Chapter XLV (1)

_Progress of Medical Science in Scotland in the Eighteenth
and Nineteenth Centuries._

THE aim of this chapter is like the last one, not an attempt to present a history of the great and important science of medicine in all its branches, but to indicate what Scotland has contributed to the progress of this science, and also to give some account of the rise, the progress, and the organisation of the several institutions in which this science was taught in our country――in other words, the medical schools of Scotland. It will therefore, in the first place, indicate the bases of medical science; in the second, touch briefly on the prevailing theory in the early part of the eighteenth century; and in the third, proceed to narrate the advance of medical science in Scotland, and the establishment of our several medical schools.

The prime phenomenon presented to medical science is life. The first requisite of this science, therefore, is to enounce what life consists of, and more particularly what constitutes human life.――(1) As to the constituent elements of the human organism; (2) with reference to its structure; and (3) its functions. In other words, the science of medicine must be founded on biology; and it rests immediately on that part of biology termed human anatomy, physiology, and pathology――based on physiological analysis; and its subsidiary sciences are chemistry, botany, and some parts of physical science. The development of biology is gradually leading to a more scientific basis in the science of medicine, and the necessary conditions of health are becoming better understood.

Without entering into many details I shall endeavour to present the chief features of the prevailing theory in medicine immediately preceding the time when the Scottish schools began to arise; such a sketch is interesting in itself, and it will enable us to understand what Scotland has done in this great department of science.

Galen, born A.D. 131, was the oracle in medical science for upwards of 1400 years; but, in 1492, Paracelsus was born. The son of a physician, he determined to follow the profession of his father. He travelled about in quest of remedies amongst the chemical practitioners of those times, and from them he learned the use of mercury and antimony, and of opium. By the application of these remedies he cured many diseases which had baffled the remedies of the Galenists; and, being a bold man, he made the most of this, and attained such a reputation that he was appointed a professor in the University of Basle. In this position he was forced to employ some method, and seizing on such theories as then existed among chemists, he formed a system of physic, supported by much new and meaningless jargon of his own. His lectures were chiefly employed in recommending his own chemical remedies, and in bold attacks upon the established schools of physic. He ordered the books of Galen and Avicenna to be brought into his school and publicly burned as useless lumber. Thus he formed a sect, and by the middle of the seventeenth century physicians were divided into the two sects of Chemists and Galenists.¹

¹ Dr. William Cullen’s Works, Volume I., pages 392‒393. 1827.

Galenism now fell rapidly in Germany, France, and England. The philosophy of Descartes had adopted many of the doctrines of the Chemists, readily united with their system, and established its credit; and the publication of Harvey’s doctrine of the circulation of the blood completed the ruin of the Galenic fabric. Bellini applied the principles of mathematics to the physiology and pathology of medicine; and his system was so specious and promising, and so consonant with the reigning philosophy, that it immediately prevailed in Italy. It was brought to this side of the Alps by Dr. Pitcairn,¹ and soon became the prevailing system in Holland, England, France, and Germany; and it is recorded that the followers of this system were always the friends of observation and experiment, and that they detected and exploded many false hypothesis.

¹ Mackintosh’s _History of Civilisation in Scotland_, Volume
III., page 329.

At the beginning of the eighteenth century the medical school of Leyden had a high reputation, which was extended by the celebrated physician Herman Boerhaave,¹ who was appointed to the Chair of Medicine in this University in 1701. He digested and taught a medical theory which held an almost undisputed sway for upwards of half a century. When he entered the school of Leyden, he found it divided between the chemical system of Sylvius de le Boe, and the mechanical system of Bellini and Pitcairn; and he had the discernment to select the most useful parts from both systems. From ♦Bellini he adopted the doctrines of obstruction, and of lentor; from the Chemists he took the doctrine of acid and alkali, but corrected and limited; he also admitted the doctrine of plethora, the only remains of the Galenic theory which the discovery of the circulation of the blood seemed to support. Thus he combined the doctrines of the mechanical or mathematical school and the Chemists; and, as he possessed good analytic and elaborative faculties, he produced a system superior to any that had before appeared. He endeavoured to simplify the study of medicine, and rejected many useless hypotheses. He lectured on the theory of medicine, botany, and chemistry, with surprising clearness, and till then unmatched precision; and students flocked to him from all quarters.²

¹ Born in 1668; died 1738.

♦ “Belini” replaced with “Bellini”

² Hamilton’s _History of Medicine_, Volume II., pages 199‒203:
Dr. Cullen’s Works, Volume I., page 411.

