Part 2 — Chapter III. (These four articles abrogated by the four articles following them, 118-122.) Article 118. The Federal Constitution may at any time be amended. (continued 108)

Pliny, Natural History (Bohn's translation), book 29, chapters 3-8 (volume 5).

MEDICAL SCIENCE: 2d Century. Galen and the development of Anatomy and Pathology.

"In the earliest conceptions which men entertained of their power of moving their own members, they probably had no thought of any mechanism or organization by which this was effected. The foot and the hand, no less than the head, were seen to be endowed with life; and this pervading life seemed sufficiently to explain the power of motion in each part of the frame, without its being held necessary to seek out a special seat of the will, or instruments by which its impulses were made effective. But the slightest inspection of dissected animals showed that their limbs were formed of a curious and complex collection of cordage, and communications of various kinds, running along and connecting the bones of the skeleton. These cords and communications we now distinguish as muscles, nerves, veins, arteries, &c.; and among these, we assign to the muscles the office of moving the parts to which they are attached, as cords move the parts of a machine. Though this action of the muscles on the bones may now appear very obvious, it was, probably, not at first discerned. It is observed that Homer, who describes the wounds which are inflicted in his battles with so much apparent anatomical precision, nowhere employs the word muscle. And even Hippocrates of Cos, the most celebrated physician of antiquity, is held to have had no distinct conception of such an organ. … Nor do we find much more distinctness on this subject even in Aristotle, a generation or two later. … He is held to have really had the merit of discovering the nerves of sensation, which he calls the 'canals of the brain' … , but the analysis of the mechanism of motion is left by him almost untouched. … His immediate predecessors were far from remedying the deficiencies of his doctrines. Those who professed to study physiology and medicine were, for the most part, studious only to frame some general system of abstract principles, which might give an appearance of connexion and profundity to their tenets. In this manner the successors of Hippocrates became a medical school, of great note in its day, designated as the Dogmatic school; in opposition to which arose an Empiric sect, who professed to deduce their modes of cure, not from theoretical dogmas, but from experience. These rival parties prevailed principally in Asia Minor and Egypt, during the time of Alexander's successors,—a period rich in names, but poor in discoveries; and we find no clear evidence of any decided advance in anatomy. … The victories of Lucullus and Pompeius, in Greece and Asia, made the Romans acquainted with the Greek philosophy; and the consequence soon was, that shoals of philosophers, rhetoricians, poets, and physicians streamed from Greece, Asia Minor, and Egypt, to Rome and Italy, to traffic their knowledge and their arts for Roman wealth. Among these was one person whose name makes a great figure in the history of medicine, Asclepiades of Prusa in Bithynia. This man appears to have been a quack, with the usual endowments of his class. … He would not, on such accounts, deserve a place in the history of science, but that he became the founder of a new school, the Methodic, which professed to hold itself separate both from the Dogmatics and the Empirics. I have noticed these schools of medicine, because, though I am not able to state distinctly their respective merits in the cultivation of anatomy, a great progress in that science was undoubtedly made during their domination, of which the praise must, I conceive, be in some way divided among them. The amount of this progress we are able to estimate, when we come to the works of Galen, who flourished under the Antonines, and died about A. D. 203. The following passage from his works will show that this progress in knowledge was not made without the usual condition of laborious and careful experiment, while it implies the curious fact of such experiment being conducted by means of family tradition and instruction, so as to give rise to a caste of dissectors. In the opening of his Second Book on Anatomical Manipulations, he speaks thus of his predecessors: 'I do not blame the ancients, who did not write books on anatomical manipulation; though I praise Marinus, who did. For it was superfluous for them to compose such records for themselves or others, while they were, from their childhood, exercised by their parents in dissecting, just as familiarly as in writing and reading; so that there was no more fear of their forgetting their anatomy, than of forgetting their alphabet. But when grown men, as well as children, were taught, this thorough discipline fell off; and, the art being carried out of the family of the Asclepiads, and declining by repeated transmission, books became necessary for the student.' That the general structure of the animal frame, as composed of bones and muscles, was known with great accuracy before the time of Galen, is manifest from the nature of the mistakes and deficiencies of his predecessors which he finds it necessary to notice. … Galen was from the first highly esteemed as an anatomist. He was originally of Pergamus; and after receiving the instructions of many medical and philosophical professors, and especially of those of Alexandria, which was then the metropolis of the learned and scientific world, he came to Rome, where his reputation was soon so great as to excite the envy and hatred of the Roman physicians. The emperors Marcus Aurelius and Lucius Verus would have retained him near them; but he preferred pursuing his travels, directed principally by curiosity. When he died, he left behind him numerous works, an of them of great value for the light they throw on the history of anatomy and medicine; and these were for a long period the storehouse of all the most important anatomical knowledge which the world possessed. In the time of intellectual barrenness and servility, among the Arabians and the Europeans of the dark ages, the writings of Galen had almost unquestioned authority; and it was only by an uncommon effort of independent thinking that Abdollatif ventured to assert, that even Galen's assertions must give way to the evidence of the senses. In more modern times, when Vesalius, in the sixteenth century, accused Galen of mistakes, he drew upon himself the hostility of the whole body of physicians."

