Chapter IV: , VII (171)

Paracelsus, of whose many names this one stands alone in
history to represent him, was an extraordinary person, born in
Switzerland, in 1493. He died in 1541. "His character has been
very variously estimated. The obstructives of his own age and
many hasty judges since have pronounced him a quack. This is
simply ridiculous. As a chemist, he is considered to have been
the discoverer of zinc, and perhaps of bismuth. He was
acquainted with hydrogen, muriatic, and sulphurous gases. He
distinguished alum from the vitriols; remarking that the
former contained an earth, and the latter metals. He perceived
the part played by the atmosphere in combustion, and
recognized the analogy between combustion and respiration. He
saw that in the organic system chemical processes are
constantly going on. Thus, to him is due the fundamental idea
from which have sprung the chemico-physiological researches of
Liebig, Mulder, Boussingault, and others. By using in
medicine, not crude vegetables, but their active principles,
he opened the way to the discovery of the proximate principles
of vegetables, organic alkalis, and the like. But perhaps the
greatest service he rendered to chemistry, was by declaring it
an essential part of medical education, and by showing that
its true practical application lay not in gold-making, but in
pharmacy and the industrial arts. In medicine he scouted the
fearfully complex electuaries and mixtures of the Galenists
and the Arabian polypharmacists, recommending simpler and more
active preparations. He showed that the idea of poison is
merely relative, and knew that poisons in suitable doses may
be employed in medicine. He prescribed tin as a remedy for
intestinal worms, mercury as an anti-syphilitic, and lead in
the diseases of the skin. He also used preparations of
antimony, arsenic, and iron. He employed sulphuric acid in the
treatment of saturnine affections. The astonishing cures which
he undoubtedly performed were, however, due not so much to his
peculiar medicines, as to his eminent sagacity and insight. He
showed the importance of a chemical examination of urine for
the diagnosis of disease."

_J. W. Slater,
Paracelsus
(Imperial Dict. of Univ. Biog.)._

MEDICAL SCIENCE: 16th Century.
The first English College of Physicians.

"The modern doctor dates only from the reign of Henry VIII.,
when the College of Physicians in England was founded as a
body corporate by letters patent in the tenth year of the
reign. This grant was in response to a petition from a few of
the most notable members of the profession resident in London,
who were perhaps moved by both a laudable zeal in the
interests of science, and a compassion for the sufferings of
the subjects of astrological and toxicological experiments.
The charter thus obtained, though probably drafted by the
promoters themselves, was found to be so inadequately worded
and expressed, that it became necessary to obtain powers to
amend it by Act of Parliament. Among these early members were
Linacre, Wotton, and others, famous scholars beyond doubt,
though possibly but indifferent practitioners. In fact, we are
constantly struck throughout the early history of the
profession by the frequent occurrence of names associated with
almost every other branch of study than that strictly
appertaining to the art of medicine. We have naturalists,
magneticians, astronomers, mathematicians, logicians, and
classical scholars, but scarce one who accomplished anything
worthy to be recorded in the annals of medical science. Indeed
it is difficult to conceive any useful object that could have
been attained by the existence of the College as a
professional licensing body, other than the pecuniary
interests of the orthodox. … It is most significant as to
the social degradation of the science of medicine, that most
of the notorious empirics of the latter half of the sixteenth
century were both highly recommended and strenuously supported
in their resistance to the proctors of orthodoxy by some of
the greatest names of the age. These self-deluded victims of
quackery were not indeed adverse in theory to the pretensions
of more regular members of the profession.
{2133}
They would patronize the Court physicians, or, if favorites of
the Crown, they might even submit to the Sovereign's
recommendation in that behalf; but none the less their family
doctor was in far too many cases some outlandish professor of
occult arts, retained in learned state on the premises, who
undertook the speedy, not to say miraculous, cure of his
patron's particular disease by all the charms of the Cabala."

_H. Hall,
The Early Medicus
(Merry England; also in Eclectic Magazine, June, 1884)._

MEDICAL SCIENCE: 16th Century.
The System of Van Helmont.