Boerhaave’s _Aphorism or Practice of Physic_ appeared in 1709, and his _Institutions or Theory of Physic_ shortly after. These two treatises contain his system; they passed through many editions, and were translated into almost every European language, and into Arabic; while they are remarkable for elegance, clearness, and brevity of style. But the influence of Descartes’ philosophy appears in his physiology, and in other parts of his system; and it is a curious fact which has not been noticed before, that through the teaching of Boerhaave’s system in Scotland, parts of the philosophy of Descartes reappear in more than one form in the medical literature of our own country. He adopted Descartes’ idea of mind and body, and other notions of this philosopher. Boerhaave in his physiology considered man as composed of two distinct substances――mind and body; the essential nature of mind is to be conscious, to think, and to will; but the essential nature of the body is to be extended and impenetrable. He says “the idea or definition of body has nothing in common with that of mind; nor has the idea of mind, on the other hand, anything in common with that of body.” He considered the study of mind to be an important part of physiology; and so he gives an exposition of the mental faculties under the heads of the internal and external senses. He states that “our bodies receive nothing else from sensible objects, to produce sensation, than a change in the surface of the nerves excited by the contact of the object. I do not say that this is to feel, but I say that we feel when this takes place. Sensation, therefore, is nothing either in the object or in the nerve affected, but a certain idea which God has assigned to this particular corporeal change. This is acknowledged by Newton in the last edition of his _Optics_.” Following Descartes, he assumed that the change produced upon the extremity of a sentient nerve must be propagated along the nerve to the brain before sensation can be produced; until his time, two mechanical explanations of this phenomenon had been given, one of which considered the nerves as solid vibratory cords, the other as hollow undulatory canals. Boerhaave adopted the latter view, and assumed that the change in the sensorium was nothing more than a repulsion of the nervous fluid against their origin in the brain. He conceived that the cerebrum controls the voluntary motions, and the cerebellum, the involuntary; but, as in other parts of the body, both these classes of motions are performed together, he assumed that the nerves of these parts must be composed of fibres, derived partly from the cerebrum and partly from the cerebellum, and retaining throughout their course a peculiar function according to the part whence they issue. He was also inclined to believe that each of the external senses had its own distinct seat in the brain.

He conceived the human body to be a combination of all sorts of mechanical contrivances or machines arranged by God into one system, so as to enable it to maintain its existence for a series of years, repairing the waste it undergoes from its own motions, and producing systems similar to itself. Thus, he attempted to explain the phenomena of the human body by the principles of mechanical philosophy, but accompanied with some limitations. He says: “I am persuaded that, even in simple bodies, general laws are insufficient to explain all the individual phenomena, much less do I suppose them capable of accounting for those in the human body, the most complex of all. But if some portions of the human body correspond in their structure with mechanical instruments, they must be governed by the same laws. For all the power of these parts is in the motion which they produce; and motion, by whatever body it is performed, takes place according to the universal laws of mechanics. There are some who think that those actions should not be explained by mechanical laws, the mechanical causes of which are unknown to us. But this is said without an accurate examination of the matter, for we do not speak of the causes but of the effects as being governed by mechanical laws. There are many and considerable motions performed in nature, of the causes of which we are ignorant; but the motions themselves are governed by supreme and universally diffused laws. The magnet, the cause of whose action is wholly unknown to us, performs its motions agreeable to a certain and ascertained law, which, when once known, can be applied, without danger of mistake, to future experiments. The human body in like manner exhibits motions, the causes of which are unknown to us; but their effects are the elevation of weights by cords affixed to them, the propulsion of fluids through determinate vessels, and other effects like those produced by mechanical causes, and they are not governed by any other laws. So it appears that both parties have erred, the mechanicians, in attempting to define all things from their art, without being sufficiently acquainted with the structure of the parts, the powers of which they expressed by numbers; and those who hated the very name of mechanics have declared that our body is independent of those very laws by which all bodies whatsoever are governed. The misfortune is that such physiological subjects are usually handled either by mathematicians unskilled in anatomy, or by anatomists who are not versed in mathematics.”¹

¹ _Institutions._

He attempted to explain the contraction of the muscular fibre upon mathematical principles, and displayed ingenuity and skill, but he failed to explain this interesting phenomenon. He had, however, a pretty distinct idea of the use and the abuse of chemistry in medical science. The following contains in his own words a kind of summary of his physiological system:――“We are obliged to confess that there are many truths, and those too of the greatest importance, in the whole of medical physiology, a knowledge of which can be acquired only by the assistance of chemistry. But the greatest glory of this valuable art is, that it alone is able to expose and correct those errors, which some whimsical dabblers in chemistry had introduced into medicine, as Boyle, Bohn, Hoffmann, Homberg, and others, have shown by beautiful examples. Those vain trifling chemists were certainly in the wrong, who have pretended by their art alone to explain physiology in all its parts; nor, however, are those less mistaken who imagine they can do this without chemistry. Let anatomy faithfully describe the parts and structure of the body; let the mechanician apply his particular science to the solids; let hydrostatics explain the laws of fluids in general, and hydraulics their actions, as they move through given canals; and, lastly, let the chemist add to all these, whatever his art, when fairly and carefully applied, has been able to discover; and then, if I am not mistaken, we shall have a complete account of medical physiology.” This is not a very perfect conception of the human organism.

But his pathology was more defective than his physiology, and took less account of the essential functions of the human body; there was no clear conception of the real normal human organism formed, far less explained, either upon mathematical or any other principles.

Such, then, was the state of medical science in the first half of the eighteenth century; and such was the system which was introduced into Scotland, and taught in the early stages of the history of our medical schools, as the following statement from the highest authority shows:――

“When I first applied myself to the study of medicine, I learned only the system of Boerhaave; and even when I came to take a professor’s chair in this University, I found that system here in its entire and full force; and as I believe it still subsists in credit elsewhere, and that no other system of reputation has been yet offered to the world, I think it necessary for me to point out particularly the imperfections and the deficiencies of the Boerhaavian system, in order to show the propriety and necessity of attempting a new one. To execute this, however, so full as I might, would lead me into a detail that can hardly be admitted of here, and I hope is not necessary, as I think that every intelligent person, who has acquired any tolerable knowledge of the present state of our science, must in many instances perceive its imperfections. I shall therefore touch only upon the great lines of this system; and from the remarks I am to offer, I trust that both the mistakes and the deficiencies which run through the whole of his works will appear.”¹ I will now proceed to the chief subject of the chapter.