W. Whewell, History of the Inductive Sciences, book 17, chapter 1, section 1 (volume 2).

{2129}

"Galen strongly denied being attached to any of the sects of his day, and regarded as slaves those who took the title of Hippocratists, Praxagoreaus, or Herophilists, and so on. Nevertheless his predilection in favor of the Hippocratic writings is well marked, for he explains, comments upon them, and amplifies them at length, refutes the objections of their adversaries and gives them the highest place. He says, 'No one before me has given the true method of treating disease; Hippocrates, I confess, has heretofore shown the path, but as he was the first to enter it he was not able to go as far as he wished. … He has not made all the necessary distinction, and is often obscure, as is usually the case with ancients when they attempt to be concise. He says very little of complicated diseases; in a word, he has only sketched what another was to complete; he has opened the path, but has left it for a successor to enlarge and make it plain.' This implies how he regarded himself as the successor of Hippocrates, and how little weight he attached to the labors of others. He held that there were three sorts of principles in man—spirits, humors, and solids. Throughout his metaphysical speculations Galen reproduces and amplifies the Hippocratic dogmatism. Between perfect health and disease there were, he thought, eight kinds of temperaments or imperfect mixtures compatible with the exercise of the functions of life. With Plato and Aristotle he thought the human soul to be composed of three faculties or parts, the vegetive, residing in the liver; the irascible, having its seat in the heart, and the rational, which resided in the brain. He divided diseases of the solids of the body into what he called distempers; he distinguished between the continued and intermittent fevers, regarding the quotidian as being caused by phlegm, the tertian as due to yellow bile, and the quartan due to atrabile. In the doctrine of coction, crises, and critical days, he agreed with Hippocrates; with him he also agreed in the positive statement that diseases are cured by their contraries."

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

MEDICAL SCIENCE: 7-11th Centuries. Medical Art of the Arabs.

