The Day the Universe Changed - James Burke [106]
In 1839, the same year, the Czech J. E. Purkinje found a jelly-like substance in animal ova and embryonic cells. He called it ‘protoplasm’or ‘substance permitting the manifestation of life’. In this half-solid, half-liquid substance lay the elementary particles of the organism. Was this the locus of life itself? The protoplasm was avidly studied. In 1846 Karl von Beer described the cleavage of a living sea-urchin egg, and noted that, before division, the nucleus had already split into two halves. In 1852 Robert Remak made the famous statement: ‘Omnis cellula e cellula’ (all cells come from other cells).
The man who brought cell theory to its triumphant maturity was another German, Rudolf Virchow, who was to become known as ‘the Pope of German medicine’because of his extraordinary influence on the entire science. A radical in early life, Virchow was involved in the German revolution of 1848. His work was to set the German medical community firmly on the road to experimental physiology.
Virchow concentrated on the area of each cell and its nucleus. He showed that some cells were specialists, producing secretions, pigments, nails or lenses. Particularly specialised were the group of cells that made cartilage, bone, connecting tissue, blood vessels and muscle fibre. Virchow also examined cellular activity in phlebitis, leucocytosis, thrombosis, blood pigmentation, inflammation, tumours and eudation. Wherever he looked he became more and more convinced that disease was a phenomenon which attacked the cell and caused it to degrade, or behave differently, so as for example to produce pus.
’We can go no farther than the cell,’he said. ‘It is the final and constantly present link in the great chain of mutually subordinated structures comprising the human body.’Virchow offered an entirely new view of illness and health, and their relationship, in an observation which altered the medical profession’s view of every aspect of their work:’… the subjects of therapy are not diseases but conditions… we are everywhere concerned only with changes in the conditions of life. Disease is nothing but life under altered conditions.’And in a bow towards his absolutist political masters, he added: ‘An organism is a society of living cells, a tiny well-ordered state.’
This progress towards the investigation of the deep structure of the body and away from involvement with the conscious patient was furthered by a technical development. At the beginning of the nineteenth century, in an England industrially well advanced, there had been much interest in ‘pneumatic chemistry’, and various attempts had been made to discover the composition of air. During these investigations, which were conducted principally by Lavoisier and Priestley, and which included the identification of gases given off when certain materials were burnt, nitrous oxide had been isolated. In 1798 an assistant at the Dr Thomas Beddoes Pneumatic Institute in Bristol breathed in the substance. His name was Humphry Davy, and when he later became a lecturer at the Royal Institute in London he gave lectures on this strange ‘laughing gas’. Although Davy himself had remarked on its potential for medical application the gas was predominantly used at fairs and parties. The effects of the gas on those inhaling it gave such affairs the name of ‘ether frolics’.
The first recorded medical application was by an American called Crawford Williamson Long, who was probably himself an addict, as was his patient. Long was a general practitioner in Jefferson County, Georgia, and later claimed to have tried inhaling ether as early as 1842. It was he who discovered its anaesthetic effect when he removed a tumour in the neck of a patient who had breathed the ether.
Lavoisier’s experiments on air established the life-giving properties of oxygen. Unfortunately, his tax-collecting activities cost him his own life during the French Revolution.
On 16 October 1846 the first publicly witnessed operation was