¹ Dr. William Cullen’s _Introductory Lectures on the Practice
of Physics_, Volume I., page 412.

As stated in a preceding volume, the first charter to the surgeons was granted by the Town Council of Edinburgh in 1506; the science of medicine, however, had made little progress in Scotland two centuries later. But towards the end of the seventeenth century a movement began and various efforts were made to found a medical school in Edinburgh, which ultimately succeeded. The influences and the efforts which led up to the founding of the Edinburgh school originated from the outside, not from within the University itself, in the early stage of its history. As stated in the last volume, the College of Physicians in Edinburgh was incorporated in 1681;¹ and the old College of Surgeons got a royal charter in 1694, and at the same time a grant from the Town Council of unclaimed dead bodies. The anatomical theatre was opened in 1697. Thus the incorporated physicians and surgeons began to form a medical school outside the University; and afterwards some of the members of these bodies were taken into the University as professors. In this way the great medical school of Edinburgh arose, and it has continued to be surrounded by extra-mural teachers, some of whom were highly distinguished members of the profession.

¹ Mackintosh’s _History of Civilisation in Scotland_, Volume
III., page 369.

In 1705, Robert Elliot, a member of the College of Surgeons, was elected by his fellow-members as the special teacher of anatomy; and the Town Council recognised his appointment under the title of Professor of Anatomy in the University, and for his encouragement granted him a salary of £15: thus Elliot became the first Professor of Anatomy in the University of Edinburgh. The teaching of chemistry was recognised by the University in 1713, when James Craufurd, a pupil of Boerhaave, was appointed Professor of Medicine and Chemistry. He was succeeded in 1726, by Andrew Plummer, a graduate of Leyden and a pupil of Boerhaave. He lectured ably upon chemical pharmacy for twenty-nine years. He was the author of the preparation known under the name of Plummer’s Pill; and it was recorded that he was a man of varied knowledge and accomplishments. The study of botany was recognised by the University authorities in 1676; and Dr. Charles Preston, the second professor of this useful branch of knowledge, was appointed in 1706. The following year he issued an advertisement in the _Edinburgh Courant_ to this effect: “Dr. Preston teaches his lessons of botany in the Physic Garden at Edinburgh, the months of May, June, July, and August, 1707. Therefore, all gentlemen and others, who are desirous to learn the said science of botany, may repair to the said garden, where attendance will be given.” Botany as a subject for lectures in a class-room scarcely then existed.

John Munro, a military surgeon, who had served in King William’s army, retired and settled in Edinburgh early in the century, and was president of the College of Surgeons in 1712. He had an only son, Alexander Munro, who was carefully educated by his father. In 1717, young Munro, at the age of twenty, was sent to study anatomy under Cheselden, in London; subsequently he proceeded to Paris, where he studied anatomy under M. Bouquet, and attended classes in the hospitals; whence to Leyden, and placed himself under Boerhaave, who gave a favourable report of his pupil’s progress. He returned to Scotland in 1719, and was admitted a member of the College of Surgeons.

In January, 1720, Alexander Munro was appointed professor of anatomy in the University of Edinburgh, and soon after commenced lecturing in the surgeons’ theatre. In 1726, Doctors Andrew Sinclair and John Rutherford were appointed professors of the theory and practice of medicine; and thus the faculty then consisted of a chair of anatomy, three professors of medicine, a professor of chemistry, and a professor of botany. These professors were appointed for life, and this was the first regular establishment of the medical faculty in the University of Edinburgh.

Munro started his course of lectures with a class of fifty-seven students, and the class gradually increased in numbers. For the first ten years the average number was sixty-seven, for the second one hundred and nine, and for the third one hundred and forty-seven: students joined his class from all parts of Scotland, England and Ireland. His course of instruction was a comprehensive one, and embraced surgery as well as anatomy; and he illustrated his teaching by dissections of the human body, and of animals, birds, and fishes, for comparison. After explaining the anatomy of each part, he treated of its diseases, especially the organs which required operations, and concluded his course with a few lectures on physiology. He delivered this course continuously for thirty-eight years, and spoke without notes except for the names and dates.

In 1726, he published his work on _The Human Bones_, which passed through eight editions in his lifetime, and was translated into most of the European languages; and it contributed much to raise the reputation of the Edinburgh medical school. The whole of his writings have been collected and published in one large volume. It was also mainly by the exertions of ♦Monro and Provost Drummond that the Royal Infirmary of Edinburgh was erected, endowed, and incorporated, the foundation stone of which was laid in 1738. When it was opened Monro attended it and delivered lectures on surgery;¹ the clinical lectures were begun in 1746.

♦ Author switched spelling from “Munro” to “Monro”.
Transcriber left as printed.

