No. 1240.

JUNE 5. 1847.

A Course of LecturesON

THE PHYSICAL PHENOMENAOF

LIVING BODIES.

DELIVERED IN THE UNIVERSITY OF PISA.

BY PROFESSOR MATTEUCCI, F.R.S.

(Translated, for THE LANCET, by S. J. GOODFELLOW, M.D. Lond.,late Physician to the Cumberland Infirmary.)

LECTURE I.

GENTLEMEN,-I never before felt so diffident of my ownpowers as I do now, when I am about to perform the dutywhich has been imposed upon me, of delivering a course oflectures upon the Physical Phenomena of Living Bodies. Butwhile I feel the difficulty of such an undertaking, I also hopethat my efforts may be rewarded by the advantages you mayderive from them. In fact, this is perhaps the first time thatsuch a course of lectures has been introduced into medicalstudies: there is no book which treats of this subject: the ele-mentary principles are, indeed, scattered here and there, butthey have never been considered in that light which is themost favourable to their development.

If, at the commencement of every course of instruction, theteacher endeavours to give an exact definition of the scienceunder consideration, to show its limits and its object; in oneword, to trace a plan or programme, certainly the necessityfor these preliminaries was never more apparent than in thepresent instance.

Living bodies possess the general properties of all naturalsubstances. The most extravagant vitalist has never dreamtof denying that living organized matter is extended, impene-trable, divisible, and porous. How can we believe that heat,electricity, light, and chemical affinity, act upon these bodiesin a manner entirely different to that in which they are ob-served to act upon other natural bodies ?In some highly esteemed works on physiology, you will find

tables of the differences, or rather of the opposing properties,supposed to exist between organized and inorganized bodies.I should find it a long and useless discussion to demonstratethat many of these pretended differences are of little or novalue. Animals and vegetables increase by intussusception,minerals by juxtaposition; or, in other words, in the first,growth takes place by internal juxtaposition, in the latter, byexternal; and that because organized bodies conceal in theirinterior the dissolved elements of new formations, while, on thecontrary, these elements are external to inorganized bodies. ’,During life there is a continual struggle between the phy- ’,

sical and vital forces, and death is the triumph of the formerover the latter. But is this sufficient to prove that vital and

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physical forces are essentially distinct and opposed in their Imode of action ? Would it be correct to say that the different Iparts which, united, form one arch, are endowed with a forceopposed to that of gravity, merely because they do not fall ?Organized living bodies, like all others in nature,are,as I have

said, extended, impenetrable, divisible, porous. Plunge theminto water, or any other fluid, and they will imbibe, such, forinstance, as pounded glass, porous bodies, and those formedof capillary tubes. This property of living bodies is of thegreatest importance. In a great number of animals, life canbe suspended for a long time with impunity, but on the appli-cation of water, which they have the power of imbibing, theyreturn to active life, and reacquire its movements. Who isnot acquainted with the beautiful experiments of our illus-trious countryman, Spallanzani, upon the rotiferous animals ?Look at a tendon, a membrane, which, as I show you, is hardand horny, appearing never to have formed a part of anorganized body; yet if we plunge it into water, you will per-ceive that, according to its imbibing power, it will becomemoist, supple, elastic, and enabled to perform, in the livingbody, the functions which belong to it.

All living bodies, as well as all others in nature, areendowed with elasticity. For example: I can, at will, stretchor compress, more or less, a piece of intestine or artery. IfI open this cock attached to the trachea, you perceive that

Ithe lung falls upon itself, whilst it swells and becomes dilated Iagain, if I force air into it. You cannot, therefore, believethat these different organs can perform their respective func-

tions, without the elasticity of the pulmonary parenchyma,,and that of the intestine and artery. Let it be destroyed, andthe functions will cease, or at least be altered.

Gravity acts upon the solid, liquid, and gaseous parts ofliving bodies, in the same manner as upon all others whichexist or are found in Nature. We cannot explain the func-tions of respiration and absorption, if we do not consider thephysical properties of the solids, liquids, and gases of theeconomy, and their conditions of equilibrium.

