Chapter VIII: Preface (7)

On March 17, 1874, as a recognition of his interest in Irish antiquities, Stokes was nominated to the presidency of the Royal Irish Academy. "It was a new departure for the members of that society," says Stokes' biographer, "which is mainly representative of literature and abstract science, to choose a physician as their head, but it was felt that the time had now come when medicine had obtained, owing to the labors of Stokes and others, such a position in {199} the estimation of literary and scientific men that the election of the Regius Professor of that art in Trinity College (to the presidency of the Royal Irish Academy) would be welcomed by the majority." Certainly no member of the medical profession could have been found more deserving of the tribute because of all that he had done for Irish medicine, and besides his broad, sympathetic, liberal interest in Irish antiquities eminently fitted him for this honorable position.

When Stokes' death was announced at the beginning of January, 1878, the medical world thought that it had lost one of its most representative men. For some years before his death many honors had come, all unsought, to this worthy protagonist of Irish medicine. He had been made a member of the Prussian order of Merit, and an honorary Fellow of many scientific societies on the Continent. He had received the rare distinction of the degree of LL.D. from Cambridge, and had been similarly honored by many other universities. Perhaps the honor that Stokes himself would have appreciated most came after his death, when the country people who had learned to know and love him asked to be allowed to carry his remains from Carrig Breac to the church of St. Fintan--the "grassy churchyard grave," where he was to be laid beside his beloved wife and children. They laid him in the same grave and beneath the same stone with her who was the beloved companion of his life, and on whose tomb he had engraved these words:

"When the ear heard her, then it blessed her;
When the eye saw her it rejoiced;
When the poor and suffering came unto her
They were comforted."

Surely a union like theirs was not destined to be but passing.

{200}

Stokes' beautiful domestic affection was but another index of one of the most beautifully rounded types of man that ever lived. The affective side of his being, profoundly tender, deeply sympathetic, thoughtful always of others first, and humanely devoted to the poor and the helpless above all others, was typical of the best side of the Irish character. For this even more than for all he did for practical medicine (yet the absence of his work would make a large lacuna in nineteenth century medical progress) the race may well be proud of him. His example still lives to animate his professional brethren, one of whom (Sir John Moore) said of him: "Those who have seen Dr. Stokes at the bedside of the sick know how gentle, how refined, how kindly was his bearing toward the patient. Amid all the ardor of clinical observation and research he never for one moment forgot the sufferer before him--no thoughtless word from his lips, no rough or unkind action ever ruffled the calm confidence reposed in him by those who sought his skill and care. In many eloquent lectures delivered in the Meath Hospital he inculcated those Christian lessons of charity and thoughtfulness; and so by precept and example he strove to teach the duties of a true and God-fearing physician."

Dominic Corrigan.

The third of the great trio of the founders of the Irish School of Medicine is Sir Dominic John Corrigan, whose name will be forever associated with the form of pulse which occurs in aortic heart disease. It was his supreme merit to have been the first to describe in all its details this type of heart disease, and the distinguished French clinician, Trousseau, declared that aortic regurgitation should be called Corrigan's Disease. At this time Trousseau was deservedly {201} looked up to as the leading spirit among the clinicians of Europe. He was never tired of commending to his students Corrigan's acute clinical observations, and insisted that it was work of this kind which assured real progress in medicine. Trousseau's suggestion as to nomenclature was not adopted in its entirety, but Corrigan's pulse is well-known all over the medical world, and there is no doubt now that it will continue for many generations to confer deserved honor on the man who first appreciated its full significance though he was not the first to recognize it--and indeed it could scarcely escape notice--but who showed just what diagnostic conclusions might be reached from it.

Corrigan's career should prove a stimulating example to the young physician just taking up that real post-graduate work in medicine which comes after he has received his degree, finished, perhaps, his hospital work, and is beginning his practice. Corrigan was only twenty-seven when he began the series of observations on which was founded his paper on aortic heart disease, which was published when he was about thirty. In this matter of youthful accomplishment, Corrigan is not alone among his distinguished Irish contemporaries. Stokes, it will be remembered, wrote his little book on the stethoscope when he was only twenty-one and had made some very important observations on disease of the chest before he had reached the age of thirty. Graves had showed very clearly the sound metal of his intelligence before he was twenty-five, and had described the cases of the nervous disease which have since come to be called after his name, Graves' disease, before his fourth decade had run more than a year or two. In fact these young men accomplished so much by their careful observation and dependence on their own resources that the medical writer of the modern times is tempted to wonder if perhaps that most precious {202} quality of the human mind in the young adult, its originality, is not obscured by the amount of information that it is expected to absorb before it is tempted to do any thinking for itself.

