Avicenna), 980-1037, in recognition of his great erudition, of
which the chief evidences are stored in his 'Canon.' This
work, though it contains substantially merely the conclusions
of the Greeks, was the text-book and law of the healing art,
even as late as the first century of modern times."
J. H. Baas,
Outlines of the History of Medicine,
pages 216-229.
"The Saracens commenced the application of chemistry, both to
the theory and practice of medicine, in the explanation of the
functions of the human body and in the cure of its diseases.
Nor was their surgery behind their medicine. Albucasis, of
Cordova, shrinks not from the performance of the most
formidable operations in his own and in the obstetrical art;
the actual cautery and the knife are used without hesitation.
He has left us ample descriptions of the surgical instruments
then employed; and from him we learn that, in operations on
females in which considerations of delicacy intervened, the
services of properly instructed women were secured. How
different was all this from the state of things in Europe: the
Christian peasant, fever-stricken or overtaken by accident,
hied to the nearest saint-shrine and expected a miracle; the
Spanish Moor relied on the prescription or lancet of his
physician, or the bandage and knife of his surgeon."
J. W. Draper,
History of the Intellectual Development of Europe,
volume 2, chapter 2.
"The accession of Gehwer to the throne of Mussulman Spain,
early in the eleventh century, was marked by the promulgation
of regulations so judiciously planned, touching medical
science and its practice, that he deserves the highest
commendation for the unwavering zeal with which he supervised
this important branch of learning taught in the metropolis.
Those evils which the provinces had suffered previous to his
rule, through the practice of medicine by debased empirics,
were quickly removed by this sagacious Caliph. Upon the
publication of his rescripts, such medical charlatans or
ambulatory physicians as boldly announced themselves to be
medici, without a knowledge of the science, were ignominiously
expelled from the provincial towns. He decreed that a college
of skilled surgeons should be forthwith organized, for the
single specified function of rigidly examining into the
assumed qualifications of applicants for licenses to exercise
the curative art in municipal or rural departments, or sought
professional employment as physicians in the numerous
hospitals upon the Mahometan domains."
G. F. Fort,
Medical Economy during the Middle Ages,
chapter 17.
"Anatomy and physiology, far from making any conquests under
Arabian rule, followed on the contrary a retrograde movement.
As those physicians never devoted themselves to dissections,
they were under the necessity of conforming entirely to the
accounts of Galen. … Pathology was enriched in the Arabian
writings by some new observations. … The physicians of this
nation were the first … who began to distinguish eruptive
fevers by the exterior characters of the eruption, while the
Greeks paid but little attention to these signs. Therapeutics
made also some interesting acquisitions under the Arab
physicians. It owes to them, among other things, the
introduction of mild purgatives, such as cassia, senna, and
manna, which replaced advantageously, in many cases, the
drastics employed by the ancients; it is indebted to them,
also, for several chemical and pharmaceutical improvements, as
the confection of syrups, tinctures, and distilled waters,
which are very frequently and usefully employed. Finally,
external therapeutics, or surgery, received some minor
additions, such as pomades, plasters, and new ointments; but
these additions were very far from compensating for the
considerable losses which it suffered by their abandoning a
multitude of operations in use among the Greeks."
P. V. Renouard,
History of Medicine,
page 267.
MEDICAL SCIENCE: 12-17th Centuries.
Mediæval Medicine.
"The difficulties under which medical science laboured may be
estimated from the fact that dissection was forbidden by the
clergy of the Middle Ages, on the ground that it was impious
to mutilate a form made in the image of God. We do not find
this pious objection interfering with such mutilation when
effected by means of the rack and the wheel and such other
clerical rather than medical instruments. But in the reign of
Philip the Second of Spain a famous Spanish doctor was
actually condemned by the Inquisition to be burnt for having
performed a surgical operation, and it was only by royal
favour that he was permitted instead to expiate his crime by a
pilgrimage to the Holy Land, where he died in poverty and
exile. This being the attitude of the all-powerful Church
towards medical progress, it is not surprising that medical
science should have stagnated, and that Galen and Dioscorides
were permitted to lay down the law in the sixteenth century as
they had done since the beginning of the Christian era. Some
light is thrown upon the state of things here from resulting
by a work translated from the German in the year 1561, and
entitled 'A most excellent and perfecte homish apothecarye or
physicke booke, for all the grefes and diseases of the bodye.'
The first chapter is 'Concerning the Head and his partes.'
'Galen sayth, the head is divided into foure partes: in the
fore part hath blood the dominion; Colera in the ryght syde,
Melancholy in the left syde, and Flegma beareth rule in the
hindermost part. If the head doth ake so sore by reason of a
runninge that he cannot snoffe hys nose, bath hys fete in a
depe tub untill the knees and give him this medicine … which
riseth into hys head and dryeth hys moyst braynes. Galen sayth
He that hath payne in the hindermost part of hys head, the
same must be let blood under the chynne, specially on the
right side; also were it good ofte to burn the heyre of a man
before hys nose. The braynes are greved many wayes; many there
are whom the head whyrleth so sore that he thinketh the earth
turneth upsydedoune: Cummin refraineth the whyrling,
comforteth the braynes and maketh them to growe agayne: or he
may take the braynes of a hogge, rost the same upon a grede
yron and cut slices thereof and lay to the greved parts.'
