DO 
 
 UJ 
 
 
THE LIBRARY 
 
 OF 
 
 THE UNIVERSITY 
 OF CALIFORNIA 
 
 PRESENTED BY 
 
 PROF. CHARLES A. KOFOID AND 
 MRS. PRUDENCE W. KOFOID 
 

 
LECTURES 
 
 ON 
 
 THE GENERAL STRUCTURE 
 
 OF THE 
 
 HUMAN BODY, 
 
 AND ON 
 
 THE ANATOMY AND FUNCTIONS OF THE 
 SKIN; 
 
 DELIVERED BEFORE 
 
 IRopal College of 
 
 IN LONDON, 
 
 IN THE COURSES FOR 1823 
 
 BY THOMAS CHEVALIER, F.R.S. 
 
 F.S.A. F.L.S. & F.H.S. 
 
 SURGEON EXTRAORDINARY TO THE KING, AND 
 PROFESSOR OF ANATOMY AND SURGERY TO THE COLLEGE. 
 
 LONDON: 
 
 PRINTED FOR 
 
 LONGMAN, HURST, REES, ORME, BROWN, AND GREEN, 
 PATERNOSTER-ROW. 
 
 1823. 
 
CSf 
 
 TO 
 
 MATTHEW BAILLIE, M.D. F.R.S., 
 
 PHYSICIAN EXTRAORDINARY TO THE KING, 
 SfC. %C. $C. 
 
 MY DEAR SIR, 
 
 \VHEN I found an expectation was en- 
 tertained that I should publish these Lec- 
 tures, several considerations immediately 
 concurred in determining me to take the 
 liberty of dedicating them to you. 
 
 They were delivered before The Royal 
 College of Surgeons ; for which estab- 
 lishment you so liberally joined with 
 Sir Everard Home, to found The Hun- 
 terian Oration. 
 
 M370338 
 
VI 
 
 From your lucid and accurate Lectures 
 and Demonstrations, my thirst for ana- 
 tomical knowledge, more than thirty years 
 since, received the greater part of its earliest 
 gratification ; and to your most kind and 
 unwearied professional care and discern- 
 ment, I have been repeatedly and deeply 
 indebted. 
 
 That you may long continue to enjoy 
 the high reputation which you have at- 
 tained by a peculiarly distinguished and 
 honourable course in life, is the sincere 
 wish of, 
 
 Dear Sir, 
 
 Your much obliged 
 And obedient Servant, 
 
 THOMAS CHEVALIER. 
 
ADVERTISEMENT. 
 
 AFTER these Lectures were printed, and 
 the publication of them awaited only the 
 completion of the figures, the eminent Phy- 
 sician to whom they are dedicated, was re- 
 moved from this life. The Author has not, 
 however, cancelled the dedication ; wishing 
 it to remain as a mark of the high estima- 
 tion in which he always held the character 
 and conduct of that excellent person. 
 
ERRATA. 
 
 Page 7. line 5. for Arvis, read Arris. 
 
 65. 6. for prostse, read praesto. 
 
 99. l> for all among, read among all. 
 
 1O6. 1. for surface, read surfaces ; and for its read it. 
 
 108. 10. for sibaceous, read sebaceous. 
 
 112. 15. for granulation, read granulations. 
 
 162. 12. for crisis, read crasis. 
 
 229. 1O. for defect, read defeat. 
 
LECTURE I. 
 
 MARCH-IS. 1823. 
 
 MR. PRESIDENT, AND GENTLEMEN ; 
 
 BEFORE I proceed to address you on those 
 subjects, to which it is my purpose to invite 
 your attention in the present course of lec- 
 tures, my duty and my feelings call upon 
 me to pay a tribute of respect to the me- 
 mory of that gentleman, whose sudden and 
 lamented decease produced a vacancy in 
 the office, in which I have now the honour 
 to appear before you. The accuracy of the 
 late Professor Wilson, as a demonstrator 
 and teacher of anatomy, was displayed, for 
 a long course of years, in one of the most 
 celebrated and most useful schools in this 
 metropolis, and will live in the remembrance 
 of many who hear me. The three courses 
 of lectures which he delivered from this 
 
chair, and which are happily preserved, by 
 publication, for the benefit of those who had 
 not the opportunity to attend them, for 
 propriety of choice, for the importance of 
 their subjects, and the judicious arrange- 
 ment of their valuable materials, secured 
 our united approbation and praise. Nor 
 must I omit to notLce that urbanity of man- 
 ners, which always gave us satisfaction and 
 pleasure, in seeing him take his place, when 
 he joined us in attention to those important 
 duties, which devolve upon the members of 
 the council of this College. It is now jny 
 task .to endeavour to supply his place in 
 this Theatre. But I must first of all ex- 
 press to you, Mr. President, and to the rest 
 of my honourable colleagues in the council^, 
 my grateful acknowledgments for that fa- 
 vourable opinion which has induced them 
 to call me to a situation, hitherto occupied 
 by professors, to whose scientific discourses 
 I have so often listened with pleasure and 
 
 instruction. 
 
 ' ' 
 
 Talent, however, is variously distributed,, 
 among those who travel in the same path 
 
3 
 
 of science. One may gather that which 
 another has overlooked, or which had not 
 previously sprung up into notice. Nor 
 does this truth necessarily imply a defi- 
 ciency, or an absolute predominance, either 
 of ability or/ of industry, in the one party 
 or the other. Spectators of the same ob- 
 ject, being themselves in different positions, 
 may notice facts and features, which no one 
 of them singly has yet had an opportunity 
 to survey ; but which the mutual communi- 
 cation of their observations may enable 
 them all advantageously to view, to recog- 
 nize, and to combine. Moreover, the eye 
 of the mind, as well as that of the body, 
 too often passes unheedingly over objects 
 and circumstances within! its ken, but 1 which 
 do not, at first, attract or fix its attention ; 
 and that attention may be afterward direct- 
 ed to them by casual events* or by inferior 
 observers. Nor is it a minor trait of cha- 
 racter which Livy has preserved of the 
 genius and character of Scipio, in his famous 
 speech to Fabius and the Roman senate, 
 before his departure for Africa, Id est viri 
 et duds oUata CASU, fleeter e ad consiliu??i. 
 
 B 2 
 
But the consilium, the object in view, must 
 have a distinct and certain pre-existence in 
 the mind. Our notices may then be ar- 
 ranged. All our observations will naturally 
 be combined by those who succeed us ; 
 with corrections, and additional facts, and 
 illustrations ; and by the whole, the public 
 will be benefited, and science advanced. 
 Nor are lesser efforts always to be despised 
 decause they are not greater ; nor the 
 greatest we can witness to be considered as 
 absolutely perfect. The temple of know- 
 ledge is to be reared by the exertions of 
 ordinary, as well as of extraordinary hands : 
 nor could its fabric have possessed the com- 
 parative altitude it has already attained, 
 without the concurrent assistance of both. 
 Both must be governed by the same invio- 
 lable principles, to which, whosoever ad- 
 heres, may render acceptable service ; and 
 from which, whosoever departs, must retrace 
 his steps. 
 
 Such, Gentlemen, are the considerations 
 which have encouraged me to undertake 
 the honourable, but responsible office, of 
 
one of your Professors of Anatomy and 
 Surgery. Here, I am well aware, there is 
 no partiality that will applaud error. Here, 
 no honest effort will lack its meed of appro- 
 bation. I feel an equal reliance upon the 
 candour, and the judgment, of those before 
 whom I am to speak. I have lived too long 
 not to be acquainted with my own weakness 
 and fallibility ; too long also not to have 
 discovered, that science, if not still in its 
 infancy, has not yet attained adolescence ; 
 and stands in need of the united exertions 
 of all who love it, to nurture, to strengthen, 
 and to mature it. And I contemplate, 
 with an undescribable satisfaction, those 
 rising abilities, of which such happy ear- 
 nests have already been given among us ; 
 and which, in their progress, will adorn and 
 fertilize our College, and the medical schools 
 of this metropolis, with a succession of able, 
 laborious, learned, scientific, and useful 
 teachers. 
 
 B 3 
 
6 
 
 THE foundation of this College by our 
 late most excellent Sovereign, the donation 
 to it by Parliament of Mr. Hunter's incom- 
 parable museum, and the consequent esta- 
 blishment of lectures to be annually de- 
 livered in this Theatre, have combined to 
 form an important epoch in the History of 
 Surgery in England, by more intimately 
 connecting the pursuit of that important 
 branch of human knowledge with general 
 philosophy, and natural history ; and fur- 
 nishing both means, and inducements, to 
 labour for its cultivation and improvement, 
 as a science. In this field of exertion Mr. 
 Hunter conspicuously led the way ; and it 
 was a wise provision of the legislature, 
 when they purchased the collection of pre- 
 parations which he had formed, that in 
 order to prevent its decay, it should be 
 preserved by this College, exposed to view, 
 and its contents publicly explained by lec- 
 tures, and proper attendants, to perpetuate 
 the good effects his talents and industry 
 had produced, both on the state of surgi- 
 cal science, and of those subjects which he 
 had brought to bear upon it. In the late 
 
Corporation of Surgeons provision had 
 been formerly made for only six lectures, 
 which were chiefly confined to the bones 
 and muscles. These were founded partly by 
 Mr. Edward Arvis in 1653, and partly by 
 Mr. John Gale in 1698 ; but they had be- 
 come merely nominal discourses, that have 
 been entirely superseded in utility and at- 
 traction by the private schools, in which 
 these parts are explained more fully, and in 
 connection with other branches of anatomy. 
 They were therefore neglected, and fre- 
 quently omitted. The Council and Pro- 
 fessors of this College have since thought it 
 justifiable, to abide rather by the spirit 
 than by the letter of the institution, and to 
 consider rather what the benevolent found- 
 ers would have done no*iv, than what they 
 contemplated at a period when there were 
 few means only, and those very limited 
 and imperfect, of attaining any portion of 
 anatomical knowledge. Their six lectures 
 are consequently understood at present to 
 embrace any subjects in human anatomy or 
 physiology, which can tend to illustrate or 
 advance the principles and practice of Sur- 
 
 B 4 
 
8 
 
 gery. To these lectures nine on surgery 
 are added, as a part of twenty-four which 
 we are required to give by the tenure of 
 that trust, on which the legislature and 
 government of the country made us the 
 noble present of Mr. Hunter's collection. 
 The remaining fifteen, as you are well 
 aware, being devoted to comparative ana- 
 tomy. 
 
 The lectures on surgery can neither be 
 calculated, nor intended, to interfere with 
 those elementary instructions which are de- 
 livered to students in the several schools of 
 this metropolis ; much less to supersede 
 them. Their object is, as I have just intim- 
 ated, to bring forth private stores, for the 
 general benefit, by exhibiting the various 
 modes of considering subjects of general 
 professional importance, which men of 
 various habits of thinking, and having dif- 
 ferent fields of observation, will necessarily 
 adopt. It has been one of the greatest and 
 most unfortunate and embarrassing disad- 
 vantages, attending medical and chirurgical 
 science, that its different practitioners and 
 
9 
 
 professors have often met with a number of 
 successful cases in quick succession, of an 
 individual character ; or of the utility of a 
 particular remedy, in their own personal, 
 and perhaps accidental experience, that has 
 led them to form hasty and illogical con- 
 clusions, not referable sufficiently to sound 
 and definite principles, and therefore which 
 have not been sustained by the experience 
 of others, and have also been ultimately 
 disappointed by their own. Medical his- 
 tory abounds with examples of this fact, 
 which has often given too empirical a cha- 
 racter to the practice of many highly re- 
 spectable men ; and furnishes a caution for 
 students and young practitioners, against 
 too great an eagerness to grasp at publicity, 
 by assuming that a method of treatment 
 must always succeed, because they have 
 seen consecutive instances of its doing so. 
 
 o 
 
 The younger members of the profession 
 have now the advantage of an opportunity 
 of re-considering the subjects they have 
 learned, with some additional illustrations ; 
 while those members of the College who 
 have finished their initiatory studies, and 
 
10 
 
 whose engagements unavoidably prevent 
 them from resorting to the situations in 
 which they had before pursued them, will 
 be enabled to keep up a connected view of 
 that system of general principles, which, in 
 the hurry of life, are apt to fade, in a 
 greater or less degree, from their former 
 impressions on the mind. They will also 
 be put in possession of those additions, in 
 their due order of arrangement, which are 
 from time to time made, to the sum of our 
 professional knowledge. More speedy and 
 general circulation will thus be given to ex- 
 tended views in the Science, and to im- 
 proved methods in the Art of surgery. We 
 shall become more useful to, and better ac- 
 quainted with, each other. Little jealousies 
 will be abolished : we shall be more ser- 
 viceable to those who confide themselves 
 to our care ; better instructors of the rising 
 generation, and contribute more fully and 
 more effectually to the general welfare of 
 mankind. 
 
 Of comparative anatomy, the field is so 
 vast, and as yet so imperfectly surveyed, 
 
11 
 
 that the institution of lectures expressly on 
 that subject was peculiarly needful. A 
 considerable part of our anatomical nomen- 
 clature has been formed from the examin- 
 ation of other animals ; and to experiments 
 which could alone be made on them, we 
 are indebted for our first knowledge of some 
 of the most important physiological facts. 
 Nevertheless, this valuable branch of science 
 had been in reality, of late, but little cul- 
 tivated, and but little employed. The 
 attention of anatomists had been chiefly 
 directed to those animals which most re- 
 semble the human subject, and to these 
 with only imperfect means of investigation. 
 An extended and general enquiry into the 
 internal structures and functions of ani- 
 mated beings in general had been, in latter 
 times, considered rather as curious than as 
 useful or necessary. Mr. Hunter, however, 
 clearly perceived its value, and referred it 
 to its proper end, namely, the .elucidation 
 of the laws and operations of the human 
 body. For this purpose he availed himself, 
 with diligence, of all the known methods of 
 examination, and formed the plan, and 
 
12 
 
 sought out the materials, of that rich collec- 
 tion, with which we are entrusted, and which 
 we are constantly labouring to increase, to 
 explain, and, as far as possible, to perfect. 
 In no place, therefore, could discourses on 
 this subject be delivered with more pro- 
 priety than in this, where the stores he 
 acquired are deposited and arranged, so as 
 to form a kind of demonstrative text-book 
 to this interesting study. Highly worthy is 
 it also of this favoured country, enabled as 
 she is by her unequalled commercial and 
 political relations, to furnish the means for 
 its promotion, to hold out a conspicuous and 
 public example, of pursuing those enquiries 
 by which Comparative Anatomy may be 
 advanced, and of prepossessing her native 
 surgeons as they grow up, and before they 
 are dispersed through her extensive empire, 
 with just ideas of its value and interest, and 
 directing their attention to its illustration. 
 - Ignoti nulla cupido. If it were not brought 
 before us in regular course, it would be in 
 great danger of falling again into neglect. 
 But being now brought forward into general 
 notice from year to year, and curiosity and 
 
13 
 
 laudable ambition being not only excited, 
 but also directed, as it has been, and is, in 
 this Theatre, the number of contributors 
 to our accumulation of specimens and facts 
 will naturally increase, and new information, 
 convertible both to present and to future 
 use, may be expected constantly to flow in. 
 The lectures of Sir Everard Home, Sir 
 Astley Cooper, Mr. Lawrence, and of Mr. 
 Brodie, need no commendation from me. 
 They have kindled feelings in their hearers 
 which are now in a course of beneficial 
 operation, and must produce results that 
 will reflect lasting honour on the examples 
 which have been set by those distinguished 
 professors, and be productive of great good 
 to those who have had the advantage of 
 attending their interesting and scientific 
 addresses. 
 
 I congratulate, therefore, the different 
 ranks of our profession, and the public at 
 large, on the foundation and progress of an 
 establishment, having such valuable objects 
 in view ; and I may repeat, that when I 
 advert to the talents of many of our mem- 
 
14 
 
 bers which are now in their bloom,- and 
 those of others, which are coming forth 
 with the most hopeful promise, I cannot 
 but feel a most gratifying anticipation, that 
 this Chair will continue to be filled by a 
 succession of professors, who will do honour 
 to themselves and to the College; and 
 that from hence will emanate those rays, 
 both of natural and chirurgical knowledge, 
 which shall extend their beneficial influence 
 to every part of the habitable globe; shall 
 contribute to dignify the pursuits, to pro- 
 mote the harmony, and to lessen the mise- 
 ries of mankind; and display more and 
 more, to admiring myriads of our race, the 
 inexhaustible power, and unfathomable per- 
 fections, of our omnipotent Creator. 
 
 But our chief concern, at present, is with 
 Surgery, and with anatomy, physiology, and 
 pathology, as constituting the foundation 
 on which it rests, and the object of which is 
 to relieve and to cure the injuries, disorders, 
 and diseases of mankind. Those, however, 
 which affect animals subservient to the- 
 necessities or conveniences of man, and 
 
especially such as possess organs similar to 
 his, in their structure or functions, should 
 not be neglected, or left out of our con- 
 templation. And we have the pleasure of 
 numbering among the distinguished mem- 
 bers of this College, a gentleman *, who, 
 after having passed through a full and 
 honourable course of professional education, 
 did not disdain to devote himself to this 
 branch of knowledge ; and has attained in 
 it a rank of scientific eminence not before 
 enjoyed by any individual in this country. 
 He has thus been enabled to render those 
 services to society, that should place the 
 study and treatment of the diseases of 
 subordinate animals on just and philosophi- 
 cal principles ; have extended an acquaint-^ 
 ance with those principles, and the practice 
 deducible from them ; and has laid the 
 foundation of much future benefit and 
 comfort to that large portion of society, 
 whose interests are materially, and often 
 essentially involved, in the health and 
 soundness of the animals that labour for 
 
 * Professor Coleman, 
 
16 
 
 them, and contribute to their sustenance, 
 or to their defence. 
 
 There is also an anatomy, a physiology, 
 a pathology, and even a surgery, of Vege- 
 tables. Are these altogether unworthy of our 
 attention ? Mr. Hunter did not think them 
 so. His acute and philosophic mind was 
 habituated to glance on every department 
 of animated nature that came under his 
 notice, so far as he could discover it bore 
 any relation to the ceconomy of the human 
 body, or could illustrate its morbid condi- 
 tions, or its restorative processes. I need 
 not here cite proofs of this. They are 
 contained in his writings, and in this mu- 
 seum ; and show that his amusements took 
 their character from the prevailing turn of 
 his mind for investigation ; and bore a stamp 
 of his scientific objects, and of the inge- 
 nuity, ability, penetration, and diligence 
 with which he pursued them. 
 
 Yet, after all, whatever things may sug- 
 gest themselves to our minds, as necessarily 
 implicated in the course of our studies, or 
 
17 
 
 as calculated to throw additional light upon 
 them, we must at last form an estimate of 
 them by their relation to the human body; 
 its structure, its functions, its injuries, its 
 diseases, its reparations, and its disso- 
 lution. And let me not be thought irrele- 
 vant, or disrespectful, in observing, that it 
 is necessary that the student of surgery 
 should take care that he be not drawn too 
 far aside by any collateral objects, on ac- 
 count of the separate interest they may 
 possess, or the amusement they may afford, 
 from the main purpose to which he is to 
 refer them, the restoration of health 
 and soundness to his patients. It was 
 Mr. Hunter's care, perhaps far beyond that 
 of any other surgeon that ever existed, to 
 make all his varied pursuits concenter in 
 this point ; and it is much owing to the 
 influence of his example, directly or indi- 
 rectly, that so much benefit has been since 
 derived from the contemplation of other 
 animated beings, and from experiments 
 made upon them, and applied to the phy- 
 siology and pathology of man. 
 
18 
 
 What then is man this being, who is 
 the subject of our Surgery, and the ulti- 
 mate object of all our investigations ? Of 
 what is he composed? How is he con^ 
 structed ? What is he to himself? How is 
 he related to other beings around him, ani- 
 mate or inanimate, and how are they re- 
 lated to him ? What are the natures, and 
 what are the influences, of his passions and 
 emotions ? What are his physical, his in- 
 tellectual, and his moral faculties ? What 
 are the destinations of his existence on this 
 globe ? How is he capacitated to fulfil 
 them ? How is he likely to fail ? What are 
 his resources when struggling with impedi- 
 ments from affliction ? And by the agencies 
 of what causes is that primaeval sentence 
 at last infrustrably fulfilled, " Dust thou 
 art, and to dust shall thou return ?" Ques- 
 tions these which embrace a field of phi- 
 losophical enquiry, vast in its extent, 
 minute in its details, and infinite in its 
 importance. 
 
 Man is a material, a living, a rational, a 
 mortal, an immortal, and an accountable 
 
19 
 
 being. Simple elements, apparently simple 
 at least, so far as our confined powers of 
 investigation extend, compose a fabric of 
 wonderful complexity, with the minutest 
 adjustment of all its parts, and of all the 
 particles of every part. In this, however, 
 he differs but little, in respect to perfection, 
 from the living bodies which surround him. 
 All nature teems with equal proofs of wis- 
 dom in design, and of perfection in the 
 adaptation of means to ends. In this view, 
 therefore, he is a machine, subject, like 
 other machines, to the same mechanical 
 principles, by which all machines must be 
 controuled. Like them, by certain laws he 
 stands, he moves, he totters, or he falls ; 
 the parts of which he is made up are kept 
 together or dissevered ; are dislocated, dis- 
 torted, or replaced. 
 
 What, therefore, is the power, that, since 
 the creation* and under obedience to the 
 laws then enacted, generates, increases, ad- 
 justs, completes, regulates, and repairs this 
 machine ? What is this power, which pos- 
 sesses that controlling influence over ordi- 
 
 c 2 
 
20 
 
 nary affinities ; which preserves and directs 
 all its parts to their destined uses ; implants 
 in them an innate repugnance to such things 
 as may injure or impede them ; makes it 
 accept of those which may assist, sustain, 
 and employ them ; makes it seek for those 
 which may promote their restoration when 
 disordered, and makes it shrink from those 
 by which their integrity, their co-existence, 
 or co-efficiency, may be endangered or 
 destroyed ? 
 
 To assert that the mere accretion and ar- 
 rangement of the materials of which liv- 
 ing bodies are composed, is competent to 
 these objects, appears to me contradictory 
 to the soundest principles of reason and 
 philosophy. It is making the very same 
 thing to be its own cause, and its own 
 effect. Often as the words of Mr. Hunter 
 on this subject have been quoted, I cannot 
 help reciting them. I am not now pro- 
 fessing, Gentlemen, to bring forth new 
 ideas respecting it ; I make these remarks, 
 as; forming what I conceive to be a suitable 
 introduction and preface, which may serve 
 
21 
 
 to connect and embody the different parts 
 of the plan I have drawn out for myself 
 with greater consistency and method; to 
 make it clearly and unequivocally under- 
 stood what are my sentiments on these 
 subjects, (established in my mind by no 
 cursory survey, but by the deliberate, and, 
 I trust, impartial and conscientious ex- 
 aminations of many years,) before I pro- 
 ceed to the minuter details, in the con- 
 sideration of which they are more or less 
 implicated ; and thus to save my audience 
 and myself from the trouble of suspect- 
 ing, or giving a controversial character to 
 any of the subsequent Lectures which I 
 may have the honour to address to you. 
 
 " Organization and life," observes Mr. 
 Hunter, "do not depend in the least on each 
 other. Organization may arise out of liv- 
 ing partSy and produce action ; but life can 
 never rise out of, or depend on organization. 
 An organ is a peculiar conformation of 
 matter, let that matter be what it may, to 
 answer some purpose, the operation of 
 which is mechanical. But mere organ-* 
 c 3 
 
22 
 
 ization can do nothing, even in mechanics ; 
 it must still have something corresponding 
 to a living principle, namely, some power." 
 
 Organization, therefore, must be con- 
 sidered as the mere mechanism, by which 
 the living principle dominates over its al- 
 lotted portion of material substance, adapt- 
 ing it to certain definite purposes, according 
 to the destiny of the living being in the 
 system of nature. " Our ideas of life," 
 Mr. Hunter has justly and beautifully ob- 
 served, "had been so much connected with 
 organic bodies, and principally those en- 
 dowed with visible action, that it required 
 a new bend to men's minds to make them 
 conceive that these circumstances were not 
 inseparable." Yet all animated nature 
 teems with proofs of the fact. 
 
 The power peculiar to life is evidenced 
 by four principal features. The first is that 
 of self-preservation, called by Dr. George 
 Fordyce, " the attraction of life' I would 
 rather call it the cohesion of life ; by which 
 the matter of which this mysterious prin- 
 
ciple takes possession, is preserved, by its 
 dominion over it, from decomposition. A 
 second is that of attraction, literally so 
 called, by which it takes and combines with 
 the living and self-preserving substance, 
 whatever tends to further and support its 
 purposes ; and in this indeed consists the 
 first overt act of the series of acts by which we 
 recognize it, and it is constantly displayed, 
 during its continuance, in nutrition. And 
 I presume it was this consideration that in- 
 duced Mr. Hunter to place on the first shelf 
 of his series of preparations, for illustrating 
 the oeconomy of life, the bulb of a common 
 hyacinth, which had been placed on a root- 
 glass at the proper season, and had just 
 begun to shoot down its roots, and show the 
 green commencement of its vernal growth. 
 To this power is necessarily superadded 
 the power of rejecting that which is incom- 
 patible with its purposes, or which, by use, 
 or by injury, or by disease, has become so. 
 But the fourth and most remarkable pro- 
 perty, and to which all the rest are sub- 
 servient and supplementary, is that which 
 has been called susceptibility, excitability, 
 
 c 4 
 
24 
 
 or irritability ; for although this latter term 
 has been chiefly applied to the muscular 
 structure, and therefore almost synonymized 
 with contractility, the import of the word 
 may be legitimately extended farther, and 
 applied to the capability which living parts 
 possess of altering their own condition, 
 either from causes arising in the mechanism 
 of which they form a part, or from causes 
 wh ich act upon them from without. Whether, 
 therefore, we look at the composition, or the 
 adaptation of the matter, the regularity of 
 the form, or the final causes of them all, we 
 must never lose sight of this active power, 
 to which the organization of the material 
 substance is, as we observed, merely a 
 mechanical instrument. Indeed we shall 
 always be exposed to serious mistake, if our 
 eyes are not constantly intent on both these 
 objects. To confine our attention to the 
 matter, and to disregard the power by which 
 it is actuated, must be an error of awful 
 amount. For how wonderfully is this 
 power displayed " in the operations con- 
 stantly going on in every organized body, 
 (I here borrow the elegant language of the 
 
25 
 
 learned President of the Linnean Society*) 
 from our own elaborate frame to the hum- 
 blest moss or fungus. Those different 
 fluids, so fine and transparent, separated 
 from each other by membranes as fine, 
 which compose the eye, all retain their 
 proper situations (though each fluid in- 
 dividually, is perpetually removed and re- 
 newed) for sixty, eighty, or a hundred years, 
 or more, while life remains. So do the 
 infinitely small vessels of an almost invisible 
 insect, the fine and pellucid tubes of a plant, 
 all hold their destined fluids, conveying or 
 changing them according to fixed laws, but 
 never permitting them to run into con- 
 fusion, so long as the vital principle animates 
 their various forms. But no sooner does 
 death happen, than without any alteration 
 of structure, any apparent change in their 
 material configuration, all is reversed. The 
 eye loses its form and brightness ; its mem- 
 branes let go their contents, which mix in 
 confusion, and thenceforth yield to the laws 
 of chemistry alone. Just so it happens, 
 
 * Introduction to Botany, p. 6. 
 
26 
 
 sooner or later, to the other parts of the 
 animal as well as vegetable frame. Chemi- 
 cal changes, putrefaction and destruction, 
 immediately follow the total privation of 
 life, the importance of which becomes 
 instantly evident, when it is no more." 
 And well does this able writer conclude 
 these remarks by observing, " that if the 
 human understanding can, in any case, 
 flatter itself with obtaining, in the natural 
 world, a glimpse of the immediate agency 
 of the Deity, it is in the contemplation of 
 this vital principle, which seems inde- 
 pendent of material organization, and an 
 impulse of his own divine energy." Yet, 
 after all, to look at this power, as if it were 
 magical, without a dutiful and scrutinizing 
 attention to the composition and arrange- 
 ment of the material under its government, 
 would lead us into all the absurdities of 
 empiricism. These two fields, then, display 
 a long and arduous task before us ; in which 
 all indeed cannot equally engage, but in 
 which some of us must labour and toil for 
 the benefit of the rest, for our own reput- 
 ation, for the honour of our profession, and 
 
27 
 
 for the security of those objects by which we 
 are all morally connected, the alleviation 
 of human suffering, and the general good 
 of mankind. 
 
 But as man is mortal, and as mortality, 
 and those things which tend to certify, to 
 accelerate, and to prevent, or rather to 
 postpone it, give to our profession its im- 
 portance, these form our greatest concern. 
 Some injuries, by their mechanical effects, 
 spoil or impair the members of which the 
 body consists, and disable man, for a longer 
 or a shorter period, from fulfilling the rela- 
 tive purposes of his existence here. Some 
 diseases sudden in their occurrence, others 
 slow in their operation, at length arrest his 
 projects, annul his energies, or reduce him 
 to an inanimate mass. Of these, who shall 
 count the number? Who can trace the 
 variety ? Who can resist the effects ? Yet 
 such is the duty, such the labour, such the 
 pleasure, and, alas ! too often such the 
 disappointment, of our most anxious and 
 strenuous efforts. 
 
28 
 
 Yet these efforts would lose their im- 
 portance, were the life of man merely like 
 that of a plant, or of a beast, and simply 
 intended for temporary display, and for 
 destruction, had he not powers, did he 
 not possess passions, were he not suscepti- 
 ble of emotions, capable of projects, and 
 answerable for purposes, different from, 
 and infinitely superior to, all other living 
 beings, which cover the surface of the earth. 
 To him has been allotted, not merely a 
 capacity to be trained, or to train, for sub- 
 servient usage ; but also the power of 
 directing that capacity to ages beyond him. 
 On him has been bestowed the power 
 of accumulating the knowledge of others 
 around him, and of those who have lived 
 before him, and of storing up the whole, 
 with such additions as he can collect, for 
 the benefit of those who are to succeed him. 
 His passions, his emotions, his wishes, his 
 designs, and his reflections, and the effects 
 of them all, are subjects of our serious and 
 necessary contemplation ; for he is ac- 
 countable, and he is immortal. No apology 
 can be necessary for saying this here. 
 
29 
 
 Surgeons indeed are chiefly concerned with 
 the body ; but it is with a body under the 
 influence of mind. For as it is not in the 
 mere mechanism of the human body, so 
 neither is it in the possession of the prin- 
 ciple of life, that it surpasses other living 
 structures ; many of which are seen to be 
 capable of retaining that principle, or rather 
 of being retained by it, and of preserving 
 the form which they had attained under its 
 influence, when they become disunited 
 from it, for a longer period than man, and 
 under circumstances which to his frame 
 would be speedily and inevitably destruc- 
 tive. It is therefore in the nobler purposes 
 for which man is formed, and the construc- 
 tion and arrangement of his organs to 
 answer and to conform to these nobler pur- 
 poses, that he surpasses them all. In many 
 sensibilities lessacute; in locomotive powers 
 greatly inferior; in muscular energies far 
 less powerful and active; and even in 
 durability of material composition exposed 
 to sudden or slow destruction, from causes 
 within him and without him, more than 
 some minute, and apparently insignificant 
 
animals ; and inferior in stature to many, 
 he is still the visible head of them all. 
 Fitted for his uses, formed for the successive 
 objects of his observation, subjected to his 
 dominion, excitements to his industry, 
 warnings to his caution, incentives to his 
 hopes, or animating evidences of his dignity 
 and his destiny, all of them call him master, 
 and feel exposed to his authority, his strata- 
 gem, or his force, whether they lurk in 
 concealment, or gnash in rage. 
 
 
 
 Yet, how superior soever in condition, 
 however superlative in beauty ; however 
 dignified in form, however noble in the 
 ultimate purposes of his creation, however 
 he may soar, " in all the magnanimity of 
 thought," 
 
 " Death's subtle seed within, 
 
 Sly, treacherous miner, working in the dark, 
 Smiles on his well-concerted schemes, and beckons 
 The worm to riot on a rose so red." 
 
 Nascentes morimur, finisque ab originc pendet. 
 
 MANIL. Astr. iv. 16. 
 
 The young disease, which must subdue at length, 
 Grows with our growth, and strengthens with our strength. 
 
31 
 
 That injuries or diseases, mechanically 
 affecting and deranging those organs which 
 are necessary to carry on the functions of 
 life, should occasion its cessation, is suf- 
 ficiently intelligible. But there are others 
 which defy or elude our present means of 
 investigation. You know I am saying no- 
 thing new when I tell you that such are 
 the cases of death from the poison of some 
 serpents ; as, for example, that of the Cobra, 
 de morte. Dr. Russell, in his History of 
 Indian Serpents, relates an instance, which 
 Mr. Bourchier communicated to him, of a 
 stout Arab, bitten by this snake, which is 
 only from six to nine inches long, and very 
 slender in its thickness ; and who expired 
 almost instantaneously, after exclaiming 
 that a snake had bit him. A Gentoo boy, 
 thrusting his hand into the wall of an old 
 house, was bitten in the hand, and in less 
 than ten minutes expired. 
 
 A Sepoy was bitten in the ankle by a 
 large snake, believed to be a Cobra de 
 capello, and was brought to Captain Gow- 
 die's house, within a quarter of an hour after 
 
the accident. His jaws were locked, his 
 eyes fixed, and very little sign of life re- 
 maining. Four large punctures were visible 
 on the ankle, to which eau de luce being 
 applied, the man gave marks of sensibility, 
 by drawing up his leg. Two bottles of 
 Madeira wine were then made warm, and 
 the jaws being forced open, so as to intro- 
 duce a funnel, almost the whole of the 
 wine, in the course of half an hour, was 
 poured down. The application of the eau de 
 luce was continued constantly for three 
 hours. The patient was now totally with- 
 out any sense of feeling whatever; and, 
 had it not been for a gentle heave of his 
 breast, every two or three minutes, Captain 
 Gowdie would have thought him dead. 
 He remained in this torpid state forty hours, 
 and then began to show signs of returning 
 life. It was twelve hours more before he 
 recovered his speech. He continued many 
 days in a languid state, but at length 
 became one of the stoutest men in the 
 regiment. No mention is made of either 
 swelling or discoloration of the ankle. 
 
