AN EIGHTEENTH CENTURY NEUROLOGIST*

By JOHN D. COMRIE, M.A., B.Sc., M.D., F.R.C.P.

Lecturer on History of Medicine, and on Clinical Medicine, University of Edinburgh.

The subject of this sketch, Robert Whytt (pronounced " White "),

was Professor of the Institutes of Medicine and of Medicine at

Edinburgh University in the middle of the eighteenth century. A man of philosophic attitude in medicine, he has been over- shadowed both during his lifetime and since his death by the more robust and practical personality of his senior contemporary and successor in the Chair of Medicine, William Cullen.

Cullen was born in 1710, Whytt in 1714- Whytt became Professor of Medicine in 1747 at the age of thirty-three, and passed out at the early age of fifty-two in 1766. Cullen did not succeed to this Chair until 1773, when he was sixty-three years of age, but he maintained a vigorous life and a huge consulting practice till the age of seventy-nine. The posthumous fame of Cullen has been a solid part of the foundation upon which rests the reputation of the Edinburgh Medical School, while Whytt has been almost forgotten and posterity has done bare justice to his writings.

Whytt's father was a member of the Scottish Bar and

proprietor of the estate of Bennochy. He died six months before Robert Whytt was born, and the mother died when the future physician was six years old. His mother having gone to reside at Kirkcaldy, the boy received his early education in the public school there, and later went to St Andrews

University, where he graduated in Arts in 173?- The next four years he spent in Edinburgh, studying medicine at the school which Monro (primus), Sinclair, Rutherford, Innes, and Plummer had done much to develop in the previous decade. In 1736 he graduated M.D. at Rheims, and returning to

Scotland next year received the degree of M.D. also from St Andrews University. In 1737 be joined the Edinburgh College of Physicians as a Licentiate, started medical practice in Edinburgh, and became a Fellow of the College in the

following year. About the time that Whytt commenced to practise, great * Read before the Fifth International Congress for History of Medicine

at Geneva on 21st July 1925. 755

John D. Comrie

public interest was manifested in the search for substances

which would dissolve stones in the bladder. This was probably due to several well-known persons having suffered from calculus about the period, but the condition seems in any case to have been commoner then than now. In 1739 a secret remedy, sold by Mrs Joanna Stephens, was considered so effectual

in dissolving stones that the secret was actually purchased by

the British Government of the day for ^5000. On disclosure it was found to consist of calcined egg-shells, soap, and aromatic bitters! Whytt had taken a great deal of interest in this

subject, and carried out an elaborate series of experiments in the Royal Infirmary of Edinburgh with lime-water made from calcined egg-shells, cockle-shells, oyster-shells, etc., which he

found had a considerable power in disintegrating calculi. Not

only had he tried the effects of the solvent in vitro, but he had carried out courses of injections into the bladder of various

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Robert Whytt, M.D., F.R.S., 1714-1766. From a portrait in the Royal College oj Physicians at Edinburgh.

Robert Whytt, M.D., F.R.S., 1714-1766. From a portrait in the Royal College oj Physicians at Edinburgh.

An Eighteenth Century Neurologist patients in the Infirmary who were suffering from vesical

calculus. His " Essay on the Virtue of Lime-water and Soap in the Cure of the Stone" was first published in 1743. In a

third editionj published in 1761, were included statements by the Right Honourable Horace Walpole, the Bishop of Llandaffe, and other eminent sufferers from stone in the bladder, bearing testimony to the success of the treatment. The treatment

upon which he finally settled was to administer daily, by the

mouth, an ounce of alicant soap and three pints or more of 1 lime-water.

An important scientific result of these researches in regard to the properties of alkalies was that Joseph Black was led

by them to his elaborate series of " Experiments upon Magnesia Alba, Quicklime, and other Alcaline Substances." While

searching for a better solvent for stones, Black in 1754 made

his great discovery of the first-known gas, " fixed air "(carbon

dioxide). Whytt busied himself, for some years after his appointment

as Professor in the University of Edinburgh, chiefly with

physiological researches. To this period belong "An Essay on the Vital and other Involuntary Motions of Animals," first

published in 1751 ; and two "

Physiological Essays" published in 1755. Of these the one was "An Inquiry into the Causes which promote the Circulation of the Fluids in the very small

Vessels of Animals." The other was entitled "Observations

on the Sensibility and Irritability of the Parts of Men and other Animals: occasioned by M. de Haller's late Treatise

on these Subjects." The Essay on Vital and Involuntary Motions contains a

? record of numerous experiments dealing especially with the

reflex movements. Descartes, in his treatise Des passiotis de

Vdme (1649), had given an explanation of reflex action, as

for example closure of the eyes on the sudden approach of an

object to them. Various other observers had pointed out

examples of reflex action, e.g., Robert Boyle had shown that a viper wriggles when pricked even several days after its head

has been cut off, and Stephen Hales showed that destruction of the spinal cord prevented reflex action. Whytt, however, was

the first to localise a reflex by showing that lasting dilatation of

the pupil might be due to compression of the optic thalamus

(p. 71). He also showed that the brain is unnecessary for

reflex action, and that a portion of the cord suffices for this, 757

!?