¹ Monro was the originator of the Medical Society, formed in
1732, for the publication of papers on medical subjects,
and he was appointed its secretary, and the editor of
the six volumes of medical essays and observations which
it published. In 1739, on the suggestion of Maclaurin,
the mathematician, its scope was extended to subjects of
philosophy and literature; but its meetings were interrupted
for some years by the Rebellion. In 1752, they were
renewed, and, under the name of The Philosophical Society
of Edinburgh, the first volume of its _Transactions_ was
published in 1754, the second in 1756, and the third in 1771;
but in 1782, a scheme was proposed for the establishment of
a society on a wider plan for the culture of every branch of
science and taste; and the Royal Society of Edinburgh, which
included all the members of the Philosophical Society, and
many other eminent men, was formed and incorporated by royal
charter in 1783.

In 1758, Dr. Monro resigned the chair of anatomy to his son, and devoted himself for the remaining nine years of his life to practice, and to lecturing in the Infirmary as one of the clinical professors. He died in 1767, in the seventieth year of his age. His merits have been summed up, by a well qualified Professor thus:――

“He had family and friends influential and plenty, but the work he had to do was of a kind at which friends could only stand and look on. He had to do a new thing in Edinburgh: to teach anatomy, and to provide for the study of it, in a town of then only thirty thousand inhabitants, and in a half-civilised and politically disturbed country; he had to gather in students, to persuade others to join him in teaching, and to get an infirmary built. All this he did, and at the same time established his fame not only as a teacher but as a man of science, and gave a name to the Edinburgh school which benefited still more the generation which followed him. This really great and good man, therefore, well earned the title often given him, of father of the Edinburgh medical school.”¹

¹ Professor Struthers, _Historical Sketch of the Edinburgh
Anatomical School_, page 25 (1867); compare Hamilton’s
_History of Medicine_, Volume II., pages 296‒299.

A chair of midwifery was regularly established in the University in 1739――Mr. Robert Smith being appointed by the town council “professor of midwifery in this city’s College, with the same privileges and immunities which the other professors in the said College do enjoy, or that are known to appertain to a professor of midwifery in any other well-regulated city or place.” It is well known that the institution of this chair, like most of the other chairs connected with medicine in Edinburgh, originated with the Colleges of Physicians and Surgeons. The Town Council had before, in 1726, on the recommendations of the Colleges of Physicians and Surgeons, appointed Mr. Joseph Gibson “professor of midwifery in this city, with power to him to profess and teach the said art, in as large extent as it is taught in any city or place where this profession is already instituted.” But Gibson had no chair in the University, he was merely appointed to teach in the city.¹ A separate chair of materia medica was instituted in 1768; and a chair of natural history was established by the Crown in 1767.

¹ _Burgh Records of Edinburgh_; Professor A. R. Simpson’s
_Introductory Lecture on the History of the Chair of
Midwifery, etc._, pages 9‒10.

Dr. Cullen and Dr. Black contributed greatly to raise and to maintain the reputation of the Edinburgh medical school, of the teaching and discoveries of the latter, I have already spoken in the last chapter. Dr. Cullen was born at Hamilton on the 15th of April, 1710; his father was a writer, and acted as factor to the Duke of Hamilton. He received the rudiments of education at the Grammar School of Hamilton, and afterward studied at the University of Glasgow. He was apprenticed with Mr. John Paisley, a practising doctor in Glasgow: to serve an apprenticeship was then almost the only way in which a knowledge of medicine could be obtained in Scotland. His master, though engaged in a large practice, had collected an extensive and valuable medical library; and Cullen fully availed himself of the advantages which it presented. When his medical studies were completed at Glasgow, in the end of 1729, he went to London, with the object of obtaining some situation in which he might have opportunities of acquiring a practical knowledge of his profession. He obtained an appointment as surgeon to a merchant ship engaged in trading to the West Indies; and during her voyage she remained for six months at Porto Bello, and this and other circumstances connected with the voyage gave him an opportunity of seeing many new scenes and peculiarities of life and manners. After returning from the West Indies, he remained for some time in London, and attended the shop of an apothecary in Henrietta Street. At this time he seems to have specially directed his attention to materia medica.

He returned to Scotland about the end of the year 1731, and was invited by Captain Cleland to live in his family and attend to the health of his son, in the parish of Shotts, near Hamilton. This was a very good locality for Dr. Cullen to commence the practice of his profession. After practising here for about two years, he resolved to devote his attention entirely to medical studies for some time, preparatively to starting as a practitioner in Hamilton. With this view he went to the village of Rothbury, in Northumberland, where he lived with a dissenting clergyman, and chiefly occupied himself in the study of philosophy and general literature, which would partly account for the wide and accurate knowledge of the history of philosophic thought which appears in his writings.

In 1734, he entered the University of Edinburgh and attended the medical classes for two years. On finishing his courses at Edinburgh, in the spring of 1736, he commenced business as a surgeon in Hamilton; and in a short time he obtained a good practice. Soon after his settlement in Hamilton, Dr. Cullen became the friend and the medical preceptor of the well-known Dr. William Hunter, whose genius and love of study were so congenial with his own; and their friendship continued till the death of Dr. Hunter in 1783. Dr. Hunter retained to the end of his life a warm feeling of gratitude for Cullen, and never omitted an opportunity of acknowledging how much he owed to him. Dr. Cullen removed from Hamilton to Glasgow in 1744, where he had a wider sphere for the exercise of his genius and his great talents. He thought that a medical school could be established in Glasgow, and his foresight was well founded.

