Andrew Marshal1742–1813

Marshaling the facts

Marshal was born near Newburgh, Fife, and initially trained in divinity at Edinburgh and later medicine at the same university, being awarded M.D. in 1782 for a dissertation on military medicine. After several years serving as surgeon to the Glasgow Regiment, Marshal returned to London in 1783 and set up a school of anatomy at Thavies Inn, London, in 1785, which attracted many students. The school closed in 1800, although Marshal continued in his medical practice for another 12 years. Between 1786 and 1794 Marshal dissected the brains of 22 patients, most from Bethlem Hospital. He described the characteristics of the mania for each patient, followed by the morbid appearances of the brain. Marshal also noted the effects of loss of the penis as a result of a gunshot wound, and, as did Hunter with his cases, he related it to the other senses: “When we compare the different senses together, two or three observations occur to us; one is, that the first four senses take place only when certain due degrees of impression are made on the extremities of the nerves distributed to that organ: if the impression is too slight, no peculiar sensation arises; if it exceeds in measure, instead of the sense of seeing, hearing, &c. there is merely a sense of pain. Thus the first four senses, when their organs are injured, agree with the sense of feeling. Another observation is, that as the sense of feeling arises from impressions made in those parts of the body, so it is more difficult to destroy than the other senses. When the extremities of the nerves of the other senses are destroyed, peculiar sensations connected with them also cease, as was mentioned above: but the remaining body of nerves retains a sense of feeling; and the extremities of the nerves appropriated to feeling only, being destroyed, the extremities of the portion left resume the peculiar susceptibility of the original extremities. In the case of W. Scott, whose penis was carried off by a gun-shot, the stump of it, which was even with the skin of the pubis, resumed the peculiar sensibility of the glans penis; also the cicatrix of sores in other parts of the body is susceptible to impressions of touch”. Marshal kept copious notes of his dissections and discoveries and these were assembled after his death by his erstwhile assistant, Solomon Sawrey (1765-1825). It was in this collection that the case above was reported. In his Editor’s Preface, Sawrey noted that Marshal: “was perpetually committing his thoughts to paper as they arose; but he could never be persuaded to put them into a state fit to be published. He had formed many new and interesting opinions upon different topics connected with his profession; and as he frequently mentioned them in conversation and in his lectures, many of them, from time to time, got abroad, and have been adopted, in the medical world, without either recollection or knowledge of their original author.” Marshal is shown in a frontispiece silhouette from his book on Morbid Anatomy, the title page of which is also given.