If you apply a sufficient degree of heat to an organizedbody, you will see the gas disengaged, the vapour of waterescape, and carbon and hydrogen burn in the air, producingcarbonic acid and water.. If the first application of heatoften hardens organic substances, and shrivels -them, instead:’of dilating and liquefying them, as ordinarily happens to in-organic bodies, you certainly cannot attribute this differenceto vital action, since life has been long extinct when these

! phenomena take place.i All these effects are caused by the particular structureand chemical properties of the elements of which thesetissues are composed. In fact, organized bodies, submittedto the action of heat, first lose the water which they contain;and this effect begins in the part exposed to the greatestheat. The substance then rolls itself up in the form of ahorn, like a sheet of paper moistened on one side, in such amanner that the longest side occupies the convexity of itsnew shape.These organic bodies often contain albumen, which coagu-

lates by heat. Their elements separate in the gaseous state,and form more simple combinations, which are consequentlymore lasting. ,

The electricity of tension pervades organized bodies, andspreads through them with more or less facility, according totheir different degrees of humidity. If the spark passesthrough them, it volatilizes, burns, and reduces them to ashes.If the electric current passes through the fluids of livingbodies, it decomposes their salts-the acids are collected atone pole, the bases at the other. Albumen coagulates at thepositive pole, where are yielded the oxygen, and a frothyliquid acid. Hydrogen goes to the negative pole, with aliquid alkali. Every one knows that rays of light, traversingthe humours of the eye, deviate from a right line by divergingand converging, according to the different density of thehumours, and the form of the parts which contain them, inthe same manner as in an optical instrument. I would add,that the elements which compose living bodies always obeythe general laws of affinity. A chemist can detect and sepa-rate them by the ordinary methods of analysis. Treat themwith chlorine, bromine, or iodine, and hydrogen will be thefirst element which is separated, and combines with thesemetalloides to form hydracids. All oxidizing action willconvert organic matter into acids. Are we justified in con-cluding from this that all the phenomena presented by livingbodies can be explained by the general properties whichthey exhibit in common with other natural substances, merelyby the action of the great physical forces-heat, light, elec-tricity, and attraction ? Such a conclusion would be as farfrom the truth as that of those who deny these general pro-perties to living bodies, and who regard them as altogetherbeyond the influence of physical agents.Examine these phenomena of living bodies, which, if I may

use the expression, are the most physical or chemical, and youwill see a considerable difference in the mode of action ofphysical and chemical agents, when acting upon organizedmatter; a difference which is inexplicable in the present stateof our knowledge of the laws which govern these forces. Donot even the phenomena of vision, which may be called en-tirely physical, present peculiarities which have not hithertobeen explained ? If the latest discoveries of science enableus to explain the distinctness of vision at all distances, andthe absence of coloured fringes, how can we explain by phy-sical laws the perception of an object as single and in its naturalposition, from a double and reversed image ? Why can wenot say that hearing and voice are simply the effects of par-ticular vibrations of the air, propagated through solids, ac-cording to the general laws of acoustics ? Science can giveno completely satisfactory answer to all these questions.The chemical action of light which decomposes carbonic

acid, carries the carbon, under the form of new combinations,into the interior of vegetables, disengages the oxygen, andproduces such combinations as the most powerful chemicalaffinities are unable to effect, is certainly different from thatwhich decomposes certain oxides and metallic chlorides, whichcan be effected by the weakest chemical action.

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If you direct the electric current upon the nerves of anyliving animal, the singularity of the phenomena exhibited willconvince you of the immense difference which exists in theeffects of the great forces of nature, upon living and organizedbodies and upon those which are inorganic and dead.What is, then, the cause of these great differences in the

mode of action of physical agents upon living bodies and uponother natural bodies ? Here is a question of primary im-portance, to which the present state of science does not per-mit us to reply with certainty. Let us not, however, abandonthe analogies which are offered to us by physics. A ray oflight which passes obliquely through a piece of glass, or abody of water, leaves the right line; if, on the contrary, itmeets with a crystal of carbonate of lime, it is divided intotwo rays, each of which deviates in a different degree. Thereason of the difference of these phenomena is the differenceof physical structure which exists between glass and crystal-ized carbonate of lime, and perhaps also between the chemicalnature of their molecules. But no doubt these modificationsof the ray of light are more owing to the diversity of struc-ture, or to the peculiarity of the molecules, than to the z’

difference of chemical composition. We know that glass actsdifferently upon the rays of light, when it is more or lesscompressed on different sides, without any change in itschemical composition.Who could confound an organized with an inorganic body?

In these groups of closed vesicles, of different dimensions,united and disposed in an irregular manner, there is certainlysomething essentially different to a mass of polyhedral particles,united in a crystal. To say, with some microscopical ob-servers, that organization is crystalization effected in a liquidby which the first crystals formed can be imbibed, is equiva-lent to admitting that the structure of a stalactite is thesame with that of the parenchyma of the lung and theliver.

