Part 32

Thus we find that the high state of perfection which the surgical art has attained is solely due to the efforts of industry to free itself from the ignoble trammels of bigotry and prejudice. Intellectual progress has invariably been opposed in every country by those powerful and interested individuals who derived their wealth and influence from the ignorance of society. Corporate bodies monopolizing the exercise of any profession will invariably retard instruction and shackle the energies of the student. It is, no doubt, indispensable that the practice of medicine in all its branches should only be allowed to such persons as are duly qualified; but whenever pecuniary advantages are derived from the grant of the permission, abuses as dishonourable as they are injurious to society will infallibly prevail. In Great Britain the period of study required in medical candidates is by no means sufficient. Five or six years is the very lowest period that should be insisted on; and, when duly instructed, degrees and licences should be conferred without fee, on all applicants, by a board of examiners unprejudiced and disinterested. This mode of granting licences would add to the respectability of the profession, while it would ensure proper attendance to the public. Physicians and surgeons would then become (what to a certain extent the latter are at present, though illegally as far as the laws of the college go), general practitioners, and society would no longer be infested by the swarms of practising apothecaries, who, from the very nature of their education, can only be skilled in making up medicines, or who must have obtained experience in the lessons taught by repeated failures in their early practice, unless perchance they have stepped beyond the usual confined instruction of their class. The consequences that arise from this fatal system are but too obvious. These men live by selling drugs, which they unmercifully supply, to the material injury of the patient's constitution. If, after ringing all the changes of their materia medica without causing the church-bell to toll, they find themselves puzzled and bewildered, a physician or a surgeon is called in, and too frequently these practitioners are bound by tacit agreement not to diminish the revenue that the shop produces. If it were necessary to prove the evils that result from the monopolizing powers vested in corporate institutions, the proof might be sought and found in the virulence and jealousy which they evince in resisting reform, from whatever quarter it may be dreaded; and it may be said that too many of the practising apothecaries of the present day stand in the same relative situation in the medical profession as the barbers of olden times.

This faculty of exercising every branch of the profession, however qualified, is of olden date, and we find on the subject the following lines in the writings of Alcuin in the time of Charlemagne:

Accurrunt medici mox Hippocratica tecta: Hic venas findit, herbas hic miscet in olla; Ille coquit pultes, alter sed pocula perfert.

ON DREAMS.

Philosophical ingenuity has long been displayed in the most learned disquisitions in an endeavour to account for the nature of these phenomena. The strangeness of these visionary perturbations of our rest--their supposed influence on our destinies--their frequent verification by subsequent events--have always shed a mystic _prestige_ around them; and superstition, ignorance, and craft, have in turns characterized them as the warnings of the Divine will, or the machinations of an evil spirit.

Macrobius divided them into various categories. The first, the mere _dream_, _somnium_, he considers a figurative and mysterious representation that requires to be interpreted. Dion Cassius gives an example of this in the case of Nero, who dreamt that he saw the chair of Jupiter pass into the palace of Vespasian, which was considered as emblematical of his translation to the empire.

The second distinction he terms a _vision_, _visio_, or a foreboding of future events. The third he deemed _oracular_, _oraculum_, and this was the case when a priest, or a relative, a deity, a hero, or some venerable person, denounced what was to happen, or warned us against it. As an example of this inspiration, for such it was considered, an anecdote of Vespasian is related. Having heard that a man in Achaia had dreamt that a person unknown to him had assured him that he should date his prosperity from the moment that Nero should lose a tooth,--a tooth just drawn from that emperor being shown to him the following day, he foresaw his destinies: soon after Nero died, Galba did not long survive him, and the discord that reigned between Otho and Vitellius ultimately placed the diadem on his brow. These inspirations were considered by Cicero, and various philosophers, as particularly appertaining to the shrine of the gods; those who sought that heavenly admonition were therefore recommended to lie down in temples. The Lacedæmonians sought slumber in the temple of Pasithea; Brizo, the goddess of sleep and dreams, was worshipped at Delos, and her votaries slept before her altars with their heads bound with laurel, and other fatidical symbols; hence divination by dreams was called _Brizomantia_. Supplications were offered up to Mercury for propitious visions, and a caduceus was placed for that purpose at the feet of beds; hence was it called [Greek: ermies].