There is another remarkable feature of Corrigan's achievement, in the recognition and description of this form of heart disease. At the time he was the physician to a hospital which had only room for six medical patients. This appointment to the little Jervis Street Hospital in Dublin had been secured only after competition, and Corrigan had to pay for the privilege of being the attending physician. This he could ill afford to do at the time, and so he resolved, as he told a friend, to make all his opportunities for the study of patients count to the greatest possible extent. He did not visit his hospital merely to see patients, but to study the cases carefully. His success is only another example of the necessity for seeing much, and not many things, if there is to be any real progress. In our day, physicians scarcely consider that they have any hospital experience unless they are the attending physicians to several hospitals, seeing at least one hundred patients a week. The result is that patients do not receive the skilled care they should, and that advance in medicine suffers because of the wasted opportunities for clinical observations while a busy attending physician rushes through a ward and the resident physician has only time for the routine work that enables him to keep just sufficiently in touch with the progress of his cases to satisfy the hurrying chief.

Before publishing his classic paper on the _Permanent Patency of the Aortic Valves_, on which his reputation as a wonderful clinical observer in medicine rests, Corrigan had called attention to some mistakes in the classification of heart murmurs as made by Laennec in Paris. At this time Laennec was considered to be the best authority in Europe {203} on diseases within the thorax. As regards diseases of the lungs, he well deserved the reputation. To him the medical world owes all that it knows about diseases of the chest, as far as these can be detected by means of the ear. His young contemporary in Ireland, however, was able to show that in diseases of the heart some of the ideas acquired in long years of study of the lungs were leading Laennec into false conclusions as regards the significance of murmurs of the heart. Even genius does not succeed in doing more than one thing well, and especially in the matter of taking a second step into the unknown. While the distinguished Frenchman might have been thought just the one to complete the work he began so well on the heart, and while his experience with the lungs might have been expected to help him in the recognition of the significance of heart murmur, this did not prove to be the case. The privilege of solving the mystery of heart diseases was to be left for his Irish contemporaries, one of the most successful of whom in this matter was Corrigan.

Anyone who wishes to see how little subsequent study has added to our knowledge of aortic disease should read Corrigan's original paper on this subject. He describes all the varying forms of affections of the aortic valve, with their various clinical manifestations. His paper is illustrated by a set of plates that would still be valuable for demonstrative purposes, and which serve to show how painstaking were his pathological studies. He illustrated experimentally his ideas of how the murmurs and thrills occur by means of an apparatus consisting of rubber tubes through which water might be allowed to flow under pressure, and varying calibre. Some of his conclusions, derived from experimental observations, will not stand the test of our modern knowledge, but they are very suggestive. Perhaps the best idea of the clinical {204} value of Corrigan's observations can be given by a quotation from his original paper, in which he discusses the interesting and difficult question of the relationship between aneurism of the aorta and inadequacy of the aortic valve. He said:

"The two diseases, aneurism of the aorta and inadequacy of the
valves, may, however, be combined. Aneurism of the ascending aorta
may, by extending to the mouth of this vessel, dilate it so that the
valves are unable to meet, and there is then a combination of the
two diseases; there is aneurism and there is permanent patency of
the aortic opening. The first cases that came under my observations
presenting the signs of inadequacy of the aortic valves were cases
in which the valves were rendered useless in this way, namely, by
the mouth of the aorta sharing in the aneurismal dilatation. These
cases led me into an error; for, meeting the signs of permanent
patency of the aortic orifice in conjunction with aneurism, I
erroneously attributed to the aneurism the signs which arose from
the permanent patency. Aneurism of the aorta of itself does not
produce the signs arising from permanent patency of the mouth of the
aorta. It can only produce them in the way already described, by
involving in the dilatation the mouth of the aorta; and hence, when
in conjunction with an aneurismal tumor of the arteria innominata or
aorta, there are found visible pulsation, _bruit de soufflet_, and
_fremissement_ in the ascending aorta, and the trunks arising from
it, we may be certain that, in addition to the aneurism, there is a
defect in the aortic valves, or that the aneurism has extended
downward, involving the mouth of the aorta. On the other hand, if
these signs be absent, the valves are sound and the mouth of the
aorta is not included in the disease. The propriety of performing
Mr. Wardrop's or indeed the common operation for aneurism about the
neck might depend on the information {205} thus obtained of the
state of the aortic valves. To perform either in a case where the
aneurismal dilatation was so extensive as to involve the mouth of
the aorta, or where the aortic valves were diseased, would only
bring the surgical treatment of the disease into unmerited
discredit."

Another very distinct contribution of Corrigan to the medicine of his time was his insistence on the distinction that exists between typhoid and typhus fever. This is one of the most interesting features of his little book on the _Nature and Treatment of Fever_. With our present knowledge, it seems hard to understand that these two fevers should have been so long confounded, but as a matter of fact it was not until the middle of the nineteenth century that the distinction between them was recognized even by the most acute observers. In this matter the French and Americans anticipated most of the rest of the world, though Corrigan's teaching in the matter had been correct for many years before others in the British Isles came to the true position.

It was his work among the poor particularly that enabled Corrigan to recognize the differences between these two diseases. He came to have one of the largest practices that any practitioner in Dublin, or for that matter in any city of the world, has ever enjoyed, if enjoyment it can be called. His office used to be crowded with patients who would occupy all his time if he allowed them to do so. In order to secure opportunities for his other work, for his lectures, for his hospital visitation, and for his pathological investigation, he had a back entrance to his house through which he could steal out--even though there were many patients waiting for him--when he felt that it was time for him to fill another engagement.