Molecules, composed of not less than three elements, ineach of which a great number of elementary atoms enter, ne-cessarily form chemical systems, the affinities of which differfrom those possessed by molecules composed generally of twoelements, and in which the number of elementary atoms issmall; and if ordinary chemical action shows us that combina-tions become more feeble in proportion as the number ofelementary atoms is increased, it explains the tendency oforganized bodies to resolve themselves into more simple com-binations ; so, also, chemistry furnishes many examples of thistendency in some compound inorganic bodies, the compositionof which bears a great analogy with some organic bodies; yetthis must not induce us to admit that the laws of inorganicchemistry are sufficient to explain exactly the chemical phe-nomena of life. We must conclude from this that the organi-zation and molecular structure of living bodies occasiongreat modifications in the action of different physical andchemical agents.We must not omit to add, that every day increases the

number of a particular class of chemical phenomena, the ex-planation of which cannot be given on the ordinary laws ofaffinity: I allude to actions of contact, or to those of a cata-lytical nature. In the greatest number of these actions, weremark that a body, ordinarily in very small quantity, causes,without undergoing any modification itself, some considerabletransformations, either of chemical composition or physicalproperties, in other combinations. In this category of phe-nemena we find the different kinds of fermentation. We shallsee that the number of these catalytic actions in living bodiesis immense. We can produce them also in our laboratories;they are of the same nature as those which the black platinapowder exerts upon a mixture of hydrogen and oxygen,and silver scattered on oxygenated water.

I should here notice a fact of some importance relative toour subject, and of which, by and by, I shall have to speakmore at length. The cellule is certainly the elementary organ,or the molecule of organic bodies. We can now explain, by theaid alone of the phenomenon of endosmose, (occasioned en-tirely by the dominion of the physical forces,) the mechan-ism of life of this little cell, and render an account of themanner in which the materials of its nutrition can penetrateit, while others are eliminated. We constantly meet with agreat series of physiological facts, of which endosmose fur-nishes the explanation. We may also add, and are able fullyto demonstrate it, that light, heat, and electricity, are pro-duced in the interior of living bodies, by the play of the samephysico-chemical actions as those which take place in inor-ganic bodies, and are attended with the same results. But canwe hope, by the aid of all these facts, and analogies, that we shallbe permitted to arrive at the complete explanation of all the

phenomena of living bodies ? At the present time, at least,this is a vain hope. Open an animal, and examine its kidneysand liver, and then inquire by what physical force it can be ex-plained, that the blood which is carried to an organ forms bileand urine. How can we, in having recourse to the play ofchemical affinities, even modified as much as we can imagineby the aid of the particular structure of organs, and even alsoby the actions of contact-I will not say comprehend-but evenhave a glimpse of the manner in which the different organseffect the separation and transformation of the constituentparts of the blood, in which all the organic elements aremixed, partly suspended, partly dissolved, and of which theremust be continually a want to repair their lost parts ? Whatcan we say of the functions of nerves, and generation !We must conclude from this,-1. That living bodies have properties common to all bodies

in nature, and that these properties exercise an influence inthe production of phenomena which are peculiar to them, andwhich cannot, therefore, be neglected or overlooked in theirexplanation.

2. That the great physical agents-heat, light, electricity,molecular attraction-act upon living as upon all other bodiesin nature; and that their action must of necessity interferein the production of functions peculiar to those bodies.

3. That these forces, when exerted upon organized matter,sometimes modify their general mode of action; and thatthis modification is owing to a difference of structure andchemical composition of organized bodies.

4. That there are, moreover, in living bodies, phenomenawhich are termed vital; that these are numerous, and of thehighest importance; that, in the present state of science, wecannot understand how the physical agents, even when modi-fied in their action by the organism, can interfere in theirproduction. This is the reason why there exists a study, ascience, which has for its object the physico-chemical pheno-mena of living bodies; like as there is an experimental phy-siology. The intimate and necessary connexion is found inthe third class of facts which we have pointed out. The or-

ganization modifies the action of physical agents, and thestudy of these modifications requires the combination of phy-sical and experimental physiology. Let us not forget that wehave formed a fourth class of phenomena of living bodies,which we have termed vital. I have said vital phenomena,and not vital forces, and in fact the difference is trulyvital.

If Newton had only or merely called that force whichrules the wonderful system of the celestial mechanics attrac-tion, or attractive force, his name would long since havefallen into oblivion; but in demonstrating that the attractionis exerted in a direct ratio to the masses, in an inverse ratioto the squares of the distance, and revealing the eternal,the unchangeable laws of this force, he has rendered his nameimmortal.To speak of vital forces, to give their definition, to interpret

phenomena by their assistance, and to be ignorant of the lawswhich govern these supposed forces, is to say nothing, or, thatwhich is worse, it is to satisfy the mind to no purpose, to stopthe search after truth. To say that the liver separates theelements of bile from the blood by means of the vital force,is to say no more than that the bile is formed in the liver. Bythis change of the word, we become conscious of a dangerousillusion.