33 
 
 An instance, not less interesting, is re- 
 lated in the eleventh volume of the Asiatic 
 Researches, of his own case, by Mr. Ma- 
 crae, civil surgeon at Chittagong ; where 
 the puncture of one fang, from a very small 
 snake, producing an injury scarcely visible, 
 nearly proved suddenly fatal. Nor in this 
 case did any particular appearance arise 
 in the part. Mr. Macrae ascribes his re- 
 covery to taking, in quick succession, con- 
 siderable doses of Sp. Ammon. Comp. The 
 effects also of the poisons of Ticunas and 
 Lamas, and of the Upas, and of the Hy- 
 drocyanic Acid, are very well known. 
 
 But injuries apparently the most trivial, 
 and where no suspicion can exist of any 
 poison being introduced, are sometimes 
 sufficient to destroy life. A stout healthy 
 young man trod on a nail in the floor of 
 a room, which went through his shoe, and 
 very slightly punctured the under surface 
 of his foot. On the tenth day after the acci- 
 dent, he began to complain of stiffness about 
 his throat, and wandering pains. In three 
 days he called on his apothecary for medi- 
 
 * 
 
34 
 
 cine to relieve them, and died with locked 
 jaw and the most violent opisthotonos, on 
 the following morning, only fifteen hours 
 from his being out. Yet on examination 
 of the body after death, the original injury 
 was scarcely visible ; nor could the smallest 
 morbid or preternatural appearance be any 
 where detected by the most careful ex- 
 amination. 
 
 I might here also cite the mysterious 
 influence of the canine, or hydrophobic 
 poison ; which, after remaining apparently 
 dormant, sometimes for months, but exerting 
 all the while a secret and deadly influence, at 
 length, with a giant's arm, invades the con- 
 stitution, producing one of the most terrific 
 diseases in the whole catalogue of human 
 miseries ; for which, let whatever may have 
 been pretended, no remedy has yet been 
 discovered ; and always cutting off the un- 
 happy sufferer, in three or four days at far- 
 thest, by a miserable death. 
 
 In other cases, we find extensive diseases 
 of the most important viscera, of the brain, 
 
and of the limbs, borne for years before 
 they produce death ; and sometimes even 
 entirely cured, after a long and painful 
 struggle. A girl of six years old, after 
 having been declining in health from Au- 
 gust, 1808, was attacked about the following 
 Christmas with sickness and head-ache, and 
 after a time became unable to see. The 
 pupils, however, contracted on the approxi- 
 mation of a candle, for a considerable time 
 afterward. At length it became quite in- 
 sensible. This child lived, with various 
 fluctuations, for a period of near six years. 
 In all this time, although having occasional 
 delirium, I always found her able to give a 
 rational answer to any question I put to 
 her. She became gradually weak, and 
 finally anasarcous, and at last died sud- 
 denly. On examination after death, I took 
 from the brain a full ale-quart of fluid. 
 There was a tumour in the cerebellum 
 about the size of a dove's egg, of that tex- 
 ture which is commonly considered scro- 
 fulous ; and a number of smaller ones of a 
 like nature were studded over the basis of 
 the cranium, producing ulceration of the 
 
 D 2 
 
36 
 
 bone wherever they lay, so as to destroy 
 in many points the roofs of the orbits. 
 On the other hand, an old friend of mine, 
 apparently in perfect health, sat down one 
 morning to make his will, for the express 
 purpose of leaving some freehold property 
 away from a drunken and profligate ne- 
 phew, who was the heir at law, to another 
 whom he justly esteemed, and in an instant 
 fell dead upon the table, with the memo- 
 randa of his intentions before him. I dis- 
 sected the body and the head ; but the only 
 mark of injury, and no doubt the cause of 
 his death, was a small extravasation of 
 blood under the pia mater, investing the 
 pons varolii, not exceeding, indeed scarcely 
 amounting to, a drachm. I may mention, in 
 passing, that this gentleman had always 
 suffered more or less from complaints which 
 he and his medical attendants considered 
 to be bilious, and resulting from an excess 
 of that secretion. The liver and its ducts 
 were, however, perfectly sound ; but the 
 cystic duct was completely obliterated, and 
 the gall-bladder, a mere small and empty 
 bag. Such, so unaccountable and so 
 
37 
 
 checquered, are the states, and fates, and 
 chances, of man on this globe, as it re- 
 spects his corporeal existence and the in- 
 tegrity of his frame. 
 
 But we must not overlook his mind ; 
 the powers with which it is endowed ; 
 the projects by which it is inspired ; the 
 emotions by which it is excited ; the disap- 
 pointments to which it is exposed ; and the 
 hopes by which it is relieved and sustained. 
 It may indeed be asked, what has all this 
 to do with Surgery ? I will tell you. Gen- 
 tlemen, what it has to do with Surgery. 
 Familiarized with others as we must neces- 
 sarily be, under all the contingencies and 
 vicissitudes of life, in every rank and sta- 
 tion, from the imperial diadem to the 
 meanest badge of poverty and distress, our 
 sentiments, and the promulgation of those 
 sentiments, must always have an important 
 influence on the tone, the conversation, 
 and perhaps often on the conduct, of the 
 society with which we are intermixed, and 
 who look up to us for relief in the most 
 trying and unexpected incidents of their 
 
 D 3 
 
38 
 
 lives. We are not indeed to pry into the 
 secret concerns of those who require our 
 assistance ; but we may eye their tempers 
 and their feelings with a philosophical, 
 though silent observance, in order to note 
 their pathological influences. Nor can it 
 always be a matter of justifiable indifference 
 to us, (such are the real, but various and ge- 
 nerally debilitating effects of the passions) 
 even as it respects the treatment of our 
 patients, whether injuries are received by 
 them, or sudden diseases invade them, or 
 latent diseases become developed, under 
 the fortitude of heroism, or the vacillations 
 of timidity ; under the consciousness of rec- 
 titude, or under the compunctions of guilt; 
 under the anxieties of embarrassment, or 
 the satisfactions of competence ; under un- 
 provided disappointment, or unexpected 
 success ; under the fretfulness and irrita- 
 bility of a peevish temper, or the composed 
 resignation of philosophy and religion ; 
 under the finer sensibilities of affection 
 and virtue, or the careless and stubborn 
 obduracy of habitual crime. In many 
 points of view men are to be considered 
 
39 
 
 as modifications of material substance, for 
 such they are ; in others they are to be 
 looked on as living animals, for such also 
 they are. But there are others in which 
 they must moreover be looked upon as 
 moral and intellectual, as accountable and 
 immortal beings. Surgeons must not forget, 
 or overlook, that higher principle in man- 
 kind on which their chief dignity and duty, 
 their powers of contemplation and reflec- 
 tion, their present and final responsibility, 
 their happiness and composure, and often 
 their greatest sufferings, in consequence, 
 depend. 
 
 " For see, how all around them wait 
 The ministers of human fate, 
 And black misfortune's baleful train ! 
 Ah ! show them where in ambush stand, 
 To seize their prey, the murd'rous band ! 
 Ah, tell them they are men \ 
 
 " These shall the fury passions tear, 
 The vultures of the mind ; 
 Disdainful anger, pallid fear, 
 And shame that skulks behind. 
 Or pining love shall waste their youth ; 
 Or jealousy, with rankling tooth, 
 
40 
 
 That inly gnaws the secret heart ; 
 And envy wan, and faded care ; 
 Grim visaged comfortless despair, 
 And sorrow's piercing dart. 
 
 " Ambition this shall tempt to rise ; 
 Then whirl the wretch from high ; 
 To grinning scorn a sacrifice, 
 And bitter infamy. 
 
 The stings of falsehood these shall try. 
 And hard unkindness' alter'd eye. 
 That mocks the tear it forced to flow ; 
 And keen remorse with blood defiTd, 
 And moody madness, laughing wild, 
 Amid severest woe. 
 
 " Lo ! in the vale of years beneath, 
 A grisly troop are seen ; 
 The painful family of death, 
 More hideous than their queen, 
 This racks the joints this fires the veins ; 
 That ev'ry laboring sinew strains ; 
 Those in the deeper vitals rage. 
 Lo ! poverty to fill the band, 
 That numbs the soul, with icy hand; 
 And slow-consuming age."* 
 
 Not that I wish Surgeons to be gloomy 
 fanatics, or expect that they should all be- 
 come abstruse metaphysicians, or subtle 
 
 * Gray. 
 
disputants in theology or in ethics ; but 
 there are among us individuals, and I trust 
 there always will be, so furnished with 
 talent, so prepared by education, so fa- 
 voured with opportunity, and so animated 
 by philanthropy, that they will feel it 
 their duty, and find it their pleasure, to 
 pursue our profession, not merely in order 
 to obtain a respectable provision, or to 
 amass an honourable fortune, but also to 
 extend the boundaries of science, and to 
 benefit succeeding generations. Such per- 
 sons will dive deep into principles. They 
 will endeavour to survey human nature in 
 its widest range, and to scrutinize its mi- 
 nutest relations. In short, they will fully 
 adopt the sentiment of Chremes in Te- 
 rence, so beautifully and philosophically in- 
 scribed by Sir William Blizard over the 
 entrance to his dissecting room : 
 
 " Homo sum human! nihil a me alienum puto." 
 
LECTURE II 
 
 MARCH 20. 
 
 THE body being made up of a combination 
 of different systems of structures, inter- 
 woven with each other, possessing distinct 
 functions, but nevertheless in a state of 
 mutual dependence, and reciprocal in- 
 fluence, it may be proper to take a view of 
 them both separately, and in the relations 
 they bear to each other, in a natural state, 
 before we attempt to analyze their morbid 
 derangements. Indeed, it is of the greatest 
 importance to us in practice that we should 
 possess and preserve a correct picture or 
 map of them in their several relations, 
 whether local or functional, at the same 
 time, in our minds ; that we may thus be 
 more promptly aware of their communica- 
 tions with, and effects upon each other, both 
 
43 
 
 in health and disease. For no considerable 
 derangement can happen in any one of 
 these systems, without others, and generally 
 all of them, being either directly or indi- 
 rectly affected ; or in such danger of be- 
 coming so, as to call for a prepared and 
 vigilant eye, on our part, to watch them 
 well and carefully, that we may be ready to 
 detect their earlier, as well as their more 
 advanced deviations from a healthy condi- 
 tion ; and also in many instances to foresee 
 the probability of such aberrations, and 
 as far as possible to provide against them ; 
 to resist them as they arise, and even after 
 they have been already counteracted or sub- 
 dued, to guard more effectually against their 
 recurrence. And it will always be an ob- 
 ject with the well-informed and judicious 
 practitioner, never, if he can help it, to at- 
 tempt the relief of one system, without 
 considering what effect his measures are 
 likely to have upon others, so as to avoid 
 any real and permanent injury to the rest. 
 
 The opinion is now very generally and 
 justly exploded, which was formerly enter- 
 tained, that growth is merely the unravel- 
 
44 
 
 ling and developement of parts, which first 
 pre-existed in miniature. On the contrary, 
 we see that different structures are succes- 
 sively built up, for the formation of the 
 complete individual. Some of them are 
 only for temporary purposes, and are to 
 be rejected or taken away as soon as 
 those temporary purposes are answered. 
 And of those which are to remain, the pro- 
 gress does not go on equally, nor always 
 contemporaneously. In the incubated egg 
 of a sparrow, I found the two eyes of the 
 chick at one period equal in bulk to all the 
 rest of the body. In the early human foetus, 
 the head bears a larger proportion to the 
 other parts than it afterward retains, and the 
 sexual organs only arrive at perfection long 
 after birth; and then attain it by a quick 
 progression, after a long comparatively 
 simple existence. It appears, therefore, 
 that the several formative processes arise 
 one out of another, in succession ; that the 
 previous establishment of some, and a good 
 degree of confirmation of the parts they 
 construct, is essential to the commencement 
 and continuance of the rest, or for their 
 own permanence and safety during the 
 
1 
 
 45 
 
 production of others ; and that thus the 
 perfection and harmony of the whole are at 
 last more effectually secured. 
 
 Let us commence by taking a general 
 view of the sanguiferous system. For al- 
 though this may, in some points of view, 
 appear to require preliminary consider- 
 ations, a similar objection might be brought 
 to any other line from which we might 
 propose to begin our enquiries. But this 
 is the first by which we are able distinctly 
 to trace the active operations of the prin- 
 ciple of life and growth. It is for this 
 reason that the obvious progress of the in- 
 cubated egg, which is so readily examinable 
 in all its stages, has so powerfully attracted 
 the careful attention of the greatest anato- 
 mists and naturalists, from Aristotle down- 
 ward to Harvey, Malpighi, and Hunter. 
 The examination of this interesting object 
 exhibits to us the first visible result of 
 vital action, by the production of that 
 distinct and diffusible substance, out of 
 which all the various parts to be evolved 
 are to receive their supply, both for the 
 support of their substance, and of their 
 
46 
 
 actions ; and this is found first in a small 
 spot, being contained in a circumscribed 
 bag, or vessel, endued with the power of 
 action and re-action on its contents, which 
 causes it to exhibit a pulsatory motion, by 
 alternate contractions and dilatations. From 
 this, tubes are soon found to proceed, that 
 extend the range of the fluid, which now 
 enters into them also ; and from these 
 again, others originate, which are formed 
 and nourished by the same fluid, and a cir- 
 culatory system is at length established, by 
 which it is transmitted along one set of 
 vessels, and returned to the heart, its ori- 
 ginal source, by another set; provision 
 being made, during the formation and 
 growth of the whole series, infallibly to se- 
 cure both the passing and returning cur- 
 rents in their right track. Nor unless these 
 different branches of the sanguiferous sys- 
 tem are properly formed, established, and 
 connected, can the animal perfectly carry 
 on and continue its functions. Some de- 
 ficiencies and derangements do not in all 
 cases stop the growth of the foetus; but 
 they generally render it unable long to sus- 
 
47 
 
 tain its vital energies, after the time has ar- 
 rived for its separation from the parent ; 
 so that it speedily perishes under exposure 
 to circumstances, which one perfectly form- 
 ed is fitted, and would be able, to endure 
 with impunity, according to the place in the 
 general system of being for which it is 
 destined. 
 
 So truly wonderful, so far surpassing all 
 our powers of conception, is the gradual,' but 
 certain production of such a circulatory sys- 
 tem, fitted up in all its minutest parts with 
 the exactitude and co-adaptation which our 
 dissections and injections now enable us to 
 demonstrate, and all this beginning and go- 
 ing on in a substance originally a mere pulpy 
 speck, that we cannot feel surprized at the 
 crude and imperfect notions of the ancient 
 philosophers and physicians respecting it, 
 nor at the incredulity with which its disco- 
 very in later times was first received. The 
 paucity of their means of investigation, 
 and of communication with each other, 
 made their pursuits in a great measure for 
 a long time to consist of repetitions of the 
 
48 
 
 same incipient enquiries, and made natural 
 knowledge advance with lame and tardy 
 steps. Aristotle, whose enquiring and com- 
 prehending mind had been led to numerous 
 and attentive examinations of the produc- 
 tion and growth of animals, noticed this 
 first appearance of the heart in the egg on 
 the fourth day of incubation ; and observ- 
 ing that from this palpitating point the evo- 
 lution or formation of other parts seemed to 
 commence and proceed ; and finding, as he 
 tells us, on dissection, that all the other or- 
 gans of the body were permeated by the 
 veins, which derived their origin from 
 thence, and being ignorant of the true use 
 of the arteries, which are found empty in 
 the dead body, concluded that the blood 
 was formed in the heart, in all the future 
 stages of life ; and was from thence pressed 
 into the veins, out of which it had no na- 
 tural exit ; but remained in them as a 
 vital juice, with an undulatory motion, to 
 moisten and warm and nourish the parts 
 to which it was distributed. This opi- 
 nion laid the foundation of the Galenic 
 theories, and remained, with various mo- 
 
49 
 
 difications, till Harvey, by anatomical in- 
 dagation, or, to use his own words, " dis- 
 sectione anatomica, multiplici experientia> 
 diligenti et accurata observatione" produced 
 those irrefragable proofs of the circulation, 
 which are detailed in his immortal work. 
 The complete demonstration of such a sys- 
 tem of vessels in animals, as his discoveries 
 presented to view, must indeed at first 
 have afforded a grand and stupendous ob- 
 ject of contemplation, and may soften the 
 derision we might be inclined to feel against 
 Riolan, who was Harvey's warmest oppo- 
 nent, and who has a chapter expressly en- 
 titled, Quod sit IMPOSSIBILIS sanguinis totius 
 circulatio^ scepius in die repetita. For even 
 now, accustomed as we are to behold it, in 
 all the lustre of its present evidence, and 
 familiarly as we are habituated to reason 
 from it, its first formation and establish- 
 ment continue, and probably ever will con- 
 tinue, a mysterious and inscrutable process. 
 And it seems difficult to suppose that a 
 person of a truly philosophical mind, not 
 pre-occupied by some other object, could 
 now pass through our museums, and atten- 
 
 E 
 
50 
 
 lively behold the developement of a sys- 
 tem of vessels, apparently so simple in its 
 commencement, and ultimately extending 
 into ramifications so infinite in number, sp 
 varied in appearance, so exquisite in te- 
 nuity, so intervolved in complication, so 
 diversified in functions, and so united in 
 purpose, without some sentiment approach- 
 ing to adoration. Let me here employ the 
 words of the late Dr. Gregory: " Nobile 
 opus, nee nisi UNI excogitandum." 
 
 Every organ and part of the body, how- 
 ever, evidently derives its origin and sup- 
 port from the action of some blood-vessel 
 or vessels which are produced for that spe- 
 cific purpose: and nothing surely can be 
 
 more curious and beautiful than to behold 
 
 
 
 vessels, having their origin from the same 
 source, and conveying the same identical 
 fluid, effecting such an immense variety of 
 results, giving existence to so great a num- 
 ber of parts, and supplying them with but 
 one and the same material, out of which 
 they derive all that is necessary to support 
 themselves, and to carry on their respective 
 

 51 
 
 functions in the animal oeconomy. In order 
 to this, they ramify and intervolve with a 
 minuteness that in many instances eludes 
 our nicest research, and, in consequence of 
 their combinations with other parts, carry 
 on an incessant and multitudinous series 
 of chemical changes. Some, indeed, have 
 been ready to suppose, that the various 
 parts of the body are nothing else than an 
 endless tissue of vessels, and that they 
 differ only, or chiefly, from each other, in 
 the modes of their subdivision and arrange- 
 ment. This, however, is a notion too ab- 
 surd to bear examination, and contrary to 
 the most manifest facts, which prove to us 
 that every part, besides having vessels and 
 nerves of its own, has olso its own peculiar ^ 
 or parenchymatous substance* by wlilcb 
 is essentially distinguishe 
 The masterly observatic in this 
 
 Theatre by Sir Anthony Carlisle, in one of 
 his lectures on this subject, will be well re- 
 membered by all who heard them, and 
 render any farther allusion to it at present 
 superfluous. 
 
 E 2 
 
52 
 
 All the different parts, then, of which 
 the body is composed, derive their pa- 
 renchymatous substance from the supply 
 which the vessels afford them ; and it is 
 the duty of the Surgeon to make himself 
 as fully as possible acquainted with the 
 origin, course, and distribution of these 
 vessels, and with the peculiar nature and 
 qualities of the respective and distinct sub- 
 stances which are maintained by their in- 
 strumentality. 
 
 In studying these, as we perceive that a 
 variety of structures are built up, so we 
 find that they are produced and perfected 
 in a certain order, form, collocation, and 
 relation to each other ; and that not only 
 is a provision made for regularly convey- 
 ing to each part its requisite portion of the 
 nutritious fluid, and returning that from 
 which the appropriate supply has been se- 
 lected ; but that also a peculiar set of ves- 
 sels, of wonderful tenuity, but of equally 
 wonderful fabric and efficiency, is appointed 
 to absorb and carry off from the paren- 
 chymatous substances, arid from the vari- 
 
ous interstices and surfaces of them, such 
 superfluities, or spoiled materials, as may 
 from time to time present themselves ; and 
 that these vessels essentially act in model- 
 ling those parts to which they are distri- 
 buted, and in accommodating them to 
 various novel and unnatural conditions, 
 into which they are occasionally brought; 
 although, in the performance of their func- 
 tions, they are not unfrequently also the 
 means of introducing into the constitution 
 things that are deleterious, and sometimes 
 fatal; and even of propagating the evil ef- 
 fects of injuries inflicted on themselves, 
 with violent and alarming rapidity, to other 
 parts. These vessels unite with others of a 
 similar nature, which take up the nutritious 
 matter from the organs of digestion, and 
 terminate in a common tube, which pours 
 their contents into the returning blood, to 
 combine and assimilate with it in the course 
 of its recirculation, that all which is useful 
 may be employed or retained, and all that 
 is unsuitable and effete may be carried off 
 by the proper and appointed organs for 
 their separation and ejection. The san- 
 
 E 3 
 
guiferous and absorbing vessels are thus 
 rendered contributory to each other's pur- 
 poses, and probably are so, by more frequent 
 and less circuitous communications, than 
 this larger, more remarkable and import- 
 ant one, the Thoracic Duct. 
 
 But as this formation and arrangement of 
 parts would alone go but a very little way 
 toward accomplishing the purposes for 
 which life is bestowed, while the powers 
 which complete that formation and ar- 
 rangement are employed in this work, they 
 are also engaged in constructing another 
 apparatus within the body, by which it is 
 to be made fit for a state of existence inde- 
 pendent of its parent ; to become capable 
 of possessing and maintaining a variety of 
 relations toward external objects ; of enjoy- 
 ing consciousness ; of providing for its own 
 support; and of continuing its kind. To 
 answer these, and other important ends, 
 the nervous system is formed, and con- 
 nected with every other part of the body, 
 all the functions of which are more or less 
 subjected to its influences, and some are 
 
55 
 
 altogether and absolutely dependent on its 
 integrity and health. 
 
 Of this system, the brain has been con- 
 sidered as the root, or center : the nerves, 
 when their connection with it is destroyed, 
 being rendered incompetent to their offices, 
 neither communicating sensation, nor con- 
 veying volition. But recent observations 
 have shown that this view of the subject is 
 imperfect, and has led philosophers some- 
 what astray in their investigations. The 
 examination of foetuses which have been 
 born without brain, or with a very im- 
 perfect one, demonstrate that neither the 
 nerves nor the organs of sense are de- 
 pendent on the brain for their formation ; 
 and that, as long as the foetus retains its 
 connection with the mother, its nourish- 
 ment and growth may go on, without a 
 proper or perfect brain of its own. It is 
 probable, therefore, that the nerves in these 
 instances do answer important purposes, as 
 long as that connection is continued ; and 
 derive, while in utero, from the mother, a 
 certain portion of that influence, which af- 
 
 E 4 
 
56 
 
 terward should be supplied by the brain of 
 the individual itself, and for want of which, 
 when born, it speedily perishes. 
 
 The observations and experiments of 
 Volta, Sir Humphrey Davy, Sir Everard 
 Home, Professor Brande, and others, have 
 thrown much additional light on the subject 
 of cerebral and nervous influence ; and 
 show that one most important, and perhaps 
 the primary view to be taken of the nervous 
 system, is that of a diffused electrical ap- 
 paratus, by the operations of which the 
 actions of the blood-vessels, in their re- 
 spective courses, are regulated, and those 
 chemical changes are effected in the mate- 
 rial supplied by them, to every part of the 
 body, that are essential to the secretions of 
 every kind ; and, of course, to nutrition, 
 which must depend on a due separation, 
 combination, and arrangement of the ele- 
 ments of which the different organs are 
 composed. 
 
 * 
 
 A more obvious, and therefore more 
 marked influence, but most probably of an 
 
analogous kind, is conveyed from the brain 
 through the nerves to the involuntary 
 muscles, and a still more sensible and con- 
 spicuous one to those which are under the 
 controul of the will, in order to excite them 
 to their proper actions. But we see also 
 that the nerves are capable of conveying to 
 them the Galvanic influence, and to excite 
 them to powerful contractions after se- 
 paration from the body to which they be- 
 longed. So that neither are the nerves 
 dependent on the brain for their existence, 
 nor for their inherent fitness to communi- 
 cate to the excitable fibres that influence 
 which causes them to act, and which in 
 the living body they conduct from the 
 brain, and the medulla spinalis. But they 
 are dependent on the brain for a perma- 
 nent, and continuous, and definite source 
 and direction of this influence, without 
 which their powers soon become uncertain, 
 and irregular ; and finally, exhausted and 
 extinct. 
 
 That other nerves should communicate 
 the impressions they receive, which are 
 
58 
 
 called sensations, to the mind, or conscious 
 principle, from their extremities by means 
 of the brain, is a fact still more deeply 
 mysterious. For the nerves have no power 
 to receive sensations apart from their con- 
 nection with the brain ; nor the brain itself, 
 except through the intervention of the 
 nerves ; neither are both together compe- 
 tent to such a result under all circum- 
 stances ; so indeed as to show the necessity 
 of admitting that conscious principle, as 
 one totally distinct from material compo- 
 sition and arrangement. In some cases we 
 can explain this incompetence, by observing 
 a mechanical impediment to the continuity 
 of their relations ; but in no case are we 
 able to comprehend their competence to 
 the effects under our notice ; nor do any 
 of our researches seem to have advanced us 
 a step toward any probable method of do- 
 ing so. 
 
 Equally, if not more remote, are we 
 from any power to explain the connection 
 which subsists between the brain and what 
 have been called the internal senses, or 
 
59 
 
 the mental faculties and propensities. Me- 
 mory, thought, judgment, the passions, and 
 their antidotes, far elude our keenest specu- 
 lations. We must take them as we find 
 them momentous facts, continually calling 
 forth our careful attention ; but an attention 
 which places us on the simple ground of 
 observers only, from which if we endeavour 
 to rise, we inevitably fall. 
 
 But as all these are more or less con- 
 nected, either by priority, co-existence, or 
 succedence, with corporeal actions, it seems 
 necessary, and is sufficiently comprehensible, 
 that there should be an organ, or organs, by 
 which the conscious principle might directly 
 communicate with those nerves, through 
 the intervention of which, the fulfilment of 
 mental purposes, by the performance of 
 those corporeal actions, is destined to be 
 effected. And as it is not an incurious, 
 neither can I discover that it is at all a 
 reprehensible subject of examination, to 
 investigate what parts of the brain more 
 immediately subserve to the exercise of the 
 different faculties or propensities which we 
 
60 
 
 discover, by their corresponding actions, 
 and where they in reality exist. Drs. Gall 
 and Spurzheim, as you well know, have 
 suggested, and to a considerable extent 
 followed up, the observation and dissection 
 of the prominent features and parts of the 
 brain which they discovered in particular 
 individuals, in whom any peculiar faculty 
 or propensity had been remarkable ; and 
 also of the structure and evolution of the 
 different parts of the brain, in animals whose 
 dispositions and habits are most strongly 
 marked, 
 
 I am neither, at present, prepared, nor 
 inclined, to contend for the verity of the 
 indications on these subjects which the gen- 
 tlemen I have named have already pub- 
 lished. But whether they be just or erro- 
 neous, I think I am still founded in asserting 
 that the mode of enquiry they have pursued 
 and recommended, although not the only 
 one by which we are likely to gain any 
 satisfactory knowledge on the subject, is at 
 least one of the most important. For to 
 this should certainly be added a careful ex- 
 amination of the brains of persons who, 
 
61 
 
 by injury, or disease, have had any parti- 
 cular faculty impaired or abolished, and 
 noting how far these deficiencies correspond 
 with the assumed offices of the parts af- 
 fected. And it ought not to be forgotten, 
 nor lead to any contempt of the theory in 
 general, that in entering on a field of in- 
 vestigation so vast, so variegated, and so 
 much dependent on minute and discri- 
 minating anatomy, many erroneous steps, 
 and inaccurate views, should at first be taken. 
 But these do not impugn the propriety of 
 the investigation, nor of the means of pur- 
 suing it. I must, however, observe, that 
 I attach less importance to the form of the 
 skull than Drs. Gall and Spurzheim have 
 done. Nor do 1 perceive that the existence 
 of the organs for the appropriation of which 
 they contend, as separate and defined, ne- 
 cessarily implies a particular formation of 
 the bony case in which they are contained, 
 any more than the existence or office of 
 the eye depends on the graduations of the 
 socket, or the greater or less protuberance 
 that the eye itself assumes, in different na- 
 tions, or in different individuals. In all 
 
62 
 
 probability ages may elapse before a suffi- 
 cient collection of facts can be accumulated, 
 to form a systematic code, worthy of gene- 
 ral reception, of the laws which govern 
 this part of the animal constitution. But 
 the search for them can be neither unrea- 
 sonable nor improper. The faculties and 
 propensities of animals may be examined 
 as innocently as their corporeal structures, 
 which indeed are the real and only instru- 
 ments by which these propensities and 
 faculties are made manifest. To suppose 
 that if we could discover the seat of any 
 of these, or, to speak more correctly, the 
 situation and structure of that part of the 
 nervous system, by which the organs con- 
 joined or allotted to them are first brought 
 into agency, and from whence their in- 
 fluence is propagated to the structures, and 
 combinations of structures, which obey 
 their impulses, we should thereby loosen 
 the bands of morality, and afford the cri- 
 minal passions an unlimited indulgence, is 
 as groundless as to imagine that because we 
 know the structure of the eye, and the ear, 
 and can point out the uses of their consti- 
 
63 
 
 tuent parts, and of the whole in their com- 
 bination, and can demonstrate the muscles 
 and nerves by which they are directed and 
 employed, we should therefore endanger 
 an immoral, or injurious use of them. Ra- 
 ther must it tend more fully to strengthen 
 the virtuous resolutions of every one bent 
 on the attainment and preservation of men- 
 tal and moral excellence, to feel the salu- 
 tary alarm of a conviction, that if he 
 disorders his frame by criminal practices 
 or excesses, he will deteriorate from the 
 vigor and perfection of his intellectual 
 habits and exercises ; and that if, he does 
 not controul the gratification of immoral 
 inclinations, there is a certain connection, 
 of strong, though perhaps not of indis- 
 soluble necessity, which will cause him to 
 suffer more or less in his bodily perfection; 
 while to add the force of habit to intellect 
 and virtue, is to keep his outward frame in 
 a state adapted to the harmony and im- 
 provement of his mental and his moral 
 nature. The mens sana and the corpus 
 sanum are perhaps more intimately Dallied 
 than many who have not attended to the 
 
64 
 
 subject are aware. Nor is the remark either 
 philosophically or ethically untrue, that 
 vice and its consequences are fastened to 
 one chain, although they do not always 
 keep an equal pace. 
 
 At all events, we may congratulate our- 
 selves on the greater and more accurate 
 degree of philosophical examination which 
 the nervous system has lately attracted ; 
 apart from those speculations, falsely called 
 metaphysical, but more justly denominated 
 by Sir A. Carlisle ultraphysical, with which 
 they were formerly blended and entangled, 
 to the injury of calm investigation, and of 
 sober induction. I trust we are more ef- 
 fectually learning to avoid those rapid 
 transitions from few, and insulated, and 
 partial facts, (facts, however, notwithstand- 
 ing,) to general conclusions, which have for 
 so many ages been the bane of medical 
 science. Deeply should this, among the 
 many wise observations of Lord Bacon, be 
 impressed on the mind of every student, 
 not to check, but to animate his enquiries; 
 not to damp, but to regulate his zeal : 
 
65 
 
 " Inductio qua procedit per enumerationem 
 simplicem, res puerilis est ; et precario con- 
 cludit ; et periculo exponitur, ob instantia 
 contradict oria ; et plerumque secundum pau- 
 ciora quam par est, et ex his tantummodo quce 
 prostcz sunt, pronunciat" The disposition 
 to form hasty inferences, which is so apt to 
 beset that period of our education when 
 the light of science first breaks in upon the 
 mind, and when the charm of novelty is so 
 apt to inspire a seductive and unwatchful 
 confidence, must be guarded against by a 
 modest and teachable temper, lest we too 
 quickly mistake the dawn of the sun for its 
 actual rise, and lose our way among the 
 mists, which are only beginning to disperse. 
 
 But to proceed: The systems to which 
 I have already adverted, enter into the com- 
 position, supply the materials, remove the 
 superfluities, and regulate the functions, of 
 every organized structure in the body. 
 Arteries, veins, absorbents, and nerves, per- 
 vade the texture of all, and are essential to 
 the support and tlie actions of all, how 
 varied soever may be their essential or 
 
 F 
 
66 
 
 subordinate uses. It is by the local or 
 general derangement of some or other of 
 these systems, that all diseases begin and 
 proceed; and by their restoration, as far as 
 possible, to a natural and harmonious state, 
 that the cure of these diseases is to be 
 effected. We are not, we cannot be, we 
 must not attempt or affect to be, magicians 
 in science. It is indeed certain, that many 
 things, indisputable in their truth, elude all 
 our powers and present means of explica- 
 tion, but must nevertheless be admitted, and 
 held fast, as facts, so far as they go. But 
 we must not be unmindful of the propriety 
 and necessity of studying the principles, as 
 well as the facts, in every case. We are 
 not merely to consider what remedy will 
 alleviate, or cure a disease, but also how it 
 alleviates or cures it. What effects, advan- 
 tageous or disadvantageous, does it produce 
 in the course of its operation, upon the 
 blood-vessels, the absorbents, and upon the 
 nerves of the parts affected, or of the con- 
 stitution as a whole; and how may we attain 
 the good, and avoid, or overcome the evil, 
 if there be any, which lies in our way. This 
 
67 
 
 is the true philosophy of Medicine and 
 Surgery. Destitute of this, we must verge 
 to empiricism. Instructed and habituated 
 to this, we advance with humble security ; 
 we multiply our own resources ; and in pro- 
 portion to our real progress, and consistency 
 of conduct, we shall deserve the confidence 
 of those who look up to us for aid. 
 
 What then, we must next enquire, are the 
 structures and offices of the numerous parts 
 into which all these systems enter ? How 
 are they united and related to each other, 
 so as to form a harmonised and perfect 
 whole ; and how is this whole, and the por- 
 tions of which it consists, related to the 
 beings, animate, or inanimate, which sur- 
 round it? How does it receive and com- 
 pound its supplies, and reject superfluous 
 and noxious intermixtures. How are the 
 nutritious substances disposed of and ar- 
 ranged in its various structures ? And by 
 what means, and subject to what results, 
 may any of those structures be violated, 
 disturbed, diseased, or destroyed. 
 