{2131}
This doctrine of like helping like was of universal
application, and in medical works of the Middle Ages we meet
constantly with such prescriptions as these:—'Take the right
eye of a Frogg, lap it in a peece of russet cloth and hang it
about the neck: it cureth the light eye if it bee en flamed or
bleared. And if the left eye be greved, do the like by the
left eye of the said Frogg." Again—'The skin of a Raven's
heel is good against the gout, but the right heel skin must be
laid upon the right foot if that be gouty, and the left upon
the left. … If you would have a man become bold or impudent
let him carry about him the skin or eyes of a Lion or a Cock,
and he will be fearless of his enemies, nay, he will be very
terrible unto them. If you would have him talkative, give him
tongues, and seek out those of water frogs and ducks and such
creatures notorious for their continuall noise making.' On the
same principle we find it prescribed as a cure for the
quartane ague to lay the fourth book of Homer's Iliad under
the patient's head; a remedy which had at least the negative
merit of not being nauseous. … For weak eyes the patient is
to 'take the tounge of a foxe, and hange the same about his
necke, and so long it hangeth there his sight shall not wax
feeble, as sayth Pliny.' The hanging of such amulets round the
neck was very frequently prescribed, and the efficacy of them
is a thing curiously well attested. Elias Ashmole in his diary
for 1681 has entered the following—'I tooke this morning a
good dose of elixir, and hung three spiders about my neck, and
they drove my ague away. Deo gratias!' A baked toad hung in a
silk bag about the neck was also held in high esteem, as was a
toad, either alive or dried, laid upon the back of the neck as
a means of stopping a bleeding at the nose: and again, 'either
frogg or toade, the nails whereof have been clipped, hanged
about one that is sick of quartane ague, riddeth away the
disease forever, as sayth Pliny.' We have even a striking
instance of the benefit derived from an amulet by a horse, who
could not be suspected of having helped forward the cure by
the strength of his faith in it. 'The root of cut Malowe
hanged about the neck driveth away blemishes of the eyen,
whether it be in a man or a horse, as I Jerome of Brunsweig,
have seene myselfe. I have myselfe done it to a blind horse
that I bought for X crounes, and was sold again of XL
crounes'—a trick distinctly worth knowing."
E. A. King,
Mediæval Medicine
(Nineteenth Century, July 1893).
"If we survey the social and political state of Europe from
the twelfth to the sixteenth century, in its relation to the
development of medical art, our attention is at once arrested
by Italy, which at this period was far ahead of the rest of
the world. Taking the number of universities as an index of
civilization, we find that, before the year 1500, there were
sixteen in Italy,—while in France there were but six: in
Germany, including Hungary, Bohemia, Bavaria, &c., there were
eight: and in Britain, two; making sixteen in all,—the exact
number which existed in Italy alone. The Italian Universities
were, likewise, no less superior in number than in fame to
those of the north. … In many of the Italian republics,
during the twelfth, thirteenth, and fourteenth centuries, the
power was chiefly in the hands of the middle classes; and it
is probable that the physicians occupied a high and
influential position among them. Galvanis Flamma describes
Milan in 1288, as having a population of 200,000, among whom
were 600 notaries, 200 physicians, 80 schoolmasters, and fifty
transcribers of manuscripts or books. Milan was about this
period at a pitch of glory which has not been equalled since
the Greek republics."
J. R. Russell,
History and Heroes of the Art of Medicine,
chapter 5.
"Three schools, as early as 1158, had a reputation which
extended throughout the whole of Europe: Paris for theological
studies, Bologna for Roman or civil law, and Salerno as the
chief medical school of the west."
G. F. Fort,
Medical Economy during the Middle Ages,
chapter 24.
"In 1215 Pope Innocent III. fulminated an anathema specially
directed against surgery, by ordaining, that as the church
abhorred all cruel or sanguinary practices, no priest should
be permitted to follow surgery, or to perform any operations
in which either instruments of steel or fire were employed:
and that they should refuse their benediction to all those who
professed and pursued it. … The saints have proved sad
enemies to the doctors. Miraculous cures are attested by
monks, abbots, bishops, popes, and consecrated saints. …
Pilgrimages and visits to holy shrines have usurped the place
of medicine, and, as in many cases at our own watering places,
by air and exercise, have unquestionably effected what the
employment of regular professional aid had been unable to
accomplish. St. Dominic, St. Bellinus, and St. Vitus have been
greatly renowned in the cure of diseases in general; the
latter particularly, who takes both poisons and madness of all
kinds under his special protection. Melton says 'the saints of
the Romanists have usurped the place of the zodiacal
constellations in their governance of the parts of man's body,
and that "for every limbe they have a saint." Thus St. Otilia
keepes the head instead of Aries; St. Blasius is appointed to
governe the necke instead of Taurus; St. Lawrence keepes the
backe and shoulders instead of Gemini, Cancer, and Leo: St.
Erasmus rules the belly with the entrayles, in the place of
Libra and Scorpius; in the stead of Sagittarius, Capricornus,
Aquarius, and Pisces, the holy church of Rome hath elected St.
Burgarde, St. Rochus. St. Quirinus, St. John, and many others,
which governe the thighes, feet, shinnes, and knees.' This
supposed influence of the Romish saints is more minutely
exhibited, according to Hone, in two very old prints, from
engravings on wood, in the collection of the British Museum.
Right hand: the top joint of the thumb is dedicated to God,
the second joint to the Virgin; the top joint of the
fore-finger to St. Barnabas, the second joint to St. John, the
third to St. Paul: the top joint of the second finger to Simon
Cleophas, the second joint to Tathideo, the third to Joseph;
the top joint of the third finger to Zaccheus, the second to
Stephen, the third to the evangelist Luke; the top joint of
the little finger to Leatus, the second to Mark, the third to
Nicodemus. Left hand: the top joint of the thumb is dedicated
to Christ, the second joint to the Virgin: the top joint of
the fore-finger to St. James, the second to St. John the
Evangelist, the third to St. Peter; the first joint of the
second finger to St. Simon, the second joint to St. Matthew,
the third to St. James the Great; the top joint of the third
finger to St. Jude, the second joint to St. Bartholomew, the
third to St. Andrew; the top joint of the little finger to St.
Matthias, the second to St. Thomas, the third joint to St.
