Page images
PDF
EPUB

Dr. A. goes on to state, that the Emperor had had a relapse, attended with ardent fever, acute pain in the liver, and also in the right ankle, with erysipelas of that limb, which symptoms he attributed to disorder of the digestive organs and of the hepatic functions. In all these phenomena, M. Hereau, on the contrary, sees nothing but the clearest symptoms of gastritis, with its attendant sympathetic affections, such as the inflammation of the ankle-joint.

On the 17th March, 1821, Antommarchi writes again to the Chevalier Colonna, that, since his last report, the hepatic disease had gained ground, and produced general disorder of the digestive organs. The patient could now only take small quantities of liquid nourishment, and even these were sometimes rejected by vomiting. On the 21st March, a small dose of emetic medicine was given, and next day the abdomen became swelled, accompanied with a paroxysm of ague fever, great oppression at the epigastrium, and sense of suffocation, from the great quantity of glairy fluid secreted from the alimentary and aerial passages. The patient demanded and took an emetic. The following day there was a severe paroxysm of fever, with icy coldness of the lower extremities-meteorism of the abdomen (tympanitis)-obstinate constipation. The emetic was again repeated, and followed by the same accident. On the 25th March, Dr. Arnott, of the 20th Regiment, advised a large blister over the abdomen-to exhibit strong purgatives, &c. This advice was rejected by the Emperor, because it was English practice. Lavements, however brought away large quantities of dense and glutinous matters. The Emperor's aversion to any thing in the shape of medicine, however simple or palatable, was truly astonishing! Heaven help the faculty in this country, should Napoleon's taste ever become the prevailing one. They might shut up shop at once! C'est une chose inouïe que l'aversion que je porte aux medicaments. Je courais les dangers avec indifference-je voyais la mort sans emotion--et je ne peux quelque effort que je fasse, approcher de mes levres un vase qui renferme la plus légère preparation!" Bonaparte was not only a spoiled child of FORTUNE, but also of PHYSIC! He had hardly ever taken a dose of Doctor's stuff, from infancy till the time of his last illness.

We find some trifling medicines, however, exhibited, and gastric irritability increase. On the 10th April, Dr. Arnott, after an examination of the royal patient, affirmed that the disease was not in the liver, but in the stomach. Saline effervescing medicines were now ordered, with opiates. The vomiting continued, with much pain in the gastric and intestinal regions. On the 18th April, he refused to take any more physic, and made a speech to Dr. Arnott, which is full of poignant accusations towards our government, and especially-"l'infame Hudson Lowe." On the 28th of the same month, the Emperor began to agree with the opinion of Dr. Arnott, contrary to that of Antommarchi, that the stomach was the seat of organic disease; and he desired that his body might be examined after death. The vomitings were very frequent, and the Emperor expressed an opinion that he was dying of the same disease which killed his father-scirrhus of the pylorus. Doctor," said he, take particular care to examine this part -put your remarks on paper, and send them to my son. I could wish to guard him, at least, from this disease." On the 2d of May, we find the royal sufferer delirious-and on the 5th his mortal career ceased!

[ocr errors]
[ocr errors]

We will not follow M. Hereau through the train of bitter reflexions which he pours on the medical attendants, and especially on M. Antommarchi, whom he loads with curses for his ignorance and obstinacy. We shall pro

ceed at once to the post-mortem examination, avoiding, however, a great deal of useless detail respecting unimportant parts, and also the phrenological admeasurements of the Emperor's head, put on record by Antommarchi.

Dissection. Besides the Generals Bertrand and Montholon, there were present Drs. Short, Arnott, Mitchell, Livingstone, and several other medical gentlemen.

The body was considerably emaciated-not being one-fourth the size it was when Antommarchi arrived on the Island. The abdomen was very much distended. The left side of the chest contained a few ounces of clear yellow serum, and the costal and pulmonary pleura was covered with coagulable lymph. The superior lobe of this lung was studded with tubercles, and there were some small tubercular excavations. There was rather a larger

quantity of clear effusion in the right side of the chest. The right lung was sound. The mucous membrane of the trachea and bronchia was red and inflamed. There was nothing particular about the pericardium, heart, or great vessels.

