Dr. Parry on Mr. Bell's Anatomy. the pulse of the femoral artery with my forefinger, I could not command its blood with the whole strength of my body, but have feen it, with horror, ruth as freely as if my hand had not been there." Vol. 2, P. 256, 257 There is nothing new under the fun. Of the truth of this general principle, our author affords an excellent illuftration. It is not new for a man to treat with ridicule what he has not the opportunity, the capacity, or the inclination to underftand. If Mr. BELL had read the paper which he criticifes, he would have feen, and then poffibly might have believed, on my affertion, that my idea of compreffing the carotid arteries was fuggefted by the actual phenomena of the difeafe before me, and not by the tales which he repro bates; whether thofe tales were well or ill-grounded. But the knowledge of this fact would not have fuited his purpofe. It would have taken away an opportunity for much declamatory invective. It would have been fomething, new to Mr. BELL under the fun. In reality, at the time of my writing the paper alluded to, I had never read thefe hiftories and remarks in Galen, Ru fus Ephefius, Morgagni, or any other author; and if I had, I fhould not have formed from them the conclufions which I have related. Phyficians, in all fuc ceeding ages, have read them without any fuch application; nay, Mr. BELL himself, who cannot, furely, be fufpected of giving another more credit for faga city than he does himself, has ftudied them with great attention; and yet, at this moment, he is fo far from having deduced from them any valuable conclufions, that he derides the important theory. to which he ignorantly afferts that they have given birth. It is true, that I have mentioned ftupor and fleep, as produced by compreffion of the carotids. I have mentioned them, because I saw them; and could I have anticipated the critique of Mr. BELL, I fhould not have omitted to mention them, out of compliment to the fcepticism of himfelf, or any other human being. Now, however, that he cannot controvert the fact, he may congratulate himself on having found fomething new under the fun. So much for the origin of this difcovery. Next as to its effects; as Mr. BELL has, in the first paragraph which I have quoted, accufed me of drawing from a fource which I had never vilited, fo in the fecond he afcribes to me words which I have never employed, and deductions 349 which I have never formed. · He makes me fay that I can entirely comprefs the carotids with my finger and thumb. This is a total mifreprefentation of my words, which muft greatly mislead all those who are inclined to repeat the experiment. In reality, after having remarked the difficulty of compreffing one carotid in men ; and the ftill greater difficulty of compreffing both, efpecially in a flate of convulfions, I add, "In women, however, who have gene rally longer and flenderer necks than men, one can often, without difficulty, produce a complete compreffion of the artery against the vertebræ of the neck," &c. "Medical Memoirs," vol. 3, p. 100. Inftead of the carotids, I fpeak of one carotid only; and inftead of uting my finger, or my finger and thumb, for the purpofe of preffure, I have never been able effectually to fucceed in any other way than by ufing the thumb only, while the neck is at the fame time kept firmly in its place by preffure on its back with the unemployed fingers of the fame hand. With me, who have probably made the experiment a hundred times as often as any other perfon, all attempts to make a competent preffure on an artery with my finger, have uniformly failed: Neither, it seems, have the effects of Mr. BELL in this way been more fuccesful. When he makes the experiment in a proper manner, the event may poffibly be different. But we will for the prefent fuppofe him to deny the poffibility, on any occafion, of completely compreffing with the thumb one carotid artery. The evidence on which I founded my affertion was, that in the inftances to which I alluded, all pulfation in the temporal artery was deitroyed by the compreffion of the correfponding carotid. But Mr. BELL informs us, that though he could fupprefs the pulfe of the femoral artery with his fore finger, he could not command its blood with the whole strength of his body (I fhould be curious to know how he applied the whole ftrength of his body by means of his fore finger), but faw it with horror rufh as freely as if his hand was not there. Does he in the first part of this fentence mean, that he fuppreffed the pulfe with the compreffing finger, fo as no longer to feel it with that finger, in the point where the compreffion was made? He certainly cannot have this meaning. The conclufion would be too frivolous. He must with us to understand, that when he had compreffed