"It probably sounds paradoxical (though it is not) to affirm that, throughout the first half of the Middle Ages, science made its home chiefly with the Semites and Græco-Romans (its founders), while, in opposition to the original relations, faith and its outgrowths alone were fostered by the Germans. In the sterile wastes of the desert the Arabians constructed a verdant oasis of science, in lands to-day the home once more of absolute or partial barbarism. A genuine meteor of civilization were these Arabians. … The Arabians built their medicine upon the principles and theories of the Greeks (whose medical writings were studied and copied mostly in translations only), and especially upon those of Galen, in such a way, that, on the whole, they added to it very little matter of their own, save numerous subtle definitions and amplifications. But Indian medical views and works, as well as those of other earlier Asiatic peoples (e. g., the Chaldeans), exercised demonstrably, but in a subordinate degree, an influence upon Arabian medicine. The Arabians interwove too into their medical views various philosophical theorems, especially those of Aristotle, already corrupted by the Alexandrians and still further falsified by themselves with portions of the Neo-Platonic philosophy; and finally they added thereto a goodly share of the absurdities of astrology and alchemy. Indeed it is nowadays considered proven that they even made use of ancient Egyptian medical works, e. g., the papyrus Ebers. Thus the medicine of the Arabians, like Grecian medicine its parent, did not greatly surpass the grade of development of mere medical philosophy, and, so far as regards its intrinsic worth, it stands entirely upon Grecian foundations. … Yet they constantly advanced novelties in the sciences subsidiary to medicine, materia medica and pharmacy, from the latter of which chemistry, pharmacies and the profession of the apothecary were developed. … The mode of transfer of Greek medicine to the Arabians was probably as follows: The inhabitants of the neighboring parts of Asia, including both the Persians and Arabians, as the result of multifarious business connexions with Alexandria, came, even at an early date, in contact with Grecian science, and by degrees a permanent alliance was formed with it. In a more evident way the same result was accomplished by the Jewish schools in Asia, the great majority of which owed their foundation to Alexandria. Such schools were established at Nisibis, at Nahardea in Mesopotamia, at Mathæ-Mechasja on the Euphrates, at Sura, &c., and their period of prime falls in the 5th century. The influence of the Nestorian universities was especially favorable and permanent, particularly the school under Greek management founded at Edessa, in Mesopotamia, where Stephen of Edessa, the reputed father of Alexander of Tralles, taught (A. D. 530). …. Still more influential in the transfer of Grecian science to the Arabians was the banishment of the 'heathen' philosophers of the last so-called Platonic school of Athens, by the 'Christian' despot Justinian I. (529). These philosophers were well received at the court of the infidel Chosroës, and in return manifested their gratitude by the propagation of Grecian science. … From all these causes it resulted that, even as early as the time of Mohammed (571-632), physicians educated in the Grecian doctrines lived among the Arabians. … Arabian culture (and of course Arabian medicine) reached its zenith at the period of the greatest power and greatest wealth of the Caliphate in the 9th and 10th centuries. At that time intellectual life was rooted in the schools of the mosques, i. e., the Arabian universities, which the great caliphs were zealous in founding. Such Arabian universities arose and existed in the progress of time (even as late as the 14th century) at Bagdad, Bassora, Cufa, Samarcand, Ispahan, Damascus, Bokhara, Firuzabad and Khurdistan, and under the scholastic Fatimides (909-1171) in Alexandria. Under the Ommyiades (755-1031), after the settlement of the Arabians in Spain in the beginning of the 8th century, were founded the famous universities of Cordova (possessing in the 10th century a library of 250,000 volumes), Seville, Toledo, Almeria and Murcia under the three caliphs named Abderrahman and Al Hakem. {2130} Less important were the universities of Granada and Valencia, and least important of all, those founded by the Edrisi dynasty (800-986) in the provinces of Tunis, Fez and Morocco. In spite of all these institutions the Arabians possessed no talent for productive research; still less, like the ancient Semites, did they create any arts, save poesy and architecture. Their whole civilization bore the stamp of its foreign origin. … 'The Prince of Physicians' (el Sheik el Reis—he was also a poet) was the title given by the Arabians to Abu Ali el Hossein ebn Abdallah ebn Sina (Ebn Sina, 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 treatment' so much in vogue with many medical men. 'Trusting to the constant attention and wisdom of nature,' they administered inert medicines as placebos, while they left to nature the cure of the disease. But they neglected the use of invaluable remedies such as opium and Peruvian bark, for which error it must be admitted they atoned by discountenancing bleeding, vomiting, etc. Stahl's remedies were chiefly of the class known as 'Antiphlogistic,' or anti-febrile."

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

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

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

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

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

G. S. Woodhead, Bacteria and their Products, chapter 3.

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

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

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

ALSO IN: W. Aneke, History of Homœopathy.

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

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

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

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

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

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

"One of the most notable events of the 18th century, or for that matter, in the history of medicine, was the introduction of the systematic practice of preventive inoculation against small-pox. We are so generally taught that this is entirely due to the efforts of Jenner, or rather we are so often allowed to think it without being necessarily taught otherwise, that the measure deserves a historical sketch. The communication of the natural disease to the healthy in order to protect them from the same natural disease, in other words, the communication of small-pox to prevent the same, reaches back into antiquity. It is mentioned in the Sanskrit Vedas as then performed, always by Brahmins, who employed pus procured from small-pox vesicles a year before. They rubbed the place selected for operation until the skin was red, then scratched with a sharp instrument, and laid upon the place cotton soaked in the variolous pus, moistened with water from the sacred Ganges. Along with this measure they insisted upon most hygienic regulations, to which in a large measure their good results were due. Among the Chinese was practised what was known as 'Pock-sowing,' and as long ago as 1000 years before Christ they introduced into the nasal cavities of young children pledgets of cotton saturated with variolous pus. The Arabians inoculated the same disease with needles, and so did the Circassians, while in the states of north Africa incisions were made between the fingers, and among some of the negroes inoculation was performed in or upon the nose. In Constantinople, under the Greeks, the custom had long been naturalized and was practised by old women instructed in the art, who regarded it as a revelation of St. Mary. The first accounts of this practice were given to the Royal Society by Timoni, a physician of Constantinople, in 1714. The actual introduction of the practice into the West, however, was due to Lady Mary Wortley Montagu, who died in 1762, and who was wife of the English ambassador to the Porte in 1717. She had her son inoculated in Constantinople by her surgeon Maitland, and after her return to London, in 1721, it was also performed upon her daughter. During the same years experiments were undertaken by Maitland upon criminals; and as these turned out favorably, the Prince of Wales and his sisters were inoculated by Mead. The practice was then more or less speedily adopted on this side of the ocean as well as on that, but suffered occasional severe blows because of unfortunate cases here and there, such as never can be avoided. The clergy, especially, using the Bible, as designing men always can use it, to back up any view or practice, became warm opponents of vaccination, and stigmatized it as a very atrocious invasion of the Divine prerogative of punishment. But in 1746 the Bishop of Worcester recommended it from the pulpit, and established houses for inoculation, and thus made it again popular. In Germany the operation was generally favored, and in France and Italy a little later came into vogue."

