Medical Observations

by Thomas Browne

Source Brit. Mus Sloane MS No. 1848

On anatomy

The subjects for anatomie in most parts of Europe are of bodies of persons hanged, wherein there seemeth to bee no considerable impediment in the exploration of parts, butt in the parts about the throat. To avoyd this inconvenience: some commend bodyes drownd, & Galen for that purpose made use of drowned apes that the parts about the neck might be more cleare & discoverable, butt thereby the inward parts are distended & relaxed by the water. Some agayne have commended poysoning, as Fallopius delivers they used that end to poyson malefactors at Pisa; butt if they used corrosive poysons there may be also inconvenience in that way. In old time, as Galen relates, the physitians dissected the bodies of German souldiers killed in the warre, butt that was also inconvenient, the parts being wounded, mangled, & most of the blood runne out. At Paris they sometimes, though more rarely, cutt up bodies of malefactors broken on the wheele, for their leggs & arms are broken & bruised, & the blowe which is given them on the brest makes a great contusion & disordereth the pectorall parts. So that the most generall practise in Europe in publick Anatomies is upon the bodyes executed by suspension. The election & choyse of a fitt body hath been consideration of Anatomists , & this they desire might bee. Butt this cannot bee strictly observed in all poynts in publick anatomies, where they make use of the bodyes of malefactors & such as can bee obtained for such administration. The subjects in most parts of Europe are bodies of persons hanged, by which kind of death the most considerable disadvantage is made on the parts about the throat. this inconvenience is avoyded by bodies killd by drowning, & Galen made use therefore of drowned Apes, monkeys, drills, baboons & animalls of the Ape kind, butt thereby the inward parts are often distended & relaxed by the water. Some have made use of bodies poysoned, as Levinus Lemnius delivers they did formerly in Italie, giving unto malefactors condemned .. dragme...ant 3 in wine, whereupon there ensued no dissipation of humor or spirits, butt all found fayre upon dissection. So that the generall practise in Europe is the same with ours this day, to dissect the bodies of persons hung in publick executions, & what impediments wee shall find in parts in the neck & throat, collar & parts contained therein wee shall find when wee come to discourse of some parts thereof.

Lungs

Observe the membrane of the lungs whether it bee very porous as Blasius delivers. And though it often adheareth unto the pleura, yet such persons complaine not much of shortnesse of breath, because the lungs and the Thorax have one motion and move together. That the head of a man is about the fourteenth part of the whole body in wayght. The lungs taking up so considerable part of the brest, it may seeme something strange that that breast may bee perced or runne through or pierced transversely through & yet the lungs escape & have no hurt, which may happen when the thrust is made in the expiration or when the lungs subside.

How the ancient martyrs which were crucified with their heads downe and, as is delivered in St. P. & St. Andrew, could live so long under an inverted position of the heart, the heart pressing upon the vessells & inverted circulation of the blood, the blood in the veynes of the head circulates with great difficultie upward.

Pericardium

Tis rare to find this part deficient. Columbus observed once a body at Rome which was without a pericardium, butt the same person was very much bubject to swounding of which hee at last dyed. Dr Lower hath also writt well de pericardio. And if hee hath not abserved whether the water therein being heated and a little evaporated will coagulate and gellie like that from blistering plasters in the skinne, you may trie it. After the uses delivered of it in ther body, few uses it surely hath out of the body. Only it may bee observed that as mens hearts are commonly in their purses, so many of the countrie people taking advantage of the figure and toughnesse of this part make little purses hereof and carry their money in it: The pericardium in man is peculiarly different in man from other animals in 2 considerations, that is in that it is not fatt and in that it is annexed to the diaphragma or midriffe. Death is expressed by expiration, and men are sayd to expire when they dye, because Spiration or breathing begins by inspiration, and endeth by expiration. this may hold in naturall deaths: butt in suspension, chaking, and violent stranlinge of animals it may happen otherwise. For they may bee surprized and their breath stopped up, ether in or at the end of their inspiration or drawing in of their breath, and when it so falleth out, there may bee also great contention and labour in the body dying and probably somewhat different then in the common way.

Navel

Whether the navell bee the center of the whole body hath been disputed by some, butt to no great advantage unto physick, butt the same may bee allowed if wee measure it by a circumference drawne about the fingers & toes when the armes & leggs are stretched out.