Philip. …
{2132}
"The credulity of mankind has never been more strongly
displayed than in the general belief afforded to the
authenticity of remarkable cures of diseases said to have been
effected by the imposition of royal hands. The practice seems
to have originated in an opinion that there is something
sacred or divine attaching either to the sovereign or his
functions. … The practice appears to be one of English
growth, commencing with Edward the Confessor, and descending
only to foreign potentates who could show an alliance with the
royal family of England. The kings of France, however, claimed
the right to dispense the Gift of Healing, and it was
certainly exercised by Philip the First; but the French
historians say that he was deprived of the power on account of
the irregularity of his life. Laurentius, first physician to
Henry IV, of France, who is indignant at the attempt made to
derive its origin from Edward the Confessor, asserts the power
to have commenced with Clovis I, A. D. 481, and says that
Louis I, A. D. 814, added to the ceremonial of touching, the
sign of the cross. Mezeray also says, that St. Louis, through
humility, first added the sign of the cross in touching for
the king's evil. … If credit is to be given to a statement
… by William of Malmesbury, with respect to Edward the
Confessor, we must admit that in England, for a period of
nearly 700 years, the practice of the royal touch was
exercised in a greater or lesser degree, as it extended to the
reign of Queen Anne. It must not however be supposed that
historical documents are extant to prove a regular continuance
of the practice during this time. No accounts whatever of the
first four Norman kings attempting to cure the complaint are
to be found. In the reign of William III, it was not on any
occasion exercised. He manifested more sense than his
predecessors, for he withheld from employing the royal touch
for the cure of scrofula; and Rapin says, that he was so
persuaded he should do no injury to persons afflicted with
this distemper by not touching them, that he refrained from it
all his reign. Queen Elizabeth was also averse to the
practice, yet she extensively performed it. It flourished most
in the time of Charles II, particularly after his restoration,
and a public register of cases was kept at Whitehall, the
principal scene of its operation."
T. J. Pettigrew,
Superstitions connected with the History and Practice
of Medicine and Surgery,
pages 34-37, and 117-121.
MEDICAL SCIENCE: 16th Century.
Paracelsus.
Paracelsus, of whose many names this one stands alone in
history to represent him, was an extraordinary person, born in
Switzerland, in 1493. He died in 1541. "His character has been
very variously estimated. The obstructives of his own age and
many hasty judges since have pronounced him a quack. This is
simply ridiculous. As a chemist, he is considered to have been
the discoverer of zinc, and perhaps of bismuth. He was
acquainted with hydrogen, muriatic, and sulphurous gases. He
distinguished alum from the vitriols; remarking that the
former contained an earth, and the latter metals. He perceived
the part played by the atmosphere in combustion, and
recognized the analogy between combustion and respiration. He
saw that in the organic system chemical processes are
constantly going on. Thus, to him is due the fundamental idea
from which have sprung the chemico-physiological researches of
Liebig, Mulder, Boussingault, and others. By using in
medicine, not crude vegetables, but their active principles,
he opened the way to the discovery of the proximate principles
of vegetables, organic alkalis, and the like. But perhaps the
greatest service he rendered to chemistry, was by declaring it
an essential part of medical education, and by showing that
its true practical application lay not in gold-making, but in
pharmacy and the industrial arts. In medicine he scouted the
fearfully complex electuaries and mixtures of the Galenists
and the Arabian polypharmacists, recommending simpler and more
active preparations. He showed that the idea of poison is
merely relative, and knew that poisons in suitable doses may
be employed in medicine. He prescribed tin as a remedy for
intestinal worms, mercury as an anti-syphilitic, and lead in
the diseases of the skin. He also used preparations of
antimony, arsenic, and iron. He employed sulphuric acid in the
treatment of saturnine affections. The astonishing cures which
he undoubtedly performed were, however, due not so much to his
peculiar medicines, as to his eminent sagacity and insight. He
showed the importance of a chemical examination of urine for
the diagnosis of disease."
J. W. Slater,
Paracelsus
(Imperial Dict. of Univ. Biog.).
MEDICAL SCIENCE: 16th Century.
The first English College of Physicians.
"The modern doctor dates only from the reign of Henry VIII.,
when the College of Physicians in England was founded as a
body corporate by letters patent in the tenth year of the
reign. This grant was in response to a petition from a few of
the most notable members of the profession resident in London,
who were perhaps moved by both a laudable zeal in the
interests of science, and a compassion for the sufferings of
the subjects of astrological and toxicological experiments.
The charter thus obtained, though probably drafted by the
promoters themselves, was found to be so inadequately worded
and expressed, that it became necessary to obtain powers to
amend it by Act of Parliament. Among these early members were
Linacre, Wotton, and others, famous scholars beyond doubt,
though possibly but indifferent practitioners. In fact, we are
constantly struck throughout the early history of the
profession by the frequent occurrence of names associated with
almost every other branch of study than that strictly
appertaining to the art of medicine. We have naturalists,
magneticians, astronomers, mathematicians, logicians, and
classical scholars, but scarce one who accomplished anything
worthy to be recorded in the annals of medical science. Indeed
it is difficult to conceive any useful object that could have
been attained by the existence of the College as a
professional licensing body, other than the pecuniary
interests of the orthodox. … It is most significant as to
the social degradation of the science of medicine, that most
of the notorious empirics of the latter half of the sixteenth
century were both highly recommended and strenuously supported
in their resistance to the proctors of orthodoxy by some of
the greatest names of the age. These self-deluded victims of
quackery were not indeed adverse in theory to the pretensions
of more regular members of the profession.
{2133}
They would patronize the Court physicians, or, if favorites of
the Crown, they might even submit to the Sovereign's
recommendation in that behalf; but none the less their family
doctor was in far too many cases some outlandish professor of
occult arts, retained in learned state on the premises, who
undertook the speedy, not to say miraculous, cure of his
patron's particular disease by all the charms of the Cabala."
H. Hall,
The Early Medicus
(Merry England; also in Eclectic Magazine, June, 1884).