Diodorus informs us that dreams were regarded in Egypt with religious reverence, and the prayers of the devout were often rewarded by the gods with an indication of appropriate remedies. But the confidence in supernatural agency and the power of magic, was only deemed a last resource, when human skill had been baffled. Some persons promised a certain sum of money for the maintenance of sacred animals, consecrated to the divinity whose aid they implored. In the case of infants, a certain portion of their hair was cut off and weighed, and when the cure was effected an equal quantity of gold was given to the successful intermediator.

The fourth division was _insomny_, _insomnium_, which was characterized by a disturbed repose, caused either by mental or bodily oppression, or solicitude. The fifth class of dreams was the _phantasm_ or _visus_, which takes place between sleeping and waking, in a dozing and broken slumber, when the person thinks himself awake, and yet beholds fantastic and chimerical figures floating around his couch. Under this class is placed the _ephialtes_, or night-mare. Macrobius represents the phantasm and the insomnium as little deserving of attention, being of no use in divination and prediction.

When these notions prevailed, the interpretation of dreams became a profitable trade; and it is a lamentable truth, that, to the present day, it is considered a speculation upon credulity. We find in Plutarch's Life of Aristides that there were tables drawn out for this purpose; and he speaks of one Lysimachus, a grandson of Aristides, who gained a handsome livelihood by this profession, taking up his station near the temple of Bacchus. Rules of interpretation were formed by Artemidorus, who lived in the reign of Antoninus Pius, and he drew his conclusions from circumstances considered either propitious or sinister. Thus, to dream of a large nose, signified subtlety; of rosemary or sage, trouble and weakness; of a midwife, disclosure of secrets; of a leopard, a deceitful person. These interpretations became so multiplied, that at last it was decreed that no dreams which related to the public weal should be regarded, unless they had visited the brains of some magistrates, or more than one individual. But what limits can any enactment assign to the influence of credulity and superstition? Cicero informs us that the Consul Lucius Julius repaired to the temple of Juno Sospita, in obedience to a decree of the senate regarding the dream of Cæcilia, daughter of Balearicus.

In more modern times we have often seen dreams resorted to, in order to assist the speculations of policy and priestcraft; some of them as absurd in their nature as revolting in their interpretation. Monkish records relate that St. Bernard's mother dreamed that she had a little white dog barking about her, which was interpreted to her by a religious person as meaning "that she should be the mother of an excellent dog indeed, who should be the hope of God's house, and would incessantly bark against its adversaries, for he should be a famous preacher, and cure many by his medicinal tongue." Our Archbishop Laurence, to whom we owe the church of Our Lady at Canterbury, was about to emigrate to France under the discouragement of persecution, until warned in a dream, and severely scourged by St. Peter for his weakness. It was on the relation not only of this dream, but on actually exhibiting the marks of the stripes he had received, that Eadbald was baptized, and became a protector of the church. It was in a dream of this description that St. Andrew instructed Peter Pontanus how to find out the spear that had pierced our Saviour's side, and which was hidden somewhere near Antioch. Antioch was at that time besieged by the Persians, and half famished; but this weapon being carried by a bishop, enabled the besieged to beleaguer Caiban, the Persian general.

The Peripatetics represented dreams as arising from a presaging faculty of the mind; other sects imagined that they were suggestions of dæmons. Democritus and Lucretius looked upon them as spectres and _simulacra_ of corporeal things, emitted from them, floating in the air, and assailing the soul. A modern writer, Andrew Baxter, entertained a notion somewhat similar, and imagined that dreams were prompted by separate immaterial beings, or spirits, who had access to the sleeper's brain with the faculty of inspiring him with various ideas. Burton divides dreams into natural, divine, and dæmoniacal; and he defines sleep, after Scaliger, as "the rest or binding of the outward senses, and of the common sense, for the preservation of body and soul."