Late in life, after his return from Parliament when he took up his practice again, it was only a very short time {206} before the same state of affairs developed once more. It almost seemed as though every sick Irishman and Irish woman wanted to have the opinion of Dr. Corrigan. He had also a large consultant practice, though he was known for being a very different man from the ordinary type of the medical consultant. As one of his younger colleagues said, "he never wore the supreme air of a consultant." He was always simple and easy in his manner, was always congenial and ready to listen to what had developed and had been found in the case before consultation with him, and had none of that superciliousness that was supposed to characterize the true high-grade consultant physician in the British Isles a half a century ago.

Within a few years after his essay on aortic heart disease, Corrigan published a paper on chronic pneumonia or, as he called it, cirrhosis of the lungs. Corrigan's successful achievements in medicine depended mainly on the fact that he studied the pathological anatomy of fatal cases with the greatest care. He had detected that in certain cases of chronic pneumonia the process seemed to be quite different from tuberculosis. Observations made postmortem showed that his clinical observations were justified by the differences observed in the organ. As a result he formulated his opinions on the subject. He called particular attention to the fact that what he found corresponded very closely with the pathological process which had been observed by Laennec in the liver, and to which the French medical pathologist had given the name of cirrhosis. It would seem as though the pathology of the time was so crude that Corrigan must surely fall into serious errors in his account of what he saw. Twenty years later, Virchow was to revolutionize pathology by the publication of his "Cellular Pathology." Notwithstanding the progress made since his time, {207} however, Corrigan's description of the condition of the lungs that he noted and of the pathological process observed is so true that even to the present day this paper remains of distinct value in medicine and represents the beginning of correct ideas on the subject.

After Corrigan's death in 1881 the London _Lancet_ said: "In the light of recent pathology Corrigan's speculations on cirrhosis of the lungs are more meritorious than ever and continue to be regarded as in the main sound. They anticipated by forty years much of the present pathology." Needless to say it is only a genius of a very high order that is thus capable of rising above the limitations of environment, and in spite of the defective knowledge of his times observing correctly and drawing proper conclusions, though all the usual accepted principles would seem to be sure to lead him from the truth. The principal lesions of chronic pneumonia, after having been the subject of much disputation, with conclusions now one way and now another in the intervening years, are at the present time recognized as being essentially due to the pathological processes Corrigan originally pointed out.

The man who thus made a permanent place for himself in the history of medicine was the son of a poor shopkeeper in one of the outlying districts of Dublin. His early education was obtained at Maynooth College, which had at that time a department for the training of youth for secular vocations, though it has since become an exclusively clerical institution. It is needless to say he acquired an excellent knowledge of the classics, of which he made abundant use later in life, and of which he was always very proud. The physician in attendance at Maynooth in his time took quite a liking to him, and it was the result of his suggestion that Corrigan took up medicine as his profession. For a time {208} he was under the tutelage of this Doctor O'Kelley, who seems to have been a very intelligent man, and a rather painstaking clinical observer. Most of his medical studies were made in Dublin and he attended the practice at Sir Patrick Dun's Hospital. It was the fashion at this time, however, for Irish students of medicine to finish their medical education at Edinburgh, whenever possible, and Corrigan spent several years there, receiving his degree of Doctor in Medicine in 1825.

He had attracted considerable attention in Edinburgh for his acute powers of observation, and received an appointment to the Meath Street Dispensary shortly after his return. From the service here he was appointed to the Jervis Street Hospital. He had to pay, however, for the privilege of being attending physician here, and this, as he said, made him more careful in endeavoring to secure all the advantages possible from his service.

After his publication of the article on "The Permanent Patency of the Mouth of the Aorta," or "Inadequacy of the Aortic Valves," he at once became recognized as one of the best clinicians in the city. This article appeared, in April, 1832, in the _Edinburgh Medical and Surgical Journal_, at a time when, as has been said, its author was not yet thirty years of age. As soon as he began his work at the Jervis Street Hospital, he gave a course of lectures, and as he was an excellent talker and a good demonstrator, he at once attracted a large class. In 1834 he joined Hargrave's School, in Digges Street, Dublin, as lecturer on the practice of medicine, and continued to hold the position for more than ten years. His success as a lecturer attracted many students from the other medical schools. Corrigan's class was often three times as large as that of other medical lecturers in the city. It not infrequently happened that as a result of his {209} popularity the medical class was two or even three times as large as the surgical and anatomical classes at the same institution. This was very unusual, for Dublin was famous for its anatomical instruction, and there were often five times as many pupils enrolled in the anatomy classes as in the medical classes.

It was not long before honors began to be showered upon Corrigan. When he was about forty the diploma of the London College of Surgeons was conferred upon him, and, as according to the by-laws of the institution the diploma can only be conferred after examination, Corrigan's examination was made to consist of the reading of the thesis, "Inadequacy of the Aortic Valves," before the faculty and the other members of the college. In 1849 the University of Dublin conferred upon him the degree of M.D., _honoris causa_.

