Experiments on Animals. Stephen Paget
Claude Bernard: it is no wonder that Sir Michael Foster says that de Graaf's work was "very imperfect and fruitless." So late as 1840, there was yet no clear understanding of the action of the pancreas. Physiology could not advance without organic chemistry; de Graaf could no more discover the amylolytic action of the pancreatic juice than Galvani could invent wireless telegraphy. The physiologists had to wait till chemistry was ready to help them:—
"Of course, while physical and chemical laws were still lost in a chaos of undetermined facts, it was impossible that men should analyse the phenomena of life: first, because these phenomena go back to the laws of chemistry and physics; and next, because they cannot be studied without the apparatus, instruments, and all other methods of analysis that we owe to the laboratories of the chemists and the physicists." (Cl. Bernard, Phys. Opér., p. 61.)
Therefore de Graaf failed, because he got no help from other sciences. But it cannot be called failure; he must be contrasted with the men of his time, Lindanus and Bartholini, facts against theories, not with men of this century. And Claude Bernard went back to de Graaf's method of the fistula, having to guide him the facts of chemistry observed by Valentin, Tiedemann and Gmelin, and Eberlé. His work began in 1846, and the Académie des Sciences awarded a prize to it in 1850:—
"Let this vague conception (the account of the pancreas given in Johannes Müller's Text-book of Physiology) be compared with the knowledge which we at present have of the several distinct actions of the pancreatic juice, and of the predominant importance of this fluid not only in intestinal digestion but in digestion as a whole, and it will be at once seen what a great advance has taken place in this matter since the early forties. That advance we owe in the main to Bernard. Valentin, it is true, had in 1844 not only inferred that the pancreatic juice had an action on starch, but confirmed his view by actual experiment with the juice expressed from the gland; and Eberlé had suggested that the juice had some action on fat; but Bernard at one stroke made clear its threefold action. He showed that it on the one hand emulsified, and on the other hand split up, into fatty acids and glycerine, the neutral fats; he clearly proved that it had a powerful action on starch, converting it into sugar; and lastly, he laid bare its remarkable action on proteid matters." (Sir Michael Foster, loc. cit.)
Finally came the discovery that the pancreas—apart from its influences on digestion—contributes its share, like the ductless glands, to the general chemistry of the body:—
"It was discovered, a few years ago, by von Mering and Minkowski, that if, instead of merely diverting its secretion, the pancreas is bodily removed, the metabolic processes of the organism, and especially the metabolism of carbo-hydrates, are entirely deranged, the result being the production of permanent diabetes. But if even a very small part of the gland is left within the body, the carbo-hydrate metabolism remains unaltered, and there is no diabetes. The small portion of the organ which has been allowed to remain (and which need not even be left in its proper place, but may be transplanted under the skin or elsewhere) is sufficient, by the exchanges which go on between it and the blood generally, to prevent those serious consequences to the composition of the blood, and the general constitution of the body, which result from the complete removal of this organ." (Prof. Schäfer, 1894.)
Here, in this present study of "pancreatic diabetes," by Dr. Vaughan Harley and others, are facts as important as any that Bernard made out: in no way contradicting his work, but adding to it. The pancreas is no longer taken to be only a sort of salivary gland out of place: over and above the secretion that it pours into the intestines, it has an "internal secretion," a constituent of the blood: it belongs not only to the digestive system, but also, like the thyroid gland and the suprarenal capsules, to the whole chemistry of the blood and the tissues. So far has physiology come, unaided by anatomy, from the fantastic notions of Lindanus and the men of his time: and has come every inch of the way by the help of experiments on animals. Professor Starling's observations, on the chemical influence of the duodenal mucous membrane on the flow of pancreatic fluid, have advanced the subject still further.
VI
THE GROWTH OF BONE
The work of du Hamel proved that the periosteum is one chief agent in the growth of bone. Before him, this great fact of physiology was unknown; for the experiments made by Anthony de Heide (1684), who studied the production of callus in the bones of frogs, were wholly useless, and serve only to show that men in his time had no clear understanding of the natural growth of bone. De Heide says of his experiments:—
"From these experiments it appears—forsan probatur—that callus is generated by extravasated blood, whose fluid particles being slowly exhaled, the residue takes the form of the bone: which process may be further advanced by deciduous halitus from the ends of the broken bone."
And Clopton Havers, in his Osteologia Nova (London, 1691), goes so far the wrong way that he attributes to the periosteum not the production of bone, but the prevention of over-production; the periosteum, he says, is put round the shaft of a bone to compress it, lest it grow too large.
Du Hamel's discovery (1739–1743) came out of a chance observation, made by John Belchier,[4] that the bones of animals fed near dye-works were stained with the dye. Belchier therefore put a bird on food mixed with madder, and found that its bones had taken up the stain. Then du Hamel studied the whole subject by a series of experiments. To estimate the advance that he gave to physiology, contrast de Heide's fanciful language with the title of one of du Hamel's papers—Quatrième Mémoire sur les Os, dans lequel on se propose de rapporter de nouvelles preuves qui établissent que les os croissent en grosseur par l'addition de couches osseuses qui tirent leur origine du périoste, comme le corps ligneux des Arbres augmente en grosseur par l'addition de couches ligneuses qui se forment dans l'écorce. Or take an example of du Hamel's method:—
"Three pigs were destined to clear up my doubts. The first, six weeks old, was fed for a month on ordinary food, with an ounce daily of madder-juice—garance grappe—put in it. At the end of the month, we stopped the juice, and fed the pig in the ordinary way for six weeks, and then killed it. The marrow of the bones was surrounded by a fairly thick layer of white bone: this was the formation of bone during the first six weeks of life, without madder. This ring of white bone was surrounded by another zone of red bone: this was the formation of bone during the administration of the madder. Finally, this red zone was covered with a fairly thick layer of white bone: this was the layer formed after the madder had been left off. … We shall have no further difficulty in understanding whence transudes the osseous juice that was thought necessary for the formation of callus and the filling-up of the wounds of the bones, now we see that it is the periosteum that fills up the wounds, or is made thick round the fractures, and afterward becomes of the consistence of cartilage, and at last acquires the hardness of bones."
These results, confirmed by Bazan (1746) and Boehmer (1751), were far beyond anything that had yet been known about the periosteum. But the growth of bone is a very complex process: the naked eye sees only the grosser changes that come with it; and du Hamel's ingenious comparison between the periosteum and the bark of trees was too simple to be exact. Therefore his work was opposed by Haller, and by Dethleef, Haller's pupil: and the great authority of Haller's name, and the difficulties lying beyond du Hamel's plain facts, brought about a long period of uncertainty. Bordenave (1756) found reasons for supporting Haller; and Fougeroux (1760) supported du Hamel. Thus men came to study the whole subject with more accuracy—the growth in length, as well as the growth in thickness; the medullary cavity, the development of bone, the nutrition and absorption of bone. Among those who took up the work were Bichat, Hunter, Troja, and Cruveilhier; and they recognised the surgical aspect of these researches in physiology. After them, the periosteal growth of bone became, as it were, a part of the principles of surgery. From this point of view of practice, issued the experiments made by Syme (1837) and Stanley (1849): which proved the importance of the epiphysial cartilages for the growth of the bones in length, and the risk of interfering with these cartilages in operations on the joints of children. Finally, with the rise of anæsthetics and of the antiseptic method, came the work of Ollier, of