MEDICAL SCIENCE: 16th Century.
The System of Van Helmont.
John Baptist van Helmont "was born at Brussels in the year
1577. … His parents were noble, and he was heir to great
possessions. He pursued in Louvain the usual course of
scholastic philosophy. … Becoming accidentally acquainted
with the writings of Thomas à Kempis and John Tauler, he from
that day adopted what goes by the vague term of mysticism.
That is, thoroughly convinced that there was a spiritual world
in intimate and eternal union with the spirit of man; that
this spiritual world was revealed to that human soul which
submitted to receive it in humility; and that the doctrines of
Christianity were not to be looked upon as a system of
philosophy; but as a rule of life, he resolved to follow them
to the letter. The consequence of this resolution was, that he
devoted himself to the art of medicine, in imitation of the
Great Healer of the body as well as of the soul; and as the
prejudices of his time and country made his rank and wealth an
obstacle to his entrance into the medical profession, he made
over all his property, with its honours, to his sister; that,
'laying aside every weight, he might run the race that was set
before him.' He entered on his new studies with all the zeal
of his character, and very soon had so completely mastered the
writings of Hippocrates and Galen, as to excite the surprise
of his contemporaries. But although styled a dreamer, and
having a mind easily moved to belief in spiritual
manifestation, he was not of a credulous nature in regard to
matters belonging to the senses. And as he believed that
Christianity was to be practised, and to be found true by the
test of experiment, so he believed that the doctrines of
Hippocrates and of Galen were to be subjected to a similar
trial. An opportunity soon occurred to himself. He caught the
itch and turned to Galen for its cure. Galen attributes this
disease to overheated bile and sour phlegm, and says that it
is to be cured by purgatives. Van Helmont, with the implicit
faith of his simple nature, procured the prescribed medicines,
and took them as ordered by Galen. Alas, no cure of the itch
followed, but great exhaustion of his whole body: so Galen was
not to be trusted. This was a serious discovery; for if he
could not trust Galen, by whom the whole medical world swore,
to whom was he to turn? … Van Helmont resolved to work out
for himself a solution of the great problem to which he had
devoted his life. Van Helmont's system may be called spiritual
vitalism. The primary cause of all organization was Archæus.
By Archæus, a man is much more nearly allied, he says, to the
world of spirits and the Father of spirits than to the
external world. Archæus is the creative spirit which, working
upon the raw material of water or fluidity, by means of 'a
ferment' excites all the endless actions which result in the
growth and nourishment of the body. Thus, digestion is neither
a chemical nor a mechanical operation; nor is it, as was then
supposed, the effects of heat, for it is arrested instead of
aided by fever, and goes on in perfection in fishes and
cold-blooded animals; but, on the command of Archæus, an acid
is generated in the stomach, which dissolves the food. This is
the first digestion. The second consists in the neutralization
of this acid by the bile out of the gall bladder. The third
takes place in the vessels of the mesentery. The fourth goes
on in the heart, by the action of the vital spirits. The fifth
consists in the conversion of the arterial blood into vital
spirits, chiefly in the brain. The sixth consists of the
preparation of nourishment in the laboratory of each organ,
during which operation Archæus, present everywhere, is itself
regenerated, and superintends the momentary regeneration of
the whole frame. If for digestion we substitute the word
nutrition, we cannot fail to be struck by the near approach to
accuracy in this description of the succession of processes by
which it is brought about. Van Helmont's pathology was quite
consistent with his physiology. As life and all vital action
depended upon Archæus, so the perturbation of Archæus gave
rise to fevers, and derangements of the blood and secretions.
Thus, gout was a disease not confined to the part in which it
showed itself, but was the result of Archæus. It will be seen
that by this theory the entire system of Galen was non-suited.
There is no place for the elements and the humours."
J. R. Russell,
History and Heroes of the Art of Medicine,
chapter 8.
MEDICAL SCIENCE: 17th Century.
Harvey and the Discovery of the Circulation of the Blood.
William Harvey, "physician and discoverer of the circulation
of the blood, was born at Folkestone, Kent, 1 April 1578, in a
house which was in later times the posthouse of the town and
which still belongs to Caius College, Cambridge, to which
Harvey bequeathed it. His father was Thomas Harvey, a Kentish
yeoman. … In 1588 William was sent to the King's School,
Canterbury. Thence he went to Cambridge, where he was admitted
a pensioner in Gonville and Caius College, 31 May 1593. … He
graduated B. A. 1597, and, determining to study medicine,
travelled through France and Germany to Padua, the most famous
school of physic of that time. … He returned to England,
graduated M. D. at Cambridge 1602, and soon after took a house
in the parish of St. Martin-extra-Ludgate in London. … On 4
August 1615 he was elected Lumleian lecturer at the College of
Physicians, … and in the following April, on the 16th, 17th,
and 18th, he delivered at the college in Knightrider Street,
near St. Paul's Cathedral, the lectures in which he made the
first public statement of his thoughts on the circulation of
the blood. The notes from which he delivered these lectures
exist in their original manuscript and binding at the British
Museum. … In 1628, twelve years after his first statement of
it in his lectures, he published at Frankfurt, through William
Fitzer, his discovery of the circulation of the blood. The
book is a small quarto, entitled 'Exercitatio Anatomica de
Motu Cordis et Sanguinis in Animalibus,' and contains
seventy-two pages and two plates of diagrams. The printers
evidently had difficulty in reading the author's handwriting,
and there are many misprints. …
{2134}
He begins by modestly stating how the difficulties of the
subject had gradually become clear to him, and by expressing
with a quotation from the 'Andria' of Terence, the hope that
his discovery might help others to still further knowledge. He
then describes the motions of arteries, of the ventricles of
the heart, and of its auricles, as seen in living animals, and
the use of these movements. He shows that the blood coming
into the right auricle from the vena cava, and passing then to
the right ventricle, is pumped out to the lungs through the
pulmonary artery, passes through the parenchyma of the lungs,
and comes thence by the pulmonary veins to the left ventricle.
