Introducción al documento

1.

“Si una tisis”, decía sir Richard Blackmore (1654-1729) en el prefacio de A Treatise of the Spleen and Vapours (1725), “es llamada con justicia por los extranjeros Tabes Anglica, o la tuberculosis inglesa, porque predomina mayormente y, de algún modo, es peculiar a este país, estoy seguro de que no hay menos razón para darle a la enfermedad que he elegido como tema de este tratado el apelativo del Spleen inglés”.[1] El escritor y médico ordinario de Guillermo III y Ana Estuardo, se sumaba así a una lista de observadores que habían destacado la prevalencia en Inglaterra del spleen, un trastorno físico y mental, históricamente asociado con la melancolía.[2] En 1690, William Temple había evocado a “un gran médico extranjero” que había llamado al país “la región del spleen”[3] y, en 1712, Joseph Addison había escrito en The Spectator que “la melancolía es una especie de demonio que acosa nuestra isla”.[4]

Esta edición del prefacio de Blackmore a su tratado sobre el spleen y los vapores busca poner de relieve la difusión, incluso entre los médicos más destacados de la época, de la percepción de que esa enfermedad era un “mal inglés”, como la llamaría George Cheyne unos años más tarde.[5] En segundo término, la elección de esta fuente se debe a que sirve de puerta de entrada a dos debates de principios del siglo XVIII en los que participó Blackmore: la célebre Querella entre los Antiguos y los Modernos[6] y una polémica, menos conocida, sobre la función fisiológica del bazo.

2.

Richard Blackmore nació en 1654 en Corsham, Wiltshire, cerca de Bath.[7] Hijo de un abogado adinerado, estudió en la Westminster School y luego en el St. Edmund Hall de Oxford. Allí conoció al célebre médico Thomas Sydenham (1624-1689), amigo de John Locke y veterano del ejército parlamentario en la guerra civil. Según una conocida anécdota, Blackmore habría preguntado al “Hipócrates inglés” qué autores debía leer para profundizar sus conocimientos de medicina y él le habría respondido: “Don Quijote, que es un muy buen libro; yo todavía lo leo”.[8] Hay distintas interpretaciones acerca de este relato, cuya veracidad, por otra parte, no es comprobable.[9] En cualquier caso, Blackmore compartía con Sydenham una preferencia por la experiencia y la práctica por sobre la formación erudita.[10] En esa época, los estudios médicos en las universidades inglesas consistían en un extenso período de lectura de textos clásicos y excluían casi todo conocimiento práctico, que el estudiante debía adquirir luego por su cuenta o como aprendiz de otro profesional. Siguiendo una trayectoria habitual desde el siglo XVI, Blackmore viajó al continente y obtuvo su doctorado en la prestigiosa Universidad de Padua, cuya tradición educativa hacía énfasis en la filosofía natural aristotélica y las lecciones en el teatro anatómico.[11]

En 1687, Blackmore fue admitido en el Royal College of Physicians. Por entonces, la corporación londinense solo representaba a una fracción del mercado de la salud —integrado también por boticarios, cirujanos y barberos, entre otros, que tenían sus propios gremios— y no estaba a la vanguardia del conocimiento médico de la época.[12] Sin embargo, a partir de un nuevo estatuto aprobado por Jacobo II, atravesaba un período de fortalecimiento que se expresaba en la duplicación del número de sus miembros —entre los cuales se incorporaron médicos graduados en universidades extranjeras y varios fellows de la Royal Society, lo cual estimuló una renovación intelectual— y en el endurecimiento de la persecución judicial contra quienes ejercían la medicina sin pertenecer al College.[13]

Inicialmente, las relaciones de Blackmore con las autoridades de la corporación fueron tensas. La confrontación más concreta estuvo vinculada con el proyecto, formalizado en 1695, de crear un dispensario para proveer medicamentos gratuitos a los pobres de Londres. El College buscaba, de este modo, mejorar su imagen pública y perjudicar a los boticarios. Blackmore integró la facción que se oponía al dispensario.[14] Esto tenía que ver con sus propias relaciones con algunos boticarios, pero en términos más generales con otro motivo de división al interior de la corporación.

Como varios de los miembros admitidos bajo el estatuto de Jacobo, Blackmore era un moderno. En medicina, esto implicaba una valoración mayor de la experiencia por sobre la erudición, una confianza en los descubrimientos recientes en anatomía que contradecían las enseñanzas de los antiguos, y la afición por espacios de sociabilidad novedosos como la Royal Society o las casas de café. [15]

Sin embargo, Blackmore también era moderno en otros sentidos. Además de médico, fue un escritor muy prolífico, autor de poesías, periódicos y panfletos políticos y religiosos. En 1695, publicó Prince Arthur, un poema épico modelado a partir de La Eneida que elogiaba a Guillermo III, que en dos años tuvo tres ediciones y una secuela. Esta obra le habría permitido ganarse el favor del monarca, quien lo hizo caballero y lo nombró como uno de sus médicos ordinarios (physician-in-ordinary) —cargo que conservaría durante el reinado de Ana—.[16]