John Baptist van Helmont "was born at Brussels in the year
1577. … His parents were noble, and he was heir to great
possessions. He pursued in Louvain the usual course of
scholastic philosophy. … Becoming accidentally acquainted
with the writings of Thomas à Kempis and John Tauler, he from
that day adopted what goes by the vague term of mysticism.
That is, thoroughly convinced that there was a spiritual world
in intimate and eternal union with the spirit of man; that
this spiritual world was revealed to that human soul which
submitted to receive it in humility; and that the doctrines of
Christianity were not to be looked upon as a system of
philosophy; but as a rule of life, he resolved to follow them
to the letter. The consequence of this resolution was, that he
devoted himself to the art of medicine, in imitation of the
Great Healer of the body as well as of the soul; and as the
prejudices of his time and country made his rank and wealth an
obstacle to his entrance into the medical profession, he made
over all his property, with its honours, to his sister; that,
'laying aside every weight, he might run the race that was set
before him.' He entered on his new studies with all the zeal
of his character, and very soon had so completely mastered the
writings of Hippocrates and Galen, as to excite the surprise
of his contemporaries. But although styled a dreamer, and
having a mind easily moved to belief in spiritual
manifestation, he was not of a credulous nature in regard to
matters belonging to the senses. And as he believed that
Christianity was to be practised, and to be found true by the
test of experiment, so he believed that the doctrines of
Hippocrates and of Galen were to be subjected to a similar
trial. An opportunity soon occurred to himself. He caught the
itch and turned to Galen for its cure. Galen attributes this
disease to overheated bile and sour phlegm, and says that it
is to be cured by purgatives. Van Helmont, with the implicit
faith of his simple nature, procured the prescribed medicines,
and took them as ordered by Galen. Alas, no cure of the itch
followed, but great exhaustion of his whole body: so Galen was
not to be trusted. This was a serious discovery; for if he
could not trust Galen, by whom the whole medical world swore,
to whom was he to turn? … Van Helmont resolved to work out
for himself a solution of the great problem to which he had
devoted his life. Van Helmont's system may be called spiritual
vitalism. The primary cause of all organization was Archæus.
By Archæus, a man is much more nearly allied, he says, to the
world of spirits and the Father of spirits than to the
external world. Archæus is the creative spirit which, working
upon the raw material of water or fluidity, by means of 'a
ferment' excites all the endless actions which result in the
growth and nourishment of the body. Thus, digestion is neither
a chemical nor a mechanical operation; nor is it, as was then
supposed, the effects of heat, for it is arrested instead of
aided by fever, and goes on in perfection in fishes and
cold-blooded animals; but, on the command of Archæus, an acid
is generated in the stomach, which dissolves the food. This is
the first digestion. The second consists in the neutralization
of this acid by the bile out of the gall bladder. The third
takes place in the vessels of the mesentery. The fourth goes
on in the heart, by the action of the vital spirits. The fifth
consists in the conversion of the arterial blood into vital
spirits, chiefly in the brain. The sixth consists of the
preparation of nourishment in the laboratory of each organ,
during which operation Archæus, present everywhere, is itself
regenerated, and superintends the momentary regeneration of
the whole frame. If for digestion we substitute the word
nutrition, we cannot fail to be struck by the near approach to
accuracy in this description of the succession of processes by
which it is brought about. Van Helmont's pathology was quite
consistent with his physiology. As life and all vital action
depended upon Archæus, so the perturbation of Archæus gave
rise to fevers, and derangements of the blood and secretions.
Thus, gout was a disease not confined to the part in which it
showed itself, but was the result of Archæus. It will be seen
that by this theory the entire system of Galen was non-suited.
There is no place for the elements and the humours."

_J. R. Russell,
History and Heroes of the Art of Medicine,
chapter 8._

MEDICAL SCIENCE: 17th Century.
Harvey and the Discovery of the Circulation of the Blood.

William Harvey, "physician and discoverer of the circulation
of the blood, was born at Folkestone, Kent, 1 April 1578, in a
house which was in later times the posthouse of the town and
which still belongs to Caius College, Cambridge, to which
Harvey bequeathed it. His father was Thomas Harvey, a Kentish
yeoman. … In 1588 William was sent to the King's School,
Canterbury. Thence he went to Cambridge, where he was admitted
a pensioner in Gonville and Caius College, 31 May 1593. … He
graduated B. A. 1597, and, determining to study medicine,
travelled through France and Germany to Padua, the most famous
school of physic of that time. … He returned to England,
graduated M. D. at Cambridge 1602, and soon after took a house
in the parish of St. Martin-extra-Ludgate in London. … On 4
August 1615 he was elected Lumleian lecturer at the College of
Physicians, … and in the following April, on the 16th, 17th,
and 18th, he delivered at the college in Knightrider Street,
near St. Paul's Cathedral, the lectures in which he made the
first public statement of his thoughts on the circulation of
the blood. The notes from which he delivered these lectures
exist in their original manuscript and binding at the British
Museum. … In 1628, twelve years after his first statement of
it in his lectures, he published at Frankfurt, through William
Fitzer, his discovery of the circulation of the blood. The
book is a small quarto, entitled 'Exercitatio Anatomica de
Motu Cordis et Sanguinis in Animalibus,' and contains
seventy-two pages and two plates of diagrams. The printers
evidently had difficulty in reading the author's handwriting,
and there are many misprints. …
{2134}
He begins by modestly stating how the difficulties of the
subject had gradually become clear to him, and by expressing
with a quotation from the 'Andria' of Terence, the hope that
his discovery might help others to still further knowledge. He
then describes the motions of arteries, of the ventricles of
the heart, and of its auricles, as seen in living animals, and
the use of these movements. He shows that the blood coming
into the right auricle from the vena cava, and passing then to
the right ventricle, is pumped out to the lungs through the
pulmonary artery, passes through the parenchyma of the lungs,
and comes thence by the pulmonary veins to the left ventricle.
This same blood, he shows, is then pumped out to the body. It
is carried out by arteries and comes back by veins, performing
a complete circulation. He shows that, in a live snake, when
the great veins are tied some way from the heart, the piece of
vein between the ligature and the heart is empty, and further,
that blood coming from the heart is checked in an artery by a
ligature, so that there is blood between the heart and the
ligature and no blood beyond the ligature. He then shows how
the blood comes back to the heart by the veins, and
demonstrates their valves. These had before been described by
Hieronymus Fabricius of Aquapendente, but before Harvey no
exact explanation of their function had been given. He gives
diagrams showing the results of obstructing the veins, and
that these valves may thus be seen to prevent the flow of
blood in the veins in any direction except towards the heart.
After a summary of a few lines in the fourteenth chapter he
further illustrates the perpetual circuit of the blood, and
points out how morbid materials are carried from the heart all
over the body. The last chapter gives a masterly account of
the structure of the heart in men and animals, and points out
that the right ventricle is thinner than the left because it
has only to send the blood a short way into the lungs, while
the left ventricle has to pump it all over the body. This
great and original book at once attracted attention and
excited discussion. In the College of Physicians of London,
where Harvey had mentioned the discovery in his lectures every
year since 1616, the Exercitatio received all the honour it
deserved. On the continent of Europe it was received with less
favour, but neither in England nor abroad did anyone suggest
that the discovery was to be found in other writers. …
Before his death the great discovery of Harvey was accepted
throughout the medical world. The modern controversy … as to
whether the discovery was taken from some previous author is
sufficiently refuted by the opinion of the opponents of his
views in his own time, who agreed in denouncing the doctrine
as new; by the laborious method of gradual demonstration
obvious in his book and lectures; and, lastly, by the complete
absence of lucid demonstration of the action of the heart and
course of the blood in Cæsalpinus, Servetus, and all others
who have been suggested as possible originals of the
discovery. It remains to this day the greatest of the
discoveries of physiology, and its whole honour belongs to
Harvey."

