XXXIX.

ceedingly laborious, and, in short, there was every mark of plethora, or over

WE had hardly printed our remarks on Sir Anthony Carlisle's speculations on the spleen and thyroid gland, when another pamphlet on the same subject was laid on our table. Mr. Dobson went to work in his investigation by a series of experiments on animals—a mode of procedure which is far from unobjectionable; but which, at all events, is superior to the closet speculations of Sir Anthony. If they are tinctured with cruelty towards dogs, they are free from spleen towards man.

Mr. D's first object of inquiry was to ascertain the changes produced on the spleen by the digestive process, and the exact period, after ingestion, at which such changes take place. We need not detail the experiments, but only their results. From these it appears that, till the expiration of three hours after a full meal, the dog's spleen does not present any visible alteration. At the end of four hours it is much enlargedand in five hours, it attains its maximum, after which it gradually decreases in bulk for 12 hours.

In the next train of experiments, Mr. Dobson removed the spleens of dogs.

"EXP. I. The spleen of a dog was removed; the animal apparently suffered little from the operation. On the following day I gave it a quantity of food; it ate voraciously; for three hours after no perceptible alteration was produced; but in four hours after, indications of uneasiness were shown; the animal became restless, and lastly sunk into a nearly torpid state; it was often moaning, the pupils were dilated,-the heart labouring; there was frequent micturition; the respiration was

ex

markably correct. The case is, on the whole, a rare and curious one. The patient was under the care of the editor, but other avocations prevented his at-tending with regularity and minuteness to the symptoms, which will account for the concise and abbreviated form of the notes.

course of two hours from this period, the animal began to recover; and in about three hours these symptoms had subsided, considerable languor remained. The animal took a large meal twice or thrice in twenty-four hours, and after each, precisely similar effects were presented. The animal became more feeble daily,—in a month after the operation, it died.

EXP. II. I next removed the spleen from another dog, but instead of giving full meals, as in the last experiment, I gave a small quantity of food every hour, or every two hours. The animal ate voraciously; no unpleasant symptoms occurred,-this plan was pursued for three weeks, when the animal to all appearance was quite well; in fact, it became fat; the ligature upon the splenic artery had come away, and the wound in the abdomen healed. I then commenced giving full meals twice in twenty fours, the same train of symptoms followed each meal, and at the same period, as in the last experiment, though perhaps not so urgent: the animal died in a month from the commencement of this plan of feeding.

In both dogs I observed that the intestinal evacuations were of a lighter colour than natural. On examining the body of each after death, a small quantity of limpid serum was contained in the bag of the Tunica Arachnoides, and more than a natural quantity in the lateral ventricles; the veins of the brain were in a highly congested state; the abdominal viscera presented no unnatural appearances, but the portal system of veins was much gorged with blood."

It may be stated that, generally speaking, the dog finishes its first digestion in three or three hours and a half-and, consequently, the turgidity of the spleen -appears to commence when the stomach is emptying itself into the duodenum. The following is the deduction which Mr. D. draws from his first series of experiments, viz.

"That the spleen acts as a reservoir for containing the additional quantity of blood which the vascular system has received, by means of the nutritive pro

cess. It is evident from the remarks on chylification there is a greater quantity of blood in the system at five hours after a meal than at any other period; and as we have premised, that the bloodvessels are not capable of containing this increase with impunity, I infer, that the spleen serves as a reservoir to hold this surplus, because, at the time the chylifactive process is at an end, the spleen is found distended with blood. Then, as detailed in the third experiment, at twelve hours after a meal, the spleen was small, and contained very little blood: the reason of this phenomenon is obvious; at five hours after a meal, the nutritive process is nearly completed; at five hours after a meal, the spleen arrives at its maximum size: now, as secretion goes on in the various emunctories, there must consequently be a reduction of the circulating mass; and to compensate for this, blood is simultaneously expelled from the spleen, so that in twelve hours the whole is removed; no more circulating through that organ than is necessary for its support."