Al mismo tiempo, el poema lo convirtió en objeto de las burlas de los wits, los escritores más destacados de su generación, quienes criticaron la tosquedad y monotonía de su estilo.[17] Como varios de sus contemporáneos, Blackmore abogaba por una reforma de las costumbres en una cultura que consideraba inmoral e impiadosa. En sus textos, responsabilizaba por esa decadencia a los wits, especialmente a los dramaturgos, con quienes mantuvo enfrentamientos recurrentes a lo largo de su carrera literaria.[18] En 1716 y 1717, Blackmore publicó en dos volúmenes sus Essays upon Several Subjects.[19] Allí incluyó un ataque a Alexander Pope, supuesto autor de una parodia blasfema del salmo primero.[20] Desde entonces, “everlasting Blackmore”, como lo llamó Pope en The Dunciad,[21] fue uno de los principales blancos del Scriblerus Club. Décadas más tarde, Samuel Johnson recordaría que el nombre del médico “fue empleado por tanto tiempo para referirse a cualquier epigrama de un escritor aburrido que finalmente se convirtió en sinónimo de desprecio”.[22]

Bajo el reinado de Jorge I, Blackmore dejó de ser médico de la corte, pero su posición en el College of Physicians mejoró porque, en 1716, fue nombrado censor y elector.[23] Al año siguiente, el segundo volumen de su colección de ensayos incluyó uno titulado “An Essay Upon the Spleen”, probablemente su primer texto dedicado a un tema médico.[24] Allí argumentaba que el bazo no tenía ninguna utilidad para la preservación de la vida del individuo, sino que su función se relacionaba con la reproducción de la especie y, por eso, podía ser extirpado sin producir efectos adversos. Además, afirmaba que la enfermedad llamada vulgarmente spleen no derivaba de ese órgano, como creían los antiguos, sino que se debía a un trastorno en el sistema de los espíritus animales. Como se verá, el autor recuperaría ambos argumentos en su Treatise of the Spleen and Vapours.

Sus publicaciones médicas se multiplicaron después de 1722, cuando Blackmore renunció a su cargo en el College y se retiró a su casa de Boxsted, Essex. Es verosímil que solo entonces, luego de una prolongada práctica del oficio, Blackmore se considerara preparado para dejar por escrito sus conocimientos médicos.[25] Los últimos ocho años de su vida los pasó produciendo tratados sobre la plaga, la viruela, la tuberculosis, la gota, la hidropesía y el spleen. En esos textos, escritos en inglés y orientados a un público no estrictamente profesional, abordaba los temas desde una perspectiva pragmática, que profundizaba algunos rasgos ya iniciados por Sydenham y privilegiaba la experiencia y la observación sobre la especulación y la erudición.

3.

En ese contexto, Blackmore escribió A Treatise of the Spleen and Vapours, que se publicó en 1725 y tuvo una segunda edición al año siguiente.[26] El tratado estaba dividido en tres secciones. La primera abordaba la estructura y función del bazo, para luego estudiar la naturaleza de los vapores, sus síntomas y sus causas. La segunda, describía los métodos para curar la enfermedad y analizaba extensamente las afecciones histéricas y su tratamiento.[27] La sección final se ocupaba sucesivamente de los cólicos, la melancolía y las parálisis. Por último, el impreso incluía una reedición del ensayo sobre el bazo de 1717.

El tratado estudiaba “este Proteo, esta enfermedad-postura”, que se confundía con otras, pues estaba “acompañada por un largo tren de quejas y una triste variedad de sufrimientos”.[28] Entre ellos, el autor incluía síntomas físicos (indisposición y dolores estomacales, dificultades para la digestión que producían “tormentas de vientos hipocondríacos”,[29] trastornos en el colon, palpitaciones, temblores, desmayos, sudores fríos y dolores musculares), pero también síntomas en la cabeza “más variados y sorprendentes” como jaquecas, mareos, aturdimientos, “gran atontamiento y melancolía”, insomnio, “a veces sueños tumultuosos, tristes y monstruosos”, entre muchos otros.[30] Sin embargo, a diferencia de otros autores contemporáneos, Blackmore no creía que la causa del spleen estuviera en el bazo, ni en otro órgano del hipocondrio, sino que derivaba de “los movimientos irregulares y desordenados de los espíritus y en la disposición irritable de los nervios”.[31] Distintos estímulos externos (impresiones violentas e inesperadas, noticias inoportunas, accidentes tristes, gritos repentinos o la mera apertura de una puerta) e internos (humores nocivos en el cerebro o la acción de fluidos ácidos o biliosos en los intestinos) podían perturbar y agitar los espíritus animales que circulaban por la “sensible y delicada constitución del sistema nervioso” y producir “movimientos desordenados y espasmos convulsivos y contracciones” de cualquier parte del cuerpo.[32]