_N. Moore,
Harvey
(Dict. of National Biog., volume 25)._

ALSO IN:
_R. Willis,
William Harvey: A history of the Discovery of
the Circulation of the Blood._

MEDICAL SCIENCE: 17th Century.
Discovery of the Lymphatic Circulation.

"The discovery of the lymphatic vessels and their purpose was
scarcely less remarkable than that of the circulation of the
blood. It has about it less of eclat, because it was not the
work of one man, but was a matter of slow development.
Herophilus and Erasistratus had seen white vessels connected
with the lymph nodes in the mesentery of certain animals, and
had supposed them to be arteries full of air. Galen disputed
this, and believed the intestinal chyle to be carried by the
veins of the mesentery into the liver. In 1563 Eustachius had
described the thoracic duct in the horse; in 1622 Aselli,
professor of anatomy at Milan, discovered the lacteal vessels
in a dog which had been killed immediately after eating.
Having pricked one of these by mistake, he saw a white fluid
issue from it. Repeating the same experiment at other times he
became certain that the white threads were vessels which drew
the chyle from the intestines. He observed the valves with
which they are supplied, and supposed these vessels to all
meet in the pancreas and to be continued into the liver. In
1647 Pecquet, who was still a student at Montpelier,
discovered the lymph reservoir, or receptaculum chyli, and the
canal which leads from it, i. e., the thoracic duct, which he
followed to its termination in the left subclavian vein.
Having ligated it he saw it swell below, and empty itself
above the ligature. He studied the courses of the lacteals,
and convinced himself that they all entered into the common
reservoir. His discovery gave the last blow to the ancient
theory, which attributed to the liver the function of blood
making, and it confirmed the doctrine of Harvey, while, like
it, it had been very strongly opposed. Strangely enough,
Harvey in this instance united with his great opponent,
Riolan, in making common cause against the discovery of
Pecquet and its significance. From that time the lymphatic
vessels and glands became objects of common interest and were
investigated by many anatomists, especially Bartholin, Ruysch,
the Hunters, Hewson, and above all by Mascagni. He was the
first to give a graphic description of the whole lymphatic
apparatus."

_Roswell Park,
Lectures on the History of Medicine (in MS.)._

MEDICAL SCIENCE: 17th Century.
Descartes and the dawn of modern Physiological science.

"The essence of modern, as contrasted with ancient,
physiological science appears to me to lie in its antagonism
to animistic hypotheses and animistic phraseology. It offers
physical explanations of vital phenomena, or frankly confesses
that it has none to offer. And, so far as I know, the first
person who gave expression to this modern view of physiology,
who was bold enough to enunciate the proposition that vital
phenomena, like all the other phenomena of the physical world,
are, in ultimate analysis, resolvable into matter and motion
was René Descartes. The fifty-four years of life of this most
original and powerful thinker are widely overlapped, on both
sides, by the eighty of Harvey, who survived his younger
contemporary by seven years, and takes pleasure in
acknowledging the French philosopher's appreciation of his
great discovery.
{2135}
In fact, Descartes accepted the doctrine of the circulation as
propounded by 'Harvæus médecin d'Angleterre,' and gave a full
account of it in his first work, the famous 'Discours de la
Méthode,' which was published in 1637, only nine years after
the exercitation 'De motu cordis;' and, though differing from
Harvey on some important points (in which it may be noted, in
passing, Descartes was wrong and Harvey right), he always
speaks of him with great respect. And so important does the
subject seem to Descartes that he returns to it in the 'Traité
des Passions' and in the 'Traité de l'Homme.' It is easy to
see that Harvey's work must have had a peculiar significance
for the subtle thinker, to whom we owe both the spiritualistic
and the materialistic philosophies of modern times. It was in
the very year of its publication, 1628, that Descartes
withdrew into that life of solitary investigation and
meditation of which his philosophy was the fruit. …
Descartes uses 'thought' as the equivalent of our modern term
'consciousness.' Thought is the function of the soul, and its
only function. Our natural heat and all the movements of the
body, says he, do not depend on the soul. Death does not take
place from any fault of the soul, but only because some of the
principal parts of the body become corrupted. … Descartes'
'Treatise on Man' is a sketch of human physiology, in which a
bold attempt is made to explain all the phenomena of life,
except those of consciousness, by physical reasonings. To a
mind turned in this direction, Harvey's exposition of the
heart and vessels as a hydraulic mechanism must have been
supremely welcome. Descartes was not a mere philosophical
theorist, but a hardworking dissector and experimenter, and he
held the strongest opinion respecting the practical value of
the new conception which he was introducing. … 'It is true,'
says he, 'that as medicine is now practised, it contains
little that is very useful; but without any desire to
depreciate, I am sure that there is no one, even among
professional men, who will not declare that all we know is
very little as compared with that which remains to be known;
and that we might escape an infinity of diseases of the mind,
no less than of the body, and even perhaps from the weakness
of old age, if we had sufficient knowledge of their causes and
of all the remedies with which nature has provided us.' So
strongly impressed was Descartes with this, that he resolved
to spend the rest of his life in trying to acquire such a
knowledge of nature as would lead to the construction of a
better medical doctrine. The anti-Cartesians found material
for cheap ridicule in these aspirations of the philosopher;
and it is almost needless to say that, in the thirteen years
which elapsed between the publication of the 'Discours' and
the death of Descartes, he did not contribute much to their
realisation. But, for the next century, all progress in
physiology took place along the lines which Descartes laid
down. The greatest physiological and pathological work of the
seventeenth century, Borelli's treatise 'De Motu Animalium,'
is, to all intents and purposes, a development of Descartes'
fundamental conception; and the same may be said of the
physiology and pathology of Boerhaave, whose authority
dominated in the medical world of the first half of the
eighteenth century. With the origin of modern chemistry, and
of electrical science, in the latter half of the eighteenth
century, aids in the analysis of the phenomena of life, of
which Descartes could not have dreamed, were offered to the
physiologist. And the greater part of the gigantic progress
which has been made in the present century is a justification
of the prevision of Descartes. For it consists, essentially,
in a more and more complete resolution of the grosser organs
of the living body into physico-chemical mechanisms. 'I shall
try to explain our whole bodily machinery in such a way, that
it will be no more necessary for us to suppose that the soul
produces such movements as are not voluntary, than it is to
think that there is in a clock a soul which causes it to show
the hours.' These words of Descartes might be appropriately
taken as a motto by the author of any modern treatise on
physiology."