 F 2 
 
68 
 
 First, we must direct our attention to that 
 series of organs, on which the support of 
 the whole animal fabric, after its exclusion 
 from the womb of the mother must depend ; 
 and the health, and actions, and diseases of 
 which, have a constant and important influ- 
 ence upon the whole ; while they, in their 
 turn, are liable to be affected by the condi- 
 tion of any other part. In all cases, the 
 state of the organs of digestion demands 
 our distinct and watchful attention. It is 
 to them that the chief materials by which 
 the whole structure of every part is sup- 
 ported are first conveyed, in order to un- 
 dergo the first processes of assimilation. 
 It is from hence the blood-vessels derive 
 their supply, through the intervention of the 
 absorbents. It is into them that the most 
 important secretions are passed, for the 
 production of which, large, and numerous, 
 and highly organized parts are constructed. 
 To the digestive organs, and their append- 
 ages, a great portion of the blood itself is 
 distributed, and large, important, and com- 
 plicated plexuses of nerves are allotted, 
 under whose influence their offices are regu- 
 
 16 
 
69 
 
 lated ; and this, for the most part, without 
 the consciousness or interference of the 
 mind. Organs which form so large a part 
 of the whole frame, which are essentially 
 necessary for the sustenance of the whole, 
 and for the repair of such injuries as may 
 occur, must necessarily possess an extensive 
 and perpetual influence over the whole. 
 Unless they go on acting aright, the consti- 
 tution must be more or less disturbed ; the 
 nutritious fluid will be deficient, or redun- 
 dant, or badly prepared, and morbid actions 
 may be naturally expected to arise in various 
 parts. Nor are those supplementary organs, 
 or their proper actions, to be overlooked, 
 which separate and eject the faeces. That 
 the effects of disorders in the abdominal 
 viscera, in producing and modifying many 
 local, as well as constitutional diseases, 
 should have attracted so large a share of the 
 attention of that distinguished member of 
 the Council of this College, whose publica- 
 tions on the subject are, or ought to be, in 
 all your hands, and who so frequently and 
 eloquently introduced them in his lectures 
 in this Theatre, is a proof of the wise and 
 
 F 3 
 
70 
 
 extensive range of his professional studies ; 
 and contributes, with many other eminent 
 qualifications, to hold him out as an ex- 
 ample to all our members. Mr. Hunter 
 appears to have devoted less attention to 
 this part of the animal economy than to 
 some others ; but he prepared the way for 
 his successors to do so, by his examination 
 of the laws of life ; by a multiplied accu- 
 mulation of beautifully illustrative prepara- 
 tions, from many animals, contained in this 
 Museum ; by his notice of the effects of the 
 gastric juice on the stomach itself after 
 death, and by his investigation and account 
 of the sympathies which are established, 
 between the different parts of the body. 
 
 Thus far, however, we have reached only 
 to the general substance, out of which the 
 living fabric of the human body is built up, 
 the oil, and wick, as it were, of the lamp 
 of life. We must now proceed to consider 
 how the flame itself is supported ; by what 
 means that form we behold flourishing in 
 health, in beauty, and in activity, is pre- 
 served so long from becoming a cold, dis- 
 
71 
 
 gusting, inanimate corpse ; and by what 
 arrangement it is, that the very atmosphere, 
 which is the agent for reducing man to his 
 original elements, is so made to be the 
 essential mean of his conservation, that the 
 privation of it, for a few short minutes only, 
 becomes the certain cause of his inevitable 
 and immediate destruction. 
 
 We learn that after the Creator had first 
 formed man out of the dust of the ground, 
 he breathed into his nostrils the breath of life, 
 and man became a living soul. A phraseo- 
 logy indicating respiration, or the conse- 
 cutive receptions and transits of air by 
 appropriate organs, to be the prime and 
 indispensable requisite of vitality. So it is 
 to all animated beings without exception. 
 For totally immersed in oil, either volatile 
 or fixed, which altogether excludes this 
 process, no vegetable can grow, nor any 
 animal body continue to live. Indeed, life 
 and breath are almost synonymous terms. 
 No object in Anatomy and Physiology is 
 more curious and important than the reci- 
 procal and uniform correspondence which 
 
 F 4 
 
72 
 
 exists between the circulation and aeration 
 of the nutritious fluid ; each process being 
 essential to the continuance of the other, 
 and both to the energies of every vital part. 
 By his superior adaptation for the regular 
 performance of these functions in their due 
 harmony, man is rendered the most univer- 
 sal inhabitant of the globe. From the most 
 frozen regions of the north, which are clad 
 in perpetual snow, to the scorching heats of 
 the equatorial line, and under transitions 
 which no other animal but himself, and 
 those most essential to his uses, can with 
 impunity endure, man breathes, man pul- 
 sates, man lives, and we must indeed also 
 add, man dies. 
 
 In the hasty view to which I must limit 
 myself, of the important organs of respira- 
 tion, 1 shall begin with that to which I have 
 just alluded: " into his nostrils was breathed 
 the breath of life." Nor is the configura- 
 tion and appropriateness of this first part 
 of the breathing apparatus, that is so con- 
 stant, and so peculiar in man, unworthy of 
 our regard ; for to man, perhaps more than 
 
73 
 
 to any other animal, is this the gate 
 through which the air usually first passes 
 in its way to the pulmonary cells ; pre- 
 senting him in its course with fragrant 
 odours ; or warning him of noxious qua- 
 lities, by which it has been impreg- 
 nated. As the organ of smell, and as a 
 feature in physiognomy, the human nose 
 has naturally commanded attention at all 
 times. As a passage for the air in breath- 
 ing, it has not been so much studied ; but 
 we may hereafter have an opportunity to 
 remark how fitly it is constructed, to con- 
 duct the respirable atmosphere directly be- 
 hind the epiglottis, and yet anterior to the 
 pharynx, into the trachea, in every inspira- 
 tion ; as well as to return that which has 
 been breathed, in a direct and opposite line, 
 through the same channel, when there is 
 no occasion, or inclination, to employ it in 
 speaking, or in other exertions which call 
 for its emission through the mouth. 
 
 But whether the air go into the bronchial 
 tubes by the mouth, or the nostrils, it is 
 made to pass into countless myriads of cells 
 
74 
 
 in the lungs, and to return from thence 
 about 30,000 times, or more, every 24 
 hours ; in order to impart through the coats 
 of those cells to the blood circulating 
 through the infinitely minute sanguiferous 
 tubes which ramify upon them, that by 
 which vitality and warmth are to be sus- 
 tained, and to carry off from them a noxi- 
 ous substance, or substances, in a gaseous 
 form. 
 
 And here, as by the digestive organs, may 
 death and life enter in at the same door. 
 The most virulent poisons may be wafted 
 on invisible wings ; and a pestilential blast 
 may at once strike down the giant, or the 
 hero, who, a moment before, bade defiance 
 to armies ; while the pale and emaciated 
 sufferer, from violence or long disease, may 
 perhaps quit his bed of languishing and 
 pain ; and inhale health and vigour in the 
 reviving breezes from the fields, or from 
 the sea. 
 
 Farther than this, it is not my purpose, 
 at present, to notice the formation of the 
 
75 
 
 blood. Its analysis is taught in our medical 
 schools, as a part of our initiatory studies ; 
 and it has been well considered in the first 
 course of lectures delivered in this place by 
 Professor Wilson, and afterward printed. 
 
LECTURE III. 
 
 MARCH 22. 
 
 HAVING in the last Lecture noticed the 
 processes by which the blood is produced, 
 let us now, for a moment or two, turn 
 our attention to those essential parts in 
 the human body, which it is the final pur- 
 pose of this plastic compound to form, to 
 nourish, and to repair, and to those ar- 
 rangements which are made for the due 
 employment of parts so constituted and 
 constructed. 
 
 And we should first, I think, notice the 
 organs of sense, the organizations of 
 which are first formed and protected; to 
 which all the rest are to be ultimately sub- 
 servient, and which, in fact, constitute the 
 essential characters of every animal, and 
 
77 
 
 define its capacities and uses in the world. 
 As soon as ever the blood-vessels are 
 brought into active operation, an advance 
 is made to the production and defence of 
 these mysterious organs. How far anterior 
 in its developement and perfection is the 
 head, the seat of them all but one, and not 
 indeed exclusive of that ; and how far does 
 the cranium itself, which contains them, at 
 first exceed the rest of the head in bulk 
 and growth. Let us not look with a care- 
 less eye, or an unheeding mind, on this ap- 
 parently pitiful and conical form, which the 
 foetal cranium at first assumes, while it is to 
 be altogether sustained by its parent, or to 
 the seeming neglect of progress in the por- 
 tion of the head below, for which no exer- 
 cise will be called, till it is destined to pro- 
 cure its own supplies by its own exertions. 
 Let us see, within the enclosures and parti- 
 tions of that almost ugly box of elementary 
 pulp, the advancing arrangements of an 
 eye from which intellect is to beam, and 
 affection to dart its tenderest glance, and 
 anger its fiercest threat : an eye more com- 
 plicated, perhaps, then, than when fully fit- 
 
78 
 
 ted for its uses, since the membrana pupil- 
 laris, that faithful and secure protector of 
 the perfect form of the visual curtain, is 
 then entire, vascular, and efficient. Let us 
 look at the elaboration of the complicated 
 labyrinth of that ear, on the nice symmetry 
 and exquisite sensibility of which all the 
 delights of conversation, all the enjoyments 
 of music, and the possibility of acquiring 
 or communicating them, primarily depend. 
 Let us mark the internal arrangement of 
 the nostrils ; their bones, their sinuses, 
 their cells, their membranes, and their 
 glands ; their fine and tender nerves, over- 
 spreading their whole surfaces, under a 
 competent cuticular protection ; preparing 
 them to transmit air, to communicate de- 
 lightful odours, to distinguish hurtful from 
 salutary substances, and to warn us of the 
 first approach of many morbid affections. 
 And let us not overlook the tongue, at this 
 period so closely immured from invasion, 
 by which the first delight of conciousness is 
 to be enjoyed, in the delicious fluid pre- 
 paring for its sustenance, and suited to its 
 desires. And when to all this is added the 
 
79 
 
 elaboration of the skin, the organ of touch, 
 in all its modifications, and also of extensive 
 transmission and absorption, both of good 
 and evil matter, we seem to have before us 
 one of the most sublime objects of interest 
 that this lower sphere can present. And 
 this interest is abundantly increased, when 
 we advert to that conscious power, which is 
 the center, the record, and the employer of 
 the whole system ; and thaj; engages, di- 
 rects, and enjoys the whole range of the 
 powers entrusted to it, in their own ap- 
 pointed, distinct, and incommutable rela- 
 tions. 
 
 And we know by what means these 
 powers are applied, and made effectual, to 
 the purposes for which they are bestowed 
 and adapted. For the instruments of loco- 
 motion (and let us not be unmindful that 
 these are not merely instruments of motion 
 but also of equipoised rest, and vigilance) 
 are superadded. We know that they con- 
 stitute by far the largest, and most osten- 
 sible parts of our frame. Perhaps, indeed, 
 Surgery is more occupied about them than 
 about the masters, who command and con- 
 
80 
 
 troul them ; so far at least as its ordinary 
 engagements, but never farther than its prin- 
 ciples reach. 
 
 When the limbs are exerted, when the 
 body sustains a load, or awaits with firm- 
 ness, or with vigilance, an expected attack ; 
 when the eye looks, or the ear attends, or 
 the fingers touch, or the nostrils expand to 
 scent the air, or when the tongue tries the 
 properties of substances which are to pass 
 over it into the alimentary canal, or to be 
 rejected as noxious or distasteful ; all this is 
 accomplished by the agency of moving and 
 contractile fibres, attached to determinate 
 points, for the most part of solid sub- 
 stance, from which they may, and do, exert 
 their force, in the most perfect accordance, 
 though with infinite variations, and count- 
 less concurrences, in order completely to 
 effect their numberless uses. 
 
 And what is the nature and arrangement 
 of this solid substance, and what are the 
 multiplied forms and fittings of its parts ? 
 Hogarth has observed, that solid objects 
 should be considered, (he spoke, you know, 
 
81 
 
 as a painter, but at the same time as a most 
 true observer,) as only thin shells, composed 
 of lines ; and I will frankly confess to you, 
 I never look at a skeleton without a degree 
 of humiliation, bordering on confusion ; al- 
 ways thinking I have instantly opened be- 
 fore me an immense volume, obvious in the 
 gross, but profoundly minute in the details, 
 of mathematical diagrams, almost infinite 
 in complexity, stupendous in design, per- 
 fect in exactitude, faultless in material, and 
 most exquisitely beautiful in the sym- 
 metrical connections of its parts. We are 
 told that Galen, by the sight of a skeleton 
 accidentally formed, perhaps by ants, and 
 presenting itself before him, was reclaimed 
 from infidelity. If, in addition to this rude 
 and unprepared object, he could have had 
 the advantage of contemplating the labours 
 of Albinus and Weitbrecht, showing the pro- 
 portion, the order, the connection, and the 
 mutual dependence of the whole compages, 
 with what emotion must that great, and 
 once idolized genius, have been filled ! My 
 friend Mr. C. Bell, has said, that he once 
 challenged a scientific architect, who is de- 
 
ceased, to produce a single principle in the 
 art of building, which he could not exem- 
 plify in the construction of the human 
 body ; and I am confident he would have 
 done it. There are ample materials ; and 
 no one can doubt his ability to explain 
 them. 
 
 This locomotive apparatus, we find to 
 consist of about 250 bones, in their perfected 
 state, and of many more while in the fcetal 
 state, before the epiphyses, and shafts, and 
 masses, are united. Of these each portion 
 originally possesses its own distinct centre of 
 ossification* The spinal column alone con- 
 taining more than 100, which equally, by the 
 incompleteness of their bony junctions, and 
 the elasticity of their cartilaginous ones, 
 adapt the mature infantile structure for its 
 passage through the pelvis, in the process 
 of parturition. Near 1000 junctures of 
 various, kinds exist, having either imme- 
 diate or dependant movements, with 400 
 muscles to act upon them and direct them; 
 beside the hollow and transparent muscles, 
 which serve the internal functions. Ten- 
 
83 
 
 , original, terminal, and inter-placed, are 
 almost numberless ; while hundreds of suit- 
 able ligaments, to adjust and sustain the 
 actions and uses of all these organs, are de- 
 monstrable under our dissections. Appro- 
 priate secretions to keep them fit for their 
 services, are provided in sufficiency, without 
 superfluity ; and their surfaces are so dis- 
 posed, and their interstices so lubricated, 
 lined, proportioned, and connected with 
 other parts, that the mighty arms of Her- 
 cules, and the resilient limbs of Antseus, 
 could maintain their struggles unbroken. 
 
 
 
 The continuousness and exact propor- 
 tions of all the arrangements from fibre to 
 fibre, and from fasciculus to fasciculus, to 
 an entire muscle ; the motions of the mus- 
 cle over contiguous parts without impedi- 
 ment, the connections of its fibres with 
 those of the tendinous substance belonging 
 to it, the insertion of it into bone, and the 
 protection of the whole from exterior dis- 
 turbance, without any undue confinement 
 of its exertions, are all secured by that fine 
 material, which is interposed, with every 
 
 G 2 
 
84 
 
 possible gradation of firmness in its texture 
 for this purpose, betwixt every existing 
 surface in the composition of every part, 
 and called reticular, or cellular membrane, 
 which we shall have occasion hereafter more 
 fully to examine. 
 
 Of this it has been too hastily supposed 
 that all parts entirely consist, only under 
 different modifications ; because after long 
 maceration it still remains, however light 
 and almost arachnoid in its texture, when 
 the parenchymatous substances that were 
 enclosed and imbedded in it are dissolved 
 and disappear. To this highly important 
 substance in the animal fabric, therefore, 
 and its various arrangements and consist- 
 encies, in and between the parts, which at 
 the same time it effectually connects, and 
 effectually separates, the attention of every 
 accomplished surgeon must be faithfully 
 directed. 
 
 Nor may we overlook the minute, and 
 curious, and safe, and effectual arrange- 
 ments, which are made of the sexual 
 
85 
 
 organs, male and female, and their corres- 
 pondence in both for the continuance of our 
 race ; and not only for this purpose, but to 
 superadd to it the 
 
 " Sole bliss of man which has survived the fall." 
 
 To cement parental, filial, and fraternal 
 affection, from the beginning of life to its 
 close, in a state where virtue sows the 
 seeds of her sweetest and most universal 
 flowers, and converts a part, at least, of 
 the wilderness of life into a garden. 
 
 , C*-V -> t /-H| f . 4 
 
 The structure, and some diseases of the 
 various parts of this important apparatus, 
 it will be remembered, were ably and deli- 
 cately treated on by my predecessor in these 
 Lectures. But on this subject, as well as on 
 most others, competent investigators know, 
 that great and sometimes perplexing ob- 
 scurities are still undispersed. 
 
 Let us also for a moment reflect on the 
 organs of communication from man to man, 
 and from man also to the inferior animals 
 over whom he reigns. Of these there 
 
 G 3 
 
86 
 
 are two kinds, the one audible, and the 
 other only visible. The first comprehending 
 speech and sound, in all their varied modifi- 
 cations ; and the second the universal lan- 
 guage of signs and looks, by which nations 
 and individuals, unknown to each other, 
 communicate their wants and their wishes ; 
 their resolutions to confer hospitality, to 
 pause in doubt, or to inflict pitiless murder 
 and revenge. 
 
 Speech, in the proper acceptation of the 
 term, is one of the peculiar prerogatives of 
 man ; and the parts adapted to its fulfil- 
 ment are fully constructed with a compe- 
 tence to all its purposes. By the natural 
 and gradually acquired employment of these 
 are all the different wishes, impressions, 
 and intentions of the mind made known ; 
 from the half unconscious and instinctive 
 cry of the suckling infant, to the powerful 
 oratory of the statesman, who makes the 
 senate to thrill with his eloquence, and 
 pours forth, from a well-furnished mind, 
 propositions, or objections, on the just, but 
 difficult determination of which, the fates 
 
87 
 
 of armies, of navies, and of nations may de- 
 pend. But speech, and the instruments of 
 speech, are, after all, merely parts of a 
 present intermediary arrangement, betwixt 
 one intellectual being and another. So 
 that tone, and shout, and song, and groan, 
 and scream, are all subdivisions of a vocal 
 and distinct indication of the impressions 
 and feelings of the mind. So far, there- 
 fore, as mind, or instinct, which surely is 
 mind, to a perishable and limited extent, 
 is concerned, man has much in common 
 with many other animals. 
 
 In birds, who have, perhaps, as a class of 
 animals, the greatest range of vocal power, 
 the organ of sound is variously situ- 
 ated, in various parts of the bronchial 
 tube, being not unfrequently near the divi- 
 sion of the trachea, as it is going into the 
 thorax. For us, and adapted to the more 
 prompt, and more expressive and authori- 
 tative exertion of the voice, it is situated 
 nearer to those parts which are to concur 
 with it in mental expression : so that the 
 exertions, and niceties of exertion, by which 
 
 G 4 
 
88 
 
 the air is emitted from the larynx, modu- 
 lated by the tongue, the teeth, the mo- 
 tions of the jaws, the nasal labyrinth, and 
 by the finally adjusting and directing lips, 
 are all made to concur in the expressions 
 of the mind. 
 
 But man has not only the organ of voice, 
 as the medium of enunciation of ideas and 
 feelings, superior to any other animal, but 
 he has also a more graduated, and perfect, 
 and extensive competence to the communi- 
 cation of them, by the language of signs, 
 which may be considered as a species of 
 telegraphic intercourse, of universal utility 
 and necessity. Each of these faculties seems 
 to be conferred on some individuals more 
 than others ; and indeed on some whole 
 classes of animals more than on others. The 
 paper of our eminent philosopher, Dr. Wol- 
 laston, " On Sounds inaudible to certain 
 Ears," published in a recent volume of the 
 Philosophical Transactions, comes strongly 
 in proof of this observation ; and it is a 
 very curious fact, recorded in the same 
 work for 1781, respecting the Termites, or 
 
white ants of Africa, that among the sub- 
 divisions of these insects, called the sol- 
 diers, those who are placed at the openings 
 of cells, of long and circuitous extent, are 
 able, on the approach of danger, to give an 
 alarm by a sound, scarcely more than au- 
 dible by man, on the emission of which, 
 numbers of the inhabitants of the citadel 
 within instantly rush forth, to protect the 
 swarm which is threatened with invasion. 
 It therefore seems admissible, that the fa- 
 culty of hearing, which is only that of dis- 
 tinguishing vibrations of an elastic medium, 
 may be confined to a particular organ 
 only, in some instances, and in others, per- 
 haps, generally diffused ; with such delicate 
 adjustment, as to influence the minutest 
 animals, in their whole configuration, and 
 produce a sense, if not of sound, yet of 
 vibration, very analagous in its distribution 
 and universality to that of touch. 
 
 Allow me, for a moment, to return to 
 the subject of signs ; for I shall have no 
 fair opportunity to resort to it hereafter. 
 Mr. Huber, in his treatise on ants, has 
 
90 
 
 made a curious observation, which I think 
 well deserves the attention and prosecution 
 of naturalists that they hold a telegraphic 
 conversation by the motions of their an- 
 tennae. I will not commit myself here by 
 either advocating or opposing this opinion : 
 I only introduce the remark for the sake 
 of exciting enquiry among those who have 
 leisure and means to pursue it. But I 
 certainly think this view of these parts not 
 unreasonable ; and I cannot deny the cir- 
 cumstances on which he has rested it. No 
 one, however, who has had the pleasure to 
 hear the Abbe Sicard lecture on the sub- 
 ject of the language of signs, and of wit- 
 nessing the surprising and most useful and 
 delightful perfection to which he has car- 
 ried it, can, as I think, be unimpressed with 
 the facts which he exhibits without re- 
 serve, from motives of compassionate and 
 universal benevolence, 
 
 But if in this faculty, which reason and 
 speech seem to render less needful to us, we 
 are perhaps much inferior to many small and 
 inconsiderable beings, we may nevertheless 
 
91 
 
 find a source of interesting enquiry as na- 
 turalists ; and Hippocrates has taught us 
 the importance of remarking the imperfect 
 and irregular, or involuntary movements 
 which take place in diseases ; and those al- 
 terations in the form and position of the 
 body, from which an accustomed observer 
 may often draw a prognosis of their ter- 
 minations. 
 
 Thus, then, constructed and ordered, we 
 have an organized, a complicated, and an 
 harmonious frame, covered by a suitable in- 
 vestiture for its protection, its support, its 
 symmetry, and its beauty, an investiture 
 of a texture apparently so simple, and yet so 
 varied in the number of its parts, and of its 
 functions, that I purpose, in the next Lec- 
 ture, to call your notice distinctly to it, and 
 to impress on the minds of students the 
 propriety of devoting to it an accurate and 
 careful attention. We have treatises after 
 treatises on the diseases of the skin, but 
 none of them begin, as they should do, 
 with the requisite analysis of its structure ; 
 as if this were almost the only organ of 
 
92 
 
 sensation of which an anatomical know- 
 ledge was needless, or at least subordinate. 
 Perhaps no part of anatomy has been so 
 much neglected ; yet surely that extent of 
 surface by which so much is absorbed, so 
 much is transpired, so much is felt, so much 
 is regulated, and all other parts are enclosed, 
 has a powerful claim on our investigation. 
 I shall be able to do but little with it ; but I 
 trust others will try to do more : for very 
 numerous are the diseases and disorders 
 and injuries of the skin, and of its append- 
 ages ; many are its connections and sym- 
 pathies with the subjacent parts. Surgical 
 remedies are, in most instances, imme- 
 diately applied to it, accomplish their in- 
 fluences through it, and are therefore 
 greatly dependent for their effects on its 
 actual condition ; while many medicines 
 exhibited internally, in a multitude of dis- 
 eases, chiefly declare the evidence of their 
 agency by their effects on this universal 
 sheath of the whole animal frame. So 
 that, if our anatomy of it be deficient, our 
 physiology and pathology must be at least 
 proportionally imperfect, and our remedial 
 
93 
 
 resources more confined and less under- 
 stood. 
 
 And now let me conclude this hasty and 
 imperfect sketch of that wonderful ma- 
 chine, some of the disorders, diseases, and 
 injuries of which, and their appropriate 
 remedies, as far as I am acquainted with 
 them, it will be my duty to lay before you, 
 with calling to your recollection, that the 
 numberless portions of which it is com- 
 posed, are not, like the interrupted and 
 tardy contrivances of human art, produced, 
 arranged, altered, and repaired by slow and 
 complicated labours, and additions of mate- 
 rials, which are first to be sought out, then 
 to be separately prepared, and afterward ar- 
 ranged in their respective masses, having 
 no power of securing or providing for their 
 own increase and regulation : but here the 
 whole derives its source from one formative 
 impulse, one universal law, by which Om- 
 nipotence has impressed, on an unconscious 
 and diminutive portion of matter, the power 
 of commencing and continuing operations, 
 
94 
 
 in the darkness of the womb, both the com- 
 plexity and order of which the research of 
 ages has been insufficient to develope. But 
 however we may be humbled, we ought not 
 to be appalled by this consideration. Truth 
 has been compared, you know, to a treasure 
 lying at the bottom of a well ; and the 
 depth of this well will be an excitement, 
 and not a discouragement, to those who 
 know the value, and have caught a glimpse 
 of the beauty, of the wealth it contains ; and 
 to which, while it reveals an approach, de- 
 mands, as an indispensable condition fol- 
 ks acquirement, diligence and zeal, and of- 
 ten an endurance of disappointment ; a 
 disappointment which is not to discourage, 
 but to re-animate that zeal to a patient re- 
 sumption of its toil, and will confer ad- 
 ditional verdure on the laurels which are to 
 crown its success. 
 
 In concluding this part of my subject, 
 then, gentlemen, allow me to say, and I 
 can assure you I say it with no insincere or 
 hypocritical profession, that I cannot quit 
 this cursory view of the human body, with- 
 
f 
 
 95 
 
 out mortifying feelings, feelings arising 
 from a consciousness of my own deficien- 
 
 V 
 
 cies. Life is too short for any individual 
 to make much progress in supplying the 
 voids which yet remain in our science ; we 
 must all, however, labour to make such ad- 
 ditions to it as our abilities and opportu- 
 nities may enable us. But little as we 
 already know, our knowledge would be more 
 insignificant than it is, if it did not conduct 
 us, and incline us to conduct others, to an 
 adoration of that infinite Wisdom and 
 Power which presides over every depart- 
 ment of the universe, and to a more ardent 
 study of the works of Him, who has or- 
 dained the production and disposal of every 
 substance in nature, from the thin and 
 almost intangible gossamer that floats on 
 the feeblest breath of the air, to the massy 
 and immovable rock that withstands the 
 most boisterous tempests of the ocean. 
 With this impression, Mr. Abernethy once 
 told you, in the happy parody of a line 
 from one of our most celebrated poets, 
 
 " An undevout anatomist is mad." 
 
96 
 
 Such, too, were the feelings of Boerhaave 
 and of Haller ; in mentioning whom, I 
 have named two of the greatest, and 
 wisest, and best of men, by whom medi- 
 cal science has ever been adorned and 
 advanced. 
 
LECTURE IV. 
 
 MARCH 25. 
 
 GENTLEMEN, 
 
 ON considering in what method 1 should 
 pursue the further prosecution of the ana-*- 
 tomicalpart of the Lectures for the present 
 season, I at first felt some difficulty : for 
 various subjects of general importance have 
 been so ably, and scientifically, and me- 
 thodically treated, by the Professors who 
 have preceded me, as to render the choice 
 of a plan somewhat embarrassing. Lectures 
 purely elementary, or simply demonstra- 
 tive, would scarcely be adapted to such an 
 audience as this ; yet neither can element- 
 ary principles, nor explanatory demon- 
 strations, be excluded or separated. Our 
 object here is to set before you facts which 
 
 H 
 
98 
 
 have been ascertained, and to exhibit to 
 you such proofs of them as this superb 
 Museum affords, of their verity and im- 
 portance ; together with such additional il- 
 lustrations as we are able occasionally to 
 supply from our own private stores. At 
 length it occurred to me, that, as in the 
 Surgical part of the Course I intended to 
 treat of those diseases which affect all 
 structures, it would be a proper preliminary 
 step to consider, first of all, the simple 
 structures themselves, as the best prepara- 
 tive for a proper understanding of their 
 disorders, their injuries, and diseases ; and, 
 as our anatomical, or rather our ocular, 
 knowledge of most morbid derangements, 
 originates in what we observe of such 
 as arise, or manifest themselves externally, 
 it would be best to commence with the 
 common integument. When I thought I 
 had determined on this plan, after a little 
 reflection, I could scarcely help saying to 
 myself, How ? talk of simple structures, 
 indeed, and begin with the common in- 
 tegument ! Where, in reality, will you 
 find one more complicated, or diversified, 
 
99 
 
 all among the parts of which the human 
 body is composed? But still, however 
 complicated it may be, it is so only from 
 an intertexture, or co-adaptation, of dis- 
 tinguishable substances ; and, as far as we 
 can separate them, we must be profited by 
 the careful analysis that resolves them 
 into the simpler materials, which are thus 
 blended, or fitted together. 
 
 Indeed, it may be fairly enquired, whether 
 there are any simple structures ? Is not 
 such a term more calculated to conceal our 
 ignorance, than to manifest our knowledge ? 
 Sir Everard Home informs us, that at his 
 request Captain Kater examined the red 
 globules of the blood by a micrometer, and 
 found their average magnitude to be the 
 5000th part of an inch in diameter ; yet 
 each of these globules is in itself a micro- 
 cosm, comprehending elements, of the ab- 
 stract nature of which we know but little ; 
 of the laws and mode of their combination 
 and arrangement, still less ; of their appli- 
 cation in the formation or uses of those 
 parts into the substance of which they enter, 
 
 H 2 
 
100 
 
 but little more ; and of their decomposition 
 in the various secretions and ejections, na- 
 tural and morbid, with which they are 
 combined, least of all. The same may be 
 said of other parts of which the blood con- 
 sists. The ultimate composition of all the 
 parts of the body may suggest to us a simi- 
 lar remark. Some surfaces present to us 
 an arrangement of vessels disposed in a par- 
 ticular manner ; and we find other surfaces 
 in which they seem arranged in the same 
 or a very similar manner, which yet per- 
 form very different offices. There is very 
 little apparent difference in the disposition 
 of the vessels of the internal coat of the 
 stomach of a child at birth, and that which 
 may be observed in the skin of the external 
 ear and forehead, at the same period, when 
 minutely injected, and the cuticle is deli- 
 cately taken off. In other instances, we 
 discover striking differences in their ar- 
 rangement ; but they serve not to explain 
 to us the differences in their products or 
 results. The conclusion to be drawn from 
 all this, is, that the simplest structures, of 
 which we can take cognizance, are still 
 
101 
 
 highly complicated ; that we are in the 
 dark respecting many of their most import- 
 ant attributes ; that we can have little or 
 no knowledge, a priori., concerning them 5 
 that we must patiently and perseveringly 
 study the facts which our faculties are ca- 
 pable of detecting ; combine and arrange 
 them to the best of our abilities, and make 
 the most consistent and judicious uses that 
 we can of the whole. 
 
 In some cases we can carry our analysis 
 farther than in others ; and in most we can 
 carry it far enough to make those useful and 
 necessary distinctions, which will greatly 
 assist our acquisition and communication 
 of theoretical and practical knowledge ; and 
 it is an acquaintance with, and conscientious 
 observance of these, by which the scientific 
 practitioner is distinguished from the mere 
 empiric, whose ignorance and disregard of 
 them leave his mind in a state incompetent 
 to that discrimination, without which the 
 employment, and in many instances the 
 success, of his own remedies, will mislead 
 and entangle him. 
 
 H 3 
 
102 
 
 My intention in making these observ- 
 ations, is not merely to moralize, or to de- 
 claim, but to excite and encourage, as far 
 as I can, the industry,, the perseverance, 
 the enquiry, the discrimination, and the 
 conscientious feelings of those who are pur- 
 suing our laborious science, to full and use- 
 ful occupation. Young gentlemen, there 
 is much to be done : many, who have gone 
 before you, have done much ; but let not 
 this consideration lull you into inactivity ; 
 let it stimulate you to additional exertions ; 
 and let the examples of those under whom 
 you have studied be as important in your 
 eyes, as their instructions, and as much de- 
 serving and demanding your imitation, as 
 your applause. 
 
 In studying the anatomy and physiology 
 of the human body, it is both customary 
 and necessary to examine parts of like 
 structure, and their arrangements, together. 
 First, we may examine the skeleton, the 
 parts which compose the solid machinery, 
 which gives the substantial form and sta- 
 bility to the whole, and on which the softer 
 
103 
 
 and more perishable parts depend for their 
 support, and the due fulfilment of their re- 
 spective offices. Then we examine the 
 muscles, the organs by which the loco- 
 motive powers of the body, and of all its 
 constituent parts, are executed: we look 
 at the system of vessels by which it is 
 nourished and repaired, and to that by 
 which it is modelled and relieved ; then to 
 the nervous system, by which it is governed 
 and influenced : then we enquire, how all 
 this fabric is supported. We go from the 
 organs of mastication to those of digestion, 
 secretion, and excretion; then we look to 
 the ultimate objects of the whole, and to 
 those organs by which its final destinations 
 are to be fulfilled. We endeavour to trace 
 the structure and relative uses of the dif- 
 ferent parts of the organs of sense, and the 
 adaptation and mutual influence of every 
 part, for its share in the purpose of the 
 whole. To understand all these things is 
 our duty, and must therefore be our labour ; 
 and to render that labour successful, it 
 must be our pleasure, notwithstanding all 
 the disagreeable circumstances by which it 
 H 4 
 
104 
 
 is unavoidably accompanied. But we may 
 sometimes reverse this order of procedure 
 with advantage, and investigate the struc- 
 ture of the body by a synthetic, as well 
 as an analytic examination. The latter 
 must, indeed, take the precedence ; but the 
 accomplished Surgeon must pursue the 
 former also ; for his mind is to go before, 
 and to travel with his knife, through con- 
 nected parts : he must give no commission 
 to his instrument of which he does not 
 foresee and understand the execution, and, 
 as far as possible, the effect. 
 