Se pueden destacar diversos aspectos del prefacio. En primer lugar, para justificar la relevancia del tema elegido, Blackmore resaltaba la frecuencia que tenían en Inglaterra las “afecciones hipocondríacas e histéricas, vulgarmente llamadas el spleen y los vapores”.[33] El nombre de “spleen inglés”, decía, le parecía adecuado pues en ese país dominaba de manera universal y tiránica sobre ambos sexos. El autor incluso afirmaba que, si bien en los climas más cercanos al sol los trastornos de la mente y la imaginación eran muy frecuentes, el spleen inglés apenas se encontraba en habitantes de otros países. Esta idea ya había aparecido en su ensayo de 1717, donde Blackmore decía que “el spleen, una cualidad casi característica de esta nación, es de una naturaleza distinta a la locura y la enajenación, que son frecuentemente las enfermedades de los países cálidos”.[34] Luego, afirmaba que “quienes están dotados de una porción moderada de spleen en su complexión, son personas de un juicio superior y una vivacidad extraordinaria de su imaginación”.[35] Se trataba de la traducción, ya habitual para la época, del tópico peripatético del genio melancólico al lenguaje de los vapores.[36] No obstante, el autor no explicaba por qué el temperamento inglés tenía esa mayor proporción de spleen.

Un segundo aspecto que vale la pena destacar del prefacio es la postura de Blackmore con respecto al debate entre antiguos y modernos. Si bien el texto no buscaba intervenir en la polémica abierta hacía más de tres décadas por William Temple, ni era una invectiva contra los wits que se habían burlado de sus incursiones literarias, el autor no podía dejar de sentar posición al respecto, lo cual da cuenta de la relevancia que tenían esas identidades en la cultura de la época.

Blackmore empleaba el lenguaje de los modernos. Como los filósofos de la Royal Society, se consideraba “un autor que aspira al beneficio general de la humanidad y quisiera extender la utilidad de sus obras a quienes las lean”.[37] Por lo tanto, escribía en inglés y no en latín, “con una expresión clara y obvia, no solo para los hijos del arte, sino para todas las personas inteligentes, aunque no sean grandes académicos o estudiosos de la medicina”.[38]

Por otra parte, Blackmore criticaba duramente a los antiguos. Especial vehemencia tenía su reprobación de la influencia de Aristóteles en la medicina académica. Calificaba el pensamiento del filósofo como “vulgar y descuidado”,[39] carente de fundamentos en la razón o la experiencia, y reivindicaba la reciente revolución en la “república del saber” que “se liberó del yugo de la servidumbre y la intolerancia aristotélica” y afirmó el “derecho natural al libre ejercicio de la razón a partir de un examen imparcial de las cosas”.[40]

Blackmore se mostraba más indulgente con los antiguos previos a Aristóteles, como los “practicantes experimentales”[41] que ejercían un arte médico simple antes del ascenso de la escuela peripatética. En otro escrito, se refería a ellos como “historiadores o registradores fiables de hechos”.[42] Sin embargo, esta reivindicación dependía de que sus observaciones fueran verificadas por estudios modernos. Así, el autor hacía referencia a los “experimentos de los antiguos” que, confirmados por “los testimonios coincidentes de los anatomistas modernos más eminentes”,[43] como Marcello Malpighi, probaban la inutilidad del bazo. En el mismo sentido, su mirada benévola hacia Anaxímenes de Mileto se vinculaba con la recuperación de su obra que había hecho Charles Le Pois para plantear la hipótesis de que todas las enfermedades derivaban de un déficit o deterioro del serum en el cuerpo.

Por último, la mayor parte del prefacio se ocupaba de la función fisiológica del bazo. La insistencia de Blackmore en este tema, sobre el que había escrito en su ensayo de 1717, es notable. No solo por la extensión que le dedicaba en el prefacio, sino por la inclusión del ensayo al final del Treatise of the Spleen and Vapours y la publicación simultánea de otro libro sobre el asunto: A Critical Dissertation Upon the Spleen (1725).[44] El motivo de esta redundancia parece ser “el reciente intento de un médico erudito y anatomista habilidoso de descubrir”[45] la función del bazo, agravado por el hecho “sorprendente” para Blackmore de que lo hiciera “sin refutar la evidencia que yo he producido para probar que tiene poca o ninguna utilidad con respecto al animal particular en el cual se encuentra”.[46]

Blackmore no nombra al “ingenioso caballero”[47] que hizo este intento y no he encontrado alusiones a este debate en la historiografía.[48] Entre la publicación del ensayo de 1717 y la del Treatise of the Spleen and Vapours de 1725,[49] algunos autores ingleses habían escrito sobre el tema.[50] Mi hipótesis es que Blackmore se refería a William Stukeley (1687-1765), un médico y anticuario nacido en Lincolnshire, miembro de la Royal Society, quien en marzo de 1722 había dictado las Goulstonian Lectures del Royal College of Physicians.[51] En ese ciclo anual de lecciones de anatomía, uno de los miembros más jóvenes de la corporación disertaba sobre un tema específico a partir de la disección de un cadáver. Stukeley dedicó su presentación, precisamente, al bazo y sus funciones. En su rol de censor y elector de la corporación, es posible que sir Richard haya presenciado las conferencias, que se publicaron al año siguiente bajo el título de Of the Spleen.[52] En esa oportunidad, Stukeley había incluido también un reporte de la autopsia de un elefante que había realizado junto con Hans Sloane, presidente del College, lo cual justificaría el apelativo de “anatomista habilidoso” empleado por Blackmore. A ello habría que sumar que Stukeley había presentado su teoría como una recuperación del saber de Hipócrates, lo cual podría explicar en parte que Blackmore iniciara su Critical Dissertation con una extensa crítica al médico de Cos y a los eruditos contemporáneos, en el marco de la cual dudaba de “las reservas de conocimiento, que algunos estudiosos escarbadores imaginan que han abierto en las elucubraciones del viejo”.[53]

