchyofcreatedintelligences。Weweremadealittlelowerthantheangels。Ispeakitnotirreverently;astheloweranimalssurpassmaninsomeoftheirattributes,soitmaybethatnoteveryangel’seyecanseeasbroadlyandasdeeplyintothematerialworksofGodasmanhimself,lookingatthefirmamentthroughanequatorialoffifteeninches’aperture,andsearchingintothetissueswithatwelfthofaninchobjective。
  Butthereareotherpositivegainsofamorepracticalcharacter。
  Thuswearenolongerpermittedtoplacetheseatofthelivingactionsintheextremevessels,whichareonlythecarriersfromwhicheachparttakeswhatitwantsbythedivinerightoftheomnipotentnucleatedcell。Theorganismhasbecome,inthewordsalreadyborrowedfromVirchow,“asumofvitalunities。“Thestrictumandlaxum,theincreasedanddiminishedactionofthevessels,outofwhichmedicaltheoriesandmethodsoftreatmenthavegrownup,haveyieldedtothedoctrineoflocalcell-communities,belongingtothisorthatvasculardistrict,fromwhichtheyhelpthemselves,ascontractorsarewonttodofromthenationaltreasury。
  Icannotpromisetodomorethantoselectafewofthepointsofcontactbetweenourignoranceandourknowledgewhichpresentparticularinterestintheexistingstateofourphysiologicalacquisitions。SomeoftheminvolvethemicroscopicdiscoveriesofwhichIhavebeenspeaking,somebelongtothedomainofchemistry,andsomehaverelationswithotherdepartmentsofphysicalscience。
  Ifweshouldbeginwiththedigestivefunction,weshouldfindthatthelong-agitatedquestionofthenatureoftheacidofthegastricjuiceisbecomingsettledinfavorofthelactic。Butthewholesolventagencyofthedigestivefluidentersintothecategoryofthatexceptionalmodeofactionalreadyfamiliartousinchemistryascatalysis。Itisthereforedoublydifficultofexplanation;
  first,asbeing,likeallreactions,afactnottobeaccountedforexceptbytheimaginativeappealto“affinity,“andsecondly,asbeingoneofthosepeculiarreactionsprovokedbyanelementwhichstandsoutsideandlooksonwithoutcompromisingitself。
  ThedoctrineofMulder,sowidelydiffusedinpopularandscientificbelief,oftheexistenceofacommonbaseofallalbuminoussubstances,theso-calledprotein,hasnotstoodthetestofrigorousanalysis。Thedivisionoffoodintoazotizedandnon-azotizedisnodoubtimportant,buttheattempttoshowthatthefirstonlyisplasticornutritive,whilethesecondissimplycalorifacient,orheat-producing,failsentirelyinthefaceofthefactsrevealedbythestudyofmanindifferentclimates,andofnumerousexperimentsinthefeedingofanimals。Imustreturntothissubjectinconnectionwiththerespiratoryfunction。
  Thesugar-makingfacultyoftheliverisanother“catalytic“mystery,asgreatastherestofthem,andnogreater。Liver-tissuebringssugaroutoftheblood,oroutofitsownsubstance;——why?
  QuiaestineoVirtussaccharitiva。
  Justwhatbecomesofthesugarbeyondthefactofitsdisappearancebeforeitcangetintothegeneralcirculationandsweetenourtempers,itishardtosay。
  Thepancreaticfluidmakesanemulsionofthefatcontainedinourfood,butjusthowthefattyparticlesgetintothevilliwemustleaveBruckeandKollikertosettleiftheycan。
  Noonehasshownsatisfactorilytheprocessbywhichtheblood-
  corpusclesareformedoutofthelymph-corpuscles,norwhatbecomesofthem。Thesetwoquestionsarelikethosefamoushouseholdpuzzles,——Wheredothefliescomefrom?and,Wheredothepinsgoto?
  Thereisaseriesoforgansinthebodywhichhaslongpuzzledphysiologists,——organsofglandularaspect,buthavingnoducts,——thespleen,thethyroidandthymusbodies,andthesuprarenalcapsules。
  Wecallthemvascularglands,andwebelievethattheyelaboratecoloredanduncoloredblood-cells;butjustwhatchangestheyeffect,andjusthowtheyeffectthem,ithasprovedaverydifficultmattertodetermine。SoofthenotedglanduleswhichformPeyer’spatches,theirpreciseoffice,thoughseeminglylikethoseofthelymphaticglands,cannotbepositivelyassigned,sofarasIknow,atthepresenttime。Itisofobviousinteresttolearnitwithreferencetothepathologyoftyphoidfever。Itwillberemarkedthatthecoincidenceoftheirchangesinthisdiseasewithenlargementofthespleensuggeststheideaofasimilarityoffunctioninthesetwoorgans。
  Thetheoriesoftheproductionofanimalheat,fromthetimesofBlack,Lavoisier,andCrawfordtothoseofLiebig,arefamiliartoallwhohavepaidanyattentiontophysiologicalstudies。ThesimplicityofLiebig’sviews,andthepopularforminwhichtheyhavebeenpresented,havegiventhemwidecurrency,andincorporatedtheminthecommonbeliefandlanguageofourtext-books。Directoxidationorcombustionofthecarbonandhydrogencontainedinthefood,orinthetissuesthemselves;thedivisionofalimentarysubstancesintorespiratory,ornon-azotized,andazotized,——thesedoctrinesarefamiliareventotheclassesinourhigh-schools。Butthissimplestatementisboldlyquestioned。Nothingprovesthatoxygencombinesinthesystemwithhydrogenandcarboninparticular,ratherthanwithsulphurandazote。Suchisthewell-