He applied to the authorities of the University for leave to deliver lectures on the theory and practice of medicine, chemistry, and botany, so bold and comprehensive was the grasp of principles which he had attained. The authorities acceded to his request, and his first courses of lectures were delivered in the University of Glasgow in 1746; and they mark an era in the history of medicine in Scotland. In the first place, he laid aside the use of Latin in the composition and delivery of his lectures, which appeared to many a rash and unpardonable innovation; in the second, he had the courage and discrimination to reject the use of the ♦_Institutions_ and _Aphorisms_ of Boerhaave as text-books, which were then generally used in the medical schools of Europe; in the third, he struck out new lines himself; and in the fourth, he was the first in Britain who assigned to chemistry its proper position as a science of great importance, and susceptible of wide application. In his introductory lectures on this memorable occasion he referred to the advantages which a teacher has when he explains his own ideas and writings, instead of commenting upon those of others, and then adds:――“I ought to give a text-book myself, but shall not attempt it, till after a little more experience in teaching. In the meantime, I shall endeavour to supply its place by an easy, clear order and method, so that the want of it may be less felt;” and in allusion to his attempting to lecture from notes, he remarked: ――“Written lectures might be more correct in the diction and fluent in the style; but they would take up too much time, that may be rendered otherwise useful. I shall be as correct as possible, but perhaps a familiar style will prove more agreeable than a formal one, and the delivery more fitted to command attention.”¹

♦ “Iustitutions” replaced with “Institutions”

¹ Dr. John Thomson’s _Life of Cullen_, Volume I., pages 4‒28.

In 1747, in accordance with the plan which he had formed of establishing a regular medical school in the University of Glasgow, Cullen was appointed Professor of Chemistry. At the commencement of his second course of chemistry, he printed and distributed among his students, “The Plan of a Course of Chemical Lectures and Experiments, directed chiefly to the improvement of arts and manufactures, to be given in the Laboratory of the College, during the session 1748.” At this time he specially directed his attention to investigate the application of chemistry to the useful arts. He suggested various improvements in the art of bleaching, and proposed an improved method for the manufacture or purification of common salt. Some of the difficulties which he had to encounter in his efforts to present a comprehensive account of chemical phenomena were thus stated by himself:――

“Chemistry is an art that has furnished the world with a great number of useful facts, and has thereby contributed to the improvement of many arts; but these facts lie scattered in many different books, involved in obscure terms, mixed with many falsehoods, and joined to a great deal of false philosophy; so that it is no great wonder that chemistry has not been so much studied as might have been expected with regard to so useful a branch of knowledge, and that many professors are themselves but very superficially acquainted with it. But it was particularly to be expected, that, since it has been taught in Universities, the difficulties in this study should have been in some measure removed, that the art should have been put into form, and a system of it attempted――the scattered facts collected and arranged in a proper order. But this has not yet been done; chemistry has not yet been taught but upon a very narrow plan. The teachers of it have still confined themselves to the purposes of pharmacy and medicine, and that comprehends a small branch of chemistry; and even that, by being a single branch, could not by itself be tolerably explained. I do not choose the invidious task of derogating from established reputations; but were it necessary, I could easily show that the most celebrated attempts towards a system or course of chemistry are extremely incomplete, as examining but a few of the objects of chemistry; that of those examined a very scanty and imperfect account of their relations to other bodies is given, and that, even what is given, is in a method inconvenient and faulty. Now this is the case with the generality of the books on chemistry; but I must take notice, however, that Dr. Stahl is one who has endeavoured to avoid these faults; he has taught chemistry with a more general view, and attempted to collect the chemical facts, and to arrange them in better order.... From what I have said, you will judge of the state of chemical learning, and what a difficult task I undertook when I engaged to teach chemistry, and it is very necessary to tell you, that I did not engage in it from any confidence of my abilities, but because it was thought proper to be undertaken, and nobody else was found to do it; and if I can be so lucky as to engage you to apply to the study, I dare say that the more you become acquainted with it, the less will my performance need an apology with you.”

In the end of the year 1753, he sent to the Philosophical Society of Edinburgh a paper entitled, “Some Reflections on the Study of Chemistry, and an essay towards ascertaining the different species of Salts.” This paper contains more wide and precise information touching the general properties and relations of the different species of salts than is to be found in any chemical work of the period; and especially the distinctive characters and compounds of soda, a substance then not generally admitted in this country to differ specifically from potash.¹

¹ Thomson’s _Life of Dr.Cullen_, Volume I., pages 57, 58.

Cullen’s reputation was rising rapidly, and in 1751 he was formally appointed to the Chair of the Practice of Medicine in the University of Glasgow, but also continued to lecture on chemistry as well as medicine for the next five years. It was a bright period in the history of this University. Adam Smith was then delivering within its walls a part of the rich store of information which afterwards appeared in the _Wealth of Nations_, while Cullen was laying a better foundation for medicine and the progress of medical science.