En Of the Spleen, Stukeley no solo no citaba a Blackmore, sino que además proponía una interpretación del bazo completamente opuesta a la suya. El anatomista argumentaba que ese órgano cumplía un rol primordial en la economía animal y que su mal funcionamiento era la causa del spleen. Stukeley, que era discípulo de Richard Mead y amigo personal de Isaac Newton, concebía al cuerpo humano como un microcosmos: una máquina maravillosa diseñada cuidadosamente por Dios.[54] Preocupado, como varios de sus contemporáneos —incluido Blackmore—, por conjurar los posibles desvíos impiadosos de la nueva filosofía natural, Stukeley quería demostrar que no había nada inútil ni azaroso en la presencia del bazo en el diseño divino.[55]

Varios pasajes del prefacio pueden leerse como respuestas a los argumentos centrales de Stukeley. La premisa principal de Blackmore era que el bazo podía ser extirpado de cualquier animal sin perjuicio para su vida y, de allí, concluía que el órgano no podía tener ninguna utilidad para la preservación del individuo. El autor insistía una y otra vez en que su planteo estaba “más allá de toda controversia por experimentos repetidos”, “innegables”, “incontestables”, y que nada podía “ser más claro”.[56] Esa reiteración podía deberse al estilo de “everlasting Blackmore” o al rencor provocado por el hecho de que su ensayo hubiera sido ignorado. No obstante, también podía relacionarse con que Stukeley había puesto en duda la veracidad de todos los reportes de experimentos que afirmaban haber extirpado el bazo de un animal sin alterar significativamente sus funciones vitales.

Por cierto, Blackmore no figuraba entre los testimonios estudiados por el anatomista, posiblemente porque en su “Essay upon the Spleen” de 1717 solo había referido experiencias de terceros. En el prefacio y en A Critical Dissertation Upon the Spleen, sir Richard decía haber removido el bazo de un perro, que luego vivió de manera saludable “por más de un año y mucho más, hasta donde sé”.[57] No obstante, su escueta relación difícilmente hubiera satisfecho los criterios de cuidado y paciencia que esperaba el médico de la Royal Society para considerar a un experimento verosímil.[58]

Por último, la premisa del diseño inteligente del cuerpo humano, que resultaba central para el argumento de Stukeley, según el cual el bazo no podía ser un tejido inútil, obligaba a Blackmore a repetir una precisión que había hecho en 1717. El órgano, decía, no tenía ninguna función con respecto a la preservación del individuo, de lo cual se seguía que debía desempeñar algún papel en la reproducción de la especie. Esta insistencia era necesaria para despejar sospechas de impiedad, pero el autor admitía no haber podido mostrar “claramente el modo en que esta víscera promueve la generación”.[59]

Estos son solo algunos de los tópicos que pueden explorarse en A Treatise of the Spleen and Vapours y otros tratados médicos contemporáneos que se ocuparon de la supuesta epidemia de spleen en Inglaterra. La riqueza de este tipo de documentos no se agota en lo que ellos pueden decir sobre teorías fisiológicas perimidas. La reproducción de esta fuente es una invitación a fomentar una lectura cercana y contextualizada que permita entender mejor por qué una sociedad, en un momento específico de su historia, podía considerarse la exclusiva representante de una patología mental.

Nota sobre la edición

En la transcripción se procuró preservar la puntuación, las contracciones, mayúsculas y bastardillas del original. Todas las notas son del editor.

BLACKMORE, Richard A Treatise of the Spleen and Vapours: Or, Hypochondriacal and Hysterical Affections. With Three Discourses on the Nature and Cure of the Cholick, Melancholy, and Palsies, J. Pemberton, Londres, 1725.

The Preface

If the Natives of this Island, either from the peculiar Constitution of the Air they breathe, or the immoderate Quantity of Flesh-Meats they eat, or of the Malt Liquors they drink, or any other secret Causes, are more disposes to Coughs, Catarrhs, and Consumptions, than the neighbouring Nations; they are no less obnoxious to Hypochondriacal and Hysterick Affections, vulgarly called the Spleen and Vapours, in a superior and distinguishing Degree. And of all the Chronical Distempers that afflict the Body, or disturb the Mind, these two, Consumptions and the Spleen, are in this Kingdom the most rife and prevalent; and either directly by their own Power, or by introducing other Diseases, make the greatest Havock and Destruction among the People. As by the various Kinds of Fevers, if Dr. Willis judges right, a third Part of the People are taken off;[60] so it is reasonable to suppose that the like Proportion of those that escape the Fury of inflammatory and malignant Fevers, are destroyed or made miserable by the Diseases of which I am speaking. And therefore as I have published lately a Treatise on the Nature of Coughs and Consumptions, and the Method of Curing them, for the Service of my Countrymen; so in the same View I have now attempted to account for the Nature and Causes of the Spleen and Vapours, and have set down the Method and Medicines, which in my Judgement are the most effectual for the Relief of the afflicted Patients.