the artery above, fo as to obliterate the pulfe below, the blood still continued to rush from b 350 Dr. Parry on Mr. Bell's Anatomy. as ftrong as if there was no preffure. Credat Judeus Apella! Till I have myself seen a firm compreffion on the femoral artery with the finger, or any other fixed power, obliterate the pulfation of the popliteal artery, and yet the blood rush through that artery when divided, as freely as when the preffure fhall have been removed, I fhall beg leave to doubt. I will not affront your readers by demon. ftrating, that fuch an affertion cannot be true. Mr. BELL must have been deceived. If the fame quantity of blood paffed through the artery in a given time as before, he could not have diminished its area by compreffion. That the femoral artery, deeply feated as it is in its leaft covered part, and imbedded in yielding, mufcular, and cellular fubftance, hould be much affected by the compreffion of the finger, is what indeed I should not à priori have expected; though Mr. BELL himself, after having, as from his own experience, denied the poffibility, in the words which I have quoted, acknowledges,on a fubfequent occafion, page 456, that "though it is not an eafy thing, it is, perhaps, not impoffible." To obliterate the pulle below from compreffion above, is, on many occafions, fufficiently eafy. Leaning the arm over the back of a chair will top the pulfe in the radial artery; and the fame thing has often been done by perfons, for fraudulent purpofes; merely by preffing the inward part of the humerus ftrongly against the fide. The effect of a tourniquet in this view, even on the largest arteries to which we have accefs, is tolerably well known to Mr. BELL; and I, who do not profefs furgery, am acquainted with no criterion by which we are to judge that the purpose of that inftrument has been anfwered, but the failure of the pulfe in fome part, or branch of the artery more diftant from the heart. It is poffible that the flow of blood through the compreffed artery, is, in neither of these cafes, entirely impeded; and whether the area of the carotid artery can be fo diminished by the preffure of the thumb, as to anfwer the purposes of a furgical operation, I will not pretend to decide; and I prefume no one, except in a case of fudden neceffity, will be hardy enough to try. It is, however, true, that I have often moft evidently moderated bleeding at the nofe by imperfect preffure for a few feconds on one carotid; which is as much as can reafonably be expected by thofe, who confider that fome of the arterial branches distributed within the nofe are derived from the internal carotids, which anastomose with each other, and within the vertebral arteries with the cranium. Mr. BELL quotes Acrel, who fays, that he stopped a hæmorrhage of the femoral artery, after every other mea fure had failed, by ftrongly refting with his thumbs against the external iliac in the groin. Page 456. The compreffion of the carotid is at least as practicable as that of the external iliac artery, not only on account of the interpofition of very little foft fubftance, but because the vertebræ of the neck form an extenfive, hard, and immoveable pillar, against which the preffure may be made. That fome circulation continues in certain cafes of Syncope, whether from furgical operations, or other causes, there is little doubt. I will not however admit that what Mr. BELL calls "a hysterical faint," is a cafe of Syncope; the face in that ftate, is all the while more or lefs ruddy and warm, the respiration free, the pulse good, and the circulation in other refpects perfect; it is an example of ftupor, of the fame nature as that which follows the Epilepfy. I beg leave to point out to Mr. BELL, that this diftinction between these two cafes, founded on the actual phenomena, is a third instance of fomething new to him under the fun. When I fpoke of compreffing the carotid arteries, it was with a view to fhew that manydifeafes arife from too great a momentum of the blood, through thofe veffels into the head; and I pointed out the effects which I had obferved from preffure on the caro tids, and certain beneficial conclufions in practice, which had refulted from those obfervations. Whether I could entirely intercept the blood that paffed through the carotids to the head, or not, was to me of no importance. For my purpose it was fufficient, that I could intercept a confider able part. All this Mr. BELL does not appear to have understood; but, begging the queftion that the whole was a filly old tale, tantalizing by an affectation of novelty, proceeds to examine the merits of the operation, as it might be applied to Surgery, of which, at the time, I never thought. This irresistible direction of all the ideas to one point, is often a very ferious malady. But