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ysic, an Dispensary, and troublecorts he made generally at
almost universal ridicule-its very name could not be uttered withont exciting smiles and jests, and, if alluded to in a class-room, a broad grin was observed on the face of every student. The leading journal of those dars commenced its critical notice of Dr Bennett's monograph as fo.iows: - We are a little surprised that any one whose aim is the promotion of medical science, which we believe to be that of the author of this treatise, not mere personal notoriety, should take such pains in introducing to the notice of his brethren any single therapeutic agent." Then, during four pages which had for their object no censure, but simply to persuade the professional public that the oil was useless or inert; it concludes with expressing our fears that the oleum jecoris aselli will prove far from equal to the expectations which Dr Bennett's treatise is likely to excite in its faroor.”
Notwithstanding every species of discouragement, however, Dr Bennett persevered in recommending it to the favourable consideration of his medical brethren, and in his Lectures on the Practice of Physic, and especially in the Poly-Clinic which he established at the Royal Dispensary, he continued to demonstrate its usefulness. The correspondence and trouble lie undertook answering inquiries with regard to the oil, and the efforts he made to improve its manufacture in Scotland, though not likely ever to be generally appreciated, were at least eminently successful. Gradually its importance came to be recognised, for inasmuch as phthisis and other grave diseases were avowedly incurable, there could be no harm in trying a new remedy. Once arrived at this point its permanent adoption was secured, for we have never yet met with a man possessing any power of observation whatever, that after a certain time did not recognise its analeptic properties. In the autumn of 1847, Dr Bennett published an appendix to his work, since which time its employment in Scotland became general. In 1849 all his facts were confirmed by Dr C. J. B. Williams of London, and in 1851 the medical officers of the Brompton Consumptive Hospital, published a report giving the most decided opinion as to its good effects in phthisical and other scrofulous diseases. Since then the demand for cod-liver oil has become as great in England as it had previously been in Scotland, and now the consumption of it may be said to be enormous, its manufacture and sale at present constituting a most important branch of commerce. Such is the history of the introduction of cod-liver oil into the medical practice of Great Britain,
But when, in 1849, the good effects of cod-liver oil were, after a trial of eight years, generally acknowledged, the theory of its action became a subject of lively discussion. The theory contended for by Dr Bennett is founded upon the fact discovered by Ascherson, that oil and albumen, when brought into contact, always occasion a membranous coagulation of the latter, and that when
See Brit. and For. Med. Rev., January 1842.
- rubbed together they produce an emulsion. Introduced at a time
when histological knowledge was only entering into the domain of science, the importance of this fact could scarcely be supposed to impress itself favourably on the minds of medical men. That nutrition was in any way connected with so mechanical a process as the making an emulsion out of oil and albumen, seemed too absurd to be entertained for a moment; and even those who, at length, could no longer shut their eyes to its good effects in practice, continued to ridicule without mercy the histological theory which had been advanced to explain its modus operandi. The following good humoured distich and note, brought out at an annual dinner of one of our medical institutions, and since printed for private circulation, indicates the sort of objections entertained of this doctrine.
“ There Williams writes that Bennett has no merit,
To prove that oil and eggs our tissues cause ;
To think that human blood was salad sauce." How to Make a Structure. If we How to make Salad Sauce. -Put place a drop of oil and another of into a large basin the yolks only of albumen on a slip of glass, and allow two fine and very fresh eggs, carethe one to flow over the other, a pel fully freed from the germs, with a licle will be observed to have formed. little salt and cayenne, stir them well This, examined microscopically, pre together, then add about a teaspoonsents the appearance of a membrane ful of the purest salad oil, and work sometimes puckered and thrown into the mixture round with a wooden elegant folds. . . . If now we spoon until it appears like cream.unite the two drops by means of Modern Cookery by Eliza Acton, p. 113. friction, we form an emulsion.--Dr Bennett on the Structural Relation of Oil and Albumen, Monthly Journal, Sept. 1847.