If a Phthisis is justly called by Foreigners Tabes Anglica, or the English Consumption, because it is most predominant, and in a manner peculiar to this Country; I am well assured there is no less Reason to give to the Distemper I have chosen for the Subject of this Treatise, the Appellation of the English Spleen; since it has here gained such a universal and tyrannical Dominion over both Sexes, as incomparably exceeds its Power in other Nations: for though in foreign Climates, especially those nearer the Sun, Disorders of the Mind, Lunacy, and disturbed Imagination, are very frequent; yet the English Spleen, as I have now named it, and as I have described it in the following Pages, is comparatively but seldom found among the Inhabitants of other Countries.

An Author that aims at the general Benefit of Mankind, and would extend the Usefulness of his Works to all that read them, should reflect, that Perspicuity is a Perfection of Writing so necessary to this end, that without it the Sense and Meaning of the Author is in a great measure lost, even to attentive Readers; while the greatest Part of Men will not peruse, but lay by and reject those Writings, because of the Difficulty of understanding them; for Man by Nature is such a slothful Animal, that he cares not for Knowledge and Instruction, that is not communicated in an easy manner; such as gives him no Trouble, and requires but little Application. For this Reason I have endeavoured to convey my Sentiments to the Reader in clear and obvious Expression, not only to the Sons of Art, but to all intelligent Persons, though not great Scholars, or Students in Physick; and I hope there will not appear to Persons of a competent Capacity any thing intricate or obscure, for want of significant and intelligible Words; though sometimes it may happen otherwise, when the Subject-Matter it self is superior to their Apprehension, who have been wholly unacquainted with such Ideas.

Since all Diseases are Deviations from the natural irritate Rectitude of the Constitution; and therefore break the Symmetry, and subvert the regular Coherence and Subordination of the various Parts, they cannot but introduce the intestine Discord and Commotions, that tend to the Dissolution of the whole Structure: It is therefore reasonable to examine what Principles the human Body is compounded of, what Order, Connexion and Dependence is observed in a perfect Composition; that so Diseases that are the Errors or Defects of those Principles, and in some degree subvert their Harmony, due Mixture and Combination, may be discovered.

After Aristotle’s ill-managed System, supported neither by Reason nor Experiment, had the good Fortune to become the Philosophy in Fashion, the Physicians generally gave into the Doctrine of his School, and formed their Notions of Diseases and their Cure, in Conformity to the Peripatetick Principles, that by a swift Growth acquired great Power and Authority: and now the Errors of this crude and lazy Philosophy being admitted into the Æsculapian Colleges, and mingling with their Conceptions, corrupted and depraved the Simplicity of the Art of Physick, as it was carried on before by the experimental Practisers. But at length a great Revolution happened in the Commonwealth of Learning, when the Authority of Aristotle, who had gained an Empire of vast Extend and long Duration over the Schools and Colleges of Knowledge, began to decline and grow out of Credit. And it is indeed wonderful that an Hypothesis of Philosophy should continue so long in great Reputation, that had only imaginary Foundations to rest upon. And now the Peripatetick Scheme began to be disgraced by many, that, from a generous Principle to assert their natural Right to the free Exercise of Reason, upon an impartial Examination of Things, threw off the Yoke of Servitude and Aristotelian Bigotry. And soon after, when the Colleges and Schools, that were defended by the Adherents of this Philosopher, had revolted and rebelled against the Prince of Science, which was then his Title, the greatest Part of the Heads of this Defection restored the Atomical or Corpuscularian Doctrine;[61] and then the Physicians turning about with the Times, espoused this Hypothesis, and framed their Notions in Conformity to it.

But Carolus Piso,[62] a French Doctor of considerable Reputation, endeavoured to revive the Philosophy of Anaxamenes, one of the first Masters of the Ionick School in Greece,[63] who taught his Scholars, that Water was the fertile Parent of all compound Bodies; while others of equal Fame ascribed their Production to Air or Earth, or Fire; for each Philosopher had his favourite Element, on which he conferred the Honour of being the sole Principle that constituted all the Varieties of corporeal Beings. Now the Author I have named, in his Poem before his Book de Morbis Serosis,[64] declares for the Doctrine above-mentioned, that all Things are produced from Water; and therefore in Congruity to that Hypothesis, labours to shew in his Treatise, that Water, or Serum, in its defective and degenerate State, whether that consists in an excessive and disproportionate Quantity, or a depraved and putrefactive Quality, is the fatal Fountain whence Diseases of all Denominations are derived.

It is true, that this Notion is extended to an unreasonable Compass; for it is certain, that the ill Constitution either natural of acquired of the solid Parts, the relaxed Tone of the Fibres, the Glands and other organical Parts of the Body, or the Obstruction of the Minute Vessels by various Impurities and Concretions, are evidently the Causes of many and great Distempers; but if that Author had confined his Notion to Fluids, and charged the Production of the greatest Part of Diseases, to which Mankind are obnoxious, on the vitiated State of those Fluids, his Hypothesis might have been looked upon as very justifiable: Since it is reasonable to believe, that the Distempers that affect the Head, the System of the Nerves and the Animal Spirits, all proceed from the depraved serous Streams, that irritate and provoke the nervous Fibres, and drive the Spirits into Disorder and Confusion, as will appear at large in the following Pages.