_T. H. Huxley,
Connection of the Biological Sciences with Medicine
(Science and Culture, etc., lecture 13)._

MEDICAL SCIENCE: 17th Century.
Introduction of Peruvian Bark.

"The aborigines of South America appear, except perhaps in one
locality, to have been ignorant of the virtues of Peruvian
bark. This sovereign remedy is absent in the wallets of
itinerant doctors, whose materia medica has been handed down
from father to son, since the days of the Yncas. It is
mentioned neither by the Ynca Garcilasso de la Vega, nor by
Acosta, in their lists of Indian medicines. It seems probable,
nevertheless, that the Indians were aware of the virtues of
Peruvian bark in the neighborhood of Loxa, 230 miles south of
Quito, where its use was first made known to Europeans; and
the local name for the tree quina-quina, 'bark of bark,'
indicates that it was believed to possess some special
medicinal properties. … In 1638 the wife of Don Luis
Geronimo Fernandez de Cabrera Bobadilla y Mendoza, fourth
Count of Chinchon, and Viceroy of Peru, lay sick of an
intermittent fever in the palace of Lima. … The news of her
illness at Lima reached Don Francisco Lopez de Canizares, the
Corregidor of Loxa, who had become acquainted with the
febrifuge virtues of the bark. He sent a parcel of it to the
Vice-Queen, and the new remedy, administered by her physician,
Dr. Don Juan de Vega, effected a rapid and complete cure. …
The Countess of Chinchon returned to Spain in the spring of
1640, bringing with her a supply of that precious quina bark
which had worked so wonderful a cure upon herself, and the
healing virtues of which she intended to distribute amongst
the sick on her husband's estates. It thus gradually became
known in Europe, and was most appropriately called Countess's
powder (Pulvis Comitissæ). By this name it was long known to
druggists and in commerce. … In memory of the great service
to humanity performed by the Countess of Chinchon, Linnæus
named the genus which yields Peruvian bark, Chinchona.
Unfortunately the great botanist was misinformed as to the
name of her whom he desired to honour. This is to be accounted
for by his having received his knowledge of the Countess
through a foreign and not a Spanish source. Thus misled,
Linnæus spelt the word Cinchona … and Cinhona, … omitting
one or two letters. … After the cure of the Countess of
Chinchon the Jesuits were the great promoters of the
introduction of bark into Europe. In 1670 these fathers sent
parcels of the powdered bark to Rome, whence it was
distributed to members of the fraternity throughout Europe, by
Cardinal de Lugo, and used for the cure of agues with great
success. Hence the name of 'Jesuits' bark,' and 'Cardinal's
bark;' and it was a ludicrous result of its patronage by the
Jesuits that its use should have been for a long time opposed
by Protestants, and favoured by Roman Catholics. In 1679 Louis
XIV. bought the secret of preparing quinquina from Sir Robert
Talbor, an English doctor, for 2,000 louis-d'or, a large
pension, and a title. From that time Peruvian bark seems to
have been recognised as the most efficacious remedy for
intermittent fevers."

_C. R. Markham,
Peruvian Bark,
chapters 2-4._

{2136}

MEDICAL SCIENCE: 17th Century.
Sydenham, the Father of Rational Medicine.