I think I have satisfactorily established the end at which itseemed necessary to arrive in the study of the phenomena ofliving bodies, which brings us back to the last analysis in theexamination of the physico-chemical phenomena of thesebodies, of their organization, of the modifications which thisorganization exerts in the general action of physical agents,and lastly, the search after the laws of phenomena purelyvital, which up to the present time are empirical.

’ I hope I have succeeded in determining what are the limitswhich we ought to impose upon ourselves in the vast extentof physiology, and what part of this we ought to study underthe title of physico-chemical phenomena of living bodies. Thegeneral principles I have just unfolded ought to be sufficientto make you estimate their importance for understanding thefunctions of living bodies. In these lectures, I propose tomyself another end no less important; it is to introduce in theexposition of physiological facts, and in the investigation oftheir laws, that precision of language, that exactness of expres-sion, that rigorous method, which are too often set aside inthe study of physiology and medicine, and which have hithertobeen almost exclusively the distinctive qualities of physicalscience. Every step that we take towards this object, howevertrivial it may seem at first, will certainly prove of great serviec

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to physiology. It will lead to a certain conquest, because itwill be founded upon a separate acquaintance with the scienceof organization, the basis of which will be established andsupported by the physical theories, which, as you know, are ealmost complete, and every proposition of which has beenTigorously demonstrated.

Hospítal Reports.LONDON HOSPITAL.

TWO CASES OF POST-PHARYNGEAL ABSCESS, FROM IMPACTIONOF FISH-BONES.

Reported by JOHN ADAMS, Assistant-Surgeon to the London Hospital.

Feb. 24th, 1846.-A young woman, twenty years of age, wasadmitted into the London Hospital, labouring under mostsevere distress from having swallowed a fish-bone. She had

applied at the hospital ten days ago, in consequence of thebone of a plaice having stuck in her throat whilst eating. Thehouse-surgeon had attempted its removal by means of a blunthook attached to the one of a probang, and failing in this, hepushed an ordinary probang down into the stomach, to forceit onwards. This was followed by considerable pain about thethroat, and difficulty of swallowing, for which she came againto the hospital. When I saw her first, besides the symptomsjust mentioned, her neck was somewhat swollen and tender,the swelling being evidently deeply seated, and it was more

perceptible on the right than on the left side; her pulse wasquick, her breathing somewhat difficult, and she labouredunder much constitutional excitement. She was immediatelytaken into the hospital, was ordered leeches repeatedly, andcalomel was administered, so as to affect the mouth. So farfrom any amelioration of the symptoms, she became graduallyworse, her dysphagia became more complete, and her breath-ing was so difficult as to threaten immediate suffocation: myattention was therefore called to her, as her symptoms becamemore urgent, and in addition to her difficulty of breathing, shehad paroxysms of suffocative cough. I suspected abscess be-hind the oesophagus. I could not examine the throat, in con-sequence of her inability to open her mouth. As the signs ofimpending suffocation were more urgent, I immediately deter-mined to open the larynx, which I did with some difficulty,owing to its being pushed rather to the left side, by the swell-ing of the neck on the right. The dyspnoea was at once re-lieved, and I left her tolerably comfortable, but still unableto open her mouth, or swallow, and complaining of excessivethirst; she was therefore ordered an enema of milk-and-water,alternating with beef-tea, every three hours.On the following day, the dyspnoea had returned, and as this

appeared to depend on partial closure of the opening, bycoagulum and a swelling of its sides, a small piece of cartilagewas removed. She was relieved at once, and the injectionswere ordered to be repeated, and one drachm of mercurialointment was rubbed in every three hours.The next day she was decidedly better, and breathed freely

through the opening. The swelling of the neck was softer,and is equal on both sides; there was no evidence of fluctua-tion. Her mouth was slightly affected by the mercury. Shewas ordered to rub in some mercurial ointment, and to con-tinue the injections. She became much worse on the dayfollowing; her difficulty of breathing increased, and she nowcomplained of great pain in the left side of the chest; herpulse became excessively quick, and her countenance was- expressive of the greatest anxiety. She died in the evening.On opening the chest, distinct marks of recent inflamma-

tion were visible in the pleura covering both lungs. In at-

tempting to remove the pharynx and oesophagus for examina-tion, an opening was made into a large, foetid abscess, fromwhich a quantity of most horribly stinking pus, mixed withair, escaped with great violence. On slitting these parts openafter removal, the fish-bone (that of the fin of a plaice, andabout an inch and a quarter long, thin, and with a sharppoint) was found at the back of the lower part of the pha-rynx, quite loose; the abscess extended some distance downthe oesophagus. In the anterior mediastinum there was aneffusion of lymph at the upper part. No opening or markof an opening was visible, indicating the situation at whichthe bone had penetrated the pharynx or oesophagus.