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

MEDICAL SCIENCE: 18th Century. Jenner and the discovery of Vaccination.

Many before the English physician, Dr. Jenner, "had witnessed the cow-pox, and had heard of the report current among the milkmaids in Gloucestershire, that whoever had taken that disease was secure against smallpox. It was a trifling, vulgar rumor, supposed to have no significance whatever; and no one had thought it worthy of investigation, until it was accidentally brought under the notice of Jenner. He was a youth, pursuing his studies at Sodbury, when his attention was arrested by the casual observation made by a country girl who came to his master's shop for advice. The smallpox was mentioned, when the girl said, 'I can't take that disease, for I have had cow-pox.' The observation immediately riveted Jenner's attention, and he forthwith set about inquiring and making observations on the subject. His professional friends, to whom he mentioned his views as to the prophylactic virtues of cow-pox, laughed at him, and even threatened to expel him from their society, if he persisted in harassing them with the subject. In London he was so fortunate as to study under John Hunter [1770-1773] to whom he communicated his views. The advice of the great anatomist was thoroughly characteristic: 'Don't think, but try; be patient, be accurate.' Jenner's courage was greatly supported by the advice, which conveyed to him the true art of philosophical investigation. He went back to the country to practise his profession, and carefully to make observations and experiments, which he continued to pursue for a period of twenty years. His faith in his discovery was so implicit that he vaccinated his own son on three several occasions. At length he published his views in a quarto of about seventy pages, in which he gave the details of twenty-three cases of successful vaccination of individuals, to whom it was found afterwards impossible to communicate the smallpox either by contagion or inoculation. It was in 1798 that this treatise was published; though he had been working out his ideas as long before as 1775, when they began to assume a definite form. How was the discovery received? First with indifference, then with active hostility. He proceeded to London to exhibit to the profession the process of vaccination and its successful results; but not a single doctor could be got to make a trial of it, and after fruitlessly waiting for nearly three months, Jenner returned to his native village. {2141} He was even caricatured and abused for his attempt to 'bestialize' his species by the introduction into their systems of diseased matter from the cow's udder. Cobbett was one of his most furious assailants. Vaccination was denounced from the pulpit as 'diabolical.' It was averred that vaccinated children became 'ox-faced,' that abscesses broke out to 'indicate sprouting horns,' and that the countenance was gradually 'transmuted into the visage of a cow, the voice into the bellowing of bulls.' Vaccination, however, was a truth, and notwithstanding the violence of the opposition belief in it spread slowly. In one village where a gentleman tried to introduce the practice, the first persons who permitted themselves to be vaccinated were absolutely pelted, and were driven into their houses if they appeared out of doors. Two ladies of title,—Lady Ducie and the Countess of Berkeley,—to their honor be it remembered,—had the courage to vaccinate their own children; and the prejudices of the day were at once broken through. The medical profession gradually came round, and there were several who even sought to rob Dr. Jenner of the merit of the discovery, when its vast importance came to be recognized. Jenner's cause at last triumphed, and he was publicly honored and rewarded. In his prosperity he was as modest as he had been in his obscurity. He was invited to settle in London, and told that he might command a practice of £10,000 a year. But his answer was, 'No! In the morning of my days I have sought the sequestered and lowly paths of life,—the valley, and not the mountain,—and now, in the evening of my days, it is not meet for me to hold myself up as an object for fortune and for fame.' In Jenner's own lifetime the practice of vaccination had been adopted all over the civilized world; and when he died, his title as Benefactor of his kind was recognized far and wide. Cuvier has said, 'If vaccine were the only discovery of the epoch, it would serve to render it illustrious forever."

S. Smiles, Self-help, chapter 4.

ALSO IN: J. Barron, Life of Edward Jenner.