Gradually released from the trammels of superstition, modern philosophers have sought for more plausible explanations of the nature and causes of dreams, but perhaps without having attained a greater degree of certainty in this difficult question than our bewildered ancestors. Wolfius is of opinion that every dream originates in some sensation, yet the independent energies of the mind are sufficiently displayed in the preservation of the continued phantasms of the imagination. He maintains that none of these phantasms can prevail unless they arise from this previous sensation. De Formey is of the same opinion, and conceives that dreams are supernatural when not produced by these sensations. But of what nature are these sensations? Are they corporeal impressions received prior to sleep, and the continuances of reflection, or are they the children of an idle brain? Although it is not easy to trace an affinity between the subjects of our dreams and our previous train of thought, yet it is more than probable that dreams are excited by impressions experienced in our waking moments, and retransmitted to the sensorium, however difficult it may be to link the connexion of our ideas, and trace their imperceptible catenation. Moreover, there does not exist a necessary and regular association in the state of mind that succeeds any particular impressions. These impressions only predispose the mind to certain ideas, which act upon it with more or less subsequent energy, and with more or less irregularity, according to the condition in which the predisposing causes have left it. It has been observed that we seldom dream of the objects of our love or our antipathies. Such dreams may not be the natural results of such sentiments. We may fondly love a woman, and in our dreams transfer this soft sensation of fondness to another individual,--to a dog that fondles us, or any other pleasing object. We may have experienced fear--in a storm at sea; yet we may not dream of being tossed about in a boat, but of being mounted upon a runaway horse who hurries us to destruction, or of flying from a falling avalanche. Our mind had been predisposed by fear to receive any terrific impression, and most probably these alarming phantasms will be of a chimerical and an extravagant nature. A man who has been bitten by a dog may fancy himself in the coils of a boa-constrictor. When dreaming, the mind is in an abstracted state; but still is its reciprocal influence over the body manifest, although it is powerless on volition. Vigilance in sleep is still awake; but her assistance is of no avail until the connexion between mind and body is aroused by any alarm from external agents. It is well known that a hungry man will dream of an ample repast. A patient with a blister on his head has fancied himself scalped by Indians in all their fantastic ornaments. Somnambulism clearly proves that the mind retains its energies in sleep. Locke has justly observed that dreams are made up of the waking man's ideas, although oddly put together. Hartley is of opinion that dreams are nothing but the reveries of sleeping men, and are deducible from the impressions and ideas lately received, the state of the body, and association. I have endeavoured to explain, on the ground of the general effects of predisposition, the anomalies which so often are displayed in these associations. Of the surprising powers of the mind in somnambulism we have many instances too well authenticated to be doubted. Henricus ab Heeres was in the habit of composing in his sleep, reading aloud his productions, expressing his satisfaction, and calling to his chamber-fellow to join in the commendation. Cælius Rhodiginus when busied in his interpretation of Pliny, could only find the proper signification of the word _ectrapali_ in his slumbers. There is not the least doubt but that the mind is capable of receiving impressions of knowledge, but more particularly inspirations of genius, when the body is lulled in a state of apparent repose. Dreams have been ingeniously compared to a drama defective in the laws of unity, and unconnected by constant anachronisms. Yet certain incoherences are not frequent: Darwin has justly remarked that a woman will seldom dream that she is a soldier, and a soldier's visions will seldom expose him to the apprehensions of child-birth. Buffon has observed, "We represent to ourselves persons whom we have never seen, and such as have been dead for many years; we behold them alive and such as they were, but we associate them with actual things, or with persons of other times. It is the same with our ideas of locality; we see things not where they were, but elsewhere, where they never could have been."

Dugald Stewart has endeavoured to account for these phenomena by the doctrine that in sleep the operations of the mind are suspended, and that therefore the cause of dreams is the loss of power of the will over the mind, which in the waking condition is subject to its control. Now, if this be the case, dreams must consist of mental operations independent of the will. However, it is not the suspension of the will and of the powers of volition that alone constitutes sleep; it is the suspension of the powers of the understanding,--attention, comparison, memory, and judgment. It is in consequence of this suspension of all our active intellectual faculties that we never can _will_ during our dreams; in that state there appears to be a resistance of the powers of volition with which the mind struggles in vain, and which is expressed both by moans, and the character of the sleeper's every feature, which portrays a state of anguish and impatience. In all dreams that are not of a morbid nature, every action is passive, involuntary. This state is widely different from delirium, in which the brain is in a morbid state of excitement; and the body is more susceptible than usual of external agency, while the mind is perplexed by hallucinations of an erroneous nature.

Dr. Abercrombie considers insanity and dreaming as having a remarkable affinity when considered as mental phenomena; the impressions in the one case being more or less permanent, and transient in the other. Somnambulism he considers an intermediate state. Dreams, according to his theory, are divided into four classes: the first, when recent events and recent mental emotions are mixed up with each other, and with old events, by some feeling common to both; the second class relates to trains of images brought up by association with bodily sensations; the third, the result of forgotten associations; and the fourth class of dreams contains those in which a strong propensity of character, or a strong mental emotion, is imbodied in a dream, and by some natural coincidence is fulfilled. The following interesting cases that fell under Dr. Abercrombie's immediate notice, illustrate his views and the above classification.

