The obstacles which have of late years been thrown in the way of anatomical pursuits are of a serious nature and likely if not soon removed, ultimately to put an end to the study of anatomy altogether.
It is of importance that this subject should be discussed for the purpose of inducing physicians to do all in their power to eradicate the prejudice that exists against it, and to convince the public of the injurious consequences which would result if so useful a branch of knowledge should cease to be cultivated.
The value of any art or science should be determined by the tendency it has to increase the happiness, or to diminish the misery, of mankind.
In how great a degree a knowledge of anatomy can effect either of these objects, I shall now proceed to enquire. Anatomy may be said to have two divisions: the first, which teaches us the condition of the different parts of the human body in health; the second, commonly called morbid anatomy, by which we become acquainted with the nature of the changes which take place in those parts from disease.
A student on commencing his anatomical studies is informed, first, of the existence of parts of which, he had never before heard; and having acquired a knowledge of their existence, then proceeds to learn the different circumstances relating to them – as their situation, external appearance, use &c.
As for instance, a student, on examining a body for the first time, sees, in the cavity of the abdomen, a bag or pouch, distended, or not, as it may happen; he is told it is the stomach.—He marks its situation, colour, figure and texture; and then, from a knowledge of these circumstances, is led to inquire respecting its use.
This, I am aware, is not to be learned from dissections only;—other means must be had recourse to, which, however would never had been suggested , if the anatomy of the organ had not been thoroughly understood.
Again, a student dissects the integuments from the front of the chest; he sees a muscle, is informed of its name, learns its origin, insertion, use, and the direction its fibres take, and so on of the different parts and organs of the human body.
A knowledge of this part of anatomy is of use in two respects; first, without it nothing can be known of morbid anatomy; and without morbid anatomy, as I shall presently show, the nature of disease can never be understood; secondly, it is indispensable to the treatment of many surgical cases, and the performance of most surgical operations.
Take, for example, a simple fracture of the bones of the leg; look at the treatment of such a case buy a man ignorant of the principles of practice, and which principles can only be accurately applied just as he may be acquainted with the origin and insertion of the different muscles exerting an influence on the fracture, in order that he may place them in a passive state, and by that means be enabled to keep the ends of the bones in accurate opposition; without some such knowledge, the suffering of the patient might be prolonged to an indefinite period, and fatal consequences in the end result from what, under proper management, would have terminated favorably, These observations apply equally to most cases of fractures.
By persons ignorant of the bones and muscles in the neighborhood of joints, dislocations will seldom be detected, or ever reduced; and thus cases which with a proper degree of skill and attention, are perfectly simple and easy of treatment, will, without it, be attended with the most serious results to the unfortunate sufferers.
As for surgical operations, it would be as natural to expect an individual who had never learnt or heard of German in his life to read and speak that language, as it would be to think that a surgeon could operate on parts, of the anatomy of which he was entirely ignorant; the one case is not more preposterous than the other.
Life, in many cases, depends on the prompt performance of surgical operations: these are the only means by which it can be saved, yet, if a surgeon has not had the power of acquiring anatomical knowledge, death will occur; when, by one acquainted with the subject, it might easily have been prevented.
I have now been considering a knowledge of the state and situation of the various parts of the human body in health;—I have alluded to its importance, as far as relates to a clear conception of the changes which take place from disease, and have spoken of its importance, as far as concerns the mechanical treatment of various accidents, and the performance of various mechanical operations.
I shall now proceed to the consideration of a still more important part of the subject. I mean morbid anatomy, which every scientific surgeon and physician will studiously cultivate – as, by acquaintance with it, the former will know when operations ought to be performed, and when to be avoided; and the latter, that on it alone could be founded any rational knowledge of the nature and treatment of disease.
Any one who takes a survey of the history of medical science, will be struck with the diversity of opinion that has existed in all ages respecting disease;—theories out of number, on almost every disorder, have been put forth, which lasted for a time, and then passed away, and are only mentioned at the present day, to illustrate the ignorance of the ages in which they were invented.
But, on an examination into the causes of this continual change of opinion on medical subjects, it will not be found very difficult of solution; a theory is good or bad, in proportion to the extent and correctness of the facts and observations on which it is founded.
On what were the theories to which I have before alluded founded? On mere conjecture in most cases; and in others, on the most narrow observation. Within a few years, opinions equally absurd as those of the ancients were held by individuals in this country; they are, however, dying away.
A change has taken place; and to what can we attribute it, if not to the more accurate views of pathology obtained by means of morbid anatomy?
Look at any part of the field of disease: take fevers, for example, and see the light which has of late years been thrown on it. We might go over the whole range of the diseases that are known, and though some are still very obscure, yet the improvement which has taken place in others, and the means by which it has been effected, are quite sufficient to convince any one, that in proportion as this branch of knowledge is cultivated, so will the obscurity and uncertainty attending disease be removed.
It will hardly be necessary to say, that by repeated dissections alone can a knowledge of anatomy be acquired.
Anatomical plates and preparations may assist, and some aid may be obtained from comparative anatomy; but it is from the dead body alone that real anatomy can be learned; and let those whose indignation is sometimes raised against persons pursuing this branch of knowledge only reflect for a moment on the nature of the pursuit, and they will soon be persuaded that it is only from absolute necessity that it is followed, from the impossibility of learning the surgical science without it.
In addition to the labour necessary to understand and remember what is dissected, there is the unwholesomeness of the occupation, and the danger incurred even by the most careful, from accidents, which in a broken up constitution, not unfrequently [sic] prove fatal.
Morbid anatomy is to be learned from post mortem examinations of individuals who have laboured under disease: to render it of much use, the previous history of the case should be known; and this cannot be done, unless the symptoms were accurately recorded at the time they were apparent;—on histories collected from friends, and written from recollection, very little dependance [sic], comparatively speaking, can be placed.
These remarks apply equally to post mortem examinations, which should be recorded at the time they were made, or as soon after as possible.
In one word, it being admitted that the science of anatomy is in a preeminent degree conducive to the happiness, and also that dissection of subjects is the best means of acquiring a knowledge of the science, it would be desirable to this end, that subjects should be attainable with the least possible difficulty. The legislature should never interfere, but to promote, the facility of obtaining subjects, and ought to exert itself to remove from the minds of the people all prejudices which have a tendency to destroy the general happiness of the nation.
But there is little hope of enlightening the people on this subject, until they are convinced that physicians are willing to have their own bodies carried to the dissecting room.
Let it but become a general practice for physicians, to give their bodies by will, for dissection and the prejudice existing on the subject will soon be done away; and it will be as common for persons to request that their bodies may be dissected, as it now is, for them to beg that their graves may be guarded, against the resurrectionist.