when the object is innocent, the patient is fuffered to walk abroad unattended. Every one has heard of Jedediah Buxton; who, though unable either to read or write, multiplied nine and thirty figures into each other by memory only. In London, they took him to Drury Lane, and to St. Andrews Dr. Parry, of Bath, on Mr. Bell's Anatomy. Church in Holborn. It might be expectthat he was aftonished at the fublime ombinations of mufical chords in the lind Stanley, and melted by the unafected pathos of Garrick. Nothing lefs. He made himfelf mafter of the exact number of words, fyllables, and letcers pronounced by Garrick; but the apid execution of Stanley defied his Dowers of reckoning, and he returned home abashed, as under irretrievable difgrace. Jedidiah Buxton was an Arithnetician. Mr. BELL is an Anatomist. Although that Gentleman could not advert to the confequences which I drew from the compreffion of the carotids, I muft beg leave to repeat them for his benefit. I learnt from it, that all nervous difeafes depend upon irritation of the brain, either from mechanical stimuli, or the fulness of its veffels; and that in every conftitution, without exception, they are to be cured, if at all, by thofe means which diminish the flow of blood to the head. I learnt from it, that all tonic medicines, as they are called, full diet, wine and all other cordials and general ftimulants, are injurious; and that the only efficacious remedies, are as low a diet as the digeftion will allow, uniform and gentle exercife, and perfeverance in evacuants, fedatives, and thofe remedies which are called febrifuge or refrigerant. = I inferred that, among the evacuants, the chief confidence was to be placed in bloodletting, not with a view of preparing for tonics, as recommended by Sydenham, nor in order to counteract accidental plethora, or = to relieve a particular fpecies of a genus, as by my late revered mafter, Dr. Cullen; but frequently, and in fimall quantities, as a radical, and generally indifpenfable remedy. And during eleven fucceeding years, I have had the fatisfaction (one of the greatest which the human mind can feel) of finding that my theoretical expectations have been infinitely more than anfwered by practical fuccefs. Thus a clafs of difcafes, which were before confi dered as incurable, are now as abfolutely within our power as the most obvious inflammations. Mr. BELL, if he would, or if he could, might have profited from the principles which I have laid down; and then he would have had no reafon to complain of my having inflicted on him the torments of Tantalus. Is it my fault, if his mind is its own tormentor? At prefent it feems that this practical fyftem of nervous difeafes is a thing news to Mr. BELL under the fun. Permit me, fir, to add with confidence, that when rft published, it was equally new to MONTHLY MAG. No.xxxi. 35x others ; for I will venture to affert, that no example can be produced, in which the practice had been defignedly employed," except in confequence of my own verbal communications to my friends of my fuccefs, in fome of thofe cafes to which I afterwards referred in my paper in the "Medical Memoirs." Excufe my thus dwelling on myself. I am compelled to do fo, left hereafter, when my method of cure in fuch difeafes comes into general ufe, as it certainly will, fome future Mr. BELL, envious of a difcovery which chance allotted to another, may rake out from amidst the duft and mould of a College library, fome dark paffage, in which he may develope my whole fyftem; and then, like his worthy predeceffor of the prefent day, exclaim, THERE IS NOTHING NEW UNDER THE SUN. With this gentleman, fo far as refpects myself in particular, I have now done. But I beg leave to add a few words on behalf of fcience in general. It is ufual with authors to difcufs grave fubjects in a grave manner; and one would have thought, that the importance of pathological inquiries would have fecured them from all admixture of levity. But Mr. BELL's conftitution is fuch as to defy all common rules of conduct. Almost in the fame page he dictates, and pouts, and fcolds, and laughs, and cries; and each fo immoderately, or in fo wrong a place, that one cannot avoid picturing to one's felf a fine lady in a fit of hyfterics. It may reafonably be hoped that age, and a little whole fome mortification,will diminish this irritability of Mr. BELL's nerves; and then, probably, medical fcience will owe much future obligation to the acuteness of his genius. I am, fir, &c. &c. Bath, April 22, 1798. C. H. PARRY. For the Monthly Magazine. A DIALOGUE IN EMPYREUM, L. Rfate, take me to thy embrace. OYAL 'martyr, brother of my With thee at least I am fecure of fympathy, the only alleviation my hard lot admits. C. Hail, brother! L. It comforts me that I have burft, although by