  groundedstatementofRobinandVerdeil。“Itisveryprobablethatanimalheatisentirelyproducedbythechemicalactionswhichtakeplaceintheorganism,butthephenomenonistoocomplextoadmitofourcalculatingitaccordingtothequalityofoxygenconsumed。“
  TheselastarethewordsofRegnault,ascitedbyMr。Lewes,whoseintelligentdiscussionofthisandmanyofthemostinterestingphysiologicalproblemsIstronglyrecommendtoyourattention。
  Thissingleillustrationcoversawidergroundthanthespecialfunctiontowhichitbelongs。Wearelearningthatthechemistryofthebodymustbestudied,notsimplybyitsingestaandegesta,butthatthereisalongintermediateseriesofchangeswhichmustbeinvestigatedintheirownlight,undertheirownspecialconditions。
  Theexpression“sumofvitalunities“appliestothechemicalactions,aswellastootheractionslocalizedinspecialparts;andwhenthedistinguishedchemistswhomIhavejustcitedentitletheirworkatreatiseontheimmediateprinciplesofthebody,theyonlyindicatethenatureofthatprofoundandsubtileanalysiswhichmusttaketheplaceofallhastygeneralizationsfoundedonacomparisonofthefoodwithresidualproducts。
  Iwillonlycallyourattentiontothefact,thattheexceptionalphenomenonofthelaboratoryistheprevailinglawoftheorganism。
  Nutritionitselfisbutonegreatcatalyticprocess。Asthebloodtravelsitsrounds,eachpartselectsitsappropriateelementandtransformsittoitsownlikeness。Whethertheappropriatingagentbecellornucleus,orastructurelesssolidliketheintercellularsubstanceofcartilage,thefactofitspresencedeterminestheseparationofitsproperconstituentsfromthecirculatingfluid,sothatevenwhenwearewoundedboneisreplacedbybone,skinbyskin,andnervebynerve。
  Itishardlywithoutasmilethatweresuscitatetheoldquestionofthevisinsitaofthemuscularfibre,sofamousinthediscussionsofHallerandhiscontemporaries。Speakinggenerally,IthinkwemaysaythatHaller’sdoctrineistheonenowcommonlyreceived;namely,thatthemusclescontractinvirtueoftheirowninherentendowments。
  ItistruethatKollikersaysnoperfectlydecisivefacthasbeenbroughtforwardtoprovethatthestriatedmusclescontractwith。
  outhavingbeenactedonbynerves。YetMr。Bowman’sobservationsonthecontractionofisolatedfibresappeardecisiveenoughunlessweconsidertheminvalidatedbyDr。LionelBeale’srecentresearches,tendingtoshowthateachelementaryfibreissuppliedwithnerves;
  andastothesmoothmuscularfibres,wehaveVirchow’sstatementrespectingthecontractilityofthoseoftheumbilicalcord,wherethereisnotatraceofanynerves。
  Intheinvestigationofthenervoussystem,anatomyandphysiologyhavegonehandinhand。Itisverysingularthatsoimportant,andseeminglysimple,afactastheconnectionofthenerve-tubes,attheiroriginorintheircourse,withthenerve-cells,shouldhavesolongremainedopentodoubt,asyoumayseethatitdidbyreferringtotheverycompleteworkofSharpeyandQuaineditionof1849,thehistologicalportionofwhichiscordiallyapprovedbyKollikerhimself。
  SeveralmostinterestingpointsoftheminuteanatomyofthenervouscentreshavebeenlaboriouslyandskilfullyworkedoutbyarecentgraduateofthisMedicalSchool,inamonographworthytostandinlinewiththoseofLockhartClarke,Stilling,andSchrodervanderKolk。IhavehadtheprivilegeofexaminingandofshowingsomeofyouanumberofDr。Dean’sskilfulpreparations。Ihavenospacetogiveevenanabstractofhisconclusions。Icanonlyrefertohisproofofthefact,thatasinglecellmaysenditsprocessesintoseveraldifferentbundlesofnerve-roots,andtohisdemonstrationofthecurvedascendinganddescendingfibresfromtheposteriornerveroots,toreachwhathehascalledthelongitudinalcolumnsofthecornea。ImustalsomentionDr。Dean’sexquisitemicroscopicphotographsfromsectionsofthemedullaoblongata,whichappeartometopromiseanewdevelopment,ifnotanewepoch,inanatomicalart。
  Ithavingbeensettledthatthenerve-tubescanverycommonlybetraceddirectlytothenerve-cells,theobjectofalltheobserversinthisdepartmentofanatomyistofollowthesetubestotheirorigin。Wehaveaninfinitesnarloftelegraphwires,andwemaybereasonablysure,that,ifwecanfollowthemup,weshallfindeachofthemendsinabatterysomewhere。Oneofthemostinterestingproblemsistofindtheganglionicoriginofthegreatnervesofthemedullaoblongata,andthisistheendtowhich,bytheaidofthemostdelicatesections,coloredsoastobringouttheirdetails,mountedsoastobeimperishable,magnifiedbythebestinstruments,andnowself-recordedinthelightofthetruth-tellingsunbeam,ourfellow-studentismakingasteadyprogressinalaborwhichIthinkbidsfairtorankwiththemostvaluablecontributionstohistologythatwehavehadfromthissideoftheAtlantic。
  Itisinterestingtoseehowoldquestionsareincidentallysettledinthecourseofthesenewinvestigations。Thus,Mr。Clarke’sdissections,confirmedbypreparationsofMr。Dean’swhichIhavemyselfexamined,placedthefactofthedecussationofthepyramids——
  deniedbyHaller,byMorgagni,andevenbyStilling——beyonddoubt。
  Sothespinalcanal,theexistenceofwhich,atleastintheadult,hasbeensooftendisputed,appearsasacoarseandunequivocalanatomicalfactinmanyofthepreparationsreferredto。