Regarding the first class, Dr. A. relates the following: "A woman, who was a patient in the clinical ward of the infirmary of Edinburgh, under the care of Dr. Duncan, talked a great deal in her sleep, and made numerous and very distinct allusions to the cases of other sick persons. These allusions did not apply to any patients who were in the ward at the time; but, after some observation, they were found to refer correctly to the cases of individuals who were there when this woman was a patient in the ward two years before."

The following is an instance of phantasms being produced by our associations with bodily sensations, and tends to show how alive our faculties continue during sleep to the slightest impressions:

The subject of this observation was an officer in the expedition to Louisburg in 1758, who had this peculiarity in so remarkable a degree, that his companions in the transport were in the constant habit of amusing themselves at his expense. They could produce in him any kind of dream by whispering in his ear, especially if this was done by a friend with whose voice he had become familiar. One time they conducted him through the whole progress of a quarrel, which ended in a duel; and when the parties were supposed to have met, a pistol was put into his hand, which he fired, and was awakened by the report. On another occasion they found him asleep on the top of a locker in the cabin, when they made him believe he had fallen overboard, and exhorted him to save himself by swimming. They then told him that a shark was pursuing him, and entreated him to dive for his life. He instantly did so, and with so much force as to throw himself from the locker upon the cabin floor, by which he was much bruised, and awakened of course. After the landing of the army at Louisburg, his friends found him one day asleep in his tent, and evidently much annoyed by the cannonading. They then made him believe that he was engaged, when he expressed great fear, and showed an evident disposition to run away. Against this they remonstrated, but at the same time increased his fears by imitating the groans of the wounded and the dying; and when he asked, as he often did, who was hit, they named his particular friends. At last they told him that the man next himself in his company had fallen, when he instantly sprung from his bed, rushed out of the tent, and was only roused from his danger and his dream by falling over the tent-ropes. A remarkable thing in this case was, that after these experiments he had no distinct recollection of his dreams, but only a confused feeling of oppression or fatigue, and used to tell his friends that he was sure they had been playing some trick upon him. It has been observed that we seldom feel courageous or daring in our dreams, and generally avoid danger when menaced by a foe, or exposed to any probable peril.

The third class of dreams relates to the revival of forgotten associations. The person in question was at the time connected with one of the principal banks in Glasgow, and was at his place at the teller's table, where money is paid, when a person entered demanding payment of a sum of six pounds. There were several people waiting, who were in turn entitled to be attended to before him; but he was remarkably impatient and rather noisy, and being besides a remarkable stammerer, he became so annoying, that another gentleman requested him to pay the money and get rid of him. He did so accordingly, but with an expression of impatience at being obliged to attend to him before his turn, and thought no more of the transaction. At the end of the year, which was eight or nine months after, the books of the bank could not be made to balance, the deficiency being exactly six pounds. Several days and nights had been spent in endeavouring to discover the error, but without success, when he returned home much fatigued, and went to bed. He dreamt of being at his place in the bank, and the whole transaction of the stammerer, as now detailed, passed before him in all its particulars. He awoke under the full impression that the dream would lead him to the discovery of what he was so anxiously in search of, and on examination he soon discovered that he had neglected to enter the sum which he had thus paid.

The following singular dreams are examples of the fourth class. A clergyman had come to Edinburgh from a short distance in the country, and was sleeping at an inn, when he dreamt of seeing a fire, and one of his children in the midst of it. He awoke with the impression, and instantly left town on his return home. When he arrived in sight of his house, he found it on fire, and got there in time to assist in saving one of his children, who in the alarm and confusion had been left in a situation of danger.

A gentleman in Edinburgh was affected with aneurism of the popliteal artery, for which he was under the care of two eminent surgeons, and the day was fixed for the operation. About two days before the appointed time, the wife of the patient dreamt that a favourable change had taken place in the disease, in consequence of which the operation would not be required. On examining the tumour in the morning, the gentleman was astonished to find that the pulsation had entirely ceased, and, in short, this turned out to be a spontaneous cure,--a very rare occurrence in surgical practice.

The following dream is still more remarkable. A lady dreamt that an aged female relative had been murdered by a black servant, and the dream occurred more than once. She was then so impressed by it, that she went to the house of the lady, and prevailed upon a gentleman to watch in an adjoining room during the following night. About three o'clock in the morning, the gentleman, hearing footsteps on the stairs, left his place of concealment, and met the servant carrying up a quantity of coals. Being questioned as to where he was going, he replied, in a hurried and confused manner, that he was going to mend his mistress's fire, which at three o'clock in the morning in the middle of summer was evidently impossible; and, on further investigation, a strong knife was found concealed beneath the coals.