Yet although it was for a long time difficult for those who had not followed the progress of physiological science to comprehend how the mixture of oil and albumen in the stomach and intestines could tend to the formation of healthy blood, a consideration of the constitution of the chyle appears to us to explain this matter without any difficulty. Thus, chyle is an emulsion formed by the union of oil and albumen derived from the food; and no one can doubt that, out of that chyle or fatty emulsion blood is formed. When, then, after giving the oil to emaciated persons, we observe that they become stronger, more muscular, and fatter, it requires little reasoning to prove that we must have added something to the chyle, through the chyle to the blood, and through the blood to the tissues. Again, when we examine chyle microscopically, we find it to be composed of exceedingly minute particles, or to consist of a molecular basis, which is soluble in æther, and therefore fatty, and that as it flows from the intestines towards the blood, through the mesenteric glands, and, lastly, through the thoracic duct, blood corpuscles may be seen to form in it. Hence, the molecular is a primary and evolving element, out of which the blood corpuscles and the blood itself are evidently formed. This view, modified as to one or more unimportant details, is the one which is in most accordance with physiology, and is most generally adopted.
This theory still finds many objectors, the latest of whom is Dr Black, who says of it
“ It may be urged that, were fat a primary and evolving element,' as considered by Dr Bennett, it would not be diminished in quantity as it flows along the lacteals; that nature would not thus all but destroy the very resources whence the nuclei of the tissues are to be drawn ; that it would exist in greater proportion in the blood ; that the quantity found in that fluid is manifestly insufficient to form with albumen the necessary nuclei for the proper nutrition of the tissues; that it would form a constituent part of healthy muscular fibre, and of other structures having a cellular basis of formation, and that, when found as a constituent part of such tissues, it would not be, as it invariably is, associated with disease. It seems, therefore, more consonant with facts to regard fat, absolutely considered as such, as taking no part in the formation and nutrition of tissues, than to look upon it as a primary and evolving element of such tissues.”—P. 146.
Here Dr Black has evidently misunderstood what is meant by “ primary and evolving element." In a note he tells us that he supposes it to mean an element which enters directly into the formation of tissues. But this, so far from being the primary, is really the ultimate element of histogenesis. By the primary element histologists comprehend the first morphological appearance which presents itself, and this is everywhere a mass of minute molecules and granules which, by uniting together, constitute primary nuclei, around which primary cells are formed. All these elements, however, are but temporary, and undergo successive elaborations, evolutions, and reformations, before they directly enter the tissues. The argument advanced by Dr Black, namely, that fat is not a primary evolving element, because it diminishes as it flows along the lacteals, is exactly that which every histologist employs to show how, by its transformations, it becomes prepared to form tissue. That oil may serve to form albumen, and that albumen may be transformed into oil, nobody can have any doubt who watches in an ovum the development of an embryo. Indeed, although we are willing to pay every attention to Dr Black's objections, and to give him credit for sincerity in expressing his opinions, it is impossible to overlook the fact, that he is not familiar with the great progress recently made in histology and embryology. He has been led away too far by the hypothesis of germinal centres, and, from what he has advanced, does not appear to us sufficiently to appreciate what may be called the molecular theory of morphology.
Passing, however, from these speculations, it may be asked, how is it that, if cod-liver oil operates in virtue of its oily or fatty matter, that any other oil or fat does not answer the same purpose? Now the fact is, under ordinary circumstances, the stomach and alimentary canal are capable of reducing all kinds of fat to the required fluidity and purity necessary for the formation of chyle. But there are a
certain class of cases where the digestive powers are evidently impaired, and cannot do so. We shall not at present enter into the theoretical views by which some have endeavoured to account for the peculiar form of dyspepsia in these cases, because we should thereby be led away too far. We may safely assume that there is such indigestion, and in the vast majority of cases a remarkable antipathy to eating all kinds of fatty, or, as it is called, rich food. It has indeed been asserted—and we find it is so by Dr Black—that tubercle frequently occurs without the slightest symptom of a dyspeptic character being present. If by this be understood that individuals who are not habitually underfed (as often occurs among the lower classes) become tubercular, and waste away, whilst the appetite remains good and digestion is perfect, we will venture to say the assertion is altogether opposed to experience. The statements of patients, indeed, would often lead a superficial examiner to conclude that their appetite and digestive powers are everything that could be wished ; but we need scarcely say that the hopeful and flattering accounts given by consumptives of themselves are not likely to deceive the sagacious physician, still less to be received by him as an argument for or against any particular theory. Our own notion, therefore, is, that in giving animal oils, we introduce an essential element of nutrition, already so prepared that it is rendered easily assimilable. Of this we are convinced, that it is in proportion to its capacity of being digested, and of forming good chyle, that its good effects are rendered obvious.