John D. Comrie

for in a brainless frog the reflexes of the upper and lower limbs are in different parts of the cord (p. 203). These are the first

attempts, I believe, since the time of Galen, to localise the seat of reflex acts. They preceded by nearly a century the important memoir presented to the Royal Society by Marshall Hall (1833) on

" The Reflex Function of the Medulla Oblongata and Medulla Spinalis." In this work too, Whytt discarded the doctrine of Stahl that the " rational soul" is the cause of all involuntary movements in animals, and he ascribed such movements to

"the effect of a stimulus acting on an unconscious sentient

principle." It is somewhat difficult at the present day to

understand the importance of the distinction. One of the Essays published in 1755, "On the Sensibility

and Irritability of the Parts of Men and Animals," brought Whytt into conflict with Albrecht von Haller, and so gained for him prominent notice in Germany, Switzerland, and France. Haller, in his treatise published in 1752,

" De partibus corporis humani sensibilibus et irritabilibus," had laid down the principle that certain parts of the body possessed sensibility, others none. Haller further had contended that "irritability," or power of

contraction, was an innate property (vis insita) of muscle fibres, independent of nervous influence and having no connection with sensation. The whole dispute, both on the side of Haller and on that of Whytt, was of a dialectic character, and tended like metaphysical disputations rather to involve the names of things than actual facts of nature. It must be remembered too that the dispute took place between sixty and seventy years before the experiments of Bell (1811) and Magendie (1822) showed the separate existence of motor and sensory nerve

paths. Whytt advanced some telling arguments in support of his contention that all muscular action was governed by nervous control. If, he says, irritability of muscles is not owing somehow to the nerves or their influence, why should irritation of the nerves or medulla produce convulsions ? Again, he says, irritability bears a proportion to sensibility and whatever

increases the latter increases irritability (e.g., inflammation). Also whatever lessens or destroys the sensibility, of muscles, also lessens or destroys their power of motion (e.g., cold). Finally, he argues, the very term irritability seems to imply a kind of life or feeling in the part endowed with it, for we never talk of irritating a stone, tree, or other inanimate object. Whether he convinced Haller or not, Whytt, in the opinion of

758

An Eighteenth Century Neurologist his contemporaries, seems to have got the better of him in

the

dispute. Of much more permanent interest, however, is Whytt's

" Observations on the Nature, Causes, and Cure of those

Disorders which are commonly called Nervous, Hypochondriac, or Hysteric." This was published in 1764. These disorders,

he says, " in a peculiar sense deserve the name of nervous,

in so far as they are, in a great measure, owing to an uncommon

delicacy or unnatural sensibility of the nerves, and are therefore observed chiefly to affect persons of such a constitution

"

(p. 489). Whytt repudiates any explanation of nervous phenomena depending upon what was a favourite mode of speech in his time, viz., "dispersion, confusion, or jarring contest of the

animal spirits." He postulates a "general sympathy" of the nerves which prevails through the whole system ; and he adds, " from this sentient and sympathetic power of the nerves, I have

endeavoured to deduce the various symptoms of the nervous kind." This treatise, which runs to 236 quarto pages, is his

most elaborate work. It shows great clinical acumen and is

well worth reading still, particularly for the vivid accounts that

Whytt gives of a great number of cases of hysteria and similar conditions.

The sympathy of the nerves in different parts includes cases of what we should call " referred pain," and Whytt to a con- siderable extent anticipates the recent concepts of Sir James

Mackenzie, Dr Henry Head and others, although he does not work out the matter with the same anatomical exactitude that

characterised the modern investigators. He refers, for example, t0 " a particular sympathy between the nerves distributed

to the

teguments of the abdomen and those of the intestines "

(p. 542)* He also mentions the pain felt in the groins and down

the thighs in scirrhus of the uterus.

Whytt's chief claim to lasting remembrance, however, lies

in the fact that he was the first to give a clear description of tuberculous meningitis, or, as he called it,

" Observations

on the Dropsy in the Brain." This is a short treatise, of

23 quarto pages, included in the collected works published after

his death. It has been warmly praised by various persons,

including the late Sir William Osier. The disease is still

described according to the three stages into which Whytt divided its symptoms, and even at the present day

there is little

to add from the clinical aspect to his description. 759

John D. Comrie Monro (secundus), who acted as Professor of Anatomy at

Edinburgh from 1754 to 1798, and whose name is familiar to

medical students in connection with the foramen connecting the lateral and third ventricles of the brain, has an interesting point of contact with Whytt in this connection. The foramen was

first observed greatly dilated in a case of hydrocephalus which

Monro and YVhytt saw in consultation in the year 1764. The

dilated foramen is figured in Monro's " Observations on the

Nervous System" (1783), Plate III., fig. 4. To continue the facts of Whytt's life. In 1752 he was

elected a Fellow of the Royal Society of London as the result of the reputation gained by his

"

Essay on the Vital and other

Involuntary Motions of Animals." Several short communica-

tions were addressed to this Society. In 1761 he was me

Tombstone of Robert Whytt in Greyfriars Churchyard. Tombstone of Robert Whytt in Greyfriars Churchyard.

An Eighteenth Century Neurologist Physician to the King in Scotland, and in 1763 he was elected President of the Royal College of Physicians at Edinburgh. He had many friends and correspondents in various parts of the

world, and in particular he maintained a close friendship with Sir John Pringle, who had been a fellow-student. He was twice

married, but was unfortunate in his family. The two children of the first marriage died in infancy, and of the fourteen children by the second wife only six reached adult years. Whytt himself was not of robust constitution, and in 1765 he took ill, dying in the following year with symptoms suggestive of diabetes. He was buried in Greyfriars Churchyard.

References.? Works of Robert Whytt, M.D., published by his son, !768. (JV.B.?The references are to pages in this work.) Dictionary of National Biography for Short Life. Memoir of the Life and Writings of Robert Whytt, M.D., by William Seller, M.D., 1862. The Life and Work ?f Robert Whytt, M.D., by Dr R. Mary Barclay (M.D. Thesis 1922).

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