death, my bonds, that I breathe not in the fullied prefence of thofe wretches whom I remember the dependants of my nod, the creeping flatterers of my rower, who won my confidence, like Dalila, to fhear me of my strength, and who have fince announced their influence over my people by a climax of Z z horrors 352 A Dialogue in Empyreum, between Louis XVI. and Charles I. horrors, by plunder, by affaffination, by regicide. C. If fympathy be thy only with, feek it rather among the kings who have feared than among those who have undergone thy fate. A hundred and fifty years refidence in Empyreum is a marvellous corrector of impaffioned judgments and fierce resentment, when we have much converfed with men of other times. L. Was ever prince mifufed like me? Always diftinguished for love toward my fubjects; did I not employ Turgot to please them-the Americans to please them-call the States-General to please them-accept the conftitution to pleafe them; and for all this, their ingratitude annihilates my income, traduces my character, and as my fources of influence abate, they drag me from the throne to a dungeon, and thence to a fcaffold. C. Let us analyze the benefits you enumerated. About the year 1774, the philofophic fect of Phyfiocrates was already organized into a political body, which had friends in most of the great incorporations of France, in the chambers of commerce, the magiftracies, the parliaments. Some powerful families among the nobility, who pleafed not at your court, fupported this faction. L. Only the Rochefoucaulds-thofe kereditary heretics. C. A fedition broke out in the metropolis. You was alarmed, and accepted at their hands Turgot for minifter, under conditions which you fubfcribed, like a conquered enemy. Security was foon reftored, and reformation began. But Turgot having the weaknefs to believe, that the opinions of the wife will never be thofe of the people, continued the reftrictions of the prefs. He formed, therefore, no barrier of public opinion against court-mutability; and, as foon as the Parifians had forgotten politics, to enter into Rouffeau's quarrel about their mutic, Turgot found his fupporters purchafed, undermined, deterred, diftanced, diffipated--and had to refign. L. It was not I who difappointed this minifter of influence, but the management of the queen's advifers. C. France is not the only country which a double cabinet has condemned to fluctuating counfels. Your next minifter was NECKER, a man whom Turgot had oppreffed for writing in favour of limitations upon the corn trade-a moderate man in temper, in abilities, and in opinions. You chofe him because the Paris bankers would lend to no one elfe. His talents, as a financier, the enemy of your enemies applauded in the English parlia ment, whilft he was borrowing capital to pay the intereft of the French debt, and thus, by the accelerated operation of compound intereft, was fecuring that financial catastrophe. L. Which the church-lands and a tax upon noble eftates might easily have averted. C. Not expecting, however, the submiffion of thefe powerful orders to your authority, like vulgar bankrupts, you fummoned a meeting of your more notable creditors, relations, and friends, who advised the convention of the state; after which, even CALONNE dared not help you through without convoking them. L. Ah! C. Of all your boafted conceffions thus far, which of them could you have avoided? Which of them was even made with a grace? Which of them was not the obvious preference between two evils? L. The the declaring for the Americans. C. And you will be rewarded for it by. the generous pity of American and Englifh republicans. Yet, even in this cafe, was you not a little eager to bufy fome ftirring fpirits among the more gallant of your nobility? To avoid a civil, wage a foreign war, is an old adage of profligate state-craft. fo. L. Some people about me might reason C. The ftates met. Is there a fingle boon they owe to your generofity? Your people pulled down the Baftille, or you would have issued lettres de cachet againft their members. Your foldiers refufed their bayonets, or you would have overawed their deliberations, and have——— L. Not I, not I, others might wishC. In a word, you found that public opinion, and confequently public force, was at the command of thefe nationaj affemblies. They railed NECKER to the clouds when you wanted to difmifs him, in order to fhew him independent of you. Reftored at their bidding, they fuffered him to refume his pompous importance. L. A cuous proof of the caprice of popular affemblies. C. The conftituting a popular affembly! Yet De Retz faid to me, after the 4th Auguft, "you fee all great bodies are populace; when they are not puppets." L. Puppets!