 Let us return to the point from which 
 we set off; and in proceeding to examine 
 the simplest and most distinguishable struc- 
 tures which we can find, let us begin with 
 an analysis of the common integument ; 
 and as my business at present is more with 
 surgical than descriptive, or philosophical 
 anatomy, the reason which has induced me 
 to bring before you a consideration of the 
 skin, leads me necessarily to commence the 
 observations to be made on this substance, 
 by an examination of the cuticle, which 
 
105 
 
 constitutes its most external part ; and then 
 to proceed, so that our minds may go, as I 
 have just hinted that our knives must go, 
 from without inward ; and thus be more 
 fully and accurately qualified to anticipate 
 and to recognize, when we employ them, 
 what these, our trusty and obedient ser- 
 vants will do, are doing, or may, intention- 
 ally or unintentionally, have already done, 
 
 I will, however, confess to you my ap- 
 prehensions, that to some of my audience 
 this subject may, at the first view, appear 
 too superficial and unimportant to merit a 
 deliberate examination in this place, where 
 nothing should be introduced that is not 
 philosophical in its nature, and practical in 
 its tendency. But I am sure that a little 
 consideration will convince you it is 
 both. More than thirty years ago, when I 
 had first made some very successful injec- 
 tions of the common integument, I was 
 forcibly struck, among other important cir- 
 cumstances, with those diversifications of 
 the cuticle, which fit and suit it to the uses 
 of the different parts of the skin, and other 
 
106 
 
 surface which its covers, both by the iden- 
 tity of its substance, and the varied con- 
 formation of its structure. I then formed 
 a purpose to pursue the investigation, but 
 the chances and changes of human life and 
 business, had interrupted this, among other 
 plans, till my being called to this situation 
 again excited my attention to it. I then 
 began to regret the paucity of the facts I 
 had ascertained, and of the proofs and 
 documents I had collected. I determined, 
 nevertheless, that I would venture to intro- 
 duce the subject here, imperfect as the 
 means of illustration within my reach may 
 at present be; for imperfect as they are, 
 they are important, and may be useful, and 
 may lead to farther experiment and observ- 
 ation by others, more capable and more at 
 leisure to carry on the enquiry. 
 
 The cuticle seems hitherto to have been 
 too slightly and too superficially noticed by 
 anatomical writers. Yet the cuticle answers 
 some of the most important purposes in 
 the animal economy. All animals are pro- 
 vided with it, in some form or other ; and 
 
107 
 
 many have it renewed several times, some 
 indeed, frequently, and periodically, during 
 the course of their life, casting it off at the 
 appointed seasons entire ; so much so, in 
 the case of some insects, and of serpents, as 
 to leave these exuviae almost in the com- 
 plete form of the creature which has quitted 
 them. Nor are vegetables destitute of a 
 similar covering. In these, it has been 
 supposed, by M. Mirbel and others, to con- 
 sist merely of an indurated or desiccated sur- 
 face of their parenchymatous or alburnous 
 substance ; an opinion altogether without 
 any foundation or analogy; its origin, its 
 growth, and its uses being altogether dis- 
 tinct. It is the protector of the alburnous 
 and parenchymatous substance, and is es- 
 sential to its attainment of perfection, and to 
 the accomplishment of many purposes car- 
 ried on within its inclosure ; but it has no 
 sensible qualities in common with it, nor 
 is it convertible to similar uses. Indeed, 
 it exists in the germen, before the pa- 
 renchyma is deposited. 
 
108 
 
 A similar idea has been entertained 
 respecting the human cuticle ; but this is 
 refuted by the fact of its existence in the 
 foetus in utero, from the earliest period ; 
 by its proportional increase and approach 
 to perfection, and fitness for its destinations 
 in that situation, where it is coated and 
 protected by a more copious, or more ac- 
 cumulated exudation, or rather secretion, 
 from the sibaceous glands, than takes place 
 after birth, or in the adult body. It is also 
 then surrounded by the liquor amnii, which 
 of itself, and most especially in that state of 
 seclusion from all means of evaporation, 
 effectually prevents the sort and mode of 
 induration supposed, from taking place. It 
 must also be observed, that when the 
 cuticle is abraded, and something like this 
 induration comes on, it is not a cuticle, but a 
 scab, formed by a healing process, (to which 
 I shall hereafter have occasion to ad vert, and 
 which was first philosophically noticed by 
 Mr. Hunter,) under the protection of which 
 new and real cuticle is actually produced. 
 Morgagni imagined, that the cuticle 'was 
 originally formed of the surface of the skin, 
 
109 
 
 first hardened by the constant pressure of 
 the liquor amnii itself; and after birth, by 
 that of the atmosphere : a supposition 
 altogether gratuitous, without evidence, or 
 even probability. As well might it be 
 affirmed that the aponeurotic expansion, 
 which covers certain muscles, and sets of 
 muscles, is owing to the pressure of the 
 superjacent parts ; instead of forming a 
 definite and distinct allotment in the con- 
 figuration and purposes of the whole body. 
 It would be an endless task to recount and 
 refute the multiplicities of conjecture and 
 hasty conclusion into which even sensible, 
 but zealous men, have been too often be- 
 trayed, concerning the formation, the 
 growth, the functions, and consequently 
 the diseases of parts. Perhaps even the 
 mere mention of them, in this situation, 
 may require an apology. Yet a delicate 
 allusion to them may not be without its use. 
 I mention them with no view to ridicule, 
 nor to triumph. But an indulgence of 
 imagination on subjects of science must 
 always be dangerous to the bperations of 
 the mind, except so far as it leads to ex- 
 
110 
 
 periment and observation, and holds the 
 judgment in a modest state of suspense till 
 these shall determine it to authorized con- 
 clusions. It is too apt also to lead us off 
 from the due and reverential contemplation, 
 without either superstition or fanaticism, of 
 that Supreme Intelligence from which all 
 other intelligence is derived, and which has 
 framed and ordered all our organs, their 
 formation, their support, their uses, and 
 their repairs, not by promiscous and doubt- 
 ful, but by concerted, and adequate, and cer- 
 tain operations. For I may ask, are we 
 even now free from this danger ? Do not 
 assumed hypotheses still beset us? Are 
 we yet out of that latitude in which 
 
 " %J* Whim the second reigns, like whim the first. 
 
 In no branch of science is it more im- 
 portant than in ours, that we should in all 
 cases take nature simply as we find her ; 
 that we should not be in haste to form con- 
 clusions, in which accurate observation and 
 correct experiment (which indeed is only 
 one path to observation) will not bear us 
 
Ill 
 
 out, step by step, without leaping or aberra- 
 tion ; for her subtleties can only be pene- 
 trated by those who will submit to become 
 her patient, her obedient, her diligent, 
 and must I not add, who are also her ca- 
 pable servants. 
 
 As the cuticle exists in human and other 
 animals, it is called epidermis, or a covering 
 for the skin ; and so undoubtedly it is. 
 So also it has been called, by vegetable 
 physiologists, in relation to plants, but im- 
 properly ; for in many parts of these there 
 is no skin for it to invest; and with re- 
 gard even to animals, the term, though 
 applicable to them in the full import of 
 its meaning, is by no means sufficiently 
 expressive of its extent, still less of its* nu- 
 merous uses. The observations of modern 
 anatomists have shown, that it not only 
 covers the skin, properly so called, but that 
 it is also continued from the boundaries of 
 the skin, over parts accessible to the at- 
 mosphere, but where the true characters of 
 skin are entirely lost. It extends over the 
 conjunctiva, the nostrils, the tympanum. 
 
112 
 
 &nd the mouth, down the oesophagus and 
 trachea, and into the anus, the vagina, and 
 the urethra. Haller says, " I have known no 
 part of the human body which could be ex- 
 posed to the air with impunity, except the 
 cuticle, and the enamel of the teeth." Such, 
 he observes, is the dryness or the acrimony 
 of the air, that the naked skin can never 
 remain in contact with it. This element 
 changes the nerves, and even the tendons, 
 into hard, pellucid, and fragile cords. The 
 bones, when denuded and subjected to its 
 immediate access, quickly die, and after- 
 wards exfoliate their suffering surfaces, or 
 throw out granulation from those surfaces 
 to supply its place : but the cuticle supports 
 it, without injury or decay; and appears 
 immutable under its influence, in all va- 
 riations of climate and temperature in 
 the habitable world. And though 'the sud- 
 den application of excessive heat or cold 
 frequently occasions it to fall off, we may 
 learn from the experiments of Dr. G* For- 
 dyce and Sir C. Blagden in the heated 
 rooms, and from the accounts of voyagers 
 to the polar regions, that this is not so 
 
113 
 
 much, in either extreme, from the de- 
 structible nature of the cuticle itself by 
 these agents, in ordinary cases, as from the 
 suddenness and excess with which their in- 
 fluences are exerted on the organization 
 underneath it, from which it is nourished. 
 Where, indeed, it is continued from the 
 true cutis, over the serous and mucous 
 membranes, its extreme thinness causes it 
 to elude general and distinct observation, 
 not instituted with a careful and express 
 view to its detection. It is nevertheless 
 capable of demonstration, and being moist- 
 ened continually by fluids secreted for that 
 purpose, is preserved in a state capable of 
 affording a mild, but effectual protection, 
 to those delicate and sensible parts, from 
 which the privation of it is always severely 
 felt, and felt to be an injury. It enables 
 them to perform their fine functions in 
 peace and with regularity ; and is so con- 
 structed, and so applied to them, that, 
 though insensible itself, it preserves both 
 their common* and peculiar sensibilities in 
 perfection, in harmony, and in ease. It 
 guards against dangers from within the 
 
114 
 
 body, and from without. The minutest 
 breach in it often affords an introduction 
 to the most malignant and deadly poisons, 
 from the influence of which, by its perfect 
 and complete integrity, the body would 
 have been securely defended. There is no 
 single substance more uniform in its com- 
 position, or more diversified in the arrange- 
 ment of its parts, on the various surfaces it 
 is appointed to cover and protect. We are 
 still very deficient as to an exact knowledge 
 of the peculiarities of its chemical com- 
 position ; and deeply do I regret this 
 deficiency, and that my own want of ac- 
 quaintance with practical and experimental 
 chemistry has left me unable to supply it. 
 Mr. Hatchett found it to consist chiefly of 
 gelatine ; but so do other parts, of very 
 different texture and uses. Sir Humphrey 
 Davy found silex to form a part of the cuticle 
 of vegetables ; and it may be worth while 
 for some examinations to be friade, in order 
 to ascertain whether it does not form a part 
 of that of animals also ; thus clothing both, 
 as it were, with a flinty coat of mail, for 
 their perpetual protection against ordinary 
 
115 
 
 dangers. Perhaps no substance can be 
 named more distinctly in proof and illus- 
 tration of the doctrine of final causes, or of 
 the original and omniscient adaptation of 
 apparently simple means, to complicated 
 and important ends. It is the most unpu- 
 trescible of all the soft parts of the body : 
 it is the great medium of intervention and 
 defence between the active living solid, and 
 the decomposing powers by which it is sur- 
 rounded* Its structure, and its prevent- 
 ive properties and influences, remain long 
 after death ; and were it not for this per- 
 manence, the skins of animals* which are 
 convertible into so many uses, for civil and 
 commercial purposes in society, would not 
 be sufficiently tenacious of their textures, 
 when dead, to be preserved for those uses. 
 Such, indeed, and so effectual are the pre- 
 servative powers of this seemingly insigni- 
 ficant and simple substance, that we see in 
 the mummies that are brought to us from 
 Egypt, that it was the practice of that 
 people, in the process of embalming, pre- 
 viously to take off the cuticle from the 
 body, in order to enable it to imbibe the 
 
 i 2 
 
116 
 
 bituminous substance, by which it was to 
 be defended from putrescency ; and that in 
 all those parts, or patches, where the cuticle 
 has escaped from a removal, the impreg- 
 nation by the bitumen has not properly 
 taken place, the places underneath these 
 appearing to owe their continuance entirely 
 to a communication of the preserving power 
 of the substance entering into those which 
 adjoin them, or are attached to them. 
 Unbroken vesications, which remain after 
 death, or are produced subsequently by 
 transudation, will retain their fulness for 
 many days, if the cuticle remain perfectly 
 entire ; while, if it be ruptured, or pene- 
 trated, desiccation of the cutis will speedily 
 ensue. All the functions of the cutis are 
 performed and prepared through its inter- 
 vention, with their requisite distinctness 
 and accuracy : Tact, in all its gradations ; 
 temperature, in its different influences and 
 changes ; absorption and exclusion, in their 
 numberless variations, and under an infinite 
 diversity of circumstances ; perspiration, in 
 all its degrees, and with all its modifica- 
 tions, take place through its well-fitted and 
 
117 
 
 appropriate structure ; not merely by the 
 promiscuous or accidental accretions of ma- 
 terial particles or properties, but by a re- 
 gular and perfect construction, arising out 
 of, and subjected to the domination of the 
 principle of life, and constituting a large and 
 distinctly organized expansion. The bulbs, 
 the hairs, the sebaceous glands, and the 
 nails, which, indeed, may be considered as 
 a production or modification of it, in a more 
 concrete form, are all kept by it in their 
 proper situations and offices. It gives the 
 finish to that delicate beauty of complexion 
 in our race, which charms us when we be- 
 hold it, and which its abrasion would im- 
 mediately impair or destroy. As Sir James 
 Smith has well and beautifully observed, 
 " both in animals and vegetables, it forms 
 a fine but essential barrier between life and 
 destruction." It is constantly in a state of 
 perpetual, and, as it were, vegetative growth 
 and decay ; its exterior surface dying off in 
 furfuraceous scales or patches, or minuter 
 particles, which demand constant ablution, 
 in order that the interior and essential may 
 be preserved in a state of competence to 
 
 i 3 
 
118 
 
 assist and promote the regular performance 
 of the functions of the parts which it in- 
 vests and protects. Leeuwenhoek imagined 
 that these scales were a part of its neces- 
 sary and original structure, and were there- 
 fore analagous to the scales of fish ; but in 
 this opinion he erred ; the scaly appear- 
 ance belonging only to the effete exterior 
 surface, which has become unfit for use, 
 and is therefore detached from the es- 
 sential part in this gradual and imper- 
 ceptible manner, as it requires removal, 
 when the interior portion is renovated. Its 
 growth and nourishment are adapted, in all 
 the places it covers, to their exigencies, so 
 as to render the fulfilment of its offices per- 
 fect in them all ; and it is therefore found 
 in all gradations, from its delicate softness 
 on the female lip, to its thickness on the 
 hand of the laborious mechanic, and on the 
 foot of the hardy ploughman. Its wonder- 
 ful tenuity, in some instances, rendering 
 it liable to excoriation from very trifling 
 causes ; and its thickness and hardness in 
 others, giving rise to some of the most pain- 
 ful and insufferable symptoms of disease 
 
119 
 
 in the parts underneath it. It clothes count- 
 less millions of papillae, and countless mil- 
 lions of transpiring and absorbing vessels 
 which are placed in a surprizing variety of 
 arrangements, to carry on, to harmonize, 
 protect, and perfect the functions of the skin, 
 and the numerous parts of which that com- 
 plicated and most important organ is made 
 up, and with which it is studded over in 
 innumerable points. Indeed, without a 
 proper contemplation of it, we shall not be 
 able thoroughly to enter into the anatomy, 
 physiology, or pathology of the cutis itself, 
 or understand the nature and remedies 
 of those diseases which arise from, or ac- 
 company a breach in its structure, or an 
 interruption of the fulfilment of its pur- 
 poses. 
 
 The cuticle appears to be nourished by 
 some vessels ramifying on the cutis, and 
 appropriated chiefly to this purpose. These 
 vessels, when stimulated, either by pressure, 
 friction, or the application of certain irrita- 
 ting substances, are soon excited to secrete 
 
 i 4 
 
120 
 
 a serous fluid underneath it, by which it is 
 speedily, and sometimes very suddenly, as 
 in scalds, loosened from the surfaces with 
 which it was in contact; and in consequence 
 of this separation it dies, and peels off. In 
 this state of detachment, the fluid under- 
 neath does not transude through it in any 
 thing like the proportion of the perspiration 
 which would have been transmitted by it, 
 had it remained in its natural situation and 
 condition ; as if its interior fabric was shut 
 up by maceration in the secreted fluid ; but 
 affording, at the same time, an additional 
 proof of the protecting power of the sub- 
 stance itself. It is, however, in all in- 
 stances ultimately destroyed, in consequence 
 of the separation. In some, it bursts from 
 the rapidity with which the secretion of the 
 serous fluid under it takes place, and its 
 own thinness and delicacy. In others, it 
 retains its continuity for days together, 
 serving then the mere subordinate office of 
 defending the cutis from farther mischief, 
 till its place has been supplied by a new 
 formation of a substance like itself. Then 
 it dries and exfoliates, unless previously 
 
removed ; but not with absolute impunity 
 to the tender and irritated surface it has 
 quitted ; which generally, by an itching or 
 tingling sensation, gives notice of the 
 change it has passed through. Finally, how- 
 ever, this ceases, unless the state of the con- 
 stitution be unhealthy, or the part in other 
 respects unsound, and things resume their 
 former and ordinary course. And even 
 when the injury is deeper, nay, when large 
 portions of substance are destroyed or ex- 
 tirpated, as after amputation, for example, 
 it is still in process of time renewed, to cover 
 every outer surface which has been exposed; 
 and like a faithful guardian spreads its de- 
 fending influence over its supporter, which 
 is at the same time its dependant the new 
 and regenerated skin. 
 
 The cuticle, however, which is found on 
 the surface of the new skin, for a con- 
 siderable time, and in some cases always, 
 proves itself inferior in its properties to that 
 which covers the skin which formed a part 
 of the natural surface of the body, as it is 
 originally constructed. It often cracks, and 
 
sooner dries. It is more liable to abrasion, 
 and more slowly renewed when abraded or 
 blistered ; and although it serves for its 
 principal destined uses, this is in a more 
 limited degree. Atmospheric changes are 
 often perceived through it more sensibly, 
 but sometimes more slowly ; though both 
 these circumstances are at length less felt if 
 the patient be young, than if he have at- 
 tained full maturity, or be advancing toward 
 old age, when the evil occurs. 
 
 In, and after many diseases it is cast off, 
 sometimes in smaller and sometimes in lar- 
 ger pieces. In the latter, the scaly appear- 
 ance is not visible ; neither is it when taken 
 from a dead body by the affusion of boiling 
 water. The late Mr. George Wilson, a 
 respectable apothecary in Bedford Street, 
 (whose incessant wit and humour some of 
 us recollect to have enlivened many a dull 
 evening's discussion), for several years suc- 
 cessively, exhibited at the Lyceum Medi- 
 cum Londinense, from a patient who was 
 subject to annual attacks of erysipelas, the 
 cuticle of the hand cast off entire in the form 
 
123 
 
 of a glove ; and from the foot, as a complete 
 sack. A case somewhat similar is recorded 
 in the sixtieth volume of the Philosophical 
 Transactions. Such instances are, 1 believe, 
 very rare ; but the thickness and substance 
 of the cuticle on the hands and feet render 
 them more likely to occur in these parts 
 than any where else on the body. This dif- 
 ference is found to exist in the cuticle of the 
 foetus before birth, so as to show its prepara- 
 tory and intended adaptation to the uses of 
 these parts. Indeed, so great is its thick- 
 ness and compactness in some instances as 
 to support the heat of burning- bodies for a 
 considerable time with comparative impu- 
 nity ; as in the cases of the smiths at Ley- 
 den, recorded by Boerhaave ; of the glass 
 manufacturers at Basle, which Haller says he 
 witnessed himself; of the inhabitants of 
 some volcanic countries ; and of those 
 wonder-workers, who sometimes exhibit 
 themselves and their feats in large towns, 
 and at fairs. Curious exemplifications, 
 however, do these feats afford of the power 
 with which the body is endowed, to adapt 
 itself to conditions and circumstances, which, 
 
124 
 
 a priori, we might naturally enough suppose 
 would be totally inconsistent with its health 
 and integrity. 
 
 The cuticle, being thus devoid of sensi- 
 bility, has been considered as not a living 
 substance. But I think a little reflection 
 will show that this opinion has been too 
 hastily formed. For we do not know of 
 any instance in which parts that are in no 
 respect living, can be closely attached to 
 those which are so, without an obvious, 
 definite, and irreconcilable difference ; a 
 difference which always tends to a final and 
 perpetual separation between one and the 
 other, or to involve both in mutual destruc- 
 tion. The vital powers of the cuticle are 
 indeed comparatively feeble ; although it 
 undergoes a more gradual, regular, and un- 
 varying transition from life and usefulness 
 to decay, than any other part. But this 
 transition may be hastened by the appli- 
 cation to it of a variety of substances while 
 connected with the living body, which have 
 no similar influence upon it when life has 
 ceased. When by the influence of any of 
 
 - 
 
125 
 
 these agents, or of others, its surface be- 
 comes unfit to correspond with the rest, 
 the more living parts which it covers take 
 the alarm, and it speedily becomes easily 
 separable from that which remains perfect. 
 Its too hasty detachment, as in many cu- 
 taneous affections ; or its more reluctant 
 separation, as in corns, is always to be con- 
 sidered as a morbid state of it ; and if the 
 fault should lie in the vessels which nourish 
 it, the same is the fact with regard to other 
 parts, the vitality of which cannot be dis- 
 puted. 
 
 In every instance, in a state of health, 
 this substance has a perfect conformity to 
 the organic structure of the true skin, of 
 which it is at once the faithful servant, and 
 the indispensable guardian : so , that in 
 order thoroughly to take cognizance of it, 
 in this point of consideration, the anatomy 
 of the cutis itself must be previously known. 
 We may, however, with the assistance of 
 magnifying-glasses, see much variety on its 
 outer surface, in the different appearances 
 it presents to us as it covers the eye, the 
 
126 
 
 scalp, the forehead, the cheeks, the nose, 
 the lips, the trunk of the body generally, 
 the scrotum and organs of generation, the 
 fingers, the palms of the hands, the legs, 
 the arms, the soles of the feet, the toes, and 
 the heels. Varieties which are original, 
 and not adventitious ; the original texture 
 being evidently intended, however, to make 
 provision for the occasional production and 
 security of the adventitious^ when, and so 
 long as it may be needed. 
 
 It therefore follows many morbid changes 
 in the true skin, as it is called, by corre- 
 sponding changes in its own condition and 
 growth, as certainly as in those which arise 
 from natural habits and occupations ; al- 
 though in morbid processes it often becomes 
 diseased, as well as the cutis itself. Some- 
 times being partially deficient ; too thin, or 
 too thick, or connected with unsightly and 
 distressing incrustations or desquamations. 
 So that, from an accurate inspection of it, 
 we may be enabled more fully to judge of 
 the state of the subjacent skin. 
 
127 
 
 For the skin is as dependent on the 
 cuticle as the cuticle is on the skin, for the 
 perfection of its structure and the per- 
 formance of its functions. Neither can 
 subsist in a state of integrity, without that 
 of the other; and therefore provision is 
 made up to a certain degree, for the re- 
 generation and concomitance of both to- 
 gether; not only under natural, but also 
 under novel and artificial circumstances. 
 A coincidence which may be seen in many 
 diseases, in a very remarkable degree, 
 accompanied also by the reproduction of 
 what has been called the rete mucosum, but 
 which ought to be rather named the second, 
 or interior epidermis, though both are 
 sometimes imperfect, and sometimes appear 
 to be redundant ; especially the cuticle, 
 which therefore more frequently for some 
 time exfoliates, after it has invested sores 
 recently healed, than when it covers original 
 surfaces ; the vessels which nourish it being 
 in such cases partly destroyed, and there- 
 fore more scanty and more feeble ; and 
 their products of course more deficient, 
 
128 
 
 both with respect to formation, and to vital 
 energy. 
 
 Inadequate as my own examinations have 
 hitherto been, I have nevertheless contem- 
 plated with admiration and surprize the 
 variegated appearances and adaptations of 
 the cuticle, to which I have already alluded. 
 Let us begin with (he hand, as the part 
 most ready for the inspection of any indi- 
 vidual in himself, and which on that ac- 
 count, probably, has more attracted the at- 
 tention of observers than any other. Here, 
 however, are many diversities of configu- 
 ration and adjustment, in order to suit it 
 to the perpetually changing duties of the 
 parts it covers, without interrupting the 
 two grand purposes of unceasing protection, 
 and of transpiration, which are going on 
 during all healthy actions, and even with- 
 stand, and persevere during many which 
 are violent and unhealthy. How else could 
 many of the arts- and manufactures, by 
 which life and society are comforted and 
 enriched, be carried on with impunity ? 
 How else could the waterman and the 
 
129 
 
 sailor ply their oars and reef and un- 
 reef their sails ; how could the scavenger, 
 the half-scorched glass-melter, the dusty 
 miller, the half-buried miner, and the peri- 
 lous labourer in lead and arsenic, sustain 
 their duties, without more materially inter- 
 rupting these uses of the cuticle, than the 
 tender sempstress, or the watchmaker ? To 
 all these conditions, and others, is this 
 material fitted, for its relative services, in 
 the grasp of the sturdy feller of timber, the 
 fine and delicate touch of a Raphael or 
 a Guido ; of a Handel, a Haydn, and a 
 Mozart. 
 
 In the fourth plate of Bidloo's great work, 
 De Lairesse, under the direction of that 
 anatomist, has represented the appear- 
 ances of the skin, covered with cuticle, as 
 it is to be seen on the hand ; and particu- 
 larly on the thumb, on the ball and the 
 back of which, two of its most striking and 
 ostensible variations are visible. The re- 
 presentations are far from being perfect; 
 especially as they only show the exterior 
 surface, and not the interior conformation. 
 
 K 
 
130 
 
 They are, however, obvious, and may serve 
 us in the first step to an illustration of this 
 part of our subject. On the ends of the 
 fingers and toes and on the ball of the 
 thumb, and on the under part of the 
 heels, it presents a curvilinear appearance ; 
 whereas in other parts it is arranged in 
 rugae in various directions; longitudinal, 
 transverse, and angular. (See Plate I. 
 fig. 1, 2.) In the former, where the nails 
 are inserted into it, it is evidently intended 
 to preserve that degree of tenseness in the 
 subjacent skin, which is essential to the 
 nicest exactitude and delicacy of the organ 
 of touch ; being stretched over the cutis, 
 from one side of the nail to the other, 
 somewhat as the skin of a drum is from 
 its frame. So essential is this circum- 
 stance, that we find in cases of paronychia, 
 where the nail is lost for a time, the sens- 
 ation of touch is materially impaired ; 
 being either benumbed, or attended with 
 pain, but in both cases comparatively un- 
 instructive ; till the regeneration of the nail 
 is sufficiently advanced to restore the cu- 
 
131 
 
 tide of the affected part to its requisite 
 firmness and stability. 
 
 The rugse which appear in other parts of 
 the cuticular surface are adapted to the 
 greater mobility of which it is to admit, and 
 to provide against the infinitely varied 
 flexures, that the uses of the parts it invests 
 necessarily demand; and they mark out 
 lines, at which a kind of ligamentous struc- 
 ture descends to the coriaceous part of the 
 skin, and which keeps the whole organ 
 steady, during these changes, without 
 rigidity ; and admits of yielding and soft- 
 ness, without the risk of laceration. (See 
 Plate I. fig. 3.) 
 
 But how is the office of perspiration car- 
 ried on through the cuticle? What and 
 where are its pores, which have been sup- 
 posed to transmit this fine exhalation? 
 Are there any in reality? If there be, 
 how are we to account for the fact before 
 alluded to, that the cuticle does not admit 
 of the evaporation of the fluid secreted in a 
 vesication, but generally serves rather to 
 K 2 
 
132 
 
 prevent it, till the formation of a new sur- 
 face, of the same kind with itself, is con- 
 siderably advanced ? And if there be no 
 such pores, by what contrivance is it that a 
 function of such indispensable importance 
 to the animal economy, and an evacuation 
 so large in its amount, and unceasing in its 
 secretion, is maintained, with such con- 
 stancy and regularity ? How is it that the 
 fluid of a miliary eruption is detained, 
 when the excessive perspiration which in- 
 duced it has ceased ? How is it also that 
 petechise remain, the extravasated blood 
 being usually absorbed, and not discharged, 
 and this so completely, that the vessels 
 which have given way heal, and a fresh 
 cuticle invests them, before that which 
 covered the spot is detached ? How is it 
 also, that various materials pass through 
 it from without, so as to combine with the 
 general mass of blood, and produce their 
 own distinct and recognizable effects ? 
 
 Pressed by this difficulty, I began an ex- 
 amination of both surfaces of the cuticle, 
 the exterior and the interior. I recollected 
 
133 
 
 that they are adapted to different circum- 
 stances : the outer being exposed to the 
 atmosphere, and being destined for pro- 
 tection ; the inner being adapted, in con- 
 junction with what has been very impro- 
 perly called the rete mucosum, to invest 
 and assist the fine vascular texture of the 
 cutis, by which the function we are con- 
 sidering is carried on. It seemed highly 
 probable, therefore, that the two surfaces 
 had each its peculiar arrangement, to cor- 
 respond with its distinct and peculiar pur- 
 poses. That which is external is, for the 
 most part, comparatively smooth and glossy ; 
 the internal is materially different. I took 
 some portions of cuticle from various parts 
 of the body, and laid it in the field of a 
 microscope, magnifying 140 times, with 
 some glazed dark blue paper under it, 
 hoping to detect the pores, by the coloured 
 paper appearing through them ; but I could 
 find none that could be properly called by 
 that name, except where it was evident it 
 had been perforated by small hairs, which 
 it had quitted. Instead of pores, I found 
 an infinite number of minute velamina, re- 
 K 3 
 
134 
 
 gularly arranged, of exquisite tenuity, pre- 
 senting a follicular appearance, and separ- 
 ated from each other by bands of a thicker 
 substance, crossing and intersecting them, 
 so as to render them distinct, as repre- 
 sented in the drawings, which have been 
 made by my son, who, in addition to his 
 being a minute and accurate anatomist, is 
 able exactly and faithfully to delineate what 
 may come under his observation. (See 
 figs. 1, 2, 3, 4, and 5. Plate II.) 
 
 The mystery now appeared approach- 
 ing to a solution ; for if the terminal ves- 
 sels of the cutaneous apparatus, of which I 
 shall have more to say in a subsequent lec- 
 ture, are lodged, as I fully believe them 
 to be, in these velamina, (of which, though 
 perfectly distinct, I attempted in vain to 
 count the number in the fortieth part of a 
 square inch,) so long as the vessels maintain 
 a vital connection with them, they transmit 
 their secretion through them, as through 
 a bibulous, and exquisitely hygrometrical 
 covering, of the finest delicacy and per- 
 fection ; while, through the same medium, 
 
135 
 
 and dependent on subjacent tubes taking 
 a contrary course inward, absorption is car- 
 ried on to a great, but less certain extent 
 and continuity. The whole purpose which 
 could be answered by pores, or holes, as 
 the term is commonly understood, is thus 
 fulfilled by an arrangement, which, while it 
 answers all the purposes, avoids all the in- 
 conveniences of perforatory pores, as it 
 obviates all chance of extravasation within, 
 of hurtful exposure without, and of confu- 
 sion in either direction. But when this 
 vital union is destroyed, the cuticle, now 
 reduced to its merely chemical but astonish- 
 ing properties of endurance, becomes in- 
 capable of continuing its transmissive of- 
 fice with any certainty or regularity. It is 
 macerated, as it were, in the subjacent ex- 
 udation, or impaired and broken through by 
 the too active exertions of the vessels which 
 formerly nourished and supported it ; so as 
 to loosen and detach itself, in pieces of va- 
 rious size, from fine powdery and furfur- 
 aceous scales, or portions, to large desquam- 
 ations, and even to the entire covering it 
 has given to a hand or a foot. 
 
 K 4 
 
136 
 
 Nor is the structure I have been de- 
 scribing without an analogy in the body ; 
 the inhalation and exhalation which are 
 constantly going on in the air-cells of the 
 lungs, appearing to take place in a manner 
 almost or precisely similar. 
 
 We may also hence see the reasons why 
 vesications on hairy parts, as the scalp, for 
 instance, do not retain the fluid effused so 
 long as others ; for when the cuticle is se- 
 parated from the hairs, the fluid readily 
 escapes by the perforations they leave 
 through it, which in consequence sooner 
 lacerates, and breaks away. 
 
 If I am not mistaken, this developement 
 of the structure and properties of the cu- 
 ticle, with what I shall hereafter bring 
 before you concerning the rest of the in- 
 teguments, opens a new field of important 
 enquiry ; and, as I expect to show, when 
 I endeavour to sum up its practical con- 
 clusions and uses, or at least that compara- 
 tively small part of them which has, as yet, 
 fallen under my observation, tends to throw 
 
137 
 
 light on the nature and influence of many 
 cutaneous diseases, and may probably help 
 us hereafter in finding out a more scientific, 
 and curative, or alleviating management of 
 them, than we could otherwise have at- 
 tained. And I am inclined to believe, 
 that to an unacquaintedness with these facts, 
 we are to ascribe that unwelcome and dis- 
 appointing pause, which has for so many 
 years continued, in the investigation of the 
 physiology and the scientific pathology of 
 the skin, both under its idiopathic and 
 symptomatic derangements. 
 
LECTURE V. 
 
 MARCH 27. 
 