"Sydenham [Thomas Sydenham, 1624-1689], the prince of
practical physicians, whose character is as beautiful and as
genuinely English as his name, did for his art what Locke did
for the philosophy of mind—he made it, in the main,
observational; he made knowledge a means, not an end. It would
not be easy to over-estimate our obligations as a nation to these
two men, in regard to all that is involved in the promotion of
health of body and soundness of mind. They were among the
first in their respective regions to show their faith in the
inductive method, by their works. They both professed to be
more of guides than critics, and were the interpreters and
servants of Nature, not her diviners and tormentors." Of
Sydenham, "we must remember in the midst of what a mass of
errors and prejudices, of theories actively mischievous, he
was placed, at a time when the mania of hypothesis was at its
height, and when the practical part of his art was overrun and
stultified by vile and silly nostrums. We must have all this
in our mind, or we shall fail in estimating the amount of
independent thought, of courage and uprightness, and of all
that deserves to be called magnanimity and virtue, which was
involved in his thinking and writing and acting as he did.
'The improvement of physic [he wrote] in my opinion, depends,
1st, Upon collecting as genuine and natural a description or
history of diseases as can be procured; and, 2d, Upon laying
down a fixed and complete method of cure. With regard to the
history of diseases, whoever considers the undertaking
deliberately will perceive that a few such particulars must be
attended to: 1st, All diseases should be described as objects
of natural history, with the same exactness as is done by
botanists, for there are many diseases that come under the
same genus, and bear the same name, that, being specifically
different, require a different treatment. The word carduus or
thistle, is applied to several herbs, and yet a botanist would
be inaccurate and imperfect who would content himself with a
generic description. Furthermore, when this distribution of
distempers into genera has been attempted, it has been to fit
into some hypothesis, and hence this distribution is made to
suit the bent of the author rather than the real nature of the
disorder. How much this has obstructed the improvement of
physic any man may know. In writing, therefore, such a natural
history of diseases, every merely philosophical hypothesis
should be set aside, and the manifest and natural phenomena,
however minute, should be noted with the utmost exactness. The
usefulness of this procedure cannot be easily overrated, as
compared with the subtle inquiries and trifling notions of
modern writers. … If only one person in every age had
accurately described, and consistently cured, but a single
disease, and made known his secret, physic would not be where
it now is; but we have long since forsook the ancient method
of cure, founded upon the knowledge of conjunct causes,
insomuch that the art, as at this day practised, is rather the
art of talking about diseases than of curing them.' … His
friend Locke could not have stated the case more clearly or
sensibly. It is this doctrine of 'conjunct causes,' this
necessity for watching the action of compound and often
opposing forces, and the having to do all this not in a
machine, of which if you have seen one, you have seen all, but
where each organism has often much that is different from, as
well as common with, all others. … It is this which takes
medicine out of the category of exact sciences, and puts it
into that which includes politics, ethics, navigation and
practical engineering, in all of which, though there are
principles, and those principles quite within the scope of
human reason, yet the application of these principles must, in
the main, be left to each man's skill, presence of mind, and
judgment, as to the case in hand. … It would not be easy to
over-estimate the permanent impression for good, which the
writings, the character, and the practice of Sydenham have
made on the art of healing in England, and on the Continent
generally. In the writings of Boerhaave, Stahl, Gaubius,
Pinel, Bordeu, Haller, and many others, he is spoken of as the
father of rational medicine; as the first man who applied to
his profession the Baconian principles of interpreting and
serving nature, and who never forgot the master's rule, 'Non
fingendum aut excogitandum, sed inveniendum, quid natura aut
faciat aut ferat.' … Like all men of a large practical
nature, he could not have been what he was, or done what he
did, without possessing and often exercising the true
philosophizing faculty. He was a man of the same quality of
mind in this respect with Watt, Franklin, and John Hunter, in
whom speculation was not the less genuine that it was with
them a means rather than an end."

_Dr. John Brown,
Locke and Sydenham and other Papers,
pages 54-90._

ALSO IN:
_T. Sydenham,
Works;
translated by R. G, Latham._

MEDICAL SCIENCE: 17th Century.
Closing period of the Humoral Pathology.
The Doctrines of Hoffmann, Stahl and Boerhaave.