It is sufficent that it is the center or very neere it of the lower venter, not contained in any other part of the body whereof there is butt one, nor in the back as the American writers deliver that the Mexican hogs have the navell aside of the spine in the back. Butt in the abdomen & middle thereof, whereby the umbicall veyne and arteries are at a covienient distance not farre from there trunck, and when it dryeth up serves to good uses in those parts of the bodie.

The navell is more conspicuous in man that in other animals, allthough the urachos in them make a part as communicating with the Allantiodes or urine bladder which is not in man, & this may happen to bee so discernable in man not only from the barenesse of the skkinne, butt from the ligation which is made upon it before it bee cutt off, & a thick skinne which after covereth it. For in quadruped beasts the funiculus being bitt off, gradually rotteth away till it cometh to the skinne & so maketh no umbo or readily visible bunch as in man.

Ear

Source Sloane MS 1849

We are now to speak of the eare and to deliver (enquire into) the severall parts therein with their actions & uses, wherein wee find some discouragement from famous Anatomists & some difficultie in the enquirie into it or consideration of it, for Vesalius complains that the manner of hearing is obscure & hee is not satisified therein, & most have been ignorant of the constitution of the organ of hearing. Valerius ab Aquapendente & Julius Casserius, who have taken much payne therein, complayne of difficultie & obscurity. The administration is also difficult from the hardnesse & fragilitie of the bones, wch therefore requires the more often repitition of the search into it.

It is also somewhat the more obscure because, in the dissecting of bodies wch dye of diseases, this part is little enquired into, & in deaf persons, either from birth or by age or disease, men have not been active to enquire into this part whereby they might the better discover the causes of deafness. However this noble organ is not to be passed over without a particular description.

The eare is divided into the outward & inward: the parts outward or Auricula hath been divided into many names & more then all are considerable, some whereof are requisite to bee knowne. This part is called Auricula, the superior part called by Aristotle innominata, is by the later writers named pinna or ala, the hollowe and cavernous part whereof is called cavernata pinnala and scapha or navicula by Casserius: the exterior circumference of the ala, or the whole circumduction, wch compasseth the concha, is the Anthelix. The cavitie in the middle of the ear concha. The very hole in it meatus Audiorius: the depression or gutter by wch the eare sometimes runnes ,sinus conche . that which from the end of the Temple is a little elevated above the hole of hearing Tragus or hircus. The part opposite unto it Antitragus.

The little half orbe made by the Tragus and Antitragus. The lower & pendulous part of the ear is called Lobus: the superior part cicada, because on this part perforated the nobler Athenians weare the figure of a grassehopper.

In the punishment of loosing the eares a part of the pinna & Helix is cutt of: in the Rickets the concha is cutt and in the toothache sometimes seared. In headaches & Rheums the Lobus is perforated & a Laureola leave, or black hellebore roote putt into it till the part inflameth & wch is commended by Bartholinus.

The outward eare is very subservient unto the inward & sense of hearing, for it collects & gathers in the transient sounds & leads them into the meatus auditorius, or hole of hearing, so that where this is wanting either by mortification as in cold regions or cutt of, there is a sensible defect in hearing. It is usually determined that where an eare is cutt of there is comonly a noyse in it resembling the gushing of water: if this bee generall, it is the more unreasonable to croppe horses & doggs, to cause an impediment in hearing.

They are immovable in man, or noe very litle motion, although there bee divers muscles belonging to this organ and wch may the lesse performe any motion because in children they are bound close for some yeares, butt in many animals they are very movable that being prone they may bee connected to evert part from whence the sound cometh, so that in some quadrupeds they are very movable as in horses, in some very litle as in Apes, in others not at all or not perceptible as in man.

The eare according to the old observation made by Aristotle is placed in the same circumference with the eye, accounting the center from the vertex of the head, where if one foot of the compasse bee placed, a line drawne by the other will interesect both the eye & the eare. Butt in quadrupeds the eare is placed high, for convienience to avoyd the incommodities in the holding downe their head & feeding upon the ground, & the avoyd the convenience in sleeping wch long eares would afford when they sleepe on their side & laye upon one side of their heads.