It was seen that when the spleen was removed, and the dog kept on full meals of animal food, he died: but when kept on abstemious fare, he went on very well. Mr. D. infers from this, that "the circulatory vessels are capable of containing only a certain quantity of blood with impunity, and that when an increase in the volume is produced, as after digestion, the spleen performs the office of a reservoir to receive the surplus; they show also, that when the fluid contained in the vessels becomes reduced in quantity, as from bleeding, the spleen affords a supply, so as to enable the various organs to perform their necessary offices and further, they afford collateral evidence of the spleen being more elastic than the blood-vessels." Mr. D. conceives that when we drink a bottle or two of wine, or large quantities of malt-liquor, the spleen performs the office of reservoir for the time. He had twice an opportunity of examining the spleens of great ale-bibbers, and found them very much enlarged-in one case, so enormously so, as to give the idea of "a bladder half filled with 'oil."

The pathology of the spleen has afforded no direct indication of its function. When the liver is diseased, the function of that viscus generally shews the existence of the malady-but, in reference to the spleen, we have no such tangible data afforded as a clue. The enlargement of the spleen, after protracted agues and remittent fevers, may be explained by the congestion of blood in this, and indeed in some other organs, during the cold stages of these diseases. The practical inferences drawn by our author are the following.

"I. That the quantity of fluid usually taken into the system at one time, is greater than the apparatus is capable of containing with impunity; and, in consequence of this, excited vascular action, with all its train of morbid consequences, is a common effect.

II. That in disorders affecting the spleen, as in Intermittent Fever, and as well of the whole vascular system, the practice of giving large quantities of fluid, is not only unphilosophical, but decidedly injurious.”

We have thus laid before our readers the substance of Mr. Dobson's pamphlet, and shall only observe that the theory proposed, and the data on which this theory is based, are much more entitled to respect than those of Sir Anthony Carlisle, notwithstanding the ENLARGED INTELLECT" which he modestly claims for himself and a few of his own rank.

66

XL. ADDRESS.

Medical Men, in this country, whose services are dedicated to the practice of their professiou through all its extensive ramifications of Medicine, Surgery, Pharmacy and Midwifery, have been aptly denominated" General Practitioners." The epithet, as distinguished from the appellations which designate those individuals who devote themselves to one branch only of the healing art, is as honourable as it is descriptive; inasmuch as it denotes the possession of qualifica tions adequate to all the emergencies of an arduous profession. It has, however, been said, that, in its relation with the titles of "Physician," and "Surgeon," the term "General Practitioner" implies a Subordinate in the social and intellectual ranks of the republic of Medicine; but such an inference is at variance with the spirit of the designation, and presents a forced acceptation of its sense, to which no individual of the class will subscribe. It will hereafter be the duty of the Association now established under the denomination of "The Metropolitan Society of General Practitioners," to discuss the subject; and, after due examination and deliberation, to confirm this or adopt another cognomen. It will, also, be the province of the Society, to institute an inquiry into the expediency of equalizing the right to professional distinctions, and to adopt such policy as shall secure for its Members the civil and literary respect to which their education, attain. ments, and practice entitle them.

The position in society occupied by General Practitioners, is one that demands their serious attention. Perplexed by multifarious duties-threatened by extensive responsibilities-oppressed by physical exertions-disturbed by conflicting interests-assailed by jealousiesharrassed by intrigue and envy-injured by corporate privileges-insulted by legal enactments, and degraded by an opprobrious mode of remuneration-the General Practitioner has more extensive evils to cope with, than he can hope to combat successfully by the unassisted force of his own mental and physical exertious. It is, therefore, a subject of astonishment, that the members of a class, around whose banner more than ten thousand individuals are spread over the cities and provinces of England and Wales, have not soouer coalesced, and formed themselves into a deliberative body with execu tive authority and means, in order to

render the knowledge, experience, and resources of the entire mass, available to every Member of the Association, who might seek or require its advice and support. By such an union, a concentration of the opinions, experience, talents, and influence of the whole class would be consummated, and its application directed upon all occasions, to the necessities and emergencies of any individual; or to the promotion of the collective interest of the whole body. In aid of a co-operative system like this, the support derived from a pecuniary fund is not to be overlooked; in fact, it is an indispensable requisite for carrying into effect any political or legal undertaking-for defending individual interests-and for supporting a domiciliary establishment, which, to ensure success to the scheme, should offer, not merely a place for the conduct of business, but the conveniences for agreeable social intercourse.

Upon the foregoing principles has the Society of General Practitioners been begun; its prosecution may be understood by the following details.