"If we take a general survey of medical opinions, we shall
find that they are all either subordinate to, or coincident
with, two grand theories. The one of these considers the solid
constituents of the animal economy as the elementary vehicle
of life, and consequently places in them the primary seat of
disease. The other, on the contrary, sees in the humors the
original realization of vitality; and these, as they determine
the existence and quality of the secondary parts, or solids,
contain, therefore, within themselves, the ultimate principle
of the morbid affection. By relation to these theories, the
history of medicine is divided into three great periods.
During the first, the two theories, still crude, are not yet
disentangled from each other; this period extends from the
origin of medicine to the time of Galen. The second
comprehends the reign of Humoral Pathology—the interval
between Galen and Frederic Hoffmann. In the last the doctrine
of the Living Solid is predominant; from Hoffmann it reaches
to the present day. … By Galen, Humorism was first formally
expounded, and reduced to a regular code of doctrine.
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Four elementary fluids, their relations and changes, sufficed
to explain the varieties of natural temperament, and the
causes of disease; while the genius, eloquence, and unbounded
learning with which he illustrated this theory, mainly
bestowed on it the ascendency, which, without essential
alteration, it retained from the conclusion of the second to
the beginning of the eighteenth century. Galenism and Humorism
are, in fact, convertible expressions. Not that this
hypothesis during that long interval encountered no
opposition. It met, certainly, with some partial contradiction
among the Greek and Arabian physicians. After the restoration
of learning Fernelius and Brissot, Argenterius and Joubert,
attacked it in different ways. … Until the epoch we have
stated, the prevalence of the Humoral Pathology was, however,
all but universal. Nor was this doctrine merely an erroneous
speculation; it exerted the most decisive, the most pernicious
influence on practice.—The various diseased affections were
denominated in accommodation to the theory. In place of saying
that a malady affected the liver, the peritonæum, or the
organs of circulation, its seat was assumed in the blood, the
bile, or the lymph. The morbific causes acted exclusively on
the fluids; the food digested in the stomach, and converted
into chyle, determined the qualities of the blood; and poisons
operated through the corruption they thus effected in the
vital humors. All symptoms were interpreted in blind
subservience to the hypothesis; and those only attracted
attention which the hypothesis seemed calculated to explain.
The color and consistence of the blood, mucus, feces, urine,
and pus, were carefully studied. On the other hand the
phenomena of the solids, if not wholly overlooked, as mere
accidents, were slumped together under some collective name,
and attached to the theory through a subsidiary hypothesis. By
supposed changes in the humors, they explained the association
and consecution of symptoms. Under the terms, crudity,
coction, and evacuation, were designated the three principal
periods of diseases, as dependent on an alteration of the
morbific matter. In the first, this matter, in all its
deleterious energy, had not yet undergone any change on the
part of the organs; it was still crude. In the second, nature
gradually resumed the ascendant; coction took place. In the
third, the peccant matter, now rendered mobile, was evacuated
by urine, perspiration, dejection, &c., and æquilibrium
restored. When no critical discharge was apparent, the
morbific matter, it was supposed, had, after a suitable
elaboration, been assimilated to the humors, and its
deleterious character neutralized. Coction might be perfect or
imperfect; and the transformation of one disease into another
was lightly solved by the transport or emigration of the
noxious humor. … Examinations of the dead body confirmed
them in their notions. In the redness and tumefaction of
inflamed parts, they beheld only a congestion of blood; and in
dropsies, merely the dissolution of that fluid; tubercles were
simply coagula of lymph; and other organic alterations, in
general, naught but obstructions from an increased viscosity
of the humors. The plan of cure was in unison with the rest of
the hypothesis. Venesection was copiously employed to renew
the blood, to attenuate its consistency, or to remove a part
of the morbific matter with which it was impregnated; and
cathartics, sudorifics, diuretics, were largely administered,
with a similar intent. In a word, as plethora or cacochymia
were the two great causes of disease, their whole therapeutic
was directed to change the quantity or quality of the fluids.
Nor was this murderous treatment limited to the actual period
of disease. Seven or eight annual bloodings, and as many
purgations—such was the common regimen the theory prescribed
to insure continuance of health; and the twofold depletion,
still customary, at spring and fall, among the peasantry of
many European countries, is a remnant of the once universal
practice. In Spain, every village has even now its Sangrador,
whose only cast of surgery is blood-letting; and he is rarely
idle. The medical treatment of Lewis XIII, may be quoted as a
specimen of the humoral therapeutic, Within a single year this
theory inflicted on that unfortunate monarch above a hundred
cathartics, and more than forty bloodings.—During the fifteen
centuries of Humorism, how many millions of lives did medicine
cost mankind? The establishment of a system founded on the
correcter doctrine of Solidism, and purified from the
crudities of the Iatro-mathematical and Iatro-chemical
hypotheses was reserved for three celebrated physicians toward
the commencement of the eighteenth century—Frederic
Hoffmann—George Ernest Stahl—and Hermann Boerhaave. The
first and second of this triumvirate were born in the same
year, were both pupils of Wedelius of Jena, and both
professors, and rival professors, in the University of Halle;
the third was eight years younger than his contemporaries, and
long an ornament of the University of Leyden."

_Sir W. Hamilton,
Discussions on Philosophy and Literature,
pages 246-249._

"The great and permanent merits of Hoffmann [1660-1742] as a
medical philosopher, undoubtedly consisted in his having
perceived and pointed out more clearly than any of his
predecessors, the extensive and powerful influence of the
Nervous System, in modifying and regulating at least, if not
in producing, all the phenomena of the organic as well as of
the animal functions in the human economy, and more
particularly in his application of this doctrine to the
explanation of diseases. … It was reserved for Hoffmann …
to take a comprehensive view of the Nervous System, not only
as the organ of sense and motion, but also as the common
centre by which all the different parts of the animal economy
are connected together, and through which they mutually
influence each other. He was, accordingly, led to regard all
those alterations in the structure and functions of this
economy, which constitute the state of disease, as having
their primary origin in affections of the nervous system, and
as depending, therefore, upon a deranged state of the
imperceptible and contractile motions in the solids, rather
than upon changes induced in the chemical composition of the
fluid parts of the body."

_J. Thomson,
Account of the Life, Lectures and Writings of William Cullen,
pages 195-196._

{2138}

"George Ernest Stahl (1660-1734), chemist, was professor of
medicine at Halle (1694) and physician to the King of Prussia
(1716). He opposed materialism, and substituted 'animism,'
explaining the symptoms of disease as efforts of the soul to
get rid of morbid influences. Stahl's 'anima' corresponds to
Sydenham's 'nature' in a measure, and has some relationship to
the Archeus of Paracelsus and Van Helmont. Stahl was the author
of the 'phlogiston' theory in chemistry, which in its time has
had important influence on medicine. Phlogiston was a
substance which he supposed to exist in all combustible
matters, and the escape of this principle from any compound
was held to account for the phenomenon of fire. According to
Stahl, diseases arise from the direct action of noxious powers
upon the body; and from the reaction of the system itself
endeavouring to oppose and counteract the effects of the
noxious powers, and so preserve and repair itself. He did not
consider diseases, therefore, pernicious in themselves, though
he admitted that they might become so from mistakes made by
the soul in the choice, or proportion of the motions excited
to remove them, or the time when these efforts are made.
Death, according to this theory, is due to the indolence of
the soul, leading it to desist from its vital motions, and
refusing to continue longer the struggle against the
derangements of the body. Here we have the 'expectant
treatment' so much in vogue with many medical men. 'Trusting
to the constant attention and wisdom of nature,' they
administered inert medicines as placebos, while they left to
nature the cure of the disease. But they neglected the use of
invaluable remedies such as opium and Peruvian bark, for which
error it must be admitted they atoned by discountenancing
bleeding, vomiting, etc. Stahl's remedies were chiefly of the
class known as 'Antiphlogistic,' or anti-febrile."