I confess that the result of this case distressed me verymuch; and I may perhaps be permitted to record the remarksI made at the time, as the justice of them is amply proved bythe result of a precisely analogous case, occurring withinfourteen months of the previous one. There could be no

doubt that the bone was pushed through the pharynx whenthe probang was used, and I have always questioned the pro-priety of employing this instrument in cases where sharp-pointed, foreign bodies are lodged in the pharynx or aesopha-gus. Indeed, I would say, that it never ought to be usedunder such circumstances. If the foreign body cannot beextracted by the oesophagus forceps, the round, button-likehook, attached by means of elastic steel, covered with ribbonto the other end of the probang, should be employed; as bythis, pins, and needles, and pieces of coin, have been repeat-edly extracted from even the lower part of the oesophagus.As this modification of the probang is not much known, Ihave sent a rough sketch of one in use at the London Hos-

pital.With regard to the treatment of this case, I suspected mat-

ter behind the oesophagus, but could not detect any fluctuationin the neck, as the fluid was close to the spine and behind thecarotid sheaths, and I could make no examination by the mouth,owing to its completely closed state. I therefore contentedmyself with relieving the patient from impending suffocation,leaving the opening of the abscess to the efforts of Nature.From the result of the examination after death, I said at thetime, that should a similar case happen, I would at any ratemake an explorative opening into the pharynx, and, if ne-cessary, to effect this I would extract some teeth; and, in theevent of matter being present, I would make an incision forits evacuation.CASE 2.-lilarch 29th, 1847: A woman of middle age applied

at the London Hospital to-day, in consequence of her havingswallowed a fish-bone on the 24th, which had stuck in herthroat. She was eating part of a plaice, when a bone passed.into the pharynx, which she could not remove. 6he had seenno medical man, and consequently no attempts had been madeto remove it but what she herself had made, and she said shehad removed two pieces of bone. She was labouring undervery great excitement, with considerable dyspnoea and diffi-culty of swallowing; her countenance was exceedingly anx-ious. She inclined her head forwards, and could not raise itwithout inducing an increased difficulty of breathing. Hervoice was altered in pitch, but was quite clear. The neck wasexamined, and a deep, indistinct, and diffused swelling wasobserved on the right side of and behind the trachea. I passedmy finger into the pharynx, but could not feel the bone; thepharynx seemed thickened, but no fluctuation could be per-ceived. I had little doubt that an abscess was forming behind.the pharynx and upper part of the oesophagus. Mr. Andrewssaw her with me, and advised the application of leeches withwarm fomentations and poultice; and she took a grain ofcalomel every four hours.31st.-She is worse in every respect; her countenance is

exceedingly anxious; the dyspnoea excessive; dysphagia com-plete. The neck is swollen, especially on the right side; theoutline of the larynx and trachea being nearly lost. I passedmy finger into the mouth, and distinctly felt an elastic swellingin the back of the pharynx towards the right side, which Ihad no doubt was an abscess communicating with the swellingon the right side of the neck. Mr. Andrews and Mr. Lukecoincided in this opinion. It was therefore determined tomake an opening at once: this was readily accomplished bythe tonsil lancet, or pharyngotome,gnided on the left forefinger.About two ounces of most foetid pus immediately gushed out;this in passing over the glottis excited a good deal of suffoca-tive cough, but she was very soon relieved, and the internalswelling as well as the external, subsided.

April 1st.-She is in every respect better; and has spat upa considerable quantity of stinking matter; the pain in herchest, of which she had previously complained, is gone. Shetakes beef-tea, and wine with sago.,

2nd.-All urgent symptoms have subsided; she spits up aquantity of foetid matter, and coughs up mucus in small quan-tities. A probe is ordered to be passed daily to keep open theorifice in the pharynx.’, It would occupy too much time to give a detailed account ofthe progress of this case from day to day, and a general de-scription of her condition will probably be sufficient.

After the first few days, in which she appeared progressingvery favourably, she became gradually much weaker; shespat up a large quantity of matter, of the most disgustingodour; she was troubled with constant cough, and her neckcommenced again to swell; she also complained of a prickingsensation in the neck. The fish-bone could not be felt. Sheseemed, indeed, to be gradually sinking, like a person dyingof phthisis. The abscess could still be evacuated withoutdifficulty, especially by the introduction of the probe or thefinger; but the escape of the matter was not easy, independent