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was accepted as a satisfactory explanation of combustionfor three-quarters of a century. But Stahl felt in a confused,dim, strenuous way that the facts of life-the selective,coordinating, prearranging processes presented by thehumblest animal or plant-were not to be accounted for bythe play of mechanical or chemical forces. So strong werehi, convictions on this point that his Arche, or VitalPrinciple, dispensed altogether withmechanics and chemistry.It was a metaphysical figment, involving error at the least asgross as that against which he contended; but within thehusk lay the germ of an all-important truth.

Later in the eighteenth century the discoveries of Black,Cavendish and Lavoisier fulfilled the preliminary conditionsfor the evolution of biology as a distinct science. Haller,Hunter, Bichat and others brought that science to the birth.From that time to this it has become more and more plainthat physics, chemistry, biology each has its own domain,its own methods, its own body of inductions, each of thelatter terms in the series using the results of its predecessorand adding new results of its own. Life is a structure built

up of physical and chemical facts. Yet to the building, tothe arrangement, to the ordering of those facts there goessomething that neither physics nor chemistry can explain anymore than algebra can explain the behaviour of a magnet.To strive to interpret the series of events which make up thelife of an animal in terms of chemical metabolism or of con-servation and expenditure of energy is an endeavour which willfail ; though it is a useful endeavour, because only thus canwe eliminate what remains. That something remains thegreatest of living British physicists has recently assured us.The admitted insufficiency, to take one instance from athousand, of Lavoisier’s theory of combustion to account forthe phenomena of animal heat, the admitted necessity ofseeking in the nervous system for a thermotaxic centre orcentres to account for the amazing adjustments of the

organism to changes of temperature in the environment,were enough to convince the biologist that though hereceives his building material from the physicist he mustconstruct the edifice for himself.The history of medicine is a strange and fascinating though

sometimes a melancholy record. We see in the fifth centurybefore our era a man of genius, gifted with that marvellousunion of the observing eye with constructive imaginationwhich astounds us in the sculptors of the Parthenon, buildingup without science, without anatomy, the fabric of medicalart of which what we still practise is but the enlargement.Inheriting from the priestly guild from which he sprang avast store of observations, and adding yet more of his own,Hippocrates was guided in dealing with them by two funda-mental principles-(l) that diseases, like other phenomena ofnature, follow a natural sequence ; (2) that the organism ofman, however complex, is yet an individual whole, each

part receiving and impressing reactions on every other.After Aristotle and Galen had done their work long cen-turies ensued of blind and sterile routine, followed by a periodof acute but one-sided analysis. By the help of such analysisit may be that the Hippocratic synthesis will be again builtupon a more enduring basis. The ideal perfection of medicalart rests upon an equally ideal perfection of the science ofhuman nature, summed up in complete knowledge of our

organism and of the influences that act on it. The goal isunattainable, yet till it be approached the physician must becontent with empirical knowledge of an infinite array of

facts-biological, psychological, ethical, which, though cer-tain as mathematics, yet do not admit of quantitativedetermination. It is only within the last generation thatthe word "subjective" " has become familiar to the bio-

logist. As the student of sensory organs deals withsome of these subjective facts, so does the student ofhuman passions deal with others, for these, no less thansensations, are functions of our organism. To determine theway in which this or that man will be affected by any morbidprocess without taking account of such facts is assuredlyimpossible. They must be taken into account at all costs ;if not by scientific process, then by wise empirical instinct.I shall conclude with saying that as medical art has beenaffected by the rise of physics and chemistry in the seven-teenth and eighteenth centuries, so will it be affected by thescientific sociology of the nineteenth and the twentieth. Nottill science has fully embraced every aspect of human life canmedical art, as founded upon science, hope to be complete.But at the dawn of modern science in the seventeenthcentury the dazzling brilliance of mathematical and physicaldiscovery led the keen and daring minds of whom I have

been speaking to the belief that all phenomena with whichthe physician deals could be spoken of in terms of mechanics.It was a legitimate and inevitable stage in the progress ofthe human mind. Without it the later stages.would have beenimpossible. It initiated the great discovery of Harvey, whomnot merely we, but future generations, will continue to venerateas the principal founder of scientific medicine.

LectureON

ANATOMY AS A SCIENCE AND IN RELATIONTO MEDICAL STUDY.

Delivered at the Opening of the Medical Session in theUniversity of Glasgon, Oct. 18th, 1892,

BY JOHN CLELAND, M.D., L.R.C.S. EDIN. &c.,PROFESSOR OF ANATOMY AT THE UNIVERSITY.