The hole of hearing is made with an oblique cavitie whereof a part is called the alvearium, or wherein lodgeth the sordes & excrements of the eare commonly called the eare wax,cerumen.This proves of some use as entangling small insects wch may creepe into it & also dust & small bodies which might offend the eare. This is made by exudation of the litle branches of the carotides Arteries, butt if it corrupteth causeth violent achings & sometimes scabs in the eare. The same is found also in the eares of beasts, butt their eares being movable they shake it out & gett that forth wch men are able to pick out by instruments or by the lesser finger, call'd therefore Aurcularis. It is saline excretion collect there from the color & tast. If it growes hard & concreted it hinders the hearing, & is therefore to bee separated & washed out by syringe & injection.

You have found of many remarkable parts of this noble organ. You may observe in some a singular condition. You may find the driest membrane of the body, the Tympane. You may find the least of muscles wch joyneth , the malleus & incus. Heere you may also see a parcell of the smallest bones, the incus, malleus & stapes, and especially the fourth small bone at the begining of the stapes if you admitt of it with Sylvius for a distinct bone, & may consider beside their uses the same peculiar qualities differing from other bones in that they encrease not & in that they have no periostium, & heere you may also observe the hardest bone called therefore the os petrosum or the stony bone, & in some fishes this bone is very remarkable as in the manati, whales, & sea horses.

Skin

A greater division of mankind is made by the skinne then by any other part of the body, that is into white & black, or negros, which are very considerable part of mankind & differenced from others not only in the skinne, butt noses, lipps, hayre of the head & thicknesse of the skull, & their skinns not only remarkable in the colour butt the smoothnesss though it had been oyled without or had more then usuall oylinesse under it, whom, notwithstanding, the scarres of the skinne are white, & though black may have the yellowe Jaundis & take fevers.

In many, especially yong persons, are,as 'tis usually named, goose skinned, wherein the same parts are a litle elevated, and some I have heard an odde observation that such as have have such skinns have not had the Lues venera.

Wee may read of hayrie hearts & so it is verified in hayrie sanguineous animalls, and Aristotle hath found butt one exception among them, that is in the hayre & some wch have hayre on the inside of their lipps.

As it affordeth a perspiration & discargeth the sweat & exhalations of the bodye...it seems close & [...], yett it is very porous & as observations of Sanctorius first confirmed it, the exhalations made of... insensible perspiration amounts to a greater wayghy then those by urine & seidge.

And therefore also when the humors are attenuated within & pores made more open without, the cutaneous discharge are aboundantly made by stones, and also in hott minerall baths & the roughnesse & hashnesse of the skin corrected by temperate soft lotions. What perspiration fishes, who live always in coole water, have, is uncertain, butt they must also have their effluviums, & how Cola, the famous Sicilian swimmer, who lived many dayes together in the sea, could endure such abatement of perpiration as the cold water maketh, it addeth unto the wonder of that course of his life.

To bee the primarie instrument of Tactus or feeling & thereby to distinguish of the Tactile qualities of heat, cold, moyst, drye, smoothnesse & the like, for though there bee a sense of feeling in inward membrane parts, yet the primarie & generall organ is the skinne wherein the nerves are dispersed, & some parts of the skinne more sensible then others, as the thinner parts, the hands & fingers, & some tempers more exquisite then others, & commonly thought to bee more exact in the spider then in man.

To seperate the cuticula by fire or hott water.

Whether a vesication will do anything upon a dead cold body.

To trie whether the water in the pericardium will coagulate & growe thick like as that wch comes from a vesicatorie.

The art of Tagliatiotus in his Curtorum Chirurgia is exercised upon this part.(Tagliacozzi, Gaspare De Curtorum Chirurgia per insitiionem Venice 1597)

The cutis, consisting of many fibrous particles & membranes, hath a signall propertie to make glue, which though practised in other animals, as in the making of Taurocolla or ox glue, yet the same might bee afforded from the like artificiall proceeeding with mans skinne.

Aristotle observes that there is humor mucrosus, in the skinne whereupon it hath an aptitude to make glue...in ox glue or Taurocallo & the like might probably bee made from mans skinne. Very thick & lasting lether is made from it.