_E. Berdoe,
The Origin and Growth of the Healing Art,
book 5, chapter 7._

"The influence of Boerhaave [1668-1738] was immense while it
lasted—it was world-wide; but it was like a ripple on the
ocean—it had no depth. He knew everything and did everything
better than any of his contemporaries, except those who made
one thing, not everything, their study. He was familiar with
the researches of the great anatomists, of the chemists, of
the botanists, of historians, of men of learning, but he was
not a great anatomist, chemist, or historian. As to his
practice, we cannot pronounce a very decided opinion, except
that he was a man of judgment and independence. Here his
reputation made his success: a prescription of his would no
doubt effect many a cure, although the patient had taken the
remedy he prescribed fifty times without any benefit. His
greatness depended upon his inexhaustible activity. He had the
energy of a dozen ordinary men, and so he was twelve times as
powerful as one. He mentions quite incidentally how he was in
the habit of frequently spending whole nights in botanical
excursions on foot; and we know he had no time to sleep in the
day. He took an interest in everything, was always on the
alert, had a prodigious memory, and indefatigable industry. On
these great homely qualities, added to a kind disposition and
an unaffected piety, his popularity was founded. It was all
fairly won and nobly worn. It is startling, however, to find
that a man whose name one hundred years ago was familiar to
the ear as household words, and of whom historians predicted
that he would always be regarded as one of the greatest as
well as best of men, an example to his race, should be already
almost forgotten. An example is of no use unless it is known;
Boerhaave is now unknown. The reason is plain;—he was not the
founder of any system, nor did he make any discovery. He
simply used with supreme success the thoughts and discoveries
of others; as soon as he ceased to live, his influence began
therefore to decline; and before his generation had passed
away, his star had waned before the genius of Cullen, who
succeeded in fixing the attention of Europe, and who, in his
turn, was soon to be displaced by others."

_J. R. Russell,
History and Heroes of the Art of Medicine,
pages 297-298._

MEDICAL SCIENCE: 17-18th Centuries.
Introduction of the Microscope in Medicine.
First glimmerings of the Germ Theory of Disease.

"Since Athanasius Kircher [1601-1680] mistook blood and pus
corpuscles for small worms, and built up on his mistake a new
theory of disease and putrefaction, and since Christian Lange,
the Professor of Pathological Anatomy in Leipzig, in the
preface to Kircher's book (1671) expressed his opinion that
the purpura of lying-in-women, measles, and other fevers were
the result of putrefaction caused by worms or animalculæ, a
'Pathologia Animata' has, from time to time, been put forward
to explain the causation of disease. … Remarkable as were
Kircher's observations, still more wonderful were those of
Anthony van Leeuwenhoek, a native of Delft in Holland, who in
his youth had learned the art of polishing lenses, and who was
able, ultimately, to produce the first really good microscope
that had yet been constructed. Not only did Leeuwenhoek make
his microscope, but he used it to such good purpose that he
was able to place before the Royal Society of London a series
of most interesting and valuable letters giving the result of
his researches on minute specks of living protoplasm. … The
world that Leeuwenhoek … opened up so thoroughly was rapidly
invaded by other observers and theorists. The thoughtful
physicians of the time believed that at last they had found
the 'fons et origo mali,' and Nicolas Andry, reviewing
Kircher's' Contagium Animatum,' replaced his worms by these
newly-described animalculæ or germs, and pushing the theory to
its legitimate and logical conclusion, he also evolved a germ
theory of putrefaction and fermentation. He maintained that
air, water, vinegar, fermenting wine, old beer, and sour milk
were all full of germs; that the blood and pustules of
smallpox also contained them, and that other diseases, very
rife about this period, were the result of the activity of
these organisms. Such headway did he make, and such conviction
did his arguments carry with them, that the mercurial
treatment much in vogue at that time was actually based on the
supposition that these organisms, the 'causæ causantes' of
disease, were killed by the action of mercury and mercurial
salts. With a kind of prophetic instinct, and certainly as the
result of keen observation, Varro and Lancisi ascribed the
dangerous character of marsh or swamp air to the action of
invisible animalculæ; in fact the theory was so freely and
forcibly propagated that even where no micro-organisms could
be found their presence was inferred with the inevitable
result, as Löffler points out, that these 'inconceivable'
worms became the legitimate butts for the shafts of ridicule;
and in 1726 there appeared in Paris a satirical work, in which
these small organisms received the name of 'fainter,'
'body-pincher,' 'ulcerator,' 'weeping fistula,' 'sensualist';
the whole system was thus laughingly held up to satire, and
the germ theory of disease completely discredited.
{2139}
Linnæus [1707-1778], however, with his wonderful powers of
observation and deduction, considered that it was possible
that there might be rescued from this 'chaos' small living
beings which were as yet insufficiently separated and
examined, but in which he firmly believed might lie not only
the actual contagium of certain eruptive diseases, and of
acute fevers, but also the exciting causes of both
fermentation and putrefaction. The man, however, who of all
workers earliest recognized the importance of Linnæus'
observations was a Viennese doctor, Marcus Antonius Plenciz.
… He it was who, at this time, insisted upon the specific
character of the infective agent in every case of disease; for
scarlet fever there was a scarlet fever seed or germ—a seed
which could never give rise to smallpox. He showed that it was
possible for this organism to become disseminated through the
air, and for it to multiply in the body; and he explained the
incubation stage of a febrile disease as dependent on the
growth of a germ within the body during the period after its
introduction, when its presence had not yet been made
manifest. … As regards putrefaction, having corroborated
Linnæus' observations and found countless animalculæ in
putrefying matter, he came to the conclusion that this process
was the result of the development, multiplication, and
carrying on of the functions of nutrition and excretion by
these germs; the products of fermentation being the volatile
salts set free by the organisms, which, multiplying rapidly by
forming seeds or eggs, rendered the fluid in which they
developed thick, turbid, and foul. This theory, admirable as
it was, and accurate as it has since been proved to be, could
not then be based on any very extensive or detailed
observation, and we find that some of the most prominent and
brilliant men of the period did not feel justified in
accepting the explanation that Plenciz had offered as to the
causes of disease and fermentation processes."