This same blood, he shows, is then pumped out to the body. It
is carried out by arteries and comes back by veins, performing
a complete circulation. He shows that, in a live snake, when
the great veins are tied some way from the heart, the piece of
vein between the ligature and the heart is empty, and further,
that blood coming from the heart is checked in an artery by a
ligature, so that there is blood between the heart and the
ligature and no blood beyond the ligature. He then shows how
the blood comes back to the heart by the veins, and
demonstrates their valves. These had before been described by
Hieronymus Fabricius of Aquapendente, but before Harvey no
exact explanation of their function had been given. He gives
diagrams showing the results of obstructing the veins, and
that these valves may thus be seen to prevent the flow of
blood in the veins in any direction except towards the heart.
After a summary of a few lines in the fourteenth chapter he
further illustrates the perpetual circuit of the blood, and
points out how morbid materials are carried from the heart all
over the body. The last chapter gives a masterly account of
the structure of the heart in men and animals, and points out
that the right ventricle is thinner than the left because it
has only to send the blood a short way into the lungs, while
the left ventricle has to pump it all over the body. This
great and original book at once attracted attention and
excited discussion. In the College of Physicians of London,
where Harvey had mentioned the discovery in his lectures every
year since 1616, the Exercitatio received all the honour it
deserved. On the continent of Europe it was received with less
favour, but neither in England nor abroad did anyone suggest
that the discovery was to be found in other writers. …
Before his death the great discovery of Harvey was accepted
throughout the medical world. The modern controversy … as to
whether the discovery was taken from some previous author is
sufficiently refuted by the opinion of the opponents of his
views in his own time, who agreed in denouncing the doctrine
as new; by the laborious method of gradual demonstration
obvious in his book and lectures; and, lastly, by the complete
absence of lucid demonstration of the action of the heart and
course of the blood in Cæsalpinus, Servetus, and all others
who have been suggested as possible originals of the
discovery. It remains to this day the greatest of the
discoveries of physiology, and its whole honour belongs to
Harvey."
N. Moore,
Harvey
(Dict. of National Biog., volume 25).
ALSO IN:
R. Willis,
William Harvey: A history of the Discovery of
the Circulation of the Blood.
MEDICAL SCIENCE: 17th Century.
Discovery of the Lymphatic Circulation.
"The discovery of the lymphatic vessels and their purpose was
scarcely less remarkable than that of the circulation of the
blood. It has about it less of eclat, because it was not the
work of one man, but was a matter of slow development.
Herophilus and Erasistratus had seen white vessels connected
with the lymph nodes in the mesentery of certain animals, and
had supposed them to be arteries full of air. Galen disputed
this, and believed the intestinal chyle to be carried by the
veins of the mesentery into the liver. In 1563 Eustachius had
described the thoracic duct in the horse; in 1622 Aselli,
professor of anatomy at Milan, discovered the lacteal vessels
in a dog which had been killed immediately after eating.
Having pricked one of these by mistake, he saw a white fluid
issue from it. Repeating the same experiment at other times he
became certain that the white threads were vessels which drew
the chyle from the intestines. He observed the valves with
which they are supplied, and supposed these vessels to all
meet in the pancreas and to be continued into the liver. In
1647 Pecquet, who was still a student at Montpelier,
discovered the lymph reservoir, or receptaculum chyli, and the
canal which leads from it, i. e., the thoracic duct, which he
followed to its termination in the left subclavian vein.
Having ligated it he saw it swell below, and empty itself
above the ligature. He studied the courses of the lacteals,
and convinced himself that they all entered into the common
reservoir. His discovery gave the last blow to the ancient
theory, which attributed to the liver the function of blood
making, and it confirmed the doctrine of Harvey, while, like
it, it had been very strongly opposed. Strangely enough,
Harvey in this instance united with his great opponent,
Riolan, in making common cause against the discovery of
Pecquet and its significance. From that time the lymphatic
vessels and glands became objects of common interest and were
investigated by many anatomists, especially Bartholin, Ruysch,
the Hunters, Hewson, and above all by Mascagni. He was the
first to give a graphic description of the whole lymphatic
apparatus."
Roswell Park,
Lectures on the History of Medicine (in MS.).
MEDICAL SCIENCE: 17th Century.
Descartes and the dawn of modern Physiological science.
"The essence of modern, as contrasted with ancient,
physiological science appears to me to lie in its antagonism
to animistic hypotheses and animistic phraseology. It offers
physical explanations of vital phenomena, or frankly confesses
that it has none to offer. And, so far as I know, the first
person who gave expression to this modern view of physiology,
who was bold enough to enunciate the proposition that vital
phenomena, like all the other phenomena of the physical world,
are, in ultimate analysis, resolvable into matter and motion
was René Descartes. The fifty-four years of life of this most
original and powerful thinker are widely overlapped, on both
sides, by the eighty of Harvey, who survived his younger
contemporary by seven years, and takes pleasure in
acknowledging the French philosopher's appreciation of his
great discovery.