There was only one setback in Corrigan's medical career in Dublin. When first proposed for honorary fellowship in the Irish College of Physicians, he was rejected. The reason was entirely apart from medical matters. Corrigan was the most active member of the Irish Board of Health, which had charge of the famine cases in Ireland, during the awful years between 1845 and 1850. This Board proposed to allow about five shillings per day to physicians who would be sent to the country to attend famine fever cases. It is easy to understand that this remuneration was considered inadequate and the Board's decision in the matter raised a storm of protest. Graves wrote very bitterly with regard to it, and blamed Corrigan for any part he might have had in it. The result was that for some time Dr. Corrigan was the most popularly hated physician in the medical profession of Dublin.

Corrigan made, up for any lack of tact he might have had {210} in this matter, however, before long, and in 1855 he obtained the license of the college. Two years later he was elected a Fellow. Before another two years had passed he was elected President of the College, and had the unprecedented honor of being re-elected four years in succession. The college further made up for its offense by having a statue of Dr. Corrigan, by the famous Irish sculptor Foley, made for its hall while he was still alive.

His own self-sacrificing work during the famine fever years was well known. After he had achieved nearly every distinction that his brother physicians could confer upon him, he was created a baronet. It was understood that this distinction was mainly meant as a reward for his services during the famine, though also for the time which he had so unstintedly given to the improvement of national education in Ireland, in the capacity of a Commissioner of Education.

Not long after his creation as a baronet, Sir Dominic stood, in Dublin, for a seat in Parliament in the Liberal interests. At first he was unsuccessful. In 1869, however, he was returned as one of the members of the government and sat in Parliament for five years. As he was a very eloquent speaker, it was thought that he would produce a very distinct impression in Parliament. His type of eloquence, however, did not prove to have any special influence in the cold British House of Commons, though Sir Dominic was always looked upon as one of the men to be counted on whenever there was under consideration legislation that affected Irish interests.

He was defeated for re-election in 1874, but it is rather to his credit than otherwise, since he had been approached by the vintners of Dublin, who were at that time all-powerful in municipal politics, and offered the membership, provided he would agree not to actively support the Sunday Closing {211} Bill, which was to come up at the next session of Parliament. Such an agreement Sir Dominic absolutely refused to consider as consistent with his legislative honor, and the result was the close of his Parliamentary career.

His years in Parliament, however, did not separate him from his interests either in medicine or in general science. He continued to be especially interested in zoology and made liberal contributions to the Dublin Zoological Garden. His residence at Dalkey, the grounds of which ran down to a rocky coast line, enabled him to obtain many specimens for his aquarium, and these were often transferred to the Dublin Zoological Gardens, for which he was one of the most active collectors. It was his custom during his Parliamentary career, though he was more than seventy, to leave London on Friday night and reach Dublin about eight o'clock on Saturday morning. From the station he went directly to the Zoological Gardens and took part in the pleasant breakfast which the Council of Officers of the Zoological Society, with some invited guests, had there every Saturday morning. He was noted for his humor, and his presence at these breakfasts was always appreciated, because in spite of his advancing years he was sure to add to the pleasure of the occasion.

His friends feared that his Parliamentary career might prove a serious drawback to his health at his time of life, and their fears were not without foundation. He suffered severely from gout, which left its marks upon his feet and made it very difficult for him to walk for a time, and maimed him for all his after-life. Though a man who had worked very hard all his life and who, at the age of seventy, practically took up another career, that of politics, Sir Dominic lived to be nearly eighty years of age; thus illustrating the old aphorism that "it is not work but worry that kills," and {212} furnishing another example of the fact that great men are great also in their superabundant vitality, and are able to spend their lives in the hardest kind of work, yet, barring accident, live on to an age beyond even that which is considered the average term of human existence.

Few men have had happier lives than Corrigan, if the high esteem of contemporaries can ever confer happiness. There was no honor in the gift of his Dublin professional brethren or of scientific bodies in which he was interested which was not conferred upon him. He was the president of the Royal Zoological Society, the president of the Dublin Pathological Society, of which he was one of the founders, and the first president of the Dublin Pharmaceutical Society. When not yet fifty years of age he was made physician in ordinary to the Queen in Ireland, and had the unapproached record of five elections to the presidency of the King and Queen's College of Physicians in Dublin--more than enough to make up for the one serious setback in his medical career, his black-balling by the college only a few years before. Foreign medical societies invited him to honorary membership and foreign universities conferred many degrees on him.

It is easy to understand then that his death was followed by tributes of the loftiest character to his professional work, to his standing as an influential member of the community and as a man of the highest intelligence and thoroughly conservative patriotism. The London _Lancet_ said in its obituary: "By the death of Sir Dominic Corrigan, the medical profession loses one of its most conspicuous members, the University at Edinburgh one of its most illustrious graduates, and the Irish race one of its finest specimens. Though a perfect Irishman, Sir Dominic was as much at home in London, and though a sincere Catholic in religion, he had {213} too much humor and too much humanity in his constitution to be a bigot. It were well for Ireland if all her public men displayed so much moderation, sense, and good humor as Sir Dominic habitually displayed in dealing with difficult and delicate questions."