 To the natural history of the cuticle has 
 generally been thought to belong that of 
 the nails and hair ; the latter I think in- 
 correctly, for they are more connected with 
 the cutis ; but the former justly, as they 
 form a continuous covering with it for the 
 skin, at the superior surfaces of the ends of 
 the fingers and toes. They are not, how- 
 ever, an identity of substance, although 
 under chemical analysis they yield the same, 
 or nearly the same, products. In a variety 
 of diseases they are readily detached from 
 it; though in a natural state they are in- 
 serted into it, strongly adhering to it, and 
 often come away with it by maceration, or 
 the action of boiling water. In the exuviae 
 of insects also, the nails separate with the 
 
139 
 
 cuticle. Their roots are surmounted and 
 enclosed by a semilunar projection of the 
 cutis, over which the cuticle extends, and 
 also grows up beyond it. In man, and 
 some other animals, they are thin and 
 flattened ; in other animals, thick and coni- 
 cal, without sensibility, and without ves- 
 sels. They much resemble horn, and in 
 some cases are converted into horn, es- 
 pecially on the great toe ; from whence I 
 have repeatedly had occasion to remove 
 them by a saw, on account of the great in- 
 convenience and pain produced by their 
 length and curvature. In some cases, how- 
 ever, I have seen a contrary departure from 
 their natural condition ; when, in conse- 
 quence of a debilitated state of the circu- 
 lation in the extremities, they have become 
 much shorter than they ought to be, the 
 last bony phalanx appearing to partake in 
 this degeneracy. They are placed on the 
 surface of extension ; but if left to grow 
 far beyond the ends of the fingers or toes, 
 they curve toward the surface of flexion. 
 They appear composed of horny fibres, 
 which grow firmly compacted together in a 
 
140 
 
 longitudinal direction, from a highly vascu- 
 lar tissue at their roots, where they are soft 
 and flexible ; and if split by violence in 
 this direction down to the root, the mark 
 of the fissure remains through life, unless 
 the whole of the nail so split should be cast 
 off. If broken in a transverse direction, no 
 such permanent deformity follows. They 
 are not perforated by pores, either for hairs 
 or sebaceous glands ; nor do they sustain 
 any part in the transpiratory function ; nor 
 are they endued with any power of con- 
 traction or relaxation. They are thinnest 
 and softest at their connection with the 
 cuticle, and increase in thickness, hardness, 
 and often in breadth and in brittleness, till 
 they have quitted it, near to the termination 
 of the extreme phalanx. In man they are 
 more fitted to be instruments for use than 
 for defence. Their substance, arched form, 
 their shape, situation, and insertion into the 
 cuticle, give greater firmness and accuracy 
 to the sense of touch at the ends of the 
 fingers, without endangering the apparatus 
 adapted to this purpose, by the requisite de- 
 grees of pressure. The interior epidermis 
 
141 
 
 is not continued under them. Being bad 
 conductors of heat, they probably also are 
 greatly useful in preserving and recovering 
 the proper and necessary warmth of these 
 delicate parts, during and after their ex- 
 posure to many gradations of temperature 
 above and below their own, on the different 
 surfaces with which they are brought into 
 contact. They asist us in an infinite va- 
 riety of manual operations, and protect the 
 termination of the bone which supports 
 them. They do not, however, depend upon 
 the bone, but upon the skin, for their sup- 
 plies and continued progression ; and if 
 their roots, or any part of their roots, be 
 left in the skin, in such proportion may 
 their substance go on to grow, although 
 the bone which was originally underneath 
 them be lost. But in this case they be- 
 come deformed ; their curvature toward the 
 line of flexion is more abrupt, and gene- 
 nerally so much so as to render them not 
 only useless, but inconvenient. Their firm 
 texture, and close attachment to the sur- 
 faces they cover, render injuries and in- 
 flammatory affections of those surfaces, and 
 
142 
 
 excrescences, which sometimes grow under 
 them, almost intolerably painful ; and have 
 furnished a cruel source to savages and per- 
 secutors for the horrid and barbarous tor- 
 tures which the former have inflicted on 
 their captives, and which the latter have 
 not scrupled to employ, in their vain and 
 infuriated attempts to violate reason, and 
 abolish the honest profession of truth. Un- 
 der inflammation and its consequences a 
 whole nail is not unfrequently detached 
 at once ; but if the vascular surface from 
 which it grew is not also destroyed, the loss 
 is gradually repaired, by the regeneration 
 of a new nail, which commonly, though not 
 always, is as perfect and as fitted for its 
 uses as the former, if the cutaneous ves- 
 sels at its root, from which it is nourished, 
 are not materially injured by the disease, 
 or the violence, which has occasioned its 
 separation. 
 
 I have just intimated that the ordinary 
 association of the hair with the description 
 of the cuticle appears to me to be some- 
 what incorrect ; not only because their 
 
143 
 
 offices are quite distinct, but because the 
 hairs merely permeate the cuticle ; they do 
 not grow from it, nor are they essential to 
 it. They grow from bulbs, which have 
 their seat on the coriaceous part of the 
 skin, and are nourished by vessels presently 
 to be described. It is the removal of these 
 bulbs, however, when the cuticle is de- 
 tached by maceration, which gives to the 
 skin most of that appearance of pores, or 
 holes, which has, and naturally enough, 
 misled anatomists who have examined this 
 organ. Of these there are millions on the 
 surface of the body, if we include among 
 them, as we ought, the lodgements of the 
 bulbs or roots of that congeries of capilluli, 
 which compose the delicate pubescence, 
 that gives the finished softness to infantile 
 and feminine beauty. This porous appear- 
 ance of the skin is still more remarkable, if 
 the sebaceous glands be also detached from 
 it, the ducts of which also open through 
 the cuticle on its external surface. But 
 neither are these, nor the hairs, nor the 
 pores in which they are fixed, much, if at 
 all, concerned in the office of perspiration. 
 
144 
 
 I shall, therefore, for a moment, defer a 
 more minute attention to them, and pro- 
 ceed with the examination of the integu- 
 ments on the plan I first proposed, going 
 from without, inward. 
 
 Immediately, then, underneath the cu- 
 ticle, you know, gentlemen, there is situated 
 another membranous substance, which has 
 been called the Rete Mucosum : impro- 
 perly so called, however; for it is neither a 
 network-like membrane, nor is it a mucous 
 substance ; except in so far as it is sooner 
 soluble by maceration, and, when putres- 
 cent, exhibits the appearance of a slimy 
 matter ; not coherent like mucus, but 
 more diffusible, and more easily washed 
 away than either the cuticle or cutis. It 
 has been by some considered as a lamina 
 of the cuticle itself ; but it is no such thing ; 
 being altogether different in its ostensible 
 properties, and intended and adapted for 
 very different uses. It should rather be 
 called the second, or interior Epidermis, for 
 reasons I shall presently explain. It varies 
 much in its colour in the natives of dif- 
 
145 
 
 ferent countries, from the fair Circassian to 
 the dusky Negro ; and considerable variety 
 is also evident in persons of different tem- 
 peraments, inhabiting the same climate, and 
 exposed to similar circumstances of parent- 
 age and habit. It is in general readily separ- 
 able, with due care, from the cuticle. It is 
 much more equable in its thickness, softer in 
 its composition, and seems placed as a more 
 certain, yielding, and delicate intermedium 
 between the variable and insensible cuticle 
 itself, and the vascular and nervous and 
 sensible substance of the true cutis. In 
 consequence of this, it serves at once duly 
 to graduate and preserve the sensibilities 
 of the cutis, and to secure the regular and 
 appropriate performance of its numerous 
 functions. Its black colour in the Negro 
 was long supposed, and by the recent ex- 
 periments and observations of Sir Everard 
 Home is now fully proved, to be a great 
 mean of the preservation of the cutis from 
 the injurious effects of a tropical sun. 
 But its preservative effects are not limited 
 to the Negro. It is in itself a bad con- 
 ductor of heat ; and, being placed imme- 
 
146 
 
 diately under another bad conductor, and 
 over a quick one, it must materially con- 
 tribute to the uniformity of temperature, so 
 necessary to an animal destined to inhabit 
 all climates, and to rule in them all. It 
 does not seem to be exactly co-extensive 
 with the cuticle ; but of this I am not sure : 
 the extreme fineness of the cuticle in some 
 parts, as over the conjunctiva, causing it, if 
 it does exist, to be too slender for detection, 
 unless under very fortunate and uncon- 
 troulable circumstances, which accident 
 only is likely to present. It appears there- 
 fore to be chiefly, if not altogether, con- 
 fined to those parts which may be in 
 danger of suffering, under the want of other 
 organic protection, from exposure to com- 
 pression, or to excessive heat, or extreme 
 cold. When the papillae of the skin, which 
 we are by and by to examine, become 
 elongated by diseased growth, they attain 
 a considerable length, before either this or 
 the cuticle break, or become perforated by 
 them. Both are elongated with them, not 
 indefinitely, but nevertheless to a very 
 remarkable degree, serving thus as an in- 
 vestiture, or exact clothing, to each indi- 
 
147 
 
 vidually, as well as to all collectively. When 
 the cutis itself has been destroyed, by in- 
 jury or disease, it may be partially, but 
 only partially, regenerated ; probably at 
 least not so completely as the cuticle ; and 
 this, perhaps, may be one considerable rea- 
 son of cicatrices being more painful at cer- 
 tain times, especially under atmospheric 
 changes, than the original skin ; for we can 
 hardly suppose that the nerves of the new 
 skin can be more perfect than those of the 
 first; indeed, we know that their sens- 
 ations are not in general so accurate and 
 instructive. It has been asserted that it is 
 never reproduced, an opinion which has 
 rested chiefly on the paleness of the cica- 
 trices of Negroes ; but this notion is in- 
 correct ; and many cicatrices of Negroes 
 are black, though less black than the sur- 
 rounding skin, as may be seen in those 
 who have recovered from confluent small- 
 pox ; much of the restorative process, in 
 all these cases, depending on the greater 
 or less depth and extent, to which the 
 blood-vessels supplying the parts affected 
 have been injured or destroyed. I have 
 
 L 2 
 
148 
 
 been somewhat surprised to find an ana- 
 tomist, generally so discriminating as Bi- 
 chat, speak so loosely and undeterminately 
 concerning this substance, which he seems 
 strangely to confound with the vascular ap- 
 paratus underneath, on the surface of the 
 corium of the cutis. He calls it a general 
 capillary system, which forms with the pa- 
 pillae an intermediate layer (une couche m- 
 termediaire] betwixt the corium and the 
 epidermis ; and adds, that it contains, in the 
 greater part of the human race, only white 
 fluids, but black fluids in the Negro. He 
 thought he had injected it ; and yet he 
 says there is no circulation going on in 
 it; a confusion of ideas that must have 
 arisen from his not having sufficiently 
 distinguished it from the vascular struc- 
 ture, from which it is entirely separate and 
 distinct, though deriving, of course, its 
 nourishment from thence. I have never 
 succeeded so far as to force any thing into 
 it, even when I have filled the cutaneous 
 vessels to the most perfect minuteness. 
 Nor do I believe that any more satisfactory 
 account can be given of the cause of the 
 
149 
 
 blackness of it in the Negro, or of its pale- 
 ness in the European, than of the yellow- 
 ness of the bile in most animals, and of its 
 vivid greenness in others, as in the turtle. 
 It is a product depending wholly on the 
 principle and operations of life. In the 
 areola of the nipples of pregnant and suck- 
 ling women, we often find it black ; but 
 only for the time those processes are going 
 on, and then resuming its former appear- 
 ance. Haller tells us he once saw it on the 
 pubis of a woman as black as the skin of an 
 ^Ethiopian ; and on the faces and hands of 
 persons exposed, in an unaccustomed de- 
 gree, to the rays of the sun and to the sea- 
 breezes, it is often found to change its tint 
 for a while, and afterward to be as it was 
 before. We need not depart in our specu- 
 lations concerning it from simple and ob- 
 vious facts. Its general uses I have already 
 stated, and that it assumes varieties to 
 answer other purposes, when they become 
 necessary. It affords a soft nidus for the 
 vascular and nervous structures of the com- 
 plicated organ which it invests, both under 
 pressure, and exposure to changes of tem- 
 
 L 3 
 
150 
 
 perature. It adds to the smoothness, soft- 
 ness, beauty, and delicacy of that organ ; 
 preserving its sensibilities, and the balance 
 of the circulation in its extreme vessels, 
 with more perfect precision than could be 
 secured without it. The privation of it 
 from any part of the surface it ought to 
 cover, is always followed by considerable 
 inconvenience ; and often occasions a neces- 
 sity for the suppurative process to secure 
 its restoration, when the detachment of the 
 cuticle alone, could be repaired by means of 
 greater simplicity, in a manner less expen- 
 sive to the constitutional powers, and oc- 
 casioning less suffering to the patient. In 
 some instances, however, its loss seems to 
 be almost immediately atoned for by the 
 effusion of a protecting stratum of coagu- 
 lable lymph. The various degrees of in- 
 tensity with which blisters act, show all 
 these circumstances, and often demand our 
 vigilance in the employment of them, lest 
 we err on the side of severity ; especially in 
 children, and persons of delicate constitu- 
 tions, on whom they should not, in general, 
 be allowed to remain longer than is suf- 
 
ficient to elevate the external epidermis. 
 If the interior be also separated, especially 
 if the blistered surface be extensive, it is no 
 uncommon thing for the vascular, and even 
 the coriaceous surface of the cutis itself 
 to slough. I have seen many lives lost 
 from this occurrence; particularly where 
 the constitution had been previously much 
 weakened, either by large bleedings, or the 
 influence of acute and severe disease : and 
 though the effusion of a stratum of the 
 coagulable lymph does sometimes appear 
 to stop this mischief, it does not so always ; 
 the stratum itself first assuming an irregular 
 honeycomb-like surface, which is usually a 
 prelude or an accompaniment to deeper 
 gangrene, and indicates a perilous failure of 
 vigour in the vital powers. 
 
 It may be remarked, further, that the in- 
 terior epidermis is more closely connected 
 with the sebaceous glands than the cuticle. 
 I shall by and by have to notice these 
 glands more particularly ; but it is to my 
 present purpose to observe, that the exterior 
 epidermis, when carefully detached from 
 
 L 4 
 
152 
 
 the interior by due maceration, does not 
 bring the ordinary sebaceous glands away 
 with it ; but the interior does. And this 
 shows that the cutaneous function must 
 inevitably suffer greater derangement when 
 this circumstance takes place than when it 
 does not ; that our endeavours in blistering 
 should usually be confined to an excite- 
 ment of the vessels which nourish these 
 parts, and not be extended to the destruction 
 of any thing more than is easily reparable; 
 namely, of the cuticle itself, for the restor- 
 ation of which more ample resources exist 
 in the constitutional energies and arrange- 
 ments ; and that, in consequence, where 
 long excitement and counter-irritation ap- 
 pear to be indicated, it is better to seek 
 it by issues of some description ; especially 
 by setons, or discharges produced in inter- 
 stitial incisions or spaces, than by what 
 have been called perpetual blisters, or other 
 methods which endanger a destruction of 
 the whole, or important part, of the cu- 
 taneous apparatus. This, as I have inti- 
 mated, will require especial attention in 
 the cases of infants, whose thin cuticle, and 
 
153 
 
 tender, and irritable, and active skin, ex- 
 pose them to much greater disadvantage 
 even than adults ; because the period of 
 growth, which is the extension of the cor- 
 poreal fabric, demands in them a more 
 uniform exercise and perfection of the 
 actions which go on upon its surface. 
 
LECTURE VI. 
 
 MARCH 29. 
 
 HAVING thus far considered the epidermal 
 parts of the common integument, I now 
 wish to take a somewhat minute view of 
 that fine vascular and nervous fabric un- 
 derneath them, which, spread out over the 
 coriaceous part of the skin that protects 
 them from within, and defended by the 
 substances already described from with- 
 out, and assisted by both, sustains its most 
 vital and essential offices. In attempting 
 this, I shall not affect to conceal that I 
 have derived many indications and much 
 assistance from the labours of others who 
 have gone before me ; but as their means 
 of investigation were inferior to those we 
 now possess, their observations necessarily 
 partake of this imperfection ; and account 
 
155 
 
 for many of their remarks being partial, and 
 comparatively unconnected, and in nume- 
 rous instances disjointed by the interpo- 
 lations of conjecture. If, therefore, I do 
 not quote them by name, it is because I 
 apprehend this would rather confuse than 
 elucidate the subject ; and because I shall 
 feel more at liberty, having enjoyed such 
 advantages, and having endeavoured to fill 
 up some of the deficiencies that have been 
 left, if I give a direct statement of what I 
 have observed ; and of what I have, so far 
 as I have already gone, perceived to be 
 worthy of farther investigation, in giving a 
 simple detail of facts, than by enumerating 
 authors, the mere recital of whose names 
 and experiments might, in many instances, 
 even obscure the distinctness and value of 
 that which they have recorded. We must 
 all ascend, at first, upon the preparatory 
 labours of those who have preceded us; 
 neither undervaluing them, nor resting per- 
 fectly satisfied in unobservance or inaction. 
 While we follow with gratitude, let us imi- 
 tate with ardour ; but at the same time with 
 that humble and circumspect consideration 
 
156 
 
 and caution, which will suggest to us, that 
 those who are to come after us may pro- 
 bably have to point out and to remedy 
 oversights and omissions of our own,, simi- 
 lar to those which have escaped our prede- 
 cessors ; but which do not, in any essen- 
 tial respect, diminish the importance of 
 their labours, or justify a censorious spirit. 
 Even errors, whether of our own or of 
 others, may not unfrequently lead to in- 
 struction, if they excite more strict and ac- 
 curate enquiry. 
 
 Let us now recall the essential functions 
 for which the skin is designed, and then 
 consider with what infinite minuteness and 
 wisdom it is constructed to answer them. 
 It is an extensive range of surface, and, at the 
 same time, a test, a sort of gauge, or meter, 
 of the correctness and healthfulness of the 
 circulation of the general mass of the nu- 
 tritious fluid : and therefore, in turn, of 
 the departures of that circulation from 
 its just proportions, its moderation, or its 
 strength. It is an organ of transpiration, 
 by which various materials, the retention of 
 
157 
 
 which would disturb the whole animal 
 economy, are discharged in combination, 
 in an almost imperceptible, or at least an 
 unconscious manner, and in a gaseous 
 form. It is a medium of absorption, 
 through which poisons and remedies are 
 both conveyed ; and it is an organ of sens- 
 ation, of which the minutest point may be 
 so touched or affected as to produce the 
 most pleasing or the most painful im- 
 pressions. Lax, and soft, and delicate, and 
 beautiful, as it seems, and as it really is, it 
 is equal to the finest stretched monochord ; 
 of which no division can be struck, inde- 
 pendent of the whole, either in actual feel- 
 ing, or actual influence. An insect scarcely 
 visible, as the furia infernalis of Lapland, 
 may distract its victim almost to madness ; 
 w 7 hile the huntsman endures the succussions 
 and the toils of the chace, not only with 
 impunity, but with delight. And may we 
 not also notice, with pleasure and admir- 
 ation, the beauty that in the human race, 
 and the human race alone, affords that con- 
 tinual and almost inexhaustible source of 
 gratification, which we derive from the con- 
 
158 
 
 temptation of juvenile and female beauty ; 
 and its harmony with the stronger and 
 bolder features, in which the masculine lines 
 and sturdier characters of the hardier sex, 
 is almost invariably and visibly stamped ? 
 
 I begin with the office, or rather, I should 
 perhaps say, the state of the skin in the 
 circulatory system, and its adaptation to 
 that purpose. The perfection of any me- 
 chanism for the conveyance of a fluid, let 
 us take even a common watering-pot, de- 
 pends as much on the due conformation 
 of its ultimate arrangements, as on the form 
 and force in which its power is lodged. 
 And here I must observe that, in order to 
 gain a better understanding of this subject, 
 I have found it useful, and not only useful, 
 but absolutely necessary, to trace the cu- 
 taneous circulation through all its stages 
 and gradations, which are more and more 
 essentially variegated than may at first be 
 imagined. I have therefore derived assist- 
 ance from very imperfect as well as from 
 more minute injections ; each serving, as 
 it were, as a measure of the graduations 
 
159 
 
 and stages of the natural and perfect in- 
 strument in question. 
 
 My plan, I have told you, was to go from 
 without, inward ; and I see no reason to 
 depart from it in this instance. It may not 
 be so methodical as might be expected ; 
 but I trust it will not be less practically 
 useful. At all events, I hazard it, with a 
 glimmering and pleasing anticipation, that 
 some who are more capable, and better in- 
 formed, will hereafter do more justice to 
 this important subject. 
 
 All the vascular surface of the skin is mi- 
 nutely penicillated or villous, a fact which 
 I had made out many years ago, but con- 
 sidered it rather more as curious and beau- 
 tiful than as important, till I recently dis- 
 covered that velaminous structure of the 
 cuticle, which I showed to you at our last 
 lecture, and the conformity of the interior 
 epidermis with it ; for in the cuticular la- 
 minae, thus lined and assisted, the penicilli, 
 or villi, terminate, or are imbedded, and 
 carry on their ultimate duties. The villi 
 observable in the lips, and at the ends of 
 
160 
 
 the fingers, have been noticed by many ana- 
 tomists, but have been considered chiefly 
 as instrumental to the peculiar and more 
 delicate sensibilities of those parts. So, 
 indeed, they are ; but they arise out of, 
 and are in fact an extension of, the general 
 formation, for particular uses, rather than 
 a departure from it. Successful injections, 
 which are difficult, frustrated often by slight 
 causes, and generally, after all our care and 
 attention, found only in patches, are never- 
 theless sufficient to verify the fact. (See 
 the plate.) 
 
 -im ; fci tn&, *MU 'lA'fV^'hfj^ 'wVvnv'-of'^HA''"**"- 
 This structure is supported underneath 
 by a perfect net-work, of more obvious 
 construction, and of more easy detection ; 
 which, though so minute as to be seldom 
 recognizable distinctly by the naked eye, is 
 in reality composed of numerous trunks of 
 vessels, for the regular supply of the ulti- 
 mate arrangement. Of these, the anas- 
 tomoses are innumerable : the plan is per- 
 fect. The disturbance of one part of this 
 highly organic surface is, in a state of 
 regular health, instantly supplied by the 
 
161 
 
 coadjutorship of that in its immediate 
 vicinity ; so as not greatly, or long, to inter- 
 rupt the discharge of its functions. All 
 this fine and well-guarded apparatus is 
 spread upon the corium, and may be com- 
 pared to the colours of the skilful painter, 
 blended upon his canvass, which at once not 
 only manifests their combination, but se- 
 cures the final effect of their requisite pro- 
 portions. This net-work is supplied by 
 larger vessels underneath, which, at acute 
 angles of various degrees, permeate the 
 corium, after having partially ramified 
 underneath it ; then subdividing, so as 
 thus to secure, as far as the requisite 
 tenuity of the structure will allow, the re- 
 gularity of the circulation, and the accu- 
 rate fulfilment of those other functions, 
 which are made to be dependent upon it, 
 (See the plate.) 
 
 I am not prepared to state, by any calcu- 
 lation, how large a proportion of the blood 
 may be computed to be continually flowing 
 over the cutaneous surface. It must, how- 
 ever, be considerable, as may be evident, 
 
 M 
 
162 
 
 not only from the contemplation of the ex- 
 tent of that surface, but from the effect of 
 injuries to the cutis alone, where the vigour 
 of the constitution is on the decline. I 
 have known a person nearly bleed to 
 death, from a few orifices left after a very 
 superficial cupping. Undoubtedly in this 
 case the vessels must have greatly lost their 
 excitability to contraction, and the blood 
 have lost its power of coagulating, being in 
 the state which our forefathers called a dis- 
 solved crisis. Yet, from the ascertained pos- 
 sibility of a few apparently trivial scratches, 
 even when no longer under the influence 
 of the exhausted receiver, draining off such 
 a quantity of blood in a few days, we may 
 certainly learn the freedom, and the power- 
 ful concurrence of the whole circulation, 
 with that which is, to appearance at least, 
 simply external; and the disturbance which 
 is likely to ensue in the whole from a 
 check, or an undue excitement of the ex- 
 terior subdivision of it ; facts which de- 
 mand our most sedulous attention, and can 
 admit of no approach to any consistent so- 
 lution, without a due and patient reference 
 
163 
 
 to the distinct powers and operations of the 
 principle of life ; while, at the same time, 
 they present to us many circumstances, in- 
 telligible only from the ordinary laws of 
 matter ; warning off the truly philosophical 
 investigator from any superstitious assump- 
 tion ; life being in all these cases the agent, 
 matter the thing acted on, and the changes 
 in matter the effects ; which controul, but in 
 no respect destroy, the inherent qualities of 
 the substance itself. 
 
 We may confidently affirm of the vascu- 
 lar surface of the skin, that it would be 
 entirely inadequate to its purposes, as a 
 part of the common integument, were it 
 not to bear such a part in the system of 
 sanguiferous transmission, in addition to 
 the uses it is to fulfil in the support, nou- 
 rishment, and assistance of those other 
 structures which are interwoven with it, 
 and to its uses as a transpiratory organ, 
 which are secured by the ultimate distri- 
 bution of the vessels which depend upon 
 this transmission, and on which I beg 
 M 2 
 
164 
 
 leave now to suggest a few remarks and 
 enquiries. 
 
 I must revert a little to the observations 
 I have brought forward respecting both the 
 exterior and interior epidermis ; the latter 
 following the former through its whole 
 velaminated texture, and receiving under- 
 neath the sudatory vessels. What if I 
 should consider this interior substance, so 
 universally found under its more firm and 
 incorruptible defender, as constituting one 
 wide and diffused perspiratory gland, sup- 
 plied by the vascular texture I have de- 
 scribed, and being the medium of convey- 
 ance from it of that subtle fluid to the 
 cuticle, which then exhales through its ve- 
 lamina, in every degree of gradation from 
 the tranquil and invisible vapour of perfect 
 health and ease, to the profuse and colli- 
 quative sweat of a languishing hectic, or the 
 third stage of a fit of ague, or the clammy 
 and panic-striking damp of the agonies of 
 death ? How else is it that our injections 
 can penetrate no farther, when this inces- 
 sant process never ends but with the end 
 
165 
 
 of life itself? I waver, under the impres- 
 sion of my hardihood, in bringing before 
 you a suspicion so novel, but which is more 
 and more confirmed by every examination 
 I have made into the subject. 
 
 That the perspiratory process is not 
 merely a secretory, or separative one, but 
 is also one attended with chemical changes, 
 is demonstrated by many well-known facts, 
 some of ordinary, and some only of occa- 
 sional occurrence ; such, for example, as 
 the odour of the perspired matter, which 
 from some persons is agreeable, in others 
 sour and sickening ; in others, as in the 
 instances of Negroes and Mulattoes, gene- 
 rally offensive ; and in almost every case is 
 so from the feet ; often also strong and 
 discoloured from the arm -pits ; circum- 
 stances which seem explicable only from 
 glandular, and therefore chemical, as well as 
 separative changes in the material brought 
 in its ordinary state to the surface of the 
 cutis. The same remark will apply to va- 
 rious changes which are observable in dis- 
 eases, especially in fevers, and other affec- 
 M 3 
 
166 
 
 tions attended with febrile action, and ge- 
 nerating morbific and infectious matter. 
 These changes may, perhaps, begin in the 
 capillary vessels, under the influence of the 
 nerves connected with them, which we 
 know, from analogy, determine, in a great 
 measure, both the quantity and quality of the 
 secretions or deposits separated from them. 
 But it is probable that the nature of the pa- 
 renchymatous substance of all glands has a 
 share in determining the chemical cha- 
 racters of their respective products ; and 
 even that their excretory ducts themselves 
 are not without some such contributory 
 uses. In this view of the interior epider- 
 mis I am confirmed by a perfect certainty 
 that the villi terminate in it. It some- 
 times happens, that from a sharp blow the 
 cuticle and it are torn up from the cutis, 
 perfectly colourless, but yet perfectly dis- 
 tinguishable ; and I have watched them 
 for a considerable time with a magnifying 
 glass in this state, while the villi, of which 
 the impressions were distinctly left on the 
 soft surface which had quitted them, were 
 bleeding below; and afterward derived a 
 
167 
 
 most acceptable covering from its re-appli- 
 cation, till the repair of the injury was 
 accomplished. So that this seems the natu- 
 ral and appropriate recipient of the capil- 
 lary arteries of the cutaneous secretion, 
 which it imbibes under the protection of 
 the cuticle, then transmits it through 
 that exquisitely fine and delicate gauze, 
 which may be called the safety-lamp of life 
 and health. Indeed, the two Epidermides 
 together form a double safety-lamp, a 
 protection of double amount, and of more 
 than double value. I may here add, that 
 on long maceration of cuticle, with which 
 the substance in question remained at- 
 tached, it falls into semigelatinous portions, 
 and more resembles that into which macer- 
 ated glands separate, than that into which 
 cellular membrane, or muscle, or indeed 
 any other structure that I have examined 
 in the same manner, is reduced, appearing 
 under the microscope in the form of irre- 
 gularly granular particles. I do not lay 
 much stress on this circumstance; but I 
 cannot help thinking those I have enu- 
 merated carry much weight with them, 
 M 4 
 
168 
 
 and derive some additional confirmation 
 from it. 
 
 I am aware that a membranous appear- 
 ance is found in skins affected by small-pox, 
 and perhaps some other eruptive diseases, 
 which has been called, from its discoverer, 
 Baynham's membrane. But this is en- 
 tirely a morbid appearance, produced by 
 the eruptive inflammation occasioning an 
 exudation of coagulable lymph, which glues 
 together the capillary vessels, and ren- 
 ders them in that state separable, in a 
 membrane-like form, from the subjacent co- 
 rium ; a circumstance of which I may have 
 more to say hereafter. But it is not found 
 in the perfectly healthy and natural skin ; 
 nor even in small-pox is it recognizable 
 beyond the limits of the inflammatory in- 
 fluence of the diseased action. But to 
 proceed : 
 
 In addition to the share which the vessels 
 of the skin take in the circulation and the 
 perspiratory secretion, they supply nourish- 
 ment to other parts, either of its own fabric, 
 
169 
 
 or so circumstanced as to be dependent 
 upon them. Of these I must notice the 
 nervous papillae, the pores, the sebaceous 
 glands, and the hairs ; then the corium, 
 and, finally, what has been called the cellular 
 membrane, reticular membrane, or cellular 
 texture ; for the same trunks supply the 
 vessels nourishing them all, and, indeed, 
 make it difficult, in some points, to pre- 
 serve an exact discrimination in speaking 
 of these vessels, though I hope we are not 
 in much danger of running into any inju- 
 rious confusion. 
 
 The papillae seem to have formerly at- 
 tracted the greatest share of attention ; for 
 the more obvious papillae of the tongue, 
 which at its tip presents one of the most 
 perfect organs of touch, so far, and perhaps 
 so far only, as the delicateness of tact re- 
 specting surfaces is concerned, and the 
 larger papillae behind, led anatomists, na- 
 turally enough, to notice the resemblance 
 of structure in those parts of the skin 
 which present elongated villi after ordinary 
 injection : but the assumption of their ge- 
 
170 
 
 neral existence throughout the whole sur- 
 face is amply supported, not only by sens- 
 ations but by facts, which occasionally 
 reveal them in a state of morbid growth, 
 from the most minute which are observ- 
 able, to what may be called, comparatively 
 speaking, an enormous size. (See the 
 plate.) Much that has been written and 
 delineated, however, respecting them, is 
 very confused, one might almost say im- 
 aginary, or perhaps has arisen from optical 
 deception, in examinations with incorrect 
 glasses. They appear to arise from fila- 
 ments of the cutaneous nerves, which per- 
 meate the corium from within, in the same 
 manner as the blood-vessels, and then form, 
 most probably in close combination with 
 them, an essential ingredient in the villous 
 structure of the surface. Though so minute 
 as to be only with difficulty distinguishable 
 in a natural state, yet from their enlarge- 
 ment in disease, and from the analogy of 
 their structure with that of larger animals, 
 I believe they have generally, if not uni- 
 versally, a conical form ; that each has an 
 artery appropriated to its own nutrition* 
 
171 
 
 which accompanies it to the termination of 
 its point in the epidermis interior. This 
 conical form being probably best adapted 
 to the regular and im perturbed exercise of 
 its sensitive purposes, keeping the finest 
 tangible point in a state of support by a 
 more compact basis, which serves as the 
 peg which keeps the string of a musical 
 instrument in its due accuracy of tension 
 and fitness for vibration. Perhaps from its 
 passage through the corium it derives a 
 participation in the solidity of that part, the 
 base of the papilla receiving from thence a 
 delicate involucrum, which determines its 
 form, and secures its competence to its uses, 
 by the fixedness which sustains the exqui- 
 sitely variable arid correct mobility of its 
 summit, in all natural conditions and gra- 
 dations, without the risk either of lacer- 
 ation, or of inflammatory excitement. In 
 the engravings published by Bidloo, and 
 copied by Boerhaave and others, these truly 
 nervous and sensible organs are confounded 
 with the bulbs of the minute hairs, or 
 pubescence, which have also a conical, 
 but less erect and pyramidal form. The 
 
172 
 
 observation of Haller is certainly well 
 founded : " Non videtur pilus verus, pa- 
 pilla hospes esse " their structure, uses, 
 mode of lodgment, and their whole ar- 
 rangement, being entirely different, and 
 their situation only contiguous, as we shall 
 see more clearly by and by : yet so closely 
 are they implicated, as to all functional pro- 
 perties, by this contiguity with the parts 
 around them 5 and subtending them, as to 
 be altered by every material derangement 
 and alteration of structure which those 
 parts undergo ; becoming, under such cir- 
 cumstances, sometimes more painfully sen- 
 sible, and at others more torpidly unfeel- 
 ing than in a natural state ; but in both 
 cases conveying less perfect and intelligible 
 impressions to the sensorium. The con- 
 tact of other substances, which they are 
 chiefly destined to give us notice of, if 
 made under proper circumstances of tem- 
 perature, force, and repetition, excites their 
 sensibility to a more intense degree ; which 
 has been supposed to be attributable, and 
 not without great appearance of reason, to 
 their becoming at such times more erect, 
 
173 
 
 as the nipple of the breast does on parallel 
 occasions ; while cold, exposure, fear, nau- 
 sea, stupor, delirium, and palsy, diminish, 
 suspend, or destroy their usefulness. 
 
 I must here, gentlemen, postpone awhile 
 the farther consideration of this subject, 
 as on next Tuesday, Professor Brodie's 
 instructive Lectures on Comparative Ana- 
 tomy will be resumed, and continued till 
 he has completed that part of them which 
 he has selected for the present season, after 
 which it will be my duty again to address 
 you. 
 
 In the lectures I have already delivered, 
 I have had two objects in view ; one to ex- 
 cite a further enquiry concerning an organ 
 of great importance in the animal economy, 
 with the structure and functions of which 
 physiology, pathology, and therapeutics, 
 must be closely and essentially connected. 
 This, as it appears to me, has not of late 
 years received a sufficient degree of atten- 
 
174 
 
 tion ; and its structure has, therefore, been 
 but superficially examined. The other has 
 been to excite, or I should rather say, to 
 promote, the study of minute anatomy ; 
 for, without a knowledge of minute ana- 
 tomy, we cannot sufficiently know anatomy 
 for physiological or pathological uses. We 
 may be good mechanics, but yet not equally 
 good healers of those who require our me- 
 chanical aid. Moreover, minute anatomy 
 opens to us a large field of interest and 
 instruction. An eloquent French writer has 
 justly observed, that man is placed between 
 two infinites, the infinitely great, and 
 the infinitely small. Over his head revolve 
 myriads of worlds, which surpass his ut- 
 most stretch of thought, by their multi- 
 tude, their magnitude, their arrangements, 
 and their movements ; and which seem 
 intended, among other magnificent pur- 
 poses, to hold out to man a pledge of in- 
 terminable sources of knowledge for his 
 immortal mind : while in " the gay motes 
 that people the sun-beams" and in the waters 
 of the meanest swamp, float millions of 
 living beings, and of the germs of living 
 
175 
 
 beings, that the unassisted eye is unable to 
 distinguish ; and of which the eye that is 
 best assisted cannot penetrate the organ- 
 ization. For myself, I must acknowledge, 
 that neither having had opportunity nor lei- 
 sure to enter far into the sublime science 
 of astronomy, but feeling the sincerest re- 
 spect and gratitude toward those who do, I 
 have thought smaller objects more within 
 my feeble competence : and here I descry 
 the infinity that is beyond me ; for even 
 microscopes, which are calculated to mag- 
 nify 8000 diameters, serve only to exhibit 
 structures, the composition of which they 
 cannot explain. So that it is most pro- 
 bable the formation of every created being, 
 whether material or intellectual, will for 
 ever remain a mystery, known only to Him, 
 who has made all things according to the 
 wise, but inscrutable counsels of His own 
 will. 
 