But the Truth is, the ill Conformation to the solid Parts, and inordinate Dispositions of the Juices or Serum, often conspire as partial and confederate Causes in the Constitution of Distempers, and by affecting the Nerves, those irregular noxious Humours must have yet a wider Province, that appears at first sight. It is reasonable to suppose, that all kinds of Feavers [sic] take their Rise from the Nerves, since they all make their first Insult and Impressions on those Parts; as appears by the Rigours, Shiverings and convulsive Catchings and Tremblings, that introduce all kinds of this Disease, whether putrid or inflammatory; and when the Matter of the Distemper is discharged from the Nerves and received into the Blood, the Symptoms mentioned before, that belong to the Genus Nervosum in the milder Sort of Fevers, disappear, and are succeeded by a boiling Heat in the Blood, and usually a great Thirst. And it is very evident, that in Fevers attended with the greatest Putrefaction and Malignity, the Blood is not at all infected; but the destructive Matter convey’d by the Air, as it were a poisonous Gass, a pestilential Damp or a deadly Exhalation, like that which is sometimes let out by Delvers from metallick Veins, abolishes in a Moment all vital Motion, by extinguishing at once the System of the Animal Spirits: Thus in the Times of raging Plague, Persons walking in the Streets have fallen down dead in an Instant, as if struck with a Flash of Lightning; and others have lived but few Hours after they were attacked: whence it is plain, that this worst sort of Fevers affect the Spirits and Nerves only, since they destroy the Patient, before they can communicate, or produce any Symptoms there.

Now it is certain, that Hypochondriacal and Hyterick Patients very often suffer the same Symptoms that introduce a malignant Fever; and so much resemble each other, that they are not easily distinguished; and therefore they often impose even upon Physicians, as well as the Friends of the Patients, as I have observed in my Treatise on Fevers.

While I agree with Piso, that the Diseases which affect human Bodies generally proceed from Depravity and ill Disposition of the Serum, or Fluids, distinguished from the Blood, I must explain my Meaning, which I suppose was the Sense likewise of the Author I have named; that is, that the Serum, which waters the Traces of the Brain, and passes through the Medulla Spinalis, and the minute Tracts of the Nerves, is not simple and unmixed elemental Water, but such as contains the generous and active Principles of refined Sulphur, Spirit, and volatile Salt, separated from the Blood by the Ministry of the Glands, or the fine Pores of the Brain; and then I conceive that the degenerate and vitiated State of such Serum is, according to the Opinion of our Author, the true Cause of most Diseases; and it is so, particularly of the Maladies I have discoursed upon in the following Treatise, will be shewn afterwards.

Since this Distemper has gone by the Name of the Spleen from the primitive Ages of Physick to this Time, one would think it reasonable to conclude, that some Defect in the Function of that Bowel had occasioned that Appellation;[65] but on attentive Enquiry into the Office of that Organ, it evidently appears to me, that it was not formed for the Benefit and Preservation of the Animal, of which it is a Part; and that therefore it is of no use at all in respect of the Individual. Physicians and Anatomists in all Ages, and in all Nations, have endeavoured to discover and settle the ministerial Duty of that organical Part; but notwithstanding the great Variety of Schemes laid down for a due Explanation of it, the Use of the Spleen is still a Secret that has eluded the Search of the most penetrating and sagacious Enquirers.

Nor does it continue less a Mystery, or involved in fewer Difficulties, since the late Attempt of a learned Physycian and skilful Anatomist to unfold it.[66] It does not however cast any Dishonour on that ingenious Gentleman, that he has not found out the Use of the Spleen, which the greatest Physicians and Anatomists in all Ages have laboured in vain to discover; for those that undertake an impossible Task, are sure to miscarry. And that this is such, I conceive I have made evident, by demonstrating that the Spleen is of no use to any Individual that enjoys it, which I have done in my Essay on the Spleen.[67] But that which is surprizing in his Conduct, is, that he should attempt, after this, to discover a new Way of accounting for the Usefulness of that Bowel, without confuting the Evidence that I have produced to prove that it is of little or no Service at all in respect of the particular Animal in which it is found.

The Extirpation of the Spleen, without any consequent Mischief, is an uncontested Matter of Fact down to this Time from the eldest Ages, even before the Art of Anatomy or Dissection of human Bodies as well cultivated, and brought to such Degrees of Perfection as it afterwards acquired. And the Experiments of the Antients [sic] in this Case have been abundantly confirmed, by the concurring Testimonies of the most eminent modern Anatomists, particularly the celebrated Malpighius[68] has recorded in his excellent Writings, many Instances of this Nature, in which himself was concerned, at least as a Director and an Eye-witness of the Operation.