About the same time the _British Medical Journal_ said, after calling attention to the distinguished contemporaries with whom Corrigan had been associated, that he was "_haud minimus inter magnos_--not the least among the great ones." "Indeed," his biographer added, "in originality of conception which, confirmed by later and independent observation, is the true test of genius, in a correct appreciation of the operation of natural laws, in producing and modifying the phenomena of disease, in a rare aptitude for testing his hypotheses by actual experience, and in a forcible exposition of them, he probably had no equal among his contemporaries."

In the midst of all his honors and political influence, including association with the highest English officials in Ireland, Sir Dominic Corrigan had remained a consistent and faithful Catholic. Educated at Maynooth as a boy, he was proud to remain the physician to the college during many of the busiest years of his life when he must have often found it very difficult to spare the time to fulfil the duties attached to the position. He was the consultant physician till the end of his life. He is not even yet, after a quarter of a century, forgotten by the poor of Dublin, who recall his kindly help in affliction and his generous aid often given in ways that would be arranged with studied care so as not to hurt delicate Irish susceptibilities.

The Irish School of Medicine has in Graves and Stokes and Corrigan a greater group of contemporaries than has been given to any other nation at one time. If we were to eliminate from nineteenth century medicine all the {214} inspiration derived from their work there would be much of value lacking from the history of medical progress. These men were deeply imbued with the professional side of their work as physicians, and were not, in any sense of the word, money-makers. Another very interesting phase in all their careers is that no one of them occupied himself exclusively with medical studies. All of them had hobbies followed faithfully and successfully together with medicine, and all of them were deeply interested in the uplifting of the medical profession, especially in securing the rights of its members and saving poor sick people from exploitation by quacks and charlatans. All of them gave of their time, their most precious possession, for the political and social interests of their fellow-men, and felt in so doing that they were only accomplishing their duty in helping their generation to solve the problem that lay immediately before it.

{215}

JOHANN MUeLLER, FATHER OF GERMAN MEDICINE

{216}

I say, then, that the personal influence of the teacher is able in
some sort to dispense with an academical system, but that system
cannot in any way dispense with personal influence. With influence
there is life, without it there is none; if influence is deprived of
its due position, it will not by those means be got rid of, it will
only break out irregularly, dangerously. An academical system
without the personal influence of teachers upon pupils is an Arctic
winter; it will create an ice-bound, petrified, cast-iron
university, and nothing else.
--Newman, _Idea of a University_.

{217}

JOHANN MUeLLER, FATHER OF GERMAN MEDICINE

Germany has come to occupy so large a place in progressive medicine during the last half-century that it is rather hard to conceive of a time when the Teutonic race was not the head and front of modern medical progress. The leadership that had existed in Italy for over five centuries only passed to Germany at the beginning of the nineteenth century. The first great leader in German medical thought was Johann Mueller, and to the wonderful group of students that gathered around him German medicine owes the initiative which gradually forced it into the prominent place it still holds in the world of medicine. The great institutions of learning that have since come in Germany did not exist with anything like their modern systematic arrangement when Mueller began his work. It was the marvellous influence of the man as a teacher, and not the scientific aids afforded by institutional methods, that brought forth the great generation of teachers which followed immediately on Mueller's footsteps. Nowhere more than in the life of Mueller can it be recognized with absolute certainty that the system and the institution count for little in education, as compared to the man and his methods.

The keynote of Mueller's career, even more than what he did for biology, and for all the biological sciences related to medicine, is the wonderful conservatism of thought which characterizes his scientific conclusions, while at the same time he began the application of the experimental methods {218} to medicine as they had never been applied before. At a time when physiologists, because of Woehler's recent discoveries of the possibility of the artificial manufacture of urea, might easily have been led to the thought that life counted for little in the scheme of the universe, Mueller continued to teach consistently that vital energy may direct chemical or physical forces, but must not be confounded with them. It looked as if in the development of the chemistry of the carbon compounds, all of which are the result of life action, that materialistic views must be expected to prevail. Mueller insisted, however, that life ever remains the guiding principle which rules and coordinates all the physical and chemical forces at play, within living organisms; and that the vital principle is entirely independent of these forces so closely attached to matter.

All Mueller's disciples, and they were the representative biological scientists in Germany during the nineteenth century, followed closely in his footsteps in this matter, and the result was a conservatism of thought in biology in Germany that is the more surprising when we realize how much German philosophers in their systems emphasized the necessity for absolute independence from all previous systems of philosophical speculation. It is so much more interesting, then, to find what was the method of education that made of Johann Mueller so conservative a thinker, while not injuring his genius for experimental observations. The influences that were at work in his earlier years were evidently those that made him subsequently the bulwark against materialistic tendencies in biology, and yet did not impair his originality. His early education was obtained under influences that are usually considered to be distinctly harmful to independence of thought, and yet they seemed to have helped him to the fulfilment of his destiny, as a great thinker and investigator. {219} Mueller is undoubtedly one of the very great men of modern science, and is the recognized founder of the system and methods of investigation which have given German medicine its present prominence and prestige.