LECTURE VII. 
 
 MAY 6. 1823. 
 
 GENTLEMEN, 
 
 PROFESSOR BRODIE having concluded his 
 lectures for the present season, it becomes 
 my duty to undertake the completion of 
 this course; and, with the permission of 
 the Board of Curators, I am going to de- 
 viate somewhat from the usual plan of 
 that part on which it is now my duty to 
 proceed. So that, instead of entering at 
 once on subjects which are particularly con- 
 sidered as surgical, I may first conclude what 
 I have to lay before you, on the anatomy 
 and functions of the skin : for, indeed, 
 without this, I could not completely fulfil 
 my own wishes respecting the attempt, at 
 
177 
 
 least, to explain those diseases to which our 
 attention is generally directed, and the 
 treatment appropriate to them. Inflam- 
 mations, for example, existing in the vari- 
 ous parts of the common integument, 
 whether phlegmonous or erysipelatous, 
 whether ordinary and general, or specific, 
 excrescences, leprous affections, many of 
 the effects of scurvy, and an almost infinite 
 number of constitutional disturbances, re- 
 quire a knowledge of this complicated or- 
 gan, for a satisfactory understanding of 
 their manifestations. In all wounds it must 
 be injured : many diseases commence in it, 
 and extend their baneful influences from 
 it to the most vital parts. 
 
 When I began to compose these lectures, 
 and had fixed on this subject as the first to 
 bring under your notice, I confess that I had 
 no idea of the extent to which it would 
 lead me. The farther I have gone, the 
 more deficient I perceive the investigations 
 of it to have been. I do not wish, by this 
 remark, to convey the least censure upon 
 others, or to arrogate the least credit to 
 
 N 
 
178 
 
 myself. I wish to urge on enquiry, ex- 
 periment, and a faithful comparison and 
 adjustment pf all the well-ascertained facts 
 that can be collected ; and the first, cer- 
 tainly, must be of those which are anatom- 
 ical ; as the basis on which all others must 
 rest, or from which they must proceed ; 
 and then those which are physiological, 
 pathological, curative, or alleviative; an 
 immense field of science, from which every 
 other region in its vast extent, may con- 
 tribute something to advance the fertil- 
 ization ; but which will require the aid of 
 many industrious labourers to bring it even 
 tp that limited degree of fruitfulness and 
 benefit, of which the circumscribed dur- 
 ation of human life, and its contingencies, 
 can admit. However, we are all interested 
 in it, both personally and professionally, 
 that we may impart relief to others, and 
 also receive it ourselves : for, you know, 
 we have no exemption from the common 
 lots of our nature ; and the animating ex- 
 pression of Gicero, which has so often been 
 quoted, may justly encourage our ex- 
 ertions: " Nulla in re, homines propius 
 
179 
 
 Diis accedunt, qoam salutem hominibus 
 dando." 
 
 Let us now examine the pores of the 
 cutis, those orifices which are so obvious 
 on its surface, when the two Epidermides are 
 taken off; which have usually been con- 
 sidered as fulfilling the perspiratory office ; 
 although it will follow, from what I have al- 
 ready laid before you, that they are differ- 
 ently destined, as to their peculiar duties ; 
 even if we may not doubt whether they 
 have or have not any correlative allot- 
 ment of function. 
 
 Of these pores there are millions, of va- 
 rious characters, on the surface of the body. 
 But numerous, I should rather say, num- 
 berless, as they are, they would be far too 
 few, too separated, and too large, to ac- 
 count for the ordinary and continual quan- 
 tity, and process, of insensible perspiration ; 
 of which the most profuse sweat is only an 
 excess ; unless it be under violent, extra- 
 ordinary, or rather morbid and disorgan- 
 izing conditions. How far these pores may, 
 N 2 
 
180 
 
 under such circumstances, contribute to 
 the display of such morbid states and ap- 
 pearances, will perhaps be better under- 
 stood, after we shall have more carefully 
 attended to their respective distinctions 
 and offices, their localities, and relative 
 connections. 
 
 The orifices, called pores, are chiefly 
 distinguishable in the corium, and are of 
 three kinds. First, the residences of the 
 bulbs of the hairs ; secondly, those of the 
 capilluli, or down, as it is commonly called ; 
 but which is, in reality, a congeries of very 
 minute hairs, possessing similar, though not 
 identical, characters and offices ; and, lastly, 
 those of the sebaceous glands. Here and 
 there the places of transit of vessels and 
 nerves make their appearance ; but these, 
 in number and amount, are very few com- 
 pared to the rest, and are readily distin- 
 guished by the order, or, perhaps, I should 
 rather say, by the uncertainty, of their ar- 
 rangement. 
 
181 
 
 The orifices indicative of the situations 
 of the sebaceous glands are not always per- 
 manent in the corium when dried ; neither 
 are those certainly so of the minuter hairs, 
 constituting the pubescence. Those of the 
 larger hairs, like those of quadrupeds, re- 
 main, and are easily recognizable after the 
 process of tanning. But should we look 
 to any, or to all of these, for an account of 
 the ordinary, or extraordinary perspiration, 
 they could not explain it. This assertion 
 appears to me so fully warranted by the facts 
 I have already introduced, and supported 
 by the preparations now exhibited*, that 
 it hardly seems worth while to detain you 
 longer upon it at present ; but rather more 
 imperative to examine those substances, 
 by the attachment of which the appear- 
 ance of pores, or perforations, to answer 
 the purpose of exhalation, has been com- 
 monly, but too hastily impressed upon the 
 notice of observers. 
 
 * A series of these preparations is deposited in the 
 College Museum. 
 
 N 3 
 
182 
 
 I shall first call your attention to the se- 
 baceous glands ; and this because they 
 appear to be first, in order of function, in the 
 growth and destination of the maturing 
 foetus; in which, toward the approach of the 
 time of its expulsion from the womb of 
 the mother, they are, comparatively at 
 least, more numerous, more constant, and 
 even more necessary, and more employed 
 in the economy of the animal, than when 
 it has emerged from its prison, and taken 
 upon itself independence of life, and of 
 Activity. Incapable of respiration, the per- 
 spiratory office not being begun, neither 
 urinary nor alvine excretions calling for 
 discharge, consciousness not yet awake, 
 the senses only in a state of preparation, 
 and even the muscular energies only such 
 as to give confirmation of its vitality, 
 and of its being on the approach to fit- 
 ness for its future condition ; it chiefly 
 requires a supply of nourishment and 
 warmth, which it derives from its parent, 
 to ensure its growth from within ; and of a 
 safe-guard exteriorly, to render all this com- 
 patible with the necessary conditions of its 
 
188 
 
 temporary abode, and its approaching de- 
 parture from it. Exteriorly, therefore, it is 
 surrounded by the Liquor Amnii ; which af- 
 fords a gentle and equable support to the 
 growing fabric, and protects it from many 
 risks of injury from violence ab extra, dur- 
 ing its early and pulpy state ; and, at a more 
 advanced period, seems destined at once to 
 impede perspiration from the skin^ and to 
 prepare and keep fit that very skin for that 
 very office, when it shall arrive into the 
 more rare atmosphere in which it is to 
 live. But in order to secure the cuticular 
 covering of the skin from harm, by being 
 so long macerated, as it were, in the fluid 
 around it, these glands secrete a clammy, 
 and somewhat unctuous substance, repul- 
 sive of water, which is entangled and ren- 
 dered adherent to it by a soft and minute 
 pubescence, composed of millions of capil- 
 luli, or little hairs, the roots of which rest 
 upon or rather in the corium ; they then 
 pass obliquely through both the interior and 
 exterior epidermis to the surface, to fulfil 
 their offices. And the separation of these, 
 leaves the appearance of pores; 
 
 N 4 
 
184 
 
 Of the sebaceous glands, I have recently 
 discovered there are two sets. One is well 
 known, and is situated behind the second 
 Epidermis, imbedded in the Corium. The 
 other, I believe, has not before been de- 
 tected. They are very minute, and lie 
 between the second epidermis and the 
 cuticle, to which they appear very firmly 
 attached. I found these on examining 
 the inner surface of some cuticle which 
 had been macerated for more than six 
 weeks, and from which the interior epi- 
 dermis, having been broken down by pu- 
 trefaction, was readily washed or rubbed 
 off. These glands remained behind, and 
 are clearly visible in the preparations I 
 have made ; entirely separate and distinct 
 from the bulbs, or roots, of the capilluli. 
 (See the plate.) In the lower figure, 
 on the same plate, they are shown as 
 seen through the exterior and semi-trans- 
 parent surface of the cuticle ; on which, 
 in a good light, and by steady attention, 
 the apertures of their sloping excretory 
 ducts are also discernible, with the mag- 
 nifying glass. They must, therefore, be 
 
185 
 
 nourished by vessels of exquisite minute- 
 ness, which admit only pale fluids, and af- 
 ford one, among many other illustrations, 
 of the infinite and impenetrable wisdom, 
 with which the most diminutive parts of 
 our bodies are constructed and arranged. 
 I once thought these might be glands 
 appropriated to perspiration ; but, on care- 
 fully tracing them through the whole sur- 
 face, I perceived this could not be their 
 office ; for I was unable to find them in 
 parts where perspiration goes on both evi- 
 dently and copiously ; but where the se- 
 baceous or ceraceous secretion (for by this 
 latter name I should prefer to distinguish 
 it) is less called for. Moreover, in large 
 cicatrices, where they are destroyed, al- 
 though perspiration goes on, from the par- 
 tially, or at least inferiorly, restored reti- 
 culated vessels, they are not reproduced 
 with it ; although the external cuticle, and 
 also the internal, evidently are so. 
 
 That these glands have allotted to them 
 a similar function to the deeper seated set, 
 I am further convinced by a remarkable 
 
186 
 
 case of a young lady, who consulted me 
 some years ago, among other medical men 
 in London, and in whom there were such 
 countless numbers of them diseased about 
 the left arm, breast, and back, as far to 
 surpass any idea that could be justified by 
 the knowledge we have of the sebaceous 
 glands that are ordinarily seen, and which 
 are situated under the interior epidermis. 
 They, however, were constantly turgid with 
 the sebaceous secretion, and produced con- 
 tinual irritation underneath. I could not 
 conceive where such numbers of glands 
 could be lodged ; but I have now no doubt 
 of their being in the situation I have at 
 length detected. * 
 
 The deeper seated set, as I have ob- 
 served, reside behind the inner Epidermis, 
 cherished, supplied, and influenced by the 
 reticular and villous texture of the blood- 
 vessels and nerves, and attached to the 
 coriaceous part of the integument under- 
 
 * My son has counted 1 40 of these in a quarter of a 
 square inch, which will make them amount to nearly 
 120 millions on the whole surface of the body. 
 
187 
 
 neath them. They have sometimes been 
 called miliary glands ; their minuteness and 
 rotundity giving them, as was thought, a 
 resemblance to grains of millet-seed. It is 
 better to denominate them from their office 
 in the animal economy, and to preserve 
 the term sebaceous, or, as I have called 
 them, ceraceous, as more indicative of the 
 nature of their secretion. Not, however, 
 that it is either suetty, or readily inflam- 
 mable ; for the matter they supply is 
 of their own distinct production and 
 character ;. but in several of its uses and 
 properties it bears an analogy to those, 
 which we frequently derive from fatty, or 
 waxy matter, in the ordinary businesses of 
 life. It repels aqueous fluids, so as to 
 call for the employment of saponaceous 
 substances, which incorporate with both, 
 readily to cleanse the surface which it over- 
 spreads. To a certain degree it prevents 
 the dangers of friction, without diminish- 
 ing sensibility. It is curious to observe 
 how the tip of the nose of the sucking 
 infant, its lips, both within and without, 
 and the contiguous parts of the chin arid 
 
188 
 
 cheek, are studded with these glands, to 
 enable it to nestle, as it were, with im- 
 punity, on its mother's breast ; where it is 
 first to feed, and smile, and play, in all the 
 simplicity and dependence of unprotected 
 infancy ; angry to be refused, eager and 
 happy to obtain, and fully contented to en- 
 joy, the earliest repast of nature's luxury ; 
 and then, and there, unconsciously, to sink 
 into innocent and happy repose : while 
 a correspondent arrangement around the 
 fountain of its protectress, enables her to 
 afford the fostering supply, with gratifi- 
 cation to herself ; and to look down on the 
 feeble and tender object of her care, with 
 all the delights, and wishes, and anticipa- 
 tions, of maternal fondness and solicitude. 
 
 In after-life, the smoothness, and soft- 
 ness, and polish of the skin, and its adapt- 
 edness for exposure to a great variety of 
 external changes, depend greatly on these 
 glands, and on the health, regularity, and 
 uniformity of their secretion ; showing the 
 wisdom of that secretion not having been 
 committed to large, or distant, and pro- 
 
189 
 
 miscuously scattered organs ; but being en- 
 trusted to myriads, in regular and appro- 
 priate distribution ; furnishing every portion 
 with a kind of never-waking Argus, with 
 its hundred eyes, to watch over its own 
 district, and to keep up a regular corre- 
 spondence with the whole. 
 
 Exposed to many dangers, they are sub- 
 ject to many diseases, and I may hereafter 
 have occasion to call your attention to 
 several of them. In the mean time, let us 
 glance at their neighbours, the capilli, and 
 capilluli ; and that substantial residence, 
 support, and security which they derive 
 from the coriaceous texture over which the 
 whole complicated organ we have been de- 
 scribing is spread out. Portions of the 
 animal fabric, which, perhaps, of all the 
 obvious and uneludable parts of the body, 
 have been most of all neglected in man ; 
 while in quadrupeds they have engrossed, 
 and justly occupied in all ages, almost the 
 whole concern of a large proportion of 
 traffickers and manufacturers, in every part 
 of the world. 
 
190 
 
 Both the longer hairs, and the pubescence, 
 which consists of an infinite number of 
 minute hairs, have this in common, that 
 they grow from small bulbs, imbedded in 
 the surface of the Corium, where they are 
 supplied by vessels from the reticulated 
 plexuses, appropriated for their nourish- 
 ment. From hence they pass through the 
 interior and exterior Epidermis, at very 
 acute angles, closely embraced by both, 
 especially by the latter, which sheaths their 
 protrusion so firmly, as not to allow them 
 easily to be detached, even after a length 
 of maceration and putrefaction, which has 
 been sufficient to destroy the interior Epi- 
 dermis, or, as it has been called, the Rete 
 Mucosum ; so that, in this respect, they 
 resemble the nails. It is evident, from this 
 arrangement, that the capillary perforations 
 cannot be perspiratory ; for the obliquity of 
 their course, and their firm adhesions, 
 would oppose a serious, if not an insur- 
 mountable obstacle, to the transmission of 
 any thing through them, while they are 
 in a natural state. It must constitute a 
 perfectly valvular obstruction. 
 
191 
 
 The hairs are inserted, or perhaps I 
 should rather say rooted, on the exterior 
 part of the Corium, in such a manner as, 
 together with this obliquity of their direc- 
 tion, to make them astonishingly secure in 
 their allotted situations. In a great num- 
 ber of animals, they appear to be like slen- 
 der horns, conical in their form ; and, as it 
 were, hermetically closed at the point, and 
 are periodically shed off. In the sheep 
 they continue to grow, that they may be 
 sheared for the benefit of their purveyors 
 and protectors. For wool is hair, adapted 
 to particular circumstances ; and we know 
 that change of climate will, in some in- 
 stances, cause a change from the one form 
 of growth to the other, so as to fit the ani- 
 mal for its new residence. In man they 
 are tubular ; and the tubes are intersected 
 by partitions, resembling, in some de- 
 gree, the sap-vessels of plants ; such, for 
 instance, as are beautifully seen in slitting 
 up the leaves and stalks of the Sparganium 
 ramosum, and other aquatic plants, which 
 are now beginning to shoot up their beau- 
 tiful, but obtrusive and deceitful verdure, 
 
192 
 
 at the muddy sides of our ponds and shal- 
 low streams. Being intended for protection 
 from violence, as well as for covering, they 
 are thus formed on the same principle as 
 the bones themselves ; their hollowness 
 preventing incumbrance from weight, with 
 rather an increase than a diminution of 
 their powers of resistance, on account of the 
 rounded form of their transverse sections, 
 
 Whether the hairs transmit any secretion, 
 may be worth enquiry. That those of the 
 head have a peculiar odour, which is often 
 retained for many years after their separ- 
 ation from it, is well known ; and we have 
 cases on record in which the removal of 
 them from the head, at an early period 
 after acute diseases, has been followed by 
 alarming symptoms, scarcely to be ac- 
 counted for by the mere additional ex- 
 posure to cold. But, at all events, when 
 the extent of the whole capillary system is 
 considered, (for to an attentive observer it 
 will soon appear that Haller is right in 
 asserting, " Homo ex sua natura hirsutum 
 est animal ; et formosissima femina faciem 
 
193 
 
 totam kirsutam habet") it will be found to 
 bear no inconsiderable or unimportant pro- 
 portion in the animal economy ; and it 
 will necessarily follow that those diseases 
 of the skin, which extend deep enough to 
 destroy their originations, must, on this 
 very account, even were that all, expose 
 the whole frame to some serious de- 
 rangements. If the morbid state of one 
 gland, as that of the breast, or an absorbent 
 gland, shall affect the whole constitution 
 with disease, these parts, so countless in 
 number, and essential in function, may be 
 naturally expected to have an influence of 
 large, though perhaps not so immediately 
 perceptible amount, on the general health 
 of the body; making up by their num- 
 bers for the smallness of their size, in the 
 share they, and the pores into which they 
 are inserted, take in the balance of the 
 constitutional actions. 
 
 It must further be observed respecting 
 the Capilluli, that they pass from the Co- 
 rium to the surface of the body, in pairs, 
 or triplets, perforating the reticular vessels, 
 
194 
 
 and both the Epidermides, at very acute an- 
 gles ; so that by the form of their bulbous 
 insertions, and the direction in which they 
 proceed outward, they serve to connect 
 together all the parts of the integument, 
 like so many fine pins, or fastenings, adding 
 to the integrity and security of the whole 
 compages. (See the Plate.) 
 
 The structure of the bulbs or roots of the 
 hairs, as developed in my son's drawing, 
 (see the Plate,) seems to throw consider- 
 able light on the pathology, and something 
 perhaps on the influence of the re- 
 medies, for Plica polonica ; a disease 
 which, from what I have learned of it, 
 especially from Professor Herberski, of 
 Wilna, and Professor Wagner, of Berlin, 
 seems, both in its progress and its cure, to 
 confirm the idea I have suggested, of the 
 capillary system bearing a material pro- 
 portion in the cutaneous functions. 
 
 I must not leave this part of the subject, 
 without adverting to the part which the 
 skin, in all probability, takes, in that duty 
 
195 
 
 which is principally fulfilled by the lungs. 
 It was by the communication of oxygen to 
 blood through the coats of a bladder, that 
 Dr. Priestley first opened to us the light 
 which has since been thrown on the ef- 
 ficiency of respiration. That change is 
 frequently produced in the stagnant blood 
 in the vessels of the cheeks of many per- 
 sons after death, especially of those whose 
 complexions have been florid, and more 
 particularly of females. This alteration 
 has so much, in some instances, renewed 
 the appearance of life, that I have been 
 several times called upon by the tender 
 anxiety of affectionate relatives, to say 
 whether the party were dead or not, before 
 the funeral ceremonies were proceeded 
 with. But the flaccidity of the cornea, 
 which almost instantly follows dissolution, 
 and the transudation of the fluids to parts 
 laid in a depending situation, which speedily 
 ensues, will always suffice to settle this 
 question. The doubt could only have been 
 raised by the fact of the oxygen of the at- 
 mosphere combining with the dead blood, 
 so as to produce an approach to the ap- 
 
 o 2 
 
196 
 
 pearance of life, and goes in verification of 
 the mode of transmission through the cu- 
 ticle, both from without and from within, 
 which I have before noticed ; for the blood, 
 though thus oxygenated, does not exude. 
 May not this circumstance, however, throw 
 some light, a melancholy, and perhaps an 
 useless light, I will confess, on the heat 
 and flush of hectic fever? When parts 
 destined to a particular function become 
 incapacitated to fulfil it, all others that 
 are capable of contributing to it, seem, as it 
 were, to be instinctively pressed into their 
 service. When the ordinary muscles of 
 respiration, the diaphragm and the inter- 
 costals, and so on, fail in their powers, 
 see how the sterno-mastoidei, and all that 
 can assist in dilating the thorax, take on an 
 unnatural action, to share in the struggle ! 
 So when the lungs become tuberculated, 
 inflamed, and ulcerated, the vessels of the 
 skin are violently compelled to hurry on 
 their action, to force on the oxygenated 
 blood before its ordinary change there can 
 take place ; and to catch the smallest breath 
 they can imbibe, to cherish the lamp of life, 
 
197 
 
 till the feeble and flickering flame is at last 
 obliged to forsake the material which sup- 
 ported it. 
 
 My late friend, Dr. S. H. Jackson, many 
 years ago had made some ingenious con- 
 jectures on this subject; but he had not 
 been habituated to philosophical and ex- 
 perimental investigation ; and therefore he 
 did not make out any facts with adequate 
 distinctness ; but it has often astonished 
 me that the observations and experiments 
 relating to it, which were published by 
 Mr. Abernethy so long since as the year 
 1793, should not have attracted a greater 
 share of attention, and have led to a farther 
 prosecution of the enquiry which he insti- 
 tuted into the functions of the skin, with 
 his accustomed zeal and discernment. He 
 ascertained, among several facts of con- 
 siderable interest and curiosity, that the 
 perspired matter differs in quality as well 
 as in quantity ; that both carbonic and 
 nitrogenous gases are perspired, and also 
 imbibed, through the skin of the living 
 body ; that oxygen is also abstracted from 
 
 o 3 
 
198 
 
 common air, and absorbed, and this with 
 great readiness ; so that in eight hours 
 eight ounces of oxygenous gas was imbibed 
 by the hand and wrist ; though, in a similar 
 exposure to nitrogenous gas, only one ounce 
 of the latter was absorbed. The account 
 he has given of the proportions of the ab- 
 sorption of different airs, shows how com- 
 plex must be the functions of the organ 
 we have been contemplating, and how very 
 much we still remain in the dark concern- 
 ing them; especially when we add to all 
 those facts, the prodigious absorption of 
 aqueous fluid from the atmosphere, which 
 is remarkably demonstrated by many cases 
 of dropsy and of diabetes. 
 
 Mr. Abernethy found also, that, besides 
 matter purely gaseous, on an average, about 
 two pounds and a half of aqueous fluid 
 were perspired daily, from a person five 
 feet six inches high, and of proportional 
 bulk ; and he takes occasion, from the 
 whole of his observations, to make some 
 highly interesting remarks on the reciprocal 
 influences of the cutaneous and pulmonary 
 
199 
 
 functions; and especially on the effects 
 of impediments and checks to the fulfil- 
 ment of the former, in producing diseases 
 of the lungs. A fact well known for a 
 long time ; but not before placed in so 
 correct and scientific a point of view j or 
 in one so indicative of the necessity of 
 farther investigation on this very account, 
 as well as for the sake of demonstration of 
 the source of glandular disease, from the 
 suppression of perspiration ; or, as I might 
 more correctly express myself, the sup- 
 pression of the actions of the Organ of per- 
 spiration. 
 
 A subject equally deserving of notice is 
 the relative connection, sympathy, and de- 
 pendences of this organ, with regard to the 
 intestinal surface, and the contents and se- 
 cretions which may be lodged or produced 
 there. For, from the commencement of this 
 tract of bowel in the pharynx, to its ter- 
 mination at the extremity of the rectum, 
 an indissoluble connection of function 
 with the skin is discernible. A disturb- 
 ance in the earliest part of the canal often 
 
 o 4 
 
200 
 
 throws the fine branches, and anastomosing 
 connections of the recurrent nerves into 
 disorder ; convulses the stomach, and sets 
 the secretory vessels of the skin in extra- 
 ordinary action. No sooner are some sub- 
 stances received into the stomach, than the 
 skin begins to show its displeasure, and im- 
 peratively to require the relief of its asso- 
 ciate from the unwelcome intruder. Ery- 
 sipelas, Urticaria, and very frequently minor 
 annoyances, give ostensible notices of the 
 enemy within ; hold out the signals of 
 distress, and sometimes of danger ; call 
 aloud for prompt assistance, and if it be 
 unattainable, lead on to serious, to long, 
 and, in some instances, to fatal disease. 
 Facts which show the vast importance of a 
 due study of the nature, offices, and de- 
 rangements of the several digestive organs, 
 their separate and combined uses, and the 
 influences of remedies upon each. And 
 here I look much to the stomach itself. 
 Its actions and secretions are still myste- 
 rious. We know not why the gastric juice 
 dissolves all sorts of food during life, and 
 dissolves the texture of the stomach itself 
 
201 
 
 after death. We cannot always tell why 
 one thing shall in some cases offend, and 
 in others please, this tyrant of the body. 
 But it must not be an unconsidered object 
 of our attention, either in diet or medicine ; 
 nor, which is more to my present purpose, in 
 the covering, the ablution, and the remedies 
 of the cutaneous organ. I perhaps ought 
 to apologize for the frequent repetition of 
 this epithet ; but I know not how to avoid 
 it 5- for the more I consider the subject, the 
 more I see of its importance generally, and 
 of the separate importance of its several 
 parts ; of our, or I should rather say, of my 
 own imperfect acquaintance with them ; 
 and the propriety of inviting the attention 
 of others, to a more full and experimental 
 enquiry into them. 
 
 From sudden, or from continued ex- 
 posure to cold, hot, impure, foggy, and 
 loaded atmospheres, how many changes 
 arrive! Not only are the eyes, the nose, 
 the ears, the palate, the throat, almost im- 
 mediately, and often violently disordered ; 
 but parts not in contact with them, in con- 
 
202 
 
 sequence of their relation to the skin, and 
 the impossibility of carrying on their func- 
 tions without it also is healthful, become, 
 as it were, enraged. Vomiting, inappe- 
 tence, indigestion, costiveness, or diarrhoea, 
 are produced. The actions of the liver, 
 and its dependent and assisting viscera, are 
 disturbed ; every thing goes wrong ; and 
 unless the cause be removed, the effects are 
 not very likely soon to cease. So also, on 
 the other hand, should the viscera of re- 
 ception, digestion, absorption, faecifi cation, 
 or evacuation, be deranged, either from sub- 
 stances taken from without, or generated 
 within, I have already hinted how Erysipelas, 
 Urticaria, miliary eruptions, and febrile heat, 
 may arise, with great suddenness and vio- 
 lence, so as to force the skin imperiously 
 to demand the prompt expulsion of the 
 unwelcome intruder upon the peace of its 
 friend. Instances like this are often seen 
 after eating muscles, lobsters, pickled sal- 
 mon, &c.; and excess in any thing may 
 occasion them. I have known them 
 brought on by eating an apple hastily, 
 when the patient was rendered heated and 
 
203 
 
 thirsty by riding. And there are peculiar 
 substances, that very generally agree with 
 persons in general, which nevertheless pro- 
 duce these effects on particular individuals. 
 I once knew a lady who could not take 
 powdered Rhubarb without an erysipe- 
 latous efflorescence almost immediately 
 showing itself on the skin ; and yet she 
 could take the infusion of Rhubarb with per- 
 fect impunity ; perhaps because the woody 
 particles of the powder adhered to, and irri- 
 tated the mucous membrane. In some in- 
 stances the evil is, in general, very transient, 
 and easily removable; but in others it is more 
 permanent, and difficult of cure. And in 
 cases less strongly marked, other outward 
 and visible signs may nevertheless be of- 
 ten readily discovered by an accustomed 
 and observant eye, in the hue and general 
 appearance of the integument. But whether 
 they be readily observed or not, their ef- 
 fects are real, and often important ; cir- 
 cumstances of great consequence in the 
 Practice of Surgery, as well as of Medicine ; 
 for if we do not keep an eye upon them, so 
 as to direct the clothing of our patients, 
 
204 
 
 the ventilation and temperature of their 
 chambers, and the due cleanliness of their 
 persons, and also that of their attendants, 
 evils may be communicated, or originated, 
 from the skin, which shall frustrate our best 
 endeavours, by throwing the viscera into a 
 state of disorder, or keeping them so ; and 
 thus tending to suspend, or destroy, the 
 digestive, the nutritive, and, of course, the 
 restorative processes of nature ; and there- 
 fore to diminish the general strength, to 
 weaken the nervous energies, without which 
 no repair can go on ; and to lead to those 
 excesses or deficiencies of the ordinary ex- 
 cretions, which so often interrupt and de- 
 feat the exertions of the constitution, and 
 the sanguine hopes and expectations of the 
 Surgeon. 
 
 Nor may we safely overlook the con- 
 nection between the renal and sudatory 
 systems ; the secretions of which have been 
 thought, and not without the appearance of 
 reason, to be in many respects similar to 
 each other. At all events, we know that co- 
 pious perspiration diminishes the quantity 
 
205 
 
 of urine, and renders the quantity of salts 
 and of lithic acid more abundant in their 
 proportions. And through the skin there 
 must, in many cases, as of diabetes, be a 
 great quantity of aqueous matter absorbed 
 from the atmosphere. We know also, from 
 the histories of some shipwrecked persons, 
 that even under a state of constitutional 
 health, a degree of sustenance appears to 
 have been afforded for a time by their 
 dipping their clothes in the sea, and wear- 
 ing them wet. The effect of these circum- 
 stances on the quantity and quality of the 
 insensible perspiration, I believe, has not 
 yet been experimentally ascertained ; but 
 it may be worth bearing in mind by those, 
 whose professional destinations may call 
 them to appointments, where such enquiries 
 might be instituted with sufficient delicacy 
 and prudence. 
 
 Moreover, we must bear in mind other 
 sympathies, established by the close in- 
 terweaving of the nerves and vessels in the 
 skin, and often reaching to distant parts; ma- 
 nifested in the relief of affections of the in- 
 
206 
 
 ternal organs, as the liver, the lungs, c., 
 both by stimulating and soothing applica- 
 tions, applied externally ; sometimes where 
 no direct connection appears to exist, but 
 which are strongly illustrative of the able 
 remarks on this subject recently made here 
 by Mr. Brodie; and of the doctrine of re- 
 mote, as well as that of continuous sym- 
 pathy, taught by Mr. Hunter, and very 
 imperfectly understood before his time, 
 although sufficiently known to be in a 
 good degree acted upon. All tending to 
 show, that the nervous system is to be 
 considered as one great whole, of which, 
 indeed, each part has its distinct allotment, 
 but can never, in a natural state, nor in 
 morbid conditions, in general, be absolutely 
 independent of, or disconnected from, the 
 other parts of that mysterious portion of 
 the animal fabric. A subject highly de- 
 serving of serious, and accurate, and scien- 
 tific examination and reflection, both in 
 pathology and in practice. 
 
LECTURE VIII. 
 
 MAY 8. 
 
 WE come now to consider the Corium, 
 that firm stratum of the skin whicli forms 
 the basis, on which the parts we have al- 
 ready noticed are spread out and supported ; 
 underneath which, and protected by it, the 
 bones, and joints, and muscles, fulfil their 
 allotted range ; and sustain, undisturbed by 
 injury or decomposition, their respective 
 offices, in the ordinary and healthful occu- 
 pations of the body. Its structure, as you 
 know, appears chiefly made up of a fibrous 
 substance, the threads of which are inter- 
 woven with each other in various direc- 
 tions, so as to give a compactness which 
 remains long after death. And when it has 
 been subjected to the process of tanning, 
 and the gelatine is united to and coagulated 
 
208 
 
 by the principle communicated by that 
 process, the skins of many animals form 
 that useful and almost indispensable article 
 in commerce and clothing which is called 
 Leather. Sir A. Carlisle informs me he has 
 been told by several of their Chiefs, that 
 a somewhat similar change is wrought in 
 it by the North American Indians in an- 
 other manner. It appears they make a 
 kind of lather with the brains of the wild 
 deer they kill. In this their women knead 
 the hides for several hours ; they are then 
 hung up to dry, and, after remaining for 
 a certain time, become unputrescible, and 
 resisting water, so as to be fit for gaiters, 
 or leggings, as they are called. Of this 
 process I had intended to make some ex- 
 periments myself, but my long and severe 
 indisposition has interrupted me. The sub- 
 ject, however, is curious, and may be worth 
 the notice of some gentlemen who have 
 more leisure to pursue it. 
 
 In man, this substance is usually thin, 
 when compared to the bulk and extent of 
 his whole body ; but a preparation on the 
 
209 
 
 table will show you a state of disease, in 
 which it has become inordinately thick; 
 and this without any other change in its 
 structure ; almost the whole disease in this 
 case, appearing to have consisted in an 
 enormous overgrowth of every part of the 
 integument of the right lower extremity. 
 (See the plate.) In many animals its 
 thickness is so great as to form a perfect 
 coat of armour for them. This is particu- 
 larly the case in the African Elephant. In 
 man it is found rather closely applied to the 
 subjacent parts, and its connection to 
 them by cellular membrane, only loose 
 enough to allow of the ordinary move- 
 ments of those parts. But Mr. Haslam, in 
 his interesting observations on madness, 
 remarks that he has frequently noticed in 
 persons who have suffered a long and vio- 
 lent paroxysm of that disease, that the 
 scalp, particularly at the posterior part of 
 the head, has become so loose, that a con- 
 siderable quantity of it could be gathered 
 up by the hand. Many years ago, there 
 was a female gipsy, who used to show her- 
 
210 
 
 self at the anatomical schools in London, 
 who had a large portion of loose skin on 
 the left breast and side, which she could 
 wrap over her body, to a considerable ex- 
 tent. In many women who have been re- 
 peatedly pregnant, and in persons who have 
 recovered from ascites, the skin of the 
 abdomen becomes lax, in a somewhat simi- 
 lar way. But this is not uniformly the case ; 
 so that the varieties in this respect afford 
 a proof of the influence of the principle 
 of life on this substance. Yet there are 
 other properties, which it seems even dur- 
 ing life to possess, as well as after death ; 
 particularly in that of receiving impreg- 
 nations, both from vitiated secretions, and 
 by substances introduced under the cu- 
 ticle. The marks made by soldiers and 
 sailors on their arms are in proof of the 
 latter, and freckles of the former ; these 
 being not, as has been supposed, affections 
 of the interior Epidermis, but of the Co- 
 rium itself; the living qualities and adapt- 
 ations of which more concern us on this 
 occasion. 
 