But he was appointed Professor of Chemistry in the University of Edinburgh, and entered upon the duties of the chair in the beginning of the year 1756. He then extended and carefully improved his lectures on chemistry, and prepared as an introduction to his course seven lectures giving a history of chemical science, which are fine specimens of that branch of scientific exposition. He occupied the chair of chemistry in Edinburgh ten years, but his class was not a very large one. During his first course of lectures the number of students was only seventeen; in the second it rose to fifty-nine; and it gradually increased, the highest number reached in one session being one hundred and forty-five. He also commenced to deliver clinical lectures in the Royal Infirmary in 1757, instead of Professor Rutherford, whose health was failing.

In 1766 he was appointed to the chair of institutes of medicine; his predecessor in the chair was an able man.¹ But Cullen taught the institutes of medicine with marked success. He divided the main subject into three divisions――physiology, pathology, and therapeutics ――embracing the consideration of health, disease, and remedy. After delivering his historical introduction, he commenced thus:――

¹ Robert Whytt was one of the luminaries of the rising medical
school; and was professor of the institutes of medicine from
1747, till his death in 1766, in the fifty-second year of
his age. He is the author of a treatise _On the Vital and
other Involuntary motions in Animals_, which attracted the
attention of many physiologists; and of a work _On Nervous,
Hysteric Diseases, and on the Sympathy of the Nerves_, a
treatise in advance of the age, which contributed to the
progress of medical science in the latter part of the
eighteenth century.

“Medicine is the art of preventing and curing diseases. The common language is that ‘Medicine is the art of preserving health and of curing diseases;’ but I have said, the art of preventing diseases; for although I do not deny that the preserving of health is the object of the physician’s care, yet I maintain that there is truly no other means of preserving health but what consists in preventing diseases. Every other idea is false, and has led to superfluous, very often dangerous, practice. I say, that health being properly understood, we cannot add to it, nor increase its powers. There is never room for our art, but when there is some defect in the constitution――some bias and tendency towards disease; and it is only by preventing this tendency, by correcting these defects, that is, by preventing disease, that we can preserve health.

“What we call the practice is the art applied to particular diseases and persons. But before considering the application of this art to particular diseases, certain general doctrines are necessary to be premised, which are called the Institutes of Medicine.” He describes physiology thus:――

“The doctrine which explains the conditions of the body and of the mind necessary to life and health, is called Physiology, or the Doctrine of the Animal Economy――I mean that physiology considers the matter of which the body is formed in its mixed, in its aggregation, and, especially, in its organisation or mechanism. With regard to the conditions of the body, physiology considers everything that natural philosophy, chemistry, or anatomy teaches with regard to it. But you are to observe that philosophy, chemistry, and anatomy consider the state of the body, and its several parts, abstracted from its several effects. The business of physiology is only to explain the conditions which these several sciences point out as applicable to the exercise of the functions of the body.

“I have added here a particular to my physiology that is not common――and ‘of the mind.’ ... However the condition of the mind may ultimately arise, we often do see conditions of mind arise, that we cannot trace to a corporeal cause; while at the same time they may produce very considerable effects upon the bodily state; so that it was necessary to say physiology referred to the conditions of the mind, as well as to those of the body. So far from being able to neglect the mind, the most considerable functions are connected with particular operations ... and, indeed, I find that the conditions of the human mind must engage our intention more than they have done hitherto.”¹ Accordingly he treats at considerable length on sensation and the functions of the brain.

¹ Cullen’s Works, Volume I., pages 3‒6; 1827.

On the death of John Gregory in 1773, Cullen became professor of the practice of physic, and held this chair for seventeen years with great advantage to the medical school, the University, the nation, and the world. He resigned his chair in the end of the year 1789, and he died on 5th February, 1790. He had been a professor in the medical faculty of the University of Edinburgh for a period of thirty-four years, and a lecturer and professor in the University of Glasgow for nine years, so that he had been a hard-working professor for a period of forty-three years. As a teacher he was remarkably successful, he had all the qualifications of a great expositor――vast and accurate knowledge, analytic powers of the first order, a mastery of method and systematic development, and a copious command of appropriate language; an intellect of a philosophic and original cast which threw new light on many points; in short, a genius who never failed to make every subject which he handled clear and interesting. He was highly respected and beloved by all earnest students of medicine, and many of his pupils rose to eminence.¹ He took a keen interest in everything connected with or bearing on medical science, and his sagacity, judgment, and practical experience were invaluable to the Universities of Glasgow and Edinburgh, and to the nation.

¹ I shall give an indication of his method from his _Nosology_:
――“The several diseases to be treated of are determined by
the nosology. What I call a genus is everywhere to afford
to me a particular subject of discourse; and under each of
these heads I shall treat the following subject.

“First, I am to give what may be called the History of the
disease――of the genus, that is, and an account of all the
special phenomena which constantly attends the appearance
of such a disease, as they are severally combined together,
or occur in succession. Secondly, the investigation of
the proximate cause, on the knowledge of which the cure of
the disease is chiefly and almost unavoidably founded....
Thirdly, from the phenomena of the disease, and with a view
to the conclusion respecting the proximate cause. I am next
to enter into a critical disquisition with regard to the
proper character and limits of every genus, and its division
into species and varieties.... Fourthly, we shall proceed
to the consideration of the remote causes, upon which the
prevention of diseases chiefly depends.... Fifthly, we shall
proceed to the prognostic.... The sixth and last article is
that for which all the others are intended, viz., the method
of cure.... You have thus, gentlemen, my plan for treating
the several heads――the several genera of diseases which are
to enter into my course.... I wish to make you critics in
nosology; but this I shall perhaps find a difficult task.
Perfect division and definition is the summit of human
knowledge in every part of science, and requires not only
the clearest but the most comprehensive views, such as, with
respect to diseases, we can arrive at only by often-repeated
exercises and much study.”――_Works_, Volume I., pages
440‒445.