[ocr errors]

There was much gas in the cavity of the peritoneum, and a soft transparent exudation covered the surface of this membrane, parietal and intestinal. The liver and spleen, indurated (durcis,) were very large and gorged with blood, (tres volumineux, &c.)--but the structure of the liver did not present any notable organic change. The gall-bladder was distended with thick and viscid bile. The liver, which was affected with chronic hepatitis, was intimately adherent, on its convex side, to the diaphragm, by means of strong and old membranes." The concave surface was strongly adherent to the stomach. The stomach itself appeared externally quite sound, exhibiting no trace of phlogosis. At the distance of three inches from the pylorus, however, where the stomach was strongly adherent to the liver, the coats of this organ were completely penetrated by an aperture. On opening the stomach, some glairy, acrid, and coffee-coloured matters were found in its cavity-and these being washed out, the mucous membrane was observed to be natural, between the small and the great cul-de-sac of this organ-" depuis le petit jusq'au grand cul-de-sac de ce viscere." Almost the whole of the rest of the internal surface of the stomach was occupied by one vast cancerous ulcer, ulcere cancereux," destructive of all, except the peritoneal coat of the organ. The pyloric extremity of the stomach was scirrhous, to the extent of an inch from the pylorus. The opening, at this part, was natural. The little epiploon was indurated and very much degenerated. The lymphatic glands of this part were enlarged, scirrhous, and some of them suppurated. The mucous membrane of the intestines was healthy. There was no other disease, cognizable by the senses, in the body. Such is the post-mortem examination, as recorded by Antommarchi. Another and much shorter account is given by the English medical attendants, differing, in some essential points, from that of the Italian physician.*

Viewing the author of the work before us as a special pleader, or an advocate, whose object (leaving duty out of the question) was to make all circum

* They tell us that, with the exception of adhesions to the stomach and diaphragm, the liver presented no morbid appearance, and they say nothing whatever respecting enlargement of that organ, or of the spleen. On the other hand, they tell us, that "almost the whole internal surface of the stomach presented one mass of cancerous affections, or of scirrhous parts changing into cancer, especially in the neighbourhood of the pylorus. The cardiac extremity only, and that of very small extent, was sound."

stances tend to support one particular point of view, we determined, like an impartial judge, to weigh the facts or evidence, without listening at all to the arguments of the pleader, and to come to a conclusion, uninfluenced by declamation or prejudice. We, therefore, made up our mind, before we read the commentaries of M. Hereau, lest we should be drawn aside by specious or sophistical ratiocination.

"" Who is

It is evident, from the accounts published by both parties, that the Emperor died of the disease in the stomach. Nor is there any proof, even in Antommarchi's version of the dissection, of HEPATITIS. The term "tres volumineux," is a mere comparative expression, and is contradicted by the English examiners who assert that "le foi ne presentait rien de malsain." In respect to the function of the liver, we have no doubt that it was disordered; but it is not a little strange that so many medical men in succession should fall into such delusion, day after day, and month after month, regarding the imaginary disease of the liver!! The nature of the disease of the stomach can scarcely admit of a doubt. Both parties agree in describing the disease as of the cancerous and scirrhous character. Into a long discussion with M. Hereau respecting GASTRITIS as the veritable nature of the complaint, we shall not enter. Neither shall we attempt to persuade him (for it is quite impossible) that this said gastritis, allowing it to be such, was not caused by the incendiary and murderous treatment of the English medical attendants. M. Hereau has no doubt about the matter-although he records the almost total abstinence from physic which Napoleon observed till a late period of his disease! As for scirrhus or cancer of the stomach, in this case, our author treats the idea with sovereign contempt. the physician," says he, "that could fail to recognise in the appearances above-mentioned, the ordinary effects of chronic inflammation kept up by perpetual excitation." Without entering into the litigated doctrines of hereditary diseases, we confess that we can see nothing in the post mortem examination, or in the living phenomena here recorded, which induces us to refer the disease of the illustrious patient exclusively to gastritis, independently of any disposition to that specific and morbid process denominated scirrhus or cancer. We are quite willing to allow that the host of moral and physical causes, of a depressing character, which had been operating on the mind and body of Napoleon, long before he was exaptriated to St. Helena, must have had a powerful influence in deranging the functions, not only of the stomach, but of all the other auxiliary organs of digestion. Still, if we consider the great temperance of the Ex-Emperor-his abstinence not only from all spirituous liquors, but even from medicine; we cannot bring our minds to the Broussaian doctrine, that inflammation-simply inflammation of the mucous membrane of the stomach and bowels was the necessary result of these moral and physical causes. If, on the other hand, we bear in mind the many instances which present themselves in practice, or are recorded on the fasti of medical science, where grief, and the other depressing passions call into activity the disposition to, or actually produce scirrhus and cancer of the stomach, we shall be inclined to conclude that the talents and fortune of Napoleon did not exempt him from the laws which govern and bind human nature in the humble as well as in the ambitious walks of life!

The case is extremely interesting in a medical as well as moral point of view. The remarkable tenacity with which both the English and the Italian medical attendants clung to the idea of HEPATITIS, and by which prepossession they overlooked the more fatal malady going on in the STOMACH, is deserving of record, though we cannot join in the acrimonious censure which

M. Hereau has poured on them. As we said before, there were several symptoms which might readily lead astray the practitioner, and induce him to think they were attributable to disease of the liver, when the extensive sympathies of the stomach were the real agents and actors in the drama. It must also be conceded, that the gastric phenomena were comparatively faint--or, at all events, they were much less prominent than might have been expected, till a late period of the disease. The inflammation in the chest-that in the membrane of the liver, and even in the peritoneum, was not accompanied by manifest or corresponding symptoms. Perhaps the character of Napoleon-his scepticism as to the powers, and his aversion to the taste of medicine, contributed to veil the whole case in a cloud of mystery which would not have attended a similar complaint in the ordinary race of mortals.