MEDICAL SCIENCE: 18th Century. The Brunonian System of Stimulation.

"John Brown, born of obscure parents in a village of Berwick, in Scotland, was remarkable, from his early youth, for an extraordinary aptitude for acquiring languages, a decided inclination for scholastic dispute, a pedantic tone and manner, and somewhat irregular conduct. Having abandoned theology for medicine, he fixed his residence in Edinburgh. … He was particularly entertained and countenanced by Cullen, who even took him into his family in the character of preceptor of his children. This agreeable relation subsisted during twelve consecutive years between these two men, whose characters and minds were so different. … But some trifling matters of mutual discontent grew at length into coldness, and changed the old friendship which had united them into an irreconcilable hatred. Their rupture broke out about the year 1778, and in a short time after, Brown published his Elements of Medicine. … Brown employed some of the ideas of his master to develop a doctrine much more simple in appearance, but founded entirely on abstract considerations; a doctrine in which every provision seems to be made for discussion, but none for practice. Cullen had said that the nervous system receives the first impression of excitants, and transmits it afterwards to the other organs endowed with motion and vitality. Brown explains thus, the same thought: 'Life is only sustained by incitation. It is only the result of the action of incitants on the incitability of organs.' Cullen regarded the atony of the small vessels as the proximate cause of fever. Brown, improving on this hypothesis, admits, with hardly any exceptions, only hyposthenic diseases. … The Scotch physiologist distinguished only two pathological states—one consisting in an excess of incitability, which he names the sthenic diathesis; the other, constituted by a want, more or less notable, of the same faculty, which he designates as the asthenic diathesis. Besides, Brown considers these two states as affecting the entire economy, rather than any organ in particular. … After having reduced all diseases to two genera, and withdrawn from pathology the study of local lesions, Brown arrives, by a subtile argumentation, to consider the affections of the sthenic order as prevailing in a very small number of instances, so that the diseases of the asthenic type comprehend nearly the totality of affections. According to this theory, a physician is rarely ever mistaken if he orders in all his cases, remedies of an exciting nature. … Never since the days of Thessalus (of charlatan memory) had anyone simplified to such a point the study and practice of medicine. We may even say that in this respect the Scotch pathologist left far in the rear the physician of Nero. To this attraction, well calculated to tempt students and practitioners, the doctrine of Brown joined the advantage of being presented in an energetic and captivating style, full of imagery, which suffices to explain its rapid progress. But this doctrine, so seductive in its exposition, so easy in its application, is one of the most disastrous that man has been able to imagine, for it tends to propagate the abuse of diffusible stimulants, of which spirituous liquors make a part, an abuse excessively injurious to health in general, and the intellectual faculties in particular—an abuse to which man is too much inclined, naturally, and which the sophisms of Brown may have contributed to spread in all classes of English society. … Notwithstanding its defects, the system of Brown made rapid progress, principally in Germany and Italy."

P. V. Renouard, History of Medicine, pages 555-560.

MEDICAL SCIENCE: 18th Century. The System of Haller.

"About the time when we seniors commenced the study of medicine, it was still under the influence of the important discoveries which Albrecht von Haller [1708-1777] had made on the excitability of nerves; and which he had placed in connection with the vitalistic theory of the nature of life. Haller had observed the excitability in the nerves and muscles of amputated members. The most surprising thing to him was, that the most varied external actions, mechanical, chemical, thermal, to which electrical ones were subsequently added, had always the same result; namely, that they produced muscular contraction. They were only quantitatively distinguished as regards their action on the organism, that is, only by the strength of the excitation; he designated them by the common name of stimulus; he called the altered condition of the nerve the excitation, and its capacity of responding to a stimulus the excitability, which was lost at death. {2142} This entire condition of things, which physically speaking asserts no more than the nerves, as concerns the changes which take place in them after excitation, are in an exceedingly unstable state of equilibrium; this was looked upon as the fundamental property of animal life, and was unhesitatingly transferred to the other organs and tissues of the body, for which there was no similar justification. It was believed that none of them were active of themselves, but must receive an impulse by a stimulus from without; air and nourishment were considered to be the normal stimuli. The kind of activity seemed, on the contrary, to be conditioned by the specific energy of the organ, under the influence of the vital force. Increase or diminution of the excitability was the category under which the whole of the acute diseases were referred, and from which indications were taken as to whether the treatment should be lowering or stimulating. The rigid one-sidedness and the unrelenting logic with which … [John] Brown had once worked out the system was broken, but it always furnished the leading points of view."