{2135}
In fact, Descartes accepted the doctrine of the circulation as
propounded by 'Harvæus médecin d'Angleterre,' and gave a full
account of it in his first work, the famous 'Discours de la
Méthode,' which was published in 1637, only nine years after
the exercitation 'De motu cordis;' and, though differing from
Harvey on some important points (in which it may be noted, in
passing, Descartes was wrong and Harvey right), he always
speaks of him with great respect. And so important does the
subject seem to Descartes that he returns to it in the 'Traité
des Passions' and in the 'Traité de l'Homme.' It is easy to
see that Harvey's work must have had a peculiar significance
for the subtle thinker, to whom we owe both the spiritualistic
and the materialistic philosophies of modern times. It was in
the very year of its publication, 1628, that Descartes
withdrew into that life of solitary investigation and
meditation of which his philosophy was the fruit. …
Descartes uses 'thought' as the equivalent of our modern term
'consciousness.' Thought is the function of the soul, and its
only function. Our natural heat and all the movements of the
body, says he, do not depend on the soul. Death does not take
place from any fault of the soul, but only because some of the
principal parts of the body become corrupted. … Descartes'
'Treatise on Man' is a sketch of human physiology, in which a
bold attempt is made to explain all the phenomena of life,
except those of consciousness, by physical reasonings. To a
mind turned in this direction, Harvey's exposition of the
heart and vessels as a hydraulic mechanism must have been
supremely welcome. Descartes was not a mere philosophical
theorist, but a hardworking dissector and experimenter, and he
held the strongest opinion respecting the practical value of
the new conception which he was introducing. … 'It is true,'
says he, 'that as medicine is now practised, it contains
little that is very useful; but without any desire to
depreciate, I am sure that there is no one, even among
professional men, who will not declare that all we know is
very little as compared with that which remains to be known;
and that we might escape an infinity of diseases of the mind,
no less than of the body, and even perhaps from the weakness
of old age, if we had sufficient knowledge of their causes and
of all the remedies with which nature has provided us.' So
strongly impressed was Descartes with this, that he resolved
to spend the rest of his life in trying to acquire such a
knowledge of nature as would lead to the construction of a
better medical doctrine. The anti-Cartesians found material
for cheap ridicule in these aspirations of the philosopher;
and it is almost needless to say that, in the thirteen years
which elapsed between the publication of the 'Discours' and
the death of Descartes, he did not contribute much to their
realisation. But, for the next century, all progress in
physiology took place along the lines which Descartes laid
down. The greatest physiological and pathological work of the
seventeenth century, Borelli's treatise 'De Motu Animalium,'
is, to all intents and purposes, a development of Descartes'
fundamental conception; and the same may be said of the
physiology and pathology of Boerhaave, whose authority
dominated in the medical world of the first half of the
eighteenth century. With the origin of modern chemistry, and
of electrical science, in the latter half of the eighteenth
century, aids in the analysis of the phenomena of life, of
which Descartes could not have dreamed, were offered to the
physiologist. And the greater part of the gigantic progress
which has been made in the present century is a justification
of the prevision of Descartes. For it consists, essentially,
in a more and more complete resolution of the grosser organs
of the living body into physico-chemical mechanisms. 'I shall
try to explain our whole bodily machinery in such a way, that
it will be no more necessary for us to suppose that the soul
produces such movements as are not voluntary, than it is to
think that there is in a clock a soul which causes it to show
the hours.' These words of Descartes might be appropriately
taken as a motto by the author of any modern treatise on
physiology."
T. H. Huxley,
Connection of the Biological Sciences with Medicine
(Science and Culture, etc., lecture 13).
MEDICAL SCIENCE: 17th Century.
Introduction of Peruvian Bark.
"The aborigines of South America appear, except perhaps in one
locality, to have been ignorant of the virtues of Peruvian
bark. This sovereign remedy is absent in the wallets of
itinerant doctors, whose materia medica has been handed down
from father to son, since the days of the Yncas. It is
mentioned neither by the Ynca Garcilasso de la Vega, nor by
Acosta, in their lists of Indian medicines. It seems probable,
nevertheless, that the Indians were aware of the virtues of
Peruvian bark in the neighborhood of Loxa, 230 miles south of
Quito, where its use was first made known to Europeans; and
the local name for the tree quina-quina, 'bark of bark,'
indicates that it was believed to possess some special
medicinal properties. … In 1638 the wife of Don Luis
Geronimo Fernandez de Cabrera Bobadilla y Mendoza, fourth
Count of Chinchon, and Viceroy of Peru, lay sick of an
intermittent fever in the palace of Lima. … The news of her
illness at Lima reached Don Francisco Lopez de Canizares, the
Corregidor of Loxa, who had become acquainted with the
febrifuge virtues of the bark. He sent a parcel of it to the
Vice-Queen, and the new remedy, administered by her physician,
Dr. Don Juan de Vega, effected a rapid and complete cure. …
The Countess of Chinchon returned to Spain in the spring of
1640, bringing with her a supply of that precious quina bark
which had worked so wonderful a cure upon herself, and the
healing virtues of which she intended to distribute amongst
the sick on her husband's estates. It thus gradually became
known in Europe, and was most appropriately called Countess's
powder (Pulvis Comitissæ). By this name it was long known to
druggists and in commerce. … In memory of the great service
to humanity performed by the Countess of Chinchon, Linnæus
named the genus which yields Peruvian bark, Chinchona.
Unfortunately the great botanist was misinformed as to the
name of her whom he desired to honour. This is to be accounted
for by his having received his knowledge of the Countess
through a foreign and not a Spanish source. Thus misled,
Linnæus spelt the word Cinchona … and Cinhona, … omitting
one or two letters. … After the cure of the Countess of
Chinchon the Jesuits were the great promoters of the
introduction of bark into Europe. In 1670 these fathers sent
parcels of the powdered bark to Rome, whence it was
distributed to members of the fraternity throughout Europe, by
Cardinal de Lugo, and used for the cure of agues with great
success. Hence the name of 'Jesuits' bark,' and 'Cardinal's
bark;' and it was a ludicrous result of its patronage by the
Jesuits that its use should have been for a long time opposed
by Protestants, and favoured by Roman Catholics. In 1679 Louis
XIV. bought the secret of preparing quinquina from Sir Robert
Talbor, an English doctor, for 2,000 louis-d'or, a large
pension, and a title. From that time Peruvian bark seems to
have been recognised as the most efficacious remedy for
intermittent fevers."
C. R. Markham,
Peruvian Bark,
chapters 2-4.
{2136}
MEDICAL SCIENCE: 17th Century.
Sydenham, the Father of Rational Medicine.