If the Spleen then may be taken out entirely from the Bodies of Animals, and those Animals continue without any Marks of Injury or Diminution of Health in any respect whatsoever, but in the Possession of as full Vigour and Alacrity as before; then will it clearly follow, that this is an unnecessary or unuseful Organ of the Body, in respect to the Individual that is possessed of it: the Consequence is as clear as Noon-day. Now it evidently appears by repeated Experiments, as I have said, that the Spleen may be taken out of the Body, without the least Detriment to the Animal; and I my self have opened the Side of a Dog, and torn off with my Fingers the Spleen from the Parts to which it grew; yet without so much as tying up the Vessels, the Wound in the Side being sowed up, the Creature soon recovered, and shewed no sign of any Damage, or loss of Strength and Spirit, and continued in this healthful State more than a Year after, and much longer, as far as I Know.

It is in vain then for Anatomists to proceed in an obstinate Opposition to the clearest Evidence, and lose their Time and Labour in searching after the Use of the Spleen; which if the Arguments I have published are conclusive, is unnecessary to Individuals. And that my Arguments are unanswerable, I hence conclude, that they having been abroad several Years in my Essay on the Spleen, cited before, no Physician or Anatomist has attempted to disprove them: And therefore I cannot but think that they look upon it as too hard a Task; for if they judged themselves able, I have no Reason to believe they are unwilling to confute my Position. And if any learned Physician or Anatomist, that thinks he can invalidate my Reasoning, and subvert my Hypothesis, would do me the Favour to detect my Error, by shewing the unconvincing Weakness of my Arguments, I will give him sincere Thanks, and retract my Mistake: And it may be likewise be a Motive yet more prevalent with him to do this good Office, when he reflects, that by his clear and rational Discourse on this Subject, he may prevent others from falling into the same Error with my self, which they may be apt to do, since so much may be said in Vidication of my Assertion; for it is past all Controversy, from repeated Experiments, as before-mentioned, that the Spleen may be wholly spared; and that after Exsection, it will not be missed by the surviving Animal. And surely if it is so very unuseful to the Individual, that it neither contributes to the Preservation of his Health, Vigour and Vivacity, nor to the Beauty and Strength of its Structure, nor the Exercise of any one of its Faculties, we may then safely conclude, (for no Demonstration can be more evident) that this Bowel, like other organical Parts, contrived for Procreation, is insignificant and unserviceable to particular Animals; and then it follows undeniably from thence, that it must be formed and designed for some Office in promoting the Propagation of the Species; for no Man that acknowledges the Perfections of the Divine Author of Nature, can imagine than an intelligent Agent would act without an End;[69] that he, that has appointed some Service and Use to the minutest Fibres and Glands of the Body, would contrive such an ample and admirable Organ, that takes up so much room in the Abdomen, and by its large Dimension and curious Fabrick, demands such Attention and Regard, should notwithstanding be subservient to no considerable Purpose whatsoever: and yet this must be the unavoidable Consequence, if it be not formed and intended for the End which I have named, since it must be destined either for the Service of the Species or the Individual.

It is impossible to inspect and contemplate this large Organ, without concluding, that it must have some important Office in the animal Administration and that it is not a superfluous and impertinent Fungus, or an Error or Sport of Nature;[70] and then it will leave in the Mind no Ground or Reason of doubting, no not the least Hesitation about granting this Conclusion, that the Duty of the Spleen, which is little, if at all, concerned about the Preservation of the Individual, must almost wholly regards the Continuation of the Kind. If it be said, that there may be other Uses of the Spleen regarding the Individual, though they are not yet discovered by any Author; and that it is not just Arguing to assert, that there is no such Use, because it is unknown, which is the Case of Multitudes of Phænomena, nor that it is allowable for me to ascertain any Use meerly from this, that others have miscarried in their Attempts to discover it:

To this I answer, that I do not assert any Use of the Spleen, but on the contrary, have provided that it has none at all, as to the Individual, which is the Point in Controversy. And my Arguments are equally conclusive against all Uses of the Spleen, which Authors have hitherto ascribed to it, and any others whatsoever, that may be imagined to be yet undiscovered. For it is certain that the Spleen may be cut or torn from the Side, without the least Hurt to the Health of the Animal, the Truth of which is established by undeniable Experiments, as above-mentioned; then what can be more clear than this, that in respect of the Animal, whence it is taken, it is an idle or superfluous Organ; so that whatsoever Use may be supposed to be so hidden, that it eludes the Observation of the most penetrating and sagacious Men, it is plain it can have no Office or Function of any Moment or Importance to the Creature, which can live very comfortably, and perform all the Functions of Nature, as well without it as with it; it follows then from what has been said, that the Propagation of the Kind, by some way or other, was the End aimed at in the Formation of this curious Bowel, and by what Ways it contributes to it, I have expressed my Sentiments in my Essay on the Spleen, at the end of these Pages, to which I refer the Reader.

But here I must declare, that if I have not been successful, as I hope I have been, in explaining the Way and Method by which it contributes to Procreation; yet still I affirm, that whatever Use it has, it must regard the Continuation of the Species, and not the Individual: And therefore if I have not sufficiently unfolded the Manner how it is performed, yet my first and main Position is not affected by it; for still it must be allowed an undeniable and established Truth from the unanswerable Arguments that enforce it, that the Use of the Spleen principally, if not wholly, respects the multiplying of Individuals.