-are fenates ever fo? I feel that kings may- C. And fometimes, as in your cafe, should. Your velos, when exerted at the request of a party, always drew attention, even after your captivation. A Dialogue in Empyreum, between Louis XVI. and Charles I. 353 Without a party among your fubjects, you had long ceafed to be attended to. L. They feemed to prize my acceptance of the constitution. C. As if willing to revive an opinion of indefeasible right, when it was likely to operate in their own favour. Was it this which duped you into over-rating your refiduum of power to far, as to think you could withstand an adminiftration enjoying the confidence of the legislative affembly? Prince-prince! L. I only wished to second the Feuillant party, who were not, like the Jacobins, aiming at my very being. C. Had you taken the most defperate into pay, thele Jacobin minifters, like all others, would have endeavonred to ftrengthen an authority which made a part of their own. They would have erected their ftatue To the reflorer of French herty, which their antagonists voted you. They would have increafed a civil lift, which was to buy them creatures. But your eternal blind preference of whatever men promifed you most appearance of power, naturally led the people to believe, that even a conftitutional king would oppofe them all he could. L. And the accuried 10th of Auguft! C. The right of nations to decree the forfeiture of a crown, my good people of England acknowledged, you know, in 1688. L. But their motives C. Were chiefly to unfeat an adminiftration. Wildman, Fletcher, and the dinterefted friends of freedom, would have preferred James with a diminished prerogative, to William with an increated influence. Burthenfome churchmen of the time could not abide a mifcreant king, willing, perhaps, out of bigotry, to tolerate both Catholics and Diffenters. William, indeed, had the like with, but he knew better than to facrifice his crown to his liberality. L. I gave no grounds of alarm or provocation, religious or civil. C. The obitinate detention of a foreign guard, which the conftitution forbad, which the legislative affembly advifed you to difmifs, and which feemed likely to co-operate with the Duke of Brunswick, then rapidly approaching towards Paris; was this no ground of alarm, of provocation? A fovereign fhould never excite jealouly, if he cannot command acquiefcence. L. They imprifoned me in avowed contempt of my conftitutional inviolability. Atrocious, faithless moniters! C. I fhall not defend it. I expected that, at the meeting of the convention, you would have been liberated-informed with as much indifference as had you been a toll-gate-keeper, that your fervices were to be difpenfed with-counselled to pafs your carnivals at Venice-and fuffered to retire upon a pension, neglected and content. L. And content? You do not fufpect me of fuch vilenefs. C. If contentment were the wifeft courfe, why not? L. O but I had friends! C. You fuppofe then, that a strong party in the country would at any time have marfhalled around your name, would have affifted you to recover your fallen dignity, and to replace the fcutcheons of your nobility among the civic honours of the country. Elfe L. Surely I do. C. And if the members of the convention were alfo aware of the existence of this party-ir the fuperftition about kings had given way rather to an oppofite enthufiafin, than a national indifference for them-if the existence of a man believed to have innate, indwelling, or divine rights, was really dangerous to that unanimous fubmiffion to the newer powers, which could alone enable them to direct the public force with fufficient energy against the foreign foe L. You are not daring to palliate the laft act of our common ill-ufage. C. I think as ill as ever of fuch as thought by my execution to fecure perfonal impunity or individual advancement; but I have had fo much converfation with Hampden, Bradshaw, Milton, and the reft of that ftamp, that I begin to enter into the grounds of their party. L. Which were C. That, although no previously exifting law juftified my removal, yet that my acting in concert with perfons hoftile to the progrefs of popular influence upon government, which they call liberty, tended to defer the improvement of the conftitution-that opinions of hereditary right cannot, by their very nature, be compounded with, but muft either be allowed to establish their fuperftitions (the monarchy or feigniorage of certain families), which is unjust to the oppofite opinicns, or must be coerced in the exercife of their claims-that the fectators of nobility, having acquiefced in the fuppreffion of peerage, and thus concentered their wishes upon the retention of kingly power, would have no pretext to revolt against the more general will, if deprived of their only poffible leader-and that the backward minority of my fon ren222 dering |