_G. S. Woodhead,
Bacteria and their Products,
chapter 3._

MEDICAL SCIENCE: 17-18th Centuries.
Hahnemann and the origin of the System of Homœopathy.

Samuel Hahnemann, originator of the system of medicine called
"Homœopathy," was born in 1755, at Meissen, in Saxony. He
studied medicine at Leipsic, and afterwards at Vienna. In 1784
he settled in Dresden, but returned to Leipsic in 1789. "In
the following year, while translating Cullen's Materia Medica
out of English into German, his attention was arrested by the
insufficient explanation's advanced in that work of the cure
of ague by cinchona bark. By way of experiment, he took a
large dose of that substance to ascertain its action on the
healthy body. In the course of a few days he experienced the
symptoms of ague; and it thus occurred to him that perhaps the
reason why cinchona cures ague is because it has the power to
produce symptoms in a healthy person similar to those of ague.
To ascertain the truth of this conjecture, he ransacked the
records of medicine for well-attested cures effected by single
remedies; and finding sufficient evidences of this fact, he
advanced a step further, and proposed, in an article published
in Hufeland's Journal, in the year 1797, to apply this new
principle to the discovery of proper medicines for every form
of disease. Soon afterwards he published a case to illustrate
his method. It was one of a severe kind of colic cured by a
strong dose of veratrum album. Before this substance gave
relief to the patient it excited a severe aggravation of his
symptoms. This induced Hahnemann, instead of drops or grains,
to give the fraction of a drop or grain, and he thus
introduced infinitesimal doses. Some years later he applied
his new principle in the treatment of scarlet fever; and
finding that belladonna cured the peculiar type of that
disease, which then prevailed in Germany, he proposed to give
this medicine as a prophylactic, or preventive against scarlet
fever; from that time it has been extensively employed for
this purpose. In the year 1810 he published his great work,
entitled Organon of Medicine, which has been translated into
all the European languages, as well as into Arabic. In this
book he fully expounded his new system, which he called
Homœopathy. His next publication was a Materia Medica,
consisting of a description of the effects of medicines upon
persons in health. These works were published between the
years 1810 and 1821, at Leipsic, where he founded a school,
and was surrounded by disciples. As his system involved the
administration of medicines, each separately by itself, and in
doses infinitely minute, there was no longer any need of the
apothecaries' intervention between their physician and the
patient. In consequence of this the Apothecaries Company
brought to bear upon Hahnemann an act forbidding physicians to
dispense their own medicines, and with such effect that he was
obliged to leave Leipsic. The Grand Duke of Anhalt Köthen,
appointed him his physician, and invited him to live at
Köthen. Thither, accordingly, he removed in the year 1821, and
there he prepared various new editions of his Organon, and new
volumes of his Materia Medica for publication. In 1835 he
married a second time; his wife was a French lady of
considerable position; and in the same year he left Köthen,
and settled in Paris, where he enjoyed a great reputation till
his death, which took place in the year 1843."

_W. Bayes,
Origin and Present Status of Homœopathy
(Translation of the Homœopathic Medical Society
of the State of New York, 1869, article 21)._

ALSO IN:
_W. Aneke,
History of Homœopathy._

_J. C. Burnett,
Ecce Medicus;
or Hahnemann as a man and as a physician._

MEDICAL SCIENCE: 18th Century.
The work of John Hunter in surgery and anatomy.

"John Hunter [born 1728, died 1793] was not only one of the
most profound anatomists of the age in which he lived, but he
is by the common consent of his successors allowed to be one
of the greatest men that ever practised surgery. One of the
most striking discoveries in this part of his profession—
indeed one of the most brilliant in surgery of his
century—was the operation for the cure of popliteal aneurism
by tying the femoral artery above the tumour in the ham, and
without interfering with it. He improved the treatment of the
rupture of the tendo achillis, in consequence of having
experienced the accident himself when dancing. He invented the
method of curing fistula lacrymalis by perforating the os
unguis, and curing hydrocele radically by injection. His
anatomical discoveries were numerous and important—amongst
others the distribution of the blood-vessels of the uterus,
which he traced till their disappearance in the placenta.
{2140}
He was the first who demonstrated the existence of lymphatic
vessels in birds; described the distribution of the branches
of the olfactory nerve, as well as those of the fifth pair;
and to him we owe the best and most faithful account of the
descent of the testicle in the human subject, from the abdomen
into the scrotum. Physiology is also indebted to him for many
new views and ingenious suggestions. … 'Before his time
surgery had been little more than a mechanical art, somewhat
dignified by the material on which it was employed. Hunter
first made it a science; and by pointing out its peculiar
excellence as affording visible examples of the effects and
progress of disease, induced men of far higher attainments
than those who had before practised it to make it their
study.' The best monument of his genius and talents, however,
is the splendid museum which he formed by his sole efforts,
and which he made, too, when labouring under every
disadvantage of deficient education and limited means. It
shows that as an anatomist and physiologist he had no
superior."

_W. Baird,
Hunter (The Imperial dictionary of universal biography)._

ALSO IN:
_S. D. Gross,
John Hunter and his Pupils._

MEDICAL SCIENCE: 18th Century.
Preventive Inoculation against Smallpox.