"Sydenham [Thomas Sydenham, 1624-1689], the prince of
practical physicians, whose character is as beautiful and as
genuinely English as his name, did for his art what Locke did
for the philosophy of mind—he made it, in the main,
observational; he made knowledge a means, not an end. It would
not be easy to over-estimate our obligations as a nation to these
two men, in regard to all that is involved in the promotion of
health of body and soundness of mind. They were among the
first in their respective regions to show their faith in the
inductive method, by their works. They both professed to be
more of guides than critics, and were the interpreters and
servants of Nature, not her diviners and tormentors." Of
Sydenham, "we must remember in the midst of what a mass of
errors and prejudices, of theories actively mischievous, he
was placed, at a time when the mania of hypothesis was at its
height, and when the practical part of his art was overrun and
stultified by vile and silly nostrums. We must have all this
in our mind, or we shall fail in estimating the amount of
independent thought, of courage and uprightness, and of all
that deserves to be called magnanimity and virtue, which was
involved in his thinking and writing and acting as he did.
'The improvement of physic [he wrote] in my opinion, depends,
1st, Upon collecting as genuine and natural a description or
history of diseases as can be procured; and, 2d, Upon laying
down a fixed and complete method of cure. With regard to the
history of diseases, whoever considers the undertaking
deliberately will perceive that a few such particulars must be
attended to: 1st, All diseases should be described as objects
of natural history, with the same exactness as is done by
botanists, for there are many diseases that come under the
same genus, and bear the same name, that, being specifically
different, require a different treatment. The word carduus or
thistle, is applied to several herbs, and yet a botanist would
be inaccurate and imperfect who would content himself with a
generic description. Furthermore, when this distribution of
distempers into genera has been attempted, it has been to fit
into some hypothesis, and hence this distribution is made to
suit the bent of the author rather than the real nature of the
disorder. How much this has obstructed the improvement of
physic any man may know. In writing, therefore, such a natural
history of diseases, every merely philosophical hypothesis
should be set aside, and the manifest and natural phenomena,
however minute, should be noted with the utmost exactness. The
usefulness of this procedure cannot be easily overrated, as
compared with the subtle inquiries and trifling notions of
modern writers. … If only one person in every age had
accurately described, and consistently cured, but a single
disease, and made known his secret, physic would not be where
it now is; but we have long since forsook the ancient method
of cure, founded upon the knowledge of conjunct causes,
insomuch that the art, as at this day practised, is rather the
art of talking about diseases than of curing them.' … His
friend Locke could not have stated the case more clearly or
sensibly. It is this doctrine of 'conjunct causes,' this
necessity for watching the action of compound and often
opposing forces, and the having to do all this not in a
machine, of which if you have seen one, you have seen all, but
where each organism has often much that is different from, as
well as common with, all others. … It is this which takes
medicine out of the category of exact sciences, and puts it
into that which includes politics, ethics, navigation and
practical engineering, in all of which, though there are
principles, and those principles quite within the scope of
human reason, yet the application of these principles must, in
the main, be left to each man's skill, presence of mind, and
judgment, as to the case in hand. … It would not be easy to
over-estimate the permanent impression for good, which the
writings, the character, and the practice of Sydenham have
made on the art of healing in England, and on the Continent
generally. In the writings of Boerhaave, Stahl, Gaubius,
Pinel, Bordeu, Haller, and many others, he is spoken of as the
father of rational medicine; as the first man who applied to
his profession the Baconian principles of interpreting and
serving nature, and who never forgot the master's rule, 'Non
fingendum aut excogitandum, sed inveniendum, quid natura aut
faciat aut ferat.' … Like all men of a large practical
nature, he could not have been what he was, or done what he
did, without possessing and often exercising the true
philosophizing faculty. He was a man of the same quality of
mind in this respect with Watt, Franklin, and John Hunter, in
whom speculation was not the less genuine that it was with
them a means rather than an end."
Dr. John Brown,
Locke and Sydenham and other Papers,
pages 54-90.
ALSO IN:
T. Sydenham,
Works;
translated by R. G, Latham.
MEDICAL SCIENCE: 17th Century.
Closing period of the Humoral Pathology.
The Doctrines of Hoffmann, Stahl and Boerhaave.
"If we take a general survey of medical opinions, we shall
find that they are all either subordinate to, or coincident
with, two grand theories. The one of these considers the solid
constituents of the animal economy as the elementary vehicle
of life, and consequently places in them the primary seat of
disease. The other, on the contrary, sees in the humors the
original realization of vitality; and these, as they determine
the existence and quality of the secondary parts, or solids,
contain, therefore, within themselves, the ultimate principle
of the morbid affection. By relation to these theories, the
history of medicine is divided into three great periods.
During the first, the two theories, still crude, are not yet
disentangled from each other; this period extends from the
origin of medicine to the time of Galen. The second
comprehends the reign of Humoral Pathology—the interval
between Galen and Frederic Hoffmann. In the last the doctrine
of the Living Solid is predominant; from Hoffmann it reaches
to the present day. … By Galen, Humorism was first formally
expounded, and reduced to a regular code of doctrine.
{2137}
Four elementary fluids, their relations and changes, sufficed
to explain the varieties of natural temperament, and the
causes of disease; while the genius, eloquence, and unbounded
learning with which he illustrated this theory, mainly
bestowed on it the ascendency, which, without essential
alteration, it retained from the conclusion of the second to
the beginning of the eighteenth century. Galenism and Humorism
are, in fact, convertible expressions. Not that this
hypothesis during that long interval encountered no
opposition. It met, certainly, with some partial contradiction
among the Greek and Arabian physicians. After the restoration
of learning Fernelius and Brissot, Argenterius and Joubert,
attacked it in different ways. … Until the epoch we have
stated, the prevalence of the Humoral Pathology was, however,
all but universal. Nor was this doctrine merely an erroneous
speculation; it exerted the most decisive, the most pernicious
influence on practice.—The various diseased affections were
denominated in accommodation to the theory. In place of saying
that a malady affected the liver, the peritonæum, or the
organs of circulation, its seat was assumed in the blood, the
bile, or the lymph. The morbific causes acted exclusively on
the fluids; the food digested in the stomach, and converted
into chyle, determined the qualities of the blood; and poisons
operated through the corruption they thus effected in the
vital humors. All symptoms were interpreted in blind
subservience to the hypothesis; and those only attracted
attention which the hypothesis seemed calculated to explain.