In recent years there have been many tributes to Mueller, because as Virchow's teacher it was considered that some of the praise for the work done by Virchow must naturally reflect on the man to whom the great German pathologist acknowledged that he owed so much of his inspiration and his training in methods of investigation. Virchow's death too very naturally led to the recall of what had been accomplished in German medicine during the nineteenth century, and for much of this Johann Mueller must be considered as at least indirectly responsible, since to him so many of the great German medical scientists owed their early training. These men, all of them, did not hesitate to attribute the progress of German medicine to the methods introduced by Mueller. At the beginning of the twentieth century something of the estimation in which he was held in a land far distant from the German Fatherland may be gathered from the following tribute paid to him in a recent meeting of the Medical Society of the State of New York by Dr. C. A. L. Read, of Cincinnati, former President of the American Medical Association. In the midst of his panegyric of Virchow Dr. Read described in some detail the medical faculty of Berlin at the time when Virchow was beginning his work as a student at that University. He said:

"In the faculty there were Dieffenbach, the foremost surgeon of his
day; Schoenlein, the great physician who had come from Zurich the
same year to join, not only the teaching body, but to act as a
reporting counsellor for the ministry and to serve as
physician-in-ordinary to the King; Froriep, who was in charge of the
Pathological Institute; Caspar, who {220} was also medical
counsellor, with a seat in the special deputation for medical
affairs in the ministry; but towering above them all was the
intellectual figure of Johann Mueller, the Professor of Physiology.
He was an original genius with daring, actually engaged in winnowing
the wheat of demonstrated truth from the prevailing chaff of
egoistic opinion which divorced physical science from speculative
philosophy. Prompted by the inspiration which he had derived in turn
from Bichat and the French school, the Professor of Physiology was
busily retesting in the laboratory truths previously elaborated by
Haller, Whytt, Spalanzani, Cullen, Prochaska, John Hunter, the
Bells, Magendie, Berzelius and Bichat himself."

This is the tribute to Johann Mueller, nearly fifty years after his death. That of Virchow, at his obsequies in Berlin, is even more enthusiastic. Virchow, then at the age of thirty-seven, at the height of his powers, already acknowledged the greatest of living pathologists, just recalled to Berlin to become Professor of Pathology in the University which he had left more or less in disgrace because of his political opinions, could not say too much of the teacher whom he respected and honored so highly and whose inspiration he felt stood for so much in his own career.

He said:

"My feeble powers have been invoked to honor this great man whom we
all, representatives of the great medical family, teachers and
taught, practitioners and investigators, mutually lament and whose
memory is still so vividly with us. Neither cares by day nor labors
by night can efface from our mind the sorrow which we feel for his
loss. If the will made the deed, how gladly would I attempt the
hopeless task of proper appreciation. Few have been privileged, like
myself, to have this great master beside them in every stage of
development. It was his hand which guided {221} my first steps as a
medical student. His words proclaimed my doctorate and from that
spot, whence now his cold image looks down upon us, his kindly eyes
beamed warmly upon me, as I delivered my first public lecture as
Privat-Docent under his deanship. And, in after years, I was the one
out of the large number of his pupils who, by his own choice, was
selected to sit beside him within the narrow circle of the faculty.

"But how can one tongue adequately praise a man who presided over
the whole domain of the science of natural life; or how can one
tongue depict the master mind, which extended the limits of his
great kingdom until it became too large for his own undivided
government? Is it possible in a few short minutes to sketch the
history of a conqueror who, in restless campaigns, through more than
one generation, only made use of each new victory as a standpoint
whereon he might set his feet and boldly look out for fresh
triumphs?

"Yet such is the task to which we are called. We have to inquire
what it was that raised Mueller to so high a place in the estimation
of his contemporaries; by what magic it was that envy became dumb
before him, and by what mysterious means he contrived to enchain to
himself the hearts of beginners and to keep them captive through
many long years? Some have said--and not without reason--that there
was something supernatural about Mueller, that his whole appearance
bore the stamp of the uncommon. That this commanding influence did
not wholly depend on his extraordinary original endowments is
certain, from what we know of the history of his mental greatness."

Virchow's tribute could not well be more enthusiastic or more ample. His appreciation has been the standard for all other medical opinions of the man. How much Mueller is honored at the present time in Germany can be best {222} appreciated from the number of times that his name is mentioned with respect and often with laudation in the proceedings of German medical societies. Scarcely a meeting passes in which more than once Johann Mueller is not referred to as the founder of the scientific method in medicine which has given Germany her present position in the very forefront of medical scientific progress. It is a common expression, said half in jest it is true, but surely more than half in earnest, that the proceedings of no medical society would be really successful within the bounds of the German fatherland unless they were hallowed by an invocation of the great name of Johann Mueller, the revered patron of modern German medicine. This is no witticism by exaggeration, after the American fashion, but a sincere Teutonic expression of feeling that occupies German medical minds with regard to the man who founded the most progressive school of modern medicine, and in doing so brought honor to his native country.