In philosophical reflections on this occasion we dare not indulge; else we should be inclined to point out the eventful life and melancholy death of NAPOLEON as affording the most instructive moral lesson that has ever been recorded on the page of history! The magic eye of imagination cannot help glancing back on the career of this wonderful man, from his humble birth on a miserable island in the Mediterranean, up to the possession of Europe's sceptre—and down again to the captive's wretched cell and sepulchre amid the barren crags of a rock, a thousand miles from any habitable shore ! When we picture to ourselves his dawning military genius at Toulon-his daring and decided politics in the storms of the Revolution-his Cæsarian ambition in assuming the purple--his rivalry of Hannibal in urging an army, with heavy artillery, over the frozen and apparently impassable summits of the very Alps crossed by the Carthagenian General

"So when proud ROME the Afric warrior braved,
"And high on Alps his crimson banners waved;
"Though rocks on rocks their beetling brows oppose,
"With piney forests and unfathomed snows-
"Where girt with clouds the rifted mountain yawns,
"And chills with length of shade the dewy lawns,
"Onward he marched to LATIUM's velvet ground!"

his Alexandrine bravery on many a bloody field, as well as his Alexandrine temerity, in warring against the elements themselves

"On Eypt's burning sands and Russia's snows”—

when (we say) we picture to our imagination these, and many other scenes of Napoleon's "strange eventful history," we are apt to be dazzled with the splendour of his arms and the lustre of his fame! But PROVIDENCE has not permitted such a facinating picture to be held up to man's ambitious view without a reverse. The halo of glory around Napoleon, which excited amazement and envy throughout the world at large, was consuming the soul of the hero with anxiety-perhaps with fear; and, the man who conquered myriads of veterans on the field of Austerlitz, was urged to commit midnight murder on the disarmed and defenceless Duc D'ENGHIEN!

Non enim Gaza, neque consularis
Submovet lictor miseros tumultus
Mentis, et curas laqueata circum
Tecta volantes!

But what signifies an individual life! The poisoned sick at Jaffa— the frozen army on the plains of Moscow, are but as mere specks in the

galaxy of havoc and destruction which marked the path of one ambitious man! Is it then wonderful-is it inconsistent with retributive justice, or an over-ruling providence, that the cause of so many wars, of such waste and expenditure of human life,-that Napoleon the destroyer, (for every great warrior is a destructive angel) should taste the bitter cup of suffering before he quitted the stage? Is he who fertilised the soil of Europe, for 20 years, with the blood of its inhabitants, to be held up as an object of universal commiseration, because he was insulated from general society, in a place where he could do no harm-because the atmosphere of St. Helena was not as bright as that of Italy-because his house of exile at Longwood was not as commodious as Versailles-because it was not, or rather (without meaning a pun) because it was a MAL-MAISON! MAL-MAISON! We believe, indeed, that Napoleon performed in this world, an exemplary expiation for whatever crimes he may have committed;-but we are convinced, at the same time, that his sufferings, mental and corporeal, were principally owing to himself. If he had been half as much the PHILOSOPHER in adversity as he was the HERO in prosperity, he might have ended his days, and very much protracted them, even at St. Helena, by scorning the petty insults of his narrow-minded jailor, and by dedicating the remainder of his life to literary recreations and a record of his eventful career. Instead of exhibiting this true PHILOSOPHY-this true HEROISM, we find the conqueror of Europe fretted about every the most trifling concern of his little establishmentquarrelling about his wine, his beef, his rations, with as much intensity as a discontented sailor in a ship of war :-pouring forth his lugubrious grievances about provender, &c. &c. to Mr. O'Meara and M. Antommarchi, with as much-nay, with far more solemnity than he formerly pronounced the dethronement of kings, and the extinction of nations! Was this in conformity with the precepts of philosophy of which he boasted so much?

[blocks in formation]

The disease and death of Napoleon are worthy of record on the page of medical history-while his life and captivity will furnish ample materials for the pens of the politician, historian, philosopher, and divine. We have performed our part of the task.

[merged small][ocr errors]

ON THE TREATMENT OF ABSCESS IN THE LIVER. By Mr. Annesley.

[ocr errors]

[Art. IV.]

In a former number, we introduced Mr. Annesley's observations on the symptomatology of hepatic abscess. He has dedicated a section to the

TREATMENT, which we are now to notice.

It is to be borne in mind that, although matter may be actually forming in the liver, yet the inflammatory action which produced it does not cease altogether with that event. In some cases it continues with considerable activity untill the abscess either makes its way externally or communicates

« PreviousContinue »