But why should cod-liver oil be more assimilable than any other kind of oil? This is a difficult question to answer. The vegetable oils, indeed, are more or less purgative, and have been largely tried, without producing any benefit. Many other animal oils have been employed, and, it is said, with some effect—for instance, neat's foot oil. We have given scate, shark, and dog-fish oil—for samples of which we hereby thank the donors—all with good effect; and we believe that these oils are little, if at all inferior to cod-liver oil. We have also given various kinds of genuine cod oil, which have been kindly forwarded to us from various parts of this country, and from abroad, and have especially to thank Mr Archibald of Newfoundland, Mr Fox of Scarborough, and Mr Hansard of London, for specimens recently forwarded to us.
We have no difficulty whatever in speaking of the rival claims of the different manufacturers of this substance, because we believein accordance with the views previously stated—that they are all good, and are medically of equal value. Yet these oils vary greatly in their physical properties. Here we cannot in justice forbear mentioning that the Messrs Parker, oil manufacturers in Leith Walk, have for many years—indeed long before Dr C. J. B. Williams spoke of the advantages of giving a pure oil-manufactured it as pure and tasteless as has been done by anybody. It is unnecessary for them to make their oil known by advertisement, for the simple reason that every drop they can produce is eagerly purchased by the druggists of Edinburgh. They were the first, as they are still among the best and cheapest producers of this substance. To meet the increased demand in England, however, an excellent, pure, and almost tasteless oil has been brought into the market, and that of Messrs Archibald and Fox have in these respects certainly never been surpassed. Those persons, therefore, who find, from experience, that they can take with greater ease those light and comparatively tasteless oils, may with great confidence employ any of them.
The notion, however, that a pale oil is superior to the brown kind, is most erroneous. Throughout Germany and the northern kingdoms of Europe the brown oil is preferred, and the assertion so readily made, that its more nauseous smell and taste prevent its introduction into practice, or interfere with its assimilation, is entirely opposed to the most extended series of facts. We can declare, from the result of no small experience, that not unfrequently the brown oil is retained on the stomach, when the light oil is not, and that children more especially, contrary to what may be supposed, in many cases prefer the brown to the more tasteless kinds. Many describe the brown oil as stimulating and acting like a cordial. The conclusion we have arrived at then, with regard to the superiority of one or other kind of oil, amounts to this, that that is the best which is most easily taken, retained on the stomach, and digested, and when we have to do with a capricious organ, experiment only can decide which that shall be.
It is only right, however, to give Dr de Jongh's view of the action of the oil, which is as follows:
“Our analyses have shown that cod-liver oil is a very compound remedy. We find in it fatty matters, biliary principles, iodine, phosphoric acid, phosphorus, butyric acid, gaduine, and several inorganic salts. To which of these principles, many of which are recognised as very active remedies, does codliver oil owe its salutary action in rheumatismal and scrofulous affections? Is it the iodine, to the fatty principle, to phosphorus, to other matters, or to the action of all these principles united ? If we consider that, in the diseases in which cod-liver oil exhibits an incontestible value, the digestion is augmented, the nutrition ameliorated, the secretions excited, the function of the lymphatic system revived, and lastly, that the ganglionic system is affected, we shall be easily convinced that it is not the biliary principles, not the fatty matters, not iodine, or any other single one which can meet all these indications. Hence why we attribute the efficacity of cod-liver oil, as much to the combined action of all these principles as to that of many among them.”—P. 255.
This is certainly an ingenious way of avoiding a difficulty. Dr de Jongh avows his want of power to resolve the question of how one or more of these principles act, and evidently regards cod-liver oil as a mixture made up of certain precious ingredients, each of which has its destined, though undiscovered object, while the whole of them unite in producing a given effect. Hence, only the oil that contains all these ingredients is a good oil, and as they are present in the brown kind as determined by analysis, this is the oil to be preferrel.