Johann Mueller was born at Coblentz, on July 14, 1801. About six months before, the Emperor of Austria by the treaty of Luneville, signed February 9, 1801, ceded to the French Republic all the Austrian possessions on the left bank of the Rhine. The electors of Treves, who were archbishops and reigning princes and who had resided for centuries at Coblentz, by this treaty disappeared forever from the list of German rulers. When Johann Mueller was born, French prefects of the Departments of the Rhine and Moselle took up their residence in the old town which had been, since the beginning of the French Revolution, a favorite dwelling place for the French nobility driven from their homes by fear of persecution.

Mueller's father was a shoemaker and lived in a small house in the street of the Jesuits, so called because the fathers had had a school in it for many years. Johann was {223} not destined to receive his education from the Jesuits, however, for the order had been suppressed nearly thirty years before his birth, and did not re-establish itself in the Rhineland for many years afterward. The circumstances of the Mueller family were not such as to encourage hopes of a broad education, though his father seems to have taken every possible means to secure as much school training as could be obtained for his son. The early death of his father promised to deprive Mueller of whatever advantages might have accrued from family sacrifices, but his mother was one of these wonderful women who somehow succeed in raising their families well and affording their children an education in spite of untoward circumstances.

Johann was the eldest of five children, with two sisters. He was very proud himself of the fact, that while he took from his father a large, strong, healthy frame and a dignified carriage, he had his mother's skill for putting things in order, her constancy of enterprise and her tireless faculty for hard work. After his father's death, his mother's energy and good sense enabled her to carry on the business established by the elder Mueller by means of assistants, and as Coblentz was the centre of a district that during the Napoleonic wars was constantly overrun with soldiery, the shoemaking trade was profitable.

Johann seems to have learned the trade, but his mother succeeded in enabling him to begin his education seriously at the age of eleven or twelve. About this time, Joseph Goerres, who was afterward the great leader of Catholic thought in Germany, and after whom is named the famous Goerres Gesellschaft which stands for so much in German Catholic life and progress, was a professor in the Sekunden Schule, or secondary school, in Coblentz, and had recently published treatises on natural philosophy with special {224} reference to physiology. Mueller entered this school in 1810 and Goerres did not resign his professorship until 1814, when owing to the publication of a political work he was obliged to flee from the country. It is not known how much influence Goerres exercised over young Mueller, but some at least of his precious love for the natural sciences, which even in his student days led to the making of natural collections of various kinds, seems to have been imbibed under the influence of the philosopher physiologist. The touching of the orbits of the two men, who were destined, more than any of their fellow-citizens of Coblentz, to influence Germany's future, must always remain an interesting consideration in the lives of both.

Johann's parents were, as might have been expected, down in the old Catholic Rhineland in the capital of the spiritual principality of Treves, faithful members of the Roman Catholic Church. Very early in life, Johann conceived the wish to become a priest. His mother, rejoiced at her son's idea, was ready to make every possible sacrifice to secure his education. It was with the intention of education for the priesthood, then, that Johann entered the Sekunden Schule, an old college of the Jesuits, in which Jesuit tradition and methods of education still survived, and in which some of the old Jesuit pupils seem still to have held positions even during Mueller's time as a student (1810 to 1817).

It would appear probable that because of the traditions of Jesuit teachings that held over at the school in Coblentz, and perhaps, too, because of the presence of some of the old masters and teachers trained by them, Mueller knew the ancient languages so well. He made his own translations of Plato and Aristotle, and consulted the latter especially always in the original and had a lifelong reverence for the great Greek philosophic naturalist's work, Latin he used {225} so well as to speak it readily, and practice in the disputations of the University at Bonn made the language still more familiar to him. It was said that he wrote Latin better than German. After the fall of Napoleon the Prussian government took up the reorganization of the schools in this part of the Rhineland, and Mueller became more interested in scientific studies. At this time he became devoted to mathematics, which he studied under the old pupil of Pestalozzi, Professor Leutzinger, to whom Mueller, in the sketch of his life prefixed to his thesis at the university, expressed the feeling that he owed a special debt of gratitude.

During his school days Mueller became a collector, as we have said, of natural objects. He was especially interested in butterflies for a time, and collected all the species in the country around. He had a curious dislike for spiders which remained with him all his life. He was able to overcome this, however, and made important studies of that insect's eyes, and of its changing expressions under the influence of fear or when about to fall upon its prey.

His feeling with regard to the insect is an index of a certain feminine quality of mind that had a characteristic expression in later life in his dislike for vivisection. He could not bring himself to the conclusion that animals must be sacrificed in the midst of horrible pain unless there was some very definite scientific point to be determined, and unless every precaution was taken to avoid inflicting needless suffering. Even then he preferred that others should do this work and more than once took occasion to point out the fallacy of physiological observations founded on animal experimentation under such anomalous circumstances, and insisted that very frequently the results gave conclusions only by analogy and not by any strict logic of animal similarity or absolute physiological nexus.