Wee had a like experience in a body which had been buries some hundreds or yeares in St. Pauls, as I have observed in the vault of the Cordiliers at Tholouze, as in dryed bodies in the sows, as in the Egyptian mummy when the skinne is taken off, and as in our own country i have seen a ratt which was found in a wall above 20 yearres and... is the back of the body, so in the... dried bodies & the Egyptian mummy it perfectly resembleth the bark of a tree.

Tails

In many animals the spine is prolonged & extendeth into a tayle wch consisteth of small spondyls as in horses,doggs, monkeys. In horses tis usuall to dock them:there are 17. Tis usuall with us to dock them & cutt off the same to make their hinder parts more full & spredding, butt not without some inconvienience unto them, for one use of the tayle is to help them to their turning,& to brush off flies & molesting insescts by the hayres. And therefore in most parts of... & a great part of Europe they dock them not, butt sometimes handsomely make them up, & they do not only not cutt them off, butt for the better grace colour their maynes 7 tayles with the tincture of Alcanna Cua. ther are 17 ricks in the tayle. Tis usall to dock them. Pliny reports of some men with tayles in India & there hath been some rare examples of men with tayles. Birds have a curious part, uropigeum or rump, whereon fethers growe, wch serveeth the use of a tayle. some men have had tayles. Aristotle sayeth that the tayle of a snake cutt off will growe agayne. i have observed the same in a green lizard; butt the greatest wonder is that tayles shold turne into leggs, as they do in the Gyrinus or Tadpole, wherein after a litle time the tayle splits or divideth, & maketh their hinder leggs.

Stomach

Aristotle in his historie of Animals sayth of the stomack of man in Scaligers translation Humanus Ventriculus canino persimilis est: paulo ipso intestino major. the stomack of a man is very like that of a dogg & a little bigger than the gutt. This if playnly taken is so wide, so irreconcilable unto truth, that I must bee fayne to say, as Scaliger hath done upon some other passages,utinam hoc non dixisset philosophs, Quomodo hoc...nescio. And therefore Scaliger takes the boldnesse to say, the stomach is not much bigger than the gutt when it is four times bigger than the greatest gutt.

It might looke somewhat more like unto truth if it bee sayd that the stomack is little bigger than the largest gutt, that is in capacity, or will containe more than the whole body of the colon, though that gutt is larger & hath advantages in its length: of the capacity of the stomack Riolanus then writeth.

Boulima

Source Bibl. Bodl. Rawl. Letters D58 Communicated to the Royal Society through Dr. Edward Browne 1st February 1671

There is a woeman now Living in Yarmouth named Eliz. Michell, an hundred and two yeares old, a person of 4 foot and an half high, very leane, very poore, and Living in a meane roome without ordinary accomodation. Her yongest sonne is 45 yeares old; though shee answers well enough to ordinary Questions, yet shee conceaves her eldest daughter to bee her mother. Butt what is remarkable in her is a kind of boulime or dogge appetite; shee greedily eating day and night all that her allowance, freinds and charitable people afford her, drincking beere or water, and making litle distinction of any food ether of broaths, flesh, fish, apples, peares, and any coarse food in no small quantity, insomuch that the overseers of late have been fayne to augment her weekly allowance. Shee sleeps indifferently well till hunger awakes her and then shee must have no ordinary supply whether in the day or night. This is the oldest example of the Sal esurinum chymicorum, which I have taken notice of. Though I am ready to extend my charity unto her yet I should bee loath to spend a peece of Ambregris I have upon her, and to afford her 6 graines for every dosis, till I found some effect therof, though that bee esteemed a specifick in her condition.

Quinine

Source Brit. Mus. Sloane MS 1895

Concerning the Cortex Peruvianus china Chini or Quinana Peruve

I am not fearfull of any bad effect from it nor have I observed any that I could clearly derive from that as a true cause: it doth not so much good as I could wish or others expect, but I can lay no harme unto its charge, and i have knowne it taken twenty times in the course of a quartan. In such agues, especially illegitimate ones, many have died though they have taken it, but far more who have not made use of it, and therefore what ever bad conclusions such agues have I cannot satisfy myselfe that they owe their evell unto such medicines, but rather unto inward tumours inflammations or atonie of partes contracted from the distemper.