(Concluded from page 929.)

As in every other branch of science, including the scienceof medicine itself, so also in anatomy the lowest stageconsists of observation, either direct and simple, or aided byartificial helps. This is the stage of "phenomenology," as ithas been aptly called ; and although deservedly described asnot in itself rising to the dignity of science, it is funda-

mental, all the rest being superstructures whose validitydepends on the soundness of the observations on whichit rests. It has, moreover, this dignity and educational

value, that it requires for its prosecution a faculty which,like every other faculty, must be trained to do goodwork, and one which cannot be neglected without detri-ment to the mind as an instrument for discovering truth. Thefaculty of observation is that by which attention is delibe-rately bestowed on details appreciated by the senses ; bywhich also they are accurately and consciously recognised andrecorded in the memory, so as to serve as data for guidance infurther observation. The artisan and scientist train it, eachin his own line ; but in general education it is very oftenneglected, while the jaded memory is brought to the front.From observation the mind passes on to reflection; and, justas in the development of the individual mind, so in the growthof every science, the accumulation of facts leads to inquiryinto their meaning. Then generalisations and meaningslearned as explanations of phenomena demand in turn to bethemselves explained, till at last studies which had becomemore and more distinct as they diverged into territories openingbefore them meet again as from different sides they are broughtinto contact with the inscrutable problems of being. But

though the progress of science may be analysed into stages,it is not to be supposed that these are practically altogetherdistinct. Anatomy having come into being in the service ofphysiology, has busied itself from the commencement withquestions of final cause, the uses which organs serve in the

economy. It never had a prephysiological era; it was impos-sible at the outset to consider structure apart from function,and inasmuch as structure cannot have come into developedexistence, either in the individual or in its totality, except bythe operation of function, any more than function can existwithout structure, anatomy and physiology cannot be per-manently dissociated. Vesalius saw clearly, and I supposehe was the first to do so, that a temporary retreat fromphysiological considerations was necessary for anatomicalprogress. He seems to have appreciated that there was

nothing constant in the human body, however purposeless itmight seem to be, which was not worthy of close inspectionand accurate description. The importance of anatomicalfact lay to him in its constancy. Doubtless in later times,heavy and painful description has often been elaborated andtaught to students as important, in a way which furnishes agood discipline to them, by men who have simply run in thegrooves which others have made who have thought thatin carrying elaboration further for its own sake they weremaking the highest advances possible,-worthy men incapableof looking below the surfaces of things, though full of thepeaceful enjoyment which comes to the honest worker. Buttoinitiate a system of elaboration which requires generations to

carry out is a different thing, and denotes faith that it will

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lead to something more ; and this was the position of IVesalius. One of those men who seem to have had a feverfor hard work, directed even in boyhood to anatomy, he wascapable of enjoying the luxury of the courts of Charles V.and his son Philip of Spain, and leaves evidence in the trulywonderful illustrations of his masterpiece, " De CorporisHumani Fabrica," of a keen enjoyment of artistic beauty ofform and the appreciation of it as pervading internal structure.But the work stands out mainly as a monument of a new ideaof precision of observation and accuracy of detail, contrastingwith what went before and laying the foundations of descrip-tive anatomy apart from physiology.

It is not till modern times that we find anatomy rising tothe conception of a rational morphology. It is only in moderntimes that the word "morphology" makes its appearance.During the last decade or so it has been a good deal employed inan altogether unnecessary way as a mere synonym for anatomyas opposed to physiology. Such a use of the word is to becondemned. The word is not morphography, but morphology,and means not the description of forms, but the study oftheir relations one to another-morphological and not topo-graphical relations. These relationships are of different kinds.There is a symmetrical correspondence of right and left sides,obvious to the eye but as yet never grappled with in its causa-tion. There is sexual correspondence, or the fundamentalidentity of organs differently developed in the two sexes, acorrespondence 10 a certain extent vaguely appreciated evenby the old anatomists. More remarkable are two otherkinds-viz., the serial correspondence of different parts inone animal and the correspondence of parts in differentanimals. One digit manifestly repeats another. The lower limbalso manifestly repeats to a considerable extent the upper, andthe mind is led on to compare the two more and more indetail. Architectural harmonies throughout the whole bodybecome apparent-in some instances so obvious that at firstit does not seem necessary to remark upon them ; in othersso questionable that further research is required to ascertainif they are real ; and even when a correspondence undoubtedlyexists there may be questions as to its details. For example,a part of the hand obviously corresponds with the heel ; butit requires a good deal of investigation to settle precisely howmuch of the hand corresponds with the heel-bone. Theseinquiries cannot be successfully carried out unless we lookat corresponding structures in different animals, and it isa matter of fact that it was only when comparative anatomycame to be systematically studied that these inquiries beganto be made. Besides this, it is really the same sort of task tomake a just comparison of the bones of the skull of a fish withthose of the human skull as it is to arrive at the morphologicalrelations of the skull to the vertebral column in man. Thus,pure human anatomy rises to a higher than a mere observa-tional stage, and leaves physiology for a time only to finditself part and parcel of a larger science of which thE