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In a sketch of Mueller's life, by Professor Bruecke, of Vienna, himself one of the most distinguished physiologists of the nineteenth century, to whom the University of Vienna has paid the tribute of a marble bust and tablet in its courtyard, the great Austrian physiologist sums up very well the reasons for Mueller's fame. Professor Bruecke's tribute may be found in the _Medical Times and Gazette_, of London, July 17, 1858. "If we inquire," he says, "what were the circumstances to which Mueller, independently of his high intellectual endowment, his gigantic power for work, the energy and massiveness of his character, and his active and vigorous bodily constitution, owed the commanding position he incontestably held among men of science in our day, we must admit that before all things this was due to the breadth and depth of the foundations upon which his intellectual cultivation had been built." Professor Bruecke then dilates on the variety of scientific interests which occupied Mueller's earlier years and the thoroughness with which he accomplished everything that he set himself to.

A very curious reflection on our modern methods of education, and especially the tendency to specialization and the formation of specialists from their very early years, is to be found in Bruecke's account of the extent and variety of Mueller's studies in all lines. Far from considering that these diverse intellectual interests hindered the development of his genius, he seems to consider that they rather aided in the evolution of that largeness of mind characteristic of the great genius. He says:

"In his schooldays Mueller's attention was directed to subjects of study far beyond the mere medical curriculum, for we find him attending the lectures of celebrated professors on poetry and rhetoric, on the German language and literature, on Shakespeare and Dante." As a matter of {227} fact, Bruecke seems to have understood that no one is so little likely to make scientific discoveries as he whose mind has been directed without diversion along the narrow lines of a specialty in science. Constantly trained to see only what lies in the sphere of this short-sighted interest, the mind never raises itself to a view beyond the horizon of the already known.

The old classical training, supposed to be so useless in this matter-of-fact, practical age, trained the minds of the men who have given us all the great discoveries in science. The evolution of intellectual power consequent upon the serious study of many things proved an aid rather than a hindrance to future original work. Not one of these great scientific investigators had at the beginning any hint of the work that he was to do. It seems almost an accident that their researches should have been conducted along certain lines which led to important discoveries. What was needed for them was not special training, but that mental development which puts them on a plane of high thinking above the already known, to look for progress in science.

Mueller continued for many years to entertain the idea of eventually becoming a priest. At about the age of sixteen, however, he became deeply interested in Goethe's work, and was especially attracted by the great poet's studies of scientific subjects. About this time he became interested in the collection of plants and animals and took up seriously the study of physiology. Lavater's work was, at that time, still sufficiently recent to have little of the novelty worn off, for young students, at least. At the age of eighteen Mueller went to Bonn and, when about to begin his university career, hesitated as to whether he should study theology or not. His natural liking for nature study, however, finally caused him to decide in favor of a scientific career, and he began the study of medicine.

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He took up his medical studies with the greatest enthusiasm. Under the special guidance of Mayer, who besides being his teacher was a personal friend, he applied himself zealously to the study of anatomy. One of his expressions in his early student days that has often been repeated, but which Mueller took the greatest care in later life to correct and deny as a lasting impression, was the famous "Whatever cannot be demonstrated by the scalpel, does not exist." The professor of physiology at the time at Bonn was the famous Fredrich Nasse, especially known for the wonderful attractiveness of his lessons and his power of arousing enthusiasm in others, and it is not surprising that Mueller, naturally so enthusiastic in scientific studies, should have acquired a liking for the study that he never afterward lost.

During Mueller's second year of medical study the University of Bonn announced its first prize, which was to be given for an investigation of the subject of respiration in the foetus. Although Mueller was only in his first year as a medical student at the time, he grappled with the difficult subject and devoted all his spare time to arranging experiments for the demonstration and investigation of doubtful points. He received the prize, and Virchow, surely a good judge in the matter, says that this work of his student days is distinguished alike by the extent of its learning and by the number and boldness of the experiments detailed. At the moment of his graduation, the young doctor, in his twenty-first year, was already a marked man. From this time on everything that he did attracted attention and had a ready audience.

Mueller's mind was constantly occupied after this time with the arranging of experiments to demonstrate natural principles. How far he carried this habit of experimenting can be understood from some of the habits of control over {229} his muscles which he had acquired by continual practice and intense attention. He had thorough control over the muscles of his ears and used often to amuse his fellow-students by their movements. The anterior and posterior muscular portions of this occipito-frontalis muscle were able readily to move his scalp and produce curious disturbances in his hair. These habits of muscular control many people have acquired. Other acquisitions of Mueller's are, however, much rarer. He could, at will, contract or dilate his pupils, having secured control over his iris by practice before a mirror, and he could use the little muscles that connect the bones within the ear, the hammer, anvil and stirrup, so as to make them produce an audible click at will.