His chief works are:――(1) _Institutions of Medicine_, 1777; (2) _First Lines of the practice of Physic_; (3) _Synopsis Nosologiæ Methodicæ_, 1785; (4) _Treatise of the Materia Medica_; (5) Various lectures and papers. Both his teaching and his writings have had great influence in advancing medical science, in almost every branch, and especially the nervous system of the human organism. This was owing not simply to the number of new facts which he discovered or the generalisations which he formed, but chiefly to the original characteristics, and the method of his teaching, which was admirably calculated to interest and arrest the attention and stimulate the powers of those who came under its influence. His own mind was comprehensive, the extent of his acquired information even outside of his special profession was vast and varied, and his knowledge of recorded philosophic thought was remarkable.

Dr. John Gregory succeeded his father as professor of medicine in King’s College, Aberdeen, in 1755; and, in 1766, he was appointed professor of the practice of physic in the University of Edinburgh. In his introductory lectures he treated on “The Duties and Qualifications of a Physician,” and these were afterwards published. In 1770, he published his _Elements of the Practice of Physic_, for the use of his class. He died in 1773, in the forty-ninth year of his age; and was succeeded in the chair by Dr. Cullen. He was the author of the well-known work, _A Comparative View of the Faculties of Man with those of the Animal World_. His son, James Gregory, also became a professor.

James Gregory was born at Aberdeen in 1753, and went to Edinburgh with his father; he was the great grandson of James Gregory the celebrated Professor of Mathematics, and himself the sixteenth Professor that had sprung from the loins of David Gregory of Kinairdy.¹ He was appointed Professor of Institutes of Medicine in 1776; and in 1788, he published a text-book for the use of his class, entitled _Conspectus Medicinæ Theoreticæ_, which was much admired for its elegant Latinity; it was adopted as a text-book in several of the German Universities. On the retirement of Dr. Cullen, Gregory was transferred to the Chair of the Practice of Physic, which he held till his death in 1821. Thus he had taught in the University for the long period of forty-five years. He took an active part in questions touching Infirmary management, and engaged in hot disputes with his brethren on these matters.

¹ It appears to me that an account of the careers of the
distinguished members of this family of Gregories would form
a very interesting subject for a volume or two among the
tomes to be printed by the New Spalding Club.

Dr. Andrew Duncan, a son of a merchant, was born at St. Andrews on the 17th October, 1744. He entered the University of St. Andrews, and graduated Master of Arts in 1762. He then proceeded to the University of Edinburgh and pursued his medical studies, and completed his course in 1769. In the absence of Dr. Drummond, during the sessions of 1774‒5 and 1775‒6, Duncan delivered lectures on the theory of medicine in the University of Edinburgh, while he undertook the editorship of a periodical work entitled _Medical and Philosophical Commentaries_. This publication contained an account of the best new books on medicine, and the cognate branches of science; medical cases and observations; and the most recent medical intelligence. It was published quarterly, forming one volume annually, and continued till 1795 under his editorship, when it had extended to twenty volumes. Subsequently he continued it under the title of _Annals of Medicine_ to 1804, when he ceased to act as editor. In 1805 its title was changed to the _Edinburgh Medical and Surgical Journal_, and under the editorship of Dr. Duncan’s son, it became one of the leading medical Journals in Europe.

On the transference of Dr. Gregory to the chair vacated by Dr. Cullen, Dr. Duncan was appointed to the chair of the Institutes of Medicine in 1790. He was an able and successful professor, and much esteemed. The style of his lectures was clear and direct, and excellent specimens of instructive exposition. He showed great interest in his pupils, often inviting them to his house, and cultivating a kindly intercourse with them. His sympathies were wide and warm. Having often seen the sad condition and suffering of insane persons, he originated a plan for the erection and endowment of a Lunatic Asylum, which he brought before the Royal College of Physicians of Edinburgh in 1792. After many difficulties had been surmounted, a petition was presented to the King, who granted a royal charter in April 1807, under which a Lunatic Asylum was built and opened at Morningside. In September 1808 the Town Council of Edinburgh presented Dr. Duncan with the freedom of the City, as a public recognition of his services to the community by the establishment of the Lunatic Asylum, and also a public Dispensary. After a long and useful life, he expired on the 5th of July, 1828, in the eighty-fourth year of his age. He was the author of a considerable number of works, including _Elements of Therapeutics_, _Medical Commentaries_, _Medical Cases and Observations_, _Heads of lectures on the Theory and Practice of Physic_, _Essay on Consumption_, and other treatises. He bequeathed to the Royal College of Physicians of Edinburgh, one hundred volumes of practical observations in his own hand-writing, which he had used as notes for his clinical lectures.