211 
 
 In this view, it appears less mutable, 
 and less easily regenerable, than the rest of 
 the integument ; and although we see it is 
 renewed in the cicatrices of wounds and 
 ulcers, yet the renewed part is less per- 
 fect, less tenacious of life, less capable of 
 giving its support to the newly formed, and 
 then supplementary reticular texture of ves- 
 sels, and to the interior and exterior epider- 
 mis, which are superinduced over it. When 
 it is regenerated after entire destruction, it 
 contains neither capillary nor sebaceous 
 pores, circumstances which strongly mark 
 the necessity and value of saving the skin, 
 that great improvement in modern Surgery, 
 when its soundness will permit, in extirpat- 
 ory operations ; and point out a great source 
 of the evils which are found to follow severe 
 cases of small-pox, in which this part becom- 
 ing impaired by the deep ulceration, or de- 
 stroyed by the sloughing, which so often 
 take place during the secondary fever, throw 
 the whole cutaneous circulation, and the 
 offices of millions of little glands, into a 
 state of derangement. This will take place, 
 however, according to the depth of the ul- 
 
 p 2 
 
212 
 
 ceration, or slough ; and, though the balance 
 of these things may in time be restored, as 
 we find to be the case with the circulation 
 of the blood, where the principal vessels 
 have been tied or obliterated, yet the alter- 
 ation must for a time be followed by irre- 
 gular and unnatural determinations to other 
 parts ; and often bring on, as we see, glan- 
 dular diseases, diseases of the joints, and 
 bones, and eyes, and of the rest of the skin : 
 and this especially in large towns, and in 
 close and unhealthy situations, which are 
 unfavourable, under the best of circum- 
 stances, for the perfect fulfilment of the 
 transpiratory and other cutaneous functions, 
 as well as for that of the lungs. If, there- 
 fore, the discovery of the power of Vaccin- 
 ation had no other merit than that which it 
 unquestionably has, in cases where it does 
 not fully prevent the reception of variolous 
 infection, of cutting off from the disease the 
 fatal stage, in which these terrible ravages 
 are principally made, it would be a remedy 
 beyond all price, worthy of universal 
 adoption, and even of general enforcement 
 by legal provision. 
 
213 
 
 Perhaps one reason of the little muta- 
 bility of the Corium is, that it consists 
 chiefly of very strong fibres, and a paren- 
 chymatous substance, which, although liv- 
 ing, have but few vessels allotted to their 
 own uses, and need but few. It is chiefly, in 
 respect to vascularity, more a transmitter 
 than an employer ; and a noble and well 
 adapted structure it is to sustain this duty, 
 with little interruption in the exercise of it, 
 on account of the combination of firmness 
 and softness in its contexture. It is also 
 elastic, and conforms itself to all natural 
 states of the perspiratory organ which it 
 subserves ; shrinking when its vessels are 
 incompletely filled, and drawing along with 
 it, in its contraction, both the Epidermides, 
 to which it is so nicely attached, by the in- 
 numerable ligamentous junctions I have be- 
 fore pointed out. Thus, by the gentlest 
 compression, it withholds for a time from 
 the glandular apparatus, a supply, of which 
 they cannot in such moments dispose ; 
 while again it readily yields to the natural 
 return of the blood, through its . former 
 transit, and becomes accommodated even 
 
 p 3 
 
214 
 
 to many excesses of fulness, strength, and 
 rapidity. Were it equally irritable with all 
 these parts, it would be unfit to preserve 
 them in a steady and consistent state, dur- 
 ing so many variations ; but its vitality 
 keeps it in complete harmony with them 
 under all, with as little as possible par- 
 ticipation in their disturbances. Hence it 
 is also adapted to all periods, and all natu- 
 ral states of life, and to the many alter- 
 ations in the bulk of the body, from in- 
 fancy and maturity to extreme old age. 
 The muscles grow from use, and diminish 
 from inaction ; fat is deposited in small or 
 in larger quantities, and is re-absorbed in 
 fever, or from declining health ; but each 
 of these changes takes place under the pro- 
 tection of the same permanent and unal- 
 tered tunic. 
 
 Immediately underneath it, the cutane- 
 ous arteries are distributed in an arbores- 
 cent, or ramified form, anastomosing freely, 
 so as to secure the regular supply of the 
 reticular and villous texture, which is their 
 ultimate destination ; and which they feed 
 
215 
 
 with the pabulum for their constant secre- 
 tion. Here they are retained by the cel- 
 lular membrane, into which the structure 
 of the Corium itself seems gradually to sub- 
 side ; so that it is sometimes a nice point 
 to distinguish where one absolutely ends, 
 and the other begins. By this arrange- 
 ment the vessels are kept at once fixed 
 and moveable ; fixed with regard to the de- 
 finite and allotted position and purpose of 
 each ; and moveable, as a connected tissue, 
 attached to moveable parts. Indeed, to 
 parts not only moveable, but perpetually 
 varying, in the minuter conformations of 
 their respective surfaces, to an infinite va- 
 riety of transitory circumstances. Who 
 can behold the human face for any length 
 of time, with a contemplative eye, and wit- 
 ness its alterations in complexion, in fea- 
 ture, in all the expressions of passion and 
 emotion, and not admire, if his attention 
 be directed to this object, the transcendent 
 wisdom, with which the integument is thus 
 adapted to the numberless, the distinct, and 
 yet consentaneous mobilities of its smallest 
 subdivisions; conveying the unerring signs 
 
 p 4 
 
216 
 
 of hatred and love ; of disgust and of de- 
 light; of doubt, of distrust, of grief, of 
 malice, and of contempt ; of veneration, of 
 pity, and of revenge ; of pride and of hu- 
 mility; of envy and of benevolence ; in all 
 their gradations and conflicts, in a silent 
 language, intelligible not only to all man- 
 kind, but even, in many instances, to the 
 very beasts that obey us? A buck that 
 was fixed on to be shot, and had never 
 feared his keeper till that purpose was 
 formed, but had mingled heedlessly with 
 the rest of the herd, no sooner saw him 
 enter the park with an intention to shoot 
 him, instead of another, than he instantly 
 took to flight, and, in a violent effort to 
 leap over a high wall, bruised one of his 
 haunches, and fell down a prey to the 
 danger he was endeavouring to avoid. 
 In dogs we often observe a prompt obe- 
 dience to the will of their masters, when 
 that will is expressed only by looks, or 
 gentle motions. 
 
 Now on what does all this depend? 
 not merely on the muscles which act upon 
 
217 
 
 the integument, but on the fine adaptations 
 of the surface which is acted upon, to obey 
 the minutest mandate of these its masters, 
 and to concur also, by marks and characters 
 of its own, in the intentions of the super- 
 intending mind. But for purposes less ob- 
 viously cognizable, though not less real, 
 every individual portion of the integument 
 is equally adapted to the numberless vari- 
 ations of movement which belong to the 
 parts it invests ; so as to be alike accom- 
 modated to the most athletic exertions of 
 Herculean force ; to the nicest touches 
 of caution and examination, and to the 
 feeblest quiverings of languor or timidity. 
 And all this in complete consistency with 
 the regular fulfilment of the cutaneous 
 functions, which go on, unconsciously and 
 uninterruptedly, however they may vary in 
 degree, between the cuticle without and 
 the Corium underneath. 
 
 To the maintenance of this balance, and 
 this unconfused appropriation of uses, the 
 structure of the Corium must essentially con- 
 tribute ; for it is not composed of fibres 
 
218 
 
 arranged like those of muscle, having one 
 determinate course; or in an angular ar- 
 rangement, so as to act in diagonal lines ; 
 but of a web-work of fibres, interwoven in 
 every conceivable line, supported by the 
 gelatine of its parenchymatous substance ; 
 so as to combine firmness, flexibility, and 
 competent elasticity, in every possible 
 direction, and combination of directions. 
 I do not know that I am at present author- 
 ized to ascribe muscularity to it ; perhaps 
 it approaches more to the nature of elastic 
 ligament, and is antagonized by the mus- 
 cular actions in the vessels subtending it, 
 and subtended by it. Such at least is its 
 texture in the human body, which we have 
 now chiefly to consider. But the part it- 
 self is common to all animals, unless we 
 except some insects ; and its conformation 
 in each is adapted to the habits and con- 
 ditions of each kind respectively, in all its 
 properties. In the African elephant it is so 
 thick and so fluted as to appear capable of 
 repelling the force of extreme violence. In 
 the rhinoceros, though less thick, it is also, 
 as it were, fluted in crossing lines. How 
 
219 
 
 soft, and yielding, and silky is it in the 
 infant and the human female ! How im- 
 penetrable in the Cuculus indicator, or 
 honey guide, in Africa ; so as to resist the 
 stings of the wild bees, on whose honey it 
 feeds, and to whose hives, by its noise in 
 the trees and other hiding-places, it directs 
 the hungry and fainting traveller through 
 the woods, for refreshment and supply ! 
 Nor, without the peculiar resisting pro- 
 perties of this substance, would Vulcan 
 himself have been able to make the seven- 
 fold shield of ^neas, at once wieldy and 
 impenetrable. 
 
 Its firmness is secured by its fibrous part, 
 and its flexibility by a more soft and 
 soluble gelatinous substance, that is inter- 
 posed between the threads ; and its elas- 
 ticity by the union of both. A part of the 
 latter, the softer material, is always, and 
 sometimes the whole, extracted in the ma- 
 cerating pits of the tanner, before it is sub- 
 jected to the full influence of the tannin. 
 When any remains, it also is combined with 
 he tannin, and remains interposed between 
 
220 
 
 the fibres. My own examinations, so far 
 as they have gone, lead me to believe, that 
 the various degrees of hardness and flex- 
 ibility in leather, much depend, cceteris 
 paribus, on the proportions in which this 
 disunion of the more soluble part from 
 the thready is allowed to take place, before 
 the finishing process ; though undoubtedly 
 much must follow from the ingredients 
 employed, and the length and circum- 
 stances of exposure to their influence. 
 
 On looking at a thin slice of the injected 
 human Corium from the wrist of a man, 
 after the superjacent parts had been re- 
 moved, it appeared to consist of a close and 
 little varied texture. I allowed the portion 
 to dry on the glass, and then re-examined 
 it. The principal vessels were passing 
 through it at very acute angles, on their 
 way to the reticular intertexture, where 
 their final functions are performed. On 
 macerating another portion for several 
 months, the Corium separated into the two 
 distinct substances already mentioned, the 
 fibrous and the pulpy. The former is the 
 
221 
 
 more ostensible matter of the compound, 
 which serves for the nidus, or resting-place, 
 of those parts of the cutaneous organ, which 
 fulfil the most obvious uses for which it is 
 constructed. But the granular portion, 
 perhaps, may answer some other end than 
 that of giving at once flexibility and com- 
 pactness to the Corium. I have lately been 
 much inclined to think it possesses some 
 muscular power, analogous to that in the 
 pallium of the molluscae, or the chrystalline 
 lens ; but I do not assert that it has. I 
 only throw out the idea, which I am more 
 readily disposed to indulge, because I have 
 found that, like muscle, after maceration, 
 it becomes sooner changed into that sper- 
 maceti-like substance called adipocere, than 
 many other parts in the frame ; though 
 most, if not all of them, except the bones, 
 the Epidermides, and the humours of the 
 eye, are liable to this mutation. 
 
 It must moreover be observed, that the 
 coriaceous texture is a bad conductor of 
 heat ; and thus serves much to preserve and 
 equalize the temperature of the parts which 
 
222 
 
 it covers, and protects from sudden and 
 violent changes, under the variations of the 
 surrounding atmosphere, in so many differ- 
 ent climates as man is destined to inhabit. 
 And it is interesting to remark, what I have 
 indeed before alluded to, that the vascular 
 texture of the integument, which is itself 
 a good conductor, is so guarded by a bad 
 one underneath it, and two bad ones over 
 it, as to possess a lodgment, in this respect, 
 of triple security to the perfection of its 
 own functions ; which so much depend on a 
 moderated uniformity and constancy of its 
 own temperature, while such a copious and 
 subtle evaporation is continually going on. 
 And how wonderfully, in various tribes of 
 animals, have hairs, and wool, and feathers, 
 and scales, their distinct and perfect arti- 
 culations, to adapt them to their several 
 abodes, and diversified habits of action ! 
 Neither could the lark nor the eagle soar, 
 nor the vulture descend, to riot on the 
 liver of its prey, nor the fish cleave its wavy 
 abode, nor the lion shake his majestic mane, 
 and overawe the strongest beasts of the 
 field, without the due arrangement of those 
 
223 
 
 millions of joints which their formation 
 displays, between all those distinguish- 
 able and separate organs of movement 
 and of endurance, which are formed be- 
 tween the Corium and each of them 
 individually. The violation of either of 
 these constitutes a sensible injury ; some- 
 times, indeed, transient, and speedily for- 
 gotten ; but in other instances, especially 
 where the frame is praeternaturally irritable, 
 capable of exciting considerable disturb- 
 ance. Nor without this harmony of united, 
 and yet moveable parts, could the Turkey 
 amuse us with his ridiculojis strut, or the 
 Peacock and the Argus with the gaudy dis- 
 play of their plumes. By its secure ar- 
 rangement the Seal, the Walrus, and the 
 Bear, riot with impunity in the frozen re- 
 gions of the north ; and the Camel and 
 the Dromedary fearlessly traverse the burn- 
 ing sands of Africa and the East. While, 
 without any such provision as plumage or 
 hair, and by the protecting nature alone of 
 the Corium itself, the stupid Rhinoceros, 
 and the sagacious Elephant, defy the power 
 
224 
 
 of a tropical sun ; and the sturdy tribes 
 of cetaceous fish, play almost fearless and 
 uncontrouled, in the boisterous waters of 
 the mighty deep. 
 
LECTURE IX. 
 
 MAY 10. 
 
 \VriEN we have divided the protecting in- 
 vestiture of the body, to which our atten- 
 tion has been hitherto chiefly directed, and 
 before we arrive at the dissection of the 
 more compact and solid parts, we come 
 in contact with the Tela Cellulosa, or, as 
 it is commonly called, the Cellular mem- 
 brane ; by which most of the various tex- 
 tures are held fast in their respective 
 relations, and boundaries of 'duty. A sub- 
 stance this, which appears to be the most 
 simple in composition, and probably on 
 that account, in part at least, the most 
 readily disordered, and the most easily re- 
 generated, of any structure in the animal 
 fabric. And, indeed, is not only the most 
 easily regenerated, but the most easily pro- 
 
 Q 
 
226 
 
 duced, in the remedial processes which oc- 
 casionally take place, and without which 
 the effects of diseases now capable of cure, 
 would, in many instances, become hopeless. 
 It is chiefly, however, by tracing its form- 
 ation and changes, under and after disease, 
 that we gain a tolerable idea of its real na- 
 ture, and are enabled to understand the ex- 
 tent of its important uses. From hence 
 we find it to be originated from the co- 
 agulable lymph, or fibrine, of the blood, 
 in its most simple and ordinary state of 
 effusion, when entered, as it speedily is, by 
 germinating vessels ; and we have, in all 
 our Museums, preparations, demonstrative 
 of the various stages of the conversion 
 of this substance into all the various ap- 
 pearances and uses that it assumes. When 
 we come hereafter to follow onward the 
 effects of inflammation, we shall see this 
 amply demonstrated. At present, we must 
 attend more to its natural and undis- 
 turbed state, or rather states, for they are 
 many, suited to many purposes, by appro- 
 priate diversifications of texture and ar- 
 rangement ; from the most yielding, to the 
 
227 
 
 most compact and inviolable. The view 
 which Haller has taken of it can hardly be 
 surpassed : he has justly observed* that this 
 same substance exists from the minutest 
 fibril, to the most compact thecce, by which 
 the trunks of arteries and veins are kept 
 safe in their appointed courses. So nu- 
 merous, and so well suited is it to all the 
 parts it at once connects, and leaves in the 
 exercise of all allowable liberty, as to ren- 
 der it a long and somewhat perplexing 
 task, for an accurate, or at least a minute 
 anatomist, to investigate, to ascertain, and 
 to discriminate its appearances and connec- 
 tions ; sometimes being so tender and feeble 
 as to break under the slightest unnatural 
 violence ; and elsewhere so firm and close, 
 as to require the most cautious eye, and 
 the most skilful hand, to separate and dis- 
 entangle the parts of which it is the safe- 
 guard. 
 
 It behoves us much to notice all these 
 facts with care ; and the peculiar circum- 
 stances and relative connections in which they 
 severally occur, and to mark the changes by 
 
 Q 2 
 
228 
 
 which they are occasionally modified. For, 
 although in some of the greater operations 
 we can treat the cellular texture without 
 much ceremony, as a thing of only second- 
 ary importance ; still, in those which are 
 more delicate, where the parts requiring 
 them are more minute and complicated, 
 and where the variation of a mere touch 
 may be of importance, it is requisite we 
 should not only know the general and ob- 
 vious path, but every step also of the way 
 we are to take. 
 
 As a part of the integument, however, to 
 which point of view I am now chiefly to 
 confine myself, the cellular texture is to be 
 considered as distinguishable into two parts, 
 if indeed they be not two states of the same 
 substance ; and not two different substances, 
 destined to separate uses. At all events, 
 the appearances they exhibit both agree 
 and differ ; the agreement and the differ- 
 ence being not vague and casual, in the 
 original conformation of the body, but con- 
 fined to certain situations, and evidently de- 
 signed for differing purposes. But thus far 
 
229 
 
 they are alike, that the portions destined 
 for the residence of animal oil are often, as 
 in some cases of dropsy, destitute of it, 
 and are left so empty of their ordinary con- 
 tents, as to become no richer than their 
 neighbours, and to sustain very much the 
 same obvious characters. But there are 
 other portions, into which fat is never depo- 
 sited, and where it would amount to a total 
 defect of all the uses of the organ in which it 
 exists. So strict and inviolable is this ap- 
 pointment, that the cellular and adipose 
 membranes have been considered by some 
 physiologists as two distinct substances. At 
 least, they have distinct, though, in some in- 
 stances, consentaneous and conjoined allot- 
 ments. This, however, is not less curious 
 than the instances of other contiguous se- 
 cretions, that from adjoining and connected 
 arteries, ramifying through a material so 
 similar, if it be not identical, fat should be 
 furnished in one spot, and never enter into 
 another, which borders close upon it, and 
 does not appear to be separated by any de- 
 finite capsule. I confess I am inclined to be- 
 lieve that every cell containing adeps should 
 
 Q 3 
 
230 
 
 be considered as a separate and appropriated 
 gland. In the medullary fat of the bones, 
 its globular or granulated appearance has 
 long been known to give countenance to 
 such an idea ; but it did not appear to be 
 borne out with relation to the fat in other 
 parts. In a preparation, however, of the 
 integument over the eye-brow of a foetus, 
 which I put up more than twenty years 
 ago, I found, when examining it a few days 
 since, that the gradual corrugating influence 
 of the spirit of wine had gently forced 
 it from its cells in a solid form, having the 
 form of separate globules, like the marrow ; 
 and, as I think, authorising the opinion 
 that they are both produced in like manner, 
 in the parts where they are respectively 
 found. Yet in after life, when the integu- 
 ment is more exposed to external pressure 
 and violence, it may be less definitely con- 
 fined to its original cells, and therefore its 
 original mode of deposition less readily 
 cognizable. It then more effectually sus- 
 tains the elasticity of the skin, and is an 
 important medium of resistance and de- 
 fence. 
 
231 
 
 But I perceive I am in danger of wan- 
 dering into a too divided and intricate 
 discussion of a subject, which would be 
 more easily understood by careful distri- 
 bution, than by the hasty and cursory com- 
 bination of its parts. My apology must 
 be, that I know so little about it, and that I 
 am sincerely endeavouring to excite others 
 to acquire more perfect information. 
 
 Nevertheless, the facts of which we are 
 in possession, show us that this fine and 
 beautiful web is so constituted as to admit 
 of the readiest transit of various fluids 
 from place to place, without serious inter- 
 ruption, under some circumstances ; and 
 perhaps in all the instances of natural func 
 tion and secretion ; while, in many diseases, 
 it is so closed up and circumscribed, as com- 
 pletely to shut out the causes of disorgan- 
 ization from the most contiguous vicinities. 
 
 We therefore find it sometimes fibrous, 
 or thready ; at others, laminated and more 
 membranous ; at others, again, interme- 
 diate and somewhat dubious, or unde- 
 
 Q 4 
 
232 
 
 / 
 
 finable, as to its exact form of arrange- 
 ment ; but always in that which is most fit, 
 and relative to its purposes, in every part ; 
 whether it be employed for connection, for 
 retention, for motion, or for support, in 
 any and every degree of appropriation. 
 And when we survey this, in connection 
 with the varied and peculiar degrees of 
 vascularity and sensibility in the parts, 
 especially the more minute ones, betwixt 
 which it is interposed, as their mutual bond 
 of union, we may more readily understand 
 the results of those morbid conditions into 
 which it is so often brought ; and that in 
 many instances determines the difference 
 between hearing and deafness ; between 
 blindness and sight; between numbness 
 and agony; and even between life and 
 death. For it must be well known to every 
 Surgeon, who has had large opportunities 
 of observation, that cases occur of super- 
 ficial inflammation, as far as external ap- 
 pearances go, and where no vital organ 
 appears to be distinctly or directly im- 
 peded in its duties, but in which the cellular 
 texture becomes a quagmire of mortified 
 
233 
 
 substance, and sets before the constitution 
 an indispensable task, to which, however, its 
 powers prove unequal, and the patient 
 sinks, in defiance of the utmost exertions 
 of human science and skill, into the inex- 
 tricable grasp of death. Thus have I known 
 a patient die from the puncture of a pin ; 
 thus have I seen another perish from ex- 
 posing himself to cold when drunk : 
 ruddy, vigorous, and healthy a few days be- 
 fore, and suddenly becoming low, dispirited, 
 anxious, and distressed, and being only re- 
 lieved by the speedy and irresistible violence 
 of " the last enemy which shall be destroyed" 
 
 In considering the varieties and uses of 
 the cellular texture, we are not either to at- 
 tend solely to the larger parts, into the 
 formation and connections of which it so 
 obviously and essentially enters ; but we 
 must also study its finer and less obvious, 
 but not less essential attachments. Such, 
 for example, as it forms between the deli- 
 cate and transparent membranes which enter 
 into the arrangements of the eye ; and the 
 vessels which, by its assistance, so curiously 
 
234 
 
 and securely permeate them, for the pur- 
 pose of nourishing them, and the humors 
 which they enclose and supply; and are 
 thus enabled, with harmony and just pro- 
 portion, for fifty, sixty, or an hundred years, 
 and sometimes more, to fulfil their respect- 
 ive offices. So also the minutest fibrils in 
 the small muscles which move the ossicula 
 auditus are as much dependent upon it for 
 their due connection to the adjoining ones, 
 as the coarse and powerful glutei them- 
 selves. 
 
 It is unnecessary to multiply these re- 
 marks; but I hope this subject will be 
 thought not unworthy of farther pursuit. 
 I hope this Museum will, in time, contain 
 a more perfect series of preparations of 
 the various arrangements of the cellular 
 texture, in every part of the body, which 
 our hands can develope ; first, as a requisite 
 to all we can know or do in the natural 
 state of it, and then in its alterations from 
 disease. This is highly important to Sur- 
 gery as a Science ; and for discerning, de- 
 scribing, and promoting, that important 
 
235 
 
 line of accurate investigation, for which 
 Mr. Hunter's name will ever deserve that 
 perpetual record and respect, of which 
 these walls, as long as they subsist, will be 
 the just and conspicuous memorial. 
 
 I know, gentlemen, that I have been 
 considered, and in this I share the fate of 
 other members of this Council, with whom 
 it must be the honour of any one to be as- 
 sociated, as a partial and flattering eulogist 
 of Mr. Hunter. But my partiality, let the 
 term, however, be properly understood, 
 my partiality has arisen from no personal 
 feeling. I never had the pleasure and ad- 
 vantage, forl was then too young, and un- 
 known, to enjoy the benefits of his personal 
 acquaintance. I was not even his pupil 
 at St. George's Hospital. But I saw him 
 there ; and 1 saw him also in cases of pri- 
 vate practice that are deeply engraven on 
 my memory ; and some of which the pre- 
 parations in this Museum revive, whenever 
 I view them ; and bring before my mind 
 the countenance, the mentality of the 
 countenance, of the man who was con- 
 
236 
 
 suited respecting them, and which made me 
 look up to him as the greatest man of his 
 time. For more than thirty years my sen- 
 timents have not been altered ; and if I 
 have been in any degree successful in my 
 feeble endeavours to attain a respectable 
 rank in my profession, it has been greatly 
 owing to my observing the genius, and try- 
 ing to follow the scientific, and at the same 
 time, the independent course, which John 
 Hunter pursued. Science indeed is always 
 dependent on the truth of its own parts and 
 relations ; and the lawful interests of those 
 who pursue it must be dependent on those 
 for whose benefit it is employed. But 
 their minds require independence, and not 
 servility, with respect to each other. The 
 diversity of impressions ultimately merges 
 in the harmony of truths ; nor need any 
 honest, and candid, and upright investi- 
 gator of fact, be ever jealous of others, on 
 account of discrepancy in opinion. Light 
 often issues from collision ; and we have 
 to explore recesses dark enough to be some- 
 times enlightened and directed, even by 
 unexpected and startling gleams. 
 
237 
 
 Haller places the Tela Cettulosa among 
 the Element a Corporis, as being one of the* 
 most universal fabrics distributed under 
 the common integument, and as also con- 
 stituting a chief part of the integument it- 
 self. But this latter assumption appears to 
 have been hasty. He placed perhaps too 
 much reliance on the confused appearances 
 produced by putrefaction, without carefully 
 enough watching that process through its 
 different stages. Putrefaction, indeed, when 
 accompanied by frequent ablution, is a great 
 anatomist ; but it cannot do much without 
 the latter, which is its indispensable assist- 
 ant ; and we must watch its progress to as- 
 certain its results, as we do that of the knife. 
 It is however a fact that, during this pro- 
 cess, by which so many parts are disen- 
 tangled, their bonds of connection are 
 dissolved, and are often thrown, perhaps, 
 too heedlessly, away, in the stinking water in 
 which it is usually accomplished ; or elude 
 us in the confusing and evaporative stages 
 of disorganization and desiccation. To the 
 progressions of this, more attention, an- 
 atomical, chemical, and physiological, is 
 
238 
 
 much wanted ; and as we advance in science, 
 from the humble steps on which we at pre- 
 sent stand, to a more commanding prospect, 
 it must riot be neglected. And let me be 
 allowed to endeavour to impress on the 
 minds of our students, and our younger 
 members, that, when they are previously 
 instructed in elementary principles, and, 
 after that, begin soberly and philosophically 
 to think for themselves, and to look around 
 them, both for direct and reflected light, it 
 is an object worthy of their sedulous at- 
 tention to follow up this object, and trace 
 it through all its progress, and that in 
 the different parts of the body. It may 
 not appear immediately to bear on our 
 specific duties, but in minute anatomy it is 
 one among many, many more, by which 
 alone structure can be developed, and which 
 are open to their toil, and demand it, dur- 
 ing that period of quiet, and leisure, and 
 disengagement from the cares of life, which 
 is chiefly the lot of those who are beginning 
 the practical part of their profession. Nay, 
 it will not only afford them interest as phi- 
 losophers, as physiologists, and as surgeons, 
 
 13 
 
239 
 
 but will help to mould their minds to dili- 
 gence, to discrimination, and to observation 
 of facts, the effect of which will have a 
 most beneficial influence on their habits, 
 their facility of discerning, their prompti- 
 tude, and, at the same time, their caution 
 in judging, their firmness in acting, and 
 their composure and accuracy in reflecting, 
 that will amply repay them for all they 
 have endured, and for all they have done. 
 
 One of the many curious and interesting 
 circumstances in the natural history, if I 
 may so speak, of the tela cellulosa, is its be- 
 ing the seat and path, every where, of the 
 trunks of the blood-vessels, absorbents, and 
 nerves, which ramify in it, as they sub- 
 divide for their respective destinations ; so 
 as every where to preserve the proper ex- 
 tent of their diameters ; to secure them as 
 much as their functions will admit from 
 pressure ab extra, and that which might 
 arise from causes within the frame ; espe- 
 cially from the constantly varying con- 
 tractions and relaxations of the muscles, 
 and the flexions and straitenings again of 
 
240 
 
 the joints. It holds the glands in their 
 seats, whether they be large or minute, and 
 connects the tough and inelastic periosteum 
 to the hard bone underneath it. Adapted 
 to all these uses, it is exposed to many 
 chances of injury and disease, of some of 
 which we shall hereafter have occasion to 
 take cognizance ; and I will repeat the 
 hint I have already given to students in 
 anatomy, to attend to all the varieties of 
 this substance when they are dissecting; as 
 to laxity and firmness, connection and use, 
 in every part. Such an attention will make 
 them more fully competent to those in- 
 cisions which they may have to execute on 
 the living body, where bleeding or other 
 circumstances may so obscure the surfaces 
 they cut, as, without this previous know- 
 ledge, occasionally to confuse them ; and 
 perhaps thus to produce all the differences 
 between failure and success. 
 
 The importance both of a general con- 
 templation and a particular examination of 
 the substance in question, will be rendered 
 still more evident, if we advert to some 
 
241 
 
 of the peculiarities which it occasions in 
 wounds, from the entrance of extraneous 
 substances into it, especially those which 
 are produced by gun-shot, to which its va- 
 rious degrees of yielding and resistance, and 
 the different extent to which it dips down 
 into the interstices of other more hard and 
 regularly-shaped structures, unite to give 
 to the path of such wounds, so varied, cir- 
 cuitous, and sometimes apparently fantastic 
 a course. Now this is all regulated by 
 fixed laws ; and although we cannot, for 
 want of a sufficient number of data, al- 
 ways know their combination, yet the 
 surgeon who is well acquainted with the 
 varieties the Tela Cellulosa assumes in the 
 injured parts, will certainly possess more 
 advantage in tracing their progress than one 
 who has not at all, or only superficially at- 
 tended to them ; will often form a more 
 correct judgment as to the actual lodgment 
 of the wounding substance, and the pro- 
 priety or the impropriety of searching after 
 it, of leaving it, or of attempting its ex- 
 traction ; and of the suitableness and regu- 
 lation of the subsequent treatment ; so that 
 
242 
 
 if it must remain, the best chance may be 
 secured of its becoming hurtless, either by 
 continuance or change of situation ; or, 
 finally, by the formation of an abscess, or 
 by the ulcerative process, or the perform- 
 ance of an operation for its removal, at the 
 fittest period, and under the most favour- 
 able circumstances* 
 
 Equally worthy of remark is the change 
 of situation, and ultimate expulsion of nar- 
 t**w and pointed bodies, as needles and pins ; 
 often in their course moving through the 
 Tela Cellulosa contrary to gravity, though 
 doubtless in obedience to fixed laws, ani- 
 tnal and mechanical ; sometimes being long 
 'qtafescent, and unthought of; at others 
 feeing productive of the most severe and 
 distressing symptoms, which cannot always 
 fee traced back to the time of their first 
 penetration, notwithstanding the pain and 
 irritation they excite, till they become dis- 
 closed by manifesting themselves exter- 
 nally, at parts remote from those at which 
 they entered. Such was the case of a 
 gentleman, who was distressed by violent 
 
243 
 
 pains in the arm for about a year, for which 
 no reason could be assigned. Sometimes 
 they were considered as rheumatic, and at 
 others as simply nervous, but yielded to 
 no remedies. He went from one bathing- 
 place to another, but all in vain. At length 
 a spot appeared on the shoulder, and a 
 needle made its appearance, upon the ex- 
 traction of which all his symptoms ceased. 
 But the most remarkable case, by far, of 
 this nature, is that, an account of which has 
 been lately sent me by my valuable friend, 
 Baron Nicolay, Russian minister at Copen- 
 hagen; and which has been published by 
 his Excellency's own physician, Professor 
 Herholdt, and would almost exceed belief, 
 were it not for the excellent character of the 
 Doctor, and that it is certified by thirty-six of 
 the most eminent medical men in that city 
 and its vicinity. It occurred in a young 
 Jewess, who began to feel colic pains, as 
 they were thought, in the middle of Au- 
 gust, 1807, which were much aggravated 
 by a blow she received on the 3d of Sep- 
 tember, in the tumult excited during the 
 siege of Copenhagen by the English army. 
 K 2 
 
244 
 
 She continued afterward suffering almost 
 every species of nervous torture and irri- 
 tation. Epilepsy, hysteria, insanity, in- 
 sensibility of body and mind, remittent 
 fever, cough, dyspnoea, vomiting of blood, 
 by turns assailed her. At length, after two 
 intervals of tolerable health, one of two 
 years* continuance, and another rather 
 longer, on the 8th of January, 1819, more 
 than eleven years from the first attack, 
 a tumor formed near the navel, which 
 was opened on the 12th of February, and 
 a needle was extracted. Tumors formed 
 afterward in different parts ; and from that 
 period to the 10th of August, 1820, two 
 hundred and seventy-three needles were 
 taken out, and she again recovered.* Af- 
 
 * From the right mamma, .... 22 
 between the mammae, . . . 14 
 the epigastric region, . . .41 
 the left hypochondrium, . .19 
 
 the right 20 
 
 the umbilical region, . . .31 
 
 the loins, 56 
 
 the hypogastric and iliac regions, . 64 
 the thighs and shoulders, . . 6 
 
 273, besides 
 the subsequent hundred from the right shoulder. 
 