study of the lower animals forms a necessary portion. Atthis stage it has not reached its highest level, but it has

gained a vantage ground from which the mind is influencedin its whole conception of animated nature. There spring,up, as there sprang up before the eye of Geoffroy St. Hilaire,a vivid view of what he called the unity of organisation-aunity which has to be recognised in many details before th(questions can be profitably asked, "How did such unity comEto be, and how did the objects come to exist in which iiis exhibited?"Doubtless the same unity in variety which is studiec

in homology of structure pervades other things as well.Time and chance have their influence on everything,and the researches of the philologist into the origins ancaffinities of words and languages display in like manner thEderivation of the complex from the elementary and of dissimilars from common origin. Perhaps simpler illustration;of gradual variation, evolution and degeneration are furnishecby the history of architecture, and illustrations even mor<

familiar are abundant in the history of dress. The hatscoats, and boots of the present day cannot be accounte<for without knowing those which have preceded thenand the influences which have operated to produce changePerhaps you think that because fashion is largely founclecon caprice its changes are sufficiently accounted for battributing them to that cause. But caprice itself is subject to law-namely, to the causation of antecedence an(environment, and every shape of garment is descended fronanother which leaves its mark on it. The lapels of dresscoats, with useless nicks and jagged points and impossiblebutton-holes without buttons to match, are the vestigia

remains of fronts which buttoned across the chest, collars that tprotected the neck, and the space left for the chin when thebreast was buttoned and the collar up. Thus, also, there isnot a discovery, not an act, not a thought which is notevolved from its antecedents, both external and internal tothe thinking agent; but the homologies of living structure,whether animal or vegetable, have their special interest inbeing, not the result of the succession of human ideas, likethe homologies of words and clothes and buildings and manyother things, but part of the order of growth by which theorganisms exhibiting them exist. There are three ascendingseries of forms which demand attention in the prosecution ofthe higher anatomy-viz., first, that passed through from theearliest stages of existence, the embryological series ; secondly,the adult forms at present existing, from the lowest to thehighest, constituting the comparative anatomy series ; and,thirdly, the forms existing in different geological epochs-the palaeontological series. The last is so imperfect at the best,and so almost disappeared as regards soft textures, thatits relics stand out only as guides to what has been whenthey are translated by that which now exists. Thus it is

present forms which in their adult diversities and their moresimilar early stages furnish the field from which the data forthe higher anatomy are derived. Not otherwise than with

eyes ready to consider all can the purely morphological investi-gation of the architectural meaning of parts be properlycarried on and the steps of evolution from the simple to thecomplex be rightly understood. But pure morphology is notthe final goal of anatomy. The history of the body is notcompleted when the stages through which it has passed havebeen described and its parts have been compared one withanother and with those of other organisms. The recognitionof stages and resemblances opens up questions of causation.What is it which effects from the ovum the development of theaggregate of millions of shapely structures constituting theorganism into one shapely and finely determined whole ? Thestarting of such an inquiry leads to another important, thoughmuch smaller, question, Is there any genetic bond of rela-tionship between different kinds of organisms ? ‘! This lttc-rquestion is now universally answered, or almost universally,by biologists, in the affirmative, not because the answer canbe proved, but because scientific probability points altogether

: in that direction. It was raised and answered in the affirma-: tive by Lamarck and St. Hilaire, and the affirmative answer hasbecome popular since Darwin wrote. But the genetic connexion