In the selection of a House for the Society's use, the Committee have been influenced by a prudent regard to economy, and a desire to restrict the extent of the Chambers to the actual necessities of the Association. The Committee did not consider it justifiable in the onset, to open an establishment upon a large scale; purposing to extend it, whenever an increase of the Society's numbers renders it necessary, or the Members themselves may call for further accommodation. Such refreshments as can be prepared under the present circumscribed fitness of the premises, are served (at a moderate charge) at any time during the day, by the persons in attendance. It is in contemplation, however, to provide dinners and other refection, as soon as the magnitude of the Society will warrant the adoption of a plan for combining the comforts and conveniences of a social club, with the more solid advantages to be derived from the Institution. The Reading Room is open from ten o'clock in the morning till ten at night; and the Daily Newspapers, periodical journals, &c. regularly laid on the table. Notwithstanding the Library offers at this time but a limited allurement, the Society has cause for congratulation in the prompt and handsome manner in which many eminent indi

viduals, not belonging to the Association, have presented their works. The Members of the Society, also, have not been tardy in offering their respective donation of books. The Library will be opened as soon as the necessary arrangements are completed.

The Committee have great pleasure in announcing, that the Treasurer's statement of the Society's affairs, shows a balance of cash in hand; and they take this opportunity of giving a pledge to its Members and to the profession at large, that they will, on no account, incur any liabilities beyond the actual resources of their funds.

The pleasure and advantages to be derived by the Metropolitan Surgeons, from the social and friendly intercourse established and confirmed through the medium of their Chambers, are too apparent to need any comment: to the country Members, also, they present a most convenient place of resort during their occasional sojourn in London, where they may meet their professional friends, mix with their unknown contemporaries, and, at leisure, contemplate the men, books, customs, manners, opinions and feelings, of the medical microcosm of the Metropolis. The Associates, likewise, join in these literary and social meetings; forming and cementing those professional ties and private friendships which ought to subsist between all the members of a liberal profession. To the student in Medicine also, the Society's Chambers afford peculiar advantages. He is supplied with books either of reference or general instruction; he has the accommodation of a comfortable room for meeting his friends, for his moments of leisure and relaxation or literary studies; and lastly, in addition to the mental and scientific improvement which he derives from attending the discussions of the Society, he associates daily with his seniors in the profession, from whose conversa tion and communications he receives both pleasure and instruction.

The amount of the annual contribution, in comparison with the advantages to be derived from it, has been fixed at a very moderate sum; the Committee feeling assured that the numbers of the Society will be equal, even at this small ratio, to the production of a fund amply sufficient for all the purposes required. The first care of the Society is the conservation of its own integrity, and the general interests of its Members. Medi

cal politics have decidedly taken a bias, unfavourable to the General Practitioner, and he stands, not only unprotected in his professional character by the fostering band of a generous government, but legislative enactments have actually been passed, which oppress and degrade him; his privileges are trampled down by the assumptions of unjust, self-created, arbitrary power; and the defence of his rights. confounded by the hazardous jurisprudence of legal mis-interpretation. These great and crying evils can only be redressed by parliamentary influence; and the chief strength of the fund arising from the contributions of the Members of this Society, lies in the power which it gives, of appealing to the legislature, and of persisting steadily against oppression and opposition, until the General Practitioner shall have obtained a distinct and legal recognition of his rights, privileges, and rank, and have burst every trammel that binds him down to a degraded subserviency. These are measures which the Society is pledged to pursue; the period of their commencement must, of course, depend upon the possession of means, and be fixed by the fat of deliberation. For the purposes of individual protection, the fund will at all times be available in every instance where, upon due inquiry and examination, it shall appear to the Society, that one of its Members sustains any injury or wrong in his professional capacity; or is called on to assert his right or defend his interest on any point that applies strictly and especially to the whole body. The subject of professional remuneration is of momentous urgency, and demands the most careful consideration. It is true, that, under the direc tion of the Lord-Chief-Justice Tenterden, a verdict was lately given in favour of the right of a General Practitioner to charge for his services; but such a decision by no means necessarily becomes a law of the land, and though dictated by the opinion of one judge to-day, it may be reversed by the dictum of ano ther to-morrow. When the Society shall have arranged a scheme for regulating a general mode of professional compen sation, by which the Medical Practitioner may be emancipated from the odious necessity of balancing his remuneration by the charge for his medicines, it will be necessary to legalize the measure by an application to Parliament. In fine, the fund formed by the annual contributions,