The color and consistence of the blood, mucus, feces, urine,
and pus, were carefully studied. On the other hand the
phenomena of the solids, if not wholly overlooked, as mere
accidents, were slumped together under some collective name,
and attached to the theory through a subsidiary hypothesis. By
supposed changes in the humors, they explained the association
and consecution of symptoms. Under the terms, crudity,
coction, and evacuation, were designated the three principal
periods of diseases, as dependent on an alteration of the
morbific matter. In the first, this matter, in all its
deleterious energy, had not yet undergone any change on the
part of the organs; it was still crude. In the second, nature
gradually resumed the ascendant; coction took place. In the
third, the peccant matter, now rendered mobile, was evacuated
by urine, perspiration, dejection, &c., and æquilibrium
restored. When no critical discharge was apparent, the
morbific matter, it was supposed, had, after a suitable
elaboration, been assimilated to the humors, and its
deleterious character neutralized. Coction might be perfect or
imperfect; and the transformation of one disease into another
was lightly solved by the transport or emigration of the
noxious humor. … Examinations of the dead body confirmed
them in their notions. In the redness and tumefaction of
inflamed parts, they beheld only a congestion of blood; and in
dropsies, merely the dissolution of that fluid; tubercles were
simply coagula of lymph; and other organic alterations, in
general, naught but obstructions from an increased viscosity
of the humors. The plan of cure was in unison with the rest of
the hypothesis. Venesection was copiously employed to renew
the blood, to attenuate its consistency, or to remove a part
of the morbific matter with which it was impregnated; and
cathartics, sudorifics, diuretics, were largely administered,
with a similar intent. In a word, as plethora or cacochymia
were the two great causes of disease, their whole therapeutic
was directed to change the quantity or quality of the fluids.
Nor was this murderous treatment limited to the actual period
of disease. Seven or eight annual bloodings, and as many
purgations—such was the common regimen the theory prescribed
to insure continuance of health; and the twofold depletion,
still customary, at spring and fall, among the peasantry of
many European countries, is a remnant of the once universal
practice. In Spain, every village has even now its Sangrador,
whose only cast of surgery is blood-letting; and he is rarely
idle. The medical treatment of Lewis XIII, may be quoted as a
specimen of the humoral therapeutic, Within a single year this
theory inflicted on that unfortunate monarch above a hundred
cathartics, and more than forty bloodings.—During the fifteen
centuries of Humorism, how many millions of lives did medicine
cost mankind? The establishment of a system founded on the
correcter doctrine of Solidism, and purified from the
crudities of the Iatro-mathematical and Iatro-chemical
hypotheses was reserved for three celebrated physicians toward
the commencement of the eighteenth century—Frederic
Hoffmann—George Ernest Stahl—and Hermann Boerhaave. The
first and second of this triumvirate were born in the same
year, were both pupils of Wedelius of Jena, and both
professors, and rival professors, in the University of Halle;
the third was eight years younger than his contemporaries, and
long an ornament of the University of Leyden."
Sir W. Hamilton,
Discussions on Philosophy and Literature,
pages 246-249.
"The great and permanent merits of Hoffmann [1660-1742] as a
medical philosopher, undoubtedly consisted in his having
perceived and pointed out more clearly than any of his
predecessors, the extensive and powerful influence of the
Nervous System, in modifying and regulating at least, if not
in producing, all the phenomena of the organic as well as of
the animal functions in the human economy, and more
particularly in his application of this doctrine to the
explanation of diseases. … It was reserved for Hoffmann …
to take a comprehensive view of the Nervous System, not only
as the organ of sense and motion, but also as the common
centre by which all the different parts of the animal economy
are connected together, and through which they mutually
influence each other. He was, accordingly, led to regard all
those alterations in the structure and functions of this
economy, which constitute the state of disease, as having
their primary origin in affections of the nervous system, and
as depending, therefore, upon a deranged state of the
imperceptible and contractile motions in the solids, rather
than upon changes induced in the chemical composition of the
fluid parts of the body."
J. Thomson,
Account of the Life, Lectures and Writings of William Cullen,
pages 195-196.
{2138}
"George Ernest Stahl (1660-1734), chemist, was professor of
medicine at Halle (1694) and physician to the King of Prussia
(1716). He opposed materialism, and substituted 'animism,'
explaining the symptoms of disease as efforts of the soul to
get rid of morbid influences. Stahl's 'anima' corresponds to
Sydenham's 'nature' in a measure, and has some relationship to
the Archeus of Paracelsus and Van Helmont. Stahl was the author
of the 'phlogiston' theory in chemistry, which in its time has
had important influence on medicine. Phlogiston was a
substance which he supposed to exist in all combustible
matters, and the escape of this principle from any compound
was held to account for the phenomenon of fire. According to
Stahl, diseases arise from the direct action of noxious powers
upon the body; and from the reaction of the system itself
endeavouring to oppose and counteract the effects of the
noxious powers, and so preserve and repair itself. He did not
consider diseases, therefore, pernicious in themselves, though
he admitted that they might become so from mistakes made by
the soul in the choice, or proportion of the motions excited
to remove them, or the time when these efforts are made.
Death, according to this theory, is due to the indolence of
the soul, leading it to desist from its vital motions, and
refusing to continue longer the struggle against the
derangements of the body. Here we have the 'expectant