Lof different beings, when established, only presents us with adevelopment or a series of developments through the ages which. is comparable with the development of the individual adult. from the ovum. It makes it all one genesis with which we have

to do, but it still remains to investigate the causation which,. carried down from parent to offspring, in a manner calledL heredity, passes through the narrow channel of a fertile ovum

and moulds different beings to their shapes. Such a tremen-dous problem is naturally liable to be attacked piecemeal,and more or less partial solutions have been offered at dif-Iferent times in Lamarck’s theory of appetency, Darwin’s; theory of natural selection and Weismann’s hypothesis already, nearly shelved. These theories all deal with heredity, butL none of them can be said to give any idea of what the source; of heredity is. It is a common notion among biologists that the

whole secret of life is to be explained by the operation of thetlaws of dead matter, and those who hold this notion think it

highly philosophical, but neither the physical nor the chemicali laboratory reveals any phenomenon similar in kind to organi-. sation, reproduction or heredity., There are two propositions which I shall now lay down ;1 both of them are founded on purely anatomical data, and3 already made familiar to some of you in the class room.- I claim them as my own, and think it is important to keep thems in view in investigating the causation of life. The first does1 something to simplify, though not to explain, the problem, and3 is that all segmentation or metamerism, animal or vegetable-, all serial homology-is simply a variety of reproduction ; that1 process which in its simplest form converts a unit of texture1 or a unicellular organism into more than one, and in the. form known as gemmation or budding of complex organisms1 presents not a single corpuscle resolving itself into a

ynumber, but an undifferentiated mass of corpuscles resolving- itself into repetitions of the forms from which it sprang.1 My other proposition, already laid before the scientific world,1 is that the organising power, including heredity, is in verte-- brate animals demonstrably not resident in the individual

e living corpuscles of which the embryo is composed, but in1 masses of these. The demonstration comes from the study

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of malformations, from instances in which heredity is opposedby mechanical obstacles, and I shall on this occasion take forexample the development of the eye in cyclopia, that curiousform of development in which an eye is placed, not indeed inthe forehead, as in the fabled cyclops, but underneath thenose. The seniors among you know that the eyes take originseparately one from another. But in cyclopia there is a

single mesial eye, shapely, though not perhaps perfect in alldetails. The masses which ought to have produced two eyes,being mechanically prevented from moving outwards, producenot two imperfect eyeballs crushed together, or intercalatedone with the other, but a single symmetrical globe with musclesarranged around it, and often with a perfect cornea. This is

only one instance among many of the same kind showingthat masses of corpuscles act consentaneously, ordered bysome pervading influence different from the chemical or

structural composition of each. Therefore, life M not, as hasbeen alleged, a mere property or set of properties, chemicalor other of protoplasm. Life, mere organic life, is not anevolution of the properties of the chemical elements ; it is

something more, a new order of things made manifest onthe earth.

I pursue this subject no further at present. My object hasbeen to show by illustration from anatomy the stages ofadvance of a division of natural science, -how, devoting itselfin the first place steadily to intricate details, it deals as itprogresses with high and varied problems and becomes moreand more evidently a factor in philosophy. I have done thisthat you who are students of medicine in this universitymay see how the hand of Medicine herself beckons youon to the largest and deepest inquiries, to a culture ofthe mind and a recognition of the universe second to nonethat can employ the intellectual powers.

ABSTRACT OF THE

Introductory Address.Delivered at Anderson’s College on Tuesday, Oct. 18th, 1892,

BY W. L. REID, M.D., F.F.P.S. GLAS.,PROFESSOR OF MIDWIFERY AND DISEASES OF WOMEN AND CHILDREN,

ANDERSON’S COLLEGE, GLASGOW.

[THE lecturer introduced his subject by recounting the

early career of Dr. William Smellie, whom he regarded asthe type of a truly successful medical practitioner, and theprominent features of whose character formed the gist of theaddress. ]

1. Smellie did not believe that poverty was a barrier tosuccess. We find careful notes of cases dated 1722, withina few months after he began practice, and there is somethingtouching in the idea of this man courting science so

assiduously, while yet obliged to sell cloth to keep himself indaily bread. Afterwards, when a somewhat scurrilous oppo-nent, amongst other charges, taunted him with the fact thathe had at first to advertise his lectures on a street lamp, hetook pains to refute thoroughly the more serious charges, butwas not concerned to deny that poverty had compelled himto resort to such a device. I have known many studentswho were ruined by having too much money ; very few,indeed, through having too little.

