Physiology: preliminary course lectures

PRELIMINARY COURSE LECTURES.

LECTURE I.

THE INFLUENCE OF PHYSIOLOGY UPON PRAC-
TICE AND UPON THE PRACTITIONER.

The Address Introductory to the Course on Physiology at the Medical
College of Ohio, September 1, 1878.

CONTENTS.

Dr. Jacob Primrose-The Exercitatio de Motu Cordis, etc.-Science vs.
Practice-The Fallacy of Experience-Some Old Receipts-Opinions
of Noted Men-Sterne, Shakespeare and Molière-The Royal Touch
and the Caul-Contributions of Physiology to Practice-The Uni-
versity of Naples-The Modern Physician-Gladstone's Response
-Harvey and Haller-Characteristics of Physiologists.

Nobody in this hall ever heard, I venture to say, of Dr.
Jacobus Primerosius. But Primrose made a good deal of
noise in his day, and many were they who thought him a
great physician. I pick out Primrose to-night from among
all the notabilities of his time because he was a representative
man. He made himself the exponent of his class. When
the immortal Harvey proclaimed that startling truth about
the circulation of the blood, which electrified the every-day
world as well as the world of science and our branch of it to
such degree that physicians met in counsel and gravely
looked in each others faces and distressedly asked "what is
now to become of us?" Primrose arose and said: "Pah! The
Ancients made good cures before Harvey was born."

Thereupon Primrose proceeded to put Harvey down.
Harvey had worked twenty years over his study before he

could solve it to his own satisfaction. Then only did he preach his doctrine. He worked on nine years more. He repeated all his old experiments. He made new ones. He called in all his friends whom he considered competent and secured their confirmation. Then only did he publish it. Harvey was fifty years old, it was in 1628, when he published this first and of all the most brilliant triumph of experimental physiology. It was written in the purest spirit of science, expressed with an accuracy the most rigid and impressed with a modesty all through it in accord with its title. He called it

“An Attempt.”

It was only a short manuscript, seventy-two pages in all, a fact in itself which put it in wonderful contrast to the gigantic folios of speculation composed at that time. There is a spirit of reverence all through it for the labors of his predecessors, especially for those of Galen. It lies now, the original paper, upon the shelves of the British museum; as to the truths contained in it, what child but knows that its heart beats with pulses of blood. There followed after Harvey in later years the next great man in physiology. This man, a Swiss, Albert Haller by name, said of Harvey: "His name is second only to Hippocrates." "Libellus aureus,” he said of his book.

Primrose felt towards Harvey, the keen envy of ignorance and pretense towards solid knowledge and sound truth. He hurried out his book under a high-sounding title in just fourteen days. The same Haller said of it: "It is subtle in cavil, in experiment empty." Harvey never noticed it

at all.

I would like to use this incident in illustration of the subject of my theme. Had the respective studies of these two men, Primrose and Harvey (I will scarcely be pardoned now

SCIENCE VS. PRACTICE.

for mentioning their names together), anything to do with their characters as men and physicians.

Besides this vindication of the study of physiology I would like to use the opportunity to speak of the influence of physiology upon practical medicine as well as upon the status of the medical practitioner.

Science vs. Practice.

It may seem strange to the non-professional observer that there could be any possible question as to the general use of physiology. A man would hardly entrust his watch for repair to an operator who was not familiar with its mechanism and the manner of its work when in good working order, but there are those in the profession now, hard as it sounds, just as there were in Harvey's day, who believe, or affect to believe, that scientific investigation unfits a man for practice. John Aubrey, who was at Harvey's funeral and “helpt to carry him into the vault," writes: "I have heard him (Harvey) say, that after his booke of the Circulation of the Blood came out, he fell mightily in his practice, and t’was believed by the vulgar that he was crack-brained; and all the physitians were against his opinion and enoyed him. All his profession would allow him to be an excellent anatomist, but I never heard of any that admired his therapeutique way. I knew several practitioners in this town (London) that would not have given 3d. for one of his bills (prescriptions), and that a man could hardly tell by one of his bills what he did aime at." We shall see shortly how much to be admired was the "therapeutique way" of Harvey's contemporaries.

It is meet that we should consider these questions now while we stand on the threshold. If we can become fully convinced of the use of its study we shall enter with more

THE FALLACY OF EXPERIENCE.

earnest zeal. Nothing so dampens enthusiasm, so hampers progress, as doubt of the utility of the work.

I might, if I chose, content myself with merely pointing to the discovery of the circulation, the event which marked a new era in practical medicine. The skeptic must shut his eyes on this discovery before he can discuss the question at all.

Is there any disease or accident incident to man in the recognition or treatment of which we do not hold this element in mind like letters of the alphabet in reading the page. Take coarser facts. Could any one diagnosticate the character of a valve disease of the heart without a knowledge of the round of the circulation. Does not the treatment of wounded arteries or diseased, as in aneurism, by placing ligatures on the vessels between the heart and the accident or disease rest upon this established course of the torrent of blood. "The active mind of John Hunter," says Mr. Hodgson, "guided by a deep insight into the powers of the animal economy, substituted for a dangerous and unscientific operation, an improvement founded upon a knowledge of those laws which influence the circulating fluids and absorbent system; and few of his brilliant discoveries have contributed more essentially to the benefit of mankind."

But I do not wish to rely for our foundation simply upon the great corner stone. I would rather upon this occasion enter into some details that you may be impressed the more firmly, that rational practice is based on the disclosures of physiology, that you may be convinced that the art of medicine, practice, is, or is fast becoming, but a dependent upon its science, physiology.

The Fallacy of Experience.

Before any knowledge was possessed of the physiological

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