His son, Andrew Duncan, was born at Edinburgh on the 10th of August, 1773. While a boy, he had pored over medical books; and at the age of fourteen he entered on an apprenticeship of five years with Messrs. A. & G. Wood, Surgeons. Afterwards he went through the courses of Arts and Medicine, at the University of Edinburgh, and graduated M.A. in 1793, and M.D. in 1794. Subsequently he studied a winter in London; and made two sojourns to the Continent, staying in each of the notable medical schools of Germany and Italy long enough to study under the professors, visit the hospitals, and acquire some knowledge of the languages and literatures of these countries. On returning to Edinburgh, he joined the College of Physicians; and issued his great work on materia medica, entitled the _Edinburgh Dispensatory_, which for many years was a standard authority in the medical schools of Europe. He was appointed professor of Medical Jurisprudence in 1807; as stated in a preceding page, he was editor of the _Edinburgh Medical and Surgical Journal_. His lectures in the chair, and the papers which he produced in his _Journal_ on this subject excited much interest both among his students and the medical profession. He taught in this chair for thirteen years; and in 1819 he was appointed professor of the institutes of medicine, which he held for two years. In 1821 he was transferred to the chair of materia medica, of which he was an able and careful teacher till 1832. As a professor in three chairs, he was remarkably successful and industrious; and made continual additions to his courses of lectures. He was also a very active and efficient member of the Senatus; and rendered invaluable service as a member of “the College Commission” for rebuilding the University. Besides the important work mentioned above, he contributed many articles on medical subjects to his own _Journal_, to the _Encyclopædia Britannica_, and the _Edinburgh Review_. His experiments on Peruvian bark, and on other substances contributed to advance pharmaceutical science. After a career of incessant and useful work, he died in 1832, at the age of fifty-nine.

As stated in a preceding page, Dr. Monro, the first Professor of Anatomy, was succeeded by his son, Alexander Monro. He was born in 1733, and educated in Edinburgh. After taking his degree in the University, he proceeded to London, Leyden, Paris, and Berlin, and in these cities he spent two years and a half in extending and completing his medical studies.

He returned to Edinburgh in 1758, and shortly after entered on his duties as Professor of Anatomy. He began his course of instruction in the University with vigour and boldness, and it was at once seen that he was master of his subject and of the art of expounding knowledge. His style was easy, clear, argumentative, and impressive; and from the first his career through half a century was a marked success.

The number of students attending his courses of lectures continued to increase; yet he found time to carry on a large practice, being one of the leading physicians of his day, and he was often consulted in important surgical cases. He also found time to produce works of original research in anatomical science; and thus raised his fame at home and abroad, and contributed to extend the reputation of the Edinburgh medical school.

Omitting several of his papers and minor publications, Monro’s chief works are:――(1) _Observations on the Structure and Functions of the Nervous System_, which appeared in 1783; (2) _The Structure and Physiology of Fishes explained and compared with those of Man and other Animals_, 1785; (3) _Experiments on the Nervous System, relative to the Nature and Effects of Animal Electricity_, 1793; (4) _Observations on the Muscles, and particularly on the Effects of their Oblique fibres_, 1794; (5) _The Brain, the Eye, and the Ear_, 1794.¹ These works gave him a reputation as an able anatomist. But it may be remarked that he had no difficulties to overcome, that he had only to step into a ready-made position and every advantage to start with, and that in such circumstances success was comparatively easy; nevertheless, he held his place with distinction and merit, alongside a body of able and brilliant colleagues and contemporaries, which is the greatest praise that can be given him. He died in 1817, at the advanced age of eighty-four years.

¹ Professor Struthers in his _Historical Sketch of the
Edinburgh Anatomical School_, states that manuscript volumes
of notes of Monro’s lectures on anatomy, physiology, and
surgery are preserved in many private and public libraries.
――Page 32.

His son Alexander was appointed Joint-Professor and successor to his father in the Chair of Anatomy, and from 1808 to 1846 he discharged the duties of the Chair. Thus the three Monros in succession held the Chair of Anatomy in the University of Edinburgh for a period of one hundred and twenty-six years: the first Monro occupied it from 1720 till 1758, the second from 1758 to 1808, and the third from 1808 till 1846, when he retired.

The third Monro was an accomplished man, fond of paintings, and spoke Latin fluently. But it was recorded that his talents as a teacher of anatomy were not equal to that of his father or his grandfather. The circumstances, however, were changed: there was then a greater number of men well qualified to teach anatomy and surgery, and the spirit of the time had become more critical and exacting than it was a hundred years before. Remembering this, there seems to be some ground, not for reversing the accepted verdict, but of somewhat modifying the opinion of the merits of the third Monro.

His writings are numerous and manifest great industry, if not original powers. The following are his most important works:――(1) _Dissertation on the varied direction of the Fibres of the Muscles_, 1812; (2) _Elements of the Anatomy of the Human Body_, in two volumes, 1825; (3) _The Anatomy of the Brain, with some Observations on its Functions_, 1831; (4) _Observations on the Different Kinds of Small Pox_, 1818. He died in 1859, at the great age of eighty-five years.

On the retirement of Monro, in 1846, Mr. John Goodsir was appointed professor of anatomy. He had gained some experience as an extra-mural lecturer, and was a remarkably successful teacher; he rendered his special subject more interesting by extending the scope of illustration to allied branches of science. He died in 1867, and was succeeded by William Turner.