These Arguments appeared so conclusive to several learned and judicious Gentlemen, that they told me, they looked upon my Hypothesis as established on good Reasons; nor have I heard any Objection made against it, except that one ingenious and learned Physician[71] told me, he thought it was too much to build an Hypothesis upon a single Experiment. But this Insinuation, that I have really built an Opinion in Anatomy upon a single Experiment, must arise from Inattention or Disingenuity; the main Hypothesis I have advanced is, that the Use of the Spleen little concerns the Individual, and therefore it must respect the Species. To evince the Truth of the Proposition, I have alleged my own Experience, and cited others from the most accurate and skilful Anatomists, that sufficiently prove that this Bowel may be entirely spared, since the Animal feels no want of it in any Respect whatsoever: And if so, my Position stands unshaken, that this Bowel was formed for the Service of Generation, since it contributes little or nothing to the Benefit of Individuals; otherwise here is an eminent Bowel made for no Purpose, since it is neither useful to the Individual nor the Species. This is my Argument, founded on numerous and undeniable Experiments on various Animals; and the Way which I have suggested how the Spleen is subservient to Procreation, is likewise strengthened by Observations. How can then any Gentleman affirm, that my Notions are only supported by one Experiment? And what if this last Opinion had been built on no Observation or Experiment at all? Are these always wanting, even when scientifick Evidence may establish the Truth of any Proposition without them? And though it should be granted, that I have not clearly shewn the Way how this Bowel promotes Generation, yet that it does so, I have clearly proved by unanswerable Arguments; and so am at least in this Disputation on an equal Foot with the whole Profession, who believe that the Spleen is formed for the Service of the Individual, but are all ignorant how it performs its beneficial Office. And therefore the Truth of my main Position, that the Spleen is formed and contrived for the sake of the Species, does not stand or fall with that of my last Suggestion concerning the Way of its Usefulness; the first I mention as certain, the last only as probable; and each Conclusion is deduced from different Premises in my Argumentation.

Notwithstanding I have some Years ago published an Essay on the Spleen, as said before, together with other Miscellaneous Tracts; yet I have there treated the Subject only as a Philosopher, that enquires into the Works and Operations of Nature: and aiming at the Entertainment and Instruction of politer Readers, I have accommodated that Writing to their Taste, who are not so well pleased with grave and severe Disquisitions: But in these Pages I have managed the Subject as a Physician, and have said no more than what prepares my Way for laying down the Method of Cure. I have however added at the latter end the Dissertation before-mentioned; which, as it relates to the same Distemper, so it contains many Things that will give more Light into the Nature of it, and its various Symptoms; and so make this Performance more clear, and the System of my Notions more compleat. Though I have endeavoured to introduce little of that Writing into this, yet some Repetition of Words, Sentiments, and Matters that often occur, and are co-incident in this Treatise, and the Essay added at the end, being unavoidable in the Conduct I have observed, will, I imagine, be forgiven by the judicious Reader.

As to the three Discourses on the Cholick, Melancholy, and Palsies, that follow this Treatise on Hypocondriacal and Hysterick Affections, I shall not anticipate the Reader, by giving any summary Account of them in this Place. All that I shall say is this, that tho’ I have not diffused and extended the Subjects to a great Length, by entering into the Consideration of many minute and less important Matters, that are fitter to swell a Volume, than to instruct and entertain the Reader; I hope, however, that I have set the Nature and Kinds of each of those Distempers, as well as the Methods of Cure, in so full and clear a Light, that he will find no Reason to complain of too great Succinctness and Brevity.

Since the writing of this Preface, I have received some Remarks from an ingenious and learned Physician, [72] who did me the Favour to peruse it, for which I return him my hearty Thanks. That which is of the greatest Importance of his Observations, is, his Objection to my Position, That the Removal or Exsection of the Spleen may be performed, without destroying the Health of the Animal. If this, says he, were plainly demonstrated, I allow (and it would be very strange it he should not) that the Spleen is unnecessary to the Individual. But then he declares, that in his Opinion the Arguments and Instances that I have brought in Evidence to establish the Truth of my Assertion, are not satisfactory; because, says he, ‘there is required a greater Space of Time, and a long Series of convincing, repeated Experiments, to support my Hypothesis.’ When I had deliberately reflected on this Remark, I continued settled in my Opinion, that I had made good my Allegation, by sufficient and unanswerable Reasons, and that I had not left any warrantable Ground of doubting about the Validity of my Proofs. And then I intended in this Preface to set the Matter in a stronger Light, and add an Answer to the Objection before-mentioned: But afterwards considering that I should not find room enough in a Preface, without swelling it into a very inordinate Size, to do this so fully and effectually, as not only to remove Objections and Difficulties from the Minds of candid and impartial Enquirer after Truth, but likewise to give them Satisfaction, who shall be the most indisposed to receive it, and thro’ the Power of Prejudice of Party-Passions, have the greatest Reluctance and Displeasure to be undeceived and rightly informed;[73] I resolved to publish a distinct Dissertation on this Subject,[74] that is, that the Spleen may be safely taken out of the Bodies of Animals without any consequent Diseases, or any greater Alterations, than those that happen upon the Exsection of the Organs subservient to the Propagation of the Species, of which my Hypothesis makes the Spleen to be one.

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Referencias

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Notas