245 
 
 terward she became ill again, and was af- 
 fected, among other things, with diabetes, 
 and a distinct limpid discharge from the 
 vagina, so copious that Dr. Herholdt has 
 not improperly called it Diabetes Vaginalis. 
 In the space of 151 days, she drank 126 
 pints of fluid, chiefly water ; and in that 
 time voided 326 pints of urine, and 529 
 pints of the vaginal fluid ; and from May, 
 1821, to July, 1822, an hundred more 
 needles were taken, by incision, from an 
 abscess in the axilla, and various places 
 about the right shoulder. Dr. H. has pro- 
 mised to communicate the final result of 
 the case, when this tragedy is ended. 
 
 It must be remembered that the cellular 
 Tela is the chief residence of many diseases, 
 and of many diseased structures of spon- 
 taneous origin ; and when we consider that 
 in this the muscles act, the vessels of natural 
 structure and function subdivide, prior to 
 their arrival and appointed distribution at 
 their proper seats, we cannot be surprized 
 that disorders here should produce unna- 
 tural actions, and, of course, unnatural, or 
 
 R 3 
 
246 
 
 at least preternatural products ; so as to 
 confer additional importance on the study 
 and the knowledge of the varieties of this 
 texture, in the cognizance and discrimimin- 
 ation of all tumors, and in the performance 
 of all operations. 
 
 This constitutes one of the most import- 
 ant demonstrations of the absolute neces- 
 sity for practical dissection. It is not 
 enough that parts should be seen in a 
 theatre, cleared for demonstration, on ac- 
 count of distinctness ; they must be traced 
 by our own hands, and that with as careful 
 an attention as possible to every circum- 
 stance. He who sees a muscle, or a blood- 
 vessel, and does not know how to dissect it 
 himself, is like the traveller who sees an 
 object which attracts his attention, and 
 which he learns indeed to recognize, but 
 does not know how to find the way to it. 
 
 The facts I have adduced, however, show, 
 that as even the most simple portions of 
 the cellular membrane are, in consequence 
 of the living principle, endued both with 
 
247 
 
 their respective portions of tone and of irri- 
 tability, they are therefore capable of enter-r 
 ing into most, if not all of the organic 
 changes and injuries of the parts they con- 
 nect. And if, indeed, the powers of life ap- 
 pear in them, on some occasions, more feeble, 
 and therefore more readily disposed to fall 
 into a state of mortification and dissolution, 
 this weakness is in a great degree com- 
 pensated, in a vast number of instances* by 
 the innate power given to the vessels which 
 support it, to reproduce it when it has 
 perished, by that exudation of coagulable 
 lymph into which they readily enter for its 
 new organization, and by other circum- 
 stances, which it will not be so much in 
 place to enumerate here, as when we cpme 
 to speak hereafter of the results of morbid 
 and violent changes. 
 
 To sum up, then, gentlemen, the details 
 of what I have laid before you, respecting 
 the common integument, I will take a 
 short retrospective view of the whole, by 
 reversing the course I have hitherto pur- 
 sued, and travel from within outward. I 
 
 R 4 
 
248 
 
 have shown you that the cutaneous vessels 
 having arrived, after their departure from 
 the greater trunks, at the Cellular Tela, im- 
 mediately underneath the Corium, there 
 again ramify ; and, after supplying the Tela 
 with enough for its own support, and those 
 portions which are to contain adeps, with 
 the material for that secretion, they pass 
 through the Corium, at very acute angles, 
 permeate that substance, and anastomose 
 on its outer surface, to form a tissue of 
 vessels perfectly reticular, and having the 
 most free and consentaneous communi- 
 cation with each other. From this reticu- 
 lated arrangement proceed the villous pro- 
 jections, which combine the perspiratory 
 and absorbent tubes. In this situation they 
 are intimately connected with the papillae, 
 arising from nervous filaments, which enter 
 the Corium somewhat in a similar manner, 
 but subdivide within that substance, which 
 holds the bases of the papillae fast, and allows 
 their conical points to project, so as to com- 
 pose a texture conjoined with that of the 
 blood-vessels, and of those which have the 
 power of absorption. All these push on 
 
249 
 
 their fine and delicate points into the in- 
 terior Epidermis, which forms for them a 
 soft and congenial resting place. Here the 
 papillae lodge in safety and healthful sen- 
 sibility ; and here the perspiratory vessels 
 secrete their fluids, whether gaseous or 
 aqueous, which finally escape through the 
 living, and thin, but sure, and, under natu- 
 ral circumstances, inviolable cloak, formed 
 by the velaminous and connected form- 
 ation of the Cuticle, or exterior Epidermis ; 
 while in their course they nourish the ca- 
 pillular bulbs, both the sets of sebaceous 
 glands, and are busily employed, at the 
 same time, in the nourishment and repair 
 of all the textures^ which support them. 
 From within, they transmit materials that 
 it would be noxious to retain ; from with- 
 out, they convey such as it must be im- 
 portant to receive. And if this beauti- 
 ful adjustment and mutual dependence be 
 disarranged, or impeded, or destroyed, who 
 can reasonably wonder that diseases, form- 
 idable in their nature, though sometimes 
 secret in their invasions, nay, even that death 
 itself, should often unavoidably follow. 
 
250 
 
 Here, Gentlemen, I must drop the pre- 
 sent consideration of this subject ; and per- 
 haps I ought to apologize for having con- 
 sidered some parts of it so much at length. 
 It is my intention, when we next meet, 
 to request your attention to such remarks 
 as I can make on the subject of Inflam- 
 mation, and then to proceed to the con- 
 sideration of its effects and its remedies. 
 Not at all expecting to be carried so far as 
 I have, I had projected and commenced an 
 enquiry into the morbid anatomy of the 
 skin, with which our pathology and our re- 
 medial assistance should begin ; but a sud- 
 den, and long, and severe illness, which be- 
 gan soon after my appointment to this office, 
 and the debilitating effects of which I still 
 feel, proved a serious obstacle to the prose- 
 cution of my purpose. The time may, how- 
 ever, arrive, when I may be able, with more 
 materials, and therefore with more satis- 
 faction to myself, to speak to you upon it. 
 At present, I feel that if there were time, I 
 could not fully do so. It would be walk- 
 ing comparatively upon a non tritum solum, 
 and must take more leisure to advance 
 
251 
 
 on it safely, and consistently with this situ- 
 ation. I trust, however, I have entered, 
 thus far, on a safe course of procedure ; and 
 should any of yoii go beyond me in it, you 
 shall have my thanks, and not my envy, 
 nor my opposition. Hanc veniam petimus, 
 damusque vicissim. My view is in perfect 
 harmony with that of the Council of this 
 College; to establish truth, not to cul- 
 tivate private interest ; but to let every 
 member have his due allotment of op- 
 portunity of observation, and of fair fame ; 
 encouraged, and upheld, and assisted, and 
 not impeded, by us, either as individuals, 
 or as a body. There is enough for us all 
 to do ; and I will not, therefore, conclude 
 this lecture, without a recital of those words 
 of the first aphorism of Hippocrates, which 
 were forty years ago indelibly impressed on 
 my mind by an eminent physician, long 
 since deceased : " C O Bug @pa%v$ 9 y Jg Te^/j/^ 
 o Jg Katgog ov$, y h Uti^oc, a-puXegy, y Ss 
 aXtTry." Life is short, and art is long, 
 and occasion sudden, and experiment danger- 
 ous, and judgment difficult. And how does 
 the venerable sage conclude this sententious 
 adage of simple and important truth ? 
 
252 
 
 By an observation, which is in substance 
 this It is therefore necessary to be pre- 
 pared. In this maxim of the Father of 
 Medicine, let us see the wisdom and the 
 necessity of uniting in sincere and honest 
 efforts to alleviate, as far as possible, the 
 afflictions of mankind ; to promote the 
 cure of their calamities ; and, when this 
 delightful object is placed beyond our ex- 
 pectations to soothe the sufferings, to ad- 
 minister the consolations, and to diminish 
 the anxieties, which may surround the bed, 
 where prostrated strength and doubtful 
 hope seek for relief and repose, or await 
 the period of final dissolution. 
 
 THE Author postpones, for the present, the publi- 
 cation of the Lectures on Inflammation and its conse- 
 quences. But as he felt it right, in concluding, to 
 allude to the present state of Surgery, and the failure 
 of the application made, several years ago, by the 
 College to Parliament, for some power to controul un- 
 authorized practitioners, he has been strongly solicited 
 by several of his friends, both in and out of the Col- 
 lege, to take the present opportunity of publishing 
 the following short Address, with which the Course 
 Was closed. 
 
IN the observations I have laid before you, 
 Gentlemen, in the lectures for this season, 
 for your indulgent attention to which, I 
 beg you will accept my sincerest thanks, 
 I am aware you must have observed many 
 things which are trite and common ; but I 
 told you at first my object was not novelty, 
 but truth, not however trivial, but im- 
 portant truth. And I have been chiefly 
 anxious to inculcate those established ge- 
 neral principles, which ought to be always 
 present to our minds, in the examination 
 and treatment of most, if not of all, the 
 diseases and injuries which occur in the va- 
 rious regions of a body, all of which are 
 formed, supplied, and nourished by the 
 same blood, conveyed and distributed by 
 the instrumentality of one system of parts, 
 modelled and relieved by another system, 
 and controuled and regulated by a third. 
 These views, therefore, are of universal 
 moment, and of absolute necessity. Igno- 
 
254: 
 
 ranee of them, or inattention to them, may 
 lead to the most dangerous and frightful 
 mistakes. How then shall I speak in terms 
 of sufficient admiration of the abundant 
 means which this metropolis affords to 
 our students, of daily witnessing their 
 exemplification, under the guidance and 
 instruction of the most experienced and 
 enlightened teachers. How can I suffi- 
 ciently extol those Hospitals and Infirm- 
 aries, under whose charitable and protect- 
 ing roofs, those who are afflicted by the 
 severest injuries, and the most formidable 
 diseases, are received, to enjoy the benefits 
 of the highest professional learning and 
 skill, the attentions of the most considerate 
 humanity, and the advantages of religious 
 counsel and consolation. We have also 
 Dispensaries, (and to the learned College 
 of Physicians was the country indebted for 
 the origination of this most extensive and 
 useful source of benefit to the poor and to 
 the public, at a time of general sickness and 
 distress). To these, patients in all stages 
 of all illnesses are admitted to notice and 
 relief, from the first hour of their occur- 
 
rence, to the final period of their course ; 
 and this without separating the sufferer 
 from those sources of domestic solace which 
 are often to be derived from the solicitudes, 
 and the affectionate attentions, that beam in 
 countenances long familiarized by relation- 
 ship, by habit, and by a mutual interest in 
 the cares and the endearments of life. 
 Thus, hi many instances, affording to an 
 anxious and tender partner in life, or to a 
 dutiful child, the last melancholy satisfac- 
 tion, to 
 
 " Explore the wish, explain the asking eye, 
 
 And keep awhile a parent (a wife a husband) from 
 the sky." 
 
 Have we not also, in addition to all these 
 institutions, others for the express cogni- 
 zance and relief of distinct diseases, and 
 diseases of particular organs ? I can assure 
 you I have no wish to depreciate these be- 
 low their real merits ; and far be it from 
 me to undervalue the learning, the science, 
 the skill, the liberality, or the integrity, by 
 which those who conduct some of them are 
 conspicuously adorned : men who count 
 
256 
 
 it their honour to promulgate, as far as pos- 
 sible, the advantages which these funds of 
 experience afford, and who are so truly 
 qualified to render them available. Happy 
 am I when these institutions, if they must 
 exist, fall into the management of such 
 meritorious and honourable persons. I 
 must, however, be honest, and must can- 
 didly acknowledge, that however well these 
 charities may be intended and conducted, 
 and how liberally soever they may be sup- 
 ported, I cannot help fearing they have a 
 real, although an undesigned tendency, to 
 continue the ancient and fallacious preju- 
 dice, that manual dexterity (so valuable 
 undoubtedly in itself), or the influence of 
 some particular remedy, may dispense with 
 the scientific guidance and controul of con- 
 stitutional energies ; to which no one can 
 be made properly competent, but by a ge- 
 neral education, and the study of gene- 
 ral experience. Moreover, these establish- 
 ments have one disadvantage, which, in 
 my opinion, none of their advantages can 
 sufficiently compensate. And it is this ; 
 that they abstract from our Hospitals 
 
257 
 
 and Dispensaries, and especially from the 
 former, which must always be the chief, 
 and indeed the only adequate resort of stu- 
 dents for instruction, a large number of 
 diseases, which occur in all places, and in 
 every rank of society; and which, therefore, 
 it is of deep importance to the public 
 welfare, and the relief of mankind, that 
 all Surgeons should have opportunities of 
 knowing, and of studying. At these iso- 
 lated institutions, a very small proportion 
 only can attend ; and a youth coming from 
 the country for the completion of his 
 studies, and whose attendance in the hos- 
 pital at which he enters, and on the requi- 
 site lectures, necessarily employs almost the 
 whole of his time, cannot possibly go about 
 from place to place, and from one institu- 
 tion to another, to see cases, which, if col- 
 lected among others in his Hospital, he 
 might, with his fellow-pupils, deliberately 
 examine, without much additional labour 
 or loss of time. So that he is obliged to 
 return, or perhaps to go into the Navy, into 
 the Army, or to the Colonies, comparatively 
 un instructed, except in theory, concern- 
 
258 
 
 ing some of the most important and ca- 
 lamitous diseases that invade the happi- 
 ness and well-being of mankind. I wish, 
 however, that all separate establishments 
 were under the superintendence of such 
 able and excellent persons as those to 
 whom I have alluded ; but I fear there are 
 too many of a very different complexion, 
 where secrecy, and not science, where pri- 
 vate interest, and not the public good, are 
 the objects in view. Nor is even this the 
 worst; are not the covers of our maga- 
 zines, and the columns of our newspapers, 
 daily and weekly, loyal and disloyal, stuffed 
 with nauseating advertisements, not only of 
 secret remedies, but of secret practitioners, 
 men who are afraid to come forth to the 
 light of an honest examination ? Do not 
 the houses in which their deceptions are 
 carried on, with the most staring impu- 
 dence, pollute our streets, by contrivances 
 to decoy the unjudging and illiterate ? Are 
 not our fences and our walls, from the 
 highest to the lowest, and down to the 
 vilest corners, defaced with the mean and 
 disgusting repetitions of their unaccredited 
 
259 
 
 names ? " Audacia hominum, qui nihil dum 
 metuunt, audent omnia." And we have 
 no power to check it. We have indeed 
 sought for this power, at its only legitimate 
 and constitutional source, on the most pub- 
 lic-spirited and disinterested terms ; from 
 no views to personal advantage, or to dis- 
 tinction, as a body, over other similar 
 establishments in the empire. But we 
 have been refused. Our motives were un- 
 fortunately misunderstood, and, of course, 
 mis-stated ; our conscientious concern for 
 the public health was mistakenly construed 
 into some selfish purpose ; and powers 
 that were conceded to the Company of 
 Apothecaries, were denied to the Royal 
 College of Surgeons. I complain not of 
 the powers that have been conceded : I be- 
 lieve they have fallen into worthy and 
 conscientious hands, and will, assist in 
 averting a part, at least, of an enormous 
 evil from the community. But I trust I 
 may respectfully complain, not indeed in 
 the name, or on the behalf of this Col- 
 lege, I am neither inclined nor author- 
 
 s 2 
 
260 
 
 ized to do so, but in the name and on 
 the behalf of my country, that more ef- 
 fectual means are not provided to repress 
 the encroachments of ignorance and im- 
 posture. But I hope the time is approach- 
 ing when a more just and liberal estimation 
 will be formed of the character of this Col- 
 lege. I hope we shall appear as suppli- 
 cants, on this subject, no more. I trust our 
 enlightened and beneficent Legislators and 
 Governors will, ere long, perceive the ex- 
 pediency, and even the necessity, of con- 
 fiding to us some authoritative controul, 
 by which they, through our means, may 
 preserve lives from being wantonly and 
 wickedly endangered ; and property, often 
 scanty and hard-earned property, from be- 
 ing basely and deceitfully extorted. But, 
 however thus shall be, let quackery stalk 
 abroad as it may, let self-interest and ar- 
 tifice creep about, as they will, it always 
 has been, and always will be, the constant 
 determination of the members of the Coun- 
 cil of this College, and of those Professors 
 who address you under their sanction, that 
 
261 
 
 neither from this chair, nor from their own 
 separate schools, shall any thing be ever 
 recommended, as deserving the regard of 
 our members and our students, or the 
 countenance of the public, but SOUND 
 
 PRINCIPLES, CONSISTENT PRACTICE, and UN- 
 BLEMISHED HONOUR. 
 
 s 3 
 

 
263 
 
 EXPLANATION OF THE PLATES. 
 
 r LATE I. jig. 1. is a representation of two por- 
 tions of the cuticle, or exterior epidermis, magni- 
 fied 12 times. It illustrates the rugce, or natural 
 wrinkles, and the corresponding ridges, or bands 
 of the cuticle; and also the capilluli, with their 
 bulbs, which passing obliquely through the rugse* 
 serve as fastenings, securing the union of the 
 cuticle and of the interior epidermis, or rete 
 mucosum, to the cutis. This figure is particularly 
 referred to (by mistake as fig. 3.) at page 131, 
 and, together with the others in this plate, at 
 page 194. 
 
 Fig. 2. exhibits the bulbs of the capilluli in 
 profile, magnified 60 times. 
 
 Fig. 3. A hair, with its bulb, extracted from 
 the leg of an adult, and magnified 400 times ; the 
 light being concentrated upon it, and shining 
 through it. See page 191. 
 
 s 4 
 
264 
 
 PLATE II. explains the proper structures of 
 the cuticle, or exterior epidermis, and of the 
 rete mucosum, or interior epidermis ; demonstrat- 
 ing that there are no pores, or regular perforations 
 through either of these integuments. This plate 
 is referred to at page 134. 
 
 Fig. 1. is a drawing of a minute portion of 
 very thin cuticle from the lip. It is represented 
 as seen in a recent state, through a lens magni- 
 fying 40 times, the light being reflected through. 
 It appears a woolly or bibulous texture, traversed 
 by darker lines, where it is partially cracked, but 
 nowhere regularly perforated or porous. 
 
 Fig. %. represents a very minute portion of 
 the cuticle of the arm, dried, and magnified 
 160 times, under the same circumstances as that 
 from the lip, and that of which the next figure 
 is a drawing. 
 
 Fig. 3. is the representation of a still more 
 minute portion of the exterior epidermis, taken 
 from the arm, dried, and magnified 400 times. 
 This, and the last figure, confirm the facts de- 
 monstrated by the first on this plate. 
 
 Fig. 4. is the appearance of a minute portion 
 of thick cuticle from the tip of the thumb, dried, 
 and magnified 240 times ; the light reflected from 
 above as well as from below, upon the object, of 
 which the external surface is here shown. The 
 
Tlaie 2. 
 

 
 
265 
 
 interior epidermis (which was removed from 
 the portions of cuticle represented in the three 
 former figures) is still adherent to this, except at 
 the angle b d e : and the dark lines a b, c d e, 
 f g, and h i, exhibit the furrows or rugae of the 
 cuticle which covers the palm of the hand when 
 examined as above described. 
 
 Fig. 5. is the reverse of the last. It exhibits 
 the bands or ridges a b, c d e, f g, and h i, corre- 
 sponding severally to the furrows shewn in the 
 last figure ; and it exhibits the velamina, or cells 
 of the interior epidermis, which is of a fibrous and 
 bibulous texture, like that of the exterior, but 
 much softer. At the angle b d e, is to be ob- 
 served the cut surface of the cuticle, which was 
 at this part split for the purpose of removing the 
 interior epidermis, and of contrasting with it the 
 fibrous and bibulous, or velaminous texture of 
 the exterior. 
 
 Fig. 6. In this drawing, the two surfaces of 
 the cuticle represented in the last figures, are 
 drawn as they appear to the naked eye, with the 
 light shining through. 
 
 It may here be observed, that the cuticle and 
 the interior epidermis, when viewed through the 
 miscroscope with a sufficiently powerful lens, 
 never put on any other appearances than those 
 which are represented in this plate ; excepting, 
 
266 
 
 first, when too strong a light is reflected through 
 them directly towards the eye ; in which case 
 they appear transparent, or simply as a film 
 (see Plate iii. figs. 1. and 2.) ; and, secondly, 
 when, from a similar cause, the prismatic colours 
 produced in all parts of the object, sufficiently 
 prove the regular tetrafbil, or catenary, or other 
 form which they may assume, to be an optical 
 deception. See Plate iv. figs. 2. 3. and 4., and 
 Plates iii. iv. and v. in confirmation of the facts 
 here proved, 
 
 PLATE III. demonstrates the existence, form* 
 and locality of the inter epidermal glands. It is 
 referred to at page 184. 
 
 Fig. 1. exhibits several of these bodies as 
 they appear on the internal surface of the moist 
 cuticle, after it has been long macerated in water. 
 One pear-shaped body is to be seen, on the left 
 of the figure, which is a bulb of a capittulus in 
 perspective, under a lens magnifying 240 times. 
 
 Fig. 2. At the lower part of this figure the 
 interior epidermis is represented upon the cuticle 
 as in fig. 5. plate ii. The interior epidermis (the 
 cuticle being torn from under it) is seen alone 
 at one part, and at the other the exterior epi- 
 dermis alone is exhibited ; the interior being 
 stripped off to shew the glands, which are thus 
 
Tlate 3 
 
 i / 
 

267 
 
 demonstrated to be inter-epidermal, was magni- 
 fied 60 times. 
 
 Fig. 3. is a representation of the inter-epi- 
 dermal glands (and of three bulbs of capilluli) 
 seen in profile, in a moist state, with a lateral 
 light, and through a glass magnifying 60 times. 
 
 In plate ii. fig. 2. some of these glands, and 
 one bulb of a capillulus in perspective, are repre- 
 sented as they appear when dried. 
 
 Fig. 4. exhibits the internal surface of the 
 moist interior epidermis in profile ; confirming 
 the fact demonstrated in figure 2., viz. that these 
 bodies are exclusively ewfer-epidermal. The 
 objects represented in this, and in the next 
 figure, were magnified 60 times, under a lateral 
 light. 
 
 Fig. 5. is a view of the external surface of the 
 moist interior epidermis, in profile. This shews 
 the original object (which was casually taken 
 from a considerable number of portions of the 
 interior epidermis) to have been deprived, in its 
 separation from the cuticle, of the inter-epidermal 
 glands j and demonstrates the stronger attach- 
 ment that these glands have to the exterior epi- 
 dermis than to the interior, when the two are 
 torn asunder. 
 
 Fig. 6. is a representation of the bodies long 
 known as the sebaceous glands of the common 
 
268 
 
 integument, as seen by the naked eye, being mor- 
 bidly enlarged from an excessive quantity of 
 their natural secretion retained in their ducts. 
 The two epidermides have here been removed, 
 and in one or two places these glands have 
 escaped, so that the deep niduli, in which they 
 were set in the cutis vera, are shewn in the 
 figure. 
 
 Fig. 7. is a view of the same sebaceous glands, 
 represented of their natural size, and appearing 
 as small specks, situated upon the cutis vera, in 
 which they are seen to be partially or entirely 
 imbedded, on the surface of the nose and upper 
 lip, where the two epidermides are both torn up. 
 Where the cuticle passes an angle in the cutis, 
 as at the edge of the lips and nostrils, &c. both 
 epidermides invariably adhere with peculiar firm- 
 ness. 
 
 PLATE IV. Jig. 1. shews the internal surface 
 of the hard cuticle of a labouring man's hand, 
 separated by long maceration from the interior 
 epidermis (which is here very thin, and very 
 strongly adherent), and afterwards dried upon 
 blue paper, and magnified nine times. The 
 inter- epidermal glands are to be counted by the 
 naked eye in the preparation from which this 
 drawing is taken : and about one hundred and 
 
PlM-e.4 
 
 JIM 
 

 
269 
 
 thirty of them are found in the surface of one 
 
 twenty-fourth part of a square inch, disposed in 
 rows, and lying in the furrows, which are the 
 reverse of those minute ridges observable upon 
 the external palmar surface of the adult hand. 
 Many of the glands are lost ; those that remain 
 appearing in the preparation (magnified six 
 times) like broken rows of pearls. An equal 
 number of the orifices of their ducts, are similarly 
 disposed in the same space, and to be counted 
 with a magnifying-glass on any adult hand. 
 See Plate v. fig. 2. 
 
 Fig. %. represents a minute portion of moist 
 cuticle, from the sole of the foot of a fetus, dis- 
 tended on a black surface. It appears in the 
 drawing as when magnified 60 or 80 times, and, 
 in these particulars, corresponds with the two 
 figures next following. 
 
 Fig. 3. is a portion of cuticle from which 
 nearly all the inter-epidermal glands have been 
 accidentally wiped off in cleaning it with a camel- 
 hair pencil, to which they adhered like minute 
 beads, too minute to be counted, but visible to 
 the naked eye. The niduli of these glands, or 
 origins of their ducts, are seen in this figure ; 
 these ducts pass very obliquely to the surface of 
 the cuticle, and they are the only perforations 
 discoverable in it. 
 
Fig. 4. exhibits the terminations, or orifices of 
 the ducts of the iriter-epidermal glands, in the 
 sole of the foot of a fetus. The ducts of these 
 glands have been long observed, and hitherto 
 they have been supposed to be pores, and the exit 
 of the perspiration. (See Plate v. figs. 1. and 2.) 
 
 Fig. 5. is a drawing of the internal surface of 
 nearly the whole of the cuticle of the thumb of 
 an infant at birth. The inter-epidermal glands 
 are here seen to be equally dispersed over the 
 back of the thumb, but arranged in rows on 
 the palmar surface. 
 
 PLATE V.Jig. 1. exhibits the inter- epidermal 
 glands on the palmar surface of the extreme 
 joint, or phalanx of the finger of a fetus, as seen 
 when the cuticle of this part is everted, filled 
 with black varnish, and magnified eight times. 
 Not all the glands are shewn in this figure, as 
 they are too numerous, and too regularly dis- 
 posed along the furrows throughout the whole 
 surface, to have been represented without con- 
 fusion. In the centre and at one corner they 
 are drawn precisely as they are in the preparation, 
 along every single furrow. 
 
 Fig. 2. is a view of the natural size of the 
 external surface of an adult thumb ; it may be 
 considered as the reverse of the last figure, 
 

 Ilate 5. 
 
 
 S'uj.C. 
 
exhibiting the orifices of the ducts of the inter- 
 epidermal glands, as these glands themselves 
 are there exhibited. The human perspiration is 
 of so unctuous a nature that it will occasionally 
 produce the same effect upon the lithographic 
 stone as the ink with which some parts of these 
 drawings are made ; and the impression of the 
 thumb, though invisible till the ink is applied 
 for printing, will occasionally print black. It is 
 always found, if when the hand is only mode- 
 rately warm, it be impressed on glass, that the 
 stain of the perspiration is left on the glass every- 
 where, EXCEPT at the orifices of the ducts of the 
 inter-epidermal glands ; the glass being wholly 
 unobscured only where these orifices have been 
 applied. 
 
 For these reasons it was thought, that an im- 
 pression of the thumb (by means of the perspir- 
 ation alone) might have been obtained so as 
 clearly to demonstrate that these orifices are un- 
 connected with the proper perspiration ; but the 
 number of copies, and the distinctness requisite 
 in every one, are too great to allow of this being 
 accomplished ; Jig. %. is therefore a copy of a 
 stamp or impression of the thumb when blacked 
 with the lithographic ink ; and the orifices in 
 this figure shewn black, are those points which 
 will be found less or not at all discoloured, in 
 
272 
 
 the impression of the thumb, moderately warm, 
 upon a piece of clear glass. 
 
 Fig. 3. shows the bulbs of the capilluli trans- 
 fixing the ridges, and the inter-epidermal glands 
 lying in the concavities or velamina of the cuticle 
 of an infant's back, seen from its internal sur- 
 face. These glands are distributed here irregu- 
 larly, not differing in size, and many of them 
 hidden by the bulbs. 
 
 Fig. 4. The preparation represented by this 
 figure is the reverse of the last ; the bulbs and 
 the glands appear as white spots ; the former of 
 a larger size, the latter of a smaller. 
 
 Fig. 5. The internal surface of the cuticle of 
 an infant's scrotum, with the bulbs of five capil- 
 luli, or immature capilli. The glands here vary 
 much as to their magnitude. This and the two 
 preceding views are magnified nine times. 
 
 Fig. 6. The inter-epidermal glands of the pe- 
 rineum of an infant magnified 20 times ; they 
 are about equal in size, very irregularly disposed. 
 
 Fig. 7. A piece of skin enormously distended 
 from the abdomen of a dropsical subject, magni- 
 fied 18 times. At the upper part are represented 
 four orifices, by some called the Pores of the 
 Cutis ; viz. one on the left of the figure ; a 
 second (from which a capillulus is almost com- 
 pletely drawn out upon a piece of black paper), 
 
Jlatc 6. 
 
 
 f 
 
 
and a third, and a fourth, on the right of the 
 drawing, which correspond to the bulbs of two 
 capilluli below. At the lower part of this draw- 
 ing are shewn the folds of the extended cuticle 
 and interior epidermis, which have been stripped 
 off from the surface of the cutis vera above ; and 
 which exhibit the bulbs of eight capilluli, to 
 every one of which an orifice (like those four 
 above mentioned) correspond ; as is seen in four 
 of them, under two of which small pieces of black 
 bristle are placed. That there are not to be 
 found on the human cutis any orifices, or pores, 
 nor regular perforations, besides those which 
 have contained capilluli, or capilli, or sebaceous 
 glands long known as such, was proved in one 
 most satisfactory preparation, exhibited at the 
 College when these lectures were delivered, but 
 since unfortunately lost, and most difficult to be 
 replaced. That from which this figure was taken 
 was too delicate for preservation ; but the facts 
 here stated are sufficiently verified by others de- 
 posited in the Hunterian Collection, and they 
 are confirmed by Jig. 7. and 6. PLATE VII., which 
 exhibit the natural foramina or niduli of the 
 bulbs of the hog's bristles as they are seen pierced 
 through the tanned skin of this animal. 
 
 PLATE VI. Jig. 1. A small portion of the hu- 
 T 
 
man cutis injected, dried, varnished, and magni- 
 fied 6 times. This figure shews the trunks of 
 those minute branches of blood-vessels which 
 transfix the corium to form its vascular surface. 
 
 Fig. 2. The more minute ramifications of the 
 arteries of the human cutis are here portrayed, 
 more superficial than those in the last figure, as 
 to situation. 
 
 Fig. 3. The helix or outer rim of this dried 
 ear continues the illustration begun in the last 
 two figures. 
 
 Fig. 4. On the helix of the ear, represented in 
 this figure, the blood-vessels are seen so minutely 
 ramified as to form a complete net- work or cover- 
 ing to the Corium, with the penicillated perspir- 
 atory vessels arising from it. Perhaps this is the 
 most minute and successful injection of the 
 cutis that has ever been made. 
 
 Fig. 5. represents a portion of the cutis from 
 the back of a child. Where the glare of the 
 varnish does not obscure the surface, the same 
 coat of vascular convolutions may be seen as in 
 the last figure. 
 
 PLATE VII. Jig. 1. represents a piece of com- 
 mon soft doe-leather, magnified 4 times ; as are 
 the first seven figures on this plate. This 
 shews the prepared leather to consist of a 
 
JZTfflCfava&er (fc 
 
 Fri/wtedfy G.JTsdbnasuled. 
 

 
purely Jibrous texture, the fibres curling in every 
 direction. 
 
 Fig. 2. represents the section of a piece of 
 horse-leather. In it there appears a granular or 
 parenchymatous substance interposed between the 
 fibres. 
 
 Fig. 3. represents a piece of human skin, 
 in which the granular substance is changed 
 (by long maceration in water) into adipocere, 
 being yet retained in the Jlbrous or membranous 
 texture, and supported by it ; so as to prove the 
 existence of both in the human corium. 
 
 Fig. 4. The external surface of a portion of the 
 human cutis tanned. It exhibits the furrows 
 and niduli of the bulbs of the capilluli ; and at 
 the upper corner, on the part of the figure next 
 to jig. 5., the surface of the section much re- 
 sembles that of horse-leather, being however far 
 finer. 
 
 Fig. 5. represents the flocculated internal sur- 
 face of a piece of human cutis tanned; and at its 
 upper part the surface of its section is exposed. 
 
 Fig. 6. The internal surface of a piece of hog- 
 leather, shewing how it is completely pierced 
 through by the niduli or rather foramina of the 
 bulbs of the bristles. 
 
 Fig. 7. The external surface of a piece of hog- 
 leather, in which the papilla? (visible to the naked 
 
eye in the preparation) are very clearly distin- 
 guishable, all pointing downwards. 
 
 Fig. 8. This is the appearance of a prepar- 
 ation of an ulcer from the leg of an adult. At 
 the upper part, and above the ulcerated surface 
 the papilla? of the cutis are seen morbidly en- 
 larged, but not otherwise diseased; and the 
 cuticle and interior epidermis, stripped from these 
 papittce, hang down from their lower margin, ex- 
 hibiting the cells or velamina in which they have 
 been lodged. Behind this pendulous portion of 
 the epidermides the ulcerated surface is por- 
 trayed, covered with a flocculent layer of coagul- 
 able lymph. 
 
 Fig. 9. represents a portion of human cutis, 
 preternaturally enlarged to an enormous extent 
 and degree, from the foot of an adult. The im- 
 mense thickness of the corium is observable in 
 the section at the upper part ; and the enlarged 
 papilla? are shewn over the rest of the drawing, 
 except at one spot, at the top of the figure, 
 where a desquamated flocculus of the moist cuticle 
 still adheres. See the portrait of the female 
 from whom this preparation is taken, in the 
 Hunterian Museum at the Royal College of Sur- 
 geons. This and the last^figures are referred to 
 at page 170,. and this at page 209. 
 
 
277 
 
 It may not be improper here to state that 
 LITHOGRAPHY (besides that it appears in general 
 the most eligible mode of publishing anatomical 
 representations) is the only mean whereby a suf- 
 ficient number of several figures in these plates, 
 could have been struck off, for a single edition of 
 this work ; nor would the Art of Lithography 
 have answered this end, nearly so well, if at all, 
 before the late very important improvements in 
 its application, for which we are indebted to 
 Mr. Hullmandel, of Great Marlborough Street, 
 London. 
 
 The preparations deposited in the College 
 Museum, illustrative of the facts here described, 
 are best seen with a double lens, magnifying 
 eight times. 
 
 THE END. 
 
LONDON : 
 
 Printed by A. & R, Spottiswoode, 
 New- Street- Square . 
 
r