2. Smellie was a man of great industry. We see thisfrom the elaborate and accurate notes he took of his cases,as well as from the fact that he taught midwifery clinicallyby attending cases of labour with his pupils, in whose presencehe delivered 1150 women during his first ten years of teach-ing. I know something of the labour involved in work ofthis sort amongst the poor, and we have evidence in thedetails of his work that time and labour were not muchthought of when expended for this purpose. He was

not industrious by fits and starts. His record of cases forthe forty years he was in practice is almost uninterruptedexcept during the year 1739, when he was searching in Londonand Paris for further instruction in his favourite subject.According to the views of certain people Smellie should havespent one evening a week at the theatre and another at a music-hall, or what in those days represented such. In my opinion

he did better. He varied his usual work by studying musicand painting as personal accomplishments. Thus, in his will heleft to the Lanark Library, which he founded, "nine Englishfloots with the thick 4to gilt music-book, " and the only knownportrait of Smellie is an oil painting now in the possession ofthe Royal College of Surgeons, Edinburgh, painted by his ownhand. Again, his obstetric plates, of which the late Dr.McClintock of Dublin says that they "have been universallyadmired for their accuracy and their execution, in which

important particulars they far surpassed anything thathad ever appeared before and have seldom been equalledsince, " are known to be partly his own work, as he

speaks of having been " assisted " with them by Dr Camper,Professor of Anatorry at Amsterdam. I should advise you,gentlemen, especially while you are students, to copy Smelliein his steady work. It is true that a clever man may put ona spurt towards the end of a session and distance his fellows,but the greatly safer plan is to keep well abreast of yourwork by doing the day’s work every day. No less would Iadvise you to have some relaxation, but let it be one whichneed not take you out of your own rooms in the evening, theevening hours being, at least for the medical student, thosein which he has most opportunity of reading steadily. The

late Dr. John Brown of Edinburgh thought that a doctor’srelaxation might wisely be literary in its character. "I liketo show, he says, "that our medicus may be not only, likeLocke, at once a good physician and metaphysician, or, likeAdams, equally great as a scholar and a domestic ’leech,’but that he may be a poet too.

"

3. Smellie was an enthusiast in his work. Our world atpresent is cursed with half-hearted workers, men who occupypositions and profess to do work in which they have little orno interest. The man of whom we are speaking was not ofthis sort ; indeed, in his heartiness he was occasionallybetrayed into making statements that sound self-laudatory.Thus, in speaking of " phantoms " and "dummies" as wenow call them, he says : "I I considered that there was apossibility of forming machines which should so exactlyimitate real women and children as to exhibit to the learnerall the difficulties that happen in midwifery, and such I

actually contrived and made by dint of uncommon labour andapplication." A pamphlet was published in 1773, directedagainst the practice of midwifery by men, which practiceSmellie had strongly supported. Yet this antagonistic authorfelt bound to speak of Smellie as an individual in the follow-ing terms : "I knew him well ...... he was an honest man ......and, what ought to recommend him and enforce his authoritywith those of his fraternity, he was an enthusiast in his pro-fession. Man-midwifery was the idol of his heart; hebelieved in his forceps as firmly as he believed in his Bible."Dr. McClintock, in giving this quotation, adds: "The indomi-table perseverance he displayed in very many of his operationsis most remarkable, and, considering the strong popular pre-judices then existing against instruments and male practi-tioners, it must have required no small degree of moral

courage and confidence in his own resources to have acted ashe did. " If any of you, gentlemen, find, as you go on withthe study of this profession of medicine, that for you it lacksreal interest and that you look forward to its practice simplyas a means of earning a living, I forewarn you that you maylook forward also to a life of comparative drudgery; for,unless brightened by real interest, the work will be foundhard to a degree.

4. Smellie’s thoroughness was remarkable, and this, ofcourse, followed on the heartiness with which he did hiswork. In the preface to his volume of lectures he says thathe hopes the reader will not imagine that it was "cooked upin a hurry, " and informs him that he had taken six years towrite it and that it had been "from time to time altered,amended and digested." What a boon it would be to usstudents and practitioners if all authors of medical bookscould say this truly of their productions. Dr. McClintock, inhis memoir of Smellie, and in its very first words, refers to thismatter of thoroughness. "As a teacher, author and prac-titioner there is no British obstetrician-certainly none of theeighteenth century-who deserves so high a place in ourestimation as William Smellie. " Is there not an importantlesson for us here ? How can a man do effectual service tohis neighbour or raise himself in his own estimation if heknows in his heart that his work is done in a slipshod slovenlymanner ? Let us, then, determine firmly-for we must allfind it a difficult task-to do to the very best of our abilitywhat duty brings to our hand.

5. Smellie had great power of observation, which is usually